INTUITING THE TRUTH OF WHAT'S HAPPENING: ON BION'S “NOTES ON MEMORY AND DESIRE”

Bion's “Notes on Memory and Desire” (1967a) is an impossible paper that this article's author has struggled with for decades. He views the paper, only two and a half pages in length, as a landmark contribution. Despite its title—and its infamous dictates to resist the impulse to remember past sessions and desire for “results”—the paper is not, most importantly, about memory and desire. It proposes a new analytic methodology that supplants awareness from its central role in the analytic process and, in its place, instates the analyst's (largely unconscious) work of intuiting the (unconscious) psychic reality of the present moment by becoming at one with it. This article's clinical examples, provided from the author's own work, illustrate something of his ways of talking with his patients.     

The relationship between family support; pain and depression in elderly with arthritis

The prevalence and chronic nature of arthritis make it the most common cause of disability among U.S.A adults. Family support reduces the negative impact of chronic conditions generally but its role in pain and depression for arthritic conditions is not well understood. A total of 844 males (35.0%) and 1567 females (65.0%) with arthritic conditions (n = 2411) were drawn from the 2012 Health and Retirement Study to examine the effect of family support on pain and depressive symptoms. Using regression analysis and controlling for age, ethnicity, gender, marital/educational status and employment/income, physical function/disability status, pain and antidepressant medications, and other clinical indicators of chronic health conditions, we examined the effects of family support (spouse, children, other) on pain and depression levels. Results indicated that depressive symptoms decreased significantly with strong family and spousal support (p < .05). Pain decreased as support levels increased, but was non-statistically significant. This study provides new insights into the relationship between family support, pain, and depression for individuals with arthritis. Future longitudinal studies are needed to evaluate family support and relationships over a wider spectrum of demographics.     

Human Dignity and the Ethics and Aesthetics of Pain and Suffering

Inasmuch as unmitigated pain and suffering areoften thought to rob human beings of theirdignity, physicians and other care providersincur a special duty to relieve pain andsuffering when they encounter it. When pain andsuffering cannot be controlled it is sometimesthought that human dignity is compromised.Death, it is sometimes argued, would bepreferred to a life without dignity.Reasoning such as this trades on certainpreconceptions of the nature of pain andsuffering, and of their relationships todignity. The purpose of this paper is to laybare these preconceptions. The duties torelieve pain and suffering are clearly mattersof moral obligation, as is the duty to respondappropriately to the dignity of other persons.However, it is argued that our understanding ofthe phenomena of pain and suffering and theirrelationships to human dignity will be expandedwhen we explore the aesthetic dimensions ofthese various concepts. On the view presentedhere the life worth living is both morally goodand aesthetically beautiful. Appropriate``suffering with' another can help to maintainand restore the dignity of the relationshipsinvolved, even as it preserves and enhances thedignity of patient and caregiver alike.     

Differential efficacy between cognitive-behavioral therapy and mindfulness-based therapies for chronic pain: Systematic review

Background/Objective: To assess the differential efficacy between mindfulness-based interventions and cognitive-behavioral Therapy (CBT) on chronic pain across medical conditions involving pain. Method: ProQuest, Science Direct, Google Scholar, Pubmed, and Embase databases were searched to identify randomized clinical trials. Measurements of mindfulness, pain, mood, and further miscellaneous measurements were included. Results: 18 studies met the inclusion criteria (fibromyalgia, n = 5; low back pain, n = 5; headache/migraine, n = 4; non-specific chronic pain, n = 4). In fibromyalgia, mindfulness based stress reduction (MBSR) was superior to the usual care and Fibroqol, in impact and symptoms. In low back pain, MBSR was superior to the usual care, but not to CBT, in physical functionality and pain intensity. There were no studies on differential efficacy between mindfulness and CBT for headache and non-specific chronic pain, but Mindfulness interventions were superior to the usual care in these syndromes. Conclusions: Mindfulness interventions are superior to usual cares in all diagnoses, but it is not possible to conclude their superiority over CBT. Comparisons between mindfulness interventions are scarce, with MBSR being the most studied. In central sensitization syndromes, variables associated with pain tend to improve with treatment. More research is needed to differentiate diagnosis and intervention.     

自我-他人重叠影响疼痛共情的ERP研究

为探究自我-他人重叠影响疼痛共情的神经机制,记录并分析被试在高、中、低重叠程度条件下共情判断的脑电活动。发现在早期N2上,重叠程度三水平间差异显著,表现为密友＜熟人＜陌生人（密友与熟人差异边缘显著）;在晚期P3上,疼痛条件下重叠程度间呈显著差异,密友比熟人、陌生人显著要大;在LPP上疼痛条件诱发更大波幅。表明早期阶段（N2）区分不同重叠程度,可能是对威胁性刺激的检测阶段,自我-他人重叠程度影响共情加工晚期阶段（P3）的社会认知评价加工。     

Relationship between the Millon Behavioral Health Inventory and the minnesota multiphasic personality inventory (MMPI) in low-back pain patients

The Millon Behavioral Health Inventory (MBHI) is being used with increasing frequency for the assessment of chronic pain, although there is a relative lack of evidence as to its utility, and prior studies have not examined low back pain. This investigation compared the MBHI to the MMPI in a sample of low-back pain patients and analyzed subgroups of pain patients based upon their MBHI responses. Subjects were 60 patients who had been admitted to outpatient multidisciplinary pain clinics of two Chicago-area hospitals. Patients completed both the MMPI and the MBHI and provided demographic information. Results of correlational analyses indicated strong relationships between the MBHI psychogenic attitude, psychosomatic correlate, and prognostic index scales and the validity scales of the MMPI. The MBHI Pain Treatment Responsivity scale (PP) correlated with 16 of the other 19 MBHI scales. PP did not demonstrate specificity with low back pain patients. The results of both the scale comparisons and the exploratory two-group cluster subgroup analysis support the notion that responses to the MBHI are largely affected by the respondent's tendency to deny psychopathology or to admit emotional distress.     

Jung and Pauli

In his early theories of the structure of the psyche, psychic energy and psychodynamics, Jung was influenced by William James's understanding of the complementary insights of depth psychology and the discoveries of subatomic physics, and his concept of field in physics and the study of the subconscious. In his relationship with Freud, Jung initially struggled with a sexually-based drive theory. But he gradually came to conceive libido as a quantitative concept, a psychic analogue of physical energy. In their own languages, both C. G. Jung and Nobel physicist Wolfgang Pauli explored the evolution of scientific thought from the naive insights about process in alchemy through Newtonian causality, space-time theories of relativity to quantum mechanics. Jung had access to thirteen hundred of Pauli's dreams. The first four hundred were basis for his research into alchemical symbolism in a modern psyche. In a later collaboration, Pauli supported Jung's synchronicity principle as scientific, and Jung fostered Pauli's understanding of the archetypal and collective factors in the psyche. They each explored the interconnections between the energies of psyche and matter, and the possibilities of acausal order and synchronicity. Pauli's ground-breaking discoveries gave scientific demonstration of alchemical intuitions. Through him, alchemical and archetypal insights entered the discourse of physics. Through Jung, the apprehensions of microphysics entered our psychological language and thought.     

Sex Differences in Clinical Pain: A Multisample Study

A recent meta-analysis of the experimental pain literature revealed effect sizes of .55 for pain threshold and .57 for pain tolerance, indicating a moderate difference in pain perception between men and women, with women reporting an increased sensitivity to pain. The current study investigated the relationship between sex and clinical pain ratings, in patients seeking care at a tertiary care facility. Five samples of chronic pain patients were recruited from several diverse clinics associated with the University of Florida. Analyses of clinical pain ratings revealed similar effect sizes for all samples, ranging from –.07 to –.25, indicating small differences, with women reporting higher levels of clinical pain. This is the first paper to report effect sizes for differences in report of pain in samples of chronic pain patients presenting for treatment at a tertiary care facility.     

Sex, Aggression, and Pain: Sociobiological Implicatios for Theological Anthropology

Theological anthropology can be enriched by paying attention to insights into human behavior taken from sociobiology. The capacity for reflective self-consciousness enables the human animal to respond to basic instincts and drives in unprecedented ways. Humans follow gender-specific sexual strategies, display aggressive behavior, and respond to physical pain as do other animals. Yet human beings have the intellectual ability to express these tendencies uniquely in either destructive or constructive ways. The human being, unlike any other animal, must reckon with sexual ethics, the problem of violence, and the meaning of suffering. In developing the basic concepts of theological anthropology—good creation, natural evil, fall, sin, and image of God—sociobiological research can lead to more adequate understanding of the human.