The use of “Pliable Media” in Promoting Symbolization in the Psychoanalytical Psychotherapy of Psychosis

2017 ◽  
Vol 41 (S1) ◽  
pp. s783-s783
Author(s):  
P. Solano ◽  
L. Quagelli
Keyword(s):  
Therapeutic Relationship ◽  
Emotional Experience ◽  
Transitional Space ◽  
Transitional Area ◽  
Working Through ◽  
Early Stages ◽  
Competing Interest ◽  
Concrete World

IntroductionIn psychosis, the capacity of symbolization is lost to different extents and patients live in a concrete world of objects. Moreover, the lack of boundaries between self/other, inside/outside severely impairs the capacity of these patients to understand and recognize reality from the delusional dimension.ObjectivesWorking through psychotic concreteness and accessing a first subjectivation of this experience, that leads to the development of a first symbolization.AimsAchieving the possibility to access a first symbolization and begin a delicate process of appropriation of the emotional experience with the establishment of the boundaries between inside/outside.MethodsThe use of “pliable media”, such as drawing, as therapeutic mediation allows a partial defraction of the violent transferential dynamics from the therapist and let unsymbolized material to emerge less destructively in the treatment fostering a first figurability.ResultsThe Squiggle game as “pliable medium” facilitates a first encounter in the therapeutic relationship and represents a primal transitional area that allows a gradual working through process to take place where the establishment of the boundaries between inside/outside could begin.ConclusionsWe suggest that the use of “pliable media” in the early stages of the psychotherapy of psychotics can significantly favor a first encounter between patient and therapist and, at the same time, provides the first experience of a transitional space where a working through process leading to first representations can take place.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Therapist's Dilemma: Be Sincere or Fake It?

2002 ◽  
Vol 10 (4) ◽  
pp. 325-329 ◽  
Author(s):  
Ron Morstyn
Keyword(s):  
Managed Care ◽  
Therapeutic Relationship ◽  
Emotional Experience ◽  
Human Relationship ◽  
Short Term ◽  
Modern Culture ◽  
Corrective Emotional Experience ◽  
Working Through ◽  
Legal Problems

Objective: To examine the pressure on therapists to fake sincerity and the significance of genuine sincerity in psychotherapy. Conclusions: There are many reasons why therapists might fake sincerity. We live in a post-modern culture of dissimulation and ‘playing the game’ that puts a premium on faking sincerity. Manualised and scripted psycho-therapies encourage fake sincerity, as do the measurement requirements of EBM, and the short-term approach of Managed Care. Kohut's ‘corrective emotional experience’ of empathy reinforces benevolent faked sincerity. Studies demonstrate the importance of the therapist appearing warm and genuine but do not differentiate appearance from reality. Therapists may fear that true sincerity will lead to crossing boundaries, harming patients, being poorly judged or medico-legal problems. Nevertheless, if therapists aren't willing to strive for genuine sincerity, despite all the attendant risks and possible complications, then they deny their patients the opportunity of working through the difficulties of achieving sincerity in any human relationship. Moments of true mutual sincerity in psychotherapy are healing not only because of the insight achieved but also because they restore the damaged hope that sincerity is possible. Therapists who fake sincerity ultimately leave their patients feeling alone and colluding in a mutually fake therapeutic relationship.

Multiple Suicide-Attempts in Adolescence: Psychodynamic Understandings on the Process of Integration of Hallucinated Bodily Experiences

2017 ◽  
Vol 41 (S1) ◽  
pp. s775-s776
Author(s):  
G. Giacomini ◽  
P. Solano ◽  
M. Amore
Keyword(s):  
Suicide Attempts ◽  
Emotional Experience ◽  
The Body ◽  
Psychotherapeutic Treatment ◽  
Working Through ◽  
Gradual Process ◽  
Self Harm ◽  
Internal Objects ◽  
Competing Interest ◽  
The Mind

Introduction.Suicidal adolescents have a severely damaged body/mind relationship where issues pertaining to adolescence and psychache are tightly intertwined causing dissociation, hallucinations and concreteness. In this conundrum, the suffering mind swings from being identified and split from the body favouring self-harm and bodily together with visual hallucinations.Objectives.Investigating and working through suicidal concreteness together with the role and meaning of hallucinations in adolescents with a story of multiple suicide attempts.Aims.Achieving a first integration and appropriation of the emotional experience with the establishment of the boundaries between mind/body, inside/outside giving up hallucinations.Methods.Prolonged intensive psychodynamic work focusing on self-representation, the working through of persecutory internal objects causing rage, hostility and attacks on the affective links with the environment allowed a gradual process of integration of the self with the decrease of suicidiality.Results.The working through and containment of persecutory internal objects led to the possibility to unconsciously give up hallucinations and integrate the emotional experience in the mind together with the development of first effective boundaries between inside/outside.Conclusions.An intense work of containment and working through of persecution and rage in the early stages of the psychotherapeutic treatment of adolescent multiple attempters can significantly favour the relinquishment of hallucinatory mechanisms and self-harm as a way to cope with intolerable anguish and psychache. This favours the process of in dwelling of the psyche in the soma as described by Winnicott.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Feelings of Guilt and Fantasies in Life Experiences of Brazilian Parents Due to Death of their Newborn: A Clinical-qualitative Study Conducted at a University Hospital

2017 ◽  
Vol 41 (S1) ◽  
pp. S616-S616
Author(s):  
L. Rodrigues ◽  
J.V. Freitas-de-Jesus ◽  
G. Lavorato-Neto ◽  
D.D. Lima ◽  
E.R. Turato ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Life Experiences ◽  
Technological Development ◽  
Emotional Experience ◽  
University Hospital ◽  
Parents And Children ◽  
Cultural Pattern ◽  
Competing Interest ◽  
The Moment ◽  
The Relationship

IntroductionThe relationship between parents and children is a complex link. In the process of pregnancy-birth-puerperium, frequent feelings such as responsibility, love, fear, uncertainty, generate strong expectations at birth. The death of a newborn may not be perceived as natural by the parents, considering the local culture and the context of great technological development of neonatology.ObjectiveTo explore possible guilt and fantasies in life experiences of parents during mourning process due to death of their newborn.MethodClinical-qualitative design, a particularization of qualitative methods here applied in clinical assistance settings with highlight to psychological aspects. Data collection with the technique of semi-directed interview with open-ended questions, in-depth. Sample intentionally constructed, with closure by theoretical saturation of information. The participants were 7 parents, mourning by the death of their child at the neonatal intensive care unit, in a university hospital of Campinas, São Paulo State.ResultsFeelings of guilt - conscious or not - lead to an internal and particular movement so that mourning can be lived. The participants showed certain embarrassment, accompanied by natural suffering facing to the cultural pattern that permeates the emotional experience. It predicts types of psychological meanings that the experience will give to the person.ConclusionHealth professionals working with bereaved parents should consider more deeply the moment these one experienced, with emphasis on the details of the death scenery, beside the problems of illness and death properly so called.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Revolutionary Education: Fostering Emotional Intelligence and Empathic Imagination Across The Mainstream Curriculum. Interdisciplinary Inquiry

2016 ◽  
Vol 33 (S1) ◽  
pp. S438-S438
Author(s):  
I. Rozentsvit
Keyword(s):  
Special Education ◽  
Emotional Intelligence ◽  
Emotional Experience ◽  
Columbine High School ◽  
Competing Interest ◽  
Metal Detectors ◽  
Bullying Programs ◽  
Sandy Hook Elementary School ◽  
K 12 ◽  
Empathic Imagination

If fostering emotional intelligence and empathic imagination and solving ethical dilemmas were discussed openly and taught methodically in K-12 mainstream (“typical”) classrooms, would we need metal detectors at the inner city schools’ entrances, and would we need special anti-bullying programs, which intend to correct bullying culture, rather than build a new one, based on kindness, openness, and consideration for others?Will we learn lessons from the Columbine High School and the Sandy Hook Elementary School massacres, and radically change educational system, to incorporate empathic imagination and emotional intelligence into mainstream K-12 curriculum – as a mandatory discipline – instead of leaving this important part of learning and character formatting only to the special education sphere?This symposium represents a collaborative effort of four educators from various disciplines who crossed boundaries to emphasize and foster emotional intelligence and empathic imagination throughout the K-12 curriculum.The following are the parts of the proposed multidisciplinary panel:– multidisciplinary approach to revolutionary education, or paradigm shift towards fostering emotional intelligence and empathic imagination across the mainstream curriculum;– Descartes’ error, the triune brain, and neurobiology of emotional intelligence;– changing our consciousness: imagining the emotional experience of the other;– teaching social skills and play therapy in schools: report from the trenches of special education;– examining cultural artifacts, tools for personal, emotional, and academic development;– growing kind kids: mindfulness and the whole-brained child;– Emotional Imprint™ at the street squash: ‘If you talk, you don’t kill.’Disclosure of interestThe author has not supplied his declaration of competing interest.

Pliable Media as Transitional Space: From Psychotic Indifferentiation Toward The Construction of Meaning in Schizophrenia

2018 ◽  
Vol 66 (5) ◽  
pp. 837-860 ◽  
Author(s):  
Paola Solano ◽  
Luca Quagelli
Keyword(s):  
Schizophrenic Patient ◽  
Complex Dynamics ◽  
Therapeutic Process ◽  
Traumatic Experiences ◽  
Transitional Space ◽  
Historical Significance ◽  
Working Through ◽  
Transference Relationship ◽  
And Function ◽  
Role And Function

Clinical material from the treatment of a highly destructive schizophrenic patient is used to demonstrate the role and function of therapeutic mediations in promoting transformation and symbolization. Use of the Squiggle Game as a therapeutic mediation is shown to sustain the therapeutic process and to facilitate working through of the obscure and complex dynamics commonly seen in the treatment of psychotic patients. The Squiggle Game presents a first transitional space entailing both the concreteness of psychosis and the potential for symbolization provided by psychoanalysis. The game becomes the first meeting ground for the progressive encounters of the therapeutic couple, primarily because in it the violent destructiveness of psychosis is partly deflected in a way that fosters development of the transference relationship. Step-by-step emotional transformations gained through the Squiggle Game are reported and discussed, together with the patient’s need to rely on nonverbal communicative modes to bring early traumatic experiences that never reached verbalization into treatment. This working through process furthered development of the dyad’s intense transference-countertransference dynamics, which stimulated construction of a link between here-and-now and there-and-then in sessions, leading to the patient’s integration and a sense of the life-historical significance of her experience.

Effectiveness of long-acting injectables and clozapine in a real-world setting during the early-stages of psychotic illness

2016 ◽  
Vol 33 (S1) ◽  
pp. S105-S105
Author(s):  
E.G. Ostinelli ◽  
E. Guanella ◽  
S. Cavallotti ◽  
C. Casetta ◽  
A. D’Agostino
Keyword(s):  
Psychotic Disorders ◽  
Pharmacological Intervention ◽  
Psychotic Illness ◽  
Treatment As Usual ◽  
Early Stages ◽  
Hospitalization Rates ◽  
Real World Setting ◽  
The Difference ◽  
Competing Interest ◽  
Long Acting

IntroductionIntervention in the early-stages of psychosis may be able to shape the clinical course; critical period (CP) is best represented by the first 5 years from first admission (FA).ObjectivesTo investigate the effectiveness of pharmacological intervention within and beyond the CP.Aims(1) To compare hospitalization rates of patients stabilized on treatment with LAIs and CLZ. (2) To determine whether treatment with LAIs and CLZ within CP can influence hospitalization rates.MethodsData were retrospectively collected from patients diagnosed with non-affective psychoses with FA between 2000 and 2014; 200 patients were then divided into three groups, according to stabilized treatment regimen during the final year of observation: treatment as usual (TAU), CLZ, LAIs. hospitalization duration (HSPD) and frequency (HSP) were calculated for each group.ResultsDespite a major severity before assignment to either CLZ or LAIs treatment, HSPD and HSP in both groups shifted below those observed for the TAU arm. Patients who began treatment with LAIs within the CP showed a highly significant decrease of both HSPD and HSP (respectively 17.4 ± 18 vs. 2.6 ± 8.2; Z = −2.856; P < 0.005 and 1.1 ± 0.8 vs. 0.2 ± 0.5; Z = −3.115; P < 0.005). No significant changes in hospitalization rates were observed for subjects who began treatment with LAIs after the CP.ConclusionsOur study confirms that treatment with either CLZ or LAIs significantly impacts the course of psychotic disorders. The data seem to suggest that LAIs and CLZ should be considered more effective than conventional oral antipsychotics in the early-stages of psychotic illness. The difference among treatments tends to wane beyond the CP, especially for LAIs.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Assimilative Psychodynamic Psychotherapy

2019 ◽  
pp. 207-227
Author(s):  
George Stricker ◽  
Jerry Gold
Keyword(s):  
Therapeutic Relationship ◽  
Future Development ◽  
Psychodynamic Psychotherapy ◽  
Emotional Experience ◽  
Illustrative Case ◽  
Corrective Emotional Experience ◽  
Potential Value ◽  
Equivalent Efficacy

Assimilative psychodynamic psychotherapy maintains a relational psychodynamic focus and methodology but assimilates interventions from other orientations seamlessly when it might help to facilitate treatment for the patient. In order to understand the potential value of these interventions drawn from other orientations, accommodation is necessary. This is done by means of an expanded three-tier model. The importance of the therapeutic relationship, particularly with regard to providing a corrective emotional experience, and the value of self-understanding is stressed. An illustrative case is presented, research summarizing the equivalent efficacy of psychodynamic psychotherapy is presented, and directions for future development are suggested.

Emotion regulation strategies in adolescents with mitral valve prolapse

2016 ◽  
Vol 33 (S1) ◽  
pp. S357-S357 ◽  
Author(s):  
E. Pervichko ◽  
Y. Zinchenko
Keyword(s):  
Emotion Regulation ◽  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Emotional Experience ◽  
Emotion Regulation Strategies ◽  
Frequent Use ◽  
Cognitive Transformation ◽  
Regulation Strategies ◽  
Competing Interest ◽  
Healthy Participants

IntroductionTwo thirds of adolescents with mitral valve prolapse (MVP) show signs of anxiety disorders. They display difficulty in emotion regulation (Van Der Ham et al., 2003; Scordo, 2007).ObjectiveTo investigate into emotion regulation strategies in MVP adolescents.MethodsA projective study of emotion regulation was undertaken with our modified version of Rosenzweig Picture-Frustration Test (Zinchenko, Pervichko, 2014). Thirty-six adolescents with MVP (mean age was 17.1 ± 0.8 years) and 40 healthy adolescents (mean age was 16.7 ± 0.6 years) took part in the study.ResultsMVP adolescents significantly more frequently (P < 0.001) would mark Rosenzweig's situations as potentially traumatizing. Ego-defence (E-D) and extrapunitive (E) reactions appear to be significantly (P < 0.05) more frequent among MVP adolescents. MVP adolescents are more than healthy subjects prone to avoid open verbal revelations of their thoughts and feelings that emerge in the situation of frustration. Content analysis of responses conditioned by cognitive control (when the task was to taper off arbitrarily the traumatizing effect of the situation) revealed that suppression of emotions was displayed by MVP adolescents in 52% of answers, and for healthy participants - 29% of answers (P < 0.001). Cognitive reappraisal strategy was displayed by MVP adolescents in 27% of answers, and for healthy participants – 38% of answers (P < 0.05). Twenty-one percent of answers of MVP adolescents and 33% of answers of healthy participants suggested cognitive transformation of emotional experience and actualization of new meanings in traumatic situations (P < 0.05).ConclusionsMVP adolescents appear to be more sensitive of frustrations and differ from healthy peers in more frequent use of the strategy of suppression of emotions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Paliperidone palmitate log-acting injection in patients with psychotic active clinic: start, change or increase of dose

2016 ◽  
Vol 33 (S1) ◽  
pp. s249-s250
Author(s):  
A.L. Gonzalez Galdamez ◽  
M.D. Piqueras Acevedo ◽  
M.R. Raposo Hernández ◽  
I. Martínez Pérez ◽  
P. Manzur Rojas ◽  
...  
Keyword(s):  
Acute Exacerbation ◽  
Descriptive Study ◽  
First Episode Psychosis ◽  
Paliperidone Palmitate ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Early Stages ◽  
Episode Psychosis ◽  
Competing Interest ◽  
Long Acting

The aim is to describe the experience of treatment with Paliperidone Palmitate long acting injection (PP) in patients with psychotic active clinic, whether diagnoses with schizophrenia or in patients with the first episode psychosis, as well as to reflect the improvement in the control of the symptoms that the patients can improve increasing the dose.MethodsWe have done a descriptive study of 34 patients hospitalized in psychiatry between January and July 2015 for psychotic active clinic who started treatment with PP or the previous dose was increased.Results91.2% of patients admitted for acute exacerbation of their usual pathology and 8.8% for a first episode psychosis. In the CGI scale, all the patients admitted scored as severe or markedly ill; going mostly mildly ill at discharge. For 55.9% of patients, the treatment was changed to PP, 29.4% of the dose was increased PP and 14.7% antipsychotic treatment was started with PP. Among patients change treatment, the main reason was non-adherence (47.4%). 70.6% of our patients were discharged with PP as only antipsychotic and 29.4% which was discharged with another antipsychotic, the most frequent association was of PP with Quetiapine (80%).ConclusionsPP is a highly effective medicament in the treatment of the schizophrenia that improves the adherence to the treatment, so in our experience and we consider it a medicament to be considered in the early stages of the disease. According to our experience and there are patients who can benefit from better control of symptoms adjusting the dose individually.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Analysis of Sound's Emotional Perception (pleasantness/unpleasantness) in Schizophrenic Patients in Early Stages of the Disease

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
C. Freitas ◽  
T. Griffiths ◽  
J.A. Ribeiro
Keyword(s):  
Emotional Experience ◽  
Clinical Severity ◽  
Future Research ◽  
Self Assessment ◽  
Sound Perception ◽  
Early Stages ◽  
Emotional Perception ◽  
Syndrome Scale ◽  
Schizophrenic Patients ◽  
Age Evaluations

Introduction:Many studies have shown that schizophrenic patients are noted to have deficits in the recognition and discrimination of facial emotions. in contrast, studies examining emotional sound perception are scarce.Objective:Evaluate emotional sound perception (pleasantness/unpleasantness) in schizophrenic patients in early stages of the disease.Methods:This study was performed on schizophrenic outpatients from the Psychiatry Departments of Hospital Santa Maria and Hospital Júlio de Matos, Lisbon. Sample group comprised 29 schizophrenic patients and 29 matched healthy controls, equal in sex and age. Evaluations included the Mini Mental State Examination; the Positive and Negative Syndrome Scale (PANSS); the Newcastle Battery of Pleasant and Unpleasant Sounds (NBPUS), which we developed to study this issue, and a visual scale of self-assessment of the emotional experience.Results and discussion:There was no statistical difference between groups. Results suggest that schizophrenic patients in early stages of the disease have a preserved emotional perception of sounds. No correlation was found between clinical severity measures (disease duration, PANSS total and sub scores) and mean unpleasantness/pleasantness rating, which may suggest that the emotional perception of sounds is rather stable during the first five years of illness.Conclusion:These results need further investigation on bigger samples studies. Future research in this area is important for the larger study of emotion and cognition.

Sign in / Sign up

Export Citation Format

Share Document