Psychosis,symbol, affectivity 1: etiopathogenesis and treatment through analytical psychology

This is the first of two papers concerning our study into an integrated approach to psychotic disorders, conducted at the University of Palermo’s Psychiatry Unit Polyclinic over approximately 15 years. Here we will explore and reflect upon the acute psychotic condition mainly from a theoretical and conceptual perspective, while in the second paper we will explore the clinical perspective. From the point of view of psychopathology, and in the light of C.G. Jung’s conceptualization of analytical psychology, as well as calling on contributions from other authors from the systemic-relational and post-psychoanalytic field, we will clarify the ideas developed over these last few years by our team. From a more speculative perspective we will advance new interpretive hypotheses in an attempt to thoroughly understand the nature of the psychotic condition, both on a psychodynamic relational and a neuroscientific level. The paper describes how we revised our understanding of psychosis from a brain disease to a process aimed at the rearrangement of psychic functioning, as anticipated by John Weir Perry nearly 40 years ago.     

On matters of mind and body: regarding Descartes

In this paper the author considers Descartes’ place in current thinking about the mind‐body dilemma. The premise here is that in the history of ideas, the questions posed can be as significant as the answers acquired. Descartes’ paramount question was ‘How do we determine certainty?’ and his pursuit of an answer led to cogito ergo sum. His discovery simultaneously raised the question whether mind is separate from or unified with the body. Some who currently hold that brain and subjectivity are unified contend that the philosopher ‘split’ mind from body and refer to ‘Descartes’ error’. This paper puts forward that Descartes’ detractors fail to recognise Descartes’ contribution to Western thought, which was to introduce the Enlightenment and to give a place to human subjectivity. Added to this, evidence from Descartes’ correspondence with Princess Elisabeth of Bohemia supports the conclusion that Descartes did in fact believe in the unity of mind and body although he could not reconcile this rationally with the certainty from personal experience that they were separate substances. In this Descartes was engaged in just the same dilemma as that of current thinkers and researchers, a conflict which still is yet to be resolved.     

Temporality and the torments of time

Immersion in time gives birth to consciousness, as well as conflict and torment. When human beings developed a sense of future, they also gained the ability to anticipate threats from nature or their fellow beings. They thereby created cultures that are bastions of survival, as well as places of poetry, art and religion where they could band together and reflect upon their common plight. The practice of psychoanalysis is in many ways a temporal process, a process of remembering, for owning and elaborating a past that gives us substance, thereby providing a basis for reflective consciousness. Stimulated by Freud's early writings, Lacan, Laplanche and their successors in particular have focussed extensively on time and psychoanalysis, and their views are a central point of this discussion. A substantial case study is offered that provides concrete examples of these perspectives. A multi‐faceted view of temporality emerges, one that is more syncopated than linear or teleological. In conclusion, I will briefly discuss recent findings in the neuroscience of memory and ‘time travel’ that underpin contemporary psychoanalytic ideas in surprising ways. It is important to remember that acceptance of the contradictory nature of temporal experience can open space for increased freedom and playfulness.     

Basic needs and complexes: similarities between feeling‐toned complexes,emotional schema and affective states

The aim of this paper is to examine feeling‐toned complexes from a developmental psychological perspective. From this perspective feeling‐toned complexes emerge when basic needs are not met. A very similar theory is put forward by Jeffery Young in his Schema Therapy (Young, Klosko, & Weishaar 2005). His basic needs concept, developed on the basis of empirical research, covers four basic needs which are: attachment, autonomy, and self‐worth, as well as play and spontaneity. My proposition is to deal with this conceptual view from a Jungian perspective insofar as we can integrate the four basic needs, however adding a fifth: the basic need for meaning in the theory of feeling‐toned complexes. Emotional schemas and feeling‐toned complexes are then comparable patterns. The strengths and weaknesses of Analytic Psychology compared to Jeffrey Young's schema therapy are further discussed. The foundation of the feeling‐toned complexes on unmet basic needs lends itself to including a further reference, namely Jaak Panksepp’s neuroscientific findings. Panksepp formulates seven basic affective systems which I discuss first, then I focus on what could be gained from the basic needs concept and finally I turn to the feeling‐complex in an attempt to integrate neuroscientific findings into complex theory.     

On Murray Jackson's 1961 ‘Chair,couch and countertransference’

One of the problems facing psychoanalysts of all schools is that theory has evolved at a much faster pace than practice. Whereas there has been an explosion of theory, practice has remained, at least officially, static and unchanging. It is in this sense that Murray Jackson's 1961 paper is still relevant today. Despite the rise of the new relational and intersubjective paradigms, most psychoanalysts, and not a few Jungian analysts, still seem to feel that the couch is an essential component of the analytical setting and process. If the use of the couch is usually justified by the argument that it favours regression, facilitates analytical reverie and protects the patient from the influence of the analyst, over time many important psychoanalysts have come to challenge this position. Increasingly these analysts suggest that the use of the couch may actually be incompatible with the newer theoretical models. This contention is strengthened by some of the findings coming from the neurosciences and infant research. This underlines the necessity of empirical research to verify the clinical effectiveness of these different positions, couch or face‐to‐face, but it is exactly this type of research that is lacking.     

The image schema and innate archetypes: theoretical and clinical implications

Based in contemporary neuroscience, Jean Knox's 2004 JAP paper ‘From archetypes to reflective function’ honed her position on image schemas, thereby introducing a model for archetypes which sees them as ‘reliably repeated early developmental achievements’ and not as genetically inherited, innate psychic structures. The image schema model is used to illustrate how the analyst worked with a patient who began life as an unwanted pregnancy, was adopted at birth and as an adult experienced profound synchronicities, paranormal/telepathic phenomena and visions. The classical approach to such phenomena would see the intense affectivity arising out of a ruptured symbiotic mother‐infant relationship constellating certain archetypes which set up the patient's visions. This view is contrasted with Knox's model which sees the archetype an sich as a developmentally produced image schema underpinning the emergence of later imagery. The patient's visions can then be understood to arise from his psychoid body memory related to his traumatic conception and birth. The contemporary neuroscience which supports this view is outlined and a subsequent image schema explanation is presented. Clinically, the case material suggests that a pre‐birth perspective needs to be explored in all analytic work. Other implications of Knox's image schema model are summarized.     

Psychosis,symbol, affectivity 2: another perspective on the treatment of psychotic disorder

This is the second of two papers concerning our study into an integrated approach to psychotic disorders conducted at the University Psychiatry Unit of Palermo’s Polyclinic over approximately 15 years; this paper concentrates on the clinical phenomena. The study aimed to find the best possible treatment and to improve the prognosis of this patient group. We have explored the efficacy of a range of psycho-therapeutic (cognitive-behavioural, systemic-relational, psychodynamic, group and others), psycho-pharmaceutical, psychiatric rehabilitative and psycho-educational treatments, with a hermeneutic approach instead of a systematic one. The study’s conclusions, described in the paper, are that all psychotic functions start with a nuclear psychic issue connected to emotional development. We describe how the most significant symptoms of acute psychotic manifestations (delusions and misperceptions) make use of an encrypted psychological meaning that can be decoded through the patient’s symbolic language. This language is a key element in diagnosis and in the choice of treatment. The paper describes how we revised our understanding of psychosis from being a brain disease to being a process aimed at the rearrangement of psychic functioning. Our significant results are described.     

Preliminary thoughts on the neurobiology of innate unconscious structures and the psychodynamics of language acquisition

This paper builds upon Britton's recent writing on ‘models in the mind’, in which he gives an account of preverbal metaphoric structures based on object relations (Britton 2015). These correspond with Jung's theory of innate unconscious structures. These innate models are considered alongside current linguistic theory following Chomsky and post‐Chomskyan views about language acquisition. Neuroscience evidence linking language and abstract thinking with structures involved in tool use are presented. The implications of these findings, and our understanding of the relational context within which language, metaphor and abstract thought are acquired, will be discussed along with the failures of symbolization and verbal communication common amongst those with severe narcissistic disorders.     

The predicting role of self-efficacyin the Job Demands-Resources Model: A longitudinal study

Resumen

El presente artículo describe algunos paradigmas clásicos para el estudio de la percepción no consciente conjuntamente con investigaciones recientes en el campo de la Neurociencia Cognitiva que hacen uso de técnicas de neuroimagen moderna, como los potenciales evocados de alta densidad y la resonancia magnética funcional, para explorar las características funcionales y bases cerebrales del procesamiento no consciente o no atentivo de la información. Numerosos datos avalan el hecho de que la percepción subliminal es una realidad en el cerebro y no una quimera.