Who has a problem with chemsex? Identity as a missing link in support services for men who engage in problematic use of psychoactive substances for sexual purposes. / Kto ma problem z chemsexem? Tozsamosc jako brakujace ogniwo uslug pomocowych dla mezczyzn problemowo uzywajacych substancji psychoaktywnych w celach seksualnych.

As the social consent for seeking help in the area of psychosexual health increases, specialists observe the current socio-cultural changes and the new phenomena they give rise to be reflected in their patients. One of these relatively new phenomena is chemsex. It is a distinct form of combining highly specific psychoactive substances and sexual activity, practised almost exclusively by men. Due to the heightened health risks, connected both with the drugs used and the frequent lack of protection during sexual activity, international public health institutions consider chemsex a health problem of men who have sex with men (MSM). Although the introduction of MSM as a category in the 1990s - mainly in the context of HIV - was based on important epidemiological premises (the behaviour, not the identification, is what is important in the context of risk), it is neglecting sexual identity that may be one of the missing links in the intersectional understanding and appropriate addressing of problematic chemsex. The article is addressed especially to psychiatrists, psychologists, psychotherapists, addiction and sexologists working with this group of patients.

From Mental Health Industry to Humane Care. Suggestions for an Alternative Systemic Approach to Distress.

The article proposes a rough outline of an alternative systemic approach to mental health issues and of a more humane mental health care system. It suggests focusing on understanding mental distress as stemming from problems in living, using medications as agents facilitating psychotherapy, or as a last resort and short-term help, according to the principles of harm reduction. It argues that understanding drugs as psychoactive substances and studying the subjective effects they produce could lead to better utilization of medications and improvements in terms of conceptualizing and assessing treatment effects. Qualitative research could be particularly useful in that regard. It also advocates a radical departure from current diagnostic systems and proposes a synthesis of already existing alternatives to be used for both research and clinical purposes. Accordingly, a general idea for an alternative mental health care system, based on a combination of Open Dialogue Approach, Soteria houses, individual and group psychotherapy, cautious prescribing, services helping with drug discontinuation, peer-led services and social support is presented. The proposition could be seen as a first step towards developing a systemic alternative that could replace the currently dominating approach instead of focusing on implementing partial solutions that can be co-opted by the current one.

Gender dysphoria, gender incongruence and gender nonconformity in adolescence - changes and challenges in diagnosis. / Dysforia plciowa, niezgodnosc plciowa i nonkonformizm plciowy w adolescencji ­ zmiany i wyzwania diagnostyczne.

Psychiatrists, psychotherapists and sexologists specialising in therapy and support of teenage patients have noticed a significant rise in reports of lack of acceptance of the gender assigned at birth, questioning it, rejecting it, and various ways of experiencing it. Although the history of work with transgender adults goes back to the 1920s, gender dysphoria in adolescents remains a complex phenomenon, and any attempts at standardisation of approaches and protocols have so far been unsuccessful. The controversies associated with the issue often result in hasty conclusions and the false - according to the authors of the present paper - assumption that the population of adolescents who experience gender dysphoria or gender incongruence is homogenous. The present article reviews the changes in the diagnoses associated with gender identity made in the DSM and ICD classifications in recent decades, psychological health and neurodiversity of patients reporting gender dysphoria, most common models of treatment, including their advantages and disadvantages, as well as the challenges for diagnosis and treatment in work with this population.

Generations of "wasted chances": Wladyslaw Heinrich and psychology in Poland.

The aim of this article is to present Wladyslaw Heinrich as one of the pioneers of Polish psychology. In the first part, Heinrich's achievements are presented in the broad context of the political, ethnic, and cultural situation in Polish territory as well as with regard to some of the most important figures in Polish psychology from the 19th and early 20th centuries (e.g., Wiszniewski, Ochorowicz, Abramowski, Twardowski). The outlined characteristics of several projects for practicing psychology show the academic centers with which Polish researchers entered into dialogue (e.g., Brentano and Freud in Vienna, Flournoy in Switzerland). The article also explains the indigenization of various trends coming from those centers and what the process of internationalization looked like. The second and main part of the article presents the scientific curriculum vitae et studiorum of Heinrich and its links to behaviorism. It is discussed in reference both to Henri Piéron's proposal for a behavior-focused psychology and to a paper by Heinrich's student Strzembosz that compares his mentor's views with those of early behaviorists such as Parmelee, Meyer, Weiss, Pillsbury, and Watson as well as to the Gestalt psychologists. Although some similarities between early American behaviorism and Heinrich's behavior-focused approach undoubtedly exist, the specific European cultural context shaped the latter in a different direction. The case of Heinrich (and Piéron) shows, however, that Watson's behaviorism was not the only form that an objective, behavior-focused psychology could take at the turn of the 20th century. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Soteria Project: A forerunner of "a third way" in psychiatry? / Projekt Soteria: zwiastun "trzeciej drogi" w psychiatrii?

The article presents a somehow forgotten, yet largely controversial, experiment and therapeutic phenomenon known as Soteria Research Project. History, circumstances and main methodological assumptions of the experiment are briefly presented. Theoretical inspirations behind therapeutic model of Soteria are discussed and analyzed, and the results of the experiment are shortly described. The Soteria Research Project is placed in historical and contemporary context and compared to other theoretical propositions and practical solutions. A summary of critical arguments against Soteria is presented. Results of the Soteria Research Project suggest that therapeutic methods employed there were at least as effective as hospital treatment as usual, despite a radical reduction in, or even a complete lack of, pharmacotherapy. These results are still very important in the context of the debate concerning effective and ethical treatment of psychiatric disorders. It is claimed that Soteria was an attempt of restoring the importance of subjective experiences and subjectivity of a psychiatric patient in organized mental health care and a forerunner of contemporary postpsychiatric approaches, which postulate larger autonomy of patients, criticize sole reliance on pharmacotherapy and contemporary diagnostic systems, and underline the importance of psychotherapeutic interventions.

DSM-5 paraphilic disorders criteria in the light of autoerotic asphyxiophilia and non-sexual form of oxygen restriction. / Kryteria zaburzen parafilnych w DSM-5 wobec asfiksji autoerotycznej i pozaseksualnej formy ograniczania doplywu tlenu.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders published in 2013 has proved to be particularly interesting in the field of sexuality. It introduced a number of significant changes in the definition of sexual norms, among them a widely discussed distinction between paraphilias and paraphilic disorders. The key criterion separating the abnormal sexual interests from the disordered ones is clinically significant distress resulting directly from sexual behavior and/or the risk of suffering or harm to another person as a result of one's sexual behavior. In the case of masochism - which addresses the phenomenon of suffering quite particularly - this distinction is troublesome. Using the example of autoerotic asphyxia - a behavior from the masochism spectrum - the authors critically examine the proposed DSM-5 method of defining the standards of sexual behavior. Interesting in this regard has been a comparison between autoerotic asphyxia and free diving - a nonsexual activity which, although also associated with possible loss of life by reduction of oxygen, has not been pathologized.