Making conscious the unconscious in order to modify unconscious processing: Some mechanisms of therapeutic change

Can research influence clinical practice?

After briefly reviewing the unfavourable reception accorded empirical research by parts of the psychoanalytic community, as well as some of the benefits to clinical practice of analysts being involved in research activities, the author examines whether the findings of process and outcome research in psychotherapy and psychoanalysis can help identify the most appropriate forms of intervention for producing therapeutic change, given the specific condition of the patient and the relationship that the individual establishes with the analyst. He argues that research findings can influence clinical practice on various levels and in different areas, and goes on to examine a number of related issues: the specificity of therapeutic interventions versus the relevance of common curative factors; the dyadic conception of technique and ways of understanding the therapeutic action of the treatment alliance; and the strategic or heuristic conception in psychoanalytic therapy. Finally, the author presents clinical material with the aim of illustrating how the knowledge acquired through research can be applied to psychoanalytic treatment.

“The Devil Made Me Do It!” An Inquiry Into the Unconscious “Devils Within” of Rationalized Corruption

Individuals involved in corruption often offer rationalizations to convince themselves and others that they are not corrupt, and that their acts are justified and acceptable. However, to confine the dynamic process of mobilizing rationalizations to this purpose is too restrictive. Drawing on psychoanalytic theory, it is argued that an unconscious urge for rationalizations develops from a need to find psychological restitution and atonement, achieved only through self-convincing beliefs of acquittal. Six unconscious motives are identified as explanations how offenders believe that rationalizations acquit them from guilt, indemnify them, or redeem the corruption. These motives represent metaphorical devils that can spawn corruption in otherwise law-abiding citizens with moral intentions. Conceptualizations bring the unconscious dynamics or rationalized corruption into consciousness, where it can be studied and worked with. This makes an important contribution toward enabling managers to be more in control of rationalized corruption, both in themselves and elsewhere in the organization.

O après-coup e a reconsolidação da memória

<p>Em diferentes áreas do conhecimento é reconhecido que a memória está sujeita a transformações ao longo do tempo. Partindo desse pressuposto, o objetivo do presente estudo é apresentar uma discussão compreendendo a ideia de que nossas recordações são suscetíveis a transformações e a concepção de <italic>après-coup</italic>. Há o delineamento de algumas ideias acerca da temporalidade em Psicanálise e do mecanismo de reconsolidação da memória segundo as Neurociências. Utilizando-se tais conceitos, evidenciou-se a viabilidade de se pensar uma interlocução entre a Psicanálise e as Neurociências.</p>

Ego, drives, and the dynamics of internal objects

This paper addresses the relationship between the ego, id, and internal objects. While ego psychology views the ego as autonomous of the drives, a less well-known alternative position views the ego as constituted by the drives. Based on Freud's ego-instinct account, this position has developed into a school of thought which postulates that the drives act as knowers. Given that there are multiple drives, this position proposes that personality is constituted by multiple knowers. Following on from Freud, the ego is viewed as a composite sub-set of the instinctual drives (ego-drives), whereas those drives cut off from expression form the id. The nature of the "self" is developed in terms of identification and the possibility of multiple personalities is also established. This account is then extended to object-relations and the explanatory value of the ego-drive account is discussed in terms of the addressing the nature of ego-structures and the dynamic nature of internal objects. Finally, the impact of psychological conflict and the significance of repression for understanding the nature of splits within the psyche are also discussed.

Rethinking pathological mourning: multiple types and therapeutic approaches

Different types of pathological mourning are discussed, with the idea that refining psychoanalytic nosology in this sector can contribute to the enhancement of interventions more suitable for each. Primary fixation to the object--extant before the loss--is differentiated from secondary fixation, which occurs when suffering in the present leads to idealization of an object that is only then felt to be actually lost. The role of narcissism, guilt feelings, and paranoid anxieties in the process of pathological mourning is considered. Clinical material illustrates some of these conditions.

After pluralism: Towards a new, integrated psychoanalytic paradigm1

After a restatement of the isolationism of psychoanalysis from allied disciplines, and an examination of some of the reasons for the diversity of schools of thought and the fragmentation of psychoanalytic knowledge, the author suggests the need to adopt principles of correspondence or external coherence along with those of hermeneutic coherence to validate psychoanalytic hypotheses. Recent developments in neurocognitive science have come to the aid of psychoanalysis in this period of crisis, resulting in the proposition of integrating both areas to form a new paradigm for the construction of the theory of the mind. This emerging paradigm tries to integrate clinical knowledge with neurocognitive science, findings from studies on the process and outcome of psychotherapy, research into the early mother-infant relationship, and developmental psychopathology. The author examines theoretical- technical models based on the concept of drives and of relationships in the light of interdisciplinary findings. He concludes that the relational model has a broad empirical base, except when the concept of drives is discredited. Interdisciplinary findings have led to the positing of the replacement of the Freudian model of drives with a model of motivational systems centred on affective processes. He draws certain conclusions which have a bearing on the technique of psychoanalytic treatment. These arise from the adoption of the new integrated paradigm.

Neurobiology of dynamic psychotherapy: an integration possible?

In the last decades, Kandel's innovative experiments have demonstrated that brain structures and synaptic connections are dynamic. Synapses can be modified by a wide variety of environmental factors, including learning and memory processes. The hypothesis that dynamic psychotherapy process involves memory and learning processes has opened the possibility of a dialogue between neuroscience and psychoanalysis and related psychotherapy techniques. The primary aim of the present article is to critically review the more recent data on neurobiological effects of dynamic psychotherapy in psychiatric disorders. Relevant literature has been selected using the databases currently available online (i.e., PubMed). The literature search has been limited to the past 10 years and to genetic, molecular biology, and neuroimaging studies that have addressed the issue of changes induced by psychotherapy. Most of the genetic studies on mental disorders have demonstrated that psychiatric conditions result from a complex interaction of genetic susceptibility and environmental effects. For none of the many psychiatric conditions investigated has a purely genetic background been found. Molecular biology studies have indicated that gene expression is influenced by several environmental factors, including early experiences, traumas, learning, and memory processes. Neuroimaging studies (using fMRI and PET) have found that not only cognitive but also dynamic psychotherapy has measurable effects on the brain. In addition, psychotherapy may modify brain function and metabolism in specific brain areas. Most of these studies have considered patients with major depressive disorders and compared the effects of psychotherapy with the effect of standard pharmacotherapy. In conclusion, recent results from neuroscience studies have suggested that dynamic psychotherapy has a significant impact on brain function and metabolism in specific brain areas. The possible applications and developments of this new area of research toward the conceptualization of an integrative approach to treatment of psychiatric disorders are discussed.