Ferenczi's variations on the death drive

This theoretical paper discusses three variations on the death drive, developed by Sándor Ferenczi. We present a brief history of the use of the term death drive among the first psychoanalysts and argue that, as early as 1913, the notion is used by Ferenczi and serves as a conceptual background for his thinking. During the 1920s, Ferenczi revisits part of this concept, focusing on what he identifies as a primacy of self-destruction. The destructive drive gains an adaptive character responsible for the mortification of parts of the individual, in exchange for the survival of the whole. In this variation, the tendency to regress also arises as the self-destruction drive and the acceptance of unpleasure involves a psychic "reckoning-machine." In the final variation, left unfinished, the death drive at times receives new names, like drive for "conciliation," and at others, the very idea of the death drive is criticized.

Friendship, Creativity and Dispute in the Freud-Fliess and Ferenczi-Groddeck Letters

In this paper we examine the different transferential relationships that occurred between two sets of friends: Freud-Fliess and Ferenczi-Groddeck; consider the impact of these variables on their productivity, creativity, and friendship; and review historical literature to analyze how the nature of their bonds shaped very different personal destinies. Freud and Fliess greatly admired each other, and expressed reciprocal support, trust, and idealization but their underlying dispute over the paternity of certain ideas ultimately led to a bitter end. Essentially, their transference can be characterized as paternal-filial. The Ferenczi-Groddeck relationship, on the other hand, shared many of the same traits as the Freud-Fliess pair: a strong friendship, mutual admiration, even idealization, but their bond evolved into a more fraternal transference, which enabled their love, admiration, and respect to develop into a mutually-enriching relationship that endured for their entire lives.

Processing negative autobiographical memories in a foreign language

The use of a foreign language has been introduced in the clinical setting as a form of emotional distance to help deal with negative experiences. However, the evidence of foreign language reducing emotionality during processing negative events is still scarce. This study aims to test whether the description and processing of a traumatic or highly emotional event in a foreign language could modulate the strength of the connection between traumatic symptomatology and emotional reaction. For this purpose, a sample of 128 healthy participants completed a series of questionnaires via an online platform. Firstly, their levels of distress, arousal and valence were assessed in their native language. Secondly, they were assigned to either the native language or the foreign language group and described a negative childhood event in the assigned language (English or Spanish), followed by five questions for processing the event. Next, their emotionality was assessed again in their native language. Finally, a questionnaire of traumatic stress symptoms and an avoidance scale were completed. Results showed that the relationship between traumatic symptomatology and emotionality was moderated by the language of processing the negative event. Specifically, traumatic symptomatology was more strongly associated with distress and arousal change when the processing task was performed in the native language. These findings suggest the influence of a foreign language on emotional reactivity when a negative experience is processed, which could be an essential tool in the treatment of disorders related to stress and trauma.

THINKING THE DREAM: DREAM AND DREAM THINKING IN SIGMUND FREUD, HANNA SEGAL, AND WILFRED BION

In the dream and its interpretation, psychoanalysis, in its founding period around 1900, identified the "royal road to a knowledge of the unconscious in the psychic life." But already in the development of Freud's work itself, the dream lost its central position: As early as in the 1920s, psychoanalysis ceased to be a theory and practice defined by dream interpretation-a caesura in a process which completed itself in 1950. Two further developments proved, up to the present day, particularly momentous for the conception of the dream: Melanie Klein's development of the concept of "unconscious phantasy" and the extension of psychoanalytic treatment to psychosis, originally declared inaccessible to psychoanalytic therapy by Freud. This article draws an itinerary of this path and the subsequent fundamental changes in the psychoanalytic reflection on the dream affecting the whole of psychoanalysis until today, by casting spotlights on essential stations: conceptions of the dream developed by Hanna Segal and Wilfred Bion, the latter's theory perpetuating Freud's dream theory as well as it conceptualizes dreams, dreaming, and thinking in a fundamentally new way.

A clinical seminar on Spinoza and Bion: a conversation between Miller AND Koritar

The present transcript follows an online discussion held on April 3, 2022, between Ian Miller, author of Clinical Spinoza: Integrating His Philosophy with Contemporary Therapeutic Practice (2022), and Endre Koritar.

The Perspective of Psychological Action Mechanism of Mindfulness Meditation: Mindfulness Meditation Blurs the Transparent Boundary Between the Unconscious and the Conscious Mind

Based on the author's clinical experience, the aim of this paper is to conceptually analyse the theory of psychological functioning and action mechanisms in the way mindfulness meditation works. Meditation is a method of revealing unconsciousness. It works in a similar way to the inhibitory and excitatory mechanisms of neurones. Block pathogenic thoughts and emotions that reach the unconscious to the conscious mind. The long-term implementation of mediation may be more effective than the short-term and interrupted implementation.

The impact of adverse childhood experiences on depression: the role of insecure attachment styles and emotion dysregulation strategies

Objectives: The previous studies have reported that adverse childhood experiences (ACEs) can have detrimental effects on victims' attachment styles, emotion regulation strategies and depression. How the insecure attachment styles and emotion dysregulation strategies play a role in the relationship between ACEs and depression among Chinese university students remains unclear. Methods: The research was made known to students studying at universities in China. Five hundred and eighty-nine college students completed questionnaires measuring ACEs, insecure attachment styles, emotion dysregulation strategies and depression. Sequential chain mediation model was built by Mplus. Results: The model showed that insecure attachment styles and emotion dysregulation strategies mediated the relationship between ACEs and depression respectively. Moreover, the sequential chain mediation showed an indirect path (ACEs - insecure attachment styles - emotion dysregulation strategies - depression). Conclusion: Following childhood adversities, students can experience elevated depression which is influenced by attachment styles and emotion regulation strategies.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-023-04613-1.

The Neurophysiology Behind Trauma-Focused Therapy Modalities Used to Treat Post-Traumatic Stress Disorder Across the Life Course: A Systematic Review

This review presents the current state of understanding of trauma-informed modalities in light of current research in neuroscience, analyzing which brain structures and processes are impacted by these modalities. Studies included in the present review met the inclusion criteria of 1) addressing post-traumatic stress disorder (PTSD) in a specific population, 2) treatment of PTSD using any of the evidence-based trauma-informed modalities considered in this review, and 3) presenting functional magnetic resonance imagery (fMRI) data, derived from BOLD signals and voxel-compression maps, of brain structures impacted by these trauma-informed modalities. Articles for this review were collated through PubMed and MEDLINE, using key terms in descending order, such as 'childhood trauma', 'adolescent trauma', and 'adulthood trauma', to 'PTSD', 'fMRI', and so on, depending on the modality in question. Based on these criteria and research methods, 37 studies remained for inclusion in the present review. Among a number of critical findings, this review demonstrates that eye movement desensitization and reprocessing (EMDR) and mindfulness therapy effectively deactivate hindbrain regions implicated in the downregulation of autonomic nervous system (ANS) hyperarousal. This review also shows that trauma-focused cognitive behavioral therapy (TF-CBT) and EMDR activate the hippocampus, anterior cingulate cortex (ACC), medial prefrontal cortex (mPFC), and orbitofrontal cortex (OFC)-areas that are implicated in crucial cognitive, affective, and behavioral processes that aid trauma survivors in navigating their challenges.

Invisible-visual hallucinations in Bion's "Attacks on Linking"

Writing Attacks on Linking, it is as if Bion had listened to his former analyst. In a lecture on technique given the year before, Klein expressed the wish that someone would write "a book about linking [...] one of the essential points in analysis". Later taken up and commented on in Second Thoughts, Attacks on Linking, has become perhaps Bion's most famous paper and, Freud aside, the fourth most cited article in the whole of psychoanalytic literature. In the short and scintillating essay Bion presents the enigmatic and fascinating concept of invisible-visual hallucinations, which subsequently seems never to have been taken up and discussed as such by other scholars. The author's proposal is therefore to reread Bion's text starting from this concept. To try to give a definition that is as clear and distinct as possible, a comparison is made with those of negative hallucination (Freud), dream screen (Lewin), and primitive agony (Winnicott). Finally, the hypothesis is formulated that IVH could give us the model of what stays at the origin of any representation; i.e. a micro-traumatic inscription of the trace of stimuli (but which may come to be actually traumatic) in the psychic fabric.

The sociology of nostalgia

Nostalgia is not a conventional topic of sociological analysis, and sociologists writing on nostalgia often rely on insights on the topic generated in neighboring disciplines. However, there is in fact relevant sociological work on nostalgia conducted by sociologists, and this article reviews is. Illustative examples of sociological topics relating to nostalgia are as follows: nostalgia and the past, examining how historical recollection or reconstruction and memory shape nostalgia, nostalgia and experiences of personal and cultural loss; nostalgia and individual or collective identity; nostalgia and social change; and nostalgia and politics.

Meaning in life through work: A cognitive-experiential self-theory (CEST) perspective

This article explores existential meaning-making from work using the cognitive-experiential self-theory (CEST). To start with, we use the tenets of CEST to elaborate on how the cues from archetype work environments—a realization facilitating work environment (RfWE) and justification facilitating work environment (JfWE)—are interpreted by information-processing systems to imbue meaning in life (MiL) as internal or external manifestations of coherence, purpose, and significance. Next, we explain how individual differences in work centrality and proactive meaning-crafting ability moderate the impact of JfWE, but not of RfWE, on MiL. Finally, we create a nomological network of existential meaning states emerging from the simultaneous presence or absence of RfWE and JfWE. In summary, by applying the information-processing lens of CEST, we develop an integrated model that explains how work drives MiL, elucidates the resultant existential states, and assesses the role of individual differences in meaning-making.

Plain Language Summary

This article develops an integrated model that outlines how work environments can augur human well-being by fostering a sense of meaning in life (MiL). Based on the cognitive-experiential self-theory (CEST), expounding parallel-competitive processing of information through the working of the experiential and rational system, we explore how the cues from archetype work environments—a realization facilitating work environment (RfWE) and justification facilitating work environment (JfWE)—influence the varied flavors of MiL and meaninglessness in life. We build the argument that RfWE activates the functioning of the experiential system to induce a feeling of internal MiL as internal coherence, internal purpose, and internal value significance. At the same time, JfWE triggers the functioning of the rational system to construct a judgment of external MiL as external coherence, external worthy purpose, and external value significance. However, the interaction between RfWE and JfWE can result in intricate scenarios, including favorable states such as holistic meaning, positive existential feelings, and positive existential narratives. Still, it can also lead individuals into meaninglessness in life through existential fatigue, existential cocoon, or existential futility. Nonetheless, individual differences in work centrality and proactive behavior to craft meaning can act as moderators to alter the intensity of work’s impact on MiL in a JfWE but not in an RfWE.

An encounter with the self: A thematic and content analysis of the DMT experience from a naturalistic field study

Introduction

N,N-Dimethyltryptamine (DMT) is an endogenous serotonergic psychedelic capable of producing radical shifts in an experience that have significant implications for consciousness and its neural correlates, especially given the “disconnected consciousness” suggested by the “breakthrough” DMT state. Its increasing usage and clinical trial indicate the growing importance of a thorough elucidation of the experience's qualitative content, over and above the phenomenological structure. This is particularly in light of the intensely pervasive effects of DMT occasions in all dimensions of the self, which are often ontologically challenging yet potentially transformative.

Methods

This is the second report on the first naturalistic field study of DMT use exploring its qualitative analysis. Screened, healthy, anonymized, and experienced DMT users were observed during their non-clinical use of the drug at home (40–75-mg inhaled). In-depth semi-structured interviews, inspired by the micro-phenomenological technique, were employed immediately after their experience. This study reports on the thematic and content analysis of one major domain of the breakthrough experiences elicited, the “self”; where analyses of the “other” were previously reported. A total of 36 post-DMT experience interviews with mostly Caucasian (83%) men (eight women) of a mean of 37 years were predominantly inductively coded.

Results

Invariably, profound and highly intense experiences occurred. The first overarching category comprised the onset of effects, encompassing super-ordinate themes including sensory, emotion and body, and space-time shifts; the second category comprised bodily effects, encompassing themes including pleasurable, neutral/both, and uncomfortable; the third category comprised the sensorial effects, encompassing open-eye, visual, and cross-modal and other; the fourth comprised the psychological effects, encompassing memory and language, awareness and sense of self, and time distortions; and the fifth comprised the emotional effects, encompassing positive, neither/both, and challenging experiences. Many further subthemes also illuminate the rich content of the DMT experience.

Discussion

The present study provides a systematic and nuanced analysis of the content of the breakthrough DMT state pertaining to one's personal and self-referential experiences of the body, senses, psychology, and emotions. The resonances both with previous DMT studies and other types of extraordinary experiences, such as the alien abduction, shamanic and near-death experiences, are also elaborated upon. Putative neural mechanisms and their promise as a psychotherapeutic agent, especially owing to deep emotional impact, are discussed.

The experience of loneliness among the Chinese bereaved parents-a qualitative study from the life course perspective

BACKGROUND

With the implementation of the 37 years one-child policy, many couples only have one child in China. Chinese parents whose only child died and did not give birth to or adopt another child are known as "Shidu" parents or "Shiduer". Characterised by elements of childlessness, bereavement, and ageing, Shiduer are at a higher risk of experiencing loneliness. However, little is known about their loneliness experience. Adopting a life course perspective, this research aims to investigate how loneliness was experienced and coped by older Chinese Shidu parents and identify the most vulnerable groups for policy intervention.

METHODS

Qualitative method was adopted for this study. Semi-structured interviews were conducted with 27 participants from urban and rural Wuhan, the capital city of Hubei province in central China, to collect data on participants' life course related resources and loneliness experience after bereavement. An abductive approach was used to analyse the data.

RESULTS

The results demonstrate that the social environment (urban/rural), timing of bereavement (midlife/older age), social network (strong/weak), and coping strategies (escape-avoidance/problem-solving) differentiate the experience of loneliness among the Shiduer. Those who lived in rural communities, those bereaved in older age, those who had a weak social network, and those who adopted the escape-avoidance strategy were found vulnerable and suffered from more chronic and intensive loneliness than their counterparts without these characteristics.

CONCLUSION

This study is among the first attempts to examine loneliness experience and coping among older Chinese bereaved parents from a qualitative, life course perspective. It provides insights into how loneliness has been perceived and experienced differently among the bereaved one-child parents in China. The results of the current study provide important implications for policymakers and practitioners/social workers for the intervention of loneliness.

The influence of culture and cognitive reserve on the clinical presentation of behavioural-variant frontotemporal dementia

Characterisation of the clinical profile of behavioural-variant frontotemporal dementia (bvFTD) has predominantly been based on Western samples. Some small studies have suggested that the clinical profile may differ in culturally and linguistically diverse populations. Additionally, there is evidence that patients from non-English speaking backgrounds may have more cognitive reserve, allowing them to tolerate more disease pathology before clinical symptoms emerge. This study aims to characterise the clinical profiles of patients with bvFTD from culturally diverse backgrounds. BvFTD patients were classified as Australian-born (Australian) or Culturally and Linguistically Diverse-English-speaking (CALD-English) and Culturally and Linguistically Diverse-Language Other Than English (CALD-LOTE). Clinical features, cognitive test performance and cognitive reserve were compared between groups. Voxel-based morphometry was used to examine the neural correlates of cognitive reserve. 107 patients with bvFTD (53 Australian, 36 CALD-English, 18 CALD-LOTE) and 51 controls were included. Analysis of neuropsychiatric features revealed more elation in Australian patients compared to CALD-English patients, with trends for CALD-LOTE patients to report more irritability. CALD-LOTE patients also had higher cognitive reserve and showed relatively greater verbal than non-verbal cognitive impairment. Neuroimaging analyses revealed that higher cognitive reserve was associated with lower integrity in the frontal-temporal regions associated with typical disease pathology in bvFTD. Our findings support the hypothesis that cognitive reserve may delay early cognitive decline in culturally and linguistically diverse patients, although these patients may still show poor verbal performance due to cultural testing biases. Clinically, these results highlight the need to consider cultural and linguistic background to inform the assessment of dementia.

TRAUMA AND THE DISRUPTION OF TEMPORAL EXPERIENCE: A PSYCHOANALYTICAL AND PHENOMENOLOGICAL PERSPECTIVE

A deep understanding of the subjective experience of time in traumatized individuals may require a comprehensive framework that takes into account both psychoanalytic and phenomenological contributions. Referring to the retroactive interpretation of past experiences, the concept of Nachträglichkeit is critical to analyze how trauma can be signified in the form of the après-coup, in which the original traces of traumatic experiences are signified only at a later time. Trauma alters the temporal sequence of past, present, and future, thus leaving the psyche in a time-shifted dimension, where the shadow of the past extends over the present, and the unbearable present hinders growth and development. A clinical vignette is presented to illustrate how trauma can disrupt the temporal nature of subjective experience by reshaping the meaning of psychic events. Ultimately, trauma treatment aims at inscribing the person's experience into a unified and coherent self-narrative.

Working Online During the Contemporary COVID-19 Pandemic

Within the psychoanalytic school there has been substantial and ongoing debate about the efficacy of teleanalysis. However, as a result of the current COVID-19 pandemic and the online work with which the Jungian analytic community has now had to engage, this paper initially focuses on analysts' actual experiences of working by teleanalysis. These experiences highlight a range of issues like "Zoom fatigue", "online disinhibition", dissonance, confidentiality, the frame and working with new patients. Alongside these issues, there were ample experiences by analysts of both productive psychotherapy apace with analytic work involving transference and countertransference phenomena, all indicating that a genuine and good enough analytic process can occur with teleanalysis. An overview of the research and literature both prior to the pandemic and as a result of it, confirms the validity of these experiences so long as analysts are cognizant of the specifics of such an online modality. Conclusions to do with the question, "what have we learned?", alongside training, ethics and supervision issues are subsequently discussed.

Ego-defense mechanisms and brief psychotherapies for the management of major depressive disorder in adults: A longitudinal and quasi-experimental study

OBJECTIVE

To evaluate the effect of psychotherapies on ego defense mechanisms and the reduction of depressive symptoms in a 12-month follow-up period.

METHODS

This longitudinal and quasi-experimental study nested within a randomized clinical trial included a clinical sample of adults (18-60 years) diagnosed with major depressive disorder using the Mini-International Neuropsychiatric Interview. Two models of psychotherapy were used: Supportive Expressive Dynamic Psychotherapy (SEDP) and Cognitive Behavioral Therapy (CBT). Defense Style Questionnaire 40 was used to analyze defense mechanisms and the Beck Depression Inventory was used to measure the depressive symptoms.

RESULTS

The total sample comprised 195 patients (113 SEDP and 82 CBT), with the mean age was 35.63 (11.44) years. After adjustments, increased mature defenses was significantly associated with reduced depressive symptoms at all follow-up times (p < 0.001) and the decrease in immature defenses was significantly associated with the reduction of depressive symptoms at all follow-up times (p < 0.001). While neurotic defenses were not associated with a reduction in depressive symptoms at any time of follow-up (p > 0.05).

CONCLUSION

Both models of psychotherapy were effective in increasing mature defenses and decreasing immature ones, as well as decreasing depressive symptoms at all evaluation times. With this, it is understood that a greater understanding of these interactions will allow a more adequate diagnostic and prognostic evaluation and the design of useful strategies that adapt to the patient's reality.

CULTURAL HISTORY OF PSYCHOANALYSIS IN THE AGE OF NEUROSCIENCE

In this paper I have chosen the topic of psychoanalysis in the age of neuroscience, with the aim of showing why the cultural history of psychoanalysis still matters. To make myself better understood I shall refrain from evaluating the current findings in neuroscience and limit myself to reporting briefly on them. Although I do not regard myself by any means as an expert in that field, I may be permitted to offer a few ideas about it. In this regard, there is presently a significant predominance of biological ideologies and practices regarding the treatment of mental illness, which implies an increase in the interest in etiology, nosology, definitions, and the effectivity of treatments. Even so, those psychoanalytic historians and/or analysts among us who are committed to psychoanalysis and its therapeutic implications, irrespective of what drugs might be prescribed and what the research findings might conclude, believe that patients still want to be listened to in depth and always will. For that reason, it is justified to ask why the cultural history of psychoanalysis still matters in a contemporary mental health environment that is ever more oriented towards the neurosciences.

Is Religion Special?

Religion makes unique claims (e.g., the existence of supernatural agents) not found in other belief systems, but is religion itself psychologically special? Furthermore, religion is related to many domains of psychological interest, such as morality, health and well-being, self-control, meaning, and death anxiety. Does religion act on these domains via special mechanisms that are unlike secular mechanisms? These could include mechanisms such as beliefs in supernatural agents, providing ultimate meaning, and providing literal immortality. We apply a critical eye to these questions of specialness and conclude that although it is clear that religion is psychologically important, there is not yet strong evidence that it is psychologically special, with the possible exception of its effects on health. We highlight what would be required of future research aimed at convincingly demonstrating that religion is indeed psychologically special, including careful definitions of religion and careful attention to experimental design and causal inference.

A century of Morita therapy: What has and has not changed

We review the history of Morita therapy (MT), which has existed for over 100 years, and examine what has changed over that period and what has not. Classic MT, which was dependent on a highly strict therapeutic approach, gradually lost its pre-eminence, but at the same time, the fundamental theory of MT was refined. This theory came to be applied to current outpatient MT and adapted to inpatient MT. As MT was refined, a standard training system for therapists was established, adaptations to modern conditions were made and expanded, and comparisons to and dialogs with other psychotherapeutic concepts such as mindfulness became possible. To better evaluate MT, further work should be conducted on its effectiveness of from a clinical epidemiological perspective.

Psychosocial and Psychodynamic Considerations Informing Factitious Disorder

Factitious disorder is a condition in which patients deceitfully present themselves as injured or ill in the absence of obvious external reward. It is difficult to diagnose and treat, and little rigorous evidence exists in the literature. While larger studies have revealed some clinical and sociodemographic patterns, there is a lack of consensus on psychosocial factors and mechanisms contributing to factitious disorder. This in turn has led to conflicting recommendations on management. In this article, we review major psychopathological theories of factitious disorder, including the role of early trauma and subsequent development of interpersonal dysfunction, as well as maladaptive gratification obtained from assuming the sick role. Common themes of interpersonal disruptions in this patient population include a pathologic need for attention and care, as well as aggression and desire for dominance. In addition to psychodynamic and psychosocial etiologic models of factitious disorder, we also review associated treatment approaches. Finally, we offer clinical implications, including countertransference considerations, as well as directions for future research.

Greed personality trait links to negative psychopathology and underlying neural substrates

Greed personality trait (GPT), characterized by the desire to acquire more and the dissatisfaction of never having enough, has been hypothesized to link with negative emotion/affect characteristics and aggressive behaviors. To describe its emotion-related features, we utilized a series of scales to measure corresponding emotion/affect and aggression (n = 411) and collected their neuroimaging data (n = 330) to explore underlying morphological substrates. Correlational analyses revealed that greedy individuals show more negative symptoms (e.g. depression, loss of interest, negative affect), lower psychological well-being and more aggression. Mediation analyses further demonstrated that negative symptoms and psychological well-being mediated greedy individuals' aggression. Moreover, exploratory factor analysis extracted factor scores across three factors (negative psychopathology, happiness, and motivation) from the measures scales. Negative psychopathology and happiness remained robust mediators. Importantly, these findings were replicated in an independent sample (n = 68). Voxel-based morphometry analysis also revealed that gray matter volumes (GMVs) in the prefrontal-parietal-occipital system were associated with negative psychopathology and happiness, and GMVs in the frontal pole and middle frontal cortex mediated the relationships between GPT and aggressions. These findings provide novel insights into the negative characteristics of dispositional greed, and suggest their mediating roles on greedy individuals' aggression and underlying neuroanatomical substrates.

The Analyst's Courage and Vulnerability in the Countertransference

Courage requires us to persist and persevere despite fear. We make choices everyday-some are courageous, and some are not courageous at all. This dimension of psychoanalytic work is significant, yet relatively neglected in the psychoanalytic literature. Maintaining a courageous stance as an analyst can be challenging and threatening. Often, the therapist faces deeply rooted fears about abandonment, envy, competition, anger, or other forms of intense emotional arousal. This requires us to confront ourselves but also, at times, confront our patient's behaviors. It is crucial to think and act independently, and deal with their disapproval and opposition, despite the risks challenging patients present. Ultimately, we need to manage our vulnerable feelings while remaining authentic, rather than hiding behind an overly clinical stance. The author presents two patients who required and inspired the courage to face her own anxieties, ultimately contributing to the treatments' progress.

Friendship of Virtue-The Place of True Friends in the Psychotherapeutic Process

This paper offers a new take on friendship, its specific qualities, how it is subjectively experienced and changes over the course of a patient's life and how it might serve as catalyst for positive change in the therapeutic process. The premise is based on the Aristotelian definition of friendship as a friendship of virtue, as well as on insights stemming from intersubjective thinking, and observations about horizontal relationships in contemporary psychoanalysis and psychotherapy. A review of the scant psychodynamic and psychoanalytic literature on friendship is presented and the author notes its marginal place in the lexicon compared with other more extensively studied relationships. Three clinical cases are presented to illustrate the potential of "friendships of virtue" as paths toward positive transformation in the course of treatment.

Some Arguments About Free Association as a Technique

Freud, early in psychoanalytic history, modified hypnotic technique and recommended, in its stead, free association. This paper takes a close look at the theoretical foundations of that technique in light of theoretical developments over the past hundred plus years. It is argued that free association is similar to an asymptote, which is never quite reached. Moreover, it is argued that the direction to free associate is contraindicated in many, if not most, psychological disturbances. Guided association or avoidance of free association is sometimes required. For a limited group of patients, whose major ego functions (abstraction, integration, and reality testing), ego strengths (impulse control, affect tolerance, and containing primary process), object relations (capacities for empathy, trust, and closeness), and superego (shame/guilt) are intact, the direction to use the couch and attempt to free associate may still be quite useful. For most people who present for treatment, however, this approach is likely not beneficial. The complex arguments about the decision-making process regarding free association are discussed.

HUNDRED YEARS OF THE PSYCHOANALYTIC PROGRESSIVE MENTAL HEALTH MOVEMENT

Beginning in 1920 and in keeping with Freud's sustained encouragement, the first two generations of European psychoanalysts initiated a progressive mental health movement by offering very low cost and free psychoanalytic services that were in harmony with Austrian social democratic and socialist political leaders' commitment to societal reforms in light of the economic and social inequities after the First World War. This synthesis of biographical and autobiographical accounts of early Freudian, Ego Psychology and Neo-Freudian theorists' contributions highlights their consideration of the effects of social injustice as central challenges to the development of psychological growth.

FERENCZI AND GENDER TROUBLE

The paper analyzes Ferenczi's contributions to contemporary debates on gender. It does not strictly adhere to what he wrote about masculinity and femininity, where he reveals himself as a man of his time, with the some of the prejudices of his time. Instead, the paper highlights the utraquistic method and the pluralist monism of Ferenczi, whereby he appears as an analyst who remains in synch with current problems. Against the purity of dualisms, Ferenczi embraced multiplicity, mixtures, and the transit between different spaces, beyond divisive frontiers. In terms of method, it resonates with Judith Butler's proposals, with the ideas defended by Paul Preciado and by Queer theory.

Long-term psychodynamic psychotherapy in a face-to-face versus videoconferencing setting: A single case study

OBJECTIVE

Due to the coronavirus pandemic and crisis, psychotherapists around the world were forced to switch to video- or tele-based treatments overnight. To date, only a few studies on the effectiveness of video-based psychodynamic psychotherapy via the Internet exist. Therefore, the goal of the present study was to examine symptom improvement, therapeutic relationship, nonverbal synchrony processes, and intersession processes within a systematic single case design and compare face-to-face to video-based approaches in long-term psychodynamic-oriented psychotherapy.

METHODS

We examined 85 sessions of a client with major depression whose psychodynamic psychotherapy changed from a face-to-face setting to a video-based setting. Video recordings were analyzed using motion energy analysis, and nonverbal synchrony was computed using a surrogate synchrony approach. Time series analyses were performed to analyze changes in symptom severity, therapeutic relationship, and intersession processes.

RESULTS

The results showed that symptom severity improved descriptively, but not significantly, across the entire course of psychotherapy. There were significant differences, however, in the therapeutic relationship, intersession experiences, and synchronous behavior between the face-to-face and video-based settings.

CONCLUSION

The results indicate that the presented methodology is well situated to investigate the question whether psychodynamic psychotherapy in video-based setting works in the sameway as in a face-to-face setting.

Diamonds and rust: The affective ambivalence of Nostalgia

Affective ambivalence is the simultaneous experience of oppositely valenced emotions, such as happiness and sadness. Historic writings on the valence of nostalgia have proposed that nostalgia can best be conceptualized as an ambivalent emotion. A growing body of research provides empirical evidence for this proposal. Here, I review and summarize this evidence that nostalgia is an ambivalent emotion, albeit more positive than negative. I end by discussing implications and future research directions.

Nostalgia, and what it used to be

As the cliché has it, nostalgia ain't what it used to be. Except this cliché is true: nostalgia hasn't always been the relatively benign, comforting longing for a lost time which we know today; it used to be a dangerous disease, a deadly form of homesickness. This article traces the surprising history of nostalgia from its origins in the late Seventeenth Century to the present. It both sketches the different ways in which nostalgia has been experienced over the past three centuries, and reviews existing literature that has sought to grasp this protean emotion across the disciplines. As the article shows, contrary to our presentist common sense, when it comes to our affective lives, history matters.

Home-Based Care and Mental Health during a Disaster: A Qualitative Analysis

Disasters adversely affect individuals' mental health; yet, research is scant on the mental health needs of frontline workers during and immediately after disasters. Our study explored this gap through the perspectives of home-based care providers (HBCP) who provided care during and after Hurricanes Irma and Harvey. In this qualitative study, five in-person focus groups were held between January and November 2019 with 25 HBCP drawn from home health care agencies in southern Florida and the Greater Houston Area. Four themes were identified using an abductive analytic approach: HBCPs' disaster-related mental health needs; HBCP resilience in the context of disaster; psychological tensions associated with simultaneously caring for self, family, and patients; and supporting patients' mental health needs during and after disaster. Our data suggest that HBCP may benefit from formal training and interventions to support their own mental health as well as that of their patients in the context of disasters.

Donor and Donation Images (DDI)-A Scoping Review of What We Know and What We Don't

Organ transplantation is associated with significant physical and psychological burden for the recipients. Qualitative reports indicate that organ recipients develop donor and donation images (DDI)-conceptions of the donor and/or the organ. A deeper understanding of DDI is needed in the care of transplant recipients. To present the current state of knowledge, we searched for and identified DDI-related publications in PubMed and Scopus. Inclusion criteria were (1) studies addressing transplant recipients, and (2) English or German language. Twenty-one studies of individuals with transplanted hearts, lungs, or kidneys were included in this scoping review. Prevalence for DDI ranged from 6% to 52.3%. DDI occurs both before and after transplantation and includes ideas about the donor as well as whether and how the recipient's personality may be altered by the transplanted organ. Some transplant recipients did indeed report personality changes following transplantation due to the adoption of assumed donor characteristics. One study showed a positive association between the presence of DDI and anxiety scores and one described a coping effect. DDI is understudied and should be systematically assessed to improve care for the vulnerable group of individuals undergoing organ transplantation. Current research gaps and future directions are discussed.

Fear of Missing Out, Emotional Intelligence and Attachment in Older Adults in Argentina

In recent years, the rise of social networks has changed relationships and lifestyles around the world. This has led to the emergence of the Fear of Missing Out (FoMO), which consists of the need to constantly check social media and the anguish that comes from feeling a lack of rewarding experiences. The impact derived from the use of technologies in a digital environment has been widely studied in young people but not so much in older adults. The main aim of this study was to analyze FoMO levels in older adults and their relationships with sociodemographic and formative factors. Another aim of this study was to analyze whether the dimensions of emotional intelligence, the different forms of attachment and psychological symptomatology affect the FoMO levels of older adults. A total of 690 older adults from Argentina aged between 60 and 90 years (M = 69.01; SD = 5.48) participated, 54.5% of whom were women, responding using a geolocated online questionnaire. The main results confirmed that older people show FoMO levels similar to other general samples. In addition, results show several predictor variables with respect to FoMO: emotional attention, insecure attachment, depression and difficulties in interpersonal relationships. The implications of the results observed in older adults are discussed.

Italian Children's Accounts of the Lockdown: Insights and Perspectives

COVID-19 lockdown-imposed restrictions emerged as a risk to children's well-being. However, the extant literature often ignored children's experiences, emotions, struggles, hopes, and expectations. Based on a large sample of Italian students (N = 906; mean age = 9.4 years, 48.8% female), we drew data from a post-lockdown school re-entry program where students completed narrative activities in 2020. These narratives underwent quantitative content analysis according to gender and school level. Overall, children reported mixed feelings about the lockdown; they felt safe at home but also experienced fear and missed their friends, school, and freedom. Screen-time, technology and friendships helped, but children struggled to make sense of the events. Our findings show how children attempted to make sense of the lockdown experience and may provide key information for the development of community coping programs to help children facing crises in the future.

Factors associated with posttraumatic growth: gratitude, PTSD and distress; one year into the COVID-19 pandemic in Lebanon

Almost one year since the COVID-19 was declared a global pandemic, mental distress remains elevated with high prevalence of post-traumatic stress disorder (PTSD). Yet studies suggest these challenging circumstances might be conducive of post-traumatic growth (PTG). This study aims to investigate the factors associated with growth after the original trauma. A sample of 252 Lebanese adults filled an online survey to determine levels of PTG, PTSD and gratitude using validated self-rating scales. Participants also subjectively evaluated the sources of their distress such as the COVID-19 pandemic, the Beirut port explosion and/or their deteriorating financials. The PTGi-SF evaluated dimensions of growth while the IES-R_22 measured the degree of distress post-trauma. The GQ-6 was used to measure the proneness to experience gratitude daily. Results indicated 41% of participants scored above the cutoff for PTSD symptomatology. Yet, PTSD was positively correlated, alongside gratitude and accumulated subjective distress, with higher levels of PTG. A forward linear regression taking PTG scores as the dependent variable further showed that more gratitude (Beta = 0.57), a higher impact of events (Beta = 0.16), and knowing anyone who died from COVID-19 (Beta = 3.93) were significantly associated with more growth. The study highlights elevated levels of PTSD symptoms in a context of a global pandemic worsened by financial and socio-political instabilities. It mostly identifies personal factors, including high initial symptomatology post-trauma and gratitude, related to the capacity for growth in spite of these accumulating hardships. As such, it advocates the need to investigate and bolster silver linings amidst unprecedented traumas.

Perception and use of social media by Indonesian adolescents and parents: A qualitative study

Social media are popular among adolescents worldwide, including the global South. The way adolescents use social media is influenced by their own perception of social media but also by how their parents use and perceive social media. This study aims to understand how Indonesian young adolescents (12-15 years old) and parents of adolescents use and perceive social media. For this purpose, we conducted eight focus group discussions and eight semi-structured interviews with 30 Indonesian adolescents and 15 Indonesian parents. Thematic analysis of the qualitative data reveals that both adolescents and parents use social media for social, practical, and pleasure activities. Most adolescents mention that they consider themselves skilled in using social media, while parents consider themselves less skilled. Both adolescents and parents mention that social media offer benefits for adolescents, including emotional, social, and practical benefits. However, adolescents and parents also mention the risks of social media use for adolescents, including social, emotional, and informational risks, as well as the displacement of more meaningful activities. As such, both adolescents and parents do not perceive social media as inherently good or bad but rather as a novel medium that offers benefits for adolescents but also involves several risks to be considered by parents and other relevant stakeholders. This study adds to our understanding of social media use in the global South and offers a theoretical basis for future studies on the impact of adolescents' social media usage on wellbeing in an Indonesian context. However, future research is necessary to depict possible differences in social media use between Indonesia and other countries in the global South.

The impact of COVID-19 home confinement on axial length in myopic children undergoing orthokeratology

CLINICAL RELEVANCE

Understanding the impact of home confinement on axial length in myopic children undergoing orthokeratology (OK) treatment facilitates the management of myopia control during coronavirus disease 2019 (COVID-19) lockdown.

BACKGROUND

The outbreak of COVID-19 and the corresponding home confinement measures have brought a considerable challenge to myopia control. The study aimed to investigate the influence of home quarantine on axial length in myopic children with OK treatment.

METHODS

Axial length measurements during and before COVID-19 home confinement were retrospectively collected from the myopic children treated with OK, and the children were prospectively followed up after finishing the quarantine. The monthly axial length growth before, during and after confinement was calculated and compared in the full dataset and subgroups stratified by age. Influencing factors for monthly axial length growth during confinement were analysed.

RESULTS

Ninety-two myopic children with OK treatment were enrolled in this study. In the full dataset, covariates adjusted (gender, time interval, baseline axial length and age) monthly axial length growth during confinement was not significantly different from that before (P = 0.213) or after the home confinement (P = 1.000). Multiple linear regression showed that the monthly axial length growth during confinement was negatively correlated with age (P = 0.002). Subgroup analysis based on age demonstrated that the adjusted monthly axial length growth was not significantly different among three periods (P > 0.05) for younger children. For children older than 12-year-old, the adjusted monthly axial length growth during home confinement was significantly slower than before the confinement (P = 0.011), but not the monthly axial length growth after the confinement (P = 1.000).

CONCLUSIONS

COVID-19 home confinement does not increase the myopic axial length elongation in children with OK treatment.

Hyper-Sensitivity to the Perpetrator and the Likelihood of Returning to Abusive Relationships

STUDY QUESTIONS

Although most women who are subjected to intimate partner violence attempt to leave their abusive partners, many return, and resultantly are at risk for even greater violence. Research to date has documented relations between several factors (income and economic dependence, frequency of intimate partner violence (IPV), fear of violence escalations, history of childhood abuse, and post-traumatic stress disorder symptoms) and women's returning to their abusive partners. Nevertheless, the contribution of women's emotional bonds with their violent partners, known as identification with the aggressor (IWA), in explaining their perceived likelihood of going back to the relationship, has remained unclear.

SUBJECTS

The current study, conducted among 258 Israeli women who had left their violent partners, aimed to fill this void.

METHODS

An online survey was conducted. Demographic variables, history of childhood abuse, frequency of IPV, economic dependence on former partner, fear of future violence escalation, post-traumatic stress disorder symptoms, IWA, and perceived likelihood of returning to the relationship, were assessed via self-report questionnaire.

FINDINGS

Results indicated that two aspects of IWA-becoming hyper-sensitive to the perpetrator and adopting the perpetrator's experience-were related to women's perceived likelihood of returning to the relationship. Furthermore, a logistic regression analysis indicated that only two factors-income and becoming hyper-sensitive to the perpetrator-uniquely contributed to explaining the likelihood of returning to abusive partners. Major implications: The current findings suggest that women's tendency to be highly attuned to their partners' feelings and needs, as a part of IWA, may impede their ability to permanently leave abusive relationships.