11,720 research outputs found
Paola on the couch: an empirically supported psychoanalytic psychotherapy of a trans woman
No full textIntroduction: Psychoanalytic accounts of gender variant patients in the recent literature are fairly rare. Psychoanalysis with these patients suffers from old biases which determined short-sighted and pathologizing interpretations of gender diversity. This contribution provides an account of a long-term psychoanalytic psychotherapy, based on an open and affirmative approach towards gender reassignment, of a trans adult woman during the crucial years prior to the decision for gender reassignment surgery (GRS).
Method: Empirical measures include the Shedler-Westen Assessment Procedure-200 (Westen & Shedler, 1999a, 1999b) and the Countertransference Questionnaire (CTQ; Betan, Heim, Zittel Conklin, & Westen, 2005) and the Psychotherapy Relationship Questionnaire (PRQ; Westen, 2000).
Results: The study illustrates the progress in Paola’s psychological functioning and in the therapeutic relationship through the clinical description of various phases of a long-term therapy (referral, one year after, and follow-up ten years after) and the findings on the measures collected at each stage.
Conclusions: The results show the benefits and the complexities of the psychoanalytic treatment with gender variant patients, supporting them in key aspects of their transition
Paola on the couch: The quest for feminine identity in an empirically supported psychoanalytic psychotherapy of a trans woman
No full textPsychoanalytic accounts of gender variant patients in the literature are rare. Psychoanalysis with these patients suffers from historical biases that determine short-sighted and pathologizing interpretations of gender diversity. This contribution provides an account of a long-term psychoanalytic psychotherapy taking an open and affirmative approach to gender reassignment. The patient was a trans adult woman, Paola, during the crucial years preceding her decision to undergo gender reassignment surgery. Through the analysis of the patient’s identifications and dreams, the psychoanalytic report focuses on the developmental process of her transition path. The study illustrates Paola’s psychological functioning and the therapeutic relationship, drawing on both clinical descriptions and empirical measures of Paola’s personality and transferential and countertransferential patterns in the therapeutic relationship at different stages of treatment. The results show the benefits and complexities of psychoanalytic treatment with gender variant patients, during key stages of their transition journey
Neurobiology of dynamic psychotherapy: an integration possible?
No full textIn the last decades, Kandel's innovative experiments have demonstrated that brain structures and synaptic connections are dynamic. Synapses can be modified by a wide variety of environmental factors, including learning and memory processes. The hypothesis that dynamic psychotherapy process involves memory and learning processes has opened the possibility of a dialogue between neuroscience and psychoanalysis and related psychotherapy techniques. The primary aim of the present article is to critically review the more recent data on neurobiological effects of dynamic psychotherapy in psychiatric disorders. Relevant literature has been selected using the databases currently available online (i.e., PubMed). The literature search has been limited to the past 10 years and to genetic, molecular biology, and neuroimaging studies that have addressed the issue of changes induced by psychotherapy. Most of the genetic studies on mental disorders have demonstrated that psychiatric conditions result from a complex interaction of genetic susceptibility and environmental effects. For none of the many psychiatric conditions investigated has a purely genetic background been found. Molecular biology studies have indicated that gene expression is influenced by several environmental factors, including early experiences, traumas, learning, and memory processes. Neuroimaging studies (using fMRI and PET) have found that not only cognitive but also dynamic psychotherapy has measurable effects on the brain. In addition, psychotherapy may modify brain function and metabolism in specific brain areas. Most of these studies have considered patients with major depressive disorders and compared the effects of psychotherapy with the effect of standard pharmacotherapy. In conclusion, recent results from neuroscience studies have suggested that dynamic psychotherapy has a significant impact on brain function and metabolism in specific brain areas. The possible applications and developments of this new area of research toward the conceptualization of an integrative approach to treatment of psychiatric disorders are discussed
Differenze di genere nel disturbo bipolare : problemi diagnostici e nuove prospettive terapeutiche
No full textClinical variables related to antidepressant-induced mania in bipolar disorder
No full textBACKGROUND: The development of mania or hypomania during antidepressant treatment is a serious complication of the clinical management of bipolar disorder (BP). The primary aim of this study was to evaluate the clinical variables related to antidepressant-induced mania or hypomania (AIM) in patients with BP. METHODS: DSM-IV BP-I or BP-II patients who had had at least one depressive episode treated with antidepressants were considered. Patients were subdivided into two groups according to the presence (n = 30) or absence (n = 106) of manic or hypomanic episodes occurring during antidepressant treatment.
Possible predictive clinical variables of AIM were considered: gender, diagnostic subtype, age at onset, duration of illness, duration of untreated illness, type of antidepressant administered, number of previous spontaneous hypomanic or manic episodes, number of previous depressive episodes, presence of lifetime suicide attempts, presence of mood stabilizer treatments, presence of psychotic symptoms during spontaneous episodes, family history for psychiatric disorders in first degree relatives. Data were compared between the two groups, with (AIM+) and without (AIM-) antidepressant-induced mania, using Student's t tests and chi-square tests. RESULTS: The lack of mood stabilizer treatments during antidepressant therapy (chi-square = 37.602, df = 1, p < 0.001) and the exposure to tricyclic antidepressants (chi-square = 4.901, df = 1, p < 0.05) resulted significantly associated to the development of AIM. LIMITATIONS: This study was not done under controlled conditions and the relatively small sample studied warrants further replications. CONCLUSIONS: These results point out the risk of mania induction associated to the use of tricyclic antidepressants in BP patients, mainly in absence of adequate mood stabilizers
Paola on the couch: An empirically supported psychoanalytic psychotherapy of a trans woman
No full textPsychoanalytic accounts of gender variant patients in the recent literature are fairly rare. Psychoanalysis with these patients suffers from old biases which determined short-sighted and pathologizing interpretations of transsexualism. This contribution provides an account of a long-term psychoanalytic psychotherapy, based on an open and affirmative approach towards gender reassignment, of a trans adult woman during the crucial years prior to the decision for gender reassignment surgery (GRS). Empirical measures include the Shedler-Westen Assessment Procedure-200 (Westen & Shedler, 1999a, 1999b; Shedler & Westen, 2006) and the Countertransference Questionnaire (CTQ; Betan, Heim, Zittel Conklin, & Westen, 2005; Tanzilli, Colli, & Lingiardi, 2009). The study illustrates the progress in Paola’s psychological functioning and in the therapeutic relationship through the clinical description of various phases of a long-term therapy (referral, one year after, and follow-up nine years after) and the findings on the measures collected at each stage. The results show the benefits and the complexities of the psychoanalytic treatment with gender variant patients, supporting them in key aspects of their transition
Lalangue
No full textUna rivisitazione critica del concetto lacaniano di "lalangue" alla luce della tesi che il linguaggio non esiste se non come oggetto di sapere, ovvero che il linguaggio è sempre e soltanto dell'ordine di "lalangue" cioè del ritornello e della morfogenesi in atto del senso
Efficacy and tolerability of quetiapine in the treatment of bipolar disorder: preliminary evidence from a 12-month open-label study
No full textBackground: The literature on the use of quetiapine for the treatment of bipolar disorder (BD) is limited to case reports, and there are no systematic studies on the efficacy of quetiapine in the prophylactic treatment of BD. The aim of the present study was to compare the efficacy of flexible doses of quetiapine and well established mood stabilizers in the maintenance treatment of BD. Methods: Twenty-eight DSM-IV BD outpatients were consecutively recruited into the study and were randomized to receive one of two open-label treatments, with quetiapine or classical mood stabilizers at flexible doses for 12 months. Clinical assessment was carried out using BPRS, CGI, YMRS and the 21-item HAM-D at baseline (T0) and every 2 months until the end of the study. ANOVAs with repeated measures were applied to the rating scale scores considering the time and the treatment group as main factors. Results: All patients experienced a significant improvement on the BPRS, CGI and HAM-D scores, with no significant side-effects and a good compliance. Limitations: This study should be considered preliminary given the small sample size investigated and the open-label design. Conclusions: If these results will be replicated on larger samples and in controlled studies, there could be relevant implications for the use of quetiapine as an alternative maintenance treatment for BD
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