Gozo, segregação e trauma na civilização neoliberal / Enjoyment, segregation, and trauma in the neoliberal civilization / Jouissance, ségrégation et traumatisme dans la civilisation néolibérale

O real, em Lacan, aparece como um resto que escapa inevitavelmente à ordem simbólica e tem um efeito traumático. O sintoma responde ao traumático preservando algo dele, mas ao mesmo tempo o disfarçando. Para isso, ele alia-se à fantasia, na qual o gozo que assinala a irrupção do traumático é projetado no Outro. Na sociedade repressiva da época de Freud, sintoma e fantasia forneciam ao sujeito uma válvula de escape que velava o trauma estrutural. Na sociedade neoliberal contemporânea, o imperativo do gozo torna isso mais difícil e o trauma estrutural mostra-se de maneira mais evidente. Além disso, a segregação em termos de tipo de gozo ou de possibilidade de acesso ao gozo reforça o elemento traumático. O establishment psiquiátrico, contudo, tende a desresponsabilizar o sujeito (e a sociedade na qual ele vive) pelo trauma.

The real, in Lacan, appears as a rest that inevitably escapes the symbolic order and has a traumatic effect. The symptom responds to the trauma by preserving something from it while disguising it. For that, it articulates itself to fantasy, in which the enjoyment that marks the irruption of the trauma is projected onto the Other. In the repressive society of the times of Freud, symptom and fantasy provided the subject with an escape valve that veiled the structural trauma. In contemporary neoliberal society, the imperative of enjoyment hinders this mechanism, thus the structural trauma appears more evidently. Moreover, segregation in terms of the type of enjoyment or the possibility of access to enjoyment reinforces the traumatic element. The psychiatric establishment, however, tends to exempt the subject (and the society where he lives) from responsibility for the trauma.

Le réel, chez Lacan, apparaît comme un reste qui échappe inévitablement à l'ordre symbolique et a un effet traumatique. Le symptôme répond au traumatisme en en préservant quelque chose, mais en le masquant en même temps. Pour cela, il s'allie au fantasme, dans lequel la jouissance qui marque l'irruption du traumatique est projetée sur l'Autre. Dans la société répressive du temps de Freud, le symptôme et le fantasme fournissaient au sujet un exutoire qui voilait le traumatisme structurel. Dans la société néolibérale contemporaine, l'impératif de jouissance rend cela plus difficile et le traumatisme structurel apparaît plus clairement. De plus, la ségrégation en termes de type de jouissance ou de possibilité d'accès à la jouissance renforce l'élément traumatique. L'établissement psychiatrique a cependant la tendance à exonérer le sujet (et la société dans laquelle il vit) de la responsabilité du traumatisme.

Complaints of dyspnea and their associations with personality traits in patients referred to psychotherapy in a day hospital.

BACKGROUND: Breathing difficulties are present in different medical conditions, yet seem to be underresearched in psychiatric patients. AIM: Assessment of prevalence of dyspnea complaints and their associations with personality traits in patients with neurotic or personality disorders referred to psychotherapy. METHODS: Retrospective chart review of medical records of 2450 patients with diagnoses F4-F6 (ICD-10). Analyses of associations between dyspnea reported in a symptom checklist SCL-O and pathological scores in the Neurotic Personality Questionnaire were carried out using univariate and multivariate regression analyses with ORs and 95%CI estimated with licensed STATISTICA 13 (StatSoftPL) software, and R version 4.1.0, RStudio version 1.4.1717 software. RESULTS: Dyspnea was reported by 46.3% women and 36.6% men (14.5% and 10.1% respectively assessed it as severely burdensome). Univariate regression analysis revealed several significant associations between reporting dyspnea or its extreme intensity and pathological scores in the NPQ. Multivariate regression analyses in women confirmed the importance of impulsiveness and exaltation for dyspnea occurrence, and feeling of being dependent on the environment, demobilization, and narcissistic attitude for its extreme intensity. In men impulsiveness, sense of being in danger, irrationality, and ponderings were associated with the presence of dyspnea, and sense of being in danger and envy with its extreme intensity. CONCLUSIONS: Complaints of dyspnea were pretty frequent. Several personality traits measured by the NPQ questionnaire were predictors of their occurrence and feeling of extreme burden.

Neurotic symptoms profile in a day hospital patients with an anamnesis of head injury in the past. / Profil objawów nerwicowych u pacjentów dziennego oddzialu leczenia zaburzen nerwicowych z historia urazów glowy.

OBJECTIVES: The aim of the study was to assess the relationship between the occurrence of brain damage and symptoms of neurotic disorders, reported by patients of the psychotherapeutic day hospital for neurotic and personality disorders before starting treatment. METHODS: Analysis of the cooccurrence of neurotic symptoms with previous head or brain tissue damage. The trauma was reported in a structured interview (Life Questionnaire) completed before treatment in the day hospital for neurotic disorders. Illustrated with OR coefficients (odds ratios), the performed regression analyzes showed statistically significant correlations between brain damage (caused by brain trauma, stroke, etc.) and symptoms listed in the symptom checklist KO"0". RESULTS: In a group of 2,582 women and 1,347 men, some of respondents reported (in the self-completed Life Questionnaire) a previous head or brain injury. Men reported a history of trauma much more often than women (20.2% vs. 12.2%; p < 0.0005). Patients who had a history of head trauma obtained a significantly higher value of the global severity of neurotic symptoms (OWK) in the symptom checklist KO "0" than patients without head trauma. This applied to both the male and female groups. Regression analyzes showed a significant relationship between head injuries and the group of anxiety and somatoform symptoms. In both groups (men and women), ?paraneurological', dissociative, derealization, and anxiety symptoms occurred more frequently. Men more often reported difficulties in controlling the expression of emotions, muscle cramps and tension, obsessive-compulsive symptoms, skin and allergic symptoms, and symptoms of depressive disorders. Women more often reported vomiting when feeling nervous. CONCLUSIONS: Patients with a history of head injuries have a higher global severity of neurotic disorders symptoms than people without such history. Men experience head injuries more often than women, and the risk of developing symptoms of neurotic disorders is higher in men. It seems that patients with head injuries are a special group when it comes to reporting some psychopathological symptoms, especially in the group of men.

Peripandemic psychiatric emergencies: impact of the COVID-19 pandemic on patients according to diagnostic subgroup.

On March 11th, 2020, the outbreak of coronavirus disease 2019 (COVID-19) was declared a pandemic. Governments took drastic measures in an effort to reduce transmission rates and virus-associated morbidity. This study aims to present the immediate effects of the pandemic on patients presenting in the psychiatric emergency department (PED) of Hannover Medical School. Patients presenting during the same timeframe in 2019 served as a control group. A decrease in PED visits was observed during the COVID-19 pandemic with an increase in repeat visits within 1 month (30.2 vs. 20.4%, pBA = 0.001). Fewer patients with affective disorders utilized the PED (15.2 vs. 22.2%, pBA = 0.010). Suicidal ideation was stated more frequently among patients suffering from substance use disorders (47.4 vs. 26.8%, pBA = 0.004), while patients with schizophrenia more commonly had persecutory delusions (68.7 vs. 43.5%, pBA = 0.023) and visual hallucinations (18.6 vs. 3.3%, pBA = 0.011). Presentation rate of patients with neurotic, stress-related, and somatoform disorders increased. These patients were more likely to be male (48.6 vs. 28.9%, pBA = 0.060) and without previous psychiatric treatment (55.7 vs. 36.8%, pBA = 0.089). Patients with personality/behavioral disorders were more often inhabitants of psychiatric residencies (43.5 vs. 10.8%, pBA = 0.008). 20.1% of patients stated an association between psychological well-being and COVID-19. Most often patients suffered from the consequences pertaining to social measures or changes within the medical care system. By understanding how patients react to such a crisis situation, we can consider how to improve care for patients in the future and which measures need to be taken to protect these particularly vulnerable patients.

Para uma nova etiologia das neuroses: notas a partir da teoria das relações objetais de Donald W. Winnicott / For a new etiology of the neuroses: notes from Donald W. Winnicott's object relations theory / Para una nueva etiología de las neurosis: notas a partir de la teoría de las relaciones objetivas de Donald W. Winnicott

O presente trabalho objetiva analisar a etiologia das neuroses em Freud e Winnicott. Para tanto, parte das principais considerações sobre os mecanismos de defesa, o recalque, a sexualidade, o complexo edípico e o conflito psíquico na psicanálise clássica freudiana, para depois propor uma nova etiologia a partir da teoria das relações objetais em Donald W. Winnicott. Os autores não consideram apenas o conflito vivido em termos da dinâmica psíquica, mas aquele vivido na dinâmica mãe-bebê, principalmente a partir dos polos opostos entre o amor e o ódio na travessia do concernimento (posição depressiva). Os autores defendem um manejo clínico de pacientes com sofrimento psíquico neurótico a partir da psicanálise transmatricial, propondo, concomitantemente à associação livre, o uso da regressão à dependência a fases primitivas de falhas ambientais (AU)

This paper aims to analyze the etiology of the neuroses in Freud and Winnicott. In order to do so, the authors build upon the main considerations on defense mechanisms, repression, sexuality, the oedipal complex, and the psychic conflict in Freudian psychoanalysis. Then they propose a new etiology based on Donald W. Winnicott's object relations theory. The authors do not only consider the conflict experienced in terms of psychic dynamics, but also the conflict experienced in the mother-baby dynamics, particularly in regards to the opposition between love and hate in the development of concern (depressive position). The authors stand for the clinical management of patients with neurotic psychic suffering based on transmatricial psychoanalysis, proposing, along with free association, the use of regression to dependence on primitive phases of environmental failures (AU)

El presente trabajo tiene por objeto analizar la etiología de las neurosis en Freud y Winnicott. Para ello, parte de las principales consideraciones sobre los mecanismos de defensa, la represión, la sexualidad, el complejo edípico y el conflicto psíquico en el psicoanálisis freudiano, para proponer una nueva etiología a partir de la teoría de las relaciones objetivas en Donald W. Winnicott. Los autores no sólo consideran el conflicto vivido en términos de la dinámica psíquica, sino el conflicto vivido en la dinámica madre-bebé, principalmente a partir de los polos opuestos entre el amor y el odio en la travesía de la concernimiento (posición depresiva). Los autores defienden un manejo clínico de pacientes con sufrimiento psíquico neurótico a partir del psicoanálisis transmatricial, proponiendo junto a la asociación libre, el uso de la regresión a la dependencia a fases primitivas de fallas ambientales (AU)

Different preprocessing strategies lead to different conclusions: A [11C]DASB-PET reproducibility study.

Positron emission tomography (PET) neuroimaging provides unique possibilities to study biological processes in vivo under basal and interventional conditions. For quantification of PET data, researchers commonly apply different arrays of sequential data analytic methods ("preprocessing pipeline"), but it is often unknown how the choice of preprocessing affects the final outcome. Here, we use an available data set from a double-blind, randomized, placebo-controlled [11C]DASB-PET study as a case to evaluate how the choice of preprocessing affects the outcome of the study. We tested the impact of 384 commonly used preprocessing strategies on a previously reported positive association between the change from baseline in neocortical serotonin transporter binding determined with [11C]DASB-PET, and change in depressive symptoms, following a pharmacological sex hormone manipulation intervention in 30 women. The two preprocessing steps that were most critical for the outcome were motion correction and kinetic modeling of the dynamic PET data. We found that 36% of the applied preprocessing strategies replicated the originally reported finding (p < 0.05). For preprocessing strategies with motion correction, the replication percentage was 72%, whereas it was 0% for strategies without motion correction. In conclusion, the choice of preprocessing strategy can have a major impact on a study outcome.

Contribution of autobiographic memory impairment to subjective memory complaints in focal epilepsy.

"My memory is terrible!" is a common refrain among people with epilepsy, but such complaints are not reliably linked to poor performances on standard tests of memory. Negative affect like depression and anxiety are the most robust predictor of these complaints; however, neither do they entirely account for the phenomenon. The contribution of autobiographic memory impairment to subjective memory complaints in focal epilepsy has not been well-explored despite autobiographic memory impairments being common in patients with epilepsy, and the face validity of relating day-to-day memory failings to such a personally relevant form of memory. The current study sought to clarify whether autobiographic memory dysfunction contributes to subjective complaints in epilepsy, above and beyond negative affect, objective memory impairment, and epileptological factors in a large sample of patients with drug-resistant focal epilepsy relative to healthy controls (N = 135). Patients were stratified into groups with mesial temporal (MT; n = 40) versus nonmesial temporal (NMT; n = 46) foci. Compared to controls (n = 46), both patient groups reported more bitter subjective memory complaints (p < 0.001, large effect size), demonstrated poorer episodic (p = 0.001, large effect size) and semantic autobiographical recall (p = 0.004, medium effect size), and had higher levels of depressive symptomatology (p = 0.011, medium effect size), and trait neuroticism (p = 0.015, medium effect size). Contrary to expectations, multiple regression analyses revealed that autobiographic memory function was not an independent predictor of subjective memory complaints in either group with epilepsy. In people with epilepsy with MT foci, objective verbal memory dysfunction, neuroticism, and female gender predicted memory complaints (R2 = 0.70, p = 0.015), whereas only neuroticism predicted memory complaints in people with epilepsy with NMT foci (R2 = 0.21, p = 0.001). Although patients' poor recall of their autobiographical memories did not contribute to their concerns about their day-to-day memory function, the findings indicate that the location of the epileptogenic focus can provide clues as to the underlying contributors to subjective memory complaints in focal epilepsy. Important clinical implications to stem from these findings include the need for clinicians to adopt a patient-tailored, multifactorial lens when managing memory complaints in people with epilepsy, taking into account both psychological and cognitive factors.

The deconstruction of the discourse on trauma in two Eastwood films: a contribution from clinical-political psychoanalytic interventions / A desconstrução do discurso sobre trauma em dois filmes de eastwood: uma contribuição das intervenções psicanalíticas clínico-políticas

RESUMO: Como algumas produções cinematográficas contribuem ao debate sobre noções de trauma em psicanálise? Analisamos dois filmes dirigidos por Clint Eastwood, "Sobre meninos e lobos" e "Sniper americano" retomando, como método de trabalho, os conceitos de narcisismo das pequenas diferenças, trauma, fala como acontecimento, acontecimento e acontecimento-ruptura, de modo a colocar em questão os pensamentos por oposição binária e ego-referenciados, que podem reforçar estereótipos e preconceitos e que obturam a mobilidade e a transformação do acontecimento traumático em propulsão para a vida. Nossa intenção é desconstruir alguns discursos que pautam a cultura contemporânea e contribuir para intervenções psicanalíticas clínico-políticas.

ABSTRACT: How can some film productions feed the debate on the psychoanalytical notions of trauma? We analyze two films by Clint Eastwood, "Mystic River" and "American Sniper" based on the psychoanalytic view of trauma. As a working method, we resume the concepts of narcissism of minor differences, trauma, speech as an event, event and event break-up to call into question binary opposition and ego-referenced thinking that can reinforce stereotypes and prejudices that hinder the mobility and transformation of traumatic events in thrusts toward life. Our intention is to deconstruct some speeches guiding contemporary culture and to contribute to clinical-political psychoanalytic interventions.

Neurotic personality traits and associated dysfunctional attitudes as factors predisposing patients to suicidal ideations at the end of intensive psychotherapy. / Nerwicowe cechy osobowosci i zwiazane z nimi dysfunkcjonalne postawy pacjentów jako czynniki predysponujace do wystapienia mysli samobójczych pod koniec intensywnej psychoterapii.

OBJECTIVES: To determine the relationshipsbetween personality traits typical for neurotic disorders and dysfunctional attitudes declared by patients without suicidal ideations (SI) prior to treatment and SI at the end of an intensive psychotherapy with a predominant psychodynamic approach in the day hospital for neurotic, behavioral, or personality disorders. MATERIAL AND METHOD: KO "O" Symptom Checklist for assessing SI, Neurotic Personality Questionnaire KON-2006 for evaluation of neurotic personality characteristics and patients' attitudes, and a Life Questionnaire, all completed by a group of 680 patients of a day psychotherapy ward, treated for the first time. Statistical analysis encompassed 466 non-SI patients, 4% of whom had SI at the end of treatment. RESULTS: A number of attitudes have been identified in patients who were significantly predisposed to SI at the end of intensive psychotherapy: physical aggression towards relatives (p < 0.001), grandiose fantasies (p = 0.043), resignation tendencies (p = 0.022), resignation feeling associated with the experience of loss of life opportunities (p = 0.037), and being guided mainly by intuition (p = 0.035). It was also observed that declaring certain attitudes was significantly associated with less than average chance of SI at the end of treatment. CONCLUSIONS: In patients who declared these attitudes, there was a higher risk of SI at the end of the psychotherapy cycle than in the remaining patients (10-30% vs. 4%), which indicates the presence of specific dysfunctions of personality, in the case of which intensive psychotherapeutic work requires particular caution -it can trigger emotional stress leading to SI instances. It can be assumed that SI are the result of the reconstruction of defense mechanisms while working on insight, confrontation with the causes and consequences of the patients' own physical aggression towards the loved ones, the realization of the size of their grandiose thinking and the insight into its function, and the insight into the causes of resignation attitudes.

Dimensions of neurotic personality and its selected predictors in individuals with arterial hypertension. / Wymiary osobowosci nerwicowej i jej wybrane predyktory wsród osób z nadcisnieniem tetniczym.

OBJECTIVES: To assess of the levels of neurotic personality dimensions in a group of patients with arterial hypertension compared to healthy individuals. To test the relationship between the overall neurotic personality score and satisfaction with life as well as tendency to notice and attach importance to the positive aspects of life, experience, and oneself in a clinical sample. METHODS: Neurotic Personality Questionnaire (KON-2006) by Aleksandrowicz, Klasa, Sobanski, and Stolarska (2007), Satisfaction With Life Scale (SWLS) by Diener et al., and the P Scale by Caprara (2009). RESULTS: Individuals with arterial hypertension (N =81) are distinguished by significantly higher levels of twenty (out of twenty-four) neurotic personality dimensions than controls without arterial hypertension (N =88). Overall neurotic personality score correlates negatively with life satisfaction and the evaluation of positive aspects of life. CONCLUSIONS: The present study adds to the knowledge on the psychosocial aspects of ill people's functioning and sets directions of work for multidisciplinary teams seeking to improve patients' quality of life.

The Marriage and Divorce of Little Willy: Psychoanalysis and Addiction.

Psychoanalysis can't treat addicts; Alcoholics Anonymous can't treat neurotics. Contrasting the two proffered therapeutics, they are obviously opposed as a rich discourse and a banality of letters or as individual and group therapy. And yet they emerged as one confused tangle in the cocaine addiction of Sigmund Freud. Finally, both have been condemned as bourgeois constructions, as the discourse of capitalism.

An evaluation of the relationship between violence exposure status and personality characteristics among infertile women.

In this descriptive study, our aim was to examine the relationship between violence exposure status and personality characteristics among infertile women. The researchers collected data from 315 infertile women at an in vitro fertilization unit of the Woman and Child Disease Training and Research Hospital in Istanbul, Turkey. An introductory information form, the Eysenck Personality Questionnaire Revised-Abbreviated Form (EPQR-A), and the Infertile Women's Exposure to Violence Determination Scale (IWEVDS) were used as data collection tools. When the relationship between the IWEVDS and EPQR-A subdimension scores of the infertile women were examined, a positive relationship was found between the being-forced-into-traditional-practices subdimension of the IWEVDS and the neuroticism subdimension of the EPQR-A. In addition, a weak negative relationship was found between the being-forced-into-traditional-practices subdimension of the IWEVDS and the lying subdimension of the EPQR-A.

[Premorbid self-medication and its factors in patients with depressive and neurotic disorders]. / Samomedikatsiia i faktory ee formirovaniia u patsientov s depressivnymi i nevroticheskimi rasstroistvami v domanifestnom periode.

AIM: To study self-medication and its factors in patients with depressive and neurotic disorders at premorbid stage. MATERIAL AND METHODS: The sample included 131 first-time admitted patients and 85 recurrent patients with depressive or neurotic disorders, who reported taking medication to cope with the symptoms during preadmission period. Lazarus coping strategies test, Shmishek personality test, test on disease attitude and patient activation were used. Social and demographic characteristics, subjective characteristics of disease, medical literacy and behavioral coping strategies were studied. RESULTS AND CONCLUSION: Over 50% of the patients used self-medication to cope with the symptoms during the preadmission period. Coping anxiety and insomnia was a key motivation to self-medication. Most frequently used medications included tranquilizers and herbal anxiolytics. Misunderstanding of origin of their state, searching for information about treatment of disease via internet, increased emotiveness and tension, lack of their correction with psychotherapy were the factors of self-medication.

Body-odor based assessments of sex and personality - Non-significant differences between blind and sighted odor raters.

People exhibit different sensitivity to the signaling properties of body odors in the social context. Here, we aimed to investigate whether visual status modulates sensitivity to socially-relevant cues carried by body odors and whether it affects psychophysical ratings of such smells. We compared abilities of 19 early-blind, 9 late-blind and 13 sighted people to accurately assess sex, neuroticism and dominance of odor donors based on body odor samples. We showed that early blind, late blind and sighted people do not differ in accuracy of sex and personality assessments based on body odor samples. Additionally, the three participating groups perceived the presented body odor samples as similarly intense, pleasant and attractive. We discuss our findings in the context of interpersonal olfactory communication and olfactory compensation.

A descriptive epidemiological study of disability prevalence attributed to neurotic disorders in China.

This study estimated the prevalence, correlates, severity and functional impairment of disabilities attributed to neurotic disorders in the Chinese population. Data from a representative national sample of 2,526,145 non-institutionalized residents were obtained from the Second China National Sample Survey on Disabilities (CNSSD) in 2006. The data were analyzed to estimate prevalence, correlates, severity and functional impairment of disability attributable to neurotic disorders by gender, age, region, and other key socio-demographic and economic factors. The disability prevalence attributed to neurotic disorders was 0.032% (805/2,526,145) in China. Women, rural residents, unemployed job status, low education level and those who were divorced or widowed showed higher prevalence rates than their counterparts. Proportions of mild, moderate, severe and extremely severe of neurotic attributed disability only accounted for 78.48%, 9.14%, 6.5% and 5.9%, respectively. Finally, these findings provide evidence that, prevalence rates of disability attributable to neurotic disorders vary greatly among different population groups and regions. Multiple disabilities including disability attributable to neurotic disorders can bring much more impairment to individuals than disability attributable to neurotic disorder only.

Psychological Therapy in Secondary Mental Health Care: Access and Outcomes by Ethnic Group.

OBJECTIVE: To explore the differences in access to, and outcomes of, psychological therapy for different ethnic groups across a South London Mental Health Trust. METHOD: This study used Trust data to explore the proportions of ethnic groups accessing psychological therapy as a proportion of all patients supported by the Trust, as well as their outcomes within broad diagnostic clusters. RESULTS: Compared to proportions in the local population, there were significantly more White/White British patients and significantly fewer patients from 'other ethnic groups' in the Trust (p < .05). There was also significantly greater proportion of Black/Black British patients with schizophrenia diagnoses compared to the proportion of Black/Black British people in the local population (p < .001). Of those accessing psychological therapy, there were significantly more White/White British and 'other ethnic group' patients and significantly fewer Black/Black British patients (p < .05). For schizophrenia diagnoses, significantly fewer Black/Black British and 'other ethnic group' patients were accessing psychological therapy (p < .05); however for behavioural and emotional disorders, there were significantly higher proportions of 'other ethnic group' and White/White British patients. Outcomes varied by diagnosis; Black/Black British patients experienced significantly higher distress scores at the beginning of therapy for depression and neurotic diagnoses (p < .05), with the latter persisting at the end of treatment. CONCLUSIONS: Across the Trust, there were significant differences in the proportion of ethnic groups in accessing psychological therapy, as well as in outcomes. More research is needed to understand the factors that may underlie these disparities.

Algunas clínicas del superyó/ideal del yo. Reflexiones / Certaines cliniques du surmoi-idéal du moi. Réflexions / Some clinical reflections on the superego-ego ideal

El objetivo de este trabajo es reflexionar sobre los desfallecimientos, hipertrofias o perversiones de la función del superyó, esencial a mi entender tanto para una buena salud psíquica como para un sano ejercicio de nuestra profesión. Pensando en los casos que presento, reflexiono sobre el riesgo que corremos los analistas de tener una ideología de la cura. En muchas ocasiones, me he encontrado con que esa ideología en mi praxis obturaba una escucha desprejuiciada. Por otro lado, he intentado pensar sobre las consecuencias de las ausencias parentales en el pasaje narcisismo ↔ Edipo, así como las consecuencias de la idealización del yo en los niños. Finalmente, este trabajo, parafraseando a Freud, es un intento de recuperación de mi neurótico. He intentado reflexionar sobre el abuso del diagnóstico de patología límite y sobre cierto abandono de las neurosis. Hay que estar preparados para la sorpresa neurótica. Incluso, estar preparados para encontrarnos reacciones a los avances del tratamiento que remedan en mucho a respuestas terapéuticas negativas sin llegar a serlo propiamente. Las respuestas del analista-terapeuta van a ser clave en la evolución de estos casos. (AU)

The aim of this paper is to reflect upon the lassitudes, hypertrophies or perversions of the superego function, essential in my view both to good psychic health and to healthy professional practice. Referring to the case material, I reflect upon the risk we run as analysts of having a particular treatment ideology. On many occasions, I have found that this ideology in my praxis has stymied unprejudiced listening. Secondly, I consider the implications of parental absences in the narcissism ↔ oedipus pathway, as well as the consequences of the idealisation of the ego in children. Finally, to paraphrase Freud, this paper is an attempt to recover my neurotic content. I have sought to reflect upon the overuse of the diagnosis of borderline pathology and indeed the neglect of the neuroses. We must be ready for the neurotic surprise. Moreover, we must be ready to encounter reactions to the progression of treatment that closely mimic negative therapeutic responses without actually being them. The responses of the analyst-therapist will be key to the progress of these cases. (AU)

Le but de cet travail c’est de réfléchir sur les défaillances, hypertrophies ou perversions des fonctions du surmoi, essentiel, à mon avis, tant pour une bonne santé psychique que pour un sain exercice de notre profession. Sur les cas que je présente, je pensé au risque que les psychanalystes courrent d’avoir une idéologie du guérison. Souvent, j’ai trouvé que cette idéologie, dans ma praxis, empêchait une écoute sans préjugés. Par ailleurs, j’ai essayé de penser aux conséquences des absences parentaux dans le passage du narcissisme à l’Œdipe ainsi que les conséquences du l’idéalisation du moi chez les enfants. Finalement, en paraphrasant Freud, ce travail est une tentative de récupération de mon névrosé. J’essaiyé de réfléchir sur l’abus de diagnostic de pathologie limite et sur un certain abandon des névroses. Il faut être préparé à la surprise névrotique. Même, être prêts à nous trouver des reactions aux progrès du traitement qui ressemblent en grand partie à des réponses thérapeutiques négatives sans arriver à l’être proprement. Les responses de l’analyste-thérapeute vont être la clé dans l’évolution de ces cas. (AU)

Three diagnostic psychiatric subgroups in comparison to self-stigma, quality of life, disorder severity and coping management cross-sectional outpatient study.

BACKGROUND: Much attention has been paid to psychological factors influencing characteristics, severity, and course of mental disorders. The objective of our investigation was to examine the interrelations among quality of life (QoL), self-stigma, and coping strategies, demographics and severity of the disorder in neurotic spectrum disorders, schizophrenia, and depressive spectrum disorders. METHODS: A total of 343 clinically stable Czech outpatients with different mental disorders (153 with neurotic spectrum disorders; 81 with depression, and 109 with schizophrenia spectrum disorders) were included. The patients were examined by their outpatient psychiatrists during regular psychiatric checkup and completed a sociodemographic questionnaire, the Quality of Life Satisfaction and the Enjoyment Questionnaire (Q-LES-Q), the Internalized Stigma of Mental Illness Scale (ISMI), the Stress Coping Style Questionnaire (SVF-78), and the Clinical Global Impression scale (CGI). RESULTS: The study demonstrates that the self-stigma and coping strategies are significant factors linked to the QoL in all diagnostic groups of patients. Patients with schizophrenia spectrum disorders had lower scores in QoL compared to the other two groups. The patients with depression or neurotic spectrum disorders had a lesser degree of self-stigma than the patients with schizophrenia spectrum disorders. The severity of the illness significantly correlated with the QoL, self-stigma, and coping strategies. CONCLUSIONS: The investigation confirmed the connection between the quality of life, self-stigma, coping strategies, and the severity of the illness, in outpatients with schizophrenia spectrum disorders, depressive, and neurotic spectrum disorders. A further longitudinal study would be useful to determine the causative relationships of these variables.

A Big Five facet analysis of sub-clinical dependent personality disorder (Dutifulness).

This study aimed to examine a Big Five, normal personality trait, "bright side" analysis of a sub-clinical personality disorder: Dependency Personality Disorder. Around 6000 British adults completed the NEO-PI-R which measures the Big Five personality factors at the domain and the facet level. They also completed the Hogan Development Survey (HDS) which has a measure of sub-clinical Dependency Personality Disorder called Dutiful as one of its eleven dysfunctional interpersonal tendencies. Correlation and regression results confirmed many of the associations between the Big Five domains and facets and sub-clinical Dependency. The Dutiful (Dependent) scale from the HDS was the criterion variable in all analyses. The results showed that those high on Dutiful are highly unstable Neurotic, Agreeable people who are low on Openness. They are Anxious, Compliant, Self-Conscious, Unassertive and Vulnerable. It is thus possible to assess subclinical personality disorder "dark-side" traits, like Dutifulness, in terms of normal "bright-side" traits. Limitations of the study are acknowledged.