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Loneliness among Adults Aging with Intellectual and Developmental Disabilities: The Importance of Living Situation.

Gerontologist

January 2025

Department of Gerontology, Donna M. and Robert J. Manning College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, Massachusetts, USA.

Background And Objectives: Loneliness is a serious public health concern among the aging population. Not only is loneliness an unpleasant emotional experience, it is also associated with worse health, well-being, and even mortality. This is a particularly important issue among the population aging with intellectual and developmental disabilities, who are more likely to experience loneliness across the life course, and who - particularly if living in an intermediate care facility (ICF) or nursing facility - may lack social connections.

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The objective of this paper is to discuss the ways in which primitive aspects of the mind, in particular, the archaic elements of character, become manifest within the analytic field. After a review of the concept, it is proposed that a "normal" character manifests through memories in behaviours/feelings, which seek the object to satisfy their needs. The characterological structure keeps primitive traumatic inscriptions under control.

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Inspired by Dana Birksted-Breen's ideas on reverberation time, the author explores the changeability and transformation of the sensations of time and space and their connection to early embodied phantasies in the treatment of a 10-year-old boy. The experience of time changes (summarized under "time elasticity" to reflect the various forms this can take) is lived out in the transference relationship from the beginning of the therapeutic encounter. The author proposes the simultaneous development of the capacity to accept "objective" time, the establishment of a tri-dimensional space within the self and between objects and tolerating separateness and separation.

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Loss and memorialization.

Int J Psychoanal

December 2024

Clinical Professor of Psychiatry, Weill Cornell Medical College, New York, USA; Editor Emeritus, The Psychoanalytic Quarterly.

Drawing upon Dana Birksted-Breen's work on temporality, and the contrast which she draws between linear, developmental time, seen as a series of unchanging moments, and bidirectional, process time, which is retranscribed again and again (Birksted-Breen [2003] 2016. "Time and the Apres-Coup." In , edited by D.

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This article identifies and offers a response to several problems that affect the quality of both clinical education and health care services. These matters are: that in clinical training and practice, health, as lived by patients (persons), is not properly considered, and is equated reductively with treating diseases/disorders; that health is seen through disease, and as restricted to a single model defined by an organism's meeting (or being returned to) biochemical or functional standards; that intellectual assumptions instilled in schools of Medicine and Psychology about realities pertaining to healthcare determine an understanding of chronic illness or life with chronic challenges focused on impairment and suffering, and not on the fuller experience of living with illness, disability or neuropsychological challenges that patients have as persons; that arts-based education reflects the same focus in understanding 'illness', and thus neglects giving attention to the creation of personal health states of those living with challenging or debilitating long-term conditions; that, consequently, the arts are instrumentalized to serve these predefined educational purposes, rather than allowed to inform clinical training through that which is intrinsic or more specific to them. As a way out of these limitations and as an illustration of how things could be done differently, Vincent Van Gogh's paintings of the Sunflowers are used as visual inspiration for how we could change the way we see, and construct new mental representations of 'health', 'chronic illness' or 'chronic challenges', 'patient as person' or even 'person as non-patient', 'the clinician's role' and 'the identity of clinical practice'.

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