Nightmare experiences and perceived ethnic discrimination amongst female university students in the United Arab Emirates: a cross-sectional study.

Perceived ethnic discrimination is known to be associated with anxiety and depression, and in turn, anxiety and depression are known to be associated with nightmare frequency and distress. This elicits a question: is perceived ethnic discrimination associated with nightmare frequency and distress? In this study, 179 female university students from the United Arab Emirates were assessed to answer that question. Results showed that while anxiety and depression were related to nightmare experiences, perceived ethnic discrimination was a stronger predictor of nightmare experiences. We posit two explanations for this finding: one based on psychoanalytical insights, and the other based on the Disposition-Stress model with neurobiological correlates. No significant differences were found across ethnicity when it comes to nightmare experiences or perceived ethnic discrimination. This is an encouraging sign of optimal societal integration in the United Arab Emirates.

Spiritual coping within medical professions: A psychometric analysis of the Numinous Motivations Inventory short form.

AIM: To examine the psychometric properties of a short form version of the Numinous Motivation Inventory (NMI) for use with healthcare providers in measuring their existential engagement with life and to assess its relationship with spiritual coping and emotional dysphoria. DESIGN: Correlational and psychometric study. METHOD: Data were collected from June to December 2022. Participants included 102 physicians, recruited from across the United States. Qualtrics was utilized to collect data, and they were evaluated with the NMI short form, Spiritual Coping Questionnaire and Depression, Anxiety, and Stress scale (DASS-21). RESULTS: Obtained fit statistics from structural equation modelling analysis indicated close fit of the NMI short form with the original model. Multiple regression analyses demonstrated the value of the NMI as a predictor of negative affect independent of spiritual coping. The NMI did not interact with Spiritual Coping, which was independent of negative affect. CONCLUSIONS: The Numinous represents an important aspect of physicians' coping. The constructs can be utilized in training and clinical settings as a valuable and easy-to-use metric for promoting and assessing wellness. The implications of these findings and the value of the NMI were discussed. IMPACT: An understanding of existential drivers can equip one to cope with the stressors of healthcare. The NMI short form has the capability to explore an individual's existential drivers through the understanding of three domains. REPORTING METHOD: Adhered to proper EQUATOR guidelines (GRRAS). PUBLIC CONTRIBUTION: No patient or public contribution.

The Listening Guide: Illustrating an underused voice-centred methodology to foreground underrepresented research populations.

AIM: To highlight the value of utilizing the Listening Guide methodology for nursing research and provide an exemplar applying this methodology to explore a novel concept in an underrepresented group-inner strength in persons newly diagnosed with mild cognitive impairment along with their care partners. DESIGN: Methodology discussion paper. METHODS: The exemplar study used the Listening Guide methods for data elicitation and analysis. Methods included adaptations for the study population and novice qualitative researchers. RESULTS: The Listening Guide methodology with adaptations enabled the research team to centre the voices of persons living with mild cognitive impairment, highlight an abstract phenomenon and attend to the influences of the sociopolitical context. Further, this methodology helped address common challenges emerging qualitative researchers encounter, including understanding methods of application, engaging reflexively and immersing in the data. CONCLUSION: The Listening Guide is a voice-centred qualitative methodology that is well suited to foreground the experiences of groups underrepresented in research and explore emerging phenomena. IMPLICATIONS FOR NURSING: Nurses are central to striving for health equity. The Listening Guide methodology offers a valuable and accessible research tool to understand the experiences and needs of underrepresented groups and shape healthcare in response. IMPACT: The Listening Guide methodology can be broadly applied to research with persons with mild cognitive impairment, and other underrepresented groups, to explore other phenomena beyond inner strength and move the science forward in representing the perspectives of groups underrepresented by research. PATIENT OR PUBLIC CONTRIBUTION: Persons living with cognitive impairment and their care partners participated in study conceptualization, interview guide development, methods development and dissemination plans.

Homework assignments in relational psychoanalytic treatment of personality disorders: A case study of a patient with narcissistic personality disorder.

Homework assignments, or specific tasks patients are asked to engage in or complete between sessions, are a controversial topic among psychoanalysts. While many argue these interventions contradict psychoanalytic principles, others believe they can help address problems and promote coping skills. We propose that homework can be a legitimate aspect of relational psychoanalysis when used in a way that is attuned to the patient's experience and that homework may be an important component of treating personality disorders (PD). We present the case of a man diagnosed with narcissistic PD. He often felt superior to and reported that he despised others, though the core self-image was of fragile. He embraced the role of the omnipotent caregiver, which came with boredom and anger and lack of satisfaction in his social life. The patient tried to control therapy, asserting that he could psychoanalyze himself. As a result, therapy was stalled and progress was limited. At this point, the therapist asked him to complete homework assignments that encouraged him to refrain from his compulsive caregiving to better understand what motivated this behavior. Through this process, the patient came to realize he acted out of avoidance, as he did not want to disclose his own vulnerabilities and flaws. At that point he was able to experience relationships while adopting different stances and finding new meanings. We argue that homework can be fully integrated into the relational psychoanalytic repertoire to improve self-reflection and foster change in patients with PD.

Recapitulation, Heredity, and Freud's View of Human Nature.

There's something strange about Freud's Civilization and its Discontents (1930). Biologically, Freud was a Neo-Lamarckian, who believed in both the modification of organisms through need and the inheritance of acquired characteristics. However, in Civilization, Freud argued that because human nature is immutable, society has dim odds of improving substantially. Lamarckians, of course, rejected that any species-nature is immutable, as species can always be transformed via the inheritance of acquired characteristics. In fact, many of Freud's Viennese contemporaries-such as Wilhelm Reich, Julius Tandler, and Paul Kammerer-took their Lamarckism to license precisely the sorts of radical social projects Freud deemed impossible. Thus the Freud of Civilization helped himself to a rigid view of human nature which, given his associated biological views, he seemingly ought to have rejected. In this paper, I explain this apparent inconsistency, and suggest Freud resolved it in the following way: Freud was not merely a Lamarckian, but also a strong and peculiar kind of recapitulationist, who believed stages of psychological development both recapitulate phylogeny, and "remain with us" throughout both individual lives and future species-history. I suggest Freud's recapitulationism supposed a certain inertia: what occurred in phylogenetic history cannot un-occur, and therefore there are aspects of our nature which we cannot un-acquire. In this way, Freud reached a rigid conception of human nature despite his Lamarckism.

Gender-affirming care through the lens of abnormal illness behaviour and abnormal treatment behaviour.

OBJECTIVE: To describe the increasing number and changing demographics of patients presenting with gender dysphoria and provide an account of patient- and clinician-related factors which may have contributed to these changes. The concept of abnormal illness behaviours introduced by Pilowsky, and its extension to the concept of abnormal treatment behaviours by Singh, provides a framework for understanding healthy and pathological interactions between gender dysphoria patients and their doctors. CONCLUSIONS: Abnormal illness behaviours driven by the reinforcing contingencies of gender-affirming care may explain, in part, the increasing number and changing demographics of gender dysphoria, as well as the increasing incidence of desistance and detransition. The under-diagnosis and under-treatment of mental health disorders by clinicians treating these patients are examples of abnormal treatment behaviours. Uncritical affirmation of patient reported gender identity appears likely to conceal unconscious motivations of some patients and clinicians, increasing the risks of harm to both.

Developing psychoanalytic case conceptualization skills through didactic teaching: A randomized controlled trial.

OBJECTIVE: Time-limited didactic interventions have been shown to be effective in developing "generic" case conceptualization skills. The objective of this study is to test whether similar interventions can be used to develop case conceptualization skills that are "specific" to a treatment modality. METHOD: University psychology students were randomized to a target (n = 62) or a control group (n = 62). The target group received a training on psychoanalytic case conceptualization skills based on the newly-developed operators model. The control group received a training on generic case conceptualization skills based on the well-established 5 Ps model. RESULTS: The students' self-efficacy for case conceptualization significantly increased in both groups. However, students in the target group reported a significantly greater increase in psychoanalytic case conceptualization skills and in their ability to make clinical inferences. The teaching method, as well as the case conceptualization models, were acceptable to students. However, the 5 Ps model was significantly more acceptable to students than the operators model. CONCLUSIONS: This is the first RCT to provide evidence that psychoanalytic case conceptualization skills can be developed through didactic teaching and that they constitute a specific set of skills that are not developed by learning generic case conceptualization skills.

Psychological Approach in the Interpretation of 20th Century Kazakh Postmodern Literature.

The aim of the study is to analyse contemporary postmodern literary works of Kazakhstan through the conceptual prism of Freudian and Jungian psychoanalysis. To achieve research goals, the following methods were used: axiomatic, content analysis, and comparative. The results of the study determined that contemporary Kazakh writers characterise a large field of motives and ideas that are revealed through text, symbols, and characters. Strong tools for their interpretation were the psychological approaches of Freud and Jung, which are the standards of psychoanalysis and have their own specific features of semantic content. Content analysis of postmodern materials has established that Kazakh stories trace the motives of mythology, religion, relationships and inner spiritual development, which consider the mental differences of the heroes of the storylines. During the psychoanalysis of the works, it was emphasised that postmodernism in the literature of Kazakhstan reflects the rejection of absolute truths, blurring the boundaries between genres, playing with traditional forms and content. Many of the characters in the stories are experiencing an identity crisis, which has been analysed through the Freudian triad and Jung's archetypal images. Kazakh literature, being woven into the cultural and historical heritage of the nation, reflects the features of mentality, socio-cultural transformations, identity and spiritual quest of heroes.

Friston, Free Energy, and Psychoanalytic Psychotherapy.

This paper outlines the ways in which Karl Friston's work illuminates the everyday practice of psychotherapists. These include (a) how the strategic ambiguity of the therapist's stance brings, via 'transference', clients' priors to light; (b) how the unstructured and negative capability of the therapy session reduces the salience of priors, enabling new top-down models to be forged; (c) how fostering self-reflection provides an additional step in the free energy minimization hierarchy; and (d) how Friston and Frith's 'duets for one' can be conceptualized as a relational zone in which collaborative free energy minimization takes place without sacrificing complexity.

A misinterpreted psychoanalyst: Herbert Silberer and his theory of symbol-formation.

The primary aim of this article is to give a more detailed exposition of the cultural, personal, and theoretical contexts in which the Viennese psychoanalyst, Herbert Silberer's theories were born. When assessing the broader picture that this approach offers, it can be concluded that Silberer was an innovative thinker who inspired several of his contemporaries. Recognized in many respects by the society and scholars of this time, he represented quite a different viewpoint that was significantly influenced by several forms of Western esoteric thinking. Yet his main aim was to contribute to the field of psychoanalysis and develop a theory in which rationalistic psychoanalytic interpretations were combined with nonreductive approaches to mystical experiences. Silberer's name is frequently mentioned in a specific context in which his tragic suicide is emphasized rather than his innovations. Upon evaluating the materials recording Silberer's private life, it seems very likely that his suicide was not triggered by the criticism of Freud alone. Silberer's family affairs, his relationship with his father, and his financial and professional struggles could have all contributed to his tragic decision. This paper contends that Silberer's oeuvre deserves greater attention and must be evaluated based upon its own merit.

Engaging with the unknown: How Judaism enabled Freud's psychological discoveries.

A large literature has formed around the question of how Freud's Jewishness and/or Judaism influenced his psychological discoveries and development of psychoanalytic theory and methods. The article organizes the literature into several core theses but brings new clarity and insight by applying two essential criteria to demonstrate an impact of Judaism on Freud's thinking: direct content and historical timing. First, there should be evidence that Freud incorporated actual content from Jewish sources, and second, this incorporation must have occurred during the most crucial period of Freud's early discovery, conceptualization, and development of psychoanalysis, roughly 1893-1910. Thus, for example, Bakan's well-known theory that Freud studied Kabbala is completely negated by the absence of any evidence in the required time period. Part I reviews the literature on the influence of Freud's ethnic/cultural Jewish identity. Part II introduces the Judaic sacred literature, explores Freud's education in Judaism and Hebrew, and presents evidence that Freud had the motive, means, and resources to discover and draw from the "Dream Segment" of the Talmud-along with the traditional Judaic methods and techniques of textual exegesis. Freud then applied these same Judaic word-centered interpretive methods-used for revealing an invisible God-to revealing an invisible Unconscious in four successive books in 1900, 1901, and 1905.

Finding one's way.

The following is a meditative reflection on an anecdote from Jeremy Safran's Psychoanalysis and Buddhism. Moving through Safran's description of an important moment in his development as a student of Buddhism, the author weaves images, practices, and ways of being and feeling into an homage to Safran's legacy integrating psychoanalytic and Buddhist praxis and epistemology.

FROM THE GATE TO THE GATEWAY: PSYCHOANALYTIC NAVIGATIONS ONLINE.

The shift towards remote or online therapy was compelled by the Pandemic. Many colleagues, who neither had practice using this modality, nor had ever considered it as a possibility, ultimately adopted it. This experience brought with it a substantial expansion of online therapy beyond that moment of emergency. It opened up new prospects of intervention, but at the same time it required a greater measure of reflection in order to understand how to inhabit this new therapy space. Setting aside provisory, intermittent, or emergency situations, which temporarily transfer therapy into a "field of tents" (Bolognini, 2021), the author proposes to consider how online psychotherapy redefines an important element of the psychoanalytic setting-the issue of the space. This is no longer the therapist's place of work, envisaged and organized by him/her/them, fixed in time, and contrived only to welcome the therapeutic relationship-one of the crucial aspects of the external setting, which together with the temporal dimension, fulfills the therapy ritual. Assuming the framework to be essential to the psychoanalytic process, this paper will focus on the methodology of online therapy. The author will describe the contributions of the neurosciences, to provide a deeper understanding of the distinctive characteristics of sharing in an online vs. an offline space. Online therapy should be assessed for its distinguishing qualities within a complete theoretical, technical, and clinical reflection specific to each case. Proceeding as if it were a mere relocation of an in-person analysis would enhance the seductiveness of a therapy that is easily accessible with any laptop anywhere, anytime, and in which one could mistake an online connection for a deep connection.

Death as rupture, mourning as repair: A relational rendering of grief.

This paper honors Jeremy Safran's legacy of scholarship and pedagogy through the lens of his emphasis on rupture and repair. Challenging a Freudian rendering of mourning as ultimately giving up a lost object, the author draws on Nicholas Abraham and Maria Torok's application of Sandor Ferenczi's concept of introjection to offer a relational rendering of the grieving process.

Psychoanalysis of the unspectacular.

From the perspective of a poet and first-year psychoanalytic training candidate, this paper develops Jeremy Safran's ideas about the dialectic between psychoanalysis and Buddhism by drawing an analogy between their processes and those of a poetry practice to define an alternative to pathological dissociation under capitalist systems of value. The paper details the writer's experience of working a day job in an office and the pathological dissociation which she subsequently attempts to overcome and critique through writing poetry. Various poems written at work are shared and analyzed as evidence. Drawing from Safran's edited volume, Psychoanalysis and Buddhism, the author then identifies aspects of Zen Buddhist meditation practice and the psychoanalytic process that focus on connecting with reality, however conflicted, as opposed to escaping it. This paper was written under the mentorship of the psychoanalyst and Zen teacher Barry Magid.

EMBRACING DISAPPOINTMENT AS PSYCHOANALYTIC PRAXIS.

Psychoanalysis involves studying how people maintain not knowing what they "know." As a result, how psychoanalytic psychotherapists orient toward what their patients may be experiencing but cannot say is at the core of psychoanalytic praxis. Jeremy Safran's unique psychoanalytic sensibilities were a model for how to yield to feeling states and relational dynamics that are at the heart of therapeutic action, but which all too frequently get bypassed. This brief recollection highlights how Safran's commitment to open inquiry and mutuality-not just with his patients but also with his students-continues to impact the field.

When psychoanalytic dyads are forced into the virtual world.

The Covid pandemic changed the daily routines for millions of people. This was the case for those who were gainfully employed, especially for those who work as psychoanalysts and psychodynamic psychotherapists. At least for a good while, the practice of psychotherapy and psychoanalysis moved from the consulting room to the virtual world of the internet. The author explores the impact virtual therapy had on three different patients. One began a three time a week analysis during the pandemic. The duo met virtually for a year and a half before their first in person meeting. The other two patients had begun twice a week analyses a few years before the pandemic, met virtually for two years, until in person sessions restarted. The patients and the author describe their experiences.

The heart of healing: Echoes of Sándor Ferenczi's legacy in Jeremy Safran's relational commitments.

In this duet of two voices honoring Jeremy Safran's legacy, the authors celebrate some points of resonance between Sándor Ferenczi's groundbreaking relational interventions and Safran's approach to the therapeutic relationship as the heart of healing. Karen Starr first highlights Ferenczi's now well-known creative experimentation with technique and his emphasis on and care for the relational dimension of psychoanalytic treatment. Jill Bresler then links Safran's career-long dedication to the therapeutic alliance to Starr's introductory remarks, honoring Safran and Ferenczi's shared dedication to expanding options in clinical practice through focus on the relationship. Recalling Safran's naming Ferenczi as a key figure in psychotherapy integration's origin story, Bresler reflects on her own learning from Safran's groundbreaking transtheoretical research into the mutative aspects of psychotherapy and his translating a psychoanalytic focus on the therapeutic relationship to CBT researchers and practitioners.

BACK TO THE FUTURE WITH SENECA'S PRACTICAL PHILOSOPHY IN MIND.

This paper regards Seneca's practical philosophy as ancestor to psychoanalytically informed psychotherapy and as a progenitor of ongoing contemporary praxis in applied ideas of mind. Facing forward into the Anthropocene, as psychoanalysis encounters Artificial Intelligence, the convergence with contemporary psychoanalytic psychotherapy of value concepts developed from Antiquity is discussed. Drawn from Seneca's Letters on Ethics, constellations of significant ideas present in ancient practical philosophy resonate with similar configurations developed two millennia later, and central to the practice of contemporary psychotherapy.

The elephant in the zoom: will psychoanalysis survive the screen?

While screen-mediated analysis long predated the pandemic, it was largely seen as non-equivalent to in-person treatment by analysts and patients alike. When COVID forced us to move our entire practices to the screen, our concerns about its limitations were replaced by relief; we could continue doing analytic work during a terrifying and challenging time. Three years later, many have chosen to continue practicing remotely for reasons that are no longer driven by fears of exposure. We mostly minimize or deny our earlier concerns about the limitations of screen work. Have we chosen convenience, ease, and a personal sense of safety over togetherness, while ignoring the underbelly of remote work? This paper identifies the convergence of several forces underlying our decision to stay remote, including guilt and anxiety about privileging our own self-interest, unmourned losses and collective PTSD, fear of the future and existential anxiety about living in a techno-culture that threatens to replace us. Our denial of these powerful forces makes it easy to rationalize a decision to embrace remote work and disavow the threat it poses to our field.