“I HEAR MY VOICE,BUT WHO IS TALKING?”: UNDERSTANDING DEPERSONALIZATION

Depersonalization is the frightening experience of being a shut‐inside, ghostlike, “true” self that observes another part of the self interacting in the outside world. The “true” self hides safely within, while the “participating” self holds all affects and impulses. This split in the ego is created via internal projective identification in the face of overwhelming affect, unavailability of adequate identifications, and insufficient support for psychic cohesion. As the transference develops, the powerful entrapping cocoon of depersonalization can be projected onto the now‐entrapping analyst, where it can be addressed. A clinical vignette illustrates these points.     

A Partial Defense of Illocutionary Silencing

Catharine MacKinnon has pioneered a new brand of anti‐pornography argument. In particular, MacKinnon claims that pornography silences women in a way that violates their right to free speech. In what follows, we focus on a certain account of silencing put forward by Jennifer Hornsby and Rae Langton, and we defend that account against two important objections. The first objection contends that this account makes a crucial but false assumption about the necessary role of hearer recognition in successful speech acts. In response, we argue that, as silencing primarily concerns communication, Hornsby and Langton are perfectly correct to treat hearer recognition as they do. The second objection contends that their particular account of silencing has the unacceptable result of undermining the responsibility of rapists. We here argue that no such result follows from their account.     

Trauma‐focused CBT with maltreated children: A clinic‐based evaluation of a new treatment manual

The effectiveness of a locally developed trauma‐focused cognitive behavioural therapy (TF‐CBT) program for maltreated children with post‐traumatic stress disorder (PTSD) was examined across different therapists in a child protection clinic setting. An earlier phase of the research piloting the program had provided promising results. This second phase involved two studies evaluating the completed TF‐CBT manual delivered by (a) the developer and (b) other therapists. A single‐case multiple‐baseline design was used to demonstrate the controlling effects of the treatment on PTSD symptoms and child coping. Eight 9–13‐year‐old abused children with PTSD were treated. Positive outcomes support the effectiveness of the TF‐CBT program delivered by both the developer and other therapists. The study design and methodology were robust enough to confirm empirically the clinically beneficial effects and potential for this new program. It was also apparent, however, from study limitations, including missing data for some patients, that there are a number of challenges in carrying out such research in a busy child protection service setting with multiply‐abused patients. This paper considers implications and ways forward for engaging in empirically supported practice as well as future development and research.     

Psychodynamic assessment of changes in children with autism under psychoanalytic treatment

In this article the authors report insights into autism developed through their extensive experience of psychoanalytic therapy with children with autism. The fi rst stages of body psychic development are seriously disrupted by this pathology, resulting in primitive anxieties of falling and of being liquefi ed. These anxieties are connected to the fragile development of body ego and of its related spatiotemporal organisation. The changes in children observed by the authors during the therapeutic process lead them to offer a psychodynamic assessment tool, which revolves principally around the development of body ego. After the initial state of 'severe autism', the authors describe three stages: the stage of 'recovery of the skin' (Bick); the established 'symbiotic phase', subdivided into 'vertical then horizontal splitting of the body ego'; and fi nally the stage of 'individuation'. First, the authors describe the principal psychoanalytic approaches to autism and refl ect on the links possible with nonpsychoanalytic work.