The impostor anticipates the truth of the other

In this paper, we will elaborate on an article by H�l�ne Deutsch on the psychology of the impostor. The impostor is a specific type of liar who imposes on others dishonest stories about his identity. From a psychoanalytic point of view, identity is by definition fraudulent as there is no real Self. But the impostor duplicates this fraud by presenting dishonest stories about personal attainments, position, or worldly possessions. Referring to Freud?s text on ?Two lies told by children,? we will demonstrate that in the neurotic subject (a) the motive for lying is love, and (b) the purpose of lying is to deny symbolic castration in order to preserve an imaginary ideal. The impostor takes this one step further: here the motive is not love but admiration, and the purpose is not denial but disavowal of the symbolic castration. Finally, we will discuss the ambivalent relation of the public towards the impostor that seems all too willing to be deceived. In that sense, the lies of the impostor anticipate the Other?s truth about castration

The dread of living without anticipation: a case of melancholia

It seems that time functions essentially different in melancholia as compared to classical neuroses. We might even say the experience of time dissapears for the melancholicus. No future is anticipated, no past determines the actually lived distress, despair and guilt. This paper illustrates by means of a case study of a melancholic woman how anticipation is necessary for the subject to be able to live. Without desire for things to come, without a past that is experienced as something that anticipated the subject as it is now, there seems to be no more than an eternal now that stupifies the subject and blurs the distinction between death and living. The absence of the structuring function of time results in the experience of utter loneliness and anxiety and consequently also shows the dramatic impact of an absence of anticipation

Improving access to and effectiveness of mental health care for personality disorders:the guideline-informed treatment for personality disorders (GIT-PD) initiative in the Netherlands

Evidence-based treatment for patients suffering from personality disorders (PDs) is only available to a limited extend in the Netherlands. Consequently, most patients receive non-manualized, unspecialized care. This manuscript describes the background, rationale and design of the Guideline-Informed Treatment for Personality Disorders (GIT-PD) initiative. GIT-PD aims to provide a simple, principle-driven, ‘common-factors’ framework for the treatment of PDs. The GIT-PD framework integrates scientific knowledge, professional expertise and patient experience to design a good-enough practice, based on common factors. It offers a basic framework including general principles, a structured clinical pathway, a basic professional stance, interventions focused on common factors, and team and organizational strategies, based on common features of evidence-based treatments and generic competences of professionals. The GIT-PD initiative has had a large impact on the organization of treatment for PDs in the Netherlands. For countries with an interest in improving their health care system for PDs, it could serve as a template that requires only limited resource

De verwondering begrijpen

Rede In verkorte vorm uitgesproken ter gelegenheid van het aanvaarden van het ambt van bijzonder hoogleraar met als leeropdracht Functionele neurogenetica aan het Erasmus MC, faculteit van de Erasmus Universiteit Rotterdam op 23 mei 201

Dietary calcium decreases but short-chain fructo-oligosaccharides increase colonic permeability in rats

An increased intestinal permeability is associated with several diseases. Nutrition can influence gut permeability. Previously, we showed that dietary Ca decreases whereas dietary short-chain fructo-oligosaccharides (scFOS) increase intestinal permeability in rats. However, it is unknown how and where in the gastrointestinal tract Ca and scFOS exert their effects. Rats were fed a Western low-Ca control diet, or a similar diet supplemented with either Ca or scFOS. Lactulose plus mannitol and Cr-EDTA were added to the diets to quantify small and total gastrointestinal permeability, respectively. Additionally, colonic tissue was mounted in Ussing chambers and exposed to faecal water of these rats. Dietary Ca immediately decreased urinary Cr-EDTA excretion by 24 % in Ca-fed rats compared with control rats. Dietary scFOS increased total Cr-EDTA permeability gradually with time, likely reflecting relatively slow gut microbiota adaptations, which finally resulted in a 30 % increase. The lactulose: mannitol ratio was 15 % higher for Ca-fed rats and 16 % lower for scFOS-fed rats compared with control rats. However, no dietary effect was present on individual urinary lactulose and mannitol excretion. The faecal waters did not influence colonic permeability in Ussing chambers. In conclusion, despite effects on the lactulose: mannitol ratio, individual lactulose values did not alter, indicating that diet did not influence small-intestinal permeability. Therefore, both nutrients affect permeability only in the colon: Ca decreases, while scFOS increase colonic permeability. As faecal water did not influence permeability in Ussing chambers, probably modulation of mucins and/or microbiota is important for the in vivo effects of dietary Ca and scFOS

Atypical B cells (CD21-CD27-IgD-) correlate with lack of response to checkpoint inhibitor therapy in NSCLC

Introduction: Checkpoint inhibitor (CI) therapy has revolutionized treatment for non-small cell lung cancer (NSCLC). However, a proportion of patients do not respond to CI therapy for unknown reasons. Although the current paradigm in anti-tumor immunity evolves around T cells, the presence of tertiary lymphoid structures and memory B cells has been positively correlated with response to CI therapy in NSCLC. In addition, double negative (DN) (CD27- IgD-) B cells have been shown to be abundant in NSCLC compared to healthy lung tissue and inversely correlate with the intratumoral presence of memory B cells. Nonetheless, no study has correlated DN B cells to survival in NSCLC. Methods: In this study, we evaluated the presence and phenotype of B cells in peripheral blood with flow cytometry of patients with NSCLC and mesothelioma before receiving CI therapy and correlated these with clinical outcome. Results: Non-responding patients showed decreased frequencies of B cells, yet increased frequencies of antigen-experienced CD21- DN (Atypical) B cells compared to responding patients and HC, which was confirmed in patients with mesothelioma treated with CI therapy. Conclusions: These data show that the frequency of CD21- DN B cells correlates with lack of response to CI therapy in thoracic malignancies. The mechanism by which CD21- DN B cells hamper CI therapy remains unknown. Our findings support the hypothesis that CD21- DN B cells resemble phenotypically identical exhausted B cells that are seen in chronic infection or function as antigen presenting cells that induce regulatory T cells.</p