The Oedipus Complex Today
Mark Solms
Freud believed that the Oedipus complex activates a constellation of (unconscious) phylogenetic memories, passed down to us not through Darwinian natural selection but rather through Lamarckian inheritance of acquired characteristics. To make matters worse from the biological point of view, he seems to have assumed that these inherited memories were what we would nowadays call ‘episodic’: that is, first-person recollections of lived events. In this talk, drawing upon knowledge from contemporary affective neuroscience, I will provide a more biologically plausible account of the Oedipus complex.
The Dynamic Nature of Memory Processes and their Roles in Therapeutic Processes
Cristina Alberini
Memory is a fundamental function for our survival; it defines an ensemble of complex processes that comprise the total of what we remember and gives us the ability to learn and adapt from previous experiences. Memory is of central importance in both psychoanalytic theories and psychotherapeutic interventions. Its multiple roles in psychoanalysis have been widely discussed since Freud’s times; yet, its mechanisms and processes have remained very poorly understood until recently. Contrary to the historical beliefs that memory processes are “fixed”, recent neurobiological studies have begun to reveal that they are highly dynamic. This knowledge suggests that we have to develop a new view about memories and their underlying mechanisms, and how they contribute and regulate identity. We will discuss these recent studies to re-think how memory processes are conceptualized in psychoanalysis and contribute to psychoanalytic interventions.
Social versus Physical Distancing: Experiences and Desires of Social Touch During COVID-19 and in Psychotherapy
Aikaterini (Katerina) Fotopoulou
We have thus conducted a survey to look at changes in life style and the experience of touch. Most governments have implemented lockdown and social distancing policies to control the spread of COVID-19. In many cases, this meant that people engaged in drastic changes in the kind and amount of touch they receive at home versus outside the house. We conducted an online survey to examine (intimate, friendly and professional) touch experiences during COVID-19, their impact on mental health and the extent to which touch deprivation results in craving touch in people with different childhood experiences of touch and different attachment styles. 1746 participants, across mainly three countries (UK, France and Mexico) took part. As predicted, we found that intimate touch deprivation during COVID-19 is associated with worse psychological wellbeing, even though this is the type of touch (vs. friendly and professional) is still the most experienced during the pandemic. Moreover, intimate touch is reported as the type of touch most craved during this period, with such effects being more prominent as the days practicing social distancing increased. These results were not moderated by the amount of supporting touch people had received in childhood (self-reported) but they were moderated by individual differences in attachment style, in that the more anxiously attached a person is, the more touch was craved during COVID-19 and the more avoidantly attached a person is, the less they craved for touch in this period. We also sampled people’s positive and negative experiences and desires of touch during psychotherapy before and after COVID-19 and will be reporting on preliminary results. These findings point to the important role of touch, particularly experienced in relation to close and intimate others, in times of social distancing and/or psychological distress.
Memory Reconsolidation, Emotional Arousal and Enduring Change in Psychotherapy: Implications for Psychoanalytic Research and Practice
Richard Lane
In a recent review article and book my colleagues and I proposed that therapeutic change in a variety of modalities results from updating prior memories through a process of reconsolidation that incorporates new emotional experiences. The proposed essential ingredients of therapeutic change include: 1) reactivating old memories and the associated painful emotions; 2) engaging in new emotional experiences that are incorporated into these reactivated memories via the process of reconsolidation; and 3) reinforcing the changes in memory by practicing new ways of behaving and experiencing the world in a variety of contexts. As such, psychoanalysis may be the treatment of choice in contexts such as recurrent maladaptive patterns of interpersonal behavior. This talk will address the implications of this model for research and practice. Examples of basic science issues include advancing understanding about how the strength of a memory, its age and the frequency of recall influence the ease with which it can be updated, how malleability varies as a function of the type of memory involved (e.g. episodic, semantic, procedural), and the largely unexplored area of how updating of semantic memories (which are the basis for schemas) occurs. Examples of clinical research issues include how to demonstrate that memory reconsolidation has occurred, the conditions that determine whether a given experience in therapy updates an old memory or creates a new one, the role of napping and sleep in therapy-related reconsolidation and the duration, number and spacing of sessions needed to achieve optimal results through this mechanism.
Bridging Psychoanalysis and Neuroscience in Outcome Studies: One example
Marianne Leuzinger-Bohleber
Background and Rationale Depression is often a chronic disorder which is difficult to treat. It remains one of the major challenges for mental health care, contributing to the suffering of individuals and their families. A previous study (LAC study) showed that psychoanalytic psychotherapies led to good results in chronically depressed, early traumatized patients, especially if the therapies had a high weekly frequency. This difficult-to-treat group of patients even achieved sustained psychic transformations. Based on more recent studies, it is to be expected that the changes achieved in the LAC study, mainly through patient self-ratings and assessments of blinded raters, can also be demonstrated at the level of brain mechanisms. The findings of the LAC Study can be theoretically substantiated by memory research as it assumes that emotional arousal and changes in memory structures are key factors for psychotherapeutic changes. Psychotherapeutic change occurs when relevant old memories and associated affects are reactivated and new emotional experiences within the therapeutic context are integrated into the reactivated memory tracks. High frequent psychoanalytic therapies are seen as particularly promising for treating early traumatized patients by some memory researchers. The intensive emotional (transference) relationship facilitates the deciphering of embodied memories of non-symbolized traumatic experiences making it possible to work on them therapeutically in a more appropriate way than in low frequency treatments. At the level of brain functioning, a recent meta-analysis showed that portions of the subgenual cingulate cortex, hippocampus, amygdala, and putamen of patients with major depressive disorder demonstrate convergent abnormalities. Earlier studies show that psychotherapy can lead to a reversal in brain abnormalities. Overall objectives The Multimodal Outcome Study of Psychoanalyses of Chronically Depressed Patients (MODE) investigates the neurobiological, psychological and psychoanalytical outcomes of manualized low and high frequent psychoanalytic psychotherapies with chronic depressed, early traumatized patients after one year of treatment. Specific aims Following a multi-perspective approach, MODE aims to examine outcome changes at brain, psychoanalytic and psychological levels while considering: a) neurobiological instruments (brain imaging); b) clinical-psychoanalytical methods; and c) established psychological instruments of comparative psychotherapy research. Impact Clinically, if MODE shows that a group of chronically depressed patients already responds well to high-frequency psychoanalytic psychotherapy after one year, even with respect to changes at brain levels, then this would be an important contribution to treatment indication, sparing these patients and their familiesmuch suffering and disappointment. From a research perspective, were MODE to demonstrate successfully convergent multimodal changes, this would be an important step forward for opening new and meaningful perspectives for integrative and translational research. This field of research will enrich mutual understanding of discipline-specific mechanisms of change. MODE is a first explanatory step in this direction, demonstrating that the science of the mind needs to break down the divides between scientific disciplines in favor of a shared endeavor that better reflects the functioning of the human mind.
Pleasure Breakdown: A Case of Addiction-like Behavior Due to a Lesion of the Right Ventral Striatum
José Fernando Muñoz Zúñiga
The basal ganglia are a set of subcortical nuclei known for their role in movement, cognition and motivation; from a functional point of view the ventral striatum has been considered part of the limbic system, playing a key role in the physiopathology of addictive disorders, among others. From an affective neuroscience point of view, the ventral striatum, particularly the nucleus accumbens, is involved in the SEEKING system, an ancient set of nuclei and pathways essential for appetitive and exploratory behaviors. Here, some introductory notes are presented regarding a patient without a neurologic or psychiatric history, who suffered an intraoperative injury to his right ventral striatum, thereafter developing addictive-like behaviors towards sugary foods. The patient has been in a neuropsychotherapy process for nine months now, for two sessions per week, in a face-to-face setting. Clinical findings and some hypotheses regarding its implications for psychoanalytic drive theory and the accumbens circuitry will be discussed.
The Influence of Psychoanalytic Concepts in the Construction of the Brain Injured Patient
Christian Salas
Since the early work of Kurt Goldstein, psychoanalysis has been an influential theoretical and clinical perspective for comprehending emotional adjustment after brain injury. This despite the fact that the psychoanalytic mainstream has for decades considered ‘organic’ patients as the paradigmatic example of contraindication. The relationship between psychoanalysis and neuropsychological rehabilitation has been equally complex, with leading authors questioning the relevance of unconscious processes and early relationships in rehabilitation. In this presentation I will introduce four psychoanalytic ideas that have strongly influenced the way in which clinicians have constructed a “psychological” patient. (1) Brain injury alters the meaning of life, and survivors, due to cognitive impairments, struggle to reconstruct such meaning. Importantly, the meaning of the injury is signified by the attachment history of the individual (Jung/Prigatano); (2) Brain Injury alters self-coherence, often fracturing healthy omnipotence and accentuating narcissistic fragilities (Kohut/Klonoff); (3) Brain injury alters psychic economy and the arrangement of psychic agencies (Freud/Solms); (4) Brain injury and its consequences are signified in the relational space. Importantly, the therapist is an active contributor in the patient’s psychological and neurological presentation (Klein/Freed/Lewis/Yeates). These ideas are an example of the polyphonic influence of psychoanalytic thinking in neuropsychological rehabilitation. Future theoretical and clinical research should explore the therapeutic implications of approaching individuals with brain injury from such diverse epistemological frameworks.
Neuropsychoanalysis in the Birthplace of Psychoanalysis
Andreas Lehrner
Neuropsychoanalysis is not a big field in Austria. Consequently, we have had to import it from South Africa – The Times They Are A Changin´. When I was asked to give a talk at the Neuropsychoanalysis Around the World online meeting I was flattered, but at the same time I did not really know what to talk about. However, now I know: I want to tell you the story of a webinar that Mark Solms gave in the semester of 2020 to our Viennese group, which is comprised of people who are interested in neuropsychoanalysis. Does this sound uninteresting? Well, for me it was an experience that is definitely worth talking about. This experience – seeing Mark at his best – is probably an experience many of you may already have had. However, sometimes telling a seemingly already known story can lead to new insights. In this talk I will provide a case example of the role that Mark Solms is playing in spreading neuropsychoanalysis around the world.