Black holes: Some notes on time,symbolization, and perversion in the psychodynamics of addiction

Abstract

The existence of man is distinguished by its split state: man stands in the middle of life yet still has an awareness of his own death. He has to compensate whatever is missing in him naturally at the societal level, created as culture, and at the individual level through creativity. Rank investigated the human ‘creative drive’, the anthropological aspiration to express oneself in creative works, and to overcome the fear of death with its help. Freud admired poets and artists, whose achievements he could not psychoanalytically access, but he considered science superior to the harmless and naïve arts. There are two anthropological radicals: premature birth and the consciousness of death. Freud's massive fear of death made it difficult for him to acknowledge the problem of death appropriately. In Rank's concept, the development of human creativity contributes towards the fear of death being alleviated so that the knowledge of death can be integrated into life; creativity belongs to the fundamental opportunities of man that may enable him to find a way through neurosis. Failure is as much a part of life as is creativity: those who do not experience and accept life in its tragic dimension are denied creativity. Only a creative person who accepts his partial failure finds the strength to continue to be creative without his imperfect work leading to the ritual repetition of the same thing again and again, that is, getting stuck in recidivism.     

The Impact of Periventricular Brain Injury on Reading and Spelling Abilities in the Late Elementary and Adolescent Years

The present study was designed: (1) to investigate the long-term consequences of both the presence and the severity of periventricular brain injury (PVBI) on intellectual, academic, and cognitive outcome in extremely-low-birthweight (ELBW: < 1,000 grams) children at a mean age of 11 years; and (2) to determine the nature of the underlying difficulties associated with academic problems in these children. The results indicated that ELBW children without PVBI performed as well as full-term children on intelligence, academic, and cognitive ability tests. In contrast, ELBW children with mild and severe PVBI achieved significantly lower scores than either ELBW children without PVBI or children who were born at term. A second analysis indicated that, after accounting for Full Scale IQ, working memory and phonological processing were significant predictors of reading and spelling performance in ELBW children. These findings suggest that the presence and severity of PVBI, and not ELBW status alone, is associated with performance on tests of intelligence, and academic and cognitive functioning, and that some of the same factors known to be associated with learning disabilities in full-term children contribute to learning disabilities in ELBW children.     

Endings as gain: The capacity to end and its role in creating space for growth

The paper describes an application of child psychotherapy in a paediatric setting. It examines the crucial part that attention to endings played in a clinical intervention where the phantasy of going on for ever threatened to inhibit growth. Case material is used to illustrate the different meanings and functions of endings and their significance in terms of parenting issues and developmental tasks. In this context the concept of negative elasticity is put forward as a useful tool for exploring the nature of boundaries. The final part of the paper focuses on the value of the external-reality experience of ending, its relationship to potential professional omnipotence and the importance of sustaining a tension between inner- and outer-world factors.     

Dropping Out of Couple Therapy

Abstract

Current literature on dropouts in marriage and family therapy includes few studies that focus exclusively on couple therapy and only a limited number of qualitative studies. Clients' perceptions of premature termination are seldom considered. This qualitative case study describes, from both the clients' and the therapist's perspectives, one couple's experience of dropping out of couple therapy after three, sessions. Findings from this case study are compared with existing literature and a fourfold typology of dropouts is proposed. We offer recommendations for future research of dropouts in couple therapy.     

胎盘提前老化分娩时间与方式决策的浅思

胎盘提前老化(Premature aging of placenta)是指妊娠足月前胎盘提前出现退行性的结构改变,是妊娠结局不良的一个敏感预测指标。因此分娩时间及方式是胎盘提前老化临床处理的关键问题。临床上需要对其病因、产科合并症、健康效益、医疗代价、产前监测等进行辩证综合分析,进行正确判断,科学决策,从而减少不良后果发生。     

Strategies for Securing Commitment to Treatment from Individuals Diagnosed with Borderline Personality Disorder

Individuals diagnosed with borderline personality disorder (BPD) are notoriously difficult to engage in treatment. The purpose of this paper is to highlight therapeutic strategies that are likely to facilitate early alliance in therapy with individuals diagnosed with BPD. The seven strategies include, collaborative assessment, the use of contracts, motivational interviewing, linking treatment targets to client goals, commitment strategies, validation, and the use of metaphors. Clinical vignettes are presented to elucidate the concepts described and demonstrate their use in clinical practice.     

The predictive validity of nonverbal communicative skills in infants with perinatal hazards

This study investigated the predictive validity to 5 years of age of nonverbal communicative skills administered at 13 months. Subjects (N = 103) were Norwegian infants with birthweight below 1501 gms. The predictors included infant competence assessed by the Early Social-Communication Scales (ESCS). Cognitive competence at 2 years was measured by the Bayley Mental Development Scale, and at 3 and 5 years by the Stanford-Binet Intelligence Scale: Fourth Edition (SB:FE). Language competence at 2 and 3 years was assessed by the Reynell Developmental Language Scales, and at 5 years by a verbal comprehension factor derived from the SB:FE. Partial correlations and multiple regression analyses suggest that the infants' initiation of communication was related to cognitive ability and language skills up to 5 years of age. In particular, joint attention was the most consistent predictor of the subsequent competencies. The Bayley cognitive index was overruled as a predictor when used in combination with initiation of joint attention.     

妊娠早产预测的策略分析

应用宫颈分泌物中高磷酸化胰岛素样生长因子结合蛋白-1(phosphorylated insulin-like growth factor-bindingprotein-1,phIGFBP-1)及宫颈长度对高危早产孕妇预测早产进行评价分析。腹部超声宫颈长度≤4.0cm结合phIG-FBP-1预测早产的阳性预测值58.33%、阴性预测值91.6%;阴道超声宫颈长度≤2.5cm结合phIGFBP-1预测早产的阳性预测值80%、阴性预测值80%。三者联合预测早产取得满意效果。这一预测策略体现了哲学的光辉。     

The relationship between the parents and the premature baby

Abstract

The arrival of a newborn baby confronts the parents with the loss of their own childhood and the process of mourning that this entails. In the case of a premature birth, where the often brutal experience of birth is followed by a forced separation of hospitalization, the situation is even more complicated, making it sometimes difficult for the mother to invest in the baby libidinally. The presence of a psychoanalyst working with the resuscitation team can facilitate the encounter with the parents, the baby, and the caretakers, and can, by “supposing a subject” in the baby, help to restore the bond between mother and child.