Harv Rev Psychiatry
October 2021
A feeling of emptiness is commonly encountered in clinical practice, but it is poorly understood, with incongruent approaches to its definition and possible role in various disorders. This review examines the conceptualization of the feeling of emptiness and its place in psychopathology. We found an imbalance between theoretical approaches to this phenomenon and empirical research, and argue that more studies using adequate assessment tools are needed.
View Article and Find Full Text PDFIn a recent book Cristopher Bollas, one of the greatest contemporary psychoanalysts, tells about how he began to bring together phenomenology and psychoanalysis in the clinical setting at the beginning of his career. Working with psychotic patients, he realized that it was first necessary to "absorb" their view of reality before being able to reflect on the mad scenarios of psychosis. In what world did they live? How did they perceive it? Only by "mirroring" this back to the patients was it possible to offer them the experience of being in front of someone trying to understand their world view.
View Article and Find Full Text PDFBackground: Borderline personality disorder (BPD) is one of the most puzzling psychiatric disorders. In order to improve its understanding and management, we have recently proposed an interpersonal dysphoria model that emphasizes the key role of the complex emotional state of dysphoria in BPD. The purpose of this study was to test the interpersonal dysphoria model using a structural equation modeling analysis.
View Article and Find Full Text PDFPurpose Of Review: The purpose of this article is to review the most recent literature on psychotic symptoms in borderline personality disorder (BPD).
Recent Findings: Both auditory hallucinations and delusional ideation (especially paranoid delusions) are relatively common in individuals with BPD. It is still difficult to distinguish these and related phenomena in BPD from the corresponding experiences in psychotic disorders and schizophrenia, despite numerous attempts to do so.
While on the one hand therapists can count on a number of codified and standardized diagnostic procedures, on the other hand it is hard to believe that in their daily work therapists slavishly follow these standardized procedures. In a clinical assessment, the diagnosis seems to be the outcome of a naïve and fuzzy process that is strongly influenced by personal training, by, theoretical models, and by one's masters as well as the experience gained in the field. What happens inside the no man's land of the clinical encounter? Can we identify some landmarks in these "amoeboid" exploratory moves? This paper addresses diagnosis not only as a noun or name ("diagnosis"), but also as a verb ("diagnosing"), arguing that a diagnostic space opens up thanks to an oscillatory state of mind that emerges at the intersection of different ways of looking "through" the symptom.
View Article and Find Full Text PDFCurr Opin Psychiatry
January 2018
Purpose Of Review: The purpose of this article is to review the most relevant conceptual models of borderline personality disorder (BPD), with a focus on recent developments in this area.
Recent Findings: Several conceptual models have been proposed with the aim of better understanding BPD: the borderline personality organization, emotion dysregulation, reflective (mentalization) dysfunction, interpersonal hypersensitivity and hyperbolic temperament models. These models have all been supported to some extent and their common components include disorganized attachment and traumatic early experiences, emotion dysregulation, interpersonal sensitivity and difficulties with social cognition.
This article aims to review the concept of emotion dysregulation, focusing on issues related to its definition, meanings and role in psychiatric disorders. Articles on emotion dysregulation published until May 2016 were identified through electronic database searches. Although there is no agreement about the definition of emotion dysregulation, the following five overlapping, not mutually exclusive dimensions of emotion dysregulation were identified: decreased emotional awareness, inadequate emotional reactivity, intense experience and expression of emotions, emotional rigidity and cognitive reappraisal difficulty.
View Article and Find Full Text PDFThe authors explore the psychic passages that were opened up within a patient, Ada, thanks to her contact with two works of art, Signorelli's frescoes in Orvieto and Picasso's painting La Nageuse--their themes, formal structures, and the conventions governing their creation. A work of art can be considered as a kind of window that allows one to look upon the imaginary world created by the artist. One can peer out of this window from the other side, permitting a look at the viewer (the patient), who is caught in a web of associations that are yet to be explored.
View Article and Find Full Text PDFPsychoanalysis has started to recoup, often quite implicitly, a more phenomenological stance, ever since psychoanalysts have started working with borderline and psychotic patients. As many of these patients have commonly been through traumatic experiences, psychoanalysts have been using an approach that questions the role of traditional psychoanalytical interpretation and pays more attention to the patient's inner conscious experiences; this approach is characteristic of a specific form of contemporary psychiatry: phenomenological psychopathology, founded by Karl Jaspers in 1913 and developed into a form of psychotherapy by Ludwig Binswanger, with his Daseinsanalyse. If what we could call a phenomenological 'temptation' has been spreading over psychoanalysis, so too has a psychoanalytical 'temptation' always been present in phenomenological psychopathology.
View Article and Find Full Text PDFThanks to the analysis of delusional perception's formal binary structure, generations of psychiatrists believed that the problem of delusion, at least from a descriptive point of view, had been resolved. The first-rank Schneiderian symptoms, and delusional perception in particular, had become reference points for the diagnosis of delusion and schizophrenia. Today, however, the phenomenon of delusional perception no longer seems to be taken into serious consideration by psychiatrists and psychopathologists.
View Article and Find Full Text PDFA clinical follow-up lasting from 1 to 6 years on 25 outpatients affected by endogenous psychoses and manifesting ego disorders demonstrates the presence of both activity and passivity experiences in schizophrenias and affective psychoses. No differential diagnosis between the two nosographical groups can be based on the phenomenological characteristics of passivity and activity experiences. Regarding the schizophrenic sample, our observations suggest reconsidering on theoretical grounds the validity of the construct 'loss of ego boundaries'.
View Article and Find Full Text PDFThe psychopathological validity of the current concept 'bizarre delusion' is questioned. A review of the literature reveals that the traditional category 'ego disorders'--though preferable to 'bizarre delusion'--is also biased, taking into account mainly 'passivity experiences' of the kind of 'Gemacht', eclipsing experiences of active influence on external reality. Although anecdotal records of activity experiences in schizophrenic psychoses have been reported since Kraepelin, any general systematization is lacking.
View Article and Find Full Text PDFThis study examines the psychological and psychopathological reactions that may appear in a man when his partner aborts. The small amount of literature that exists on the subjects was examined, and several men were, interviewed at the time their partners aborted voluntarely. It turns out that in spite of the man's lack of recognition of any reactions (reinforced by current attitudes and by the scant psychological and medical interest in the subject), there is considerable emotional involvement in the lost parenthood, both for the man and the woman.
View Article and Find Full Text PDFRiv Patol Nerv Ment
March 1984
Paternity, like maternity, provides an occasion for profound modifications of an individual's social role and internal world. Such modifications may be defined as "the job of becoming a parent". The authors examine psychological symptoms that appear at the advent of paternity, with special attention given to acute disorders and the couvade syndrome.
View Article and Find Full Text PDFThe reactions of father and/or mother at the time of the birth of the first son are here analysed (post partum "blue", "couvade", paternal acting and neurotic depressions). These manifestations are considered as masked depressive states. Analogies between the freudian concept of the mourning work and the work of becoming parents are seen as an internal process for both parents to consider all their losses (the role of the son, the privileged role of the pregnant woman, the exclusive relationship with the partner .
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