Playfulness and adolescence: mentalization and neuropsychoanalysis perspective.

The article attempts at conceptualizing the basic principles of how adolescents develop, getting out of childhood and proceeding to enter young adulthood. The age period of adolescence is marked with intense emotional states, lines of thinking, beliefs and transitions that caregivers often face challenges making sense of or mirroring. Combining mentalization-based approaches with neuropsychoanalytic findings about how basic emotional systems governing playful behavior work can shed additional light into the communication channels and specificities therapists might consider when engaging in such endeavor.

Self and Others: Empirical and Neuropsychoanalytic Considerations of Superego and Conscience.

Freud's mature theorizing about human morality entrenched the functioning of the superego in anxiety stemming from the fear of punishment, a view with which many later psychoanalysts took issue, producing a debate as to the distinction between superego and conscience. This debate would later be mirrored more broadly in academic psychology concerning distinctions between shame and guilt. This is an area where the clinical observations and theoretical discussions of psychoanalysis have subtly guided research in cognitive psychology and the cognitive and affective neurosciences. These areas, in turn, have both clarified and supported psychoanalytic theory and practice without negating the rich phenomenological and theoretical basis on which psychoanalysis rests.

CULTURAL HISTORY OF PSYCHOANALYSIS IN THE AGE OF NEUROSCIENCE.

In this paper I have chosen the topic of psychoanalysis in the age of neuroscience, with the aim of showing why the cultural history of psychoanalysis still matters. To make myself better understood I shall refrain from evaluating the current findings in neuroscience and limit myself to reporting briefly on them. Although I do not regard myself by any means as an expert in that field, I may be permitted to offer a few ideas about it. In this regard, there is presently a significant predominance of biological ideologies and practices regarding the treatment of mental illness, which implies an increase in the interest in etiology, nosology, definitions, and the effectivity of treatments. Even so, those psychoanalytic historians and/or analysts among us who are committed to psychoanalysis and its therapeutic implications, irrespective of what drugs might be prescribed and what the research findings might conclude, believe that patients still want to be listened to in depth and always will. For that reason, it is justified to ask why the cultural history of psychoanalysis still matters in a contemporary mental health environment that is ever more oriented towards the neurosciences.

Drive, instinct, reflex-Applications to treatment of anxiety, depressive and addictive disorders.

The neuropsychoanalytic approach solves important aspects of how to use our understanding of the brain to treat patients. We describe the neurobiology underlying motivation for healthy behaviors and psychopathology. We have updated Freud's original concepts of drive and instinct using neuropsychoanalysis in a way that conserves his insights while adding information that is of use in clinical treatment. Drive (Trieb) is a pressure to act on an internal stimulus. It has a motivational energic source, an aim, an object, and is terminated by the satisfaction of a surge of serotonin. An instinct (Instinkt) is an inherited pattern of behavior that varies little from species to species. Drives are created by internal/ventral brain factors. Instincts require input from the outside that arrive through dorsal brain structures. In our model unpleasure is the experience of unsatisfied drives while pleasure if fueled by a propitious human environment. Motivational concepts can be used guide clinical work. Sometimes what had previously described psychoanalytically as, "Internal conflict," can be characterized neurobiologically as conflicts between different motivational systems. These motivational systems inform treatment of anxiety and depression, addiction in general and specific problems of opioid use disorder. Our description of motivation in addictive illness shows that the term, "reward system," is incorrect, eliminating a source of stigmatizing addiction by suggesting that it is hedonistic. Understanding that motivational systems that have both psychological and brain correlates can be a basis for treating various disorders. Over many papers the authors have described the biology of drives, instincts, unpleasure and pleasure. We will start with a summary of our work, then show its clinical application.

Neuromimesis: Picturing the Humanities Picturing the Brain.

What do neuroscientific visualizations of mental functioning depict? This article argues that neuroscientific imaging from Santiago Ramón y Cajal's pen and ink drawings onward falls within the mimetic tradition, that dealing with the artistic representation of reality. Cajal's iconic images of pyramidal neurons and glial cells surprisingly suggest a non-realist approach to picturing the brain and the mind that opens a new methodological link between humanities and neurosciences. In it, aesthetic works offer a perspective on mimetic practices in neurosciences, providing insight into representational strategies that make otherwise invisible psychic phenomena observable. This approach draws needed attention to the role of metaphor in neuroscientific research. It also reimagines how interdisciplinary scholarship might engage with works of art. While it is a common practice to read humanities objects featuring the brain and/or the mind in terms of their neuroscientific content, films like The Headless Woman (La mujer sin cabeza, dir. Martel, 2008), explored here, show that doing so can easily inhibit interpretations with greater explanatory bearing. Together, Cajal's images and Martel's film help elaborate a fresh methodological paradigm-distinct from that of neuropsychoanalysis-that situates aesthetic objects as a long-neglected tool for studying the brain by virtue of (not despite) their imaginative investments.

Incorporating Brain Explanations in Psychoanalysis: Tennessee Williams as a Case Study.

Despite Tennessee Williams's genius as a playwright who could represent his inner emotional struggles in his art, psychoanalysis was unable to free him from the powerful "blue devils" within him. Williams's inability to engage with psychoanalysis presents an opportunity to discuss ways that contemporary thinking about brain structure and function might guide our understanding and treatment of patients such as Williams. One of the core defensive behaviors that made analysis difficult for Williams was his avoidance of painful emotions through compulsive writing, sex, alcohol, and drug-addictive behaviors. These pre-mentalized reactions became Williams's habitual procedural body response, which occurs below the level of the self-reflective brain. Within a relatively traditional ego psychological frame, Lawrence Kubie, Williams's analyst in 1957, attempted to prohibit the compulsive behaviors to be able to process the underlying painful affects in the analysis. However, given that this level of mind and brain functions was Williams's chief means of regulation, Williams could not engage in the psychoanalytic process and left the treatment after one year. I propose that Williams was operating in brain circuits below the level of "higher" reflection or interpretation-receptive circuits and therefore he was unable to make use of a traditional ego psychological model. A review of these brain circuits seeks to encourage therapists to utilize simplified brain explanations for patients, which can destigmatize the pathologic behaviors and enhance engagement in the treatment process.

Clinical wisdom, science and evidence: The neglected gifts of psychodynamic thinking.

We review five key areas of contemporary psychodynamic practice and research to highlight the contributions psychodynamic concepts can make to clinical psychiatry. These areas are as follows: (1) Contributions to understanding the development of subjectivity. (2) The psychodynamic understanding of the effects of early childhood trauma and their consequences in adult life. (3) The vital importance of the psychodynamic notion of the 'holding environment' based on an understanding of the dynamics of the development of subjectivity and trauma which, if applied, might improve the quality of psychiatric care in the public mental health system and enhance both the clinical competence and morale of clinicians in the system. (4) The emerging scientific disciplines of Neuropsychoanalysis and Affective Neuroscience, which illustrate the importance of seriously studying the mind as well as the brain. (5) A brief summary of some research into the clinical effectiveness and efficacy of psychoanalysis and its related psychodynamic therapies.

Affective Neuroscience Contributions to the Treatment of Addiction: The Role of Social Instincts, Pleasure and SEEKING.

Addiction is an illness prevalent in the worldwide population that entails multiple health risks. Because of the nature of addictive disorders, users of drugs seldom look for treatment and when they do, availability can be difficult to access. Permanence in treatment and its outcomes vary from case to case. Most models work from a multidisciplinary approach that tackles several dimensions of addictive disorders. However, the different etiological factors claim for a personalized treatment to enhance opportunities for better results. Problems in relationships with others play an important role in the etiology and the recovery process of addiction. This paper focuses on the social-environmental causes of addiction based on an affective neuroscience approach that attempts to integrate the interplay between social instincts, pleasure, and the SEEKING system in addiction. To advance toward better treatment strategies, it is pertinent to understand the limitations of the current multidisciplinary models. Acknowledging the social nature of the human brain may help to identify the quality of different types of traumatic early life experiences in drug users and how to address them in what may become a neuropsychoanalytic treatment of addiction.

"Project for a Spatiotemporal Neuroscience" - Brain and Psyche Share Their Topography and Dynamic.

What kind of neuroscience does psychoanalysis require? At his time, Freud in his "Project for a Scientific Psychology" searched for a model of the brain that could relate to incorporate the psyche's topography and dynamic. Current neuropsychoanalysis builds on specific functions as investigated in Affective and Cognitive (and Social) Neuroscience including embodied approaches. The brain's various functions are often converged with prediction as operationalized in predictive coding (PC) and free energy principle (FEP) which, recently, have been conceived as core for a "New Project for Scientific Psychology." We propose to search for a yet more comprehensive and holistic neuroscience that focuses primarily on its topography and dynamic analogous to Freud's model of the psyche. This leads us to what we describe as "Spatiotemporal Neuroscience" that focuses on the spatial topography and temporal dynamic of the brain's neural activity including how they shape affective, cognitive, and social functions including PC and FEP (first part). That is illustrated by the temporally and spatially nested neural hierarchy of the self in the brain's neural activity (second and third part). This sets the ground for developing our proposed "Project for a Spatiotemporal Neuroscience," which complements and extends both Freud's and Solms' projects (fourth part) and also carries major practical implications as it lays the ground for a novel form of neuroscientifically informed psychotherapy, namely, "Spatiotemporal Psychotherapy." In conclusion, "Spatiotemporal Neuroscience" provides an intimate link of brain and psyche by showing topography and dynamic as their shared features, that is, "common currency."

The Emergence of Psychoanalytic Metaneuropsychology: A Neuropsychoanalytically Informed Reconsideration of Early Psychic Development.

This paper is principally concerned with reappraising some of the major disagreements that separated the Viennese and the London Kleinians during the British Psychoanalytical Society's Controversial Discussions. Of particular focus are questions pertaining to the genesis of ego development, the beginnings of object-relating, and the role of unconscious phantasy in respect of these phenomena. The aim of the investigation is to inquire into the light that may be shed on the once intractable conflicts surrounding these questions by bringing to bear more recent developments from psychoanalysis and the neurosciences. First, various key issues from the Controversial Discussions are outlined, before the paper turns to work by Jaak Panksepp and Mark Solms that bears on these older arguments and the Freudian theories that underpinned them. With these conceptual foundations established, three questions are posed and discussed with a view to understanding the implications of recent neuropsychoanalytic thinking for some of the entrenched conflicts that divided the British Society. These questions include: (1) what does it mean for the ego if the id is conscious? (2) What does recent neuroscientific knowledge tell us about whether the ego should be thought of as present from birth? (3) How can we understand and locate unconscious phantasy if the main part of the mind that Freud thought of as unconscious is not so? Research from the arena of infant development-particularly the material and analysis of infant observation-is drawn on to illustrate various conclusions. The paper ultimately concludes that taking such an interdisciplinary approach can reveal renewed justification for aspects of the Kleinian metapsychology.

Clinical Applications of Neuropsychoanalysis: Hypotheses Toward an Integrative Model.

Neuropsychoanalysis has been established as a field based on the dialog between psychoanalysis and the neurosciences. Freud was a neurologist for 20 years and used the neuroscientific knowledge of his time as the foundation of his metapsychology. Psychoanalysis has predominantly relied on its own method to develop techniques for the different psychoanalytic treatments. It rarely uses contributions from fields outside psychoanalysis that could enrich its understanding of the mind. Neuropsychoanalysis has informed and revised several topics in psychoanalysis, for example consciousness and the unconscious, dreams, and affect amongst many others. Clear clinical applications of neuropsychoanalysis can be appreciated in the work with neurological patients. However, a constant question from clinicians is whether neuropsychoanalytic findings can contribute to psychoanalytic treatments with non-neurological patients. This paper explores clinical applications of neuropsychoanalysis mainly based on affective neuroscience to propose an analysis of emotions that may contribute to the gradual development of a neuropsychoanalytically informed psychotherapy. The task of integrating neuroscientific knowledge into psychoanalytic technique is still considered a challenge of accentuated complexity, but it is at the same time a necessary and promising endeavor that aims at improving the quality of the treatments available for human suffering and psychopathology.

Against Neuropsychoanalysis: Why a Dialogue With Neuroscience Is Neither Necessary nor Sufficient for Psychoanalysis.

The author argues against neuropsychoanalysis by focusing on the metaphysical issues. Neuropsychoanalysts argue that the philosophical theories of dual aspect monism (DAM) and anomalous monism support their position. The author contends that not only do DAM and anomalous monism not offer support for neuropsychoanalysis; they are also inconsistent with its claims. The conceptual distinction between the mental and the physical - the so-called "epistemological dualism" cited by neuropsychoanalysis-stands as an insurmountable barrier to the project of neuropsychoanalysis. By way of example, the author offers an analogy with artworks. The author concludes the paper by arguing that neuropsychoanalysis deflects from the real project of psychoanalysis, which is the study of persons, not so-called "mindbrains."

Affective Neuroscience: The Suitability of a Web App to Monitor Affective States at Work.

This work describes in detail the use of a new tool, a web-app, based on the conceptual framework of affective neuroscience, in particular on Panksepp's 7 basic emotional systems. Affective neuroscience has been used effectively in many areas, but there have been very few applications in the workplace, due to the lack of a smart implementation tool. The novelty of this work does not lie in the new information, but in a new "clinical" approach. There is a theoretical framework that allows data to be interpreted rather than simply described. Furthermore, the knowledge of working realities through the web app is specific and longitudinal. Finally, emotions are detected in hic et nunc, so the role of reflexive-cognitive mediation and recall bias are minor. This "more situated" knowledge can then guide specific leadership strategies. This paper presents the results of the tool's application in a company in Northern Italy. The findings of our project, which recorded basic affective states and the functioning of several working teams, are detailed herein. The project's 488 web-app records are summarized in this report, alongside our examination of related mood tags. Through this project, our analysis has enabled to determine affective neuroscience profiles of the teams analyzed, allowing the researchers to identify areas of possible interventions. The data appear very encouraging.

Drive and Instinct-How They Produce Relatedness and Addiction.

Addictive drugs are responsible for mass killing. Neither persons with addiction nor the general populace seem conscious of the malevolence of governments and drug dealers working together. How could this be? What is the place of psychoanalysis in thinking about deaths from addiction and in responding to patients with addiction? To answer these questions, we revise concepts of SEEKING, drive, instinct, pleasure, and unpleasure as separable. We review the neurobiological mechanism of cathexis. We discuss how addictive drugs take over the will by changing the SEEKING system. We review how opioid tone in the central nervous system regulates human relationships and how this endogenous hormonal system is modified by external opioid administration. We differentiate the pleasure of relatedness from the unpleasure of urgent need including the urgent need for drugs. We show how addictive drug-induced changes in the SEEKING system diminish dopaminergic tone, reducing the motivation to engage in the pursuit of food, water, sex, sleep, and relationships in favor of addictive drugs. With this neuropsychoanalytic understanding of how drugs work, we become more confidently conscious of our ability to respond individually and socially.

Revision of Drive Theory.

Several deep revisions of Freud's theory of the drives are proposed: (1) Drives are conscious and are in fact the source of all consciousness. (2) Drive energy is equated with variational free energy and is therefore quantifiable in principle. (3) There are not two drives but many, seven of which may be described as "emotional" as opposed to "bodily" drives. (4) All drives are self-preservative or preservative of the species; there is no death drive at work in the mind. This means, at the mechanistic level, that all drives are homeostatic and anti-entropic. (5) The great task of mental development is to supplement instinctual predictions about how our multiple drive demands may be met and reconciled with each other. This work is done by learning from experience, mainly through voluntary behavior, which is governed by conscious feelings.

Childhood Trauma, Personality, and Substance Use Disorder: The Development of a Neuropsychoanalytic Addiction Model.

BACKGROUND: While traditional psychoanalysis has been criticized as insufficient for the treatment of substance use disorder (SUD), recent progress in the field of neuropsychoanalysis has generated new and promising hypotheses regarding its etiology. However, empirical research applying this framework has been sparse. AIM AND SCOPE: The present overview aims at developing and empirically validating a neuroscientifically informed psychodynamic framework regarding the etiology of SUD. For this purpose, this review provides a concise overview of the most relevant historical and contemporary psychoanalytic theories on SUD etiology. Furthermore, the original research summarized in this paper consists of three studies investigating connections between childhood trauma, primary emotions, personality structure and attachment, as well as their relation to SUD development and treatment. CONCLUSIONS: The results highlight the empirical validity of the neuropsychoanalytic approach towards SUD etiology. In particular, the findings underscore the conceptualization of SUD as a disorder related to dysfunctional attachment and affect regulation abilities especially linked to increased SADNESS and ANGER dispositions, which mediated the relationship between SUD and traumatic childhood relationships. Based on these findings, a refined model of SUD etiology is proposed, which should be tested in future studies.

O nascimento e o desenvolvimento da neuro-psicanálise / The birth and development of neuro-psychoanalysis / El nacimiento y desarrollo del neuro-psicoanálisis

A Neuro-Psicanálise é uma área de investigação e estudo conceptual e epistemológico focado na reavaliação das hipóteses propostas pelo modelo psicanalítico da mente perante o recente manancial de novos dados científicos provindo de diferentes áreas de Cérebro e da sua atividade cerebral, o que tem permitindo o desenvolvimento e esclarecimento dos modelos neuro-dinâmicos relacionados com a atividade mental tanto consciente, assim como inconsciente. Os autores fizeram uma resenha sobre as circunstâncias de ordem histórica, filosófica e científica por detrás do nascimento deste movimento de diálogo entre a Psicanálise e as Neurociências Modernas, a Sociedade Internacional para a Neuro-Psicanálise, cujos fundamentos históricos estão consubstanciados na própria obra e vida de Sigmund Freud, o qual iniciou a vida profissional, como investigador em laboratórios de histologia médica, aí se interessou pelo estudo do sistema nervoso central e mais tarde iniciou atividade clínica em Neurologia. Somente a partir dos anos 50 do Seculo XX ocorreram as primeiras iniciativas precursoras para uma investigação neurocientífica moderna e foi na década de 80 que começou a surgir o manancial de dados científicos provindos de diferentes áreas de investigação neurológica, os quais permitem aventar as possibilidades de existirem eventuais correlações e correspondências entre os termos psicológicos e psicanalíticos com certas áreas e circuitos neurofisiológicos do Cérebro, assim possibilitando reabertura de um diálogo tão desejado por Freud e expresso na sua monografia intitulada: "Projecto para uma Psicologia Científica" de 1895, entre o modelo psicanalítico da Mente e os modelos neurobiológicos e neurocientíficos do Cérebro.

Neuro-Psychoanalysis is an area of conceptual and epistemological research focused on the reevaluation of hypotheses proposed by the psychoanalytic model of Mind (Psyché) facing recent and new scientific data emerging from the investigations over different Brain's areas and activities, which allows a development and clarification of new neuro-dynamic models related to both conscious and unconscious mental activity. The authors reviewed the historical, philosophical and scientific circumstances behind the birth of this movement of dialogue between Psychoanalysis and Modern Neurosciences, the International Society for Neuro-Psychoanalysis, whose historical foundations are embodied in the work and life of Sigmund Freud, who started his professional life as a researcher in medical histology laboratories and became interested in the study of the central nervous system and later on began his clinical practice in Neurology. Only at the decade of the 50s, the first precursor initiatives over modern neuroscientific research have taken place and only at the 80s emerge several sources of scientific data from different areas of neurological research which allowed the first possibilities for possible correlations and correspondences between psychological and psychoanalytic terms with certain areas and neurophysiological circuits of the Brain, thus enabling the reopening of a dialogue desired by Freud, in his monograph entitled: "Project for a Scientific Psychology" from 1895, between the psychoanalytic model of Mind and new neurobiological and neuroscientific models of the Brain.

El neuro-psicoanálisis es un área de investigación y de estudio conceptual y epistemológico centrado en la reevaluación de las hipótesis propuestas por el modelo psicoanalítico de la Mente frente a la riqueza reciente de nuevos datos científicos provenientes de diferentes áreas del Cerebro y su actividad cerebral, lo que ha permitido desarrollo y clarificación de modelos neurodinámicos relacionados tanto con la actividad mental consciente como inconsciente. Los autores revisaron las circunstancias históricas, filosóficas y científicas detrás del nacimiento de este movimiento de diálogo entre la Psicoanálisis y las Neurociencias, la Sociedad Internacional para el Neuro-Psicoanálisis, cuyos fundamentos históricos están encarnados en el trabajo y la vida de Sigmund Freud quien comenzó su vida profesional como investigador en laboratorios de histología médica e se interesó en el estudio del sistema nervioso central y más tarde comenzó la actividad clínica en Neurología. Solo a partir de los años 50 del siglo XX tuvieron lugar las primeras iniciativas precursoras para la investigación neurocientífica moderna, y fue en los años 80 que comenzó a surgir la fuente de datos científicos de diferentes áreas de la investigación neurológica, lo que permite avanzar las posibilidades de la existencia de posibles correlaciones y correspondencias entre términos psicológicos y psicoanalíticos con ciertas áreas y circuitos neurofisiológicos del cerebro, permitiendo así la reapertura de un diálogo tan deseado por Freud en su monografía titulada: "Proyecto para una psicología científica" de 1895 entre el modelo psicoanalítico de la mente y los nuevos modelos neurobiológicos y neurocientíficos del cerebro.