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Building a cathedral: neuroscience and the legacy of Leon Wolfe.

This article describes the scientific legacy of Dr. Leon Wolfe, with illustrations from his contributions to insect physiology, glycolipid, and eicosanoid biochemistry as well as to our understanding of neuronal ceroid lipofuscinoses and lysosomal storage diseases. In addition to the written record, Wolfe inspired all who knew him with his boundless imagination and enthusiasm for science and his ability to see the promise and potential of every experiment.

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The psychodynamic of panic attacks: a useful integration of psychoanalysis and neuroscience.

This article tries to explain, in the light of some neuroscientific and psychoanalytical considerations, the repetitive pattern of panic attacks. Freud considered the panic attack as an 'actual neurosis' not involving any conflictual process. Recent neuroscientific findings indicate that psychosomatic reactions, set off by a danger situation, depend on the primitive circuit of fear (including the amygdala) characterised by its speed, but lack accurate responses and may also be activated by harmless stimuli perceived erroneously as dangerous. The traumatic terror is stored in implicit memory and may be set off by a conditioned stimulus linked to a previous danger situation. In the panic attack, the traumatic event is created by the imagination and this construction (a micro-delusion), built in loneliness and anxiety, has the same power as the real trauma. A mutual psychosomatic short-circuit between body and psyche, in which terror reinforces the somatic reactions and the psychic construction, is established. Therefore, it is important to highlight these constructions in order to analyse and transform them. In the second part of the article the author reviews the main psychoanalytical theories about panic attacks, stressing how, in his opinion, panic attack is a consequence of the breakdown of the defence organisation at various levels and may appear during periods of life crisis. Two patients suffering from a deficit of personal identity are presented. The various organisations and the different levels (biological, neuroscientific, associative, traumatic) of the panic attack determine different kinds of therapeutic approaches (pharmacological, cognitive and psychoanalytical). While the psychopharmacological treatment is aimed at reducing the neurovegetative reaction and the cognitive method is attempting to correct the associative and perceptive processes of fear signals, psychoanalytical therapy represents both a specific means to free patients from panic attacks as well as an indispensable route for their emotional growth.

Adult↗

Projective identification and consciousness alteration: a bridge between psychoanalysis and neuroscience?

The authors claim that projective identification in the process of analysis should be considered in a circumscribed manner and seen as a very specific type of communication between the patient and the analyst, characterised through a modality that is simultaneously active, unconscious and discrete. In other words, the patient actively, though unconsciously and discretely--that is, in specific moments of the analysis--brings about particular changes in the analysts state. From the analyst's side, the effect of this type of communication is a sudden change in his general state--a sense of passivity and coercion and a change in the state of consciousness. This altered consciousness can range from an almost automatic repetition of a relational script to a moderate or serious contraction of the field of attention to full-fledged changes in the analyst's sense of self. The authors propose the theory that this type of communication is, in fact, the expression of traumatic contents of experiences emerging from the non-declarative memory. These contents belong to a pre-symbolic and pre-representative area of the mind. They are made of inert fragments of psychic material that are felt rather than thought, which can thus be viewed as a kind of writing to be completed. These pieces of psychic material are the expression of traumatic experiences that in turn exercise a traumatic effect on the analyst, inducing an altered state of consciousness in him as well. Such material should be understood as belonging to an unrepressed unconscious. Restitution of these fragments to the patient in representable forms must take place gradually and without trying to accelerate the timing, in order to avoid the possibility that the restitution itself constitute an acting on the part of the analyst, which would thus be a traumatic response to the traumatic action of the analytic material.

Consciousness↗

The human mind: building bridges between neuroscience and psychiatry.

This essay proposes the existence of four unique behavioral characteristics that distinguish Homo sapiens from its nearest evolutionary kin, the great apes. These are inventiveness, capacity for language, curiosity, and self-reflection or self-analysis. Some would counterargue that none of these features are "unique" to humans. Examples would be given of animal "intelligence" involving at times surprising problem-solving abilities. Even "conversations" between humans and parrots might be cited. However, this is to misunderstand what the focus is in the article. This is not a thesis on the continuity or discontinuities of evolution. Every well-trained biologist learns about evolution and understands that the most complex human traits have some hint of related traits in nearest relatives. Rather, the emphasis of this article has been to select and emphasize certain distinctive aspects of human behavior that are the most important features distinguishing human "uniqueness." Uniqueness may be quantified by the number and complexity of processes within the four attributes presented in this article. While this may be an interesting mathematical exercise, the author would rather take it for granted that the outcome would be that humans are significantly more complex in each of the four features referred to than the great apes. For those in the mental health field, one would hope that this overview of the most highly evolved systems in human brain may provide a useful framework where creative therapeutic processes can be applied to the ultimate beneficiary, the client or patient. This article proposes that psychosis can be considered the impossibility of conflict resolution among the special neuronal assemblies that separately mediate feelings of attachment versus abandonment, security versus anxiety, calmness versus anger, fulfillment versus helplessness, and satisfaction of sexual needs. Given this model, the role of the therapist is to consider whether the client is in touch with the various equilibrium points in their current life situation or crisis. A questionnaire designed to help access information on these internal states may work better than an oral interview because it forces the client to reflect. How much conflict does the client feel in sorting out personal priorities? Does the client have any practice at resolving internal conflicts? If unpracticed, is the client likely to act out in destructive ways to self or others to resolve the pressure of internal conflicts? I am sure that we can all think of current well-publicized destructive acts in which one has to wonder precisely what model of mind the psychotherapists were using to assist the client. At a higher level, each human has the potential to be creative. Whether expressed as curiosity about the universe and nature or inventiveness, as in improving the quality of one's life or by the use of gifted language as in art and music, the therapist needs to determine how to assist the client into these kinds of self-defined fulfillments, which one hopes will reduce the other tensions of conflict resolution. There is no doubt that the journey for both the client and therapist will be challenging. Ultimately, the journey is the reward for both the client and therapist. In closing, the following quotation seems appropriate. Sydney Brenner (2002), a pioneer in molecular biology, reviewed a current book on the Science, Politics, and Ethics of the Human Genome Project (Sulston and Ferry 2002). He states, "What I found interesting in the account is that Sulston doesn't tell us anything about the genomes he has sequenced. What did he find there that excited him? What did he learn about genes, about life, about evolution, about worlds to come? It is the play of Hamlet without Hamlet" (p. 794).

Animals↗