American Journal of Psychoanalysis最新文献

Since its inception, psychiatry has undergone several periods of radical identity transformation. Initially limited to psychotherapy alone, the advent of medications stimulated an era of biological psychiatry. For years, medications served as the mainstay of biological treatments, paralleled by a rise in treatment resistance. Brain stimulation therapies are psychiatry's newest arm of intervention and represent an area ripe for exploration. These techniques offer new hope to treatment-resistant patients, but in a manner often dissociated from psychoanalytic conceptualization and the practice of psychotherapy. There is growing interest in bridging this divide. In this article, we continue the efforts at interweaving what may seem to be disparate approaches through the topic of treatment resistance. This article aims to engage interventional psychiatrists in considering psychosocial dimensions of their treatments and to provide education for psychoanalytic clinicians on the history, mechanism of action, and applications of brain stimulation technologies.

Thirty years ago, we proposed the similarity between the functioning of artificial intelligence and the human psyche, suggesting multiple parallels between the Freudian model proposed in the "Project for Psychology for Neurologists" and the connectionist theories applied in the generation of parallel distributed processing systems (PDP), also known as connectionist models. These models have been and continue to be the foundation of general artificial intelligences like ChatGPT, evolving and gaining prominence in everyday life. From the earliest applications in psychiatry, recreating computationally simulated modes of illnesses, to the use of deep learning models, especially in the field of computer vision for tasks such as image recognition, segmentation, and classification. Recurrent Neural Networks (RNN) and Long Short-Term Memory (LSTM) are employed for tasks involving sequences of data, such as natural language processing, or models based on the Transformer architecture, like BERT and GPT (Generative Pre-trained Transformer), which have revolutionized natural language processing. In this present work, we analyze the significance of the emergence and exponential growth of these types of tools in the field of healthcare, from medical diagnosis and patient care to psychological attention and psychotherapeutic treatment, exploring the changes and transformations in the forms of subjective expression that are arising. We also examine and argue for the importance and validity of the relational dimension proposed by our psychoanalytic approach in contrast to the potential use of these tools as treatment models.

The COVID pandemic has had a major impact on the mental health of the population, especially on female adolescents. Eating disorders and gender identity problems have increased markedly. Online activities have also grown enormously during this period occupying a large portion of adolescents' time. We explore the use of social networking and online gaming by adolescent girls and boys. We discuss their possible influence on different levels of psychological distress in boys and girls in the face of the pandemic. We propose that online games, mainly used by young boys, might offer them some emotional protection through mechanisms related to the body and its experience, to the group dynamics of competition, collaboration, and hierarchy, to the possibility of expressing aggression, and to the construction of a clearer and more stable identity. An unprejudiced look at new technologies is mandatory, if we are to avoid projecting our fears and expectations onto them.

The Internet was created as a space and a structure to share knowledge, information, and opinions for the sake of science and progression of humanity. Today, the Internet is co-created and modified by its users networking from all over the world. It is a representation of humankind, a social structure reactive to local and global societal processes. For the youngest generations the Internet is an integral part of their social milieu influencing both normal and pathological development from their very first year of life. Discussing the roots of totalitarianism, Erik H. Erikson distinguished between wholeness and totality in personal and social development and provided a wonderful metaphor of productive and pathogenic functioning for the impact of the Internet. Conceived as a fruitful association and organization for the development of wholeness in individuals and a future humanity, it largely keeps this promise. But under unfavorable social conditions and/or pathogenic individual predispositions, it can take a totalitarian structure and mode of action.

While screen-mediated analysis long predated the pandemic, it was largely seen as non-equivalent to in-person treatment by analysts and patients alike. When COVID forced us to move our entire practices to the screen, our concerns about its limitations were replaced by relief; we could continue doing analytic work during a terrifying and challenging time. Three years later, many have chosen to continue practicing remotely for reasons that are no longer driven by fears of exposure. We mostly minimize or deny our earlier concerns about the limitations of screen work. Have we chosen convenience, ease, and a personal sense of safety over togetherness, while ignoring the underbelly of remote work? This paper identifies the convergence of several forces underlying our decision to stay remote, including guilt and anxiety about privileging our own self-interest, unmourned losses and collective PTSD, fear of the future and existential anxiety about living in a techno-culture that threatens to replace us. Our denial of these powerful forces makes it easy to rationalize a decision to embrace remote work and disavow the threat it poses to our field.

The Covid pandemic changed the daily routines for millions of people. This was the case for those who were gainfully employed, especially for those who work as psychoanalysts and psychodynamic psychotherapists. At least for a good while, the practice of psychotherapy and psychoanalysis moved from the consulting room to the virtual world of the internet. The author explores the impact virtual therapy had on three different patients. One began a three time a week analysis during the pandemic. The duo met virtually for a year and a half before their first in person meeting. The other two patients had begun twice a week analyses a few years before the pandemic, met virtually for two years, until in person sessions restarted. The patients and the author describe their experiences.