Narrowing the Gap: Imaging Disparities in Radiology.

It may seem unlikely that the field of radiology perpetuates disparities in health care, as most radiologists never interact directly with patients, and racial bias is not an obvious factor when interpreting images. However, a closer look reveals that imaging plays an important role in the propagation of disparities. For example, many advanced and resource-intensive imaging modalities, such as MRI and PET/CT, are generally less available in the hospitals frequented by people of color, and when they are available, access is impeded due to longer travel and wait times. Furthermore, their images may be of lower quality, and their interpretations may be more error prone. The aggregate effect of these imaging acquisition and interpretation disparities in conjunction with social factors is insufficiently recognized as part of the wide variation in disease outcomes seen between races in America. Understanding the nature of disparities in radiology is important to effectively deploy the resources and expertise necessary to mitigate disparities through diversity and inclusion efforts, research, and advocacy. In this article, the authors discuss disparities in access to imaging, examine their causes, and propose solutions aimed at addressing these disparities.

Autotheory: Toward the Embodying of Analytic Framing.

Autotheory is an emerging idea in feminist theory that emphasizes the inevitability of the subjective and embodied personal within any development, understanding, or application of theory. Autotheory offers a way to bring the sexed and gendered body of the analyst back into view in clinical practice and is a possible route to relibidinizing psychoanalytic theory. The embodied part of the "personal" contribution of the analyst will be examined through conceptions of framing and the frame, extending and further conceptualizing ideas prominently addressed within relational and intersubjective theories. Framing activity as a developmental goal for psychoanalytic process is considered in relation to the ways in which autotheoretical texts enact or depict the unceasing interplay of relational experience and theory that forms subjectivity. A clinical vignette describes the experience of framing activity during remote videoconference therapy.

The Portal: Framing and Neutrality in the Age of Virtual Treatment.

The author proposes that the concept of framing activity provides a useful approach to neutrality by synthesizing relational approaches with an extension of José Bleger's (1967, 2012) conceptualization of the frame as containing primitive aspects of the analysand. She argues that the analytic frame also serves as a depository, or bulwark, for the analyst's ideological alignments. Identifying how ongoing framing activity is in tension with this bulwark affords a means of approaching, interrogating, and "doing" neutrality that elaborates the flexibility and self-reflection that contemporary psychoanalytic thinking seeks to bring to an earlier, more rigid idea of "the frame." Clinical vignettes focus on framing and its connection to neutrality in the context of remote treatments.

THE ANALYST'S RELOCATION: ANALYSIS TERMINABLE, INTERMINABLE, AND DISLOCATED.

The analyst's relocation is relatively neglected in the literature. Yet relocation is profoundly unsettling, striking at the psychoanalytic contract in a way that illness or even severe countertransference disturbances do not, and this unsettling aspect of resettling can disturb analytic functioning. The few previous papers about relocation focus on how to best understand and manage "reality" intrusions in terms of the nature and status of the transference relationship. In this paper, an engagement with object relational ideas is the prism through which to examine the dislocations of relocation and the potential disruptions of thinking caused by the vicissitudes of moving.

"Worthless female material": nursemaids and governesses in Freud's cases.

The figure of the governess, central in Freud's own history, is present in most of his cases. Freud described his nursemaid as "the prime originator" of his neuroses. Well after Freud's abandonment of the seduction theory, female servants were consistently portrayed as seducing boys, while their relationship with girls consisted of identification and rivalry. The role of Freud's own surrogate mother in his life and writing is examined, and two cases, Lucy R. and Dora, are looked at through the lens of female caretaking. A review and integration of relevant literature is followed by an exploration of the perplexing adherence in Freud's writing to the reality of seduction by a governess, even after he had abandoned the seduction theory. It is argued that it is in the figure of the female maid that the "shadowy" early history of Freud's mothering experiences may actually be engaged, however indirectly and unconsciously. This figure, and Freud's powerful, problematic identification with her, is a thread that when pulled helps unravel struggles in Freud's early theoretical development around issues of female sexuality and analytic authority. Revisiting Lucy R. and Dora provides a new perspective on Freud's difficulty with maternal transferences, and restores to their original importance his "worthless" governesses, those first analysts.

Psychoanalysis and the Catholic Church in Italy: the role of Father Agostino Gemelli, 1925-1953.

Agostino Gemelli, a Catholic priest, psychiatrist, administrator, and educator, was an important figure in the early history of psychoanalysis in Italy. He was one of the few establishment figures to grapple with Freud's ideas in Italy during the first half of the twentieth century, a period during which Italy, compared to the rest of Europe and to the United States, was relatively impermeable to psychoanalysis. One of the factors that contributed to this was the opposition of the powerful Catholic Church, which identified in psychoanalysis a challenge to its authority. The author argues that Father Gemelli's shifting positions about psychoanalysis between 1925 and 1953 reflected the exigencies of his historical circumstances. Gemelli was able to identify in psychoanalysis an integrated view of the human condition in stark opposition to the brutal reductionism of psychiatry in Italy at that time, but also encountered in it elements intolerable to the Church. Examining specifically what it is that Gemelli could accept of psychoanalysis, and what needed to be rejected, between 1925 and 1953, illustrates the particular challenge posed by psychoanalysis to Catholicism in Italy.