A community survey of psychological symptoms: evaluating evolutionary theories regarding shamanism and schizophrenia

Evolutionary theories regarding shamanism and schizophrenia provide hypotheses testable through analysis of survey data. A questionnaire, administered to a predominately African-American sample in North Carolina (N?=?965), surveyed schizotypal experience and other psychological symptoms, absorption and related psychological variables, childhood and adolescent difficulty, and incidence of unusual experiences (apparitions, paranormal dreams, waking ESP, out-of-body experience, near-death experience, sleep paralysis, UFOs, spiritual healing, and religious experiences). Study findings replicated Mirowsky's results regarding overlapping boundaries between psychiatric diagnoses. Findings also supported evolutionary hypotheses regarding correlations between schizotypal experiences, psychological variables related to shamanism, unusual experiences, and childhood/adolescent difficulty. Findings suggest use of religion-based cognitive behavioural therapy for distressed people reporting frequent unusual experiences.     

Parental object representations,attachment to God,and recovery among individuals with psychosis

This study explored the relationships between object representations of mother and father and recovery among outpatients with psychotic disorders, and examined the role of attachment to God in moderating those relationships. A total of 46 outpatients diagnosed with schizophrenia or schizoaffective disorder participated. Benevolent representations of mother and father were associated with recovery whereas punitive representations were negatively associated with recovery. Secure attachment to God amplified the association between benevolent representations of father and recovery. Secure attachment to God was found to buffer the relationship between mild-to-moderate punitive parental representations and recovery; however, this relationship was not evident for those with the most punitive parental representations. Directions for future research and clinical implications are discussed.     

When soft voices die: auditory verbal hallucinations and a four letter word (love)

Understandings of auditory verbal hallucinations (also referred to as “hearing voices”), and help for people distressed by them, are dominated by a biomedical framework. Yet, many people who have sought help for the distress and/or impairment caused by hearing voices express dissatisfaction with treatment solely within this framework, highlighting the need for a more rounded, biopsychosocial-spiritual approach. This paper examines the neglected role of a fundamental part of human experience, love, in the experience of hearing voices. First, we argue a lack of love is likely to play a causal role in voice-hearing experiences. Second, we demonstrate that a lack of love is central to the distress and dysfunction often caused by hearing voices. Finally, we show that love plays a core role in recovery. Given this centrality of love, we argue that an interdisciplinary approach to hearing voices involving the mind sciences and theology/religion may be fruitful. The relevance of this for psychotherapeutic interventions for people who hear voices is discussed.     

Psychotic panic and feared sexual assault – ‘homosexual panic’: the historical role of feared homosexual assault as a contributing factor to self-attack

Some psychotic patients fall into acute persecutory panic, a subjective experience of helpless terror in the face of anticipated imminent annihilation or dismemberment. These states occur in a wide range of psychotic illnesses and are often associated with command hallucinations and fear of homosexual assault. In a desperate attempt to escape from imaginary enemies, such patients often attack themselves and imagine suicide is survivable. This article addresses the dread of homosexual assault, previously referred to as homosexual panic, and its relationship to patients who attack themselves in a state of desperate psychotic persecution.     

Transcendence techniques and psychobiological mechanisms underlying religious experience

In this paper the author explores the process by which the combined influence of specific cultural factors and individual transcendence techniques activates psychobiological mechanisms that, in turn, trigger the appearance of special states of consciousness, namely religious trance. Most of these religious and spiritual experiences rationalize a threat common to all cultures, namely the risk of losing one's Ego.

The activation of individual transcendence techniques paraphrases denial defence mechanisms insofar as it involves avoidance of the external reality to preserve homeostasis. The mentioning in psychoanalytic terms of a ‘death instinct’ (i.e. a drive opposite to the attachment/life instinct) as a possible source of detachment/transcendence phenomena is still worth considering.

The Freudian example of ‘the cotton-reel mother’, whom the child could make disappear and then reappear again, is a powerful one of the phenomenon of detachment dynamics.

Cross-cultural research on the varieties of trance shows that Altered States of Consciousness can be induced by both collective and personal rituals that allow the subject to reach the altered states of consciousness by making the whole world appear or disappear in fantasy. While some of the highest forms of supernatural experience, such as ecstasy, mysticism and the communion with the Absolute, engender enough social approval to allow to believe that such experiences mitigate or prevent mental disorders, when the supernatural experiences occur in bizarre features they are indicators of a clear psychopathology.

The perspective of transcultural psychiatry offers the best method of outlining the great ethnographic variety of these experiences and, subsequently, making a comparative analysis of the links that exists among culture, psychopathology and the supernatural in a given situation.

From a clinical point of view, it becomes increasingly clear that psychiatrists need expertise to draw clinical inferences based on the specific patient's culture and his psychopathological presentation, especially when the patient's life history is characterized by the multi-faceted activity of transcendence techniques.     

The unity of consciousness in pre-psychotic states. A phenomenological analysis / La unidad de la conciencia en estados pre-psicóticos. Un análisis fenomenológico

This paper explores the way in which the phenomenon called delusional moods — an alteration of consciousness that characterizes the moment that precedes the adoption of delusional beliefs — would challenge the claim that consciousness is necessarily deployed as an experiential unity. After exploring three basic characterizations of the unity of consciousness, it is concluded that during delusional moods only some of them are completely altered. Finally, after complementing the analysis with the examination of some psychotic states, it is concluded that, from the three dimensions of the unity of consciousness that are explored, only one seems to be fundamental.     

Stupidity in the analytic field: Vicissitudes of the detachment process in adolescence

This paper has the objective of broadening the understanding of technical aspects in working with adolescents who defend themselves against detachment from infantile aspects through defensive organizations. These organizations numb the adolescent toward both triangular reality and narcissistic defenses. The families of such young people may be part of the organization and the analyst can also be recruited to participate in it. But the analyst's perception can become blurry and this fact makes him appear stupid. Aspects of the myths of Narcissus and Oedipus are used here as models for studying stupidity. The analysis of a psychotic teenage girl who is symbiotic in relation to her family shows how the analytical field can be invaded by defensive configurations. Collusions of idealization and domination/submission involve the young person, her family and the analyst but the defensive organizations are only identified after their traumatic breakdown. The expansion of the symbolic network allows symbiotic transgenerational organizations to be identified, while models related to enactments prove helpful for understanding technical ups and downs. The paper ends with imaginative conjectures where Oedipus, as ‘patient’, is compared to the patient discussed here. These conjectures lead to reinterpretations of aspects of the Oedipus myth. The reinterpretations, together with the theoretical and clinical study, may serve as models for understanding the technical ups and downs in working with troubled teens.     

TWO PSYCHOTIC PLAYWRIGHTS AT WORK: THE LATE PLAYS OF AUGUST STRINDBERG AND TENNESSEE WILLIAMS

August Strindberg and Tennessee Williams both became severely deranged during their playwriting careers. Both emerged from the most intense form of their derangement and wrote plays afterward. Strindberg, however, wrote his greatest plays after his psychosis; Williams, before his. Strindberg's psychosis spurred his creativity; that of Williams severely damaged his. This paper proposes that Strindberg mastered his psychosis and that in his late plays he dramatically symbolized psychotic processes. Williams, on the other hand, could neither access nor master his, and his late plays embody the repeated, unsymbolized acting out of his psychosis within an aesthetic context. These differences between the two playwrights become clear not through analysis of dramatic characters, but through changes that each playwright made to the dramatic medium itself.