Psychoanalysis of COVID-19 Patient Narratives: A Descriptive Study.

Background and Objectives: COVID-19 patients are a psychologically vulnerable patient group who suffer from both physical symptoms and psychological problems. The present study is a psychoanalytic investigation of COVID-19 patients utilizing Lacan's desire theory. We aimed to explore the manner in which patients' desire is presented in their lived experience narratives and sought to discover factors which directly impacted on this process. Materials and Methods: In-depth semi-structural interviews were conducted with 36 COVID-19 patients in China. During each interview, participants narrated their lived experiences of COVID-19 infection. Emotions, metaphors, and behaviors in patient narratives were collated as the main points for psychoanalysis. Results: Our findings demonstrated that the desire for being a healthy person made patients emotionally sensitive to the social environment. Anxiety and obsessive behaviors emerged in the process, which reveals their desire for that which they lack. Furthermore, public fear with respect to COVID-19 was somehow converted to psychological pressure on COVID-19 patients. Thus, these patients attempted to "de-identify" their identity as "patients". Positive responses of COVID-19 patients to the external world included admiring medical personnel, government, and country, while negative responses included interpersonal conflicts or complaints about discrimination. Following the rules of the Other, COVID-19 patients were influenced by the Other's desire in constructing their own image of a healthy person. Conclusions: This study revealed COVID-19 patients' psychological need to rid themselves of the identity of "patient" at the individual and social level. Our findings have clinical implications in helping COVID-19 patients to reshape their identity and to live a normal life.

Through a Glass Darkly: a clinical journey.

The use of the empathic mode for engaging and communicating with patients has become widely accepted by many psychoanalytic psychotherapists since Kohut's early formulations (Kohut, 1971; Atwood & Stolorow, 2014). However, diagnostic understanding based on ongoing empathic immersion with our patients is often complicated because it is continually being modified as we know them more deeply and as transference and countertransference factors influence our perceptions. To illustrate the complexity of diagnosis when it is grounded in ongoing empathic engagement with our patients, I describe in detail my treatment of an elderly woman who initially presented with severe and acute symptoms of psychological, cognitive, and physical impairment. As the treatment has progressed, my diagnostic understanding has been continually modified to include a combination of psychodynamic and organic factors including PTSD, intense unresolved grief, and extreme feelings of guilt and need for punishment. Adding further to this conundrum, I have been frequently challenged by my own responses to the fluctuations in her progress, especially to periods of hopefulness followed by periods of despair and regression.

Tales of COVID-19: Fear of Contagion and Need for Infection.

The pandemic has been such a dramatic experience that it has newly illuminated the factors that can transform Hegel's necessary "infection"-a permeability to the other and the intersubjective foundation of the ego-into a contagion that alienates the subject. The dialectic between these two kinds of otherness represents what is truly at stake in any encounter-i.e., mutual recognition. Therefore, despite the terrible load of concreteness and suffering that bears directly on psychoanalysis, the theater of analysis still stands, so that the "tales of COVID-19" should also be listened to as fictional, that is, as unconscious communications in the here and now.

Shared Trauma, the Renegotiation of the Frame, and the Preservation of What Is Essential: Transformations in Psychoanalytic Treatment in the Time of the Pandemic.

In this paper, the author describes a process, renegotiation of the frame, that emerged as he contemplated with his patients the continuation of work together in the face of the COVID-19 pandemic. Such a renegotiation lends itself to the formation of bastions, as described by Baranger and Baranger (1969); attention to these bastions demonstrates that the psychoanalytic process continues and can deepen. An extended clinical vignette is presented to illustrate. If a more broadly defined functional frame is considered, not only may the frame be used as a clinical tool in a more nuanced way, but in addition, aspects of the traditional narrowly defined frame may be seen to contribute to the formation of bastions that, unaddressed, could impede the analytic process.

Bound by Infinities: Technology, Immediacy and Our Environmental Crisis.

This paper explores the relationship between human desire, technology, and imagination, emphasizing (1) the phenomenology of this relationship, and (2) its ontological and ecological ramifications. Drawing on the work of Bion and Winnicott, the paper will develop a psychoanalytic container for attitudes contributing to our current climate-based crisis, paying special attention to the problematic effect technology has had on our sense of time and place. Many of our technologies stunt sensuous engagement, collapse psychic space, diminish our capacity to tolerate frustration, and blind us to our dependence on worlds beyond the human. In short, our technologies trouble our relationship to our bodies and other bodies. The paper argues that omnipotent fantasies organizing our relationship to technology, to each other, and to the nonhuman world, have cocooned us in a kind of virtual reality that devastates a sense of deep obligation to the environment.

The archetype of the apocalypse. Analysing the pandemics of racism, COVID-19 and climate change.

What we are witnessing in the present time in human history, in the 2020's, is a vortex of intersecting pandemics - jolting revelations that are unfolding with a terrific energy and force - so much so that we cannot ignore them or escape them. These include the world-wide pandemics of racism, COVID-19 and climate change. This paper argues that all of these swirling pandemics are manifestations of the archetype of the apocalypse, which is constellating now in a very powerful way. Any one of these phenomena could swallow humanity whole as a species. Together they represent a seemingly overwhelming challenge for us to meet over the next century of life on earth. If humanity cannot meet the challenge of these combined negative forces, it could simply perish. A multi-layered intersecting set of challenges such as this has never yet occurred in human history. We must therefore be very alert to what is going on, and as to how we can consciously mediate these threats, both individually and collectively. It also presents an unprecedented opportunity for humanity to evolve and grow psychologically both individually and collectively, nationally and globally.

Ce dont nous sommes témoins à l'heure actuelle dans l'histoire de l'humanité, dans les années 2020, est un vortex de pandémies qui s'entrecroisent - des révélations choquantes qui se déploient avec une énergie et une force formidables - tellement que l'on ne peut les ignorer ou leur échapper. Cela inclue la pandémie mondiale de racisme, la COVID-19, et le changement climatique. Cet article soutient que toutes ces pandémies tourbillonnantes sont des manifestations de l'archétype de l'apocalypse, qui se constelle en ce moment de manière très puissante. Chacun de ces phénomènes pourrait avaler l'humanité toute entière en tant qu'espèce. Ensembles ils représentent un défi apparemment insurmontable auquel nous avons à faire face durant le siècle à venir de la vie sur terre. Si l'humanité ne peut pas faire face au défi de ces forces négatives combinées, elle pourrait tout simplement périr. Un tel ensemble - de défis qui s'entrecroisent sur plusieurs niveaux - ne s'est encore jamais produit dans l'histoire humaine. Ainsi nous devons être très vigilants à ce qui se passe, et à comment nous pouvons consciemment opérer une médiation de ces menaces, à la fois individuellement et collectivement. Cela représente également une opportunité sans précédent pour que l'humanité évolue et grandisse psychologiquement à la fois individuellement et collectivement, au niveau de la nation et globalement.

Lo que estamos atestiguando en el presente de la historia humana, en el año 2020, es un vórtice de pandemias entrecruzadas - revelaciones que sacuden y se despliegan con tremenda fuerza y energía - tanto que no podemos ignorarlas ni escapar de éstas. Estas incluyen la pandemia mundial del racismo, el COVID-19 y el cambio climático. El presente trabajo argumenta que todas estas turbulentas pandemias son manifestaciones del arquetipo del apocalipsis, el cual se está constelando en la actualidad de manera poderosa. Cualquiera de estos fenómenos podría tragarse a la humanidad entera como especie. Juntas representen un aparentemente abrumador desafío para nosotros, a confrontar durante el próximo siglo de vida en la tierra. Si la humanidad no puede afrontar los desafíos de estas fuerzas negativas combinadas, podría simplemente perecer. Nunca ha ocurrido en la historia humana, una intersección de desafíos como éstos, en múltiples niveles. Tenemos que estar muy alertas respecto a lo que está pasando, y sobre cómo podemos conscientemente mediar estas amenazas, ambas individual y colectivamente. También presenta una oportunidad sin precedentes para que la humanidad pueda evolucionar y crecer psicológicamente, tanto individual, como colectivamente, nacional y globalmente.

George Floyd's death and COVID-19: inflection points in the Anthropocene Era?

George Floyd's death, the COVID-19 pandemic and climate change are on a continuum from the immediate shock of viewing a video-recorded murder, to millions dying worldwide from disease, to deaths related to climate change accumulating over a millennium. They participate in the powerful archetypes of death and inequality. 'Increase', Hexagram 42 in the I Ching, archetypically addresses inequalities at all levels - racial, economic, political and the profound imbalance between humans and the environment. Floyd's death highlights the consequences of systemic racism and income inequalities. The pandemic as 'nature's revenge' hits minority populations harder due to underlying health conditions resulting from poverty and greater exposure to the virus in the workplace. President Trump as Trickster showed Americans their shadow and his response to the pandemic amplified its severity. The pandemic has shocked our social, political and economic systems and paused our species rush into environmental disasters at many levels. The disruptions present opportunities for reflection, experimentation and developing new systems as old forms are challenged. The ecological dimensions of Jung's concepts emphasize interconnectedness at all levels and the paradigm shift he called a 'new age' provides a framework for altering the course of the Anthropocene Era.

La mort de George Floyd, la pandémie de COVID-19 et le changement climatique sont sur un continuum: du choc immédiat à la vue d'un meurtre enregistré sur une vidéo, aux millions de personnes dans le monde mourant de maladie, aux morts en lien avec les changements climatiques qui s'accumulent depuis plus de mille ans. Tout cela participe aux archétypes puissants de la mort et de l'inégalité. 'L'augmentation', l'Hexagramme 42 du Yi King, aborde de manière archétypale les inégalités à tous les niveaux - racial, économique, politique et le déséquilibre profond entre les humains et l'environnement. La mort de Floyd souligne les conséquences du racisme systémique et des inégalités de revenus. La pandémie en tant que 'revanche de la nature' frappe les minorités plus durement du fait de conditions de santé fragilisées par la pauvreté et l'exposition plus élevée au virus sur le lieu de travail. Le président Trump comme archétype du filou a montré leur ombre aux Américains, et sa réponse à la pandémie en a amplifié la sévérité. La pandémie a secoué nos systèmes sociaux, politiques et économiques et provoqué une pause dans la précipitation de notre espèce vers des désastres environnementaux à plusieurs niveaux. Les perturbations offrent des opportunités pour réfléchir, pour expérimenter et développer de nouveaux systèmes tandis que les vieilles formes sont mises en cause. Les dimensions écologiques des concepts de Jung mettent l'accent sur l'aspect interconnecté à tous niveaux et le changement de paradigme qu'il a appelé « nouvel âge ¼ fournit un cadre de travail pour modifier le cours de l'Ere de l'Anthropocène.

La muerte de George Floyd, la pandemia del COVID-19 y el cambio climático están en un continuum que va desde el shock de mirar una muerte a través de una cámara de video, a millones muriendo alrededor del mundo por una enfermedad, a muertes relacionadas con el cambio climático acumulándose a través de los milenios. Estos forman parte de los poderosos arquetipos de la muerte y de la desigualdad. "El Aumento", Hexagrama 42 en el I Ching, aborda arquetípicamente las desigualdades a todos los niveles - racial, económico, político y el desbalance profundo entre los humanos y el contexto. La muerte de Floyd evidencia las consecuencias de un racismo sistemático, y de las desigualdades en los ingresos. La pandemia, como 'venganza de la naturaleza' afecta más duramente a las poblaciones minoritarias debido a las condiciones básicas de salud resultantes de la pobreza y de una mayor exposición al virus en los lugares de trabajo. El presidente Trump como Trickster mostró su sombra a los americanos y su respuesta a la pandemia amplificó la severidad de esta. La pandemia ha impactado nuestros sistemas social, político y económico y detuvo, a muchos niveles, la carrera de nuestra especie hacia los desastres medioambientales. Las alteraciones presentan oportunidades para la reflexión, la experimentación y el desarrollo de nuevos sistemas a medida que son desafiadas las viejas formas. Las dimensiones ecológicas de los conceptos de Jung enfatizan la interconectividad a todos los niveles y el cambio de paradigma que denominó'nueva era' provee un marco de referencia para alterar el curso de la Era Antropoceno.

Brazil: hate and intolerance in times of pandemic in a mixed-race country.

This paper intends to analyse the current political and social situation in Brazil and show how this context has influenced the management of the public health crisis generated by the COVID-19 pandemic. To this end, the authors conducted an investigation into Brazil's historical roots, which have not only engendered deep class differences but, also, social psychopathologies such as dissociation and perversion. Finally, this paper presents a symbolic analysis of social exclusion and how the mythical figure of Sophia can inspire a renewed movement of inclusion and tolerance.

Cet article se propose d'analyser la situation politique et sociale actuelle au Brésil et de montrer comment ce contexte a influencé la gestion de la crise sanitaire publique générée par la COVID-19. Dans ce but, les autrices ont conduit une enquête approfondie sur les racines historiques du Brésil, racines qui ont engendré non seulement de profondes différences de classes mais également des psychopathologies sociales, telles la dissociation et la perversion. Cet article présente en conclusion une analyse symbolique de l'exclusion sociale et montre comment le personnage mythique de Sophia peut inspirer un mouvement renouvelé d'inclusion et de tolérance.

El presente trabajo intenta analizar la situación actual política y social en Brasil y muestra como este contexto ha influenciado el manejo de la crisis de la salud pública generada por la pandemia del COVID-19. A este fin, las autoras llevaron a cabo una investigación sobre las raíces históricas de Brasil, las cuales, no solamente han generado profundas diferencias de clase, sino también psicopatologías sociales como disociación y perversión. Finalmente, el presente trabajo presenta un análisis simbólico de la exclusión social y cómo la figura mítica de Sophia puede inspirar un movimiento renovador de inclusión y tolerancia.

[Cough as a Psychosomatic Entity - A short journey through historical and current concepts, and impacts of the corona pandemic]. / Husten aus Sicht der Psychosomatischen Medizin.

Cough as a Psychosomatic Entity - A short journey through historical and current concepts, and impacts of the corona pandemic Abstract. In this chapter, we focus on the psychosocial relevance of the symptom and the phenomenon cough. We will be reflecting about cough in the current corona crisis and will highlight a historical case that played an important role in the development of psychoanalytic theory. In the second part, we are outlining current psychosomatic concepts on coughing in order to elucidate the significance of this fundamental symptom.

Playing and virtual reality: Teleanalysis with children and adolescents during the COVID-19 pandemic.

What has come into question in our analytic practice with children and adolescents during the COVID-19 pandemic? Do the new practices related to the virtual allow the creation of a therapeutic playground and the continuity of an analytic process? In the literature, the effectiveness and the perplexities raised in teleanalysis with adults are described. Conversely, no research on the use of the virtual in child analysis is available. Given the specificity of the developmental age, the three authors present their clinical experience and theoretical and technical reflections on the remote setting with children and adolescents. Particular emphasis is given to the technical changes and to the deep meaning that these changes have had in reference to the analytic relationship. Using the Winnicottian theoretical vertex, the opposition between fetishistic and transitional use, the denial of separation and recognition of otherness in the analytic virtual space will be discussed using clinical examples. The video tool may generate in children a great excitement and unleash the infantile sexual perversions. The co-creation of an intermediate virtual playground allows sufficient psychic continuity to work on the unconscious material, and even to make emerge previous traumas that then find a chance to be worked-through.

Destructive populism as "perverted containing": A psychoanalytical look at the attraction of Donald Trump.

The author examines the appearances and formation processes of destructive populist developments in the Western world from a psychoanalytical perspective, using the example of Donald Trump and his voters. She draws on the concepts of Sigmund Freud, Melanie Klein, Wilfred Bion, Herbert Rosenfeld and Otto Kernberg, which build on each other, and drafts the basic features of a psychoanalytic explanatory model of destructive populist social processes. She illustrates the phenomenon of the ¼destructive populist fit« between Trump and his followers by means of an analysis of Donald Trump's well-documented election campaigns in 2016 and 2020, supplemented by his actions during the COVID 19 crisis in 2020. On the psychoanalytical understanding of the effectiveness of his methods and the susceptibility of voters to destructive populism, she applies Bion's model of containing in conjunction with Herbert Rosenfeld's destructive narcissism and develops the concept of ¼perverted containing«: in the course of regression to a paranoid-schizoid level, aggressively destructive and omnipotent affects are idealised and the container function of democratic society is increasingly decomposed, distorted and finally twisted. Beta-elements are not detoxified and digested but, on the contrary, are fueled. This dynamic implies permanent escalation through ever new destructive-exciting acts in order to maintain the symbiotic-destructive fit in the mode of destructive narcissism.