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Results for “Reality Testing”

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PubMed1995

Delusions in the transference. Psychotherapy with the paranoid patient.

This article has attempted to combine a theoretical and practical approach to the challenge presented in psychotherapy of paranoid and delusional patients. The essential ingredients of psychotherapy of non-psychotic patients--such as the frame, the therapeutic alliance, transference, countertransference, and interpretation--all play roles in the psychotherapy of paranoid, psychotic, delusional patients as well. Differences in defense mechanisms and dynamics and their working through, however, can make unfamiliar the factors that are basic to any psychotherapy. A familiarity with the unique problems of psychotic individuals in psychotherapy may help to make the work less bewildering and frightening, although no less challenging.

Adult↗
PubMed1995

[Chrome sirens, herostratic machines. "Desiderata: psychology of things" (G. Anders): for reorientation of psychology].

Taking up Günther Anders' hypothesis of the "antiquated nature of the human", Lütkehaus expounds a "psychology of things" suitable as a replacement for all form of human psychology, including psychoanalysis. The basic assumption of the psychology of things is that as the human individual as a subject is totally ruled by technologies and machines-cars, computers, the media etc. -all talk of the subject and subjectivity has become completely obsolescent. In the psychology of things psychic productions are seen as frozen masks of the spiritual in which the human individual cultivates and indulges the illusion of a non-existent subjectivity. With references to the dropping of the atom bomb on Nagasaki and the annihalation machinery of the Nazis the author attempts to concretize this new paradigm.

Humans↗
PubMed1995

[Psychoanalytic aspects of crisis and crisis intervention].

"Crisis" is defined as the lack of the development of defense- and/or coping-mechanisms in the conflict between drive-claims or narcissistic needs versus the influences of the super-ego and/or conditions of outside reality. The term crisis, introduced by Erich Lindemann (1944), characterizes a state which was already known to Sigmund Freud. Central to his thought was an antagonism between the pleasure principle dominating the unconscious and the reality principle being directed toward the outside world. Different possible causes of crises are for example sudden and unexpected intrusions in a life situation which was previously experienced as stable, or a narcissistic trauma and loss that could not be worked through as grief and that lead to a reactive-depressive state, or a shock resulting from demands of the super-ego during inner or outer experiences. Principles of a psychoanalytically oriented therapy are discussed, the outcome of which is the better, the more there is a good working alliance and good development of insight.

Adaptation, Psychological↗
PubMed1995

[Objectivity and subjectivity of knowledge in nomological social sciences].

In this article the question is discussed in how far the processes of understanding in the nomological social sciences an "objectivication", which is demanded of psychoanalysts, can be used for psychoanalytically gained insights to human behavior. For one it is shown that it is impossible in principle to verify or falsify hypotheses within the nomologically oriented methodological self understanding. Furthermore the logical, empirical scientific process obligated to proving hypotheses is pursued in the perspective of a psychoanalytic social psychology and the thesis is developed that these insights, which are gained in nomological research projects are also always products of neurotic-blind interaction, so that nothing can be said of the value of knowledge gained in these research findings as long as the scientists do not clarify their research practice psychoanalytically.

Aggression↗
PubMed1994

Formulation of interpretation. From truth to experience.

The task of formulating an interpretation is discussed in terms of seeing it as the analyst's search to make the interpretation relevant to that specific point in the analytic process, in order to make it into something that can be felt by the patient as true and meaningful. Illustrations from the literature from Freud onwards are used to show how this search has been part of the history of psychoanalytic technique, which is still ongoing in order to make our newer understandings into something meaningful and therapeutic for the patient. One area that is particularly emphasised in this paper is the need to include consideration of the patient's relationship with his body as part of the analytic understanding in order for the patient to be able to experience an interpretation as having affective meaning and to create a link to external reality.

Adult↗
PubMed1994

What is a clinical fact?

As a preliminary to the question, 'What is a clinical fact?', the author asks the wider question, 'What is a fact?', answering that facts are double in aspect: they both say how the world is, and they also depend on our species, our language, theory, etc. A claim of fact in any empirical discipline--in the natural sciences or in human studies with their different methods--is a truth claim which is not infallible or unique to the fact, and also a claim that must offer itself for verification. Using the clinical record of three sessions, she then tries to answer the question, 'What is a clinical fact?', offering the starting formulation that clinical facts, under the unusual conditions of an analytic hour which give an analyst access to a patient's inner world, manifests themselves in the form of immediate psychological realities between patient and analyst. On the way, the author discusses the analyst's anxieties about making a claim of clinical fact; further striking features emerge about clinical facts in the three sessions, and some unsolved problems, i.e. the variety of analytic theories, subjectivity and objectivity, are noted. Even while they bear the perplexities of their problems, clinical facts are of great significance to the study of the mind. They extend the domain of psychology to the area of the mind's interiority, with its human experiences of subjective meaning, conscious, and especially unconscious.

Adolescent↗
PubMed1994

Principles and clinical applications of periodontal controlled drug delivery with tetracycline fibers.

Controlled drug delivery of antibiotics in the periodontal pocket is a scientifically tested clinical reality. Application of pharmacokinetic principles allows effective suppression of the pathogenic microflora, which, in turn, results in resolution of inflammatory signs. In the cases presented, tetracycline fibers were employed as a supplement to mechanical therapy and oral hygiene in a variety of clinical situations. Outcomes included depression of periodontal pathogens, reduction of bleeding on probing, decrease in probing pocket depths, and increase in probing attachment levels. A novel therapeutic approach based on root planing for debridement, local drug delivery for control of the pathogens, and oral hygiene for preventing recolonization is discussed.

Adult↗
PubMed1994

[Fictional film and the audience. A metapsychological study].

Comparing and contrasting dreams and films we find a complex behind of affinities and distinctions between the dream state and the film state. The author classifies the totality of these partial distinctions and similarities in terms of three factors deriving from the discrepancy between sleep and the waking state: first, the inconsistent knowledge of the subject with regard to what he is doing; second, the presence or absence of real perceptual material; and third, the qualitative difference between dream text and film text. Metz shows that, unlike dreams, which obey primary events, films have much greater affinities with secondary events and the pre-conscious figments of daydreaming. Dreams, the author contends, belong to childhood and night, while films and daydreams are more adult and belong to the day and the evening.

Adult↗
PubMed1994

[The dis-positive: metapsychological observations of the reality impression].

In the author's view, Plato's myth of the cave is an exact description of the movie theatre. In both there is a constraint to immobility, repetition and a return to a former state--a primary-process throwback to the immobility of the newborn infant and the sleeper. The captive in the cave, the cinema-goer and the sleeper are all-albeit in different ways--victims of an illusion of reality, an impression that deviates from reality, and are hence subjects of the unconscious. It is this more-than-the-real, this desire for desire, that in Baudry's view informs the history of cinema.

Adult↗
PubMed1994

[Human behavior between instinct, feelings and responsibility].

The paper deals with the fundamental problem: How does the brain (in the way it is and the way it functions) influence human experience, behaviour and social interaction? Deriving from this question, there's the matter of how all this influences people as road users. After some epistemological considerations the following subjects are dealt with the article: the human perception and human "reality", the limits of human imagination, the basis of human learning, the complexity of processes within the brain, the reaction to changes and the ability to concentrate as well as McLean's theory of the triune brain. The subjects are complemented by aspects of biological and socio-cultural evolution of man, starting from evolutionary ethics going right up to the problem of responsibility.

Alcoholic Intoxication↗
PubMed1994

[Do infants have fantasies?].

The author develops a three-stage theory of mental processes. In his view the first psychic imprints take the form of sensory-motor schemata (Piaget), perception-affect-action patterns (Lichtenberg) and generalized representations of interaction (Stern). At the age of one-and-a-half, mental activity begins to exist in the form of the ability to freely evoke images. In this way the child is able to transcend reality and to think in terms of things which are absent or have never really existed. At this stage active imagination sets in, combining the real and the possible. The closing stage of this development is the linguistic encoding of the mental. The author suggests reserving the term "fantasy" for the second and third stages and discusses the implications of this proposal for the concept of unconscious fantasy.

Fantasy↗
PubMed1995

[Fragmented psychotherapy of a boy returned from Bergen-Belsen].

Like an artist giving expression to his vision of reality, the psychoanalyst is also guided by a certain vision of psychic reality. With reference to the case of an orphan boy who survived Bergen-Belsen, the author traces the difficult process of attaining empathy with a vision of reality marked by the years spent in a concentration camp and the world of unimaginable horrors experienced there. After a long period of silence in which a relationship of trust was gradually built up, the young man found it possible to find expression for his un-utterable experiences, his unrest in the unconscious. The word Bergen-Belsen had become utterable.

Child↗
PubMed1994

[Truth and reality].

Communication presumes the truth of statements. According to H. Weyl, the direct occurrence is subjective and absolute, the objective world relative, represented by figures and symbols, after induction of a co-ordinate system into the world. Sentences shall express relations between persons, things and properties. The message of a sentence is true, if the facts of a case prove right in reality. Thomas von Aquin: "Veritas est adaequatio rei et intellectus." To recognize a fact the reception of both "objective" signs and "subjective" forming of models are necessary. The objective and the subjective are linked strongly in the cognition. A true sentence develops if the meaning of the signs, which derive from the facts are in harmony with those, which come from the sentence by itself. Signs have to be decoded (subjectively). The attempt of making accessible the "objective" world is done with a system of rules and methods, which is without contradiction and clear in itself. Reality can be recognized only in that manner in which language can present it. "A sentence is true, if the facts of the case, which is referred by the sentence, are true." The problem, the reference of this message by itself, was solved by Tarski, inducing the term "object language" and declaring the sentences as objects of the natural (meta-)language. There are no terms as "true" or "wrong" in the object language. K. R. Popper differentiates 3 worlds: world of reality, of subjectivity, and of objectivity. Communication results from the subjective world, she rouses up emotions and reflexes. Nevertheless objectivity remains the controlling instance for messages and imaginations of the subjective ideas. The objective ideas differ from subject ones because of the possibility of associating ideas of a certain class of constellation of signals to the reality (concrete ideas), or because they can be found in a system of rules, which enables one to associate to a constellation of signals and to control this association (abstract ideas). These ideas of the "3rd world" may be regarded as supervising instances for intersubjective communication.

Communication↗
PubMed1994

Mental health work with Gulf War evacuees: the use of a transitional therapeutic space.

This paper describes the intervention of a mental health team formed during the Persian Gulf War to provide assistance to people evacuated from their homes after they were seriously damaged or destroyed by Iraqi Scud missiles. The intervention was based on the view that a crisis upsets the person's emotional equilibrium, resulting in a new and alien emotional state, which is frightening to the person involved by virtue of its strangeness. The disturbance may result in the development of a frozen, rigid unadaptive internal state, i.e. trauma. The mental health team used the interaction between external and internal realities, within a transitional space which enabled the development of a potential space.

Adaptation, Psychological↗
PubMed1994

[The structure and psychodynamics of delusion].

Discussing classical psycho-analytic interpretations of delusion the authors show that neither the notion of "projection" nor the theory of regression to very early stages of ego-formation provide a satisfying explanation for the difficulty of those patients to discern inner world from external reality. An approach to this crucial question rather has to consider the underlying structural differences in order to differentiate between neurotic and psychotic symptom formation. The basis for psychotic symptoms is identified in a deficient mode of symbol-formation impeding certain structural patterns or spheres of conflict from being integrated into the whole of the subject's existence. If required under certain circumstances those "excluded" parts of the personality overwhelm the subjective experience arising as something radically strange and uncanny. A psychotic phenomenon like delusion bears witness of this break down, but at the same time is an attempt to cope with this threatening experience.

Adult↗
PubMed1994

Interpretation and creationism.

This paper is an attempt to raise questions about certain underlying and implicit assumptions in some hermeneutic and narrative approaches to psychoanalysis. Starting from the view that Freud saw interpretation in the clinical setting as an attempt to unveil the analysand's psychic reality, it is argued that he envisaged that psychoanalysis aims to interpret what is real in the analysand's inner world--an empirical line of thought underpinned by the idea of analytic neutrality and an emphasis on the analysand's capacity to judge reality. By contrast, the tendency within the hermeneutic-narrative tradition is to demote psychic reality in favour of an emphasis on the analyst's capacity to interpret in order to help his analysand construct meaning. This approach may be said to put the analyst's words in the place of those of the Creator; in other words, it amounts to a 'verbal creationism', which the author argues is rooted in the idealistic philosophy of Hegel, Vico and Descartes and, further back, can be traced to the Book of Genesis--a conclusion causing the author to express some reservations.

Creativity↗