Devouring and Asphyxia: Paradigm Crisis,the Depletion of the Hero and Complex Thought1

This article deals with the profound paradigm crisis that affects modernity and threatens the destiny of humanity. This crisis results from the lack of perspective offered by the paradigm of modernity with its emphasis on unilateral rationality, scientific objectivity, and exploitation of natural resources by a hyper development of an inflated Hero archetype. The emergence of a new paradigm of complexity, C. G. Jung’s complex psychology, and Ameridian perspectivism, may offer new paths to approach these serious problems lived by modern man. A clinical vignette illustrates how complex psychology may also help with individual patients suffering from psychosomatic complaints.     

Bodily states of anxiety: the movement from somatic states to thought

My paper attempts to stimulate thought about the relationship between physical and mental 'states of anxiety' by looking at some experiences in the consulting room, particularly at those moments when shifts from predominantly somatic to predominantly psychic forms of representation appeared to be taking place. These experiences are considered in conjunction with some of the ideas of Jung, Fordham, Bion, Winnicott, Meltzer and others relevant to the body-mind question. I conclude with some imaginative speculations.     

Understanding alexithymia within a psychoanalytical framework

The object of this paper is to provide a metapsychological definition of alexithymia as described in 1967 in terms of operational thinking and negative hallucination. This is a familiar and established concept in the fields of psychopathology, psychology, and of clinical and psychosomatic medicine. From a psychoanalytic and psychosomatic point of view, the term is conceptually close to P. Marty's “operative thinking”, as described in 1963, even though we know they do not belong to the same epistemological field: on one hand Neuroscience, Psychiatry and the objectalization of the symptom at different levels, and on the other, as regards mechanical functioning, a psychoanalytic clinical approach within the dynamics of the relationship between transference and counter‐transference. The present authors consider that Freudian metapsychology, as now complexified by Andrè Green, allows for a metapsychological approach to alexithymia insofar as it relates to Marty's operative thinking. Thus does Green’s conceptualization of the mother’s negative hallucination, of negative introjection, of a psychically ‘dead (and insecure) mother’, now provide us with the opportunity to describe, in metapsychological terms, the genesis of this particular mode of psychical functioning. Given the mother’s negative hallucination produces a host structure as a background to negativity that will fit future object representations, we will assume that in the case of … future operational or alexithymic …?, this negative hallucination will pathologically and defensively involve the endo‐psychic perception of affect.     

Is there evidence for the use of art therapy in treatment of psychosomatic disorders,eating disorders and crisis? A comparative study of two different systems for evaluation

A comparative study of two different systems for evaluation. Scandinavian Journal of Psychology 53, 47-53. As with any type of treatment the requirement for evidence based practice (EBP) has also affected art therapy (AT) when used as an intervention. This review evaluates the available evidence for using AT for psychosomatic disorders, eating disorders and crisis. The search in Cochrane, Best Practice, AMED, CINAHL, PION, PsycINFO and PubMed from 1987 until now resulted in a huge number of articles but only 32 articles met our criteria for evaluations. The articles were assessed with two evaluation systems, the GRADE system used by the Swedish Council on Health Technology Assessment (SBU) and the US Preventive Services Task Force (USPSTF/Task Force). When comparing the results we found that the GRADE evaluation system rejected the quality in 84% of the 32 studies and the USPSTF/Task Force 41% of these studies. An evidence base for AT was found only according to the criteria of USPSTF/Task Force. Hence, the evidence concept is not explicit, which means that effective treatments run a risk of not being implemented in health care. We suggest a broader view of what constitutes evidence in order to make it possible to include different types of research designs and methods.     

抑郁和焦虑与心血管疾病

抑郁焦虑与心血管疾病的关系最能体现身与心两者相互影响、不可分割的特点。但临床上,心血管疾病患者抑郁焦虑的诊疗率不足1％。这说明现有的诊疗理念和方式没有将心血管疾病和精神障碍联系起来,给患者全面全程的干预和管理。这样的缺陷不仅增加患者的痛苦和功能障碍,也增加心血管疾病的发病率和病死率,还增加患者及社会的医疗负担。本文结合临床经验,从心身一体的诊疗理念,谈谈抑郁焦虑与心血管疾病。     

慢性疼痛与抑郁的心身医学整合观

生物医疗观对慢性疼痛患者的诊疗作用较差。慢性疼痛常因为心理应激、个性、行为和疾病状况而复杂化,增加了患者诊疗的难度。患者常因情感症状、生活压力,而失去信心,陷入无助地痛苦选择冲突中。应用一种系统的跨学科方法重建和保持医生的共情和患者的积极心理,采用疾病状态、生活经历、个性特征和行为模式的四种心身整合观点,综合评估抑郁和慢性疼痛患者。设计综合诊疗方案评定的痛苦作用,在方案制定的过程中认识到这四个观点彼此不同,相互补充,全面阐释影响患者痛苦的生物、心理和社会的多种原因。心身整合观点为设计合理的治疗方案提供了方法,提高了医生成功治疗慢性疼痛患者的可行性。     

Dream and loss—on triangulation and its implication on the capacity for self-reflection in psychoanalytic work

This paper takes as its starting point Freud's idea that the loss of the object and its inner restoration is an on-going process, which has a crucial influence on the facing of reality. The author's aim is to illustrate that it is by working through the loss of the object that an inner triangulation may be experienced. The idea of triangulation is based on Ronald Brittens definition of it as the image of a mental space in which subjective experiencing can be combined with observing. Via a clinical material, where the distinction between self and object may be endured only with difficulties, the author discusses how phantasizing may serve as an evasion of a notion of an inner catastrophe and how a collapsed triangular space can be restored. In this discussion, the differentiating aspect by negation is touched upon. In connection to another clinical case, the author discusses how the analysand creates what the author calls an illusion about the mutual inter-changeability of the objects. This is used to protect the analysand from experiencing feelings of Oedipal competition, and through that, mourn the illusion of an exclusive place in the Oedipal triad. The conclusion is that the capacity to create meaning comprises the idea of the possibility of together with the subjective experience, internalizing the perspective of ?the other”. Further, that the working through of the Oedipal situation stabilizes the capacity for an observing thinking, since it places the person in a triangular position where he/she is able both to identify with the parties in the Oedipal arena and to observe hislher own contribution to the Oedipal interplay.     

论神经哲学的兴起

人类心身问题的研究一直是科学界关注的热点。近年来,国外学者将神经科学与哲学研究统一起来,集合两门学科的研究方法、综合双方的研究成果,以此来共同推进人类心身问题的研究,因此诞生了一门介于神经科学和哲学之间的独立学科,它有着学科交叉的研究领域和特殊的跨学科研究方法,这门学科就是神经哲学。     

Physical complaints,anxiety, and its body outcomes: A psychophysiological field study

The relationship between the subjective experience of physical complaints and anxiety and physiological measurements was investigated in a psychophysiological field study. Dependent physiological variables were heart rate and electromyogram (EMG). Of 178 adolescents two extreme groups, each equal in age and sex, were assigned: one group (N=9) characterized by high scores in anxiety and physical complaints, and the other group (N=9) by low scores in these factors. The assertion was that particularly strong psychophysiological reactions would be found to be dependent on individual psychological dispositions. All adolescents were measured with a portable psychophysiological recording device during a normal school day of 7 hr. In the physiological measurements, the two groups differed from each other in that the adolescents reporting many physical complaints and having a high score in anxiety showed an overall higher EMG and an overall lower heart rate (not significant) during the course of the day. This pattern could be reproduced after 2 months. The physiological data appear to be rather stable. The high-scoring group's reactions were more inflexible in relation to the physiological measurements, and they showed a tendency to respond in the same way to different situations, while the other group reacted more flexibly to situational demands.     

试论心身疾病的中医病机

心身疾病是指那些心理一社会因素在疾病的发生和发展中起重要作用的躯体疾病。其概念决定了心身疾病不具有专业领域性,不同心身疾病有着不同的病理变化。发掘其病理共性、找寻规律性,对该学科发展的标准化方向至关重要。该文从中医基本病机层次,探讨了心身疾病的发生、发展与变化的机理,试图对科研与临床操作提供有益思路。