脐血干细胞移植治疗肌萎缩侧索硬化伦理问题的思考

肌萎缩侧索硬化症是神经系统一种致死性疾病,目前尚无有效治疗方法,脐血干细胞移植为其生存带来了希望。详细论述了脐血、干细胞与伦理学,肌萎缩侧索硬化与生命伦理学的关系,以及如何在肌萎缩侧索硬化治疗中体现生命伦理学的核心精神。面对脆弱的生命,医务人员、伦理学者和管理部门应该如何为此类疾病患者生命和健康作出应尽的职责。     

保留的跨通道启动与老化：对于近期观点的总结

通道内重复启动的研究提示老年人内隐记忆未受损, 这不只体现在视觉通道上还包括其他感觉通道(例如触觉、听觉和嗅觉)。然而很少有研究考察启动任务是否具有通道特异性。在以年轻人为被试的研究中发现跨通道迁移(视觉到触觉和触觉到视觉)和通道内迁移(视觉到视觉, 触觉到触觉)具有相似性。一项最近的研究进一步探索老年人在跨通道启动任务上是否受损。结果显示视觉和触觉间的跨通道启动在年轻被试和老年被试上都是保留的且具有对称性。并且, 对于自然声响、图片的通道内和跨通道启动任务随着年老化发展仍旧保留。这些行为结果和其它最近神经科学结果显示跨通道启动发生于枕叶后纹状皮层区, 而这一区域在老年人中未损坏。这一领域未来的研究方向包括利用不同知觉通道间、利用熟悉的和新异的刺激并结合行为的和脑成像的方法, 通过设计完善的跨通道启动来研究正常老人与阿尔兹海默病人, 还包括将设计得完善的启动任务包括在用于改善老年人记忆功能的项目中。     

'The healing power of love': The literary/analytic bond of marriage in Freud's essay on Gradiva

Freud 's declared position regarding the management of 'transference love' advocated 'abstinence', objectivity and even 'emotional coldness in the analyst'. However, his essay on Jensen's Gradiva reveals an identification with an involved and responsive 'maternal' analytic position associated with theorists such as Ferenczi, Balint and Winnicott. These theorists attribute the origins of transference love to the pre-oedipal stage, shaping their analytic model on the basis of the early relationship with the mother. Freud generally had difficulty identifying with such a position, since it entailed addressing his own inner feminine aspects. Yet a literary analysis of his 'Gradiva' reveals this stance in his textual performance, i.e. in the ways in which he reads and retells Jensen's story. Freud 's narration not only expresses identification with Zoe, the female protagonist, but also idealizes her 'therapeutic' conduct, which is closer in spirit to that of object-relations theorists. His subtext even implies, however unintended, that an ideal treatment of transference love culminates in a psychical 'marriage' bond between the analytic couple, a metaphor used by Winnicott to describe the essence of the mother–baby (analyst/patient) bond. Freud 's reading process is itself analogous to Zoe's 'therapeutic' conduct, in that both perform a creative and involved interaction with the text/patient.     

Good vibrations: Analytic process as coupled oscillations

This paper develops a new model for the action of psychoanalysis based on concepts from non-linear dynamics (chaos theory and complexity theory). It shows that the analyst–analysand couple may be conceptualized as a new configuration with its own properties that promote complex development in both members of the couple. These developments are an emergent result of the formation of the analyst–analysand couple and are significantly independent of the particular content of the manifest interaction of the couple. The well-studied phenomena of coupled oscillators suggest the specific features of the analysand–analyst interaction that are likely to be most important in conceptualizing analytic change. The model has substantial clinical applications since efforts to arrange for a coupled oscillator system that is central to it are distinct from many of the traditional considerations associated with creating an analytic situation.     

Child versus adult psychoanalysis: Two processes or one?

Child analysis continues to be seen as a different technique from adult analysis because children are still involved in a developmental process and because the primary objects continue to play active roles in their lives. This paper argues that this is a false dichotomy. An extended vignette of the analysis of a latency‐aged girl is used to demonstrate that the psychoanalytic process that develops in child analysis is structurally the same as that in adult analysis. Both revolve around the analysis of resistance and transference and use both to promote knowledge of the patient’s mind at work. And both techniques formulate interventions based on the analyst’s appraisal of the patient’s mental organization. It is hoped that stressing the essential commonality of both techniques will promote the development of an overarching theory of psychoanalytic technique.     

The family myth: its deconstruction and replacement with a balanced humanized narrative

Abstract :  According to Carl Jung the mythopoeic activities of the collective unconscious contribute to the trajectory of personal individuation ( Segal 1998 ). The 'family myth' represents an imaginal narrative that emphasizes the importance of the family's founders, its collective values, and its position with respect to 'outsiders'. Sigmund Freud identified the importance of the Oedipal myth as the basis of nuclear family dynamics ( Rudnytsky 1992 ); however, the 'myth of the family' represents in reality a 'family of myths', each emphasizing different elements of potential interpersonal dynamics. But whereas some myths foster the child's optimal separation from parental influence and promote the process of individuation, others tend to hinder development.
One potentially deleterious form of the family myth tends to serve the narcissistic wishes of parents in their bid to maintain influence over the child by fostering the archetypal features of their role. The children who are the targets of the myth are thwarted in their psychological development by virtue of the fact that they are denied the opportunity to humanize their archetypal projections onto their parent(s). The result is a persistence of childlike attitude with respect to people and situations that they encounter outside the nuclear family. The persistent constellation of the child archetype is evidenced by features of the puer aeternus, with deficits in the ability to work, form stable adult relationships, and create a separate nuclear family. The significance of this type of family myth in the inappropriate preservation of puerile attitudes is examined and the desire of the offending parent(s) to promote their own immortality is explored. The contribution of the myth to the transference and transference resistance is explicated and suggestions are offered with respect to how to approach this critical issue in analysis.     

Transferences Toward the Co-Therapist Couple: Triadic Relationships and Selfobject Needs

This paper examines transferences toward the male/female co-therapists within a developmental context, using concepts from self psychology, intersubjectivity, and infant research. In addition, it proposes that some individuals have selfobject needs specifically related to the parental unit, so triadic relationships can influence one's development. Clinical examples elucidate the repetitive and selfobject dimensions of the transferences within the intersubjective field formed by the triad of a patient and the male and female co-therapists.     

Self-control in adult humans: variation in positive reinforcer amount and delay.

In five experiments, choice responding of female human adults was examined, as a function of variations in reinforcer amount and reinforcer delay. Experiment 1 used a discrete-trials procedure, and Experiments 2, 3, 4, and 5 used a concurrent variable-interval variable-interval schedule. Reinforcer amount and reinforcer delay were varied both separately and together. In contrast to results previously reported with pigeons, the subjects in the present experiments usually chose the larger reinforcers even when those reinforcers were delayed. Together, the results from all the experiments suggest that the subjects followed a maximization strategy in choosing reinforcers. Such behavior makes it easy to observe self-control and difficult to observe impulsiveness in traditional laboratory experiments that use adult human subjects.     

Don't get stuck in the mother: regression in analysis

This paper was part of an afternoon workshop on regression. It re views the author's recollections of her own analysis and clinical work with the purpose of discovering the sources of her own ideas on regression. Two specific forms of regression are then delineated – negative therapeutic reaction as described by Rosenfeld and 'umbilical transference' as a possible future development.