A psychoanalytic look at repetitive outbreaks of brief psychosis.

This article aims to take a psychoanalytic look at brief psychoses at risk of repetition. By this we are referring to very florid psychotic symptomatology that first appears in adults with no significant history of psychopathology. This is almost completely reversed with pharmacological treatment; however, the threat of repetition persists. We illustrate the difference from schizophrenia and borderline pathology. We present two cases in detail to demonstrate, first of all, that psychoanalytic therapy drastically improves the prognosis. Furthermore, both case studies, in patients with comparative richness of mental functioning outside of their psychotic episodes, afford us direct access to the essence of psychotic functioning. We will demonstrate how the external triggers are specific to each case and how these relate to unsymbolised material in each patient. These are themes that are heavily loaded with traumatic weight in the patients' histories, concerning elements which previous generations had not worked through, and which remain in a kind of non-symbolic register outside of word-presentations, associatively disconnected from the rest of the mental functioning until sparked by the particular external trigger which activates all of their pathogenic potential. We intend to analyse the improvement of these patients and we make considerations about technique.

Transexualidades de hombre a mujer / Transsexualité d’homme à femme / Male to female transsexualities

El propósito de este trabajo es intentar comprender más profundamente cómo se llega a la transexualidad de hombre a mujer. Presenta una discusión psicoanalítica sobre un estudio controlado de dos grupos: uno de 25 transexuales de hombre a mujer y el otro, de 25 controles, con sexo masculino e identidad de género masculina. Se estudian variables relacionadas con las representaciones de sus familias de la primera infancia. En la muestra de transexuales, la figura paterna se percibe como más negligente, las madres y los padres como más sobreprotectores e intrusivos, y los sujetos se ubican más cerca de sus madres y lejos de sus padres que en la muestra de los controles. Un tercio de la muestra de transexuales han recibido tamiento hormonal y cirugía completa de reasignación y aproximadamente un tercio presenta pechos femeninos, pero mantiene los genitales masculinos. Los resultados del estudio se discuten utilizando la teoría freudiana de las identificaciones: identificación primaria, narcisista e histérica. Dichos procesos de identificación se proponen como posibles vías para el establecimiento de una identidad de género divergente del sexo biológico. (AU)

The purpose of this work is to more deeply understand how male to female transsexualism occurs. It presents a psychoanalytic discussion on a controlled study of two sample groups, one of 25 adult male to female transsexuals and cohort control of 25 people of male sex and male gender identity. The variables related to these people’s representations of their early childhood families are studied. In the transsexual sample, the father figure is perceived as more negligent, the mothers and fathers as overprotective and intrusive, and the people remember being much closer to their mothers. One third of the transsexual sample has undergone total reassignment and approximately one third present female breasts but maintain male genitals. The results of the study are discussed using Freudian identification theory: primary, narcissistic, and hysterical identification. Said identification processes are proposed as channels of influence for the establishment of gender identity separate from biological factors. (AU)

Le propos de ce travail est d’essayer de comprendre plus profondément comment on arrive à la transsexualité d’homme à femme. Il présente une discussion psychanalytique sur une étude contrôlée de deux groupes : un de 15 transsexuels d’homme à femme et un autre, de 25 contrôles, de sexe masculin et identité de genre masculin. L’on étudie des variables aux représentations de leurs familles de la petite enfance. Dans l´échantillon des transsexuels, la figure paternelle est perçue comme plus négligente, les mères et les pères sont plus surprotecteurs et intrusifs, et les sujets se situent plus près de leurs mères et plus loin de leurs pères que dans l´échantillon de contrôle. Un tiers de l´échantillon de transsexuels a reçu un traitement hormonal et une chirurgie complète de réaffectation et environ un tiers présente des seins féminins, mais maintiennent les génitaux masculins. Les résultats de l’étude sont discutés en utilisant la théorie freudienne des identifications : identification primaire, narcissique et hystérique. Ces processus d’identification sont proposés comme des chemins possibles pour l’établissement d’une identité de genre divergeant du sexe biologique. (AU)

La formación psicoanalítica. Introducción al tema monográfico / No disponible

No disponible

Lo arcaico en el proceso analítico. Introducción al tema del monográfico / No disponible

No disponible

A development of Freudian metapsychology for schizophrenia.

The author states that psychoanalysis has much to contribute to schizophrenia. Beginning with a development of Freudian metapsychology, he addresses the in-depth psychopathological study of a session (the first on the couch) with a schizophrenic patient who hears voices and feels that he is being watched. Since the symptoms appear at the level of the heard word and the visual image - key to Freudian metapsychology - he delineates a circuit for the word and one for the image, describing a blockage in both and the consequences of these. Furthermore, with regard to the patient's progress, he demonstrates first a quantitative improvement in symptoms, and later qualitative changes in his functioning. He shows how, over a time, functioning is improved in a once-a-week on-the-couch setting after two years of face-to-face treatment.

La realidad en Flor sin Piel / The reality in Flower without Skin

El autor parte de la viñeta clínica de una paciente compleja para preguntarse por cuál es la realidad que condiciona el modo de sentirse de la paciente y cuál es la realidad en la que el psicoanalista puede intervenir. Revisa el concepto de noúmeno de Kant y recorre cómo Freud ubica lo incognoscible en el inconsciente no reprimido. Termino revisando más adelante algunas de las vías de acceso a esta parte del psiquismo que tanto condiciona el modo de sentir la realidad (AU)

The autor starts with the exposition of the clinical material of a complicated case. The aim is to think about what is the reality that conditions the feelings of the patient. And what is the reality that the psychoanalyst can change. He reviews Kant’s concept of noúmeno, and goes over how first Freud places the unknownable in the repressed unconscious, and after he focus on non-repressed unconscious. Finally, the author reviews some of the ways to make contact with that part of the psychism that conditions so much the way of perceiving reality (AU)

"Si puo morire d'amore": reflexiones sobre la denominada violencia de género / "Si puo moriré d'amore": reflexions on the so called gender violence

Partiendo de un planteamiento más social y superficial de la denominada violencia de género se va entrando en estratos más profundos de la violencia en las relaciones de pareja. Se llega a un tipo de relación con posiciones bien delimitadas para el hombre (hombre-niño desamparado y dependiente) y la mujer (mujer-madre omnipotente) en que ambos forman una entidad representacional conjunta en que se reniega la castración de la mujer a través del fetiche hombre-bebé, al modo de las perversiones maternas descritas por Schaeffer. La violencia y la agresión asesina aparecen al detectarse cualquier factor tercero que pueda romper la burbuja narcisista formada por ambos (AU)

Starting from a more social and superficial approach to the so called gender violence, the author enters to deeper levels of the violence in couples. He arrives to the description of a type of relationship with well-established roles for the man (child-man with helplessness and dependence) and the woman (mother-woman with omnipotence) in which both form a joint representative entity. In this entity the castration of the woman is object of disavowal through the fetish child-man, with the conceptual reference of the maternal perversions described by Schaeffer. The violence and the mortal aggression appear when any third element is detected with the risk of breaking the narcissistic bubble created by both man and woman (AU)

Negative signs and symptoms secondary to antipsychotics: a double-blind, randomized trial of a single dose of placebo, haloperidol, and risperidone in healthy volunteers.

OBJECTIVE: Despite the clinical observation that antipsychotics can produce negative symptoms, no previous controlled study, to our knowledge, has evaluated this action in healthy subjects. The present study assessed observer-rated and self-rated negative symptoms produced by conventional and second-generation antipsychotics in healthy volunteers. METHOD: The authors used a double-blind, placebo-controlled trial of single doses of haloperidol (5 mg) and risperidone (2.5 mg) in normal subjects. Thirty-two subjects were administered haloperidol, risperidone, and placebo in a random order. Motor variables and observer-rated negative symptoms were assessed after 3-4 hours and subjective negative symptoms and drowsiness after 24 hours. RESULTS: Neither of the active drugs caused significant motor extrapyramidal symptoms after administration. Haloperidol caused significantly more negative signs and symptoms than placebo on the Scale for the Assessment of Negative Symptoms (SANS) and two self-rated negative symptom scales: the Subjective Deficit Syndrome Scale total score and an analog scale that evaluates subjective negative symptoms. Risperidone caused significantly more negative signs and symptoms than placebo on the Brief Psychiatric Rating Scale (BPRS), the SANS, the Subjective Deficit Syndrome Scale total score, and the analog scale for subjective negative symptoms. After control for drowsiness, risperidone but not haloperidol produced more negative symptoms than placebo on the BPRS and the SANS. Significance was lost for the subjective negative symptoms with both drugs. CONCLUSIONS: Single doses of both haloperidol and risperidone produce negative symptoms in normal individuals. Drowsiness may be an important confounding factor in the assessment of negative symptoms in antipsychotic trials.