La psychothérapie focalisée sur le transfert

La psychothérapie focalisée sur le transfert (PFT) est une version modifiée de la psychothérapie psychodynamique classique et spécialisée pour les troubles graves de la personnalité. Elle se fonde sur les principes de la psychanalyse et sur la théorie des relations objectales. L’organisation du monde psychique se structure à partir de l’expérience des interrelations personnelles impliquant une pulsion venant buter contre un objet et produisant un affect agréable ou désagréable. L’expérience ainsi vécue structure une dyade relationnelle impliquant une représentation de Soi et une représentation de l’autre liées par l’affect éprouvé. Par la suite, les représentations s’intègrent les unes aux autres pour former un monde interne évolué, souple, dynamique, adaptée à la réalité externe ou, au contraire, un monde primitif, rigide et fréquemment en conflit avec la réalité externe. La psychothérapie focalisée sur le transfert se propose justement de faire évoluer la structure de la personnalité par le biais d’une analyse soutenue de l’expérience relationnelle vécue avec le psychothérapeute, la mise à jour des représentations de soi et de l’autre et de l’affect qui les lie et la prise de conscience des désirs et motifs inconscients de la personne. Une phase de diagnostic différentiel par le biais d’une entrevue structurale et l’élaboration d’un contrat psychothérapique précède la psychothérapie proprement dite. Le premier but de la psychothérapie focalisée sur le transfert est d’engager la personne dans une observation et une prise de conscience des représentations d’elle-même et des autres. Ces représentations sont le plus souvent biaisées par l’organisation inconsciente du monde interne.Transference focused psychotherapy is a version of psychodynamic psychotherapy that is modified and specialized for patients with borderline personality disorder. It is based on psychoanalytic principles with an emphasis on object relations theory. A fundamental concept in this model is that the organization of an individual’s psyche is structured around internalized versions of interpersonal relations. The relationship experiences that are internalized involve a specific representation of the self, a specific representation of the other (the object of the libidinal or aggressive drive) and an intense affect that links them. However, this movement toward integration of the internal representational world does not take place in individuals with borderline personality, who continue to experience life in a way that is based on rigid and extreme views of self and others. The goal of transference focused psychotherapy is to help individuals advance to an integrated internal world through the analysis of the patient’s ongoing experience of his or her relationship with the therapist. It is assumed that the analysis of this relationship will bring to light the internal representations of self and other, and the corresponding affects, that are related to unconscious desires and motivations, and that underlie the individual’s extreme and discontinuous experience in life. The therapy begins with a specific diagnostic interview and the establishment of a treatment contract with the patient before the psychotherapeutic work begins. The first goal of the therapy is to engage the patient in the process of observing and gaining awareness of the representations of self and other that guide his or her perceptions of the world. The therapy then helps the patient to understand the internal forces that have kept theses representations segregated from each other and to integrate them into a more mature and coherent sense of self and others.La psicoterapia focalizada en la transferencia (PFT) es una versión modificada de la psicoterapia psicodinámica clásica y especializada para los trastornos graves de la personalidad. Se funda en los principios del psicoanálisis y en la teoría de las relaciones objetales. La organización del mundo psíquico se estructura a partir de la experiencia de las interrelaciones personales, que implican una pulsión que se topa con un objeto y produce un afecto agradable o desagradable. La experiencia así vivida crea una estructura de díada relacional que implica una representación de Sí y una representación del otro, ligadas por el afecto experimentado. A continuación, las representaciones se integran unas con otras para formar un mundo interno evolucionado, flexible, dinámico, adaptado a la realidad externa o, por el contrario, un mundo primitivo, rígido y frecuentemente en conflicto con la realidad externa. La psicoterapia focalizada en la transferencia se propone justamente hacer evolucionar la estructura de la personalidad por medio de un análisis sostenido de la experiencia relacional vivida con el psicoterapeuta, la actualización de las representaciones de sí mismo y del otro, del afecto que las une y la toma de conciencia de los deseos y motivos inconscientes de la persona. Una fase de diagnóstico diferencial, mediante una entrevista estructural y la elaboración de un contrato psicoterapéutico, precede a la psicoterapia propiamente dicha. El primer objetivo de la psicoterapia focalizada en la transferencia es comprometer a la persona a una observación y una toma de conciencia de las representaciones de ella misma y de los demás. Estas representaciones frecuentemente son tergiversadas por la organización inconsciente del mundo interno.A Psicoterapia Focada na Transferência (PFT) é uma versão modificada da psicoterapia psicodinâmica clássica e especializada para os transtornos graves da personalidade. Ela fundamenta-se nos princípios da psicanálise e na teoria das relações objetais. A organização do mundo psíquico estrutura-se a partir da experiência das inter-relações pessoais implicando uma pulsão vindo chocar com um objeto e produzindo um afeto agradável ou desagradável. A experiência assim vivenciada estrutura uma díade relacional implicando uma representação de Si e uma representação do outro, ligadas pelo afeto vivenciado. Em seguida, as representações integram-se umas às outras para formar um mundo interno evoluído, flexível, dinâmico, adaptado à realidade externa ou, pelo contrário, um mundo primitivo, rígido e freqüentemente em conflito com a realidade externa. A psicoterapia focada na transferência propõe-se justamente fazer evoluir a estrutura da personalidade através de uma análise apoiada na experiência relacional vivenciada com o psicoterapeuta, a atualização das representações de si e do outro e do afeto que os une e a tomada de consciência dos desejos e motivos inconscientes da pessoa. Uma fase de diagnóstico diferencial, através de uma entrevista estrutural e a elaboração de um contrato psicoterápico precede a psicoterapia propriamente dita. O primeiro objetivo da psicoterapia focada na transferência é levar a pessoa a uma observação e uma tomada de consciência das representações dela mesma e dos outros. Estas representações são mais freqüentemente desviadas pela organização inconsciente do mundo interno

Incidence de certains facteurs sur l’issue d’une psychothérapie dans un essai clinique randomisé auprès de patients avec trouble de personnalité limite (TPL)

Au Personality Disorders Institute, nous avons étudié l’efficacité de la psychothérapie focalisée sur le transfert (PFT), une psychothérapie psychodynamique manualisée qui se déroule deux fois par semaine à l’intention de personnes souffrant de troubles de personnalité limite (TPL). Nous avons comparé la PFT à la thérapie dialectique comportementale (TDC) et à la psychothérapie psychodynamique de soutien (PPS) dans un essai clinique randomisé auprès de 90 patients ayant un TPL. Dans un premier temps, nous présentons certains fondements à l’origine du développement des TPL, suivis d’une discussion des bases théoriques de la PFT. Nous abordons ensuite les caractéristiques des patients qui influent sur les résultats du traitement. Nous présentons des données à la fois cliniques et empiriques dans une discussion de cas individuels représentatifs de l’échantillon de patients borderline traités en PFT.At the Personality Disorders Institute we have been investigating the efficacy of Transference-Focused Psychotherapy (TFP), a twice weekly manualized psychodynamic psychotherapy for borderline personality disorder compared to Dialectical Behavior Therapy (DBT) and Supportive Psychotherapy (SP) in a randomized clinical trial of 90 borderline patients. We will first present some developmental foundations of BPD, followed by a discussion of the theoretical foundations of TFP. We will then discuss patient characteristics that have an impact on outcome. We will present both clinical and empirical data in a discussion of individual cases that were representative of a sample of borderline patients treated in Transference-Focused Psychotherapy (TFP).En el Personality Disorders Institute estudiamos la eficacia de la psicoterapia focalizada en la transferencia (PFT), una psicoterapia psicodinámica hecha manual, que se lleva a cabo dos veces por semana para las personas que sufren de trastornos de personalidad límite (TPL). Comparamos la PFT con la terapia dialéctica comportamental (TDC) y la psicoterapia psicodinámica de apoyo (PPS) en una prueba clínica aleatoria en 90 pacientes con TPL. En un primer momento, presentamos ciertos fundamentos al origen del desarrollo de las TPL, seguidos de una discusión de las bases teóricas de la PFT. Enseguida abordamos las características de los pacientes que influyen en los resultados del tratamiento. Presentamos los datos, a la vez clínicos y empíricos, en una discusión de casos individuales representativos de la muestra de pacientes límite tratados por medio de PFT.No Personality Disorders Institute, estudamos a eficácia da psicoterapia focalizada na transferência (PFT), uma psicoterapia psicodinâmica manualizada que é realizada duas vezes por semana com pessoas que sofrem de transtornos de personalidade borderline (TPB). Comparamos a PFT com a terapia comportamental dialética (TCD) e com a psicoterapia psicodinâmica de apoio (PPA) em um teste clínico randomizado junto a 90 pacientes que sofrem de um TPB. Primeiramente, apresentamos alguns fundamentos originários do desenvolvimento dos TPB, seguidos de uma discussão sobre as bases teóricas da PFT. Abordamos, em seguida, as características dos pacientes que influenciam os resultados do tratamento. Apresentamos dados, ao mesmo tempo clínicos e empíricos em uma discussão de casos individuais representativos da amostragem de pacientes borderline tratados em PFT

Observation of an Excited Bc+ State

Using pp collision data corresponding to an integrated luminosity of 8.5 fb-1 recorded by the LHCb experiment at center-of-mass energies of s=7, 8, and 13 TeV, the observation of an excited Bc+ state in the Bc+π+π- invariant-mass spectrum is reported. The observed peak has a mass of 6841.2±0.6(stat)±0.1(syst)±0.8(Bc+) MeV/c2, where the last uncertainty is due to the limited knowledge of the Bc+ mass. It is consistent with expectations of the Bc∗(2S31)+ state reconstructed without the low-energy photon from the Bc∗(1S31)+→Bc+γ decay following Bc∗(2S31)+→Bc∗(1S31)+π+π-. A second state is seen with a global (local) statistical significance of 2.2σ (3.2σ) and a mass of 6872.1±1.3(stat)±0.1(syst)±0.8(Bc+) MeV/c2, and is consistent with the Bc(2S10)+ state. These mass measurements are the most precise to date

At What Stage of Neural Processing Does Cocaine Act to Boost Pursuit of Rewards?

Dopamine-containing neurons have been implicated in reward and decision making. One element of the supporting evidence is that cocaine, like other drugs that increase dopaminergic neurotransmission, powerfully potentiates reward seeking. We analyze this phenomenon from a novel perspective, introducing a new conceptual framework and new methodology for determining the stage(s) of neural processing at which drugs, lesions and physiological manipulations act to influence reward-seeking behavior. Cocaine strongly boosts the proclivity of rats to work for rewarding electrical brain stimulation. We show that the conventional conceptual framework and methods do not distinguish between three conflicting accounts of how the drug produces this effect: increased sensitivity of brain reward circuitry, increased gain, or decreased subjective reward costs. Sensitivity determines the stimulation strength required to produce a reward of a given intensity (a measure analogous to the KM of an enzyme) whereas gain determines the maximum intensity attainable (a measure analogous to the vmax of an enzyme-catalyzed reaction). To distinguish sensitivity changes from the other determinants, we measured and modeled reward seeking as a function of both stimulation strength and opportunity cost. The principal effect of cocaine was a two-fourfold increase in willingness to pay for the electrical reward, an effect consistent with increased gain or decreased subjective cost. This finding challenges the long-standing view that cocaine increases the sensitivity of brain reward circuitry. We discuss the implications of the results and the analytic approach for theories of how dopaminergic neurons and other diffuse modulatory brain systems contribute to reward pursuit, and we explore the implications of the conceptual framework for the study of natural rewards, drug reward, and mood

Observation of the Decay Λ0b→Λ+cτ−¯ν

The first observation of the semileptonic b-baryon decay Λb0→Λc+τ-ν¯τ, with a significance of 6.1σ, is reported using a data sample corresponding to 3 fb-1 of integrated luminosity, collected by the LHCb experiment at center-of-mass energies of 7 and 8 TeV at the LHC. The τ- lepton is reconstructed in the hadronic decay to three charged pions. The ratio K=B(Λb0→Λc+τ-ν¯τ)/B(Λb0→Λc+π-π+π-) is measured to be 2.46±0.27±0.40, where the first uncertainty is statistical and the second systematic. The branching fraction B(Λb0→Λc+τ-ν¯τ)=(1.50±0.16±0.25±0.23)% is obtained, where the third uncertainty is from the external branching fraction of the normalization channel Λb0→Λc+π-π+π-. The ratio of semileptonic branching fractions R(Λc+)B(Λb0→Λc+τ-ν¯τ)/B(Λb0→Λc+μ-ν¯μ) is derived to be 0.242±0.026±0.040±0.059, where the external branching fraction uncertainty from the channel Λb0→Λc+μ-ν¯μ contributes to the last term. This result is in agreement with the standard model prediction

A study of CP violation in the decays B±→[K+K-π+π-]Dh± (h= K, π) and B±→[π+π-π+π-]Dh±

The first study of CP violation in the decay mode B±→[K+K-π+π-]Dh± , with h= K, π , is presented, exploiting a data sample of proton–proton collisions collected by the LHCb experiment that corresponds to an integrated luminosity of 9 \,fb - 1 . The analysis is performed in bins of phase space, which are optimised for sensitivity to local CP asymmetries. CP -violating observables that are sensitive to the angle γ of the Unitarity Triangle are determined. The analysis requires external information on charm-decay parameters, which are currently taken from an amplitude analysis of LHCb data, but can be updated in the future when direct measurements become available. Measurements are also performed of phase-space integrated observables for B±→[K+K-π+π-]Dh± and B±→[π+π-π+π-]Dh± decays

Measurement of the branching fraction and CP asymmetry in B plus . J/.. plus decays

The branching fraction and direct $C\!P$ asymmetry of the decay $B^{+}\rightarrow J/\psi \rho^{+}$ are measured using proton-proton collision data collected with the LHCb detector at centre-of-mass energies of 7 and 8 TeV, corresponding to a total integrated luminosity of 3\mbox{fb}^{-1}. The following results are obtained: \begin{align} \mathcal{B}(B^{+}\rightarrow J/\psi \rho^{+}) &= (3.81 ^{+0.25}_{-0.24} \pm 0.35) \times 10^{-5}, \nonumber \\ \mathcal{A}^{C\!P} (B^{+}\rightarrow J/\psi \rho^{+}) &= -0.045^{+0.056}_{-0.057} \pm 0.008, \nonumber \end{align} where the first uncertainties are statistical and the second systematic. Both measurements are the most precise to date.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2018-036.htm

Study of charmonium decays to KS0KπK^0_S K \pi in the B→(KS0Kπ)KB \to (K^0_S K \pi) K channels

A study of the $B^+\to K^0_SK^+K^-\pi^+$ and $B^+\to K^0_SK^+K^+\pi^-$ decays is performed using proton-proton collisions at center-of-mass energies of 7, 8 and 13 TeV at the LHCb experiment. The $K^0_SK \pi$ invariant mass spectra from both decay modes reveal a rich content of charmonium resonances. New precise measurements of the $\eta_c$ and $\eta_c(2S)$ resonance parameters are performed and branching fraction measurements are obtained for $B^+$ decays to $\eta_c$, $J/\psi$, $\eta_c(2S)$ and $\chi_{c1}$ resonances. In particular, the first observation and branching fraction measurement of $B^+ \to \chi_{c0} K^0 \pi^+$ is reported as well as first measurements of the $B^+\to K^0K^+K^-\pi^+$ and $B^+\to K^0K^+K^+\pi^-$ branching fractions. Dalitz plot analyses of $\eta_c \to K^0_SK\pi$ and $\eta_c(2S) \to K^0_SK\pi$ decays are performed. A new measurement of the amplitude and phase of the $K \pi$ $S$-wave as functions of the $K \pi$ mass is performed, together with measurements of the $K^*_0(1430)$, $K^*_0(1950)$ and $a_0(1700)$ parameters. Finally, the branching fractions of $\chi_{c1}$ decays to $K^*$ resonances are also measured.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-051.html (LHCb public pages

Test of lepton flavour universality using B0→D∗−τ+ντB^0 \to D^{*-}\tau^+\nu_{\tau} decays with hadronic τ\tau channels

The branching fraction $\mathcal{B}(B^0 \to D^{*-}\tau^+\nu_{\tau})$ is measured relative to that of the normalisation mode $B^0 \to D^{*-}\pi^+\pi^-\pi^+$ using hadronic $\tau^+ \to \pi^+\pi^-\pi^+(\pi^0)\bar{\nu}_{\tau}$ decays in proton-proton collision data at a centre-of-mass energy of 13 TeV collected by the LHCb experiment, corresponding to an integrated luminosity of 2 fb$^{-1}$. The measured ratio is $\mathcal{B}(B^0 \to D^{*-}\tau^+\nu_{\tau})/\mathcal{B}(B^0 \to D^{*-}\pi^+\pi^-\pi^+)= 1.70 \pm 0.10^{+0.11}_{-0.10}$, where the first uncertainty is statistical and the second is related to systematic effects. Using established branching fractions for the $B^0 \to D^{*-}\pi^+\pi^-\pi^+$ and $B^0 \to D^{*-} \mu^+\nu_\mu$ modes, the lepton universality test, $\mathcal{R}(D^{*-}) \equiv \mathcal{B}(B^0 \to D^{*-}\tau^+\nu_{\tau})/\mathcal{B}(B^0 \to D^{*-} \mu^+\nu_\mu)$ is calculated, $$\mathcal{R}(D^{*-}) = 0.247 \pm 0.015 \pm 0.015 \pm 0.012\, ,$$ where the third uncertainty is due to the uncertainties on the external branching fractions. This result is consistent with the Standard Model prediction and with previous measurements.Comment: All figures and tables, along with machine-readable versions and any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-052.html (LHCb public pages

Measurement of angular and CP asymmetries in D0→π+π-μ+μ- and D0→K+K-μ+μ- decays

The first measurements of the forward-backward asymmetry of the dimuon pair (A_{FB}), the triple-product asymmetry (A_{2ϕ}), and the charge-parity-conjugation asymmetry (A_{CP}), in D0→π+π-μ+μ- and D0→K+K-μ+μ- decays are reported. They are performed using data from proton-proton collisions collected with the LHCb experiment from 2011 to 2016, corresponding to a total integrated luminosity of 5  fb^{-1}. The asymmetries are measured to be A_{FB}(D^{0}→π^{+}π^{-}μ^{+}μ^{-})=(3.3±3.7±0.6)%, A_{2ϕ}(D^{0}→π^{+}π^{-}μ^{+}μ^{-})=(-0.6±3.7±0.6)%, A_{CP}(D^{0}→π^{+}π^{-}μ^{+}μ^{-})=(4.9±3.8±0.7)%, A_{FB}(D^{0}→K^{+}K^{-}μ^{+}μ^{-})=(0±11±2)%, A_{2ϕ}(D^{0}→K^{+}K^{-}μ^{+}μ^{-})=(9±11±1)%, A_{CP}(D^{0}→K^{+}K^{-}μ^{+}μ^{-})=(0±11±2)%, where the first uncertainty is statistical and the second systematic. The asymmetries are also measured as a function of the dimuon invariant mass. The results are consistent with the standard model predictions