Psychoanalytic Concepts and the Structural Theory

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.

Previous articleNext article No AccessNew Biological BooksTopography and Systems in Psychoanalytic Theory. Volume 3, No. 2. Merton M. Gill Psychoanalytic Concepts and the Structural Theory. Jacob A. Arlow , Charles Brenner Joseph D. LichtenbergJoseph D. Lichtenberg Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by The Quarterly Review of Biology Volume 40, Number 2Jun., 1965 Published in association with Stony Brook University Article DOIhttps://doi.org/10.1086/404641 Views: 1Total views on this site PDF download Crossref reports no articles citing this article.

Our clinical practice is contextualized by a co-participant trauma constituted by a confluence of upheavals–pandemic, politics, an epistemological crisis, pervasive distrust of expertise and evidence. Psychoanalytic work, parallel to the external world, has become defamiliarized, if not, at sometimes unrecognizable. The affect on the frame and the boundaries of the therapeutic frame and of the psychoanalytic institution are explored with an awareness of the uncertainty of the future. The experience of the onset of the pandemic is discussed with awareness of an unknown future.

The article presents an overview of the author's research, which focuses on the articulation between individual psychoanalytic treatment, psychoanalytic work in group settings, and listening to health care teams that are in difficulty within psychiatric institutions. It aims principally to contribute to the understanding of specific and intersecting aspects of unconscious psychic reality in all these arenas. Having outlined the nature of psychoanalytic work in group settings, the author presents his main hypothesis: in groups there is not only one space of psychic reality (that of the group as a whole), but three. The first is that of "the singular subject in the group"; the second is that of "intersubjective links" contracted between subjects when they meet with an other or more than one other in the group; the third is that of "the ensemble" that the subjects develop and of which they are part, because they shape and are shaped by it. Furthermore, the author presents the theoretical and clinical models that he has formulated in addition to their corresponding concepts: in particular the models of the group psychic apparatus, the internal group and psychic "groupality". The elements that form the theory of the link, which was based on the specificity of transference, and the concept of unconscious alliances are described.

MLR, 105.3, 2010 901 subject, the emergence of thebody inpopular and artistic culture of the early twen tieth century becomes a site of contest. According to Cowan's Foucault-inspired account, the project of a Willenskultur addresses a particularly modern form of fear', namely that the human subject had become subject to itsown objectification, and so needed rehabilitation by an ethics of self-mastery'. Yet, as Cowan shows, the theories of and practices eliciting will-power often proceed from contradictory principles: in self-help psychology, for instance, practitioners assert the primacy of mind over body, and yet promote performances of the body to produce states of mental motivation. The cultural obsession with channelling energies ofmind and body towards efficientproductivity arises in response to economic instability and the unpredictability of modern capitalism. Mann's Buddenbrooks, Impressionist novels, Doblin's story 'Die Tanzerin und der Leib', and the neurasthenic poetry of Ernst Blass are among themodern literaryworks thatCowan places within the context ofmodern nervousness. The struggle between nervous pathology and self-mastery is, Cowan argues, mapped out inKubin's novel Die andere Seite, inwhich theAmerican entrepreneur Herkules Bell embodies modern will-power and the dreaming Patera establishes an aesthetic, nostalgic refuge from the insecurities ofmodern progress. That Bell and Patera turn out to be aspects of one hybrid subjectivitymay be symbolic of the inextricability of nervousness and will in themodern German discourse of the self. The relevance of these phenomena to the twoworld wars and to the rise of Fascism is reserved, regrettably,forbrief treatment in an afterword, yet it is the latterwhich gives historical urgency to the topic. Nevertheless, Cowan has admirably amended any view ofmodernity forwhich the decisive paradigm is the Freudian relinquish ment ofwill to unconscious forces or the collapse of the subject's integrity,showing self-mastery to be a neglected technique of the selfdeveloped in response towhat Simmel called the Tragedy' ofmodern culture. Fordham University Jennifer Gosetti-Ferencei Geschlechterentwurfe im literarischenWerk von Lou Andreas-Salome unter Beruck sichtigung ihrerGeschlechtertheorie. By Katrin Schutz. (Epistemata Litera turwissenschaft, 622) Wurzburg: Konigshausen & Neumann. 2008. 290 pp. 39.80. ISBN 978-3-8260-3732-0. Lou Andreas-Salome (1861-1937) is better known inGermany for her life than her letters, forher association with famous men rather than as the essayist, author, and psychoanalyst that she was. Katrin Schutz addresses this deficit by examin ingAndreas-Salome's fiction in the light of her theoretical work on sexuality, in particular the ground-breaking essay 'DerMensch alsWeib'. Schutz explores the central tension between the positive connotation given to female sexuality in this essay and the social constraints depicted in the fiction,which curtail the possibili ties for celebrating that sexuality. 'Der Mensch alsWeib' is an intervention in turn-of-the-century debates about the essential nature of woman. It unproblematically locates this squarely within 902 Reviews biology but departs from contemporary male theorists in seeing woman as primary, rather than defined in relation toman. 'Das Weibliche', deriving as itdoes from the egg, may be less developed and differentiated than 'dasMannliche', but this is viewed as a positive; women should revel in their closeness to nature, their difference, their ability to enjoy life and think inways other than the logical. If men, like the sperm, have to strive, compete, and propel themselves, women are already fully legitimated. This biological thinking seems blithely unconcerned by the contemporary demands of the firstwomen's movement, a movement which Andreas-Salome was aware of but never joined. Rather, it shows her intellectual immersion?she was among thefirstwomen to study at university?in the (usually male, oftenmisogynist) literature and philosophy of the period, ofwhich Schiitz gives a useful overview, from Ibsen and Tolstoy toNietzsche, Mobius, and Wei ninger, the strongest influence on her own theory being Wilhelm Bolsche's Das Liebesleben inderNatur. Andreas-Salome's twenty-fiveNovellen and novels spring from her early career, roughly 1885 to 1903, preceding her friendship with Freud and her psychoana lyticalwork by some years. Schiitz provides a reading of each text, drawing out common themes such as the sexual submission of the woman, marriage as le galized prostitution, the family as a place of conflict, and incest. A final chapter draws up a typology...

Does past pain influence current pain: biological and psychosocial models of sex differences

The author considers what seem to be norms and values concerning session frequency and length of treatment in ‘traditional’ and current child and adolescent psychotherapy practice, and the impact of training expectations and models of training on identity and status as a child and adolescent psychotherapist. In the UK National Health Service, there is pressure to do more in less time: the norm is once‐weekly work. Such an expectation does not sit comfortably with psychoanalytic theory and training, which remains rooted in higher frequency, longer‐term cases. For trainees, this can lead to feelings of fraudulence and questioning whether less frequent therapies imply that the work is not psychoanalysis. The author explores, through a literature review, a case study and research material, how one might acknowledge the tension between these conflicting values about time; how psychoanalytic work in all its forms might be valued and be valuable for patients; and urges the need to feedback clinical experience into training structures and ongoing learning.

Multisensory spatial interactions: a window onto functional integration in the human brain

Three American neurologists (C. K. Mills, C. L. Dana, and M. A. Starr) explored the anatomical limits of the motor and tactile systems in the brain from 1884 to 1895. Their papers and critiques of one another show contemporary knowledge, limits of their thinking, and difficulties deciding between alternatives. The issue for them was whether there were separate sensory and motor regions or whether there was a combined sensory-motor region. They based their localization arguments on clinical and laboratory findings and on the conclusions of H. Munk and D. Ferrier. There is a discussion about why differences were unresolved.

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The article is dedicated to the issues of treatment of cerebral small vessel disease (CSVD), one of the most common pathological processes that is a leading cause of different types of cerebrovascular disorders and cognitive impairment. It also discusses the reasons for the development of small vessel pathology, which is usually referred to as the “chronic cerebral ischemia” in the Russian neurology. Emphasis is made on the etiopathogenetic factors affecting small calibre vessels, in which the metabolic-angiogenic mechanisms, in particular endothelial dysfunction and oxidative stress, are dominant.Difficulties in studying CSVD are explained by the disease course features and the insufficient introduction of unified approaches to the terminology and diagnosis. The article presents new data on the pathogenesis of small vessel disease based on the clinical and pathological findings and achievements of neuroimaging. A modern classification is provided, the clinical manifestations of vascular cognitive disorders associated with chronic cerebrovascular insufficiency are described in detail.The authors consider the issue of choosing and using drugs for the treatment of cerebrovascular diseases through the lens of understanding their own clinical experience and scientific research findings. They provide data of their own research on the antioxidant status and changes in the phospholipid composition of blood plasma in patients with chronic cerebral ischemia during separate and combined administration of 2-ethyl-6-methyl-3-hydroxypyridine-succinate (Neurox) and citicoline (Neupilept), which are natural metabolites and are involved in biochemical processes throughout the body. Based on the literature review and their own data, the authors conclude that complex pharmacological therapy can be effectively used in patients with CSVD, which is due to various points of “application” of pharmacological activity in the pathogenetic processes chain.

Patients with addictive disorders often report difficulty remembering trauma, although research shows traumatic experiences as being common antecedents of the onset of addictive illness. Based on clinical experience and review of the clinical and legal research literature, the author proposes that a cluster of six clinical findings is a potential indicator of internal corroboration that trauma occurred, especially child sexual abuse. These six clinical findings include: the presence of a high-risk disorder or illness; posttraumatic stress disorder; age regression, flashbacks, abreactions, or other re-experiencing of the trauma; repetitions, repetition compulsions, or reenactments; characteristics of the memories themselves; and other patterns, dynamics, and connections. This framework can serve as a useful and clinical paradigm for all illnesses, including the addictive disorders.

Necrotizing fasciitis is a rare, destructive soft tissue infection which starts on the skin and subcutaneous tissue, and spreads quickly towards the deeper tissues. Its etiology includes trauma, surgical intervention, perineal abscess, soft tissue infection, minor invasive procedures, abrasion, contusion, burn, laceration, bite, and penetrating injuries. The mortality of the disease can increase in the presence of predisposing factors such as diabetes, hypertension, immunodeficiency, self-care insufficiency, alcoholism, and advanced age. The clinical presentation of necrotizing fasciitis may vary. It is often observed in the abdominal region, the lower extremity, the perineal, perianal, scrotal and genital regions. Between December 2011 and September 2016, a retrospective study of all patients admitted due to necrotic wounds and/or tissue defects was undertaken. Their clinical records were reviewed with respect to age, sex, associated morbidities, defect localization, treatment, and outcomes. Thirteen cases were admitted to the emergency department. There were 10 female and 3 male patients. The defects were located in the gluteal (one), trochanteric (one), thoracic (two), upper extremity (three), lower extremity (two) and perineal region (four). Pressure sores, insect bites, trauma, diabetes mellitus and perineal infections were detected in the etiology of the cases. As observed in our study, NF can present with very different etiological, demographical and clinical findings. The cases presented some rarely observed characteristics in terms of age, sex, etiology, and infection localization. Therefore, it should be kept in mind that necrotizing fasciitis can exhibit extraordinary characteristics causing confusion with other soft tissue infections, and a detailed and meticulous evaluation must be performed for diagnosis. Level of Evidence: Level IV, therapeutic study.

Dental problems are rarely mentioned in the training of medical students or physicians in travel medicine, and there are little data on dental problems of travellers in the literature. We studied the epidemiology of dental problems amongst trekkers in Nepal to develop strategies for preventive care during/before travelling and propose a curriculum for dental First Aid training. We undertook a prospective, cross-sectional questionnaire and clinical dental survey of Trekkers at Manang (3550 m, Annapurna Circuit, Nepal). The questionnaire was developed based on published literature and clinical experience (exploring: availability of dental kits, dental history, current dental problems, and nutritional behavior). Dental examination included: dental status, papillary bleeding index (PBI), and plaque index (Quigley and Hein; QH). Questionnaire and clinical findings were compared to data of the Annapurna Conservancy Authority about the number of days of trekkers in the region to estimate the incidence of dental problems of trekkers. None of the 309 participants carried a dental first aid kit. Dental problems, potentially treatable with a dental first aid kit, were reported by 50/309 (16.5%). Oral hygiene en route was significantly worse than home hygiene practice; overall increased plaque indices were found (Median QH: 2.25 in women; 2.36 in men). Participants who visited a dentist ≤6 months before departure had significantly fewer problems, and had lower PBI [males 0.07 (IQR 0.0 to 0.29), females 0.0 (IQR 0.0 to 0.11)]. Combining our findings with data of the park authorities on person days in the region (2007), we found a risk of dental problems as follows: any dental problem 1:23.7 trekking days; gingival bleeding 1:37.7 trekking days; dental pain 1:145.2 trekking days; lost fillings 1:339 trekking days; fractured teeth 1:509 trekking days. Dental problems can pose significant discomfort for anybody travelling in regions with low/missing infrastructure. Improved awareness regarding dental first aid is essential and physicians counseling travellers in preventive strategies should advise a dental checkup pre-departure. Dental first aid and emergency treatment in the field should be included in the training curricula in travel medicine for both undergraduate and postgraduate students.

Traumatic posterior fossa epidural hematoma (PFEDH) is rare, but among children it may have a slightly higher incidence. With the widespread use of CT scanning, the diagnosis of PFEDH can be established more accurately, leading to an increased incidence of the lesion and possibly to a better patient prognosis. This study presents 40 pediatric cases with PFEDH. The authors assessed the type of trauma, clinical findings on admission, Glasgow Coma Scale scores, CT findings (thickness of the hematoma, bone fracture, compression of the fourth ventricle, and ventricle enlargement), type of treatment, clinical course, and prognosis. Early postoperative CT scans (within the first 6 hours) were obtained and reviewed in all surgical cases. Twenty-nine patients underwent surgery and 11 patients received conservative therapy and close follow-up. All patients fared well, and there was no surgical mortality or morbidity. Based on the data in this large series, the authors conclude that PFEDH in children can be treated in experienced centers with excellent outcome, and there is no need to avoid surgery when it is indicated.