Relación entre fantasías de flagelación y sueño diurno

En su trabajo "Pegan a un niño" Freud describe una fantasía que, según él, se encuentra en sorprendente porcentaje entre los enfermos que acuden al tratamiento analítico por histeria o neurosis obsesiva. […] La fantasía de flagelación se encuentra cargada invariablemente, con un alto grado de placer y tiene origen en un acto de satisfacción autoerótica placentera. […] En un párrafo de su obra Freud dice: “En dos de mis cuatro enfermas se había desarrollado, sobre la fantasía masoquista de flagelación, una superestructura artística de sueños diurnos que tenía gran significado en sus vidas. La función de tal superestructura era permitir el sentimiento de excitación satisfecha aun cuando se abstuviera del acto onanístico.” De varios sueños diurnos podemos seleccionar uno que parece creado especialmente para ilustrar esta observación. Fue elaborado por una joven de 15 años cuya vida de ensueños a pesar de su abundancia no había entrado nunca en conflicto con la realidad. El origen, evolución y terminación del mismo pudo establecerse con certeza y se comprobó durante el análisis su derivación y dependencia de una fantasía de flagelación de larga data.El comentario sobre este escrito se encuentra en "Documentos relacionados".Hospital Interzonal General de Agudos "Prof. Dr. R. Rossi

Interactional positioning and narrative self-construction in the first session of psychodynamic-interpersonal psychotherapy

The purpose of this study is to identify possible session one indicators of end of treatment psychotherapy outcome using the framework of three types of interactional positioning; client’s self-positioning, client’s positioning between narrated self and different partners, and the positioning between client and therapist. Three successful cases of 8-session psychodynamic-interpersonal (PI) therapy were selected on the basis of client Beck Depression Inventory scores. One unsuccessful case was also selected against which identified patterns could be tested. The successful clients were more descriptive about their problems and demonstrated active rapport-building, while the therapist used positionings expressed by the client in order to explore the positionings developed between them during therapy. The unsuccessful case was characterized by lack of positive self-comment, minimization of agentic self-capacity, and empathy-disrupting narrative confusions. We conclude that the theory of interactional positioning has been useful in identifying patterns worth exploring as early indicators of success in PI therapy

A psychoanalytic concept illustrated: Will, must, may, can — revisiting the survival function of primitive omnipotence

The author explores the linear thread connecting the theory of Freud and Klein, in terms of the central significance of the duality of the life and death instinct and the capacity of the ego to tolerate contact with internal and external reality. Theoretical questions raised by later authors, informed by clinical work with children who have suffered deprivation and trauma in infancy, are then considered. Theoretical ideas are illustrated with reference to observational material of a little boy who suffered deprivation and trauma in infancy. He was first observed in the middle of his first year of life while he was living in foster care, and then later at the age of two years and three months, when he had been living with his adoptive parents for more than a year

Embryonic Pig Pancreatic Tissue Transplantation for the Treatment of Diabetes

BACKGROUND: Transplantation of embryonic pig pancreatic tissue as a source of insulin has been suggested for the cure of diabetes. However, previous limited clinical trials failed in their attempts to treat diabetic patients by transplantation of advanced gestational age porcine embryonic pancreas. In the present study we examined growth potential, functionality, and immunogenicity of pig embryonic pancreatic tissue harvested at different gestational ages. METHODS AND FINDINGS: Implantation of embryonic pig pancreatic tissues of different gestational ages in SCID mice reveals that embryonic day 42 (E42) pig pancreas can enable a massive growth of pig islets for prolonged periods and restore normoglycemia in diabetic mice. Furthermore, both direct and indirect T cell rejection responses to the xenogeneic tissue demonstrated that E42 tissue, in comparison to E56 or later embryonic tissues, exhibits markedly reduced immunogenicity. Finally, fully immunocompetent diabetic mice grafted with the E42 pig pancreatic tissue and treated with an immunosuppression protocol comprising CTLA4-Ig and anti–CD40 ligand (anti-CD40L) attained normal blood glucose levels, eliminating the need for insulin. CONCLUSIONS: These results emphasize the importance of selecting embryonic tissue of the correct gestational age for optimal growth and function and for reduced immunogenicity, and provide a proof of principle for the therapeutic potential of E42 embryonic pig pancreatic tissue transplantation in diabetes

Defensive coping and health-related quality of life in chronic kidney disease: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Coping with the stresses of chronic disease is considered as a key factor in the perceived impairment of health related quality of life (HRQL). Little is known though about these associations in chronic kidney disease (CKD). The present study aimed to investigate the relationship of defensive coping and HRQL among patients in different CKD stages, after adjusting for psychological distress, sociodemographic and disease-related variables.</p> <p>Methods</p> <p>The sample consisted of 98 CKD patients, attending a university nephrology department. Seventy-nine (79) pre-dialysis patients of disease stages 3 to 4 and 19 dialysis patients were included. HRQL was assessed by the 36-item Short-Form health survey (SF-36), defensive coping by the Rationality/Emotional Defensiveness (R/ED) scale of the Lifestyle Defense Mechanism Inventory (LDMI) and psychological distress by the depression and anxiety scales of the revised Hopkins Symptom CheckList (SCL-90-R). Regression analyses were carried out to examine the association between SF-36 dimensions and defensive coping style.</p> <p>Results</p> <p>Patients on dialysis had worse scores on SF-36 scales measuring physical aspects of HRQL. In the fully adjusted analysis, a higher defensive coping score was significantly associated with a lower score on the mental component summary (MCS) scale of the SF-36 (worse mental health). In contrast, a higher defensive score showed a small positive association with the physical component summary (PCS) scale of the SF-36 (better health), but this was marginally significant.</p> <p>Conclusions</p> <p>The results provided evidence that emotional defensiveness as a coping style tends to differentially affect the mental and the physical component of HRQL in CKD. Clinicians should be aware of the effects of long-term denial and could examine the possibility of screening for defensive coping and depression in recently diagnosed CKD patients with the aim to improve both physical and mental health.</p