Towards an Integrated Analytical Psychology: Return to Freedom and Dignity
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This essay draws on Frantz Fanon's insights about the sociogenesis of psychiatric disorders, and on the insights of feminist standpoint theory, to sketch a map toward sociogenic mental health. We argue that psychiatry should move away from iatrogenesis (the harms of our current individual-level and pathologizing approach) toward sociogenesis of mental health through robust collaboration with social movements of oppressed people, and their collective healing approaches, ranging from harm reduction centers to community gardens. The essay ends with the outlines of a reinvented, community collaborative psychiatry that supports sociogenesis.
Coherence Therapy is an empirically derived experiential psychotherapy based on Psychological Constructivism. Symptoms are viewed as necessary output from an implicit model of the world. The therapist curates experiences and directs attention toward discovering the model. Rendered explicit, the model is juxtaposed with contradictory knowledge driving memory re-consolidation with resolution of the symptom. The Bayesian Brain views perception and action as inferential processes. Prior beliefs are combined in a generative model to explain the hidden causes of sensations through a process of Active Inference. Prior beliefs that are poor fits to the real world are suboptimal. Suboptimal priors with optimal inference produce Bayes Optimal Pathology with behavioral symptoms. The Active Inference Model of Coherence Therapy posits that Coherence Therapy is a dyadic act of therapist guided Active Inference that renders the (probable) hidden causes of a client’s behavior conscious. The therapist’s sustained attention on the goal of inference helps to overcome memory control bias against retrieval of the affectively charged suboptimal prior. Serial experiences cue memory retrieval and re-instantiation of the physiological/affective state that necessitates production of the symptom in a particular context. As this process continues there is a break in modularity with assimilation into broader networks of experience. Typically, the symptom produced by optimal inference with the suboptimal prior is experienced as unnecessary/inappropriate when taken out of the particular context. The implicit construct has been re-represented and rendered consciously accessible, by a more complex but more accurate model in which the symptom is necessary in some contexts but not others. There is an experience of agency and control in symptom creation, accompanied by the spontaneous production of context appropriate behavior. The capacity for inference has been restored. The Active Inference Model of Coherence Therapy provides a framework for Coherence Therapy as a computational process which can serve as the basis for new therapeutic interventions and experimental designs integrating biological, cognitive, behavioral, and environmental factors.
Dissociation is a complex phenomenon, which occurs in various clinical conditions, including dissociative disorders, (complex) post-traumatic stress disorder (CPTSD, PTSD), and borderline personality disorder (BPD). Traumatic stress is considered an important risk factor, while the etiology of dissociation is still debated. Next to traumatic experiences, temperamental and neurobiological vulnerabilities seem to contribute to the development of dissociation. Stress-related dissociation is a prevalent symptom of BPD, which may interfere with psychosocial functioning and treatment outcome. More research in the field is strongly needed to improve the understanding and management of this complex phenomenon. This article collection brings together research on dissociation and trauma, with a special focus on BPD or sub-clinical expressions of BPD. In this editorial, recent conceptualizations of dissociation and relevant previous research are introduced in order to provide a framework for this novel research.
The role of childhood trauma in the development of borderline personality disorder (BPD) in young age has long been studied. The most accurate theoretical models are multifactorial, taking into account a range of factors, including early trauma, to explain evolutionary pathways of BPD. We reviewed studies published on PubMed in the last 20 years to evaluate whether different types of childhood trauma, like sexual and physical abuse and neglect, increase the risk and shape the clinical picture of BPD. BPD as a sequela of childhood traumas often occurs with multiple comorbidities (e.g. mood, anxiety, obsessive-compulsive, eating, dissociative, addictive, psychotic, and somatoform disorders). In such cases it tends to have a prolonged course, to be severe, and treatment-refractory. In comparison with subjects who suffer from other personality disorders, patients with BPD experience childhood abuse more frequently. Adverse childhood experiences affect different biological systems (HPA axis, neurotransmission mechanisms, endogenous opioid systems, gray matter volume, white matter connectivity), with changes persisting into adulthood. A growing body of evidence is emerging about interaction between genes (e.g. FKBP5 polymorphisms and CRHR2 variants) and environment (physical and sexual abuse, emotional neglect).
High prevalence of borderline personality disorder (BPD) diagnosis is observed among sexual minority samples. It is unclear if sexual minority individuals are systematically diagnosed with BPD at higher rates than heterosexual individuals, and if potential diagnostic disparity can be explained by differences in maladaptive personality domains. Utilizing data from partial hospital patients (N = 1,099) the current study explored (a) differences in the frequency of diagnosis of BPD based on sexual orientation, (b) whether disparities explained differences in psychopathology across groups, and (c) the congruence between traditional methods of BPD diagnosis (i.e., clinical assessment) versus diagnosis based on elevations in self-reported maladaptive personality domains consistent with the alternative model for personality disorders. Sexual minority individuals were more likely to be diagnosed with BPD than heterosexual individuals (odds ratio [OR] = 2.43, p < .001), even after controlling for differences in clinical correlates of BPD diagnosis (age, gender, comorbid posttraumatic stress disorder, maladaptive personality domains; OR = 1.59, p < .05). Diagnostic disparity was highest for bisexual compared with heterosexual patients. These results suggest that clinicians may be predisposed to provide a BPD diagnosis to sexual minority patients that is independent of presenting psychopathology and bear important implications for future research aimed at discerning whether such predisposition is due to measure or clinician bias.
Consensus is emerging that the constellation of dark personalities should include the sadistic personality. To build a four-factor measure, we modified and extended the Short Dark Triad (SD3) measure to include sadism. A series of three studies yielded the Short Dark Tetrad (SD4), a four subscale inventory with 7 items per construct. Study 1 (N = 868) applied exploratory factor analysis (EFA) to a diverse 48-item pool using data collected on MTurk. A 4-factor solution revealed a separate sadism factor, as well as a shifted Dark Triad. Study 2 (N = 999 students) applied EFA to a reduced 37-item set. Associations with adjustment and sex drive provided insight into unique personality dynamics of the four constructs. In Study 3 (N = 660), a confirmatory factor analysis (CFA) of the final 28 items showed acceptable fit for a four-factor solution. Moreover, the resulting 7-item subscales each showed coherent links with the Big Five and adjustment. In sum, the four-factor structure replicated across student and community samples. Although they overlap to a moderate degree, the four subscales show distinctive correlates – even with a control for acquiescence. We also uncovered a novel link between sadism and sexuality, but no association with maladjustment.
Objective:
Attention to personal appearance and observers' judgments are integral components of narcissism. However, empirical evidence focused on the association between grandiose/vulnerable traits of narcissism and social appearance anxieties is limited. Moreover, body shame represents a topic of debated interest in the field of narcissism and women's experience of self-consciousness. The aim of the present study is to evaluate the unexplored relationship between covert and overt facets of pathological narcissism and social appearance anxiety, analyzing the mediating role of objectified body shame.
Method:
Pathological vulnerable and grandiose narcissism, social appearance anxiety and body shame were assessed in a convenience sample of 775 young women (M=24.1, SD=4.52).
Results:
Body shame fully mediated the association between pathological narcissism and social appearance anxiety, especially for vulnerable narcissists' women.
Conclusions:
As expected, vulnerable narcissism had a positive association with social appearance anxieties, and body shame acted as a mediating risky factor. Moreover, as hypothesized and differently from recent findings, also overt narcissism was related to body shame and appearance anxieties. These findings suggest that feelings of shame are essential to deeper understand the narcissistic core features and outcomes. Research and clinical implications are discussed.
This paper offers a formal account of emotional inference and stress-related behaviour, using the notion of active inference. We formulate responses to stressful scenarios in terms of Bayesian belief-updating and subsequent policy selection; namely, planning as (active) inference. Using a minimal model of how creatures or subjects account for their sensations (and subsequent action), we deconstruct the sequences of belief updating and behaviour that underwrite stress-related responses - and simulate the aberrant responses of the sort seen in post-traumatic stress disorder (PTSD). Crucially, the model used for belief-updating generates predictions in multiple (exteroceptive, proprioceptive and interoceptive) modalities, to provide an integrated account of evidence accumulation and multimodal integration that has consequences for both motor and autonomic responses. The ensuing phenomenology speaks to many constructs in the ecological and clinical literature on stress, which we unpack with reference to simulated inference processes and accompanying neuronal responses. A key insight afforded by this formal approach rests on the trade-off between the epistemic affordance of certain cues (that resolve uncertainty about states of affairs in the environment) and the consequences of epistemic foraging (that may be in conflict with the instrumental or pragmatic value of 'fleeing' or 'freezing'). Starting from first principles, we show how this trade-off is nuanced by prior (subpersonal) beliefs about the outcomes of behaviour - beliefs that, when held with unduly high precision, can lead to (Bayes optimal) responses that closely resemble PTSD.
In the early nineties of the twentieth century Jaak Panksepp coined the term “Affective Neuroscience” (AN) today being accepted as a unique research area in cross-species brain science. By means of (i) electrical stimulation, (ii) pharmacological challenges, and (iii) brain lesions of vertebrate brains (mostly mammalian), Panksepp carved out seven primary emotional systems called SEEKING, CARE, PLAY, and LUST on the positive side, whereas FEAR, SADNESS, and ANGER belong to the negative affects. Abundant research into human clinical applications has supported the hypothesis that imbalances in these ancient primary emotional systems are strongly linked to psychiatric disorders such as depression. The present paper gives a concise overview of Panksepp's main ideas. It gives an historical overview of the development of Panksepp's AN thinking. It touches not only areas of neuroscience, but also shows how AN has been applied to other research fields such as personality psychology. Finally, the present work gives a brief overview of the main ideas of AN.
In The Writing of the Disaster, Maurice Blanchot includes a brief discussion of the Narcissus myth, implicitly inviting us to ask, as Claire Nouvet notes, "what is 'disastrous' in Narcissus's story." Translating this question into a postcolonial context, this essay argues that what is "disastrous" in colonial narcissism is the profound disturbance the story reveals in Narcissus's capacity to relate to others: a disturbance which imprisons Narcissus in a "crippling solipsism." In seeking to sow the seeds for an effective response, the paper draws on contemporary psychoanalytic theories of narcissism to propose that Narcissus's "grandiose" disavowal of relationality is a mere smokescreen to cover up his profound vulnerability and fear: a fear of the other which originates in relational trauma. Making reference to the settler colonial context, I argue that this traumatic core of the narcissistic condition has remained largely occluded because trauma studies' dominant event-based model of trauma is ill-equipped to recognise colonialism's relational trauma. To break with colonial narcissism's toxic legacy, I therefore propose, a relational trauma theory—such as it is developed in the work of D. W. Winnicott and Masud Khan—is needed.
This article proposes a critical review of racial issues in Brazil and its relationship with Jungian and post-Jungian psychology. We begin with a brief historical review. Then, we brought some contemporary debates on the subject, identifying the main publications of post-Jungian psychology and its relationship with the clinical work. The idea of cultural complex opens important keys to analyze it, as well as some ideas of the archetypal school on the subject. There is a strong racial complex present in Brazilian psychological life, which permeates psychotherapeutic care. As a conclusion we point out the fundamental importance of listening to the multiple in the face of a homogeneous discourse present today, in a more or less direct and violent way.
This groundbreaking new translation of The Interpretation of Dreams is the first to be based on the original text published in November 1899. It restores Freud’s original argument, unmodified by revisions he made following the book’s critical reception which included, under the influence of his associate Wilhelm Stekel, the theory of dream symbolism. Reading the first edition reveals Freud’s original emphasis on the use of words in dreams and on the difficulty of deciphering them and Joyce Crick captures with far greater immediacy and accuracy than previous translations by Strachey’s Freud’s emphasis and terminology. An accessible introduction by Ritchie Robertson summarizes and comments on Freud’s argument and relates it to his early work. Close annotation explains Freud’s many autobiographical, literary and historical allusions and makes this the first edition to present Freud’s early work in its full intellectual and cultural context.
This special issue aims to provide a comprehensive overview of the current state of the Bayesian Brain Hypothesis and its standing across neuroscience, cognitive science and the philosophy of cognitive science. By gathering cutting-edge research from leading experts, this issue seeks to showcase the latest advancements in our understanding of the Bayesian brain, as well as its potential implications for future research in perception, cognition, and motor control. A special focus to achieve this aim is adopted in this special issue, as it seeks to explore the relation between two seemingly incompatible frameworks for the understanding of cognitive structure and function: the Bayesian Brain Hypothesis and the Modularity Theory of the Mind. In assessing the compatibility between these theories, the contributors to this special issue open up new pathways of thinking and advance our understanding of cognitive processes.
In this article, I outline three primary ways in which Philip Bromberg’s work has reshaped the terrain of much of current psychoanalysis: (1) movement of the emphasis in psychoanalytic thinking from repression to dissociation; (2) premising personality disorders on dissociation; and (3) a redefinition of the unconscious. I also describe some of my work that expands on or is related to these. The latter involves a significant extrapolation of Bromberg’s understanding of personality disorders as dissociation-based, highlighting the differing dissociative structures of borderline personality disorder, “masochism,” and malignant narcissism, or psychopathy. In addition to describing how the intrapersonal dynamics involving a dissociated, punishing self-state (similar to an abusive alter) resemble the psychodynamics of archaic, or harsh superego, I enter a plea for the recognition, following some of Bromberg’s concepts, of the importance of the dissociative unconscious.
Heavily exploited for its reddish, decay-resistant heartwood, the tallest conifer, Sequoia sempervirens, is a major component of coastal forests from extreme southwestern Oregon to California’s Santa Lucia Mountains. Primary Sequoia forests are now restricted to < 5 % of their former distribution, and mature secondary forests with trees over 60 m tall are even scarcer due to repeated logging. Leveraging allometric equations recently derived from intensive work in both forest types, we climbed, measured, and core-sampled 235 trees in 45 locations distributed across the species range to examine growth trends and understand how tall Sequoia are responding to recent environmental changes. Paired samples of sapwood and heartwood collected along the height gradient were used to quantify Sequoia investment in decay resistance. During the 20th century, trees in most locations began producing more wood than expected for their size with this growth surge becoming pronounced after 1970 and ending around 2000. Radial increments—ring widths—correlate with climatic variables related to water availability, and these relationships are strengthening as temperatures rise. Sensitivity to drought increased from north to south along a 6° latitudinal gradient of decreasing precipitation and summer fog frequency. Sequoia trees north of 40° were least sensitive to drought, producing similar biomass annually during dry and wet years, whereas trees farther south produced less biomass during individual drought years. Hotter 21st century drought barely affected Sequoia growth efficiency (biomass increment per unit leaf mass) north of 40° until the fourth consecutive year (2015), when growth efficiency dropped precipitously, recovering within two years. South of 40°, Sequoia trees exhibited steadily declining growth efficiency during the multi-year drought followed by recovery, but recovery did not occur south of 37° despite ample precipitation in 2017. Sequoia growth efficiency is currently highest in secondary forests north of 40°, where trees produce relatively small amounts of heartwood with the lowest decay resistance (least fungicide) while receiving the most nocturnal summer fog. Increasing sink limitations, whereby rising temperatures, drier air at night, and extreme tree height collectively lower turgor pressure to inhibit cambial activity, may reduce Sequoia growth efficiency while contributing to more durable biomass production. Heartwood and fungicide increments are higher in primary than secondary forests across the species range. Crown structural complexity promotes development of vascular epiphytes and arboreal soil habitats in Sequoia forests with sufficient moisture availability. These habitats are lacking in secondary forests and rare in primary forests south of 40°. After logging, restoration of tall Sequoia forests can be achieved via silviculture that maximizes height increments during early stand development and then retains some dominant trees in perpetuity, allowing them to gain full stature, produce increasingly decay-resistant heartwood, and support significant arboreal biodiversity.
Of the various behavioral differences between males and females, physical aggression is one of the largest. Regardless of gender, children’s physical aggressiveness peaks between two and four years of age but then starts diverging, as girls learn more quickly than boys to suppress such overt behaviors. By puberty there is a sizable gender difference in physical aggression and violence. Studies in rodents suggest that sex differences in aggression and rough-and-tumble play are mediated by the amygdala, whose volume in males is enhanced by prenatal testosterone. However, efforts to extend this model to humans have shown limited success. This paper takes a critical look at current assumptions about gender differences in aggression and their neural basis. Aggression and empathy are competing impulses that engage much of the same cortico-limbic circuitry and are highly sensitive to social factors and early adversity. Learning, or neuroplasticity, is both a primary cause and key intervention for minimizing male aggression and violence. © 2021 by The Wenner-Gren Foundation for Anthropological Research. All rights reserved.
Background:
Emotional abuse is a form of maltreatment that most strongly predicts adult depressive symptoms in community samples. Introject theories suggest that some depressive symptoms stem from survivors having learned to treat themselves the way they were treated by their perpetrators.
Objective:
Malevolent introjects may undermine self-compassion, which may subsequently maintain feelings of shame. Thus, we hypothesized that self-compassion and shame would mediate the path from retrospective reports of maltreatment to concurrent depressive symptoms in adulthood.
Participants and setting:
Participants were 244 adult community members and college students living in a Southwestern American metroplex.
Method:
We ran a multiple mediator path model with emotional abuse as the independent variable. We specified four covariates: physical abuse, sexual abuse, physical neglect, and emotional neglect, and held constant the variance they explained in self-compassion, shame, and depression.
Results:
Our final model accounted for 53.1% of the variance in adult depressive symptoms. A significant indirect effect from emotional abuse passed through both mediators and ended in adult depressive symptoms. We also found an indirect path from emotional neglect to depression passing through both mediators.
Conclusions:
It appears emotional abuse and emotional neglect can undermine the formation of self-compassion. Low self-compassion predicts greater shame and depressive symptoms. Our model suggests self-compassion may be a particularly effective intervention point for survivors of emotional maltreatment.
Consciousness remains a formidable challenge. Different theories of consciousness have proposed vastly different mechanisms to account for phenomenal experience. Here, appealing to aspects of global workspace theory, higher-order theories, social theories, and predictive processing, we introduce a novel framework: the self-organizing metarerpresentational account (SOMA), in which consciousness is viewed as something that the brain learns to do. By this account, the brain continuously and unconsciously learns to redescribe its own activity to itself, so developing systems of metarepresentations that qualify target first-order representations. Thus, experiences only occur in experiencers that have learned to know they possess certain first-order states and that have learned to care more about certain states than about others. In this sense, consciousness is the brain's (unconscious, embodied, enactive, nonconceptual) theory about itself.
This article sets out the relevance of recent theoretical developments in the areas of mentalizing, attachment and epistemic trust in relation to group therapy. It begins with an account of the role of mentalizing in the attachment context in the development of epistemic trust—defined as trust in the authenticity and personal relevance of interpersonally transmitted knowledge about how the social environment works. It then explains the particular way in which this emphasis on social communication is pertinent to group therapy and its function as a training ground for mentalizing and the initial experimentation with the opening of epistemic trust in a social context. The article finishes with an account of how mentalization-based group work is undertaken.