Pandemic psychoanalysis

This book draws on a number of Freud's lesser-known works to explore psychoanalytic perspectives on memory, mourning and repetition. It is remarkable that Freud in his speculations on the human psyche often took his point of departure in an insignificant detail. It might be a lapse of memory or a detail in a piece of art. From here he uncovered the many layers of the psyche, its complex structure and the processing of meaning right to the limit of understanding. At this point Freud´s exploration encountered the unknown, an internal outland as difficult to acknowledge as the external reality. Freud did not invent the unconscious but he demonstrated how it works. The unconscious according to Freud does not exist, but insists on making itself visible. The eleven essays in this book draw a picture of the critical humanistic thinking so characteristic of Freud. His concepts and suppositions were the result of many years’ speculations, based on observation, experience and ideas, and although they are marked by the time and culture from which they emerged, they demonstrate a revolutionary knowledge of the psyche transcending the knowledge of his time. In her reading of the chosen texts the author has chosen the position of a contemporary interpretation. Examining how psychoanalytic work on the topics of memory, mourning and repetition has changed since Freud and how these themes remain of crucial importance in contemporary psychoanalytic theory, this book intersperses theory with clinical practice. It will be of great interest to training and practicing psychoanalysts, as well as scholars of art, literature and sociology.

Utopia and clinical praxis in Luigi (Gino) Pagliarani di Carla Weber This paper is an analysis of some aspects related to the Luigi (Gino) Pagliarani’s reasearch and psychoanalytic work. The current psychoanalytic discussion highlights that Pagliarani’s work anticipated many questions about the current mental disorder’s rising and is an important motivating force for further research. He considered the knowledge as strictly related to its change in action and, on the other hand, he favoured the action as a place for meaning’s and significance’s exploration. He considered the episteme of the puer, the possibility of being of everybody, and he gave to psychoanalysis the role of creating and bringing up the puer of everybody. The aim of a psychoanalytic work is a sentimental training, which gives a beauty’s awareness, holding of the angst that a real life can cause. For him, psychoanalysis is substantially praxis’ ethic, that can develop in the aesthetic conflict’s overcoming. In the human possibilities’ research, Pagliarani considered psychoanalysis as without landing place, guided by the utopia, by the vision of a place that doesn’t exist, but that could raise in the dialogue with the other, in a reality’s good analysis. A place in which it is possible to find out different ways of a responsible life. The psychoanalysis for Pagliarani is relationship and the technique is related to the possibilities of changing conditions. He suggests in the psychotherapic work to create a psychic and real space, with a continuous interaction, on which it is possible to work with the patient in a psychoanalytic view. For this reason, he searched and emphasised the value of the hic and hunc, which can be found in the setting as an original place that can also be a rising place. Clinical praxis explores conditions to create a movement of the most possible individual expression, of a metempsychotic experience, in which a re-birth could be founded, as choice to being in the word in a responsible way. A co-evolutionary approach, gathered and done till the most sustainable condition, because in the analytic relationship it can be taken in the present and lived again in the analyst- patient couple to taking on a changing meaning. Key words: psychoanalysis, psychotherapic relationship, aesthetic conflict.

As with any number of clinical ‘schools’ and approaches, Lacanian psychoanalysts encounter individuals whose presenting complaint is drug addiction. Psychoanalysis has often been underestimated in its effectiveness in treating addiction, data for other approaches being less stellar than often realized. Within the Lacanian orientation, addiction has been widely addressed, not as a specific syndrome but as a symptom with implications for the frame of the psychoanalytic work. In such Lacanian formulations, both clinical and cultural contexts are examined in disentangling the effects of drug use for addicted persons and within the social ideals, representations and prohibitions that undergird the value and significance of drug use in any given culture. Formal elements and functions of the process and products of speaking within psychoanalytic work inform Lacanian clinical practice. These elements can be discerned within individuals’ desires and speech and within the social contract. Lacanian concepts of subjectivity necessarily interact with the traditions and meanings inherent to Western societies. Such elements may be posited as the aftermath of the social necessity of speech, a process that fundamentally informs subjectivity. This article illustrates – using analysis of recent technological inventions – fantasies about technology, cultural representations of technology, and important parallels between technology and addiction. The authors take a psychoanalytic look at technology through current Lacanian clinical thinking on the subjective structure related to addiction.

The germinal proposition of psychoanalysis is, of course, that pathogenic mental conflicts underlie symptom-formation. A mode of the psychic apparatus which regulates and discharges mental energy should not only elucidate how mental forces oppose each other but also be consistent with clinical findings. In 1900, on the basis of accessibility to consciousness, Freud proposed a topographic model of the mind with activities taking place in three separate regions. Psychoanalytic work was, consequently, directed towards facilitating the emergence of the unconscious (force) via the preconscious into the conscious—a popular view delineating the essential task of psychoanalysis and one still erroneously held by many physicians, including psychiatrists. By 1923, however, broader clinical experiences demonstrated that mental conflicts may be generated in other ways: through opposing unconscious forces in opposition to moral forces, and through pressures from the external world. In order to attain larger consistency of theory and practice without retracting the

This paper describes the functioning of the Community Psychoanalysis Consortium (CPC) and the role of the Community Consultants in the Community Psychoanalysis Track at the Psychoanalytic Institute of Northern California. The existence of the CPC and its projects is an interruption of psychoanalytic training as exclusive to privatized psychotherapeutic practice, reclaiming and extending psychoanalytic pedagogical traditions that thrive in community mental health contexts. Persistent difficulties encountered in the exchanges between those steeped in institutional psychoanalysis versus community mental health are illustrated and analyzed as symptoms of a series of broader cultural splits. The work of the CPC is a collective effort toward training psychoanalysts to perform transgressive psychoanalytic community-based work. We see this effort as essential, as those community programs that continue to operate do so under continual threat of being dismantled and/or defunded. We assert, however, that community psychoanalysis is not primarily about expanding the borders of who gets analyzed. Rather, it is about who takes up the analytic gaze, what depths are probed, what resistances are seen to be at issue, and what other investments might be possible when dominant structures are confronted and collective libidinal resources are freed up.

Professionalism in Psychiatryby GabbardGlen O., M.D., RobertsLaura Weiss, M.D., Crisp-HanHolly, M.D., BallValdesha, M.D., HobdayGabrielle, M.D., and RachalFunmilayo, M.D. Washington, DC, American Psychiatric Publishing, 2012, 218 pp., $60.00 (paper).

Retrieving to the path of Freud and Lacan around the concepts of subject, drive and enjoyment in their relations with the order of reality, this article presents a discussion on clinical and political consequences of the Freudian discoveries in “Beyond the Pleasure Principle”. It seeks to demonstrate how these psychoanalytic notions, essentially clinical, may constitute a very important intersection between clinical practice and policy through the location of this instinctual, ethical and political drama in a topology of social bond. For this, it is considered the design of the subject in its radical inadequacy in the face of reality or order, be it clinically understood as an order of language, or as a normative, symbolic or imaginary order in the social bond. Key words: psychoanalysis, ethics, policy.

Methicillin-Resistant Coagulase-Negative Staphylococcusposes a challenging situation in healthcare settings. The spread of resistance among such organisms against major drugs is alarming as it limits the treatment options for serious infections. Traditionally, Vancomycin had remained a mainstay of treatment of Methicillin-Resistant Staphylococci. Linezolid introduction into the clinical practice was a major breakthrough since it provided orally administered treatment of Methicillin-Resistant Staphylococci. Widespread use of Linezolid has gradually turned the impending fear of emergence of resistance against this novel drug into a reality. We report first case of Linezolid-Resistant Methicillin-Resistant Staphylococcushemolyticusfrom Pakistan, isolated from a leukemic patient. The organism caused a necrotic lesion on the right forearm at cannulation site of intravenous catheter. Ooze swab yielded the pure growth of Linezolid-Resistant Methicillin-Resistant Staphylococcushemolyticus.

The Playwright's Autre Scène in Michel Tremblay's Le vrai monde? Olivia Jones Choplin When Freud first turns to the play Oedipus Rex in The Interpretation of Dreams, it is not immediately to define the Oedipus complex, but to invite us to consider the functions of both theater and clinical practice: "The action of the play consists in [. . .] the process of revealing, with cunning delays and ever-mounting excitement-a process that can be likened to the work of psychoanalysis-that Oedipus himself is the murderer of Laïus [. . .]1 What is revealed, then, in the play and in the analytic cure, is a type of self-knowledge that was formerly inaccessible. In her book Theaters of the Mind: Illusion and Truth on the Psychoanalytic Stage, contemporary psychoanalyst Joyce McDougall places the theatrical metaphor at the center of her reflection about clinical psychoanalysis. She writes: Each of us harbors in our inner universe a number of "characters," parts of ourselves that frequently operate in complete contradiction to one another, causing conflict and mental pain to our conscious selves. For we are relatively unacquainted with these hidden players and their roles. Whether we will it or not, our inner characters are constantly seeking a stage on which to play out their tragedies and comedies. Although we rarely assume responsibility for our secret theater productions, the producer is seated in our own minds. Moreover, it is this inner world with its repeating repertory that determines most of what happens to us in the external world.2 What happens when these "secret theater productions" become actual theater? When the autre scène manifests itself on the theatrical stage? When a playwright's creation is his acting out, and his writing becomes precisely a way of avoiding self-knowledge? If the unconscious has sometimes been dubbed l'autre scène, this [End Page 67] theatrical metaphor is perhaps nowhere more appropriate than in Michel Tremblay's play Le vrai monde?. Tremblay is a renowned Québécois playwright who exploded onto the stage in Montreal in 1968 with his play Les belles-soeurs. Over the past four decades, he has written both novels and plays, and he continually experiments with formal and structural elements in his theater. In this play, Michel Tremblay the playwright creates the character of Claude the aspiring writer, whose first manuscript is a play about the relationships in his own family. As Tremblay's play unfolds, so does Claude's, and the simultaneous theatrical representation of the two plays allows the audience to question the motives of the budding young playwright as a character on Tremblay's larger scène. This mise en abyme structure juxtaposes Tremblay's play with his fictional playwright's, creating a complex interplay between the two scenes that encourages both readers and spectators to reflect on the psychic function of artistic endeavor. A quick summary of the plot of Claude's play will be helpful here: Alex II, Claude's "father" and a traveling salesman, comes home from a road trip to find his wife Madeleine II completely changed towards him. She confronts him for his womanizing, telling him that she knows he has fathered at least one illegitimate child and that she wants a divorce. She will no longer put up with the farce of their marriage. Claude's "sister" Mariette II, a go-go dancer, comes home to find her father brooding after his conversation with Madeleine II. She proceeds to tell him that she does not want him to come see her dance anymore with his salesmen friends because she finds it perverse to dance in front of her father, whose eyes on her resemble those of his friends. She also hints at a past incident where, drunk, he forgot his familial relationship to her and nearly raped her, but was interrupted by Claude who came in and saved her. Alex II is outraged. Madeleine II also brings up this incident as the one time in her life where Alex II struck her in anger, and the moment that changed her feelings for him (and her life) forever. She then tells him to get out, and the last scene of...

This article investigates mindfulness-based interventions (MBIs) in a clinical setting and considers the benefits of socially engaged mindfulness practices. The main aim is to consider the relationship between MBIs, especially as a clinical practice (including disengagement from negative ruminations and difficult emotions) and Buddhist mindfulness as a practice of social engagement for systemic change. While MBIs and engaged Buddhism both aspire to ease suffering for individuals and societies alike, they differ as the former emphasizes psychological treatment of the individual and the latter includes a call to action for more widespread change in the political, economic, and social arenas. At the center of this article is an inquiry into mindfulness practice in relation to engagement, disengagement, and re-engagement with objects of the internal and external world and what that means for the practitioner as well as society at large. It will be concluded that the amendment of mindfulness-based practices with lovingkindness and compassion-based practices shifts the emphasis from the clinical treatment of an individual patient toward a more holistic approach that includes the wellness of all beings. This shift is desirable and necessary as it considers a broader set of causes of psychological suffering and helps to reconcile the divide between disengaged cognitive practice and social engagement.

It has been difficult to know what does and does not constitute competent psychoanalytic work and so equally difficult to assess when it is being practised and when it is not. This makes difficult any form of disciplined evaluation of the outcome of training, which has a series of problematic outcomes for psychoanalytic practice, psychoanalytic institutions and the relationship to allied disciplines and professions. In this paper, the author considers how far it might be possible to devise a framework for assessment of training programmes within a disciplined psychoanalytic pluralism. The aspiration is to develop a transparent framework, based on an empirically supported demonstration of analytic capacity. The framework needs to be sensitive and subtle, and to be able to withstand challenge. It needs to take cognisance of the twin facts that there is more than one way to practise psychoanalysis and that it is necessary to avoid ‘anything goes’. Drawing on an ongoing project undertaken by European IPA institutes, the author describes some of the problems colleagues have been experiencing in European institutes, because they have not had available transparent criteria for assessment. He outlines a preliminary form of a proposed method for making more transparent and supportable assessment. The author intends for this paper to inspire hope, enquiry and debate.

Daydreaming is a cognitive phenomenon characterized by the redirection of attention from the external world to inner representations. Although serving several adaptive functions, excessive daydreaming has been related to emotional problems and poor psychosocial adjustment. During adolescence, this phenomenon has been scarcely explored as potential psychopathological correlate. This study aims to explore daydreaming frequency and association with psychopathological symptoms in a non-referred population. Participants were adolescents from a community sample (N=251). Daydreaming was assessed through the Daydreaming Frequency Scale (DDFS). Youth Self-Report (YSR) and Strength and Difficulties Questionnaire (SDQ) were used as self-reports to evaluate psychopathological problems and adaptive functioning. Excessive daydreaming was present in 12.7% of participants. DDFS scores were significantly elevated in respondents with clinical scores for internalizing, depressive, obsessive-compulsive, and post-traumatic stress problems. Symptom severity correlated positively with the DDFS. Higher daydreaming was also associated with emotional symptoms, conduct problems and total difficulties on the SDQ. Adolescents who daydream show increased depressive, obsessive-compulsive, and post-traumatic stress symptoms. Possible cognitive processes at play in the relationship between daydreaming and psychopathology are discussed. Daydreaming may represent a silent psychopathological index that deserves better recognition in the clinical practice and in mental health initiatives for adolescents.

The role of social class in the analytic encounter has been given little attention in our psychoanalytic literature and training institutes. This dimension of the treatment relationship tends to remain invisible most of the time. However, when the analyst raises the fee, it can become a catalyst for bringing social class concerns of both patient and analyst into the treatment room. In the case presented below, the fee increase evokes shame, envy, and guilt for both participants in this dyad, each raised in a working-class home. The author considers unconscious dynamics informing psychoanalytic work between patients and analysts who outwardly appear to have no conflict about their social class origins, but privately harbor much shame and anger about where they come from.

DSM-5, trouble de la personnalité schizotypique et nosographie psychanalytique structurale française

Annabelle Starck presents psychoanalytic work with refugees in the International Clinic (IC) at the Frankfurt Psychoanalytic Institute (FPI) in Frankfurt am Main. The IC is part of the Psychosozialer Verbund Rhein Main (PSV), in which five organizations with many years of experience in working with trauma, migration and flight work together. Psychoanalytic therapy and counselling services with and without interpreters offer refugees prompt initial stabilization and crisis intervention. Some patients also opt for longer and more in-depth treatment. After a presentation of the work of IC (Ž. Čunović and R. Maccarrone Erhardt), Ms. Starck, candidate in DPV training, will demonstrate low-frequency psychotherapy with a patient from North Africa. She will focus on the extent to which the training situation additionally influences the constellation of psychotherapy “in threes”, i.e., with the support of an interpreter. She will show what necessities dealing with traumatized refugees often are demanded of us. Through reflection in supervision and with oneself, this treatment retains the psychoanalytical character that we care for deeply. Finally, our colleague shows how she was able to help improve the psychological condition of a severely traumatized woman and give her a new perspective on life.