Parenthood and parental functions as a result of the experience of parallel psychotherapy with children and parents

The concept of parenthood as defined in classical theory and later theorizations is discussed. Parenthood is defined as a transformative process, activated by the idea of having a child and by interaction with the child, through which a constellation of affective and psychic capacities is developed, promoting growth and psychic change and evolving over time. Parental functions, rather than being learnable skills, are considered as mind functions linked to character traits that cannot be split from the personality as a whole and are, as such, susceptible to improvement through psychotherapeutic work. The author illustrates this with a model of psychotherapies and parallel analyses of parents and children tested and elaborated in public and private practice, showing its therapeutic and cognitive advantages. The central thesis of the paper is that whatever the approach and working method with the parents, the therapeutic space offered encourages certain processes that are vital for the structuring of the self and the psychic growth of the child: creation of a space for the representation and emotional investment of the child; improvement in the parental functions; and identification with the therapist as a new or reactivated developmental object. Two clinical cases illustrate the parallel evolution of therapeutic relationships and of the parent‐child relationship.     

Some psychoanalytical experiences with the new fertility techniques

Abstract

The contingencies in life histories of one male and two female patients of their wish to engage in new techniques for fertility and procreation are explored. Remarkable denial strategies defending narcissistic vulnerabilities were found in all cases. Although they are in fact quite stressful and at best moderately succesful the new medical-technical solutions can acquire magic qualities warding off unresolved conflicts around omnipotence and gender differentiation. In the treatment-process transference undergoes distinct shifts in quality, intensity as well as object when oedipal and pre-oedipal conflicts tend to be acted out with the administering physician. As to the fate of the psychic development of children begotten in these new forms of procreation and parenting, e.g. lesbian couples, much is yet unclear; though complex and fluid defenses coloured by denial and magical qualities towards the father introject have been observed.     

A Preliminary Report Comparing Trauma-Focused and Present-Focused Group Therapy Against a Wait-Listed Condition Among Childhood Sexual Abuse Survivors with PTSD

Summary

The movement among states to promulgate, publish, and implement treatment standards for programs and providers of treatment for men who batter has gained increasing momentum in recent years. This movement, in turn, has created controversy. On the one hand, there are those who view the process of standards development, as well as the products, as essentially good and evolving. On the other hand, there are those who have argued that the process has been flawed, exclusionary, and the products based more on philosophy than sound science. The present paper describes the thoughts of a researcher who also served as chair of a state standards committee. The role of research in standards development and evolution is discussed. The role and contribution of researchers to a collaborative process of standards development and implementation is discussed. Suggestions for enhancing the collaborative process are provided.     

The Application of Attachment Theory and Mentalization in Complex Tertiary Structural Dissociation: A Case Study

The concept of structural dissociation can provide useful information for increasingly complex applications of mentalizing in therapeutic settings; however, little integration of the two approaches has emerged. Grounded in the intricate case of a woman diagnosed with dissociative identity disorder, this case study integrates and applies the concepts of structural dissociation and mentalizing from an attachment perspective. Client history includes pervasive spiritual and sexual abuse, as well as extreme neglect throughout her development. The presenting problems, relevant history (including the profound impact of neglect), and the therapeutic models that guided treatment are described. Also presented are the specific therapeutic interventions that have facilitated and strengthened therapeutic alliances, levels of integration, and mentalizing capacity in this challenging but rewarding study of human resiliency.     

Deductive and inductive conditional inferences: Two modes of reasoning

A number of single- and dual-process theories provide competing explanations as to how reasoners evaluate conditional arguments. Some of these theories are typically linked to different instructions—namely deductive and inductive instructions. To assess whether responses under both instructions can be explained by a single process, or if they reflect two modes of conditional reasoning, we re-analysed four experiments that used both deductive and inductive instructions for conditional inference tasks. Our re-analysis provided evidence consistent with a single process. In two new experiments we established a double dissociation of deductive and inductive instructions when validity and plausibility of conditional problems were pitted against each other. This indicates that at least two processes contribute to conditional reasoning. We conclude that single-process theories of conditional reasoning cannot explain the observed results. Theories that postulate at least two processes are needed to account for our findings.     

Portrait of the therapist as a shaman

What follows will show that an understanding of the nature and purpose of shamanism contains a number of insights that bring to light some important, but often obfuscated, aspects of Western therapeutic practices. the point of departure of the argument is the theory of shamanism developed by the inventor of structural anthropology: Claude Lévi-Strauss. It will be argued, in particular, that his theory of shamanism provides a key to the therapeutic action of symbols upon the body as well as to the broader social function of therapy in general.     

Religion,trauma and non-pathological dissociation in Northern Ireland

This study assessed the relationships between non-pathological dissociation, trauma and religion in members of the Northern Irish diaspora in England. One hundred and seventy-nine opportunity sampled participants completed the non-pathological absorption and imaginative involvement items from the Dissociative Experiences Scale, the Age Universal Intrinsic-Extrinsic Religious Orientation Scale, and a measure of exposure to traumatic events in the form of political violence derived from the Irish Social Mobility Survey (1973), the Social Attitudes Survey (1978), the Social Identity Survey (1995) and the Northern Ireland Referendum and Election Survey (1998). Analysis indicated that non-pathological dissociative experiences were not significantly predicted by intrinsic religiosity, extrinsic religiosity, direct exposure to political violence or indirect exposure to political violence, but were significantly predicted by some specific religious practices. Findings are discussed with specific reference to research on dissociation, trauma, and religion.     

The Skin Picking Impact Scale: Factor structure,validity and development of a short version

In the present study, we examined the psychometric properties of the Skin Picking Impact Scale (SPIS; Keuthen, Deckersbach, Wilhelm et al., 2001), a 10 item self‐report questionnaire designed to assess the psychosocial impact of skin picking disorder (SPD). Participants were 650 individuals who met criteria for SPD in an online survey. Exploratory and confirmatory factor analyses demonstrated a unitary factor structure with high internal consistency (α = 0.94). Consequently, we constructed an abbreviated 4‐item version that retained good internal consistency (α = 0.87) and a robust factor structure. Both the short and the full versions demonstrated discriminant and convergent/concurrent validity. In conclusion, the findings indicate that both versions are psychometrically sound measures of SPD related psychosocial impact; however, some potential limitations of the full scale are discussed.     

‘I am not crying. I am rubbing my eyes’: Annie and the hollow object

This article explores the relationship between the development of severe eczema and asthma in an eight-year-old girl and her difficulties with experiencing psychic pain and conflict. The author focuses on the transference dynamics that preceded and surrounded the psychosomatic reaction in the session. The observations in this case may explain why patients, despite feeling taken over by intense physical sensations, can display flatness and superficiality of affect giving the appearance that they are emotionally ‘hollow’. The author proposes that these patients experience an emotional sense of emptiness in themselves and in their objects that is the result of a very early defence of dissociation caused by overwhelming anxieties of annihilation that are lived out in and through the body. The appearance of a psychosomatic symptom during the session can follow the emergence of sudden and intense raw hostile feelings towards the primary object, accompanied by a sense of danger and profound anxiety, as the hated object is also desperately needed for the subject’s own physical/emotional survival. The analyst can contribute to triggering these episodes by failing to contain the patient’s projections, which may lead to the patient feeling forced to re-introject unprocessed and unbearable ‘psycho-physical’ emotions. This article discusses the different degrees – and forms – of symbolic functioning in connection to this girl’s experience of her eczema and asthma and their manifestation in the transference relationship to the therapist.     

Sources and management of resistance in child treatment

This paper traces the analytic work with a severely traumatised two-and-a-half-year-old girl Phoebe, whose early life was marked by chronic abuse and a violent murder she witnessed a few months prior to the beginning of treatment. Bringing the trauma in the room in a dissociative form, in line with post-traumatic stress disorder presentation, was Phoebe's unconscious means of communicating her pre-verbal encounters by projecting onto me the rage, shock and helplessness of her predicament. Thus, countertransference responses were a helpful window into her internal world, which was governed by cataclysmic losses and primitive states of fear. The importance of containment of the complex feelings aroused in the work and protecting against potential re-enactment of the abusive elements the patient, the family and often the professional network brought in the therapy is highlighted. The author hopes that this paper will encourage the offering of psychoanalytic psychotherapy to traumatised children particularly the under fives.