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Some observations on reality testing as a clinical concept.

This paper asserts that reality testing is a complex ego activity which cannot be characterized globally as either intact or defective. In normals, neurotics, and "borderlines" it is actually a highly variable function. Some problems of nomenclature are addressed. Among many analysts there is an implicit tendency to concretize the means by which reality testing is performed. This may lead to certain conceptual problems and clinical inaccuracies. The relationship of reality testing to unconscious conflicts from all phases of development is emphasized and illustrated. Issues in the technical handling in analysis of manifestations of disturbed reality testing are discussed.

Borderline Personality Disorder↗

A one year follow-up of the multimodal treatment for chronic pain.

Twenty-three outpatients with chronic pain began a 3-part treatment package designed to provide symptom control, stimulus control and social system modification. Fourteen patients completed the full course of therapy. The remaining 9 patients were designated as partial completers. A mean of 22.9 weekly hour long therapy sessions resulted in statistically significant decreases in pain, depression, anxiety and medication intake. These improvements were maintained at 1 year follow-up. This study is consistent with the notion that chronic pain is maintained by a combination of inter- and intrapersonal factors. A controlled comparison of this treatment program with other treatments for chronic pain is indicated.

Adult↗

[Reality orientation training: a method of group therapy of patients with dementia. Problems and possibilities of evaluating the effect of treatment of patients with various forms of dementia].

Authors describe a method called reality orientation training, a possibility of group treatment for patients suffering from dementia. They summarize the main statements of the literature and give account of their own battery for diagnostic classification and treatment. They outline the practical difficulties in the measurement of the effectivity of the treatment employed in demented patients.

Dementia↗

[Asymmetry and mutuality in the analytic relationship: lessons for today from the relationship between Freud and Ferenczi].

Against the background of the controversy between Freud and Ferenczi on the nature of the psychoanalytic relationship, Hoffer examines the perennial issue of the way in which analysts come to terms with the warring claims of asymmetry (Freud) and mutuality (Ferenczi) in analysis. While discerning an inherent tendency towards mutuality in the psychoanalytic constellation, the author nevertheless calls for the upholding of asymmetry because the psychoanalytic relationship is not a relationship "of the usual kind". The analyst, he contends, must sustain the tension between mutuality and asymmetry and use this reflected tension as a therapeutic instrument for fathoming the patient's psychic reality.

Adult↗

Some views of psychic reality.

This paper is based on the Presidential Address given at the end of the San Francisco Congress in August 1995. The author concentrates on discussing the three main Panel presentations on psychic reality from the technical, clinical and theoretical perspectives and in the context of the life cycle. Referring to Grinberg's introduction to the Congress, he reiterates that psychic reality forms the central point from which psychoanalysis can be contemplated. A special mention is given to the Panel on multidisciplinary perspectives of psychic reality, which includes contributions from two well-known philosophers, in connection with the current epistemological status of psychoanalysis in the context of the Congress's main theme. The author concludes by quoting a sonnet, which he feels illustrates the complex dialectic between reality and fantasy, between truth and lies.

Deception↗