Childhood fantasy play relates to adult socio-emotional competence

Childhood fantasy play and creation of imaginary companions are thought to confer socio-emotional benefits in children, but little is known about how they relate to socio-emotional competence in adulthood. A total of 341 adults (81 males) aged 18 and above (M = 31.47, SD = 12.62) completed an online survey examining their fantasy play as a child, their childhood imaginary companion status, and their adult socio-emotional competence. Adults who reported higher levels of childhood fantasy play were found to be significantly more prosocial, empathetic, and emotionally intelligent than their counterparts after controlling for demographic factors. Recall of a childhood imaginary companion, however, was significantly related only to higher scores for perspective-taking and did not explain unique variance in any adult competence measure. Findings suggest that engagement in fantasy play during childhood may be a precursor to later socio-emotional competence, while benefits previously associated with imaginary companions specifically may not extend into adulthood.     

Cognitive function after open-heart surgery: Are postoperative neuropsychological deficits caused by cardiopulmonary bypass?

Despite the many technological developments in arterial perfusion and cardiac surgical procedures, open-heart surgery is still believed to pose a significant risk for cerebral injury. There are several potential causes of brain damage during open-heart surgery, including prolonged or severe arterial hypotension, as well as emboli emanating from the cardiopulmonary bypass circuit or the operative field. This article reviews the available neuropsychological studies of outcome following cardiac valve replacement and coronary artery bypass grafting. Because both procedures are life-saving operations, the research in this area has been quasi-experimental and fraught with methodological problems. Nonetheless, the findings converge to suggest that cognitive dysfunction occurs after open-heart surgery, and that the deficits are attributable, at least in part, to factors specific to the operation or to the patient being maintained on cardiopulmonary bypass. Preliminary findings suggest that embolization is the primary cause of perioperative deficits in uncomplicated operations. Studies have also consistently found preoperative deficits in this population, suggesting that neuropsychological dysfunction is caused by severe chronic cardiac disease as well as open-heart surgery.     

Validity of the multiple-stimulus without replacement preference assessment for edible items

Studies have shown that the multiple-stimulus without replacement (MSWO) preference assessment is an effective assessment format for identifying preferred items. However, it is possible that factors other than reinforcer quality might influence selections by some individuals when the MSWO array consists of edible items. The validity of the MSWO results was evaluated by comparing items identified as most and least preferred by the MSWO assessment in a concurrent-schedule (CS) format. Varying edible items were used in each study. The MSWO format accurately identified the higher quality edible item for most participants across studies (76%); however, the MSWO format did not predict the highest quality edible item in the CS assessment for 20% to 30% of participants in each study.     

Effects of socially appropriate singing on the vocal stereotypy of children with autism spectrum disorder

This study evaluated the effects of children with autism spectrum disorder engaging in socially acceptable singing on their vocal stereotypy. A multiple‐baseline across four participants with embedded multielement designs was used to assess the effects of the singing intervention upon later occurrence of vocal stereotypy for each participant. Results showed that fewer instances of vocal stereotypy occurred during and after singing intervention sessions. Additionally, two children began to emit appropriate singing after intervention, which suggests that the topography of their vocal stereotypy (e.g., monosyllabic or screeching sounds) was altered to some extent. Overall, results suggest positive implications for teaching appropriate vocal behaviors as functional replacements for vocal stereotypy.     

COUNTERTRANSFERENCE IDENTIFICATION AND FANTASY IN PSYCHOANALYTIC PROCESS

The development of more nuanced understandings of psychoanalytic process is among the primary tasks of contemporary psychoanalytic theorizing. One piece of this complex undertaking involves the examination of moments when the analyst's countertransference position changes. Shifts in the analyst's feelings and thoughts in relation to the patient are complex events in which experiences registered at many levels of organization and via many modes of perception combine to contribute to meaning‐making and furthering of the treatment process. The author explores the role of fantasy in giving form and meaning to alterations experienced as a change of attitude or affect, through close examination of one such moment of shift.     

“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.     

HANSEL AND GRETEL: A TALE OF TERROR

In the analysis of a woman with multiple childhood traumas, the fairy tale “Hansel and Gretel” figured prominently. The author discusses the use of the fairy tale in this case at various levels. He suggests an interplay between a national myth, the fairy tale, and a personal myth—the patient's psychodynamics. The fairy tale can be used to illuminate personal meanings derived from it. In the experience of childhood trauma, the repeated reading of a fairy tale can help organize and defend against terrifying anxiety.     

Who's afraid of the Wolfe couple: the interlocking traumatic scene

Fulfilling intimate relationships require a constant emotional and psychological struggle to disentangle strangleholds created by the interpenetration of unresolved complexes stemming from previous disappointing relational experiences. These complexes may manifest as an encrypted pattern of engagement that each partner brings to the marriage, like a 'malignant dowry'. The dowry box, once opened, releases its nefarious contents to create an extremely complex and entangled drama I call the 'interlocking traumatic scene'. Partners unconsciously entrap each other to play a part in such a scene with double (sometimes multiple) roles for each antagonist. The imaginal space between the two characters can be seen as a projection screen, upon which are superimposed two separate shadow plays, one on each side of the screen. A third play, which is a co-created product of these two individual traumatic scenes, can also be observed. Three plays are performed simultaneously. The defensive systems that the two individuals bring to the equation dovetail together, but the actual interlocking mechanism itself deadlocks in such a way that it seems to have its own malignant presence, a 'malevolent third' (after Ogden 1994). I outline therapeutic interventions using the metaphor of the therapist as 'anti-director' and I introduce my concept of the conjoint selected fact (after Bion 1963 after Poincaré 1952).     

The dual aspect of fantasy: Flight from reality or imaginative realm? Considerations and hypotheses from clinical psychoanalysis1

This paper discusses the view that fantasizing, understood as a flight into fantasy, belongs to a type of mental functioning distinct from imaginative fantasy. From this the idea emerges, proposed by Winnicott, that withdrawal into fantasy assumes a dissociative quality, which is formed early on as a defensive solution following the loss of hope in object relations. Such a defence becomes the foundation for a dangerous enclave in which the individual ends up enclosing himself, experiencing an illusory self-sufficiency. In this perspective, the author maintains that the flight into fantasy must be understood as a risk factor for the draining of the self or for a crystallization into psychopathological structures, becoming an automatic activity of 'non-thought' that substitutes for the working-through processes necessary for the development of the mind. The paper investigates this psychopathological dynamic, which was already present in Breuer and Freud's writings, examining subsequent contributions of various authors. Clinical material (of both children and adults) illustrates how the flight into fantasy may take the form of an anti-relational realm of the mind, compromising the operations necessary to the integration of psychic life. There is also a discussion of which therapeutic tools may help the patient to gradually abandon the withdrawal in favour of an authentically nourishing relational nature.