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Concept: Jacques Lacan

45

Narcissism levels have been increasing among Western youth, and contribute to societal problems such as aggression and violence. The origins of narcissism, however, are not well understood. Here, we report, to our knowledge, the first prospective longitudinal evidence on the origins of narcissism in children. We compared two perspectives: social learning theory (positing that narcissism is cultivated by parental overvaluation) and psychoanalytic theory (positing that narcissism is cultivated by lack of parental warmth). We timed the study in late childhood (ages 7-12), when individual differences in narcissism first emerge. In four 6-mo waves, 565 children and their parents reported child narcissism, child self-esteem, parental overvaluation, and parental warmth. Four-wave cross-lagged panel models were conducted. Results support social learning theory and contradict psychoanalytic theory: Narcissism was predicted by parental overvaluation, not by lack of parental warmth. Thus, children seem to acquire narcissism, in part, by internalizing parents' inflated views of them (e.g., “I am superior to others” and “I am entitled to privileges”). Attesting to the specificity of this finding, self-esteem was predicted by parental warmth, not by parental overvaluation. These findings uncover early socialization experiences that cultivate narcissism, and may inform interventions to curtail narcissistic development at an early age.

Concepts: Sociology, Child, Childhood, Knowledge, Psychoanalysis, Jacques Lacan, Narcissism, Narcissistic parents

28

This article is about the Freud-Frink-Brill relationship, certain events in the history of psychoanalysis in the United States in the years 1919 to 1925, and some speculative explanations for these events. It is not a critique of psychoanalytic theory or practice.

Concepts: United States, Psychotherapy, Unconscious mind, Psychoanalysis, Jacques Lacan, Sigmund Freud, Anna Freud, Psychoanalytic theory

13

Complex networked systems ranging from ecosystems and the climate to economic, social, and infrastructure systems can exhibit a tipping point (a “point of no return”) at which a total collapse of the system occurs. To understand the dynamical mechanism of a tipping point and to predict its occurrence as a system parameter varies are of uttermost importance, tasks that are hindered by the often extremely high dimensionality of the underlying system. Using complex mutualistic networks in ecology as a prototype class of systems, we carry out a dimension reduction process to arrive at an effective 2D system with the two dynamical variables corresponding to the average pollinator and plant abundances. We show, using 59 empirical mutualistic networks extracted from real data, that our 2D model can accurately predict the occurrence of a tipping point, even in the presence of stochastic disturbances. We also find that, because of the lack of sufficient randomness in the structure of the real networks, weighted averaging is necessary in the dimension reduction process. Our reduced model can serve as a paradigm for understanding and predicting the tipping point dynamics in real world mutualistic networks for safeguarding pollinators, and the general principle can be extended to a broad range of disciplines to address the issues of resilience and sustainability.

Concepts: Scientific method, Mathematics, Symbiosis, Dimension, Systems theory, Real number, Point, Jacques Lacan

12

Low-Frequency Oscillations (LFO) in the range of 7-9 Hz, or theta rhythm, has been recorded in rodents ambulating in the real world. However, intra-hippocampus EEG recordings during virtual navigation in humans have consistently reported LFO that appear to predominate around 3-4 Hz. Here we report clear evidence of 7-9 Hz rhythmicity in raw intra-hippocampus EEG traces during real as well as virtual movement. Oscillations typically occur at a lower frequency in virtual than real world navigation. This study highlights the possibility that human and rodent hippocampal EEG activity are not as different as previously reported and this difference may arise, in part, due to the lack of actual movement in previous human navigation studies, which were virtual.

Concepts: Brain, Hippocampus, Electroencephalography, Mammal, Europe, Primate, Jacques Lacan, Theta rhythm

6

Jouissance is a Lacanian concept, infamous for being impervious to understanding and which expresses the paradoxical satisfaction that a subject may derive from his symptom. On the basis of Freud’s “experience of satisfaction” we have proposed a first working definition of jouissance as the (benefit gained from) the motor tension underlying the action which was [once] adequate in bringing relief to the drive and, on the basis of their striking reciprocal resonances, we have proposed that central dopaminergic systems could embody the physiological architecture of Freud’s concept of the drive. We have then distinguished two constitutive axes to jouissance: one concerns the subject’s body and the other the subject’s history. Four distinctive aspects of these axes are discussed both from a metapsychological and from a neuroscience point of view. We conclude that jouissance could be described as an accumulation of body tension, fuelling for action, but continuously balancing between reward and anxiety, and both marking the physiology of the body with the history of its commemoration and arising from this inscription as a constant push to act and to repeat. Moreover, it seems that the mesolimbic accumbens dopaminergic pathway is a reasonable candidate for its underlying physiological architecture.

Concepts: Psychology, Ventral tegmental area, Dopamine, Mesolimbic pathway, Unconscious mind, Psychoanalysis, Jacques Lacan, Psychoanalytic theory

6

In contemporary Lacanian psychoanalysis, Verhaeghe’s theory of actualpathology psychopathology in psychosis and the Millerian idea of “ordinary psychosis” provide diverging conceptual approaches to psychosis. In this paper, the two approaches to psychosis are examined with a particular emphasis on “mild psychosis” and compensatory mechanisms. Despite the shared focus on similar clinical phenomena, particularly body disturbances, these two theories provide different explanations of psychosis. Verhaeghe’s theory of psychosis is a synthesis of Lacanian theory, Freud’s idea of actual neurosis and psychoanalytic attachment concepts. Moreover, these ideas are situated in the “schizophrenia/paranoia dichotomy” an important heuristic device utilized in clinical practice with psychosis. In contrast, the Millerian field of ordinary psychosis aims to broaden the idea of psychosis by reviving the idea of “mild psychosis” and the different forms of stabilization possible in psychosis. Clinicians adapting the idea of ordinary psychosis aim to rethink pivotal Lacanian concepts-“untriggered” psychosis and stabilization-beyond the scope of the schizophrenia/paranoia dichotomy. Although the idea of ordinary psychosis requires further development, it promise greater utility than Verhaeghe’s model, as it provides a broader and more nuanced approach to the complex vicissitudes of triggering and restitution in psychosis.

Concepts: Psychology, Psychiatry, Abstraction, Unconscious mind, Psychoanalysis, Jacques Lacan, Sigmund Freud, Psychoanalytic theory

1

While mental illness is a significant health challenge worldwide, the availability of specialists is limited, especially in rural areas and for psychiatric emergencies. Although tele-psychiatry, via real-time videoconferencing (VC), is used to provide consultative services in areas that lack psychiatrists, there are a paucity of studies on the use of VC for psychiatric emergencies. We examine how VC matters for patient involvement and professional practice in the first Norwegian emergency tele-psychiatric service. Through a decentralised on-call system, psychiatrists are accessible 24/7 by telephone and VC for patients and nurses in regional psychiatry centres. Based on 29 interviews with patients, psychiatrists and nurses, this article addresses how participation is fostered by VC, and how it may change the social dynamics of therapeutic emergency encounters. We identified four contributions of the ‘video-mediated gaze’ in the therapeutic encounter including those of the: (1) immediacy of assessment, (2) increased transparency, (3) sense of access to the ‘real’ expert, and (4) fostering of the patient’s ‘voice’ in therapeutic decisions. These VC inflections of the therapeutic encounter are a mix of the pragmatic (1 and 2) and the symbolic (3 and 4), assembling in these contexts to foster patient-centeredness. With a sociological approach to video-conferenced emergency psychiatry, the identification of symbolic affordances adds necessary nuances to the application of new technologies into fragile therapeutic communication.

Concepts: Sociology, Doctor-patient relationship, Psychiatry, Psychiatric medication, Jacques Lacan, Psychoanalytic theory, Psychiatrist, Emergency psychiatry

1

In the rubber hand illusion (RHI), participants view a rubber hand that is stroked synchronously with their real, hidden hand. This procedure results in experiencing an increased sense of ownership over the rubber hand and demonstrates how multisensory information (vision, touch) can influence the sense of body ownership. However, it has also been suggested that a (lack of) sense of ownership over an own body part may in turn influence bodily processes. This suggestion has previously been supported by the observation that a decrease in skin temperature in the real hand correlated with ownership over the rubber hand. However, this finding has not been consistently replicated. Our lab has conducted several studies in which we recorded temperature of the hands during the RHI using various measures and in different circumstances, including continuous temperature measurements in a temperature-controlled room. An overall analysis of our results, covering five attempts to replicate the traditional RHI experiment and totalling 167 participants, does not show a reliable cooling of the real hand during the RHI. We discuss this failure to replicate and consider several possible explanations for inconsistencies between reports of hand temperature during the RHI.

Concepts: Sense, Somatosensory system, Experiment, Suggestion, Hand, Jacques Lacan, The Real, Body

1

The lack of understanding of the real costs (not charge) of delivering healthcare services poses tremendous challenges in the containment of healthcare costs. In this study, we applied an established cost accounting method, the time-driven activity-based costing (TDABC), to assess the costs of performing an abdomen and pelvis computed tomography (AP CT) in an academic radiology department and identified opportunities for improved efficiency in the delivery of this service.

Concepts: Costs, Medical imaging, Economics, Cost, Cost accounting, Jacques Lacan, The Delivery, Activity-based costing

1

Research has shown that child sexual abuse victims are overrepresented among sexual abuse offenders, leading to the sexually abused-sexual abuser hypothesis. However, a large proportion of child sexual abuse victims do not go on to sexually offend, and such individuals are labeled as resilient victims. Surprisingly few studies have looked at why some male victims of sexual abuse do not go on to offend. In-depth qualitative interviews were conducted with 47 resilient men focusing on their beliefs as to why they had not gone on to sexually abuse others. Results revealed four themes for why the victims did not offend: empathy, morals, lack of sexual desire, or a combination of the previous three. In regard to the process of developing their resiliency, some participants claimed they made a conscious decision, whereas others reported the decision was an unconscious one. The various factors that were reported as contributing to the conscious or unconscious decision (becoming aware of sexual abuse, admitting the experience had happened to them, empathy, social support, and lack of sexual desire to abuse) are discussed, along with the four themes, and the implication of these results for prevention. Finally, conclusions are drawn that the victim-offender pathway is far from inevitable as most participants stated their reason for not offending was directly related to their own experience of sexual abuse victimisation.

Concepts: Psychological trauma, Consciousness, Human sexual behavior, Child abuse, Abuse, Jacques Lacan, Bullying, Victimisation