Superego formation, adolescent transformation, and the adult neurosis

The superego is heir to the Oedipus complex but has a much larger developmental legacy which includes preoedipal precursors and the influence of latency and adolescence. The superego continues to change in function and content throughout life, and radical transformation in adolescence may result in developmental discontinuity as well as core developmental continuity. A case is discussed in which adolescence was overlooked in previous analysis and in which adolescent superego modification had a major impact on the patient's character and his adult neurosis. The developmental significance of adolescence experienced under conditions of social isolation and rejection with forebodings of the Holocaust was unrecognized in sanctioned silence and shared analytic denial. These repeated earlier experiences of silent submission and stifled protest, and the silent suffering of the patient and his family, were an integral part of his humiliating and emasculating adolescent experiences. The intimidated adolescent, threatened from within and without, identified with the aggressor as well as with the victim. Identification with the aggressor and glorified victor contributed to a final adolescent structuralization of a punitive, sadistic superego and a rigidly perfectionistic ego ideal. As an adult, he tended to passive masochistic compliance with diminished self-esteem and unconscious self-denigration. He was prone to shame and guilt, self-criticism, and hidden hypercritical attitudes toward others. The adolescent internalization of aggression, intense castration anxiety, and pervasive narcissistic mortification led to retreat from resolution of revived oedipal conflict and to concomitant detrimental superego alteration. These issues were of major importance for analytic understanding and therapeutic progress.     

The capacity for rapid shifts in level of mental concentration

This investigation continues the exploration of a largely neglected topic in the field of attention, levels of mental concentration, by ascertaining under optimal conditions the capacity for shifting quickly from one level to another. Previous research in our laboratory had applied a set of five post-hypnotically cued levels of concentration or “cognitive arousal”, covering a very wide range, to a variety of perceptual and cognitive tasks. In the present study two highly trained undergraduate hypnotic subjects, one male and one female, were given progressively shorter time durations in which to respond to the post-hypnotic cues before viewing tachisto-scopically flashed consonants under cue influence. The results indicate a striking capacity to shift degrees of cognitive arousal very rapidly to one extreme or the other, on the order of 100 ms or less.     

Subclmical depression and role fulfillment in domestic settings: Spurious relationships,imagined problems,or real effects?

Considerable evidence has accumulated in support of the hypothesis that subclinical depression may inhibit role performance in important ways. However, interpersonal stress and marital discord often precede the development of depressive symptomatology and may independently predict deficits in family role functioning. In addition, cognitive theories suggest that persons with subclinical depression may report poor role functioning even in the absence of any real performance deficits. The current research examines the possibility (1) that the effect of depression on the fulfillment of important family roles is attributable to previously unmeasured contextual variables of ongoing interpersonal stress and/or relationship dissatisfaction or, alternatively, (2) that this relationship is the result of depressive distortion associated with self-report of symptoms and performance. Multiple regression analyses of interview data collected from 495 community-dwelling adults found, however, that depression is related to role functioning beyond any spurious effects attributable to interpersonal stress, spousal stress, or marital satisfaction. In addition, the effect of depression persists when collateral reports of role functioning utilized. Accordingly, it appears that subclinical depression is related to decrements in role performance, and this effect is not entirely due to contextual elements or shared method variance between self-report measures.The authors acknowledge research support from Research Grants R01-AA-07250 and R01-AA-07218 from the National Institute on Alcohol Abuse and Alcoholism, Research Grant R01-DA-07417 from the National Institute on Drug Abuse, and National Institutes of Mental Health Grant A-41487-07.     

The collective representation of affliction: Some reflections on disability and disease as social facts

A perspective is developed for approaching affliction as a social fact. Disability and disease are considered as two ways in which we suffer a disjunction which arises from the need to take initiative with respect to the inexorable, whether that means the mark of disability or the unconquerability of disease. The story of affliction always raises and masks in certain respects the problem of suffering as the collective representation of our experience of subjectivity where that experience passes through the separateness of being marked to the singularity of being without hope.     

Hemiplegic writing in severe aphasia

Three patients with severe aphasia and right hemiplegia are described who could write to dictation with the right arm using a limb prosthesis though agraphic with the "intact" left hand. The phenomenon of "hemiplegic writing" is explained as an access to submerged or preprocessing levels in language and action structure, through the use of older proximal motor systems. This interpretation has implications for our understanding of language and brain function, as well as for approaches to the treatment of patients with severe language disorders.     

Inferential processing of context: Studies of cognitively impaired subjects

Language comprehension tasks involving pronoun coreference were administered to a group of demented patients, a group of patients with cardiac disease, and groups of normal elderly persons and young adults. Pronoun coreference was constrained by either lexical, syntactic, or contextual cues. No differences were found between old and young subjects for any task. While the demented patients were impaired on all tasks, the cardiac patients were specifically impaired in the inferential processing of context.     

On the concept and consequences of the primal scene.

The concept of the primal scene is in need of redefinition and clarification. The primal scene is not identical with its regressive transformations or later derivatives. Because of the different implications for normal development and for psychopathology, the primal scene as a universal fantasy should be differentiated from the primal scene as real experience. The effects of exposure to the primal scene are considered in relation to the developmental level of the child, other problems in the parent-child relationship, and cultural attitudes.     

A combination of combat experience,early abduction,and severe traumatization fuels appetitive aggression and violence among abductees of rebel war in Northern Uganda

Individuals who perpetrate violence may likely perceive violence as appealing and infliction of violence to derive pleasure is termed as appetitive aggression. Individuals who were abducted as children into an armed group often experience a higher number of traumatic event types, that is traumatic load and are usually socialized in a violence-endorsing environment. This study aims to investigate the interaction between age at initial abduction with that of traumatic load, and their influence on appetitive aggression along with perpetration of violent acts by former members of an armed rebel group of both sexes. Semi-structured interviews were conducted among a target group of formerly abducted rebel-war survivors (including participants with and without combat experience) from Northern Uganda. Participants included 596 women and 570 men with N = 1,166 (M_age = 32.58, SD_age = 9.76, range: 18–80 years). We conducted robust linear regression models to investigate the influence of age at initial abduction, traumatic load, combat experience, and biological sex on appetitive aggression as well as their perpetrated violent acts. Our study shows, appetitive aggression and the number of perpetrated violent acts were specifically increased in individuals who were abducted young, experienced several traumatic events in their lifetime, and with previous combat experience. For perpetrated violence men showed increased levels whereas for appetitive aggression the association was independent of biological sex. Therefore, early abducted individuals with a higher traumatic load, who have combat experience, need to be given special intervention to prevent any further violence.     

Family Environments of Women Seeking BRCA1/BRCA2 Genetic Mutation Testing: An Exploratory Analysis

Although there is some understanding of the shared characteristics and predictors of psychological distress of women participating in hereditary breast and ovarian cancer registries, these same characteristics are only beginning to be identified in research on community women seeking genetic testing for BRCA1/BRCA2 gene mutations. This study provides an initial exploration of characteristics associated with family environments for 51 community women waiting to receive such genetic testing results. Thirty-four of the 36 women classified on family environment type of the Family Environment Scale (FES) were from Personal Growth-Oriented families. Comparisons of women with and without personal cancer histories resulted in a trend for women with personal cancer histories to be classified as from Independence-Oriented families. Reported distress appears to vary for different family emphases based on family and personal cancer history. A moral-religious family emphasis consistently appeared to be associated with decreased psychological distress. Preliminary analyses comparing these community women (who were not part of a hereditary registry but were self- or physician-referred) seeking genetic testing with normal and distressed family means found that increased cohesion and expressiveness may be related to decreased conflict, indicative of potentially supportive family environments for these women. When compared with normative data, a subset consisting of the Ashkenazi Jewish women showed a trend of less cohesion than normal families, but similar cohesion levels as distressed families.