基于双加工理论解释下信念偏差效应的神经机制

信念偏差效应是指人们已有的知识信念对逻辑推理的影响现象.对此,双加工理论认为这是由于信念偏向系统和逻辑分析系统之间的冲突所导致的.近年来,该理论得到来自认知神经科学证据的有力支持:一方面,基于功能磁共振成像(fMRI)、近红外光谱(NIRS)以及重复性经颅磁刺激(rTMS)等技术的研究从不同角度证实右侧前额皮层与信念偏差抑制有关;另一方面,基于脑电(ERP)的研究表明,晚期正成分和晚期负成分可能参与了不同推理类型下信念偏差效应的认知加工.未来的研究可以从工作记忆、不同加工阶段、推理前提本身可信度、实验分析、实验材料生态学效度以及思维训练等方面对信念偏差效应作进一步探索.     

Erna and Melanie Klein

Erna was one of the child patients treated by Melanie Klein in Berlin, employing her recently discovered play technique. Since Erna died in Chile, the authors considered the IPA Congress in Santiago an opportunity to present a paper as a homage both to Erna and, especially, to Klein. She learned much from that very disturbed child, which she later used to sustain the ongoing development of her theories. The paper explores biographic data relevant to understanding both the case and the theories. It analyses the case material to follow Klein in the discovery and the handling of the child's transference and the harsh expressions of hate, jealousy and envy, which are brought in, with sad consequences, by strong persecutory feelings. Klein's comparison of this case with that of Freud's Wolf-man is also considered, mostly to show that the similarities were less than originally claimed, and that Klein, perhaps, was introducing a theoretic shift which led her technique to gradually change from ' Nachträglichkeit ' to the 'signification-resignification' pair, akin to Strachey's concept of the mutative interpretation. Lastly, the comprehension of Erna's strong psychotic traits and the links with later developments of the theory on psychosis are studied.     

THE USE OF THE ANALYST AND THE SENSE OF BEING REAL: THE CLINICAL MEANING OF WINNICOTT'S “THE USE OF AN OBJECT”

“The Use of an Object and Relating through Identifications” (1968) represents Donald Winnicott's theoretical and clinical legacy. The author develops this concept from a clinical point of view, through the analysis of a woman with psychotic functioning. He reflects upon the dramatic quality of risks inherent in the processes linked to the use of the object with seriously disturbed patients. He explores different meanings of the analyst's survival, linking it to the analyst's response. The processes of the use of the object—that is, the encounter between the patient's potential destructiveness and the analyst's capacity to respond through his own judicious subjectivity—let the patient experience the analyst's capacity to keep his own subjectivity, authenticity, and creativity alive. It is starting from the traces of this live object that patients gradually form their own personal sense of being real.     

‘It’s silly these doors don’t open’: a six-year-old girl emerges from a chronic state of emotional withdrawal

This clinical paper explores the way in which the first two years of a long-term psychotherapy helped six-year-old Anna to lessen her retreat into a chronic withdrawn emotional state. Over the course of the first year she would occasionally pick up the fridge from the doll’s house and try to open the doors, but because the fridge was actually a block of wood the doors could not open. In treatment, this inquiry came to represent the difficulties of engaging and making contact with a baby who found it very hard to feed. The author describes how, as Anna entered into a therapeutic relationship, it slowly became clear that there was an inner world jam-packed with persecutory anxieties and a family history of unmourned loss and trauma. Through fear Anna slammed the doors to her mind – to knowing herself – and by not feeding, Anna starved herself of opportunities for mental growth. It took some time for her to state, “it’s silly these doors don’t open, they should”. In the discussion of this clinical material the author draws on the work of Francis Tustin, Alessandra Piontelli and Marguerite Reid to consider the link between intergenerational and prenatal trauma and subsequent emotional disturbance in the child.     

Herbert Rosenfeld in Italy, 1978–1985

Abstract

In this paper, the author attempts to shed some light on Herbert Rosenfeld’s thought and his way of working when was in Italy during 1978–1985. In particular, the author would like to show, in a sketchy way, the evolution of his thought, with specific regard for the new way in which he looked at clinical practice at that time. In the author’s opinion, the Rosenfeld that he and his group met and got to know in Italy was able to open new horizons in clinical practice, implicitly questioning some of his own or his circle’s previous viewpoints.     

奖赏环路与阿片成瘾:喙内侧被盖核的调节作用

喙内侧被盖核(RMTg)位于腹侧被盖区(VTA)的尾部, 富含抑制性的γ-氨基丁酸(GABA)能神经元.RMTg是中脑边缘多巴胺系统的一个综合调节器.它的GABA能神经元接受外侧缰核(LHb)的输入, 然后投射到VTA多巴胺能神经元, 进而抑制多巴胺的释放.这三个脑区是奖赏环路的重要组成部分, 其中RMTg在阿片类物质激活的奖赏环路中尤为重要.阿片类物质主要通过抑制RMTg GABA能神经元使VTA多巴胺能神经元去抑制, 进而激活奖赏系统.因此, RMTg有望成为治疗药物成瘾(尤其是阿片成瘾)的一个重要靶点.此外, 胆碱类物质作用于RMTg的毒蕈碱受体能够抑制阿片类物质诱导的奖赏效应.未来研究应深入探讨RMTg调控的负性奖赏环路, 这对弱化觅药动机,促进消退和戒断具有重要意义.     

Executive dysfunction affects word list recall performance: Evidence from amyotrophic lateral sclerosis and other neurodegenerative diseases

The Rey Auditory Verbal Learning Test (RAVLT) is widely used in clinical practice to evaluate verbal episodic memory. While there is evidence that RAVLT performance can be influenced by executive dysfunction, the way executive disorders affect the serial position curve (SPC) has not been yet explored. To this aim, we analysed immediate and delayed recall performances of 13 non‐demented amyotrophic lateral sclerosis (ALS) patients with a specific mild executive dysfunction (ALSci) and compared their performances to those of 48 healthy controls (HC) and 13 cognitively normal patients with ALS. Moreover, to control for the impact of a severe dysexecutive syndrome and a genuine episodic memory deficit on the SPC, we enrolled 15 patients with a diagnosis of behavioural variant of frontotemporal dementia (bvFTD) and 18 patients with probable Alzheimer's disease (AD). Results documented that, compared to cognitively normal subjects, ALSci patients had a selective mid‐list impairment for immediate recall scores. The bvFTD group obtained low performances with a selectively increased forgetting rate for terminal items, whereas the AD group showed a disproportionately large memory loss on the primary and middle part of the SPC for immediate recall scores and were severely impaired in the delayed recall trial. These results suggested that subtle executive dysfunctions might influence the recall of mid‐list items, possibly reflecting deficiency in control strategies at retrieval of word lists, whereas severer dysexecutive syndrome might also affect the recall of terminal items possibly due to attention deficit or retroactive interference.     

ON BECOMING ABLE TO PLAY: INDIVIDUAL CHILD PSYCHOANALYTIC PSYCHODRAMA AND THE DEVELOPMENT OF SYMBOLIZATION

In this paper, the authors analyze the relevance and transformative potential of individual psychoanalytic psychodrama in the treatment of children with severe impairments in symbolization. Central features of this modality, including promoting the representation of early traumatic experiences, are presented and discussed. Specific features include double‐envelope containment of the co‐therapists’ group and play leader, consequent diffraction of the transference‐determining portrayal, gradual integration, and initial figuration of coexisting split‐off fragments. Drawing on in‐depth clinical material, the authors show how psychodrama tempers the potentially traumatic effects of the encounter with the object, allowing these patients to access the transitional area of play.     

Too close for comfort: the challenges of engaging with sexuality in work with adolescents

This paper explores some of the ways in which sexuality can intrude into the psychotherapeutic relationship and present both opportunities and risks to our work with adolescents. It highlights some of the complexities of this area of the clinical encounter, exploring the particular difficulties encountered by both patient and therapist when sexuality emerges in the transference and countertransference. While we are well aware of the centrality of sexual development during adolescence, far less has been written about the way in which sexuality and the erotic transference emerges and impacts on both patient and therapist. Given the profoundly unsettling nature of this area of work and its capacity to disrupt our thinking and psychic equilibrium, it is easy to underestimate how much we are drawn to avoid, negate and defend ourselves against registering such experiences. Through the discussion of clinical material with two adolescent patients, this paper explores some of these dynamics, addressing some of the technical dilemmas that frequently challenge us in this area of work. These include questions about whether and when it is therapeutically important and effective to take up and interpret the emergence of sexuality more directly in the transference and some of the risks to our patients when we ‘play safe’ and fail to do so. Most importantly, this paper aims to facilitate further thinking and discussion about an important but uncomfortable and easily neglected area of our work.     

From the Couch to the Chair: Applying Psychoanalytic Theory and Practice in Counseling

In this article, the authors offer a contemporary perspective on psychoanalytic theory. The authors present a clinical vignette that illustrates how one analyst applied the principles of transference, countertransference, and resistance in a modern clinical setting. The authors describe how analysis is similar to and different from humanistic counseling and conclude by describing how analytic insights might be applied in the clinical practice of counselors.