Joanna E. Bettmann, Gabrielle M. Kouris, I. Anderson, Bryan Casselman
{"title":"Wilderness as Healing Environment: Treating Adolescent Substance Misuse in Wilderness Therapy","authors":"Joanna E. Bettmann, Gabrielle M. Kouris, I. Anderson, Bryan Casselman","doi":"10.1080/00797308.2020.1859270","DOIUrl":"https://doi.org/10.1080/00797308.2020.1859270","url":null,"abstract":"ABSTRACT This paper reviews three psychoanalytic conceptualizations of substance misuse, discussing the implications for substance treatment deriving from these conceptualizations. The paper also presents wilderness therapy as an evidence-based approach, reviewing the outcomes and primary components of such programs. Finally, the paper concludes with two case studies of adolescents with substance use disorders treated in wilderness therapy.","PeriodicalId":45962,"journal":{"name":"Psychoanalytic Study of the Child","volume":"74 1","pages":"249 - 264"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00797308.2020.1859270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58906457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Of Being and Becoming: Psychoanalysis, Race and Class in an Urban ER","authors":"Michael Slevin","doi":"10.1080/00797308.2020.1859295","DOIUrl":"https://doi.org/10.1080/00797308.2020.1859295","url":null,"abstract":"ABSTRACT Psychoanalysis in the United States has traditionally been a practice of long-term, individual therapy conducted within the safe and comfortable surroundings of a consulting room. Through my work as a white man with a largely African American, low-income patient population in a hospital emergency room, I learned it can also be used in that fast-paced, crisis environment. Doing so, I learned, required a full engagement with my biases, cultural history, memories and personal traumas. It required understanding how structural racism is embedded in the work, the role it plays in defining my patients’ reality coming into the ER, and their options once there. Although the first priority is to determine safety: Is the person in danger of harming themselves or another, if one broadens the scope of one’s attention, as an analyst does, to the full person, do one’s perspective, role and opportunities shift? I learned that I could do more than provide a descriptive diagnosis and disposition; I could actually begin the healing process. I learned I could better understand myself and my patients. The process was healing to both of us.","PeriodicalId":45962,"journal":{"name":"Psychoanalytic Study of the Child","volume":"74 1","pages":"77 - 89"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00797308.2020.1859295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49547155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"“Daddy’s Head Is Broken”: The Treatment of Children of Severe Alcoholics","authors":"M. Brady","doi":"10.1080/00797308.2020.1859275","DOIUrl":"https://doi.org/10.1080/00797308.2020.1859275","url":null,"abstract":"ABSTRACT The author explicates the complex family relationships of children of severe alcoholics, and internalizations of these relationships, which can be addressed in the treatment of children and in corollary parent work. Children of serious alcoholics (or other substance use disorders) share features with other children whose parents are troubled. However, the author suggests that it is useful to consider what children of severe alcoholics have in common. Children of serious alcoholics can experience the substance of abuse as a mysterious potion, which their alcoholic parent prefers to them. Additionally, alcoholics (along with other substance abusers) expose their children to the specific results of inebriation or withdrawal from alcohol. The author discusses the following common experiences of the children of severe alcoholics: extreme difficulty in understanding parental addiction, particularly for very young children; an unconscious struggle to repair the damaged parent and to try to protect that parent from strain; and guilt at the often-necessary exclusion of the addicted parent from the household unit. Another confusing issue is mourning for a parent who is still alive and in some contact, yet severely impaired. The author describes parent work in these situations (collateral to a child psychoanalysis or psychotherapy), both with the “co dependent” parent and the alcoholic parent.","PeriodicalId":45962,"journal":{"name":"Psychoanalytic Study of the Child","volume":"74 1","pages":"234 - 248"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00797308.2020.1859275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47951346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Psychotherapy with Young People Addicted to Internet Pornography","authors":"Ariel Nathanson","doi":"10.1080/00797308.2020.1859286","DOIUrl":"https://doi.org/10.1080/00797308.2020.1859286","url":null,"abstract":"ABSTRACT This paper describes common themes and developments in the treatment of three young people suffering with addiction to Internet Pornography. Central to their experience is an unconsciously motivated search, assisted by Internet algorithms, aimed at matching unconscious phantasy with a pornographic enactment. As pornography is abundant, free and highly diverse, patients are able to find what they unconsciously look for. The match between unconscious phantasy and its pornographic enactment becomes the substance of their addiction. The paper follows central theme emerging in long-term psychotherapy with these patients. It explores the links between infantile relational difficulties and trauma, lack of early containment, inability to tolerate and regulate extreme states of mind, and pornography addiction. The paper shows how treatment can slow down the addictive cycle to reveal what lies at its core. Exploring early trauma and deprivation allows for containment to replace the desperate need to avoid psychic pain. Arrested relational development can be resumed and patients can begin to enjoy sexual relationships, reducing the need for addictive pornographic use.","PeriodicalId":45962,"journal":{"name":"Psychoanalytic Study of the Child","volume":"74 1","pages":"160 - 173"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00797308.2020.1859286","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46398953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Introduction - Addiction: A Ubiquitous Problem","authors":"Laura Whitman, W. Olesker","doi":"10.1080/00797308.2020.1859302","DOIUrl":"https://doi.org/10.1080/00797308.2020.1859302","url":null,"abstract":"The editors of this section wished to explore psychoanalytic approaches to addiction and substance abuse; though not sub-specializing in that domain, in our own practices, we found we were both treating several patients with opiate, alcohol, and marijuana dependence. As of 2014, one in four young adults aged 18–25 reported misuse of prescription or illicit substances, which include marijuana, stimulants, and heroin. The National Survey on Drug Use and Health (NSDUH) is a nationwide survey of 70,000 people aged 12 and older on tobacco, alcohol, and drug use and mental health in the United States. It has been conducted yearly since 1971. Results from the most recent survey, in 2019, give us cause for both hope and concern. Opiate use has diminished, now affecting about 2 million people. Marijuana was the most frequently used illicit substance, and its use is increasing; 17% of those over 12 years old had used it in the past year. In youth 12 to 25 years old, marijuana smoking is associated with depression and concurrent opioid and alcohol abuse.","PeriodicalId":45962,"journal":{"name":"Psychoanalytic Study of the Child","volume":"74 1","pages":"227 - 233"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00797308.2020.1859302","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49474778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Children Exposed to Pornographic Images on the Internet: General and Specific Aspects in a Psychoanalytic Perspective","authors":"F. D’Alberton, A. Scardovi","doi":"10.1080/00797308.2020.1859277","DOIUrl":"https://doi.org/10.1080/00797308.2020.1859277","url":null,"abstract":"ABSTRACT Online access to the Internet by minors is an increasingly widespread phenomenon, which offers a hitherto-unknown interactivity to children giving them easy access to pornographic images. These images can assume traumatic relevance, relating at the same time to the complexity of infantile sexuality. In this paper we investigate the phenomenon from a metapsychological point of view, highlighting the importance for the child to rely on an adequately present adult and pointing out that it’s not just the content of pornographic images, but the lack of contact with an Object, that constitutes trauma for children. This leads to take in count also the internal difficulties of the adult in facing these situations, with implications for our care practices.","PeriodicalId":45962,"journal":{"name":"Psychoanalytic Study of the Child","volume":"74 1","pages":"131 - 144"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00797308.2020.1859277","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48790152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Black Boys in the Eye of the Storm","authors":"Kirkland C. Vaughans","doi":"10.1080/00797308.2020.1859300","DOIUrl":"https://doi.org/10.1080/00797308.2020.1859300","url":null,"abstract":"ABSTRACT It is essential that the psychoanalytic community begin to observe and study racism’s effects, its transgenerational and structurally embedded manifestations, so that psychoanalysis and psychotherapy can be more helpful to Black people, and especially to Black children and adolescents, whose developing psyches are, unfortunately, being shaped within a culture of ongoing, if unacknowledged, racism. Black children are caught in the crosshairs of society’s brutal stereotypes that exclude them from social, educational, and employment opportunities. Such exclusions are sometimes exacerbated by their own non-adaptive responses to the hostile culture in which they live, thus affirming deep-seated racialized beliefs and social structures. Greater psychoanalytic attention to theorizing and understanding cultural attitudes on race, to understanding the impact of racism on how we think about Black boyhood with a psychoanalytic interrogation of transgenerational trauma, could positively impact our understanding of how racism impacts the therapeutic process for us all as clinicians and as citizens. It is doubtful that we will ever make the therapeutic arena hospitable to Black boys or Black men without integrating in our theoretical formulations the insidious effect of structural racism in American society impacting clinicians in all areas of mental health care.","PeriodicalId":45962,"journal":{"name":"Psychoanalytic Study of the Child","volume":"74 1","pages":"47 - 58"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00797308.2020.1859300","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44222975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Effect of Marijuana Use on Personality Development in Adolescence and Young Adulthood","authors":"Rex H. McGehee","doi":"10.1080/00797308.2020.1859284","DOIUrl":"https://doi.org/10.1080/00797308.2020.1859284","url":null,"abstract":"ABSTRACT This paper considers the effects of marijuana on personality development during adolescence, integrating psychoanalytic views of development, information from neuroscience research, and recent social realities including legalization of marijuana in many states. The psychoanalytic treatment of a 16-year-old boy with marijuana dependence is presented. The paper concludes with recommendations for the treatment of adolescents who are marijuana users.","PeriodicalId":45962,"journal":{"name":"Psychoanalytic Study of the Child","volume":"74 1","pages":"265 - 279"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00797308.2020.1859284","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41773094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Psychodynamic Functions of Digital Media within Our Child/Adolescent Sessions – From Interference to Enhancement – A Benevolent Viewpoint","authors":"R. Holloway","doi":"10.1080/00797308.2020.1859281","DOIUrl":"https://doi.org/10.1080/00797308.2020.1859281","url":null,"abstract":"ABSTRACT To provide a structure for our thinking about the impact of digital media on our therapeutic work, I have outlined a way of organizing such thinking. I utilize the idea of the “psychodynamic functions” digital media perform within the context of our therapeutic work. Based mainly on my own experiences as a therapist, I outline 16 “psychodynamic functions,” which are the most frequent and salient ones. I provide additional structure by organizing these “psychodynamic functions” into three categories. The three categories are the “enhancing functions” that are likely to contribute to the richness of our psychoanalytic work, the “straddling functions” which are likely to have both enriching, enhancing aspects at times, along with defensive or impeding aspects at other times, and finally, the “defensive functions” which seem always to have defensive purposes. Equipped with these conceptualizations of psychodynamic functions, I consider seven detailed clinical examples of children and adolescents who have used digital media in their sessions. These examples include one patient suffering from trauma, one at a neurotic level of functioning, and five who were on the autism spectrum (either Asperger’s or high-functioning autism). I conclude with integrated reflections on the case illustrations, including discussion of how formulating the psychodynamic functions illuminates the types of in-session interventions to consider.","PeriodicalId":45962,"journal":{"name":"Psychoanalytic Study of the Child","volume":"74 1","pages":"349 - 378"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00797308.2020.1859281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42081631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Systemic Racism and Othering within Government Agencies: A Psychoanalytic Interpretation of Environmental Injustice in the Flint, Michigan Water Crisis","authors":"M. Rudden","doi":"10.1080/00797308.2020.1859292","DOIUrl":"https://doi.org/10.1080/00797308.2020.1859292","url":null,"abstract":"ABSTRACT The severe water emergency in Flint, Michigan between 2014 and 2016 was inarguably caused by systemic organizational dysfunction. The Michigan Governor Snyders’ Flint Water Advisory Task Force, in their analysis of the severe water emergency in Flint, Michigan, emphasized the degree of systemic organizational dysfunction, providing evidence that the agencies involved demonstrated a disregard for the poor and black citizens of Flint and participated in environmental injustice. The author traces, through journalists’ reports, e-mails between and among officials, first-hand testimony and the timeline provided by the Task Force, that the performance of the involved agencies (the state Department of Environmental Quality and the Michigan Department of Health Services) was tainted by systemic racism, Othering and by the dehumanization of Flint citizens the majority of whom were African American, and poor. The scandal was finally made public when a pediatrician showed unequivocal data on the alarmingly high lead levels in children who ingested the water. An organizational analysis based on psychoanalytic principles (Freud, Bion, Hopper) further supplements her observations that systemic racism aided and abetted severe systemic dysfunction.","PeriodicalId":45962,"journal":{"name":"Psychoanalytic Study of the Child","volume":"74 1","pages":"90 - 104"},"PeriodicalIF":0.5,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00797308.2020.1859292","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42777274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}