A Steppenwolf called Brian: Reflections on childhood suffering and creativity

Through the life of the writer Brian Aldiss, this paper explores the idea that if parents are unable to give a child a solid sense of self, the child may grow up with a burning need to find that self through artistic creation. One not uncommon reason for this failure is if the child is a replacement for another child who has died and the parents have not been able to do the grief work required in mourning. This task is often more problematic in the case of a stillbirth. Examples are given of other creative people, such as Freud and Dali, where a previous death in the family may have been the spur to their finding a special identity through their creativity.     

The influence of sex hormones on functional cerebral asymmetries in postmenopausal women

Studies investigating changes in functional cerebral asymmetries (FCAs) with hormonal fluctuations during the menstrual cycle in young women have led to controversial hypotheses about an influence of estrogen (E) and/or progesterone (P) on FCAs. Based on methodical, but also on principal problems in deriving conclusions about hormone effects from correlational designs, the present study investigated hemispheric asymmetries in postmenopausal women, who received hormone replacement either with E alone (E group, n = 32), an E–P combination (E–P group, n = 29) or no hormone substitution (control group, n = 31). Speed and accuracy of responses to a word- and a face decision task, both presented laterally by means of the visual half field technique, were assessed. The control group showed the typical pattern of hemispheric asymmetry with more correct responses to verbal stimuli presented in the right visual field (RVF) and to face stimuli presented in the left visual field (LVF). A hormone-effect was demonstrable only for the verbal task, in which the E group showed an enhanced performance of the right hemisphere (LVF). The E–P group showed no significant differences to the control group or the E group. The results suggest a role of E in the modulation of FCAs at least with regard to verbal processing.     

Creativity and oedipal fantasy in Austen's Emma: 'An ingenious and animating suspicion'

Austen's Emma is one of the great novels of the Western tradition. In this paper the author explores the meaning of Emma's 'ingenious and animating suspicion' that Jane Fairfax seduced her best friend's husband, Mr Dixon. The interpretation that a psychoanalytic understanding makes possible shows how this suspicion represents an oedipal fantasy projected on to Miss Fairfax. Further exploration demonstrates how the fantasy is linked both to Emma's systematic unkindness to Jane Fairfax and to Emma's famous insult to Jane's aunt, Miss Bates. Emma's suspicion projects an oedipal fantasy with its incestuous impulses on to her rival and satisfies an envious aggression at the same time. The author's purpose in this paper is to bring to light through psychoanalytic understanding Austen's dramatisation of the complexity and creativity of the oedipal situation. In addition to the regression in oedipal fantasy, the primary process also functions with a progressive quality that expands and enriches the ego, a double movement described in Keats's 'negative capability', which has been elaborated by Bion. The primal-scene fantasies are often brought alive in the analytic transference. These situations and painful emotions are dramatically portrayed through Austen's genius as vehicles for change. A sudden integration follows a phase of disorganization: 'It darted through her with the speed of an arrow. Mr Knightley must marry no-one but herself'. Emma, who is Austen's 'imaginist', moves from the projected fantasy of the sad love triangle through envy aggression and the narcissistic blows of self-doubt and loss of love to moments of illumination and connection.     

全膝关节置换术后镇痛策略

安全、有效的术后镇痛是全膝关节置换术（total knee replacement,TKR）后各项功能恢复的有力保证,与术后很长一段地间内患者的生活质量息息相关。目前关于TKR术后镇痛策略有多种形式和方法。外周神经阻滞和硬膜外镇痛（epidural control analgesia,CEA）的效果可靠,而外周神经阻滞的术后并发症更少,更为理想。     

Toward a refined view of aggressive fantasy as a risk factor for aggression: interaction effects involving cognitive and situational variables

Over three decades of research have established a positive connection between fantasizing about aggression and enacting aggression. Such findings have provided strong evidence against the catharsis view of aggressive fantasy. However, little attention has been paid to the potentially nuanced nature of the link between fantasy aggression and actual aggression. In the present article, we examined the influence of four variables in the aggressive fantasy–aggressive behavior link: gender, exposure to violence, fantasy absorption, and level of fantasy about harm befalling loved ones and the self (dysphoric fantasy). Using data from a diverse, community‐based sample of 7–14‐year olds and their mothers, we replicated the general finding that aggressive fantasy is positively associated with real‐world aggressive behavior. However, we also found that the interaction of aggressive fantasy and exposure to violence related significantly to aggression, as did the relation between aggressive fantasy and dysphoric fantasy. When exposure to violence was low, even high levels of aggressive fantasizing did not predict aggressive behavior, and, when aggressive fantasizing was low, even high levels of exposure to violence did not predict aggressive behavior. Similarly, when dysphoric fantasy was high, the connection between fantasy aggression and real aggression was markedly attenuated. The implications of these findings for intervention efforts and future research are considered. Aggr. Behav. 35:313–323, 2009. © 2009 Wiley‐Liss, Inc.     

Renewal of object relations through dream-work

In this paper I describe my work with a suicidal patient. The patient was a woman who failed to realize her creative potential in a much wished for and unattainable profession of teacher and transferred all her energy and desire for leadership into her family life. The slogan of her life was the pathetic phrase: 'Everything or nothing!' Her views on life differed from those of her husband who, at the age of 48, started a love affair with a 25-year-old woman. In relation to this, the patient became depressed and attempted suicide twice (by poisoning) in two years. From the Toxicology Department she was referred to the Psychiatric Department where she was treated as an out-patient.     

FANTASY WORLDS AND SELF-MAINTENANCE IN CONTEMPORARY AMERICAN LIFE

Abstract. Because actual social experience is often damaging to conceptions of self, individuals in all societies engage in identity work beyond ordinary social interaction. For people in religious groups, identity work may involve the subjective experience of interactions with spirit beings as in altered states of consciousness such as dreams, reverie, or trance. In memories, anticipations, and fantasies, secular Americans, too, may experience gratifying imaginary social interactions when they gain recognition and acclaim from imagined others. Unlike spirit relations these fantasies are not culturally defined as "real." However, like spirit relations, they may have very real effects on self-maintenance.     

Measuring sport fantasy proneness and deflated reality in sport and performance: Development and validation of two context-specific instruments

Fantasy-prone personalities and generalized states of pessimism and hopelessness have been linked to various behavioural, cognitive, and health related outcomes in the general population. Nevertheless, to date, knowledge of sport-specific fantasy proneness and athletes’ perception of deflated reality in sport is scarce, possibly due to a lack of appropriate psychometric instruments to examine these two important context-specific constructs. In this research, we developed the Sport Fantasy Proneness Scale (SFPS) and the Deflated Reality in Sport Scale (DRSS), first assessing the content validity of items for the instruments following a rigorous process. Through two cross-sectional samples (Study 1: Sample 1 N = 255, Sample 2 N = 260) and one longitudinal sample (Study 2: Sample 3 N = 118) of competitive athletes in the UK, we then examined factorial, convergent, discriminant, and concurrent validity and measurement invariance (Study 1), as well as internal consistency, and test-retest reliability (Study 2) of the two new scales. Results revealed robust construct validity and reliability of scores on the two instruments and suggested very good invariance when implementing the new scales to athletes from different sports and competitive levels and good invariance for cross-gender comparisons. The new scales fill a gap in the sport psychology literature and provide researchers and practitioners with robust psychometric instruments to examine new research questions and tackle issues relevant to athletes’ sport-specific fantasy proneness and perceptions of deflated reality.     

Psychosocial and Biomedical Predictors of Attention and Memory in End-Stage Renal Disease Patients

This study examined the neurocognitive functioning of 554 end-stage renal disease (ESRD) patients to determine the underlying factor structure of tests of attention and memory and to assess the differential impact of psychosocial and biomedical variables on these factors. Analysis revealed three underlying factors: Sustained Attention, Focused Attention, and Memory Recall. Hierarchical regression analyses revealed that psychosocial and biomedical variables were most strongly related to the Focused Attention factor. Education, vocabulary score, age, race, age by creatinine, creatinine, and renal replacement therapy accounted for 30% of variance in Focused Attention; sex, depression, and hypertension were unrelated. After controlling for demographic and medical variables, type of renal replacement therapy was a statistically, but not clinically, significant predictor of Focused Attention, with peritoneal dialysis associated with better attentional performance relative to hemodialysis. The potential relationship between focused attention and compliance is discussed.