Psychoanalysis: Romantic, not wild.

The thesis of this article is that a decisive shift has occurred in analytic aim from dynamic and form “normativity,” or preconceived psychic outcome, to an open-ended process, the result of which is not foreseen. This shift in analytic theory and technique is related to the transformation in the humanities in the early 19th century from neoclassicism to the Romantic Movement. In opposition to the neoclassical ideal for art and life as the Greek and Roman forms, the romantic theorists and poets found such a preconceived ideal as stifling of human potential, passion, and creativity. Analogously, psychoanalysis has moved from a theory aiming at a preconceived outcome defined as psychic structure to an open-ended view that defines the process by a method of inquiry for the realization of latent and inhibited psychic capacities. Just as the Romantics saw the highest good as Bildung, or the actualization of self potential, so the focus of contemporary psychoanalysis is on the realization of the uniqueness of the self rather than the establishment of a given psychic form. This interpretation of analysis is contrasted to “wild analysis,” which is atypically characterized as the imposition of psychic form on the analytic process. The proposed concept of analysis as an analogue of the Romantic interpretation of the human condition has specific technical implications focusing on the creation of new ways of being and relating. A clinical case is presented to show the concrete implications of this Romantic view of analysis. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Mental health and psychic structure: an empirical study

Psychodynamic clinicians cite psychic structure and structural changes observed in treatment as sources of important information about unconscious psychological processes and configurations. Empirical studies have had difficulty demonstrating that psychic structure measures something different from psychiatric symptoms and everyday functioning. This study examined the relationship between psychic structure and mental health using the Health-Sickness Rating Scale (HSRS) to measure mental health and two different measures to assess psychic structure: Kernberg's personality organization (PO) and Wallerstein's Scales of Psychological Capacities (PSYCAP). Bivariate correlations and multiple regression analyses were computed based on ratings for 124 psychiatric inpatients and psychotherapy clients. Correlations showed that mental health and psychic structure are substantially interrelated, and multiple regression analyses indicated that 44% of the variance of HSRS is explained by psychic structure measured with the two methods taken together. The findings provide some support for a general factor of mental health and psychic structure and a "pure" component of psychic structure that is independent from mental health. Different factor-analytic models for understanding the relationship between mental health and psychic structure are discussed.     

Combined versus sequential hormonal replacement therapy: a double-blind, placebo-controlled study on quality of life-related outcome measures

BACKGROUND: To compare combined and sequential hormonal replacement therapies to each other as well as placebo in patients suffering from the postmenopausal syndrome. Clinical outcomes were measured concerning both the specific postmenopausal symptoms (using the Kupperman scale) and health or well-being dimensions (using subscales of the General Health Questionnaire and specific depression and anxiety scales). METHODS: A prospective randomized double-blind study over 12 months of 105 normal early postmenopausal women in the setting of a general hospital. RESULTS: Both hormone replacement therapies were superior to placebo on the Kupperman scale (sweating, hot flushing, myalgia and vertigo). The psychic symptoms on the Kupperman scale were psychometrically invalid. However, psychic symptoms as measured by the Beck Depression Inventory and the General Health Questionnaire were significantly improved by the hormonal replacement therapies. No differences were observed when combined therapy was compared to sequential therapy. CONCLUSION: One-year treatment with hormonal replacement therapy is superior to placebo in measuring the somatic and psychic symptoms of the menopausal syndrome. No differences were found in this respect between combined and sequential replacement therapy.     

Gender identities, lesbianism, and potential space.

Offers a conception of individual gender identity as multifaceted rather than unitary, arguing that traditional conceptions of gender force a false dichotomy. Lesbian relationships afford a degree of freedom from the conventional restrictions of gender and need to be explored within this context. Traditional psychoanalytic theory posits masculine identity as the basis for lesbian development. It is argued that lesbian identity instead reflects a diversity of representations and identifications that may be drawn on in intimate connections. This fluidity can be understood in the terms of D. W. Winnicott's (1971) conception of potential space with its possibilities for creativity and psychic expansiveness. The reparative power of psychic play in lesbian relationships can lead to an enlarged sense of what is feminine. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Debatable issues in the problem of somatoform and related disorders

The questions of including into ICD-10 and DSM-III-R of extranosological category--somatoform disorders is discussed. Some positive moments were considered, but inexpediency of the limitation of somatoform disorders to psychological disturbances only, doubtfulness of both including psychosomatic diseases in this category and age limitations in beginning and duration of the disease were stressed. The concept of somatopsychic diseases was proposed with three main variations: 1) with relatively independent rise of somatic and psychic disorders, 2) with prevailing etiopathogenic role of psychic factor (psychosomatic disorders, somatized psychic disturbances, somatoform neurotic and psychosomatic disturbances), 3) with prevailing etiopathogenic role of somatic factors (somatogenic psychic disorders). The actual distribution of somatopsychic disturbances are presented on the syndromal, nosologic and personal levels using data of prophylactic medical examination of one big enterprise's employees.     

Health and violence as perceived by young people, a study of the Parisian region

We know better the violences made by the youngs than those they suffer from. The purpose of this study is to assess, as for a city surrounding Paris, the prevalence of the violences they felt and its relation with the psychic uneasiness. Some 344 youngs (from 15 to 25 years old) selected in the city, have filled in an autoquestionnaire. It has shown that 61.6% of them have already suffered from violences, among them 44.5% from adults and what is more from institutional adults. 13.7% of the selected youngs were victims of regular violences in school sphere and 12.8% in urban environment. The expression of a psychic uneasiness is linked to the previous violences they have felt. The feeling of call for help by a psychologist or a psychiatrist is in relation with the past psychic discomfort and not with the past suffered violences.     

Testing the limits of sense and science: American experimental psychologists combat spiritualism, 1880–1920.

American psychologists faced great difficulty at the turn of the century as they tried to erect and maintain boundaries between their science and its "pseudoscientific" counterparts—spiritualism and psychic research. The public solicited their opinions regarding spiritualism, and a few psychologists wanted to conduct serious investigations of spiritualistic and psychic phenomena. However, many psychologists believed that such investigation risked the scientific reputation of their infant discipline. Because they could not readily avoid the topic, some psychologists studied spiritualistic and psychic phenomena in order to prove them fraudulent or explain them via naturalistic causes, and others developed a new subdiscipline, the psychology of deception and belief. This article argues that psychologists used their battles with spiritualists to legitimize psychology as a science and create a new role for themselves as guardians of the scientific worldview. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Holocaust trauma reconstructed: Individual, familial, and social trauma.

Psychic trauma is characterized by ego damage, regression, and relative helplessness. Following a historic catastrophe, psychic trauma with ego damage is frequently encountered as cumulative trauma. Reconstruction was essential to the understanding of an adult patient initially unaware of his holocaust trauma. When the patient was a child, he and his parents were simultaneously traumatized. Intrapsychic intergenerational psychosocial and neurobiological factors were adverse codeterminants of his cumulative trauma. Isolated affects and fragmented memories required sequential connection in the context of family, identity, and society. Reconstruction importantly contributed to ego reintegration of a lost, lacerated childhood, and to adaptive mastery of trauma and conflict. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Seeing and being seen: Emerging from a psychic retreat.

Reviews the book, Seeing and being seen: Emerging from a psychic retreat by John Steiner (2011). John Steiner is one of the foremost contemporary Kleinians of London who along with analysts like Betty Joseph and Ronald Britton, as well as many others, have been extending Kleinian thought in a way that greatly sharpens our understanding of the way in which internalized object relations are subtly recreated and enacted in microscopic aspects of the unconscious emotional interplay between patient and analyst. In the current work Steiner focuses with microscopic precision on the vulnerabilities patients tend to feel as they begin to emerge from a psychic retreat; vulnerabilities that make them want to go right back into hiding in a place where they will remain unseen. Coming out of a psychic retreat exposes patients to the dangers of being seen in an unflattering light that evokes intolerable feelings of shame, humiliation, and embarrassment. Shame evokes not only wishes to hide but wishes to get revenge on the shaming object as well as persecutory fears that the shaming object might retaliate. Emergence from the psychic retreat evokes not only the fears of being seen but the fear of seeing as well. As we emerge from a psychic retreat we may see that others have good qualities and good things that we lack and that makes us feel envious and shamefully inadequate. We then want to punitively spoil the good qualities and good things that make us feel shamefully inadequate thus activating further persecutory anxiety that others will retaliate. What is particularly original in Steiner’s treatment of these issues is how he puts these issues in the context of the triadic object relations of the oedipal conflict. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Imipramine in alopecia areata. A double-blind, placebo-controlled study

Alopecia areata (AA) is a dermatologic disease whose onset is significantly associated to life events. Its course may often be characterized by high levels of anxiety and depression. These observations suggested a rationale for using an antidepressant in AA. Thirteen patients were enrolled in a double-blind, placebo-controlled study of efficacy of imipramine in alopecia. After six months clinically significant hair regrowth occurred in 5 of the 7 patients on imipramine, whereas no response was observed in the placebo group. An improvement in psychic symptomatology was present in both groups. Our preliminary results indicate the potential efficacy of imipramine in patients with AA, not acting directly through a reduction of anxiety or depression.     

Siblings, transference, and the lateral dimension of psychic life.

The author considers developmental and transferential implications of the lateral dimension of psychic life, which entails the challenge to forge a unique and valued identity in a world of one’s equals, beginning with siblings. The lateral dimension intersects with the vertical dimension of hierarchical relationships, notably those between child and parent. Consideration of the lateral dimension and its particular developmental challenge promises to expand our understanding of the processes of identity development and of transferences involving both siblings and parents. Moreover, conceiving of psychic life as comprising two dimensions may help to contextualize existing psychoanalytic understanding of sibling-related processes in light of fundamental tenets of psychoanalytic theory. A detailed clinical case provides an opportunity to consider the entwined roles of siblings and parents in the developmental challenges of the lateral and the vertical dimensions, and the ways in which identifications with parents and siblings may address those challenges. The author concludes that attention to the lateral dimension and its sibling-centered processes rewards us with a more comprehensive view of identity development and transference. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The ethnic unconscious and its role in transference, resistance, and countertransference: An introduction.

Introduces the Special Section "Ethnicity and psychoanalysis." The authors address how psychoanalytic formulations focus in the main on the study of the individual's internal structure, the study of the mind as a theater of conflict without much concern with the possible influence of ethnic components in psychic structure. Their interest is to extend the study of the mind as a theater of conflict to include the issue of ethnicity and ethnic tension. The authors further discuss providing a psychoanalytic perspective on ethnic tension, the ethnic unconscious, cultural background factors, and the psychological mechanism of ethnic tension in relation to the articles of the special section. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpretation of psychic conflict and adversarial relationships: A self-psychological perspective.

Transference, as described in conflict theory, and self object transference, as considered within self psychology, are represented in a changing figure and ground relationship. An emphasis on conflict and resistance analysis may structure analytic treatment along an adversarial dimension, with implications for self object and object-related transferences. The analytic approach to psychic conflict involves interpreting what the patient defensively needs to ward off. The approach to self-pathology is to interpret the self object functions that the patient needs for self-consolidation and self-maintenance. Accurate assessment of instances in treatment where psychic conflict is the predominant configuration requires a clinical theory that embraces multiple perspectives. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Merleau-Ponty, interiority and exteriority, psychic life and the world.

Reviews the book, Merleau-Ponty, interiority and exteriority, psychic life and the world by Dorothea Olkowski and James Morley (1999). This book is a brief but informative and thoughtful anthology brings together the work of a number of contemporary scholars in philosophy, psychology, psychiatry, and comparative literature to demonstrate how Merleau-Ponty's understanding of the psyche (interiority) and the material world (exteriority) has not only tremendous implications for philosophy, but also for the natural and social sciences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychic retreats or psychic pits?: Unbearable states of mind and technological addiction.

New technologies are highly interactive. They promote imaginative involvement and allow the experience of different self-states, such as those involving withdrawal or “psychic retreat”. According to Steiner, psychic retreats are areas of the mind populated by imagination and ideas which are poorly aligned with reality. Psychic retreats are not necessarily pathological in themselves—for instance, they can be used positively for counteracting anxiety or enhancing creativeness. However, with technological addiction there is a misuse of psychic retreat: here the total absorption with computer applications serves to hide painful or unbearable states of mind, and to protect the patient from overwhelming feelings through segregating self-states with a disconnection in their representations. Therefore, in clinical work with individuals suffering from technological addiction exploring the use of psychic retreats can serve as an aid to both diagnosis and treatment. Where the dysfunctional use of new technologies constitutes a temporary withdrawal from a specific painful event, this can have the function of protecting the individual from inner conflict; in the most serious cases however, technological addiction is grounded in more chronic and pathological dissociative mechanisms, and serves to prevent the mind from reactivating traumatic states connected to childhood experience of emotional neglect or abuse. While it is likely that the first condition can be positively handled with appropriate identification and treatment, the latter is much more difficult to deal with, particularly where the addictive behavior hides the weakness of the self, and psychic retreats are pervasively used to protect the patient from mental breakdown. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mind over matter: Perceived success at psychokinesis.

Four experiments with 212 undergraduates showed that Ss' estimates of success on a psychokinetic (PK) task were independent of actual performance. In Exp I, Ss given a positive introductory set or no set about PK evidenced more illusory control than Ss given a negative set. In Exp II, both degree of general belief in psychic phenomena and the number of practice trials that Ss received influenced performance estimates, with high believers who received 10 practice trials providing the highest estimates and low believers who received 1 practice trial the lowest. In Exp III, Ss actively involved with the PK task judged their performance more positively than passively involved Ss. Exp IV showed that when they were actively involved in the task, Ss with an internal locus of control (Rotter's Internal–External Locus of Control Scale) gave higher estimates of their success than Ss with an external locus of control. When passively involved, internals and externals did not reliably differ in their estimates, but their estimates were lower in those of active/internals. Results support E. J. Langer's illusion-of-control theory and highlight the importance of general psychic belief and locus-of-control orientation in affecting perceived success at a psychic task. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Forgiveness as an intrapsychic process.

Reviews the literature on forgiveness, considers it as a health-inducing process, and offers an intrapsychic conceptualization of forgiveness. An object relations model based on the schema proposed by J. Gartner (1988) explains forgiveness as a lengthy process of self and object representations and complementary defenses undergoing a series of remodifications to develop optimal resolution. Simultaneously, other psychic agencies are disrupted by altering internal images and defenses, broadening the scope of resulting disequilibrium. Gradual, congruent, parallel revision of major psychic systems is necessary for real absolution and exoneration. An illustrative case example of a 36-yr-old married female with depression is provided. The application of this object relations model of forgiveness in psychotherapy and psychoanalysis is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interviews with the dead. Using meta-life qualitative analysis to validate Hippocrates' theory of humours

BACKGROUND: Hippocrates devised his theory of the 4 humours (blood, phlegm, black bile and yellow bile) 24 centuries ago. Since then, medicine has evolved into a complex body of confusing and sometimes contradictory facts. The authors, seeing a need to determine the validity of his theory, hired a psychic. METHODS: The psychic interviewed 4 eminent ancient physicians, including Hippocrates. A randomized double-blind cross-over design was used for this meta-life qualitative analysis. RESULTS: All of the interviewees agreed that the theory of humours is an accurate model to explain disease and personality. INTERPRETATION: Hiring a psychic to conduct after-death interviews with key informants is a useful way to validate scientific theories.