Psychoanalytic literature, August 2008

Mourning and melancholia revisited: correspondences between principles of Freudian metapsychology and empirical findings in neuropsychiatry.

Psychopharmacology Unit, University of Bristol, Bristol, UK. R.carhart-harris@bris.ac.uk.

ABSTRACT: Freud began his career as a neurologist studying the anatomy and physiology of the nervous system, but it was his later work in psychology that would secure his place in history. This paper draws attention to consistencies between physiological processes identified by modern clinical research and psychological processes described by Freud, with a special emphasis on his famous paper on depression entitled 'Mourning and melancholia'. Inspired by neuroimaging findings in depression and deep brain stimulation for treatment resistant depression, some preliminary physiological correlates are proposed for a number of key psychoanalytic processes. Specifically, activation of the subgenual cingulate is discussed in relation to repression and the default mode network is discussed in relation to the ego. If these correlates are found to be reliable, this may have implications for the manner in which psychoanalysis is viewed by the wider psychological and psychiatric communities.

PMID: 18652673 [PubMed - in process]

PMCID: PMC2515304

A psychodynamic understanding of conversion nonepileptic seizures in a young woman with acquired blindness.

The Mount Sinai School of Medicine, New York, NY 10029, USA. jocelyn.soffer@mssm.edu

PMID: 18622362 [PubMed - in process]

Group therapy for patients with psychogenic nonepileptic seizures: A pilot study.

Department of Psychiatry and Behavioral Medicine, Stanford University Medical Center, 401 Quarry Road, M/C 5723, Stanford, CA 94305, USA.

Great advances have been made in the diagnosis of people with psychogenic nonepileptic seizures (PNES) since the advent of video/EEG monitoring. However, treatment options for this population have lagged significantly. This pilot study was undertaken to evaluate whether group therapy done with a psychodynamic focus would offer a useful intervention. Twelve patients entered the study and seven completed at least 75% of the 32 weekly sessions. The Beck Depression Inventory and the Global Severity Index of the Symptom Checklist-90 showed improvement as well as an overall decrease in PNES frequency. The data suggest that group therapy focusing on interpersonal issues may benefit patients with PNES.

PMID: 18621147 [PubMed - as supplied by publisher]

[Autism: exploring historical psychiatric and psychological concepts.]

AG Geschichte der Nervenheilkunde an der Klinik für Psychiatrie und Psychotherapie.

Autism today is a widely used term, yet what is understood by autism has changed considerably since first being introduced in scientific discourse almost 100 years ago. Autism is one example for the influence of the psychoanalytic school of Sigmund Freud on scientific psychiatry at the beginning of the 20th century. In particular psychoanalysis had an impact on Eugen Bleuler's concept of schizophrenia. The Swiss psychiatrist did not only acknowledge and follow a biological, but also a psychological approach to psychiatry and thus opened up his subject to psychoanalytic thoughts. This paper provides insights into the term's conceptual history - or, more specifically and precisely - sheds light on the expansion of the term's scope, which got to be used for more and more symptoms and phenomena. When Bleuler first presented the term autism, he used it to refer to a classical schizophrenic symptom. Since, however, Bleuler was not very specific and exclusive in his definition, the term was soon used for other phenomena as well, such as to describe a schizoid symptom in the sense of today's schizoid personality disorder (schizoid autism). The concepts of autistic hebephrenia and depressive autism are further examples how the term was used and give insight into how the contents behind the term changed, got less and less specific and widened its scope. Due to its growing vagueness its suitability and usability as a psychopathological term decreased. This process further was strengthened when the word autism got more and more widely used in colloquial language for different aspects of day-to-day routine and thinking. Thus in psychiatry today, autism is exclusively used in connection with the so-called autism spectrum disorders, but has, as other formerly exclusively technical terms, different and rather unspecific meanings in everyday communication.

PMID: 18677680 [PubMed - in process]

Predicting the outcome of antidepressants and psychotherapy for depression: a qualitative, systematic review.

Depression Research Group, Mentrum Mental Health Care, Amsterdam, The Netherlands. rien.van@mentrum.nl

As treatment outcome in depression varies widely, it is important to understand better the predictive value of particular patient characteristics. However, qualitative systematic reviews of the association between easily identifiable patient characteristics and outcome for commonly used treatment options have been unavailable. This article provides an overview of the consistency of findings on the association between sociodemographic factors and depression characteristics, on the one hand, and outcomes of pharmacotherapy, cognitive-behavioral therapy, and interpersonal/psychodynamic psychotherapy for major depression, on the other. There were no findings indicating that gender was associated with treatment outcome in the case of tricyclic antidepressants. There are some indications that younger patients respond worse to tricyclics, whereas especially women appeared to have better outcomes with modern antidepressants (selective serotonin/norepinephrine reuptake inhibitors). Marital status may be related to better outcome in the case of antidepressants and cognitive-behavioral therapy. Longer duration of depression was identified as a negative predictor, most consistently in psychotherapy. In none of the treatment modalities was recurrence a negative predictor. The relation between severity of depression and outcome appeared to be complex, precluding any straightforward inferences.

PMID: 18661365 [PubMed - in process]

Transgenerational transmission of trauma: guilt, shame, and the "heroic dilemma".

Department of Psychoanalytic Studies, Sigmund Freud University. felix.de.mendelssohn@inode.at

PMID: 18573029 [PubMed - indexed for MEDLINE]

Modern psychoanalysis and Leslie Rosenthal.

Eastern Group Psychotherapy Society, USA. rlin@aol.com

Personal Name as Subject:

Rosenthal L

PMID: 18573028 [PubMed - indexed for MEDLINE]

The courage of the group therapist.

Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, MA, USA.

This report strives to legitimize for the field of psychodynamic group therapy the reflection on and study of courage. The authors surveyed group therapy leaders, asking them to describe courageous moments in their own group practice, and then explored the common themes arising in these examples, including openly confronting their mistakes, facing their own and group members' anger, and dealing with unexpected moments in group sessions. Attending to courageous leader moments-and the feelings of hope and pride that they engender-help to neutralize the negative emotions that group leaders are constantly invited to contain. Paradoxically, accessing courageous moments can also evoke feelings of shame in the leader. If we are to require ourselves to embrace the sometimes terrifying challenge of journeying into the unknown with our patients, we must learn to be honest not just about our mistakes and our weaknesses, but also about our successes and our strengths.

PMID: 18573026 [PubMed - indexed for MEDLINE]

Group therapy as psychic containing.

Centre for Psychoanalytic Studies, University of Essex, Colchester, UK. rhinsh@essex.ac.uk

This article will examine how the psychoanalytic idea of containing can be used in group therapy to form a conceptual bridge such that the group dynamics are not simplistically reduced to individual dynamics, nor that the individual is lost in the "group-as-a-whole" concept. I take the concept of "containing" as versatile in the sense that Bion (1970) meant it to be-that is, the psychological phenomenon of containment is manifest at various system levels: intrapsychic, interpersonal, group, and societal. This article will explore how far this "bridging concept" can be pursued to understand groups theoretically. The article will review various forms of containing, following Bion's ideas, and in particular a therapeutic, or flexible, form in contrast to rigid and fragile forms.

PMID: 18573023 [PubMed - indexed for MEDLINE]

Re: "Diary of my analysis with Sigmund Freud".

PMID: 18655319 [PubMed - in process]

Book reviews.

PMID: 18593264 [PubMed - in process]

Film review.

New York Medical College, Valhalla, NY.

PMID: 18593263 [PubMed - in process]

A view from Riggs: treatment resistance and patient authority--VII. A team approach to treatment resistance.

The Austen Riggs Center, 25 Main Street, Stockbridge, MA 01262-0962, USA. sharon.krikorian@austenriggs.net

Treatment resistant patients frequently require treatment modalities beyond combined psychopharmacology and individual psychotherapy. They often require a team effort to manage crises, contain anxiety, and create a psychological space for examining the impact and meaning of behavior. The use of a treatment team as an adjunctive therapeutic modality helps individual team members understand regressions as repetitions of family dynamics, unearths the underlying meaning of behavior, engages patients' authority, and prioritizes the importance of relationships in effecting change. Through engagement with team members and with the team leader's authority, patients may assume responsibility for their behavior, reevaluate familiar roles, and increase self-awareness and psychological integration. The team helps its members identify, bear, and metabolize negative countertransference, address associated anxieties realistically, and optimize the environment for change.

PMID: 18593262 [PubMed - in process]

A view from Riggs: treatment resistance and patient authority--introduction to paper VII.

Admissions and Professional Relations, The Austen Riggs Center, 25 Main Street, Stockbridge, MA 01262, USA. eric.plakun@austenriggs.net

PMID: 18593261 [PubMed - in process]

En garde against traces of cartesianism-a reply to clay C. Whitehead.

PMID: 18593260 [PubMed - in process]

Commentary on "Living within the cellular envelope: subjectivity and self from an evolutionary neuropsychoanalytic perspective" by Harry R. Brickman.

Psychiatry, University of North Carolina, NC, USA. ahorus@earthlink.net

PMID: 18593259 [PubMed - in process]