Mental models and language registers in the psychoanalysis of psychosis: An overview of a thirteen‐year analysis2

The author suggests that the use of mental models and language registers may help an analysis to proceed, especially in psychosis, when the patient has not yet developed a mental space that will allow him/her the functions of knowledge and containment of emotions. Models, according to Bion, are a primitive approach to abstraction and a manifestation of the analyst's reverie that enables him/her to transform sense data into alpha‐elements. Ferrari, in a further development of Bion's theories, hypothesises a relationship between the transference and the internal level of body‐mind communication, and proposes the use of language registers to sustain the psychoanalytic process. The author presents several clinical examples from a thirteen‐year, four‐session‐a‐week analysis of a psychotic analysand who was initially confused, paranoid and altogether unable to bring self‐reflective thought to bear on her overwhelming emotions and had, by the end of the analysis, completely recovered from her psychotic symptoms. The clinical material shows how the technical tools of mental models and language registers helped in the construction of a mental space and spatio‐temporal parameters, permitting the patient to tolerate overwhelming concrete emotions and finally to recognise and work through the emotions of an intense transference.     

The Disappearing “Advantage of Abstract Examples in Learning Math”

When teaching a novel mathematical concept, should we present learners with abstract or concrete examples? In this experiment, we conduct a critical replication and extension of a well-known study that argued for the general advantage of abstract examples (Kaminski, Sloutsky, & Heckler, 2008a). We demonstrate that theoretically motivated yet minor modifications of the learning design put this argument in question. A key finding from this study is that participants who trained with improved concrete examples performed as well as, or better than, participants who trained with abstract examples. We argue that the previously reported “advantage of abstract examples” manifested not because abstract examples are advantageous in general, but because the concrete condition employed suboptimal examples.     

Hegel and Sellars on the Unity of Things

ABSTRACT

I have claimed previously that Hegel and Sellars are both, in the end, monistic visionaries, though with radically different visions of the grand unity of things. In this paper I explain and defend that claim. Section one differentiates several kinds of monism; section two discusses Hegel’s vision of the underlying unity of thing, while section three does the same for Sellars. The compare-and-contrast assignment is brought to completion in section four.     

Taking time: the tempo of psychoanalysis

In this article the author argues that in order to be psychoanalysis, the 'here and now' technical approach needs to be firmly grounded theoretically and technically in a practice that includes the notion of reverie or its equivalent. The author has argued previously that the analyst's theory is the essential 'third' of the two-person analytic situation. She now suggests that it is specifically the theories of temporality and the attitude of 'evenly suspended attention' or its more contemporary development, 'reverie', that are the crucial aspects of that theory. She refers to these essential aspects as the 'theory in practice' in so far as they are more than a technical approach or a theory of practice but reflect directly a particular analyst's internalisation of the whole psychoanalytic theoretical corpus. While she believes this to be an essential component in any true psychoanalysis, in developing her argument the author looks at situations in which the analyst is particularly prone to forgo this temporal aspect, as is the case when patients show an absence of symbolic thinking within the analytic situation. In fact, with those patients reverie and the visual images it produces within the analyst's mind offer perhaps the only hope of a meeting ground between the concrete and the symbolic and the possibility of avoiding an impasse. Impasse, she suggests, has at its root the absence of reverie as a third and temporal element, inevitably giving rise to concrete thinking on the part of patient and analyst and so to a situation that cannot evolve.     

Metaphor and the violent

During the treatment of violent individuals who were, incidentally, highly verbal, the authors noticed that physical assaults were often preceded by the perpetrator s use of metaphors. It was observed that the linguistic metaphors failed to function as ordinary as if devices and became concretised. When this occurred, the perpetrators resorted to a physical attack. In this paper, the authors argue that the capacity to interconnect (which is considered to be the essence of psychic work) is dependent upon what can be conceptualised as a primary mental frame or warp. Distortion of the warp will, in turn, weaken the weaving, or interconnecting function of the ego, which is considered analogous to the interconnecting in linguistic metaphors. Clinical material from the treatment of three violent men (two in psychotherapy and one in analysis) is used to illustrate the hypothesis that the concretised use of metaphor represents a restitutive, but failed attempt to maintain a psychic coherence in the face of an imminent breakdown.     

From molecular to molar: a paradigm shift in behavior analysis

A paradigm clash is occurring within behavior analysis. In the older paradigm, the molecular view, behavior consists of momentary or discrete responses that constitute instances of classes. Variation in response rate reflects variation in the strength or probability of the response class. The newer paradigm, the molar view, sees behavior as composed of activities that take up varying amounts of time. Whereas the molecular view takes response rate and choice to be "derived" measures and hence abstractions, the molar view takes response rate and choice to be concrete temporally extended behavioral allocations and regards momentary "responses" as abstractions. Research findings that point to variation in tempo, asymmetry in concurrent performance, and paradoxical resistance to change are readily interpretable when seen in the light of reinforcement and stimulus control of extended behavioral allocations or activities. Seen in the light of the ontological distinction between classes and individuals, extended behavioral allocations, like species in evolutionary taxonomy, constitute individuals, entities that change without changing their identity. Seeing allocations as individuals implies that less extended activities constitute parts of larger wholes rather than instances of classes. Both laboratory research and everyday behavior are explained plausibly in the light of concrete extended activities and their nesting. The molecular- view, because it requires discrete responses and contiguous events, relies on hypothetical stimuli and consequences to account for the same phenomena. One may prefer the molar view on grounds of elegance, integrative power, and plausibility.     

The different representational frameworks underpinning abstract and concrete knowledge: Evidence from odd-one-out judgements

Recent evidence from neuropsychological investigations of individuals with global aphasia and deep or deep-phonological dyslexia suggests that abstract and concrete concepts are underpinned by qualitatively different representational frameworks. Abstract words are represented primarily by their association to other words, whilst concrete words are represented primarily by their taxonomic similarity to one another. In the current study, we present the first evidence for this association/similarity distinction to be gathered from healthy research participants. Using a semantic odd-one-out task, it is shown that normal participants identify associative connections more quickly than similarity-based connections when processing abstract words, but that the pattern is reversed for concrete words. It is also demonstrated that the typical concrete-word advantage observed in many cognitive tasks is abolished and even reversed when participants have to comprehend the semantic associations between words. The data provide converging evidence for the different representational frameworks hypothesis and suggest that claims based on information from previous neuropsychological investigations can be generalized to normal cognition.     

‘Emotional turbulence’: the development of symbolic thinking in the psychotherapeutic treatment of an adolescent girl

Abstract

This paper is drawn from doctoral research which analysed clinical data from the once weekly psychotherapy of a young person who experienced both gender identity dysphoria and an eating disorder and whose depression had proved resistant to other interventions. Based on the psychoanalytic thinking of Klein, Segal, Bion and others regarding the role of symbolisation in development, the links between symbol formation, the depressive position and the negotiation of the Oedipus complex are outlined. Special attention is given to current thinking about the nature and genesis of gender identity dysphoria in the light of these concepts. The association with autistic features for a number of cases is briefly explored. In the light of these theoretical links, findings from the study are used to investigate and illustrate the movement this patient made within her therapy from an emotionally turbulent position where concrete thinking was manifest, to a more symbolic way of thinking that allowed emotional change, and less concrete acting out. Clinical narrative excerpts as well as findings from the study are used to discuss the progress made by the patient and to evaluate how her journey may inform future practice.     

The symbolic and concrete: Psychotic adolescents in psychoanalytic psychotherapy

Unique disturbances in symbolisation are characteristic of the pathology of schizophrenia. Drawing on the case vignette of a psychotic adolescent, the author discusses theoretical problems in the symbolisation process in general and then in psychosis, in particular the relation between 'concretism' as a thought disorder and other psychotic defences. The ability to symbolise on the one hand and to maintain sufficiently stable ego boundaries on the other hand are examined in their relation. The author's clinical experience supports her hypothesis that there is a close relationship between the impairment of the symbolisation process in the adolescent or adult psychotic patient and his/her inability to engage in symbolic play as a child. Special attention is paid to the role of early trauma and consequent pathology of object relations for disturbances of symbolic play in childhood. Regression to concrete thinking is understood as the chance of the psychotic patient to give some meaning to reality in an unreal, delusional world and as his/her last chance to communicate at all. Conclusions are drawn for psychoanalytic techniques in the treatment of patients who are deeply regressed in this respect. Special attention is given to the particular circumstances and challenges of adolescence and to providing psychoanalytic psychotherapy to adolescent psychotic patients.