On the aesthetic illusion.

The aesthetic illusion--the experience of the content of a work of art as reality--occurs through the mobilization and intensification of typical infantile fantasies in the beholder. This necessarily evokes intrapsychic conflict in the mature adult. Two illusion-producing strategies ameliorate this conflict and effect the aesthetic illusion. The first illusion is that the artist's proffered fantasy is the beholder's own personal and private fantasy. This isolates the beholder from the shame- and guilt-evoking social surround. The second illusion is that the protagonist depicted in the work is an actual person. This defends the beholder from the painful emotions attendant upon his instinctually gratifying identification with the protagonist. The first illusion is necessary for the establishment of the second, but it is the second that establishes the aesthetic illusion. The aesthetic illusion exists in a highly unstable dynamic equilibrium with the beholder's usual reality orientation. If either orientation is too powerful, the dynamic equilibrium is disrupted and the aesthetic experience as such is abolished.

Constant mental change and unknowability in psychoanalysis.

Conflict and compromise formation are central aspects of mental life. They dispose to constant mental change. Limitations of knowability in psychoanalysis are inextricably connected with constant mental change--the latter sometimes diminishing unknowability and sometimes exacerbating it. This paper explores three kinds of unknowability in psychoanalysis and their relation to constant mental change. That relation clarifies to some degree the implications of certain controversial proposals for change in psychoanalytic theory, method, and technique.

Methotrexate and sulfasalazine promote adenosine release by a mechanism that requires ecto-5'-nucleotidase-mediated conversion of adenine nucleotides.

We and others have shown that an increased extracellular concentration of adenosine mediates the antiinflammatory effects of methotrexate and sulfasalazine both in vitro and in vivo, but the mechanism by which these drugs increase extracellular adenosine remains unclear. The results of the experiments reported here provide three distinct lines of evidence that adenosine results from the ecto-5'-nucleotidase- mediated conversion of adenine nucleotides to adenosine. First, pretreatment of a human microvascular endothelial cell line (HMEC-1) with methotrexate increases extracellular adenosine after exposure of the pretreated cells to activated neutrophils; the ecto-5'-nucleotidase inhibitor alpha, beta-methylene adenosine-5'-diphosphate (APCP) abrogates completely the increase in extracellular adenosine. Second, there is no methotrexate-mediated increase in extracellular adenosine concentration in the supernate of cells deficient in ecto-5'-nucleotidase, but there is a marked increase in extracellular adenosine concentration in the supernates of these cells after transfection and surface expression of the enzyme. Finally, as we have shown previously, adenosine mediates the antiinflammatory effects of methotrexate and sulfasalazine in the murine air pouch model of inflammation, and injection of APCP, the ecto-5'-nucleotidase inhibitor, abrogates completely the increase in adenosine and the decrement in inflammation in this in vivo model. These results not only show that ecto-5'-nucleotidase activity is a critical mediator of methotrexate- and sulfasalazine-induced antiinflammatory activity in vitro and in vivo but also indicate that adenine nucleotides, released from cells, are the source of extracellular adenosine.

Observation and theory in psychoanalysis: the self psychology of Heinz Kohut.

The development of self psychology by Heinz Kohut illustrates the influence of observational method on theory formation in psychoanalysis. In 1959 Kohut began to emphasize empathy and introspection over the traditional combination of free association and evenly suspended attention. This became an important part of a process of revision in psychoanalytic theory which culminated in self psychology. This paper demonstrates how and why that particular change in observational method influenced that particular revision of theory.

Psychoanalytic observation.

The recent focus on empathy as the essential activity in psychoanalytic data gathering has underemphasized the complexity of psychoanalytic observation and has failed to identify what truly makes it unique among modes of psychological investigation. It is a process that includes introspection and empathy. However, it also includes the analyst's observation of the patient's behavior, and particularly verbal behavior, in a way that is not necessarily empathic. The psychoanalytic use of introspection and behavioral observation together, as they are modified by the analysand's free association and the analyst's evenly hovering attention, provides a unique method of data gathering. The transient, mutually related regressions of analyst and analysand which partly constitute the analyzing instrument modify the field of observation available to both, providing better access to derivatives of the analysand's unconscious mental functioning. This more complex concept of psychoanalytic observation, as opposed to that in which empathy is predominant, has important implications for psychoanalytic training, clinical work, and theory.

On the analyzing instrument.

Starting from certain unpublished remarks by Otto Isakower about "the analyzing instrument," we de define it more precisely. The analyzing instrument has two constituents: a voluntary and controlled, situation-specific and goal-specific regressed state of mind in the analysand and a near-identical one of the same nature in the analyst. These parts function together through mutually evocative communication, leading to the elucidation of the analysand's unconscious fantasy-memory constellations.