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At least 145 records · Page 8Linked to original sources
PubMed1987

Falling off the couch.

The patient's therapeutic regression intensifies certain unconscious meanings of the analytic couch. In addition to representing the analysis or the analyst in general, the couch can represent the unconscious, or it may take on the symbolic significance of the analyst's or mother's arms, lap, breasts, or womb. When the genetic roots of the patient's transference include substantial experiences of disappointment, narcissistic injury, and mistrust, the theme of falling from the couch may emerge as a dream, an association, or even an enactment. This theme usually implies the presence of a deepening but mistrustful transference, based on earlier disappointments by the patient's primary objects. Falling off the couch may be associated with being dropped as an infant, rolling out of bed as a child, birth, miscarriage, castration, death, termination, defending against passive wishes, punishment for sexual or aggressive transgressions, escaping an attack, descending into the unconscious, or wanting to be picked up and comforted.

Accidental Falls↗
PubMed1980

Enuresis: a functional equivalent of a fetish.

The split in the ego between consciousness and unconsciousness which sometimes eventuates in fetishism can also be clinically manifested in sleep disturbances, depersonalization, dejà vu and a variety of alterations in the sense of reality. It is suggested that this same split comprises the central dynamic mechanism in enuresis. The sleep disturbance which accompanies enuresis involves a confusion between waking and sleeping, sometimes taking the form of a dream that one is awake. Three patients(adult males) revealed in the course of their analyses that they suffered from childhood enuresis accompanied by a sleep disturbance. Milder forms of sleep disturbances persisted into adult life. In these analyses, certain perceptual distortions, difficulties in the sense of reality, and between fantasy and reality, confusions between waking and sleeping, could all be linked to the functional split between consciousness and unconsciousness and eventually to disavowal of the female genitals. The enuresis represented a functional equivalent of the fetish (and it may be that the urinary stream itself actually served as a fetish). Psychological test data from nine enuretic boys were examined as well. This material clearly demonstrated that these boys wished to deny the differences between males and females, that they suffered from sleep disturbances and that they confused reality and fantasy, sleeping and waking. The combined data suggest the existence of a functional split in the ego used in the service of defence, the product of a regressive fixation and a reinstatement of an archaic mode of thought.

Adolescent↗
PubMed1987

Effects of oedipal triumph caused by collapse or death of the rival parent.

It is suggested that the threat of castration at the phallic-oedipal phase results in repression, effecting no change in the unconscious fantasy, that the resolution of the Oedipus complex depends on developments during latency and adolescence, and that during this period one of the determinants impeding the resolution may be the collapse or death of the rival parent. Death of the oedipal rival results in a confusion of the unconscious wish with an external happening. The child, unable to cope with the consequent guilt, resorts to repression. Thus, the critical aspects of the oedipal triumph remain potentially operative in the unconscious, hindering the patient's functioning in all closely associated areas. Three clinical illustrations of oedipal triumph are described to indicate some of the psychodynamic issues that arise in the analysis of such patients. Of particular importance are: the concept of reality testing; differential adaptation to the unconscious sense of guilt; the varying degrees of resistance evidenced in the analysis of such patients; and the impact of oedipal determinants in differential outcome of bereavement.

Adult↗
PubMed1997

Termination as a psychoanalytic event.

After noting that the debate on termination encompasses both the singularity of clinical practice and the generality of theory, the authors propose an approach that focuses on the actual event of termination, for which the termination process is seen as a preparation. They show that termination as a process has featured in psychoanalytic theory for many years and give examples of different conceptions of it from the literature of the last seventy years. However, in their view the event of termination, as an act of passage and an entity that can be consigned to memory, is of particular importance and comprises a complex configuration that has the three coordinates of direction, communication and temporality, which are discussed in turn. Dreams, parapraxes and acting out, as well as parting gifts from the analysand to the analyst, assume particular significance in the context of termination, which sometimes emerges only after the analysis has ended. The concept of termination as event, in the authors' view, offers a typological framework that accounts for the differences between successfully terminated analyses, analyses that are broken off unilaterally by the patient or the analyst, impasse situations and interminable analyses. The points raised are illustrated by clinical vignettes.

Humans↗
PubMed1982

The psychopathology of hallucinations--a methodological analysis.

A psychiatry based on operational and dynamic principles requires a new definition of hallucinations which is both heuristically useful and helpful for the understanding of the phenomenon of hallucinations. The time-hallowed definition of hallucinations as 'perceptions without stimulation of the sense organs' is both incorrect and a relic of late 19th century para-physiological thinking. Heuristically it leads into a blind alley. Central to the redefinition of hallucinations is the conception of the hallucinator, the author of his hallucinations, homologous to the dreamer, the author of his dreams. This idea was held firmly by early French 19th century clinicians, who were inspired by a holistic and operational conception in philosophy. Hallucinations are a multifaceted complex human mental activity and defined by means of a number of parameters held together as an indivisible whole. Hallucinations are described phenomenologically, psychologically, dynamically, psychodynamically, emotionally, logically, nosologically, and interpersonally.

Dreams↗
PubMed1997

The clinical workstation.

We have spent many years hearing about the benefits that we are about to reap from computers, but often seem to find that workloads are increased rather than decreased by the demands for ever more complex data. I certainly hope that the possibilities being offered up in this review represent more than idle dreams, and may be the first signs of computer systems that genuinely help to reduce our workload.

Computer Communication Networks↗
PubMed1995

The concept of psychic homosexuality.

The author examines the concept of psychic homosexuality, as it is used by French authors, based on Freud's ideas in The Ego and the Id (1923). Being intimately bound up with the organisation and development of psychic bisexuality in both sexes, psychic homosexuality is a concept that proves to have many meanings conceptually and in clinical use. In particular there is the question as to whether it is of the same kind and performs the same function in men as in women. Arguing that the primary relationship with the mother is crucial to the psychic organisation of the feminine and the masculine and that their fate is different in the development of the girl and the boy through to the structured identifications that result from the Oedipus complex, the author describes the case histories of a man and a woman. He concludes that psychic homosexuality might most usefully be considered not as a singular entity but as a set of plural entities. The advantage of this way of conceptualising things is illustrated in the way certain fantasy configurations connected with infantile sexual theories were able to be more richly understood. The author ends by drawing out some implications of these distinctions for technique.

Adult↗
PubMed1983

A study on feminine sexuality.

This article tends to demonstrate the existence of an early feminine identification in the girl. For this purpose it presents some clinical material pertaining to a woman with clear evidence of an early Oedipus complex, involving a precocious link with the penis and the father. We found that the difficulties revealed by the patient with respect to her feminine identifications and her sexuality, are due to deficiencies in relation to the primary object, that were shifted to a difficult link with the penis. The material also shows that some positive elements in the tie of this particular patient with the father, were subsequently important in the acquisition of feminine aspects.

Adult↗
PubMed1996

Functional neuroanatomy of human rapid-eye-movement sleep and dreaming.

Rapid-eye-movement (REM) sleep is associated with intense neuronal activity, ocular saccades, muscular atonia and dreaming. The function of REM sleep remains elusive and its neural correlates have not been characterized precisely in man. Here we use positron emission tomography and statistical parametric mapping to study the brain state associated with REM sleep in humans. We report a group study of seven subjects who maintained steady REM sleep during brain scanning and recalled dreams upon awakening. The results show that regional cerebral blood flow is positively correlated with REM sleep in pontine tegmentum, left thalamus, both amygdaloid complexes, anterior cingulate cortex and right parietal operculum. Negative correlations between regional cerebral blood flow and REM sleep are observed bilaterally, in a vast area of dorsolateral prefrontal cortex, in parietal cortex (supramarginal gyrus) as well as in posterior cingulate cortex and precuneus. Given the role of the amygdaloid complexes in the acquisition of emotionally influenced memories, the pattern of activation in the amygdala and the cortical areas provides a biological basis for the processing of some types of memory during REM sleep.

Adult↗
PubMed1996

Possible involvement of an endogenous benzodiazepine receptor ligand of the inverse agonist type in the regulation of rapid-eye movement (REM) sleep: an hypothesis.

1. Rapid-eye movement (REM) sleep is a complex behavioral state characterized by desynchronized electroencephalographic (EEG) activity, postural atonia, rapid, saccadic movements of the eyes, and vivid dreaming. 2. A recently developed class of drugs, the inverse agonist beta-carboline-3-carboxylates, elicits a number of effects similar to the properties of REM sleep, such as desynchronized cortical EEG and penile erections. 3. The hypothesis is put forth that an endogenous beta-carboline-3-carboxylate exists which may initiate many aspects of REM sleep. 4. Clinical relevance of this hypothesis is discussed with regard to REM anxiety dreams, night terrors, narcolepsy, and depression.

Animals↗
PubMed2006

Sleep disturbances in the aftermath of trauma and posttraumatic stress disorder.

Sleep disturbances, including nightmares and insomnia, are prominent following trauma and with posttraumatic stress disorder (PTSD) and likely contribute to the pathogenesis of the disorder. Findings from laboratory studies of PTSD have been inconsistent in terms of documenting objective impaired sleep maintenance but have been somewhat more consistent in indicating alterations of rapid eye movement (REM) sleep. Studies of the early aftermath of trauma can reduce the complexity associated with chronicity and comorbidity, and may have implications for early diagnosis and prevention. Multiple studies indicate that dream content is affected by recent threatening experiences. The development of PTSD is associated with a more replicative type of nightmare content. Sleep is reported to be generally disrupted following trauma especially among those developing PTSD. The limited number of studies that provide objective recorded indices during the early aftermath of trauma also provide a mixed picture regarding overall sleep maintenance. Recent data suggest that a more specific disruption of REM sleep may be associated with the development of PTSD and that this disruption is associated with an increased signal of sympathetic nervous system activation during REM sleep. Disrupted REM sleep and increased sympathetic/noradrenergic activity may have implications for understanding recent promising interventions for PTSD sleep disturbance that can be applied to early intervention.

Humans↗
PubMed1988

From the archaic matrix of the oedipus complex to the fully developed oedipus complex. Theoretical perspective in relation to clinical experience and technique.

The opposition between the "archaic matrix of the oedipus complex" and the fully developed oedipus complex leads the author to compare two distinct types of patients: those who do not conform to the neurotic model (patients who probably witnessed and were the victims of disintegration of the family and the effacement of the father's image) and the neurotic patient for whom Freud's discovery was intended. The consequences of differences of organization specific to each type of patient are numerous. This study restricts itself to examining the different mode of interpretation in each case, although the choice of this does not depend solely upon the analyst, since interpretation is the product of the encounter between patient and analyst.

Adult↗
PubMed1982

The choice of a name: "Dora" and Freud's relationship with Breuer.

I have suggested that Freud's choice of the pseudonym Dora for his eighteen-year-old hysterical patient, Ida Bauer, was over-determined. Dora, it seems likely, was named not only after Freud's sister's nursemaid, as Freud himself explained, but also after Dora Breuer, Josef Breuer's youngest daughter. This theory is based on an examination of the similarities in the lives and symptoms of Anna O. (Breuer's famous hysterical patient of 1880-1882) and Dora; on an analysis of the transferences and countertransferences in the cases of these two young women; and on evidences of the persistent significance of Josef Breuer in Freud's life after 1895. These specific inquiries also call attention to the nature of hysteria at the end of the nineteenth century and to the ever-present complexities of the physician-patient relationship.

Adolescent↗