Katalin Csigó: Psychoanalytical treatment of obsessive-compulsive disorder: facing the results of cognitive neuroscience
Mónika Andrejkovics, Éva Gasparik, Petra Bokor, Ede Frecska: The new paradigm of medicine and psychotherapy: The bio-psycho-socio-spiritual (BPSS) model
Ferenc Boldvai, Gyöngyvér Kárpáti, János Csorba, Judit Mészáros: Experiences of play-drama in individual psychology during group work with children suffering from adaptational problems
László Bokor: The neuroscientific approach of transference
From the present history of the Hungarian psychotherapy. Interview with János Füredi by Gábor Szőnyi
Debate on psychotherapy conducted via specific communication channels (like VOIP) – Tibor Cece Kiss
Ethical questions in therapeutic practice 7. – Csaba Horgász ¨ Gyula Kapusi ¨ Andrea Kútvölgyi
Letter to the Editor – Judit Székács
Awards: Emőke Bagdy
In memoriam Zsuzsa Alpár – Anna Halász
Conferences – Médea Kis¨ Gabriella Novotny ¨ Petra Kovács ¨ Gabriella Vizin
Book reviews – Tibor Cece Kiss ¨ Anita G. Tóth ¨ Ferenc Túry
Lists of professional books – Animula ¨ Medicina ¨ Oriold és Tsai ¨ Park Könyvkiadó¨ Ursus Libris
Psychoanalytical treatment of obsessive-compulsive disorder: facing the results of cognitive neuroscience
Obsessive-compulsive disorder (OCD) is currently listed among anxiety disorders based on the DSM-IV-TR diagnostic manual. This will change in DSM-V, because of our neuroanatomical, neuropsychological knowledge. OCD is not obviously anxiety disorder. This idea among psychoanalysts appeared much earlier then in cognitive neuroscience. I try to integrate the results of different disciplines – cognitive neuroscience, psychoanalysis, neuropsychology – in my article for better understanding of OCD. The latest theory of neuroanatomical background of OCD is the interconnections theory of fronto-striatal loops. Current knowledge regarding the cognitive profile of OCD executive function deficits and non-verbal memory deficits are identified. In this article, I illustrate, how our knowledge about the neurocognitive differences can translate into the language of clinical practice and psychoanalytical work. The OCD-specific neuropsychological deficits (decision-making, set-shifting, inhibition deficits) are considered structural deficit, which makes interpretation based psychoanalytical work difficult. In this article, I argue, that psychoanalytical work can be used in treatment of OCD. Instead of interpretation of symptoms, the focus of psychoanalytical work should be the interpretation of obsessional mode. The key elements of modified psychoanalytical techniques are: separation of obsessional and „real” self; development of internal experiences of different self areas; identification of obsessional part of the self as an ego-dystonic element; changing of self-definition; integration of ego-dyston self element; creating a new, more integrated self.
Keywords: obsessive-compulsive disorder – neuropsychology – psychoanalysis
Mónika Andrejkovics, Éva Gasparik, Petra Bokor, Ede Frecska:
The new paradigm of medicine and psychotherapy: The bio-psycho-socio-spiritual (BPSS) model
There has been a growing interest in and urge for the incorporation of spirituality within the framework of contemporary medicine. Crisis in health care is a worldwide phenomenon, which may indicate the need for a paradigm shift. The recommended bio-psycho-socio-spiritual model of medicine is the extension of the current biopsychosocial paradigm by the spiritual dimension. On one hand, the present article calls the professionals’ attention to work out the details of a theoretical model and to lay down the basic rules of its practical implementations. For this purpose, developing common terminology, establishing a set of scientific methodological tools, and setting guidelines are the necessary requirements.
On the other hand, the authors recommend approaching the concept of spirituality within the framework of identification. In this perspective, spiritual orientation results from identification on a meta-level, when the individual transcends the culturally set bonds of her/his particular community and extends those with values of a broader organizational level or some higher entity. A transpersonal experience may facilitate the process of identification. By being enabled for meta-identification one can find more values, meaning and purpose in life. Faith is an important motivational factor in the process, which may be advanced further by spiritual-transcendental experiences.
Keywords: bio-psycho-socio-spiritual model – BPSS model – paradigm shift – spirituality
Ferenc Boldvai, Gyöngyvér Kárpáti, János Csorba, Judit Mészáros:
Experiences of play-drama in individual psychology during group work with children suffering from adaptational problems
This study illustrates group work with children of hard of hearing suffering from adaptational problems. The aim of the group was to correct the adaptational problems of children with hearing difficulties applying individual psychological (IP) play-drama facilitated by Hanna Kende. The work was characteristic in a number of ways: the participants suffered from hearing difficulties as well as behavioural problems. The authors illustrate the frames of interpretation for behavioural problems characteristic of people with deficit sense organs. They point out the specific attributes of the work, and supply practical advise as well. They provide detailed account of the call-pictures that stimulate the psychic work and theoretical explanation of the process. They illustrate the coordination between the call-pictures and the personal orientation of treatment. Give details of the running of the group work. Describe the method to turn the simplistic two dimensional events of children with hearing difficulties into creative drama in three dimensional space. Consider the tension built up according to the structuring of the group meetings, the impulsive acts, aggressive signals, and their possible handling. The active, action-centred, self- evaluating dramatic technique have favourable influence on aggressive behaviour and adaptational problems, as it is indicated by their work so far. According the experiences of the authors the method can be successfully used with groups of children with deficit sense organs suffering from behavioural difficulties.
Keywords: hearing difficulties – Individual psychology – IP child- drama – adaptational problems of deficient children.
The neuroscientific approach of transference
Transference is the most conventional concept of psychoanalysis. Although psychoanalytic theories perceive transference from different approaches, nobody contests its central significance.
Transference is determined by the representations stored by neural networks. The determining role of representations in relational situations and in self experience organising activity is the result of their readiness/standby condition for activation. Procedural learning, which is due to the neuron plasticity, is responsible for character traits and makes possible the therapeutic changes in the same time.
The implicit procedural memory has primarily significant meaning for psychoanalysis, because it contains the defence mechanisms and those elements of representations witch are not adaptable to the consciousness narrative.
Transference is resulted by the representations stored in the implicit procedural memory located in the Amygdala and the prefrontal cortex. The recognition of the therapeutic situation as a “familiar” situation is the result of the activation of previously coded neural patterns. The mirror neurons provide the unconscious, rapid and immediate answer both on the external or internal stimuli.
The activity of multimodal neurons of Amygdala and the firing of mirror neurons are reinforced by the over stimulating experiences. The traumatic experiences are stored in the implicit-procedural memory belonging to the mentioned structures.
The mirror neurons have important role in the performed attitudes of social relationships, because the processes of joining and insertion in the neural level make possible the rapid recognition of complex stimuli of interactions.
During the psychoanalytic process the neural patterns of the trauma calm down through the modification of neural networks. The process comes off through the changes of representations that define the transference. During the healing process new relational configuration connects to the old experience.
Keywords: transference – representation – cognitive neuroscience – neural network – memory system – mirror neuron
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