Intrapsychic Conflict Research Articles

KEPRIBADIAN TOKOH LOUISE DALAM CHANSON DOUCE

The subject of this research is Chanson Douce, a novel by Leila Slimani, published by Gallimard in 2016. The aim of this research is to describe the character of Louise, to explain the interactions of Louise with the other characters represented in the novel Chanson Douce, and analyse Louise`s personality. The theories used are character and characterization theory from the point view of literary psychology, the relation between social background and characterizations, and personality theory by Karen Horney. Louise is a neurotic sufferer who doesnˈt have a happy experience life also environment factor that canˈt fulfil her neurotic needs anymore that becomes the top of Louiseˈs intrapsychic conflict in self hatred form. The conclusions of this research are the environment and the experiences of life have a big impact on the formation of an individualˈs personality and the external appearance is not a guarantee that a person is in good mentally or psychologically health.

Mass social media-induced illness presenting with Tourette-like behavior.

Currently, we are facing a new manifestation of functional neurological disorder presenting with functional Tourette-like behavior (FTB). This study aimed to show characteristics of this phenotype presenting as an outbreak of “mass social media-induced illness” (MSMI) and to explore predisposing factors. Between 5–9/2021, we prospectively investigated 32 patients (mean/median age: 20.1/18 years, range: 11–53 years, n = 16 females) with MSMI-FTB using a neuro-psychiatric examination, a comprehensive semi-structured interview and aspects of the Operationalized Psychodynamic Diagnostic System. In contrast to tics, numbers of complex movements and vocalizations were nine times greater than of “simple” symptoms, and of vocalizations one and a half times greater than of movements. In line with our hypothesis of MSMI, symptoms largely overlapped with those presented by German YouTuber Jan Zimmermann justifying his role as “virtual” index case in current outbreak. Typically, symptoms started abruptly at a mean age of 19 years and deteriorated gradually with no differences between males and females. In all patients, we identified timely-related psychological stressors, unconscious intrapsychic conflicts, and/or structural deficits. Nearly all patients (94%) suffered from further psychiatric symptoms including abnormalities in social behavior (81%), obsessive-compulsive behavior (OCB) (47%), Tourette syndrome (TS) (47%), anxiety (41%), and depression (31%), about half (47%) had experienced bullying, and 75% suffered from coexisting somatic diseases. Our data suggest that pre-existing abnormalities in social behavior and psychiatric symptoms (OCB, anxiety, and depression), but also TS in combination with timely-related psychological stressors, unconscious intrapsychic conflicts, and structural deficits predispose to contagion with MSMI-FTB.

An antisemitic transference and countertransference

AbstractThe author presents a clinical psychoanalysis in which his Jewish patient fears that her non‐Jewish analyst hates her for being Jewish. Antisemitic expressions of hate toward the analyst have been well‐documented, but a fear of the analyst's hateful transference to the patient has not been previously examined in a published report. This transference led to an impasse in the treatment and prompted exploration of countertransference on the analyst's part; was he, unconsciously, expressing any religious hatred? The author examines a technical question of whether such a transference can be analyzed in the usual way as a displacement of infantile trauma? Or do the antisemitic aspects of the transference need to be examined and understood in their cultural and religious implications first and then analyzed as a real aspect in the external world before its infantile roots can be exposed? In this particular case, the author concludes that the latter approach is necessary and useful to facilitating clinical progress. The author suggests that this approach may be applicable to other analyses where there are racial, class, or religious differences and the patient develops fears about the analyst's attitude. The author offers this case as an example of the necessary integration of cultural and sociological issues into the classical model of intrapsychic conflict.

Exploring the associations between psychodynamic constructs and psychopathology: A network approach.

Psychodynamic therapy effectively reduces symptomatology by focusing on underlying (unconscious) processes instead of symptoms. Nevertheless, the exact interrelationship between psychodynamic constructs and psychopathology remains unclear. This study uses network analysis to explore these associations. We computed a cross-sectional partial correlation network between psychodynamic constructs (i.e., personality functioning, interpersonal relations, and active and passive modes of intrapsychic conflicts according to the Operationalized Psychodynamic Diagnostics [OPD] system) and psychopathology (i.e., depression and somatization) in a naturalistic sample of 341 adults registering for psychodynamic outpatient therapy. We estimated node centrality, node predictability, and bridge symptoms and used community detection analysis. Bootstrap methods were applied to assess network stability. Psychodynamic constructs and psychopathology resulted in separate but connected clusters. Personality functioning emerged as the most influential node in the network and was bridging the clusters. The network was found to be highly stable, allowing reliable interpretations. The results offer important insights on how psychodynamic constructs relate to psychopathology, which can be used to inform treatment approaches. The findings suggest that personality functioning may be an important intervention target. However, future research is needed to include a broader range of diagnoses. In addition, longitudinal studies may clarify the direction of causality.

The Relationship of Character Accentuations and Professional Self-Determination of Adolescents

A study was conducted to identify high-risk groups among adolescents, with a level of accentuations, characterized by a high probability of adaptive disorders in the professional sphere, which contribute to the development or intensification of intrapsychic conflict, frustration and emotional tension, mental stress. The questionnaires of K. Leonhard and N. Shmishek “Character Accentuationsˮ, “Orientationˮ (I. L. Solomin) and “Professional Readinessˮ by A. P. Chernyakovskaya. The relationship between the accentuations of the character of adolescents and their professional self-determination was determined using a correlation analysis – the r-Spearman criterion was used. Adolescents were tested, students of grades 10 and 11 in the amount of 60 people aged 15–17 years (including 22 boys and 38 girls). It is concluded that adolescents with dysthymic, anxious-fearful, exalted, affective-labile and stuck character accentuations are more vulnerable in the context of professional self-determination, more successful adolescents with hyperthymic, pedantic, demonstrative, excitable and emotive character accentuations.

Special Report: How to Work With Patients Using Problem-Focused Psychodynamic Psychotherapies

Special Report: How to Work With Patients Using Problem-Focused Psychodynamic Psychotherapies

Magnitude of Preoperative Anxiety and Associated Factors Among Adult Surgical Patients in Debre Berhan Comprehensive Specialized Hospital.

BackgroundAnxiety is an un-pleasurable emotional state associated with psychophysiological changes in response to an intra-psychic conflict. The perioperative period is one of the worrying events for most surgical patients. Despite preoperative anxiety having many negative consequences on post-operative physical and mental health, no adequate information on the degree to which the preoperative period exposed clients to preoperative anxiety and its associated factors.ObjectiveTo assess the prevalence of preoperative anxiety and associated factors among adult surgical patients in Debre Berhan Comprehensive Specialized Hospital, Ethiopia.MethodsInstitution-based cross-sectional study was conducted from June 1, 2020, to August 30, 2020. State-Trait Anxiety Inventory Scale (S-STAI) was used to measure the level of pre-operative anxiety. A systematic random sampling technique was employed to collect the data. The data were entered to Epi-Data version 4.6 and exported to SPSS version 25 for data analysis. A statistically significant association was declared at a p-value less than 0.05.ResultsA total of 330 patients were enrolled in the study with a response rate of 93.2%. The prevalence of a high level of preoperative anxiety was 53.6% (95% CI (49.6–58.7)). Being female 3.2 (2.19, 3.71) illiterate 4.1 (2.01, 15.39), fear of death 2.12 (1.30, 3.44), results of operation 2.60 (1.75, 4.18), postoperative pain 2.35 (1.37, 4.02), and surgical complication 1.9 (1.03, 12.13) were statistically significant factors.ConclusionPreoperative anxiety affects more than half of surgical patients which is a high and serious health burden. Additionally, this study revealed that being female, illiterate, fear of death, having a history of surgical complications and fear of complications, and fear of postoperative pain were significantly associated with preoperative anxiety. Assessing during the preoperative period helps to detect and ameliorate the problem. Preoperative counseling and informed consent taken as a prerequisite for surgery will help in reducing preoperative anxiety.

Psychiatrist and Peritoneal Dialysis

IntroductionPeritoneal dialysis (PD) is an equal method of treating patients with end stage renal disease ( ESRD). The patients are left to themselves in the new situation. The psychiatrist recognizes their needs and through group therapy enables them to heal quality intrapsychic conflicts.ObjectivesThe study analized data on the intensity of depression, anxiety of an individual patient respectively, but also of his family member (caregiver) too. The control questionnaires are foreseen for both groups one year after group therapy participation. The assumption is that symptoms of depression and anxiety will be less expressed with group support by the psychiatrist.MethodsTwo questionnaires were used: Hamilton’s rating scale for depression and Hamilton’s anxiety rating scale and identical questionnaires for member of the family caring for the patients. 13 patients who accepted group therapy were examined in our institution. They were of different gender and age, mean age 53±13.46 mini-max 25-72 years.ResultsAverage months of dialysis duration 29.15±21.84 min-max 6-84 Dialysis was performed without an assistant but with some help n 13( 100%) from the patient. They describe ailments from anxiety (30.77%) and depression ( 38.46% ) which they did not have premorbidly, and feel rejected on the emotional sphere, although not on the part of organic medicine.ConclusionsEmphasis is placed on the emotional state and needs of the patient with severe physical ailments, in other words, demanding treatment methods, as well as the importance of emotional support from family members without whom these patients would have a poorer quality of life.DisclosureNo significant relationships.

BASIC HOPE AND EXISTENTIAL ANXIETY AMONG ADULTHOOD GENERATIONS

Purpose. This study attempts to show the level of basic hope and existential anxiety among younger adults/emerging adulthood and middle adult generations. Basic hope is seen as a positive feeling playing a fundamental motivational role in the regulation of human behavior. It has been pointed out that hope is a prospective emotion that, contrary to fear/anxiety, is directed toward the future. Existential anxiety is thought to be inversely related with hope which means that existential anxiety is associated with unresolved intra-psychic conflicts. Methods. A sample of 139 younger and adult participants from the general population was examined. They represented three stages of adulthood: emerging adulthood (59), early adulthood (28), middle adulthood (52). They completed two self-measure questionnaires focused on basic hope (Basic Hope Inventory – 12 by Trzebiński and Zięba) and existential anxiety (Existential Anxiety Questionnaire by Weems and associates). Results. The results indicate that the younger generation/emerging adulthood displays a higher level of existential anxiety and lower level of basic hope than other adult generations. Young people who feel higher existential anxiety do not believe that their future will be positive. Adult women display a higher level of basic hope than men while the level of existential anxiety is similar in both women and men Conclusions. The results document developmental characteristics of the stage named emerging adulthood. At this stage of development, people are particularly vulnerable, full of fear for their future, they have to make important decisions about their education, professional decisions, and close interpersonal relationships. As their hope is low and existential anxiety is high they do not perceive their future positively.

EVALUATION OF PSYCHOSEXUAL DYSFUNCTIONS ON INDIVIDUALS (MALE) CONSUMING ALCOHOL

Sexual dysfunctions occur with a frequency that would overwhelm the health services if they all presented for help. Disinterest or ignorance from the part of a physician is also noticed with respect to the psychosexual complaints of patients. Sexual dysfunction can arise as a result of biological problems, relationship problems, intrapsychic conflicts, lack of proper sexual knowledge, medical disorders, and use of medicines such as antihypertensive and antidepressants. Chronic and persistent alcohol dependence is also a well- known cause of sexual dysfunction, which can cause marked distress and interpersonal difficulty leading to worsening of alcohol abuse. Sexual dysfunctions in alcohol dependence can be because of the depressant effect of alcohol, alcohol- related disease, or a multitude of psychological factors related to alcohol use. The Indian population currently passing through the rapid changing phase of substance dependence is manifesting increased psychosexual dysfunction which, in turn, might contribute to the causation of mental illnesses, including mood disorders, among the vulnerable. There are only limited studies from India regarding the psychosexual dysfunction among alcohol- dependent individuals. Alcohol dependence has very high prevalence among Indian population, but the psychosexual problems among the population often remain unattended. The study stresses the need of specialists to look for sexual problems in their clients.

Coping with the crisis: A mindfulness manipulation positively affects the emotional regulation of action crises

Action crises are the intrapsychic conflicts people face when hesitating between continuing and giving up on a goal after the accumulation of setbacks. They are detrimental to goal achievement and psychological health. While many predictors of action crises have been identified, including dispositional mindfulness, almost none have been investigated in terms of their helpfulness during an action crisis. This experimental laboratory study tested whether a 15-minute mindfulness meditation influenced the emotional regulation of imagined action crises. Participants (N = 121, 105 students, 44 men, M = 28.26 years) were randomly assigned to meditate with a body scan meditation recording or to read magazines after identifying their most important current personal goal. Those in the body scan condition reported more adaptive emotion regulation strategies after reading an action crisis scenario personalized with their goal than those in the control, magazine-reading, condition. This effect was found even when controlling for baseline action crisis and baseline autonomous and controlled motivation. No difference between the groups was found in terms of maladaptive emotion regulation. Results suggest that mindfulness training is a promising tool to help people cope with goal-related difficulties such as action crises.

The OPD-CA-2 axis interpersonal relations: A helpful tool for treatment planning? Relationship patterns of adolescent patients with persistent intrapsychic conflicts, structural deficits and trauma sequelae disorders

The axis interpersonal relations of the Operationalized Psychodynamic Diagnosis in Childhood and Adolescence (OPD-CA-2; OPD-CA-2 Task Force, OPD-CA-2. Operationalized Psychodynamic Diagnosis in Childhood and Adolescence. Theoretical Basis and User Manual. Hogrefe, 2017) allows to describe how children and adolescents handle relationships both with relevant attachment figures (e.g., parents) and with the examiner in a standardized way. In the current study, the axis interpersonal relations was used in an inpatient adolescent sample. The aim of the study was to identify typical relationship patterns depending on the patients’ structural level. By inspecting the relationship patterns of all ratings, we identified three groups of patients: The first group included patients with a limited structural level and clearly recognizable intrapsychic conflict dynamics (“focus: conflict”), the second group included patients with a low structural level (“focus: structure”), and the third group included patients who had been exposed to severe traumatic experiences with relevant attachment figures (“focus: trauma”). The relationship characteristics of these three groups were described and illustrated by prototypical cases. Conclusions for clinical practice were discussed as well.

Operationalized psychodynamic diagnosis in childhood and adolescence (OPD-CA): Changes across psychodynamic child and adolescent therapy

Psychodynamic therapies are effective in reducing mental health symptoms. However, little is known in terms of changes in the core psychodynamic concepts, like the structural level, interpersonal relatedness, and intrapsychic conflicts. The current study focused on these psychodynamic concepts – measured with the Operationalized Psychodynamic Diagnosis in Childhood and Adolescence (OPD-CA) – over the course of therapy and its relation to therapy outcome. Additionally, the OPD-CA axis treatment prerequisites was tested as a predictor of outcome. Therapists assessed the OPD-CA as well as the level of psychosocial impairment of 146 patients (aged M = 12.7 years, 62% female) at the beginning and end of therapy as part of a larger study on the effectiveness of psychodynamic psychotherapy. Structural level, interpersonal relations, and conflicts improved significantly over the course of therapy. Positive outcome was predicted by communicative abilities, positive self-relatedness and a high conflict level at the beginning of therapy as well as the improvement of these variables during therapy. Among the treatment prerequisites, only the subjective level of psychosocial impairment and the intrapsychic resources were predictive of outcome. Psychodynamic psychotherapy for children and adolescents may improve central psychodynamic concepts like structural level, interpersonal relations, and conflicts.

One diagnosis—different conflicts: Using the OPD-CA conflict axis as tool for treatment planning

OPD-CA has set itself the goal of collecting important information that goes beyond diagnosis and are helpful for the indication of therapy and the planning of the therapeutic process. The focus of this article is the Conflict axis of the OPD-CA. Using the example of two patients who have the same diagnosis, F93, it is demonstrated that the same symptoms can be based on very different psychodynamic conflicts. These should be dealt with in therapy so that the development-hindering function of intrapsychic conflicts is eliminated. In addition, it makes sense to use other axes of the OPD-CA, such as Prerequisites for treatment, which gives information about the motivation of the patient and his or her resources, and the axis Structure, which examines the structural requirements for long-term psychodynamic therapy. This is also discussed in the two cases and some information on how to proceed in therapy is given. This concerns also additional work with the parents of the patients.

Psychodynamic conflicts: Development of a questionnaire for the assessment by patients and their therapists

Psychodynamic conflicts: Development of a questionnaire for the assessment by patients and their therapists Abstract. The OPD-CA conflict questionnaire represents a means of recording modes of coping with unconscious conflicts according to the Operationalized Psychodynamic Diagnostics (OPD-CA) for patients and their therapists. To select the items for the conflict questionnaire, we combined the expert ratings and psychometric quality criteria using a sample of 427 adolescents (53.6 % patients) and 44 therapists. The short version contains 28 items, which include 7 intrapsychic conflicts and their active and passive coping modes (total ICC = .855; p < .001). We found expected differences between healthy and clinically abnormal adolescents with a higher level of conflicts among outpatients. A comparison of the therapist's version with two different methods (assessment according to the sheet in OPD-CA and the conflict questionnaire) produced consistent assessments of the same patient both in the expert assessment (total ICC = .861; p < .001) and from the point of view of 52 participants in two OPD-KJ training courses (total ICC = .825; p < .001).

Changes in the Level of Conflict through Psychodynamic Psychotherapy: The Perspective of Adolescent Patients and their Therapists

Changes in the level of structure and conflict are, in addition to alleviating of symptoms, central goals of psychodynamic therapies. This study examines this question with a focus on intrapsychic development-impairing conflicts in the sense of the OPD-CA on a sample of 121 adolescents and their 46 therapists. At the beginning, in the middle and at the end of the M = 73.27 hours (SD = 17.40) therapy, they assessed the level of conflict and structure from the patients' and the therapists' perspectives. The results show large effect sizes with regard to the reduction of the overall conflict level from the point of view of the therapists (η2 = .33). While the therapists reported higher initial values in almost all intrapsychic conflicts and significant linear decreases over time, the therapy tended to sensitize the patients to the existence of an intrapsychic development-impairing conflict. With regard to the structural level, which was already quite good at the start of treatment, there were no significant changes over time. However, the overall structural level and the conflict scales contributed to the explanation of the variance in the severity of symptoms at the end of therapy.

Reliability and validity of the OPD-CA Conflict Questionnaire in an adolescent inpatient sample

Reliability and validity of the OPD-CA Conflict Questionnaire in an adolescent inpatient sample Abstract. Abstracts: The OPD-CA Conflict Questionnaire (OPD-CA-CQ) assesses intrapsychic conflicts according to the Operationalized Psychodynamic Diagnosis in Childhood and Adolescence (OPD-CA-2) in a simple and time-efficient way. The questionnaire exists in two versions: as a self-report measure for adolescents and as an informant-report measure for therapists. We examined the psychometric criteria of the questionnaire (internal consistency, construct validity, convergent validity) in a sample of adolescent inpatients. Overall, results were heterogeneous: Some scales of the questionnaire seem to be suitable for assessing the corresponding intrapsychic conflicts, while others require a critical review. Particularly the conflict scales closeness vs. distance and submission vs. control need revision.

The dynamics of doubt: Short-term fluctuations and predictors of doubts in personal goal pursuit.

An action crisis denotes an intrapsychic conflict in which a person feels torn between holding on to and letting go of a personal goal. It is characterized by the experience of goal-related doubts. To extend the existing understanding of action crises, we investigated the dynamics of doubts in daily life and addressed two questions: (1) To what extent do doubts with respect to a personal goal fluctuate in daily life? (2) In which situations do individuals primarily have doubts? In an experience sampling study (N = 254), we assessed doubts about a personal goal five times a day over 10 days. Our findings indicate that the level of doubt varies between individuals but also fluctuates within persons. Doubts increase in response to negative goal-related events and decrease in response to positive goal-related events. Individuals with higher (vs. lower) levels of action crisis have particularly high levels of doubt during goal-related (vs. -unrelated) activity. We discuss the implications of these findings for research on goal disengagement and point to the relevance of studying motivational parameters from a dynamic perspective.

A Comparison of Two Repertory Grid Measures of Personal Construct Conflict

Intrapersonal conflicts have long been recognized as potential contributors to negative psychological and emotional states. Using repertory grids personal construct psychologists have developed methods for identifying implicative dilemmas, a type of conflict that arises from incongruous constructions of a person’s actual and ideal selves. Recent studies have reported greater numbers of implicative dilemmas among clinical samples when compared to controls. Another approach to conceptualizing and measuring intrapsychic conflicts is Chambers’ coordinate grid procedure, a modified repertory grid technique that assesses logical inconsistencies within a person’s construct system. The purpose of this study was to investigate the relationship between implicative dilemmas and logical inconsistencies in a sample of college students. Previous studies have moreover reported positive associations between repertory grid measures of construct system conflict and standardized assessments of depression, anxiety, and self-esteem. These associations were also examined in this study. Results revealed no systematic relationship between implicative dilemmas and logical inconsistencies, and neither repertory grid index was associated with scores on the depression, anxiety, and self-esteem questionnaires. Actual-ideal self-discrepancies were found to be associated with self-esteem, however, and examination of two individual grids revealed the clinical utility of the repertory grid procedures.

Relational Determination in Interpersonal and Intrapsychic Experience

Summary The task of this article is to review the principle of relational determination, as described by Solomon Asch (1952) which expands over Karl Duncker’s (1939) critique of ethical relativism. Relational determination has much to offer to the therapeutic community first with regard to interpersonal relations and social relations. My main goal is to extend this relational analysis to intrapsychic life, which may expose new potentialities for internal conflict resolution and personal integration, predicated on the cultivation of relational understanding (i.e., recognition of relational determination in organization of conscious experience). But this approach is best illustrated in its application to value differences and conflict across societies, which are typically viewed from the absolutist or relativist perspective. The principle of relationality casts doubt on elementaristic assumptions common to both (e.g., meaning constancy). Such assumptions lead to some ill-considered conclusions: of irreconcilable moral differences dividing both individuals and groups, deprived of any basis in understanding. Those views fail to consider the contexts underlying the meanings and valuations we impute. When these are taken into account, Duncker’s hypothesis of an invariant relation between meaning and value finds support. Value differences (or changes) need not represent fundamental differences in morality, but instead (factual) differences in understanding of the situation. If so, then value differences may indeed be both understandable and reconcilable. Relational determination reveals this same potentiality with regard to intrapsychic conflict, where the same presumption of irreconcilable differences must be overcome. Work by Erich Neumann provides a valuable depth psychological perspective on this inner conflict, which accords surprisingly well with the relationality principle in particular and field theory in general. From that vantage point, psychological defenses may be recognized as structural properties of yet unreconciled psychical fields. Gestalt theory’s relational view, which aligns well with Neumann’s account of a “new ethic” helps to reveal the processes by which these defensive postures might abate, as value realms that earlier dwelt in hostile opposition develop more of a conscious and respectful relation with each other, as the individual inches toward greater wholeness.