Permeability and Demarcation in the Psychoanalytic Process Functions of the Contact‐Barrier1

Introjection, identifi cation and projection are concepts that designate processes in which something is being put into or taken out of something else. These processes presuppose the overcoming of some form of separation between two entities. The permeability or impermeability of a fi ctive boundary between the representations of subject and object set the emotional tone of their coexistence. There are moments of complete diffusion, in which subject and object can no longer be differentiated, and moments of autistic enclosure in which the individual can no longer be reached at all. Permeability and demarcation result from the processing of stimuli carried out by the ‘contact‐barrier’, as an ego function. Stimuli of internal, libidinal or aggressive origin, as well as ‘im‐pressions’ of external origin, are classifi ed and processed with the aid of various kinds of factors arising from coagulated object‐relational experiences. Whereas for Freud the contact‐barrier regulates the quantity of energy and founds a topographical structure, Bion understands the contact‐barrier as a psychic function that simultaneously regulates boundary demarcation and making contact. In the psychoanalytic process, the contact‐barrier created by patient and analyst regulates the events in the transference and countertransference. An awareness of the struggle for contact and demarcation at the dynamic boundary representations that are constantly being recreated by both partners in the analytic process may be helpful in our clinical work. The author presents an examination of the ways in which patient and analyst make contact and demarcate the boundaries, which provides a better understanding of the dynamics of transference processes. He demonstrates this in relation to clinical material.     

On the determination of autistoid organizations in non-autistic adults

Psychogenic autistic phenomena occurring in non-autistic adults are being increasingly discussed in the psychoanalytical literature. The author endeavours to determine autistoid organizations, which are understood to be a particular form of pathological retreat. Together with the use of autistic objects, two-dimensional levelling out, the failure of unconscious communication, and of projective identification, a characteristic of these retreats is that they are meant to afford protection against paranoid-schizoid fears of the external and unintegrated states of the internal world. The formation of such autistic reactions should be sought not only in traumatic separations and the inadequate containment of primary objects, but also in constitutional weakening. Intolerance accompanying projective identification and damage to primal fantasies/preconceptions are discussed. In conclusion, a clinical illustration with autistoid and hypochondriacal retreats clarifies some of the aspects discussed.     

A service learning based intervention to change attitudes toward obese individuals in kinesiology pre-professionals

The purpose of this study was to conduct an intervention to change attitudes toward obese individuals. Ninety-five Kinesiology undergraduates conducted a FITNESSGRAM service-learning project with school-aged children. They completed anti-fat attitude test (AFAT) and explicit attitude assessments before and after the intervention. The results indicated participants had anti-fat bias toward obese individuals on the lazy/motivated scale, but not on the other four scales on pre measurements. Their anti-fat attitudes concerning whether people are responsible for their weight were significantly reduced through the intervention. Five themes emerged from the undergraduates’ reflective papers that support the efficacy of the intervention: Healthy lifestyle—an individual choice, barriers to physical activity, multi-factorial nature of obesity, and promotion of physical activity through information and encouragement. The findings partially support experiential learning as a potential mechanism to reduce individuals’ anti-fat attitudes.

The psychodynamic of panic attacks: A useful integration of psychoanalysis and neuroscience1

This article tries to explain, in the light of some neuroscientific and psychoanalytical considerations, the repetitive pattern of panic attacks. Freud considered the panic attack as an ‘actual neurosis’ not involving any conflictual process. Recent neuroscientific findings indicate that psychosomatic reactions, set off by a danger situation, depend on the primitive circuit of fear (including the amygdala) characterised by its speed, but lack accurate responses and may also be activated by harmless stimuli perceived erroneously as dangerous. The traumatic terror is stored in implicit memory and may be set off by a conditioned stimulus linked to a previous danger situation. In the panic attack, the traumatic event is created by the imagination and this construction (a micro‐delusion), built in loneliness and anxiety, has the same power as the real trauma. A mutual psychosomatic short‐circuit between body and psyche, in which terror reinforces the somatic reactions and the psychic construction, is established. Therefore, it is important to highlight these constructions in order to analyse and transform them. In the second part of the article the author reviews the main psychoanalytical theories about panic attacks, stressing how, in his opinion, panic attack is a consequence of the breakdown of the defence organisation at various levels and may appear during periods of life crisis. Two patients suffering from a deficit of personal identity are presented. The various organisations and the different levels (biological, neuroscientific, associative, traumatic) of the panic attack determine different kinds of therapeutic approaches (pharmacological, cognitive and psychoanalytical). While the psychopharmacological treatment is aimed at reducing the neurovegetative reaction and the cognitive method is attempting to correct the associative and perceptive processes of fear signals, psychoanalytical therapy represents both a specific means to free patients from panic attacks as well as an indispensable route for their emotional growth.     

自闭症儿童依恋及其与功能领域关系的研究

以中国大陆16个特殊儿童康复机构的278名自闭症儿童作为研究对象,通过问卷法探讨自闭症儿童的依恋及其与功能领域的关系。结果发现:(1)自闭症儿童依恋总体水平偏低;(2)自闭症儿童依恋与各个功能领域的发展有着极为紧密的联系;(3)影响自闭症儿童总体依恋发展水平的因素是儿童自身的障碍程度,具体取决于交往、认知、感觉、生活自理等功能领域的发展情况。     

Should I trust you? Autistic traits predict reduced appearance‐based trust decisions

Facial impressions of trustworthiness guide social decisions in the general population, as shown by financial lending in economic Trust Games. As an exception, autistic boys fail to use facial impressions to guide trust decisions, despite forming typical facial trustworthiness impressions (Autism, 19, 2015a, 1002). Here, we tested whether this dissociation between forming and using facial impressions of trustworthiness extends to neurotypical men with high levels of autistic traits. Forty‐six Caucasian men completed a multi‐turn Trust Game, a facial trustworthiness impressions task, the Autism‐Spectrum Quotient, and two Theory of Mind tasks. As hypothesized, participants’ levels of autistic traits had no observed effect on the impressions formed, but negatively predicted the use of those impressions in trust decisions. Thus, the dissociation between forming and using facial impressions of trustworthiness extends to the broader autism phenotype. More broadly, our results identify autistic traits as an important source of individual variation in the use of facial impressions to guide behaviour. Interestingly, failure to use these impressions could potentially represent rational behaviour, given their limited validity.     

The use of observation in the psychoanalytic treatment of a 12-year-old boy with Asperger's syndrome

The author describes some aspects of a once-weekly psychoanalytic psychotherapy of a 12-year-old boy diagnosed with Asperger's syndrome. The patient's emotional and cognitive development had been impaired since early life, possibly due to an internal deficit and to the likelihood of inadequate environmental holding. He was unaware of having difficulties but was underachieving academically, was socially isolated and often visibly unhappy in his life. The patient's denial, splitting, and projection of emotion and insight presented the therapist with the difficult task of how to reach him. In order to communicate with him emotionally, the therapist created a modified technique which reflected the patient's development from part-object to whole-object relationships. This development became apparent in the sessions and was interpreted in the transference relationship. An account of the patient's early years was pieced together from a detailed commentary of what was being observed and intuited by the therapist during the sessions, as well as by an understanding of the countertransference. By the end of two years' treatment, the patient's sensitivity and creativity, which had been buried beneath a self-sufficient, autistic-like encapsulation, finally began to emerge in his communications with his therapist.