Reflections on the role of the analytic setting in the light of COVID-19

There have been many reflections, both individual and collective within our Institutes, on the effects on our work with patients caused by COVID-19 and the requirement to move suddenly from the setting of our own consulting rooms to working with patients online (see also, the previous issue of this Journal). This paper focuses on what we have learned from these experiences that can add to our knowledge about the role of the setting in analytic work. Drawing on Bleger’s (1967) seminal paper highlighting the usual setting as a mute projection carrier for primitive wishes and affects, the paper explores how different patients have reacted to the loss of the analyst as the guardian of the setting and in particular as an embodied presence. Some key questions and challenges for both patients and analysts during the pandemic, when ‘the setting begins to weep’, are explored.     

Gender detransition: a case study

Within the last decade, there has been a sharp global rise in the number of young people identifying as transgender. More recently, there appears to be an increase in the numbers of young people detransitioning or returning to identifying with their natal sex after pursuing medical transition. A case is presented of a young woman who pursued a gender transition and returned to identifying as female after almost two years on testosterone. The author considers and critiques the affirmative model of care for gender dysphoric youth in light of this case.     

SC-IAT范式下中学生良心的内隐性

目的:研究探讨了单类内隐联想测验(Single Category Implicit Association Test,SC-IAT)测量中学生良心的可行性,并分析内隐良心和外显良心的关系。方法:采用E-prime3.0软件编制SC-IAT良心测量程序,测量了中学生内隐良心; 采用青少年良心问卷测量了中学生的外显良心,并运用相关技术分析两者之间的关系。结果:SC-IAT实验中,中学生良心的内隐效应显著,且不存在性别、独生与否、学段、家庭结构、家庭所在地等人口统计学指标上的显著差异; 内隐良心与外显良心之间的相关不显著。结论:(1)中学生良心存在积极内隐效应;(2)外显良心和内隐良心相互分离,是两个不同的建构。     

自然数码奇象记忆法记忆复杂数字的神经机制

本研究采用学习-再认范式和复杂数字记忆材料,考察自然数码奇象记忆法相对于机械记忆法在记忆提取上的优势及神经机制。行为结果表明,自然数码奇象记忆法比机械记忆法的再认准确率更高。事件相关电位分析结果显示,再认提取阶段奇象记忆条件下诱发的N400和N700波幅显著更低,这说明奇象记忆提取更容易。在自然数码奇象记忆条件下,正确再认旧数字诱发的前额区、左顶枕叶区及中顶枕叶区N700成分与使用自然数码奇象记忆有关。本研究表明,采用自然数码奇象记忆可以减少或跨越语义加工,从而提高个体对材料的记忆效率。     

Plus de contention ni d’isolement sans contrôle du juge judiciaire

Although of old and common use, the use of isolation and restraint in psychiatry was not regulated until 2016 with the creation of article L. 3222-5-1 of the Public Health Code. However, the Court of Cassation considered that, as a form of care, it was beyond the office of the liberty and custody judge to controle its implementation. Questioned by a plea of unconstitutionality submitted by the Court of Cassation, the Constitutional Council considered, with its decision of 19 June 2020, that these measures constituted a deprivation of liberty requiring judicial review at short notice. The Sages thus declare the provisions of article L. 3222-5-1 unconstitutional, with delayed effect as of December 31, 2020, requiring legislator to rethink and organise the supervision and control of decisions of restraint and isolation.     

Le vaccin,un médicament devenu l’arme absolue promise contre la COVID-19 : une réglementation adaptée ?

As the first vaccines against COVID-19 arrive on the market, the question of the safety of these products arises in the public debate. The major concern is about the possible occurrence of adverse effects, particularly in the context of the use of novel pharmaceutical technologies such as mRNA. It is important to remind both patients and professionals that a vaccine is not only a medicinal product in its own right, but also a special medicinal product: biological and immunological. As a result, its supervision is draconian, and despite the urgency, no requirements have been lowered. The speed of marketing is the result both of adapted clinical trials and optimized evaluation procedures.     

Dynamiques représentationnelles et identitaires au cours de la socialisation professionnelle de jeunes recrues LGBT

This article examines the ways in which representational and identity transformations work during the socialization in the workplace of young LGBT hires, linked to discrimination perceived in their workplace environment as well as their impact on professional goals. Working within the theoretical framework of active socialization, the study is based on the IMIS method and proposes a detailed analysis of two cases recently entering the transportation workplace. The results show that, depending on how severe the perceived discrimination is in the workplace, previous experiences of homophobia encountered in other environments and already built self-image are reactivated in different ways, leading to a more or less important reconstruction of professional and identity representations, as well as the future goals of the individual. These elements are discussed from the point of view of interactions between environments and possible interventions by valuing diversity and accompanying the integration of young hires into organizations.     

γ节律神经振荡：反映自闭症多感觉整合失调的一项重要生物指标

多感觉整合是对不同感官信息进行选择、联系、统一乃至解释的加工过程, 它需要神经系统不同功能区域的共同投入与相互协调, 以实现多种感觉信息的时间捆绑以及全局性的预测编码。而γ神经振荡因具有反映神经皮层兴奋/抑制的平衡状况, 实现多感官信息的时间同步, 以及通过跨频耦合实现全局性预测编码的特点, 在多感觉整合的加工过程中发挥着重要作用。相比正常个体, 自闭症患者神经系统中的GABA中间神经元存在结构与功能异常, 导致γ神经振荡紊乱, 由此破坏了正常的时间同步以及预测编码加工, 并最终引发多感觉整合失调。基于上述因果关联, 未来研究可结合无创可逆性干预技术, 以γ节律神经振荡为生物反馈指标, 形成科学系统化的临床干预治疗方案。     

创造力产生过程中的神经振荡机制

创造力究竟是怎么产生的, 目前尚未得出一致的结论。神经电生理技术因其高时间分辨率, 可以准确地揭示创造力产生进程中的神经振荡机制, 从而帮助人们更深刻地理解创造力的本质。近年来的研究发现, 单节律alpha神经振荡会随着创造力的增加而增强, 这反映了创造力产生过程中的内部信息加工需求增加、自上而下的抑制控制增强。同时, 多频段神经振荡交叉节律耦合体现了创造性产生过程中额叶、颞叶和顶叶等多脑区之间信息交流的动态变化。未来研究应该以整合理论框架为基础, 结合多层次多方法的研究工具, 引进更生态化的数理计算方法, 并利用计算神经科学建模来预测个体创造力发展趋势, 从而全面深刻地认识创造力的本质。