Marketing: a tool that serves hospitals' survival instincts.
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The desire for knowledge, which was much discussed by Freud, Abraham and Melanie Klein, had for many years scarcely been mentioned in the analytical literature until it was taken up again by Bion, but from a different point of view. For Freud the desire for knowledge was related to the sexual instinct-it was even called an epistemological instinct although it was never considered to be an instinct in the narrow sense of the word. Abraham and Klein followed Freud, but in her later writings Klein understood the desire for knowledge as part of the defence against anxiety dur to fantasied damage done by the aggressive instincts. In this paper I discussed Bion's contribution to the psychoanalysis of knowledge in detail and illustrated it by clinical examples. Bion restricts the concept of knowledge to what is knowable and knowledge can only be an approximation to the truth. Interpretations make the truth knowable. The desire for knowledge of the truth is for Bion elementary and necessary for mental health. This view, although different from, is not dissimilar to, Freud's who described the compelling nature of the desire for knowledge as an epistemological instinct.
The author discusses Freudian dualistic conception of drives and contends that it can be reduced to a monistic one, on the basis of modern conceptions of Biology, and after scanning the original writings of Freud on the subject of drive and instinct. The word Trieb (drive) is used by Freud as compared with Instinkt (instinct); in 1915 the concept is defined through its attributes: thrust, source, objet and goal; being object and goal contingent for the drive and fixed for instincts. The first dualism is love vs. hunger; the drives are either sexual or autoconservative. But Biology demonstrates today that all life movements are autoconservative. The second dualism, love vs. hate, and the third one, Eros vs. Thantos, interpreted through Biology, show that there is always a prevailing therm, the first one. In this view, instinct should be but one successful drive, "frozen" through time because of its very success, and transmitted through philogenetic channels, in order to be enlivened in each ontogenetic process.
The objective of the present study was to evaluate the importance of genetic and environmental sources of variation for results of behaviour tests recorded at juvenile and breeding performance tests in the Hovawart dog. For these analyses behaviour test results of 1882 (juvenile evaluation), respectively 929 dogs (breeding performance test) born in 1995 to 2000 had been used. Variance component estimation was performed for the traits appearance, play instinct, hunting affinity, group of people, shoot, acoustical and optical influences and temperament using multivariate linear animal models and Residual Maximum Likelihood (REML). The models included test-year-season, sex, litter size, age and inbreeding coefficient of the animal as fixed effects. Additive genetic effects of the animal, permanent environmental effect of the litter and the effect of the kennel were considered as random factors. The sex of the dog was significant for appearance, play instinct, hunting affinity, acoustical and optical influences of juvenile evaluation and for the traits temperament, play instinct, hunting affinity, acoustical and one of the optical influences of breeding performance test. The age of the dog at test significantly influenced the traits play instinct, hunting affinity and acoustical influences of juvenile evaluation and optical influences and hunting affinity of breeding performance test. All traits with exception of hunting affinity and group of people were significantly affected by the test-year-season. The inbreeding coefficient was significant for appearance of juvenile evaluation and play affinity of breeding performance test. The effect litter size did not influence any of the traits significantly. The estimated heritabilities for the behaviour traits of juvenile and breeding performance test ranged from h2 = 0.01 to h2 = 0.13, respectively h2 = 0.01 to h2 = 0.14, with standard errors of up to 0.03. The additive genetic correlations between most of the traits were moderately to highly positive (r(g) = 0.20 to r(g) = 1.0, respectively r(g) = 0.29 to r(g) = 1.0). Negative additive genetic correlations were only found for a few traits of juvenile (r(g) = -0.02 to r(g) = -0.58) and breeding performance test (r(g) = -0.28 to r(g) = -0.83). Progress in breeding for the behaviour traits investigated here may only be meaningful when information from all relatives is used in an animal model instead of selection based on the phenotype of the single animal.
The author lists the different positions of Freud with respect ot the comprehension of the aggressive impulse on a metapsychological as well as on a clinical level, resulting in the concept of the death instinct in 1920. From the cruelty of the child over the instinct for mastery to the comprehension of the economy of instincts in 1915 in "Instincts and their Vicissitudes", Freud demonstrates his hesitations polarized by the conflict with Adler in regard to the aggressivity. The Post-Freudians and in particular Melanie Klein have retaken the texts of Freud in order to go beyond the compulsion of the almost fetishistic instinctual duality in the Kleinian group, more or less disputed by the structural analysts who speak about the neutralization of aggressive impulse.
The presumed opposition of nature and nurture has been a major concern of western civilization since its beginnings. Christian theologians interpreted Adam and Eve's eating of the forbidden fruit as the origin of an inherited 'original sin'. Saint Augustine explicitly applied the concept to human mental development, arguing that, because of original sin, children are inclined toward evil and education requires physical punishment. For centuries, it was considered parents' moral and religious obligation, not to nurture their children, in our current sense of that word, but to beat the willfulness out of them. 16thC humanists fought back, arguing that "schools have become torture chambers" while it is adults "who corrupt young minds with evil". Locke's (1690) statement that children are born as a 'white paper' was crucial in rejecting the dogma of an inborn (and sinful) nature. The original sin vs. white paper argument merged with another ancient dichotomy: inborn instinct (which controls animal behavior) vs. the reason and free will which humans have. Darwin made the concept of inherited instinct, common to both man and animals, one cornerstone of his theory of evolution. The 20(th)C saw scientists recast the debate as instinct vs. learning, bitterly argued between behaviorists and ethologists. Laboratory experimentation and field observation showed that behavior could develop without learning but also that conditioning paradigms could powerfully mold behavior. The progress of genetics and neurobiology has led to the modern synthesis that neural development, and hence behavior, results from the interdependent action of both heredity and environment.
A 16-year-old physically and mentally retarded male developed a complete Klüver-Bucy syndrome similar to that demonstrated in animal experiments and characterized by so-called psychic blindness, oral tendencies, hypermetamorphosis, emotional disturbance, and hypersexuality after severe brain trauma with loss of consciousness and a transitory hemiplegia. In addition, transitory oral and grasp reflexes were observed. Despite the severity of the clinical symptoms, the patient was able to realize and report on his subjective experience of the reflex and on the instinct-motivated behavior associated with the Klüver-Bucy syndrome. In the case described, two basic behavior patterns could be differentiated, each influencing drive and the abnormally increased sexuality. The first phase of the illness was dominated by relatively constant automatic reactions. These had the character of pre-determined instinctive behavior and were more or less emotionally neutral. In the second phase of the illness, the instinctive behavior became less evident and the patient was able to respond more normally to his sensory-motor impulses. Also, emotional experience such as frustration, pleasure, and displeasure regained their meaning for the patient.
We sought to distinguish between aggressivity and true violence. Violence is a vital force, a life instinct, or, more particularly, a survival instinct. Violence is neither good nor bad. Everything depends on the way in which this essential instinct is used in the succession of crises that mark the affective development of each and every one of us, and, in particular, during the crisis of adolescence. The measure of prevention could be based on the elements of pure violence and not on established aggressivity. The primary prevention of the deviations toward natural violence fits into the framework of the education for health. That is only possible if we today prepare future parents and educators of the children of tomorrow.