470 research outputs found

    Paola on the couch: an empirically supported psychoanalytic psychotherapy of a trans woman

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    Introduction: 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

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    Psychoanalytic 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?

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    In 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

    Clinical variables related to antidepressant-induced mania in bipolar disorder

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    BACKGROUND: 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

    I piccoli padiglioni universitari progettati da Enrico Mandolesi a Cagliari

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    Between 1962 and 1964, Enrico Mandolesi designed three small pavilions for the University of Cagliari: the Great Models Pavilion for the Institute of Construction 377 377 Antonello Sanna, Giuseppina Monni, Emanuela Quaquero I PICCOLI PADIGLIONI UNIVERSITARI PROGETTATI DA ENRICO MANDOLESI A CAGLIARI Science, the Pavilion for the Institute of Hydraulics and the Institute of Genetics. In all cases, the “pictorial” dimension, placing on the same level the warm tones of the clinker and the neutral one of the reinforced concrete, shows the author’s firm belief that all the materials have the same relevance. This is a lesson that Mandolesi learns from Mario Ridolfi, precursor of the Italian realism that abolishes the hierarchy between structural elements and finishes and declares that the creative idea of architecture lies in the precision of details. In the Great Models Pavilion for the Institute of Construction Science he chose to create a new volume connected to preexisting buildings with a small building. The horizontal and vertical windows declare the non-structural nature of the envelope made of bricks. A cultured design approach that uses the paradigm of the Illinois Institute of Technology by Mies van de Rohe. The Institute of Genetics is a building composed of two small volumes articulated on two levels and hinged to an independent stairway with a square plan. In this case, on a formal level, the basic principle is the horizontality that Mandolesi pursues at every level of detail. The author applied a combined solution that includes solid brick walls and a steel structure that connects to the frames of the fixtures. Both cases represent an accurate narration of construction stories that uses the combination of different materials, classic elements and modern solutions, the rough surfaces of reinforced concrete and the smooth ones of brick strips

    Paola on the couch: An empirically supported psychoanalytic psychotherapy of a trans woman

    No full text
    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 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

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    Una 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
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