‘Battling with the unlaid ghost’: psychotherapy with a child traumatised in infancy

This paper attempts to explore the nature and consequences of early trauma on the mental development of a 9-year-old boy I have called Luke. The traumatic event occurred within the context of a more chronic and ongoing trauma, which was due to the lack of receptive and containing parental figures. The combination of these two kinds of traumatic experiences had a destructive impact on the making of Luke's internal world and greatly disrupted the development of his capacity for thought. I will specifically refer to the theory of trauma and to Bion's theory of thinking in order to illustrate the crucial link between trauma and mental work and the complex challenge it brings. I will describe how, during the course of 2 years of intensive treatment, Luke gradually became able to restore his capacity for mental functioning, which made it possible for him to begin to think about and make sense of his extreme emotional experiences.

Dans cet article, l'auteur cherche à explorer la nature et les conséquences, pour le développement psychique d'un garçon de neuf ans qu'il appelle Luke, d'un traumatisme précoce. L'événement traumatique s'est produit dans le contexte d'une situation traumatique plus chronique et plus globale en raison de l'absence de figures parentales réceptives et contenantes. L'association de ces deux types de vécu traumatique, avec leur impact destructeur sur la construction du monde interne de Luke, a créé des perturbations majeures du développement de sa capacité à penser. L'auteur se réfère tout particulièrement à la théorie du traumatisme ainsi qu'à la théorie de l'activité de pensée de W. R. Bion afin d'illustrer le lien fondamental qui existe entre traumatisme et travail psychique, ainsi que le défi complexe que ce travail doit confronter. L'auteur montre qu'au cours de deux années de traitement intensif Luke a progressivement retrouvé ses capacités de fonctionnement psychique, de sorte qu'il a pu commencer à réfléchir à ses vécus émotionnels insoutenables et réussir à y comprendre quelque chose.

Mots-clés: Traumatisme, “pare-excitation”, fonctionnement psychique, théorie de l'activité de pensée, fonction alpha, attaques contre l'activité de liaison

Riassunto: In questo articolo si cerca di esplorare la natura e le conseguenze del trauma precoce sullo sviluppo mentale di un bambino di nove anni che chiamerò Luca. L'evento traumatico accadde all'interno di un contesto di trauma pi[ugrave] cronico e duraturo dovuto all'assenza di figure parentali recettive e contenitive. La combinazione di questi due tipi di esperienze traumatiche ebbe un impatto distruttivo sul mondo interno di Luca e interferì enormemente con lo sviluppo della sua capacità di pensare. Farò principalmente riferimento alla teoria del trauma e alla teoria del pensiero di Bion per illustrare il legame particolare tra trauma e lavoro mentale e la complessa sfida che ne consegue. Descriverò come durante il lavoro intensivo di due anni, Luca divenne gradualmente capace di recuperare la sua capacità di funzionamento mentale che gli permise di incominciare a pensare e dare un senso alle sue esperienze emotive estreme.

Parole chiave: trauma, scudo protettivo, funzionamento mentale, teoria del pensiero, funzione alfa, attacco al legame

Der Artikel versucht, die Eigenschaften und Konsequenzen von frühem Trauma auf die psychische Entwicklung eines 9-jährigen Jungens, den ich Luke nenne, zu betrachten Das traumatische Ereignis passierte im Umfeld eines mehr chronischen und fortdauernden Traumas, wegen Mangel an rezeptiven und haltenden elterlichen Figuren. Die Kombination dieser zwei Arten von Trauma hatte eine destruktive Auswirkung auf das Entstehen von Lukes innerer Welt und störte erheblich die Entwicklung seiner Denkfähigkeit. Ich werden mich speziell auf Traumatheorie und auf Bion's Theorie des Denkens beziehen, um die entscheidende Verbindung zwischen Trauma und mentaler Arbeit und der komplexen Herausforderung, die das mit sich bringt, zu illustrieren. Ich werde beschreiben, wie Luke allmählich im Laufe einer zwei-jährigen intensiven Behandlung in der Lage war, seine Fähigkeit für mentales Funktionieren wiederherzustellen, was es ihm ermöglichte anzufangen, über seine extremen emotionalen Erfahrungen nachzudenken und Sinn herzustellen

Keywords: Trauma, Schutzschild, mentales Funktionieren, Theorie des Denkens, Alphafunktion, Angriffe auf Verbindungen     

Exposed: phallic protections,shame and damaged parental objects 1

Using ideas derived from Dana Birksted-Breen (‘Phallus, penis and mental space’, International Journal of Psycho-Analysis, 77: 649–57, 1996), this article explores the clinical experience with ‘Tommy’, a young boy who suffered multiple traumas and neglect. Birksted-Breen describes a phallic state of mind, which, amongst other things, serves to repudiate the potential for a creative link between internal parental objects and a capacity for thinking. In order to survive psychically, Tommy frequently turned to a phallic state of mind. The deficits in his internal and external objects meant that helpful parental qualities, linked with the development of psychic bisexuality, were not available for introjection and identification. The paper suggests a link between Tommy's employment of phallic (and at times perverse) ways of thinking, related to his intrusive attempts to expose and humiliate his psychotherapist, and to an experience of shame associated with inadequate internal objects. The serious compromise to the development of a creative psychic bisexuality in the patient is reflected in the countertransference strain on the psychotherapist's own internal couple.     

On Phallicism; Developmental Aspects,Neutralization, Sublimation and Defensive Phallicism

Many children in need of psychotherapy are latency-age boys who have little or no contact with their fathers. Their problems typically include low self-esteem, identity problems, depression, difficulties in peer relationships, and aggression. Clinical material illustrates that the consequences for the child of fatherlessness depend on many factors, among them the mother's attitude to the father and other mature males. If the mother devalues all men, her son has little space to grow into a healthy adult. The male therapist may be experienced as a threat to the mother-son union, which may render his efforts to help the boy fruitless. If, in contrast, the mother's experiences of her own father and other men are more positive, her pride in her son's masculinity may strengthen his need to find support for his male development. These observations are discussed as affecting the capacity for triadic object representations in mothers and sons.     

Chapter 4 Interpretation in Short-Term Therapy

Abstract

There is much theoretical and clinical literature on the role of interpretation in psychoanalysis, psychoanalytic psychotherapy, and brief dynamic psychotherapy, but little supporting research data. Using 112 audiotaped sessions from 38 patients in supportive-expressive time-limited treatment, the present study hypothesized that therapists would modify the object and temporal content and frequency of their interpretations in relation to the level of patient functioning. The results did not support this hypothesis. Therapists were not less active with more interpretations for higher functioning patients, nor were they more active with fewer interpretations for lower functioning patients. Therapists were more active and made more genetic interpretations with married patients, regardless of level of patient functioning. The findings are discussed in terms of their implications for supportive-expressive psychodynamic therapy.     

The relationship between face recognition ability and socioemotional functioning throughout adulthood

The relationship between face recognition ability and socioemotional functioning has been widely explored. However, how aging modulates this association regarding both objective performance and subjective-perception is still neglected. Participants, aged between 18 and 81 years, performed a face memory test and completed subjective face recognition and socioemotional questionnaires. General and social anxiety, and neuroticism traits account for the individual variation in face recognition abilities during adulthood. Aging modulates these relationships because as they age, individuals that present a higher level of these traits also show low-level face recognition ability. Intriguingly, the association between depression and face recognition abilities is evident with increasing age. Overall, the present results emphasize the importance of embedding face metacognition measurement into the context of these studies and suggest that aging is an important factor to be considered, which seems to contribute to the relationship between socioemotional and face-cognitive functioning.     

Rumination and self-reflection in stress narratives and relations to psychological functioning

The longitudinal study aims to expand what is known about the costs and benefits of narrating stressful experiences by exploring changes in rumination within the narrative process and comparing it to changes in self-reflection. Rumination (e.g., brooding, self-criticism, and negative emotions) and self-reflection were measured in stress narratives of 56 college students. There were several goals: (1) examine changes in narrative rumination and narrative self-reflection over 3 days of writing, (2) examine the relations among the changes in narrative rumination variables and narrative self-reflection and (3) examine how changes in narrative rumination and narrative self-reflection relate to multiple measures of psychological functioning. Overall, individuals increased self-reflection over the 3-day writing task. Individuals who increased ruminative brooding across the 3 days of writing showed lower ego identity development (short term and long term) and self-esteem (short term), while increased self-criticism was positively correlated with identity distress (short term). Implications of the different aspects of narrative rumination, specifically in the context of stressful experiences, are discussed.     

成人认知功能的发展与老化：一项控制同辈效应的横断研究

为探索成人认知功能的发展与认知老化轨迹,基于中华成人智力量表常模样本数据,统计控制教育水平和职业构成以部分消除同辈效应,考察智商和智力指数的年龄趋势。结果晶体智力指数(CI)在25~44岁间增加0.69分后缓慢递减,高低差值3.3分;注意记忆指数(AMI)在25~44岁间共减少3.3分,45岁后各组均数以3分左右的速度递减。流体智力指数(FI)和智商的年龄差异模式与AMI类似,幅度缩减。提示中国成人晶体智力在74岁前比较稳定,没有明显老化,流体智力和注意记忆能力可能在45岁开始明显线性老化。     

Program for the Education and Enrichment of Relational Skills: Parental Outcomes With an ADHD Sample

The goal of the current study was to examine the effect of the Program for the Education and Enrichment of Relational Skills (PEERS®), a 14-week parent-assisted friendship-building program for adolescents with ADHD, on parental functioning, quality of the parent-adolescent relationship, and family functioning. Participants included 25 parents of adolescents with ADHD. Families completed PEERS®. Measures of parenting stress, parental efficacy, parent-adolescent communication, parent-adolescent involvement, causal attributions for negative social interactions, and family chaos were completed by parents at pre- and post-treatment. Parents demonstrated statistically significant improvements in parenting stress and parent-adolescent communication and marginally statistically significant improvement in parental efficacy. Parents also demonstrated reliable change in parenting stress, parent-adolescent communication, parent-adolescent involvement, and family chaos. Overall, these findings demonstrate the benefit of PEERS® at improving parental functioning, quality of the parent-adolescent relationship, and family functioning for families of adolescents with ADHD.     

Demographic factors,childhood maltreatment and psychological functioning among university students' in Ghana: A retrospective study

This study retrospectively investigates the influence of child (i.e., gender), care‐giver (e.g., who grew up with), household size (i.e., number of siblings grew up with) and community (i.e., rural versus urban) factors on childhood maltreatment, as well as the impacts of maltreatment on psychological functioning. A cross‐sectional survey and self‐report methodology is used to gather data from 300 students of the University of Ghana. The results show that being a male, growing up in rural areas, living with more than 3 siblings in the same household and being raised by both biological parents have significant main effects on childhood maltreatment. Analyses of the interaction effects show that living with more than 5 siblings in a rural household with “other” parents (i.e., non‐biological parents) has a significant effect on physical abuse. Furthermore, males from rural households consisting of more than 3 siblings and who did not grow up with both biological parents endorsed significantly more physical abuse and physical neglect, compared with the females. With respect to the psychological outcome, childhood maltreatment significantly predicts and account for significant variance in depression (34%), self‐efficacy (18%) and life satisfaction (22%). The findings and the implications of the study are briefly discussed.     

Capturing Context-Related Change in Emotional Dynamics via Fixed Moderated Time Series Analysis

Much of recent affect research relies on intensive longitudinal studies to assess daily emotional experiences. The resulting data are analyzed with dynamic models to capture regulatory processes involved in emotional functioning. Daily contexts, however, are commonly ignored. This may not only result in biased parameter estimates and wrong conclusions, but also ignores the opportunity to investigate contextual effects on emotional dynamics. With fixed moderated time series analysis, we present an approach that resolves this problem by estimating context-dependent change in dynamic parameters in single-subject time series models. The approach examines parameter changes of known shape and thus addresses the problem of observed intra-individual heterogeneity (e.g., changes in emotional dynamics due to observed changes in daily stress). In comparison to existing approaches to unobserved heterogeneity, model estimation is facilitated and different forms of change can readily be accommodated. We demonstrate the approach's viability given relatively short time series by means of a simulation study. In addition, we present an empirical application, targeting the joint dynamics of affect and stress and how these co-vary with daily events. We discuss potentials and limitations of the approach and close with an outlook on the broader implications for understanding emotional adaption and development.