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At least 1,153 records · Page 64Linked to original sources
PubMed1996

The concept of psychic reality--how useful?

The author argues that Freud coined the phrase 'psychic reality' to indicate how neurotic patients and others treat unconscious psychic concepts and fears as if they were real. They respond to the challenges of everyday life not in terms of objective reality, but rather in keeping with their inner 'psychic' reality. With the development of different schools of thought in psychoanalysis, opinions as to precisely what constitutes the contents and character of unconscious mental functioning differ enormously, to the extent that there is no general agreement as to the nature and quality of unconscious mental elements. Psychoanalysts do not have a shared view of what constitutes psychic reality, with the result that genuine scientific interchange has become increasingly difficult and attenuated. The author considers that what is required is the exploration and enunciation of an agreed upon methodological approach to the interpretation of clinical data and thence to the formulation of mutually acceptable psychoanalytic concepts.

Communication Barriers↗
PubMed1995

Psychological vicissitudes of theory in clinical work.

The author discusses the ways in which psychoanalytic theories, like other theories, attempt to systematise the understanding of observations. Freud remarked that systems also have unconscious meanings. The author discusses these unconscious vicissitudes of psychoanalytic theories of both clinical and more abstract kinds, at various levels of psychological function. Learning psychoanalysis repeats in some respects the developmental processes of learning about 'reality'. The role of authority and superego function in learning and utilising theories is emphasised. The enduring unconscious relationship of theory to authority contributes to adherence to, misapplications of, and rejection of theories, as well as to anti-theoretical attitudes. The concept of an 'analysing instrument' illustrates the way in which a useful exploratory idea may acquire prescriptive and constrictive implications. Analysis of the analyst's attitudes towards theory and its applications is an aspect of countertransference analysis.

Authoritarianism↗
PubMed1996

[Body image of patients with acute paranoid schizophrenia. A follow-up study].

In the light of the heterogeneous literature on disturbances of body image in schizophrenic patients, we examined body schema, body concept and body cathexis, their changes during hospital treatment and their correlations with psychopathology in 38 patients with acute paranoid schizophrenia. The image-marking method according to Askevold, the Body Distortion Questionnaire, a visual-analogue scale on body cathexis and psychopathometric scales were applied. Body schema was also investigated in 27 healthy controls. On average, patients underestimated the size of their lower extremities, indicating a centralized body schema. They accurately assessed proximal fixed points. Underestimation was significantly correlated with anxiety, overestimation with grandiosity. Body schema and body concept were relatively independent from each other and from body hallucinations. Disturbances of body perception were reduced significantly, but not completely, during the time from admission to discharge. The results confirm and clarify some findings in the literature on a distorted perception of body size and support theories on body perception in schizophrenia.

Acute Disease↗
PubMed1997

Psychic reality and the interpretation of transference.

Beginning with Freud's concept of psychic reality as the product of external events and the patient's unconscious fantasies, the author suggests that projective identification, as described by Klein, gives an account of how these two elements combine to produce one's psychic reality. The transference is an aspect of psychic reality that represents a confusion between the patient and one of his or her objects--the analyst--brought about by projective identification. A clinical example illustrates how the patient's transformation of the analyst's interpretations through projective identification contributes to the transference. Analysis of the transference in the analytic relationship allows patients to experience their role in the formation of their experience of the world, "live" and as it happens. This promotes the integration of the patient's personality. The author compares this approach with other approaches to the transference.

Adult↗
PubMed1996

The status of psychic reality in adolescence. An adult female patient's quasi-adolescent material and the analyst's counter transference response.

The author holds that the crisis of adolescence is in fact one of psychic reality, its elements being loss of boundaries, externalisation and the involvement of a third party. In this view, it is essential to conceive of adolescence differently from adulthood, in that, for example, an adolescent's acting out may not be solely a matter of regression but to a considerable extent a consequence of his or her physical development. It is noted that the boundaries between psychic and material reality are fluid throughout life and that adolescents crave identificatory models. The author stresses the importance of the psychic reality of the other in the adolescent's crisis. After considering various views, including those of Freud, on psychic reality and the crises of adolescence, he illustrates his thesis by the clinical example of two adolescent episodes of perversion forming part of an adult female patient's material. In the author's view, these instances of acting out had helped the patient to regain her auto-erotic capacity in the pleasure of fantasy life. He considers that a mutative interpretation must touch upon the primal fantasy and therefore involve the entire person of the analyst in the transference.

Acting Out↗
PubMed1996

Non-random associations between fears, beliefs and behaviors among panic patients.

Self-report questionnaires have been used to compare panic patients' fears, anxious thoughts and behaviors with those of a group of controls. Individual items revealed significant differences between groups in all three areas: factor analysis revealed group differences in the pattern of intraquestionnaire associations between items. Correlational analysis of factor scores revealed significant group differences in the pattern of interquestionnaire associations. These findings only partly support a formulation of panic based upon "catastrophic interpretations." On the other hand, they do provide evidence of cognitive rigidity among panic patients which can be interpreted as evidence of impaired effortful processing when anxious.

Adult↗
PubMed1997

Misunderstanding and psychic truths.

The author begins by pointing out that the psychoanalytical method and the concept of the unconscious are necessary conditions if the concept of psychic reality is to maintain its psychoanalytical relevance. She emphasises the importance of the concept of Nachträglichkeit, or retroactive assignment of new meaning, as a link between the concepts of psychic reality and historical truths on the one hand and decentred listening and misunderstanding on the other. Recalling the Freudian development of the concept of psychic reality, she stresses that 'the other' is present from the outset in the constitution of the psyche; she discusses the relations between intrasubjectivity and intersubjectivity in the transference and concludes that, through the function of 'listening to listening', misunderstanding becomes the royal path to the discovery of the patient's psychic reality. Some clinical examples are discussed in detail to illustrate the function of decentred listening. The author's viewpoint is not based on criteria concerning a correspondence, or lack of correspondence, between psychic reality and material reality. Her aim is to link psychic reality and historical truths as a way of overcoming solipsism.

Animals↗
PubMed1997

Distortions of time in the transference: some clinical and theoretical implications.

The author considers that patients' distortions of time can frequently and readily be observed in clinical psychoanalysis, reflecting both their psychopathology and their reactions to the temporal aspects of the psychoanalytic setting. These phenomena are considered in order to examine the assumptions that can implicitly be made about the nature of space and time in object-relations theory. Two case histories are given to exemplify these clinical phenomena-the first being an example of a fixation and the second one of a psychic retreat. These cases are compared to demonstrate the unconscious processes underlying the particular time distortions being considered, their impact on the patient's lives and their manifestation in the clinical setting. On the basis of these studies, it is suggested that the asymmetry of the 'arrow of time' cannot be assumed in the structure of psychic reality. The clinical evidence suggests that psychic reality has to be seen as discontinuous and that the structure of the discontinuities is revealed by the impact that the temporal aspects of the psychoanalytic setting have on the patient.

Humans↗