Rebirth fantasy and the psychoanalytic process

In this paper, Jungian and Freudian perspectives on the fantasy of rebirth are explored and a brief review of the literature on the theme is used to show how that the rebirth fantasy seems to be a universal fantasy in the human mind, connected with the experience of both destruction and creation. In the psychoanalytic process the rebirth fantasy is connected with initial hopes for a better life, but is also a vehicle for creating the analytic pair and for separating from the 'totalitarian object'. An account of clinical work with a patient is given to illustrate the mutual and parallel process of rebirth in both the patient and the therapist. For the patient, the therapy was experienced as an awakening or a birth. The therapist was initially doubtful about the patient's capacity to engage in the analytic process but his involvement and interest were 'born' during the early sessions, enabling the patient to rely on him to lead her out of the claustrophobic power of the totalitarian object.     

Understanding Children with War-Zone Traumatic Stress Exposed to the World's Violent Environments

This article discusses the common and unique configurations of stress responses of children to traumatizing experience in the world's warzones like Bosnia-Herzegovina, Croatia, Rwanda, Liberia, Mozambique, El Salvador, the Middle East, and other nations caught up in the throes of declared and undeclared wars. Children are the most vulnerable, and suffer the greatest. The new concepts of warzone traumatic stress (WZTrS) and warzone traumatherapy (WZTrT) are presented to expand the discussion of the treatment of warzone children beyond today's exclusive focus either on intrapsychic factors alone or on material-resource replenishing alone. These terms are an alternative to current approaches to treatment in which a discrete stressor has been identified as the responsible toxic agent that produced the child's symptoms. Most warzone children have experienced a multiplicity of stressors—a virtual matrix of violent war stressors. The WZTrT model recognizes that the mental, social, and cultural needs of traumatized children change over time—from the time they are exposed to raging toxic war stressors to the time when war hostilities end. Thus warzone traumatherapy attempts to address the child's needs on a continuum based upon a time-referenced intervention model. The model presented here acknowledges the child's adaptational strengths, and the multitheoretical employing of psychodynamic, cognitive, and behavioral techniques grounded in cultural/racial sensitivity and indigenous folk medicine as indispensable tools in warzone therapy for children. Additionally, the model takes into account the special features of relevant international policies of the United Nations (UN) and Non-Governmental Organizations (NGOs) geared to assist in the recovery and integration of warzone traumatized children. WZTrT embraces Western models of interventions integratively and flexibly employed with the personal, cultural, social, spiritual, and economic factors existing in the world of the traumatized child. Hopefully, the article will contribute to creating innovative ways of conceptualizing the mental, physical, social, cultural, and economic needs of warzone children in order to advance conceptual, technical, scientific, and practical aspects of child-relevant warzone interventions.     

Subjective Sleep Disturbances in Sexual Assault Survivors: Associations With Trauma and Posttraumatic Stress Disorder Symptom Severity

Prior work implicates sleep disturbance in the development and maintenance of posttraumatic stress disorder (PTSD). However, the majority of this literature has focused on combat veteran men, and limited work has examined links between sleep disturbance and PTSD symptoms in sexual assault survivors. This is a notable gap in the literature, as sexual trauma is disproportionately likely to result in PTSD and is more common in women. We sought to examine the relations between subjective sleep disturbance, sexual assault severity, and PTSD symptoms in a sample of sexual assault survivors with PTSD (PTSD+), without PTSD (PTSD-), and healthy controls. The sample (N = 60) completed the Insomnia Severity Index and prospectively monitored their sleep for 1 week using the Consensus Sleep Diary. The sexual assault survivors also completed the Sexual Experiences Survey and PTSD Checklist-5. Results of group comparisons found that the PTSD+ group reported significantly higher insomnia symptoms, longer sleep onset latency, more nocturnal awakenings, and lower sleep quality compared to the healthy control group and higher insomnia symptoms compared to the PTSD- group. Results of regression analyses in the sexual assault survivors found that insomnia symptoms and number of nocturnal awakenings were significantly associated with higher PTSD symptoms, and sexual assault severity was significantly associated with higher insomnia symptoms, longer sleep onset latency, and lower sleep quality. These findings highlight specific features of sleep disturbance that are linked to trauma and PTSD symptom severity among sexual assault survivors.     

Current scientific interest in dissociative amnesia: A bibliometric analysis

In a bibliometric analysis, we used the PubMed search engine to count the number of publications identified by the search term “dissociative amnesia” for the years 2011–2020. We then counted publications from the same decade for five representative comparison disorders: “panic disorder,” “anorexia nervosa,” “obsessive–compulsive disorder,” “attention deficit hyperactivity disorder,” and “bipolar disorder.” Our search yielded only 89 publications for “dissociative amnesia,” and only seven of these involved localized or selective amnesia for specific events. By contrast, we found between 3000 and 21,000 publications for each of the five comparison disorders during 2011–2020. We performed several additional secondary analyses, all of which suggested that the diagnosis of “localized or selective dissociative amnesia” has generated little scientific interest in recent years. Examining possible hypotheses to explain this lack of interest, it appears most likely that the concept of localized or selective dissociative amnesia is not widely accepted among scientists at present.     

Conceptualizing splitting: On the different meanings of splitting and their implications for the understanding of the person and the analytic process

While “splitting” is a familiar concept, its meaning is not as self‐evident as is commonly assumed. In different contexts, it refers to different phenomena and is supported by different understandings of psychic dynamics. In this paper, the author presents four different conceptualizations of splitting, which capture the essential aspects of contemporary psychoanalytic discourse on the concept. There is a dissociative kind of splitting, which involves splitting off, in the face of trauma, whole personalities, which to some extent remain accessible to consciousness; there is a disavowal kind of splitting that splits off our awareness of disturbing realities or their meanings in our efforts to avoid the inner restraints imposed by repression; and there are two forms of splitting of the object into good and bad—one focusing on the splitting of representations of the object due to ego weakness and environmental determinants, and the other on the splitting of the mind itself in a primarily destructive act aimed at sparing the good from the destructiveness of our death instinct. All four conceptualizations have their origins in Freud's writing and then are further developed in the work of later analysts. The author argues that understanding the nature of these various conceptualizations of splitting can contribute to analytic theory and practice. It also sheds light on the essential nature of analytic approaches and how they offer different perspectives on the unity and disunity of man's basic nature.     

Therapeutic moments are the key: foster children give clues to their past experience of infant trauma and neglect

Foster parents often despair over the lack of information about the past experience of the children in their care, particularly with children who have experienced infant trauma and neglect. In the context of family therapy these unknowns pose both a challenge and an opportunity. The author proposes that foster children gives clues to their past experiences in therapeutic moments, which the therapist may recognize as a result of her own inner conversation. In conjunction with a sound theoretical knowledge of infant trauma and neglect, these moments have the capacity to open a dialogue in the relationships between therapist, child and foster family. This dialogical process offers an opportunity for the child's past experience of infant trauma and neglect to be expressed in silence, and the foster parent's present experience to be heard in stillness, opening for them a way to go on beyond the family therapy sessions.     

Mentalization in children and mothers in the context of trauma: An initial study of the validity of the Child Reflective Functioning Scale

This study examined the validity of the Child Reflective Functioning Scale (CRFS: Ensink, Target, & Oandason, 2013, Child reflective functioning scale scoring manual: for application to the Child Attachment Interview. London, UK: Anna Freud Centre – University College London), a measure designed to assess reflective functioning (RF) or mentalization during middle childhood. Participants were 94 mother–child dyads divided into two subgroups; 46 dyads where children had histories of intrafamilial (n = 22 dyads) or extrafamilial (n = 24 dyads) sexual abuse, and a community control group composed of 48 mother–child dyads. RF of children and their mothers was assessed using videotaped and transcribed data gathered using the Child Attachment Interview and the Parent Development Interview (PDI: Slade, Aber, Bresi, Berger, & Kaplan, 2004, The parent development interview‐Revised. New York, NY: The City University of New York). The findings indicate that the CRFS proved reliable, with excellent intraclass correlation coefficients for general RF, as well as RF regarding self and others. Significant differences in RF were found between sexually abused children and the control group, and also between children who had experienced intrafamilial and extrafamilial sexual abuse. This provides support for the discriminant validity of the CRFS. Furthermore, maternal RF was associated with child RF. Both abuse and maternal RF made significant contributions to predicting children's RF regarding themselves, but child sexual abuse was the only variable that made a significant contribution to explaining variance in children's RF regarding others.     

Posttraumatic Growth in Trauma Recollections of 9/11 Survivors: A Narrative Approach

The relationship between posttraumatic growth (PTG) and adaptation is unclear. This study is the first to examine PTG in trauma narratives of survivors of the World Trade Center (WTC) attacks. Participants recalled their experiences 7 and 18 months post 9/11, and content analysis was conducted to detect PTG. Posttraumatic stress was also measured. PTG was commonly reported. Relating to others and positivity were frequent in the PTSD and non-PTSD group, although less frequent over time in the PTSD. Greater appreciation for life was reported by the non-PTSD group but relatively absent in the PTSD group. Women but not men reported relating to others across time. It appears that there are distinct profiles of growth implicated in distress and adaptation.