The death drive: Conceptual analysis and relevance in the Spanish psychoanalytic community1

Based on a six‐year doctoral research, the author carries out a historical, epistemological and paradigmatic assessment of the controversial concept of the death instinct. The author analyses this notion’s speculative nature; its relation with the second principle of thermodynamics; the feasibility of a return to an inorganic state; the death drive’s metaphorical and isomorphic uses, as well as its theoretical and doctrinaire approaches; its relationship with repetition compulsion and masochism; the influence of Freud ’s scientific background on its formulation; and its context‐dependent meaning. Although this paper stems mainly from the theoretical aspects of the study, it also offers some clinical thoughts on the basis of a clinical vignette. The author stresses the underlying healing aspects of repetition in the analytic situation. Next, he presents concise comments on his empirical research on the current professional usage of the death drive in the Spanish psychoanalytical community. This research covered more than 27% of Spanish psychoanalysts (IPA) and psychotherapists (EFPP). The essay’s conclusions point to the ambiguous character of the death drive concept and its literal unacceptability and the absence of consistent arguments for its acceptance.     

医师知识结构和思维方式与肺血栓栓塞症诊断

肺血栓栓塞症是常见的临床病症,因其临床表现多样,易发生误诊漏诊而导致较高的病死率.但"凡事顸则立,不顸则废",充分掌握肺血栓栓塞症的知识、以正确的思维方式引导临床诊疗可以有效减少和避免误诊漏诊.     

Hemispheric connectivity and the visual–spatial divergent-thinking component of creativity

Background/hypothesis

Divergent thinking is an important measurable component of creativity. This study tested the postulate that divergent thinking depends on large distributed inter- and intra-hemispheric networks. Although preliminary evidence supports increased brain connectivity during divergent thinking, the neural correlates of this characteristic have not been entirely specified. It was predicted that visuospatial divergent thinking would correlate with right hemisphere white matter volume (WMV) and with the size of the corpus callosum (CC).

Methods

Volumetric magnetic resonance imaging (MRI) analyses and the Torrance Tests of Creative Thinking (TTCT) were completed among 21 normal right-handed adult males.

Results

TTCT scores correlated negatively with the size of the CC and were not correlated with right or, incidentally, left WMV.

Conclusions

Although these results were not predicted, perhaps, as suggested by Bogen and Bogen (1988), decreased callosal connectivity enhances hemispheric specialization, which benefits the incubation of ideas that are critical for the divergent-thinking component of creativity, and it is the momentary inhibition of this hemispheric independence that accounts for the illumination that is part of the innovative stage of creativity. Alternatively, decreased CC size may reflect more selective developmental pruning, thereby facilitating efficient functional connectivity.     

Enhanced divergent thinking and creativity in musicians: a behavioral and near-infrared spectroscopy study

Empirical studies of creativity have focused on the importance of divergent thinking, which supports generating novel solutions to loosely defined problems. The present study examined creativity and frontal cortical activity in an externally-validated group of creative individuals (trained musicians) and demographically matched control participants, using behavioral tasks and near-infrared spectroscopy (NIRS). Experiment 1 examined convergent and divergent thinking with respect to intelligence and personality. Experiment 2 investigated frontal oxygenated and deoxygenated hemoglobin concentration changes during divergent thinking with NIRS. Results of Experiment 1 indicated enhanced creativity in musicians who also showed increased verbal ability and schizotypal personality but their enhanced divergent thinking remained robust after co-varying out these two factors. In Experiment 2, NIRS showed greater bilateral frontal activity in musicians during divergent thinking compared with nonmusicians. Overall, these results suggest that creative individuals are characterized by enhanced divergent thinking, which is supported by increased frontal cortical activity.     

Constructive Thought Strategies and Job Satisfaction: A Preliminary Examination

In order to examine the potential of constructive thought strategies for enhancing employee job satisfaction, an existing dispositional model of job satisfaction was expanded and tested. Structural equation modeling techniques indicated significant relationships among constructive thought strategies, dysfunctional thought processes, subjective well-being, and job satisfaction. In addition, two competing models were examined to test for the full or partial mediation of the effects of constructive thought strategies on job satisfaction. The implications of these findings for constructive thought strategy training interventions are discussed, along with directions for future research efforts.     

A loss of status and a sense of defeat: an evolutionary perspective on professional burnout

This longitudinal study among Spanish teachers (N = 558) examined burnout from an evolutionary social rank perspective. The types of stress differed among various school levels, and a sense of defeat was highest among teachers in primary schools. A low status, a loss of status and a sense of defeat were independent cross‐sectional predictors of burnout. Longitudinally a sense of defeat predicted an increase in burnout over time, especially among males and teachers in high schools. The status related variables were in general more important predictors of burnout than stressors that are usually associated with burnout. Copyright © 2007 John Wiley & Sons, Ltd.     

非雄激素依赖型前列腺癌与肿瘤干细胞——浅析辩证思维之于临床医学的方法论作用

在前列腺癌的治疗中,由于癌细胞的不断“升级”使得治疗屡屡受挫。近来提出的肿瘤干细胞理论认为:肿瘤是一种干细胞疾病,只有消灭了“种子”,才能克服癌症。从自然辩证法的角度,结合肿瘤干细胞理论对前列腺癌的诊疗加以分析,解释非雄激素依赖型前列腺癌的发病机制,以一种新的思维指导临床治疗。     

浅谈影像诊断思维特征

人类的科学思维方式是一个多层次、多形态、多要素的系统。对每一种事物的认识过程都有特定的思维方式。疾病的诊断是一个主观反映客观的认识过程,反映客观的真实程度愈高,诊断的正确性愈高,而客观真实性的再现,在相当程度上取决于人的主观意识,人的主观意识又通过人的思维活动来实现。所以,人的思维在疾病的诊断中占有重要意义。而医学影像诊断思维又有其特点,即以形象思维为先导,以逻辑思维来归结,又有非逻辑思维闪现,如直觉、灵感、经验思维。只有各种思维形式有机的交叉运用,才能得出最接近真实的诊断结论。     

抑郁焦虑共病研究及其辩证思维

抑郁、焦虑障碍是临床上很常见的两种疾病,两者之间的症状具有重叠性,共病率很高;目前由于两者的病因和发病机制不太明了,很难做出全面系统的判断。对抑郁、焦虑共病现象采取辩证的思维方法、科学的研究方法,以期探讨共病现象的本质及其规律,为临床诊断、治疗、预防提供更全面、更有效的措施与方案。     

Thinking with,and about,patients too scared to think: Can non‐interpretive maneuvers stimulate refl ective thought?

Patients incapable of higher-order (symbolic) thinking can often not tolerate evidence of the analyst's separate existence, particularly when that 'otherness' becomes evident in the process of the analyst's refl ecting upon and interpreting how the patient experiences or represents the analyst. The patient's intolerance of the analyst's efforts to think (refl ect upon and interpret) renders the usual psychoanalytic maneuvers employed to stimulate refl ective thought ineffective with such patients. Such patients have to learn to tolerate multiple perspectives before they can allow the analyst, or themselves, to think in the other's presence. The author presents two clinical vignettes that illustrate how the analyst's efforts to think about the patient were experienced by the patient as both intolerably distancing and as rejecting of an aspect of the patient's subjective reality. Working psychoanalytically with such patients requires the analyst to forgo the use of narrow interpretations that elucidate unconscious meanings and motives in favor of alternate technical maneuvers capable of facilitating the development of symbolic thinking and refl ective thought (insightfulness). These maneuvers include a demonstration of the analyst's willingness and ability to withstand (rather than 'interpret away') how he is being psychically represented by the patient, without becoming destroyed by, or lost within, the patient's characterization of him. Beside modeling a tolerance of alternate perspectives of one's self, other non-interpretive maneuvers that help facilitate the development of self-refl ective thought include: stimulating the patient's curiosity about the workings of his own mind by identifying incompletely understood behaviors or reactions worthy of greater psychological understanding, and insinuating doubt about the adequacy of the patient's explanations of such phenomena.