Neurologic Basis of Mental Disorders

This is the entire book.

"Why Are Our Pictures Puzzles?" is an attempt to understand why scholars have begun writing at such tremendous length on individual pictures. Before the 20th c., one of the longest texts on a single painting was Vasari's description of Leonardo's "Last Supper." In the last forty years it has become common for historians to write entire books on individual artworks.

Why have we started experiencing images as so complex? Why do they seem to us like puzzles, waiting to be solved? Why doesn't it concern us that previous generations did not think of writing at such length?

This book also has a couple of chapters on what I consider to be psychotic behavior about images: compulsive sighting of supposedly hidden images, and a crazy art historical book about a painting written by Dalí. So I have tagged the book with psychoanalytic terms.

The book itself is still in print and in copyright, but I found a full pdf of this on the internet (for example on scribd), so I decided to post it on here on academia.edu, where at least it can have the correct context and links.

Therapy can be confusing: two people converse in a private room, one in distress, the other described as a helpful expert. At least one of the two is likely to express thoughts and feelings usually kept secret. In other circumstances, the exchange of such intimacies may herald a more physical relationship. For therapists, however, the professional relationship explicitly precludes such contact. The BACP Ethical Framework for Good Practice in Counselling and Psychotherapy,1 for example, requires that practitioners must not abuse their client’s trust in order to gain sexual, emotional, financial, or any other kind of personal advantage. Sexual relations with clients are prohibited, along with sexualised behaviour.

While psychotherapists and counsellors generally acknowledge that sexual attraction is a common and often ordinary human response to another, they also recognise that acting on such feelings in therapy will quickly become problematic. The early psychoanalytic community had to confront and respond to such instances as Jung’s relationship with Sabina Spielrein.2 Rosie Alexander’s3 description of the times she sat on her therapist’s knee and felt his erection, elicits a mixture of emotions in the reader, not least shock, and the narrative is saturated with a sense of betrayal.

There have been several types of research investigating boundary breaches and sexual boundary violations.4 In spite of these, however, there is little certainty about how common sexual boundary violations are, as the sources of information about them (confession, client reporting, complaints to organisations, and knowledge of colleagues’ conduct) are all vulnerable to error. Further studies have attempted to identify characteristics of transgressing therapists and the factors that contribute to such events (see Moggi et al5 for an example), and to understand the effects on clients who have experienced therapist-client sex.6 If sexual feelings are ubiquitous and sexual attraction a real possibility in the context of the therapy relationship, how are these managed in therapy? Complaints about sexual boundary violations form a small proportion of complaints about therapists and health professionals.4, 7, 8 Is it the prospect of opprobrium from colleagues or the threat of sanctions from regulatory agencies that contains the relationship within professional boundaries? Do reported violations represent only a small proportion of actual sexual boundary violations? .......

Aim: To identify therapists’ views on sexual boundaries and the strategies they employ to manage them in therapeutic practice. Method: In-depth qualitative interviews were conducted with a sample of 13 accredited, experienced practitioners of psychotherapy or counselling. A grounded theory approach, informed by principles from Free Association Narrative methodology, was employed, in which team members used debriefing sessions for extending depth of understanding of the interviews. Findings: There is consensus about boundaries at the extremes, but variability about fantasy, flirtation and touch. A core process was generated from accounts of successful management of sexual attraction. We identified four problematic ways of reacting to boundary pressure, each with potential to harm clients and therapy. Discussion: A participant-observer stance was conceptualised as essential for managing threats to boundaries, consistent with the empathic stance. Minor boundary crossings were viewed by interviewees as both potential precursors of more serious transgressions, and as opportunities for understanding the client's difficulties. Implications for practice: These span training, accrediting organisations, supervision and therapy practice.

Research into the use of transitional objects (Winnicott, 1971) by adult clients in psychotherapy has given little attention to the question of how a transitional object (TO) works. This question is addressed through the use of a semi-structured interview. Data was collected on the clinical practice and theoretical understanding of TO emergence and use of three psychodynamic-interpersonal (PI) and three Gestalt psychotherapists. A grounded theory analysis suggests that a TO works by a process of embodiment which can be structured with reference to a four-level model consisting of physical, process, contextual and conceptual levels. Therapists of both orientations emphasized the TO as a focus of intersubjectivity within the therapeutic relationship. Differences between the PI and Gestalt therapists are also examined. The clinical implications of this four-level model of embodiment for the use of TOs in psychotherapy are explored, together with suggestions for further research.

Shaun Gallagher has actively looked into the possibility that psychopathologies involving “thought insertion” might supply a counterexample to the Cartesian principle according to which one can always recognize one’s own thoughts as one’s own. Animated by a general distrust of a priori demonstrations, Gallagher is convinced that pitting clinical cases against philosophical arguments is a worthwhile endeavor. There is no doubt that, if true, a falsification of the immunity to error through misidentification would entail drastic revisions in how we conceive the boundary between self and other. However, I argue that (1) the idea of unearthing an exception to the Cartesian thesis is, on further reflection, not a realistic prospect and that (2) this casts doubt on the attempt to conjoin first-person phenomenology and third-person cognitive science in the service of philosophical debates.

This thesis examines the topic of embodied memory in Krapp’s Last Tape, a one-act play by Samuel Beckett, and how ordering mechanisms in theatre can inform the design and construction of the architectural space holder of memory.
The first section will aim to introduce a variety of new directions in the translation of memory to architecture.
The purpose of this is to develop a new and playful method of storing memories over time, as a way of preserving and protecting them from the natural editing or erasing caused by the ephemeral nature of the human mind. In order to develop this, I will be analysing the one-act play Krapp`s Last Tape, written by the Irish playwright Samuel Beckett; the particular performance I will be looking at took place at London’s Greenwich Theatre in December 1975, directed by Patrick Magee, with the part of Krapp being played by actor Max Wall.
To aid this process I have developed the website www.memory.surf, which navigates through each memory and offers the user the possibility of voyaging through Krapp’s memories by changing the chronology of the initial events. In order to translate Krapp’s memories accurately, I have been in close contact with Professor James Knowlson, author of Samuel's Beckett biography Damned To Fame.
My research includes surveys of literature, media, and precedents, some of which includes an analysis of the Greenwich Theatre performance, a website, a James Knowlson interview, and last –but certainly not least –  the installation model.
As a result, I have designed and produced an installation based on Krapp’s recorded memories, which offers a feasible means of recording, storing and replaying a memory. More specifically, my objective is to explore how exactly memories can be translated into space, by designing spaces based on memories.

The phenomenology of typification, as developed by Alfred Schutz, provides a way of demystifying two persistent “mysteries” of psychiatric diagnosis: rapid diagnosis and the praecox feeling.  The criteria of psychiatric disorders which are contained in classification manuals, such as DSM-III, are shown to presuppose in psychiatrists the pre-conceptual ability to typify these disorders.  When employed within the “critical attitude” described by Husserl, these pre-conceptual skills are fully scientific.

Permeation of carbon dioxide has been measured for two types of composite polymeric hollow fiber membranes for feed pressures up to 18 MPa at a temperature of 313 K. The membranes consist of a polyamide copolymer (IPC) layer or a polyvinyl alcohol (PVA) layer on top of a polyethersulfone (PES) support membrane. For both membranes, the carbon dioxide permeance has a maximum as a function of the feed pressure at about 8 MPa. A good description of the maximum in the carbon dioxide permeance is possible with a model based on the ratio of the density to viscosity. A comparison with permeation results for nitrogen for feed pressures up to 16 MPa, supports the findings that viscous flow is the main mechanism for mass transport across the membranes. Both membranes show an increase in the carbon dioxide permeance as a function of the exposure time to supercritical carbon dioxide. Cross-linking of the IPC layer resulted in a stable IPC-based membrane at the cost of a small reduction in the carbon dioxide permeance.

An illustrative analysis is offered demonstrating the potential of conversation analysis for psychotherapy research. Extracts are presented from an unresolved problematic theme selected from an unsuccessful eight-session psychodynamic-interpersonal therapy of a female client presenting with a major depressive episode. The authors identify descriptive devices and communicative skills on which the client and therapist draw in the process of problem formulation. They demonstrate the way in which differing versions of the client’s problems were presented and how the client and therapist pursued differing attributional projects. Specifically, the authors examine how internal and external accounts of the client’s underlying problems were accomplished and warranted and how the therapist attempted the transformation of problems. The quality criteria pertaining to conversation analysis are indicated, the implications for therapeutic practice explored, and the relationship between the present findings and previous research discussed.

Blaming events in therapy were used as a focus for discussions with family therapists in order to examine their construal of the therapeutic process when working with families who blame. Interview transcripts were used as data which were analysed using a qualitative methodology, with a view to building a theoretical model. We present an exploratory model that allows therapists to position their therapy within a broader framework of psychological approaches. When prompted by a video-clip of blaming from the therapy setting, therapists tended to categorize current difficulties in terms of fear and control issues from past relationships and consequent underlying beliefs, and they also described the resultant negative outlook as a direct challenge to therapist idealism. Interestingly, the two themes that emerged from the interview data with the most categories and quotes were ‘unhealthy allocation of responsibility for problems’, which is arguably the main source of overt blaming, and ‘family identity and cohesion’, so often a point of contention during therapy.

An adaptation of the Penn State Worry Questionnaire (PSWQ) [Meyer, T. J., Miller, M. L., Metzger, R. L. and Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28, 487–495.] for weekly assessment of worry was evaluated in a brief treatment study. Cognitive restructuring techniques were taught to 28 nonclinical high-worriers, 14 of whom served as a control group in a lagged waiting-list design. Results showed that the Penn State Worry Questionnaire-Past Week (PSWQ-PW) was highly reliable and substantially valid in the assessment of both (a) weekly status of worry and (b) treatment-related changes in worry: average Cronbach's alpha was 0.91; average convergent correlation with a past-week adaptation of the Worry Domains Questionnaire [Tallis, F., Eysenck, M. W. and Mathews, A. (1992). A questionnaire for the measurement of nonpathological worry. Personality and Individual Differences, 13, 161–168.] was 0.63 and pre-post improvement on PSWQ-PW showed a 0.71 correlation with the Questionnaire of Changes in Experiencing and Behavior [Zielke, M. and Kopf-Mehnert, C. (1978). Veränderungsfragebogen des Erlebens und Verhaltens. Weinheim, Germany: Beltz Test Gesellschaft.]. It is concluded that the PSWQ-PW is a useful instrument for monitoring pathological worry in experimental and applied settings.

Both lay concept and scientific theory have embraced the view that nonpathological worry may be helpful for defining and analyzing problems. To evaluate the quality of problem elaborations, concreteness is a key variable. Two studies with nonclinical student samples are presented in which participants elaborated topics associated with different degrees of worry. In Study 1, participants' elaborations were assessed using problem elaboration charts; in Study 2, they were assessed using catastrophizing interviews. When participants' problem elaborations were rated for concreteness, both studies showed an inverse relationship between degree of worry and concreteness: The more participants worried about a given topic the less concrete was the content of their elaboration. The results challenge the view that worry may promote better problem analyses. Instead they conform to the view that worry is a cognitive avoidance response.

The aim of this study was to further understanding of blame in systemic therapy. Five families were chosen by their therapeutic team as engaging in blaming of a kind that the therapists found difficult to work with. Couples from each of the five families participated. A video extract from therapy identified by therapists as typifying blaming within the family was used as a focus for semistructured interviews with each parent. Transcripts were analyzed according to the procedures of grounded theory. On the basis of this inductive qualitative analysis, a framework of understanding emerged from the data consisting of the core category, “dialectical understanding,” and an accompanying set of overarching themes. These themes capture the way in which participants oscillated among 13 dialecics in their discussion of blame within their family and within family therapy. The model provides a framework for analyzing the style and content of therapy conversations with a view to helping therapists facilitate therapeutic change in this difficult client group.

Suicide has a high comorbidity with impulsivity and depression, and finding imaging biomarkers indicative of patients at high
risk for suicidal behavior is invaluable to the clinician. Using single-photon emission computed tomography (SPECT) imaging,
we have previously reported regional cerebral blood flow (rCBF) decreases in the medial prefrontal cortex, ventral tegmental area
and subgenual cingulate cortex (Brodmann area 25 (BA 25)), a region found to be hypoperfused with treatment-resistant
depression. From 2007 to 2010, we have extended our analysis to include nine additional completed suicides. In all, 27 healthy,
age- and gender-matched subjects from a previously acquired healthy brain study served as controls to our 21 completed
suicides. All 21 suicides had been previously diagnosed with depression according to Diagnostic and Statistical Manual of
Mental Disorder-IV criterion. Voxel-by-voxel analyses were performed using statistical parametric mapping to compare
the differences in technetium-99m hexamethylpropylene amine oxime brain uptake between the groups. Factor analysis of the
data identified the top 10 regions of hypoperfusion in the suicidal group, including the bilateral superior frontal lobes, the right
precuneus, the rolandic operculum, postcentral gyrus, left caudate and insular cortex. We also demonstrate more focal
decreases in rCBF in the subgenual cingulate cortex (BA 25) in 18 subjects, supporting our previous hypothesis that
hypoperfusion of BA 25 may be a risk factor for suicide in depressed patients. This work suggests that SPECT might be useful in
predicting risk for suicide completion in subjects with depression or treatment-resistant depression. Further investigation of this
work is necessary to better understand the predictive value of this finding.

What is psychiatry? Psychiatry is a medical specialty in the same way as cardiology or surgery. According to the psychiatrist Marshall Hubsher, the psychiatry is dedicated to the diagnosis, prevention and treatment of mental illnesses. Some of the most common mental illnesses are major depression, anxiety disorders, attention deficit disorder and schizophrenia.

Psychiatry uses a bio-psycho-social approach, that is to say, that combines an understanding of the biology of the brain, the psychology of the individual and the effects of his social situation. Biology Every emotion, thought, and behavior starts in the brain. But the brain is an organ of the human body. It is affected by hormonal and biochemical fluctuations, a lack of nutrients, hydration or sleep, the presence of drugs or alcohol, and even by some infections and tumors.

Psychology In Marshall Hubsher's opinion, it is the set of perceptions, thoughts, emotions and reactions of the individual. His way of perceiving and analyzing a situation will influence how he feels and how he interacts with those around him. Some ways of thinking can generate pleasant emotions and harmonious interactions, others less. The social situation The well-being or the suffering of an individual can be very affected by what he lives on a daily basis. Is he alone or surrounded by family and friends? Does he have a safe home and enough money to support himself? Does he have a lot of responsibilities? Is there any significant change such as a new job, a marriage or a divorce, bereavement, a move? Marshall Hubsher claims that all these biological, psychological and social factors are taken into account in the diagnosis and treatment of mental disorders.

The medicalisation of the behaviour of children is a phenomenon that is attracting growing attention, with particular concern about the increased likelihood of children living in disadvantaged contexts receiving a medical diagnosis, such as attention-deficit hyperactivity disorder, and treatment. This paper reports on a study of professionals involved with children experiencing behavioural problems. The professionals interviewed in this study articulated their own reservations about the medicalisation of children’s behaviour and revealed a number of strategies for interrupting the process towards diagnosis. These interruptions, analysed using Deleuze and Guattari’s concept of deterriorialisation, took place along linguistic, visual and affective planes and were successful in encouraging teachers and head teachers to see alternatives to the medical route. The findings have implications for existing practice in the response to, and support for, behavioural problems and for teacher education.

Psychological distress and deficits in executive functioning are likely to be important barriers to effective weight loss maintenance. The purpose of this paper is twofold. First, in the light of recent evidence in the fields of neuropsychology and obesity, particularly on the deficits in the executive function in overweight and obese individuals, a conceptual and theoretical framework of obesity maintenance is introduced by way of a clinical obesity maintenance model (COMM). It is argued that psychological variables, that of habitual cluster Behaviors, emotional dysregulation, mood, and health literacy, interact with executive functioning and impact on the overeating/binge eating behaviors of obese individuals. Second, cognizant of this model, it is argued that the focus of obesity management should be extended to include a broader range of maintaining mechanisms, including but not limited to cognitive deficits. Finally, a discussion on potential future directions in research and p...