Depressive Position Research Articles

The Middle East Tragedy: Between Utopia and Dystopia

ABSTRACT This paper discusses the present Israeli-Palestinian war, with an emphasis on the destructive clash between two utopian visions: the vision of “Greater Israel” – including all Palestinian territories – of the far right in Israel, and the vision of destroying the state of Israel, fundamental in Hamas ideology. The dystopic result of this clash is explored from a psychoanalytic point of view, relying in part on Ogden’s notion of historicity as achieved only in the depressive position, and Jessica Benjamin’s notion of a “doer and done-to” mode which excludes recognition of the reciprocal interaction that is essential to that historicity. A brief review of the history of the Palestinian-Israeli conflict, lasting more than a hundred years, points to the constant reciprocal influences leading to its deterioration, and ends with the hope for a pragmatic compromise that would alleviate the suffering and traumatization on both sides.

Nonviolence meets the depressive position: Gandhi and Klein

Nonviolence meets the depressive position: Gandhi and Klein

Esquisse pour une psychopathologie psychanalytique de l’environnement

ObjectivesThe environment is a concept that allows us to re-examine classical psychoanalytic psychopathology, starting with the nature of the symptom and the processes that structure it, then the notions of the normal and the pathological. This article thus proposes the main axes of a psychoanalytic psychopathology of the environment in an intersubjective dimension. MethodWe carry out a singular reading and analysis of Donald W. Winnicott's theories on the environment and the concepts related to it, in particular dependence, the self, aggressiveness, and repair. Then we describe their complementarities and their breaks with Anglo-Saxon theories, as developed by Sándor Ferenczi, Melanie Klein, and Michael Balint. ResultsThere are different types of failures depending on whether the environment impinges affectively and bodily on the needs of the infant through seduction, torment, or disappearance. What matters is the moment of dependence during which they take place, generating either potentially a psychotic or manic-depressive organization at the moment of absolute dependence, or potentially an antisocial organization at the moment of relative dependence. The failures of the environment (Winnicott) can thus be considered complementary to the paranoid-schizoid and depressive positions (Klein), as well as to the concepts of ocnophilia and philobatism (Balint). DiscussionThe concept of environment also shows how motor skills constitute an important intersubjective experience in the construction of the self. In parents, this manifests itself above all in ordinary holding; in infants, in the aggressiveness at the origin of their spontaneous gestures, both destructive and creative, then becoming more broadly restorative in the family and social environments. Regression to dependence may become necessary for the exploration of primary experiences inherent to the individual-environment dyad, and may also have a function of intersubjective reintegration. ConclusionThis sketch for a psychoanalytic psychopathology of the environment is therefore relevant for interpreting the sufferings of the self as intersubjective “disorders” and for analyzing clinical cases of regression to dependence in the analytic situation.

Dissociation in suicidal depression: a Reformulated Object-Relations Theory (RORT) perspective

The Interpersonal-Psychological Theory of Suicidal Behavior (IPTS) posits that suicide stems from a motivation to die by suicide, emanating from perceived-burdensomeness and failed belongingness, and a capacity to kill oneself. We propose a bridge between IPTS and dissociation theory/research via a recent reformulation of Melanie Klein’s notion of the depressive position, as comprised of three elements: Demeaning affect, compensatory affect-regulatory maneuvers, and mental representation of self-as-deficient and others as judgmental/punitive and at times seductive. This position is formed in childhood, proceeds to adulthood, and is projected into the future with the hope of finding respite from criticism. This hope is then thwarted by the sufferer’s interpersonal action leading to interpersonal strife. We posit that, in the Basic Level, a trauma-based, dissociative structure is formed, whereby the reformulated depressive position disengages from benign and benevolent mental processes, in turn creating interpersonal havoc. In the Advanced Level, dissociative mechanisms are utilized to assist the now depressed-suicidal position to succeed in its mission: Killing the self. A chilling case illustration of this pattern is presented and discussed. Clinically, we recommend a routine measurement of both dissociation and suicide risk, and appraisal of the psychodynamic connecting dissociation and suicidality.

DW Winnicott’s Debt to and Divergence from Melanie Klein: A Psychoanalytic Genealogy

Abstract: This is a two-part paper. Its second part assays the development of DW Winnicott’s conceptions relative to Melanie Klein’s, particularly after 1945, regarding areas such as infantile development, pathogenesis, diagnosis, and therapeutics. It then explores his alignments with and departures from her depressive position views. Finally, it examines his revision of her depressive position formulations. It does this particularly in relation to his proposition that infants dissociate from one another their experience of themselves and of their mother conditioned either by having interacted with her in ruthlessly intense states directed to her or when having been tenderly nurtured by her.

I felt a funeral, in my brain: from sticky baby to recycling machine

ABSTRACT This paper seeks to describe how a three-year-old boy´s infantile trauma was actualized in the transference and recounts the work required to contain his primitive infantile states. The author explores the self-protective and communicative function of the child’s adhesive and omnipotent behaviour and the appearance of somatic reactions in the sessions. Somatic symptoms were linked to raw, abrupt, and hostile feelings in the child towards the analyst in the transference, followed by a sense of acute danger. Understanding and surviving a shared experience led to a dream and a dawning recognition and tolerance of separation in the child. His unintegrated infantile parts were gradually able to enter the playroom where they could be addressed in the transference. Being separate and unable to possess the analyst triggered intense ambivalence and physical attacks on the analyst and led to the emergence of a fatherly attitude in the analyst. Working through his oedipal ambivalence with the help of a third, an internal father, paved the way to symbolization, the creation of a ‘recycling machine’ and the depressive position. The author will discuss the somatic reactions linked to his infantile states, the dream and the symbolic meaning of the recycling machine.

Die Wunde des Verlustes nach Tod

The psychoanalytic level of understanding of grief and pathological grief is explained and a focused psychoanalytic treatment approach is presented. Clinical experiences with the loss of a parent through suicide are discussed and substantiated using a case vignette. Blocked and repressed feelings can be revived by working on the dynamics of the conflict. An integration in the sense of developing a depressive position (according to Melanie Klein) can be achieved.

War: A heavy mental burden for present and next generations

In this essay I offer meditations on the war in Ukraine from a distance, while reflecting back on my own memories of the war in Yugoslavia. I explore the role of paranoid-schizoid and depressive positions in making sense of the atrocity that is war.

Estimation of solidification cracking susceptibility in Al–Si–Cu alloy weld: effects of anisotropic permeability and deformation orientation

Weld solidification cracking susceptibility (SCS) was evaluated using an analytical model developed considering the anisotropic permeability (i.e., permeability which is different in directions parallel and perpendicular to the primary dendrite arms) and deviation of the imposed deformation from the normal direction with respect to the primary dendrite arm (ϕ). The model was investigated for Al–Si–Cu alloys in the solid fraction range from 0.87 to 0.94. Low Si- high Cu content alloys showed the maximum SCS due to variation in the physical properties of weld pool, i.e., viscosity, solidification range and solid fraction as a function of temperature. Decrease in deviation of the deformation direction (ϕ) led to increase in the SCS. Using the anisotropic permeability as a function of the primary dendrite arm spacing (λ1) led to a change in the peak position of shrinkage pressure depression towards the high Si-high Cu content alloys. Arc oscillation imposed a dual impact on the SCS of weld: (i) increased the SCS by enhancement of the base metal dilution, i.e., adding more Cu into the weld pool and (ii) decreased the SCS by refining the weld microstructure and twisting the grain boundaries which in turn changed the deformation direction on the grain boundaries. Results of the weldability test on Al–Cu sheets welded using Al–Si filler metal were in good agreement with the model prediction.

Structural position and some features of the geological structure and the development of the Black Sea Depression

The structural position of the Black Sea deep-sea depression is generally determined by its location in the area of intersection of diagonal transcontinental tectonolineament belts. The different thickness of deposits of the same age in different depressions emphasizes the bloc structure of the earth's crust in the water area. Space photographs clearly show the contours of the depression are enveloping by the long arcs of the mountain ranges and valleys of the Caucasus, Ajaro-Trialetia, and the Eastern and Western Pontides. Such large oval and arcuate, partially sequentially superimposed structures (the Miesian plate, Pannonian and Bohemian massifs) are characteristic of the entire southeastern border of the East European platform and reflect the activity of the processes of destruction of its southern foreland in the zone of development of the classic geosyncline. The available data allow us to assume the superimposed nature of the Black Sea depression, formed as a result of mainly vertical tectonic movements in the field of development of mantle plume activations.

Odd one in: a psychotherapist’s experience of interaction with the judicial system in working with patients with high levels of destructiveness

During arrest and investigation, the perpetrator of a murder can find themselves not only locked up in a place of detention, but also in a close dyadic relationship with the judicial system, duplicating the role of the archaic, punitive superego. This con-figuration does not encourage psychic triangulation as a space in which traumatic reality can be accepted and symbolised, nor does it foster an ability to reflect on the crime committed, to grieve, and repent. The alternative position can mean identifica-tion with the criminal community, in which protective narcissistic identity feeding can take place, reinforcing the ego, but not bringing it any closer to contact with reality and the capacity for coming to the depressive position. When mature psychic mechanisms fail to work, archaic processes come into play, fraught with severe manic conditions with a high risk of destructive enactment. This article presents the clinical experience with a forensic patient whose situation went beyond these typical scenarios. The result was the experience of valuable observation and the possibility of building therapeutic relations with the patient in a state of active psy-chotic enactment.

Babies in therapy, psychoanalytic interventions for infants and their parents.

Babies in therapy: The study "Psychoanalytic interventions for infants and their parents" conducted on infants through the lens of psychoanalysis and clinical work with both parents and infants all contribute to our knowledge of the nature of early relationship disorders. Psychoanalytic theory's concepts of the depressive position, early defense mechanisms, transference, and psychosomatic reactions to depressive emotions are shown to be crucial in clinical cases, giving therapists new tools for intervention and increasing efficiency. Psychoanalysts have researched the long-lasting effects of early disappointments and the sense of being helplessly abandoned; they emphasize that a disruption in the relationship with the caregiver can produce a psychic economy oriented on the avoidance of anxiety, leaving less energy for development. New parents and their sick infants can benefit from early therapies with therapeutic potential and the possibility of preventing future narcissistic pain issues if they are based on psychoanalytic thinking and knowledge of early symptoms.

Buy and sale bonding agreements as a mean of fraud legal relation debt receivables

This research is a normative legal research. Perjanjian Pengikatan Jual Beli (PPJB) it can be said to be an agreement that arises or is born to due open nature Book III BW so that the implementation of previously unknown agreements such as PJBB is possible based on the principle of contact freedom. Accounts payable begins with an agreement called a debt agreement, but in practice the general public turns out to make a lot of quasi or fake agreements by making a deed of money debt agreement with land certificates or house certificates as collateral then packaged as PPJB. PPJB which is used to disguise debt is actually an agreement that is legally deviant. Legally deviant contracts are made by parties who are in a depressed position and there is no element of agreement of the will and it is an abuse of circumstances.

Matriarchy, Matricide and Mourning

Matricide is suggested as an important counterpart to the traditional oedipal manifestations of patricide. This paper turns to The Oresteia to examine its murderous protagonists and the meaning of the drive to eliminate mothers. A daughter may enact unconscious matricidal wishes in order to separate from an ambivalent tie to her mother, by excising femininity and femaleness in herself. The author explores early bisexual pulls that can emanate from primal scene identifications. The capacity to relinquish the option to have all options is brought in as a ubiquitous and painful developmental move away from having and being all sexes. Father's role as crucial in the sexual development of daughters, including Freud's role in relation to his daughter Anna, is considered and mourning is linked to Klein's Depressive Position. The author includes clinical material of two children from the literature and draws on interviews conducted with trans men to reflect on these struggles. The paper explores early awareness of the difference between the sexes and argues that this can fuel a protest for daughters, sometimes manifesting as a ‘no‐mother’ or matricidal state of mind. If these wishes or phantasies remain unmourned, they can at times lead to a concrete flight from femininity.

Down Syndrome and its Oral Effects in Saudi Arabian Region

The most prominent congenital syndrome is Down syndrome (DS). With the greatest number of births of all chromosomal disorders, it is the most well-known reason of physical as well as intellectual impairment. A comparatively elevated incidence of Down syndrome has been discovered in Saudi Arabia. Only few papers have been undertaken thus far describing the features of face and other oral features of Saudi Down syndrome subjects. To review the available literature on Down syndrome and it's oral effects in Saudi Arabia region. Down syndrome also described as trisomy of chromosome 21. It is a genetic autosomal inherited condition i.e non-sex chromosomal disorder that affects one in six hundred to one in two thousands live births in various populations and is marked by a deficit in physical and intellectual development. Due to the comparative elevated incidence of DS in Saudi Arabia—1 in every 554 live births—DS subjects were specifically chosen for this review of literature. There are now more people with DS as a result of the lowered mortality rate and rising incidence in Saudi Arabia population. The most noticeable craniofacial features are found in DS patients, along with other distinguishing physical and systemic manifestations. Midface deficit, prognathism of mandible, depressed position of nasal bridge, slanting of eyes, folds at the epicanthic region, condition of hypotelorism in ocular area, and strabismus constitute the documented craniofacial characteristics. Muscle hypotonia also affects the perioral muscles, which results in a lowering of the mouth's angle. A comparatively elevated incidence of Down syndrome has been discovered in Saudi Arabia. Only few papers have been undertaken thus far describing the features of face and other oral features of Saudi Down syndrome subjects. It can be concluded that individuals with Down syndrome in Saudi Arabia had a significantly higher incidence of facial as well as cranial features in comparison to the normal healthy counterparts. By using the search algorithms “(Down syndrome and dental caries, periodontal diseases), “(Down syndrome and deformity within oral structures), “(Down Syndrome and problems in occlusion and Craniofacial structures).”The researcher searched the Cochrane Central Systematic Reviews Registry, ISI Web of Science, and Medline without language restriction up to July 2022. Only few papers have been undertaken thus far describing the features of face and other oral features of Saudi Down syndrome subjects. It can be concluded that individuals with Down syndrome in Saudi Arabia had a significantly higher incidence of facial as well as cranial features in comparison to the normal healthy counterparts.

Psychoanalyzing democracies: Antagonisms, paranoia, and the productivity of depression

Psychoanalyzing democracies: Antagonisms, paranoia, and the productivity of depression

WHEN WORDS KILL

In the article I am presenting a single case study focusing on the patient’s speech. The patient is a 32 years old woman, suffering from a severe personality disorder. My purpose is to illustrate how the development from a fragmented speech to a coherent text corresponds to the development of relating to the object (the therapist), conceptualized as a development from the paranoid-schizoid to the depressive position.

Understanding the impact of the COVID-19 pandemic on psychiatric trainees and what can help.

The COVID-19 pandemic has increased rates of psychological distress and burnout in healthcare staff. How can we understand our experiences of the pandemic? We reflect on the experiences of psychiatry trainees in two north London mental health trusts. From a psychoanalytic understanding, states of extreme anxiety can lead to a manic defence and functioning in the paranoid-schizoid position. This position is derived from object relations theory and is characterised by binary thinking, splitting, projection, defensiveness and 'knee-jerk' decision-making. This can affect our perceptions, responses to others, relationships and ability to function and, therefore, our clinical practice and well-being. We consider the importance of recognising these processes and of organisational containment and having space to reflect. This supports functioning in the depressive position, a state of mind where we can tolerate anxiety, address difficult realities and develop new ideas. We hope these understandings are helpful to our colleagues in all professions.

Distribution of vegetative dysfunctions and depressive positions among sexually active students and students without sexual debut of National Pirogov Memorial Medical University, Vinnytsya

Annotation. Autonomic dysfunction syndrome is one of the most common disorders, which has a wide range of interpretations among specialists of different profiles. The autonomic nervous system (ANS) occupies a significant place in the development of somatic pathology. The course and manifestation of all pathological conditions is associated with autonomic dysfunction. Together with vegetative disorders, depressive disorders are also widespread among students. The aim of the study: to identify the clinical psychopathological features of somatized depressive disorders and autonomic dysfunction among sexually active students in comparison with students without a sexual debut of 4th year of study at Vinnytsya National Pirogov Memorial Medical University. A survey of 308 medical students was carried out. Obtained data were analyzed using the program “Statistica 6.1” using nonparametric methods of estimation of the obtained results. It was found that among medical students is a very high percentage of depressive disorders (96.1%) and disorders of autonomic function (69.8%). However, the manifestations of vascular dysfunction in young people are not related to their sexual activity. Mild and minimal manifestations of depressive disorders are also not associated with sexual activity. Symptoms of very severe depression are more prevalent in virgin girls than in sexually active girls and boys.

The interpersonal dynamics consultation in a therapeutic community for borderline patients: containing relationships at the coal face

The Interpersonal Dynamics (ID) consultation is a structured method of group reflective practice which helps staff mentalize transference and countertransference dynamics with patients. We present a detailed ID consultation of a female patient in an inpatient therapeutic community for people with severe personality disorders and demonstrate how this method sheds light on this patient’s internal world as externalised interpersonally with staff in the treatment setting. The resulting enactments are discussed in relation to several psychoanalytic theories and concepts, including Bion’s theory of containment and Ogden’s interpersonal definition of projective identification. We conceptualise our population of patients based on their use of primitive psychological defences such as splitting and projective identification and on the idea that they live at the border between what Klein described as the paranoid-schizoid and the depressive positions. We argue that the ID consultation functions as a container for staff and patients by bringing together and integrating the parts of the patient which are split off and projected into different staff members. Furthermore, the ID consultation is an invaluable triangular space that facilitates the move from difficult dyadic subjective experiences with patients to triadic objective perspectives and from passive reactions to responsive thinking and understanding.