Clinical Intuition under Scrutiny: From Potholes to Possibilities

In this article the author explores the use of imagination and clinical intuition in psychotherapy. She discusses the functions of imagination and how the capacity to be creative and for flexible imagining emerges within a secure attachment relationship in early childhood. Winnicott's ideas are important here. She also discusses what happens when trauma or relationship failings compromise the transitional space and uses case examples to illustrate some responses to this breakdown. To set the scene the author discusses changing views on illusion and imagination from Freud onwards to the present day when we are informed by recent findings in neuroscience and interpersonal neurobiology. It is richly illustrated with theory and case material.

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Portals through Liminal Space: Commentary on Shapiro and Marks-Tarlow’s “Varieties of Clinical Intuition”

Psychoanalytic Dialogues ◽

10.1080/10481885.2021.1902738 ◽

2021 ◽

Vol 31 (3) ◽

pp. 294-301

Author(s):

Janine de Peyer

Keyword(s):

Liminal Space ◽

Clinical Intuition

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Cancer of unknown primary site

Oxford Textbook of Oncology ◽

10.1093/med/9780199656103.003.0059 ◽

2016 ◽

pp. 965-974

Author(s):

Nicholas Pavlidis ◽

George Pentheroudakis

Keyword(s):

Expression Profiling ◽

Cancer Of Unknown Primary ◽

Primary Site ◽

Unknown Primary ◽

Unknown Primary Site ◽

Clinical Intuition ◽

Genome Wide ◽

Genetic Signatures ◽

Genome Wide Expression ◽

Tumour Origin

This chapter covers cancer of unknown primary site (CUP), and includes information on epidemiology, molecular biology, pathology, and multidisciplinary management of clinicopathological subsets. Previously, these tumours were diagnosed and treated based on clinical presentation, light microscopy and clinical intuition. Today, the majority of cancers of unknown primary site are becoming less unknown, more accurately classified, and appropriately treated by the use of multiplex or genome-wide expression profiling platforms. These techniques allow for precise and correct knowledge of the true tumour origin, leading to more rational and effective treatment. However, there also may be genetic signatures that are primary-independent, pro-metastatic, and possibly CUP-specific.

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Autism spectrum heterogeneity: fact or artifact?

Molecular Psychiatry ◽

10.1038/s41380-020-0748-y ◽

2020 ◽

Vol 25 (12) ◽

pp. 3178-3185 ◽

Cited By ~ 9

Author(s):

Laurent Mottron ◽

Danilo Bzdok

Keyword(s):

Autistic Traits ◽

Fold Increase ◽

Autism Spectrum ◽

Machine Learning Algorithms ◽

Qualitative Properties ◽

Diagnostic Practices ◽

Clinical Intuition ◽

Dsm 5 ◽

Diagnostic Threshold ◽

Categorical Diagnosis

AbstractThe current diagnostic practices are linked to a 20-fold increase in the reported prevalence of ASD over the last 30 years. Fragmenting the autism phenotype into dimensional “autistic traits” results in the alleged recognition of autism-like symptoms in any psychiatric or neurodevelopemental condition and in individuals decreasingly distant from the typical population, and prematurely dismisses the relevance of a diagnostic threshold. Non-specific socio-communicative and repetitive DSM 5 criteria, combined with four quantitative specifiers as well as all their possible combinations, render limitless variety of presentations consistent with the categorical diagnosis of ASD. We propose several remedies to this problem: maintain a line of research on prototypical autism; limit the heterogeneity compatible with a categorical diagnosis to situations with a phenotypic overlap and a validated etiological link with prototypical autism; reintroduce the qualitative properties of autism presentations and of current dimensional specifiers, language, intelligence, comorbidity, and severity in the criteria used to diagnose autism in replacement of quantitative “social” and “repetitive” criteria; use these qualitative features combined with the clinical intuition of experts and machine-learning algorithms to differentiate coherent subgroups in today’s autism spectrum; study these subgroups separately, and then compare them; and question the autistic nature of “autistic traits”

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