Exploring a patient's shift from relative silence to verbal expressiveness: Observations on an element of the analyst's participation

By tracing a portion of close process of a patient's shifts from a relatively silent and inhibited stance to one in which he is beginning to verbalize more about his experience and fantasy, I will illustrate some tensions between the analyst's role as facilitating expressiveness and as occupying a place in the patient's internalized world. Since the analyst's functions as facilitator and as internal object (often an obstacle to the patient's expressiveness) are sometimes in conflict with one another, it is important for the analyst to be able to work internally with this conflict as he works with his patient. Splitting processes between these two functions may provide the analyst with cues related to the patient's and the analyst's resistance to understanding the patient's communication of unconscious conflict and the patient's recruitment of the analyst into the patient's internalized world.     

How people make decisions about predictive genetic testing: An analogue study

Abstract

Persons scoring high on negative affectivity (NA) have more subjective health complaints. In this study, we tested the hypothesis that high NA persons are more likely to experience internal sensations as threatening signs of health problems. Low and high NA participants (N=44) were given four breathing trials: one room air trial followed by three trials containing 5.5% CO₂ which induced transient low intensity somatic sensations. Prior to each CO₂ trial, participants received either positive, negative or uncertain labelings of the sensations that might occur. Participants rated the (un)pleasantness of the experienced somatic sensations and the perceived intensity. Also respiratory responses were measured. During CO₂ trials, reliable main effects of information were found but no effects involving NA were observed, neither on pleasantness ratings nor on respiratory responses. However, during room air breathing, high NA participants reported more intense somatic sensations than low NA participants. Post-experimental data suggested that high NA participants had more negative meanings and worries about the consequences of the physical sensations. It is concluded that interpretational biases in high NA is situated at the level of attributional processes.     

Toward a Theory of Progressive Evolution (Large-Scale Stages of Evolutionary Progress)

Here I discuss the basic elements, major stages, and completion of progressive evolution. The cosmic world of self-realization is based on extensive self-development within a closed contour: temporal counter-transitions of spatial counter-elements (energy bonds and media and, basically, substance structures) form of local worlds within it through evolution of informational structures.

• The organic world of reproduction develops through the open informational path: the initial substance, through energy exchange and metabolism, reproduces similar substance; the latter interacts with the environment and, subsequently, reproduces its like, and so on.

• The animal world of self-regulation builds up a closed informational contour in the environment through the informational input and command output.

• The human world of self-cognition forms the intensive type of development within the internal closed informational contour of cognition. Counter-transitions of ideal images and signs relate to their real prototypes. In the course of cognition, abstractive thinking develops and brings man to the possibility of reflection of the initial world in its integrity (thus, elevates man to the infinite, by Hegel).

     

ISLAMIC BIOETHICS IN THE TWENTY‐FIRST CENTURY

Islamic bioethics is in good health, this article argues. During the twentieth century, academic researchers had to deal with a number of difficulties including the scarcity of available Islamic sources. However, the twenty‐first century witnessed significant breakthroughs in the field of Islamic bioethics. A growing number of normative works authored by Muslim religious scholars and studies conducted by academic researchers have been published. This nascent field also proved to be appealing for research‐funding institutions in the Muslim world and also in the West, such as the Qatar National Research Fund (QNRF) and the Netherlands Organization for Scientific Research (NWO). On the other hand, the article argues that contemporary Islamic bioethics is in need of addressing news issues and adopting new approaches for the sake of maintaining and improving this good health in the future.     

胰腺癌综合治疗面面观

在胰腺癌的综合治疗中,手术切除是清除肿瘤负荷的最有效的局部治疗方法,但其效果会受到胰腺癌恶性行为和解剖位置的限制.从“重视全面、避免关注片面”的哲学高度,科学看待手术和其他综合治疗手段的关系和意义,有助于对胰腺癌的综合治疗有一个正确的理解,也有助于临床治疗措施的制定.本文首先对胰腺癌治疗过程的若干问题进行再思考,在此基础上再认识胰腺癌的综合治疗,最后对胰腺癌诊治发展进行展望,以期有一个相对全面的解读.     

THE VALUE OF UNCERTAINTY

The author discusses some of the characteristics of Roy Schafer's contributions to psychoanalysis that he finds most valuable, such as his openness to uncertainty, his anti‐reductive view of analytic constructions, his unique formulation of the analyst's role, and his close attention to how the patient engenders particular emotional reactions in the analyst. The author also presents a clinical vignette illustrating the value of the analyst's tolerance of uncertainty in the face of the patient's push for interpretations, explanations, and reassurance.     

CONTAINING,TRANSLATING, AND INTERPRETIVE ACTING OUT

In analytic treatment, when patients project unspoken aspects of their internal self and object world, the analyst has to find ways to understand and communicate those expelled phantasies without the patient feeling accused, seduced, or persecuted; even when we do our best at interpreting such inner conflicts, the patient may experience our interpretations as assaults, forcing them to give up themselves or their hope for reconnecting with an object. The patient will resist or fight our efforts through the use of projective identification. Caught up in patient's projections, the analyst in turn may enact some of these phantasies by becoming the object rather than translating its presence in the transference, by overemphasizing one side over another of the patient's conflict, or by interpreting accurately but prematurely. These issues are illustrated in two case presentations and discussed in relation to the views of contemporary Kleinian writers on transference and countertransference.     

Moved by the Spirit: Theological Literatures of LGBT Advocacy

Debate over the question of how to effectively acknowledge and advocate for the presence of LGBT people as legitimate members of religious denominations and a population entitled to ministry has generated a substantial body of monographic literature within the field of theology. The earliest works were published during the era of the homophile movement in the 1960s prior to the Stonewall riot in 1969 that marks the beginning of the contemporary gay and lesbian civil rights movement. The subsequent decades have witnessed an expansion and diversification of this genre with the emergence of specific liturgies and ceremonies addressing significant LGBT life events, autobiographies and biographies of openly lesbian and gay clergy, and writings confronting issues of ethnicity and activism.     

Transcending the caesura: the reading effects of Borges's fiction

This essay explores the assumption that the sense of perplexity and surprise that characterizes the reading of many of Borges's works of fiction is related to these stories' direct and explicit exposition of transitive thoughts transcending caesurae (Bion, 1977). Borges presents a world in which diverse and even contradictory points of view or interpretations coexist. These texts allow for paradox to be acknowledged and to remain unresolved. The author suggests that Borges's writing style, the form of his stories and essays, allows for the containment of the anxiety that the possibility of evolutionary change may create. Borges's works of fiction symbolize the paradoxical nature of the caesura: inner continuity where there appears to be a break After reviewing Bion's concepts of caesura and transcendence of caesura, the stylistic devices that Borges uses in relation to the coexistence of different perspectives or interpretations will be discussed. A psychoanalytical reading of Borges's Theme of the Traitor and the Hero and The South enriches the understanding of processes of failure and success in transcending caesurae. The relevance of the transcendence of the caesura for analytic listening is underscored.     

Lewis Carroll and psychoanalysis: why nothing adds up in wonderland

Each generation of psychoanalyst has found different things to value and sometimes to censure in Lewis Carroll’s remarkable fiction and flights of fancy. But what does Carroll’s almost ‘surrealist’ perspective in the Alice stories tell us about the rituals and symbols that govern life beyond Wonderland and Looking‐Glass World? Arguing that Carroll’s strong interest in meaning and nonsense in these and later works helps make the world strange to readers, the better to show it off‐kilter, this essay focuses on Jacques Lacan’s Carroll – the writer–logician who stressed, as Lacan did, the difficulty and price of adapting to the symbolic order. By reconsidering Lacan’s 1966 homage to the eccentric Victorian, I argue that Carroll’s insight into meaning and interpretation remains of key interest to psychoanalysts intent on hearing all that he had to say about psychic life.