Wisdom won from illness: The psychoanalytic grasp of human being

From its inception psychoanalysis claimed not merely to be an effective therapy for psychological suffering, but to shed light on the human condition. But what kind of insight does psychoanalysis offer? This paper locates psychoanalysis in the western philosophical tradition, arguing that psychoanalysis provides not only theoretical wisdom about the human, but practical wisdom of a peculiar kind. The human mind, through its self‐conscious understanding can be immediately and directly efficacious in shaping its own structure.     

On the capacity to suffer one's self

Problems in the establishment of the sense of a ‘psychic’ skin, in the ways described by Bick and Meltzer for example, commonly give rise to distortions in the capacity for self‐experiences as a consequence of difficulties in relation to projective and identificatory processes. These latter may acquire a markedly adhesive character as a defence against the anxieties that arise. This makes for considerable technical difficulties in an analysis. This essay addresses the nature of these problems and considers some of the ways in which they may be approached clinically.     

Defensive high-anxious individuals with chronic back pain demonstrate different treatment choices and patient persistence

The aim of this study is to determine whether the experience of, and response to chronic back pain was different for defensive high-anxious individuals than other personality types (defensive high-anxious, high-anxious, repressor and low-anxious). Participants (n = 111) were recruited from a heterogeneous sample of individuals who had reported back pain within the last 6 months. Self-report measures of trait anxiety and defensiveness were used to determine personality type. In addition, pain, treatment history, disability, depression and satisfaction with treatment were recorded. Despite reporting similar levels of pain to other personality groups, defensive high-anxious individuals reported significantly greater disability and depression (p < 0.01). Of the defensive high-anxious individuals, 92% sought more than one intervention. In comparison, repressors predominantly self-managed their pain with only 10% utilising more than one intervention. Surprisingly, there were no differences in treatment satisfaction between the four groups. The present study suggests that personality type is an important factor influencing patients’ treatment options, with defensive high anxious individuals substantially more likely to seek multiple interventions and remain within the care system. The present study provides a basis for future research into the role of personality type in the management of chronic pain.     

癌症疼痛心理社会干预治疗的研究进展

癌症疼痛是一种复杂和多维的感受,与心理和社会因素相互影响。本文回顾近期国内外相关研究指出,许多重要的社会心理因素与疼痛有关,包括心理压力、应对方法、社会支持以及社会经济因素,它们是疼痛管理的难点。近期的国内外研究表明缓解癌痛的心理社会干预措施包括：疼痛教育、应对技能训练和催眠等,它们对疼痛治疗管理是有益的补充,同时抗抑郁药物应用对疼痛治疗有益。     

治疼必需知痛

疼痛是人体可感知所有伤害性刺激中最难以忍受的恶性刺激,医学范畴下的疼痛是指组织损伤的前提下产生的＂躯体的不愉快的疼感觉＂加上＂与之相匹配的痛苦情感体验＂两方面内容。长期以来我们的医疗行为＂过多关注组织损伤对疼的调控、忽视了痛苦体验的人文关怀＂制约了我们服务层次。新的生物医学模式下诊疗工作强调细化疼痛分类、躯体与心理并重,以专科诊疗思路指导临床,提高医务人员对病痛的理解、引导供需匹配式的人性医疗服务是时代发展务实之举。     

心身障碍共病与慢性疼痛关联的结构模型

常见的心身障碍共病可以理解为一种新的精神疾病结构模型：情绪障碍、抑郁、焦虑及躯体化障碍等归为内化性疾病谱系的组成元素,物质滥用和反社会行为障碍归为外化性疾病谱系的组成元素。本文分析探讨评估慢性疼痛与这一模型的联系。社会心理和生物学的研究证据表明慢性疼痛与内化性障碍密切相关,提示内化-外化性疾病模型可以作为一个有效的研究架构,为探讨慢性疼痛与情感、抑郁焦虑及其他相关精神障碍的关联共病机制提供新的研究方向和新思路。     

Alexithymia and Early Maladaptive Schemas in chronic pain patients

Psychological factors have an impact on subjective pain experience. The aim of this study was to explore the occurrence of alexithymia and Early Maladaptive Schemas in a sample of 271 first visit chronic pain patients of six pain clinics. The patients completed the study questionnaire consisting of the Toronto Alexithymia Scale‐20, the Finnish version of the Young Schema Questionnaire short form‐extended, the Beck Depression Inventory‐II, and pain variables. Alexithymic patients scored higher on Early Maladaptive Schemas and had more pain intensity, pain disability and depression than nonalexithymic patients. Both alexithymia and depression correlated significantly with most Early Maladaptive Schemas. The co‐occurrence of alexithymia, Early Maladaptive Schemas and depression seems to worsen the pain experience. Screening of alexithymia, depression and Early Maladaptive Schemas may help to plan psychological treatment interventions for chronic pain patients.     

Real men are made,not born! Incidental exposure to energy drinks may promote men's tolerance of physical pain

The energy drink market has grown exponentially since the debut of Red Bull. Advertising of energy drinks tends to reinforce an emphasis on masculine identification. However, no previous study has addressed the symbolic effect of energy drinks on pain tolerance, that is, a particular masculine characteristic. We conducted a priming‐based experiment to show that energy drink primes elevated men's pain tolerance. Induced conformity to masculinity norms mediated the priming effect of energy drinks on pain tolerance. These findings suggest that mere reminders of masculinity‐related products can lead men to behave accordingly in seemingly irrelevant domains (i.e., pain tolerance). Besides distraction and placebo treatment, the connection between a symbolic masculinity prime and greater tolerance of pain may shed lights on an alternative route for pain control.     

MEDEA BY EURIPIDES: PSYCHIC CONSTRUCTIONS FOR PREVERBAL EXPERIENCES AND TRAUMAS

The author introduces Euripides's Medea as a metaphor of the psyche's attempt to express and symbolize preverbal, unrepresented experiences and wounds visited upon it before there was any word for trauma. He suggests that Medea, the wild foreigner whose murderous magic is unleashed when the facilitating environment betrays her, could be thought of psychoanalytically as the deepest uncharted realms of primitive, traumatized existence yearning to find a way to represent itself on the stage of language and reality. Euripides can help us understand this deep realm of the psyche, with which psychoanalysis also grapples; he presents the realization of an object that traumatically fails to contain preverbal elements and transform them.