Essay // Coronavirus (Covid-19 / SARS-CoV-2): A wake up call to Human Civilization

Coronavirus Chinois COVID-19

What we know about the ugly SARS-CoV-2 virus is that it is among a group of coronaviruses that causes diseases in animals and birds, and respiratory tract infections in humans. These infections tend to be mild, but in rarer forms such as the Middle East respiratory syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS) they can be fatal. The current outbreak declared by the World Health Organization (WHO) is caused by SARS-CoV-2 which has a close genetic similarity to bat coronaviruses and are thought to have been its likely origin.

 

The wild tornado in the body: how the infection starts and kills

COVID-19 seems to be spread in a similar way to cold and flu bugs; through droplets being left on surfaces after a person coughs or sneezes, which are then touched by other people and spread furtherThe Coronavirus (SARS-CoV-2 / CoVID-19) is currently killing thousands of people every hour globally and clinicians and pathologists are still trying to fully understand how it inflicts such damage as it tears through the human body. Although it well know that the lungs are ground zero (i.e. the main point of impact), the virus can extend to many other organs including the heart and blood vessels, kidneys, guts and brain. « Its ferocity is breathtaking and humbling », said Krumholz a cardiologist from Yale university.

The infection begins when an infected subject expels virus-laden droplets and another person inhales them, the SARS-CoV-2 coronavirus then enters the nose and throat and finds a comfortable home in the lining of the nose according to scientists from the Wellcome Sanger Institute. This region is lined with cell-surface receptor known as ACE2 (i.e. Angiotensin-converting enzyme 2) which are present throughout the body to help regulate blood pressure but it also marks tissues vulnerable to infectionThe virus requires this receptor to enter a cell, and once inside it hijacks the cell’s machinery, multiplies itself and takes over new cells. During the period where the virus is multiplying itself, an infected person may shed copious amounts of it, especially during the first weekThere may not be any symptoms at this point, or the victim may develop a fever, dry cough, sore throat, loss of smell and taste, or head and body achesIf the immune system does not destroy the virus at this early stage, then it moves down the windpipe and starts to wreck havoc in the lungs where it can become deadly.

The thinner, distant branches of the lungs respiratory tree end in tiny air sacs called alveoli [alveolus (single], each lined by a single layer of cells that are also rich in ACE2 receptors, the very same receptors that allows the virus to penetrate. When we are in good health oxygen crosses the alveoli into the capillaries, which are tiny blood vessels that lie beside the air sacs (alveoli), this oxygen is then transported to the other regions of our bodyBut, when the immune system is stressed and fighting ardently against the virus, the battle disrupts the oxygen transferThe front-line white blood cells release inflammatory molecules called chemokines, which in turn create more immune cells that target and destroy virus-infected cellsWhen these infected cells are destroyed by the chemokines, they leave a stew of fluid and dead cells – pus – behindThis process is the scenario that takes places in pneumonia and the corresponding symptoms are: coughing; fever; and fast, shallow breathing. In some cases, we find COVID-19 patients who recover, sometimes simply with oxygen breathed in through nasal prongs.

However, in other unfortunate scenarios, patients often deteriorate suddenly to develop a condition referred to as acute respiratory distress syndrome (ARDS), where they struggle to breathe as the oxygen levels in their blood falls abruptly. On x-rays and computed tomography scans, the lungs of these patients are shown to be riddled with white opacities where instead healthy dark space [i.e. air] should beThese cases end up on ventilators and many dieAutopsies have shown their alveoli (air sacs) stuffed with fluid, white blood cells, mucus and the detritus of destroyed lung cells.

Coronavirus COVID-19 Breathing, lungs, alveoli, immune system

Image: The cross section shows immune cells crowding an inflamed alveolus (air sac) whose walls break down during attack by the virus causing reduced oxygen intake – patients cough, experience rising fever and breathing becomes difficult

Some clinicians are suspecting the driving force that leads to severely ill patients’ downhill trajectory and death to be a disastrous overreaction of their own body’s immune system, a reaction referred to as a « cytokine storm« , which viral infections are known to trigger. Cytokines are chemical signaling molecules that guide a healthy immune response, however, in a cytokine storm, the level of cytokines rise beyond the level of what is needed, and hence this excessive rush [i.e. storm] of immune cells also start to attack and destroy healthy tissues – these individuals’ blood vessels leak, blood pressure drops, blood clots form, and catastrophic organ failure can follow.

Some studies (Chen et al., 2020) have demonstrated elevated levels of these inflammation-inducing cytokines (Huang et al., 2020) in the blood of hospitalised COVID-19 patients. Jamie Garfield, a pulmonologist who treats COVID-19 patients at the Temple University Hospital argues that the real morbidity and mortality of this disease is probably driven by this out of proportion inflammatory response of the human immune system to the virus. However, other medical professionals are not convinced. “There seems to have been a quick move to associate COVID-19 with these hyperinflammatory states. I haven’t really seen convincing data that that is the case,” said Joseph Levitt, a pulmonary critical care physician at the Stanford University School of Medicine. Levitt is also worried that efforts to develop several drugs to dampen the cytokine response could actually cause harm by suppressing the immune response that our body needs to fight off the virus.

We find different views among the academic community on this new virus. Others are viewing it from a completely different perspective, and are focusing on the heart and blood vessels, that they believe is playing a significant role in the rapid deterioration of some patients.

Tearing the heart

All the classic symptoms of a heart attack was observed in a 53-year-old Italian woman in Brescia along with signs in her electrocardiogram and high levels of blood marker suggesting damaged cardiac muscles. Further tests revealed cardiac swelling and scarring, and a left-ventricle – which is usually the powerhouse chamber of a human heart – so weak that only one-third of the normal amount of blood could be pumped. When doctors injected dye in her coronary arteries to look for what they believed to be a blockage that is usually associated with heart attacks, they found nothing. The next test carried out revealed that the culprit was in fact COVID-19.

It is still a mystery to academics how the virus attacks the heart and blood vessels but many preprints and scientific papers attest that such damage is common. A JAMA cardiology paper observed damages to the heart in nearly 20% of COVID-19 patients (Shi et al., 2020) out of 416 hospitalised patients in Wuhan, China. Another Wuhan study revealed that 44% of 36 patients admitted in ICU had arrhythmias, i.e. irregular heart beats (Wang et al., 2020).

What has been discovered, is that the disruption extends to blood itself. Among 184 COVID-19 patients in a Dutch ICU, 38% had blood that clotted abnormally, and about one-third already had clots (Klok et al., 2020). Blood clots are very dangerous since they can break apart and end up landing in the lungs, blocking vital arteries – a condition known as pulmonary embolism, which has killed many COVID-19 patients. Blood clots from arteries can also end up in the brain, causing stroke. Many COVID-19 patients have dramatically high levels of D-dimer, a byproduct of blood clots. Hence, it is very likely that blood clots have a major role in the disease severity and mortality with the COVID-19 pandemic.

Infection may also lead to the constriction of blood vessels. There are reports emerging of ischemia [i.e. an inadequate blood supply to an organ or part of the body, especially the heart muscles] in the fingers and toes – reduction in blood flow can cause swollen, painful digits and eventually tissue death. Blood vessels carry oxygen to various parts of our body, and when they become constricted problems will logically arise. In the lungs, the constriction of blood vessels may explain the reports of a very perplexing phenomenon seen in patients with pneumonia caused by COVID-19: some patients although having extremely low blood-oxygen levels are not gasping for breath. Since we are still uncovering the depths of the virus, one explanation may be that at some stages of the disease, the virus modifies the delicate balance of hormones that regulate blood pressure and constricts the blood vessels going to the lungs. Logically, constricted blood vessels will lead to oxygen uptake being impeded – this may be the cause of low blood-oxygen levels rather than clogged alveoli (air sacks) as explained above.

It is very important to take note that if COVID-19 targets blood vessels, it may explain why patients with pre-existing damage to those vessels, such as those with diabetes and high blood pressure, face a higher risk of serious disease. The recent data from the Centers for Disease Control and Prevention (CDC) on hospitalised patients in 14 US states found that bout one-third had chronic lung disease and nearly as many had diabetes and half had pre-existing high blood pressure (Garg et al., 2020). It has also been observed that there is a very low number of cases suffering from asthma and other respiratory diseases. The risk factors seem to be vascular: diabetes, obesity, age and hypertensionAcademics are still in the dark regarding the causes of cardiovascular damageSince the lining of the heart and blood vessels are rich in ACE2 receptors just like in the nose and the alveoli, it is possible that the virus may be directly targeting and attacking themAnother possibility for cardiovascular damage could be the lack of oxygen caused by a combination of factors: lack of oxygen, chaos in the lungs and damages to blood vesselsA cytokine storm unleashed by the immune system itself could also be responsible for damages to the heart as it does for other organsCOVID-19 is a new virus and the academic community do not have all the answers to these questions: who is most vulnerable? Why some patients are hardly affected while others are hit so severely? Why does it develop so rapidly and why it is so hard for some patients to recover?

Destruction in multiple zones

While there is worldwide tension regarding the shortage of ventilators for failing lungsless attention has been given to dialysis machines. Jennifer Frontera, a neurologist from New York University’s Langone Medical Center who has treated thousands of COVID-19 patients pointed out that if patients are not dying from lung failure, they are dying from renal failure. Hence, her hospital is developing dialysis protocols with different machines to support additional patients. As usual, the ACE2 receptors, a favoured penetrating site for the virus, is abundantly present in kidneys. Going by a preprint, 27% of 85 hospitalised patients in Wuhan had kidney failure (Li et al., 2020). Another report read 59% of nearly 200 hospitalised COVID-19 patients in China’s Hubei and Sichuan provinces had protein in their urine (Diao et al., 2020), and 44% had blood clotboth suggest that kidney damage took placePatients with acute kidney injury (AKI), were more than five times as likely to die as COVID-19 patients without it, the same Chinese preprint reported.

“The lung is the primary battle zone. But a fraction of the virus possibly attacks the kidney. And as on the real battlefield, if two places are being attacked at the same time, each place gets worse,” says Hongbo Jia, a neuroscientist at the Chinese Academy of Sciences’s Suzhou Institute of Biomedical Engineering and Technology and a co-author of that study.

The electron micrographs from the autopsies of kidneys revealed viral particles (Diao et al., 2020), suggesting a direct viral attack. However, the kidney injury may also be a collateral damage caused by ventilators – that heighten the risk of kidney damage – as do some antiviral compounds such as remdesivir [which is being used experimentally in COVID-19 patients]. The immune system’s cytokine storms may also severely reduce blood flow to the kidney and often causing fatal damage. Diabetes can also increase the chances of kidney injury. Hence people with chronic kidney diseases are at a higher risk for acute kidney injury.

Combo hits to the brain

Another range of symptoms in COVID-19 patients focus on the brain and the central nervous systems (Mao et al., 2020). Frontera says that neurologists are required to assess 5% to 10% of coronavirus patients at her hospital and believes that it may be a gross underestimate of the number of patients whose brains are struggling since many are sedated and on ventilatorsPatients have suffered from brain inflammation, encephalitis (Moriguchi et al., 2020), with seizures and with a sympathetic storm [i.e. a hyper reaction of the sympathetic nervous system that causes seizure-like symptoms and is mostly observed after a traumatic brain injury]. Some COVID-19 patients even lose consciousness for a short amount of time while others suffer strokes. The loss of the sense of smell has also been widely reported. Frontera and others are asking themselves whether in some cases, infection depresses the brain stem reflex that senses oxygen starvation; this may provide an explanation to why despite dangerously low blood oxygen levels, patients are not gasping for air.

The former coronavirus behind the 2003 severe acute respiratory syndrome (SARS) epidemic – a cousin of COVID-19 – could infiltrate neurons and at times caused encephalitisSince ACE2 receptors are present in the neural cortex and brain stem, the virus could interact with those receptors and penetrate the brain. In a case study in the International Journal of Infectious Diseases, a team of academics from Japan found traces of COVID-19 traces in the cerebrospinal fluid of a patient who developed meningitis and encephalitis, insinuating that COVID-19 can penetrate the central nervous system.

COVID-19 encephalitis tissue damage in the brain

Image: Tissue damage in the brain (milky white areas shown by the arrows) as a result of encephalitis developed by a 58-year-old woman infected with COVID-19 / Source: (Poyiadji et al., 2020)

However, other factors could also be damaging the brain, such as a cytokine storm triggered by patients’ immune system itself, leading to swelling, and the blood’s exaggerated tendency to clot could trigger strokes. The collection of neurological data from care patients received is ongoing at a worldwide consortium that now include 50 centers in order to identify the prevalence of neurological complications in hospitalised COVID-19 patients and document how they fare.

The aim of course is to better understand the virus’ impact on the nervous system, including the brain. Sherry Chou, a neurologist speculates about an invasion route for the virus: through the nose, then upward through the olfactory bulb which connects to the brain, which may explain the loss of smell.

To the gut

Diarrhea with blood, vomiting and abdominal pain was reported in early March 2020 from a 71-year-old woman from Michigan who returned from a Nile river cruise. Doctors suspected the common stomach bug, e.g. Salmonella. However, after she developed a cough, nasal swabs revealed that she was positive for COVID-19. Gastrointestinal (GI) infection was diagnosed after a stool sample was positive for viral RNA and an endoscopy revealed signs of colon injury according to a paper in The American Journal of Gastroenterology (AJG) (Click to see).

This case adds to a growing body of evidence suggesting that like the SARS, COVID-19 can infect the lining of the lower digestive tract where, once again, the ACE2 receptors needed for the virus to enter are abundant. As many as 53% of sampled patients’ stool samples have shown to contain viral RNA. The virus’ protein shell was also found in gastric, duodenal and rectal cells in biopsies by a Chinese team who reported it in a paper in Gastroenterology (Xiao et al., 2020). “I think it probably does replicate in the gastrointestinal tract,” said Mary Estes, a virologist at Baylor College of Medicine.

Up to 50% of patients, making up about 20% across studies experience diarrhea. Gastrointestinal Infection (GI) however is not on the CDC’s list of COVID-19 symptoms which could lead to some COVID-19 cases to go undetected. The co-editor of Gastroenterology, Douglas Corley of Kaiser Permanente, Northern California said: “If you mainly have fever and diarrhea, you won’t be tested for COVID.”

So, can COVID-19 be passed on through feces? We do not know if the stool contains active, intact, infectious virus or simply RNA and proteins, there is no evidence to date. Based on experiments with SARS and with the virus that causes Middle East respiratory syndrome, a cousin of COVID-19, the risk from fecal transmission is probably low. 

Finally, the virus also affects the eyes as one-third of hospitalised patients develop conjunctivitis – reddish, watery eyes – although it is not clear if the virus directly attacks the eyes (Wu et al., 2020). Some other reports have also suggested liver damage since more than 50% of COVID-19 (Zhang, Shi and Wang, 2020) patients hospitalised in two Chinese centers had elevated levels of enzymes (Fan et al., 2020) which suggest injury to the liver or bile ducts. However, many experts reportedly told Science that direct viral hits are unlikely, stating that other events in a failing body, like drugs or an immune system overdrive, are more likely driving the liver damage.

It is important to note that these findings are just the beginning, and it will take years of serious research to fully understand COVID-19 along with the range of cardiovascular and immune effects it might trigger. We can only hope to find a way to stop this ugly virus in its track through the combined efforts of planet Earth’s scientific force and medical geniuses.

At present, whilst COVID-19 appears to be more contagious than SARS or MERS, the fatality rate is relatively low (around 3%) when compared with MERS (34%) and SARS (10%), with early data suggesting the elderly and those with underlying health conditions are at a higher risk.

In France, if Mentonians are concerned about coronavirus, it is in fact mainly for their elders. « Menton is a town of old people. If the epidemic spreads, they’ll all be dropping like flies. It’s going to be no man’s land, » said Denis, arm in arm with his 88-year-old mother. « I’m not afraid for myself: I know the virus won’t kill me. But I’ve told my mother, ‘you’re not going out of the house any more,’ » explained Véronique, in her fifties, as she folded a tablecloth from her shop in the centre of town.

By advocating the use of chloroquine to treat people suffering from Covid-19, the brave maverick, Professor Didier Raoult became the target of criticism in a very short time. Raoult did, however, receive some support, notably from Jean-Marie Bigard, who recounted one of his telephone conversations with the much-scorned professor. « We talked about how he thanked me for supporting him (…) And then he said something funny to me, saying: ‘All the time I was thinking about this story, I only thought about one thing, and that was your sketch about the bat,’ » the comedian said. Furthermore, even if it is not a miracle cure, a range of other medical professionals claim to have successfully treated a range of COVID-19 sufferers with hydroxychloroquine, while some studies have shown its ability to inhibit the virus in vitro.

Didier Raoult au micro d'Apolline de Malherbe sur BFM TV d'purb dpurb site web

Image: Didier Raoult au micro d’Apolline de Malherbe

While research is focusing on treatments and vaccines, Didier Sicard a professor from Sorbonne University also a specialist in infectious diseases who has a long experience in scientific work on the HIV, argued that researchers should go back on the field and inquire on the animal origin of the epidemic. Professor Sicard noted that the abrupt transformation of primary forests has brought humans closer to bats and hence a reservoir of viruses that has not yet been closely studied. While China has only recently, on the 24th of February 2020, immediately and completely banned all traffic and consumption of wild animals, conscious of its dietary culture of eating practically anything that moves, it is important to note that such a legislation exists since 2003 without it being strictly respected by Beijing. Hence, Professor Sicard reasonably argues for an international health court. The former Chair of the Advisory Committee on Ethics from 1999 to 2008 emphasizes the extent to which, in this epidemic, the issue of contact is paramount – everyone must behave like a model.

les dermatologues alertent sur de nouveaux symptômes cutanés d'purb dpurb site web

Image: Femme consultant son médecin / Woman consulting her doctor Source: AFP – B. BOISSONNET

Sicard also points out that the starting point of this pandemic is an open market in Wuhan where wild animals, snakes, bats, pangolins, preserved in wicker crates, accumulate. In China, these animals are bought for the Rat Festival and are quite expensive and considered as food of choice. In this wild meat market, these animals are obviously touched and handled by the vendors throughout the day, skinned, while they are stained with urine; ticks and mosquitoes also make a kind of cloud around these poor animals by the thousands. These conditions have meant that a few infected animals have inevitably infected other animals within a few daysOne can hypothesize that a vendor injured himself or touched contaminated urine before putting his hand to his face. Here we go! What strikes Sicard is the indifference at the starting point of this ugly virus. As if society was only interested in the point of arrival: the vaccine, the treatments, the resuscitation. But for this not to happen again, the starting point should be considered vital. And it’s impressive to see how it’s being neglected. The indifference to wildlife markets around the world is dramatic. It is said that these markets bring in as much money as the drug market. In Mexico, there is such a traffic that customs officers even find pangolins in suitcases.

Wildlife Alliance Pangolin Rescue (South America)

Image: Un pangolin sauvé au Mexique par la Wildlife Alliance / A pangolin being rescued in Mexico by the Wildlife Alliance

Estimated number of Asian pangolins in international trade between 1977 and 2012 as reported to CITES

Chart: Estimated number of Asian pangolins in international trade between 1977 and 2012 as reported to CITES, and estimated number of pangolins in illegal trade in Asia between July 2000 and 2013. Illegal trade is based on seizures made in or trade recorded in Cambodia, China, Hong Kong SAR, India, Indonesia, Lao PDR, Malaysia, Myanmar, Nepal, Pakistan, Philippines, Singapore, Sri Lanka, Taiwan (P.R. China), Thailand and Vietnam. Source: CITES trade database (UNEP World Conservation Monitoring Centre, Cambridge, UK), and for illegal trade, various sources / Source: (Challender, Harrop and MacMillan, 2015)

Jean-Christophe Ruffin, a doctor, diplomat and writer from the Académie Française said: “Now is not the time to burden anyone and sue, it will come. But they’ll have to be done. We’ll have to learn from this. This proves one thing: when we get out of this terrible crisis, as infectious disease specialists say, there will be others. And we can’t be in a situation like that again.”

« It is of course not the first time that animals are at the origin of sanitary crises, in fact they are responsible for the majority of epidemic crises: HIV, H5N1 avian flu, Ebola. These viral diseases always come from a reservoir of animal viruses », Sicard pointed out, and there’s almost no interest in them. It’s the same with dengue fever. “I have a very close relationship with Laos, and when the disease appears, the local people there say, ‘We have to control the mosquitoes’. But in reality, it is during the dry season, when there are only larvae, that a policy of exterminating mosquito larvae should be implemented. But nobody does it because people say ‘oh, there are no mosquitoes, why do you want us to use insecticides? And the Pasteur Institute of Laos is sputtering in vain, asking local people to make the effort before the disease bursts”, Sicard explained to France Culture, saying “It is exactly like the work that’s left to be done on the bats. They are themselves carriers of about 30 coronaviruses! We need to do some work on these animals. »

Pangolin sauvé des mains d'un trafiquant local, Uganda. 9 avril 2020.

Image: Pangolin sauvé des mains d’un trafiquant local, Uganda. 9 avril 2020 • Crédits : Isaak Kasamani – AFP

The latter also added: « Obviously, it is not very easy: going into caves, well protected, taking vipers, pangolins, ants, looking at the viruses they harbour, this is ungrateful work and often despised by laboratories. Researchers say: ‘We prefer to work in the molecular biology laboratory with our cosmonaut hoods. Going into the jungle, bringing in mosquitoes, is dangerous. Yet, these are by far the most important routes. Moreover, we know that these epidemics will start again in the years to come repeatedly if we don’t definitively ban the traffic of wild animalsThis should be criminalized as an open-air sale of cocaineThis crime should be punishable by imprisonmentI am also thinking of those battery farms for chicken or pork that are found in ChinaEvery year they give new flu outbreaks from viruses of avian origin. Gathering animals like that is not seriousIt is as if veterinary art and human medical art had nothing to do with each other. The origin of the epidemic should be the subject of a major international mobilisation.

Prof Sicard argued that we need to reconstruct the epidemiological pathway by which bats have tolerated coronaviruses for millions of years, but have also dispersed them. It contaminates other animals.

MERS coronavirus evolves to infect different species

Letko, M., Miazgowicz, K., McMinn, R., Seifert, S., Sola, I., Enjuanes, L., Carmody, A., van Doremalen, N. and Munster, V., 2018. Adaptive Evolution of MERS-CoV to Species Variation in DPP4. Cell Reports, 24(7), pp.1730-1737.

When bats hang in caves and die, they fall to the ground. Then the snakes, vipers in particular, who love their corpses, eat them. Just like the young bats that fall down and are immediately eaten by these snakes which are therefore probably intermediate hosts for viruses. In addition, there are clouds of mosquitoes and ticks in these caves and we should try to see which insects are also possible transmitters of the virus. Another hypothesis concerns the transmission that occurs when bats go out at night to eat fruit. Bats have an almost automatic reflex; as soon as they swallow, they urinate, explained Sicard. They will therefore contaminate the fruits of these trees and the civets, which love the same fruits, hence contaminating themselves by eating them. The ants participate in the agape and the pangolins – for which the most wonderful food is ants – devour the ants and become infected in their turn. It is this whole chain of contamination that needs to be explored. Probably the most dangerous reservoirs of viruses are snakes, because they are the ones that are constantly feeding on bats, which are themselves carriers of coronavirusesSnakes could therefore be a permanent host for these viruses, and obviously eating them is not only disgusting but dangerous. But that is exactly what we need to know and check. Researchers should therefore capture bats, but also do the same work on ants, civets, pangolins and try to understand their tolerance to the virus. It’s a bit ungrateful, but essential.

Didier Sicard also elaborated on the relation between the local Eastern Asian population and the bats, saying “What struck me in Laos, where I often go, is that the primary forest is regressing because the Chinese are building stations and trains there. These trains, which cross the jungle without any health precautions, can become the vector of parasitic or viral diseases and carry them through China, Laos, Thailand, Malaysia and even Singapore. The Silk Road, which the Chinese are in the process of completing, may also become the route for the spread of serious diseases. Caves are becoming more and more accessible there. As a result, humans tend to get closer to where the bats live, and bats are also a highly sought-after food source. Humans are now also building fruit tree parks close to these caves because there are no more trees due to deforestation. The inhabitants feel that they can gain territory, like in the Amazon. And so, they are building agricultural areas very close to extremely dangerous virus reservoir areas. I don’t have the answer to all these questions, but I just know that the starting point is not well known. And that it’s totally ignored. It’s being turned into folksy conference speeches. They talk about bats and the curse of the pharaohs.”

Sicard also said that there must be some serious studies about the ability of bats to harbour coronaviruses, saying “but when I go to the Pasteur Institute in Laos which is run by an exceptional man, Paul Brey, this director has the fibre of a Louis Pasteur, he has been passionate for twenty years about transmission issues, but he is extremely lonely. Even the study of mosquitoes, which is fundamental to understanding the transmission of diseases in Laos, is almost abandoned. And Paul Brey keeps telling me that there are about thirty species of coronavirus in bats. So, the scientific effort is not up to the task.” Sicard added, “When the French Ministry of Foreign Affairs removes the virologist’s post at the Pasteur Institute, which is a few hundred kilometres from the Chinese border, we are finished. This happened in November 2019. We are going to try to get that post back, but it is still frightening to think that even at the very gates where viral infectious diseases come from, it is hard to put all the effort into it. The Pasteur Institute of Laos is supported very moderately by France, it is supported by the Japanese, the Americans and the Luxembourgers. France contributes to it, but it does not make it a major research tool.”

The role of this Pasteur Institute according to Professor Sicard is to train local researchers, “To carry out epidemiological studies on the existing viruses chikungunya, dengue fever and now coronavirus, to be a place for high-level biological scientific studies in a remote, tropical territory, but with a high-security laboratory. To be as close as possible to where epidemics occur and to have laboratories that are up to the task. It is very difficult for relatively poor countries to have high level scientific equipment. The network of Pasteur Institutes – which exist in several countries – is a structure that the world envies. But institutes like the one in Laos need much more help than they do now. These laboratories are struggling to make ends meet and they are also having difficulty recruiting researchers. Most of them prefer to be in their laboratory at the Pasteur Institute in Paris or in a Sanofi laboratory or at Merieux, but to become an explorer in the jungle, there aren’t many people who do that. But that’s what Louis Pasteur did, he went to see the farmers in the vineyards, he went to see the shepherds and their sheep.»

La science n'a pas de patrie, parce que le savoir est le patrimoine de l'humanité, le flambeau qui éclaire le monde d'purb dpurb site web

Traduction(EN): « Science has no homeland, because knowledge is the heritage of humanity, the torch that lights up the world. » – Louis Pasteur

Science is an integral part of human culture and has played a huge part in the construction of the modern societies that humanity lives in today, and I believe the essay, « History on Western Philosophy, Religious cultures, Science, Medicine & Secularisation » gives a decent picture of where we came, where we have come and where we are going as a civilisation. « Louis Pasteur would come out of his laboratory. Just like Alexandre Yersin who was in the field in Vietnam when he discovered the plague bacillus », Sicard declared, « so, entomological research and research on transmitting animals is not up to the challenge. Of course, it exists, but it must account for perhaps 1% of research. Because what fascinates the candidates for the Nobel Prize is to find a treatment or a new virus in molecular biology and not to reconstitute the epidemiological chains. And yet the great infectious discoveries were born this way: the agent of malaria, Plasmodium, was discovered by a Frenchman, Alphonse Laveran, in the field in Tunisia. And this is fundamental research that is carried out on a scale that has been somewhat forgotten. »

Is the study of animal really crucial? Sicard said: “The plague remains an exciting example. The reservoir of the plague are rats. There are populations of rats that are very resistant and that transmit the plague bacillus, but they don’t care. And then there are populations of rats that are very susceptible. All it takes is a few individuals from the susceptible rat population meeting the resistant rat population one day to get infected. The susceptible rats die. At that point, the fleas that feed on the blood of the rats, desperate not to have more live rats, will start biting humans. Reconstructing this very beginning of the chain of transmission makes it possible to act. In places where the plague is still rife, in California, Madagascar, Iran or China, when we see that a few rats start to die, that is exactly the time to intervene: it is extremely dangerous because that is when the fleas will start to want to bite humans. In plague areas, when we see hundreds of dead rats, it is a real bomb. Fortunately, the plague is a disease of the past. There must still be 4,000 or 5,000 cases of plague in the world. That is not a huge number and then the antibiotics are effective. But this is an example, to show that the animal origin is fundamental and always difficult to apprehend. It is nevertheless essential for understanding and makes it possible to put in place prevention policies. Today, if we continue to sell wild animals on a market, we are in a delirious situation. The precautionary principle must be applied.”

While wild animal traffic is prohibited and there is an international convention that monitors all sales, in China this international convention is not respected, declared Sicard, adding “It is clear that if we ask each country to organise itself nationally, nothing will change. China initially put pressure on the WHO not to call it a pandemic. It tried to block it because it is a major contributor to the funding of the WHO.

20200415_WHO_Contributions

Les plus gros contributeurs au budget de l’OMS / Source: Statista France

It would therefore be important for it to be a totally independent health tribunal, like an international war crimes tribunal, with independent inspectors who verify what is happening on the ground. In Laos, in the countryside, there are many markets where wild animals are sold like chickens or rabbits. There is general indifference because it is the local culture. And culture is the most difficult thing to change in a country,” observed Didier Sicard. Indeed, rightly concluded, since culture, which is a mode of behaviour passed down by individual groups to other generations unfortunately is also sometimes constitutive of a range of atrociously bad and unproductive habits [e.g. medical, dietary, physical (health), linguistic, educational, artistic, perceptive, emotional, managerial and political patterns].

« Avant, avec mes amis, on avait peur des Chinois. Maintenant, on voit sur Twitter qu’on a peur de nous, les Italiens ! »

Alicia à franceinfo

Sicard also commented on what struck him on the attitude of the French population, stating, “the gap between a kind of indifferent casualness, hardly any critical look at Italy and China and the brutal discovery of the health disaster. We have gone from recklessness to extreme anxiety and both are equally toxicrecklessness creates contamination and extreme anxiety leads to irrational behaviour. The proof of this is the flight of Parisians, Lyonnais and inhabitants of large cities to their second homes. This seemed to me at first to testify to a very short-sighted vision, as if one could escape, in war, from the arrival of the German armies. And then an extraordinarily individualistic behaviour, in the wrong sense of the word: ‘Save whoever you can, I shut myself up in my countryside and then it’s too bad for the others, I protect myself’. Of course, I imagine that if you can protect the elderly and keep them safe, that’s fine. But when we see young couples or groups of friends who are now saying to each other, we’re going to go on holiday! This is all the more shocking because this epidemic is about something completely different from just saving someone. On the contrary, it’s a question of asking how each can be seen by the other as a role model.”

Professor Didier Raoult also pointed out in 2009, that human civilization is still savage and prehistoric when it comes to a culture of medical hygiene because most of us do not know how to handle viruses due a lack of knowledge and social organisation, i.e. it is a pattern of behaviour that is still not firmly embedded in culture of the non-scientific majority. Raoult even pointed out 11 years ago that if a mutant respiratory virus was to appear we would be facing a considerable disaster, and here we are.

Didier Raoult « On ne sait pas lutter contre la contagion d’un virus respiratoire » | Archive INA (2009)

A similar argument was also recently brought forward by Bill Gates in 2018 who suggested that a new diseases could kill 30 millions in 6 months, while his foundation published a simulation showing an epidemic spreading from China, which is coincidentally now facing a « serious situation » to deal with the accelerating deadly coronavirus epidemic that has put the world on its knees. « In the case of biological threats, that sense of urgency is lacking, » Gates said, adding that countries need to prepare for pandemics in the same serious way they prepare for war; he asserted that a small non-state actor even had the ability to construct a deadly form of smallpox in a laboratory environment. The philanthropist explained in an interview on Virtual TED Interview that if the United States enacts such a strict isolation law, positive results could be seen within the first 20 days. According to Gates, the United States was too late to react. If they had started testing people who might have had the virus as early as February, they could have escaped total isolation. « There are no half measures. It’s not right to say « keep going to restaurants and buying houses, ignore the pile of dead bodies in the corner. It’s irresponsible to tell people not to worry, » said Bill Gates, also adding that the public must, at all costs, maintain the law of isolation for as long as it is necessary to save lives and prevent the situation from becoming similar to that in Wuhan and Northern Italy.

20200331_Lockdown

#COVID19 : en se basant sur des modèles prédictifs, des chercheurs de l’UCL ont estimé que l’ensemble des mesures de #confinement ont déjà permis de sauver plusieurs dizaines de milliers de vies en Europe / Source: Statista France

In an essay written on the Oxford Martin School website at the University of Oxford Ian Goldin and co-authored by Robert Muggah, a similar orientation is suggested, i.e. for the world to become more interdependent since our world has become more connectedHowever, globalisation must be managed efficiently in order to fight systemic risks such as the COVID-19.

We saw how the growing complexities of the global financial system was badly managed by public authorities controlled by politicians, and supposedly financial « experts », people who were supposed to have graduated from the supposed best institutions, simple parvenus turned mechanical thinkers, and what did they do? Together, as a pack of ruthless & cannibalistic great white sharks, they took the whole world into the financial crash in 2008; it is not even the first time in history and nothing tells us that they will not do it again. The full blame can be attributed to the dangerous negligence and overconfidence of this very special and particular breed.

Banker sitting on the street

Image: Un banquier assis dans la rue / A banker sitting on the street

This has led to mediocre, cheap, uncharismatic and atavistic populists politicians without any sophisticated outlook about a connected world to storm to power since the world’s political and economic « elites » were held responsible for the 2008 financial crisis. But we now see how these populists lack the sophistication to lead a new modern and interconnected world as we are living through this crucial phase in human history where civilisation is changing era.

These atavistic minds who grabbed power in the US are following an ancient tradition that does not have its place anymore in our modern world, i.e. blaming foreigners for everything and turning their back to the outside world, and hence also making themselves insignificant among noble world leading societies, i.e. those who together set an example to civilisation and shape the human civilisation of the future.

LesFrancaisNapproventPasLaPolitiquedesUSASondage

Une majorité de 80% des citoyens français se méfient des Etats-Unis et n’approuvent pas leur politique / Source: Le Figaro

The grotesque US president, Donald Trump spurned scientific thinking about a range of serious issues such as climate change, spread fake news through petty news agencies and twitter ogres and even shunned traditional allies and international institutions such as the World Health Organization and the Paris Climate Agreement, decisions that have not been met with approval by many sensible Americans; for example, Melinda Gates sees Trump’s decision as absurd, and with the evidence of infections rising fast, most extremist nationalist politicians are compelled to recognise the traumatic human and economic costs of COVID-19. Hence, it is also not surprising that in France, a literary, intellectually hungry and constantly evolving nation of voracious and sophisticated self & world-cultivating book readers & writers, Trump is viewed as one of the greatest disasters of the modern world, compared to the pigs of George Orwell’s « Animal Farm », and has even been paraded as a clown along with Macron in Nice.

Trump le clown avec Macron la marionnette au carnaval de Nice

« Complice du pire » / Trump le clown et Macron la marionnette au carnaval de Nice, 2019 / Source: 20minutes

« Do me a favor, speed it up, speed it up. », this is what the naive Trump told the National Association of Counties Legislative Conference, because the ignorant, infantile, insensitive and obese politician may believe that if he repeats it a couple of times the vaccine may suddenly appear. A vaccine takes longer to be safe and ready, and most people with some scientific foundation know this. As the American chemist, inventor, musician, professor, entrepreneur and former chancellor of the University of North Carolina, Herbert Holden Thorp wrote for ScienceMag, China has rightfully taken criticism for blocking attempts by scientists to report the truth about the coronavirus, the US under Trump and his circus have been doing the same thing. To inform Fauci and other government scientists that all public comments must be cleared with Pence is bordering on dictatorship and an assault on individual freedom and dignity. It is clearly not a time for a mediocre, disconnected, unsophisticated and atavistic American politician who does not fear ridicule by making an absolute ass of himself through his denial of evolution, climate change and the dangers of cigarette smoking to come around and tell people how to live, what to believe in and shape the public messagethis is dangerous to every single person who lives in the US. It is however encouraging to see that Fauci, Francis Collins [director of the U.S. National Insitutes of Health (NIH)], and their colleagues across federal agencies have ignored these instructions and gradually spread the message, because transmission rates and death are not measurements that can be changed with Trump’s will and an extroverted presentation. The Trump administration repeatedly lied, saying that the virus spread in the US was contained, when it was very clear from genomic evidence that community spread was occurring in Washington State and beyondThis kind of distortion during such a deadly pandemic is unacceptable and contributed to the federal government’s slow response. Although the words of the Trump administration have never mattered to or registered in the brain of learned individuals, these words are now clearly a matter of life and death in the US during the pandemic.

Most intellectually cultivated, smart and refined individuals do not expect politicians or mediocre gossip journalists to know much about philosophical discourse, the foundations of scientific reasoning, objectivity, statistics, to be able to read and fully understand a scientific paper, let alone understand brain physiology, the laws of evolution and gravity, p-value, logical reasoning or know what ostinato and legato are; and that is perhaps why most of the finest intellectuals remain in their league and keep their distance from street politicians and the common crowd, because they likely know that it would be like trying to communicate with non-receptive, indifferent and inanimate objects such as pebbles or truffles.

Some White Truffles

Image: Truffes blanches / White truffles

Hence, it is very likely that to most sensible and intellectually cultivated individualsattempting to have a conversation with those objects would be a waste of time, neuronal activity and calorie; while also having to leave the noble realm of philosophical discourse, their library with names such as Darwin, Voltaire, Balzac, Descartes, Rousseau, Lacan, Satie and Debussy, and sometimes even their piano or violin, to then have to jump into a world of slimy reptilian characters and see weird and untrustworthy faces of brains inferior to their own trying to tell them how to live, and also having to endure mockery of the lowest, most infantile and animalistic kind from some of the vilest and most frustrated peasant-like parvenus in politics with severe inferiority complexes. So these cultured intellectuals keep quiet in the distance and focus on writing books instead.

mona_lisa_pic_d'purb dpurb site web french embassy ambassade de france usa

Source: Services culturels – Ambassade de France aux États-Unis / Cultural Services – French Embassy in the US

As a bilingual Franco-British intellectual, in the French speaking world for me, it would be like attempting to have a sophisticated discussion about « les métaphores artistiques d’Eugène Delacroixla structure du psychisme, la philosophie du désir, la motivation chez le sujet cartésien, l’héritage voltairien, et la dialectique Lacanienne » with « simplets » [i.e. simple minds] like Bécassine, Nabilla, Bamboula, Darmanin, Hollande, Pompili and Morano in a small village bistrot; and in the Anglo-Saxon sphere with Postman Pat, Nigel Farage, Harry Potter or Mr.Bean in an ancient and derelict pub in England, or Homer Simpson, Forest Gump, Joe Biden and Donald Trump in the US – so, what I mean and what most intellectually superior individuals understand is that it would be useless and unproductive because of the unsynchronised psyches caused by different levels of intellectual cultivation and heritage.

If the majority of humans read and manage to grasp and fully understand the essay, « Psychoanalysis: History, Foundations, Legacy, Impact & Evolution », they should realise that the human psyche, its development, cultivation and construction are composed of many layers, while the essay, « The Concept of Self » would also guide individuals about self-conception and identity. After studying intellectual humility, psychologists have found that individuals with this personality trait have superior general knowledge (Krumrei-Mancuso, Haggard, LaBouff and Rowatt, 2019). Intellectual humility has consequences for learning and styles of thinking; the process of learning itself requires intellectual humility to acknowledge that one lacks a particular knowledge and hence has something to learn in order to continue evolving. In the same study in the Journal of Positive Psychology, Krumrei-Mancuso and her colleagues found that intellectual humility was associated with less claiming of knowledge that one does not have, indicating a more accurate assessment of one’s own knowledge. In the study, intellectual humility was also correlated with being more inclined to reflective thinking, and also possessing more « need for cognition » [i.e. enjoying thinking hard and problem solving], greater curiosity, and open-minded thinking. In the journal Self and Identity, the results from a study by Porter and Schumann (2017) suggest that intellectual humility can be increased in individuals through a growth mindset of intelligence; hence we could all benefit from intellectual humility in our lifetime development. The authors concluded that « teaching people a malleable view of intelligence may be one promising way to foster intellectual humility and its associated benefits. »

Les métiers qui inspirent le plus (et le moins) confiance d'purb dpurb site web

Les métiers qui inspirent le plus (et le moins) confiance / Source: Statista France

Many uncharismatic, simple-minded, grotesque and mediocre politicians need to acknowledge that their lack of knowledge, creativity and cultivation makes their ambitions of leadership impossible, and also understand that the ancient and stagnant political structure with parties and group agendas as it is nowadays can be considered as a discipline that is dead-alive and on its last leg; that hardly elicits the passionate interest of the civilised crowd anymore. The politics of parties and division is ongoing for the simple reason that civilised society has not yet implemented an organised and sophisticated concept to replace it and use it to manage our modern and interconnected human civilisation.

Regarding the degraded and cheap form of politics around the world in the 21st centurypeople at large need to firmly understand that every time typical, plain and ignorant office workers stack enough money aside to be able to afford quitting their day job in order to join a group of politicians in a movement, it does NOT suddenly transform them into a superior authority that requires everyone to stand in line to listen to everything that comes out of their mouths; they cannot and will never win a noble and sophisticated philosophical debate by insulting and disrespecting intellect and science simply because it does not always conform to their wishes and is often against their disconnected and backward outlook, while also at times being too challenging for most of their average, limited, naive, unproductive, boring and uncreative brains.

Un théoricien de la psychologie d'élite d'purb dpurb site web

Traduction(EN): « An elite psychology theorist who deals with brain behaviour and sculpture at the granular level will not listen to the absurdities of a simple mind, even if the partners of this simple mind can pay all the advertisers in the world to publish their nonsense on toilet paper, cereal boxes, the cheap animal press to bus stops. We are above that! Every time a drugged out publisher of an obscure corner of the Internet creates a title with an image he considers degrading, it has no effect on us, none, zero; with his sweaty, sticky fingers slamming on a dirty keyboard on the 10th floor of an old building in a crowded corner of a polluted urban jungle? we are above these little defamation campaigns organized by childish politicians and the Jewish media they love so much. It cannot be anti-semitic to simply state that the majority of the press is owned, and hence controlled by Jews. My message to these people is this: « Try to grow up! Not a single intelligent person in the world is defined by your impulses… you are worse than children. People define themselves… simple….. your opinions, they’re just simple opinions as simple as your mind! » -Danny J. D’Purb

So, these simple animalistic minds and parvenus in the media along with those who hold their leash in politics need to seriously understand that no matter how many rotten tomatoes they throw at the wall of reason, these bricks were built on science, philosophy and intellect, and they will NEVER go down; for example, we know for a scientific fact that alcohol consumption and smoking cause cancer, and that flesh in a state of decomposition is a breeding place for maggots, no amount of headlines, photo editing or covers will ever change those facts and convince any intellectually cultivated mind otherwise, although that does not seem to stop some cheap, corrupt and deluded media businesses and journalists from trying – Trump could be a suitable equivalent example. We all know that some people are hired to do so, but they would make their own lives easier and less stressful by knowing the limits of rational possibility, that is, by understanding the simple logic that covering gold with manure and swine scum will never transform it into those.

During the CoVID-19 pandemic, these haters of intellect and science then insist on something as serious as a vaccine that science cannot provide on demand – as if it was as simple as feeding or mass breeding pigs on a farm. As Holden Thorp also noted, for the past 4 years the obese Trump and his circus have made deep cuts in the scientific budget including cuts to funding for the Centers for Disease Control and Prevention and the NIH. For their selfish political goals, the grotesque administration’s disregard for the science of the Environmental Protection Agency and the National Oceanic and Atmospheric Administration, and the stalled naming of a knowledgeable director for the Office of Science and Technology Policy has caused a lot of harm over 4 years to US residents and the credibility of the US itself on the world sceneNow, with the devastation caused by CoVID-19, Trump suddenly needs the discipline he disrespected and ignored, i.e. science. Yet, to cite Thorp, « the centuries spent elucidating fundamental principles that govern the natural world—evolution, gravity, quantum mechanics—involved laying the groundwork for knowing what we can and cannot do. The ways that scientists accumulate and analyze evidence, apply inductive reasoning, and subject findings to scrutiny by peers have been proven over the years to give rise to robust knowledge. These processes are being applied to the COVID-19 crisis through international collaboration at breakneck, unprecedented speed […] the same concepts that are used to describe nature are used to create new toolsSo, asking for a vaccine and distorting the science at the same time are shockingly dissonant.«

The website PubPeer.com allows users to comment on scientific articles in post-publication, but also to report suspicions of breaches of scientific ethics. The site highlighted gaps in several high-profile articles, which in some cases led to retractions and accusations of scientific fraud as noted by the blog RetractionWatch.com, which analyzes retractions of scientific articles and comments on issues related to scientific integrity. PubPeer exists because of the inability of some hard empirical science to sometimes replicate its results and effectively self-correct itself.

A reliable vaccine must have a strong scientific foundation and will have to be manufacturable and safe. To achieve this, it will take some time, and although the top scientists are working as fast as they can to deliver this life changing vaccine, we should not expect a miracle in time-scale [e.g. in 3 weeks]. The business executives from those giant pharmaceutical companies who see life in terms of bank notes, have every thing to gain in getting the vaccine fast but luckily for people, even they also understand that we cannot use magic to get there in a week. However, we can perhaps take a positive note from this tragedy, since a couple of years ago Trump declared his skepticism about vaccines and even tried to launch an antivaccine task, but today crippled with CoVID-19, he suddenly loves vaccinesHerbert Holden Thorp beautifully said it: « If you want something, start treating science and its principles with respect. »

The Centers for Disease Control’s worst-case scenario suggests that about 160 million to 210 million Americans will be infected by December 2020; as many as 21 million will need hospitalisation and between 200,000 and 1.7 million people could die within a year. Harvard University researchers believe that 20% to 60% of the world’s population could become infected, and estimate that 14 million to 42 million people could lose their lives.

Une disparité qui pose question les hommes meurent plus du #COVID19 que les femmes malgré le fait qu'ils aient été contaminés

Une disparité qui pose question : les hommes meurent plus du #COVID19 que les femmes malgré le fait qu’ils aient été contaminés à part à peu près égale. Dans certains pays, cette différence est particulièrement marquée / Source: Statista France

As Ian Goldin also suggested, the extent to which excess mortality can be prevented depends on how quickly societies can organise itself medically and culturally to reduce new infections, isolate the sick and manage health services and resources humanly and efficiently, and also on how long relapses can be prevented and contained.

20200403_Coronavirus_Testing_FR

La France compte rattraper son retard sur les #tests et a fait du #dépistage massif son fer de lance pour lutter contre le #covid19. Voici un état des lieux du nombre de tests réalisés par habitant dans une sélection de pays / Source: Statista France

While intelligent campaigns that teach and reshape human cultures on hygienic habits to deal with viruses may help, without a reliable and effective vaccine, COVID-19 will remain as a hugely disruptive force for years, the pandemic will inflict more suffering and damage on poorer and most vulnerable communities within many countries, highlighting the risks associated with rising inequality.

20200422_COVID_Heilung

COVID-19 : quel est le statut des cas identifiés ? / Statista France

In the US, over 60% of the adult population suffers from chronic disease, around 1 in 8 Americans live below the poverty line, and more than 75% of them live from paycheque to paycheque, and over 44 millions in the US have no health coverage at all; and to make matters even worse, they also constitute the largest culture of obesity and community of fat people on the planet.

Un gros obesity obésité

Speaking with the Conversation France, Frédéric Altare, the director of the département d’immunologie at the Centre de Recherche en Cancérologie et Immunologie Nantes-Angers confirmed that being overweight is the major comorbidity associated with severe forms of Covid-19, which require admission to resuscitation in hospital. It can be estimated that, in some places, up to 80% of these may be related to obesity and that if we take a national average, obesity certainly accounts for more than half of the proportion of people admitted to intensive care. The fact that obesity creates a bias in favour of worsening the disease is also confirmed by the outbreak of the epidemic in the United States, a culture of hot dogs and big bellies where almost 40% of the population is severely obese. Since we are on the topic of hot dogs, a review of evidence in the British Medical Journal found that all processed meats [e.g. sausages, bacon, ham, and corned beef] are highly carcinogenic, i.e. they cause cancer, those foods all now appear in the same risk group for cancer (group 1) as asbestos, cigarettes and alcohol (Kmietowicz, 2015).

ocde_obesity_update_data_2017

Le graphique présente les taux d’obésité (IMC>30kg.m-2). La moyenne des pays de l’OCDE est de 19,5% d’obèses. Les Etats-Unis, le Mexique, la Nouvelle Zélande et la Hongrie sont les pays les plus touchés avec respectivement 38,2, 32, 4, 30,7 et 30% d’obèses. Le Japon, la Corée, l’Italie et la Suisse sont les pays les moins touchés avec 3,7, 5,3, 9,8 et 10,3% d’obèses. La France est à 15,3% de taux d’obésité (donnée OCDE basée sur du déclaratif légèrement inférieure aux résultats d’ESTEBAN, basé sur des mesures) / Source: Centre de recherche et d’information nutritionnelles (Cerin)

This association between obesity and severe forms was already well-known for other respiratory infections such as the avian flu. The people at higher risk are those who have passed the morbid obesity milestone. Whether an individual is overweight is assessed using the famous « body mass index« , or BMI [You can check your BMI here], which is the ratio of weight to height squared. A person with a BMI above 25 is considered to be slightly overweight. From 30, we speak of proven overweight with the onset of obesity, at 35 we begin to speak of severe obesity, and from 40 we enter into what is called « morbid » obesity. Morbid, because the people concerned are considered to be at risk of developing pathologies, mainly cardiovascular and atherosclerosis, but also type 2 diabetes, liver diseases, certain forms of cancer.

The challenges to deal with the COVID-19 epidemic are also dramatic in Latin America, Africa and South Asia, where health systems are weaker and governments are less able to respond, risks caused by the failure of politicians such as Bolsonaro and Modi to take the issue seriously enough, argued Ian Goldin of Oxford University and Robert Muggah from the University of Rio de Janeiro.

In poor communities where many individuals share a single room and depend on day to day work to feed themselves, social isolation will be difficult and around the world as individuals lose their income, we should expect rapidly rising homelessness and hungerIn the US, a record of 3.3 million people have already filed for unemployment benefit, and across Europe unemployment is also reaching record levels. Yet, in richer countries some safety nets exist even if they are struggling to organise themselves, but poor countries simply do not have the capacity to ensure that no-one dies of hunger.

Homelessness in the USA

Image: Une femme sans-abri tient dans ses bras son fils de 2 ans dans l’une des villes de tentes de Seattle / A homeless woman holds her 2-year-old son at one of Seattle’s tent cities Source: Business Insider (France)

All responsible and realistic governments around the world should therefore ensure that all people in need have a basic income to ensure that no-one starves as a result of this crisis. Goldin rightly observes that the COVID-19 pandemic provides a turning point in national and global affairs, it shows our interdependence and also that the general public tends to rely on governments to protect and save them and not the private sector, thus badly organised governments lead to human disasters… a song that most people are already familiar with.

In agreement with my own suggestions, Goldin and Muggah also argue that at a time when faith in democracy is at its lowest point in decades, deteriorating economic conditions will contribute to even more political and social instabilityThere is already a tremendous trust gap between politicians and citizensSome politicians are sending mixed signals and citizens are receiving conflicting messages; this reinforces their lack of trust in public authorities controlled by politiciansDue to a shortage of international leadership from the US government, cities, businesses and philanthropies are stepping up.

Bill Gates Delivers A Speech At The Fundraising Day At The Sixth World Fund Conference In Lyon

Bill Gates delivers a speech at the fundraising day at the Sixth World Fund Conference in Lyon, France, on October 10, 2019. At the head of his foundation, Microsoft’s founder, wisely advocates international cooperation against the virus. (Photo by Nicolas Liponne/NurPhoto)

With the range of serious viral infections that have blighted the world during the last decades, it was only a matter of time for others to appear; most perceptive minds probably knew, but unfortunately these minds are a minority on our planet. « What’s to stop some form of SARS showing up? » Bill Gates asked in 2014, referring to the 2002-2003 epidemic of severe acute respiratory syndrome, caused by another coronavirus. Next, he said, could be « SARS II. » Bill and Melinda Gates established their foundation in 2000 and have always focused on biomedical innovations against disease and ways to deliver them. In 2014, during the Ebola epidemic that killed thousands worldwide, the Foundation was active in helping to stamp out the virus.

Governments should also take notice that the way a society cares for and treats its residents reveals a lot about their philosophy and their values about human life and dignityAs a modern civilisation, free high standard healthcare for all should be one of the priorities for all sophisticated and civilised societies, because people do not go to the hospital for fun, freebies or to collect free candies but end up there in situations of distress. Whether the public hospital has a homeless person, a high-earning lawyer, a student or a child at their doorstep, the quality of medical care should be at the highest standards for all, and societies who want to set an example to the world should certainly start with healthcare, because caring for the population is not spending but investing – a population in good health leads to progress at multiple levels [i.e. physical and brain development, educational achievement, psychological health, professional performance, etc]. Research and medical advancement are sectors that no government should discriminate because it ensures a healthy and progressive society.

Bill Gates in 2016 met Trump in the Manhattan skyscraper where the Trump Organisation is based and wanted to discuss « science and innovation ». Gates who co-chairs Bill and Melinda Gates Foundation – which is focused on infectious disease research and treatments – told Trump before he took office that he ought to make preparedness for the danger posed by viral pandemics a priority of his administration. But, of course, with Trump’s ignorance and lack of sophistication these words probably did not register on his brain who now says that « nobody could have predicted » the CoVID-19 virus » when Bill Gates did warn him. The only horribly stupid question that a scientifically illiterate Trump asked Bill Gates during that meeting was whether there’s « a difference between HIV and HPV ». Gates later recounted: « I was able to explain that those are things that are rarely confused with each other.”

“I feel terrible,” Bill Gates says now. And, “I wish I had done more to call attention to the danger,” even if it is the government’s responsibility to keep itself well informed and protect its population. Gates and his charitable organisation have so far committed more than $300 million to various coronavirus relief efforts, which is about 3 times the contribution of the whole of the US to the World Health Organisation.

Gates Foundation spending on pandemic preparedness

Gates Foundation direct spending on pandemic preparedness / Source: Bill & Melinda Gates Foundation

The point he made to Trump back then is more or less the same one he’s been stressing for years, including during a much-touted 2015 TED Talk in which he described viruses as posing the “greatest risk of global catastrophe.” “If anything kills over 10 million people over the next few decades, it’s most likely to be a highly infectious virus rather than a war,” Gates said at the time. “Not missiles, but microbes.” As of now the US is the global epicentre of the COVID-19 pandemic with more than 4.5 millions cases confirmed and 87, 000 deaths according to the Johns Hopkins COVID-19 resource center, exceeding the 58,220 lives lost over nearly 2 decades in the Vietnam war.

The Bill & Melinda Gates Foundation have invested $100 million to fight the new coronavirus in China; Twenty million will go to institutions including the World Health Organization (WHO), the American and Chinese Centers for Disease Control and Prevention, and the National Health Commission in China. Twenty million will be allocated to public health authorities in sub-Saharan Africa and Southeast Asia, areas that have been disproportionately affected by recent epidemics including the H1N1 pandemic in 2009. Up to $60 million will be spent on research into vaccines, treatments and diagnostic tools. Other groups such as the Wellcome Trust, Skoll, the Open Society Foundations, the UN Foundation, and Google.org are also scaling up assistance.

It is clearly not the appeals to atavistic and extremist nationalism and closed borders that will trigger solutions and make the most out of the complexities of our interconnected global civilisation in times of crisis where coming together as one planetary civilisation with a unified economic, scientific and medical force is key to destroying this virus and also prepare for the next epidemicthe solution is not about closing the borders or opening the borders, but to create a strong, safe, reliable and intelligent filtration system that is also flexible, reasonable and humane to people and allows movement in and out that contributes to the multi-layered forms of development of a country and civilisation as a whole (e.g. intellectual, academic, educational, linguistic, literary, cultural, scientific, medical, technological, economic, etc), through the transmission of connaissance (knowledge) and savoir-faire (know-how). If those who feel that they have the responsibility to shape our human civilisation read and fully understand the essay, « Psychological Explanations of Prejudice & Discrimination« , they should come to realise what the theory of evolution is about; scientifically there is no such thing as a « pure » race [because all human primates on earth are the product of migration, breeding and evolution]. The theory of evolution formulated by Charles Darwin revealed to mankind that there is no stable and eternal essence, and that any idea of an exceptionally pure entity that would be beyond evolution does not exist – everything on our planet is in a constant state of flux/change [so from a scientific, evolutionary and organic standpoint, racism is a totally archaic absurdity since we are all simply organic matter on a small blue planet in the vast universe being recycled, recreated and reshaped in a continuous process]. Darwin stated very clearly that he honestly thought that evolution is accepting the idea that there is no end to evolution and it goes in all directions. The French philosopher Barbara Stiegler wisely suggested that the task of creating the consent of the masses should be left in the hands of experts in psychology [i.e. those who understand the psychic structure and philosophies of how humans and societies operate, develop and evolve].

Ian Goldin and Robert Muggah agree on the idea that the spread of COVID-19 must be met with a coordinated international effort to find vaccines, mobilise medical supplies and, when the volcanic dust settles, to ensure that we never again face what could be an even deadlier disease. They write on the University of Oxford’s Oxford Martin School website : « Now is not the time for recriminations: it is the time for action. National and city governments, businesses, and ordinary citizens around the world must do everything they can to flatten the epidemic curve immediately, following the examples set by Singapore, South Korea, Hong Kong, Hangzhou and Taiwan. »

Bill Gates remains optimistic about the crisis, since Covid-19 will allow the world to accumulate experience and prepare for the next pandemic. The modern and forward-thinking philantropist believes that the innovation shown by countries in the northern hemisphere could be of great help to countries in the south that are likely to be affected by the virus in the coming seasons, Gates is convinced that the fight against the virus requires a more realistic count of the number of proven cases, the Microsoft founder will finance the free distribution of testing tests in his city of Seattle. For him, the coronavirus could be the epidemic of the century. In practice, as soon as the tests are available, they will be distributed on demand in Seattle. The aim is that anyone with symptoms will be able to make the diagnosis themselves, by rubbing a cotton stick into the back of their nostrilsThe Foundation says it can quickly process thousands of tests every day and deliver results within 48 hours maximumPositive screenings will be notified to the patients, as well as to public health authorities. Positive patients will then be asked to complete an online questionnaire to detail their recent travels and the people they may have been in contact with. The aim is to better monitor the epidemic and to ensure that potential patients do not travel to hospitals or doctors’ offices.

“You can’t get ‘outside », said Professor Didier Sicard, who also argues for a universal attitude, which comes at a right time to educate world culture on medical hygiene, « We must not consider that we are 30 years old and in good health and that we are not going to be fooled by all this talk. » Everyone must realize that they may be unknowingly contaminating others. The epidemic has passed through people who have returned from China or Italy. Didier Sicard says: « I know the example of an Italian woman who went to Argentina. She attended a wedding and kissed everyone. This woman infected 56 people! Irresponsibility in times of epidemics does immense damage. On the contrary, we have to respect the measures. Like waiting, for example, in front of the supermarket before entering if you see that there are people. »

20200402_Masken_FR

Quelle est l’efficacité des masques de protection ? / Source: Statista France

Où les masques sont déjà omniprésents

Où les masques sont déjà omniprésents: le gouvernement a annoncé que des masques seraient distribués aux Français / Source: Statista France

Surgical face masks have been proven to significantly reduce the detection of influenza virus RNA in respiratory droplets and coronavirus RNA in aerosols, with a trend toward reduced detection of coronavirus RNA in respiratory droplets, hence surgical masks have the potential to prevent the transmission of human coronaviruses and influenza viruses from symptomatic individuals (Leung et al., 2020). Until antivirals and vaccines are ready, the face mask will become the indispensable and essential accessory for us all at all times, when we are outdoors or in environments frequented by others. Most popular among lay people, the cloth mask is already being widely used and it is re-usable; this accessory will be the key to ease us all out of lockdown and offer some temporary protection to us and the people around us until the vaccine and antivirals are readyTHE MASK IS NOT A MIRACLE PROTECTION, SO INDIVIDUALS MUST REMAIN VIGILANT AND NEVER LOWER THEIR GUARD and are advised to seriously take notice of where their hands and fingers are going and ensure that it does not get in contact with their face [i.e. mouth, eyes, ears], carry a hand-sanitiser with at least 60% alcohol with them at all times and use it properly, maintain a safe distance of about 1 metre minimum from all other individuals at all times, and also stay away from those who are not wearing masks as micro droplets from their breath and mouth may contaminate others.

Safety Goggles Coronavirus CoVID-19

A study published in the PNAS using highly sensitive laser light scattering showed that micro droplets generated by asymptomatic carriers of COVID-19 during speech can emit thousands of oral fluid droplets per second and these can remain in the stagnant air of confined environments for up to about 15 minutes. This confirms that there is probability that normal speaking causes airborne COVID-19 virus transmission in confined environments (Stadnytskyi, Bax, Bax and Anfinrud, 2020).

People should also not be ashamed about their appearance due to protective measures, nothing is enough for a deadly virus, and I would personally recommend using safety goggles that completely seal the eyes when outdoor in highly frequented public places such as shopping areas. People should also never lose their focus about the possible sources of contamination indoors, such as shoes and clothes worn outside. It may be life-saving to organise a specific routine such as leaving shoes worn outside in a corner, sanitise hands when touching themPerhaps as soon as one gets home, instantly remove and place all clothes worn outside in a basket far from people in the house, outside in a sheltered place may be convenient for washing then disinfect oneself and shower.

We must NEVER FORGET that there is a deadly virus circulating and any minor slip or even a small reflex [e.g. scratching the eyelids] can mean death. The Académie de Médecine recommends the facial mask for all.

How to maintain your cloth mask

Coronavirus CoVID-19 Scorpion Face Mask

Image: Scorpion of Mortal Kombat may motivate the younger generations to wear their masks and maybe even the more mature generations

There are many people who do not know that the cloth mask MUST COVER THE NOSE AND THE MOUTH otherwise it would be pointless, hence it is advisable to tell any person not wearing their mask properly to do so; the mask should also not be used for more than 4 hours. Generally, the cloth mask must be washed every time that it has been used, taking into consideration that usage should not exceed 4 hours. Hence, it is obvious that every individual will need to have a few in order to rotate them during the day appropriately. The Association Française de normalisation (Afnor) also advises to wash this protection every time it is dirty or wet or badly positioned on the face. To be worn properly, the mask must cover the nose and the mouth and should not be placed in waiting position on the forehead or around the neck. The Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM) also stated that all mask makers must give details on how to wash and disinfect their masks. Here is a list of some helpful advices for an optimal maintenance:

  • Wash at 60 degrees celcius with your usual laundry for at least 30 minutes preferably in the machine, or if not available, by hand
  • Dry the mask in the 2 hours that follow the washing in a dryer, or if not available, with a hair dryer
  • At the slightest sign of wear (e.g. hole or deformation) the mask must be discarded.

Here are also a few things that you MUST NOT DO:

  • Place it in a microwave
  • Iron it without washing it
  • Use bleach or alcohol
  • Dry it in open air

Coronavirus Putting Your Mask On

Before the wash

Before the washing process, the Afnor precisely explained in its FAQ that it is not necessary to systematically disinfect the inner tube [i.e. the area that holds the laundry] before washing your masks. However, Afnor recommends to run an empty wash if you have accidentally added a used mask with other clothes during a wash at a temperature lower than 60 degrees celcius. In this case, we must proceed, before the wash, with a cold rince of the inner tube with bleach, or run an empty wash in the machine at 60 degrees celcius or 95 degrees celcius without spin.

During the wash

Masks should be washed with your usual detergent at a temperature of 60°C for at least 30 minutes in the washing machine or, if this is not possible, by hand. The use of fabric softener is not recommended. It is best not to use any product other than your usual detergent, as any other product could degrade the mask fabric. Furthermore, the Afnor specifies that you can wash your masks with sheets or towels, in order to « ensure the mechanical aspect of the wash ».

The Drying Process

The Afnor believes that « the mask should be completely dried within the two hours that follows the washing« . Whenever possible, the mask should therefore be tumble dried after cleaning the filters. Drying in the open air is slower, but it can be an alternative, » we find on the Afnor website.

Can the mask also be blown dry? The option is mentioned in a standard notice for fabric/cloth masks put online by the Direction générale des Enterprises. But Afnor does not recommend this method, because of the « poor control of the temperature level », which can lead to damage to the fabric. If you nevertheless choose this option, for lack of any other solution, it is therefore essential to pay attention to the temperature supported by the mask. The ANSM also recommends, if possible, steam ironing the mask. This can help to complete the drying process, adds the Afnor. Here again, be careful with the temperature so as not to damage the fabric or the elastics.

Whichever option you choose, all layers of the mask must be completely dry. As a final step, before storing it in a clean, airtight package, visually inspect the mask. If you notice any deterioration (wear, deformation, holes, etc.), discard the mask.

If Washing Is Not Possible

It is not recommended to microwave the mask. Steam ironing or hair drying is not a substitute for washing either. Finally, it is absolutely not recommended to use bleach or alcohol to disinfect a mask. Not only can these two products alter the quality of the mask by degrading the fabric, but bleach is also dangerous to your health (with risks of skin irritation or respiratory problems).

The Stop-postillons site, created by doctors, nevertheless gives this advice, if one cannot disinfect one’s mask right away: « keep it in an airtight box (for example a plastic box disinfected with bleach) », then « wait a week ». You can also find a simple method to make your own mask that does not require any additional material except a pair of scissors and a t-shirt.

On masks, Didier Sicard declared: « …they are psychological protectors for walkers and not virological protectorsEvery French person has to say to themselves: I do everything so that others can’t blame me for anything. We need an attitude where we look for the other’s gaze before our ownThat alone will bring efficiencyMasks are obviously protective for doctors and caregivers in an environment where the virus circulates. But when you have people walking down the street wearing masks, it’s paradoxical. They think they’re protecting themselves from others, but there’s a huge gap between the uselessness of masks on the street and the vital usefulness of masks in hospitals. I myself was at the pharmacy on Saturday morning and I showed my doctor’s card to see if I could buy masks. The pharmacist told me there were none left. So, if I needed them to treat a patient, I wouldn’t have been able to go see him, or I might have contaminated him. We have seen too many people walking down the street wearing masks as a kind of panoply. There is a major political drama in this absence of masks.”

Sicard pointed out that masks should be reserved for carers, stating: “To anyone who works around the virus. When you see cashiers at the supermarket who don’t have masks while customers have masks, there is something completely counterproductive. Those who don’t need them have got them, and those who really need them are missing them. This is directly related to individual behaviour. I would never have dared to walk down the street with a mask until the caregivers had masks. It’s something that would have frightened me. It basically shows people’s blindness and ignorance. If you walk around without meeting anyone, there is no point in wearing a mask.”

Didier Sicard

Didier Sicard

From an ethical standpoint, the attitude of carers who are now on the front line when they were on strike a few weeks back struck Sicard, who said: “That’s their duty. A doctor is mobilized in his inner self to do his job. Cowards don’t come at the beginning. So, it seems both admirable and normal to me. The suffering of the hospital body, I’ve been seeing it for ten or fifteen years. The number of my colleagues who have told me, you are so lucky to be retired! We suffer, it’s terrible, the hospital has become a business. And I totally agree with what they said: the hospital has been martyred. With purely economic decisions that ignored the interests of patients and doctors. The number of doctors who took early retirement should be measured by explaining that their profession no longer had any interest and that they felt they were spending their time filling in forms and boxes. There has been a real ransacking of the public hospital over the last decade. The last Minister of Health who was still really aware of his role and who respected health care workers was Xavier Bertrand. After that, it was a disaster.”

Sicard also did not think that this broken health system had any repercussions today faced with the current sanitary crisis in France, adding: “All the measures that made the hospital non-functional have temporarily disappeared. The administrators are terrified in their offices and do nothing. The doctors are doing everythingThey have regained all their power.

DocPaints

There is a certain happiness for them in finding the job they always wanted to do. The administration has packed up its bags, or more precisely, it is in charge. The balance of power has been reversed: a year ago, doctors were at the orders of the administration; now, it is the administration that is at the orders of the doctors. This is a very interesting phenomenon. Doctors themselves are no longer hindered by being forced to fill the beds with patients who bring in money, which was the principle until then. Now they’re going back to their core business. Which is the fight against death. Deep down, they find the deep DNA of their craft. It’s almost a paradox: there is less distress in the medical profession now at peak activity, than there was six months ago when they were desperate and depressed because they felt that their profession had lost its meaning.”

Sicard seems to rightly observe and believe that the politicians will remember this period and that civilisation is changing era: “I can give you an example for which I’ve been fighting for two years. I won’t name the hospital, but I know a woman who specializes in burn surgery. At the hospital, her department was closed and she didn’t have a position anymore. Nevertheless, she wanted to continue working with children with burns. However, her burn unit was transformed into a plastic surgery unit for buttocks and breasts. Because it brings in a lot of money. But she always tells me that if there was a fire in a school with forty or fifty burned children, we would no longer have the capacity to take them in because we consider that burns are not profitable enough and that it is better to focus on surgery for the stars. »

20200123_Capitalism

Où perd-on foi dans le capitalisme ? / Source: Statista France

« This economic vision of medicine, which has been introduced over the last ten years, is an absolute disaster, » declared the experienced medical professional This was of course a public hospital, “In the private sector, institutions do what they want. However, it is not normal for the public sector to destroy an activity that is not profitable – because burns are very expensive and bring in very little money and there is no private activity capable of dealing with them – and to dismiss it in favour of profitable activities. Basically, the public was anguished at the idea that it had to invest heavily in top-of-the-range equipment to match the private sector. The public will never have as much money as the private sector and will never be able to keep up. And by spending money on highly specialized sectors, we end up neglecting the most vulnerable people, be they the elderly, alcoholics or people in precarious situations. The public hospital has ended up forgetting its hospital function, as I have said on several occasions. Ninety per cent of doctors have been aware of this and it has been a terrible suffering for them. Just as it was for nurses and other care workers to do a job that was linked to money.”

Macron le clown

La majorité des Français pensent que le Macron banquier est inutile comme leur président / Source: Odoxa

Professor Sicard believes that we have no assurance that politicians will change their views on health care, however he thinks that the French will remember and will hold them to account, saying: “President Macron had promised to stop activity-based pricing, the current system of hospital financing. Economists have been pushing the envelope, saying that we would no longer be able to measure the cost of this or that operation. And the head of state gave up. I think that after this crisis, the President of the Republic will modify this activity-based pricing. The hospital will ask to be reimbursed on what it achieves and what it considers its priority. We have to trust the hospital not to treat patients unnecessarily and fill beds as if we were at the club méditerranée. The hospital will regain its true public care function.”

pas-assez-medecins-scolaires-dans-les-ecoles-francaises d'purb dpurb site web

Image: Médecin scolaire au travail en France / School doctor at work in France

In the UK, at Oxford University, researchers have been working with Oxford University Hospitals NHS Foundation Trust to reduce clinical research activity to allow researchers to prioritise research on COVID-19 and to support the pressing clinical needs of the NHS. The academic community will have to work together with governments, funders and healthcare providers to combat this ugly COVID-19 virus and Oxford has a long history of responding to health emergencies, e.g. during the 2014 Ebola crisis among negro communities in Africa, Oxford scientists lead the way in undertaking human vaccine studies, and Oxford’s strength in research around infectious diseases and international health, alongside its leading work in emergency vaccine development places it in a great position to contribute to better comprehension around the effective control of this horrific epidemic.

Coronavirus Researchers at Oxford

Source: Oxford University Research

The Oxford team has already tested a potential coronavirus vaccine successfully on several animal species. The World Health Organisation (WHO) has reported that over 70 vaccines are being developed globally for the Covid-19. The Oxford team will join 3 other groups of researchers, 2 in the US and 1 in China for the start of human trials. Professor Sarah Gilbert, a vaccinologist at Oxford University said she is « 80 per cent » confident it will be a sucess. Patrick Vallance, the UK’s chief scientific adviser said that it would be « very lucky » if a coronavirus vaccine was available widely within a year.

Exscientia Oxford Science Park

Image: Researchers at the laboratory of British pharmatech company Exscientia at Oxford Science Park in Oxford, part of an initiative to develop coronavirus treatments. Source: Adrian Dennis/AFP via Getty Images

The Oxford group are among the most advanced viral vaccine group in the world and have been working on vaccine preparedness for several years which means that they should be able to test and evaluate Covid-19 vaccine candidates rapidly.  The group have unique unique viral vector delivery and expression systems combined with diverse expertise from basic virology to vaccine production scale-up. The UK has no current vaccine manufacture however, and may have to rely on its Western European neighbours (e.g. France, Belgium and Germany) that have industrial level manufacturing capabilitiesThe Jenner Institute and Oxford Vaccine Group, could develop a jab that would be ready as early as September, almost a miracle in speed for such a demanding task as people are dying by the thousands every couple of hours globally.

Worldometers Coronavirus Cases

COVID-19 CORONAVIRUS PANDEMIC Live Counter (here last updated on May 20, 2020) / Source: Worldometer (Click to see the live counter)

So, we are going to need  a technology that allows us to deliver billions of doses over a year. The team at the University of Oxford said that they expect to produce a million doses of their experimental vaccine as early as September; months ahead of the official 12-to-18 month timeline quoted by experts around the world. “Then we’ll move even faster from there, because it’s pretty clear that the world is going to need 100s of millions of doses ideally by the end of the year to end this pandemic and let us out of lockdown safely”, said Professor Adrian HillDirector of the Jenner Institute, University of Oxford.

Part des Français prêts à accepter des mesures de quarantaine afin d'endiguer la propagation du nouveau coronavirus d'purb dpurb site web

Part des Français prêts à accepter des mesures de quarantaine afin d’endiguer la propagation du nouveau coronavirus (COVID-19) en France en 2020 / Source: Statista France

20200317_Virus_Spread

Pourquoi la distanciation sociale est primordiale / Source: Statista France

The Oxford University team’s experimental product, called « ChAdOx1 nCoV-19 », is a type of immunisation known as a recombinant viral vector vaccine and is just one of at least 70 potential Covid-19 candidate shots under development by biotech and research teams around the world. The vaccine was chosen as the most suitable vaccine technology for the virus as it can generate a strong immune response from one dose, said the team. When asked how they managed to move the usually lengthy process of vaccine approval along so quickly, Professor Sarah Gilbert, who is leading the study, said it was their ongoing research into Disease X – an as yet unknown infectious agent earmarked as a potential pandemic in the making – which allowed them to pivot so quickly to Covid-19.

Collaboration and cooperation sarh gilbert d'purb dpurb site web

Traduction(EN): « I am in no doubt that we will see an unprecedented spirit of collaboration and cooperation. » – Sarah Gilbert

We should be looking into creating a planetary medical organisation that is minutely planned and efficiently organised around the latest and finest technological advancements. All vaccine researchers and developers worldwide have a responsibility towards mankind to synchronise their knowledge and findings in the development of the ultimate vaccine.

The World Health Organization will also have to prioritise works on the linguistic synchronisation of planet Earth’s medical worlds since this unification of the medical talents and expertise worldwide is of upmost importance for the future of mankind and civilisation. What we mean by linguistic synchronisation is that the whole medical community will need to work in one language as it will speed up development, and will also be one step towards building a united planetary society, even if individuals are free to learn or study other tertiary languages if that is what they desire.

scientific-revolution

It is also to be noted that with all the difficulties that such a delicate intellectual responsibility and duty involve due to the lack of sophistication, open-mindedness, personality along with the persistent culture of atavism of many rigid, naive, ignorant, infantile and petty little minds, especially in the Anglo-Saxon sphere, reminding me of a comedic post about the 29 things French people love about Britain, but more particularly in the even more savage industrial and mechanical wild west of the US, as a bilingual Franco-British individual with native mastery of French and English, I have always invested my time and energy in the cause of mankind’s evolution and tried my best to act as a cultural bridge between the academic, medical, scientific, intellectual, psychological, philosophical, and psycholinguistic realms of the 2 most widely spoken languages in the so called « developed world » – that sometimes unfortunately still feels like concrete jungles through the savage behaviour, actions and reasoning of the passionless and unsophisticated creatures that are supposed to set an example, inspire, guide a civilisation and create a humane and harmonious society where « le dépassement de soi » is a realistic pursuit and where individuals can grow in multiple ways, truly « live » in the full sense of the term and not simply have a plain and meaningless existence where achievement is purposeless and devoid of sense.

In our times, however, there are still many regions of the world that are linguistically « undeveloped »; where the majority cannot even master simple communication in English, let alone grasp the finesse, artistry, romanticism, emotional sensibility, humane values and depth of the psychical realm of literary French.

Les politiciens en manque d'éducation linguistique et littéraire d'purb dpurb site web

Traduction(EN): « Can anyone tell me how a simple female monkey with electrodes, let alone a (so-called) minister of culture, can talk without dying of shame about a « learning » summer?
I repeat: a learning summer.
A summer, therefore, that learns.
That learns what? 
To write French, no doubt. » / Source: Twitter (Juan Asensio)

Indeed, just like many useless, cheap, uncultivated and frustrated street politicians in France, the great majority of their political counterparts in other parts of the world also fail to do so, unconsciously suffering from a lack of literature, self-cultivation, artistic exposure, self-respect and dignity combined with a constant complexe d’infériorité towards those who are wiser, smarter, nobler in spirit, more intelligent, creative, charismatic and sophisticated than them; I would recommend them to sit down and listen to the university lectures of Prof. Michel Butor [E.g. Les récits philosophiques de Balzac], it may help towards their cultural evolution, but also ease the pain on those forced to endure them, such as their wife and children.

Honoré de Balzac d'purb dpurb site web

Honoré de Balzac (1799 – 1850)

It is time for them to firmly understand that we still have some « adultes surdoués » as Monique de Kermadec » phrases it, or « Overmen » as Friedrich Nietzsche puts it i.e. highly talented and skilled individuals who live and exist out there, especially in the psyches of the French speaking world and heritage [e.g. Napoléon, of whom even the great German Georg Wilhelm Friedrich Hegel himself described seeing as follows: « I have seen the Emperor », he writes « this soul of the world – getting out of the city to go on reconnaissance; it is indeed a marvellous feeling to see such an individual who, concentrated in one point of space, sitting on his horse, stretches out over the world and dominates it. »]; individuals who have the savoir-faire and creative power to manage dozens of governments worldwide, a film/video/music/media production company, a publishing house, who could also give a lesson in professional artistic photography, post-production and presentation, and even train a whole generation of original, sophisticated, witty, poetic, literary and noble writers, and not just in Oscar Wilde’s granular Oxford English, although plain and flat compared to French, but also « la langue Française de Balzac » in all its precise articulations, depth, style and literary artistry.

Logically, to  such individuals, running a press/publishing/media business would be a piece of cake, something achievable half-asleep with superior values, style, efficiency and impact than the mass of mediocre newspapers and their usually obese owners and political sympathisers out there; if such a direction was a career choice and goal for those gifted individuals at a particular point of their life – of course!

Besides, my whole life I have questioned my own sanity because I have always felt misunderstood and different from the rest of the crowd and highly sensible and receptive to what most primates around me could not even hear, sense, feel, see, perceive or understand, and also never found anyone in the Anglo-Saxon realm with a mastery of French similar to mine, and nobody in the French realm with a mastery of English as mine, thinking that I could be fake, I then realised that linguistic discourse and speech are not fake, but are very real and alive, as Jacques Lacan also concluded. Luckily, I recently read Monique de Kermadec’s book « L’Adulte Surdoué » and found out that humanity has a minority of individuals out there in the world who also feel misunderstood and are hard to classify, because just like myself, these « weird fools » and misunderstood individuals have an IQ of above 145 [which I only recently found out myself from a small IQ test on the MENSA website that only measured up to 145, which is sufficient for me to know without an exact number since this is a statement of fact not an exercise of arrogance – delivering me from my torment to confirm that the weird ones are not us, but the mediocre majority that surrounds us and cannot follow our discourse or understand our lightning speed judgements because of their lower IQ – valuable things in nature are rare, that is why they are valuable].

Chef d'orchestre

Superior individuals with superior intellect will not see these cold-blooded, cannibalistic, reptilian political primates as a model to follow, as an inspiration, as a source of comfort, safety, hope or stability, as a spiritual guide or as an ultimate authority, but instead just see them as a bunch of other disconnected and divisive money-minded politicians and cold bureaucrats passing by, like the thousands of mediocrities who have lived and died before them and who have been responsible for some of the most castastrophic human disasters in history without ever being able to accept their mistakes, while also not having any major positive impact on the world, and who are at this minute rotting in a forgotten grave with maggots sliding through their bones. We could even ask ourselves whether some of them have green blood, and imagine the horror and agony it must be for any woman for whatever reason to have to wake up next to one of those reptilian primates every morning, with its mouth half open drooling on a pillow with its « haleine de boudin ».

Le gouvernement du clown macron

Le gouvernement a-t-il été à la hauteur de la situation ? / Source: Odoxa

And to stress the point that most of the mediocre politicians nowadays cannot be trusted with the heart of the people, the historical and legendary verbal whipping from the great Napoleon himself to the evil, lying, sly, dishonest, disloyal and backstabbing politician, Talleyrand, who was plotting against the emperor with Fouché in 1834, comes to mind; looking at the untrustworthy face and straight in the eyes of the unscrupulous man, the emperor Napoléon said:

« Vous êtes un voleur, un lâche, un homme sans foi. Vous ne croyez pas à Dieu ; vous avez toute votre vie manqué à tous vos devoirs, vous avez trompé, trahi tout le monde […] Tenez, Monsieur, vous n’êtes que de la merde dans un bas de soie. »

Napoléon à Talleyrand - de la merde dans un bas de soie d'purb dpurb site web

Traduction(EN): « You’re a thief, a coward, a man of no faith. You do not believe in God; all your life you have failed in all your duties, you have deceived, betrayed everyone […] Here, sir, you are nothing but shit in a silk stocking. » – Napoléon (to Talleyrand, during the Council of Ministers convened at the Château des Tuileries) / Source: L’Histoire en Citations

Nowadays with the adaptive and dynamic technology and skilled software engineers available, we should be creating a sophisticated planetary medical system where the latest findings, empirical studies, analysis and statistics of the medical experts of the whole world are instantly synchronised and available in one place [with instant full-access to all medical journals worldwide], while respecting the personal and non-medical details of patients by a tested and proven system of indexing that does not allow for personal details to be input but only strict medical/scientific details.

We should be focusing on specialised and highly encrypted [an encryption specially devised for this system that is 100% safe so that even if there are hacks and data breaches, the data will never be usable due to the powerful encryption] servers only accessible through highly controlled card systems, only available to the medical departments of hospitals and universities from all around the globe.

Such a system would speed up development for both medical professionals and patients. For example, If a patient suffering from cervical, skin, ovarian, testicular or lung cancer in any part of the world (e.g. Rio de JaneiroNew York, Moscow, Port-Louis, Bombay, Tokyo, Alabama, Berlin, Jerusalem, Ottawa, Cape Town, Zurich, London, Grenoble or Paris) has a CT scan, that scan would be instantly uploaded and classified in the medical database on the specialised and encrypted servers and made available to all medical departments and professionals in the world connected to the system, who would then have the options to add comments or questions, with their involvements being rewarded by points.

The heads of medical faculties at universities could even have the option to use these live data and cases to train medical students, and in doing do, provide a revision to the diagnosis and treatments of patients while also subjecting the cases to constructive criticism and/or new treatments being developed.

Infirmière avec les personnes âgées d'purb dpurb site web

Image: Étudiante en médecine en formation / Medical student in training

A similar scenario could also apply for all diseases and all types of treatment that would be minutely and systematically classified while remaining intuitive to browse, sort by a range of variables and access for medical professionals; the age, blood group, weight, height, sex and other medical details only would be made available on the specialised server, not private non-medical information. Such an advanced system would not only connect the medical community, stamp  out medical negligence and raise medical standards, but also provide a massive dataset from which a range of institutions could carry medical research and have a more precise conclusion from statistical tests.

This system with a well organised database could also be used to manage a global blood bank and ensure that it is evenly distributed internationally so that even those with rare blood groups can be treated efficiently when health problems arise;

Serrurier d'Amiens

Image: Un serrurier au travail / Locksmith at work

for example, if the daughter of a motel owner, fried chicken and hot dog seller in Illinois happens to be of a very rare blood type and she finds herself in desperate need of it to remain alive, she could instantly have access to the rare blood which could have been collected from the other side of the globe and extracted from the veins of a locksmith in Amiens, an aborigine in New Zealand, a noodle seller in China, a dwarf circus-performer from an English village, a banker in India, an Eastern European stripper in Las Vegas, a heavy truck driver in Madagascar, a kangaroo keeper in Australia, a potato farmer in Germany, a gay bouncer and bodybuilder in Austria, an old and bald Breton who edits a low class « plouc » newspaper in Northern France, a retired, frustrated, useless and senile politician in Brazil, a peasant with a limited vocabulary and a strong « Marseillais » accent, or a globally known French writer, intellectual, philosopher and creative artist – because such an efficient and sophisticated system would allow for a systematic management of blood banks globally.

la collecte de sang d'purb dpurb site web

Image: Don de sang / Blood donation

That system would also include the profiles of medical professionals accessible between them along with a system of forums, awards, points and chats where any medical department and expert could post messages regarding the recruitment of patients for studies, the latest findings of particular medicines and treatments from the wide range of departments and specialities; and also the top articles from scientific journals made available by different departments – until we work on such a sophisticated system, humanity will continue to suffer from a lack of organisation and management.

A system as sophisticated and organised as that would lead to the world being up-to-date and synchronised medically, with patients also receiving the latest treatments or having the option to travel to different parts of the world for new treatments against deadly diseases or terminal stages that are still in the trial phase and also doctors remaining focused and sharp through the latest updates in their specific fields while also giving them the ability to instantly ask questions on the forum/chat to other experts in their fields right from the operating table if they are unsure or would like some words of support or confirmation.

An Example of collaborative software Microsoft Teams d'purb dpurb site web

Image: Microsoft Teams, un exemple de modèle pour une application collaborative / Confinement: le nombre d’utilisateurs quotidiens a augmenté de 12 millions en l’espace d’une semaine. Le 11 mars, Microsoft Teams comptait 32 millions d’utilisateurs quotidiens, pour ensuite voir ce chiffre passer à 44 millions le 18 mars / Source: Statista France

They may even have a live camera streaming system on their foreheads or face while conducting surgery so that it can be seen by all those connected to the system in private clinics, hospitals and the medical faculties of universities worldwide. Such a system could be regulated by an independent global medical authority that would also deliver certifications to all institutions and professionals who apply for it, patients could also see a particular logo on their treatment locations to see that they are part of such a system; if this is implemented even minor hospitals in small villages will suddenly have the boost and expertise of the top medical experts behind them. This would lead to an instant rise in medical standards worldwide.

Femme-et-son-médecin_france d'purb dpurb site web

Image: Une femme en France discutant avec son médecin / A woman discussing with her doctor in France

In the 21st century with the affordability of powerful multi-core processors, high-definition audiovisual equipment and high speed broadband it is a scenario that is very realistic and not a far-fetch scene from one of the infantile mass produced science-fiction fantasies of the Hollywood industry.

We need to apply the technological ingenuity of mankind appropriately to make the most of our lives in this world and allow our fellow humans to live more and stress less, and not simply focus all that technological prowess into creating brain numbing and absurd entertainment media and other petty devices and apps that lead humanity to a culture of mundane, mediocre, meaningless and useless social blogging and nonsense, where bored and pathetic people share photos of their sandwiches, drinks, breakfast and make-up tips with the world. From an article in the Lancet, Sarah Gilbert said: « WHO is in the process of creating a forum for everyone who is developing COVID-19 vaccines to come together and present their plans and initial findings. It is essential that we all measure immunological responses to the various vaccines in the same way, to ensure comparability and generalisability of our collective findings. Work is continuing at a very fast pace, and I am in no doubt that we will see an unprecedented spirit of collaboration and cooperation, convened by WHO, as we move towards a shared global goal of COVID-19 prevention through vaccination”.

Share of vaccines being developed in each country

I also take the opportunity to salute all the medical teams and healthcare workers operating all over the world for the courageous task they are undertaking and also express all my gratitude and support to my local NHS GP surgery in West London who have always been there when I needed them and who are still texting their patients to show their concern and support in these difficult times affecting the entire human civilisation.

NHS UK Message

« This is a snapshot of the message I received from my local GP surgery in West London on Friday, 10th of April at about midnight (UK time) even if I am out of the UK at the moment after more than 14 years without taking any holiday or leave of absence from the country. My plans to return in January with a trip to Oxford has been ruined by this ugly Coronavirus pandemic, and now all the flights have been frozen… my heart remains and will forever be in Western Europe. » -Danny D’Purb

Steps to prevent infection are vital:

There are many things we can do to protect ourselves and the people we interact with. As with a cold, a flu vaccine won’t protect people from developing COVID-19. The best thing we can do at this point is to follow the same preventive measures as we would against the flu. It is widely known that individual can catch the flu when people sneeze and/or cough on them, or when they touch a dirty doorknob. We should wash our hands thoroughly especially before eating or touching the facial area and cavities and also after using the bathroom, while also avoiding others with flu-like symptoms – these are the best strategies for the time being.

Officer worker having lunch in London

Déjeuner d’un employé de bureau âgé à Londres / Elderly office worker in London having lunch

The following preventive actions are also recommended:

  • Wash hands with soap and water for at least 20 seconds. Dry them thoroughly with an air dryer or clean towel. If soap isn’t available, use a hand sanitizer with at least 60% alcohol.
  • Stay at home if sick.
  • Avoid touching nose, eyes, and mouthUse a tissue to cover a cough or sneeze, then dispose of it in the trash.
  • Use a household wipe or spray to disinfect doorknobs, light switches, desks, keyboards, sinks, toilets, cell phones, and other objects and surfaces that are frequently touched.
  • It may also be important to create a household plan of action. You should talk with people who need to be included in your plan, plan ways to care for those who might be at greater risk for serious complications, get to know your neighbours, and make sure you and your family have a household plan that includes ways to care for loved ones if they get sick. This includes planning a way to separate a family member who gets sick from those who are healthy, if the need arises.
  • Medical professionals recommend that people voluntarily wear cloth face masks in public settings where other social distancing measures are difficult to maintain, including grocery stores and pharmacies, especially if they live in an area of significant community-based transmission. It should be noted that the cloth mask is not meant to protect the wearer from infection. It is instead meant to slow the spread of the virus (if people who have the virus and do not know it wear masks, they help prevent transmitting it unknowingly to others). Health experts advise making face coverings at home from simple materials, and reserving surgical masks and N95 respirators for health care workers and other medical first responders.

While everyone should take precautions, measures may be critical for adults over 65 years old (the risk seems to gradually increase with age starting at age 40, according to the World Health Organization) and those with chronic conditions (such as diabetes, heart disease, and lung disease).

Les plus de 70 ans, principales victimes du #COVID19 pourraient être confinés plus longtemps

Les plus de 70 ans, principales victimes du #COVID19 pourraient être confinés plus longtemps / Source: Le Parisien

People in these higher risk categories especially should stock up on household items, groceries, medications, and other supplies in case they need to stay home for an extended period of time.

20200402_Toiletpaper

#Consommation : les Français se seraient-ils montrés plus raisonnables que les autres face à l’achat-panique ? On peut se poser la question au regard de cette estimation de la hausse des ventes de #papiertoilette par pays en mars / Source: Statista France

Steps to follow if you become infected and fall ill:

Until now, information available shows that the severity of COVID-19 infection ranges from very mild (sometimes with no reported symptoms at all) to severe to the point of requiring hospitalization. Symptoms can appear anywhere between 2 to 14 days after exposure, and may include:

  • Fever
  • Cough
  • Difficulty breathing

Getting in touch with one’s medical provider for advice in the eventuality of experiencing these symptoms, especially if you have been in close contact with a person known to have COVID-19 or live in an area with ongoing spread of the disease is recommended.

Most people will have a mild illness and will usually be able recover at home without medical care. Seek medical attention immediately if you are at home and experience emergency warning signs, including difficulty breathing or shortness of breath, persistent pain or pressure in the chest, new confusion or inability to arouse, or bluish lips or face. This list is not final, so consulting your medical provider if other concerning symptoms are noticed is vital.

François Sureau : « Les Français ne sont pas un troupeau de moutons ou une garderie d’enfants »

To conclude, just like Goldin and Muggah, I also believe that the major Western European players, China, Japan and especially France, a world leading and cultivating nation, must set an example for history by stepping up and leading a global effort, forcing the deteriorated and unstable US government and the uncharismatic politicians controlling it into a global response, which includes accelerating vaccine trials and ensuring free distribution to the world once the ultimate vaccine and antivirals are perfected and finalised. Governments and financial institutions around the world will also need to take dramatic action toward massive investments in health, sanitation and basic income and also provide financial support to both struggling employers and employees.

Potential Treatment

As for potential treatments that have managed to save some lives until the vaccine is finalised, we have some studies suggesting that convalescent plasma [i.e. donated blood from people who have recovered since this donor blood has antibodies to COVID-19lead to shorter hospital stays and lower mortality for patients who received the treatment while no severe adverse effects were observed (Chen, Xiong, Bao and Shi, 2020). It has also been shown that chloroquine, hydroxychloroquine and tocilizumab have the potential to act as a potential cure in « some » patients but they are not guaranteed to function in all cases of COVID-19. The last substance, TOCILIZUMAB has even recently shown to cure COVID-19 patients with severe underlying medical conditions; it has cured a patient who recently had a kidney transplant (Fontana, et al. 2020), and others with asthma (Schleicher, Lowman and Richards, 2020), systemic sclerosis (Distler, 2020), multiple myeloma (Zhang, et al. 2020) and sickle cell (De Luna, et al. 2020).

Some doctors in France are claiming to have healed patients infected with CoVID-19 through the use of antihistaminesa well-known and easily accessible medication against seasonal allergies, and some patients are claiming that in 24 hours their symptoms disappeared [i.e. blocked nose, runny nose, aches and pains]. Although no empirical studies have been carried out yet, these French doctors are claiming that since antihistamines can reduce inflammation in its early stages it can prevent progression towards dangerous stagesDr Hélène Rezeau-Frantz prescribed antihistamines to 18 patients who were symptomatic but untested and after a couple of hours they all started feeling better. These doctors are claiming that antihistamines carry no risk of serious adverse effects and genuinely believe that we may be on an interesting trail towards treatment and are asking for serious studies to be carried out on antihistamines.

All these recent advances have been referenced below in the « Références (Études Scientifiques) » section, and academics & medical professionals are kindly urged to read, analyse and continue further research in this direction and the world can also help by spreading this information as far and wide as they can without wasting a single second.

Réflexion

This is a very stressful and testing time for not only the academic community but also to the rest of the human population and until safe solutions are developed to counter COVID-19, as mentioned above, we cannot lower our guards or act recklessly towards this dangerous and deadly virus.

Skulls in the Opdas Mass Burial Cave

Image: Skulls in the Opdas mass burial cave (for illustrative purposes only)

We must NEVER FORGET that there is a deadly virus circulating and any minor slip or even a small reflex [e.g. scratching the eyelids] can mean death. We must follow the barrier moves at all times and be incredibly conscious of our every move and actions while also constantly maintaining a strict clinical hygiene. Those who are not following these protective rules are not only playing with their own life but with those of others and a good suggestion for these dangerous, irresponsible and immature people would be to imagine 288, 212 human corpses stacked in a heap in front of them and ask themselves whether they would like to be part of it, because this is the number of lives the CoVID-19 epidemic has claimed in a few months which includes many highly trained and experienced doctors. We have also heard and read some rumours in the media regarding the impact of weather and climate on the COVID-19 pandemic. What a recent study in Science (Baker et al., 2020) found is that humid climates tend to favour stronger outbreaks, however summer and sunshine will not limit the pandemic growth substantiallyThe only things that will give us all our life back are effective antivirals and/or a reliable vaccine.

It is also understandable that many people are also eager to get back to resuming their normal lives and having been confined for so long many want to travel or go on holidays, especially confined couples.

Lady in Red - ALLoyd d'purb dpurb site web

Image: Lady in red / A.Lloyd

However, it is imperative to understand that as long as effective antivirals and vaccines are not finalised, this incredibly dangerous virus will be circulating among human populations. Hence, as matters currently stand the wisest behaviour for the time being is to wait and be patient while also minimising unimportant social interactions and travel and only focus on what is truly important. We should only leave the house for essential and vital reasons such as for work [if impossible to work from home] and for food provisions.

Thanking all my readers, followers and supporters for their kindness, time, loyalty and trust.

Sincerely,

Danny D’Purb

Le Boléro de Ravel par l’Orchestre national de France en #confinement #ensembleàlamaison

(FR) Vous trouverez ci-dessous une liste des principaux articles relatifs à la crise COVID-19 en cours. La liste ci-dessous sera continuellement mise à jour comme tous nos articles sur le siteVeuillez visiter ce poste périodiquement pour plus d’informations pendant que nous luttons ensemble contre cet horrible virus en tant qu’une civilisation des créatures les plus intelligentes de la Terre.

(EN) Below is a list of the top articles related to the ongoing COVID-19 crisis. The list below will be continuously updated as all of our posts on the website. Please visit this post periodically for more information as we fight this ugly virus together as a civilisation of the smartest creatures on Earth.

*****

Références (Études Scientifiques) – Cliquez sur les liens

  1. Ahmed, S., Quadeer, A. and McKay, M., (2020). Preliminary Identification of Potential Vaccine Targets for the COVID-19 Coronavirus (SARS-CoV-2) Based on SARS-CoV Immunological StudiesViruses, 12(3), p.254.
  2. Aljofan, M. and Gaipov, A., (2020). COVID-19 Treatment: The Race Against TimeElectronic Journal of General Medicine, 17(6).
  3. Amuasi, J., Walzer, C., Heymann, D., Carabin, H., Huong, L., Haines, A. and Winkler, A., (2020). Calling for a COVID-19 One Health Research CoalitionThe Lancet.
  4. Asian Pacific Journal of Allergy and Immunology, (2020). Immune responses in COVID-19 and potential vaccines: Lessons learned from SARS and MERS epidemic.
  5. Baker, R., Yang, W., Vecchi, G., Metcalf, C. and Grenfell, B., (2020). Susceptible supply limits the role of climate in the early SARS-CoV-2 pandemicScience, p.eabc2535.
  6. Bennardo, F., Buffone, C. and Giudice, A., (2020). New therapeutic opportunities for COVID-19 patients with Tocilizumab: Possible correlation of interleukin-6 receptor inhibitors with osteonecrosis of the jawsOral Oncology, p.104659.
  7. Bergin, C., Browne, P., Murray, P., O’Dwyer, M., Conlon, N., Kane, D., Laffey, J., Ní Choitir, C., Adams, R., O’Leary, A., King, F. and Gilvarry, P., (2020). Interim Guidance For The Use Of Tocilizumab In The Management Of Patients Who Have Severe COVID-19 With Suspected Hyperinflammation [V3.0]. The Irish Health Repository.
  8. Bi, Q., Wu, Y., Mei, S., Ye, C., Zou, X., Zhang, Z., Liu, X., Wei, L., Truelove, S., Zhang, T., Gao, W., Cheng, C., Tang, X., Wu, X., Wu, Y., Sun, B., Huang, S., Sun, Y., Zhang, J., Ma, T., Lessler, J. and Feng, T., (2020). Epidemiology and transmission of COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: a retrospective cohort studyThe Lancet Infectious Diseases,.
  9. Carsetti, R., Quintarelli, C., Quinti, I., Piano Mortari, E., Zumla, A., Ippolito, G. and Locatelli, F., (2020). The immune system of children: the key to understanding SARS-CoV-2 susceptibility?The Lancet Child & Adolescent Health,.
  10. Cellina, M., Orsi, M., Bombaci, F., Sala, M., Marino, P. and Oliva, G., (2020). Favorable changes of CT findings in a patient with COVID-19 pneumonia after treatment with tocilizumabDiagnostic and Interventional Imaging,.
  11. Challender, D., Harrop, S. and MacMillan, D., (2015). Understanding markets to conserve trade-threatened species in CITESBiological Conservation, 187, pp.249-259.
  12. Chang, R. and Sun, W., (2020). Repositioning Chloroquine as Ideal Antiviral Prophylactic against COVID-19 – Time is Now.
  13. Chen, L., Liu, H., Liu, W., Liu, J., Liu, K., Shang, J., Deng, Y. and Wei, S., (2020). [Analysis of clinical features of 29 patients with 2019 novel coronavirus pneumonia]Chinese Journal of Tuberculosis and Respiratory, 43(0):E005.
  14. Chen, L., Xiong, J., Bao, L. and Shi, Y., (2020). Convalescent plasma as a potential therapy for COVID-19The Lancet Infectious Diseases, 20(4), pp.398-400.
  15. Colson, P., Rolain, J., Lagier, J., Brouqui, P. and Raoult, D., (2020). Chloroquine and hydroxychloroquine as available weapons to fight COVID-19International Journal of Antimicrobial Agents, p.105932.
  16. Cortegiani, A., Ingoglia, G., Ippolito, M., Giarratano, A. and Einav, S., (2020). A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19Journal of Critical Care.
  17. Day, M., (2020). Covid-19: ibuprofen should not be used for managing symptoms, say doctors and scientistsBMJ, p.m1086.
  18. De Luna, G., Habibi, A., Deux, J., Colard, M., d’Alexandry d’Orengiani, A., Schlemmer, F., Joher, N., Kassasseya, C., Pawlotsky, J., Ourghanlian, C., Michel, M., Mekontso-Dessap, A. and Bartolucci, P., (2020). Rapid and Severe Covid-19 Pneumonia with Severe Acute Chest Syndrome in a Sickle Cell Patient Successfully Treated with TocilizumabAmerican Journal of Hematology,.
  19. Diao, B., Wang, C., Wang, R., Feng, Z., Tan, Y., Wang, H., Wang, C., Liu, L., Liu, Y., Liu, Y., Wang, G., Yuan, Z., Ren, L., Wu, Y. and Chen, Y., (2020). Human Kidney is a Target for Novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection.
  20. Dong, L., Hu, S. and Gao, J., (2020). Discovering drugs to treat coronavirus disease 2019 (COVID-19)Drug Discoveries & Therapeutics, 14(1), pp.58-60.
  21. Fan, Z., Chen, L., Li, J., Tian, C., Zhang, Y., Huang, S., Liu, Z. and Cheng, J., (2020). Clinical Features of COVID-19 Related Liver Damage.
  22. Fazzi, E. and Galli, J., (2020). New clinical needs and strategies for care in children with neurodisability during COVID‐19Developmental Medicine & Child Neurology,.
  23. Fontana, F., Alfano, G., Mori, G., Amurri, A., Lorenzo, T., Ballestri, M., Leonelli, M., Facchini, F., Damiano, F., Magistroni, R. and Cappelli, G., (2020). Covid‐19 pneumonia in a kidney transplant recipient successfully treated with Tocilizumab and HydroxychloroquineAmerican Journal of Transplantation,.
  24. Fu, B., Xu, X. and Wei, H., (2020). Why tocilizumab could be an effective treatment for severe COVID-19?Journal of Translational Medicine, 18(1).
  25. Gao, J., Tian, Z. and Yang, X., (2020). Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studiesBioScience Trends, 14(1), pp.72-73.
  26. Gao, Q., Bao, L., Mao, H., Wang, L., Xu, K., Yang, M., Li, Y., Zhu, L., Wang, N., Lv, Z., Gao, H., Ge, X., Kan, B., Hu, Y., Liu, J., Cai, F., Jiang, D., Yin, Y., Qin, C., Li, J., Gong, X., Lou, X., Shi, W., Wu, D., Zhang, H., Zhu, L., Deng, W., Li, Y., Lu, J., Li, C., Wang, X., Yin, W., Zhang, Y. and Qin, C., (2020). Development of an inactivated vaccine candidate for SARS-CoV-2Science, p.eabc1932.
  27. Garg, S., Kim, L., Whitaker, M., O’Halloran, A., Cummings, C., Holstein, R., Prill, M., Chai, S., Kirley, P., Alden, N., Kawasaki, B., Yousey-Hindes, K., Niccolai, L., Anderson, E., Openo, K., Weigel, A., Monroe, M., Ryan, P., Henderson, J., Kim, S., Como-Sabetti, K., Lynfield, R., Sosin, D., Torres, S., Muse, A., Bennett, N., Billing, L., Sutton, M., West, N., Schaffner, W., Talbot, H., Aquino, C., George, A., Budd, A., Brammer, L., Langley, G., Hall, A. and Fry, A., (2020). Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 — COVID-NET, 14 States, March 1–30, 2020 Morbidity and Mortality Weekly Report, 69(15), pp.458-464.
  28. Guo, C., Li, B., Ma, H., Wang, X., Cai, P., Yu, Q., Zhu, L., Jin, L., Jiang, C., Fang, J., Liu, Q., Zong, D., Zhang, W., Lu, Y., Li, K., Gao, X., Fu, B., Liu, L., Ma, X., Weng, J., Wei, H., Jin, T., Lin, J. and Qu, K., (2020). Tocilizumab treatment in severe COVID-19 patients attenuates the inflammatory storm incited by monocyte centric immune interactions revealed by single-cell analysis.
  29. Hamzavi, I., Lyons, A., Kohli, I., Narla, S., Parks-Miller, A., Gelfand, J., Lim, H. and Ozog, D., 2020. Ultraviolet germicidal irradiation: Possible method for respirator disinfection to facilitate reuse during the COVID-19 pandemicJournal of the American Academy of Dermatology, 82(6), pp.1511-1512.
  30. Hu, Z., Song, C., Xu, C., Jin, G., Chen, Y., Xu, X., Ma, H., Chen, W., Lin, Y., Zheng, Y., Wang, J., Hu, Z., Yi, Y. and Shen, H., (2020). Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, ChinaScience China Life Sciences.
  31. Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M., Xiao, Y., Gao, H., Guo, L., Xie, J., Wang, G., Jiang, R., Gao, Z., Jin, Q., Wang, J. and Cao, B., (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, ChinaThe Lancet, 395(10223), pp.497-506.
  32. Jin, Z., Zhao, Y., Sun, Y., Zhang, B., Wang, H., Wu, Y., Zhu, Y., Zhu, C., Hu, T., Du, X., Duan, Y., Yu, J., Yang, X., Yang, X., Yang, K., Liu, X., Guddat, L., Xiao, G., Zhang, L., Yang, H. and Rao, Z., (2020). Structural basis for the inhibition of SARS-CoV-2 main protease by antineoplastic drug carmofurNature Structural & Molecular Biology,.
  33. Juan, J., Gil, M., Rong, Z., Zhang, Y., Yang, H. and Poon, L., (2020). Effects of Coronavirus Disease 2019 (COVID-19) on Maternal, Perinatal and Neonatal Outcomes: a Systematic Review of 266 Pregnancies.
  34. Kearney, J., (2020). Chloroquine as a Potential Treatment and Prevention Measure for the 2019 Novel Coronavirus: A Review.
  35. Kim, Y., Dema, B. and Reyes-Sandoval, A., (2020). COVID-19 vaccines: breaking record times to first-in-human trialsnpj Vaccines, 5(1).
  36. Klok, F., Kruip, M., van der Meer, N., Arbous, M., Gommers, D., Kant, K., Kaptein, F., van Paassen, J., Stals, M., Huisman, M. and Endeman, H., (2020). Incidence of thrombotic complications in critically ill ICU patients with COVID-19Thrombosis Research,.
  37. Kmietowicz, Z., (2015). Processed meats are carcinogenic, says new review of evidenceBMJ, p.h5729.
  38. Kong, W., Li, Y., Peng, M., Kong, D., Yang, X., Wang, L. and Liu, M., (2020). SARS-CoV-2 detection in patients with influenza-like illness. Nature Microbiology, 5(5), pp.675-678.
  39. Krumrei-Mancuso, E., Haggard, M., LaBouff, J. and Rowatt, W. (2019). Links between intellectual humility and acquiring knowledge. The Journal of Positive Psychology, 15(2), pp.155-170.
  40. Lamers, M., Beumer, J., van der Vaart, J., Knoops, K., Puschhof, J., Breugem, T., Ravelli, R., Paul van Schayck, J., Mykytyn, A., Duimel, H., van Donselaar, E., Riesebosch, S., Kuijpers, H., Schippers, D., van de Wetering, W., de Graaf, M., Koopmans, M., Cuppen, E., Peters, P., Haagmans, B. and Clevers, H., (2020). SARS-CoV-2 productively infects human gut enterocytesScience, p.eabc1669.
  41. Letko, M., Miazgowicz, K., McMinn, R., Seifert, S., Sola, I., Enjuanes, L., Carmody, A., van Doremalen, N. and Munster, V., (2018). Adaptive Evolution of MERS-CoV to Species Variation in DPP4Cell Reports, 24(7), pp.1730-1737.
  42. Leung, N., Chu, D., Shiu, E., Chan, K., McDevitt, J., Hau, B., Yen, H., Li, Y., Ip, D., Peiris, J., Seto, W., Leung, G., Milton, D. and Cowling, B., (2020). Respiratory virus shedding in exhaled breath and efficacy of face masksNature Medicine,.
  43. Li, Z., Wu, M., Yao, J., Guo, J., Liao, X., Song, S., Li, J., Duan, G., Zhou, Y., Wu, X., Zhou, Z., Wang, T., Hu, M., Chen, X., Fu, Y., Lei, C., Dong, H., Xu, C., Hu, Y., Han, M., Zhou, Y., Jia, H., Chen, X. and Yan, J., (2020). Caution on Kidney Dysfunctions of COVID-19 Patients.
  44. Liu, J., Cao, R., Xu, M., Wang, X., Zhang, H., Hu, H., Li, Y., Hu, Z., Zhong, W. and Wang, M., (2020). Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitroCell Discovery, 6(1).
  45. Lu, C., Chen, M. and Chang, Y., (2020). Potential therapeutic agents against COVID-19Journal of the Chinese Medical Association, p.1.
  46. Lurie, N., Saville, M., Hatchett, R. and Halton, J., (2020). Developing Covid-19 Vaccines at Pandemic SpeedNew England Journal of Medicine.
  47. Mao, L., Jin, H., Wang, M., Hu, Y., Chen, S., He, Q., Chang, J., Hong, C., Zhou, Y., Wang, D., Miao, X., Li, Y. and Hu, B., (2020). Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, ChinaJAMA Neurology,.
  48. Mahase, E., (2020). Covid-19: what treatments are being investigated?BMJ, p.m1252.
  49. Mihai, C., Dobrota, R., Schröder, M., Garaiman, A., Jordan, S., Becker, M., Maurer, B. and Distler, O., (2020). COVID-19 In A Patient With Systemic Sclerosis Treated With Tocilizumab For Ssc-ILD. Annals of Rheumatic Diseases, 79(5).
  50. Miller, A., Reandelar, M., Fasciglione, K., Roumenova, V., Li, Y. and Otazu, G., (2020). Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19: an epidemiological study.
  51. Moazzen, N., Imani, B., Aelami, M., Motevali, N., Kianifar, H., Khoushkhui, M. and Ahancian, H., (2020). How to boost your immune system against Coronavirus infection?Arch Bone Jt Surg, 8(1).
  52. Moriguchi, T., Harii, N., Goto, J., Harada, D., Sugawara, H., Takamino, J., Ueno, M., Sakata, H., Kondo, K., Myose, N., Nakao, A., Takeda, M., Haro, H., Inoue, O., Suzuki-Inoue, K., Kubokawa, K., Ogihara, S., Sasaki, T., Kinouchi, H., Kojin, H., Ito, M., Onishi, H., Shimizu, T., Sasaki, Y., Enomoto, N., Ishihara, H., Furuya, S., Yamamoto, T. and Shimada, S., (2020). A first case of meningitis/encephalitis associated with SARS-Coronavirus-2International Journal of Infectious Diseases, 94, pp.55-58.
  53. Oberemok, V., Laikova, K., Yurchenko, K., Fomochkina, I. and Kubyshkin, A., (2020). SARS-CoV-2 will continue to circulate in the human population: an opinion from the point of view of the virus-host relationship. Inflammation Research,.
  54. Parvin, F., Islam, S., Urmy, Z., & Ahmed, S. (2020). THE SYMPTOMS, CONTAGIOUS PROCESS, PREVENTION AND POST TREATMENT OF COVID-19. European Journal of Physiotherapy and Rehabilitation Studies, 0. Retrieved from https://www.oapub.org/hlt/index.php/EJPRS/article/view/52
  55. Patel SK, Pathak M, Tiwari R, Yatoo MI, Malik YS, Sah R, Rabaan AA, Sharun K, Dhama K, Bonilla-Aldana DK, Rodriguez-Morales AJ. (2020). A vaccine is not too far for COVID-19J Infect Dev Ctries
  56. Patruno, C., Stingeni, L., Fabbrocini, G., Hansel, K. and Napolitano, M., (2020). Dupilumab and COVID ‐19: what should we expect?Dermatologic Therapy,.
  57. Porter, T. and Schumann, K. (2017). Intellectual humility and openness to the opposing view. Self and Identity, 17(2), pp.139-162.
  58. Rosenbloom, D. and Markard, J., (2020). A COVID-19 recovery for climateScience, 368(6490), pp.447-447.
  59. SaifAddin, B., Almogbel, A., Zollner, C., Wu, F., Bonef, B., Iza, M., Nakamura, S., DenBaars, S. and Speck, J., (2020). AlGaN Deep-Ultraviolet Light-Emitting Diodes Grown on SiC SubstratesACS Photonics, 7(3), pp.554-561.
  60. Santos, I., Grosche, V., Sabino-Silva, R. and Jardim, A., (2020). Antivirals against human and animal Coronaviruses: different approach in SARS-CoV-2 treatment.
  61. Schleicher, G., Lowman, W. and Richards, G., (2020). Case Study: A Patient with Asthma, Covid-19 Pneumonia and Cytokine Release Syndrome Treated with Corticosteroids and TocilizumabWits Journal of Clinical Medicine, 2(SI), p.47.
  62. Schrack, J., Wanigatunga, A. and Juraschek, S., (2020). After the COVID-19 Pandemic: The Next Wave of Health Challenges for Older AdultsThe Journals of Gerontology: Series A,.
  63. Shenker, N., Aprigio, J., Arslanoglu, S., Aye, N., Bærug, A., Bar Yam, N., Barnett, D., Bellad, R., Bertino, E., Bethou, A., Bharadva, K., Olin, A., Billeaud, C., Buffin, R., Cassidy, T., Chugh Sachdeva, R., Clifford, V., Coutsoudis, A., Deb, S., Domjan, A., Fang, L., Festival, J., Franks, A., Garcia-Lara, N., Gaya, A., Golubiú-Úepuliú, B., Groff, L., Grøvslien, A., Hamilton Spence, E., Heidarzadeh, M., Hosseini, M., Hughes, J., Israel-Ballard, K., Jain, K., Jain, S., Jayaraman, S., Jones, F., Kale, P., Kasar, J., Kithua, A., Klein, L., Klotz, D., Lin, Y., Liu, X., Lockhart Borman, L., Lundstrom, J., Malzacher, A., Mansen, K., Mathisen, R., Mileusnic-Milenovic, R., Moe, Z., Moro, G., Mukherjee, S., Myint, S., Nangia, S., Ngerncham, S., Njeru, F., Olonan-Jusi, E., Opie, G., Palmquist, A., Reimers, P., Saboute, M., Sakamoto, P., Sanchez, S., Shenker, N., Singh, H., Singh, J., Singh, P., Staff, M., Sulfaro, C., Thi Hoang, T., Tiit-Vesingi, A., Tiwari, S., van Goudoever, J., Vickers, A., Waiyego, M., Weaver, G., Wesolowska, A. and Wright, J., (2020). Maintaining safety and service provision in human milk banking: a call to action in response to the COVID-19 pandemicThe Lancet Child & Adolescent Health,.
  64. Shi, J., Wen, Z., Zhong, G., Yang, H., Wang, C., Huang, B., Liu, R., He, X., Shuai, L., Sun, Z., Zhao, Y., Liu, P., Liang, L., Cui, P., Wang, J., Zhang, X., Guan, Y., Tan, W., Wu, G., Chen, H. and Bu, Z., (2020). Susceptibility of ferrets, cats, dogs, and other domesticated animals to SARS–coronavirus 2Science, p.eabb7015.
  65. Shi, S., Qin, M., Shen, B., Cai, Y., Liu, T., Yang, F., Gong, W., Liu, X., Liang, J., Zhao, Q., Huang, H., Yang, B. and Huang, C., (2020). Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, ChinaJAMA Cardiology,.
  66. Srivastava, N. and Saxena, S., (2020). Prevention and Control Strategies for SARS-CoV-2 InfectionMedical Virology: From Pathogenesis to Disease Control, pp.127-140.
  67. Stadnytskyi, V., Bax, C., Bax, A. and Anfinrud, P., (2020). The airborne lifetime of small speech droplets and their potential importance in SARS-CoV-2 transmissionProceedings of the National Academy of Sciences, p.202006874.
  68. Sun, P., Lu, X., Xu, C., Sun, W. and Pan, B., (2020). Understanding of COVID‐19 based on current evidenceJournal of Medical Virology.
  69. Taipale, J., Romer, P. and Linnarsson, S., (2020). Population-scale testing can suppress the spread of COVID-19.
  70. Thorp, H., (2020). Do us a favorScience, 367(6483), pp.1169-1169.
  71. Thorp, H., (2020). Time to pull togetherScience, 367(6484), pp.1282-1282.
  72. van Kraaij, T., Mostard, R., Ramiro, S., Magro Checa, C., van Dongen, C., van Haren, E., Buijs, J., & Landewé, R. (2020). Tocilizumab in Severe COVID-19 Pneumonia and Concomitant Cytokine Release SyndromeEuropean Journal of Case Reports in Internal Medicine, 2.
  73. Vidyasagar, V. and Nithish, C., (2020). Convalescentplasma as potential therapy for recently emerged novel CoVID-19EPRA International Journal of Research & Development (IJRD), 5(4).
  74. Wadman, M., (2020). How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toesScience,.
  75. Wang, C., Li, W., Drabek, D., Okba, N., van Haperen, R., Osterhaus, A., van Kuppeveld, F., Haagmans, B., Grosveld, F. and Bosch, B., (2020). A human monoclonal antibody blocking SARS-CoV-2 infectionNature Communications, 11(1).
  76. Wang, D., Hu, B., Hu, C., Zhu, F., Liu, X., Zhang, J., Wang, B., Xiang, H., Cheng, Z., Xiong, Y., Zhao, Y., Li, Y., Wang, X. and Peng, Z., (2020). Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, ChinaJAMA, 323(11), p.1061.
  77. Wang, M., Cao, R., Zhang, L., Yang, X., Liu, J., Xu, M., Shi, Z., Hu, Z., Zhong, W. and Xiao, G., (2020). Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitroCell Research, 30(3), pp.269-271.
  78. Williamson, E., Walker, A., Bhaskaran, K., Bacon, S., Bates, C., Morton, C., Curtis, H., Mehrkar, A., Evans, D., Inglesby, P., Cockburn, J., Mcdonald, H., MacKenna, B., Tomlinson, L., Douglas, I., Rentsch, C., Mathur, R., Wong, A., Grieve, R., Harrison, D., Forbes, H., Schultze, A., Croker, R., Parry, J., Hester, F., Harper, S., Perera, R., Evans, S., Smeeth, L. and Goldacre, B., (2020). OpenSAFELY: factors associated with COVID-19-related hospital death in the linked electronic health records of 17 million adult NHS patients.
  79. Wu, P., Duan, F., Luo, C., Liu, Q., Qu, X., Liang, L. and Wu, K., (2020). Characteristics of Ocular Findings of Patients With Coronavirus Disease 2019 (COVID-19) in Hubei Province, ChinaJAMA Ophthalmology,.
  80. Xiao, F., Tang, M., Zheng, X., Liu, Y., Li, X. and Shan, H., (2020). Evidence for Gastrointestinal Infection of SARS-CoV-2Gastroenterology, 158(6), pp.1831-1833.e3.
  81. Xu, X., Han, M., Li, T., Sun, W., Wang, D., Fu, B., Zhou, Y., Zheng, X., Yang, Y., Li, X., Zhang, X., Pan, A. and Wei, H., (2020). Effective Treatment of Severe COVID-19 Patients with Tocilizumab
  82. Yang, L., Tian, D. and Liu, W. (2020). Strategies for Vaccine Development of COVID-19Sheng wu gong cheng xue bao (Chinese journal of biotechnology)
  83. Yonesi, M. and Rezazadeh, A., (2020). Plants as a Prospective Source of Natural Anti-viral Compounds and Oral Vaccines Against COVID-19 Coronavirus.
  84. Zhang, C., Shi, L. and Wang, F., (2020). Liver injury in COVID-19: management and challengesThe Lancet Gastroenterology & Hepatology, 5(5), pp.428-430.
  85. Zhang, C., Wu, Z., Li, J., Zhao, H. and Wang, G., (2020). The cytokine release syndrome (CRS) of severe COVID-19 and Interleukin-6 receptor (IL-6R) antagonist Tocilizumab may be the key to reduce the mortalityInternational Journal of Antimicrobial Agents, p.105954.
  86. Zhang, W., Zhao, Y., Zhang, F., Wang, Q., Li, T., Liu, Z., Wang, J., Qin, Y., Zhang, X., Yan, X., Zeng, X. and Zhang, S., (2020). The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The Perspectives of clinical immunologists from ChinaClinical Immunology, 214, p.108393.
  87. Zhang, X., Song, K., Tong, F., Fei, M., Guo, H., Lu, Z., Wang, J. and Zheng, C., (2020). First case of COVID-19 in a patient with multiple myeloma successfully treated with tocilizumabBlood Advances, 4(7), pp.1307-1310.
  88. Zhou, P., Yang, X., Wang, X., Hu, B., Zhang, L., Zhang, W., Si, H., Zhu, Y., Li, B., Huang, C., Chen, H., Chen, J., Luo, Y., Guo, H., Jiang, R., Liu, M., Chen, Y., Shen, X., Wang, X., Zheng, X., Zhao, K., Chen, Q., Deng, F., Liu, L., Yan, B., Zhan, F., Wang, Y., Xiao, G. and Shi, Z., (2020). A pneumonia outbreak associated with a new coronavirus of probable bat originNature, 579(7798), pp.270-273.

 

Références (Générales) – Cliquez sur les liens

  1. Statista France: Nombre de personnes guéries du coronavirus (COVID-19) dans le monde au 23 avril 2020, selon le pays (2 Avril 2020)
  2. Quotidien Présent:  Un virus qui n’aime pas les politiciens (16 Mars 2020)
  3. France Info: « Les vieux vont tomber comme des mouches » : à Menton, près de la frontière italienne, le coronavirus est sur toutes les lèvres (28 Fevrier 2020)
  4. QueFaire: Préparer sa mort, transmettre, organiser ses obsèques (14 Octobre 2014)
  5. France Info: Un homme de 101 ans est parvenu à vaincre la maladie. (2 Avril 2020)
  6. SudOuest: Gironde : à 105 ans, elle a vécu deux guerres et guéri du Covid-19 (19 Mai 2020)
  7. Los Angeles Times: If I become infected with the coronavirus, what are my odds of survival? (19 Mars 2020)
  8. France Culture: Coronavirus chinois : plus mystérieux que la peste, le paludisme, le choléra (25 Janvier 2020)
  9. France Info: Réaction tardive, complaisance envers la Chine… Pourquoi la gestion de la pandémie de Covid-19 par l’OMS est autant critiquée (15 Avril 2020)
  10. France Info: Coronavirus : visualisez l’évolution du nombre de morts dans le monde en un graphique animé (7 Avril 2020)
  11. Paris Match: Coronavirus : ce professeur à la Sorbonne annonçait la catastrophe (6 Avril 2020)
  12. France Inter: PORTRAIT – Didier Raoult, chercheur disruptif (24 Mars 2020)
  13. France Inter: Coronavirus : 10 façons de se dire bonjour sans se faire la bise ou se serrer la main (2 Mars 2020)
  14. Yale University Medicine: 5 Things Everyone Should Know About the Coronavirus Outbreak (15 Avril 2020)
  15. Harvard T.H. Chan School of Public Health: Coronavirus (COVID-19): Press Conference with Marc Lipsitch (4 Mars 2020)
  16. RTL: Coronavirus : Trump suspend sa contribution à l’OMS, une décision « absurde », selon Melinda Gates (16 Avril 2020)
  17. Financial Times: Donald Trump has poured fuel on the flames of coronavirus (12 Mars 2020)
  18. France Culture: Pourquoi le système de santé américain n’est pas solidaire (1 Avril 2020)
  19. Le Figaro: Aux Etats-Unis, l’épidémie semble frapper démesurément les Noirs (8 Avril 2020)
  20. Le Figaro: Coronavirus :  pourquoi New York est-elle si durement touchée? (13 Avril 2020)
  21. YouTube (New York Times): ‘People Are Dying’: Battling Coronavirus Inside a N.Y.C. Hospital (26 Mars 2020)
  22. BFMTV: Davantage d’Américains sont désormais morts du coronavirus qu’à la guerre du Vietnam (29 Avril 2020)
  23. L’Express: Le chômage, l’autre tragédie américaine (28 Avril 2020)
  24. Usbek & Rica: Quand Bill Gates prédisait l’apparition d’une pandémie (17 Mars 2020)
  25. Red Action: Bill Gates avait averti en 2018 qu’une nouvelle maladie pourrait tuer 30 millions de personnes en 6 mois (27 Janvier 2020)
  26. Forbes France: Covid-19 : Pourquoi Bill Gates Reste Optimiste (1 Avril 2020)
  27. Ouest France:  Bill Gates s’engage dans le développement de sept vaccins (7 Avril 2020)
  28. Oxford University Research: Covid-19 bears out the research: Music brings people together* (27 Mars 2020)
  29. Le Figaro: À réécouter : notre sélection de disques pour s’évader du confinement (19 Mars 2020)
  30. France Musique: Musique émoi de confinement 2 (3 Mai 2020)
  31. France Inter: Philo : Penser le confinement, cette « expérience commune » de Nietzsche qui constitue un peuple (25 Mars 2020)
  32. France Inter: Du plasma de patients guéris pour traiter les malades du Covid-19 : un essai clinique commence lundi (3 Avril 2020)
  33. France Culture: Didier Sicard : « Il est urgent d’enquêter sur l’origine animale de l’épidémie de Covid-19 » (27 Mars 2020)
  34. France Culture: Covid-19 : sur la piste de l’origine animale (10 Mai 2020)
  35. Oxford University / Oxford Martin School: China’s Announcement on Wildlife Trade – What’s New and What Does It Mean? (12 Mars 2020)
  36. France Bleu: Le Limousin Quentin Bontemps nous raconte le début du déconfinement à Wuhan en Chine (9 Avril 2020)
  37. France Inter: Comment la Corée du Sud a réussi, jusqu’ici, à dompter l’épidémie de coronavirus (1 Avril 2020)
  38. Oxford University Research: Digital contact tracing can slow or even stop coronavirus transmission and ease us out of lockdown (16 Avril 2020)
  39. Oxford University Research:Oxford scientist develop rapid testing technology for COVID-19 (18 Mars 2020)
  40. Oxford University Research:Coronavirus (COVID-19) Research Priorities (13 Mars 2020)
  41. Oxford University Research: First patients enrolled in new clinical trial of possible COVID-19 treatments (23 Mars 2020)
  42. Oxford University Research: Oxford COVID-19 vaccine programme opens for clinical trial recruitment (27 Mars 2020)
  43. Twitter (Didier Raoult): Nouveaux résultats de l’IHU Méditerranée Infection : 80 patients traités par une association hydroxychloroquine/azithromycine. (27 Mars 2020)
  44. Caducee: #COVID19 : Un médecin américain aurait traité avec succès plus de 500 patients avec l’hydroxychloroquine (26 Mars 2020)
  45. News 24.fr: Coronavirus UK: Un médecin décrit les symptômes comme «rien de tel que la grippe» (17 Mars 2020)
  46. Guardian: Coronavirus: UK will have Europe’s worst death toll, says study(8 Avril 2020)
  47. Guardian: UK failures over Covid-19 will increase death toll, says leading doctor, Richard Horton, editor-in-chief of the Lancet (18 Mars 2020)
  48. Financial Times: Coronavirus may have infected half of UK population – Oxford study  (24 Mars 2020)
  49. University College London (UCL): COVID-19: UCL academics mobilise to provide critical advice and expert comment (16 Avril 2020)
  50. University College London (UCL): UCL, UCLH and Formula One develop life-saving breathing aids for the NHS
  51. Oxford University Research: Ventilator project given the green light by UK government to proceed next stage of testing (31 Mars 2020)
  52. Statista France: COVID-19 : quel est le statut des cas identifiés ? (24 Avril 2020)
  53. YouTube (L’Express): Coronavirus : pourquoi l’Allemagne s’en sort mieux que la France ? (10 Avril 2020)
  54. France Inter: William Dab : « Plus on retarde le travail de terrain, plus il va falloir prolonger le confinement » (11 Avril 2020)
  55. Oxford University Research: Universities into the breach (9 Avril 2020)
  56. France Culture: Jean-Christophe Rufin : « Le coronavirus méritait discussion, mais elle n’a pas eu lieu faute de moyens » (1 Avril 2020)
  57. Oxford University / Oxford Martin School: The world before this coronavirus and after cannot be the same: « Now is the time to start building the necessary bridges at home and abroad. » (30 Mars 2020)
  58. France Inter: Le confinement fait drastiquement baisser les émissions de CO2 dans le monde(mais ça ne va pas durer) (11 Avril 2020)
  59. Le Parisien: Coronavirus : le coup de gueule du président des médecins, contaminé à son tour (19 Mars 2020)
  60. Le Figaro: Masques: Macron le grand bouffon frustré souhaite «l’indépendance pleine et entière» de la France «d’ici la fin de l’année» (31 Mars 2020)
  61. Twitter (Nicolas Chung): Bonjour Twitter, je ne fais jamais ça mais nécessité fait loi : une amie médecin en hôpital en IdF cherche imprimantes 3D pour fabriquer les dispositifs d’adaptation pour les masques Decathlon. Merci pour votre aide et vos RT. (1 Avril 2020)
  62. Oxford University Research: Infectious disease experts provide evidence for a coronavirus mobile app for instant contact tracing (17 Mars 2020)
  63. Oxford University Research: Coronavirus Researchers at Oxford (18 Mars 2020)
  64. Clinical Trials Arena: Coronavirus treatment: Vaccines/drugs in the pipeline for COVID-19 (16 Avril 2020)
  65. l’Opinion: Coronavirus: l’Afrique suit la prescription de chloroquine du Pr Raoult (30 Mars 2020)
  66. Le Point: Coronavirus : une nouvelle étude de Didier Raoult sur la chloroquine (28 Mars 2020)
  67. fr: Les malades chroniques traités à la chloroquine sont-ils immunisés contre le coronavirus ? (3 Avril 2020)
  68. L’internaute: Vaccin et médicaments contre le coronavirus : le point sur les avancées (16 Avril 2020)
  69. La Libre.be: La Chine commence à tester sur les êtres humains un vaccin « efficace » contre le nouveau coronavirus, a indiqué mercredi le ministère de la Défense à Pékin. Il est développé sous la direction de l’épidémiologiste Chen Wei. Le vaccin a été approuvé après de premiers tests. Il peut désormais être testé sur les êtres humains. Le ministère de la Défense le décrit comme sûr et efficace, et a précisé que les préparations pour sa production en masse sont en cours, rapporte l’agence de presse espagnole Europa Press. (18 Mars 2020)
  70. Xinhuanews: (COVID-19) La Chine approuve trois vaccins de COVID-19 pour des essais cliniques (14 Avril 2020)
  71. UK Research and Innovation: Coronavirus: the science explained
  72. Confédération Suisse: Federal Office of Public Health FOPH: New coronavirus (14 Avril 2020)
  73. France Inter: « L’État ne va pas pouvoir continuer à soutenir l’économie à ce niveau-là pendant longtemps », selon le Medef (11 Avril 2020)
  74. France Culture: Youtube: Coronavirus : crise économique ou changement de modèle ? (12 Mars 2020)
  75. Le Figaro: Coronavirus : Cristiano Ronaldo transformerait ses hôtels en hôpitaux (15 Mars 2020)
  76. Gala: VIDEO – Didier Raoult : ce surprenant aveu fait à Jean-Marie Bigard (1 Avril 2020)
  77. Sputnik France: Un pilote de la compagnie aérienne AirAsia a quitté son avion par la fenêtre du cockpit en apprenant que plusieurs passagers pourraient être porteurs du nouveau coronavirus (23 Mars 2020)
  78. Le Figaro: Aides-soignants, caissiers, camionneurs… Les gilets jaunes sont devenus les «premiers de tranchée» (9 Avril 2020)
  79. France Bleu: Confinement : qui a gagné ou perdu le plus de population en Auvergne-Rhône-Alpes ? (9 Avril 2020)
  80. Statista France: Ces produits qu’on s’arrache en plein confinement (8 Avril 2020)
  81. Oxford University Research: The economic impact of COVID-19 (7 Avril 2020)
  82. The Conversation France: Conversation avec Frédéric Altare : l’obésité, facteur très aggravant du Covid-19 (2020)
  83. Science Media Centre: Expert reaction to Times Interview about vaccines with Prof Sarah Gilbert (11 Avril 2020)
  84. The Lancet: Sarah Gilbert: carving a path towards a COVID-19 vaccine (18 Avril 2020)
  85. The Telegraph: A vaccine for Covid-19 could be ready by the end of summer (17 Avril 2020)
  86. France Inter: Coronavirus : voici des sources fiables pour vous informer en évitant les fake news (17 Mars 2020)
  87. Le Point: Coignard – Covid-19 sur le « Charles de Gaulle » : une allégorie française (20 Avril 2020)
  88. France Bleu: Coronavirus : les dermatologues alertent sur de nouveaux symptômes cutanés (7 Avril 2020)
  89. Ouest France: Pour Anne Soupa, journaliste, théologienne et bibliste, le confinement ces dernières semaines a accentué notre inventivité sur la manière d’être présent (28 Avril 2020)
  90. Paris Match: Edgar Morin, paroles de sage (16 Avril 2020)
  91. Guardian: Priti Patel has said removing coronavirus restrictions in the UK will not be a binary choice and the government would not give a date for the end of lockdown. The home secretary added that five tests will have to be met before schools can reopen but said giving a date ‘would be irresponsible and get hopes up’, saying: « We want to prevent a second wave of this horrendous virus. To do that we have to ensure that we continue with the measures we have put in place. » (25 Avril 2020)
  92. YouTube (Telegraph): Priti Patel: « We know people are frustrated but we are not out of danger yet. It is imperative that people continue to follow the rules designed to protect their families, their friends and their loved ones; this will continue to save lives. We all want to return to living our lives as normally and as soon as safely as we can… but the 5 tests we have laid out must be met…» (25 Avril 2020)
  93. Le Figaro: Hervé Morin: «La reprise des cours aurait pu attendre septembre» (27 Avril 2020)
  94. RTL: Coronavirus : l’université d’Oxford promet un vaccin pour septembre (28 Avril 2020)
  95. RFI: Déconfinement en France: Martine Wonner (LaREM) : «Ce plan va être bancal faute de thérapeutique adaptée» (28 Avril 2020)
  96. Le Point: Déconfinement : ce qui attend les Français le 11 mai (28 Avril 2020)
  97. Le Point: Masque, visière, gants… Les coiffeurs ainsi que de nombreux commerces, sont autorisés à rouvrir en Suisse, où le déconfinement se fait en plusieurs étapes. (27 Avril 2020)
  98. Science Daily: Ultraviolet LEDs prove effective in eliminating coronavirus from surfaces and, potentially, air and water (14 Avril 2020)
  99. Emeral Insight: Only vaccines or drugs will end social distancing (29 Avril 2020)
  100. France Info: Le coronavirus vaincu par des antihistaminiques ? Certains médecins généralistes français assurent avoir guéri des patients du CoVID-19 avec des antihistaminiques. (7 Mai 2020)
  101. Le Figaro: Rebond de Coronavirus: Plusieurs quartiers de Pékin confinés (13 Juin 2020)
  102. France Inter: Karine Lacombe : « Le virus ne va pas disparaître et risque de ressurgir par clusters » (17 Juin 2020)
  103. Our World in Data: Coronavirus Disease (COVID-19) – Statistics and Research

 

Mis à jour le Jeudi, 2 Juillet 2020 | Danny D’Purb | DPURB.com

____________________________________________________

Bien que le but de la communauté de dpurb.com ait toujours été et sera toujours de se concentrer sur une culture moderne et progressiste, le progrès humain, la recherche scientifique, l’avancement philosophique et un avenir en harmonie avec notre environnement naturel, les efforts inlassables dans la recherche et la fourniture à notre précieux public des dernières et meilleures informations dans divers domaines ont malheureusement leur coût sur nos administrateurs très humains, qui malgré le temps sacrifié et le plaisir de contribuer à l’avancement de notre monde grâce aux discussions sensibles et idées novatrices, doivent gérer les contraintes qui testent même le plus fort d’esprit. Votre précieux soutien assurerait que notre travail demeure à la hauteur de ses normes et rappellerait à nos administrateurs que leurs efforts sont appréciés tout en vous permettant de ressentir une certaine fierté par notre cheminement vers une civilisation humaine éclairée. Votre soutien bénéficierait à une cause qui se concentre sur l’humanité, les générations actuelles et futures.

On vous remercie encore une fois de votre temps.

N’hésitez pas à nous soutenir en envisageant de faire un don.

Sincèrement,

L’équipe @ dpurb.com

____________________________________________________

While the aim of the community at dpurb.com has  been & will always be to focus on a modern & progressive culture, human progress, scientific research, philosophical advancement & a future in harmony with our natural environment; the tireless efforts in researching & providing our valued audience the latest & finest information in various fields unfortunately takes its toll on our very human admins, who along with the time sacrificed & the pleasure of contributing in advancing our world through sensitive discussions & progressive ideas, have to deal with the stresses that test even the toughest of minds. Your valued support would ensure our work remains at its standards and remind our admins that their efforts are appreciated while also allowing you to take pride in our journey towards an enlightened human civilization. Your support would benefit a cause that focuses on mankind, current & future generations.

Thank you once again for your time.

Please feel free to support us by considering a donation.

Sincerely,

The Team @ dpurb.com

Donate Button with Credit Cards

Essay // Psychoanalysis: History, Foundations, Legacy, Impact & Evolution

Hampstead dpurb.com d'purb website Psychoanalysis

Photographie: Danny D’Purb © 2008

History and Background

In contemporary psychology, the psychoanalytic movement’s place is both unique and paradoxical. Focussing on the study of the mind as a “software” running on the brain as the “hardware”, psychoanalysis remains the only discipline that truly focuses on the mechanism and processes behind our thoughts. Unlike empirical behavioural science and other “cogno-sciences” that can be fairly barbaric and obstinate in the forced application of the rigid mathematical and reductionist systematic procedures embedded in the classic scientific method when dealing with an entity as complex and organic as the human mind; psychoanalysis has remained focussed in understanding human psychology by capturing it in all its details, depths, dimensions and linguistic aspects.

The scientific method although a proven mathematical approach to inquiries in the hard sciences [e.g. biology, medecine, physics, chemistry, astrophysics, material science, astronomy, etc], shows its limitations when used as a tool for psychological inquiry in the measurement of variables that are incredibly hard to measure such as emotions, values, motives, desires, libidinous intensity or dreams. It is also fair noting that humans are different from simple organisms, molecules or robots, hence psychoanalysis remains the only discipline focused on the mind [the software] assuming that most human beings have a physiologically healthy brain [the hardware].

However, modern sciences have discovered how abnormalities in the brain’s physiology due to birth defects or injury may result in behavioural problems linked to a deficient mind due to the defective brain [hardware] at its disposal. Hence, nowadays most good intellectuals in the field of psychoanalysis would likely be a better psychologist with an in-depth knowledge of the physiology of the brain, i.e. the major areas affecting core functions such as speech [Wernicke and Broca’s], vision [the occipital lobe], and motor abilities [parietal lobe], etc.

Cerveau & Fontions dpurb-com

This is because some psychological problems may on rare occasion be caused by brain injuries or physiological abnormality due to virus, trauma, stroke or injury. In those cases where such a scenario materialises, the psychotherapist may refer the patient to a neurosurgeon who may be more appropriate to inspect the extent of the problems on the defective brain [hardware] which may lead to a clearer perspective of the limitations being imposed on the mind of the affected individual and how it impacts processes such as the conscious, the preconscious and the unconscious [based on Sigmund Freud’s 1st ground breaking theory of mental life, the Topographic Model, which was also adopted by Jacques Lacan who argued convincingly that post-Freudian psychoanalysts had swayed too far from the fundamental concepts and turned psychoanalysis into a confusing genre].

However, as we are in the developmental stages of conception of the organic theory, a theory that takes the focus on the individual organism’s creative ability to another level, we are going to remain focussed on the mind. The organic theory was inspired by the brain’s magnificent ability to learn any age, and thus give the individual human organism the ability and freedom to define, create, redefine, recreate and shape itself based on its inherited and acquired abilities, desires and personal constructionist developments throughout its life – yes, the individual does have choices and these impact the person’s internal working model of mental life and the person as a whole along with his or her environment.

While psychoanalysis remains one of the most widely known schools of psychology it is perhaps not universally understood. The founder of psychoanalysis, Sigmund Freud is perhaps one of the most famous psychologist of the last century even if his chosen discipline, psychoanalysis, has little in common with the other schools of thought and psychology.

Psychoanalysis views the mind as an active, dynamic and self-generating entity, and this is in the German tradition of mental life [it was also a founding assumption for Jean Piaget as he developed his Theory of Cognitive Development in Children]. Freud saw psychoanalysis as a revolution of the mind that had to disturb the consciousness of the world, and viewed the unconscious as a reservoir of impulsive force repressed in the biological depths of the soul.

Exploding Raphaelesque Head - Salvador Dali (1951) dpurb d'purb website

« Tête Raphaélesque Éclatée » par Salvador Dali (1951)

It is also important to note that Freud was trained in hard sciences, yet his system shows little appreciation for systematic and reductionist empiricism. As a physician, Freud used his observational skills to build his system within a medical framework, basing his theory on individual case studies. He did not depart from his understanding of 19th-century science in the effort to organise his observations, neither did he attempt to test his hypotheses rigorously through independent verification. As he testified, he was psychoanalysis and did not tolerate dissension from his orthodox views. Nevertheless, Freud had a tremendous impact on 20th century psychology, perhaps more importantly, the influence of psychoanalysis on Western thought, as reflected in literature, philosophy and art, significantly exceeds the impact of any other system and school of psychology.

 

The Active Mind

OrangeLightFlowers-dpurb-com-1200

Photographie: Danny D’Purb © 2012

Going back to the philosophical foundations of modern psychology in Germany during the 17th, 18th and 19th centuries, we found that the tradition of Leibniz and Kant clearly emphasised mental activity. This is in contrast to British empiricism, which assumed the mind to be a passive entity [such as a sponge that simply soaks in what is thrown at it]. The German tradition held the most logical and creative assumption that the mind itself generates and structures human experience in characteristic ways [being « active »]. Whether through Leibniz’s monadology or Kant’s categories, the psychology of the individual could be understood only by examining the dynamic, inherent activity of the mind.

Throughout the years, as psychology evolved into an independent discipline in the latter part of the 19th century under Wundt’s tutelage, the British model of mental passivity served as a guiding philosophy. Clearly, Wundt’s empiricistic formulation was at odds with German philosophical precedents, recognised by both Stumpf and Brentano. Act psychology and the psychology of non-sensory consciousness represented by the Würzburg School were closer to the German philosophical assumptions of mental activity than to Wundt’s structural psychology. The Gestalt movement encompassed these alternatives to Wundt’s psychology in Germany. Eventually, as the rational outcome guided intellectuals, Wundt’s system was replaced by Gestalt psychology, turning into the dominant psychology in Germany prior to World War II – one based on a model of the mind that admitted inherent organisational activity.

The assumptions underlying mental activity in Gestalt psychology were highly qualified, where construct for mind involves the organisation of perception, based on the principle of isomorphism, which resulted in a predisposition toward patterns of personal-environmental interactions. The focus on organisation meant that the way of mental processes, not their content, was inherently structured. In other words, individuals were not born with specific ideas, energies, or other content in the mind; rather, the organisational structure was inherited to acquire mental contents in characteristic ways. Accordingly, the Gestalt movement, while rightly rejecting the rigidity of Wundt’s empiricistic assumptions and concepts, did not reject empiricism completely [as a technique to study some basic and easily defined variables (such as traits) and their relation(s) to others]. Instead, the Gestaltists advocated a compromise between the empiricist basis of British philosophy and the German model of activity. Consequently, this opened psychological investigation to the study of complex problem-solving and perceptual processes.

Consistent with the Gestalt foundations, psychoanalysis was firmly grounded in an active model of mental processes, however it shared little of the Gestalt commitment to empiricism. Freud’s views on personality were consistent not only with the activities of mental processing suggested by Leibniz and Kant, but also with the 19th century belief in conscious and unconscious levels of mental activity. In acknowledging the teachings of such philosophers as Von Hartman and Schopenhauer [Read the Essay on our Review of « Die Welt als Wille und Vorstellung »(The World as Will and Idea), Freud developed motivational principles that depended on energy forces beyond the level of self-awareness.

Schopenhauer

Arthur Schopenhauer (1788 – 1860)

Moreover, for Freud, the development of personality was determined by individual, unconscious adaptation to these forces. The details of personality development as formulated by Freud are outlined below; however, is also important to recognise the fundamental basis of Freud’s thinking. Psychoanalysis is based on the implication of mental activity further than any other system of psychology. As a major representative of a reliance on mental activity to account for personality, psychoanalysis is set apart from other movements in contemporary psychology. In addition, psychoanalysis unlike the other branches of psychology, did not emerge from reductionist empirical research that stubbornly tries to apply mechanical scientific methodology to measure complex non-physical abilities; rather it was the product of the applied consequences of clinical practice [i.e. it was a force that was born on the field to treat mental problems as they surfaced throughout human history].

 

The Treatment of Mental Illness

Besides being the founder of the psychoanalytic movement in modern psychology, Freud is also remembered for his efforts in pioneering the upgrade in the treatment of mental and behavioural abnormalities, and was instrumental in psychiatry’s recognition as a branch of medicine that specifically deals with psychopathology. Before Freud’s works in attempting to devise effective methods of treating the mentally ill, individuals who deviated from socially acceptable norms were usually treated as if they were criminals or demonically possessed. Although shocking controversies in the contemporary treatment of mental deviancy appear occasionally, not too long ago such abuses were often the rule rather than the exception.

The treatment of mental illnesses was never a pleasant chapter in Western civilisation and it has been pointed out many times that abnormal behaviour is often mixed up with criminal behaviour as with heresy and treason. Even during the period of enlightenment during the European Renaissance, the cruelties and tortures of the inquisition were readily adapted to treat what we nowadays qualify as mental illness. Witchcraft continued to offer a reasonable explanation to such eccentric behaviour until recent times. Prisons were established to house criminals, paupers, and the insane without any differentiation. Mental illness was viewed as governed by evil or obscure forces, and the mentally ill were looked upon as crazed by such weird influences such as moon rays. Lunatics or “moonstruck” persons, were appropriately kept in lunatic asylums. As recently as the latter part of the 19th century and the beginning of the 20th century, the institution of for the insane in Utica, New York, which was progressive by the standards of the time, was called the Utica Lunatic Asylum. The name reflected the prevailing attitude toward mental illness.

Philippe_Pinel_à_la_Salpêtrière_dpurb_1200

« Dr. Philippe Pinel at the Salpêtrière », 1795 by Tony Robert-Fleury. Pinel ordering the removal of chains from patients at the Paris Asylum for insane women

Reforms in the treatment of the institutionalised insane were slowly introduced during the 19th century. In 1794, Philippe Pinel (1745 – 1826) was appointed the chief of hospitals for the insane in Paris, and managed to improve both the attitude toward and the treatment of the institutionalised insane. In the United States, Dorothea Dix (1802 – 1887) accomplished the most noticeable reforms in the treatment of the mentally ill. Beginning in 1841, Dix led a campaign to improve the condition of indigent, mentally ill persons kept in jails and in poorhouses. However, these reforms succeeded in improving only the physical surroundings and maintenance conditions of the mentally ill; legitimate treatment was minimal. [Even today, in 2019, the US seems to have more people with eccentric behaviours and with questionable mental stability, for example, Donald Trump, who has been singled out as being mentally ill by more than one. See: (1) The Dangerous Case of Donald Trump, (2) Trump Is ‘Mentally Ill’ Says Former Vermont Governor and Doctor Howard Dean, (3) American psycho? Donald Trump’s mental health is still a question, (4) Psychiatrist: Trump Mental Health Urgently Deteriorating & (5) Stanford’s Zimbardo asks: Is President Trump mentally ill?

Confidence in US

Around the world, favorability of the U.S. and confidence in its president decline / Source: Pew Research Center

The US has more women in prison than China, India & Russia combined

According to the International Centre for Prison Studies, nearly a third of all female prisoners worldwide are incarcerated in the United States of America. There are 201,200 women in US prisons, representing 8.8 percent of the total American prison population. / Source: Forbes

Most people in prison

Highest to Lowest – Prison Population Total / Source: World Prison Brief

Efforts to develop comprehensive treatments were plagued by various quacks, such as the pseudoscience developed by Mesmer that dealt with the “animal spirit” underlying mental illnesses [although it may be true today if expressed as a metaphorical description to some of the behavioural manifestations of some mental disorders in some individuals].

White Dogs & Tootsie Pops by Marie Hughes dpurb 1200

« White Dogs and Tootsie Pops » by Marie Hughes

Similarly, the phrenology of Gall and Spurzheim advocated a physical explanation based on skull contours and localisation of brain functions – which was of course also wrong.

Gradually however, attempts were made to develop legitimate and effective techniques to treat emotional and behavioural abnormalities. One of the more productive investigations involved hypnotism and was pioneered by a French physician, Jean Martin Charcot (1825 – 1893). Charcot gained widespread fame in Europe, and the young Freud amazed by his abilities, studied under him, as did many other talented physicians and physiologists. He treated hysterical patients with symptoms ranging from hyper-emotionality to physical conversions of underlying emotional problems that the patient could not confront when conscious.

Jean Martin Charcot - dpurb1000

Une leçon clinique à la Salpêtrière (1887) » with Jean Martin Charcot in Front (A Clinical Lesson at the Salpêtrière) par André Brouillet à l’Université Paris Descartes

Another French physician in Nancy, namely Hippolyte Bernheim (1837 – 1919), developed a sophisticated analysis of hypnosis as a form of treatment, using underlying suggestibility to alter the intentions of the patient. Finally, Pierre Janet (1859 – 1947), a student of Charcot, used hypnotism to resolve the forces of emotional conflict, which he believed were basic to hysterical symptoms. However, it was Sigmund Freud who went beyond the techniques of hypnotism to develop a comprehensive theory of psychopathology from which systematic treatments evolved. Later, Jacques Lacan (1901 – 1981) would pulverise the tradition inherited from hospital medecine which consisted of displaying  a patient before an audience of practitioners or students and asking questions whose deeper meaning was supposed to escape the patient. The actors in this ceremonial, the patients, trained by years of confinement, actually produced all the symptoms that the masters of the asylum expected of them. Lacan shattered this clinic with his gaze in order to give a voice to the mentally ill. Jean-Bertrand Pontalis said: « Lacan était extraordinairement courtois avec ses malades, les traitant pas du tout comme des patients d’asile – c’est la moindre des choses, mais ce n’est pas toujours le cas – comme des êtres humains et les amenaient peu à peu, créant une atmosphère de confiance, à les laisser parler très très librement. Pour l’anecdote, c’est assez savoureux, je me souviens qu’une fois il y avait une femme qui était paranoïaque qui se plaignait qu’on l’a suivi partout, « On me suit, on me suit, on me suit, on me suit partout… », Lacan à la fin lui dit, « Ne vous inquiéter pas chère madame, je vais trouver quelqu’un pour vous suivre » entendant par la, un médecin qui pourra lui traiter. Comme si lui-même, dans ces années-là était en train d’inventer et de s’inventer. Nous participions en accord avec lui en résonance avec lui à un mouvement inventif. » [French for: « Lacan was extraordinarily courteous with his patients, treating them not at all like asylum patients – to say the least but this is not always the case – like human beings and gradually, creating an atmosphere of trust, he led them to let them speak very, very freely. For the anecdote, it’s quite tasty, I remember that once there was a woman who was paranoid complaining that she was followed everywhere, « They follow me, they follow me, they follow me, they follow me everywhere… », Lacan at the end said to her, « Don’t worry dear lady, I’ll find someone to follow you » hearing by this, a doctor who will be able to treat her. As if he himself, in those years, was in the process of inventing and inventing himself. In agreement with him, we were participating in an inventive movement in resonance with him. »]

 

A Biography of Sigmund Freud

Sigmund Freud for dpurb-com 1200

Sigmund Freud (1856 – 1939) / Image: Freud Museum London

Since psychoanalysis as we know it today is hugely influenced by the foundations laid by Sigmund Freud, it is worthwhile to have an understanding about the major points in his life. Sigmund Freud (1856 – 1939) was born on the 6th of May 1856 in Freiberg, Moravia, at that time a norther province of the Austro-Hungarian Empire, today a part of the Czech Republic.

Freud was the eldest of 8 children, and his father was a relatively poor and not very successful wool merchant. When his business failed, Freud’s father moved with his wife and children [as many jews are accustomed to migrating to better places in the quest for a better life and income] first to Leipzig and then to Vienna when Freud was 4 years old. The young Freud remained in Vienna for most of the rest of his life, and his precocious genius was recognised by his family, and he was allowed many concessions and favours not permitted to his siblings. For example, young Freud was provided with better lighting to read in the evening, and when he was studying, noise in the house was kept to a minimum so he would not be disturbed.

Freud’s interest were varied and intense, and he showed an early inclination and aptitude for various intellectual pursuits. Unfortunately, Freud was a victim of the 19th century Jew-dislike which was obvious and severe in central and Eastern Europe after the numerous accounts of Jews being banished from places all over Europe due to their occult and violent religious practices on Christian infants [e.g. human sacrifices] along with their known habits in monopolising the majority of the press businesses to then distort news and heritage to their agendas and economic advantage.

However, although Freud was an atheist and more scientifically minded, his Jewish birth precluded certain career opportunities, most notably an academic career in university research. Indeed, medicine and law were the only professions open to Vienna Jews.

Freud’s early reading of Charles Darwin intrigued and impressed him to the point that a career in science was most appealing. The closest path that he could follow for training as a researcher was an education in medicine. Hence, Freud entered the university of Vienna in 1873 at the age of 17. However, because of his interests in a variety of fields and specific research projects, it took him 8 years to complete the medical coursework that normally required 6 years.

Eel

In 1881, he received his doctorate in medicine. While at university, Freud was part of an investigation of the precise structure of the testes of eels, which involved his dissecting over 400 eels. Later, he moved on to physiology and neuroanatomy and conducted experiments examining the spinal cord of fish. While at Vienna, Freud also took courses with Franz Brentano, which formed his only formal introduction to 19th century psychology.

Franz Brentano dpurb 1200

After waiting for Freud for about 4 years, his fiancée, Martha Bernays, a jewish girl from a business family and the grand-daughter of a famous Rabbi in Hamburg, married him. While she did not show great interest in Freud’s intellectual pursuits, her younger sister Minna became a very close intellectual partner of Freud. Carl Jung one of Freud’s intellectual ally who would become one of his firmest critic would even later say that he learned from Minna that Freud was in love with her and their relationship was very “intimate” – although we have no factual confirmation of such. She was so close to the young couple, that she moved in with them in the 1890s to set up was has been “jokingly” called a “ménage a trois”. As for Martha, she was also a charmer, intelligent, well-educated and fond of reading who as a married woman ran her household efficiently and was almost obsessive about punctuality and dirt. Firm but loving with her children, French analyst René Laforgue said that she spread an atmosphere of peaceful joie de vivre through the household. Shortly after Freud’s wedding, he recognised that a scientific career would not provide adequate income, since anti-Jewish sentiments were strong around Europe and this worked against Jewish advancement in academia even if Freud himself was not a practising Jew or had any religious sentiments. So Freud reluctantly decided to begin a private practice. Although the young couple were very poor in the early years of their marriage, Freud was able to support his wife and his growing family, which eventually included 6 children. The early years in private practice were very difficult, requiring long hours for a meagre financial reward that basically did not challenge him. Freud was also an atheist and did not want psychoanalysis to be seen as a purely Jewish endeavour, and his close network although were mainly Jewish later slowly grew to incorporate European intellectuals where some of the most significant would disagree with some of his assumptions and leave his circle after keeping only a few of his fundamental concepts about the theory of mental life.

During his hospital training, Freud had worked with patients with anatomical and organic problems of the nervous system. Shortly after starting private practice, he became friendly with Josef Breuer (1842 – 1925), a general practitioner who had acquired some local fame for his respiration studies. This friendship provided needed stimulation for Freud, and they began to collaborate on several patients with nervous disorders, most notably the famous case of Anna O., an intelligent young woman with severe, diffuse hysterical symptoms. In using hypnosis to treat Anna O., Breuer noticed that some specific experiences emerged under hypnosis that the patient could not recall while conscious. Her symptoms seemed to be relieved after talking about these experiences under hypnosis. Breuer treated Anna O. daily for over a year, and became convinced that the “talking cure”, or “catharsis”, involving discussion of unpleasant and repulsive memories revealed under hypnosis, was an effective method in alleviating her symptoms. Unfortunately, Breuer’s wife became jealous of the relationship; that would later be called positive transference of emotional feelings to the therapist”. This would later be explained as patients falling in love with the new object [in this case, the psychoanalyst] at which they redirect feelings and desires retained in childhood at characteristic stages of therapy. This looked suspicious to Breuer’s wife. As a result, Breuer terminated his treatment of Anna O. Freud was also very professional with his clients and never had any mistresses or took advantage of his female patients. In opposition to positive transference, the psychoanalyst may also face negative transference in treatment with patients, which refers to aggressive affects, definitions that would also be taken by Lacan who criticised Ego-psychology for defining transference simply in terms of a range of affects. Lacan explained that transference does not refer to any mysterious property of affect in patients, and even when it reveals itself under the appearance of emotion, it only acquires meaning by the virtue of that very precise dialectical moment in which it is produced; that is to say that transference with patients often manifests itself in the form of strong affects, such as love and hate, but it does not consist of such emotions, it is part of the structure of the intersubjective relationship of patients in praxis with the psychoanalyst at that very moment. Lacan saw the Symbolic aspect of transference, which is repetition, as a feature that helped the treatment of patients since it reveals the meaningful signifiers of the personal history of Subjects, while the Imaginary aspect (love and hate) during treatment acts as resistance to psychoanalytic praxis.

Jean Martin Charcot Treating Mentally Ill Women 1000 dpurb

Jean-Martin Charcot (1825 – 1893) / Charcot first began studying hysteria after creating a special ward for non-insane females with « hystero-epilepsy ». He discovered two distinct forms of hysteria among these women: minor hysteria and major hysteria. His interest in hysteria and hypnotism « developed at a time when the general public was fascinated in ‘animal magnetism’ and ‘mesmerization' », which was later revealed to be a method of inducing hypnosis.
Charcot argued vehemently against the widespread medical and popular prejudice that hysteria was rarely found in men, presenting several cases of traumatic male hysteria. He taught that due to this prejudice these « cases often went unrecognised, even by distinguished doctors » and could occur in such models of masculinity as railway engineers or soldiers. Charcot’s analysis, in particular his view of hysteria as an organic condition which could be caused by trauma, paved the way for understanding neurological symptoms arising from industrial-accident or war-related traumas.

In 1885, Freud received a modest grant that allowed him to go to Paris to study with Jean-Martin Charcot for 4 and half months. During that time he not only observed Charcot’s method of hypnosis [which he never managed to master as Charcot did] but also attended his lectures, learning about the master’s views on the importance of unresolved sexual problems in the underlying causality of hysteria. When Freud returned to Vienna, he gave a report of his work with Charcot to the medical society, but its cold reception left him with resentment that affected his future interactions with the entrenched medical establishment and its rigid and reductionist methods at understanding and solving the problems of the mind.

Freud continued his work with Breuer on hypnosis and catharsis, but gradually abandoned the former in favour of the latter, being not very gifted with hypnotic techniques, but also for 3 major reasons regarding its effectiveness as a treatment with general applicability. First, not everyone can be hypnotised; hence its usefulness is limited to a select group. Second, some patients refuse to believe what they revealed under hypnosis, prompting Freud to conclude that the patient must be aware during the step-by-step process of discovering memories hidden from their accessible consciousness. Third, when one set of symptoms were alleviated under hypnotic suggestibility, new symptoms often emerged. Freud and Breuer were moving in separate directions, and Freud’s increasing emphasis on the primacy of sexuality as the key to psychoneurosis contributed to their break. Nevertheless, in 1895 they published Studies on Hysteria, often cited as the first work of the psychoanalytic movement, although it sold only 626 copies during the following 13 years – perhaps due to the lack of sophistication and interest in the workings of the mind at that particular point in history, or the level of the academic discussions that may not have been adequate for the intellect of the average mind at the time.

Freud’s preferred method of treatment, catharsis, involves engaging with patients and encouraging them to speak of anything that comes [occupies] their mind, regardless of how discomforting or embarrassing it might be. This “free association” took place in a relaxed atmosphere, usually on the classic psychologist couch in a reclined position to promote comfort. The main reason behind the logic of catharsis and free association is that – like hypnosis – it would allow hidden thoughts and memories to manifest in consciousness. However, in contrast, to the method of hypnosis, the patient would be aware of these emerging recollections. Another ongoing process during free association is “transference”, which involves emotionally laden experiences that allow the patient to relieve earlier, repressed episodes. Since the psychoanalyst is often part of the transference process [as mentioned earlier where the repressed emotions are often redirected onto] and is often the object of his patients’ emotions, Freud recognised transference as a powerful tool to assist patients in resolving sources of anxiety. Lacan proposed that it is important to also understand that although the existence of transference plays an important part for psychoanalytic treatment, it is not enough by itself, it is also necessary for the psychoanalyst to deal with the transference in a unique way, this is what differentiates true psychoanalysis from suggestion because the psychoanalyst refuses to use the power given to him by the transference. Lacan believed like any other interpretation, the analyst must use all his « art » in deciding if and when to interpret the transference and must above all avoid gearing his interpretations exclusively to interpreting the transference; the analyst must know exactly what he wants to achieve by such an interpretation and it should not rectify his patients’ relationship to the vague concept of « reality », but instead maintain analytic dialogue. Transference is the displacement of affect from one idea to another and Freud viewed it as a positive factor that helps the progression of treatment since it provides a way for patients’ history to be faced in the immediacy of the present relationship with the analyst; the way patients relate to the analyst is revealing as they inevitably repeat earlier relationships with other meaningful others [especially those with the parents or parental figures] – this logic is underlined in the theory of attachment of John Bowlby. Jacques Lacan later remarked that if transference with most patients often manifests itself under the appearance of love, it is first and foremost the love of knowledge (savoir) that is concerned. Transference is the attribution of knowledge to the Other, the assumption that the Other is a Subject who « knows » [Le Sujet supposé savoir], and as soon as that « knowing » Subject appears, we have transference. Lacan used Plato’s symposium to illustrate the relationship between analysands (i.e. patients) and the analyst; Alcibiades compared Socrates to a plain box which enclosed a precious object, just as Alcibiades attributes a hidden treasure to Socrates so patients see the object of their desire in the analyst (i.e. « objet petit a » in Lacanian terms). The psychoanalyst must sometimes situate himself/herself as the substitute for objet petit a in the course of psychoanalytic praxis. Lacan also identifies the compulsion to repeat with the symbolic nature of transference, the symbolic determinants of all Subjects, and this helps the progression of treatment by revealing the meaningful signifiers of Subjects’ personal history; he also locates the essence of transference in the Symbolic and not in the Imaginary, although it clearly has powerful imaginary effects.

In 1897, Freud began a self-analysis of his dreams, which evolved into another technique important to the psychoanalytic movement. In the analysis of dreams, Freud distinguish between the manifest content [the actual depiction of the dreams] and the latent content, which represented the symbolic world of the patient. In 1900, he published his major work, The Interpretation of Dreams. Although it sold only 600 copies in eight years, it later went through eight editions in his lifetime. In 1901, he published The Psychopathology of Everyday Life, the book in which his theory began to take shape. Freud argued that the psychology of all people, not only those with neurotic symptoms, could be understood in terms of the unconscious forces in need of resolution.

When his reputation as a pioneer in psychiatry started to grow due to his prolific writings, Freud attracted admiring followers, among them was the notable Carl Jung. In 1909, G. Stanley Hall, president of Clark University, invited him to the United States to give a lecture series as part of that institution’s 20th anniversary. The lectures were published in the American Journal of Psychology and later in book form, serving as an appropriate introduction to psychoanalytic thought for American audiences.

As psychoanalysis was perceived as radical by the medical establishment, early believers form their own associations and found the journals to disseminate their competing views. However, Freud’s demand for strict loyalty to his interpretation of psychoanalysis led to some discord within the movement [perhaps for the betterment of the field itself as many branches kept the fundamental concept of unconscious (Id), pre-conscious (SuperEgo), and conscious (Ego) but fused other theoretical and scientific perspectives to explain and treat a range of mental illnesses]. Carl Jung broke away in 1914, so that by the following year, three rival groups existed within the psychoanalysic movement. Nevertheless, Freud’s views continued to evolve. Impressed by the devastation and tragedy of World War I, Freud came to view aggression, along with sexuality, as a primal instinctual motivation. During the 1920s Freud expanded psychoanalysis from a method of treatment for mentally ill or emotionally disturbed persons to a systematic framework for all human motivation and personality.

In 1923, Freud developed cancer of the jaw and experienced almost constant pain for the remaining 16 years of his life. He underwent 33 operations and had to wear a prosthetic device. Throughout this ordeal however, he continued to write and see patients, although he shunned public appearances. With the rise of Hitler and the anti-Jewish sentiments that arose with his campaigns with the National Socialists, Freud’s works were unfortunately singled out as they were not seen as a scientific endeavour but rather as a Jewish science, and his books were burned throughout Germany. However, Freud resisted fleeing from Vienna. When Germany and Austria were politically united in 1938, the Gestapo began harassing Freud and his family. President Roosevelt indirectly relayed to the German government that Freud is an intellectual who must be protected. Nevertheless, in March 1938 some thugs invaded Freud’s home. Finally, through the efforts of friends, Freud was granted special permission, but only after promising to send for his unsold books in Swiss storage so that they could be destroyed. After he signed a statement saying that he had received good treatment from the police, the German government allowed him to leave for England, where he died shortly after, on September 23, 1939.

 

An overview of the Psychoanalytic System based on Freud’s Research

Before our in-depth examination of psychoanalytic theory, it is important to recognise that the theory has an unusually broad focus. Psychoanalysis contains a theory of personality, but it also offers theoretical tools for understanding culture, society, art and literature. It is also a clinical theory that aspires to explain the nature and origins of mental disorders, and that is associated with an approach to their treatment. To give some more sense to Freud’s breadth, consider that he wrote on topics as diverse as the meaning of dreams and jokes, the origins of religion, Shakespeare’s plays, the psychology of groups, homosexuality, the causes of phobias and obsessions, and much more besides. Even as a theory of personality, psychoanalysis is primarily an account of the processes and mechanisms of the mind, rather than an account of individual differences.

In addition to its breadth of focus, the psychoanalytic theory has many distinct components that have also been modified and explored by a range of skilled psychoanalysts, making it hard to integrate into a single unitary model of the mind since they are inter-connected in complex ways.

Freud’s views evolved continually throughout his long career in the collective result of his extensive writings as an elaborate system of personality development. Personality was described in terms of an energy system that seeks an equilibrium of forces. This homeostatic model of human personality was determined by the constant attempt to identify appropriate ways to discharge instinctual energies, which originate in the depths of the unconscious. The structure of personality, according to the psychoanalytic model consists of a dynamic interchange of activities energised by forces that are present in the person at birth. This homeostatic model was consistent with the prevailing views of 19th-century science, which saw the mechanical relations of physical events studied by physics as the term of scientific inquiry. Freud’s model for psychoanalysis translated physical stimuli to psychic energies or forces and retained an essentially mechanical description of how such forces interact.

As the writings on the dpurb.com website are the foundations for the Organic Theory of Psychological Construction, we are going to be focused not on the later structural model which repositioned the Unconscious, Conscious and Pre-Conscious across the Id, Ego and SuperEgo, but with the first topographic model (1900 – 1905) adopted by both Carl Jung and Jacques Lacan. This model, has been more influential and is more flexible in accommodating competing view points about the structure of mental life across individuals.

The topographic model refers to the levels or layers of mental life. Freud proposed that mental content – ideas, wishes, emotions, impulses, memories, and so on – can be located at one of the three levels: the Conscious (later known as the Ego), the Preconscious (SuperEgo) and the Unconscious (Id), . It is important however, to understand that Freud use these terms to describe degrees of awareness and unawareness, but also to refer to distinct mental systems with their own distinct laws of operation. Unconscious cognition is categorically different from Conscious cognition, in addition to operating on mental content that exists beneath awareness. To convey this point, the three levels of the topographic model was referred to as the ‘systems’ Cs., Pcs., and Ucs.

Topographic Model_C_S_U_dpurb_1000

The Topographic Model


The Conscious (which would later be known as Ego with a partial unconscious side, and also “Le Moi” in Lacanian Theory)

Consciousness is merely the proverbial ‘tip of the iceberg’ of mental activity. The contents of the Conscious are simply the small fraction of things that the person is currently paying attention to: objects perceived, events recalled, the stream of thought that we engage in as a running commentary on everyday life. [This is the main focus of most other branches of Psychology such as Biological Psychology and Cognitive Psychology]

 

The Preconscious (which would later be known as the Super-Ego, le « Grand Autre » in Lacanian Theory)

Of course, not all of all mental life happens under the spotlight of awareness and attention. There are many things to which we could readily pay attention to but do not, such as ideas or plans we have set aside or memories of what we were doing last week or yesterday. Without any great effort these things or events, which in the present are out of consciousness, can be made conscious. Those form the domain of the Preconscious.

The boundary between the Conscious (Ego) and the Preconscious (Super-Ego) is a permeable one. Thoughts, memories and perceptions can cross without great difficulty according to the momentary needs and intentions of the individual. They also share a common mode of cognition, which in psychoanalysis is known as the ‘secondary process’. Secondary process cognition is the sort of everyday, more or less rational thinking than generally obeys the laws of logic.

 

The Unconscious (which would later be known as the Id, L’inconscient or the « Ça » in Lacanian Theory)

The Unconscious (Id) is perhaps one of the most celebrated theoretical concepts in psychoanalysis’ legacy. However, Freud did not invent or discover the unconscious as is sometimes claimed – versions of the unconscious had been floating around intellectual circles for some time – but Freud gave it a much deeper theoretical analysis than anyone before him. Freud distinguished between mental contents and processes that are descriptively unconscious and those that are dynamically unconscious. The descriptively unconscious simply exists outside consciousness as a matter of fact, and therefore include Preconscious material that can become conscious if it is attended to. Freud’s crucial contribution was to argue that some thoughts, memories, wishes and mental processes are not only descriptively unconscious, but also cannot be made conscious because of a countervailing force keeps them out of awareness. In short, mental life that is dynamically unconscious is a subset of what is descriptively unconscious, one whose entry to consciousness is actively thwarted. The Freudian unconscious corresponds to the dynamic unconscious in this sense.

Freud held that the Unconscious contains a large but unacknowledged proportion of mental life that operates according to its own psychological laws. The barrier between the Unconscious (Id) and the Preconscious (SuperEgo) is much more fortified and difficult to penetrate than the border between the Preconscious (Super-Ego) and Conscious (Ego). In addition, it is policed by a mental function that Freud likened to a “censor”. The censor’s role is to determine whether the contents of the Unconscious would be threatening / objectionable or socially unacceptable to the person if they became conscious. If the censor judges them to be dangerous in this type, the person will experience anxiety without knowing what caused it. In this case, these thoughts become wishes and so on, and will be normally be repelled back into the Unconscious, in a process referred to asRepression” [it is fundamental and very important to understand that Repression is something else than a conscious judgement which rejects and chooses]. Unconscious material, by Freud’s account, has an intrinsic force propelling it to become conscious. Consequently, repression required an active opposing force to resist it, just as effort is required to prevent a surf board made of white foam to rise to the surface when it is submerged in the ocean. Under the constant pressure of Unconscious material bubbling towards the Preconscious, the censor cannot possibly bar entry to everything. Instead, it allows some Unconscious material to cross over the barrier after it has been transformed or disguised in some way so as to be less objectionable and more socially acceptable. This crossing might take the form of a relatively harmless impulsive behaviour, or in the form of private fantasy, the telling of a joke, or in a slip of the tongue, where the person says something ‘unintentionally’ that reveals to the trained eye and mind the repressed concerns and wishes [such as that of a psychoanalyst – as Jacques Lacan proposed: repression can take the form of a metaphor and the skilled psychoanalyst must be able to decipher a chain of clues with a great deal of verbal dexterity where crossword puzzles may help in training. Lacan also viewed the Grand Autre (Preconscious/Superego) as the discourse of the Unconscious]. Psychoanalysis focuses on how phenomena such as these can be interpreted, the process that involves uncovering the unconscious material that is concealed within their “disguises” [i.e. forms].

To Freud, dreams represent a particularly good example of the disguised expression of the Unconscious wishes. They offered, he wrote, “the royal road to the Unconscious”. One reason for this is that during sleep, the sensor relaxes and allows more repressed Unconscious material to cross the barrier. This material, transformed into a less threatening form by a process referred to as the “dream-work, then takes the shape of a train of images in the peculiar form of consciousness that we call dreaming. It is believed, that each dream has a “latent content” of Unconscious wishes that is transformed into the “manifest content” (or dream narrative) of the experienced dream. In psychoanalytic praxis with patients, the interpretations of dreams takes the same road, but in reverse, in order to decode the transformations rendered by the dream work so as to bring out the latent content based on the manifest content. Freud described the « latent contents » as made up of « latent thoughts« , a term that was always used in the plural form and never precisely described, but the context of its usage seems to suggest that it connoted representations, affects, wishes and conflictual patterns that are all profoundly marked by infantilism and fantasy [e.g. having super powers and flying while dressed in a nylon costume]. Latent thoughts also contain whatever supplies the dream’s « raw material »: the days residues, somatic sensations, and excitations that directly impact instinctual impulses. The transformation carried out by the dream work has to allow the Unconscious wishes during the wake state to be fulfilled during the dream while concealing the elements of threat they contain. If the latent content is not concealed sufficiently through the “dream-work” process, the sleeper will register the threat and be awoken [sometimes in shock and sweat], and to avoid this shock the dream-work may alter the identities of the people represented in a wish, for example, if an individual has an Unconscious wish to harm a loved one, the dream work might produce a dream in which the individual instead harms someone else or in which the loved one is harmed by another person, neutralised in this way, the unconscious wishes find conscious expression in the dream. Freud explained that « latent thoughts » were generally preconscious; they are used by the dream work because they are a relay point and medium for unconscious cathexes [i.e. objects (or ideas) that have a quantity of psychical energy attached to them; to say that an object or idea is « libidinally » cathected means that it is charged with sexual energy deriving from sources internal to a patient’s psyche; the Id (Unconscious) or the instinctual pole of personality is said to be be the source all types of cathexes]. Dreams also showcase the distinct form of thinking that operates in the Unconscious: Primary processthinking, which unlike the secondary process than governs the Conscious (Ego) and Preconscious (Super-Ego), shows no respect for the laws of logic and rationality. In primary process thinking, something can stand for something else, including its opposite, and can even represent two distinct things at once. Contradictory thoughts can coexist and there is no orderly sense of the passage of time or of causation. Basically, primary process thinking captures the magical, chaotic qualities of many dreams, the mysterious images that seems somehow significant, the fractured storylines, the impossible and disconnected events. To Freud, dreams are not simply night-time curiosities, but reveal how the greater part of our mental life proceeds beneath the shallows of conscience.

 

Foundations of the later “Structural” model: concepts to consider and synthesise with the Topographic Model

We are now going to have a look at the later version of Freud’s psychoanalytic theory where the Unconscious [this time referred to as the Id] is still the fundamental concept, however decades later in 1923, another 3-way dissection of the mind was proposed. This time Freud called it the Psychic Apparatus and the 3-way dissection of the mind was defined in terms of distinct mental functions instead of levels of awareness and their associated processes.

Modèle_Structurel_Id(LeCa)_Ego(Moi)_SuperEgo(Surmoi)_IcebergModel_dpurb

The Structural Model of the Psychic apparatus

In original German, the terms Es (Id), das Ich (Ego) and Über-ich (Super-Ego) were used. As we take a look at these structures, it is important to remember that they were not proposed as real underlying entities, but rather as a sort of conceptual shorthand for talking about different kinds of mental processes. Our aim here is to synthesise the logical concepts of the Structural Model with the earlier Topographic Model of the Unconscious (Id), the Preconscious (Super-Ego) and the Conscious (Ego), however although it is convenient to talk about the Id, Super-Ego and Ego “doing” such-and-such or being “in charge of” so-and so, it is important to remember that they were not intended to refer to distinct sub-personalities within the individual.

 

The Id (Unconscious, das Es / Inconscient / Le Ça)

The Id [completely/dynamically unconscious] represents the part of the personality that is closely linked to the instinctual drives that are the fundamental sources of motivation in Freudian theory. According to Freud, these drives are chiefly sexual and aggressive in nature. On one hand we have the “life instincts” concerned with preserving life and binding together new “vital unities”, the foremost expression of this concern being loving sexual union. Opposed to these life instincts, on the other side, we have the set of “death instincts”, whose corresponding concern is with breaking down life and destroying connections, its goal is a state of entropy or nirvana, where there is a complete absence of any form of tension [motivation] – the most obvious form of these instincts were aggressiveness expressed inward towards the self or outward towards others. Freud proposed that these instinctual biological drives were powered by a reservoir of instinctual “psychic energy” grounded in basic biological processes; the sexual form of this energy was referred to as libido. Although the unconscious Id is a biological underpinning, its contents are manifested in psychological phenomena such as wishes, ideas, intentions, and impulses. These phenomena are therefore sometimes described as “instinct- derivatives”. Some of these phenomena are innate, whereas others have been consigned to the Id by the process of repression. All of the Id’s contents, however are unconscious. Freud proposed that the Id operated according to what he called the “pleasure principle” which states that the Id’s urges strive to obtain pleasure and avoid “unpleasure” without delay. Unpleasure results from increased accumulated excitation and pleasure results from its reduction. Lacan used the term « Jouissance » to describe an excessive quantity of excitation that has the potential to take the Subject to that extreme point where the erotic borders upon death and where subjectivity risks extinction; the « pleasure principle » tries to prevent such savage scenarios [To Lacan, the pleasure principle is a commandment — which can be phrased — « Enjoy as little as possible. » The pleasure principle leads the subject from signifier to signifier, by generating as many signifiers as are required to maintain at as low a level as possible the tension that regulates the whole functioning of the psychic apparatus]. One of Lacan’s contribution to the debate on feminity advances the concept of a specifically feminine jouissance which goes beyond the phallus: a jouissance of the order of the infinite like mystical ecstacy where women may experience this without being conscious about it. Therefore the pleasure principle serves to reduce tension and to return the psyche to a state of equilibrium or constancy. Pleasure, in Freud’s understanding, represented a discharge of libido or instinctual energy which is accompanied by a release of tension. The Id is not in contact with the rules or structures of individuals’ environment [i.e. the Symbolic rules of civilised society], but rather relates to the other structures of personality, the Ego & the Superego [conscience] that in turn must mediate between the Id’s raw instincts and the external world; immune from reality and social convention, the Id which is guided by the pleasure principle, seeks to gratify instinctual libidinal needs [that are simply biological] either directly through a sexual experience, or indirectly by dreaming or fantasizing. The latter, indirect gratification was called the primary process [governed by the pleasure principle] and has its own « rules » [e.g. allowing contradictions in logic] that differ from Ego functions and conscious thought. The exact object of direct gratification in the pleasure principle is assumed to be determined by the psychosexual stage of the individual’s development [as explained in 3rd part of the essay on The 3 Major Theories of Development], however the legitimacy and precision of this theory has been questioned and revised over the years and it gave way to the more empirical Theory of Attachment of John Bowlby. In short, the Id strives to satisfy its drives enabling immediate, pleasurable release of instinctual energy. It is the most primitive and least accessible structure of personality. As originally described by Freud, the Id is psychic energy of an irrational nature, and in the form of libido, it can manifest itself and be of a sexual character that is incestuous, uninhibited, savage, irrational and boundless, which instinctually determines unconscious processes. In psychoanalysis, this natural, wild and irrational urge is assumed to be present in all human beings. Elisabeth Roudinesco pointed out that Freud had distinguished that in humans it is the desire for incest and not the horror of it, that eventually leads individuals to forbid themselves from expressing it while also rejecting it; that is to say that in healthy, civilised and psychologically stable individuals with a well developed conscience [i.e. Superego] there is a respect for the symbolic laws that govern human relationships ethically [Lacan proposed that these symbolic structures are primarily governed by language] and which involve abiding by a structure that respects shared social values that sustain a functional human civilisation, i.e. the passage from raw and savage nature [Id] to civilised culture [Super Ego]. Many modern psychoanalysts believe that repression, masturbation and sublimation are inescapable in order to manage the raw and wild instincts of the Id and to channel them in more productive endeavours that are in the best interests of individuals and civilised society.

 

The Ego (Conscious & partially unconscious, Ich / Le Moi)

The Ego, is a mental function and complicates the picture of immediate gratification that the Id strives for. The Ego, a “psychic agency”, arises over the course of development as the child learns that it is often necessary and desirable to delay gratification. The bottle or breast does not always appear the instant that hunger is first experienced, and sometimes it is better to resist the urge to urinate at the bladder’s first bidding if one is to avoid the unpleasure of wet pants, embarrassment, and a parent’s howls of dismay. The Ego, often called the “executive” of personality because of its role in channeling Id [unconscious] energies into socially acceptable outlets [ego is believed to start developing between the ages of 1 and 2 as the child confronts the environment]. The Ego crystallises out this emerging capacity for delay, and in time becomes a restraint on the Id’s impatient striving for discharge. However, it cannot be an inflexible restraint. Its task is not to delay the fulfilment of wishes and impulses endlessly, but to determine when and how it would be most sensible or prudent to do so given the demands of the external environment at a particular time. It operates, that is, on the “Reality principle”, which simply requires that the Ego regulate the person’s behaviour in accordance with external conditions [at a given time or place according to certain rules or laws or conventions, and of course this changes as society redefines “reality” in terms of what it acceptable and not]. Freud emphasized that the Ego is not the dominant force in the personality [unlike Ego psychologists in the US state], although he believed it should strive to be. A famous statement of Freud regarding the goal of Psychoanalytic treatment is “Where Id was, there Ego shall be”. By his account, the Ego not only emerges out of the Id in the course of development – beforehand, the infant is pure Id [instinctive and irrational] – but it also derives all of its energy from the Id. Freud had a gift for metaphor, and he likened the Ego’s relation to the Id as a rider’s relation to a wilful horse. The horse [Id] supplies all of the pair’s force, but the rider [Ego] may be able to channel it in a particular direction. Fortunately, this “rider” [Ego] has a repertoire of skills at its disposal. Freud proposed that the Ego could employ a variety of “defence mechanism” in the service of the reality principle. These mechanisms come in a diverse range, and all represent operations that the Ego performs to deal with the threats to the rational expression of the person’s desires, whether from the Super-Ego or the external environment. These Ego defence mechanisms are common processes in everyday mental life, and many of them are carried out by the Ego unconsciously, showing that there is an unconscious part in the Ego. The Ego being governed by the reality principle, is aware of environmental demands and adjusts behaviour so that the instinctual pressures of the id are satisfied in acceptable ways, and the attainment of specific objects to reduce libidinal energy in socially appropriate ways was called the “secondary process” [the “primary process” being the Unconscious (Id)]. Some of the most well known defence mechanisms are denial, isolation of affect, projection, reaction formation, repression and sublimation.

 

The Super-Ego (Conscious & partially unconscious, Über-ich / Le Surmoi / L’Autre / Le Grand-Autre)

The differentiation of the structures of personality, called the Super-Ego, is believed to start appearing by the age of 5. In contrast to the Id and Ego, which are internal developments of personality, the Super-Ego is an external imposition. That is the Super-Ego is the incorporation of moral standards perceived by the Ego from some agent of authority in the environment, usually an assimilation of the parents’ views as the child develops – both positive and negative aspects of these standards. The Super-Ego’s emergence complicates the task of the Ego in regulating the expression of the Id’s impulses in response to demands and opportunities of the external environment. The Super-Ego represents an early form of conscience, an internalised set of moral values, standards, and ideals. These moral precepts are not the sort of flexible, evolving, reasoned, and discussable rules of conduct that we tend to imagine when we think of adult morality, however, instead they tend to be relatively harsh, absolute and punishing; adult morality as refracted through the immature and fearful mind of a child. The Super-Ego therefore represents the shrill voice of societal rules and restrictions, a voice that condemns and forbids many of the sexual and destructive wishes, impulses and thoughts that emerge from the Id. The positive moral code is the Ego ideal, i.e. a representation of behaviour for the individual to emulate. The conscience embodies the negative aspect of the Super-Ego, and determines which activities are to be taboo. Conduct that violates the dictates of the conscience produces “guilt” in healthy individuals. Hence, the Super-Ego and the Id are in direct conflict, leaving the Ego to mediate. The Ego now becomes the servant of three masters: the Id, the Super-Ego and the External Environment [Societal Rules]. It is now not enough to reconcile what is desired with what is possible under the circumstances because now the Ego also needs to take into consideration what is socially prohibited and impermissible. Instinctual drives must still be satisfied; which is a constant, however the Ego now attempts to satisfy them in a way that is flexibly “realistic” – that is, in the person’s best interests under current conditions – but also “socially” permitted. These prohibitions are often very unreasonable and inflexible, rejecting any expression of the drive with an unconditional “NO”, either because the moral structures of a particular “culture” are intrinsically rigid, atavistic or unsophisticated, or because the child’s internalisation of these structures is simply black-and-white, without any grey area to compromise for an adequate expression of the drive. Thus, the Super-Ego imposes a pattern of conduct that results in some degree of self-control through an internalised system of rewards and punishments.

Given the demands that it faces, the Ego can either find a way to express the Id’s desires successfully, or its attempts to arbitrate can fail. In this case, psychological trouble is likely to follow. If the Id wins the struggle, and the desire finds expression in a more-or-less unaltered and primitive form, the person may experience guilt or shame: the Super-Ego’s sign that it has been violated, and may also have to pay the price of a short-sighted, impulsive action. If on the other hand, the Super-Ego wins the struggle and dominates a person excessively, that individual may become overly rigid, rule-bound, uncreative, unquestioning, anxious and joyless. The forbidden desires may well go “underground” and manifest themselves in symptoms such as anxieties, compulsions or in occasional “out-of-character” impulsive behaviour or emotion.

 

Intrapsychic Conflict: the Roots of Personality

The major motivational constructs of Freud’s theory of personality was derived from instincts, defined as biological forces that release mental energy. Hence, from the account of the Unconscious (Id), the Conscious [and partly unconscious, Ego) and the Preconscious (Super-Ego), it implies that conflict within the mind’s opposing forces is inevitable, because the demands of society – or “civilisation” – are generally opposed to the natural instincts and drives of human beings. Indeed, intrapsychic conflict is one of the fundamental and defining concepts of psychoanalysis. Conflict within the mind is at the root of personality structure, mental disorder, and most psychological phenomena [e.g. artistic expressions of various forms]. The goal of personality is to reduce the energy drive through some activity acceptable to the constraints of the Super-Ego [Preconscious].

Freud classed inborn instincts to life (eros) and death (thanatos) drives. Life instincts involve self-preservation and include hunger, sex and thirst. The libido is that specific form of energy through which life instincts arise in the Id. The death instinct (Thanatos) may be directed either inwards, as in suicide or masochism, or outwards, as in hate and aggression. The notion that personality equilibrium must be maintained by discharging energy in acceptable ways, leads to anxiety which plays a central role. Essentially the view is that anxiety is a diffuse fear in anticipation of unmet desires and future evils. Given the primitive character of Unconscious (Id) instincts, it is unlikely that primary goals are ever an acceptable means of drive reduction; rather they are apt to give rise to continual anxiety in personality. Freud described three general forms of anxiety.

(i) Reality (or Objective) Anxiety
(ii) Neurotic Anxiety
(iii) Moral Anxiety

Reality or objective anxiety, is a fear of the real environmental danger [e.g. heights, depth, fire, etc] with an obvious cause; such fear is appropriate as it has survival value for the organism. Neurotic anxiety comes about from the fear of potential punishment inherent in the goal of instinctual gratification. It is a fear of punishment for expressing impulsive desires. Finally, moral anxiety is the fear of the conscience through guilt or shame in healthy individuals. In order to cope with anxiety, the Ego develops defence mechanisms, which are elaborate, largely unconscious processes that allow a person to avoid unpleasantness and anxiety-provoking events. For example, an individual may avoid facing anxiety by self-denial, conversion [whereby the anxiety caused by repressed impulses and feelings are ‘converted’ into a physical complaint such as a cough or feelings of paralysis], or projection, or may repress thoughts that are a source of anxiety into the unconscious. Many defence mechanisms are described in the psychoanalytic literature, which generally agrees that although defence mechanisms are typical ways of handling anxiety and maintaining a sense of psychological stability, they must be recognised and controlled by the individual himself/herself for psychological health. Lacan sees « defence » as being on the side of the Subject [being stable symbolic structures of subjectivity].

Denial

Refusing to acknowledge that some unpleasant or threatening event has occurred; common in grief reactions

Isolation of Affect

Mentally severing an idea from its threatening emotional associations so that it can be held without experiencing its unpleasantness; common in obsessional people

Projection

Disavowing one’s impulses thoughts and attributing them to another person; common in paranoia

Reaction formation

Unconsciously developing wishes or thoughts that are opposite to those that one finds undesirable in oneself; common in people with a rigid moral code

Repression

Repression is one of the most basic concepts in psychoanalysis. It involves repelling threatening thoughts from consciousness, to confine them in the unconscious.

Freud distinguished between: (i) primal repression [a « mythical » forgetting of something that was never conscious, an ordinary « psychical act » by which the unconscious is first constituted. Lacan saw this as a structural feature of language, its necessary incompleteness, the impossibility of ever formulating the « truth about truth » (because human language is limited and can never capture and completely express the Unconscious), the symbolic signifying chain of the unconscious where linguistic discourse originates];

and (ii) secondary repression [concrete acts of repression whereby some idea or perception that was once conscious is expelled from the conscious (E.g. motivated forgetting; common in post-traumatic reactions). Lacan saw secondary repression as a specific psychical act by which a signifier is elided from the signifying chain, it is structured like a metaphor and involves the return of the repressed, since repression does not destroy the ideas or memories but merely confines them to the unconscious, the repressed material is liable to return in distorted form, in symptoms, dreams, slips of the tongue, etc. To Lacan, it is always the signifier that is repressed, never the signified, which corresponds to Freud’s view that what is repressed is not the « affect » (which can only be displaced or transformed) but the « ideational representative » of the drive. Lacan proposed that repression is what distinguishes neurosis from other clinical structures – psychotics foreclose, perverts disavow and only neurotics repress]

Lacan maintained that it is very important not to confuse repression with the conscious judgement of a Subject that rejects and chooses.

Sublimation

The concept of Sublimation was first introduced by Freud in 1905 in his essays on Sexual theory. Sublimation is the act of unconsciously deflecting raw, irrational and uninhibited sexual and aggressive impulses/drives towards different, socially acceptable expressions and human activity [e.g. artistic creations, sports and intellectual work] that has no connection to sexuality but gets its power from the psychic energy in the sexual drive [la pulsion sexuelle]. Sublimation thus works as a socially acceptable escape valve for excess libidinal (sexual) energy which would otherwise have to be discharged in socially unacceptable forms [e.g. perverse behaviour] or in neurotic symptoms. This means that complete sublimation would spell the end of all perversion and neurosis. While Freud believed complete sublimation might be possible for some particularly refined or cultured people, Lacan pointed out that absolute/complete sublimation is not possible for human beings, [since all healthy humans with a healthy brain, a functional hypothalamus and sexual organs will experience sexual urges and feelings] and that perverse sexuality to satisfy the drive is possible and accessible (e.g. prostitution, perverse behaviour, private fantasies, etc) but must be sublimated because it is prohibited or badly viewed by civilised society and is also not in the individual’s best interests. Lacan follows Freud in emphasising the fact that the element of social recognition is central to the concept of sublimation, since it is only when the drives are diverted towards this civilised dimension of shared social values that they can be said to be sublimated. This dimension of shared social values allows Lacan to tie in the concept of sublimation with Ethics. [Note: Perversion to Lacan is not simply a savage and grotesque natural means of discharging the libido, but a highly structured relation (reaction) to the manifestation of the sexual drives [instinct/need], which are in themselves in the form of language in civilised people rather than simple biological urges/drives. Lacan also revised Freud’s initial view that sublimation simply involves the redirection of the drive to a different (non-sexual object), but explains that the initial object that the drive was directed at does not change but only its position in the structure of fantasy [for the Subject] changes, i.e. only the nature of the object to which the drive was directed changes not the object itself; this is made possible because the drive is “already deeply marked by the articulation of the signifier”. In the average psyche, the sublime quality of an object is thus not due to any intrinsic property of the object itself, but simply an effect of the object’s position in the symbolic structure of fantasy for a particular Subject.]

Table 1: A List of The Most Common Defence Mechanisms

Freud placed great emphasis on the development of the child because he was convinced that neurotic disturbances manifested by his adult patients had origins in childhood experiences. And as the last model proposed by Freud, the Genetic Model, explains, the psychosexual stages are characterised by different sources of primary gratification determined by the pleasure principle. Freud basically wrote that the child is essentially autoerotic. The genetic model has been previously described in the 3rd section of the essay, The 3 Major Theories of Childhood Development. [Please refer for more details]

However, the genetic model in psychoanalysis has been extensively revised and many of the concepts have given way to other theories [such as the Bowlby’s Theory of Attachment] nowadays that consider other sides in the development of personality. Other theories of peronality have also shown how personality continues to evolve and only stabilises around the age of 30. However, the genetic model of Freud laid the groundwork for other theorist such as John Bowlby and Mary Ainsworth who based their guiding principles to uncover the theory of attachment on pre-oedipal developments first mentioned by Sigmund Freud. These attachment types have been discussed in the Essay, The 3 Major Theories of Childhood Development, and although it may not be completely true for all people, the logic behind the psychosexual stages should always be considered to some extent when analysing clients along with attachment types – not to forget to assess the self-reflective abilities of the person, since this has been proven to have more impact on self-adjustment related to adult personality, emotional intelligence and attachment types.

 

The Relationship between the Topographic Model and the Structural Model

It is important to assimilate the knowledge from the structural model and synthesise them with the topographic model. It can be seen that although the later model is conceptually distinct from the first model, they do map onto one another to some degree. The content of the Id, of course, lies firmly within the Unconscious, and is forbidden from entry to the consciousness unless disguised in the form of dreams, slips of the tongue, symptoms, and so on. However the Ego is not completely conscious unlike many ego psychologist may claim along with cognitive psychologist, as it has a strong Unconscious component, given that a great deal of psychological defence mechanisms are conducted instantly out of awareness, and hence is sometimes inaccessible to introspection by the patient – hence requiring a skilled psychoanalyst to guide therapy and treatment. The Super-Ego also has an Unconscious fraction, reflecting as it does and often “primitive”, and irrationally punishing through rigid morality – at least as much as it reflects our reasoned beliefs and principles. Although many concepts have been revised and alternative treatments relating to mental illness have also been devised by other schools of thought in psychology, the sheer complexity and uniqueness of the psychoanalytic system has formed a remarkable achievement. Indeed, Freud even had to invent new terminology to express his thoughts, and these terms have become an accepted part of our vocabulary.

Psychisme: Les théories de Freud ont-elles évolué? (2013)

 

Psychoanalytic Evidence: From the perspective of Empirical Methodology (Mainstream Science)

Freud ardently believed along with all good psychoanalysts that psychoanalysis is a science, not an empirical science, but a science of the mind that slices not with blades or questionnaires, but with concepts through the linguistic and philosophical realm of a patients subjective reality. It is also fair to consider that Freud himself was an accomplished biological scientist before he developed psychoanalytic theories. Biological ideas are interwoven in his work, as is his concepts of drive, instinct, and psychic energy. Nevertheless, the methods that he used to obtain evidence for the psychoanalytic theory were very different from the reductionist and empirical methods used by the government institutions, laboratory scientists or the statistical psychologists with their quantified questionnaires exploring basic “traits”. As an anatomist and physiologist, Freud made systematic observations of living and dead organisms, and conducted controlled empirical experiments. Hence, he must have come to the same conclusion as ourselves, which is, mental life cannot be fully explained by the mechanical explanations, although a lot can be learnt from understanding the physiology of the brain, but the “software” itself, that generates the mind, is an entity that empirical science comes short in terms of its methodologies. Hence, as a psychoanalyst, Freud introspected and speculated about his own mental life, and listened closely to what his patients told him during sessions of psychoanalytic therapy. It is quite clear, that dissecting an eel is completely different from dissecting a personality with all its complexities, and that observing the stream of one’s consciousness or another’s speech [i.e. discourse] is very different from conducting a controlled experiment with observable variables. So, psychoanalytic evidence is clearly unlike the evidence on which most “hard physical sciences” are based.

However, it is important to understand that the critique of psychoanalysis from the methodology of empirical science may not be rational. Because psychoanalysis was never intended to be a mechanical « hard » science, although it learns from neuroscience and cognitive-psychology of certain very basic aspects of the physiology of the brain and its functions. These questions about Empirically Supported Treatment (EST) came to the forefront of psychotherapy literature in 1993, when Division 12 of the American Psychological Association worked to publish a list of criteria for what constitutes EST (Chambless, et al., 1996; Task Force on Promotion and Dissemination of Psychological Procedures, 1995; Taskforce on Psychological Intervention Guidelines, 1995). A list of treatments were published that we empirically supported and very few psychodynamic treatments were included, nor were interpersonal or humanistic therapy included. Not surprisingly, these guidelines and list became anything but unifying for psychotherapists and psychotherapy researchers.

Freud Dessin

Westen, Novotny and Thompson-Brenner (2004) made some important critiques of the literature on ESTs. They noted that ESTs are often designed for a single, Axis I disorder, and patients are screened to maximise their homogeneity and to minimise their diagnostic comorbidity. Treatments are manualised and brief, and outcomes are assessed often by reductions in the primary symptom reduction for that particular disorder. Westen et al. suggested that EST researchers always tend to assume the following:

  • Psychopathology is highly malleable
  • Most patients can be treated for a single problem or disorder
  • Psychiatric disorders can be treated without much attention to underlying personality factors
  • Experimental methodology used to develop ESTs has ecological validity in clinical practice

Westen et al. (2004) basically contended that these assumptions are not valid, not to say wrong. There is considerable diagnostic comorbidity, making most patients ineligible to participate in EST research trials. There also is considerable stability of psychopathology of psychiatric symptoms, even after “successful” completion of EST. And clinicians of all theoretical orientations see patients well beyong the time allotted in treatment manuals (see Morrison, Bradley, & Westen, 2003; Thompson-Brenner, Glass, & Westen, 2003; Westen & Morrison, 2001 for an excellent review of these issues).

Norcross (2002a) offered an additional perspective on why the EST literature has been so controversial. First, he explained that EST research rarely addresses the fact “that the therapist is a person, however much he may strive to make himself an instrument of the patient’s treatment” (Orlinsky & Howard, 1977, p.567 as cited by Norcross 2002a). This idea has been demonstrate very well in empirical literature. For example, Wampold (2001) concluded in a meta-analysis of psychotherapy studies that the qualities of the therapist play a much stronger role in the outcome of treatment that does the treatment itself. Second, Norcross stated that therapy research has savagely neglected the important question of studying the therapy relationship. Instead, the focus has been more on the application and mastery of a technique (not a relationship). Third, who the patient is affects treatment outcome. As attention has been directed towards the study and implementation of psychotherapy techniques to different categories of disorders, small attention has been given to the patient characteristics that affect outcome, such as comorbid conditions, capacity for insight, and a history of interpersonal relatedness.

Psychoanalytic and psychodynamic therapies certainly are related to these issues. Analytic and Dynamic models of therapy are very focused on the behaviour and qualities of the therapist, with special attention to issues of the therapeutic alliance, neutrality, transference, and countertransference.

Freud's Couch at Freud Museum London

The couch that started everything: Freud’s psychoanalytic couch at the Freud Museum in London

It is important to also consider that one’s training in how to conduct psychoanalytic or psychodynamic psychotherapy is focused on how therapists present themselves and how patients respond to this. Such a focus automatically puts the therapeutic alliance at the centre of attention, something that has taken on more interest over the years (Fairbairn, 1952; Greenberg, 1986, 2001a; Pine, 1998; Stolorow, Atwood & Brandchaft, 1994; Wallerstein, 2002). Psychoanalysts have also recognised that the personality and qualities of the patient affect how therapy should be conducted (e.g., Gabbard, 2000, 2004); that is, one approach to working with patients does not fit all patients. Furthermore, many psychotherapists have been reluctant to allow their therapy relationships to be subject to empirical investigation (Bornstein, 2005), as a form of respect for the privacy of their clients, making it very hard to provide more objective data that the support the validity of psychoanalysis. In contrast, other schools of thoughts derived from the behavioural school and the medical fields have very willingly offered their data for empirical investigations.

Often accompanying this philosophical criticism regarding scientific testability is a factual criticism that psychoanalysts have seldom tried to test their theories scientifically. This criticism may have some truth to it, however many psychoanalysts have responded to the call for more scientific inquiry by asserting that it is unnecessary and that clinical evidence of the treatments curing mental illness of various types is quite sufficient.

FIGURE B - SUCESS RATES WITH ADULTS & CHILDREN

Success Rates of Psychotherapy with adults and children, and Therapy from other schools of thought [traditions] based on Effect Sizes from Meta-analyses / Source: dpurb.com

Other psychoanalysts have argued that scientific support for their theories is irrelevant. Psychoanalysis, they suggest, is not an empirical science, but a science of subjective experience and linguistic dissection, so it is inappropriate to judge it by the mainstream reductionist empirical scientific standards of modern day academia.

Many see psychoanalysis as a “hermeneutic” discipline, an approach to interpretation which is rather like a school of literary criticism or biblical scholarship. To them, psychoanalytic theory is a way to decipher mental life, an interpretative technique for uncovering meaning. Its goal, they say, is to understand psychological phenomena in terms of their underlying reasons rather than explaining them as objective science in terms of causes. Some have gone so far as to suggest that the goal of psychoanalytic understanding is not to ascertain literal or scientific truth – for example, what “truly happened in a person’s past to make them the way they are today” – but instead to formulate “narrative truth”, a story that gives coherent meaning to the person’s experiences [from their perspective in terms of what matters to them] (Spence, 1980).

LePromeneurSolitaire-dpurb-com-1200

Photographie: Danny D’Purb © 2018

What Jacques Lacan clearly meant by a complete reconstitution of a subject’s history as the aim of psychoanalysis, is that « history » is not a simple objective sequence of past events, but the present synthesis of the past as it is subjectively perceived and interpreted by the continously evolving Subject in his/her uniqueness. Lacan’s used the term « après coup » [retroaction, i.e. how the present affects the past] and pointed out that linguistic discourse itself is structured by retroaction, since only when the last word of a sentence is uttered or read that the initial words gain meaning; with retroaction also comes « anticipation« , which refers to the way in which the future also affects the present, and like retroaction, anticipation also structures linguistic discourse, since the first words of a sentence are ordered in anticipation of the words to come. Jacques Lacan also pointed out how in the « psyche » [mind], present events affect past events [i.e. retroaction]; because the past is simply a set of stories in the mind of an individual that is edited and reinterpreted in the light of new experiences and information of the constantly evolving Subject in his/her uniqueness; most healthy individuals with desires, sculpt the stories of their past experiences to make it work towards their development; they take a particular perspective to extract meaning and significance from their past experiences [in terms of what matters to them and what does not] so that they contribute towards their development, progress and desires [See the Essay: The Concept of Self]. Lacan also pointed out that psychoanalysis is not concerned by what most empiricists would call the « real past » as an objective sequence of events devoid of subjective signification, but rather with the way these experiences exist in the psyche/mind of a particular individual and how he/she interprets (i.e. perceives) and reports them in order to find out what holds significance for a particular Subject and what does not.

We can thus conclude that there will always be something “uniquely special” about psychoanalytic evidence, for all its empirical flaws. A completed psychoanalytic treatment may sometimes [depending on the type of patient] occupy four or five sessions each week over a period of several years, amounting to perhaps 1000 hours in which the analyst listens closely to the patient’s innermost thoughts. These thoughts, often too intimate and raw to be shared even with loved ones, range widely over the patient’s personal history and lived experiences. They are recounted in a wide variety of mood-states and frames of mind. These millions of spoken words and feelings may not represent the kind of systematically and objectively collected data on which the scientific theory of personality [that the hardcore empiricist loves] can easily be built. However, it is hard to declare that the analyst does not understand the patient’s personality better than someone who might interpret the patient’s responses, dashed off in a matter of minutes, to a trait questionnaire. Indeed, there is something valuable about psychanalytic evidence, but it is very hard to build an empirical theory out of it since we are not dealing with matters of hard sciences [e.g. biology, medecine, physics, chemistry, astrophysics, material science, astronomy, etc], but the mind of human beings that embodies their whole existence and worlds.

 

Empirical Evidence for the Existence of Unconscious Processes

More and more psychoanalytic thinkers and sympathisers are starting to find creative ways to test psychoanalytic hypotheses in rigorous empirical ways to conform with academic science, despite all the difficulties that this involves. This research is now very extensive, and therefore difficult to summarise. However, a broad conclusion can be drawn from it: specific Freudian claims typically fail to receive experimental support but do work in treating mentally ill patients in clinical practice. What Freud learned from his clinical practice is that sexuality always involves a dimension of the impossibility of reaching « total » satisfaction for any Subject, and in order to achieve some satisfaction it is necessary to renounce total satisfaction, this renunciation is one of the references to the concept of « castration », where castration is a condition for satisfaction. Castration refers to the separation installed by the Oedipal law in both sexes and thus is a requirement of civilised culture; it is the positive side of the prohibition of incest, this instinctual renunciation, is the structuring function in the resolution of the Oedipus complex and is necessary for all cultural achievement.

Freud elaborated three possible outcomes for the « castration complex/anxiety » in women: (i) a total repudiation of sexuality; (ii) the adopting of a masculine position and the repudiation of penis envy; and (iii) motherhood as a treatment of penis envy through the symbolic equation of penis equals child. As for males, Freud believed that the castration complex/anxiety serves to free the boy from the Oedipus complex; it is the prohibition of the primordial object [i.e. the mother(s) or mother figure(s)] and leads to a lack in individuals which will orient them to look elsewhere [i.e. go out into the world and seek a true partner], and in this way, desire is inaugurated; for a number of psychoanalysts however, the « castration complex » of Freud did not have the major structuring role in the construction of sexual difference and they instead turned to other explanations, such as biological and developmental theories.

The concepts of Penis envy [According to Freud, woman’s desire to have a child is rooted in the envy of the man’s penis. When a girl first realizes that she does not possess a penis, she feels deprived of something valuable (symbolically), and seeks to compensate for this by obtaining a child as a « symbolic substitute » for the penis she has been denied. Even though the girl may at first resent the mother for depriving her of a penis and turn to the father or father figure in the hope that he will provide her with a symbolic substitute (i.e. a child), she later turns her resentment against the father when he does not provide her with the child as substitute. Freud argues that penis envy persists into adulthood, manifesting itself both in the desire to enjoy the penis in sexual intercourse, and in the desire to have a child (since the father or father figure does not provide her with a child, the woman turns to another man instead). On this particular component of psychoanalysis, Lacan follows Freud, arguing that the child always represents for the mother a substitute for the symbolic phallus which she lacks (a type of lack known as « privation »). However, Lacan emphasized that the symbolic substitute for the phallus (i.e. the child) never really satisfies the mother; her desire for the symbolic phallus persists no matter how many children she has. The mother’s basic dissatisfaction and sense of privation is perceived by the child from very early on; the child realizes that she has a desire that aims at something beyond her dual relationship with him, the imaginary phallus. The child then seeks to fulfil the mother’s desire by identifying with the Imaginary phallus (or by identifying with the mother imagined as possessing a phallus, i.e. the phallic mother). In this way, the « privation » of the mother is responsible for introducing the dialectic of desire in the child’s life for the first time. Alfred Adler argued that the concept of « penis envy » should not be expressed literally but symbolically as women’s frustration at not being able to match male dominance in society, i.e. the phallus as representing male dominance in society. Karen Horney contested the claims of penis envy, which seems to suggest that some concepts may not apply to everyone, hence the wide scope of psychoanalytic theory to suit different developmental cases], Castration Anxiety and Repression, cannot be demonstrated easily through the simple methods used for mainstream science and empirical experiments in a laboratory, although some effort has been made. A study at the Harvard Medical School in Boston at the Massachusetts Mental Health Centre involving college aged women [ranging from 17 to 43 years old] and men [ranging from 18 to 23 years old] carried out by Rosalind Jones in 1994, tested the Freudian theory claim that the « natural » development of feminity involves the woman’s substitution of the wish for a baby in place of her original wish for a penis [i.e. penis envy]. In the study, the pregnancy message used was « Reproduction. The birth of a child. I should become pregnant. Entering my uterus. Entering my womb. I could become pregnant. To be fertilized. Becoming pregnant. The contraceptive field. To become pregnant. I could become pregnant, big with child »; the original penetration message was « I feel opened up. Things are getting through. It gets into me. I am opened up. Things are getting into me. I am sensitive. I feel things inside of me »; and the Revised Penetration message was « I feel opened up. He is getting through. He gets into me. I am sensitive sexy. I feel him moving into me. He is getting into me. » Consistent with Freud’s speculation about the phallic significance of pregnancy for women, Jones (1994) found that female subjects who were exposed to the subliminal pregnancy message produced significantly more phallic imagery responses to inkblots than did women in any other experimental conditions (p<.01).

Dreaming also does not seem to always preserve sleep by disguising latent wishes, and there is very little empirical evidence to back up the theory of Psychosexual stages, although it influenced the Theories of Attachment devised by John Bowlby. More « general » Freudian concepts however have often received a good deal of scientific support. There is today, plenty of evidence to suggest the existence of unconscious mental processes, for the existence of conflict between these processes and conscious cognition, and for the existence of processes resembling some of the defence mechanisms. Two illustrative studies can support his work. First, Fazio, Jackson, Dunton and Williams (1995) found that people who sincerely profess to having absolutely no racial prejudice can be shown to associate negative attributes with Black faces more than White faces in a laboratory task. This finding which has been replicated countless times by social cognition researchers, shows that the conscious attitudes of individuals may conflict with their “implicit” attitudes [unconscious]. Second, Adams, Wright and Lohr (1996) hooked male subjects up to a daunting instrument called the penis plethysmograph, which measures sexual arousal by gauging penile circumference. It was found that men who reported strong anti-gay (homophobic) attitudes demonstrated an increased arousal when shown videos of homosexual acts, whereas non-homophobic men did not. This finding seems to reveal some form of defence mechanism consistent with the psychoanalytic view that homophobia is a reaction formation against homoerotic desires. However, none of these illustrative studies can be considered as completely conclusive, and all have been controversial and subjected to various interpretations. For example, anxiety, shock, or anger rather than sexual arousal may have caused the increased penile blood flow of Adams et al.’s homophobic subjects.

These experiments prove that with enough creative ingenuity, some psychanalytic propositions can be scientifically tested. Doing so should contribute to the important task of sifting what is worth retaining in psychoanalytic theory for strict empiricists of the hard sciences.

 

Unconscious Processes: Integrating Cognitive Neuroscience and Psychodynamic Theory

In various ways, the evidence for the existence of mental processes that are outside of direct conscious awareness are apparent in every scenarios of life. Here are some examples:

  1. We sometimes cannot remember the name of a particular person of importance, only to be able to recall it hours or days later at a time and place when knowing the name is not required
  2. Despite one’s intention to offer some control over the process, dreaming appears to occur at its own timing and pace.
  3. On September 11, 2001, and the days following, many Americans watched hours of news report focussed on the same attacks on the United States. Although deeply upset by the contents, many individuals could not stop themselves from watching these videos, saying that it was as if something in them drew them to reports in spite of conscious awareness of disbelief and outrage
  4. Many patients who seek psychotherapy are unable to stop unwanted behaviours or interpersonal problems, despite conscious awareness of their harmfulness to them and their life. These problems range from relatively simple [e.g. drinking too much alcohol] to relatively complex [e.g. placing oneself in situations in which one is often taken advantage of or obsessing about one’s body image if certain kinds of fattening foods are consumed].

Soignez votre intestin, pour vous sentir bien d'purb dpurb site web

Other examples are evident too, simple exercises that can be easily performed. For example, consider when 3 lines are drawn in the shape of a triangle with the ends of each line however, not touching one another, leaving a small gap between all their extremities. We can come to realise that, depending on the space between the lines, the image is instantly perceived as a triangle by the individual, a triangle with missing edges; 3 lines that are coming together like a triangle, or just 3 lines at different angles.

When taking into consideration perceptual phenomena such as this [i.e. an example of the Gestalt principle of closure], it is evident that the mind does the following very quickly, without conscious awareness of how the process occurs, yet meaning and understanding are formed.

  • Takes in sensory information
  • Determines what the information is
  • Assembles the information in such a way that a percept or concept is formed
  • The percept or concept is “perceived” and “understood”

The evidence for the existence of unconscious processes is widely known in cognitive psychology. In a seminal paper in the American Psychologist, Shevrin and Dickman (1980) demonstrated how conclusions from the studies of selective attention, cortical evoked potentials, and subliminal perception provide support for the concept of an unconscious mind and posit that “no psychological model that seeks to explain how human beings know, learn, or behave can ignore the concept of unconscious psychological processes” (p. 432). They also noted that the initial stage for processing all stimuli occurs outside of consciousness and that it affects what is known consciously. This early stage is different in how it operates from conscious cognition, and conscious cognition necessarily occurs after considerable preconscious processing. Years, later, their conclusions and ideas appear to be no less true.

 

Empirical and Cases Studies Demonstrating Unconscious Processes

In studies of subliminal perception, which began in 1950s, the processing of unperceivable stimuli and its effect on behaviour has provided interesting results about the unconscious mind. Shevrin and Fisher (1967) subliminally presented participants with a picture of a pen and knee just prior to falling asleep. When they awoke from rapid eye movement (REM; dream stage) sleep, participants’ associations to their dreams were of a pen or knee or included less rational kinds of associations (a finding that had been well demonstrated in past sleep studies). These included words that sound like pen or knee, such as pennant, hen, or neither. In contrast, those who awoke during non-REM sleep, which had been associated with few dreams or dreams that were more rational, had associations such as penny (pen + knee) or related words, such as nickel and dime.

Shevrin (2006) noted that this study demonstrated that 2 levels of unconscious processing – irrational and rational – were taking place. He deduced that once inhibitions [e.g. defences] weaken – in this case, being awakened from sleep – more rational processes are overtaken by irrational ones. Surprisingly, the more irrational process observed in this study produced content similar to what was found in severe types of psychopathology: repetition and clanging. In a follow-up study with the same methodology, Shevrin (1973) presented participants with the same stimuli, this time while they were fully awake and more proximal to entering the sleep state. Again, they found a similar pattern of results in which the type of associations produced varied depending on when participants were awakened.

Even more interesting results were described by Shevrin and colleagues (Shevrin, 1988; Shevrin, Bond, Brakel, Hertel & Williams, 1996; Shevrin et al., 1992), who set out to demonstrate that unconscious and conscious processes operate differently. In these studies, patients were selected who had either pathological phobic reactions or extended grief. They were then assessed via interview, and 4 psychoanalysts listened to the interviews carefully. By way of consensus, the psychoanalyst researchers derived a conceptualisation of the core conflicts for each patient; then went on to select the patients’ words that they believed captured the patients’ conscious experience of the symptoms and words that represented unconscious conflict. These words along with unrelated words were then presented both subliminally and supraliminally to the patients, who were then asked to classify them as belonging together. Using event-related potentials to detect patients’ ability to classify or respond to words in similar ways, the researchers found that words representing unconscious conflicts were correctly classified only when presented subliminally and that the reverse was true for supraliminally presented words; they were correctly classified only when presented supraliminally. Here, we find some sense to Lacan’s deductions regarding the unconscious being structured like language and the linguistic dexterity that psychoanalyst should be able to handle to decipher and understand the fullness of the patient’s mind [conscious and unconscious].

Shevrin (1996) concluded, “…When [these studies are] taken in combination, [they] show that unconscious psychological causes affect consciousness in a qualitatively different way… and that unconscious conflict has an existence independent of the psychoanalyst’s inferences from conscious manifestations, an independence supported by brain correlates” (p. 591, italics in original). Shevrin also published reviews of research showing an association between subliminal perception and dreaming (Shevrin, 1986) and subliminal perception and repression (Shevrin, 1990).

In a more recent meta-analysis from more than 100 studies of subliminal perception, Weinberger and Hardaway (1990) found that psychodynamic material presented subliminally had a noticeable and predictable effect on behaviour, suggesting very clearly that unconscious processes affect overt behaviour. For instance, studies by Silverman and colleagues (Silverman, 1983, 1986; Silverman, Bronstein & Mendelsohn, 1976; Silverman, Kwawer, Wolitzky & Coron, 1973; Silverman, Lachman & Milich, 1982; Silverman, Ross, Adler & Lustig, 1978) found that subliminally presented messages of Oedipal content (e.g., “Beating dad is okay”) to male participants yielded more competitiveness in a subsequent dart-throwing game than non-Oedipal messages. [Note: Freud proposed that at the Oedipal stage, a competition between father/son and daughter/mother takes place, before it is resolved in the child gradually adopting the same-sex parent’s values as his/her own in the development of an early form of Conscience (Super-Ego/Preconscious)]

Bradley and colleagues (Bradley, Mogg & Millar, 1996; Bradley, Mogg and Williams, 1994, 1995) performed a series of studies in which words related to depression (e.g. misery, grief, despair) are subliminally presented to individuals who fall into 3 groups: those meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for major depression, those with subclinical levels of depression and those operating as controls. They consistently found that on implicit memory tests, depressed and subclinically depressed individuals correctly identity words related to depression more often than those who are not depressed. Although their findings have not been consistently replicated for patients suffering with anxiety, studies with depressive patients suggest that a level of processing occurs below conscious awareness that increases individuals’ awareness of and identification of depressive material. Clinically, it would suggest that to effectively treat and manage depression, addressing issues related to unconscious sensitivity to depressive material is very important. Given the relatively high relapse rates for depression and other disorders that are treated with methods focussing more on conscious awareness – via cognitive and behavioural therapies (Westen & Morrison, 2001) – it seems that attention to unconscious processes has the potential to effectively address some depressive disorders.

Eagle (1987) provided support for the notion of unconscious processing in studies of perceptual illusions and dichotic listening, a type of selective attention task. For instance, in the Ames room experiment (Ittleson & Kilpatrick, 1951), the ceiling and floor were not parallel, and the 2 subjects stood either towards the front or back of the room. This led perceivers to believe that the people very different in size , despite the fact that they were not. In the dichotic listening task (Lewis, 1970), individuals heard 2 different messages in each ear but were trained to attend to just one of those messages. When asked to repeat what was heard in the trained ear, individuals had less of a reaction time in producing the words when the words in the other ear were semantically similar [the meaning was synonymous / it meant the same thing]. This means that, there was a facilitative effect on performance when a semantically similar word was processed (unconsciously) in the “unattended” ear.

Further studies of patients who have experienced brain injuries provide interesting clinical observations that support the presence of unconscious processes. Milner, Corkin and Teuber (1968) reported the famous case of a patient known as H.M., who had undergone surgery on his medial temporal lobes to control very severe seizures. We nowadays know that just below the this part of the cortex lies the hippocampus, which is considered as an important anatomical locus for learning new information and storing it in working and long-term memory. Because of the damage done to the medial temporal lobes by the procedure, H.M. failed to remember anything that was new to him past surgery. H.M. however could remember information if he rehearsed it, although it was quickly lost if he was interrupted.

One interesting consequence of this procedure was that H.M. appeared not to have lost all “affective” components of certain experiences. For instance, H.M. had the occasion to visit his mother, who was hospitalised. After leaving the hospital, he had no recollection of visiting her, although he had the idea that something may be wrong with her. H.M. experienced other events like this, demonstrating well that implicit learning was still occurring for “affectively charged” situations and that the unconscious effects of this learning could be identified in everyday life.

Later studies of unconscious affective processing have suggested that there are at least 2 neural pathways that process affective information (LeDoux, 1989, 1995, as cited in Westen, 1999). One of these pathways originates in the thalamus and transmit sensory information to other brain regions, whereby emotional meaning is attached to the information. The other pathway, also originating in the thalamus, sends the sensory information to the cortex, where higher levels of emotional processing and emotional meaning are executed.

Mark Solms has reported some exciting work on the effects of unconscious processes on commonly observed clinical syndromes (e.g., Solms, 2000a, 2000b, 2001, 2002, 2004). Solms has taken a very active role in recent times in integrating the findings of neuroscience and psychoanalysis, which has created a relatively new discipline of study known as neuro-psychoanalysis. An interesting set of case of studies has been provided (Solms, 2000a) on patients who have experienced a strike on the right temporal lobe in the region, where the middle cerebral artery lies. In these case studies, psychoanalytic theory and treatment is integrated into the neurological understanding of the deficits the patients are experiencing.

Right hemisphere syndrome is a neurological disorder consisting of 3 major symptoms: ansognosia, neglect and spatial perception and cognition deficits. Anosognosia is the indifference or outright denial of an illness, which in the present case was the loss of the use of the patient’s left arm and side. Neglect occurs when patients ignore their paralysed limb and side. Patients often feel disgust when they are compelled to attend to the left side of the body, sometimes experiencing a sense of revulsion.

The spatial and cognitive deficits observed consist of defective facial recognition, imperceptions of facial emotion, environmental disorientation, and various kinds of apraxia [the inability to complete an activity involving muscle movement]. There are various theories about the emotional deficit in patients with right hemisphere syndrome. One theory suggests that the stroke affects attentional arousal that is mediated through activity in the right perisylvian region of the temporal lobe, which consequently gives rise to anosognosia and neglect. Another theory has focused on the fact that the left hemisphere is more involved with positive emotional processing and the right with more negative emotional processing. Since, the right hemisphere is damaged in this case, anosognosia and neglect occur because there is little to no processing of negative effect in the right hemisphere. A final theory states that it is the right hemisphere that is dominant for the perceptual representation of bodily states, which include more somatic or visceral perceptions. When this part of the brain is damaged or compromised, the brain can only rely on past somatosensory representations of bodily states, which provide the patient that there is no deficit or problem.

Solms (2000a) described Mr.C., a 59-year-old engineer who experienced right hemisphere syndrome after complications from a mild stroke. Only part of the visual field of the patient was remaining and he would not attempt to compensate for it [i.e. neglect], and he also ignored sensory stimulation that occurred on the left side of his body [anosodiaphoria]. He ignored and minimised his paralysed left arm, referring to it as being “like a dead piece of meat, but not it’s just a little bit lame and lazy” (p.71). Other deficits existed due to right parietal damage.

Mr.C. was “aloof, imperious and egocentric” (Solms, 2000a, p.72). He seemed unconcerned about others and would sit blankly at times staring into space. However, on occasion he would burst into tears or look as if this were the case. These periods however, were brief yet stood in stark contrast to the emotional coldness that he often presented with. During one physical therapy session, Mr. C. was making very little progress in learning how to walk. The physiotherapist reported to the treating psychologist that Mr. C. seemed “indifferent to the errors he was making, and he simply ignored her when she pointed them out to him” (p.74). In a session next day, Mr. C. told the psychologist that the physiotherapist indicated that he had been making mistakes, sounding as if he was confession something. Then, he said that another therapist had asked him to do some activities with blocks but that he could not do it. At this point, the therapist replied to Mr. C.:

 

“…it was difficult for him to acknowledge the problems his stroke had left him with, but it seemed that he was now more able to see them. Mr.C., carried on… [saying] his physiotherapy was “okay” but that his arm had not progressed to the degree that he required. Then, at this point, he suddenly  withdrew from conversing… and began to exercise his left hand and arm with the right one. [The therapist] commented that is seemed as if he could not bear the wait, and wanted his arm to be completely better instantly… [He replied] “I just don’t want my left arm to get weak from non-use.” [The therapist then replied] perhaps it was too painful for him to acknowledge what he was on the verge of recognising a moment earlier – namely that his arm really was completely paralysed – and that the question of whether it would recover or not was largely beyond his control. This comment provoked an instantaneous crumpling of his face and a burst of painful emotion accompanied by pre-tearfulness. [Turning to the therapist] he said in desperation “but look at my arm [pointing to his left arm] – what am I going to do if it doesn’t recover? (pp. 74-75)

 

Solms (2000a) noted that this case demonstrates how unconscious material that was too painful to acknowledge was accessed through careful interpretations. Furthermore, the case example controverts the theory that these patients lack negative emotions or have no awareness of their bodies and their deficits. In Mr. C’s case, it is clear that implicit processes were at work and that the emotional response originated out of the complex, associative networks were formed by this patient’s unconscious processing of the painful loss of his bodily integrity.

Transference phenomena can also be better understood in the light of recent findings in cognitive psychology. To understand transference phenomena, Westen and Gabbard (2002b, pp. 103-104) highlighted important ideas in recent studies of cognitive processing.

  1. More representations consist of memory traces that are multimodal, which include semantic, sensory and emotional components.
  2. Representations of self and other exist as potentials for activation. Because there are potentials, they are subject to modification, which will interact with new knowledge, further developing the self and other representations.
  3. Memory networks consist of semantic, episodic and procedural knowledge, along with differing affects and motives.
  4. Unconscious procedures to manage emotions are defences and may be triggered outside of awareness. Co-occurring motives and affects may also be activated, such that the person may not be aware of either one or the defence being used.
  5. Conscious representation are some of many representations that get activated. Consciousness is a serial processing system, whereas multiple parallel processes get activated that are not available to consciousness.

As may be observed in these principles, Westen and Gabbard (2002b) suggested that transference phenomena represent a dynamic, ongoing process that occurs at the conscious and unconscious level. Because multiple cognitive events occur at one time, transference phenomena can be highly complex phenomena and can represent one of many possible reactions to the therapist, as well as other meaningful individuals in the patient’s life. In fact, multiple transferences can occur. For instance, a patient may feel particularly challenged by his work and may experience some feedback from his female supervisor about his recent difficulties with his job. Suppose the patient’s mother took great strides to help him whenever he felt frustrated in his school activities or work, such that he came to unconsciously expect her to provide assistance during challenging times. At work the patient may have experienced the supervisor’s comments as an invitation for help and assistance. Should no help be forthcoming, the patient would become irritated and disappointed with such a difficult supervisor. Likewise, suppose that this patient’s father was unavailable to help him. He may have to come to view male authorities as uncaring and disinterested in his plight. Thus, in his present treatment, the patient may find himself feeling scared and anxious towards his male therapist when talking about his recent disappointment with the supervisor. An exploration of his interaction with his supervisor may elicit anxiety in the patient towards his therapist whom he experiences as a disinterested and uncaring male. Likewise, he may feel very frustrated towards the therapist who is not willing to tell him how to manage his interactions with his supervisor, reflecting a maternal transference to the therapist who unconsciously should be offering help and assistance quickly and without much effort on the patient’s part.

 

The Psychoanalytic Account of Motivation

The account of human motivation, resting on sexual and death instincts, has been a big talking point for critics of psychoanalysis from the very beginning. Jung’s departure from the psychoanalytic movement was largely caused over disagreements over the motivational concepts. Jung questioned the centrality of sexuality and argued for the importance of spiritual motives. Alfred Adler on the other hand proposed a basic desire for social superiority and a “will to power”. Later writers within the psychoanalytic tradition also sought to expand the theory of motivation to include drives for mastery and competence, and for interpersonal relatedness.

In general, there has always been 2 major issues, the first is whether the sexual and death instinct are plausible sources of human motivation. Second, whether they are sufficient explanations of motivation, or whether additional motives that are not reducible to these drives are needed.

With respect to the first issue, it may be hard to deny [from a universal and organic standpoint] that sexual wishes and drives are powerful sources of motivation, especially if we include “sexual” desires as a part of loving relationships and for bodily pleasure. From a biological and evolutionary perspective it could not be otherwise, since reproductive success is the basic currency of individual genetic fitness, not to mention species survival [in all species including primates and mammals].

From this perspective, the psychoanalytic emphasis on sexual drives – an emphasis shared by no other personality theory – is a very strong point of the psychoanalytic theory, even if we are allowed to disagree and investigate some particular claims that may not apply to some individuals regarding the effects of the Psychosexual stages in childhood as proposed by Freud [which inspired John Bowlby’s Theory of Attachment], or discuss the other drives that are non-sexual [e.g. Romantic love and its expressions].

Romantic Love dpurb site web 2019.jpg

From the same evolution standpoint, a death instinct directed inwards towards self-destruction is questionable. However, this negative judgement on the death instinct, which is shared by many contemporary psychoanalysts, does not mean that we need to dispense with the idea of aggressive drives. Aggressiveness could be theorised not as a form of self-destructiveness, but rather as a way to strive for social dominance [among a particular frame, circle or group], i.e. to fend off “attackers” in defence of one’s own “territorial grounds” or to assert one’s personal choice or interest.

The second issue is whether sexual and perhaps aggressive drives are broad enough to capture the full range of human motivations. The answer, is clearly not. Since, we also have drives for achievement, approval, non-sexual relatedness, creativity, self-esteem, and so on? The other question is biologically-based motives that “push” us towards certain kinds of behaviour enough? Do future-oriented motivational concepts, like goals and personal ideals not “pull” us towards desirable endpoints? When these questions are raised, basic Freudian account of motivation may seem limited in their scope, leaving out motives that are socially shaped or personally determined. However, the issue is not so easily resolved, since psychoanalysts may agree that motivations beyond the instinctual drives are required to describe how our behaviour is guided, however it may still be argued that all these motivations are simply multiple layers of the very same instinctual drives. For example, achievement striving could be described psychoanalytically as a socially shaped motive that is underpinned and powered by aggressive urges [that are applied in different forms to achieve our goals, i.e. not in a physically violent manner, but competitively in multiple sophisticated social ways]. On the same note, creativity might be understood as a sublimated expression of individuals’ sexual drives [e.g. artistic creations], based on some unconscious desire for unifying and making connections that Freud saw as the hallmark of life instincts.

Victor Hugo La Musique

Traduction(EN): « What we could not say and what we could not silence, music expresses. » -Victor Hugo (1802 – 1885)

However, even if the claim that human motivation is ultimately based on a few instinctual drives that govern all living organism, it would still be more enlightening and accurate to patients to describe their motivation in a more complex way, i.e. expressed to meet the sophisticated and multi-layered human societies we live in. So, in the end there is no objective or empirical way to establish the question of motivation with a clear “true or false” – we will have to use logical reasoning and theories about what drives “life” forward.

Documentaire: L’invention de la Psychanalyse (1997)

 

The 2 Major Disciples of Psychoanalysis: Carl Jung and Jacques Lacan

The psychoanalytic movement was largely the invention of Sigmund Freud, and his influence far exceeds that of his early followers who subsequently tried to modify psychoanalysis. The major principles of psychoanalysis were redefined and reinterpreted until by 1930 the movement was fragmented into competing views. Nevertheless, those writers who departed from Freud’s speculation retain the basic model of psychoanalysis that conceived of personality in terms of an energy reduction system with three levels of awareness that is the conscious [that contains the Ego], preconscious [that holds the Super-Ego] and the unconscious [the wild Id]. The psychoanalytic movement has been very active since Freud’s death in 1939, and has led to many new theoretical developments influencing all schools of psychology rather than standing still as we have just covered regarding the reconciliation of some fundamental concepts with Cognitive psychology and Neurosciences.

 

Carl Jung (1875 – 1961)

Carl Jung

One of the most fascinating and complicated scholars of this century, Carl Jung (1875 – 1961) was born to a poor family in a northern Swiss village. He managed to gain entrance to the University of Basel and received a doctorate in medicine in 1900. Jung spent most of the rest of his life in Zürich, teaching, writing and working with patients. After reading The Interpretation of Dreams in 1900, Jung began corresponding with Freud and finally met him in 1907. Eventually he accompanied Freud to America in 1909, where he also lectured and introduced his own work to American audiences. However, Jung began to apply psychoanalytic insights to ancient myths and legends in search for the key to the nature of human psyche. Such independent thinking did not meet with Freud’s approval, and there is also some speculation that the Jung made a critical analysis of Freud’s personal life that may have contributed to tensions between them. Freud secured the post of the first president of the International Psychoanalytic Association for Jung in 1911, but by this time their rift was beyond healing. Finally, in 1914, Jung withdrew from the Association and severed all interactions with Freud due to the over-emphasis of the defining stages of infant sexuality among other aspects of pure Freudian theory. Jung continued his own interpretations of psychoanalysis and made several expeditions to study primitive societies in Western United States, Africa, Australia and Central America. His prolific writings on subjects ranging from anthropology to religion provided novel insights to age-old problems of human existence from the psychoanalytic perspective.

Jung’s “Analytical psychology” refined many Freudian concepts and emerged as the first major alternative to Freudian theory (1900); however, Jung retained Freud’s terminology [Unconscious, Conscious and Preconscious], and as a result the same terms often carry different meanings. Jung (1912) renamed the Id as the Personal Unconscious, the Ego as the Personal Conscious [although the term Ego also appears in some of Jung’s writings], and the Super-Ego as the Collective Conscious [although the term Persona also appears in some of his writings]. After that Jung’s (1912) analytical psychology also added the Collective Unconscious to Freud’s (1900) structure of personality which is part of the Id.

Jung, like Freud, believed that the central purpose of personality is to achieve a balance between conscious and unconscious forces within the personality. However, Jung described two sources of unconscious forces. What is the personal unconscious, consisting of repressed or forgotten experiences similar to Freud’s preconscious level. The contents of the Personal Unconscious [Id] are accessible to full consciousness. Jung’s Personal Unconscious held complexes, which were groups of feelings with a defined theme than give rise to distorted behavioural responses. According to Hall and Lindzey (1970), “… a [complex] is an organised group or constellation of feelings, thoughts, perceptions, and memories which exists in the Personal Unconscious” (p.82). Unlike archetypes [which reflect the cumulative experiences of the entire human race, Homo Sapiens], Complexes reflect each individual’s unique experience. For example, a boy who repressed negative emotions about his mother could become an adult with the complex, experiencing intense feelings and anxieties when images or stimuli associated with motherhood are encountered [because they are dominated by their mothers], for e.g. some mothers might offer nourishment only after – not before – their babies stop crying, thus communicating the unconscious message that the mother is all-powerful.

The second source of unconscious forces in to Jung’s theory, is the Collective Unconscious, more powerful source of energy that contains inherited contents shared with other members of a particular group, i.e. it consists of aspects of personality, common to all humans, that we have inherited from our ancestors. Jung here was talking about individual similarities and not differences in personality. As the personal unconscious has complexes, the collective unconscious has archetypes, defined as primordial images evolved from human beings primitive ancestry of specific experiences and attitudes passed on over centuries [after all humans did evolve from basic primates to the sophisticated beings were now are]. Hall and Lindzey (1970) define archetype as “…a universal thought form (idea) which contains a large element of emotion” (p.84). Although modern science has shown that direct environmental influences has more power in shaping the individual mind, some aspects may be retained from evolutionary psychology although it is important to consider the fact that human societies are constantly evolving in more ways than one. At the time that Jung devised his theory however, he listed such archetypes as birth, death, unity, power, God, the devil, magic, the old sage and the earth mother. As Weitz (1976) noted, according to Jung’s Analytical Psychology, archetypes equip humans to interact with particular aspects of their physical and social worlds in a particular manner, thus archetypes are adaptive from an evolutionary standpoint. For example, Jung (1912) contended that all humans possess a “mother figure” archetype that not only gives them readily accessible image of a generic mother at birth but also predisposes them to interact with their actual mothers in a particular manner [e.g. crying, sucking]. Solomon (2003) noted that in Jung’s Theory, collectively experienced archetypes provide basic themes around which personally experienced complexes are organised. For example, all individuals are born with a readiness to seek nourishment from their mothers (the mother archetype), some individuals may find that their mothers use this readiness against them (mother complex).

The notion of a collective unconscious in personality that provides the individual with patterns of behaviour fits well with Jung’s preoccupation with myths and symbols. Jung believed that the adequacies of a society’s symbols to express archetypal images are an index of the progress of civilisation. [e,g, the Ancient Greeks who after sophisticating their society through the evolution of their values, philosophy & educational system, saw peasants turn into conquerors, sculptors, poets and artists who even went on to colonise countries that later changed the history of those who colonised them in timeless ways / See: L’épopée de la Grèce antique (2016)].

Jung focussed on the middle years of life, when the pressures of sexual drives supposedly give way to anxiety about the more profound philosophical and religious issues of the meaning of life and death. By reinstating the notion of the spiritual soul, Jung argued that the healthy personality has realised the fullness of human potential to achieve self-unity and complete integration. According to Jung, this realisation occurs only after the person has mastered obstacles during the development of personality from infancy to middle age. Failure to grow in this sense results in the disintegration of personality. Accordingly, the person must individualise experiences to achieve a “transcendent function” by which differentiated personality structures are unified to form a fully aware self.

Both Jung (1921) and Freud (1905) wrote about libido, or psychic energy, that presumably fuels individuals’ behaviour, however Jung viewed libido in a less sexualised form. Jung redefined libidinal energy as the opposition of introversion – extraversion in personality, bypassing Freud’s extreme sexual emphasis. Extraversion forces are directed externally to the people and the environment, and then nurture self-confidence. Introversion leads the person to an inner direction of contemplation, introspection and stability. Jung (1921) believed that all individuals are capable of experiencing introversion as well as extraversion over time, however, individuals at any particular point in time may be characterised as experiencing either introversion or extraversion. The opposing energies must be balanced for proper psychological functioning, sensation, thinking, feeling and intuition. An imbalance between extraversion introversion is partly compensated for in dreams. Indeed, for Jung dreams have important adaptive value in helping the person maintain equilibrium. Jung has been praised for developing a dichotomy of flow of psychic energy [i.e. introversion vs extraversion] that has been recast as one of the major personality traits in various trait theories [for empiricists who believe the main focus should be the “conflict-free” conscious part of the ego, to which many basic concepts of Cognitive Psychology can be applied].

In addition to introversion versus extraversion as a pair of opposing directions of flow of psychic energy [i.e. inwards versus outwards], Jung (1921) postulated that thinking vs feeling and sensing vs intuition represent 2 pairs of opposing modes of adaptation and functioning.

As Jung grew older, his writings increasingly came to emphasise mysticism and religious experiences, domains usually ignored by mainstream empirical psychology. Out of all the early founders of psychoanalysis, Jung held views in sharpest contrast to those of empiricism. However, he offered a unique treatment of critical human issues that had not been systematically studied by psychologists and still remain in the realm of speculative philosophy. Perhaps Jung was more of a philosopher than a psychologist, nonetheless he provoked and confronted issues not readily accommodated in other systems of psychology.

 

Jacques Lacan (1901 – 1981)

Jacques Lacan

One of the most famous post-Freudian development, especially popular in Europe and South America, was initiated by the colourful French psychoanalyst Jacques Lacan. Lacan was the son of a successful oil and soap salesman from Paris. His mother was a firm Catholic and his younger brother entered a monastery in 1929.

The two early philosophical influences of Jacques Lacan were Spinoza & Nietzsche:

(i) Baruch Spinoza (1632 – 1677)

Baruch Spinoza dpurb site web

Traduction(EN): « Joy is man’s passage from less to greater perfection. » -Baruch Spinoza

Spinoza is known as the philosopher of nature and human passions who identified the concept of « God » and Nature. Spinoza proposes that wisdom is the intellectual love of the true God, immanent to reality [that is, scientific studies of Nature are to understand the forces that govern the creations of « God », e.g., medicine, etc.]. Spinoza is considered a Cartesian, i.e. a disciple of Descartes. Spinoza believed in Ethics as a geometrical method that manifests the philosopher’s will to proceed in a rigorous manner, as mathematicians do; he strives to express in Ethics, in an objective manner, the fundamental essence of all things, in other words, the basis of understanding. In Spinoza’s philosophy, Ethics does not designate a moral code, but the true knowledge of the true concept of « God », immanent to the world [which is said to be contained in the nature of a being and does not come from an external principle], the practical science of what is: a single substance, absolutely infinite, of which we are only modes. Spinoza’s concept of « God », the object of Ethics, has nothing to do with that of the Judeo-Christian religion, a principle transcendent to the world – Spinoza does not believe in transcendence. So, we see oppositions to Nietzsche which Jacques Lacan also synthesized with his more modern theories of the psyche. Spinoza did not believe in transcendence and expelled any anthropomorphic representation of the divine [Note: Anthropomorphism is the attribution of characteristics of human behaviour or morphology to other entities such as gods, animals, objects, phenomena, even ideas]. God is nothing else but an absolutely infinite Being, composed of an infinity of attributes, a unique Substance [the Substance designating what is in itself and conceived by itself]. Therefore, God identifies Himself with this substance and designates the whole of reality or Nature, understood as the unity of things and the only Being to which realities relate: Deus sive Natura – God or Nature [a united and infinite nature]. Of this unique substance, of this Nature being one with God [although not interchangeable], human intelligence grasps only two Attributes, Extension and Thought (L’Étendue et la Pensée), the Attribute being defined by Spinoza as what the understanding perceives as constituting its essence. In this perspective, the particular objects of the world represent modifications of the infinite Substance that is Nature [i.e. God’s transcendence], in other words « modes« , that is, affections of this substance. Thus, each particular creature appears as a mode of God, as being in something else, by means of which it is conceived. This tripartition of Substance-Attribute-Mode allows us to grasp the meaning of the concepts of Nature-naturing (natura naturans or Nature-naturante) and Nature-natured (natura naturata or Nature naturée). Nature naturing for Spinoza is God himself, as he is in himself and conceived by himself, as the producer of all reality, i.e. as doing what nature creates/does. Nature natured is considered as everything that follows in the nature of God and his attributes, that is to say, everything that is produced by the Substance of God as he is in it through it. The problem with Spinoza’s system is that it was absolutely deterministic; the infinite attributes of God necessarily produce certain effects, and Spinoza assumes that nothing is given by chance in nature. In Spinoza’s magnum opus, The Ethics (L’Éthique), he speaks of absolute necessity, which has the meaning that everything is already determined by divine Nature to produce an effect [in modernity we know from empirical research that natural and environmental determinants combine to define humans]. Spinoza sees contingency [in other words, what cannot be] simply as a defect in our understanding, a lack of real knowledge. The essence of human nature lies in an active element in all of us that Spinoza calls “conatus”, the effort by which everything strives to persevere in its being, i.e. a natural inclination to strive toward preserving an essential being, where virtue/human power is defined by success in this preservation of being by the guidance of reason as one’s central ethical doctrine, with the highest virtue being the intellectual love or knowledge of God/Nature/Universe. When the “conatus” becomes self-conscious, it is called “desire”, which is therefore identified with « appetite » accompanied by consciousness itself. Thus, conatus and desire correspond to the dynamic affirmation of our being. We find here some link to Schopenhauer’s philosophical meditations about the “Will” and also Lacan’s focus on “Desire” being at the heart of psychoanalytic praxis. However in Spinoza’s reflections, human desires are modified by the intervention of external environmental causes, since we are subject to the action of forces to which we are bound, being all a part of Nature, and it is from this effect that passions are born, passive modifications of our being; this is linked to Lacan’s concept of “chaine signifiante” [signifying chain] which is the structural basis of the unconscious and the roots of linguistic discourse and speech. The two fundamental passions are sadness and joy from which the other passions derive: sadness is the passage to a lesser perfection, while joy is the passage to a greater perfection. Spinoza believed that man’s life is marked by the sad procession of sad passions [hatred, envy, jealousy, la mauvaise foi, etc.] which reduce man to a state of servitude, of passivity; this is where the philosopher comes in, whose responsibility it is to heal man from his sad passions: to make him maître (master) of himself.

Auguste Dumont - Génie de la Liberté (1836) Or dpurb site web

« Génie de la Liberté » par Auguste Dumont, 1836

In Spinoza’s philosophy, virtue is acquiring true knowledge of our passions through the right ideas and notions. Therefore, the virtuous discovers the dynamism that animates him, which allows him to regain the power of the conatus: to know reality and to reach the fullness of existence [Virtue and life are thus inseparable]. The wise man is therefore the one who reaches true knowledge and, in this way, achieves the fullness of existence. The wise man lives under the regime of reason, in this way the Spinozist citizen also finds the agreement and unity of his semblables (fellow men). Therefore, the state must be rationally created, because only the rational state opens the way to freedom, according to the laws of human nature, that is to say, aware of the infinite nature of humanity. Spinoza seems to be situated in the democratic thought where all have equal rights with total freedom of opinion, thus the destiny of free men, living under the regime of reason, in a free city, is outlined. By gaining access to la connaissance vraie (true knowledge), man again becomes a God for man. So, we can see that Spinoza is a rigid penseur de système (system thinker), allowing man to free himself from his illusions and find and accept his place in Nature. Spinoza’s philosophy is not only intellectual but also practical and truly powerful: wisdom is acquired through knowledge; joy is maintained through the search for good passions. Thus, man can persevere in his being.

(ii) Friedrich Wilhelm Nietzsche (1844 – 1900)

Friedrich Nietzsche dpurb site web

Traduction(EN): « The greatness of man is that he is a bridge and not an end. » – Friedrich Nietzsche

Nietzsche is the philosopher of the “will to power”, conceived as creation and vital fullness, as the overwhelming affirmation of life. What is essential is our world as it is joy and will-power. As for the illusion of the afterworlds, Nietzsche hunts it down in all its forms. Nietzsche can be considered a moralist above all. It is clear that Nietzsche’s philosophy is one of the most complex thoughts, a complexity linked as much to his poetic and aphoric writing as to his refusal to situate himself clearly in the philosophical tradition, and we find this in Lacan who was also a literary and profound writer with a singular thought, a synthesis of several schools of thought, where the mediocre reader finds himself in the middle of a nightmare when trying to read it and may even start to question the level of his own intellectual abilities, his place and purpose in the universe. Unseizable, Nietzsche’s writings must be approached like a mountain, a slow progression. Nietzsche diagnosed the essence of the mortal crisis of our time: he described it, in its main characteristics, and in a quasi-clinical manner. He studied it at various levels and, in so doing, often announced with the greatest precision what was only beginning to emerge at the end of the nineteenth century; this fatal disease of modern times, ours, is nihilism, the reign of the absurd, of Nothing (« nihil », as the etymology tells us). Nihilism or the absence of sense, makes becoming a purposeless process and all traditional ideals lose their value. Nihilism, this « Nothing » symbolizes the death of the Divine and the Suprasensible in man [Nietzsche’s death of God can be interpreted symbolically as the death of sensitivity and goodness in man]: we have killed him [the Divine], Nietzsche sometimes tells us, and darkness is now the lot of our world. This death of the Divine as seen by Nietzsche also announces a new dawn in our time: the coming of the « Last Man » which signifies the completion of nihilism. The « Last Man » designates the most despicable thing in this world: the one who is powerless to create and love, the individual totally enslaved and enjoying a programmed and petty « happiness » – he thus hops on the surface of the earth. Lacan, like myself, did not completely follow Nietzsche, but used some of the concepts of the German of the time and then refined them in the field of psychology for the twentieth century. Concepts of metaphysics are sometimes exaggerated in a negative way by Nietzsche, and the advances of our era make some of his views obsolete. One of Nietzsche’s exaggerations seems to be the origin of metaphysics, which he believed to be the by-product of the suffering and resentment of those unable to create positively, and which also engendered moral values [good and evil]. We see that Lacan did not take up everything from Nietzsche, but showed originality by relying on what was worth keeping in our modern world and which could be synchronized with his psychology based on the creative force of language in the Cartesian Subject [i.e. based on Descartes’ model: « Je pense, donc je suis »]. However, we still have concepts of Nietzsche that are in the name of positive creation, and the perfection of the individual and society, and they still have a place in modern philosophical thinking such as those of Jacques Lacan, which assimilate reason, logic, empiricism, metaphysics, genetics, and human and societal evolution.

La matière de leur création, de leur pensée ou de leur écriture dpurb site web

Credits: D.R / Centre Pompidou  « Le festival Hors Pistes dédié chaque année à explorer les images en mouvement et rencontrer celles et ceux  qui en font la matière de leur création, de leur pensée ou de leur écriture… » Source: FranceCulture, 2020

Lacan synthesized Nietzsche’s influence with the strong constructionist and linguistic logic of his pychoanalytic theory, which directs us towards a system of thought where sophisticated and civilised individuals orient, identify and group themselves by « psychical » understanding, connection and similarity, with language [i.e. the communicative discourse and/or speech] as a founding pillar, and not by the atavistic logic of the simple physical/biological illusions of the imaginary since this brings us, human beings, closer to animal psychology; the reasoning behind Lacan’s theory suggests that civilised individuals should see others as semblables [fellow men] not based on the physical but on the « psychical », with a founding pillar being language; the individual should rise above the illusions of solidarity of the physical to embrace the psychical. This is avant-garde and synchronised with the reasoning of science and discoveries of the 19th century with the contributions of Darwin, Freud and Kant. Nietzsche’s inspiring concept is that of « The Will to Power » (Volonté de Puissance) which should not be interpreted by the simple mind as the appetite for power or the spirit of domination or competition, because this would be to conceive or understand it in a very restrictive or destructive way. To Nietzsche, « The Will to Power » is a set of essentially competitive impulses [in the « mediocre »], but also the very movement of creative transcendence [in the noble soul of the « aristocrat » – the term was used by Nietzsche in its essentially spiritual meaning to design the best, that in his times, were individuals from the aristocracy, being those who had a privileged access to the best teachers, institutions and collections of books, which has since changed into mostly vast, yet simple, inheritances of wealth and land; hence in our present society the « aristocrat » term could define the gifted and valiant mind with a wealth of knowledge, profoundly educated, cultivated, creative and consciously connected with the positive values of humanity and nature, i.e. with the ability to shape and have a lasting impact on generations]. This « Will to power » can also mean the struggle for life and also spiritual fullness and existential superabundance. « The Will to Power » is an ambivalent notion that cannot be reduced to its most superficial or trivial forms or manifestations; in its noblest dimension, it is a vital, plastic, destructive but also creative force [which seems to be connected to Shiva, the Hindu god, and Dionysus, his Greek equivalent in the phallic cult according to Alain Daniélou (See the Essay: History on Western Philosophy, Religious cultures, Science, Medicine & Secularisation)]. To understand the essence, it is the body of man [of the human being] that we must take as a reference point, for the body is wisdom and reason, which can be defined as intelligent dynamism, the organic faculty of understanding and thinking: every organism thinks and it is permissible to speak of an unconscious bodily thought [for after all, it is through the senses available from the different organs acquired through the multiple facets of the evolution of the human body that man sees, hears, discovers, smells, touches, tastes, reads, feels, expresses a wide range of emotions, learns, thinks, writes, creates and gains an understanding of human existence and the wider environment (i.e. the natural world), and adjusts to optimise his « psychical » experience].

Friederich_Nietzsche par Edvard Munch,1906

« Friedrich Wilhelm Nietzsche » par Edvard Munch (1906)

Nietzsche seems to rehabilitate the unconscious as a psychic reality beyond the clear and transparent grasp of oneself. The authentic « Will to Power » as affirmation and fullness reveals, within its creative superabundance, the true field of life and transcendence.

« Puisse chacun avoir la chance de trouver justement la conception de la vie qui lui permet de réaliser son maximum de bonheur. »

French for: « May everyone have the chance to find just the right conception of life that allows them to achieve their maximum happiness. »

– Friedrich Nietzsche

For Nietzsche, among the creations of life is, first and foremost, Art, which Nietzsche conceived in a much more global and dynamic form, where it becomes an invention of harmonious forms, a production destined to embellish the whole of human existence. Nietzsche conceals ugliness, he humanises or hides everything ugly. This set of materials and signs created by the artist who manifests an ideal of beauty is only an appendix of this production of forms that is art in general, this “ivresse de la vie”: a will to exist through harmonious forms. The field of creative life includes artistic activity, authentic work, and generally everything that concerns the positive edification of values: work, the shaping of all things, linked to joy, but does it differ profoundly from the miserable labour for gain? To the powers of life are also attached the authentic moral values, those created by the best,  « les maîtres » (the masters) who are in the vital current of the « Volonté de Puissance » (Will to Power). Thus, Nietzsche’s thought is elitist: the beautiful creative individuality is opposed to the vile herd [the mass]. This « elitist » morality, i.e. this creative act, this triumphant affirmation of values, an affirmation that takes place in joy, is a thousand leagues away from the morality of the « slaves » [metaphor], which is linked to the resentment that gives birth to negative values and “la mauvaise foi” (nastiness, hatred, evil, etc.). What should the man in a world devoid of the divine values believe in? Believe in yourself, in your own power, free yourself from all dominant morality and ideology and follow your own path: become who you truly are and desire – this is what Friedrich Wilhelm Nietzsche would have said. Nietzsche calls for exceptional people to no longer be ashamed in the face of a supposed morality-for-all, which he deems to be harmful to the flourishing of exceptional people. He cautions, however, that morality, per se, is not bad; it is good for the masses, and should be left to them. Exceptional people, on the other hand, should follow their own « inner law »; a favorite motto of Nietzsche, taken from Pindar, reads:

« Become what you are. »

Le Voyageur contemplant une mer de nuages (Der Wanderer über dem Nebelmeer) Caspar David Friedrich d'purb dpurb site web

« Le Voyageur contemplant une mer de nuages » (Der Wanderer über dem Nebelmeer) par Caspar David Friedrich, 1818

In what he considered to be the zenith of his philosophical creation, « Also sprach Zarathustra » [Thus Spoke Zarathustra], Nietzsche portrays the path of a wise man who only addresses himself, a nomad who accepted the disappearance of the divine among men as a personal liberation, a being who freed his mind completely of the burden of ultimate truths, a hermit who did not need anyone anymore and who had overcome hatred and resentment, living in harmony with himself and the cosmic forces of nature: an Übermensch (un Surhomme/an Overman).

It is to be noted that « Thus Spoke Zarathustra », Nietzsche’s magnum opus, completely opposes and rejects the unscientific notion of a superior or pure group or organic composition (i.e. « race »), but instead focuses on the superior individual [organism] who can appear from anywhere as an agent and expression of the cosmic forces of nature.

Les Forces Cosmiques de la Nature: l’Océan (2020)

Yet, while there are no superior groups but only superior individuals, we may still reasonably argue that there are languages that are superior since they offer the ability to interact with a wider audience, but also because these languages offer an entry point and the gift of belonging by creating a social bond to the specific social environments they originate from; environments that may also be considered as superior if the way they are organised [i.e. philosophy, educational system, values, culture and government] lead to more chances of individual human development and life satisfaction, mainly due to the progressive outlook and heritage of their sophisticated and evolving institutions and the way they are managed. However, it is important to understand that any individual speaking in a superior language does not automatically lead to everything being said in that language to be worthy of consideration because while the communicative patterns (i.e. language) of human primates vary from regions, the IQ and creativity of the individuals do not, as the Organic Theory clearly states. Jacques Lacan also reached a fairly similar conclusion since he also distinguished the speaking Subject of the enunciation [i.e. how words are pronounced] from the Subject of the statement [i.e. the genuine message of the discourse], which suggests that in order to evaluate the true worth of any linguistic discourse, it is the genuine message that should be extracted; in other words, it should be translated in the appropriate language of the reader/listener so that its true value and meaning can be assessed. Thus, individuals who intend to share their wisdom and contribute to the world’s development would have an advantage in adopting and mastering a communicative pattern (i.e. language) deemed superior by the fact that it comes with modern human values and is weaved in the fabric of a more refined and sophisticated intellectual, psychosocial, philosophical and artistic heritage [e.g. French, which is the most desired and most spoken second language in the UK and in Germany] since it would be understood by the wider audience of the civilised world, where the major intellectual and cultural evolution/revolution takes place.

Anglais VS Français Habsburg d'purb dpurb site web

Traduction(EN): « The English language is a shotgun: the shot is scattered. The French language is a rifle that shoots bullets, precisely. » -Otto von Habsburg

So Nietzsche rightly concluded that there are no superior groups, but only superior individuals that come from the wider human population and together these individuals constitute the force that shapes civilisation; this conclusion had unconsciously acknowledged what science would certify about a century later in 2018, as a genome-wide association meta-analysis in 267, 867 individuals identified 1,016 genes linked to intelligence, which is a highly heritable trait and a major determinant of human health and well-being (Savage, Jansen, Stringer et al., 2018). Before Nietzsche, no philosopher had placed so much emphasis on the individual perspective; he restored the existential mission of philosophy by detaching himself from all the irrational conventions of his time, abandoning lengthy theoretical papers to redact concise reflections on the way of living one’s own life. Nietzsche’s philosophy is centred around the personal sphere of the individual.

In modern times, with the advances of psychology, we can conclude that a superior psyche will include a superior understanding, judgement and vision as the French psychologist, Monique de Kermadec also pointed out regarding « l’adulte surdoué » [i.e. the gifted adult]. The criterion of authenticity always appears to be linked, in Nietzsche’s view, to the affirmation and creative power of life. Nietzsche uses the god Dionysus [whom the French orientalist Alain Daniélou connects to Shiva for his cycle of destruction and creation as an equivalent] as a symbol of life, the most overflowing being of life, who in Nietzsche’s thought embodies the process of “becoming” as destruction and creation; Dionysus is sensuality, the enjoyment of a force that destroys but also generates/creates. The term dyonysism refers to the identification with the principle of ecstasy and life. Thus arises the Übermensch (Overman/Surhomme) for Nietzsche, who faced with the death of the divine, nihilism and the « Last Man » [which designates what is most despicable in this world, the one who is powerless to create and love, i.e. the individual totally enslaved and enjoying a programmed and petty « happiness », those who think that this symbolic death of the divine means nihilism and pure destruction], will have to face these despicable « Last Men »; one could therefore see the Übermenschen (Overmen/Surhommes) as agents of the divine rising to counter evil and the decline of the positive values of civilization; the concept of the Übermensch also seems to share some similarities to what Monique de Kermadec qualifies as l’« Adulte Surdoué » [The gifted adult].

Video: Monique de Kermadec : L’adulte surdoué : bien vivre sa douance (2012)

Freud Entouré par des Idiots dpurb site web

Traduction(EN): « Before you diagnose yourself with depression or low self-esteem, first make sure you are not surrounded by idiots. » – Sigmund Freud

For Nietzsche, the earth is no longer in the hands of the divine, but in the hands of those despicable « Last Men, » and the outrage against the earth is now what is the most dreadful. Nietzsche fights against immorality in the name of immoralism, and shows us that the death of the divine is not enough to animate the world with a new morality, and that without the will to power [if it is animated by a weak will], « morality » can turn into nihilism [a nothing, or the absence of sense that makes “becoming” a purposeless process where all traditional ideals lose their value]. The construction of a new morality will be so superior to the old one that it calls, according to Nietzsche, new men, Übermenschen (Overmen/Surhommes), and this new morality will be precisely the « Will to Power ». In order to clarify the concept of Übermensch (Overman/Surhomme) let us clear up misunderstandings by explaining what the Übermensch (Overman/Surhomme) is not, here is a negative definition:

« All beings up to now have created something beyond themselves that is superior to them. What is the ape for man? That is precisely what man must be for the Übermensch (Surhomme/Overman) »

Nietzsche in his time was not an evolutionist, which has changed in our time, and therefore not in possession of the data on the genetics of Übermenschen (Supermen/Surhommes), he conceived of the emergence of the Übermensch (Overman/Surhomme) by the man who surpasses himself: a transcendental man who surpasses himself to become what he really is deep down.

Ubermensch Surhomme Superman dpurb site web

The notion of the Übermensch (Overman/Surhomme) is the backdrop of Nietzsche’s philosophy, it is from the Übermensch (Overman/Surhomme) that Nietzschean thought makes its entrance and all his other themes must be understood from this notion. Thus, to Nietzsche, by pushing back the forces of reaction, of simple negation, those linked to the « NO », by surpassing himself towards those of life and positive creation, man transcends himself towards the Übermensch (Overman/Surhomme), towards a superior human type, free of mind and heart. The Übermensch (Overman/Surhomme) is for Nietzsche the meaning of the earth, the next term of evolution. It is also very important to avoid any misinterpretation of Nietzsche’s « Übermensch » (Overman/Surhomme) which has been wrongly caricatured over the years, it is not specifically or solely about the « blonde beast » of Germanic myths as it is often portrayed by ignorant and mediocre journalists and the masses. After Friedrich Nietzsche’s death, his sister Elisabeth became the curator and editor of Nietzsche’s manuscripts, reworking his unpublished writings to fit her own German nationalist ideology while often contradicting or obfuscating Nietzsche’s true philosophical orientation which were instead explicitly opposed to antisemitism and nationalism but promoted a more universal ideology. Through her published editions, Nietzsche’s work wrongly became associated with fascism and Nazism; 20th century scholars contested this interpretation of his work and corrected editions of his writings were soon made available. Nietzsche’s thought enjoyed renewed popularity in the 1960s and his ideas have since had a profound impact on 20th and early-21st century thinkers across philosophy—especially in schools of continental philosophy such as existentialism, postmodernism and post-structuralism—as well as art, literature, psychology, politics and popular culture. Nietzsche’s philosophy is thus organized around a few major concepts: that of the Übermensch (Overman/Surhomme), the Dionysian and, of course, the Will to Power.

Documentaire: Schmutte, H. (2016). Nietzsche : entre génie et démence. ARTE. [Notice: If the video cannot be viewed from your region, we recommend using HOLA VPN (Click Here, it is FREE!)]

Let us add, finally, the concept of the Eternal Return (any state of the universe returns periodically and this seems to be an intelligent metaphor that explains the state of matter in the universe, constantly being recycled and reshaped). Nietzsche thus (like Lucretia or Spinoza) drew a philosophy of joy, creation and vital fullness. Nietzsche celebrated life and stressed that the secret of the greatest enjoyment is to live intensely and dangerously. Today, Nietzsche’s work and intellectual contribution are considered as revolutionary for its time, however in the very beginning they were not appreciated and recognised for their true worth by his contemporaries; the philosopher struggled to live with his publications and found himself on the fringes of society without any income or fixed accommodation at 35 years old, which had turned out to be a point of no return for him after he put an end to his teaching activities, adopting a nomadic life and living in modest accommodations. An amazing achievement for Nietzsche was the fact that he was named professor even though he had not completed his thesis.

During Jacques Lacan’s studies at the Collège Stanislas he was introduced to the work of Baruch Spinoza & Friedrich Nietzsche, and draws from his years in uniform, the intimate conviction that the most violent psychological wounds and sufferings always arise within communities apparently subjected to the greatest normality. Lacan had felt misunderstood by his father, who had destined him to a business life. He thus enters the modernity of the twentieth century by way of an intellectual rebellion, eager to explore the essence of « madness » whose shadows he had perceived in his own family, Lacan turned to psychiatry. In 2001, Elisabeth Roudinesco said: « Il faut voir l’apport de Lacan comme un tableau moderne. Lacan n’est plus dans l’univers classique des représentations mais dans l’univers de la peinture moderne. C’est la peinture de Picasso par rapport à la peinture classique (…)  toute la modernité est passée. » [French for: « Lacan’s contribution should be seen as a modern painting. Lacan is no longer in the classical universe of representations but in the universe of modern painting. It is Picasso’s painting in relation to classical painting… all modernity has passed. »]

Lacan-carte d'étudiant.jpg

During the early 1920s, Lacan actively engaged with the Parisian literary and artistic avant-garde movements. Having met James Joyce, he was present at the bookshop where the first readings of passages from Ulysses in French and English took place, shortly before it was published in 1922. Lacan also had meetings with Charles Maurras, whom he admired as a literary stylist, and he occasionally attended meetings of Action Française (of which Maurras was a leading ideologue), of which he would later be critical on some aspects that he firmly disagreed and considered as outdated, such as the positivist sociology of Maurras which presents the subject as a simple product of his « milieu » [circle], derived from his culture which was even pushed to absurd extremes by Édouard Pichon to theorise about a « national unconscious ». Lacan was more avant-garde and perhaps unknowingly embraced future psychological advances of neuroscience by founding his logic on the thesis of German biologist and philosopher Von Uexküll who convincingly argued about the multitude of determining factors of the environment and not simply the basic evolution of species, but on the sophisticated elaboration of language [discourse / langage] which identifies the development of the individual psyche to a social structure.

In his famous « Rome Discourse, » Lacan stated: « Le symbolique, l’imaginaire et le réel, les trois registres par lesquels j’ai introduit un enseignement qui ne prétend pas innover, mais rétablir quelques rigeurs dans l’expérience de la psychanalyse, les voilà, jouant à l’état pur dans leurs rapports les plus simples. » [French for: « The symbolic, the imaginary and the real, the three registers through which I have introduced a teaching that does not claim to innovate, but to re-establish some rigour in the experience of psychoanalysis, here they are, playing in a pure state in their simplest relationships.]«  In that same discourse in Rome in 1953 addressed to the Société Française de Psychanalyse, Lacan denounced the way that the role of speech in psychoanalysis had come to be neglected by contemporary psychoanalytic theory, and argues for a renewed focus on speech and language. This remains one of the fundamental modification from Freudian conception: the human being is linked to language. The founding statement of Lacan’s theory defines psychoanalysis as a practice of speech and a theory of the speaking subject. Lacan asserted that psychoanalysis is distinguished from other disciplines in that the analyst works on the Subject’s speech [i.e. linguistic discourse], pointing out that Freud often referred to language when he was focusing on the Unconscious; after all language is the « talking cure » and is constitutive of the psychoanalytic experience. It would be impossible to understand the concept of « madness » without analysing the true reasoning behind it through language and to know if it is « madness » or subjective construction and interpretation that is stable in a particular Subject’s psychical realm. It is the emphasis on language [linguistic discourse] that is regarded as the most distinctive feature in Lacan’s theory which also criticises the way other forms of psychoanalysis tend to play down the importance of linguistic discourse and instead emphasise « non-verbal communication » of the analysand (e.g. body language, etc) at the expense of speech. To Lacan this is a fundamental error for the following main reasons. Firstly, all human discourse is inscribed in a linguistic structure [whatever the language]; even body language is a form of language with the same structural features. Secondly, the aim of psychoanalytic praxis is to articulate the truth of one’s desire in speech [i.e. linguistic discourse] rather than in other forms – the fundamental rule of psychoanalysis is based on the principle that linguistic discourse is the only way to the Subject’s « truth ». Thirdly, linguistic discourse through speech is the only tool and means of access that the psychoanalyst has, since no one can read minds. Any analyst who does not understand and master the way speech and linguistic discourse work does not understand psychoanalysis itself.

Lacan proposed that like the words uttered by God in Genesis, speech is a « symbolic invocation » which creates ex nihilo, « a new order of being in the relations between men. » Lacan distinguished « la parole pleine » [full speech] from « la parole vide » [empty speech] in 1953. La « parole pleine » [full speech] articulates the symbolic dimension of language; it is a speech that performs [qui fait acte]. La « parole pleine » [full speech] is defined by its identity with that which it speaks about, it is one full of meaning. « La parole vide » [empty speech] is one that simply has signification. The aim of psychoanalytic praxis is to articulate « la parole pleine » [full speech], which can be hard work; « la parole pleine » [full speech] can be quite laborious (pénible) to articulate. The speech act also contains the essence of efficacious transference, which involves an exchange of signs that transforms both the speaker and the listener. Each time a man speaks to another in an authentic and full manner, we find in a true sense, « symbolic transference » – a process that takes place and changes the nature of the two beings present. The Symbolic dimension of language is that of the signifier and full speech, the true discourse of the Other [Big Other / Grand Autre / Superego], the Unconscious. The Imaginary dimension of language is that of the signified, signification and empty speech, the wall of language which interrupts, distorts and inverts the discourse of the Other [Big Other / Grand Autre / Superego]; Lacan proposed that language is as much there to be found in the Other [Grand Autre / Superego] as to drastically prevent us from understanding him. It is important to note that language has both a Symbolic and an Imaginary dimension; there is something in the symbolic function of human discourse that cannot be eliminated, and that is the role played in it by the imaginary [which is shaped by the Symbolic]. Psychoanalytic theory claims that speech is the only means of access to the truth about desire; a particular type of speech without conscious control termed « free association ». The ethics of psychonalysis enjoin analysands [patients] to recognise their own part in their sufferings, so that the psychoanalyst can then help them work through their problems and psychical barriers.

Lacan developed psychoanalytic theory in radically new directions that relied heavily on linguistic theory and other intellectual trends in the late 20th-century France, such as the structuralist movement. It was proposed that the Unconscious is structured like a language, so that its operations can be likened to linguistic phenomena [e.g. repression was likened to a metaphor]. Hence, to uncover unconscious material the psychoanalyst must decipher a chain of clues with a great deal of verbal dexterity. Lacan also held that the ego [le Moi], although conscious and able to orchestrate a wide range of operations, is not a complete organ of self-control as Ego psychologists from the US claim, but largely also an unstable and ultimately illusory sense of personal unity. To Lacan, our sense of wholeness is a fiction and our selves are profoundly “de-centred” around a tissue of identifications with people [and characters] we have known [directly or indirectly exposed to – this extends to the arts, fictional characters, mentors, etc].

Lacan’s (1973/1977) version of Psychoanalytic Theory pointed out that Ego Psychologists [e.g. Anna Freud, Heinz Hartmann, Erik Erikson] and Object Relations Theorists [e.g. Melanie Klein, Donald Winnicott and Ronald Fairbairn] had strayed too far from Freud’s original (1900, 1923) original version of psychoanalytic theory. This is even in direct contrast to Jacques Lacan’s own mentor, Ego Psychologist Rudolph Loewenstein who was also a close associate and collaborator of Ego Psychologist Heinz Hartmann.

 

« Pendant un certain temps, on a pu croire que les psychanalystes savaient quelque chose, mais ça n’est plus très répandu (rires). Le comble du comble, c’est qu’ils n’y croient plus eux-mêmes (rires), en quoi ils ont tort, car justement ils en savent un bout, seulement, exactement comme pour l’inconscient dont c’est la véritable définition, ils ne savent pas qu’ils le savent. »

French for: « For a while, you might have thought that psychoanalysts knew something, but it’s not very common anymore (laughs). The worst thing is that they no longer believe it themselves (laughs), in which they are wrong, because they know a bit of it, only, exactly as for the unconscious, of which this is the true definition, they don’t know that they know it. »

-Jacques Lacan, Conférence de Louvain, 1972

 

Lacan, however, seems to have set the record straight in accentuating the fundamental and widely accepted foundations of psychoanalysis by advocating a “return to Freud” [not Anna Freud’s (1923) version of Ego Psychology], but rather to Sigmund Freud’s Topographic Model of the 1900 that defined the mind into 3 levels of awareness, i.e. the Unconscious [Le Ça], the Preconscious [Le grand Autre] and the Conscious [Le Moi].

Rocha (2012) noted that Lacan (1973/1977) was especially concerned with the Unconscious [l’inconscient, le « Ça », the « It », the ID] as the “ideal worker” within individuals’ personality structures. In a 1973 television interview, Lacan famously argued that the Unconscious does notthink, nor calculate, nor judge; the unconscious simply works!” Lacan contended that like the ideal worker in a capitalist society, the Unconscious generates a product in compliance with rigid, hierarchical rules and regulationsin particular, the product of unthinking and unquestioning in the fulfillment of individuals’ desire – which seems like something psychoanalysis should address and change for a humane, intelligent and creative civilisation.

As for dreams, Lacan stressed that dreams are important products of the Unconscious [l’inconscient, le « Ça », the « It », the ID] that allow individuals tofeel” [at least during the sleeping state] that they have fulfilled their desire, however, dreams may also contain anxiety-provoking contents that individuals do not desire. As Meyer (2001) interestingly pointed out, in Lacan’s psychoanalytic theory, the problem of the Unconscious [l’inconscient, le « Ça », the « It », the ID] in finding expression is the problem of discourse with the “Other” [Le grand « Autre », the big « Other », Preconscious Superego in the domain of the symbolic]. Indeed, infants enter the world without knowing how to communicate their desire to caregivers via language, with its own rules and structure. It is also to be noted that in Lacanian Theory of Psychoanalysis, infants’ desire arises from the “loss and longing” that they experience when they are separated from their caregivers [especially their mothers or mother-figure in most cases] – precisely the person from whom the infants first learn early forms of basic communication [language] since the helpless infant’s needs are met after his/her various demands are expressed in sounds and specific actions. Waintrater (2012) also pointed out that in Lacan’s Theory, individuals’ desire are not solely tied to infantile sexuality. If anything, Lacan’s concept of unconscious desire complements John Bowlby’s (1969) concept of infants’ need for attachment. Lacan uses the term « Manque« , French for « Lack » which is always related to desire. It is a lack which causes desire to arise [desire is the metonymy of the lack of being (manque-à-être)], however the precise nature of what is lacking [i.e. symbolic lack] varies from one individual to another. In 1955, when the term « Manque (Lack) » first appears, it designates first and foremost « manque-à-être » [want-to-be] which is the « lack of being« , hence what is desired is « being », i.e. not the lack of this or that, but the lack of « being » whereby the being exists, this lack of being [manque-à-être] is the heart of analytic experience and the very field in which the neurotic patient’s passion is deployed. An important distinction to be noted is between the lack of being [Manque-à-être / want to be] which relates to desire, and the lack of having [Manque-à-avoir] which relates to demand.

 

Distinction between Need, Demand & Desire

Need

In the context of this distinction, « need » comes close to what Freud referred to as « instinct » (Instinkt); that is, a purely biological concept opposed to the realm of the drive (Trieb), it is an appetite which emerges according to the requirements of the organism and which abates completely (even if only temporarily) when satisfied. The human subject, being born in a state of helplessness, is unable to satisfy its own needs, and hence depends on the Other [usually a role occupied by the mother in most cases] to help it satisfy them. In order to get the Other’s help, the infant must express its needs vocally; need must be articulated in demand. The primitive demands of the infant may only be inarticulate screams, but they serve to bring the Other to minister to the infant’s needs. However, the presence of the Other soon acquires an importance in itself, an importance that goes beyond the satisfaction of need, since this presence symbolizes the Other’s love. Hence demand soon takes on a double function, serving both as an articulation of need and as a demand for love. However, whereas the Other can provide the objects which the subject requires to satisfy his needs, the Other [usually mother at this stage] cannot provide that unconditional love which the subject craves. Hence even after the needs which were articulated in demand have been satisfied, the other aspect of demand, the craving for love, remains unsatisfied, and this leftover is desire.

The concept of a pre-linguistic need is thus merely a hypothesis, and the subject of this pure need is a mythical subject; even the paradigmatic need of hunger never exists as a pure biological given, but is marked by the structure of desire. Nevertheless, this hypothesis is useful to Lacan for maintaining his theses about the radical divergence between human desire [which is inscribed in the Symbolic order] and all biological categories; need is thus an intermittent tension which arises for purely organic reasons and which is discharged entirely by the specific action corresponding to the particular need in question.

 

Demand

Lacan argues that since the infant is incapable of performing the specific actions that would satisfy its biological needs, and hence Lacan bases the distinction on the fact that in order to satisfy his needs the infant must articulate them in language; in other words, the infant must articulate his needs in a « demand » [for them to be met by the mother who will perform the specific actions]. However, in doing so, something else is introduced which causes a split between need and demand; this is the fact that every demand is not only an articulation of need but also an (unconditional) demand for love. Now, although the Other to whom the demand is addressed (in the first instance, the mother) can and may supply the object which satisfies the infant’s need [e.g. the breast to satisfy the child’s hunger], she is never in a position to answer the demand for love unconditionally, because she too is divided. The result of this split between need and demand is an insatiable leftover, which is desire itself. It is this double function which gives birth to desire, since while the needs which demand articulates may be satisfied, the craving for love is unconditional and insatiable, and hence persists as a leftover even after the needs have been satisfied; this leftover constitutes desire. In the seminar of 1956-7, Lacan argues that the cry of the human infant — its call (l’appel) to the mother — is not merely an instinctual signal but is « inserted in a synchronic world of cries organized in a symbolic system. » In other words, the infant’s screams become organized in a linguistic structure long before the child is capable of articulating recognisable words.

Demand is thus intimately linked to the human subject’s initial helplessness. By forcing the patient to express himself entirely in speech, the psychoanalytic situation puts him back in the position of the helpless infant, thus encouraging regression.

« Through the mediation of the demand, the whole past opens up right to early infancy. The subject has never done anything other than demand, he could not have survived otherwise, an we just follow on from there. » However, while the speech of the patient is itself already a demand (for a reply), this demand is underpinned by deeper demands (to be cured, to be revealed to himself). The question of how the psychoanalyst engages with these demands is crucial. Certainly the psychoanalyst does not attempt to gratify all of the patient’s demands, but nor is it simply a question of frustrating them.

 

Desire 

Lacan follows Spinoza in arguing that « desire is the essence of man. » Desire is simultaneously the heart of human existence and the central concern of psychoanalysis. However, when Lacan talks about desire, it is not any kind of desire he is referring to, but always « unconscious » desire. This is not because Lacan sees conscious desire as unimportant, but simply because it is unconscious desire that forms the central concern of psychoanalysis. The aim of psychoanalytic praxis is to lead the patient to recognise the truth about his/her desire. It is only possible to recognize one’s desire when it is articulated in speech. Hence in psychoanalysis, « what’s important is to teach the subject to name, to articulate, to bring this desire into existence. » However, it is not a question of seeking a new means of expression for a given desire, for this would imply a expressionist theory of language. On the contrary, by articulating desire in speech, the patient brings it into existence.

« That the subject should come to recognise and to name his desire; that is the efficacious action of analysis. But it isn’t a question of recognising something which would be entirely given. … In naming it, the subject creates, brings forth, a new presence in the world. » [adds to reality what was previously not there through language]. This seems to have a link to Schopenhauer’s concept of the « Will » which he proposed can be understood through the potential of the human brain so that as it is kindled by a spark it brings the whole world as idea into existence [Freud was inspired by Schopenhauer and so was Lacan indirectly]; knowledge proceeds from the « Will » which here is « Desire » – knowledge that is either from the senses or is rational as it is destined to serve the will in its aim of expressing itself.

However, there is a limit to how far desire can be articulated in speech because of a fundamental « incompatibility between desire and speech; « it is this incompatibility which explains the irreducibility of the unconscious (i.e. the fact the the unconscious is not that which is not known, but that which cannot be known). « Although the truth about desire is present to some degree in all speech, speech can never articulate the whole truth about desire; whenever speech attempts to articulate desire, there is always a leftover, a surplus, which exceeds speech. »

It is important to distinguish between desire and the drives. Although they both belong to the field of the Big Other, hence are within the Symbolic field/order (as opposed to love which lies in the imaginary field/order but still has effects in the symbolic order, love requires reciprocity, but the drives only pure activity), desire is one whereas the drives are many. In other words, the drives are the particular (partial) manifestations of a single force called desire (although there may also be desires which are not manifested in the drives). There is only one object of desire, object (petit) a, which is represented in any object which sets desire in motion, especially the partial objects which define the drives [The « objet petit a » is the leftover behind the introduction of the Symbolic dimension in the Real, it denotes a surplus meaning and enjoyment which has no « use value » but persists for the mere sake of enjoyment; it is linked to the illusory/imaginary concept of semblance]. The drives do not seek to attain the objet petit a, but rather circle round it. The object (petit) a is not the object towards which desire tends, but that which sets desire in motion. It plays an increasingly important part in Lacan’s concept of psychoanalytic praxis, in which the psychoanalyst must situate himself/herself as the substitute for objet petit a, i.e. the cause of the analysand’s [patient’s] desire. The universal feature of desire is commonly evident in hysterics [hysteria has changed in appearance nowadays but has not disappeared], being people who unconsciously sustain another person’s desire and convert another’s desire into their own. So, in the psychoanalytic praxis/treatment of hysterics, the most important part for the psychoanalyst is to discover the place [i.e. not the physical or anatomical locality, but the psychical locality / The « Other » scene in Lacanian terms] from which the patient desires [i.e. the Subject with whom he/she identifies] and not simply the object of the patient’s desire. Desire is not a relation to an object, but a relation to a lack (Manque-à-être / Lack of being). A major point from Lacan’s discourse on desire is that desire is a social product constituted in a dialectical relationship [i.e. which is embedded in linguistic discourse] with the perceived desires of other subjects.

Alexandre Kojève, whose seminars were followed by Lacan and also other intellectuals de « premier plan » of the time such as Maurice Merleau-Ponty, Georges Bataille, Jean Hyppolite and  Raymond Queneau gave the example of the Oedipus complex to point out that desire is essentially desire to be the object of another’s desire; Kojève argued that this is illustrated for the first « time » during the Oedipus complex, when the young developing subject desires to be the object of the desire of the first « Other » in his life [which is usually the mother or a mother figure in most cases], when the subject desires to be the object of desire [symbolic phallus] of the mother. Lacan argues that the child must detach himself from the imaginary relation with the mother in order to enter the social world; failure to do so can result in any one of various peculiarities ranging from phobia to perversion.

One of Lacan’s most often repeated formulas is: « man’s desire is the desire of the Other [i.e. the Big Other/Superego]. » This can be understood in many complementary ways, of which the following are the most important. Desire is for the thing that we suppose the Other desires, which is to say, the thing that the Other lacks. Hence, the subject desires from the point of view of « another »; the object of man’s desire is simply an object desired by someone else, which in most cases is the main reason why the object becomes desirable, and unfortunately not because of the natural quality of the thing in itself [Note: this is of course applicable to the common majority, since the consciousness of individuals with superior reflective abilities and philosophical values will likely lead them to perceive, think and behave differently].

Desire is essentially the « desire of the Other‘s [i.e. Grand Autre’s / Superego’s] desire », which implies both the desire to be the object of another’s desire, and the desire for recognition by another. Desire is essentially a desire for recognition.

Lacan takes this idea from Hegel, to state:

Desire is human only if the one desires, not the body, but the Desire of the other. . . that is to say, if he/she wants to be ‘desired’ or ‘loved’, or, rather, ‘recognised’ in his/her human value. . . . In other words, all human, anthropogenetic Desire . . . is, finally, a function of the desire for ‘recognition‘.

On love and desire, the former is a metaphor, while the latter is metonymy; love is located in the imaginary order but generates effects in the symbolic order where desire is located. We do find some similarities between love and desire in Lacan’s work since it is assumed that both can never be fully satisfied [i.e. insatiable]. The structure of love as « the wish to be loved » is also identical to the structure of desire in which the subject desires to become the object of the Other’s desire. Love involves an imaginary reciprocity, since to love is also to wish to be loved.

Desire is metonymy, and hence a constant force which can never be fully satisfied [because humans tend to have other desires once one is achieved and also because Desire may not only arise from Lack but may also be a productive force in itself]. Desire is the constant ‘pressure’ which underlies the drives and keeps individuals moving forward towards progress [with the right choice(s) and/or the right guidance]. As Elisabeth Roudinesco said: « Lacan est un penseur sceptique et en même temps passionné, c’est-à-dire l’engagement, la possibilité de croire encore en quelque chose, c’est-à-dire au désir, existe, donc il ne faut pas désespérer le Sujet mais la seule chose qui peut compter c’est l’éthique du désir, puisqu’il ne nous reste plus que ça : ne pas céder sur son désir ; ça c’est l’héroïsme Lacanien. » [French for: « Lacan is a sceptical and at the same time passionate thinker, that is to say commitment, the possibility of still believing in something, that is to say, in desire, exists, so one should not abandon the Subject, but the only thing that can count is the ethics of desire, since that is all we have left: not to give up on one’s desire; that is Lacanian heroism. »]

In order to achieve the desire for recognition all Subjects must impose the idea that they have of themselves on others (i.e. the rest of the humanity); this leads all individuals in a form of personal fight [which not necessarily violent, but rather a dialectical discourse] with the rest of humanity for recognition and pure prestige; Lacan argues that it is only by risking one’s life for recognition that one can prove that he is truly human. Lacan introduced « la dialectique du maître et de l’esclave », to use the metaphors « Master » and « Slave » to point out that human civilisation is only possible because we have those who direct (Masters/Maîtres) and those who receive directions (Slaves/Esclaves); civilisation would not be possible if it was composed of only masters or of only slaves, both are required and play a fundamental role in the advancement of civilisation. A Subject can both be a master and a slave, i.e. a master to one, but at the same time a slave for another in a different domain. To Lacan, the master signifier is that which represents a particular Subject for all other signifiers but can never represent the Subject completely since there is always some surplus which escapes representation.

 

The 3 Registers: Real, Imaginary and Symbolic

Firstly, the « Real » is not « reality », and there is no « objective reality » because there is only a subjective « reality » that holds significance for any individual Subject, and this subjective reality takes shape by its knots with the Imaginary and the Symbolic register [both conceived from the Real, which also then ties itself to the 2 other registers] that the Subject identifies with linguistically. It is in this sense that Lacan is a formidable realist and ties himself to all the great Realist Schools of Philosophy. The Real is a domain outside the symbolic Subject, the Real is the domain of the inexpressible since it does not belong to language. The Lacanian « Real » contains the « Lack » which generally manifests itself in real nothingness. To indicate that something is lacking, requires the assumption that it is possible for it to be present, which introduces the Symbolic domain into the Real. The « Real » simply stands for what is neither symbolic nor imaginary and is never truly known; it is mediated by the 2 orders of the Imaginary and the Symbolic; thus while the Real is present, these uncanny objects are treated as alien, meaningless and reminders of the symbolic lack in the subject’s identity formation; and « lack » is what causes desire to arise, which leads to the Subject’s unique development and growth.

Lacan said:

« L’inconscient reste le cœur de l’être pour les uns, et d’autres croiront me suivre à en faire l’Autre (symbolique) de la réalité. La seule façon de s’en sortir, c’est de poser qu’il est le réel, ce qui ne veut dire aucune réalité, le réel en tant qu’impossible à dire, c’est-à-dire en tant que le réel c’est l’impossible, tout simplement . »

French for: « The unconscious remains the heart of the being for some, and others will believe they follow me to make it the Other (symbolic) of reality. The only way to get out of it is to pose that it is the real, which does not mean any reality, the real as impossible to say, that is to say as the real is the impossible, quite simply. »

Jean-Bertrand Pontalis who was psychoanalysed by Lacan, assisted to his presentations while also participating in the famous seminars that he transcribed the résumés. Pontalis said: « On est un peu perdu et on se dit c’est peut-être génial, c’est peut-être moi qui comprend rien, ça me rappelle que d’ailleurs Lacan disant – alors qu’il y avait au début de ses séminaire des gens comme Maurice Merleau-Ponty, Jean Hyppolite venait, Paul Ricœur et bien d’autres – je l’entends encore dire – peut-être pas s’adressant à eux mais l’auditoire en général : « Mais enfin, vous allez commencer à l’ouvrir votre comprenoire ? » Voilà, donc je ne peux pas dire que ça m’émeuve, parce qu’il a quand même un côté comédien même très comédien, il en remet un peu comme il en remettait dans sa vêture, avec ses vestes, ses cols Mao à l’époque et puis ensuite les fameux cigares torsadés. » [French for: « We’re a bit lost and we say to ourselves that maybe it’s great, maybe it’s me who doesn’t understand anything, it reminds me of Lacan saying – while at the beginning of his seminars there were people like Maurice Merleau-Ponty, Jean Hyppolite came, Paul Ricoeur and many others – I still hear him say, perhaps not addressing them but the audience in general: « But finally, you will begin to open your understanding? » So I can’t say I’m moved, because he still has a comedian side, even very comical, like he used to portray with his clothes, with his jackets, his Mao collars at the time, and then the famous twisted cigars. »].

Jacques Lacan jeune.jpg

Jacques Lacan (1901 – 1981)

Christian Jambet explained how the real is « nothing », but gets its subjective significance from knots with the imaginary and the symbolic register of the individual Subject: « Le nœud était là pour essayer de transmettre, pas simplement le réel comme vérité ou le réel comme indicible, mais le réel comme ce qui est là dans sa plus grande nudité et sa plus grande insignifiance. La chute d’une ficelle et en même temps son enroulement. Qu’est-ce qui reste quand ça se défait ? Un rien. Et en même temps que ce rien forme la chose la plus complexe, c’est-à-dire tous ces nœuds du langage ont quoi nous sommes pris et qui tissent notre vie. » [French for: « The knot (Borromean) was there to try to transmit, not simply the Real as truth or the Real as unspeakable, but the real as what is there in its greatest nakedness and insignificance. The fall of a string and at the same time its knots. What remains when it unravels? A nothing, and at the same time this nothing forms the most complex thing, that is to say, all those knots of language that we are caught in and that weave our lives. »].

Lacan psychanalyse noeud-borromeen danny d'purb dpurb site web.jpg

Le Noeud Borroméen (The Borromean Knot or Chain) / We could refer to this figure as a chain since it involves the interconnection of several different threads. Although a minimum of three threads or rings [Real, Imaginary & Symbolic] are required to form a Borromean chain, there is no maximum number; the chain may be extended indefinitely by adding further rings, while still preserving its Borromean quality

Secondly, we have the Imaginary register/order which is the domain of the formation of the Ego in the mirror stage by identification with the counterpart [or specular image, i.e. the little other (petit autre)] and this dual illusory relationship between the Ego and the counterpart is characterised by narcissism and alienation. Lacan also accused the major psychoanalytic schools of reducing psychoanalysis to the imaginary domain where the Ego lies. Although the imaginary is structured by the symbolic, the Imaginary register is the dimension of the human subject which is most closely linked to animal psychology; this means that in man’s imaginary, the relation has deviated from the realm of human nature and shifted to the realm of image and imagination, deception and lure [sexual behaviour is especially prone to the lure in animals, which is straightforward]. The principal illusions of the imaginary register are those of wholeness, synthesis, autonomy, duality and similarity, which is in fact untrue and deceptive.

Thirdly, we have the Symbolic register/order [which is constructed largely via language and discourse] and which is one of the aspects of the Subject that is revealed via the individual’s dreams. The Symbolic register is the fundamental cornerstone for Lacan; the Subject’s relationship with the Symbolic is at the heart of psychoanalysis. Psychoanalysts are essentially practitioners of the symbolic order [i.e. civilised culture and the symbolic are thus imposed on raw nature]. Lacan criticised the psychoanalysis of his day for ignoring the symbolic register and reducing everything to the imaginary order of the Ego, and this for Lacan is a betrayal of Freud’s most basic insights; « Freud’s discovery is that of the field of effects, in the nature of man, produced by his relationship to the symbolic order« . Lacan argues that it is only by working in the Symbolic field that the psychoanalyst can produce changes in the subjective position of the patient and foster progress and growth; these changes will also structure the illusions produced by the Ego [le « Moi »] in the Imaginary order, since the Imaginary is influenced by the Symbolic. As Elisabeth Roudinesco pointed out: « ces illusions existent, elles forment notre psychisme ; nous vivons dans un monde d’illusions, de représentations et qui nous marque à vie et qui resterons d’ailleurs » [French for: « these illusions exist, they form our psyche; we live in a world of illusions, of representations and which marks us for life and will remain so for the future…« ].

Un monde d'illusions Elisabeth Roudinesco Jacques Lacan danny d'purb dpurb site web.jpg

« We live in a world of illusions… » -Elisabeth Roudinesco, 2001

Hence, a well adjusted psyche will allow the Subject to generate the appropriate illusions in the imaginary register of the Ego [Le Moi] that are synchronised with the true Subject [i.e. true product of the Symbolic register tied by language(s)] and his/her desires which has its roots in and is structured by the « scene » [i.e. NOT physical or anatomical locality, but PSYCHICAL locality] of the Other [i.e. Big Other/Grand Autre/Superego] where language and discourse originate. The well adjusted Imaginary of the Ego [le Moi] reflects the individual’s desires and unique personality, and contributes to growth since it allows the Subject to imagine creatively while regulating the wild desires of the Unconscious [ID / It / Ça / Inconscient] according to the symbolic laws of the Big Other [i.e. Grand Autre / Superego under the ID]. The balance between these 3 domains [ID – Superego – Ego] differs from one individual to the other leading to differences in personality.

Structural components [or registers/orders] of the Subject that are revealed via dreams are the Imaginary and the Real. Lacan argued that the psychanalyst’s interpretation of dreams can be viewed as analogous to a linguist’s translation of a language, unearthing the meaning that particular symbols hold for an individual [e.g. a client in psychotherapy or an individual seeking psychoanalytic guidance to enhance themselves]. Lacan noted that a specific difficulty that arises when psychoanalysts interpret the content of clients’ dreams is that, by the time the clients have awakened a large portion [if not most or all] of the dream has vanished, and this can be problematic if clients are reflecting on dreams that they experienced several year (decades?) ago. According to Lacanian Theory, Marder (2013) noted that dreams are oriented towards future interpretation, by dreamers themselves or by someone else (e.g. Psychoanalysts). Hence, truly important content are likely to survive clients’ transition from sleeping to waking states.

Lacan also pointed out as Stockholder (1998) noted, that Freud’s (1923) Structural model, i.e. the later version of his Psychoanalytic Theory with its dictinctions among Id, Super-Ego and Ego had distorded the true meaning of the first Topographic Model. And perhaps rightly observed, since the Ego which was meant to be conscious, revealed an unconscious element in its ability to instantly generate defence mechanisms outside the awareness of the patient, when before the function of the Ego was just one component present in the Conscious, i.e. the Ego [le Moi], was a part of the « Conscious », as a level of consciousness and not assumed to be a distinct mental functions as part of the new 3 part dissection [ID, SuperEgo and Ego]. However, they can be synthesised and enhanced, as we are doing with Freud, Jung and Lacan along with other discoveries in the realms of Neuroscience and Cognitive-Psychology to explore the psychology of the singular organism and its powers of definition to a level that no other psychologist has attempted to before our endeavour.

Lacan’s theory relocates the ID [Ça / L’Inconscient / Symbolic], Super-Ego [Surmoi, Le grand Autre: the big Other / Symbolic] and the Ego [Moi / Imaginary order] across the Unconscious, Preconscious and Conscious.

 

The Subject: Uniqueness in the speaking being, le parlêtre

Although psychoanalytic praxis has powerful effects on the ego, it is the Subject, and not the ego, on which psychoanalysis primarily operates. Different from the ego, the Subject is a product of the symbolic Grand Autre, i.e. the « Big Other » [Superego under the influence of the ID]. The Subject means no more than « human being » and in 1953 Lacan establishes a clear distinction between the Subject and the Ego which remained a one of the most fundamental distinctions in his work.  Whereas the Ego is part of the imaginary order, the Subject is part of the symbolic.

Lacan distinguished between 3 kinds of subject. Firstly, we have the impersonal subject, independent of the other, the pure grammatical subject, the noetic subject, the « it » of « it is known that ». Secondly, we have the anonymous reciprocal subject who recognises himself in equivalence with the other (ego reflection / petit autre / little other). Thirdly and finally, we have the personal subject in his uniqueness completely constituted by the act of self-affirmation. It is the third sense of the term subject, i.e. the personal subject in his uniqueness that constitutes the focus of Lacan’s work, and this also seems to be in line with our philosophy of construction and singularity in the creation of the individual. Lacan’s subject is the « subject of the unconscious », i.e. it is a product of the expression of the unconscious through the symbolic « Grand Autre » [Superego]. Lacan argues that this distinction can be traced back to Freud: « [Freud] wrote Das Ich und das Es in order to maintain this fundamental distinction between the true Subject of the unconscious and the Ego as constituted in its nucleus by a series of alienating identifications. A complex and unique domain such as the subject should not be objectified or reduced to a thing; « What do we call a subject? Quite precisely, what in the development of objectivation, is outside of the object. » References to language come to dominate Lacan’s concept of the subject from the mid-1950s on. It is very important however to distinguish the term « language » when reading the translations of Lacan’s work in English since the inexistence of some words in English make the translation from French inaccurate. Most importantly, in the French language we have two terms that both translate to « language » in English, these are the French terms « langue » [which refers a specific language, e.g. French or English] and « langage » [which refers to the prosody, expressive, grammatical and communicative structure of the language being used, the discourse of a particular Subject from any « langue » (specific language) since all « langues » (specific languages) come with different levels of structure, being a universal feature], it is the latter term « langage » referring to the general structure of the communicative pattern and linguistic discourse and not « langue » that is of interest to Lacanian psychoanalysis, i.e. the content of the discourse. So, it is important to note that in English, the term « language » in Lacan’s writings most often refers to  the French term « langage » [i.e. the structure and content of the communicative pattern or discourse] and not « langue ». Linguistic discourse (le langage) is a single paradigm of all structures and the basic units are the signifier; the unconscious is a treasury of signifiers in the Symbolic structured like language that finds expression to define the Subject where discourse becomes a social bond. Lacan distinguishes the Subject of the enunciation [i.e. how words are pronounced] from the Subject of the statement [i.e. the genuine message of the discourse] to show that because the Subject is essentially a speaking being (parlêtre), he/she is inescapably divided [i.e. by different forms of communicative patterns]. Language is a constantly evolving domain and not a nomenclature [i.e. not complete, sealed, strictly and methodically organised], beyond its use for conveying information, language is foremost an appeal to an interlocutor. In the early 1960s Lacan defines the subject as that which is represented by a signifier for another signifier; in other words, the subject is an effect of language and in philosophical « discourse » it denotes an individual self-consciousness; linguistic discourse is a mediating element that allows the Subject to attain his desired recognition from others [i.e. the rest of humanity] while creating a social bond; this perfectly illustrates Lacan’s thesis about the determination of consciousness by the Symbolic register. « The subject is a subject only by virtue of his subjection to the field of the Other [Grand Autre / Big Other / Superego / from the Symbolic register]. »The philosophical connotations of the term « Subject » are particularly emphasised by Lacan, who links it with Descartes’s philosophy of the cogito: « Je pense donc que je suis » [I think therefore, I am] – « in the term subject . . . I am not designating the living substratum needed by this phenomenon of the subject, nor any sort of substance, nor any being possessing knowledge in his pathos . . . nor even some incarnated logos, but the Cartesian subject, who appears at the moment when doubt is recognised as certainty. » The fact that the symbol of the subject, S, is a homophone of the Freud’s term Es (‘Id’) illustrates that for Lacan, the true subject is the subject of the unconscious [i.e. the impact of the expression of the instincts and language of the unconscious through the SuperEgo/Big Other/Grand Autre on the subject and ego – which differs in individuals. Lacan forced us to admit that we all have mental automatism. We all have, deep inside us, this inner voice that will inhabit the language [or languages] with which we will speak. Perhaps a good example of the expression of the unconscious inner voice is through music, which Lacan saw as a fundamental language of our unconscious thoughts, and therefore the bearer of an enigmatic knowledge, i.e. a form of language that would therefore have a meaning, corresponding for example to that of the different emotions that satisfy the various states of mind and that possibly supports an imaginary form of communication]. In 1957 Lacan strikes through this symbol to produce the symbol $, the « barred subject, » thus illustrating the fact that the subject is essentially divided; the division of the subject by different forms of communicative patterns.

Niklos Koda Tome 7 Magie Blanche et Le spiborg - Mort et Déterré

Déssins: « Niklos Koda » par Olivier Grenson & « Mort et Déterré » par Jocelyn Boisvert et Pascal Colpron

L’Autre [Grand Autre / Big Other / Superego] as an early form of conscience from the Symbolic order/register & the mysterious origins and social bond of language [Speech / Linguistic discourse]

Lacan distinguishes between the Superego and the ego-ideal and argues that in most cases the primary function of the Superego is to repress sexual desire for the mother or mother figure in the resolution of the child’s early Oedipus complex and following Freud he also argues that the Superego is an early form of conscience that develops from the Oedipal identification with the father but also incorporates the maternal origins of an archaic form of the superego [conscience] derived from Melanie Klein’s thesis. Hence, Lacan proposed that in most people, the Oedipus complex is a process which imposes Symbolic structures on sexuality and allows the Subject to emerge – the imposition of culture on nature. When Lacan returned to the subject of the Superego [Grand Autre / Big Other] in his 1953-4 seminar, he located it in the symbolic order, as opposed to the imaginary order of the ego: the superego [i.e. Grand Autre] is essentially located within the symbolic plane of speech and has a close relationship with the « law » [law here does not refer to a particular piece of legislation, but to the fundamental principles which underlie social relations, i.e. a set of universal principles which makes social existence possible, the structures that govern social exchange, for e.g. gift giving or the formaton of pacts. Since the most basic form of exchange is communication [e.g. the exchange of words, the gift of speech], the symbolic « law » is fundamentally a linguistic entity/dimension, it is the law of the signifier. This law then is revealed with an order of language – the symbolic order itself. Lacan argues that the « law » is human because it separates man from other animals by regulating sexual relations that are among animals, unregulated. It is the law of the pleasure principle which commands the subject to « Enjoy as little as possible » and maintains the subject at a safe distance from the « Thing » (the forbidden object of desire), making the subject circle round it without ever attaining it because if the subject transgresses, it is experienced as suffering/evil – it is fortunate then that the thing is usually inaccessible and/or out of direct reach; the thing is impossible to imagine, it is unknowable and beyond symbolisation]. The « law » as such is a symbolic structure which regulates subjectivity and in this sense prevents disintegration of the wholeness of the individual’s psycheThe law of the superego however is believed to have a senseless and blind character of pure imperativeness and simple tyranny, so it is at one and the same time the law and its destruction, the Superego [only partially conscious] is thus the « big Other » which imposes a purely oppressive morality on the neurotic subject but also the will-to-enjoy and is related to the voiceThe big « Other » must be considered a locus in which speech is constituted, it is thus only possible to speak of the « big Other » as a subject in a secondary sense where a psychoanalyst may occupy this position and thereby « embody » the « Big Other » for a patient / analysand.

In arguing that speech originates not in the Ego or even in the Subject, but in the partially unconscious « Other » [i.e. Big Other / Grand Autre / Superego], Lacan is stressing that speech and language are beyond conscious control, they come from an other place/scene [i.e. psychical localities], outside consciousness, and hence « the unconscious is the discourse of the big Other » [i.e. the effect on the subject of speech that is addressed to that subject from elsewhere, by another subject (forgotten or unknown) from another « scene », i.e. psychical locality] and belongs wholly to the symbolic order. As Christian Jambet pointed out, this means that the fragments of discourse that the individual will articulate has its roots in the big Other’s scene(s) [i.e. NOT physical or anatomical locality, BUT PSYCHICAL localities], which is precisely the treasure of signifiers where language – which is very real – is structured, along with the individual’s desires. In 1969, Lacan begins to use the term « discourse«  to denote a « social bond » founded in language; an incredibly rational observation because there is nothing more social than language – the vital ingredient in any form of social activity. [Note: This leads to individuals not sharing anything in common with others in their direct geographical environment, because different individuals will be connected to different psychical localities.]

Parlez-vous Lacan

Gillett (2001) noted that, in Lacan’s view, language does not perfectly convey individuals’ desire to other persons, partly because individuals do not fully understand their own desire, and partly because language is an inherently social medium that can lead to misunderstanding as well as understanding between individuals and other persons. Language however is a very powerful social medium [as can be seen also from the essay, The Concept of Self]

Le Langage et la Réalité danny d'purb dpurb site web 1600.jpg

Traduction(EN): « There will always be something special about language because language creates reality. Language reveals the truth of the subject and adds to reality what was not there before. Hence, the difference between truth and reality is that truth adds to reality what was not there before. Empiricists who study traits should never forget that constructs would not exist if they had not first been created through language. Hence language, creates reality! » -Danny J. D’Purb

Jacques Lacan saw the unconscious [ID / Le Ça] as a structure of language whose formal logic unfolds in the manner of a Bach flute or a poem by Mallarmé and argued that the unconscious is structured like language. In the unconscious [i.e. the place where the treasure of signifiers is] as well as in the acquisition of language, individuals may follow rules regarding the use of symbols without having deliberately learned [and without having overtly been taught] those rules [something “special” and even “mystical” about language]. In addition the unconscious [like language] is regarded as a “network of signifiers”, a history of signifiers that shape the subject; the term signifier (le significant) referring to any symbol that is used [on its own, or in combination with other symbols] to stand in for, or to represent, something else [the signified – le signifié]. In conceiving the « big Other » as a place/scene, Lacan alludes to Freud’s concept of not physical or anatomical locality, but « psychical locality« , in which the unconscious is described as « the other scene ». In Lacanian terms the « other scene » is the big Other. The term « scene » was used by Lacan to denote the imaginary but also symbolic theatre in which the Subject plays out his fantasy; a fantasy which is however firmly built on the edifice of the Real [i.e. the world] and shaped by the symbolic order. The scene of fantasy is a virtual space which is framed, similarly to the scene of a play which is framed by the proscenium arch in a theatre, whereas beyond the frame lies the « real » space where the world is. Lacan uses the notion of « scene » to distinguish between 2 processes: (i) Acting out, and (ii) Passing to the Act. Since, the scene is symbolic and built on the real, the process of « Acting Out » takes place within the frame, i.e. inside the scene and is inscribed in the symbolic order; whereas the process of « Passing to the Act » is an exit from the scene, a crossing over from the symbolic into the real. It is highly likely that the impact of the arts, education, exposure and personal development has an important role to play in the development of the partially unconscious « big Others » and « the other scene ». The greatest child psychologist of all time, Jean Piaget argued that all forms of social interaction [which also includes artistic exposure] in the process of learning play an important role in « cognitive growth ».

This also leads to the important question of the « use » of art. Art is a very lucrative business in the 21st century with the wide range of outlets available digitally to deliver the works to the consumer/audience; but what are we consuming? What is the effect that we look for when we fully process the artworks that we choose? What happens after complete psychical digestion by the different psyches among us? Art is used to mark history, to leave a trace, not of the events, but of the line of thought of those living at the time it is focusing on. Back to the fundamentals of philosophy, the famous quote « je pense donc je suis » [French for: « I think therefore I am »] from Descartes explains to us that man is gifted with a conscience unlike animals. It is because we are organisms with the ability to think that we are human beings. Spinoza argued that we all have a conatus, an identity that is unique to each of us; the horse runs, the human being thinks. It is hence essential to question oneself, to meditate on a particular topic or another in order to blossom and thrive as human beings. Art is praxis, like philosophy it is an activity that produces no added value and has no other purpose other than the « perfecting of the agent » as Aristotle put it – it is an activity that allows for this work of reflective meditation. In this sense, a painting cannot be considered as a mere decoration as it is not a question of finding it « beautiful » or « ugly », but it implies a work of reflection and a particular mental visualisation. Of course, art does not speak to everyone. Serge Gainsbourg pointed out that we have 2 types of art: major and minor ones. Major art forms are those that only the trained mind can understand: architecture, painting, the classics and poetry; For example, this piece by the French philosopher and winner of the 1927 Nobel Prize in literature, Henri Bergson ( – ):

« L’état suprême de la beauté, c’est la grâce. Or, dans le mot grâce, on entend aussi la bonté. Car la bonté, c’est la générosité d’un principe de Vie qui se donne indéfiniment. »

– Henri Bergson

Then we have the Minor art forms, which are those that speak to everyone. It is obviously difficult to perceive, interpret and explore the knowledge, layers of meaning and wisdom in artistic literary compositions if we do not have a good vocabulary and a deep understanding of literary voice [i.e. tone and mood], linguistic style [i.e. Imagery, Simile, Metaphor, Personification] and aural imagery [i.e. Alliteration, Assonance and Onomatopoeia] ; similarly it would be hard to understand all the hard work behind the construction of a cathedral if we do not have any understanding of architecture, although nothing prevents us from appreciating its grandeur and contemplating it at length; this is also applicable to painting which is linked to a profound understanding of scales, light, reflections, shadows, colours, paints, textures and brush strokes. Going by Metry Sephora’s straightforward way to understand a work of art, we can firstly ask ourselves what it is about; what is the painter presenting to us? What do we see in the distance? Secondly, how is it all represented? [Techniques, colours, materials, movements] What do we see from up close and what feelings are elicited? Thirdly, it is about the moment the art work mirrors us. Sometimes we are already touched and are able to evade by imagining the setting presented to us, we reminisce about moments experienced and we reflect on a particular topic. In some other cases, the art work does not touch us and we have to question ourselves deeper, through the life of the artist; why did the artist represent this? What was going on in his/her life at that particular time? In what context did he/she realise it? What was the train of thought of the time?

Les Fenêtres [Windows] par Robert_Delaunay (1912)

« La Fenêtre » par Robert Delaunay. 1912 [de la série « Les Fenêtres »] / Musée de Grenoble

The above painting is « La Fenêtre » [The Window] » by the French painter Robert Delaunay (1885 – 1941) completed between 1911 and 1912 which is part of the series, « Les Fenêtres [Windows]« , which include 13 paintings inspired by the reading of « La loi du contraste simultané des couleurs » written in 1839 by Gustave Chevreuil; we know that the Delaunays created a cultural movement on their own and Blaise Cendrars (1887 – 1961) and Guillaume Appolinaire (1880 – 1918) were great admirers of their work which is part of the Cubist movement. This painting also inspired Apollinaire for his poem also entitled « Les Fenêtres » [Windows] where the writer tried to create a simultaneity between words as Delaunay does with colours. The painter seeks the original essence of colour, while the poet seeks the original essence of words. If we were to analyse this work, we could first observe the mixture and contrast of colours, it is not linear as a Mondrian art work, but still keeps a sense of organisation since the shapes do not spread in every direction, with different shades of blue and orange dominating the work. Secondly, we can conclude that it is rectangular and is a work of oil on canvas measuring 45.8 x 37.5 cm kept at the Musée de Grenoble and that the paint is smooth with movements executed naturally making it pleasant and relaxing to the eyes. Thirdly, based on the life of the painter we know that Robert Delaunay was part of a generation of avant-garde artists who were particularly prolific on the artistic scene between 1912 and 1914, representing the cubist and neo-impressionist movement, and that he was inspired by the scientific works of Chevreul on colours, by the work of Seurat and also that of Cézanne. At that time in the early 20th century, modern painting had tended towards abstraction, and in 1912 Apollinaire diagnosed the birth of a new pictoral art: « The new painters paint paintings where there is no longer a real subject ». By 1912, Delaunay had turned to orphism which led to the series of painting containing « La Fenêtre » [The Window]. More specifically orphic cubism had been distinguished from scientific cubism in 1912 by Apollinaire during the exposition of the Section d’Or, with the term orphism clearly linked to his poem « Orphée » (1908) which deals with pure poetry – a sort of « luminous language ». Another interpretation of this term is proposed: the name makes the analogy of the painting with music.

Peindre avec la musique DnP danny d'purb dpurb site web

Indeed, at the start of the 20th century, music represented modern art par excellence, perfectly abstract, therefore pure as a universal art form, with a totalising function. Music could unite all the arts, as in Wagner’s operas with the concept of the Gesamtkunstwerk [i.e. A total work of art characterized by the simultaneous use of many media and artistic disciplines, and by the symbolic, philosophical or/and metaphysical significance it holds. This use stems from the desire to reflect the unity of life]. Robert Delaunay and his wife indeed created a cultural movement around them, through works concentrated on the arrangement of colours on the canvas seeking pictorial harmony. We all have a conatus, for some it is art, for others it is literature, drama and poetry, readers out there should perhaps try to find theirs?

So, getting back to the big Other [SuperEgo / Grand Autre], it is is always « lacking » something for the subject and the mythical complete and perfect Other does not seem to exist. In 1957, when Lacan introduces the algebraic symbol for the barred Other (A), lack comes to designate the lack of a signifier in the Other [It is Lack that causes Desire to arise]. Lacan introduces the symbol S(A) to designate « the signifier of a lack in the Other. [Note that Lacan uses the term « Grand Autre » with capital A which here is referred to as the « Other » with capital O, i.e. the « big Other » and not the « petit autre » which is the reflection or projection of the Ego [counterpart and specular image] in the imaginary order referred to as the « other » or « little other », « o » « petit autre » « a ».]

 

Lacanian Terms: L’Inconscient [Id], L’Autre [Grand Autre/Big Other/Superego] & Le Moi [Ego: its birth and the Mirror Stage]

To clarify Lacanian terms, firstly, we have the « inconscient« ; being the unconscious ID in the domain of the symbolic which is the unconscious origin of the individual’s discourse, the symbolic « it » or « Ça » beyond the imaginary ego: man is lived and spoken by the unconscious « it » or « Ça ». Hence the phrase which Lacan frequently uses when discussing the unconscious ID, « it speaks » (le « Ça » parle). Hence, Lacan argued that the concept of the unconscious was badly misunderstood by most of Freud’s followers who reduced it to being « merely the seat of instincts« , and against this simplistic biological mode of thought Lacan argued that the unconscious is not simply the seat of instincts but is also and primarily linguistic because we can only grasp the unconscious when it is explained and transformed into words. One should see in the unconscious the effects of speech on the subject, as it is the determination of the subject by the symbolic order. The unconscious is a kind of memory in the sense of a symbolic history of signifiers [i.e. a treasure chest full of signifiers where discourse originates] that have determined the subject in the course of his/her life. Psychoanalysis involves unearthing the meaning that particular symbols hold for an individual. What this seems to suggest is that the unconscious absorbs a wide range of signifiers (signifiants) [that symbolise something else, « le signifié » or « signified » in a deeper exploratory sense] throughout the subject’s life and these later find expression and guide desires through the Superego [Grand Autre / Big Other / the symbolic discourse of the unconscious] and in turn symbolically shapes the imaginary creations of the Ego [Moi] and define the Subject according to his abilities to achieve his desires – the outcome differs depending on the subject’s individual creativity and intelligence.

Le Penseur par Auguste Rodin (1882) dpurb site

«Le Penseur» par Auguste Rodin (1882) représente un homme dans une réflexion profonde, semblant utiliser toute son intelligence pour résoudre un problème.

Since it is an articulation of signifiers in a signifying chain, the unconscious is a kind of knowledge (symbolic knowledge, or savoir) – an « unknown knowledge. » For the Cognitive-Behavioural mind, these signifiers may be considered as « stimuli » [received in different forms, e.g. visual, auditory, mental] however their reception and their responses are completely unconscious and generate effects in the depth of the mind [unconscious] that cannot be measured or seen [the nightmare of the empiricist]. Hence, the unconscious is the location of a chain of signifiers [that stand for something else in a signifying chain] that define the subject through the course of his/her life and where linguistic discourse originates.

We then have the « Moi », which is the equivalent of the Ego, a formation in the imaginary order as opposed to the Subject [le parlêtre as explained above, which is the true product of the symbolic order]. The Ego is a méconnaissance [a failure to understand/recognise, which is also the structure of paranoiac delusions] of the Symbolic, the Ego is the seat of resistance and is structured like a symptom at the heart of the Subject, the human symptom par excellence, the mental illness of man. Méconnaissance is to be distinguished from ignorance: whereas ignorance is a passion for the absence of knowledge, méconnaissance is an imaginary misrecognition/misconstruction of a symbolic knowledge (savoir) that the Subject does possess somewhere. The structural homology between the ordinary constitution of the Ego and paranoiac delusions is what leads Lacan to describe all knowledge (connaissance), in both neurosis and psychosis, as « paranoiac knowledge. » Lacan also argued that the proponents of Ego-psychology betrayed Freud’s radical discovery by relocating the ego as the center of the subject. In opposition to this school of thought, Lacan maintains that the ego is not at the center, that the ego is in fact an object. ‘ The ego is a construction which is formed by identification with the specular image in the Mirror stage and is thus the place where the subject becomes alienated from himself, transforming himself into the counterpart. Malin (2011) pointed out that in Lacanian Theory, a major event in infants’ personality and social development is the mirror stage, when infants enter into language as a uniquely human form of interaction with all caregivers in the child’s environment [although infants are not likely to consciously experience language prior to age 2]. As Luepnitz (2009) noted, Lacan believed that infants often enter into language at a crucial point when they literally recognise themselves in a mirror, with caregivers [i.e. can include others such as teachers rather than direct parents] pointing to the reflection and approvingly saying to the infants, “Look, that’s you!” – even if infants are unlikely to remember the event in itself.

Rene Magritte - Not To Be Reproduced (1937)

« Not to be reproduced » by René Magritte, 1937

And as Hivernel (2013) noted, the 2 major outcomes of the mirror stage are the emergence of the Subject, a product of the symbolic order (i.e., individuals’ gradual awareness regarding their uniqueness) and the others (i.e. individuals’ gradual awareness regarding the rest of humanity, to whom they are connected to varying degrees). The other major outcome of the mirror stage is the birth of the Ego [Le Moi, the imaginary formation], and infants may experience joy at this moment, which occurs (and, in fact, is necessary) before infants can truly understand the power of symbols in language. However, one of the unfortunate outcomes of the mirror stage was that infants gradually begin to look outward, and not inward in search for identity; and such external orientation toward individuals’ own identity is doomed to fail. This seems to make perfect sense even from the objective and mechanistic outlook that the Organic Theory considers; i.e., any organism whose reality or sense of it is based on the geographical mental conditioning of a group of organisms [about 4 or 5] will have a limited perspective of reality and lack a wider outlook of the world as it truly is. Unlike US Ego psychologists who considered the Ego as the dominant component that should be worked on and strengthened, Lacan argued against such irrational therapy because the ego is the « seat of illusions » and to increase its strength would only increase the subject’s alienation, the ego is the source of resistance to psychoanalytic treatment and strengthening it would increase those resistances [i.e. all obstacles that arise during psychoanalytic praxis and interrupt its progress, when the subject breaks the fundamental rule of saying everything that comes into his mind]. Lacan argued that the true goal of psychotherapy should be therapists’ unearthing the clients’ unconscious desire via the “talking cure” of psychoanalysis – not strengthening the Ego mindlessly, as this may leave individuals in a state of delusion without an Ego adjusted to their abilities – and may even lead to individuals allowing their Ego [imaginary moi] to dominate the Super-Ego [Grand Autre, Big Other] and favour irrational release of the ID’s [Inconscient / Ça] psychic energy without any remorse or rational control. Because of the imaginary fixity of the Ego, it is resistant to all subjective growth and change and to the dialectical movement of desire, hence, by undermining the fixity of the ego, psychoanalytic treatment aims to restore the dialectic of desire and reinitiate the « coming into being » of the Subject, a product of the Symbolic. This is in direct contrast to the Ego Psychologists’ perspective. Lacan criticised ego-psychology as practised in the US for confusing the concept of « Resistance » with that of « Defence », and his distinction differs from Anglo-American psychoanalysis. Lacan explained that Defence is on the side of the subject whereas Resistance is on the side of the object. Defences are relatively stable symbolic structures of subjectivity while resistances are rather transitory [periodic / like a phase] forces which prevent the object from being absorbed in the signifying chain [of signifiers]. Resistance belongs to the « imaginary » order of the Ego and not to the symbolic level of the true Subject, because in the symbolic order of the Unconscious, there is no resistance, but only a tendency for repetition. Hence, resistances are « imaginary lures » of the Ego which the analyst must be wary of being deceived by. This is why Lacan maintained that the aim of analysis can never be to strengthen the Ego because this would increase imaginary resistances. Ego psychology shifted emphasis on overcoming the resistances of patients and this was heavily criticised by Lacan who thought that this lead to an « inquisitorial style » of psychoanalysis that sees resistances as based on the « fundamental ill will » of the patients, which is not always the case; this to Lacan overlooked the structural nature of resistance and reduces analysis to an imaginary dual relation. Lacan encourages the « analysis of resistances » but only on the condition that this phrase is properly understood, in the sense of « knowing at what level the answer should be pitched« ; what Lacan means is that the crucial thing is that the psychoanalyst should be able to distinguish between interventions that are primarily oriented towards the Imaginary and those that are oriented towards the Symbolic and know which are appropriate at each moment during psychoanalytic praxis with patients. Lacan argued for « Structural Resistance », which is not a question of ill will on the part of the patient but is a resistance that structures, and it is inherent in the analytic process. Resistance is due to a structural incompatibility between desire and human speech [i.e. discourse] and hence Lacan points out to a certain irreducible level of resistance which can never be overcome, that is, even after the reduction of resistances, there is a residue – which may be what is truly essential for a particular Subject. This irreducible « residue » is essential since it is respect for this residue by psychoanalysts that distinguishes true psychoanalysis from mere suggestion. Psychoanalysis to Lacan, respects the right of the patients to resist suggestion and indeed values that resistance. When the Subject’s resistance opposes suggestion, it is only a desire to maintain the Subject’s true desire, and as such it would have to be placed in the realm of « positive transference ». Lacan points out that while psychoanalysts cannot and should not try to overcome « all resistances », they can minimise them or at least avoid exacerbating them. To do this, psychoanalysts could recognise their own part in the resistances of their patients since to Lacan, there is no other resistance to analysis than that of the analyst himself. The patient’s resistance is always that of the analyst, and when a resistance succeeds it is because the analyst is in it completely, i.e. because the analyst understands. Hence, the analyst should always follow the rule of neutrality; psychoanalytic treatment works on the principle that by not forcing the patient, resistance is reduced to the irreducible minimum, thus, analysts should avoid all forms of suggestion.

Finally, as already explained above, we have the « Grand Autre » or simply « Autre » [Capital A] or « Big Other » which is the preconscious Superego also in the domain of the symbolic register; being the discourse of the unconscious. The big « Other » designates an otherness that transcends the illusory otherness of the imaginary because it cannot be assimilated into the psyche through identification, Lacan equates the big « Other » with language and the « law » [i.e. the structures that govern social exchange] and hence the big « Other » is inscribed in the symbolic register, and indeed the big « Other » is symbolic because it differs for each subject and is the symbolic order which mediates the relationship with a particular subject. The little « other«  is a reflection or projection of the ego [le Moi], it is the counterpart and the specular image, unlike the « big Other » which is in the symbolic order, the little « other » is inscribed in the imaginary order of the Ego.

 

The concept of Adaptation and Psychoanalysts as the Grand Autre [Big Other / Superego]

Lacan also questioned whether the ego of the psychoanalyst gives the measure of reality to the patient in trying to adapt the latter. Because if so, this would turn the analyst [who are also different in terms of talent, creativity and vision from one person to another] into the arbitrer of the patient’s adaptation to reality, hence the analyst’s own understanding [or lack of understanding] of reality would be assumed to be absolute and perfect where he would be considered as the perfection of adaptation compared to the patient [as is the case in Ego-psychology practiced in the USA]. This to Lacan turns psychoanalysis as an exercise of power and social control where the analyst forces his own particular view of reality onto the patient and this is not psychoanalysis but suggestion. This Lacanian refusal to force an adaptation of the ego to reality is in direct opposition to the « Ego-psychology » of the US psychoanalytic movement that Lacan accused of wrongly reading the works of Freud. Lacan regards it as simple to understand why the adaptation theme was developed by European and Jewish psychoanalysts who had emigrated to the USA in the late 1930s, and this is simply because these analysts felt not only that they had to adapt to life in the USA, but also that they had to adapt psychoanalysis to American tastes [i.e. to fit the average american psyche]. One of Lacan’s fiercest criticism is based on the following argument: the notion of « adaptation to reality » is founded on the creatively irrational and naive empiricist epistemology that wrongly assumes an unproblematic notion of « reality » for all Subjects, as an objective and self-evident given, this discards what psychoanalysis has discovered about the construction of reality by the Ego on the basis of its own « méconnaissance » [i.e. subjective understanding of reality]. So when the analyst assumes that he is better adapted to the vague notion of « reality » than the patient, he has no other option but to fall back on his own Ego’s interpretation of reality, since it is the only « reality » he knows, this leads to the distorted and simplistic definition of « the part that thinks as we do » as being the healthy part of a Subject’s Ego. This practice of Ego-psychology turns psychoanalysis as an exercise of prepackaged suggestion to mould the psyche of individuals to these analysts’ own « idea » of reality in order to fit a simplistic mainstream model in line with the requirements of the mechanical philosophies of empiricist epistemology and industrialisation. The inability of the analyst to sustain a praxis authentically, as is usually the case, results in an exercise of power.

The simplistic biological concept of adaptation [as often assumed in simple deterministic animal psychology] can be problematic when applied to psychoanalysis since in evolutionary biology it is assumed that organisms/animals are driven to « adapt » themselves to fit their environment and hence implies a harmonious relation between the Innenwelt (inner world) and Umwelt (surrounding world). The observation of animals in nature or in laboratories tends to guide the reasoning of many empirical scientists who are simplistic and biologically oriented, it is important to ask a few questions. For example, which animals to focus on as models to be inspired by? In nature, we have many animals who mate for life and are monogamous [e.g. albatrosses, bald eagles, barn owls, penguins, beavers, shingleback skinks, gibbons (primates), wolves, swans & french angelfish]. On the other hand, we also have other animals such as common pheasants, lions, gorillas, tigers, red deers, elks, and hamadryas baboons (primates) who have a different mating system, where the fittest male mates with multiple females to ensure the constant enhancement and fitness of future generations; and hence are polygamous.

Maladies Génétiques.jpg

Image: Degenerates / Some controversial doctors under the Third Reich proposed that the curse of diseased genes destroy entire families, and that degenerates can only give birth to their similars. It lead to sterilisation that was supposed to prevent them from spreading their misery to innocent children [as the aim was a strong and genetically healthy people], and also the « Aktion T4 » program which was mass involuntary euthanasia. Certain German physicians were authorised to select patients « deemed incurably sick, after most critical medical examination » and then administer to them a « mercy death » (Gnadentod). From September 1939 until the end of the war in 1945; from 275,000 to 300,000 people were euthanised in psychiatric hospitals in Germany and Austria, occupied Poland and the Protectorate of Bohemia and Moravia (now the Czech Republic). The Holy See announced on 2 December 1940 that the policy was contrary to the natural and positive Divine law and that « the direct killing of an innocent person because of mental or physical defects is not allowed » but the declaration was not upheld by some Catholic authorities in Germany. In the summer of 1941, protests were led in Germany by the Bishop of Münster, Clemens von Galen, whose intervention led to « the strongest, most explicit and most widespread protest movement against any policy since the beginning of the Third Reich », according to historian Richard J. Evans.

Hence, this poses questions to the simplistic biological perspective of adaptation: should humans follow the latter polygamous animal model and select the fittest and smartest males through physical and intelligence tests and use their sperm to inseminate all women on earth desiring to have children [or vice-versa or in combination with the eggs of the fittest and smartest females to help couples conceive]; could this reduce malformations and other ugly diseases?

Population en bonne santé d'purb dpurb site web.jpg

Image: Physically healthy females exercising

Or should we follow the monogamous model of the bald eagle, penguin, barn owl, swan, wolf and French angelfish? Based on our evolutionary history, it seems that we humans are monogamous by design due to the size of our brains that allow us to build sophisticated relationships and also experience complex emotions [that animals cannot due to the limited biological architecture of their brain that is optimised for survival and hunting], and hence, humans should not follow animals blindly but use some aspects that we may learn from the study of animals in nature with great precautions to help humans live a better life [for example: giving a choice of healthy sperm and egg donors to couples who cannot conceive or fear passing down incurable and other debilitating diseases] and gradually create a genetically healthy civilisation.

Bébé Gorille Albinos avec son ami d'purb dpurb site web

Image: Baby Albino Gorilla with his friend

François Rabelais, the french doctor, writer, monk & priest seems to have phrased it well in his magnum opus, Pantagruel (1694): « Science sans conscience n’est que ruine de l’âme. » [French for: « Science without conscience is nothing but the ruin of the soul »]

So, the idea of harmony between the inner world (Innenwelt) of the organism and its environment (Umwelt) which is implicit in the concept of adaptation from the simplistic biological perspective [e.g. in animal psychology] is innaplicable to human beings since man’s inscription in the symbolic order re-shapes and restrains his natural behaviours and instincts [i.e. because of civilised society and the sophisticated and multi-layered aspects of human life, man cannot allow himself to follow his wild instincts blindly as animals do in nature], and this means that « in man, the imaginary relation [to nature] has deviated » [the nurture VS nature debate]. This is different for all animal machines who tend to be strictly riveted to the conditions of the external environment, whereas in the human being we have a « certain biological gap ». So, compared to the simplistic biological perspective of animal adaptation where the organism follows its wild instincts and not human reasoning, we can suggest that humans are essentially « maladaptive animals » and this may well be for the betterment of our lives since we live in a sophisticated society and not in the wild nature (la nature sauvage) like animals, where meeting basic needs is a constant struggle in a matter of life and death.

Yet, adapting to the Umwelt (surrounding world) in human psychology is not the ultimate path of perfection because it is not designed to meet all of the true desires of human beings [as Freud suggested, intrapsychic conflict is inescapable because of the demands of society] and hence does not guarantee the complete satisfaction and enhancement of the individual [being highly complex beings with huge brains and different personalities that seek different goals], especially when the Umwelt (surrounding world) itself which is assumed to be « reality » is not a simple objective thing [such as for animals in nature] but is itself a product of the Ego’s fictional misrepresentations and projections. Therefore to Lacan it is not a question of adapting the Ego to reality, but of showing the imaginary « Ego » that it is only too well adapted since it assists in the construction of that very reality and hence the task of the psychoanalyst is rather to subvert the patient’s illusory sense of adaptation since it blocks access to the unconscious, and hence gain access to it. In 1955 Lacan states that « the dimension discovered by analysis is the opposite of anything which progresses through adaptation » and hence refused to explain human phenomena and mental life in terms of adaptation. To Lacan, and many inspired by his views, it is more about « adjusting » than adapting, i.e. adjusting to be functional in our chosen path/field based on our individual characteristics and abilitiesLacan maintained that psychoanalytic intervention should not aim to adapt the Ego to reality, and this seems reasonable since « reality » is a social construct under constant change as we primates are evolving and adapting to the discoveries of our constantly changing civilisation, but also because the Ego is an imaginary formation as opposed to the Subject which is the true product of the symbolic. To Lacan, psychoanalysts should adopt the role of the « big Other » [Grand Autre / Super-Ego) in therapeutic interventions as a counterpart to the client’s « Subject », thus making it possible for clients to peer beneath their own conscious (typically not completely true narratives), into their unconscious (and “true”) desire(s) [and perhaps guide or help the patient to realise their dreams within the realms of reality in civilised society].

Lacan’s suggestion seems to give the individual the creative freedom to create himself through language and discourse, exist and be unique within the reasonable limits of a mentally adequate and healthy person, while only adjusting his behaviour to be able to function and exist in his chosen individual world without losing his individuality. Since reality and culture are social constructs that are always changing through collaboration, the individual can both be shaped by them and also shape them [for e.g. human culture teaches a child how to use a fork and a knife to eat, but it can also be shaped by an individual if he invents/discovers something or adopts a philosophy that affects/inspires human cultures. In the past smoking was allowed everywhere and it was common culture to see people and even doctors smoking in public buildings, but since we found about the harmful effects of cigarette smoke, today culture has been reshaped and smoking is banned indoor in most public places. The invention of the mobile phone has also affected human culture and behaviour when before people used public phone boxes]; this concept of being shaped by and also shaping human cultures is known as mutual constitution and is reflected in the artefacts of all societies through the arts, literature and languages [as we explained in the Essay: The Concept of Self].

 

Challenging the established procedures of Psychoanalytic Practice

Lacan was also innovative and challenged the established procedures of Psychoanalytic practice [which promoted multiple sessions lasting an hour or more apiece, across several years] to advocate brief, impromptu [i.e. unscheduled] therapy that could be completed in a matter of minutes.

As early as 1950, Lacan had questioned the ritual of the 55-minute timed sessions imposed by the IPA as intended to preserve patients and students in training from the all-powerful transference of the masters; Lacan pulverized this rule. He invented the rule of the session of variable duration that leads the analyst to intervene in the cure by caesuras or by interpretations so that the analysand explores his unconscious fantasies more rapidly and wastes less time in uttering empty words.

« La psychanalyse est une pratique délirante, mais c’est ce qu’on a de mieux actuellement pour faire rendre patience à cette situation incommode d’être homme. C’est en tout cas ce que Freud a trouvé de mieux. Et il a maintenu que le psychanalyste ne doit jamais hésiter à délirer »

French for: « Psychoanalysis is a delirious practice, but it is the best we have at the moment to make this uncomfortable situation of being a man bear with patience. It is in any case the best Freud found. And he maintained that the psychoanalyst should never hesitate to be delirious »

Ornicar. (1977). Ouverture de la section clinique. Bulletin périodique du champ freudien. 9, 13.

The decision of Lacan to adapt sessions according to the Subject’s abilities and individuality seems logical and is based on Lacan’s concept of « the time for understanding« . Lacan’s approach to the questions of time remains one of his distinctive features. In Lacan’s paper « Logical Time » (1945), he distinguished between logical time and chronological time. Logical time has a tripartite structure, the 3 moments of which in every subject are:

(i) the moment of seeing [i.e. perceiving]
(ii) the time for understanding
(iii) the moment of concluding

Lacan explains that these 3 moments are not constructed in terms of objective chronometric units, but in terms of an intersubjective logic based on a tension between hesitation and urgency. Logical time is the intersubjective time that structures human action and varies from one individual to another based on their abilities. This seems logical since the main factors that influence successful therapy are the relationship between the therapist and the client, but also the aptitudes of the client [which varies from one individual to another depending on their intelligence, reflective abilities, understanding and will power].

Nous En France - Sarkozy - d'purb

Traduction(EN): « Us in France, we are different from others. To live, we have to drink, eat, but also to cultivate ourselves. » -Nicolas Sarkozy

Since Lacan’s theory is mainly based on French society – one with a history of challenging the limits of the individual in the name of excellence – it seems fair to acknowledge his opinions [in a sense that not all patients require multiple sessions depending on their individual characteristics, response to the relationship with the psychoanalyst, understanding of their own mental condition and desires and reflective abilities] as rational, economical, time-saving and flexible in accommodating individual differences.

In 1971, Maria Belo, a Portuguese psychoanalyst, had decided to do an analysis with Lacan after her sister’s suicide, which turned her life upside down. She would say:

« La qualité de sa présence faisait que ça déclenchait un travail, chaque séance déclenchait un énorme travail analytique en moi et quand j’arrivais chez moi, j’écrivais des lettres de plusieurs pages que chaque fois j’allais mettre dans sa boîte à lettres (…) Je pense aussi que ce que Lacan faisait avec les séances très courtes était très lié à ce qu’il était. Si on pense à cette époque, la grande époque de l’école Freudienne où il était mythifié par beaucoup de gens que, il avait vraiment besoin, par rapport au transfert, de secouer les gens et de faire des trucs que personnes d’autres n’a eu raison de faire après. »

French for: « The quality of his presence meant that it triggered work, each session triggered an enormous analytical work in me and when I arrived home, I wrote letters of several pages that each time I would go to put in his mailbox (…) I also think that what Lacan did with the very short sessions was very much linked to what he was. If we think back to that time, that great era of l’École Freudienne where he was mythified by many people that, in relation to transference, he really needed to shake people up and do things that no one else did afterwards. »

 

« Le transfert c’est l’amour. On se demande simplement : pourquoi est-ce qu’on aime un être pareil ? Pour l’instant je laisse la question en suspens… »

French for: « Transference is love. We simply ask ourselves: why do we love such a being? For the moment I leave that question open… »

-Jacques Lacan

 

However, partly as a reaction to Jacques Lacan’s criticism of Ego Psychoogy [as practiced in the United States], and partly as his advocacy of brief, impromptu therapy, the US-oriented International Psychoanalytic Association, majorly Anglophone and not very open to the virtuosity of Lacanian speculation, barred Lacan from training future psychoanalysts. For the IPA, brief therapy is unacceptable, they wanted to consider accepting Lacan’s teaching as long as he remained in the IPA as a philosopher and/or a theorist but definitely not as a trainer of students.

LesFrancaisNapproventPasLaPolitiquedesUSA

A majority of 80% of French citizens are wary of the US and do not approve its politics / Source: Le Figaro

Lacan found himself in a situation that had never been that of Freud: he found himself in a situation where he would become the director of his school, that is to say that by later founding l’École Freudienne de Paris in 1964 he would exercise functions that Freud never exercised. Lacan was at the same time the master of thought, the analyst, the political leader of his school, and was responsible for all the functions, whereas Freud had delegated political power to his disciples.

« Je fonde – aussi seul que je l’ai toujours été dans ma relation à la cause psychanalytique – l’École Française de Psychanalyse (…) dont rien dans le présent ne m’interdit de répondre personnellement la direction…»

French for: « I am founding – as alone as I have always been in my relationship to the psychoanalytic cause – the École Française de la Psychanalyse (…) whose direction I am personally responsible for as nothing in the present prevents me to do so…. »

– Jacques Lacan

Hence, criticized by the IPA, proponents of a rigid legislation, Lacan left the Société Psychanalytique de Paris which was frequented by Marie Bonaparte who thought she was the only heiress of Freud whose memory she piously celebrated with the support of the IPA.

Lacan then participated in 1953 with Daniel Lagache, François Perrier, Serge Leclerc and Wladimir Granoff in the creation of the Société Française de Psychanalyse ; his friend Françoise Dolto, founder of a new psychoanalytical approach to childhood, gave him her support. La Société Française de Psychanalyse would become a sophisticated cultural melting pot for all the youth of that generation and Lacan would train them by being, in the words of Elisabeth Roudinesco, « l’analyste, le contrôleur, le maître, l’initiateur, l’éveilleur » [French for: « the analyst, the controller, the master, the initiator and the awakener »] through his seminars which took place at the Sainte Anne Hospital followed by the presentation of the mentally sick. Lacan became the great renovator and the great re-inventor of psychoanalysis in France. That generation felt like the pioneers of something new around Lacan, but they would have also liked to remain in the IPA, in its Freudian legitimacy, of which they were no longer a part of since their masters had resigned. The characteristic of Lacan was that he contested the whole practice of the IPA that was trying to be Freud. Lacan is the only one to suggest a return to the origins of Freudian theory, i.e. not post-Freudism. Thus at that point, Lacan posed himself as the re-founder, and an intellectual who was transgressive since Lacan would not respect any irrational IPA rule, which of course humiliated the IPA who could not digest Lacan and his perspectives, and perhaps also unable to grasp the sophisticated subtleties of Lacan’s theory which had its origins in the French heritage. Unique in its kind, the École Freudienne de Paris would allow Lacan to place the desire to be an analyst at the heart of the training of didacticians. Jean-Bertrand Pontalis declared: « Comme si lui-même (Lacan), dans ces années-là était en train d’inventer et de s’inventer. Nous participions en accord avec lui en résonance avec lui à un mouvement inventif. » [French for: « As if he himself (Lacan), in those years was inventing and inventing himself. In agreement with him, we were participating in an inventive movement in resonance with him.« ]

Furthermore, despite [or perhaps because of?] the IPA’s decision to bar Lacan from training future psychoanalysts, the proportion of Psychoanalysts adopting a Lacanian perspective has only grown since Lacan’s death in 1981with half or more of the world’s psychoanalysts adopting Lacanian concepts. Jardim, Costa Pereira and de Souza Palma (2011) applied Lacanian Theory to understanding the personality disorder of Schizophrenia [formerly known as “madness”], interpreting a case study [along with fictional examples from literary works] in terms of failure to achieve an integrated Ego from infancy onwards. McSherry (2013) argued that Lacan’s Theory of Psychoanalysis could benefit mental health nursing practice since various forms of personality disorders [including but not limited to Schizophrenia] can be understood readily in terms of Lacan’s theory.

Lacan described woman as a « symptom of man » that enters the psychic economy of men as the cause of their desire. This has led to debates among feminists: some saw his theories as a way of challenging fixed concepts of sexual identity while others believe that the concept of symbolic order reinstates the inequality of the sexes, and the privileging of the phallus simply repeats alleged misogynies of Freud.

The British psychoanalyst Juliet Mitchell who was one of the first to introduce Lacan’s system of thought to the Anglophone crowd thought that his work was misinterpreted and misused for a political purpose for the left and for feminism; Mitchell suggested that a possible reason for this could have been due to the « stupidity » of the English crowd, unable to grasp the subtleties of Lacan. Malone (2012) noted that Lacan was ambivalent towards the growing tendency for empirical clinical psychologists to align their discipline with the hard sciences [e.g. Biology, Medecine, Physics, Chemistry, Astrophysics, Material Science, etc] and not with the humanities [e.g. Literature, Poetry, Music, Art (Sculpture, Painting and others), Drama (Theatre), etc], and viewed psychoanalysis as ideally informed by both the humanities and by the sciences.

Documentaire: Jacques Lacan, La Psychanalyse Réinventée (2001)

Lacan has been hailed as the “French Freud” who has established a tradition of French psychoanalysis that rivals American and British psychoanalysis in terms of international influence. Although Lacan’s theory has been cast as a uniquely French theory [culturally and linguistically speaking], it has nonetheless struck a chord with many [and, perhaps, most] of the world’s most influential modern day psychoanalysts, shattering perceptions across languages and cultures worldwide. Perhaps unsurprisingly, a decade later, much psychoanalytic research in the US itself will seem to confirm Lacan’s perspectives as discussed above.

After the publication of his writings in 1966, Lacan became a recognized thinker, admired by his students and hated by his opponents. At L’École Normale, the salle Dussane, a large crowd flocked to listen to him.

« Quand je comprenais je trouvais ça génial… »

French for: « When I figured it out, I thought it was great… »

-Françoise Dolto

The writer Philippe Sollers lyrically describes the harmonies and dissonances of the main stage of Jacques Lacan’s seminar:

Philippe Sollers sur Lacan - danny d'purb dpurb site web.jpg

« Lacan monte à la tribune comme une gravure de Dürer (Albrecht), drôle de Saint, drôle de moine chevalier prêcheur d’un autre âge. Lacan c’est de la lenteur ponctuée, du soupir, de la passion tortueuse, de l’envolée, de l’anecdote, de largo, de la moquerie, de l’insulte, du tonnerre intermittent, du pinaillage à n’en plus finir, de l’ennuis massif, du mot d’esprit, du sublime. Il y a Lacan mystique, Lacan chancelier, Lacan l’ancêtre, Lacan Don Juan, Lacan Satan, Lacan charlatan, Lacan malicieux, Lacan généreux, Lacan vaniteux, Lacan persifleur, ronchonneur, hurleur, murmureur, souffleur, séducteur ; il y a Lacan cigare et Lacan mouchoir, Lacan accablé, Lacan vraie, l’étonnant et que ça donne comme la nervure exacte d’un gai savoir. » -Philippe Sollers

French for: « Lacan rises to the platform like an engraving by Dürer (Albrecht), a strange Saint, a strange knightly monk preacher from another age. Lacan is punctuated slowness, sighing, tortuous passion, flight, anecdote, largo, mockery, insult, intermittent thunder, endless nitpicking, massive trouble, witty words, the sublime. There is mystical Lacan, Chancellor Lacan, Lacan the ancestor, Lacan Don Juan, Lacan Satan, Lacan charlatan, malicious Lacan, generous Lacan, vain Lacan, Lacan persifleur, grumbler, howler, whisperer, blower, seducer; there is Lacan cigar and Lacan handkerchief, overwhelmed Lacan, true Lacan, the astonishing and that which gives like the exact vein of a cheerful knowledge. » -Philippe Sollers

 

Jacques Derrida would say:

« Je n’imagine pas que quelqu’un qui était engagé comme il l’a été avec une telle passion de la vérité là où le sens même du mot vérité était si difficile à faire entendre, je n’imagine pas qu’une telle personne ait pu vivre autrement que tragiquement (…) ce qui m’a aidé à résister à toute réponse agressive à Lacan, je pensais que cet homme avait une responsabilité tragique à assumer et quel que soit sa parade, son paraître, son apparat, etc… les scènes qu’il faisait, il devait y avoir de la blessure secrète là et je l’ai ressenti et je l’ai respecté. »

French for: « I cannot imagine that someone who was engaged as he was with such a passion for the truth where the very meaning of the word truth was so difficult to convey, I cannot imagine that such a person could have lived any other way but tragically (…) which helped me to resist any aggressive response to Lacan, I thought that this man had a tragic responsibility to assume and whatever his parade, his appearance, his pomp, etc., the scenes he made, there must have been some secret wound there and I felt it and I respected it. »

Jacques Lacan dpurb site web.jpg

Jacques Lacan (1901 – 1981)

Jacques Lacan addressing the audience of the Grande Rotonde of the University of Louvain, the 13th of October 1972:

« La mort est du domaine de la foi, vous avez bien raison de croire que vous allez mourir bien sûr ; ça vous soutient ; si vous n’y croyez pas, est-ce que vous pourriez supporter la vie que vous avez ? Si on n’était pas solidement appuyés sur cette certitude que ça finira ? Est-ce que vous pourriez supporter cette histoire ? »

French for: « Death is a matter of faith, you have good reason to believe that you are going to die of course; it sustains you; if you don’t believe in it, could you bear the life that you have? If you weren’t firmly supported by the certainty that it will end? Would you be able to bear it? »

Conclusion: Legacy, Impact & Evolution of Psychoanalysis

Psychoanalysis is a unique movement in psychology that grew out of the same German model of mental activity that produced act psychology and the Gestalt movement. However, psychoanalysis received its immediate expression through the needs of the mentally ill. Psychoanalysis was born as a clinical discipline, not an academic development based on empirical methodology to fit a particular field’s reductionist requirements for acknowledgement. For this reason, psychoanalysis, especially as proposed by writers after Freud, gives the impression of an ad hoc movement that develops as particular problems arise – it could be seen as adaptive and constantly evolving. Psychoanalysis did not adhere to the commitment to the reductionist empirical methodology expressed in those mechanical systems of behavioral studies generated by academic research. Psychoanalysis set out not to simply study basic observable behaviour [e.g. in animals studies], but to study the psychic apparatus that constitutes the human mind which obviously guides and impacts behaviour. Hence, there was and still is little interaction between psychoanalysis and those systems grounded on empiricism and reductionist methodologies that are stubborn in trying to capture an entity as the mind when most of the constructs cannot be seen or touched, or accurately measured. Stated quite simply, psychoanalysis and the other schools of psychological models do not speak the same language.

Although different and hardly understood by common mainstream empirical and academic psychology, psychoanalysis did assume a dominant role in psychiatry. This is completely understandable in light of the origins of psychoanalysis as a response to clinical problems as they manifested themselves. Indeed, psychoanalytic writings enjoyed an almost exclusive position in psychiatry and clinical psychology until the 1960s, when behaviour modification and mechanical and reductionist Pavlovian derivatives based on Behaviourism [such as Cognitive Psychology] began to compete as an alternate model of therapy for behavioural adjustment [Read: the Essay on the Origins of the Cognitive Behavioural Model: Biological Constraints in Learning, which also suggests an unconscious drift in other animals].

Pavlov Dog Labs

Psychoanalysis continues to exert a marked influence on art, literature, and philosophy. This influence reflects major contributions of Freud: his comprehensive analysis of the unconscious. On the same line, literary and artistic expressions are interpreted in light of the unconscious activities of the artist as well as the unconscious impressions of the perceiver. Psychologists today may choose unconscious motivations or simply to refer to subliminal or subthreshold activities. However, any truly comprehensive theory of psychological activity can no longer be limited to conscious aspects of behaviour. Although some psychologists may disagree with some Freudian concepts and interpretations, Freud did identity some dynamic processes that influence the activity of the individual: processes that psychology cannot ignore anymore.

As mentioned earlier, psychoanalysis has a unique position in the history of psychology. Freud did not develop a theory that generated testable hypotheses or other empirical implications. Yet, on another level, Freud accomplished what few other theorists have: He revolutionised attitudes and created a new set for thinking about personality. The findings of other more empiricist theories of personality disturbance have often confirmed many of Freud’s observations. If his views do not meet the criteria of empiricistic study, they nevertheless mark a man of genius and insight, whose influence pervades people’s thinking about themselves in ways that few others have achieved.

The psychoanalytic theory is an enormously complex and ambitious one, and it aims to make sense of a much broader array of psychological and social phenomena than other theories, and does so with a collection of explanatory concepts. Hence, the sheer range and scope of psychoanalytic theory, and its aspiration to be a total account of mental life, should be recognised and applauded. In comparison, all other schools of psychology to study personality look decidedly timid and limited in focus. Even if other approaches tend to have more empirical foundations and hence more credential in academic psychology, they tend to leave out much of what we might want to include in a comprehensive theory of human behaviour. To many intellectuals and lay people alike, any account of personality that does not acknowledge that humans are like psychoanalytic theory portrays us, i.e., driven by deeply rooted motives, inhabiting bodies that bring us pleasure and shame, shaped by our early development, troubled by personal conflicts, and often a mystery to ourselves – is fundamentally limited.

While the empirical limitations are a fact, some of these problems are due in part to the intrinsic difficulty of what psychoanalytic theory tries to explain. Others could be partially overcome if researchers made a more concerted effort to determine which psychodynamic ideas stand up to closer, “scientific enquiry”. However, psychoanalysis cannot be judged only by empirical perspectives, and it would be a mistake to abandon it impatiently, given how much a suitably revised and empirically updated theory of psychodynamics in the future might deepen the studies of personality.

Even for all its failings to the empirical scientist, on some aspects, psychoanalysis is at least partly responsible for several important and scientifically respectable ideas that has always had a kernel of truth and was later developed by other researchers. While Freud’s idea of the dynamic unconscious remains controversial, it can no longer be disputed today that unconscious cognition is now a fact and an uncontroversial idea in cognitive and social psychology, where huge volumes of research now explore non-conscious or “implicit” attitudes. We now know from neuroscientific research that the brain has networks for both explicit and implicit [unconscious] learning as Yang and Li (2012) found after examining the neural correlates for these 2 types of learning on artificial grammar sequences. We have brain networks of different connectivity that underlie explicit and implicit learning. While both processes involve activation in a set of cortical and subcortical structures, the study found that explicit learning engages a network that uses the insula as a key mediator whereas implicit learning evokes a direct frontal-striatal network. Individual differences in working memory also differentially impact the two types of sequence learning.

 

*****

References

 

  1. Adams, H. E., Wright, L. W., & Lohr, B. A. (1996). Is homophobia associated with homosexual arousal? Journal of Abnormal Psychology, 105, 440-5.
  2. Adler, A. (1956). The individual psychology of Alfred Adler. L. Ansbacher & R. R. Ansbacher (Eds.). New York. Basic Books.
  3. Adler, A. (1958). What life should mean to you. New York: Capricorn Books.
  4. Bornstein, R.F. (2005). Reconnecting psychoanalysis to mainstream psychology. Psychoanalytic Psychology, 22, 323-340.
  5. Bradley, B.P., Mogg, I. & Millar, N. (1996). Implicit memory bias in clinical and non-clinical depression. Behaviour Research Therapy, 34, 865-879.
  6. Bradley, B.P., Mogg, I. & Williams, R. (1994). Implicit and explicit memory for emotion-congruent information in depression and anxiety. Behaviour Therapy and Research, 32, 65-78.
  7. Bradley, B.P., Mogg, I. & Williams, R. (1995). Implicit and explicit memory for emotion-congruent information in depression and anxiety. Behaviour Therapy and Research, 33, 755-770.
  8. Brennan, J. (2014). History and Systems of Psychology (6th Ed).
  9. Carr, A. (2012). Clinical psychology. 1st ed. New York: Routledge.
  10. Chambless, D.L., Sanderson, W.C., Shoham, V., Bennett Johnson, S., Pope, K.S., Crits-Cristoph, P. et al. (1996). An update on empirically validated therapies. Clinical Psychologist, 49, 5-18.
  11. Eagle, M. (1987). The psychoanalytic and cognitive unconscious. In R. Stern (Ed.), Theories of the unconsciousness and theories of the self, 155-189. Hillsdale, NJ: Analytic Press.
  12. Ellenberger, H. F. (1970). The discovery of the unconscious. New York: Basic Books.
  13. Fairbairn, W.R.D. (1952). An object relations theory of personality. New York: Basic Books.
  14. Fazio, R., Jackson, J. R., Dunton, B., & Williams, C. J. (1995). Variability in automatic activation as an unobstrusive measure of racial attitudes: A bona fide pipeline? Journal of Personality and Social Psychology, 69, 1013-27.
  15. Fordham, F. (1953). An introduction to Jung’s psychology. London: Penguin.
  16. Freud, S. (1920). The psychopathology of everyday life. New York: Mentor.
  17. Freud, S. (1938). The history of the psychoanalytic movement. In A. A. Brill (Ed. And Trans.), The basic writing of Sigmund Freud. New York: Random House.
  18. Freud, S. (1955). The interpretation of dreams. In J. Strachey (Ed.), The standard edition of the complete works of Sigmund Freud (Vols. IV and V). London: Hogarth.
  19. Freud, S. (1965). New introductory lectures on psychoanalysis. New York: W. W. Norton.
  20. Gabbard, G.O. (2000). Psychodynamic psychotherapy in clinical practice (3rd). Washington, DC: American Psychiatric Press.
  21. Gabbard, G.O. (2004). Long-term psychodynamic psychotherapy. Washington, DC: American Psychiatric Publishing Incorporated.
  22. Gay, P. (1988). Freud: A life for our time. New York: Norton.
  23. Gillett, G. (2001). Signification and the unconscious. Philosophical Psychology, 14, 477-498.
  24. Gorog, J. (2009). Le réel et le travail de l’inconscient. Analyse Freudienne Presse, 16(1), p.115.
  25. Gravitz, M. A., & Gerton, M. I. (1981). Freud and hypnosis: Report of post-rejection use. Journal of the History of the Behavioural Sciences, 17, 68-74.
  26. Greenberg, J. (2001a). The analysts’s participation: A new look. Journal of the American Psychoanalytic Association, 49, 359-381.
  27. Greenberg, J.R. (1986). Theoretical models and the analyst’s neutrality. Contemporary Psychoanalysis, 22, 87-106.
  28. Hale, N. G. (1971). Freud and the Americans. New York: Oxford University Press.
  29. Hall, C. S., & Lindzey, G. (1970). Theories of personality (2nd).  New York:  Wiley & Sons.
  30. Hall, C. S., & Lindzey, G. (1970). Theories of personality (Rev. ed.). New York: Wiley
  31. Haslam, N., Smilie, L., & Song, J. (2017) An Introduction to Personality, Individual Differences and Intelligence (2 Eds.). Sage Publications Ltd.
  32. Hivernel, F. (2013). “The parental couple”:  Franciose Dolto and Jacaues Lacan:  Contributions to the mirror stage.  British Journal of Psychotherapy, 29, 505-518.
  33. Huprich, S. K. (2008). Psychodynamic Therapy: Conceptual and Empirical Foundations. Routledge
  34. Ittleson, W.H. & Kilpatrict, F.P. (1981). Experiments in perception. Scientific American, 185, 50-55.
  35. Jardim, L. L., Costa Pereira, M. E., & de Souza Palma, M. (2011). Fragments of the Other:  A psychoanalytic approach to the ego in schizophrenia.  International Forum of Psychoanalysis, 20, 159-166.
  36. Jones, E. (1955). The life and work of Sigmund Freud. New York: Basic Books.
  37. Jones, R. L. (1994). An Empirical Study of Freud’s Penis-Baby Equation. The Journal of Nervous and Mental Disease, 182(3), 127–135
  38. Jung, C. G. (1933). Modern man in search of a soul. New York: Harcourt Brace.
  39. Jung, C. G. (1953). Psychological reflections (J. Jacobi, Ed.). New York : Harper & Row.
  40. Jung, C. G. (1959). The basic writings of C. G. Jung. New York: Random House.
  41. Kainer, R. G. (1984). Art and the canvas of the self: Otto Rank and creative transcendence. American Imagi, 14, 359-372.
  42. Kapnist, E. (2001). Jacques Lacan : La psychanalyse réinventée. ARTE France, INA
  43. La-Philosophie.com : Cours, Résumés & Citations de Philosophie. (2020). La philosophie de Nietzsche. [online] Available at: https://la-philosophie.com/philosophie-nietzsche [Accessed 20 Jan. 2020].
  44. La-Philosophie.com : Cours, Résumés & Citations de Philosophie. (2020). La philosophie de Spinoza. [online] Available at: https://la-philosophie.com/philosophie-spinoza [Accessed 20 Jan. 2020].
  45. LeDoux, J. (1989). Cognitive-emotional interactions in the brain. Cognition and Emotion, 3, 267-289.
  46. LeDoux, J. (1995). Emotion: Clues from the brain. Annual Review of Psychology, 46, 209-235.
  47. Leichsenring, F. & Rabung, S. (2011). Long-term psychodynamic psychotherapy in complex mental disorders: A meta-analysis. British Journal of Psychiatry, 199, 15-22.
  48. Leichsenring, F., Rabung, S. & Leibing, E. (2004). The efficacy of short-term psychodynamic psychotherapy in specific psychiatric disorders: A meta-analysis. Archives of General Psychiatry, 61, 1208-1216.
  49. Lewis, J.L. (1970). Semantic processing of unattended messages during dichotic listening. Journal of Experimental Psychology, 85, 225-228.
  50. Luepnitz, D. A. (2009). Thinking in the space between Winnicott and Lacan.  International Journal of Psychoanalysis, 90, 957-981.
  51. Macmillan, M. (1985). Souvenir de la Salpêtrière: M. le Dr. Freud à Paris, 1885. New Zealand Journal of Psychology, 14, 41-57.
  52. Malin, B. D. (2011). Kohut and Lacan:  Mirror opposites.  Psychoanalytic Inquiry, 31, 58-74.
  53. Malone, K. R. (2012). Lacan, Freud, the humanities, and science.  Humanistic Psychologist, 40, 246-257.
  54. Marder, E. (2013). Real dreams.  Southern Journal of Philosophy, 51, 196-213.
  55. McSherry, A. (2013). Jacques Lacan’s theory of the subject as real, symbolic and imaginary:  How can Lacanian theory be of help to mental health nursing practice?  Journal of Psychiatric and Mental Health Nursing, 20, 776-781.
  56. Meyer, P. (2001). Freud and the human sciences.  Annals of Psychoanalysis, 29, 247-258.
  57. Miller, J. and Lacan, J. (2017). Jacques Lacan : Conférence de Louvain. La Cause Du Désir, N° 96(2), p.7.
  58. Milner, B., Corkin, S. & Teuber, H.L. (1968). Further analysis of the hippocampal amnesic syndrome Fourteen year follow-up study of H.M. Neuropsychologia, 6, 215-234.
  59. Morrison, C., Bradley, R., & Westen, D. (2003). The external validity of efficacy trials for depression and anxiety: A naturalistic study. Psycology and Psychotherapy: Theory, Research, and Practice, 76, 109-132.
  60. Norcross, J.C. (2002a). Empirically supported therapy realationships. In J.C. Norcross (Ed.), Psychotherapy relationships that work. New York: Oxford.
  61. Orlinsky, D. & Howard, K.E. (1977). The therapist’s experience of psychotherapy. In A.S. Gurman & A.M. Razin (Eds.), Effective psychotherapy: A handbook of research, 566-589. New York: Pergamon.
  62. Pine, F. (1998). Diversity and direction in psychoanalytic technique. New haven, CT: Yale University Press.
  63. Rocha, G. M. (2012). The unconscious:  Ideal worker?  International Forum of Psychoanalysis, 21, 17-21.
  64. Roudinesco, E. (1993). Jacques Lacan : Esquisse d’une vie, histoire d’un système de pensée. Fayard.
  65. Samuels, A. (1994). The professionalisation of Carl G. Jung’s analytical psychology clubs. Journal of the History of the Behavioural Sciences, 30, 138-147.
  66. Savage, J.E., Jansen, P.R., Stringer, S., et al. (2018). Genome-wide association meta-analysis in 269,867 individuals identifies new genetic and functional links to intelligence. Nat Genet 50912–919
  67. Schick, A. (1968 – 1969). The Vienna of Sigmund Freud. Psychoanalytic Review, 55, 529-551.
  68. Schmutte, H. (2016). Nietzsche : entre génie et démence. ARTE. [online] Available at: https://www.youtube.com/watch?v=25uLlN5uNF0 [Accessed 9 Feb. 2020].
  69. Sephora, M. (2018). A quoi ça sert l’art ?. Ap.D Connaissances. [online] Available at: https://apdconnaissances.com/2018/04/02/a-quoi-ca-sert-lart/ [Accessed 20 Jan. 2020].
  70. Shevrin, H. & Dickman, S. (1980). The psychological unconscious: A necessary assumption for all psychological theory? American Psychologist, 35, 421-434.
  71. Shevrin, H. & Fisher, C. (1967). Changes in the effects of a waking subliminal stimulus as a functioning of dreaming and non-dreaming sleep. Journal of Abnormal Psychology, 72, 362-368.
  72. Shevrin, H. (1973). Brain wave correlates of subliminal stimulation, unconscious attention, primary and secondary-process thinking and repressiveness. Psychological Issues, 30, 56-87.
  73. Shevrin, H. (1986). Subliminal perception and dreaming. Journal of Mind and Behaviour, 7, 379-395.
  74. Shevrin, H. (1988). Unconscious conflict: A convergent psychodynamic and electrophysiological approach. In M. J. Horowitz (Ed.), Psychodynamics and cognition, pp, 117-167. Chicago, IL: University of Chicago Press.
  75. Shevrin, H. (1990). Subliminal perception and repression. In J.L Singer (Ed.), Repression and dissociation: Implications for personality theory, psychopathology, and health, 103-119. Chicago, IL: University of Chicago Press.
  76. Shevrin, H. (1996). Psychoanalytic research: Experimental evidence in support of basic psychoanalytic assumptions. In E. Nersessian & R.G. Kopff, Jr. (Eds.), Textbook of psychoanalysis, 575-603. Washington, DC: American Psychiatric Press.
  77. Shevrin, H. (2006). The contribution of cognitive behavioural and neurophysiological frames of reference to a psychodynamic nosology of mental illness. In Alliance of Psychoanalytic Organisations, Psychodynamic diagnostic manual (PDM), 483-509. Silver Spring, MD: Alliance of Psychoanalytic Organisations.
  78. Shevrin, H., Bond, J., Brakel, L, Hertel, R., & Williams, W.J. (1996). Conscious and unconscious processes: Psychodynamic, cognitive, and neurophysiological convergences. New York: Guilford.
  79. Shevrin, H., Williams, W.J., Marshall, R.E., Hertel, R.K., Bong, J.A. & Brakel, L.A.W. (1992). Event-related potential indicators of the dynamic unconscious. Consciousness and Cognition, 1, 340-366.
  80. Silverman, D.K. (1986). Some proposed modifications of psychoanalytic theories of early child development. In J. Masling, (Ed.), Empirical studies of psychoanalytic theories, 49-72. Hillsdale, NJ: Erlbaum.
  81. Silverman, L.H., Bronstein, A. & Mendelsohn, E. (1976). The further use of psychodynamic activation method for experimental study of the clinical theory of psychoanalysis: On the specificity of the relationships between symptoms and unconscious conflicts. Psychotherapy: Theory, Research, and Practice, 13, 2 -16.
  82. Silverman, L.H., Kwawer, J.S., Wolitzky, C. & Coron, M. (1973). An experimental study of aspects of the psychoanalytic theory of male homosexuality. Journal of Abnormal Psychology, 82, 178-88.
  83. Silverman, L.H., Lachman, F.M. & Milich, R.H. (1982). The search for oneness. New York: International University Press.
  84. Silverman, L.H., Ross, D.L., Adler, J.M. & Lustig, D.A. (1978). Simple research paradigm for demonstrating subliminal activation effects: Effects of Oedipal stimuli on dart-throwing accuracy in college males. Journal of Abnormal Psychology, 87, 341-347.
  85. Silverman, L.S. (1983). The psychodynamic activation method: Overview and comprehensive listing of studies. In J. Masling (Ed.), Empirical studies of psychoanalytic theories (Vol. 1), pp. 69-100. Hillsdale, NJ: Erlbaum.
  86. Sirkin, M., & Fleming, M. (1982). Freud’s “project” and its relationship to psychoanalytic theory. Journal of the History of the Behavioural Sciences, 18, 230-241.
  87. Solms, M. (2000a). A psychoanalytic contribution to contemporary neuroscience. In G.vandeVijver&F.Geerardyn(Eds.), The pre-psychoanalytic writings of Sigmund Freud, 17-35. London: Karnac Books.
  88. Solms, M. (2000b). Preliminaries for an integration of psychoanalysis and neuroscience. Annals of Psychoanalysis, 28, 179-200.
  89. Solms, M. (2001). The interpretation of dreams and the neurosciences. Psychoanalytic History, 3, 79-91.
  90. Solms, M. (2002). An introduction to the neuroscientific works of Sigmund Freud. In M Velmans (Ed.), Investigating phenomenal consciousness: New methodologies and maps. Advances in Consciousness Research Series (M. Stamenov, Seried Ed.), pp. 67-95. Amsterdam: John Benjamins Publishing.
  91. Solms, M. (2004). Is the brain more real than the mind? In A. Casement (Ed.), Who owns psychoanalysis?, 323-324. London: Karnac.
  92. Solomon, H. M. (2003). Freud and Jung:  An incomplete encounter.  Journal of Analytical Psychology, 48, 553-569.
  93. Spence, D.P. (1980). Narrative truth and historical truth: Meaning and interpretation in psychoanalysis. New York: W.W. Norton.
  94. Stockholder, K. (1998). Lacan versus Freud:  Subverting the Enlightenment.  American Imago, 55, 361-422.
  95. Stolorow, R.D., Atwood, G.E. & Brandchaft, B. (1994). The intersubjective perspective. Northvale, NJ: Aronson.
  96. Task Force on Promotion and Dissemination of Psychological Procedures (1995). Training in and dissemination of empirically validated psychological treatments: Report and recommendations. Clinical Psychologist, 48, 2-23.
  97. Task Force on Psychological Intervention Guidelines (1995). Template for developing guidelines: Interventions for mental disorders and psycho-social aspects of physical disorders. Washington, DC: American Psychological Association.
  98. Thompson-Brenner, H., Glass, S., & Westen, D. (2003). A multidimensional meta-analysis of psychotherapy for bulimia nervosa. Clinical Psychology: Science and Practice, 10, 269-287.
  99. Waintrater, R. (2012). Intersubjectivity and French psychoanalysis:  A misunderstanding?  Studies in Gender and Sexuality, 13, 295-302.
  100. Wallerstein, R.S. (2002). The growth and transformation of American ego psychology. Journal of the American Psychoanalytic Association, 50, 135-169.
  101. Wampold, B.E. (2001). The great psychotherapy debate: Models, methods, and findings. Mahwah, NJ: Erlbaum.
  102. Weinberger, J. & Hardaway, R. (1990). Separating science from myth in subliminal psychodynamic activation. Clinical Psychology Review, 10, 727-756.
  103. Weitz, L. WJ. (1976). Jung’s and Freud’s contributions to dream interpretation:  A comparison.  American Journal of Psychotherapy, 30, 289-293.
  104. Westen, D. & Gabbard, G.O. (2002b). Developments in cognitive neuroscience: II. Implications for theories of transference. Journal of the American Psychoanalytic Association, 50, 99-134.
  105. Westen, D. & Morrison, K. (2001). A multidimensional meta-analysis of treatments for depression, panic and generalised anxiety disorder: An empirical examination of the status of empirically supported therapies. Journal of Consulting and Clinical Psychology, 69, 875-899.
  106. Westen, D. (1999). The scientific status of unconscious processes: Is Freud really dead? Journal of the American Psychoanalytic Association, 47, 1061-1106.
  107. Westen, D., Novotny, C.M., & Thompson-Brenner, H. (2004). The empirical status of empirically supported psychotherapies: Assumptions, findings, and reporting in controlled clinical traits. Psychological Bulletin, 130, 633-663.
  108. Yang, J. and Li, P. (2012). Brain Networks of Explicit and Implicit Learning. PLoS ONE, 7(8), p.e42993.

 

Mis-à-jour le Jeudi, 16 Avril 2020 | Danny J. D’Purb | DPURB.com

____________________________________________________

While the aim of the community at dpurb.com has  been & will always be to focus on a modern & progressive culture, human progress, scientific research, philosophical advancement & a future in harmony with our natural environment; the tireless efforts in researching & providing our valued audience the latest & finest information in various fields unfortunately takes its toll on our very human admins, who along with the time sacrificed & the pleasure of contributing in advancing our world through sensitive discussions & progressive ideas, have to deal with the stresses that test even the toughest of minds. Your valued support would ensure our work remains at its standards and remind our admins that their efforts are appreciated while also allowing you to take pride in our journey towards an enlightened human civilization. Your support would benefit a cause that focuses on mankind, current & future generations.

Thank you once again for your time.

Please feel free to support us by considering a donation.

Sincerely,

The Team @ dpurb.com

Donate Button with Credit Cards

Essay // Clinical Psychology: Controversies that surround modern day mental health practice

MentalHealth

Modern day mental health practice could be defined as the application of the four main schools of thoughts that dominate the field of psychology in the clinical setting, by abiding to strict criteria set out by packaged behavioural sets, diagnostically defined by names and categorised depending on the core nature of their specific characteristics in terms of behaviour, aetiology and epidemiology. While these four [biological, psychodynamic, cognitive-behavioural & systemic] main schools of thought have contributed to the development and ongoing evolution of the field of psychology, they also have downsides when applied to different types of psychological cases, with some being more efficient in treating particular disorders while others being hardly efficient and questionable. Applying and integrating these four schools of thoughts with new intuitive fact-based theories to explain psychological constructs and disorders are leading to major innovations in psychology; however with each field’s limitations controversies over the validity of their interpretations and the efficiency of their applied doctrines remain a constant topic of debate among scholars and clinicians.

One of the main controversies that surround modern day mental health practice is the medicalisation of psychological disorders, a tradition influenced by the field of medicine which contradicts an important founding philosophy of psychology, which was originally initiated to study the “mind”, not the physical characteristics of the brain as an organ. Furthermore, evidence suggests that psychological problems are not caused exclusively by organic factors. In anxiety, depression and/or schizophrenia, people with genetic vulnerability to the development of those psychological disorders only do so when exposed to particular stresses in their environment (Hankin & Abele, 2005). However, on the other side of the argument, evidence has also shown that deficiencies in genetics and neurobiological anatomy are linked to psychological difficulties and disorders, and hence nowadays, integrated approaches are used in a variety of assessments when treating patients affected by psychological disorders.

On the theme of medicalization, the debate over eating disorders has led to one of the major controversies within the field between advocates of the biomedical conceptualisation of eating disorders and the feminist position (Maine & Bunnell, 2010). The former sees an individual woman as a patient with a debilitating disease, in need of a cure to her illness; while the feminist position views eating disorders as a condition that is gender specific with the woman as a victim of socio-cultural pressures generated by a male-dominated society governed by a hedonistic economic reality focused on the pursuit of the thin ideal. There is an important distinction that should be made here for the benefit of patients since the feminist view may not fully comprehend that in the case of obesity and emaciation related to eating-disorders, the patients are at severe risk of medical complications such as growth retardation, osteoporosis, gastrointestinal bleeding, dehydration, electrolyte abnormalities and cardiac arrest [in chronic cases]. The social feminist constructivist perspective may be interpreting eating disorder as an image debate of “Fat” versus “Thin”. This may lead to the normalisation of obesity and destructive eating habits which in turn may result in further medical complications that involve surgical interventions. As for the feminists, it may be ethical to acknowledge that obesity & emaciation associated with eating disorders are major health issues that precede further complications such as diabetes, cancer and high blood pressure; and should not be confused with social stigma regarding image, but seen as a sign of poor-health and lifestyle that require attention and effort in providing patients with the medical and psychological help they need to adjust their patterns of life to a healthy one by adopting a culture synchronised with dietary & nutritional education.

Secondly, the medicalization of anxiety disorders as distinct medical & psychological conditions may seem less favourable to the biological model previously mentioned. A mass market of pharmacological products used in treatment has been favoured for being more convenient and less time consuming. This may lead to patients feeling disempowered and hopeless when being treated as victims of an uncontrollable illnesses requiring pharmacological treatment, while already being in a state of distress, shock, disbelief and/or confusion.

Number of people who take antidepressants

Diazepam (Valium) or other benzodiazepines that are highly addictive have also been prescribed for years to treat anxiety disorders. The long term side effects have been trivialised along with the arrogant act of medicalizing fear and courage (Breggin, 1991). Critics of the medicalization of experiences argue that if patients are helped in understanding that panic attacks develop from the misrepresentation of bodily sensations and hyperventilation, this knowledge along with their own courage may strengthen them to take control of their fear. Research has also shown how patients who are educated in cognitive-behaviour techniques learn to use problem-solving and develop other skills (e.g. social – help them build meaningful lasting relationships while letting go of psychosocial burdens) that they lack to reappraise situations that may formerly have brought distress.

TheDownfallOfTheWildAnimals.jpg

The tragic death of one of the most talented vocalists on the planet, Chris Cornell, has sent a shock throughout the arts world and reports have revealed that the gifted artist was on Lorazepam [a benzodiazepine medication sold under the name Ativan used in the treatment of anxiety disorders], the substance is known to heighten the risk of suicide in those suffering from depression, while a recent investigation (Bushnell et al., 2017) has also shown no meaningful clinical benefit from the addition of benzodiazepines during treatment initiation.

Global Suicide rate per 100 000 population

Suicide Rates Around the World per 100 000 (2016)

Estimated rate of suicide per 100,000 population in selected countries in 2016. / Source: Statista

To prevent such tragedies from affecting the human race, more emphasis could be placed on « the mind » with clear guidance on the « thinking styles » (cognitive scripts) to adopt in the protection of the individual organism’s own psyche (mind). Simple foundations based on psychological logic should be propagated educationally to help people understand their uniqueness as organisms while protecting their psyche [mind] from the influence/control of external environmental factors that are beyond their control [e.g. biased negativity, uninformed prejudicial comments of meaningless acquaintances, etc]; acknowledging the fact that as long as an individual organism is within the boundaries of the law, he is allowed to live the life of his choice, and external factors would only affect one’s psyche if attention is given to them; and selectively ignoring parts of the environment  is also an acquired skill vital in maintaining sanity, along with the ability to select experiences that are positive & progressive to the organism [while discarding negative ones] in the context and theme of their chosen individual lifestyles.

ChrisCornell

An artist many might consider to be the Fréderic Chopin & the Edouard Manet of Rock, composing with his heart and painting with his voice, enigmatic vocalist Chris Cornell, known for timeless titles such as « What You Are« , « Like A Stone« , « The Last Remaining Light« , « Exploder« , « Be Yourself« , « Getaway Car » & « Dandelion » left a hole in the hearts of millions touched by his work. His tragic death is a reminder that further research is required in understanding the thought structure of artistic individuals whose psychological subjective reality would likely be deeper and more complex compared to the average person – an approach focusing on the « mind » rather than the « behaviour or brain » in the tradition of Sigmund Freud would likely reveal and explain the granularity of their psyche; and whether their suicidal decisions are rooted in full awareness and motivated by a reality they consider to be inadequate for their state of consciousness and IQ; and whether appropriate interventions involving the restructuration of their psychosocial patterns/exposure [to prevent the burden of stress] may be more individualistic & appropriate.

This would also shift the focus to the individual’s mind, courage & abilities to handle the world while maintaining a stable sense of self and resilience; and not turn them into biological organisms that are having their neurochemistry savagely altered by powerful chemical substances that are known to affect individuals differently with dangerous & sometimes fatal outcomes.

PrinciplesOfPsychology

The same would apply to sufferers of post-traumatic stress disorder who would benefit of a non-pharmacological and empowering intervention to manage and take control of recurrent intrusive and distressing memories – it may be useful to study fear, distress and courage as normal psychological processes happening on a dimensional scale on a normal continuum from one individual to another where those on the extreme ends of the scales may be considered for psychological interventions.

Similarly, antidepressant medication used to treat depression remains controversial due to its questionable efficacy and side-effects. The high level of effectiveness of SSRIs reported in academic journals was greatly due to only trials with positive results of antidepressants being published while those where antidepressants were found to be no more effective than placebos being rejected. The effects of TCAs and SSRIs have also been found to be negligible in mild to moderate depression but effective in severe depression in meta-analyses (Fournier et al., 2010). The negative side-effects of antidepressants are known to be risky and dangerous where symptoms such as loss of sexual desire and impotence, weight gain, nausea, sedation or activation, and dizziness are known to be some of the more disturbing ones, with effects varying with types of antidepressants – for depressed pregnant women, health risks may affect their offspring. Dangerous antidepressants such as MAOIs are only prescribed to patients who can follow strict dietary patterns that exclude foods with thyramine (e.g. cheese) to prevent risks of high blood pressure and hypertensive crises. Although meta-analyses suggest benefits may outweigh the risks, an increased risk of suicide has also been noted among patients under 25 (Bridge et al., 2007).

Edouard Manet - Le Suicide

Edouard Manet (1832 – 1883), « Le Suicidé« 

Electroconvulsive therapy has also sparked a major controversy as a primitive, dangerous and non-scientific practice for the brevity of its effect and negative side-effects on memory (Read & Bentall, 2010). A thorough review of studies on the effectiveness of ECT and its side-effects [retrograde and anterograde amnesia] revealed it to be effective for a brief duration in treating severe depression [in cases that are unresponsive to psychological treatment] and questionably only supported by psychiatrists with a vested interest in proving ECT’s effectiveness. ECT has also been associated with a slight but significant risk of death, and a qualitative study of patients’ negative experiences concluded that for some ECT leads to fear, shame and humiliation, and reinforces experiences of worthlessness and helplessness associated with depression.

brainbuilding

Medicalization has also led to controversy over the diagnosis of schizophrenia, a condition classified as a disease by the World Health Organization and ranked second only to cardiovascular diseases in terms of overall disease burden internationally (Murray & Lopez, 1996). Diagnosis is believed to be part of best practice in the patient’s “best” interest, however a strongly presented viewpoint by Thomas Szasz (2010) qualified diagnosis as an act of oppression as it may pave way for involuntary hospitalisation; where a deviant, maladjusted or poorly educated person may be subjected to « control » processes that they are not fully aware of – this has been proposed as a « possible » explanation for the greater rates of schizophrenia among ethnic minorities (particularly Africans in the US & those of low-SES groups). This view has also been supported by many who argue that schizophrenia as a distinct category may not be a fully valid diagnostic, but a fabrication constructed that may stigmatise disadvantaged or poorly educated people – while this may be positive in shaping « unacceptable behaviour » and protect citizens & society, some people with moderate symptoms may also be forcefully hospitalised. Thus, nowadays, schizophrenia is not a single definite disorder anymore, but one among others, as it has been revised and turned into a spectrum, known as the schizoid spectrum [with other related disorders]. In the treatment of schizophrenia, medicalisation has also led to the evaluation of psychotherapy as a possibly ineffective treatment (Lehman & Steinwachs, 1998). Freud & others in his discipline acknowledged the treatment of psychosis as problematic with psychotherapy as psychotic individuals tend not to develop transference [interpretation of their hidden feelings, defences & anxiety] to the analyst – unlike neurotic patients. For personality disorders, addictions and other severe mental health problems medicalisation has led to the development of alternative methods of treatment that unlike the traditional authoritarian & hierarchically organised inpatient mental health settings, are run in a more democratic line where service users are encouraged to take an active role in their rehabilitation rather than simply being passive recipients of treatment.

clinicalpsychology

Therapeutic communities have turned out to be effective in the long-term treatment of difficult patients with severe personality disorders with the outcome being more positive with longer treatments. These therapeutic communities are believed to lead to improvements in mental health and interpersonal functioning. For drug misuse issues, the assumption that clinicians make over users attempt to quit being due to conscious guidance & coherent plans should be revised as no evidence suggests so, and more evidence argue that unconscious processes, classical and operant conditioning, erratic impulses, and highly specific environmental cues affect the development and cessation of drug use (West, 2006). According to West, interventions should not stimulate adolescents to think of what ‘stage’ they are in or be matched to a stage, but maximum tolerable pressure should be put on the young person to cease drug use – which contradicts the stages of change model (DiClemente, 2003; Prochaska et al., 1992) where 30 days are allocated to stages [pre-contemplation, contemplation, action & maintenance] based on no evidence. While concepts such as harm reduction programmes with needle exchange, safe injection sites, and the provisions of free tests of quality of MDMA sold at raves remain controversial, some believe they prevent mortality and morbidity (Marlatt & Witkiewitz, 2010), while others argue they send the message that hard drug use [such as heroin] may be acceptable.

The second major controversy in modern day mental health practice remains the “Person or Context” debate where many in the field still question the validity of focusing on context as it shifts attention from the individualistic characteristics of the patient, and whether the focus should shift depending on the disorder and the patient’s age. For example in the treatment of childhood disorders, if difficulties are assumed to be individual ‘psychiatric’ illnesses the risk of focus being solely on the child and not on broader social environment may lead to medical treatments and individual therapy without addressing important risk factors for those of such young age who are influenced by their social environment, e.g. teacher, school and wider social context. This may not be the case for some adults who value a sense of autonomy more than being influenced by wider social contexts that they have no connection to, interest in or affinity for. In contrast, to the autonomic adult, treatment cases of other childhood behaviour disorders such as oppositional defiant disorder and conduct disorders may be particularly problematic, since the major risk factors that should be addressed are social: through interventions such as parent training, family therapy, multisystemic therapy and treatment foster care. For ADHD, the bold emphasis on medication is dangerous as the effects are limited to only 3 years (Swanson & Volkow, 2009), while growth and cardiovascular functioning may be affected that may lead to somatic complaints such as loss of appetite, headaches, insomnia and tics, which are present in 5-12% of cases (Breggin, 2001; Paykina et al., 2007; Rapport & Moffitt, 2002).

Another interesting argument comes from the Scottish psychiatrist and psychoanalyst R. D. Laing (2009) in the 1960s and 1970s who opposed the view that schizophrenia was a genetically based medical condition requiring treatment with antipsychotic medication. His dimensional approach led him to view schizophrenia as a ‘sane reaction to an insane situation’ where the contents of psychotic symptoms were simply viewed as psychological responses to complex, confusing, conflicting and powerful parental injunctions that left no scope for more rational and adaptive modes of expression. Thus, Laing proposed that the treatment involved creating a context where insight into the complex family process [e.g. poor housing, low SES, deviant parents with drug problems, over-involved family members who maintain the patient’s stress, alcohol problems, sexual deviance, incest, lack of financial stability, poor educational motivation, poor emotional education, lack of problem solving skills, lack of sophistication, poor nutrition, restricted finances, etc] of patients with schizophrenia and psychotic response to these could be facilitated. The context here seems partially important in the case where the patient’s delusions and hallucinations are linked, where their interpretation would be the client’s response to conflicting parental injunctions. The experience of psychosis and recovery was a process where the individual could emerge stronger with new and valuable insights regarding the solutions to their problems. However, this has not been supported by any evidence or subsequent research. In contrast, strong scientific evidence points to the importance of a more client-centred individual approach focussed solely on the patient with defective inherited neurobiological factors as major focus for the role they play in schizophrenia, and antipsychotic medication for the reduction of symptoms in two-thirds of psychotic patients affected (Ritsner & Gottesman, 2011; Tandon et al., 2010). Research has supported the hypothesis that suggests the family does affect the psychotic process and that psychotherapy has a place in the management of psychosis, for example personal trauma, including child abuse increases the risk of psychosis, and stressful life events including those within the family can precipitate an episode of psychosis, and high levels of family criticism, hostility and emotional over-involvement increase the risk of relapse (Bebbington & Kuipers, 2008; Hooley, 2007; Shelvin et al., 2008). So for those with a strong sense of family, and heavily involved peers, family therapy delays relapse in troubled families characterized by « extreme » levels of expressed emotion; and cognitive behaviour therapy which stresses the idea that psychotic symptoms are understandable and on a continuum with normal experience can help patients control these psychotic symptoms (Tandon et al., 2010), with solutions to rebuild their lives, their own identity and manage their social circle intelligently by differentiating types of relationship and expectations.

personality

The third and last controversy to be addressed is the ongoing debate in clinical psychology over the categorisation of psychological disorders where many have been arguing over a dimensional outlook on psychological conditions that offers more precision in diagnosis along with a more scientific approach. In the case of childhood behaviour disorders with regard to scientific approaches, there is an ongoing debate over whether they should be viewed and classified in categorical or dimensional terms. While DSM are based on rigid categories, most empirical studies support the view of a dimensional outlook. Furthermore, factor analytic studies consistently show that common childhood difficulties belong to two dimensions of internalizing and externalizing behaviour, which are normally distributed within the population (Achenbach, 2009). Young children diagnosed with oppositional defiant disorder (ODD), conduct disorder and ADHD are part of a subgroup of cases with extreme externalizing behavioural problems, while those with anxiety or depressive disorders have extreme internalizing behaviour problems (Carr, 2006a). By the same dimensional approach, children diagnosed with intellectual disability fall at the lower end of the continuum of intelligence, a trait also normally distributed within the population (Carr et al., 2007). The dimensional approach is not only more scientific, but also has a less stigmatizing and rational approach to human uniqueness. The dimensional approach has also enhanced the movement critical of qualifying psychological deficiencies as ‘real psychiatric illnesses’, conditions such as ADHD, conduct disorder and other DSM diagnoses. Questions have been raised over whether they are invalid fabrications or spurious social constructions (Kutchins & Kirk, 1999). Those who trust the evidence of the dimensionality of childhood disorders argue that they may simply be traits distributed normally among the population where some cases fall on the extreme ends of certain traits, while those who point to the interests of pharmaceutical industries’ financial motives argue that they are spurious social constructions. The latter seems unethical but is a part of the decadent and immoral economic reality that we have allowed to exist. As parents, health and educational professionals, it is clear that the pharmaceutical industry and governments may all gain from conceptualising children’s psychological difficulties as ‘real psychiatric illnesses’. Some schools or uncaring parents may prefer children to receive a diagnosis of ADHD with stimulant therapy as they may have difficulty meeting their needs for intellectual stimulation, nurturance and clear limit-setting; thus these children in their care become more aggressive and disruptive.

In the case of schizophrenia, a dimensional approach has also led to the schizotypy construct as a dimensional alternative to the prevailing categorical conceptualization of schizophrenia (Lenzenweger, 2010). In contrast to the categorical view based on Kraepelin’s (1899) work and used in the DSM which sees schizophrenia as a discrete diagnostic category, this one proposes that anomalous sensory experiences, odd beliefs and disorganized thinking exist in extreme forms of schizophrenia as hallucinations, delusions and thought disorder, but these are simply on continuum with normal experience [i.e. it is present in all ‘normal’ people but peaks in abnormal ones] – a position originally advocated by Bleuler (1911). Research measures have provided support for the dimensional construct of schizotypy (Lenzenweger, 2010) where the continuum may be composed of sub-dimensions; from normal to psychotic experiences. Schizotypy is heritable; and patients with high schizotypy scores but who are not psychotic show attentional, eye-movement and other neuropsychological abnormalities associated with schizophrenia. Further, the dimensional approach has also led to the distinction between schizophrenia and split personality where 40% in the UK equated split or multiple personality with schizophrenia – as popular culture often does. It is clear that schizophrenia does not refer to such characteristics.

dr_jekyll_and_mr_hyde_poster_d'purb

The closest equivalent to split personality is a condition known as dissociative identity disorder (DID), where the central feature is the apparent existence of two or more distinct personalities within the same individual, with only one being evident at a time. Each personality (or alter) is distinct with its own memories, behaviour and interpersonal style. In most cases, the host personality is unaware of the existence of alters and these vary in knowledge of each other. Evidence suggests that the capacity to dissociate is normally distributed within the population and an attribute many use to manage their own lives and network. Those with high degree of this trait may cope by dissociating their consciousness from the experience of trauma (such as child abuse, extreme graphic violence, etc) in early childhood by entering a trance-like state. This dissociative habit is negatively reinforced (strengthened) as an effective distress-reducing coping strategy over repeated traumas in early childhood as it brings relief from distress during trauma exposure. Eventually a sufficient number of experiences become dissociated to constitute a separate personality that may be activated in later life at times of stress or trauma through suggestion in hypnotic psychotherapeutic situations. Treatment often simply involves helping clients integrate the multiple personalities into a single personality and develop non-dissociative strategies for dealing with stress [e.g. argument with work colleagues, new manager, divorce, adolescents leaving home for studies, partner with alcohol problems, over-involved family members, etc] – this helps them deal with tough situations by facing them with problem-solving abilities and skills to come out with a firm resolution and have their views understood. Core symptoms of multiple personality disorder are not treated with psychotropic medication unlike schizophrenia but involves psychological education for patients to learn the skill of mentalizing [understand their own state of mind and that of others].

whoareyou

Finally, with personality disorders, the dimensional approach has led to the trait theory in conceptualizing important aspects of behaviour and experience from a limited number of dimensions. Any given trait is believed to be normally distributed in the population, for example, introversion – extraversion, most people show a moderate level of the trait, however those who exhibit extremely low or high levels [extremes] would have the sort of difficulties attributed in the DSM. So, normal people only differ from the abnormal in the degree to which they show particular traits. The trait theory has become dominated by the five-factor theory (McCrae & Costa, 2008) in recent years. This model includes the dimensions: neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness. There is evidence for the heritability of all of factors within the Five Factor Model except agreeableness which seems to be predominantly determined by one’s environment (Costa & Widiger, 1994). Thomas Widiger has proposed that the five-factor model may be used as an alternative system for describing personality disorders (Widiger & Mullins-Sweatt, 2010). Widiger also argues that trait theory offers a more scientifically useful approach to assessment with good psychometric properties embraced by its questionnaires (De Raad & Perugini, 2002) – they are reliable and valid, and have population norms. Compared to categorical classification systems, trait models offer a more parsimonious way of describing patients with rigid dysfunctional behaviour patterns which in turn offers a more parsimonious way to conceptualize the development of effective treatments.

LondonCity

Photo: The Promise of Dawn (J.Hawkes)

The major controversies in modern day mental health practice seem to revolve around the precision and the validity of constructs as psychological illnesses, and since they may stigmatise those who suffer from them, the constant research into better and more modern interpretations and explanations of their characteristics and treatment seem bound to revolutionise the field of psychology, as the movement takes a more dimensional approach; with a new generation of psychologists applying the rules with an open mind and a creative outlook on new perspectives and methods – the field of psychology looks set on a positively progressive course.

UneNation

« A great aggregation of men sane in mind & warm in the heart, creates a moral conscience that is known as a nation » – Ernest Renan / Source: Université Paris 1 Panthéon-Sorbonne

Arthur Hughes - A Music Party 1864

Arthur Hughes (1832 – 1915), « A Music Party« 

****

References

  1. Achenbach, T. M. (2009). ASEBA: Development, findings, theory, and applications. Burlington, VT: University of Vermont Research Centre for Children, Youth and Families.
  2. Bleuler, E. (1911). Dementia praecox or the group of schizophrenias. New York: International University Press.
  3. Breggin (1991). Toxic psychiatry. London: Harper Collins.
  4. Breggin, P. (2001). Talking back to Ritalin: What doctors aren’t telling you about stimulants and ADHD. New York: Da Capo Press.
  5. Bridge, J. A., Iyengar, S., & Salary, C. B. (2007). Clinical response and risk for reported suicidal ideation and suicide attempts in paediatric antidepressant treatment: A meta-analysis of randomized controlled trials. Journal of the American Medical Association, 297, 1683-1696.
  6. Bushnell, G., Stürmer, T., Gaynes, B., Pate, V. and Miller, M. (2017). Simultaneous Antidepressant and Benzodiazepine New Use and Subsequent Long-term Benzodiazepine Use in Adults With Depression, United States, 2001-2014. JAMA Psychiatry, 74(7), p.747.
  7. Carr, A. (2006a). Handbook of child and adolescent clinical psychology: A contextual approach (second edition). London: Routledge.
  8. Carr, A. (2012). Clinical psychology. 1st ed. New York: Routledge.
  9. Carr, A., O’Reilly, G., Walsh, P., & McEvoy, J. (2007). Handbook of intellectual disability and clinical psychology practice. London: Brunner-Routledge.
  10. Costa, P. & Widiger, T. (1994). Personality disorders and the five factor model of personality. Washington, DC: APA.
  11. De Raad, B., & Perugini, M. (2002). Big five assessment. Bern, Switzerland: Hogrete & Huber.
  12. DiClemente, C. (2003). Addiction and change. New York: Guilford.
  13. Fournier, J., DeRubeis, R., Hollon, S., Dimidjian, S., Amsterdam, J., & Shelton, R. (2010). Antidepressant drug effects and depression severity. Journal of the American Medical Association, 303, 7-53.
  14. Hankin, B., & Abele, J. (2005). Developmental psychopathology: A vulnerability-stress perspective. Thousand Oakes, CA: Sage.
  15. Kraepelin, E. (1899). Psychiatrie (sixth edition). Leipzig, Germany: Barth.
  16. Kutchins, H. & Kirk, S. (1999). Making us crazy: DSM – The psychiatric bible and the creation of mental disorders. New York: Constable.
  17. Laing, R. D. (2009). Selected works of R. D. Laing, Volumes 1-7. (Vol. 1. The divided self. Vol 2. Self and others. Vol. 3. Reason and violence. Vol. 4. Sanity and madness in the family. Vol. 5. The politics of the family. Vol. 6. Interpersonal Perception. Vol. 7. Knots.) London: Routledge.
  18. Lehman, A., & Steinwachs, D. (1998). At issue: Translating research into practice: The Schizophrenia Patient Outcomes Research Team (PORT) treatment recommendations. Schizophrenia Bulletin, 2, 1-10.
  19. Lenzenweger, M. (2010). Schizotypy and schizophrenia. New York: Guilford.
  20. Maine, M. & Bunnell, D. (2010). A perfect biopsychosocial storm: Gender, culture, and eating disorders. In M. Maine, B. McGilley, & D. Bunnell (Eds.), Treatment of eating disorders: Bridging the research-practice gap (pp. 3-16). San Diego, CA: Elsevier.
  21. Marlatt, G. A., & Witkiewitz, K. (2010). Update on harm-reduction policy and intervention research. Annual Review of Clinical Psychology, 6, 591-606.
  22. McCrae, R. R., & Costa, P. T., Jr. (2008). The five-factor theory of personality. In O. P. John, R. W. Robins, & L. A. Pervin (Eds.), Handbook of personality: Theory and research (third edition, pp. 159-181). New York: Guildford Press.
  23. Murray, C., & Lopez, A. (1996). The global burden of disease: A comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Cambridge, MA: Harvard University Press.
  24. Paykina, N., Greenhill, L., & Gorman, J. (2007). Pharmacological treatments for attention-deficit hyperactivity disorder. In P. Nathan & J. Gorman (Eds.), A guide to treatments that work (Third Edition, pp.29-70). New York: Oxford University Press.
  25. Prochaska, J., DiClemente, C., & Norcross, J. (1992). In search of how people change: Applications to addictive behaviours. American Psychologist, 47, 1102-1114.
  26. Rapport, M. & Moffitt, C. (2002). Attention deficit/hyperactivity disorder and methylphenidate: A review of height/weight, cardiovascular, and somatic complaint side effects. Clinical Psychology Review, 22, 1107-1131.
  27. Read, J., & Bentall, R. (2010). The effectiveness of electroconvulsive therapy: A literature review. Epidemiologia e Psichiatria Sociale, 19, 333-347.
  28. Ritsner, M., & Gottesman, I. (2011). The schizophrenia construct after 100 years of challenges. In M. Ritsner (Ed.), Handbook of schizophrenia spectrum disorders, Volume I: Conceptual issues and neurobiological advances (pp. 1-44). New York: Springer.
  29. Swanson, J. M., & Volkow, N. D. (2009). Psychopharmacology: Concepts and opinions about the use of stimulant medications. Journal of Child Psychology and Psychiatry, 50 (1-2), 180-193.
  30. Szasz, T. (2010). Psychiatry, anti-psychiatry, critical psychiatry: What do these terms mean? Philosophy, Psychiatry, & Psychology, 17, 229-232.
  31. Tandon, R., Nasrallah, H. A., & Keshavan, M. S. (2010). Schizophrenia, “just the facts” 5. Treatment and prevention past, present and future. Schizophrenia Research, 122, 1-23.
  32. West, R. (2006). Theory of Addiction. Oxford: Blackwell.
  33. Widiger, T.A., & Mullins-Sweatt, S. N. (2010). Clinical utility of a dimensional model of personality disorder. Professional Psychology: Research and Practice, 41, 488-494.

 

Mis à jour le Mercredi, 26 Juin 2019 | Danny J. D’Purb | DPURB.com

____________________________________________________

While the aim of the community at dpurb.com has  been & will always be to focus on a modern & progressive culture, human progress, scientific research, philosophical advancement & a future in harmony with our natural environment; the tireless efforts in researching & providing our valued audience the latest & finest information in various fields unfortunately takes its toll on our very human admins, who along with the time sacrificed & the pleasure of contributing in advancing our world through sensitive discussions & progressive ideas, have to deal with the stresses that test even the toughest of minds. Your valued support would ensure our work remains at its standards and remind our admins that their efforts are appreciated while also allowing you to take pride in our journey towards an enlightened human civilization. Your support would benefit a cause that focuses on mankind, current & future generations.

Thank you once again for your time.

Please feel free to support us by considering a donation.

Sincerely,

The Team @ dpurb.com

Donate Button with Credit Cards

Essay // Psychological Explanations of Prejudice & Discrimination

Paralympic-Cheetah-blades

Prejudice and discrimination are usually classified as behavioural attitudes towards a certain group or individual based on a multitude of reasons [according to different psychological theories]. The main reasons for prejudice are believed to be rooted in individual psychological processes related to groups, social influence and/or upbringing.

Authoritarian Personality

One plausible explanation for prejudice is the authoritarian personality, which suggests that those belonging in the category are concerned with status and upholding conventions, are very conformist and tend to be obsequious to those they see as holding a higher status – while treating those ‘below’ with contemp. Authoritarian personality is believed to be the result of strict and punitive upbringing which later leads to hostility being directed towards disliked [justified or unjustified] groups through the process of « displacement ». Adorno et al (1950) found strong and positive correlations between respondents’ scores on the F-Scale and scores on other measures intended to assess anti-semitism (AS scale) and ethnocentrism (E scale). However, the PEC-scale (Political and economic conservatism) was not strongly related, which only led to the conclusion of how people who are anti-Semitic are also « likely » to be hostile towards most « out-groups ».

The Adorno et al (1950) test only consisted of agreement that could only be geared towards anti-Semitism, ethnocentrism and fascism, which might have led to the problem of acquiescent response. The fact that the interviewer knew the interviewee’s F-score might have also led to experimenter bias; and the theory also falls short in the explanation of mass changes in behaviour: “Antisemitism in Nazi Germany grew during a decade or so, which is much too short a time for a whole generation of German families to have adopted new forms of childrearing practices giving rise to authoritarian and prejudiced children (Brown, 1988)” [not plausible]. The reality is that anti-Semitism may have been the result of a more sinister social and economic problem caused, inflicted by or related to the jews powerful Zionist business associations on the German economy at a time where the country was suffering [people, heritage, identity, economy…].

Stereotyping

Social Roles

Individual identity differs according to heritage, education, language(s), individual choices, profession and social roles

Another form of prejudice is stereotyping, which plays a major part in the process of inter-cultural [note: culture may refer to groups defined by language, geography, religion, and other common similarities] prejudice where the root of its cause has proven to be fairly ambiguous in explanation.

Art - D'Purb Website

Groups founded and united based on the behavioural patterns of a particular geography [usually] tend to stereotype others negatively [i.e. out-group(s): the other group(s) with petty differences in the way they go by their daily activities as all human primates on this planet – as the chart below suggests].

Development Era_The World as One Consuming Unit

Where Do We Buy What? (Source: Statista)

It is believed that the process of stereotyping is the result of minimising mental effortreminiscent of Carl Jung‘s quote:

« Thinking is difficult, that is why most people judge. »

LesConsOseTout_Audiard

Stereotyping is linked to psychological processes within the individual and is assumed to be connected to environmental influences that lead to a prejudiced mind; where out-groups and there members are defined unrealistically by single characteristics (negative usually). Stereotyping can sometimes [at least when dealing with members of the public who may not be deemed as « intelligent or smart », even bordering on plain « stupid »] play a role in the legitimisation of prejudiced and discriminatory treatment of other individuals who simply [consciously or unconsciously] made the choice to live by different modes of group-oriented behavioural patterns (culture).

Rational reasoning and the humane ability to understand each group’s choices while also respecting each group’s boundaries [geographical, social, economic, psychosocial, linguistic, etc] are surprisingly never considered by individuals and authorities in the quest to correct the mistakes of a world designed on outdated ideologies [e.g. the scientifically poor logic of global communism] to design a new one based on creative scientific reasoning, evolutionary logic, design & progressive innovation.

Bloomsbury 113 D'Purb Website

Another reason why some individuals resort to stereotyping others may be insecurity. That is, some individuals may be frustrated at their inability to conquer other(s) who are above their league in terms of abilities and achievements, and may stereotype these individuals in their quest to compensate for their own lack of abilities and feeling of inferiority when faced with these individuals who are more talented than them. Arguably, it may also be that these petty common brains who stereotype, simply fear that their competitors may be able to excel and deliver a similar or even superior performance/output than them if not distracted and slowed by insignificant and childish acts of stereotyped behaviour.

Carl-Gustav-Jung

Traduction(EN): « Thinking is difficult, that is why most people judge. » -Carl G. Jung

Prejudice as an Illusionary Cure to Low Self-Esteem/Insecurity

The Social Learning Theory, on the other hand, assumes prejudice as the result of maintaining self-esteem of both the individual and the in-group (individuals with the same behavioural patterns as the individual/tribe) members – where one tends to be biased towards glorifying the group whilst also paying particular attention to criteria that make the group look better. This is related to our sense of identity being determined by the groups we belong to and thus tend to be biased towards favouring them. Tajfel et al (1982) showed how schoolboys chose the strategy to allocate more points to their own group at the expense of getting least overall – showing bias in the absence of competition. The two main problems however are the fact that [1] the tendency for favouritism might be group-oriented and not universal (Wetherall, 1982), and also how [2] most studies show bias towards in-group (which could not only be prejudice but stereotyping or other influences).

Unrealistic Conflict? Competition for the same Resource(s) while presuming in-group members to be « unconditional benefactors »

Finally, the realistic conflict theory suggests that prejudice arises when two or more groups compete for the same resource which in turn leads to a tendency to favour in-group members, while being hostile and denying resources to out-groups. This was proven in Sherif et al (1961) where the artificially stimulated competitive conflict lead to negative stereotyping towards out-group which persisted even after the competition. However, the validity was questioned over the artificiality of the situation and the samples (US American boys only?); as Tyerman & Spencer also showed how competition does not always cause prejudice – where UK scouts co-operated instead. Furthermore, individuals with different upbringing and philosophical orientations had not been considered, which in turn affects the ecological validity of the finding where inferences from generalisation would likely lack precision – with a world in constant social evolution with more psychological research being constantly published to guide society towards a more harmonious design.

LesVieuxChiensFrustrés

Reflection & Conclusion: Relocation, Adaptation, Design & Assimilation

Together, the theories seem to offer a plausible explanation for prejudice but cannot be ranked; as they compensate each other’s weak points. A sensible application of each theory – depending on the situation – seems like the rational method forward, since factors such as group-based behavioural patterns (culture), present situation/environment and norms/values remain vital considerations when researching about prejudice, its causes & a more direct approach to solutions.

Furthermore, the world has made such leap socially with the technological era, and people have been inclined towards knowledge, discoveries and innovation with social media contributing towards a more educated humanity [i.e. a civilisation with its different societies that come with their own values, philosophy, feelings and behavioural and communicative patterns, that are the main seperators and organising factors in each group’s identity].

 

Relocation

A new and strong global inclination towards a realistic synchronised unity [where the world’s population can live harmoniously in their own geographical location with their chosen units, laws and lifestyle], may shape intellectual thought in the decades to come now that the experience learnt from psychosocial disasters due to badly managed population shifts [that turned out to be destructive to the safety of Western European nations] could be considered in future policies. [Visit the website of the Banque Mondiale for more precise population statistics].

Unbelievable African Population Growth

Source: UN via The Guardian

Negro Population Counter

The current population of Africa is 1,300,976,080 as of Wednesday, December 5, 2018, based on the latest United Nations estimates. / Source: Worldometers (Click to see a live count of the majorly negro population of Africa)

S’installer en Afrique: les clés pour réussir ses projets sur le continent (2018)
La Taille Du Continent Africain

The Size of the African Continent: With the speed of progress and the development brought by the digital era, an increasing number of Negro people nowadays, with their global population rising at a rate faster than any other group, are considering a relocation to their homelands in Africa

Organisms who do not want to/cannot assimilate, should consider a relocation to an environment that is adjusted and more suited to their evolutionary needs, as this seems like the most rational solution, such as the growing number of sensible Negro people nowadays who are gradually shifting back to their homelands in Africa to help it grow economically and culturally with the world developing at a speed never seen before in this era partly accelerated with modern technology.

Africa Unite - Negro People

A great example of environmental and socio-psychological synchronisation is India, with 94% of Hindus being the native Hindi-speaking population of India who also live there, although Hinduism and its various branches of philosophy [explored by one of the most influential Western philosopher, Arthur Schopenhauer, and also many others such as Aldous Huxley, Alfred North Whitehead, Arnold Toynbee, François Voltaire, Rudolf Steiner, Wilhelm von Humbolt & Will Durant] – as other major religious cultures such as Christianity – also spread in influence globally.

India United

Hinduism, Hindus and India

Like Christianity & the other major religions, Hinduism and its philosophy also gradually spread in influence across the globe. However, 94% of people who practice Hinduism  are the native Hindi-speaking population of India

The Climate Collapse disaster has also made Civilization aware of the importance of « synchronised unity » in matters of global human advancement –  future research surrounding prejudice and discrimination would likely benefit the human world more if applied in intra-group scenarios – should the world’s population be managed and geographically engineered according to each group’s evolutionary logic [to fit their respective psycholinguistic, cultural and organic environments to further refine group evolution and guide society towards a harmonious pattern of living] for each group by their respective identities, collective beliefs, values & vision.

Chart of the Year - Global Poverty

A Visual History of Global Poverty from 1820 – 2015 / Source: Our World In Data

Infant Mortality 1950 - 2015

Infant Mortality, 1950 to 2015 / Source: Our World in Data

Global Income Inequality is Falling 1820 - 2000

Global Income Inequality is falling, 1820 – 2000

As World poverty is down, solving matters of the 3rd world on location along with a systematic and diplomatic relocation of culturally alien migrant crowds seems rational. Progress & development globally means relocation should be considered in the future if human beings are realistic about world peace, and the understanding of evolutionary science and its application to humanity.

World Charity by Country

Charitable giving by country / Source: Guardian DataBlog

libray users cite impacts from personal learning d'purb dpurb website

Library users and Learning / Source: Pew Research Centre (Internet & Technology)

In the 21st century, there are associations in the UK affiliated to the Indian, Chinese and Muslim communities that have started working in collaboration with the Home Office and are offering members of their respective communities an easy voluntary return to their country of origin without any use of force along with a financial help of about £ 2000 to find a job or start a business in their home country, this service is also open to the Jewish and Negro communities and all other unassimilated individuals. In France, many unassimilated Jews have begun to move back to their communities in Israel and in doing so are setting a positive example and encouraging the rest; the government of Israel is also supporting the return of Jews to their homeland and helping them adjust to their language and community.

Video: Quitter La France Pour Israel : Le Défi De l’Intégration des Juifs

We, as Western Europeans should consider a diplomatic process for relocating incompatible populations [who struggle to and/or cannot adjust to assimilate] according to their respective societies and cultural identity for peace; with links and cooperation in business and education if necessary to support the sophistication and the continuous linguistic and cultural development of human societies on Planet Earth.

Geographical management towards synchronisation and stability by exploring the logic of the « Organic theory » involves prioritizing one’s « own organisms » [i.e. organisms that are part of or have become part of one’s own society through complete assimilation] for psycholinguistic, cultural, social & genetic chemistry, evolution and enhancement.

nous

For example, if I myself were a retrograde and atavistic burden to Western Europe or France because of my religious beliefs, maladaptive needs, genes, intelligence [lack of], organic composition, fitness/health, education, philosophical perspectives, traditions, psycholinguistic heritage and national outlook, then I would change geographical location to one that is more suited to myself to be able to live much more comfortably. But since, I am of 100% Franco-British heritage and would not feel at « home » in a different environment other than Western Europe, I have fully assimilated and live here, thus, the concept of « Geographical Management », which is simply the process of keeping together organisms sharing similar beliefs, philosophy, culture, vision, perception, goals, intellect, language(s) and identity for chemistry, stability and mutual understanding: a synchronised and functional society founded on modern evolutionary science & humanistic philosophy.

We need to understand the identity of a society in terms of linguistic, cultural [mostly behavioural and perceptive patterns], and genetic authenticity but also consider and follow the progressive course of evolution as modern and sophisticated beings to include evolved organisms that assimilate, enhance, stabilise, and strengthen the group with superior or gifted genes that also care about, have a sense of belonging, take pride, interact, speak for and identify with the culture and nation. All humans are similar yes, but not equal … similar physiologically [blood, bone, organs, etc] but not equal in any case [culture, philosophy, language(s), IQ, genetics, fitness/health, intelligence, vocabulary, sensibility, skills, etc].

Rodin

Hence to foster evolution in a stable society that is also progressive, we should aim to create the consent of the masses as Walter Lippmann suggested in his theoretical essays; by all forms of communication possible [as a therapeutic form of expression to save ourselves as a species on planet Earth and learn to develop a sophisticated outlook of our planet] because scientifically there is no such thing as a pure race [all of us human primates on earth are the product of migration, breeding and evolution], and as Darwin’s theory of evolution revealed, there is no eternal essence, and any idea of an exceptionally pure entity that would be beyond evolution does not exist – everything is in a constant state of flux [so from a scientific, evolutionary and organic standpoint, racism is a totally archaic absurdity since we are all simply organic matter on a small blue planet in the vast universe being recycled, recreated and reshaped in a continuous process]. The philosopher Barbara Stiegler wisely suggested that the task of creating the consent of the masses should be left in the hands of experts in psychology [i.e. those who understand the psychic structure and philosophies of how humans and societies operate, develop and evolve].

 

Adaptation

For cases of exceptional organisms who have moved to a new locations [geography] to create themselves and build their lives, it would certainly be helpful for them to see themselves as individual with the power to reshape their whole being if they intend to be able to live a life that is not restrictive and is in complete synchronisation with the new society and people they choose to be a part of; thus assimilation seems to be the only reasonable and humane option.

It is fundamental for all to understand that geographical groups have evolved and have gained and maintained a structured organisation because each region on planet Earth and its respective organisms [of a particular type of organic composition – what some refer to as “race”] have created societies and behavioural patterns that led to a group with some form of synchronisation and organisation.

Human evolution

But, it is also very important to consider that from the perspective of the universality of life on Planet Earth, any human organism of whatsoever type of organic composition can procreate with one another. This simple but fundamental scientific observation means that if the laws of evolution and nature that contain and govern all life on this planet had different intentions, then organisms of different organic compositions would not be able to create new life.

This does not mean that countries should be encouraging uncontrolled and savage communist/zionist mass invasion policies in terms of migration to disrupt their own stability, since preserving a sense of synchronisation and organisation for all groups involves promoting agendas with organisms that have evolved in their environment and have the characteristics to support the continuity and  productivity of their group & societyYet, it is vital to understand that when Charles Darwin formulated his theory of evolution he changed life forever as we knew it – perhaps this is why he built the reputation of a rockstar of science and biology – because he cancelled this once believed fallacy of the stable and permanent concept, but revealed that everything continues to evolve from here onHence, it is of vital and fundamental importance for all groups [around the world] to consider the never-ending and ongoing process of evolution and natural selection, a process that affects all organisms on planet Earth similarly and also the singular adaptive evolution of some superior and genetically gifted organisms [See: [I] Psychology: The Concept of Self, [II] How our Neurons work, [III] The Temporal Lobes: Vision, Sound & Awareness and [IV] The 3 Major Theories of Childhood Development]

Darwin sur l'adaptation environmentale Oxford University Press Quote D'Purb dpurb site web

Traduction(EN): Charles Darwin (1809 – 1882), best known for his theory on evolution by natural selection, demonstrated that all species have developed over time from common ancestors and that individuals with characteristics most suited to the environment are more likely to survive and reproduce.

Putz_Michel_Richard_Orpheus_and_Eurydice D'Purb Website

 

Design

All societies should be asking the question of whether some select superior organisms [whatever the field in which they may excel / See: Scientists discover 1,000 new “intelligence genes” & 2 types of extroverts have more brain matter than most common brains] would enhance them as a group [i.e. upscale their organic composition], since we are now in 2019 and are part of a generation that has the scientific knowledge that previous generations before us did not have.

After all, the choice of partnership should always remain that of the individual, and since the criteria in partnership selection differs from one individual to another [e.g. some may look for physical attributes, others for emotional intelligence, or philosophical sensibilities, or particular personality traits, and on extremely rare occasions some may be incrediby lucky to find all the qualities in a single organism, etc], this may lead some individuals to choose from a range of organic compositions.

Human-Design-Organic-Composition

In the 21st century, with the knowledge of genetics and health, couples who want children worldwide should also consider whether the future wellbeing of their children involves more than simply good food, education and upbringing, but also good genes that also lead to better attributes. Hence, couples who choose to embrace the reality of science in 2019, may choose sperm or eggs from healthy donors if they do not consider themselves as genetically healthy or gifted; and this may also open the door to creating a healthier generation of humans on planet Earth and also encourage healthy males and females, to donate sperm and eggs as a contribution to the better design of a new generation of mankind. Since, science has always been seen by many as the study of God’s work, to create a better world, and this gave us better medicines and treatments after our understanding of the laws of nature evolved, so it seems reasonable to also look at genetics and design similarly.

Masters of Deception - Salvador Dali 026 - D'Purb Website

We also know that environmental and psycho-social influences have more salience and effect in shaping the mind of the individual, so avant-garde couples who choose to have a child through donated eggs or sperm should understand that the child will be theirs as the infant will carry their names, manners, attitudes and values, and not the donor’s. A good way of looking at it may be to simply think of the donor as a piece of healthy flesh that the couple borrowed to give their child a better design, health and future.

« spermini » par l'artiste maurizio cattelan d'purb website 1200

«Spermini», l’oeuvre par l’artiste Maurizio Cattelan / Source: Fondation Louis Vuitton

 

Assimilation

As for human organisms that have chosen to shift their geography to be part of a new society along with its heritage, they do not seem to have any other concrete option but to fully « assimilate » and prove their genetic fitness/health and abilities, and hence become an asset to the new group by becoming a part of it to help maintain its stability and sense of synchronisation.

Men and women who make the choice and who have the necessary education and intelligence to guide them, build themselves and change cultural / national identification registers when they have the capacity for development, the linguistic heritage and the genetics of intellect with a mastery of expression and speech. It is only then that they manage to represent a nation or an empire [or two?]. In 2019, as far as ‘The Organic Theory’ [which focuses on the singularity of the individual organism] is concerned, there is no debate between intellectuals in psychology, but simply the discovery of the new mechanical / scientific perspectives that it introduces to explain the psychological and philosophical conception of the individual – as Carl Sagan phrased it, ‘Science is a way of thinking much more than it is a body of knowledge’. Construction [training], which ‘can be’ mechanical and structured in its application [e.g. distance learning by text / video / audio], develops indirectly to create and give a socio-cultural dimension to the individual once the desired skills have been fully adopted, mastered, and deployed in life. The term ‘social’ is also far too vague to be important as such… the term ‘social’ can simply be defined as the interaction and exposure [of all types] between organisms. So the term ‘social’ is not really valid scientifically and it lacks precision itself since it may refer to a wide range of variables. What we are left with then is only the individual’s choices, language(s) & abilities of personal development [e.g. psycholinguistic & cultural synthesis]: the major factors in the psychological & philosophical explanation of his/her singular conception [to note that each conception is unique to the individual human organism such as his/her fingerprints, skull shape, or body structure: singularity]. Thus: training, meritocracy, order and love! [See: The Concept of Self]

Feuerbach_Anselm(1829-1880)_Paolo_And_Francesca D'Purb Website

If the new organisms lack genetic fitness/health, then it seems reasonable to consider conceiving [through healthy donors] or adopting children of the similar organic composition of the majority from the respective societies they moved to and live in, as this will contribute in fostering the growth and continuity of the group and ease assimilation.

So for organisms who do change their mode of existence, i.e. organisms that have the potential and have taken the decision to and do assimilate in Western European societies, the best option seems to see, breathe & live” [as a way of speaking] like the new society and nation they chose to be a part of, and also “feel” the new group’s pain, joy, values and heritage [even religion if possible / See: The Relationship between Religion and Discrimination].

Assimilation generally means to see the members of one’s new community as one’s own « blood », just like those from avant-garde French schools of thought do, as it will be in any individual’s best interest in living « fully » [although it is vital for all organisms to also consider the problems of «bad blood», since social incompatibility and/or a lack of chemistry – which is not necessarily hateful – within organisms of the same geographical environment are common due to a range of factors (e.g. intelligence, philosophy, values, sensibility, personality, character, emotional relatedness, tastes, etc)].

Tennessee

Any society that cannot add highly talented organisms with exceptional genes that have the potential to enhance and sharpen them as a group through the process of assimilation, would be missing out and will forever have a weakness over avant-garde societies that can. However, it is important not to take the process of assimilation lightly as it is not a costume party. Assimilation is not an easy process as we have found.

The large majority of organisms who change geographic locations do not seem to have the abilities or the desire to assimilate, since it involves focusing their loyalty and dedication to the new society and people while also adopting [e.g names that are sycnhronised with the society’s heritage as it is commonly done in France] and mastering new behavioural and communicative patterns [as Nicolas Sarkozy also pointed out], which requires learning & adjusting.

Hence, the diplomatic deportation and relocation of incompatible organisms along with campaigns to help them settle still remain the best solution to alleviate the burden of mass migration and psycho-social disruption to Western European societies, because assimilation requires skills and dedication and the majority of foreign organisms fail to master them.

Nous En France - Sarkozy - d'purb

Traduction(EN): « Us in France, we are different from others. To live, we have to drink, eat, but also to cultivate ourselves. » -Nicolas Sarkozy

However, we should also take note that there are some [not many] “incredible” individuals who manage to assimilate and become fully part of their new societies, and guide, manage and promote it passionately.

DocPaints

These individuals who have made the tremendous effort to become fully part of their new society where they have moved to and have the potential to enhance, guide and promote it should be applauded and encouraged because these individuals who have proven their genetic fitness/health, psycholinguistic/cultural belonging, national loyalty & identity are not in a new society simply for economic gains [as a foreign leech] but see themselves as part of the national community/family, and have taken the sensitive personal decision to completely blend in [assimilate] and become natives of their new societies where it reflects in their values, sentiments, perception, behaviour & nationalistic feelings.

Charles Darwin sur l'evolution par la sélection naturelle D'Purb Website

Traduction(EN): « I have called this principle, by which, each slight variation, if useful, is preserved by the term of natural selection. » -Charles Darwin / Note: Darwin devised the Theory of Evolution and was against bad breeding, and even supported a campaign to make marriage between cousins illegal due to the range of diseases and disabilities caused by consanguineous inbreeding [See: (1) Inbreeding, Consanguinity and Inherited Diseases, (2) The Role of Inbreeding in t