Many have taken swings and hit home-runs, doubles, or fouled out when defining psychoanalysis, psychoanalytic psychology, or the psychodynamic perspective. What we know for sure is that it is both a theory of mental life and a professional technical practice. As a theory, it consists of core principles, constructs, and models for the classification of mental functioning. As a practice, it is comprised of a dialectical continuum between affirmation and confrontation (or support and expression). Psychoanalytic theory conceptualizes human psychology at the level of motivation (instincts, drives), social relationships (object relations), personality (ego functioning), psychopathology (defense mechanisms, neurosis), development (separation-individuation), neuroscience (neuropsychoanalysis), and cognition (ego functioning). It literally can be subdivided into domains the exact same way as academic psychology. It should not be surprising many central constructs to both differ in name only or in emphasis.

After finally imbibing virtually every legal action, court document, and news article regarding the 2014 DOJ - LSAT Consent Decree which was the end result of an investigation started in 2010 by California, which went to court in 2012, & was thereafter under the reigns of Perez… twitter.com/i/web/status/1… What the embedded thread above describes is a view justifying skepticism for interpreting processing speed as veridical de facto & categorically tapping core dimensions of ADHD. It appears the LSAT was actually well aware of every theoretically & empirical development in clinical… twitter.com/i/web/status/1…

It does seem like 2014 was monumental in ushering in safetyism, & there is more of proximate concrete causal explanation than typically understood. It’s the deleterious sequelae of Perez in Civil Rights at DOJ going drunk with power and apparent unstoppable competence. Disorder… twitter.com/i/web/status/1… Trigger warnings only make sense imo in the context of an admin policy of risk management such that the institution is seen to be mitigating risk of discrimination against a new postmodern, overly general protected class covered by the ADA for example.

It is my impression that the NYC private schools have been so inundated with requests for accommodations since 2020 in the context of Covid that “accommodation review committees” have been formed. It is my impression that such “committees” were not a thing before. Someone needed to take a principled stance against green lighting academic accommodations for what is really more of a motivational and personality factor than a purely cognitive limitation. I’m talking about “test anxiety” or “anxiety” - vague, overly general & impressionistic

These are entirely anti-empirical claims tbf. One of my very close friends from high school, saw at reunion, had top surgery senior year. Most def went the puberty as a male. Graduated HS had full surgery. Hot af. I think if she had not undergone puberty as a male or whatever… twitter.com/i/web/status/1… For her, the masculine voice seemed like the most distressing part of having to wait until 16 or 18. This was 01’/02’ New York City, notably N = 1 out of a high school of about 100 students at the most, a high school where if the first handful of teenagers were to transition with… twitter.com/i/web/status/1…

Are you ready for the how to diagnose ___ personality disorder blog drops from years back again for the nth time? Well, ladies & gentlemen, as Artu would say, “welcome to my show.”

1/ Adaptive functioning dictates that I re-up that 🔥 in light of some movement within academic psych that appears drunk on the wokeness applied to psychiatric nosology.

2/

Personality Disorder (PD) Types? No! It’s PD Dimensions | Psychology Today psychologytoday.com/us/blog/person…

In light of recent articles purporting to summarize the evolution of PD dx in the DSM w/a focus on current controversies, here is a throw back to one of my first @PsychToday posts where I break it down for you in a clear, factual, neutral, and comprehensive sans any discussion of label changes due to concerns of stigma

2/

The adaptive expression of aggression involves (a) confrontation - communicating that you’re angry and why while experiencing, expressing, & regulating the corresponding affect in vivo - and (b) closure. The “good enough” other can withstand this & is not at risk of being lost. twitter.com/i/web/status/1… This process is fundamental to the rupture-repair dynamic in psychotherapy as well as the development of secure attachment and healthy mental representations of self, other, & relationships from birth onwards.

The principle that we relate to others as though they were significant others from our past (& that individual differences exist in the extent to which we do & when) is perhaps among the most important research supported contributions #psychoanalysis. Extant research in social… twitter.com/i/web/status/1… The principle that mental processes occur outside of awareness, I.e., unconsciously, implicitly, and automagically, has found a plethora of scientific support in cognitive psychology. Debate exists as to whether this evidence constitutes support for psychoanalytic theory.

#Betterhelp evidently warns patients about the signs of #countertransference and instructs them what to say should it come up. What they are instructed to do is to terminate. When I saw this at first, I just thought it was beyond stupid. Upon further reflection, it’s worse. It’s… twitter.com/i/web/status/1… Research on the therapeutic relationship & alliance has shown that it predicts outcomes of therapy. Recent research has looked more closely at this & found therapy marked by a “V curve” in the therapeutic relationship is what determines therapy outcome. V curve - good outcome. No… twitter.com/i/web/status/1…

If you want to know how much or if your insurance will cover your psychotherapy or psychological testing with a licensed psychologist, here are some tips to use when you call your insurance company to find out: 1/ 1. You will be asked which CPT codes are going to be used. Here are the answers: If therapy, ask about 90834 and 90837.

2. You will be asked what is dx code for the procedure referred to by said CPT codes (this question is obviously incoherent bc u can’t know the dx

2/

The history of Gordon Allport editorship of the journal during this period is also rather interesting in the context of an apparent power struggle at Harvard or Stanford w famous psychologist Boring who gave the chair job to Allport around the same time he took over editorship.

https://twitter.com/DrWinarick/status/1419236457307414533

Boring evidently was not a fan of the Jews which imo explains why AA Roback, whose books on the history of psychology, psychiatry, and personality are by far the most scholarly, comprehensive, detailed & impressive accounts I’ve ever encountered, never became recognized as big.

The capacity for guilt, ambivalence, agency, empathy, and being alone are core concepts in psychodynamic theory. These are always the “goals” of #psychodynamic therapy regardless of what DSM symptom profile a patient may display. Steps:
1. Enhance meaning-making & the capacity to symbolize experience by using techniques aimed at getting someone curious about their own mental life (clarify, paraphrase, validate, explore, interpret) by being curious about their mental life & modeling reflective functioning.

Some controversy over the historical record here. Did Freud get passes for his sisters to leave Nazi Germany?

Word on the street is yes but it was a luke warm effort and too late by the time he did try to get them out.

Maybe Freud hate-scholar @PeterDKramer knows more on this?

https://twitter.com/draaronb/status/1561755956404523018

A few other questions:

1. What was Freud’s perception of rising authoritarianism-fascism-genocide in Germany and Vienna before he left for London?

2. How did it show up in his writing other than as a mangled concept known as the death instinct?

THREAD 🧵

“Schizoidia Everywhere” by Dr. W

#Solitary individuals may experience a variety of different emotional experiences & internal conflicts that would not be readily observable from behavior because generally the #solitary look they same because they are #solitary.

1/n However, clinical experience & empirical research have shown that distinctions among #solitary types in connection to emotional functioning, social needs, and attachment-related dynamics vary considerably and have diagnostic implications.

2/n

One major difference in clinical training for ppl who go to CBT oriented versus psychodynamic schools is in connection to the supervisory process which has implications for therapist skill and ability at the post doctoral level & beyond. The difference involves process notes.1/n In hardcore psychodynamic supervision, you might be asked to write a process note for each session which just about the worst possible task ever. It involves literally writing down every thing, every utterance from the session you can remember in like movie script form.2/n

While everyone loves the throw shade on the chemical imbalance theory of depression, I would like to remind everyone that neurotransmitters are chemicals & balance refers to their activity in the brain. Greater or lesser activation of a neurotransmitter refers to differences

1/ in levels of that neurotransmitter (ie its balance.) Aside from physiological activity like action potentials and volumetric changes in matter in different regions, the list of physical substrates one can point to in the brain is limited.

2/

“Daniel, have u been to the unit yet?”
“No. Why? Should I have?”
“Yes you should go there now. They may need to call on all available on your patient, XXXX.”
[hurries to unit. Patient is standing on the couch screaming & sees me]: “Fuck my coordinator, white devil. White devil!!” Me: [back at rounds]. “It didn’t go that well. He called me a white devil and was screaming, cursing at me so I left.”

Attending: [looking down at unrelated notes; monotone] “alright.”

Integrative model of #psychopathology - bridging the gap b/t categories & dimensions:

Two broad categories of functioning - (a) self-regulation and (b) attachment - with sub-facets that covary in specific patterns representing pathological syndromes with a categorical quality. (A) Self-regulation
A1. defense styles
A2. coping skills
A3. Emotional functioning
A4. Self-control skills

(B) Attachment
B1. Attachment style
B2. Interpersonal Patterns
B3. Object-relations

Need to add other dimensions tbh. TBC.

The built-in. Evidently. I think it’s great but looks a little like a kitchen and it’s not in the kitchen.

One political party celebrates Orban reciting Hitler at their convention. One political party facilitates-if not promotes-forcing child rape victims to give birth or face criminal penalties.

1/ One political party exploits having visible Nazi supporters as evidence of woke hysteria. One political party is totally out of control, capable of anything, on a fascist bender.

2/