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Narcissism and Dissociation
Narcissistic Personality and Trauma
Narcissistic Personality and Spirituality
Narcissistic Personality and PTSD
Narcissistic Personality and EMDR
Narcissistic Personality and Dissociaiton
Narcissistic Personality and DID
Narcissism and Wellness
Narcissism and Trauma
Narcissism and Spirituality
Narcissism and PTSD

Psychological

and Physiological

Trauma Research

 

 

Seize Your Journeys

 

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Traumatic stress is found in many competent, healthy, strong, good people.  No one can completely protect themselves from traumatic experiences.  Many people have long-lasting problems following exposure to trauma.  Up to 8% of persons will have PTSD at some time in their lives. People who react to traumas are not going crazy.  What is happening to them is part of a set of common symptoms and problems that are connected with being in a traumatic situation, and thus, is a normal reaction to abnormal events and experiences.  Having symptoms after a traumatic event is NOT a sign of personal weakness.  Given exposure to a trauma that is bad enough, probably all people would develop PTSD.

By understanding trauma symptoms better, a person can become less fearful of them and better able to manage them. By recognizing the effects of trauma and knowing more about symptoms, a person will be better able to decide about getting treatment.

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Narcissistic Personality Disorder

Diagnostic Features

            The essential feature of Narcissistic Personality Disorder is a pervasive pattern of grandiosity, need for admiration, and lack of empathy that begins by early adulthood and is present in a variety of contexts.

            Individuals with this disorder have a grandiose sense of self-importance (Criterion 1).  They routinely overestimate their abilities and inflate their accomplishments, often appearing boastful and pretentious.  They may blithely assume that others attribute the same value to their efforts and may be surprised when the praise they expect and feel they deserve is not forthcoming.  Often implicit in the inflated judgments of their own accomplishments is an underestimation (devaluation) of the contributions of others.  They are often preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love (Criterion 2).  They may ruminate about “long overdue” admiration and privilege and compare themselves favorably with famous or privileged people.

            Individuals with Narcissistic Personality Disorder believe that they are superior, special, or unique and expect others to recognize them as such (Criterion 3).  They may feel that they can only be understood by, and should only associate with, other people who are special or of high status and may attribute “unique,” “perfect,” or “gifted” qualities to those with whom they associate.  Individuals with this disorder believe that their needs are special and beyond the ken of ordinary people.  Their own self-esteem is enhanced (i.e., “mirrored”) by the idealized value that they assign to those with whom they associate.  They are likely to insist on having only the “top” person (doctor, lawyer, hairdresser, instructor) or being affiliated with the “best” institutions, but may devalue the credentials of those who disappointment them.

            Individuals with this disorder generally require excessive admiration (Criterion 4).  Their self-esteem is almost invariably fragile.  They may be preoccupied with how well they are doing and how favorably they are regarded by others.  This often takes the form of a need for constant attention and admiration.  They may expect their arrival to be greeted with great fanfare and are astonished if others do not covet their possessions.  They may constantly fish for compliments, often with great charm.  A sense of entitlement is evident in these individuals’ unreasonable expectation of especially favorable treatment (Criterion 5).  They expect to be catered to and are puzzled or furious when this does not happen.  For exampled, they may assume that they do not have to wait in line and that their priorities are so important that others should defer to them, and then get irritated when others fail to assist “in their very important work.”  This sense of entitlement combined with a lack of sensitivity to the wants and need of others may result in the conscious or unwitting exploitation of others (Criterion 6).  They expect to be given whatever they want or feel they need, no matter what it might mean to others.  For example, these individuals may expect great dedication form others and may overwork them without regard for the impact on their lives.  They tend to form friendships or romantic relationships only if the other person seems likely to advance their purposes or otherwise enhance their self-esteem.  They often usurp special privileges and extra resources that they believe they deserve because they are so special.

            Individuals with Narcissistic Personality Disorder generally have a lack of empathy and have difficulty recognizing the desires, subjective experiences, and feelings of others (Criterion 7).  They may assume that others are totally concerned about their welfare.  They tend to discuss their own concerns in inappropriate and lengthy detail, while failing to recognize that others also have feelings and needs.  They are often contemptuous and impatient with others who talk about their own problems and concerns.  These individuals may be oblivious to the hurt their remarks may inflict (e.g., exuberantly felling a former liver that” I am now in the relationship of a lifetime!”;  boasting of health in front of someone who is sick).  When recognized, the needs, desires, or feelings of others are likely to be viewed disparagingly as signs of weakness or vulnerability.  Those who relate to individuals with Narcissistic Personality Disorder typically find an emotional coldness and lack of reciprocal interest.

            These individuals are often envious of others or believe that others are envious of them (Criterion 8).  They may begrudge others their successes or possessions, feeling that they better deserve those achievement, admiration or privileges.  They may harshly devalue the contributions of others, particularly when those individuals have received acknowledgment or praise for their accomplishments.  Arrogant, haughty behaviors characterize these individuals.  They often display snobbish, disdainful, or patronizing attitudes (Criterion 9).  For example, an individual with this disorder may complain about a clumsy waiter’s “rudeness” or “stupidity” or conclude a medical evaluation with a condescending evaluation of the physician.”

 Diagnostic and statistical manual of mental disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association, p.714-715.

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FUNCTIONAL NEUROANATOMY

In order to best understand this atlas it is important to have a sense of the functional neuroanatomy of the brain. Over the next several pages there is a brief summary of the 5 major brain systems that relate to behavior, along with the general location seen on SPECT of these areas.


 

The Deep Limbic System


side active view


underside surface view


underside active view

Functions

  • sets the emotional tone of the mind

  • filters external events through internal states (emotional coloring)

  • tags events as internally important

  • stores highly charged emotional memories

  • modulates motivation

  • controls appetite and sleep cycles

  • promotes bonding

  • directly processes the sense of smell

  • modulates libido

Problems

  • moodiness, irritability, clinical depression

  • increased negative thinking

  • perceive events in a negative way

  • decreased motivation

  • flood of negative emotions

  • appetite and sleep problems

  • decreased or increased sexual responsiveness

  • social isolation

The Basal Ganglia System


left side active view


underside active view

Functions

  • integrates feeling and movement

  • shifts and smoothes fine motor behavior

  • suppression of unwanted motor behaviors

  • sets the body's idle or anxiety level

  • enhances motivation

  • pleasure/ecstasy

Problems

  • anxiety, nervousness

  • panic attacks

  • physical sensations of anxiety

  • tendency to predict the worst

  • conflict avoidance

  • Gilles de la Tourette's Syndrome/tics

  • muscle tension, soreness

  • tremors

  • fine motor problems

  • headaches

  • low or excessive motivation

The Prefrontal Cortex


dorsal lateral prefrontal cortex
outside view


inferior orbital prefrontal cortex
outside view


side surface view
dorsal lateral prefrontal area


inferior orbital prefrontal area
inside view


underside surface view
inferior orbital prefrontal area


top-down surface view
dorsal lateral prefrontal area

Functions

  • attention span

  • perseverance

  • judgment

  • impulse control

  • organization

  • self-monitoring and supervision

  • problem solving

  • critical thinking

  • forward thinking

  • learning from experience

  • ability to feel and express emotions

  • influences the limbic system

  • empathy

Problems

  • short attention span

  • distractibility

  • lack of perseverance

  • impulse control problems

  • hyperactivity

  • chronic lateness, poor time management

  • disorganization

  • procrastination

  • unavailability of emotions

  • misperceptions

  • poor judgement

  • trouble learning from experience

  • short term memory problems

  • social and test anxiety

The Cingulate Gyrus


inside side view


side active view


active top-down view


active front-on view

  • allows shifting of attention

  • cognitive flexibility

  • adaptability

  • helps the mind move from idea to idea

  • gives the ability to see options

  • helps you go with the flow

  • cooperation

Problems

  • worrying

  • holds onto hurts from the past

  • stuck on thoughts (obsessions)

  • stuck on behaviors (compulsions)

  • oppositional behavior, argumentative

  • uncooperative, tendency to say no

  • addictive behaviors (alcohol or drug abuse, eating disorders, chronic pain)

  • cognitive inflexibility

  • obsessive compulsive disorder

  • OCD spectrum disorders

  • eating disorders, road rage

The Temporal Lobes


side view


side surface view


underside surface view


active side view

Functions

Dominant Side (usually the left)

  • understanding and processing language

  • intermediate term memory

  • long term memory

  • auditory learning

  • retrieval of words

  • complex memories

  • visual and auditory processing

  • emotional stability

Problems

Dominant Temporal Lobe

  • aggression, internally or externally driven

  • dark or violent thoughts

  • sensitivity to slights, mild paranoia

  • word finding problems

  • auditory processing problems

  • reading difficulties

  • emotional instability

Non-dominant Side (usually the right)

  • recognizing facial expression

  • decoding vocal intonation

  • rhythm

  • music

  • visual learning

  • difficulty recognizing facial expression

  • difficulty decoding vocal intonation

  • implicated in social skill struggles


Either/Both Temporal Lobe Problems

  • memory problems, amnesia

  • headaches or abdominal pain without a clear explanation

  • anxiety or fear for no particular reason

  • abnormal sensory perceptions, visual or auditory distortions

  • feelings of déjà vu or jamais vu

  • periods of spaciness or confusion

  • religious or moral preoccupation

  • hypergraphia, excessive writing

  • seizures

 

 

Secure Attachments as a Defense Against Trauma

 “All people mature and thrive in a social context that has profound effects on how they cope with life’s stresses.  Particularly early in life, the social context plays a critical role in fuffering an individual against stressful situations, and in building the psychological and biological capacities to deal with further stresses.  The primary function of parents can be thought of as helping children modulate their arousal by attuned and well-timed provision of playing, feeding, comforting, touching, looking, cleaning, and resting—in short, by teaching them skills that will gradually help them modulate their own arousal.  Secure attachment bonds serve as primary defenses against trauma-induced psychopathology in both children and adults (Finkelhor & Browne, 1984).  In children who have been exposed to severe stressors, the quality of the parental bond is probably the single most important determinant of long-term damage (McFarlane, 1988).”  van der Kolk, Bessel, Alexander C. McFarlane, and Lars Weisaeth, eds.  1996. Traumatic stress: The effects of overwhelming experience on mind, body, and society.  New York and London: Guilford Press. .p. 185

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Sleep Disorders

 

            “The sleep disorders are organized into four major sections according to presumed etiology.  Primary Sleep Disorders are those in which none of the etiologies listed below (i.e., another mental disorder, a general medical condition, or a substance) is responsible.  Primary Sleep Disorders are presumed to arise from endogenous abnormalities in sleep-wake generating or timing mechanisms, often complicated by conditioning factors.  Primary Sleep Disorders in turn are divided into Dyssomnias (characterized by abnormalities in the amount, quality, or timing of sleep) and Parasomnias (characterized by abnormal behavioral or physiological events occurring in association with sleep, specific sleep stages, or sleep-awake transitions).

            Sleep Disorder Related to Another Mental Disorder involves a prominent complaint of sleep disturbance that results from a diagnosable mental disorder (often a Mood Disorder or Anxiety Disorder) but that is sufficiently severe to warrant independent clinical attention.  Presumably, the pathophysiological mechanisms responsible for the mental disorder also affect sleep-awake regulation. 

            Sleep Disorder Due to a General Medical Condition involves a prominent complaint of sleep disturbance that results from the direct physiological effects of a general medical condition on the sleep-wake system.

            Substance-Induced Sleep Disorder involves prominent complaints of sleep disturbance that result from the concurrent use, or recent discontinuation of use, of a substance (including medications).

            That systematic assessment in individuals who present with prominent complaints of sleep disturbance includes an evaluation of the specific type of sleep complaint and a consideration of concurrent mental disorders, general medical conditions, and substance (including medication) use that may be responsible for the sleep disturbance.

            Five distinct sleep stages can be measured by polysomnography:  rapid eye movement (REM) sleep and four stages of non-rapid eye movement (NREM) sleep (stages 1, 2, 3, and 4).  Stage 1 NREM sleep is a transition from wakefulness to sleep and occupies about 5% of time spent asleep in healthy adults.  Stage 2 NREM sleep, which is characterized by specific EEG waveforms (sleep spindles and K complexes), occupies about 50% of time spent asleep.  Stages 3 and 4 NREM sleep (also known collectively as slow-wave sleep) are the deepest levels of sleep and occupy about 10%-20% of sleep time.  REM sleep, during which the majority of typical storylike dreams occur, occupies about 20%-25% of total sleep.

            These sleep stages have a characteristic temporal organization across the night.  NREM stages 3 and 4 tend to occur in the first one-third to one-half of the night and increase in duration in response to sleep deprivation.  REM sleep occurs cyclically throughout the night, alternating with NREM sleep about every 80-100 minutes.  REM sleep periods increase in duration toward the morning.  Human sleep also varies characteristically across the life span.  After relative stability with large amounts of slow-wave sleep in childhood and early adolescence, sleep continuity and depth deteriorate across the adult age range.  This deterioration is reflected by increased wakefulness and stage 1 sleep and decreased stages 3 and 4 sleep.  Because of this, age must be considered in the diagnosis of a Sleep Disorder in any individual.

            Polysomnography is the monitoring of multiple electrophysiological parameters during sleep and generally includes measurement of EEG activity, electroculographic activity, and electromyographic activity.  Additional polysomnographic measures may include oral or nasal airflow, respiratory effort, chest and abdominal wall movement, oxyhemoglobin saturation, or exhaled carbon dioxide concentration; these measures are used to monitor respiration during sleep and to detect the presence and severity of sleep apnea.  Measurement of peripheral electromyographic activity may be used to detect abnormal movements during sleep.  Most polysomnographic studies are conducted during the person’s usual sleeping hours—that is, at night.  However, daytime polysomnographic studies also are used to quantify daytime sleepiness.  The most common daytime procedure is the Multiple Sleep Latency Test (MSLT), in which the individual is instructed to lie down in a dark room and not resist falling asleep; this protocol is repeated fives times during the day.  Sleep latency (the amount of time required to fall asleep) is measured on each trial and is used as an index of physiological sleepiness.  The converse of the MSLT is also used:  In the Repeated Test of Sustained Wakefulness (RTSW), the individual is placed in a quiet, dimly lit room and instructed to remain awake; this protocol is repeated several times during the day.  Again, sleep latency is measured, but is it used here as an index of the individual’s ability to maintain wakefulness.

            Standard terminology for polysomnographic measures is used throughout the test in this section.  Sleep continuity refers to the overall balance of sleep and wakefulness during a night of sleep.  “Better” sleep continuity indicates consolidated sleep and wakefulness; “worse” sleep continuity indicates disrupted sleep with more wakefulness.  Specific sleep continuity measures include sleep latency—the amount of time required to fall asleep (expressed in minutes); intermittent wakefulness—the amount of awake time after initial sleep onset (expressed in minutes); and sleep efficiency—the ratio of actual time spent asleep to time spent in bed (expressed as a percentage, with higher numbers indicating better sleep continuity).  Sleep architecture refers to the amount and distribution of specific sleep stages.  Sleep architecture measures include absolute amount of REM sleep and each NREM sleep stage (in minutes), relative amount of REM seep and NREM sleep stages (expressed as a percentage of total sleep time), and latency between sleep onset and the first REM period (REM latency).

            The text for each of the Sleep Disorders contains a section describing its relationship to corresponding disorders in The International Classification of Sleep Disorders:  (ICSD) diagnostic and Coding Manual, published in 1990 by the American Sleep Disorders Association.

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Substance Dependence

Features

The essential feature of Substance Dependence is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues use of the substance despite significant substance-related problems.  There is a pattern of repeated self-administration that can result in tolerance, withdrawal, and compulsive drug-taking behavior.  A diagnosis of Substance Dependence can be applied to every class of substances except caffeine.  The symptoms of Dependence are similar across the various categories of substances, but for certain classes some symptoms are less salient, and in a few instances not all symptoms apply (e.g., withdrawal symptoms are not specified for Hallucinogenic Dependence).  Although not specifically listed as a criterion item, “craving” (a strong subjective drive to use the substance) is likely to be experienced by most (if not all) individuals with Substance Dependence.  Dependence is defined as a cluster of three or more of the symptoms listed below occurring at any time in the same 12-month-period.

Tolerance (Criterion 1) is the need for greatly increased amounts of the substance to achieve intoxication (or the desired effect) or a markedly diminished effect with continued use of the same amount of the substance.  The degree to which tolerance develops varies greatly across substances.  Furthermore, for a specific drug, varied degrees of tolerance may develop for its different central nervous system effects.  For example, for opioids, tolerance to respiratory depression and tolerance to analgesia develop at different rates.  Individuals with heavy use of opioids and stimulants can develop substantial (e.g., 10-f0ld) levels of tolerance, often to a dosage that would be lethal to a nonuser.  Alcohol tolerance can also be pronounced, but is usually less extreme than for amphetamine.  Many individuals who smoke cigarettes consume more than 20 cigarettes a day, an amount that would have produced symptoms of toxicity when they first started smoking.  Individuals with heavy use of cannabis or phencyclidine (PCP) are generally not aware of having developed tolerance (although it has been demonstrated in animal studies and in some individuals).  Tolerance may be difficult to determine by history alone when the substance used is illegal and perhaps mixed with various diluents or with other substances.  In such situations, laboratory tests may be helpful (e.g., high blood levels of the substance coupled with little evidence of intoxication suggest that tolerance is likely).  Tolerance must also be distinguished from individual variability in the initial sensitivity to the effects of particular substances.  For example, some first-time drinkers show very little evidence of intoxication with three or four drink, whereas others of similar weight and drinking histories had slurred speech and incoordination.

Withdrawal (Criterion 2a) is a maladaptive behavioral change, with physiological and cognitive concomitants, that occurs when blood or tissue concentrations of a substance decline in an individual who had maintained prolonged heavy use of the substance.  After developing unpleasant withdrawal symptoms, the persons is likely to take the substance to relieve or to avoid those symptoms (Criterion 2b), typically using the substance throughout the day beginning soon after awakening.  Withdrawal symptoms, which are generally the opposite of the acute effects of the substance, vary greatly across the calluses of substances, and separate criteria sets for Withdrawal are provided for most of the classes.  Marked and generally easily measured physiological signs of withdrawal are common with alcohol, opioids, and sedatives, hypnotics, and anxiolytics.  Withdrawal signs and symptoms are often present, but may be less apparent, with stimulants such as amphetamines and cocaine, as well as with nicotine and cannabis.  No significant withdrawal is seen even after repeated use of hallucinogens.  Withdrawal from phencyclidine and related substances has not yet been described in humans (although it has been demonstrated in animals).  Neither tolerance nor withdrawal is necessary or sufficient for a diagnosis of Substance Dependence.  However, for most classes of substances, a past history of tolerance or withdrawals is associated with a more severe clinical course (i.e., an earlier onset of Dependence, higher levels of substance intake, and a greater number of substance-related problems).  Some individuals (e.g., those with Cannabis Dependence) show a pattern of compulsive use without obvious signs of tolerance or withdrawal.  Conversely, some general medical and postsurgical patients without Opioid Dependence may develop a tolerance to prescribed opioids and experience withdrawal symptoms without showing any signs of compulsive use.  The specifiers With Physiological Dependence and Without Physiological Dependence are provided to indicate the presence or absence of tolerance or withdrawal.

The following items describe the pattern of compulsive substance use that is characteristic of Dependence.  The individual may take the substance in larger amounts or over a longer period than was originally intended (e.g., continuing to drink until severely intoxicated despite having set a limit of only one drink) (Criterion 3).  The individual may express a persistent desire to cut down or regulate substance use.  Often, there have been many unsuccessful efforts to decrease or discontinue use (Criterion 4).  The individual may spend a great deal of time obtaining the substance, using the substance, or recovering from its effects (Criterion 5).  In some instances of Substance Dependence, virtually all of the person’s daily activities revolve around the substance.  Important social, occupational, ore recreational activities may be given up or reduced because of substance use (Criterion 6).  The individual may withdraw from family activities and hobbies in order to use the substance in private or to spend more time with substance-using friends.  Despite recognizing the contributing role of the substance to a psychological or physical problem (e.g., sever depressive symptoms or damage to organ systems), the person continues to use the substance (Criterion 7).  The key issue in evaluating this criterion is not eh existence of the problem, but rather the individual’s failure to abstain from using the substance despite having evidence of the difficulty it is causing.

 

Specifiers

            Tolerance and withdrawal may be associated with a higher risk for immediate general medical problems and a higher relapse rate.  Specifiers are provided to note their presence or absence:

With Physiological Dependence.  This specifier should be used when Substance Dependence is accompanied by evidence of tolerance (Criterion 1) or withdrawal (Criterion 2).

Without Physiological Dependence.  This specifier should be used when there is no evidence of tolerance (Criterion 1) or withdrawal (Criterion 2).  In these individuals, Substance Dependence is characterized by a pattern of compulsive use (at least three items from Criteria 3-7).”

 

Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. P. 193-195.

 

 

 

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PTSD, DID, and EMDR

Posttraumatic Stress Disorder

"The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1).  The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2).  The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F).

Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness.  For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury.  Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts.  Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease.  The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase.

The traumatic event can be reexperienced in various ways.  Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3).  These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal.  Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator).

Stimuli associated with the trauma are persistently avoided.  The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2).  This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3).  Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event.  The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6).  The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7).

The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma.  these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5).  Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."

 

Dissociative Identity Disorder (DID)

"The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B).  There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C).  The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.).  In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play.

Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness.  Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name.  Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed.  The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive).  Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect.  Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict.  Occasionally, one or more powerful identities allocate time to the others.  Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations.

Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent.  The amnesia is frequently asymmetrical.  The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories.  An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions).  Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought).  There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood.  Transitions among identities are often triggered by psychosocial stress.  The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual.  Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts.  The number of identities reported ranges from 2 to more than 100.  Half of reported cases include the individuals with 10 or fewer identities."

Diagnostic and Statistical Manual of Mental Disorders. 2000.  4th ed. Washington, D.C.: American Psychiatric Association.

EMDR

Eye Movement Desensitization and Reprocessing

"Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an information processing therapy and uses an eight phase approach.

During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session.

Eight Phases of Treatment

The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations.

During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete.

In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions.

After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced.

In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two.

The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system.

After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures." www.emdr.com

__________________

Major Depressive Disorder

Diagnostic Features

The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C).  Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder.  In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B).

            The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent.  It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes.  For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months.  During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission).

            The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance.  If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features.  If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission.

            If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder.  However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted.  Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369

Course

Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s.  Epidemiological data suggest that the age at onset is decreasing for those born more recently.  The course of Major Depressive Disorder, Recurrent, is variable.  Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older.  Some evidence suggests that the periods of remission generally last longer early in the course of the disorder.  The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode.  At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode.  Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance  of having a fourth.  About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder).

            Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases).  For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery.  The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value.  A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode.  Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state.

            Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder.  The severity of the initial Major Depressive Episode appears to predict persistence.  Chronic general medical conditions are also a risk factor for more persistent episodes.

            Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce.  Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes.  Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder.

            It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder.  Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder.  A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373

 

Diagnostic and statistical manual of mental disorders. 2000. 4th ed.  Washington, D.C.: American Psychiatric Association.

 

________________

Major Depressive Disorder

 “Diagnostic Features

The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C).  Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder.  In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B).

            The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent.  It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes.  For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months.  During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission).

            The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance.  If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features.  If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission.

            If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder.  However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted.  Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369

 “Course

Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s.  Epidemiological data suggest that the age at onset is decreasing for those born more recently.  The course of Major Depressive Disorder, Recurrent, is variable.  Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older.  Some evidence suggests that the periods of remission generally last longer early in the course of the disorder.  The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode.  At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode.  Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance  of having a fourth.  About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder).

            Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases).  For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery.  The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value.  A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode.  Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state.

            Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder.  The severity of the initial Major Depressive Episode appears to predict persistence.  Chronic general medical conditions are also a risk factor for more persistent episodes.

            Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce.  Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes.  Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder.

            It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder.  Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder.  A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373

 Diagnostic and statistical manual of mental disorders. 2000. 4th ed.  Washington, D.C.: American Psychiatric Association.

________________

DID-PTSD-EMDR

Dissociative Identity Disorder (DID)

"The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B).  There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C).  The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.).  In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play.

Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness.  Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name.  Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed.  The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive).  Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect.  Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict.  Occasionally, one or more powerful identities allocate time to the others.  Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations.

Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent.  The amnesia is frequently asymmetrical.  The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories.  An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions).  Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought).  There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood.  Transitions among identities are often triggered by psychosocial stress.  The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual.  Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts.  The number of identities reported ranges from 2 to more than 100.  Half of reported cases include the individuals with 10 or fewer identities."

Diagnostic and Statistical Manual of Mental Disorders. 2000.  4th ed. Washington, D.C.: American Psychiatric Association.

PTSD, DID, and EMDR

Posttraumatic Stress Disorder

"The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1).  The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2).  The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F).

Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness.  For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury.  Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts.  Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease.  The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase.

The traumatic event can be reexperienced in various ways.  Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3).  These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal.  Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator).

Stimuli associated with the trauma are persistently avoided.  The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2).  This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3).  Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event.  The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6).  The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7).

The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma.  these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5).  Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."

 

EMDR

Eye Movement Desensitization and Reprocessing

"Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an information processing therapy and uses an eight phase approach.

During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session.

Eight Phases of Treatment

The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations.

During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete.

In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions.

After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced.

In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two.

The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system.

After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures." www.emdr.com

 1Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures (2nd ed.). New York: Guilford Press.

2Shapiro, F. (2002). EMDR as an Integrative Psychotherapy Approach: Experts of Diverse Orientations Explore the Paradigm Prism. Washington, DC: American Psychological Association Books.

 ___________________________

Major Depressive Disorder

 “Diagnostic Features

The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C).  Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder.  In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B).

            The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent.  It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes.  For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months.  During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission).

            The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance.  If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features.  If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission.

            If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder.  However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted.  Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369

 “Course

Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s.  Epidemiological data suggest that the age at onset is decreasing for those born more recently.  The course of Major Depressive Disorder, Recurrent, is variable.  Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older.  Some evidence suggests that the periods of remission generally last longer early in the course of the disorder.  The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode.  At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode.  Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance  of having a fourth.  About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder).

            Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases).  For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery.  The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value.  A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode.  Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state.

            Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder.  The severity of the initial Major Depressive Episode appears to predict persistence.  Chronic general medical conditions are also a risk factor for more persistent episodes.

            Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce.  Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes.  Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder.

            It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder.  Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder.  A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373

 Diagnostic and statistical manual of mental disorders. 2000. 4th ed.  Washington, D.C.: American Psychiatric Association.

________________

DID-PTSD-EMDR

Dissociative Identity Disorder (DID)

"The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B).  There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C).  The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.).  In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play.

Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness.  Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name.  Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed.  The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive).  Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect.  Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict.  Occasionally, one or more powerful identities allocate time to the others.  Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations.

Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent.  The amnesia is frequently asymmetrical.  The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories.  An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions).  Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought).  There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood.  Transitions among identities are often triggered by psychosocial stress.  The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual.  Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts.  The number of identities reported ranges from 2 to more than 100.  Half of reported cases include the individuals with 10 or fewer identities."

Diagnostic and Statistical Manual of Mental Disorders. 2000.  4th ed. Washington, D.C.: American Psychiatric Association.

PTSD, DID, and EMDR

Posttraumatic Stress Disorder

"The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1).  The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2).  The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F).

Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness.  For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury.  Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts.  Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease.  The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase.

The traumatic event can be reexperienced in various ways.  Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3).  These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal.  Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator).

Stimuli associated with the trauma are persistently avoided.  The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2).  This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3).  Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event.  The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6).  The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7).

The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma.  these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5).  Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."

 

EMDR

Eye Movement Desensitization and Reprocessing

"Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an information processing therapy and uses an eight phase approach.

During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session.

Eight Phases of Treatment

The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations.

During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete.

In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions.

After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced.

In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two.

The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system.

After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures." www.emdr.com

 1Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures (2nd ed.). New York: Guilford Press.

2Shapiro, F. (2002). EMDR as an Integrative Psychotherapy Approach: Experts of Diverse Orientations Explore the Paradigm Prism. Washington, DC: American Psychological Association Books.

 

 

 

 

Narcissistic Personality

 

Narcissism and Trauma

 

Title:   Studies in Countertransference and Gender: Female Analyst/Male

Patient in Two Cases of Childhood Trauma.

Author(s):     Bernardez, Teresa, Michigan Psychoanalytic Council, US

Address:        Bernardez, Teresa, 835 Westlawn, E. Lansing, MI, US     

Source:         Journal of the American Academy of Psychoanalysis & Dynamic

Psychiatry, Vol 32(1), Spr 2004. pp. 231-254.

 

Journal URL:

http://www.guilford.com/cartscript.cgi?page=periodicals/jnap.htm&cart_id

=547216.21319

Publisher:      US: Guilford Publications

 

Publisher URL: http://www.guilford.com

ISSN:  0090-3604 (Print)

Digital Object Identifier:       10.1521/jaap.32.1.231.28327        

Language:     English

Key Concepts:         countertransference; gender; female analyst; male

patient; childhood trauma; paternal transference; erotic transference;

narcissistic; masochistic submission

Abstract:       The paternal transference and the erotic transference

have been singled out in the literature as more problematic for women

analysts with male patients. Two clinical cases provide evidence for

their appearance indicating that the reactions they trigger in women may

explain the difficulties in their recognition and interpretation. In

these particular cases, the author analyzes her counterresistance to a

projected narcissistic, cruel father object and her defense of

masochistic submission, following more stereotypical gender lines. And

in the case of an eroticized transference, the fears of a symbiotic and

incestuous merger made more difficult the elucidation of the complex

transference reaction. The hypothesis is forwarded that cultural

prohibitions are partly responsible for the lack of recognition of these

transferences and for the challenging Countertransference that they

elicit.

  _____ 

 

Record: 2

         

Title:   The Empire of fear: The American political psyche and the

culture of paranoia.  

Author(s):     Clarke, Simon, Centre for Psycho-Social Studies, Faculty

of Humanities, Languages and Social Science, University of the West of

England, Frenchay Bristol, United Kingdom, Simon.Clarke@uwe.ac.uk

 

Hoggett, Paul, Centre for Psycho-Social Studies, Faculty of Humanities,

Languages and Social Science, University of the West of England,

Frenchay Bristol, United Kingdom

Address:        Clarke, Simon, Centre for Psycho-Social Studies, Faculty

of Humanities, Languages and Social Science, University of the West of

England, Frenchay Campus Coldharbour Lane, Frenchay Bristol, United

Kingdom, BS16 1QY, Simon.Clarke@uwe.ac.uk     

Source:         Psychodynamic Practice: Individuals, Groups & Organisations, Vol

10(1), Feb 2004. pp. 89-106.

 

Journal URL: http://www.tandf.co.uk/journals/routledge/13533339.html

Publisher:      United Kingdom: Taylor & Francis

 

Publisher URL: http://www.taylorandfrancis.com/

ISSN:  1475-3634 (Print)

 

1470-1057 (Electronic)

Digital Object Identifier:       10.1080/14753630310001656018   

Language:     English

Key Concepts:         political psyche; paranoia culture; civilizing process;

paranoid conviction; narcissism; fear        

Abstract:       Paradoxically, the more powerful the USA has become the

more that paranoia seems to mark its relation to itself and to others.

In this article we argue that there is a connection between its denial

of its own destructiveness, self-idealization expressed in the belief

that America represents the end point of the civilizing process towards

which all other societies are drawn, and the paranoid conviction that an

enemy Other (communism, Islam) aims to corrupt or destroy 'God's chosen

people'. First Vietnam and now September 11th inflicted grievous

injuries upon this narcissism and we suggest that the invasion of Iraq

can be considered as an indication that the USA has failed to 'work

through' this trauma, instead it has sought to reassert an imaginary

omniscience. Just as the destruction of the Twin Towers was the breaking

through of the Real upon the Imaginary, so the 'Real war in Iraq has

begun after the 'Imaginary' war was declared 'over' by Bush.

  _____ 

 

Record: 3

         

Title:   Névrose, Œdipe et blessure narcissique.    

Translated Title:       Oedipus complex and narcissistic wounds. 

Author(s):     Dessuant, Pierre

Source:         Revue Française de Psychanalyse, Vol 67(4), Oct-Dec 2003. pp.

1203-1208.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         Oedipus complex; narcissism; narcissistic trauma;

Freudian theories; post-Freudian theories; narcissistic trauma;

narcissistic wounds  

Abstract:       Discusses Freudian and post-Freudian theories on

narcissism, narcissistic trauma, and the Oedipus complex. The views of

psychoanalysts M. Klein, B. Grunberger, O. Kernberg, and O. Rank are

examined. It is maintained that human beings experience narcissistic

wounds throughout life and continually seek to safeguard their

narcissism. The Oedipus complex is viewed as offering people a

compensatory solution.

  _____ 

 

Record: 4

         

Title:   Névrose: Quid, hic et nunc?

Translated Title:       Neurosis: Something, here, and now?       

Author(s):     Cournut, Jean

Source:         Revue Française de Psychanalyse, Vol 67(4), Oct-Dec 2003. pp.

1263-1284.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         neurosis; psychoanalytic discussion; diagnosis; Freud's

Ratman; psychoanalytic therapy; neurotic depression; narcissism;

destructiveness       

Abstract:       Presents a psychoanalytic discussion of the diagnosis of

neurosis in relation to Freud's case of the Ratman. It is maintained

that longer psychoanalytic therapy would have revealed possible early

traumas in this case. The distinction between neurosis and psychosis,

the relationship between neurosis and perversions, the characteristics

of neurotic depression, and the links between neurosis and

destructiveness and neurosis and narcissism are discussed.

  _____ 

 

Record: 5

         

Title:   Ecstatic stigmatics and holy anorexics: Medieval and

contemporary.         

Author(s):     Farber, Sharon Klayman, Private Practice,

Hastings-on-Hudson, NY, US

Source:         Journal of Psychohistory, Vol 31(2), Fal 2003. pp. 182-204.

Publisher:      US: Assn for Psychohistory

 

Publisher URL: http://www.psychohistory.com

ISSN:  0145-3378 (Print)

Language:     English

Key Concepts:         near-death experiences; destructive narcissism; high

risk behaviors; psychic functions; european culture; psychic trauma;

death anxiety; religion        

Abstract:       Despite our anxieties about death, the wish to know what

death feels like is universal. People want to know what death is like,

and they also want to live to tell the tale. The closest they will get

to experiencing death is in the painful ecstasies of near-death

experiences, in which they come close to dying and then miraculously

seem to be resurrected from the dead and reborn, like Jesus. This is

true both for those who flirt with death today and for the medieval

mystics, who engaged in remarkable high risk behaviors such as

self-starvation, binging and purging, and self-mutilation. Topics

discussed in this article include: death anxiety and the eroticization

of death; Jesus' suffering and the European culture of death; multiple

psychic functions of self-harm; an identification with a suffering

Jesus; trauma and addition to pain and suffering; destructive narcissism

and the erotic dance with death; the medieval mystics and the cultural

transmissions of stigmata; severe psychic trauma in the lives of the

medieval mystics; today's ecstatic stigmatics and holy anorectics.

  _____ 

 

Record: 6

         

Title:   L'agir et la question de la souffrance chez les super héros.        

Translated Title:       Action and the problem of suffering amongst the

super heros.  

Author(s):     Gaye-Bareyt, H., Hôpital de jour Cerep, Paris, France,

hdjb.cerep@free.fr

Address:        Gaye-Bareyt, H., 10, avenue du

Pasteur-Martin-Luther-King, esc. J, 78230, Le Pecq, France,

hdjb.cerep@free.fr   

Source:         Neuropsychiatrie de l'Enfance et de l'Adolescence, Vol 51(4),

Jun 2003. pp. 201-204.

 

Journal URL:

http://www.elsevier.com/inca/publications/store/6/2/1/3/7/6/index.htt

Publisher:      Netherlands: Elsevier Science

 

Publisher URL: http://elsevier.com

ISSN:  0222-9617 (Print)

Digital Object Identifier:       10.1016/S0222-9617(03)00052-7   

Language:     French

Key Concepts:         suffering; super heros; acting; trauma; ill treatment;

self-expression; narcisistic omnipotence; social services; personality

disorder; behavioural problems; team issues        

Abstract:       Using the case history of a child treated in an

institution for personality disorder and behavioural problems, the

author discusses the different clinical issues which confront a team

taking charge of a case of Acting. In this case there is both a real

trauma (ill treatment) and a form of self-expression bearing the

hallmarks of a form of narcisistic omnipotence. A new form of care will

be put in place by the social services and the Day Clinic. The team will

be remobilised around the theme of developing and caring in the context

of a visible mental suffering the meaning of which is as yet unclear. As

a situation evolves, the child's identification with the super hero

creates both a way forward and a form of defence in the search for a

stronger hold on reality. The author considers the similarities between

this classic form of psychosis and a certain type of cartoon, the Space

Opera, which provides both an understanding, and a representation of the

pregenital expression of the drive.

Conference:   CEREP, Nov, 2000, Paris, France    

Conference Notes:    Portions of this research were presented at the

aforementioned conference.  

  _____ 

 

Record: 7

         

Title:   Trauma and defences: Their roots in relationship. 

Author(s):     Knox, Jean, Private practice, Oxford, United Kingdom,

jm.knox@btinternet.com

Address:        Knox, Jean, 209 Woodstock Rd,, Oxford, United Kingdom,

OX2 7AB, jm.knox@btinternet.com 

Source:         Journal of Analytical Psychology, Vol 48(2), Apr 2003. Special

issue: Trauma: Clinical and theoretical aspects. pp. 207-233.

 

Journal URL:

http://www.blackwellpublishers.co.uk/asp/journal.asp?ref=0021-8774

Publisher:      United Kingdom: Blackwell Publishing

 

Publisher URL: http://www.blackwellpublishing.com

ISSN:  0021-8774 (Print)

Language:     English

Key Concepts:         psychodynamic models; defenses; attachment theory;

affect regulation; unconscious fantasy; narcissism; archetypal defenses;

developmental perspective; neurobiological issues; child; primary

caregiver      

Abstract:       In this paper the differing psychodynamic models of

defences are outlined and compared with an attachment theory perspective

in which affect regulation plays a central role. Behavioural and

intrapsychic distance regulation (defensive exclusion) are seen as the

main strategies for affect regulation and are the manifestations of the

habitual pattern of emotional regulation in the relationship between the

child and the primary caregiver. A new perspective on unconscious

fantasy is offered, in which fantasies are seen to be actively created

as defensive narratives to protect the development of healthy narcissism

and to become integrated into a person's internal working models.

Archetypal defences are explored from a developmental perspective and

some neurobiological issues relevant to defences are highlighted.

  _____ 

 

Record: 8

         

Title:   9/11 as a collective trauma.

Author(s):     Wirth, Hans-Jürgen

Source:         Journal of Psychohistory, Vol 30(4), Spr 2003. pp. 363-388.

Publisher:      US: Assn for Psychohistory

 

Publisher URL: http://www.psychohistory.com

ISSN:  0145-3378 (Print)

Language:     English

Key Concepts:         2001 attack on World Trade Center; Freud's death

instinct hypothesis; human potential for destructiveness; psychosocial

factors; syndrome of fanaticism; collective trauma of 2001 attack       

Abstract:       In discussing the attack of September 11, 2001, on the

World Trade Center, the author suggests that Freud's hypothesis

regarding aggression, self-annihilation, or the death instinct must not

be truncated to a mono-causal interpretation of destructive action, but

that, instead, the theoretical achievement of Freud's death instinct

hypothesis lies in the mere insistence that each of us carries within

the potential toward destructiveness. Although the human destructive

potential is ever-present, to what extent the individual is beset by

such destructive instincts, and whether the destructive fantasies are

acted out, depends on many other complexly interlinked conditions. Among

them are those defined by the concepts of malign narcissism, delusions

of grandeur, feelings of powerlessness, individual and collective

traumatizations, fanaticism, fundamentalism, and paranoid world views.

The author discusses the syndrome of fanaticism, and September 11, 2001,

as a collective trauma, including the reactions of some of his patients

to that event.

  _____ 

 

Record: 9

         

Title:   Agonie, clivage et symbolisation.    

Author(s):     Daoust, François

Address:        Daoust, François, 1209 Fleury est, Montreal, PQ, Canada,

H2C1R2        

Source:         Journal of the American Psychoanalytic Association, Vol 51(2),

Spr 2003. pp. 684-689.

Publisher:      US: Analytic Press

 

Publisher URL: http://analyticpress.com

Reviewed Item:        René Roussillon (1999). Agonie, clivage et

symbolisation; Paris: Presses Universitaires de France, 245 pp.

ISSN:  0003-0651 (Print)

Language:     English

Key Concepts:         narcissistic identity disorders; theoretical

elaboration; clinical manifestations; defensive structure; psychic

processes; object relations 

Abstract:       In this work, the author develops his theoretical

elaboration of the clinical manifestations of narcissistic identity

disorders or, more specifically, the transferential expressions of

identity disorders and narcissistic disorders of self-regulation. He

examines these patients' difficulties with the symbolization of their

personal history and, consequently, their problems with the subjective

appropriation of relevant aspects of instinctual life, narcissism, and

object relations. The 15 chapters include rewritten versions of 12 texts

published during the last 10 yrs, as well as 3 n3w texts, including a

thorough introduction that provides an excellent overview of the book.

Roussillon proposes a theoretical-clinical model delineating the

sequence of psychic processes typical of narcissistic identity

disorders. The main assumption guiding his approach is that suffering in

connection with these pathologies is the result of a specific defensive

structure established to fend off the impact of a split-off primary

trauma which, through the repetition compulsion, continues to threaten

the organization of the psyche and the development of subjectivity.

  _____ 

 

Record: 10

         

Title:   Traumatic Abuse in Cults: A Psychoanalytic Perspective. 

Author(s):     Shaw, Daniel, Private Practice, New York City, NY, US

Source:         Cultic Studies Review, Vol 2(2), 2003. pp. [np].

 

Journal URL: http://www.culticstudiesreview.org

Publisher:      US: American Family Foundation

 

Publisher URL: http://www.csj.org

ISSN:  1539-0152 (Print)

 

1539-0160 (Electronic)

Language:     English

Key Concepts:         psychoanalysis; traumatic abuse; cults; cult leaders;

narcissism; leadership         

Abstract:       Using his own 10 year experience in Siddha Yoga under

the leadership of Gurumayi, the author presents psychoanalytic

conceptualizations of narcissism in an effort to develop a way of

understanding cult leaders and their followers, and especially of

traumatic abuse in cults from the follower's perspective. A

psychoanalytically informed treatment approach for working with

recovering cult followers is proposed, consisting of providing: 1) an

understanding of the leader's extreme dependence on the follower's

submission and psychological enslavement; 2) a clear and firm, detailed

understanding of the leader's abusiveness; and 3)an exploration of

normative and/or traumatic developmental issues for the follower, as

part of a process of making sense of and giving meaning to the

follower's experience.

  _____ 

 

Record: 11

         

Title:   Narcissism, a Relational Aspect of Dissociation.    

Author(s):     Howell, Elizabeth F., Institute for the Psychoanalytic

Study of Trauma and Dissociation, NY, US, efhowell@aol.com

Address:        Howell, Elizabeth F., 111 Hicks Street, #5P, Brooklyn,

NY, US, efhowell@aol.com   

Source:         Journal of Trauma & Dissociation, Vol 4(3), 2003. Special issue:

Theoretical Approaches to Dissociative Processes. pp. 51-71.

 

Journal URL: http://www.haworthpressinc.com/store/product.asp?sku=J229

Publisher:      US: Haworth Press

 

Publisher URL: http://www.haworthpress.com

ISSN:  1529-9732 (Print)

Language:     English

Key Concepts:         pathological narcissism; trauma-generated dissociation;

dissociation; dissociative psychopathology

Abstract:       Pathological narcissism is an inevitable result of

trauma-generated dissociation. It is also a relational aspect of

dissociation, for in dissociative psychopathology the mutuality of

relationships, both interpersonal and intrapsychic, has collapsed in

significant ways. Dissociation of both aggression and dependency

characterizes the "closed system." While an open system allows

interaction with the outside and transformation of the individual

through interactive interchange with another, a closed system precludes

transformation and intersubjectivity. Grandiose, domineering self-states

may be understood as procedural, somatoform, dyadic enactments. These

working models of attachment are at the core of much of the narcissistic

entitlement, grandiosity, domination, and self-sufficiency that are so

often found in dissociative disorders and in narcissism. It is possible

to have a real impact on the closed system of narcissistic

psychopathology by providing a safe attachment within the therapeutic

relationship, and empathizing with the expression of self-protective

aggression while containing its destructiveness. As a safe attachment

figure with expertise, the therapist has the opportunity to facilitate

positive transformation.

Conference:   18th International Fall Conference of the International

Society for the Study of Dissociation, 18th, Dec, 2002, New Orleans, LA,

US     

Conference Notes:    An earlier version of this paper was presented

at the aforementioned conference. 

  _____ 

 

Record: 12

         

Title:   La relation homosexuelle est-elle une relation incestuese?

Translated Title:       Is the homosexual relation an incestuous

relation?       

Author(s):     Gérard, Christian

Source:         Revue Française de Psychanalyse, Vol 67(1), Jan-Feb 2003.

Special issue: Homosexualités. pp. 113-128.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         homosexuality; narcissism; primary object; traumatic

seduction; psychic functioning      

Abstract:       Discusses the question of homosexuality as related to

the constitution of an infantile fixation in the context of primary

homosexuality and the development of narcissism. Traumatic experience is

the consequence of the abandoning character of the relation to the

primary object. The representational emptiness thus created is presented

as the negative part of a trauma, allowing the development of drive

fusion by another trauma in a register of too much sexuality, thus

posing the question of traumatic seduction. The latter, the positive

part of the trauma, thus takes the form of defensive eroticization

expressing itself as homosexuality. The trauma should thus be considered

in light of psychic functioning.

  _____ 

 

Record: 13

         

Title:   Up close and personal: September 11, through the lens of a

psychotherapist.      

Author(s):     Alper, Gerald, American Inst for Psychotherapy &

Psychoanalysis, New York, NY, US

Address:        Alper, Gerald, 107 East 10th Street, Apt. 4B, New York,

NY, US

Source:         Journal of Loss & Trauma, Vol 7(4), Oct-Dec 2002. pp. 251-261.

 

Journal URL: http://www.tandf.co.uk/journals/titles/15325024.html

Publisher:      United Kingdom: Taylor & Francis

 

Publisher URL: http://www.taylorandfrancis.com/

ISSN:  1532-5024 (Print)

 

1532-5032 (Electronic)

Digital Object Identifier:       10.1080/10811440290057657        

Language:     English

Key Concepts:         World Trade Center; September 11 attack; patients;

existential consciousness; narcissistic preoccupations; pervasive

inhibition of intimacy; mental health profession; symptom relief  

Abstract:       The author, a Manhattan-based psychotherapist situated

less than 2 miles from the World Trade Center, provides numerous,

graphic clinical vignettes of how patients, some of whom actually

witnessed the September 11 attack, reacted to the devastation. Two

stages are delineated: an initial one in which patients experienced a

raising of existential consciousness, a desire to prioritize their

lives, an upsurge in the need for meaningful human contact, and a

manifest concerted effort to relate in a more compassionate manner, and

a second stage, seemingly a backlash to the first, in which patients,

now angry, retreated into frank narcissistic preoccupations. Patient

dynamics are then placed in a broader context and examined from C.

Lasch's concept of a culture of narcissism and from D. W. Winnicott's

formulation of a true and false self. Drawing on his own extensive

studies of the self, the author explores the dynamics of what he calls

the pervasive inhibition of intimacy, narcissistic giving, and the

danger of a mental health profession that yields to pressure to deliver

unrealistically rapid symptom relief.

  _____ 

 

Record: 14

         

Title:   Le risque somatique à l'adolescence: Révélation d'une

potentialité traumatique.     

Translated Title:       The somatic risk in adolescence: The revelation

of a traumatic potential.     

Author(s):     Jean-Strochlic, Christine

Source:         Revue Française de Psychanalyse, Vol 66(3), Jul-Sep 2002. pp.

729-743.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         trauma; diabetes; narcissism; puberty; development;

psychoanalysis        

Abstract:       Discusses the positive and negative consequences of

trauma, with reference to the psychotherapy of a 17-yr-old female

adolescent who had suffered from insulin-dependent diabetes since

childhood. The traumatic potential of puberty, the manifestations of

behavioral neurosis and narcissistic trauma, and the outcome of

masochism are examined.

  _____ 

 

Record: 15

         

Title:   The other other: When the exotic other subjugates the familiar

other. 

Author(s):     Papadopoulos, Renos K., U Essex, Colchester, England,

r.papadopoulos@psychology.bbk.ac.uk

Address:        Papadopoulos, Renos K., 20 Woodriffe Road, London,

England, E11 1AH, r.papadopoulos@psychology.bbk.ac.uk

Source:         Journal of Analytical Psychology, Vol 47(2), Apr 2002. pp.

163-188.

 

Journal URL:

http://www.blackwellpublishers.co.uk/asp/journal.asp?ref=0021-8774

Publisher:      United Kingdom: Blackwell Publishing

 

Publisher URL: http://www.blackwellpublishing.com

ISSN:  0021-8774 (Print)

Digital Object Identifier:       10.1111/1465-5922.00303  

Language:     English

Key Concepts:         exotic & familiar other; analytical psychology       

Abstract:       In this paper, the theme of the other will be examined

and it will be argued that it is important to differentiate between 2

distinct types of other--the "exotic" other which is distant and very

different from the subject, and the "familiar" other which is closer to

the subject. The dynamic relationship between these 2 others will be

investigated, and emphasis will be given to the process through which

the exotic other tends to subjugate the familiar other. This

relationship will then be discussed in its various applied forms, in the

contexts of clinical practice and socio-political dimensions. In

particular, a new reading of C. Jung's approach to the "primitive" will

be developed, based on the subjugation of the "familiar" other by the

"exotic" other. A similar line of investigation will be followed to

examine the concept of psychological trauma. In addition, S. Freud's

"narcissism of minor differences" and W. Bion's distinction between

"narcissism" and "socialism" will be considered in the light of this

differentiation between these two others.

  _____ 

 

Record: 16

         

Title:   El bosque de Mecedapa. Acerca de la (re)actualización de los

traumatismos precoces.      

Translated Title:       The forest of Mecedapa. About the

(re)actualization of early traumas.  

Author(s):     Yardino, Stella, niconat@multi.com.uy

Address:        Yardino, Stella, Priamo 1529 C. P. 11400. Manuel Pagola,

Montevideo, Uruguay, 3268/707, niconat@multi.com.uy  

Source:         Revista Uruguaya de Psicoanálisis, No 95, Apr 2002. pp. 74-93.

Publisher:      Uruguay: Asociacion Psicoanalitica Del Uruguay

 

Publisher URL: http://www.apuruguay.com

ISSN:  0484-8268 (Print)

Language:     Spanish        

Key Concepts:         psychoanalytic treatment; pathological narcissism;

symbolic functioning; primitive defenses    

Abstract:       The paper presents an approach to early mournings

considered as early traumas that, overwhelming the capacities of the

still developing psyche prevents a process that cannot be included in

the symbolic functioning, becoming trapped in the body as "scars"

waiting to have a place in the psyche. Helplessness, archaic anxiety as

a consequence of the loss can be disguised as omnipotence to preserve

the ego from fragmenting itself. This defense, necessary at the time of

maximum vulnerability is a risk because if it continues it could be the

cause of a pathological evolution of narcissism. Even when a

psychoanalytic treatment takes place there could remain scars to be

reactivated in vital moments of profound changes in which drives could

be affected emerging more primitive defenses compromising the

identifications that support ego sources, as it happens in adolescence.

This would show a vulnerable core in all mournings that when reactivated

would cause omnipotent defenses to come to light like the ones of

pathological narcissism. As an example the author shows a vignette of a

prepubertal patient who returns after a previous analysis.

  _____ 

 

Record: 17

         

Title:   Projective identification and its relationship to infant

development.

Author(s):     Grotstein, James S., Los Angeles Psychoanalytic Inst,

Psychoanalytic Ctr of California, Los Angeles, CA, US

Source:         Primitive mental states: Psychobiological and psychoanalytic

perspectives on early trauma and personality development, Vol.

2. Alhanati, Shelley (Ed); pp. 67-98. London, England: Karnac Books,

2002. xviii, 277 pp.   

ISBN:  1-892746-91-3 (hardcover)

Language:     English

Key Concepts:         projective identification; dissociative defenses;

historical background; depressive positions; schizoid mechanisms;

primary narcissism; key assumptions         

Abstract:       (from the chapter) Presents a wide ranging discussion of

Klein's (1946) concept of projective identification and its historical

background. The author notes that today many of the key assumptions of

Klein's ideas are finding greater acceptance and respect than they did

initially, both in the clinical and the theoretical arenas. These

assumptions include: the notion of the separateness of the infant from

the object from birth onward, if not before (absence of primary

narcissism); the operation of the principle of genetic continuity from

the beginning; the notion of the organization of the infant's inchoate

anxieties into sequential, coherent affective clusters (persecutory and

depressive) with corresponding phantasies within the embrace of the

paranoid-schizoid and depressive positions respectively; and the

consideration of the basic defenses against these respective anxieties:

the schizoid mechanisms (splitting, projective identification,

idealization, and magic omnipotent denial of reality) and the manic

defenses (triumph, contempt, and control), to which the author adds

depressive, obsessive, and dissociative defenses or techniques as well.

The two aspects of projective identification, one referring to contents

of mind (feelings, needs, etc) and the other to the mind itself are

discussed.

  _____ 

 

Record: 18

         

Title:   Histeria e estados-limite: Quiasma. Novas perspectivas.  

Translated Title:       Hysteria and borderline states: Chiasma. New

perspectives.

Author(s):     Green, André

 

Berliner, Claudia, (Trans)

Source:         Revista Brasileira de Psicanalise, Vol 36(3), 2002. pp. 465-486.

Publisher:      Brazil: Revista Brasileira de Psicanalise

 

Publisher URL: http://www.rbp.org.br/

ISSN:  0486-641X (Print)

Language:     Portuguese   

Key Concepts:         object representations; borderline personality;

pathological defenses; hysterical neurosis; borderline states;

psychoanalysis        

Abstract:       Discusses the relationship between borderline

personality states and hysteria (hysterical neurosis). The role of

conflict, trauma, pathological defenses, the unconscious, the body,

affect, object representations, narcissism, and the superego in

borderline states and hysteria are compared.

  _____  

 

Record: 19

         

Title:   Acerca de los contenidos de la revista.     

Translated Title:       On the contents of the review.      

Author(s):     Tabares, Jaime

Source:         Revista de Psicoanalisis de la Asociacion Psicoanalitica de

Madrid, Vol 37, 2002. pp. 13-17.

Publisher:      Spain: Asociacion Psicoanalitica de Madrid

 

Publisher URL: http://www.apmadrid.com

ISSN:  1135-3171 (Print)

Language:     Spanish        

Key Concepts:         mental temporality; time; mental historicity;

narcissistic trauma; borderline functioning 

Abstract:       Discusses the examination of mental temporality in the

articles contained in the present issue of this journal. Emphasis is on

various aspects of time, mental historicity, narcissistic trauma in

adolescence, and borderline functioning.

  _____ 

 

Record: 20

         

Title:   Actualidad del trauma narcisista en la adolescencia.       

Translated Title:       The present time of narcissistic trauma in

adolescence. 

Author(s):     Hernández, María

Source:         Revista de Psicoanalisis de la Asociacion Psicoanalitica de

Madrid, Vol 37, 2002. pp. 117-133.

Publisher:      Spain: Asociacion Psicoanalitica de Madrid

 

Publisher URL: http://www.apmadrid.com

ISSN:  1135-3171 (Print)

Language:     Spanish        

Key Concepts:         narcissistic infant trauma; adolescence; puberty;

autoeroticism; ego; genital sexuality; narcissism-object conflict;

psychoanalytic work 

Abstract:       Discusses the reactivation of traumatic narcissistic

infantile phenomena during puberty and adolescence. Emphasis is on

autoeroticism, the constitution of the ego, genital sexuality, and the

reopening of the narcissism-object conflict. The clinical case of an

18-yr-old girl is presented to illustrate the prevalence of narcissistic

traumatic issues during adolescence and the ways in which they hinder

psychoanalytic work.

  _____ 

 

Record: 21

         

Title:   Le concept de trauma chez Freud. 

Translated Title:       Freud's concept of trauma. 

Author(s):     Panaccio, Monique, CLSC Lac-St-Louis, Pointe-Claire, PQ,

Canada

Address:        Panaccio, Monique, CLSC Lac-St-Louis,, 180, avenue

Cartier,, Pointe-Claire, PQ, Canada, H9S 4S1       

Source:         Revue Quebecoise de Psychologie, Vol 23(3), 2002. pp. 155-164.

Publisher:      Canada: Revue Quebecoise de Psychologie

 

Publisher URL: http://www.rqpsy.qc.ca/

ISSN:  0225-9885 (Print)

Language:     French

Key Concepts:         chronological development; clinical vignette; Freudian

concepts; psychic reality; death drive; trauma; economics; anguish;

object relations; narcissism 

Abstract:       Outlines the chronological development of Freud's

concept of trauma, emphasizing different theoretical routes of Freud's

thought. Beginning with the theory of seduction, followed by the

assertion of psychic reality, Freud arrived at his formulation of the

economic conception of trauma that allowed him to introduce the death

drive. Using the notion of anguish, Freud links trauma to the object and

therefore to narcissism. At the end of his life, Freud reiterated the

essential economical meaning of the term trauma. A clinical vignette of

a 75-yr-old French woman who suffered a traumatic traffic accident is

used to illustrate Freudian concepts about trauma.

  _____ 

 

Record: 22

         

Title:   Cluster analysis of types of inpatient pathological gamblers.      

Author(s):     Lesieur, Henry Richard, Massachusetts School Of

Professional Psychology, US

Source:         Dissertation Abstracts International: Section B: The Sciences &

Engineering, Vol 62(4-B), Oct 2001. pp. 2065.

Publisher:      US: Univ Microfilms International

 

Publisher URL: http://www.il.proquest.com/umi/

ISSN:  0419-4217 (Print)

Order Number:          AAI3011834  

Language:     English

Key Concepts:         inpatient pathological gamblers; typologies; cluster

analysis        

Abstract:       The objective of this research on inpatient pathological

gamblers was to test a model of types of pathological gamblers derived

from previous theorizing in the literature. Similarities and differences

among typologies of pathological gamblers are reviewed and a unified

meta-typology is proposed. The literature on the interrelationships

among variables in research on pathological gambling is also reviewed.

The unified meta-typology was examined using archival data from 156

pathological gamblers from an inpatient treatment program They were

predominantly (71.2 percent) male, with a mean age of 40.9 years (range

21 to 74). They were also predominantly Caucasian (86.5 percent; 5.8

percent African-American; 7.7 percent other). A K-means cluster analyses

was conducted to examine the hypothesized meta-typology. Two-cluster and

three-cluster analysis produced a closer fit with the hypothiesised

meta-typology. Discriminant analysis of the two and three-cluster

solutions was conducted. The clusters were partially validated using

different measures of the variables included in the cluster solution.

The two-cluster solution divided gamblers into "normal problem gamblers"

and "serious problem gamblers." The three cluster solution divided

gamblers into "normal problem gamblers," "moderately impulsive action

seekers," and "impulsive escape seekers." Both solutions ranged in

severity of psychopathology on measures of depression, anxiety,

impulsivity, trauma, dissociation, and using gambling as a means of

escape from interpersonal problems. In the three-cluster solution, the

"moderately impulsive action seekers" had a younger age of onset of

gambling problems, higher levels of excitement seeking, and greater

endorsement of narcissism/power themes for gambling than individuals in

the other two clusters. The relationship of the three-cluster solution

to different typologies in the literature is discussed.

  _____ 

 

Record: 23

         

Title:   Bone marrow transplantation in a patient who experienced torture

in a prisoner of war camp: Narcissism and survival.         

Author(s):     Gregurek, Rudolf, U Zagreb, School of Medicine, Zagreb,

Croatia, rudolf.gregurek@zg.tel.hr

 

Tocilj-Šimunkovic, Gorana, U Zagreb, School of Medicine, Zagreb, Croatia

 

Klain, Eduard, U Zagreb, School of Medicine, Zagreb, Croatia

Address:        Gregurek, Rudolf, U Zagreb, School of Medicine, Clinic

for Psychological Medicine, Kispaticeva 12, 10000, Zagreb, Croatia,

rudolf.gregurek@zg.tel.hr    

Source:         Journal of Loss & Trauma, Vol 6(1), Jan-Mar 2001. pp. 21-28.

 

Journal URL: http://www.tandf.co.uk/journals/titles/15325024.html

Publisher:      United Kingdom: Taylor & Francis

 

Publisher URL: http://www.taylorandfrancis.com/

ISSN:  1532-5024 (Print)

 

1532-5032 (Electronic)

Digital Object Identifier:       10.1080/108114401753197440      

Language:     English

Key Concepts:         posttraumatic stress disorder; bone marrow

transplantation; prisoner of war; war camp; torture; trauma;

psychotherapy; acute myelogenous leukemia; Croatia     

Abstract:       Post-traumatic stress disorder has been described as a

syndrome from which an individual may suffer as a result of

extraordinary trauma. Torture of prisoners of war in Serbian camps

during the war in Croatia is just such a stressful situation that

requires mobilization of all defense mechanisms of an individual. The

authors present a case study of a 33-yr-old male former prisoner of war

who acquired acute myelogenous leukemia several months after release and

was treated with bone marrow transplantation. On release the patient was

medically examined, like all prisoners of war, and the findings did not

suggest any disease. Because of the situation, the patient was in

psychotherapeutic observation and treatment after his illness was

diagnosed and throughout the transplantation treatment.

  _____ 

 

Record: 24

         

Title:   Omagh: The beginning of the reparative impulse? 

Author(s):     Kapur, Raman

Address:        Kapur, Raman, Threshold, McBrien House, 432 Antrium

Road, Belfast, England, BT15 5GB   

Source:         Psychoanalytic Psychotherapy, Vol 15(3), 2001. pp. 265-278.

Publisher:      United Kingdom: Taylor & Francis

 

Publisher URL: http://www.taylorandfrancis.com/

ISSN:  0266-8734 (Print)

 

1474-9734 (Electronic)

Language:     English

Key Concepts:         society; recovery; trauma; reparative impulse     

Abstract:       Northern Ireland is at a crossroads. They can either

work through to a better state of mind where relationships are trusted

and valued, or they can regress to a primitive state of human relations

where envy and hate are the main currency of day-to-day relations. This

paper suggests the current signs are positive: that this society is

beginning to make a recovery from the trauma of the past. Through

highlighting how rage and narcissism have been key features of a

dysfunctional response to trauma, the author argues that there is now

evidence that people want another way of expressing their inner worlds.

It is up to all of the people who are in contact with Northern Ireland

to take our responsibilities seriously in constructing a pluralistic and

creative society that can have more positive experiences of human

relations.

  _____ 

 

Record: 25

         

Title:   Chiasmus. Prospektiv: Die Grenzfälle aus der Sicht der

Hysterie;retrospektiv: Die Hysterie aus der Sicht der Grenzfälle. 

Translated Title:       Chiasmus. Prospective: Borderline disorders from

the viewpoint of hysteria. Retrospective: Hysteria from the viewpoint of

borderline disorders. 

Author(s):     Green, André

Source:         Psyche: Zeitschrift für Psychoanalyse und ihre Anwendungen, Vol

54(12), Dec 2000. pp. 1191-1221.

Publisher:      Germany: Verlag-Klett-Cotta Stuttgart

 

Publisher URL: http://www.klett-cotta.de/

ISSN:  0033-2623 (Print)

Language:     German        

Key Concepts:         hysteria & borderline disorder & clinical &

metapsychological aspects of chiasmus    

Abstract:       Notes, in the author's introductory remarks, that the

word "chiasmus" means "crossing," in anatomical terminology, as well as

being a rhetorical figure of speech. The author juxtaposes, on the basis

of some essential points (conflict, trauma, defense mechanisms,

unconscious and id, the body, affects, representations, ego, narcissism,

identification, object, and superego) clinical and metapsychological

aspects of the psychic apparatus. From this can be deducted similarities

and differences of the 2 nosological entities, hysteria and boderline

disorders. As central results, one can recognize, on the side of

hysteria, the erotic nature of fixations, a relatively structured ego,

the significance of bisexuality, and, in borderline disorders, a

tendency to regress, a prevalence of destructivity, an impaired

structure, and narcissistic problematics, along with, after noticeable

attempts at regression, a clinging to an objectal pole.

  _____ 

 

Record: 26

         

Title:   Beyond empathic failures: Cultural racism as narcissistic trauma

and disenfranchisement of grandiosity.     

Author(s):     Miliora, Maria T.

Source:         Clinical Social Work Journal, Vol 28(1), Spr 2000. pp. 43-54.

 

Journal URL: http://www.wkap.nl/journalhome.htm/0091-1674

Publisher:      Netherlands: Kluwer Academic Publishers

 

Publisher URL: http://www.wkap.nl

ISSN:  0091-1674 (Print)

Digital Object Identifier:       10.1023/A:1005159624872  

Language:     English

Key Concepts:         cultural racism & narcissistic trauma &

disenfranchisement of grandiosity, self-esteem & confidence & ambition

Abstract:       Applying a self-psychological perspective, this paper

explores the effects of cultural racism on a person's sense of self.

Racism assaults victims with experiences of being perceived as

less-than-human by the social milieu. Such experiences can utterly erode

self-esteem and ambition and cause a "depression of disenfranchisement"

whereby one feels abjectly ungrandiose. The paper utilizes a literary

example and one from clinical experience to illustrate how chronic

experiences of antipathy--derived from cultural racism--can erode a

person's sense of self by virtue of the disenfranchisement of

grandiosity.

  _____ 

 

Record: 27

         

Title:   Duelo en la procreación y en la esterilidad femenina: Enfoque

psicodinámico y proyectivo. 

Translated Title:       Mourning in feminine procreation and sterility:

A psychodynamic and projective approach.

Author(s):     Clement, Anne K., U de Nancy, Nancy, France

 

Theis, Amandine

 

de Tychey, Claude

 

Ráez de Ramírez, Matilde, (Trans)

Source:         Revista de Psicologia, Vol 18(1), 2000. pp. 87-106.

Publisher:      Peru: Pontificia Univ Catolica del Peru

 

Publisher URL: http://www.pucp.edu.pe/

ISSN:  0254-9247 (Print)

Language:     Spanish        

Key Concepts:         psychoanalytic interpretation of mourning related to

reproduction & sterility, 29 yr old female   

Abstract:       Presents the psychoanalytic assessment of mourning

regarding reproduction and sterility in the case of a 29-yr-old woman

with many psychological conflicts. Based on the results of interviews

and Rorschach testing, the case is discussed from the standpoint of the

negation of the internalized maternal image, the lack of rejection of an

incestuous phantasm, the phantasm of body control, the weight of

traumas, the hypothesis of parthenogenesis, the existence of an

anaclitic couple, narcissism, and the presence of an invalidating

transgenerational or intergenerational mandate.

  _____ 

 

Record: 28

         

Title:   El dolor: Una forma particular del afecto.   

Translated Title:       Pain: A particular form of affect.    

Author(s):     D'Alvia, Rodolfo

Source:         Revista de Psicoanalisis, Vol 56(3), Jul-Sep 1999. pp. 635-650.

Publisher:      Argentina: Asociacion Psicoanalitica Argentina

 

Publisher URL: http://www.apa.org.ar

ISSN:  0034-8740 (Print)

Language:     Spanish        

Key Concepts:         sensory motor & psychic & defensive pain as affect in

psychoanalysis        

Abstract:       Discusses an affective modality which the author

believes has not been paid sufficient attention in psychoanalysis,

namely, pain, which can be categorized in 3 different types:

sensory-motor, psychic and defensive. Referring to different Freudian

texts, the author describes the relationship between affect and psyche

and between psyche and trauma. Pain that is historicized is part of

psychoanalysis: the characteristics this pain acquires differ, depending

on its relation with mourning, the forbidden and aggression. Regarding

clinical work, the author discusses the vicissitudes of pain in

narcissistic pathologies: he presents 3 clinical vignettes that

illustrate some of the characteristics of pain in these patients. The

author outlines some clinical indicators of pathological narcissism, and

develops some ideas on pain in hypochondriasis. Concludes with an

attempt to differentiate the manifestations of affect in the most

frequent pathologies, recommending ongoing research into this subject.

  _____ 

 

Record: 29

         

Title:   Group and milieu therapy for veterans with complex posttraumatic

stress disorder.       

Author(s):     Shay, Jonathan, Dept of Veterans Affairs, Boston, MA, US

 

Munroe, James

Source:         Posttraumatic stress disorder: A comprehensive text. Saigh,

Philip A. (Ed); Bremner, J. Douglas (Ed); pp. 391-413. Needham Heights,

MA, US: Allyn & Bacon, 1999. xiv, 434 pp.

ISBN:  0-205-26734-3 (hardcover)

Language:     English

Key Concepts:         Veterans Improvement Program team treatment model &

group & milieu therapy, American male Vietnam war veterans with complex

PTSD  

Abstract:       This chapter discusses the use of group and milieu

therapy for American male Vietnam war veterans with complex

posttraumatic stress disorder (PTSD).

 

(from the chapter) Topics include: introduction (the core treatment

issue is social trust, destruction of normal narcissism, "combat ages

you," destruction of the combatant's community, how lack of social trust

becomes a problem for mental health professionals, the paradox of

therapy for trauma); Veterans Improvement Program (VIP) team treatment

model (our posture toward new members; stage I: safety, sobriety, self

care; stage II: constructing a cohesive narrative and grieving; stage

III: reconnection); defining concepts and practices of the VIP team

treatment model (restoration of community, tests of trust, team as

community and team plus community, the rhetoric of treatment for combat

PTSD, summary of VIP team practices); and divergences in the team model

from the value pattern of the professional.

  _____ 

 

Record: 30

         

Title:   The sociopolitical context of the delayed memory debate.         

Author(s):     Kristiansen, Connie M., Carleton U, Ottawa, ON, Canada

 

Gareau, Carolyn

 

Mittleholt, Jennifer

 

DeCourville, Nancy H.

 

Hovdestad, Wendy E.

Source:         Trauma & memory. Williams, Linda M. (Ed); Banyard, Victoria L.

(Ed); pp. 331-347. Thousand Oaks, CA, US: Sage Publications, Inc, 1999.

xiii, 384 pp.   

ISBN:  0-7619-0771-8 (hardcover)

 

0-7619-0772-6 (paperback)

Language:     English

Key Concepts:         social & psychological & political underpinnings of

beliefs about recovered memories   

Abstract:       (from the chapter) The research reported in this chapter

was designed to examine the social, psychological, and political

underpinnings of people's beliefs about recovered memories. Two studies

were designed to examine the extent to which the just world, backlash,

and narcissism hypotheses account for people's beliefs regarding adults'

recovered memories of child abuse. In the first study, these hypotheses

were tested using data provided by a sample of university students. The

second study consisted of a conceptual replication that was conducted to

examine the generalizability of the findings to the general public.

 

Results indicate that people's beliefs about the validity of recovered

memories are strongly tied to autocratic misogyny, social denial, and

narcissistic self-interest. The author suggests that if people's beliefs

about the validity of recovered memories are rooted primarily in

ideology rather than science, the debate's adverse effects on survivors

are unjustifiable and unconscionable. It is suggested that this

sociopolitical debate is retraumatizing women with recovered memories,

having a detrimental effect on their therapy, and causing some survivors

to doubt their memories and remain silent.

Conference:   Trauma and Memory: An International Research Conference,

Jun, 1996, Durham, NH, US  

Conference Notes:    Most of the chapters in this volume were

originally presented at the "Trauma and Memory: An International

Research Conference," held in Durham, N. H., in June 1996.       

  _____ 

 

Record: 31

         

Title:   Soul murder revisited: Thoughts about therapy, hate, love, and

memory.       

Author(s):     Shengold, Leonard, New York U, The Psychoanalytic Inst,

New York, NY, US

Source:         New Haven, CT, US: Yale University Press, 1999. viii, 328 pp.    

ISBN:  0-300-07594-4 (hardcover)

Language:     English

Key Concepts:         child abuse & neglect & consequences for adulthood &

psychoanalysis        

Abstract:       (from the jacket) Serving as an extension of the themes

discussed in Soul Murder: Child Abuse and Deprivation (see record

1989-98382-000), psychoanalyst Dr. Leonard Shengold offers his latest

reflections on the circumstances in which the willful abuse and neglect

of children arises and on the consequences of this abuse, providing

examples from literature and from clinical material. Dr. Shengold

describes various types of child abuse as well as techniques of

adaptation and denial by soul murder victims. He explores the

psychopathology of soul murder, addressing such issues as instinctual

drives, aggression and sexuality, love, and narcissism. Finally he

offers suggestions about therapy for the abused and neglected,

emphasizing the need to restore the ability to care about and love

others.

  _____ 

 

Record: 32

         

Title:   Aporie nella storia della psicoanalisi.

Translated Title:       Aporias in the history of psychoanalysis.   

Author(s):     Fornaro, Mauro, U Cattolica del Sacro Cuore,

Dipartimento di Psicologia, Milan, Italy

 

Giacobbi, Secondo

Source:         Archivio di Psicologia, Neurologia e Psichiatria, Vol 59(6),

Nov-Dec 1998. pp. 698-728.

Publisher:      Italy: Universita Cattolica del Sacro Cuore

ISSN:  0004-0150 (Print)

Language:     Italian

Key Concepts:         history of psychoanalysis; paired opposite concepts       

Abstract:       Discusses the history of psychoanalysis with reference

to paired opposite concepts associated with controversies within the

psychoanalytic community. Among aporias, or opposite concepts,

considered are real trauma/imaginary trauma, internal/external,

drive/object, object/narcissism, division/cohesion, ego primacy/id

primacy, oedipal/preoedipal, maternal/paternal, insight/emotional

correctness, construction/reconstruction, one-person clinic/two-person

clinic, and neutrality/empathy. The role of these conceptual

oscillations in the development of modern psychoanalysis is described.

  _____ 

 

Record: 33

         

Title:   Depresiones narcisistas en la neurosis.      

Translated Title:       Narcissistic depressions in neurosis.

Author(s):     Uriarte, Clara

Source:         Revista Uruguaya de Psicoanálisis, No 88, Nov 1998. pp. 55-76.

Publisher:      Uruguay: Asociacion Psicoanalitica Del Uruguay

 

Publisher URL: http://www.apuruguay.com

ISSN:  0484-8268 (Print)

Language:     Spanish        

Key Concepts:         relation between narcissism & depression & loss,

children        

Abstract:       Links narcissism and depression. When the movements of

primary structuration of narcissism as linkages with secondary

identifications are flawed, the intrapsychic elaboration of a loss is

blocked, establishing the bases for a future depression. In the genesis

of depression, one must consider that the esteem one's self-image

deserves is built in the context of intersubjectivity. The child who

does not feel esteemed and recognized by its mother grows up damaged at

the level of its self-esteem. The father's absence not only from the

mother's psychic structure, but in reality, affects the child's

identificatory movements and worsens its narcissistic vulnerability.

Nostalgia is described as a specific affect linked to the narcissistic

trauma inflicted by a loss.

  _____ 

 

Record: 34

         

Title:   Le fonctionnement opératoire dans la pratique psychosomatique.

Translated Title:       Operative functioning in psychosomatic practice.

 

Author(s):     Smadja, Claude

Source:         Revue Française de Psychanalyse, Vol 62(5), Nov-Dec 1998.

Special issue: Psychosomatique et pulsionnalité. pp. 1367-1440.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         psychoanalytic perspective on operant functioning &

alternatives to primary narcissism & superego & objectification in

relation to truama in psychosomatic medicine      

Abstract:       Describes the concept of "operative" (French

"opératoire") functioning, the 1962 French psychoanalytic discovery

(which the author terms a true scientific discovery) as the core concept

of psychosomatic medicine. Alterations in the constitution of primary

narcissism, the prevalence of ideal formations to the detriment of a

functional superego, and the deficits of hallucinatory instinctual lines

favoring a traumatic situation, are the basis of the operative clinical

experience. Such phenomena also give meaning to the latter's main

indicators, namely, essential depression and operative thought. In the

author's conceptualization, the place of the object in the operative

functioning configuration is either temporarily or chronically

non-existent, while the reality of the group's existence imposes itself

upon the patient's ego with greater or lesser force. Two clinical

observations of psychosomatic patients in an "operative state"

illustrate the author's theme.

  _____ 

 

Record: 35

         

Title:   Quatre questions à propos du fonctionnement opératoire.

Translated Title:       Four questions regarding operative functioning.    

Author(s):     Aisenstein, Marilia

Source:         Revue Française de Psychanalyse, Vol 62(5), Nov-Dec 1998.

Special issue: Psychosomatique et pulsionnalité. pp. 1453-1458.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         psychoanalytic perspective on operant functioning &

alternatives to primary narcissism & superego & objectification in

relation to truama in psychosomatic medicine & P. Martz's theory,

comment      

Abstract:       Refers to C. Smadja's article, "Operative functioning in

psychosomatic practice" (record 1999-13162-001) and to the teachings of

French psychoanalyst, Pierre Marty. Aisenstein compares Freud's

identification with psychoanalysis to Marty's identification with

psychosomatics. Aisenstein declares her agreement with Smadjas's

positions on operative functioning. She compares one of her clinical

cases, in which the patient conformed to the views of the group almost

compulsively, showing an incapacity to be alone with the other, to the 2

clinical examples cited by Smadja. Aisenstein notes, in agreement with

both Freud and Marty, that a theory draws continuing life and relevance

from remaining forever unattainable and unconquered. She reformulates

the 4 questions she considers fundamental to Smadja's psychosomatic

theory: what is monism and what is dualism; is a form of deconstruction,

which is not destruction, conceivable; non-sense and sense; whether it

is possible to design a model of non-neurotic pathologies which cannot

be reduced to a borderline syndrome.

  _____ 

 

Record: 36

         

Title:   Commentaire sur l'opératoire.        

Translated Title:       A note on operativity.        

Author(s):     Fain, Michel

Source:         Revue Française de Psychanalyse, Vol 62(5), Nov-Dec 1998.

Special issue: Psychosomatique et pulsionnalité. pp. 1493-1497.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         psychoanalytic perspective on operant functioning &

alternatives to primary narcissism & superego & objectification in

relation to truama in psychosomatic medicine, commentary       

Abstract:       Refers to Claude Smadja's 1998 article (see record

1999-13162-001), which describes not only the birth of psychosomatics,

but also its development and dynamics. The conflicting opinions on the

operative life stem from different implicit postulates. Smadja tries to

reconcile them. Collective psychology plays an essential role in

operative manifestations, deriving from a state deficient in primary

narcissism that bars the path of the pleasure principle. Patients

suffering from somatic disorders consciously admit that they need others

to judge what they did, which sometimes gives them a

pseudo-exhibitionistic side. Topics addressed include hypochondriasis,

whose manifestations the author illustrates with a phobia defined by him

as having a serious prognosis. The problems of patients who hate the

size and shape of their noses ("nosophobia") do not cease even after a

rhinoplasty. The author also discusses some articulations between the

death instinct and operative functioning.

  _____ 

 

Record: 37

         

Title:   Le bruit de la rue: Des mécanismes de maîtrise aux processus de

somatisation. 

Translated Title:       The noise of the street: From the mechanisms of

mastery to the processes of somatization.

Author(s):     Press, Jacques

Source:         Revue Française de Psychanalyse, Vol 62(5), Nov-Dec 1998.

Special issue: Psychosomatique et pulsionnalité. pp. 1591-1600.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         psychoanalytic perspective on operant functioning &

alternatives to primary narcissism & superego & objectification in

relation to truama in psychosomatic medicine, commentary       

Abstract:       Refers to C. Smadja's article (see record

1999-13162-001) which the present author defines "a return to Freud,"

finding in it a reframing of the contributions of the French school of

psychosomatics in a psychoanalytic model derived from the 2d topography.

In this connection, the author notes that the psychoanalytic perspective

with regard to somatizations correlates with the conceptualization of

the effects of trauma, according to which the trauma does not so much

generate psychic effects, but its effects on the psychic apparatus

consist in playing havoc with its functioning. To use Freud's term, one

might say that such effects revive the ancient theory of "shock." The

author cites clinical examples to illustrates his theme. Topics

addressed include an attempt to articulate the author's arguments with

recent developments regarding borderline states; the concept of primary

mastery, and the necessity to compare recent theoretical developments

with P. Marty's psychosomatic model.

  _____ 

 

Record: 38

         

Title:   Peut-on se passer de la référence à l'économie psychosomatique?       

Translated Title:       Is it possible to avoid referring to the

economic viewpoint in psychosomatics?    

Author(s):     Debray, Rosine

Source:         Revue Française de Psychanalyse, Vol 62(5), Nov-Dec 1998.

Special issue: Psychosomatique et pulsionnalité. pp. 1603-1606.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         psychoanalytic perspective on operant functioning &

alternatives to primary narcissism & superego & objectification in

relation to truama in psychosomatic medicine, commentary       

Abstract:       Disagrees with C. Smadja's categorization (see record

1999-13162-001) of operative functioning as a distinct entity

corresponding to an ego pathology-2nd topography. The present author

finds this concept too rigid and too dangerously reductionistic. She

sees it as a new way of referring to "structural psychosomatics," which,

in her opinion, do not exist. Yet Debray agrees with Smadja's assertion

that "every psychoanalytic clinical case is a psychosomatic case." She

credits Smadja with opening the door to an innovative therapeutic

technique in which he excels. Moreover, the concept of a psychosomatic

economic viewpoint is indispensable for evaluating the place of

somatization in the general functioning of a subject. Operative

functioning is rare in its pure form, which might correspond more

closely to a truly static pathology, triggered almost at birth, which it

would be almost impossible to treat.

  _____ 

 

Record: 39

         

Title:   Maladie opératoire?  

Translated Title:       Operative illness?     

Author(s):     Obadia, Jean-Paul

Source:         Revue Française de Psychanalyse, Vol 62(5), Nov-Dec 1998.

Special issue: Psychosomatique et pulsionnalité. pp. 1617-1620.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         psychoanalytic perspective on operant functioning &

alternatives to primary narcissism & superego & objectification in

relation to truama in psychosomatic medicine, commentary       

Abstract:       Questions the entire theory proposed by C. Smadja in his

article (see record 1999-13162-001) regarding the existence of an

"operative" pathological personality configuration, or even of an

"operative illness." The present author examines the pruported

paradigmatic clinical case described by Smadja, noting that the

patient's personality traits, as portrayed by Smadja, are exactly the

opposite of what an "operative" patient is supposed to exhibit. Smadja's

patient shows imagination (e.g., by wondering whether his cancer is an

act of divine retribution for his transgressions), fantasies regarding

his future lifestyle and career, even a certain originality and

rebelliousness. all this in place of the automatism, conformism.

incapacity to symbolize and to perceive anything beyond "facts" and

concrete reality.

  _____ 

 

Record: 40

         

Title:   Consideraciones sobre el sujeto de nuestro tiempo y su

patología.     

Translated Title:       Considerations on subjects of the postmodern era

and their pathologies.         

Author(s):     Fernández, Roberto

Source:         Revista de Psicoanalisis, Vol 55(4), Oct-Dec 1998. pp. 857-873.

Publisher:      Argentina: Asociacion Psicoanalitica Argentina

 

Publisher URL: http://www.apa.org.ar

ISSN:  0034-8740 (Print)

Language:     Spanish        

Key Concepts:         traumatizing impact of recent sociocultural changes &

effect on narcissistic stability & organization of identity & emergence

of pathology & human subjectivity in post-modern era    

Abstract:       Examines the conditions required for the emergence of

human subjectivity in what has been called the "postmodern era," using

the theory of narcissism as a guideline. The author considers the

traumatizing impact of recent socio-cultural changes and their effect

upon narcissistic stability. This effect has resulted in manifestations

that are considered pathological as a result of the fractures in the

narcissistic organizations that affect the organization of identity. The

author describes some characteristics of social processes and their

connotation in the libidinal economic circuit they support; they

establish, in turn, relationships with the signifiers of historical

continuity, which, being altered, affect individual chances for

subjective historicization. Special emphasis is placed on the body as a

recurrent stage for the manifestation of the breakage of narcissistic

precariousness. Likewise, it becomes possible to re-establish the role

of psychoanalysis in the scientific and social dialog as a unique

viewpoint for the exploration of the construction of the psychic

subject.

  _____ 

 

Record: 41

         

Title:   Frida Kahlo: Trauma y creación.     

Translated Title:       Frida Kahlo: Trauma and creation.  

Author(s):     Agrest Wainer, Beatriz

Source:         Revista de Psicoanalisis, Vol 55(4), Oct-Dec 1998. pp. 993-1008.

Publisher:      Argentina: Asociacion Psicoanalitica Argentina

 

Publisher URL: http://www.apa.org.ar

ISSN:  0034-8740 (Print)

Language:     Spanish        

Key Concepts:         narcissistic reorganization of physical & psychic pain

following traffic accident through self-portraits & other art of Mexican

painter F. Kahlo       

Abstract:       Explores the relationships or transitions between

trauma, creativity and narcissism exemplified by the life and work of

Mexican painter Frida Kahlo (1907-1954). The author focuses especially

on Kahlo's physical and psychic suffering, and on the question of

whether her work has to do with art, madness, or pain. The author

traces, in psychoanalytic terms, the almost unbearable trauma that Kahlo

suffered in a traffic accident that left her with a broken body and

psychic pain beyond the possibility of cathartic abreaction. By entering

the world of painting, however, Kahlo attained a narcissistic

reorganization through her self-portraits, many of which are illustrated

in this article. The author discusses the avatars of narcissism in

connection with the death instinct, with data from Kahlo's personal

history, and with the analysis of her work. The author offers different

hypotheses on the relationship between trauma and creative work that

results from traumatic situations in life.

  _____ 

 

Record: 42

         

Title:   Affect regulation and narcissism: Trauma, alexithymia, and

psychosomatic illness in narcissistic patients.      

Author(s):     Krystal, Henry, Michigan State U, East Lansing, MI, US

Source:         Disorders of narcissism: Diagnostic, clinical, and empirical

implications. Ronningstam, Elsa F. (Ed); pp. 299-325. Washington, DC,

US: American Psychiatric Association, 1998. xxv, 483 pp.         

ISBN:  0-88048-701-1 (hardcover)

Language:     English

Key Concepts:         effect of psychic trauma on affect & self esteem

regulation & development of & psychotherapeutic treatment strategies for

narcissistic disorders & alexithymia with psychosomatic illness    

Abstract:       (from the chapter) The purpose of this chapter is to

discuss how normal affect regulation and self-esteem regulation can be

influenced by the occurrence of infantile psychic trauma or massive

psychic trauma later in life. The impact of affect regression on the

development of narcissistic disorders is discussed, as well as

alexithymia with psychosomatic disorders and specific treatment

strategies for narcissistic alexithymia patients.

  _____ 

 

Record: 43

         

Title:   Discussion of Anna Ornstein's "The fate of narcissistic rage in

psychotherapy."      

Author(s):     Harris, Adrienne, New York U, Postdoctoral Program in

Psychoanalysis & Psychotherapy, New York, NY, US

Source:         Psychoanalytic Inquiry, Vol 18(1), 1998. Special issue:

Aggression: Contemporary controversies. pp. 82-88.

 

Journal URL: http://www.analyticpress.com/psychoanalytic_inquiry.html

Publisher:      US: Analytic Press

 

Publisher URL: http://analyticpress.com

ISSN:  0735-1690 (Print)

Language:     English

Key Concepts:         self psychological perspective on aggression &

narcissistic rage during psychotherapy, male 35 yr old, commentary on

case report   

Abstract:       Comments on the report by A. Ornstein (see record

1998-00586-005) of narcissistic rage in a 35-yr-old male psychotherapy

client. The author discusses and offers her own interpretation of the

abusing, nonrepentant, and dissociated patient and the therapist's

countertransference experience and reactions; the dissociated retelling

by the client of the occasions of destructive violence as a

communication to the analyst of one feature of the patient's internal

experience of the original trauma experienced; the seemingly 2-phased

repair offered by the analyst and crucial aspects of the recovery from

trauma; the increased cohesion and self-structure in the patient, which

coincided with the lessening of narcissistic rages and destructive

responses to injury; and, finally, the concepts of selfobject

transference and projective identification.

  _____ 

 

Record: 44

         

Title:   Défense et illustration de la notion de "greffe métaphorisante."

 

Translated Title:       Defense and illustration of the notion of

"metaphorizing graft."         

Author(s):     Gagnebin, Murielle

Source:         Revue Française de Psychanalyse, Vol 61(4), Oct-Dec 1997.

Special issue: Aprè l'analyse... pp. 1301-1310.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         psyche & analytical treatment incompletion & unmasking

of narcissism & metaphorizing graft & recreation & mourning,

professional criticism

Abstract:       In response to the thesis of "narcissistic gain" caused

by traumas to come in the post-narcissistic period and developed by C.

and S. Botella, M. Gagnebin, translating the field of analysis into the

field of art criticism (the "homo post analyticus" could thus be

considered as the "artist of his own life") proposes the notion of a a

"metaphorizing graft." She gives three examples of this phenomenon that

indicate a painful and decisive task of recreation. Prompted by the

critic's discourse, this construction, a sort of "signifying" cutting

can sometimes have powers comparable to those of psychoanalytical

interpretation, powers that concern not the artist but his developing

work.

  _____ 

 

Record: 45

         

Title:   The impact of parental communication of Holocaust related trauma

on children.   

Author(s):     Eskin, Vivian, New York U, US

Source:         Dissertation Abstracts International Section A: Humanities &

Social Sciences, Vol 57(8-A), Feb 1997. pp. 3680.

Publisher:      US: Univ Microfilms International

 

Publisher URL: http://www.il.proquest.com/umi/

ISSN:  0419-4209 (Print)

Order Number:          AAM9701782 

Language:     English

Key Concepts:         parental narcissism & children's perception of parental

communication of Holocaust experiences & children's guilt & anger &

depression, parent child dyads       

Abstract:       This intergenerational study of Holocaust survivors and

their children examined relationships among parental narcissism,

children's perceptions of parental communication of Holocaust

experiences, and children's guilt, anger, and depression. Parental

narcissism was measured by the Selfism Scale. Children's perceptions of

parental communication of Holocaust experiences was measured by the

Communication Questionnaire. Children's guilt, anger, and depression

were measured, respectively, by the Mosher Forced Choice Guilt Scale,

the State-Trait Anger Expression Inventory, and the Center for

Epidemiologic Studies Depressed Mood Scale. Results based on 46 parent

child dyads indicated parental narcissism was related to parental

guilt-inducing communication, but positively, to children's trait anger.

Children's depression and anger were related to several dimensions of

parental communication.

  _____ 

 

Record: 46

         

Title:   Narcisismo originario del niño. Sus relaciones con la

organización del psiquiamo. 

Translated Title:       Primary narcissism in a child. Its correlation

with the organization of the psychic apparatus.   

Author(s):     Basso, Graciella

Source:         Revista de Psicoanalisis, Vol 54(1), Jan-Mar 1997. pp. 239-255.

Publisher:      Argentina: Asociacion Psicoanalitica Argentina

 

Publisher URL: http://www.apa.org.ar

ISSN:  0034-8740 (Print)

Language:     Spanish        

Key Concepts:         psychic organization & primary narcissism, children         

Abstract:       Quotes Freud's different definitions of narcissism,

originally based on a correlation with the Greek myth of Narcissus.

Freud used the term in a genetic sense, conceptualizing narcissism as a

developmental stage between autoeroticism and object love. In his

seminal 1914 paper "On Narcissism," Freud described a "primary

narcissism" as an original libidinal cathexis of the self from which

some is later given off to objects. Freud used the term "primary

narcissism" to mean a first state in life, prior even to the formation

of an ego, which is epitomized by life in the womb. The author expands

on Freud's thought and on postfreudian contributions with further

references to fetal development, birth trauma and extrauterine life from

dependence to autonomy.

  _____ 

 

Record: 47

         

Title:   The effects of paternal abuse and abandonment on a daughter's

psychological development: The father-daughter relationship in two

contemporary american novels.      

Author(s):     Wittstein, Sandra Shor, The Union Inst, US

Source:         Dissertation Abstracts International: Section B: The Sciences &

Engineering, Vol 57(5-B), Nov 1996. pp. 3437.

Publisher:      US: Univ Microfilms International

 

Publisher URL: http://www.il.proquest.com/umi/

ISSN:  0419-4217 (Print)

Order Number:          AAM9629573 

Language:     English

Key Concepts:         paternal abuse & abandonment & daughter's psychological

development in American fiction     

Abstract:       This study uses literary personae to demonstrate aspects

of a father's influence on his daughter's psychological development and

establishes the historical precedent for using fictional characters to

describe and illustrate psychological states. Its unique contribution to

this body of literature is that the characters are not merely analyzed

in order to demonstrate a particular pathology. Each character is

presented as a projected client who tells her story in the first person.

The researcher devised this format to present a fictional character as a

living, feeling person. An analysis of each life script reveals a

variety of pathological conditions due to paternal abuse and

abandonment; consequently, the literature review is quite extensive,

covering the following areas: cumulative trauma; addiction etiology and

symptomatology, e.g., pathological narcissism, anorexia nervosa, and

kleptomania; the impact of the father on female development; and

traumatic and narrative memory. Harrison's Exposure and Simpson's The

Lost Father, along with other contemporary novels read in preparation

for this discussion and analysis, illustrate American women writers are

wrestling with the complexities of the father-daughter relationship. The

two "cases" in this study demonstrate that fiction is an appropriate

venue to study paternal abuse and abandonment and a valid source as a

clinical tool. The researcher contends this is the first study to do so.

The protagonists in this discussion are white, well educated, and middle

class. Nevertheless, the researcher suggests the conclusions are valid

for women from other ethnic and socioeconomic groups; further research

is needed to substantiate these suppositions. The researcher also

suggests that the study's conclusions have clinical, educational, and

legal significance for treatment and prevention of paternal abandonment

and abuse. Furthermore, she posits future research might employ the

study's presentation of literary characters.

  _____ 

 

Record: 48

         

Title:   Otto Kernberg's etiological and treatment strategies of

narcissistic personality disorders.   

Author(s):     Stiles, Steven Joseph, United States International U, US

Source:         Dissertation Abstracts International: Section B: The Sciences &

Engineering, Vol 57(3-B), Sep 1996. pp. 2166.

Publisher:      US: Univ Microfilms International

 

Publisher URL: http://www.il.proquest.com/umi/

ISSN:  0419-4217 (Print)

Order Number:          AAM9623692 

Language:     English

Key Concepts:         etiological & treatment approach of Otto Kernberg in

addressing narcissistic personality disorders, humans      

Abstract:       The problem. This paper addresses the etiological and

treatment approach of Otto Kernberg in addressing the narcissistic

personality disorder. It is believed that Kernberg's

neutral-interpretive approach falls short in addressing all the needs of

an individual with this disorder. An additional nurturing component is

recommended in order to prevent additional trauma, supply a needed

holding environment, and prevent early termination of therapy. Method.

Becoming aware of Kernberg's theoretical concepts involved researching

the origin of narcissism which led up to the formation of the

narcissistic personality disorder, as well as looking at the theories

and theorists who influenced Kernberg's outlook on this disorder. What

follows is a presentation of Kernberg's approach to the narcissistic

personality disorder, and a critical analysis of his work pertaining to

this subject matter. This is followed by a critical discussion of the

concept of the narcissistic personality disorder and recommendations for

future research and study of the narcissistic personality disorder.

Results. Results suggest that Kernberg was rather one dimensional,

viewing this disorder in a metapsychological format. Kernberg (1989)

viewed the disorder as originating in pre-oedipal infancy, as a result

of mother-child interaction. Kernberg placed great emphasis on the harsh

introjects that color the child's interaction with the mother. Kernberg

ignored the possibility of a Sociological, and for the most part an

oedipal etiological influence. This would include a consideration of

gender, and cultural issues. Kernberg's approach to therapy neglects a

nurturing component, which it seems individuals with this disorder have

a need for. The author's personal preference is to use Kernberg's

confrontive and interpretive reality testing method, but incorporate an

additional nurturing component of treatment, in refining and taming

Kernberg's approach by utilizing empathetic methodologies.

  _____ 

 

Record: 49

         

Title:   Factors associated with two facets of altruism in Vietnam War

veterans with post-traumatic stress disorder.      

Author(s):     Barash, Ronit Kishon, Columbia U, US

Source:         Dissertation Abstracts International: Section B: The Sciences &

Engineering, Vol 56(11-B), May 1996. pp. 6453.

Publisher:      US: Univ Microfilms International

 

Publisher URL: http://www.il.proquest.com/umi/

ISSN:  0419-4217 (Print)

Order Number:          AAM9606908 

Language:     English

Key Concepts:         development of preliminary version of Interpersonal

Behavior Questionnaire (IBQ), assessment of two facets of altruism,

Vietnam War veterans with post-traumatic stress disorder        

Abstract:       This study was designed to develop a preliminary version

of a self-report measure, the Interpersonal Behavior Questionnaire

(IBQ), that distinguishes two theoretically derived facets of altruism

among people who have been traumatized and suffer from Post-Traumatic

Stress Disorder (PTSD). The subjects were 100 men who served in vietnam

war and were diagnosed as having PTSD. A premise of this investigation

was that PTSD patients who have experienced trauma have a great need to

restore a sense of meaning to their lives through helping others. The

likelihood of helping, across diverse situations, was labeled "Help

Intention". It was further proposed that the degree of benefit may be

associated with the nature of the motivation to help others. Thus, the

present study extended previous research into altruism by defining a

second facet of altruism, "Maturity of Motivation to Help". This second

facet was expected to reflect degrees of maturity along a developmental

line that was conceptually based on object relations theory. The study

was the first to empirically assess the intention and motivation to help

in a series of hypothetical situations through a self report measure. It

was expected that the two facets would relate differentially to

prosocial orientations (e.g., nurturance), to personality variables

(e.g., level of object Relations, Narcissism, Empathic Concern), and to

trauma variables (PTSD symptoms, Combat Exposure, Secondary Trauma). The

study included an initial attempt to establish the convergent,

construct, and discriminant validity (and the internal consistency) of

the instrument in the patient population studied. The results provided

initial support that the IBQ yields two distinct, albeit moderately

related, dimensions of altruism. The findings of that the scale has

quite reasonable psychometrics properties provides support for the

notion that a concept of motivation to help, based on the intrapsychic

elements, may indeed be measurable.

  _____ 

 

Record: 50

         

Title:   The severed self: Gender as trauma.        

Series Title:   Progress in self psychology; Vol. 12.

Author(s):     Crawford, Janice, The Training & Research Inst for Self

Psychology, New York, NY, US

Source:         Basic ideas reconsidered. Goldberg, Arnold (Ed); pp. 269-283.

Hillsdale, NJ, US: Analytic Press, Inc., 1996. xxii, 309 pp.

ISBN:  0-88163-228-7 (hardcover)

Language:     English

Key Concepts:         impact of gender system on conflict between biological

sexes & within self   

Abstract:       (from the chapter) seeks to question whether in fact the

gender system as we have come to construct and maintain it is itself a

major source of conflict between the biological sexes and within the

self / does this gender system ultimately obstruct rather than

contribute to, at the very least, cohesive self-experience and, at most,

aspects of the numinous self-experience H. Kohut (1966) referred to as

"cosmic narcissism" / although sex in the biological sense of being male

or female is acknowledged, this chapter implicitly questions the

meanings and impact of biology on destiny / the prevailing school of

thought assumes that biological differences are the cause of conflict

between the sexes / this paper assumes that these differences do not in

themselves inevitably result in conflict

  _____ 

 

  _____ 

 

Record: 1

         

Title:   Castration and narcissism in Ferenczi.       

Author(s):     Bertrand, Michèle, U Besançon, France

Source:         Ferenczi's turn in psychoanalysis. Rudnytsky, Peter L. (Ed);

Bókay, Antal (Ed); et al; pp. 209-223. New York, NY, US: New York

University Press, 1996. xiv, 292 pp. Publisher URL:

http://www.nyupress.nyu.edu       

ISBN:  0-8147-7475-X (hardcover)

Language:     English

Key Concepts:         S. Ferenczi's vs S. Freud's psychoanalytic theories on

castration complex & narcissism     

Abstract:       (from the introduction) because shame is linked to body

image, it can reflect anxieties of castration or mutilation / in

"Castration and Narcissism in Ferenczi," [the author] investigates S.

Ferenczi's understanding of the connection between these 2 pivotal

psychoanalytic concepts / although in his earlier writings Ferenczi

adhered to Freud's definition of the castration complex as pertaining

specifically to the threatened loss of the penis, he came increasingly

to emphasize broader concerns of trauma, psychic pain, and narcissistic

injury / examining many of Ferenczi's papers, including those on war

neuroses, tics, and Gulliver fantasies, as well as "Thalassa," [the

author] balances his perspective and Freud's, concluding that castration

must be defined more broadly to include all of its avatars

  _____ 

 

Record: 2

         

Title:   Theories of aggression and violence.        

Series Title:   Forensic focus series, No; 1

Author(s):     de Zulueta, Felicity, Charing Cross Hosp, Riverside

Mental Health Trust, London, England

Source:         Forensic psychotherapy: Crime, psychodynamics and the offender

patient, Vol. 1: Mainly theory. Cordess, Christopher (Ed); Cox, Murray

(Ed); pp. 175-186. Philadelphia, PA, US: Jessica Kingsley Publishers,

Ltd., 1996. xx, 313 pp. Publisher URL: http://www.jkp.com       

ISBN:  1-85302-240-3 (hardcover)

 

1-85302-371-X (hardcover)

Language:     English

Key Concepts:         neurophysiological underpinnings of trauma & abuse &

narcissistic rage bolstered by psychological defense mechanisms in early

attachment relationships & manifestation of violence      

Abstract:       (from the chapter) [suggest that] there are at least 2

dimensions involved in the manifestation of human violence / the 1st

stems from the neurophysiological underpinnings of the attachment system

and their profound disruption as a result of trauma and abuse / the 2nd

arises from the self in the form of narcissistic rage derived from a

matrix of internalized early attachment relationships bolstered by

powerful psychological defence mechanisms such as denial, dissociation,

splitting, projection and projective identification, all commonly used

when dealing with trauma and abuse

 

implications for forensic psychotherapy [the therapist's need to deny

the reality of the trauma and the dangers of re-enactment, importance of

supervision]

  _____ 

 

Record: 3

         

Title:   Neurosis narcisista: Cliníca y operatoria.   

Translated Title:       Narcissistic neurosis: Clinical work and

operating mode.      

Author(s):     Greco, Néstor

 

Kitainik, Daniel

 

López Moreno, Clara M.

 

Ojman de Kitainik, Hilda

Source:         Revista de Psicoanalisis, Vol 53(1), Jan-Mar 1996. pp. 69-88.

Publisher:      Argentina: Asociacion Psicoanalitica Argentina

 

Publisher URL: http://www.apa.org.ar

ISSN:  0034-8740 (Print)

Language:     Spanish        

Key Concepts:         multiple meanings of transference in narcissistic

neurosis, implications for psychoanalysis   

Abstract:       Notes that Freud's term, "transference" is polysemous.

Beyond the meaning of psychoanalytic phenomenon, it has other meanings,

such as transference of charge, or passage from a system to another.

Freud's term, narcissistic neurosis, comprises all functional psychoses:

Freud used the term mostly as the antithesis of transference neurosis.

Topics addressed, illustrated with 3 clinical vignettes and fragments of

sessions, include: comeback of the concept of narcissistic neurosis; the

narcissistic "operating mode;" positions of the analyst, in the

analysand's perception, in the transferential-countertransferential

field, e.g., ideal (as in H. Kohut's "idealizing transference"), judge,

denigrated Other, persecutor (representing reality as trauma). The

problematics of interpretations (vicissitudes of therapeutic

intervention) and reality, acknowledged only as mirror of one's own

thought, are also discussed. (English abstract)

  _____ 

 

Record: 4

         

Title:   Acerca del narcisismo normal y patológico en la niñez y

adolescencia.

Translated Title:       On normal and pathological narcissism in

childhood and adolescence. 

Author(s):     Lenarduzzi, Hebe

Source:         Revista de Psicoanalisis, Vol 53(1), Jan-Mar 1996. pp. 119-134.

Publisher:      Argentina: Asociacion Psicoanalitica Argentina

 

Publisher URL: http://www.apa.org.ar

ISSN:  0034-8740 (Print)

Language:     Spanish        

Key Concepts:         pathological & normal narcissism, children & adolescence

 

Abstract:       Argues that narcissistic disorders in infancy and

adolescence result in clinical histories not included in classical

nosography and resembling those of adulthood. Referring to P. and O.

Kernberg's, also H. Kohut's, research, the author defines pathological

(as distinguished from normal) infantile narcissism as characterized by

a symptomatological triad, i.e., illusion of wholeness, omnipotence, and

invulnerability. Illustrating his theme with 3 clinical vignettes, the

author traces the etiological sequence of childhood pathological

narcissism to an early-infancy trauma, causing defenselessness,

mobilizing disavowal as a defense, and leading to narcissistic

unbalance. Empathy and a nonthreatening, nonretaliatory attitude in

managing the patient's aggression on the analyst's part constitute the

best therapy, especially when working simultaneously with the child's

parents, who also tend to suffer from pathological narcissism. (English

abstract)

  _____ 

 

Record: 5

         

Title:   Clivages, théories sexuelles infantiles et écoute de l'analyste.

 

Translated Title:       Splittings, infantile sexual theories and the

analyst's listening.   

Author(s):     Bokanowski, Thierry

Source:         Revue Française de Psychanalyse, Vol 60 (Spec Issue), 1996. pp.

1567-1571.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         role of ego splitting mechanisms in capacity for

listening to analysands' infantile sexual theories, psychoanalysts,

conference presentation     

Abstract:       Explores the role "splitting" mechanisms play in the

psychoanalyst's listening to the infantile sexual theories of his/her

patients: the latter's expression of such theories is bound up with the

patients' traumas and their narcissism. The analyst's listening, on the

other hand, is unconsciously conditioned (not always advantageously) by

the analyst's own infantile traumas and by his/her narcissism. The

author questions whether the analyst's capacity for listening

receptively to the patient's infantile sexual theories (especially when

they express a serious psychopathology) is affected by the elaboration

of his/her own. Freud's case of the Wolf Man (1910) illustrates, "inter

al," the pathology of transferential splitting and narcissistic

splitting, and the challenge they represent for the analyst.

Conference:   56th Congress of Francophone Psychoanalysts of the

Romance Countries, May, 1996, Paris, France      

  _____ 

 

Record: 6

         

Title:   Trauma, inner conflict, and the vicious cycles of repetition.       

Author(s):     Wurmser, Léon

Source:         Scandinavian Psychoanalytic Review, Vol 19(1), 1996. pp. 17-45.

Publisher:      United Kingdom: Blackwell Publishing

 

Publisher URL: http://www.blackwellpublishing.com

ISSN:  0106-2301 (Print)

 

1600-0803 (Electronic)

Language:     English

Key Concepts:         psychoanalysis, trauma & inner conflict & narcissism &

vicious cycles of repetition, 39 yr old female with severely

self-destructive life pattern 

Abstract:       Examines the concepts of trauma, narcissism, and

conflict causality theoretically and clinically, exploring the recurrent

sequences of compromise formations that form characteristic vicious

circles of a narcissistic, masochistic, and addictive kind, and ends

with some technical conclusions and a psychological and philosophical

reconsideration of the concept of repetition compulsion. The case of a

39-yr-old unmarried White woman who sought help for a severely

self-destructive life pattern is used to illustrate the concepts. The

repetition compulsion, reflected in the "vicious cycles," is viewed as

an attempt to attain in symbolic ways affect regulation and conflict

resolution which proves blocked. Narcissistic crises, loyalty conflicts,

and shame-guilt dilemmas have a commanding position in the triggering of

those sequences, of the ensuing impulsive actions, and of the splitting

of consciousness and identity.

  _____ 

 

Record: 7

         

Title:   Exhibitionism as countershame.      

Author(s):     Silverstein, Judith L.

Source:         Sexual Addiction & Compulsivity, Vol 3(1), 1996. pp. 33-42.

Publisher:      United Kingdom: Taylor & Francis

 

Publisher URL: http://www.taylorandfrancis.com/

ISSN:  1072-0162 (Print)

 

1521-0715 (Electronic)

Language:     English

Key Concepts:         exhibitionism as countershame & sexualized form of

pathological narcissism & obsessive compulsive features  

Abstract:       Supports the theory that exhibitionism is a sexualized

form of pathological narcissism with obsessive-compulsive features. It

is contended that genital exhibitionism is motivated by a need for

attention and admiration as well as by a wish to overcome shame and

feelings of inadequacy. Genital exhibitionism is a sexualized form of

countershame. It is an unsuccessful repetition compulsion to overcome

the trauma of shame and humiliation and to create feelings of pride and

power leading to sexual arousal.

  _____ 

 

Record: 8

         

Title:   Prisoners of childhood: The drama of the gifted child and the

search for the true self.      

Author(s):     Miller, Alice

 

Ward, Ruth, (Trans)

Source:         New York, NY, US: Basic Books, Inc, 1996. x, 118 pp.     

ISBN:  0-465-06287-3 (hardcover)

Language:     English

Key Concepts:         role of childhood experiences & trauma in destruction of

& search for self & authentic feelings in psychoanalysis, patients with

narcissistic disturbances     

Abstract:       (from the jacket) Alice Miller defines the ideal state

of genuine vitality, of free access to the true self and to authentic

individual feelings that have their roots in childhood, as "healthy

narcissism." Narcissistic disturbances, on the other hand, represent for

her solitary confinement of the true self within the prison of the false

self.

 

The examples [the author] presents make us aware of the child's

unarticulated suffering and of the tragedy of parents who are

unavailable to their children--the same parents who, when they were

children, were available to fill their parents' needs. In her

psychoanalytic work, Dr. Miller found that her patients' ability to

experience authentic feelings, especially feelings of sadness, had been

for the most part destroyed; it was her task to help her patients try to

regain that long-lost capacity for genuine feelings that is the source

of natural vitality.

  _____ 

 

Record: 9

         

Title:   Codependence, narcissism, and childhood trauma.

Author(s):     Irwin, Harvey J., U New England, Dept of Psychology,

Armidale, NSW, Australia

Source:         Journal of Clinical Psychology, Vol 51(5), Sep 1995. pp.

658-665.

 

Journal URL: http://www.interscience.wiley.com/jpages/0021-9762/

Publisher:      US: John Wiley & Sons

 

Publisher URL: http://www.wiley.com/WileyCDA/

ISSN:  0021-9762 (Print)

 

1097-4679 (Electronic)

Language:     English

Key Concepts:         alcoholic parents & childhood trauma & narcissistic

traits, codependence, 18-70 yr olds         

Abstract:       Determined whether (1) codependence in adulthood would

be predicted by a childhood with an alcoholic parent and by a diversity

of childhood traumatic experiences and (2) narcissistic traits would be

negatively weighted predictors of codependent tendencies. 190 adults

(aged 18-70 yrs) completed the Codependency Inventory, the Spann-Fischer

Codependency Scale, the Narcissistic Personality Inventory, the

Narcissistic Personality Disorder Scale, the Children of Alcoholics

Screening Test, and the Survey of Traumatic Childhood Events.

Codependence was not predictable by childhood trauma and, although a

relationship between codependence and narcissism was established, the

relationship was more complex than had been anticipated.

  _____ 

 

Record: 10

         

Title:   Identification and groups of belonging.      

Author(s):     Rouchy, Jean Claude

Source:         Group Analysis, Vol 28(2), Jun 1995. pp. 129-141.

Publisher:      US: Sage Publications

 

Publisher URL: http://www.sagepublications.com/

ISSN:  0533-3164 (Print)

Language:     English

Key Concepts:         psychoanalytic view of primary & secondary groups of

belonging & relationship of singular subject with collective entity &

effects of personal & social trauma on structuring of psyche     

Abstract:       To move from the intrapsychic field of identification to

the psychosocial field of identity it is necessary to refer to "groups

of belonging," which create, within transitional space, the conditions

for metabolizing psychic reality and the outside world, the

differentiation of the ego and non-ego, the space within and the space

without, narcissism, and the cathexis of objects. Such a group thus

constitutes the missing link enabling us to determine both the

relationship of the singular subject with the collective entity (and

vice versa) and their mutual involvement. The distinction between the

primary (or natural) group of belonging and a secondary (or instituted)

group of belonging makes it possible to account for their evolution

across generations, and the effects of personal and social traumas on

the structuring of the psyche.

  _____ 

 

Record: 11

         

Title:   Anxiety and resistance to changes in self-concept.        

Author(s):     Stern, Gloria J., Columbia U, Coll of Physicians &

Surgeons, New York, NY, US

Source:         Anxiety as symptom and signal. Roose, Steven P. (Ed); Glick,

Robert A. (Ed); pp. 105-119. Hillsdale, NJ, England: Analytic Press,

Inc, 1995. x, 182 pp.         

ISBN:  0-88163-118-3 (hardcover)

Language:     English

Key Concepts:         establishment of psychoanalytic transference &

resistance to changes in self concept & experiences of narcissistic

vulnerability in psychoanalysis, traumatized patients with anxiety

disorders      

Abstract:       (from the chapter) faced with a change in their

self-concept, patients in psychoanalysis experience anxiety stemming

from a sense of narcissistic vulnerability / patients who are more

traumatized frequently present with symptomatic anxiety disorders that

are an expression of the trauma chronically reenacted / as they invest

the transference with aspects of the disavowed self and object

representations that are associated with the trauma, their anxiety

disorder improves / thus, there are antianxiety effects of the

establishment of the transference / the analyst may experience a

counterresistance in response to frustration as the patient prefers to

remain tranquil rather than face the reintegration required for change

  _____ 

 

Record: 12

         

Title:   Narcissism and leadership: Some differences in male and female

leaders.        

Author(s):     Jorstad, Jarl

Source:         Nordic Journal of Psychiatry, Vol 49(6), 1995. pp. 409-416.

Publisher:      United Kingdom: Taylor & Francis

 

Publisher URL: http://www.taylorandfrancis.com/

ISSN:  0803-9488 (Print)

Language:     English

Key Concepts:         narcissism & leadership, females vs males  

Abstract:       Discusses narcissism in terms of female leadership.

Normal narcissism is connected to a childhood stage and is an important

element in self-esteem and self-confidence. Several factors complicate

normal development, resulting in narcissistic injuries. Pathological

narcissism is a result of grave deficits and traumas in early childhood.

Women in leading positions are found to share common traits, such as,

close and satisfying relationships with their fathers, and experiencing

bosses as helpers and supporters. Conditions that reinforce narcissistic

vulnerability in leaders include youthfulness with little life

experience, lack of adequate training, weak personal or professional

identity, too much or too little self-esteem, and organizational

factors. While men are possibly more predisposed to narcissistic

grandiosity, women's attitude toward a leading career is characterized

by higher degree of narcissistic vulnerability and lower self-confidence

and aggressive self-assertion.

  _____ 

 

Record: 13

         

Title:   Psychoanalytic theories of war.     

Author(s):     Goreta, Miroslav, Vrapce Psychiatric Hosp, Zagreb,

Yugoslavia

Source:         Socijalna Psihijatrija, Vol 23(3-4), 1995. pp. 199-209.

Publisher:      Croatia: Croatian Psychiatric Society

ISSN:  0303-7908 (Print)

Language:     English

Key Concepts:         psychoanalytic theories of war & narcissism        

Abstract:       Presents recent psychoanalytical theories of war,

emphasizing and elaborating the particular contribution of

self-psychology, with special emphasis on earlier experiences of

narcissistic traumas and actual needs for reestablishing the

narcissistic homeostasis. The dynamics of relations between the leader

and the nation can best be understood within the framework of the

theoretical conceptualization of self-aggrandizement and identification

with the idealized object, however, the outbreak of war is only in part

the direct consequence of aggression. Aggression is only the secondary

phenomenon used as an instrument for waging war, not its original cause.

A scientific interpretation of the war events taking place on the

territory of the former Yugoslavia is provided, and some potential

solutions to the current state of war, including preventive measures, is

presented. (Serbo-Croatian abstract)

  _____ 

 

Record: 14

         

Title:   Das Trauma der Erkrankung--Krisen der Selbstwertregulation bei

Krebskranken.

Translated Title:       Disease trauma: Narcissistic crises in

oncological patients.

Author(s):     Kruse, Johannes, Heinrich Heine U, Düsseldorf, Germany

 

Wöller, W.

Source:         Zeitschrift für Psychosomatische Medizin und Psychoanalyse, Vol

41(4), 1995. pp. 370-385.

Publisher:      Germany: Vandenhoeck & Ruprecht

 

Publisher URL: http://www.vandenhoeck-ruprecht.de/

ISSN:  0340-5613 (Print)

Language:     German        

Key Concepts:         psychic trauma leading to narcissistic crisis, cancer

patients       

Abstract:       Notes that oncological diseases often represent a

psychic trauma, which leads affected individuals to a narcissistic

crisis. Starting from the concept of a narcissistic regulation system,

the origins of the destabilization of the self are described, and

parallels are drawn with the traumatic situation in persecution trauma.

The patients' cravings for symbiotic relationships, often with an

idealized physician substituting for an idealized parental figure, or

with close relatives, in a vain search for unobtainable reassurance, are

discussed. While such relationships may help the patient stabilize

his/her own self, they also involve the danger of traumatization within

an object relation. The consequences for the process of mourning and

integration are discussed. Seven clinical examples illustrate the

authors' theme. (English abstract)

  _____ 

 

Record: 15

         

Title:   The draining fantasy in male schizophrenics and in normal Sambia

males.

Author(s):     Reisner, Andrew D., Community Counseling Services,

Galion, OH, US

Source:         Psychoanalytic Psychology, Vol 11(1), Win 1994. pp. 63-75.

 

Journal URL: http://www.apa.org/journals/pap.html

Publisher:      : Lawrence Erlbaum Associates, Inc.

ISSN:  0736-9735 (Print)

Digital Object Identifier:       10.1037//0736-9735.11.1.63         

Language:     English

Key Concepts:         causes & manifestation of draining fantasy,

schizophrenic & healthy Sambian males     

Abstract:       Demonstrates that the draining fantasy (DF, the

association of semen with milk and the fear of being drained of this

"semen/milk" during intercourse) exists both in some male schizophrenics

and in normal men of the Sambia tribe in New Guinea. The multiple causes

of the DF are elucidated. For male schizophrenics, the DF is traced to

oral trauma and fixation, impaired self-other boundaries, and

sexually-tinged narcissism. For Sambia males, the DF is traced to an

oral fixation stemming from early overgratification and to desires and

fears of being re-engulfed by the mother. The DF among the Sambia is

also fueled by male narcissism and castration fears. Although the Sambia

occupy a higher developmental level than schizophrenics (roughly

narcissistic to oedipal, as compared to early oral to narcissistic,

respectively), there is sufficient overlap between the groups to account

for manifestations of the DF.

  _____ 

 

Record: 16

         

Title:   Pour entretenir le narcissism . . . Quel enfant convoquer?

Translated Title:       To keep narcissism alive . . . Which child must

one summon?

Author(s):     Cohen, Sidney

Source:         Revue Française de Psychanalyse, Vol 58(3), Jul-Sep 1994. pp.

771-783.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         revived narcissism through reminiscences of childhood,

analysands    

Abstract:       Notes that people's frequent reminiscences of their

childhood fill an essentially narcissistic need, specifically, that of

keeping narcissism alive and well. Narcissism is not a definitive

acquistion, but a state that must be continuously revived because of the

losses it continuously suffers in every contact with the outside world.

The figure of the child would serve to support the autoerotic

withdrawals necessary for this function. Sometimes, however, this

self-cathexis operates with fixed modalities of recourse to the child

(e.g., to act, rather than summon, the child; the child of repetition;

the child of the evoked trauma). The author highlights the latter

through a clinical example. (English, German, Spanish & Italian

abstracts)

  _____ 

 

Record: 17

         

Title:   Countertransference and World War II Resistance fighters: Issues

in diagnosis and assessment.         

Author(s):     Op den Velde, Wybrand, St Lucas Hosp, Dept of

Psychiatry, Amsterdam, Netherlands

 

Koerselman, G. Frank

 

Aarts, Petra G. H.

Source:         Countertransference in the treatment of PTSD. Wilson, John

Preston (Ed); Lindy, Jacob D. (Ed); pp. 308-327. New York, NY, US:

Guilford Press, 1994. xxv, 406 pp.  

ISBN:  0-89862-369-3 (hardcover)

Language:     English

Key Concepts:         sociohistorical factors, paranoid & narcissistic & other

forms of countertransference, mental health personnel & traumatized

World War II Resistance fighters, Netherlands      

Abstract:       (from the chapter) discuss the phenomena of

countertransference in those who are professionally responsible for the

treatment, psychotherapy, and medico-legal examination of [trauma]

survivors of Nazi persecution during World War II in the Netherlands /

discuss special forms of countertransference, which include paranoid and

narcissistic reactions in the mental health professional, and explain

their relationship to historical events and societal attitudes toward

those who fought against Nazi oppression: the Resistance fighters

  _____ 

 

Record: 18

         

Title:   Narcissistic transference: The product of overlapping self and

object fields. 

Author(s):     Margolis, Benjamin D., Private practice, New York, NY,

US

Source:         Modern Psychoanalysis, Vol 19(2), 1994. pp. 139-147.

 

Journal URL: http://www.iup.com/order.cfm?bookno=MP&action=info&J=J

Publisher:      US: International Universities Press

 

Publisher URL: http://www.iup.com

ISSN:  0361-5227 (Print)

Language:     English

Key Concepts:         narcissistic transference & self & object fields,

analysands    

Abstract:       Characterizes the phase at which the narcissistic,

preoedipal patient (POP) is arrested as representing a level of

development in which self and object are comingled in varying degrees

and argues that transference among POPs is narcissistic rather than

object related. The author describes negative transference and its

implications for therapy and argues that patient-analyst transactions

can have meaning for the POP, but only if they take the form of

emotional interchanges. The role of the analyst in building therapy and

the narcisstic transference is discussed. Narcissistic transference can

reproduce within the analytic framework the overlapping self-object

state that was obtained in the period of early narcissism, allowing the

POP to reexperience and work through with the analyst the emotional

traumas of his/her 1st yrs of life.

  _____ 

 

Record: 19

         

Title:   Fenômenos psicossomáticos e neuroses traumáticas: Uma

convergência metapsicológica?      

Translated Title:       Psychosomatic phenomena and traumatic neuroses:

A metapsychologic convergence?   

Author(s):     Machado, Roaldo Naumann

Source:         Revista Brasileira de Psicanalise, Vol 28(1), 1994. pp. 129-142.

Publisher:      Brazil: Revista Brasileira de Psicanalise

 

Publisher URL: http://www.rbp.org.br/

ISSN:  0486-641X (Print)

Language:     Portuguese   

Key Concepts:         metaphysical convergence of traumatic neurosis &

psychosomatic symptoms, analysand        

Abstract:       Refers to an article by D. Maldavsky (1993) on the

metapsychology of traumatic neuroses. In this article Maldavsky

mentioned a defensive biological formation, which he called

"anti-stimuli armor," formed by dead superficial skin cells, which is

broken by the intensity of the outside trama at the onset of the

traumatic neurosis. Freud's related concepts of energy and cathexis are

discussed. Topics addressed include the concept of a monotonous,

indifferent energy typical of absolute narcissism that plays an

important role in an S's ability to abreact an initial shock when a

metapsychological convergence occurs between traumatic neurosis and

psychosomatics. A clinical vignette illustrates some aspects of this

complex issue. (English abstract)

  _____ 

 

Record: 20

         

Title:   Narcisismo, patologia de risco e doença somática.

Translated Title:       Narcissism, risk pathology and somatic disease.   

Author(s):     D'Alvia, Rodolfo, Inst Psicossomático, Buenos Aires,

Argentina

Source:         Revista Brasileira de Psicanalise, Vol 28(1), 1994. pp. 143-152.

Publisher:      Brazil: Revista Brasileira de Psicanalise

 

Publisher URL: http://www.rbp.org.br/

ISSN:  0486-641X (Print)

Language:     Portuguese   

Key Concepts:         narcissism & etiological risk of organic disorder,

psychotherapy clients        

Abstract:       Discusses the etiology of some organic disorders based

on the concept of narcissism. Narcissistic parental demands on the

infant cause the configuration of a predominant ideal ego in the latter

which, in the mode of external excitations, acts like a trauma. The

instinctual tension thus generated in the infant exceeds its defensive

capabilities, with consequent economic alterations in the distribution

of the psychic charges that escape mental processing through being

discharged in the biological body and thereby originating the specific

psychic structure called psychosomatic. The author describes organic

disorders frequently found in patients undergoing psychotherapy and

illustrates with a clinical vignette the death risk threatening an

increasing number of these patients. (English abstract)

  _____ 

 

Record: 21

         

Title:   Zur narzi-Stischen Dynamik aexueller Beziehungen in der

Therapie.      

Translated Title:       Narcissistic dynamics in sexual relationships

during therapy.        

Author(s):     Hirsch, Mathias

Source:         Forum der Psychoanalyse: Zeitschrift für klinische Theorie &

Praxis, Vol 9(4), Dec 1993. pp. 303-317.

 

Journal URL:

http://link.springer.de/link/service/journals/00451/index.htm

Publisher:      Germany: Springer Verlag

 

Publisher URL: http://www.springeronline.com

ISSN:  0178-7667 (Print)

 

1437-0751 (Electronic)

Language:     German        

Key Concepts:         transferential & narcissistic dynamics of client

therapist sexual relationships, male psychoanalysts & their female

clients

Abstract:       Identifies narcissistic needs as the underlying cause of

sexual relationships between male psychoanalysts and their female

patients. For the analysts, such relationships represent a compromise

between acting out a grandiose fusion fantasy and, at the same time, a

fear of symbiosis, mastered through the analyst's insistence on

maintaining the analytic setting even when having sex. This

ritualization borders on sexual perversion. The patient, however,

typically tends to sexualize her early narcissistic needs (often

triggered by a real sexual trauma in her childhood), which are

misinterpreted by the analyst as being sexual needs. Although there is a

collusion, this does not absolve the analyst from his responsibility to

avoid the actualization of the transferential relationship into sexual

contact. (English abstract)

  _____ 

 

Record: 22

         

Title:   Narcissistic injury and its relationship to early trauma, early

resources, and adjustment to college.      

Author(s):     Zamostny, Kathy P., U Maryland Counseling Ctr, College

Park, US

 

Slyter, Susan L.

 

Rios, Peggy

Source:         Journal of Counseling Psychology, Vol 40(4), Oct 1993. pp.

501-510.

 

Journal URL: http://www.apa.org/journals/cou.html

Publisher:      US: American Psychological Assn

 

Publisher URL: http://www.apa.org

ISSN:  0022-0167 (Print)

Digital Object Identifier:       10.1037//0022-0167.40.4.501       

Language:     English

Key Concepts:         utility of Narcissistic Injury Scale & structural

equation modeling analyses of effects of early trauma & resources on

psychological damage & college adjustment, college students    

Abstract:       Used structural equation modeling to test the

hypothesized model that the effects of early trauma are buffered by

early resources and that these variables, in turn, affect psychological

damage and subsequent adjustment. In addition, the utility of the

Narcissistic Injury Scale (NIS; S. L. Slyter, 1991), an

operationalization of A. Miller's (1981) construct of narcissistic

injury, was assessed. 250 students completed questionnaires measuring

past trauma, early resources, psychological damage, and adaptation to

college. Results supported the reliability and validity of the NIS.

Structural equation analyses resulted in a final model with a very good

overall fit. The path linking early trauma to psychological damage and

then subsequent adjustment accounted for the most variance. The

hypothesized buffering effects of early resources were not supported.

Counseling and research applications are discussed.

  _____ 

 

Record: 23

         

Title:   Narcissism, interpersonal adjustment, and coping in children of

Holocaust survivors. 

Author(s):     Baron, Lisa, Coney Island Hosp, Brooklyn, NY, US

 

Reznikoff, Marvin

 

Glenwick, David S.

Source:         Journal of Psychology: Interdisciplinary & Applied, Vol 127(3),

May 1993. pp. 257-269.

 

Journal URL: http://www.heldref.org/html/jrl.html

Publisher:      US: Heldref Publications

 

Publisher URL: http://www.heldref.org

ISSN:  0022-3980 (Print)

Language:     English

Key Concepts:         interpersonal adjustment & coping & narcissism, adult

children of Holocaust survivors vs Jewish European born parents

immigrating before WWII     

Abstract:       Tested the theory of intergenerational transmission,

which suggests that the Holocaust trauma, combined with circumstances in

the survivors' lives (e.g., early loss of a parent) and circumstances in

their children's lives (e.g., having a father who survived) would result

in poorer interpersonal adjustment and coping and greater narcissism

than in children of survivors without these circumstances and children

of parents who immigrated from Europe before World War II. 241 adult

children (mean age 35.71 yrs) of Holocaust survivors and 109 adult

children (mean age 44.64 yrs) of escaped European-born parents completed

several tests, including 4 scales of the California Psychological

Inventory and the O'Brien Multiphasic Narcissism Inventory (M. L.

O'Brien, 1987). Results fail to support the attribution of adjustment

and personality differences in children of survivors to survivor status.

  _____ 

 

Record: 24

         

Title:   Faudra mieux surveiller les petitsp. 

Translated Title:       We'll have to keep a better eye on the

childrenp.     

Author(s):     Szwec, Gérard

Source:         Revue Française de Psychanalyse, Vol 57(2), Apr-Jun 1993. pp.

591-603.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         role of child as narcissistic object choice in analytic

psychotherapy, adult incarcerated for nonviolent pedophilia      

Abstract:       Suggests that the child represents for the pedophile a

choice of a narcissistic object. Through the child, the pedophile

vicariously enjoys what he would have liked to experience himself. The

pedophiliac scenario allows identification with a father of whom the

mother has transmitted only the erotic role, while denying his role as

mediator, supporter, and legislator. This scenario only allows

identification with a mother who loves her child with an incestuous love

and preservation of the fetishistic illusion such a child represents.

This theme is illustrated with the clinical example of an adult,

incarcerated for a nonviolent pediphile act, who had previously been

treated by the author as a child, and whose early traumas and

transferential problems are discussed. (English, German, Spanish &

Italian abstracts)

  _____ 

 

Record: 25

         

Title:   Oedipus: Uncovering intergenerational cycles of violence.

Series Title:   Clinical practice series, No; 28

Author(s):     Robbins, Kenneth X., Alexandria Hosp, Dept of

Psychiatry, Attending Psychiatrist, Alexandria, VA, US

Source:         Rediscovering childhood trauma: Historical casebook and clinical

applications. Goodwin, Jean M. (Ed); pp. 7-26. Washington, DC, US:

American Psychiatric Association, 1993. xxv, 215 pp.      

ISBN:  0-88048-460-8 (hardcover)

Language:     English

Key Concepts:         uses the myth of Oedipus to describe intergenerational

family dysfunction & aid in therapy 

Abstract:       The Greek myth of Oedipus is used to illustrate

multigenerational family dysfunction. The mythical nature of the story

is then used by therapists to decrease their own cognitive dissonance as

well as intolerance for ambiguity and uncomfortable affects. Such

mythical thinking by the therapist serves as a counterbalance and check

against reductionism based on his or her personal anxieties, blind

spots, etiological assumptions, and cultural beliefs.

 

(from the chapter) the royal family of Thebes / Oedipus myths and

hostility toward children / Oedipus myths and disorders of narcissism /

the clinical importance of mythical thinking by the therapist

  _____ 

 

Record: 26

         

Title:   Acerca de la depresión en la infancia.       

Translated Title:       On depression in childhood. 

Author(s):     Rozenbaum, Ana

Source:         Revista de Psicoanalisis, Vol 50(1), Jan 1993. pp. 157-166.

Publisher:      Argentina: Asociacion Psicoanalitica Argentina

 

Publisher URL: http://www.apa.org.ar

ISSN:  0034-8740 (Print)

Language:     Spanish        

Key Concepts:         psychoanalytic perspective on genesis & development of

childhood depression, 8 yr old female        

Abstract:       Discusses depression in childhood, exemplified by the

material provided by the analysis of an 8-yr-old girl. The concepts

examined include early psychic trauma; psychopathogenic identifications;

the relation between the name given to a child and parental narcissism;

and validity of the parental narrative during the initial interview. The

author further discusses the way in which a combination of these factors

contributes to the genesis and later development of a depressive

structure in childhood. The importance of the historicization and

disidentification process is stressed since this process may enable

patients to establish their own identity, modify their history, and

become free from pain and suffering. (English abstract)

  _____ 

 

Record: 27

         

Title:   Slings and arrows: Narcissistic injury and its treatment.  

Author(s):     Levin, Jerome David, New School for Social Research,

Alcoholism & Substance Abuse Counselor Training Program, Director, New

York, NY, US

Source:         Northvale, NJ, US: Jason Aronson, Inc, 1993. xv, 313 pp.         

ISBN:  0-87668-550-5 (hardcover)

Language:     English

Key Concepts:         dynamic psychotherapeutic treatment of narcissistic

injury, case illustrations      

Abstract:       (from the jacket) "Slings and Arrows" deals with

narcissistic injury--the deep wounds to our core selves that lacerate,

diminish, fragment, and impoverish us, lowering our self-esteem and

inducing rage, shame, and humiliation. In this volume Dr. Jerome Levin

presents the dynamic psychotherapeutic approach to the treatment of

narcissistically wounded patients.

 

Beginning with an illuminating account of the self, our understanding of

it, narcissism, and narcissistic injury, Levin goes on to illustrate

these insights with detailed case narrations in which patients and

therapists come alive in their mutual struggle to grow and heal through

soothing, hurt, insight, and catharsis. In the process, patient and

therapist confront abandonment, traumatic childhood abuse, unrequited

love, loss, and mortality.

 

(from the book) [The author defines] narcissistic injury as a wound to

the core self accompanied by feelings of humiliation, shame, and rage

and [extends] that definition to include shame at the humiliation of

those we love and with whom we identify.

  _____ 

 

Record: 28

         

Title:   The pathogenic impact of child sexual abuse as compared to that

of other types of childhood trauma: The role of disclosure, response to

disclosure, and narcissistic parenting.       

Author(s):     Moor, Avigail, U Colorado, Boulder, US

Source:         Dissertation Abstracts International, Vol 53(5-B), Nov 1992. pp.

2550.

Publisher:      US: Univ Microfilms International

 

  _____ 

 

Record: 29

         

Title:   Rescue fantasies and the secret benefactor.       

Author(s):     Gillman, Robert D., Baltimore-Washington Inst for

Psychoanalysis, MD, US

Source:         Psychoanalytic Study of the Child, Vol 47, 1992. pp. 279-298.

Publisher:      US: Yale Univ Press

 

Publisher URL: http://www.yale.edu/yup/

ISSN:  0079-7308 (Print)

Language:     English

Key Concepts:         narcissistic masochistic & oedipal meanings of secret

benefactor rescue fantasy, male 40 yr old analysand, conference

presentation  

Abstract:       Traces the concept of rescue fantasies from Freud's

earliest idea of the mother as the fallen woman to later ideas of

ambivalent rescue of the father, siblings, and children. Clinical

vignettes from work with children and adults illustrate these points as

well as the reparative rescue fantasies in response to trauma and

narcissistic hurt via identification with an aggressor. The contemporary

family romance myth of the secret benefactor (e.g., superhero) is

described. The case of a man in his 40s illustrates the

narcissistic-masochistic and positive and negative oedipal meanings of

the secret benefactor rescue fantasy. Application to countertransference

enactments in the analyst is suggested.

  _____ 

 

Record: 30

         

Title:   The basic fault: Therapeutic aspects of regression.        

Author(s):     Balint, Michael

Source:         Evanston, IL, US: Northwestern University Press, 1992. xxvii,

205 pp.        

ISBN:  0-8101-1025-3 (paperback)

Language:     English

Key Concepts:         explores regression in psychoanalysis with patients

suffering from a fundamental disorder in object relations, "the basic

fault," 

Abstract:       (from the cover) When it was first published in 1968,

Michael Balint's "The Basic Fault" laid the groundwork for a far-ranging

reformation in psychoanalytic theory. This reformation is still

incomplete, for it remains true today that despite the proliferation of

techniques and schools, we do not know which are more correct or more

successful--and all psychoanalysts continue to encounter intractable

cases of mental disorder. Balint cogently argues that ordinary, "rigid"

techniques and theories are doomed to failure in such cases because of

their emphasis on interpretation. The interpretive technique is most

useful to patients who suffer from conflicts emerging from the Oedipal

period of development; but the "difficult" cases (many of whom are now

referred to as borderline personality disorders) must be treated

differently, as these patients suffer from the consequences of a more

fundamental disorder: "the basic fault."

 

Balint understands the basic fault as the result of a skewed

relationship between the child and a person in its environment, a trauma

which leads to primitive object relationships, intense and overwhelming

anxiety, and propensity to regression under stress. In response to this

phenomenon, Balint distinguishes between malignant regression and a

benign form of regression that can lead to a "new beginning." Abandoning

ego psychology, he develops a theory of primary love and the primary

object relationship which puts him in the forefront of British object

relations theorists and anticipates the ideas of figures such as Heinz

Kohut. Above all, he holds that the most important aspect of therapy is

the patient-analyst relationship, and that the analyst must learn to be

attentive to the subtle details in the evolution of this relationship.

 

"The Basic Fault" continues to illuminate the crucial current issues in

psychoanalysis and psychotherapy in general: the nature of self, the

role of developmental defects, the value of empathy, and the central

importance of the relationship between therapist and patient.

Notes: Originally published in 1969 by Tavistock Publications.

Reprinted in 1979 by Bruner/Mazel in the series: "Bruner/Mazel classics

in psychoanalysis."   

  _____ 

 

Record: 31

         

Title:   Narcissistic injury in patients with traumatic brain injury. 

Author(s):     Klonoff, P. S., St Joseph's Hosp & Medical Ctr, Barrow

Neurological Inst Adult Day Hosp for Neurological Rehabilitation,

Phoenix, AZ, US

 

Lage, G. A.

Source:         Journal of Head Trauma Rehabilitation, Vol 6(4), Dec 1991. pp.

11-21.

Publisher:      US: Lippincott Williams & Wilkins

 

Publisher URL: http://www.lww.com/

ISSN:  0885-9701 (Print)

Language:     English

Key Concepts:         self psychology & esteem & narcissistic injury, brain

injured patients       

Abstract:       Explores an amalgamation of the theoretical input of

self psychology as proposed by H. S. Kohut (1973) with a current model

of rehabilitation of patients with documented brain injury. The

juxtaposition of this theoretical framework with the catastrophic

reactions experienced by neurologically impaired individuals can

facilitate a better appreciation of the effects of narcissistic injury

on self-esteem. It is proposed that individuals with a history of

narcissistic problems that predate acquired brain injury show a course

of recovery marked by intensified problems with accepting and coping

with the effects of the brain injury. They also show a less positive

outcome related to problems with realistic vocational/academic planning.

Case examples of 2 male patients with traumatic brain injury are

provided.

  _____ 

 

Record: 32

         

Title:   A critique of the role of psychotherapy in brain injury

rehabilitation.

Author(s):     Christensen, Anne-Lise, U Copenhagen, Ctr for

Rehabilitation of Brain Damage, Denmark

 

Rosenberg, Nicole K.

Source:         Journal of Head Trauma Rehabilitation, Vol 6(4), Dec 1991. pp.

56-61.

Publisher:      US: Lippincott Williams & Wilkins

 

Publisher URL: http://www.lww.com/

ISSN:  0885-9701 (Print)

Language:     English

Key Concepts:         role of psychotherapy in rehabilitation, traumatically

brain injured outpatients, commentary      

Abstract:       Discusses some aspects of psychotherapy in traumatically

brain injured (TBI) outpatients, focusing on articles by G. P. Prigatano

(see record 1992-14061-001), P. S. Klonoff and G. A. Lage (see record

1992-13521-001), and L. Lewis (see record 1992-14098-001). Prigatano's

comprehensive cognitive and psychodynamic therapy stresses the issue of

goals of psychotherapy: ability to work, love, and play. The main

hypothesis of Klonoff and Lage is that H. S. Kohut's (1973) theory of

narcissism provides concepts suitable for a better understanding of

reactions in some patients to TBI. Lewis claims that psychotherapy,

based on sensitivity to the patient's experiences, is possible, but that

countertransference might cause reluctance in therapists to treat this

group. Overall, there appears to be a consensus that psychotherapy is an

essential element in the rehabilitation of TBI.

  _____ 

 

Record: 33

         

Title:   Two faces of narcissism.     

Author(s):     Wink, Paul, U Michigan, Ann Arbor, US

Source:         Journal of Personality & Social Psychology, Vol 61(4), Oct 1991.

pp. 590-597.

 

Journal URL: http://www.apa.org/journals/psp.html

Publisher:      US: American Psychological Assn

 

Publisher URL: http://www.apa.org

ISSN:  0022-3514 (Print)

Digital Object Identifier:       10.1037//0022-3514.61.4.590       

Language:     English

Key Concepts:         principal components analysis of MMPI narcissism scales

& correlation with personality scales vs O based narcissism measures vs

spouse ratings, adults & married couples   

Abstract:       Examines the lack of strong correlations among existing

self-report measures of narcissism. A principal-components analysis of 6

Minnesota Multiphasic Personality Inventory (MMPI) narcissism scales

resulted in 2 orthogonal factors, 1 implying Vulnerability-Sensitivity

and the other Grandiosity-Exhibitionism. Although unrelated to each

other, these 2 factors were associated with such core features of

narcissism as conceit, self-indulgence, and disregard of others. Despite

this common core, however, Vulnerability-Sensitivity was associated with

introversion, defensiveness, anxiety, and vulnerability to life's

traumas, whereas Grandiosity-Exhibitionism was related to extraversion,

self-assurance, exhibitionism, and aggression. Three alternative

interpretations of these results are considered, and an argument for the

distinction between covert and overt narcissism is made.

  _____ 

 

Record: 34

         

Title:   Trauma sexuel, blessure narcissique et carence narcissique.

(Pour introduire une métapsychologie des souffrances psychiques.).     

Translated Title:       Sexual trauma, narcissistic wound, and

narcissistic deficit: Introducing a metapsychology of psychic suffering.

 

Author(s):     Bayle, Gérard

Source:         Revue Française de Psychanalyse, Vol 55(4), Jul-Aug 1991. pp.

911-924.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         sexual trauma vs narcissistic wound vs deficit &

associated ego splitting & defense mechanism     

Abstract:       Presents a revised concept of trauma, leading to a

distinction between sexual trauma, associated with anxiety; narcissistic

wound, associated with pain; and narcissistic deficit, involving psychic

anesthesia and catastrophic anxiety. These phenomena involve 2 types of

ego splitting, functional and structural. The metapsychological

configuration of these types of psychic sufferings is described. The

defense mechanisms triggered by these attacks of the ego are explored

from a genetic perspective. The overflow of repression is seen as

involving functional splitting, the latter capable of being transmitted

from one generation to another. (English, German & Spanish abstracts)

  _____ 

 

Record: 35

         

Title:   The relationship between codependence and narcissism. 

Author(s):     Cermak, Timmen, Genesis Psychotherapy & Training Ctr,

Clinical Director, San Francisco, CA, US

Source:         Children of chemically dependent parents: Multiperspectives from

the cutting edge. Rivinus, Timothy M. (Ed); pp. 131-152. Philadelphia,

PA, US: Brunner/Mazel, Inc, 1991. xxii, 364 pp. Publisher URL:

http://www.taylorandfrancis.com/ 

ISBN:  0-87630-595-8 (hardcover)

Language:     English

Key Concepts:         examines the relationship between narcissistic

personality & codependency in children of substance-abusing parents   

Abstract:       (from the introduction) starting with Freud's

understanding of narcissism and then proceeding to the current theories

of self-psychology and trauma theory, the author [Cermak] reconstructs

the potentially traumatic childhood of a child of a chemically dependent

parent / helps us to understand, developmentally, how a COSAP [child of

a substance-abusing parent] may wind up repeating the pattern of either

the chemically dependent or the codependent parent

 

describes the bipolar aspects of the narcissistically injured

codependent child and clarifies how dependent and pseudomutual

personality traits can coexist in the same patient with narcissistically

aggressive and apparently "selfish" traits / discusses the therapy of

these disorders

 

(from the chapter) at the Genesis Psychotherapy and Training Center, . .

. we have developed an evaluation procedure that automatically assesses

adult COAs [children of alcoholics] on six different axes / this chapter

focuses mainly on one of these axes (codependence) and introduces the

other five in order to provide an overall perspective

  _____ 

 

Record: 36

         

Title:   Group psychotherapy in an acute inpatient setting: Techniques

that nourish self-esteem.    

Author(s):     Kurek-Ovshinsky, Cathie, Detroit Receiving Hosp &

University Health Ctr, MI, US

Source:         Issues in Mental Health Nursing, Vol 12(1), Jan-Mar 1991.

Special issue: Psychiatric nursing for the 1990s: New concepts, new

therapies. pp. 81-88.

 

Journal URL: http://www.tandf.co.uk/journals/tf/01612840.html

Publisher:      United Kingdom: Taylor & Francis

 

Publisher URL: http://www.taylorandfrancis.com/

ISSN:  0161-2840 (Print)

 

1096-4673 (Electronic)

Language:     English

Key Concepts:         reparative techniques in group psychotherapy, self

esteem & narcissism, psychiatric inpatients

Abstract:       Describes a conceptual model and reparative techniques

used in group therapy in a 15-bed acute inpatient psychiatric unit

located in a 340-bed metropolitan trauma center. The group met daily for

1 hr. Patients suffered from chronic mental illness and polysubstance

abuse and from complex medical problems (e.g., spinal cord injuries,

burns). Narcissism is discussed, using S. C. Roy and S. L. Roberts's

(1981) adaptive modes of self-concept and interdependency. Narcissism

sustains group adaptations at the pregroup level. Reparative group

techniques provide interdependent experiences that support and nourish

patients' self-esteem, diminishing narcissistic adaption.

  _____ 

 

Record: 37

         

Title:   Traumatismos precoces: Cicatrices y lagunas dentro de lo

psíquico.       

Translated Title:       Early traumas: Scars and gaps in the psyche.      

Author(s):     de Pantazoglu, Clara U.

Source:         Revista Uruguaya de Psicoanálisis, No 74, 1991. pp. 147-160.

Publisher:      Uruguay: Asociacion Psicoanalitica Del Uruguay

 

Publisher URL: http://www.apuruguay.com

ISSN:  0484-8268 (Print)

Language:     Spanish        

Key Concepts:         early narcissistic traumas & scars in deferred action of

analytic process, analysands         

Abstract:       Discusses the concept of narcissistic traumas,

comparable to psychic scars. These narcissistic scars, caught in a

complex interlacing with oedipal conflicts, will suffer different

destinies with regard to their possibilities of resignifications in the

deferred action of the analytic process. With some patients, it is

possible to give new meanings to significant spaces within the psyche.

In other patients, serious obstacles paralyze the fruitful movement of

analytic deferred action and thus contribute to the persistence of

feelings linked to helplessness in situations of loss. The notion of

psychic gaps as a result of the impossibility to give meaning to events

with devastating effects on the infantile psyche is addressed. Two

clinical vignettes illustrate some of the situations examined. (English

abstract)

  _____ 

 

Record: 38

         

Title:   El dilema del paciente narcisista-fronterizo: Entre la

desmentida y la discriminación.      

Translated Title:       The dilemma of the narcissistic-borderline

patient: Between denial and discrimination.

Author(s):     Schkolnik, Fanny

 

Svarcas, Manuel

Source:         Revista Uruguaya de Psicoanálisis, No 74, 1991. pp. 161-169.

Publisher:      Uruguay: Asociacion Psicoanalitica Del Uruguay

 

Publisher URL: http://www.apuruguay.com

ISSN:  0484-8268 (Print)

Language:     Spanish        

Key Concepts:         pathologies of narcissistic deficit & analytic

experience, narcissistic borderline patients

Abstract:       Discusses cases of narcissistic-borderline patients who,

at times, appear to be frankly crazy, yet communicate their experiences

to the analyst in an intimate way. These analytic encounters are

bewildering and enigmatic. The pathologies of narcissistic deficit,

disavowal, ego splitting, and discrimination are highlighted. In such

cases, the concept of disavowal differs from that posed by Freud,

insofar as it does not refer to phallic probmenatics but to the trauma

of alterity that is at the origins of the ego. This process is deployed

in the intersubjective field, with the participation of the mother and

the family environment promoting and sustaining the disavowal of the

Other. (English abstract)

  _____ 

 

Record: 39

         

Title:   Nouveauté, traumatisme et écriture.        

Translated Title:       Novelty, trauma and writing.

Author(s):     Clancier, Anna

Source:         Revue Française de Psychanalyse, Vol 55(1), Jan-Feb 1991. pp.

203-207.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         innovation & self organization & narcissim & creativity,

writers, conference presentation    

Abstract:       Discusses the phenomona of innovation,

self-organization, and narcissism in creative humans. Discoverers and

innovators in science and the arts have psychic structures with special

qualities. These individuals are often haunted by archaic traumas and

threats of destruction. It is suggested that for psychoanalysts,

physicians, psychiatrists, and artists writing is a defense against

destruction. Writing is a compulsion to writers. The act of writing

involves the combined presence of narcissistic and objectal libidos. The

written text is a place for conflict resolution where narcissism may

satisfy its desire to endure. Confessional writers, such as F. R. de

Chateaubriand, M. Montaigne, and J.-J. Rousseau, exemplify this theme.

  _____ 

 

Record: 40

         

Title:   On narcissistic identification and the shadow of the object.       

Author(s):     Ahumada, Jorge L.

Source:         International Review of Psycho-Analysis, Vol 17(2), 1990. pp.

177-187.

Publisher:      United Kingdom: Institute of Psycho-Analysis

ISSN:  0306-2643 (Print)

Language:     English

Key Concepts:         development of Freud's clinical model of narcissistic

identification & loss as trauma & alteration of ego, 1910-17       

Abstract:       Examines Freud's two-person psychology clinical model of

narcissistic identification (NCI), involving loss-as-trauma and leading

to an alteration of the ego. To attempt some conceptual ties between

early views on NCI in 1910 and later ones in 1917, Freud's struggles

with the issues of NCI, loss, and alteration of the ego are explored.

The purpose is to build a foundation for a conceptual distinction

between NCI and melancholic identification and between rivalrous and

restitutive narcissism. Two vignettes on actual losses illustrate (1)

enactment of transposition in a dream and (2) splitting of the ego and

the redressal of transposition by refinding a place within the (primal)

object. (French, German & Spanish abstracts)

  _____ 

 

Record: 41

         

Title:   On the initial stage of psychic experience. 

Author(s):     Vauhkonen, Kauko, Finnish Psychoanalytical Society,

Finland

Source:         Scandinavian Psychoanalytic Review, Vol 13(1), 1990. pp. 16-31.

Publisher:      United Kingdom: Blackwell Publishing

 

Publisher URL: http://www.blackwellpublishing.com

ISSN:  0106-2301 (Print)

 

1600-0803 (Electronic)

Language:     English

Key Concepts:         interpretation of repetitive dream in early childhood in

conjunction with illness & fever, adult patient      

Abstract:       Describes the dream of an adult patient that occurred

with compulsory repetitiveness in early childhood in conjunction with

illness and fever. The dream is interpreted as repeating the origin or

birth of awareness, (i.e., psychic consciousness) as the consequence of

thumb sucking during the fetal stage. Issues relevant to the dream

include the primary trauma, primal repression, primary narcissism, the

pleasure principle, repetition compulsion, and the primordial

experiential contents of Eros and Thanatos.

  _____ 

 

Record: 42

         

Title:   Die Rekonstruktion eines während einer Kinderanalyse erfolgten

Traumas und ihre Bedeutung für den Entwicklungsproze-S.        

Translated Title:       Reconstruction of a trauma experienced during

child analysis and its significance for the developmental process.

Author(s):     Berberich, Eva

Source:         Zeitschrift für Psychoanalytische Theorie und Praxis, Vol 5(3),

1990. pp. 191-203.

Publisher:      Germany: Stroemfeld Verlag

 

Publisher URL: http://www.stroemfeld.com

ISSN:  0169-3395 (Print)

Language:     German        

Key Concepts:         reconstruction of traumatic interaction with father &

oedipal development in child analysis, 6.5 yr old male with

uncontrollable aggressivity & anxiety & narcissistic inadequacy  

Abstract:       Describes the reconstruction of a traumatic event,

experienced by a 6.5-yr-old male patient in analysis for uncontrollable

aggressivity, anxiety, and inadequacy of his narcissistic defenses. The

S witnessed the mercy killing, by his father, of a mortally wounded deer

which had been struck by a car. This happened just when the S's fragile

ego was beginning to recover from earlier traumas and severe oedipal

conflicts. Reconstruction of the deer-killing episode highlighted not

only the S's present reactions to the trauma, but past psychopathogenic

events, as S and analyst reenacted a hunt in which the analyst played

the dual role of father-quarry, enabling the S to achieve an oedipal

triumph by symbolically killing his father. (English abstract)

  _____ 

 

Record: 43

         

Title:   Les enfants de la double culture ou le fantasme de métissage.   

Translated Title:       Children of two cultures, or the "half-caste"

phantasy.     

Author(s):     Audras de la Bastie, Marguerite A., U Lyon I, France

Source:         Psychanalyse à l'Université, Vol 14(55), Jul 1989. pp. 49-58.

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0338-2397 (Print)

Language:     French

Key Concepts:         existential narcissistic trauma, children with parents

from different races or cultures or social groups, France, conference

presentation  

Abstract:       Explores the existential problems of children born of 2

different races or cultures, namely, the half-caste phantasy, which the

author defines as the effort of narcissism to reconcile 2 irreconcilable

elements, the body (animal essence, sexuality) and the mind, partaking

of the divine essence. Herself the offspring of a French nobleman and a

peasant woman, and a counselor at a French group therapy center for

immigrant children, the author possesses firsthand knowledge of the

asymmetry of crossbreeding compounding the primal narcissistic trauma of

having been born of a man and a woman. (English & Spanish abstracts)

  _____ 

 

Record: 44

         

Title:   Ferenczi Tinha Razão? Algumas Considerações Sobre a Teoria do

Trauma.       

Translated Title:       Was Ferenczi right? A few considerations

regarding the theory of trauma.     

Author(s):     Bastos, Liana A.

Source:         Revista Brasileira de Psicanalise, Vol 23(3), 1989. pp. 71-81.

Publisher:      Brazil: Revista Brasileira de Psicanalise

 

Publisher URL: http://www.rbp.org.br/

ISSN:  0486-641X (Print)

Language:     Portuguese   

Key Concepts:         Freud's vs S. Ferenczi's theories of trauma &

introjection vs incorporation vs identification in structuring &

destructuring of psyche      

Abstract:       Discusses the theory of trauma as conceived by Freud and

S. Ferenczi to explain introjection (a concept created by Ferenczi),

incorporation, and the mechanisms of identification in the structuring

and destructuring of the psyche. Ferenczi's psychoanalytic contributions

have been largely ignored but have merit, despite the divergences they

may provoke. Ferenczi's experience with difficult patients characterized

his professional life and led to his theoretical and technical

innovations. Ferenczi pioneered the notions of the analyst's narcissism,

capacity for empathy, and the analytic setting as a space facilitating

changes. Two clinical examples illustrate Ferenczi's concepts. A

critical approach to Ferenczi's ideas may lead to a reappraisal of his

place in the history of psychoanalysis. (English abstract)

  _____ 

 

Record: 45

         

Title:   Dora. Traumatismes sexuels et traumatismes narcissiques.        

Translated Title:       Dora: Seuxal and narcissistic traumas.      

Author(s):     Hanus, Michel

 

Strauss, Marianne

Source:         Revue Française de Psychanalyse, Vol 52(6), Nov-Dec 1988. pp.

1305-1319.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         narcissistic vs sexual traumas & transferential &

countertransferential relationships in Freud's Dora case   

Abstract:       Argues that in Freud's (1902) intricate Dora case

narcissistic rather than sexual traumas played the chief role. The

bisexual, 4-way erotic entanglements in Dora's adolescent life (Mr. K,

Mrs. K, her father, her mother) were manifestations of her search for

(1) love rather than sex and (2) acceptance of herself as she was to

enhance her self-esteem. Dora experienced severe narissistic traumas at

being sexually solicited then slandered, the latter by Mrs. K. Dora's

transferential and countertransferential relationship with Freud was

beneficial to her, enabling her to tell her side of the story, thus

restoring her credibility and her self-confidence. (English, German &

Spanish abstracts)

  _____ 

 

Record: 46

         

Title:   La trauma: les trois temps d'une valse.     

Translated Title:       Trauma: A waltz in triple meter.     

Author(s):     Couvreur, Catherine

Source:         Revue Française de Psychanalyse, Vol 52(6), Nov-Dec 1988. pp.

1431-1449.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         narcissistic anxiety & fear of losing love object & of

castration in emotional trauma & Freudian hypothesis of positive vs

negative trauma outcome, psychoanalysis, traumatized female  

Abstract:       Discusses the temporal dimension of trauma, which is

always in the past because it is only a memory that the traumatic event

becomes pathogenic by deferred action. Illustrating her theme with a

case history, the author shows that the triple meter of the trauma waltz

consists of narcissistic anxiety, fear of losing the love object, and

fear of castration. Topics examined in detail include Freud's hypothesis

that trauma may have a double outcome, negative and positive, the latter

when trauma acts as a symbolic wound opening up the inner space of

neurotic memory and of creation. (English, German & Spanish abstracts)

  _____ 

 

Record: 47

         

Title:   Primal repression and other states of mind.

Author(s):     Kinston, Warren, Brunel U SIGMA Ctr, Programme for

Psychoanalytic Research, Uxbridge, England

 

Cohen, Jonathan

Source:         Scandinavian Psychoanalytic Review, Vol 11(2), 1988. pp. 81-105.

Publisher:      United Kingdom: Blackwell Publishing

 

Publisher URL: http://www.blackwellpublishing.com

ISSN:  0106-2301 (Print)

 

1600-0803 (Electronic)

Language:     English

Key Concepts:         psychostatic framework of mental states relating to

nature of narcissism & trauma & repression, implications for

psychoanalysis        

Abstract:       Presents a psychostatic framework of mental states

relating to the nature of narcissism, trauma, and repression. It is

suggested that the state of an analysand at any time in the analysis can

be determined from assessment of his/her relatedness to the analyst and

distance from primal repression (see W. Kinston and J. Cohen, 1986). The

4 mental states (or states of relatedness) described are the open state

(or spontaneous relatedness) distant from primal repression; the

neurotic state (or neurotic relatedness) near primal repression; the

object-narcissistic state (or object-narcissistic relatedness) when

emergence of primal repression is imminent; and primal repression

itself. The authors discuss forms of analytic responsiveness required by

each state.

  _____ 

 

Record: 48

         

Title:   Alteración del yo debida a procesos defensivos.   

Translated Title:       Ego alterations through defense processes.         

Author(s):     Beland, Hermann

Source:         Revista de Psicoanalisis, 44(4), Jul-Aug 1987. pp. 797-820.

Publisher:      Argentina: Asociacion Psicoanalitica Argentina

 

Publisher URL: http://www.apa.org.ar

ISSN:  0034-8740 (Print)

Language:     Spanish        

Key Concepts:         psychoanalytic resistAnce & ego alterations induced by

psychic defense mechanisms, conference presentation   

Abstract:       Discusses ego alterations induced by psychic defense

mechanisms, considering topics such as traumatic anxiety and the

feasibility of metapsychological approaches to ego alterations. Also

examined are the roles of deferred-action trauma, free aggressivity, and

rejection of the feminine element in the self in psychoanalysis

resistance; the role of obsessive and hysterical states as ego-syntonic

structures; the structure of the psychotic personality; and destructive

narcissism associated with a psychotic structure. A clinical vignette of

a 27-yr-old woman illustrates the possibility of a therapeutic

structural change related to the ego-syntonic nature of character

neuroses.

  _____ 

 

Record: 49

         

Title:   A self-psychological reevaluation of posttraumatic stress

disorder (PTSD) and its treatment: Shattered fantasies. 

Author(s):     Ulman, Richard B., New York Medical Coll

 

Brothers, Doris

Source:         Journal of the American Academy of Psychoanalysis & Dynamic

Psychiatry, Vol 15(2), Apr 1987. pp. 175-203.

 

Journal URL:

http://www.guilford.com/cartscript.cgi?page=periodicals/jnap.htm&cart_id

=547216.21319

Publisher:      US: Guilford Publications

 

Publisher URL: http://www.guilford.com

ISSN:  0090-3604 (Print)

Language:     English

Key Concepts:         self psychological reevaluation & treatment of

posttraumatic stress disorder & archaic narcissism, 38 yr old male

veteran with postcombat pattern of drug abuse, case report     

Abstract:       Presents the case of a 38-yr-old male veteran as a basis

for posing a self-psychological reevaluation of PTSD and its treatment.

The S reported a postcombat pattern of abusing drugs (e.g., lysergic

acid diethylamine, cocaine, marihuana). The case illustrates the

reconstruction and working through of the unconscious meaning of combat

trauma. It demonstrates that the clinical process of reconstruction and

working through facilitated the therapeutic transformation of faulty

restored fantasies (defensive and/or compensatory) of archaic

narcissism. Evidence of increased psychic structuralization was found in

a marked diminution of PTSD symptoms.

  _____ 

 

Record: 50

         

Title:   À soi-même étranger: A propos du texte "Le clivage du Moi dans

le processus de défense"--Déni, traumatisme? castration?         

Translated Title:       A stranger to oneself: Regarding the text of the

"ego splitting in the defense mechanism"--denial, trauma, castration?   

Author(s):     Baranes, Jean-José

Source:         Revue Française de Psychanalyse, Vol 50(4), Jul-Aug 1986. pp.

1079-1096.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     French

Key Concepts:         ambiguities in Freudian concept of psychic operation of

denial 

Abstract:       Discusses the complexities and ambiguities of Freud's

concept of the psychic operation of denial. The author places this

Freudian construct in the context of the infantile genital organization,

the oedipal complex, primary narcissism, fear of castration, and ego

splitting. Denial is also seen as a refusal to internalize separation,

absence, and loss of the maternal object, as well as a major determinant

of impasse in difficult analytic situations. An individual becomes a

stranger to him/herself when denial blurs the boundaries between

imagination and reality and symbols become more powerful and real than

the things they symbolize.

  _____ 

  _____ 

 

Record: 1

         

Title:   Primal repression: Clinical and theoretical aspects.

Author(s):     Kinston, Warren, Brunel U, Brunel Inst of Organisation &

Social Studies Programme for Psychoanalytic Research, London, England

 

Cohen, Jonathan

Source:         International Journal of Psycho-Analysis, Vol 67(3), 1986. pp.

337-355.

Publisher:      United Kingdom: Inst of Psychoanalysis

 

Publisher URL: http://www.ijpa.org

ISSN:  0020-7578 (Print)

Language:     English

Key Concepts:         clinical & theoretical aspects of primal repression &

trauma

Abstract:       Examines the properties and presentation of primal

repression. The concept of primal repression is described as referring

to an absence of psychic structure that can be mended and enhanced in

the process of emotional growth. It is seen as a part of the mind where

trauma persists and an area that is closely related to the unrepressed

unconscious. It is suggested that direct emergence of primal repression

is a threat to life and that its activation is therefore risky. It is

noted that, while primal repression is generally avoided during

psychoanalysis by object-narcissism buttressed by neurotic defenses, it

may be reached and worked with in the presence of a noninternalizable

valuing and nurturing relationship, described as primal relatedness.

This relationship is therefore the interactional context for emotional

growth. 14 clinical examples are presented to demonstrate characteristic

features of this region of the mind as viewed through the process of

psychoanalysis. Case vignettes illustrate the experiences of patient and

analyst as primary relatedness is established; the consequent

re-emergence of traumatic states and unmet needs, often initially in the

form of severe physical and psychological deterioration; primitive forms

of symbolization in the course of repairing primal repression; and the

role of action in emotional growth. (French, German & Spanish abstracts)

  _____ 

 

Record: 2

         

Title:   Narcissism and the personal myth.  

Author(s):     Lester, Eva P.

Source:         Psychoanalytic Quarterly, Vol 55(3), 1986. pp. 452-473.

Publisher:      US: Psychoanalytic Quarterly

 

Publisher URL: http://www.cyberpsych.org/psaq/

ISSN:  0033-2828 (Print)

Language:     English

Key Concepts:         concept of personal myth of E. Kris in obsessive

character structures & narcissism  

Abstract:       Suggests that the concept of the personal myth (PMY),

the defensive constellation described by E. Kris (1956) in obsessive

character structures, can be enlarged to include similar constructs in

cases of narcissistic pathology. The conditions necessary for the

development of the PMY are viewed as not being specific to particular

types of neurotic disorder, as Kris implied. It is contended that the

nuclear fantasy of the PMY is not always of the family romance type. The

PMY of the poet N. Kazantzakis is outlined, and its origins and

defensive functions are traced through the poet's life and work.

Biographical data and Kazantzakis's work support the claim that his PMY

was a protective shield against anxiety originating in early

narcissistic trauma. (22 ref)

  _____ 

 

Record: 3

         

Title:   Comments on Dr. Golden's paper "A view of narcissism through

psychohistory."       

Author(s):     DeMause, Lloyd, Inst for Psychohistory, New York, NY

Source:         Issues in Ego Psychology, Vol 8(1-2), 1985. pp. 100-104.

Publisher:      US: Washington Square Inst

ISSN:  0097-6555 (Print)

Language:     English

Key Concepts:         view of narcissism through psychohistory, comments on

article by L. Golden  

Abstract:       Responds to L. Golden's (see record 1986-30140-001)

article on narcissism through psychohistory, noting the official

opposition to psychohistory among psychoanalysts. It is argued that the

disasters of history are self-inflicted solutions to intrapsychic

conflict rather than simple repetitions of previous historical trauma.

The present author agrees with Golden's suggestions that psychoanalytic

investigation of history should be allowed and that some current leaders

may be shamans offering magical solutions to fantasies. (3 ref)

  _____ 

 

Record: 4

         

Title:   Self preservation and the preservation of the self.

Author(s):     Modell, Arnold H., Boston Psychoanalytic Inst, MA

Source:         Annual of Psychoanalysis, Vol 12-13, 1984-1985. pp. 69-86.

Publisher:      US: Analytic Press

 

Publisher URL: http://analyticpress.com

ISSN:  0092-5055 (Print)

Language:     English

Key Concepts:         changing forms of neuroses & need to reflect

self-environment conflict in psychoanalytic theoretical assumption,

implications for narcissistic personality      

Abstract:       Asserts that the forms of the neuroses on which some

theoretical assumptions of psychoanalysis are based are continually

changing and that there has been an actual increase in the number of

narcissistic neuroses. In contemplating a change in the model of the

neuroses, psychoanalysts are forced to consider the relation between a

new area of conflict, that between the self and the environment, and the

more traditional source of conflict in the neuroses, the Oedipus

complex, which may also be active in the narcissistic personality.

Although significant failures of the parental holding environment do

occur, and narcissism is in part a response to these traumas,

narcissistic disorders may also reflect unspecified social forces, so

that individual trauma alone cannot account for the adult neurosis. Much

of narcissism is really a system for self-preservation. Implications for

the work of analysis are discussed. (44 ref)

  _____ 

 

Record: 5

         

Title:   Fort--visa mig vagp Reflexioner kring texter av Alice Miller och

Richard Wagner.      

Translated Title:       Quickly--show me the wayp Reflections on the

works of Alice Miller and Richard Wagner.  

Author(s):     Dahlin, Olov

Source:         Psykisk Hälsa, Vol 25(2), 1984. pp. 71-83.

Publisher:      Sweden: Svenska Föreningen för Psykisk Hälsovard

ISSN:  0033-3212 (Print)

Language:     Swedish       

Key Concepts:         psychoanalytic view of innocence of children & effects

of R. Wagner's operas on A. Hitler, comments on works by A. Miller      

Abstract:       Discusses the significance of 3 works by Swiss

psychoanalyst Alice Miller dealing with the innocence of children and

examines the effect of Richard Wagner's epic operas on Hitler. Miller's

works are concerned with the conflict between the child's nature and

culture, narcissism in childhood, and the relation of the child to the

family and the outside world. Hitler's underlying childhood conflicts

and trauma are considered the cause of his obsessive fascination with

the characters in Wagner's musical trilogy. (6 ref)

  _____ 

 

Record: 6

         

Title:   Narcisismo e depressione.   

Translated Title:       Narcissism and depression.  

Author(s):     Muscatello, C. F, U degli Studi, Clinica Psichiatrica,

Bologna, Italy

 

et al.

Source:         Rivista Sperimentale di Freniatria e Medicina Legale delle

Alienazioni Mentali, Vol 107(6), Dec 1983. pp. 1277-1290.

Publisher:      Italy: Istituti Ospedalieri Neuropsichiatrici di San

Lazzar

ISSN:  0370-7261 (Print)

Language:     Italian

Key Concepts:         narcissism & depression      

Abstract:       Uses Freud's ambiguity concerning melancholy and object

loss as a starting point for research on depression; the concept of

narcissism is used to clarify these 2 terms. From this viewpoint,

melancholy is not a reaction to the loss of a beloved object (object

loss), but a powerless effort to take hold of the unreachable object of

narcissistic desire. Recognizing the existence of the entity of loss is

insufficient without an emphasis on the futility of any attempt of

narcissistic bonus in the depressive. The mechanism underlying the

melancholic event is in the depressive's attempt to overcome incapacity

to enjoy the love of an object in a narcissistic manner by claiming a

fanciful loss of it. Failures caused by melancholy continue the

narcissistic trauma and give sensations of self-depreciation, impotence,

and disillusion. Whether the unchanging motives of self-depreciation,

impotence, and shallowness in narcissism are sufficient to outline all

types of depression is considered. (30 ref)

  _____ 

 

Record: 7

         

Title:   Psychopathologie de la puerpéralité.         

Translated Title:       Puerperal psychopathology. 

Author(s):     Scharbach, H., Regional Hospital Ctr, Child & Adolescent

Medical Psychological Service, Nantes, France

 

Moisan, M.

Source:         Annales Medico-Psychologiques, Vol 141(3), Mar 1983. pp.

323-335.

 

Journal URL:

http://www.elsevier.com/inca/publications/store/6/2/2/2/8/8/

Publisher:      Netherlands: Elsevier Science

 

Publisher URL: http://elsevier.com

ISSN:  0003-4487 (Print)

Language:     French

Key Concepts:         pregnancy & puerperium & mental & physical illness        

Abstract:       Notes that in contrast to notions from past centuries,

the child, and particularly breastfeeding, has taken on considerable

importance, leading to social concern and protection during pregnancy,

with associated medical attention. This, in turn, has created a

connection between pregnancy and illness, whether physical or mental.

This theme is developed and analyzed from a number of aspects: (1) the

desire to have a child; (2) pregnancy and filiation; (3) maternity as a

physiological regression or primary narcissism; (4) trauma, rupture, or

continuity of delivery; and (5) abandonment of primary narcissism for

psychological birth from a breastfed child. These aspects are further

discussed in an extensive review of a case study in order to emphasize

the risks of puerperal psychosis from a relapse and from an evolutionary

viewpoint. Regardless of approach to puerperal psychoses, the authors

stress the need to maintain or reintroduce the child into the "field of

therapeutic action."

  _____ 

 

Record: 8

         

Title:   Otto Rank: Beginnings, endings, and current experience. 

Author(s):     Novey, Riva

Source:         Journal of the American Psychoanalytic Association, Vol 31(4),

1983. pp. 985-1002.

Publisher:      US: Analytic Press

 

Publisher URL: http://analyticpress.com

ISSN:  0003-0651 (Print)

Language:     English

Key Concepts:         life of O. Rank & evaluation of his theories 

Abstract:       Discusses Rank's (1884-1939) life, the evolution of his

technical theories, and their relation to modern psychoanalytic ideas.

Rank is seen as a classical analyst with a special interest in art,

mythology, and religion. His theoretical writings concerning preoedipal

development, symbiotic union and separation, narcissism, and creation of

a cohesive self preceded the writings of contemporary psychoanalysts.

Three important contributions of Rank are his birth trauma theory,

leading to the theory of self-birth; emphasis on the present experience;

and idea of creative potential in the termination process of therapy.

His original thinking regarding present experience challenged

stereotyped use of interpretation of the past, demanded respect for the

patient's ability to use him/herself actively in therapy, and insisted

on skillful dealing with transference in the present. Rank was also able

to impart a dedicated interest in the ending process, developing an

enhanced understanding of difficulties and potentials involved in

termination of cases. Rank's ideas were supported by those seeking a

conceptual framework for a sound, goal-limited psychotherapy. (30 ref)

  _____ 

 

Record: 9

         

Title:   Theories of narcissism and trauma. 

Author(s):     Cohen, Jonathan A., U Colorado Medical Ctr, Denver

Source:         American Journal of Psychotherapy, Vol 35(1), Jan 1981. pp.

93-100.

 

Journal URL: http://www.ajp.org

Publisher:      US: Assn for the Advancement of Psychotherapy

 

Publisher URL: http://www.ajp.org

ISSN:  0002-9564 (Print)

Language:     English

Key Concepts:         psychic trauma, organization of memory & drives &

affects, female sexually molested by father, implications for

psychotherapy        

Abstract:       Presents a theoretical point of view that emphasizes the

effects of psychic trauma on the organization of memory, drives, and

affects. Using illustrative material from a case of father-daughter

incest, the usefulness of this point of view for understanding

pathogenesis and the process of psychotherapeutic change is

demonstrated. (12 ref)   

  _____ 

 

Record: 10

         

Title:   Narcizam i psihoze.   

Translated Title:       Narcissism and psychoses.  

Author(s):     Sedmak, Tomislav, Inst of Mental Health, Day Clinic for

Psychoses, Belgrade, Yugoslavia

Source:         Psihijatrija Danas, Vol 13(4), 1981. pp. 327-340.

Publisher:      Yugoslavia: Inst Za Mentalno Zdravlje

 

Publisher URL: http://solair.eunet.yu/~imz

ISSN:  0350-2538 (Print)

Language:     Serbo-Croatian        

Key Concepts:         pathological narcissism & psychoses         

Abstract:       Uses a framework of personality structure to discuss

pathological narcissism and psychoses. Narcissistic features in

psychoses should be controlled through the relationship among the object

image, self-image, and reality. The most successful way to trace

narcissistic psychosis in a patient is to follow the development of

object relations and subsequent personality structures. Splitting occurs

most frequently in schizophrenics who neither experience any kind of

acceptance nor create an integrated object or self-image. Instead,

disintegration and regression are manifested. The depressed patient

experiences omnipotence through object acting, during which an

integrated object is created to maintain a positive self-image and

self-esteem. The depressed patient is susceptible to narcissistic trauma

because of an incomplete narcissistic experience. Some depressives keep

searching for the objects necessary to restore balance after the trauma,

while others prolong the trauma through introjection. Mania is another

defense from depression enacted to prevent the experience of regression

or underestimation or the loss of self-esteem. Mania is similar to

narcissism but does not include stability or structure cohesion. (58

ref)

  _____ 

 

Record: 11

         

Title:   Narcizam kao deklanširajuci faktor. 

Translated Title:       Narcissism as an initiating factor.   

Author(s):     Taskovic, Aleksandar, KBC Inst of Psychiatry &

Neurology, Belgrade, Yugoslavia

 

Ivaniševic, Vesna

Source:         Psihijatrija Danas, Vol 13(4), 1981. pp. 341-344.

Publisher:      Yugoslavia: Inst Za Mentalno Zdravlje

 

Publisher URL: http://solair.eunet.yu/~imz

ISSN:  0350-2538 (Print)

Language:     Serbo-Croatian        

Key Concepts:         narcissistic conflicts & development of psychopathology 

Abstract:       Narcissism is considered as an idealization of contents

created in the process of individuation. In craving for perfection, the

human mind comes into conflict with the processes aimed at the

maintenance of present satisfactions. Such conflict comprises

existential narcissism. The new ideals are created within the framework

of the normal. The traumas interrupting the balance of these conflicts

lead to the psychopathological disorders that include neuroses and

psychoses. (3 ref)

  _____ 

 

Record: 12

         

Title:   Family characteristics of patients with borderline and

narcissistic disorders.

Author(s):     Mandelbaum, Arthur, Menninger Foundation, Family &

Marital Therapy Staff Training Program, Topeka, KS

Source:         Bulletin of the Menninger Clinic, Vol 44(2), Mar 1980. pp.

201-211.

 

Journal URL:

http://www.guilford.com/cartscript.cgi?page=periodicals/jnme.htm&cart_id

=547216.21319

Publisher:      US: Guilford Publications

 

Publisher URL: http://www.guilford.com

ISSN:  0025-9284 (Print)

Language:     English

Key Concepts:         family characteristics, patients with borderline &

narcissistic disorders

Abstract:       In a paper presented at a Menninger Clinic workshop in

1979, the author discusses the influence of the family situation in

creating and fostering borderline and narcissistic symptoms. When a

patient is diagnosed as having these symptoms, certain family patterns

and characteristics can be observed: Family relationships are troubled;

parents disagree about child-raising policies; both parents are deeply

enmeshed with their families of origin; there is a high incidence of

early childhood traumas; boundaries between the parents and between

parents and children are blurred; and there is a long family history of

behavior patterns showing fear of change, rigid rules, and unsuccessful

solutions tried over and over. Case examples illustrate these family

characteristics. (9 ref)

  _____ 

 

Record: 13

         

Title:   The drug of choice.  

Author(s):     Milkman, Harvey, Metropolitan State Coll, Drug/Alcohol

Inst

 

Frosch, William

Source:         Journal of Psychedelic Drugs, Vol 9(1), Jan-Mar 1977. pp. 11-24.

Publisher:      US: Haight-Ashbury Publications

 

Publisher URL: http://www.hafci.org

ISSN:  0022-393X (Print)

Language:     English

Key Concepts:         personality traits, heavy heroin vs amphetamine use,

White middle-class male adults      

Abstract:       Studied personality characteristics of heavy users of

heroin and amphetamines (at least 5 times/mo for several years), in

comparison with those of normal Ss. All Ss were White middle-class

males, 20-30 yrs old, with 10 Ss in each of 3 groups (heroin,

amphetamine, and normal). The drug users were interviewed in abstinence

and under slight intoxication (10-25% of habitual dosage), and the

normal Ss were interviewed twice without drugs. The drug users were

generally low in various aspects of ego functioning; and heroin users

were lower than amphetamine users. An analysis of ego functions

indicated that the choice of drugs is related to the style of coping

with infantile traumas. Those who regressed to passive narcissism chose

heroin, and those who created a fantasy of omnipotence preferred

amphetamines.

  _____ 

 

Record: 14

         

Translated Title:       The dynamic understanding of narcissism. 

Author(s):     Corman, Louis

Source:         Evolution Psychiatrique, Vol 40(4), Oct-Dec 1975. pp. 729-757.

Publisher:      Netherlands: Elsevier Science

 

Publisher URL: http://elsevier.com

ISSN:  0014-3855 (Print)

Language:     French

Key Concepts:         narcissism, review with emphasis on distinction between

primary & secondary narcissism      

Abstract:       Reviews the subject of narcissism, beginning with

Freud's early formulations, emphasizing the distinction between primary

and secondary narcissism which are sometimes confused. Primary

narcissism is that of the newborn which derives from the prenatal state

of complete protection and gratification without conflict and a vague

sense of perfect self-containment and omnipotence. Secondary narcissism

develops after the establishment of the ego as a function of the

development of object relations, and is a consequence of the reparation

of wounded self-esteem. Secondary narcissism is contrasted with

narcissistic retreat, which forces a return to a previous narcissistic

position because of obstacles met with in the exchange with objects.

Retreat is a pathological form of narcissistic response; it involves the

rupture or limiting of affective relationships, overevaluation of the

self, and usually a depressive retreat. The narcissistic wound is

generally compensated for by various forms of narcissistic behavior and

relationships. The causes of narcissistic retreat and its related

narcissistic trauma, and the role of healthy narcissism are also

discussed.

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Record: 15

         

Title:   A narcissistic defence against affects and the illusion of

self-sufficiency.       

Author(s):     Modell, Arnold H.

Source:         International Journal of Psycho-Analysis, Vol 56(3), 1975. pp.

275-282.

Publisher:      United Kingdom: Inst of Psychoanalysis

 

Publisher URL: http://www.ijpa.org

ISSN:  0020-7578 (Print)

Language:     English

Key Concepts:         narcissistic defense against affects, illusion of self

sufficiency    

Abstract:       Considers that a narcissistic defense against affects,

unlike isolation, is a defense against an object relationship. Similar

to denial, it entails the ego's structural modification, consisting of

establishing a precocious but fragile sense of self. While the

narcissistic defense may occupy a sector of the personality, when there

is a more massive structural arrest it forms the basis for the

narcissistic character disorder described by H. Kohut (1971) and for the

false self of D. W. Winnicott (1960, 1969). The borderline patient may

also have a precocious sense of self leading to the illusion of self

sufficiency, but he suffers from a failure of internalization, leading

to object hunger while the narcissistic character denies object need.

The contributing environmental traumas (i.e., mother's nonacceptance of

child's autonomy) are less severe in the narcissistic character but

result in fear of maternal intrusiveness and form the basis of

difficulty in establishing a therapeutic alliance. Perhaps the

psychoanalytic setting as a "holding environment" provides the healing

force. (26 ref)

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Record: 16

         

Title:   Narcissistic trauma, object loss, and the family romance.

Author(s):     Gediman, Helen K., Albert Einstein Coll of Medicine,

Yeshiva U

Source:         Psychoanalytic Review, Vol 61(2), Sum 1974. pp. 203-215.

Publisher:      US: Guilford Publications

 

Publisher URL: http://www.guilford.com

ISSN:  0033-2836 (Print)

Language:     English

Key Concepts:         narcissistic trauma & object loss, family romance

fantasy, case reports         

Abstract:       Describes 2 cases of the family-romance fantasy, one of

a man with a noticeable birth defect, the other of a woman adopted into

an aristocratic family who suffered traumatic object losses. The

fantasies served to restore self-esteem after disillusionment. The

effect of the fantasy on transference and countertransference in the

psychoanalytic training situation is discussed.

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Record: 17

         

Translated Title:       Psychotherapeutic interventions in

post-traumatic reactions.   

Author(s):     Bloch, Gottfried R.

 

Bloch, Noretta H.

Source:         Dynamische Psychiatrie, Vol 7(5), 1974. pp. 277-290.

Publisher:      Germany: Pinel-Verlag für Humanistische Psychiatrie und

Philosophie

ISSN:  0012-740X (Print)

Language:     German        

Key Concepts:         restoration of shaken narcissistic equilibrium &

fostering adaptive ego mechanisms & directive intervention &

adaptational coaching, aims of therapy for patients suffering traumatic

experiences   

Abstract:       Contends that the aim of therapy with patients who have

suffered a traumatic experience is to help them tolerate drastic

emotional and physical impairments and to master as fast as possible the

psychological effects. Lack of motivation for treatment, resistance,

difficulty in gaining insight, and disheartening actual situations may

discourage both patient and therapist. The focal problem is to restore

the shaken narcissistic equilibrium and its stability prior to the

insult. Ego-mechanisms supporting development towards the adaptation to

the post-traumatic condition are utilized; directive intervention and

adaptational coaching are integrated in the total approach.

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Record: 18

         

Title:   Observations on children who have witnessed the violent death of

one of their parents: A contribution to the study of traumatization.      

Author(s):     Lebovici, Serge

Source:         International Review of Psycho-Analysis, Vol 1(1-2), 1974. pp.

117-123.

Publisher:      United Kingdom: Institute of Psycho-Analysis

ISSN:  0306-2643 (Print)

Language:     English

Key Concepts:         traumatic & nontraumatic effects of child's viewing

parent's violent death, case reports

Abstract:       Uses 3 case examples to illustrate traumatic and

nontraumatic effects of a child's viewing a parent's violent death. A

general lack of concern by society toward the effect of such a death on

the child is noted. These children are seen as sometimes identifying

with the victim. Aftereffects noted in the 3 children include

depression, guilt, primary repression, psychosomatic symptoms, and

narcissism.

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Record: 19

         

Title:   Threads in the fabric of a narcissistic disorder.    

Author(s):     Wylie, Harold W.

Source:         Journal of the American Psychoanalytic Association, Vol 22(2),

1974. pp. 310-328.

Publisher:      US: Analytic Press

 

Publisher URL: http://analyticpress.com

ISSN:  0003-0651 (Print)

Language:     English

Key Concepts:         psychoanalytic observations, narcissistic disorder,

adult male in analysis

Abstract:       Describes an adult male in his 1st 4 yrs of analysis. He

had been troubled throughout his life by grandiose fantasies and

disturbed relationships. The meaning of these disturbances is discussed,

and their connection with an early childhood relationship in which a

grandiose self-image was pathologically reinforced. Early childhood

trauma interfered with the normal developmental maturation of

narcissism, and the grandiose self persisted without transformation into

adult life. Traces of this grandiosity are viewed as threads woven into

the fabric of the patient's character.

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Record: 20

         

Title:   Organic brain syndromes and suicide.       

Author(s):     Rice, Emanuel, Mt. Sinai School of Medicine, City U. New

York

Source:         International Journal of Psychoanalytic Psychotherapy, Vol.

2(3), Aug 1973. pp. 338-363.

Publisher:      US: Jason Aronson, Inc.

ISSN:  0091-0600 (Print)

Language:     English

Key Concepts:         organic brain syndrome & normal pressure hydrocephalus,

suicide & attempted suicide 

Abstract:       Discusses the relationships between organic brain

syndromes, neuropathology, and psychopathology and reviews the

literature. A basic frame of reference is the psychoanalytic structural

theory and its recent elaborations. Recent contributions to the study of

narcissism and a recently discovered organic brain syndrome (OBS),

normal pressure hydrocephalus (NPH) are considered. Suicidal phenomena

are prevalent in the early phases of OBS, and the importance of the

awareness of this possibility is stressed. The cerebral injury and its

sequelae are viewed as psychological traumas that necessitate defensive

maneuvers of a regressive nature. Suicide is viewed as a possible

outcome of the defensive resolution of conflict. The manifest

psychiatric picture in OBS is a reflection of the premorbid conflicts,

or weak points, that are peculiar to the patient. A case of NPH with a

history of attempted suicide, and another suggestive of NPH was

successful suicide, are presented and their dynamics discussed. (21 ref)

  _____ 

 

Record: 21

         

Title:   A dream of the Marquis de Sade: Psychoanalytic reflections on

narcissistic trauma, decompensation, and the reconstitution of

delusional self.        

Author(s):     Bach, Sheldon, 365 West End Ave., New York, N.Y

 

Schwartz, Lester

Source:         Journal of the American Psychoanalytic Association, Vol. 20(3),

Jul 1972. pp. 451-475.

Publisher:      US: Analytic Press

 

Publisher URL: http://analyticpress.com

ISSN:  0003-0651 (Print)

Language:     English

Key Concepts:         psychoanalytic reflections on narcissistic trauma &

decompensation & reconstitution of delusional self, interpretation of

dream of Marquis de Sade   

Abstract:       Examines a dream of the Marquis de Sade and a series of

perverse fantasies from one of his major works, viewing them both as

attempts to cope with narcissistic decompensation. The public image of

the Marquis is a manifestation of a delusional grandiose self,

constructed in a restitutive attempt to recathect a traumatically

disrupted childhood narcissistic self-object. The masochistic fantasies

are seen as attempts to restitute delusionally idealized self-objects,

and the sadistic fantasies as efforts to animate a delusional grandiose

self. (16 ref.)

  _____ 

 

Record: 22

         

Title:   Self-pity, self-comforting, and the superego.       

Author(s):     Milrod, David

Source:         Psychoanalytic Study of the Child, Vol 27, Feb 1972. pp.

505-528.

Publisher:      US: Yale Univ Press

 

Publisher URL: http://www.yale.edu/yup/

ISSN:  0079-7308 (Print)

Language:     English

Key Concepts:         self-pity & self-comforting affective states, resistance

to analysis    

Abstract:       Self-pity and self-comforting are affective states which

offer a powerful resistance to analysis because they provide libidinized

oedipal gratification via the rewarding function of the superego, which

is activated by a narcissistic wound viewed by the patient as unjust. In

addition, they offer a strong defense against self-directed punitive

aggressive drives. Narcissism is heightened and there is an interference

with object relationships. The genetic basis seems to be a significant

trauma in the anal period which interferes with self-directed aggression

(later reflected in an intolerance for guilt feelings) at a time when

the stability of the self-representation has not yet been established.

In the ensuing regression, the individual retreats to the early oral

phase, focusing on maternal comforting and partial fusion of self and

object images. (24 ref.)

  _____ 

 

Record: 23

         

Title:   Some aspects of the interaction between mother and impaired

child: Mother's narcissistic trauma. 

Author(s):     Lax, Ruth F., 164 E. 81st St., New York, N.Y

Source:         International Journal of Psycho-Analysis, Vol. 53(3), 1972. pp.

339-344.

Publisher:      United Kingdom: Inst of Psychoanalysis

 

Publisher URL: http://www.ijpa.org

ISSN:  0020-7578 (Print)

Language:     English

Key Concepts:         birth of defective child & narcissistic trauma,

mother-child interaction      

Abstract:       Discusses the narcissistic trauma caused by the birth of

a defective child, and the implications of the subsequent depressive

reaction for mother-child interaction. When a defective child is born

the mother becomes aware that her narcissistic aspirations for the child

are doomed to failure. She feels depressed, hopeless, inferior in this

irrevocable situation. Both self and baby are devalued. The mother's

unconscious attitude toward the child, not the overt behavior, affects

the child's image of himself. This happens whether the child is born

defective or is normal but fails to coincide with the image of the hoped

for baby. (15 ref.)

  _____ 

 

Record: 24

         

Title:   Infantile trauma, narcissistic injury and agoraphobia.      

Author(s):     Stamm, Julian L., State U. New York, Downstate Medical

Center, Brooklyn

Source:         Psychiatric Quarterly, Vol. 46(2), 1972. pp. 254-272.

 

Journal URL: http://www.wkap.nl/journalhome.htm/0033-2720

Publisher:      Netherlands: Kluwer Academic Publishers

 

Publisher URL: http://www.wkap.nl

ISSN:  0033-2720 (Print)

Language:     English

Key Concepts:         infantile trauma & narcissistic injury, agoraphobia, 38

yr. old woman in analysis    

Abstract:       Presents a detailed case history of a 38-yr-old married

woman with 2 children who entered analysis with a wide range of

symptoms. After 7 yr. of analysis, the crucial significance of her

heightened narcissistic vulnerability as an added factor in the genesis

of agoraphobia is elaborated. The significance of the conflict between

ego identifications and a pathological ego ideal in the pathogenesis of

the syndrome is also highlighted. (17 ref.)

  _____ 

 

Record: 25

         

Title:   Essai sur la situation analytique et le processus de guérison.     

Translated Title:       The analytic situation and the healing process.    

Author(s):     Grunberger, Bela

Source:         Revue Française de Psychanalyse, 21, 1957. pp. 373-458.

 

Journal URL: http://www.spp.asso.fr/Publications/Rfp/index.htm

Publisher:      France: Presses Universitaires de France

 

Publisher URL: http://www.puf.com

ISSN:  0035-2942 (Print)

Language:     NonEnglish    

Key Concepts:         PSYCHOANALYSIS, DYNAMICS; BEHAVIOR DEVIATIONS   

Abstract:       The dynamics of analysis are treated under several

headings: Narcissistic aspects, narcissism and the oedipus, narcissistic