The shock of the real: Psychoanalysis, modernity, survival

The contemporary relevance of psychoanalysis is being increasingly questioned; Off the Couch challenges this view, demonstrating that psychoanalytic thinking and its applications are both innovative and relevant, in particular to the management and treatment of more disturbed and difficult to engage patient groups. Chapters address: Clinical applications in diverse settings across the age range the relevance of psychoanalytic thinking to the practice of CBT, psychosomatics and general psychiatry the contribution of psychoanalytic thinking to mental health policy and the politics of conflict and mediation. This book suggests that psychoanalysis has a vital position within the public health sector and discusses how it can be better utilised in the treatment of a range of mental health problems. It also highlights the role of empirical research in providing a robust evidence base. Off the Couch will be essential reading for those practicing in the field of mental health and will also be useful for anyone involved in the development of mental health and public policies. It will ensure that practitioners and supervisors have a clear insight into how psychoanalysis can be applied in general healthcare

Reduced GABA-B/GIRK-mediated regulation of the VTA following a single exposure to cocaine

In this paper, Arora and colleagues expand on their previous work on GIRK channels in the ventral tegmental area (VTA) presenting evidence that a single exposure to cocaine reduces inhibitory GABAergic transmission to dopamine (DA) neurons in the ventral tegmental area. Mice receiving i.p. injections of cocaine saw a short lived (1-5 days) decrease in GABAb mediated G-protein coupled inwardly-rectifying potassium (GIRK) currents in DA neurons in the VTA. This decrease parallels an NMDA-mediated increase in the frequency of glutamatergic neurotransmission. Chronic cocaine injections had no additional effects beyond those seen with single injections. Though they found no change in mRNA levels for GABAb receptors, GIRK channels, or RGS-2 (a G-protein regulator), immunoelectron microscopy indicated a decrease in levels of GIRK channels in the plasma membrane of the dendrites of VTA DA neurons. The cocaine-mediated decrease in GIRK currents was abolished in the presence of D2/3R antagonist sulpiride, but not in the presence of D1/5 antagonist SCH23390, indicating a link between D2/3 receptor activation and GIRK activity. Interestingly, the addition of quinpirole, a D2/3 agonist, elicited similar GIRK currents, though they were smaller than those mediated by GABAb receptors. Similarly, acute injections of cocaine significantly diminished quinpirole-evoked currents