Through a case study, the importance of supporting the positive transference is stressed—from both a psychological and neurobiological perspective. The article argues that the neurobiology of expectation underlies transference. This neurobiology has been investigated particularly over the past several decades in work concerning the placebo effect. By understanding the neurobiology of expectation, one gains a better understanding of the neurobiology of the transference. This enables clinical predictions—and decisions—that are informed not just by the teachings of psychology but also by the science of biology.
Non-adherence to treatment and risk-reduction measures not only leads to increased morbidity and mortality in patients with HIV/AIDS but is also a major public health hazard. While there are multiple determinants of non-adherence, one that is particularly complex and refractory to intervention appears to be the history of childhood trauma and the development of post-traumatic stress disorder (PTSD). While behavioral intervention is occasionally helpful in increasing a patient's commitment to self-care, it is our view that the use of a more psychoanalytic framework, as well as the development of a psychodynamic understanding of the patient's history and struggles, may provide both patient and clinician with a more profound understanding of the forces that perpetuate non-adherence, thus facilitating a more cohesive and empathic approach to treatment. It is the aim of this article to explore, from a psychodynamic perspective, the possible connections between early childhood trauma resulting in PTSD and non-adherence to risk reduction and HIV treatment.
Much has been written in the secondary literature on Freud's aggression-release perspective vis-à-vis competitive sports. Very little has been written, however, on Freud's own explicit contribution to play, games, and sport. That is likely the result of Freud's reluctance to take up them--especially from the gamesman's and sportsman's points of view. One can, however, tease out the development of Freud's thoughts on games, play, and sport through a careful examination of his corpus over time. In doing so, one finds an early view of play and games, where the drives behind those activities are self- and other-preservative, and a later view, where Freud introduces his death drive. The article ends with some notions on what Freud might have said on the fanaticism that accompanies competitive sport, had he expressly taken up the issue.
Passionate love is a powerful emotional/biological force. So too is heart-break a powerful emotional/biological force. This article studies the neurobiological underpinnings of the two. The argument is that passionate love is best understood not as an affective dysregulation but rather as an addiction. And similarly that heart-break is best understood, and treated, not as an affective dysregulation but as an addiction. Clinical examples are given.
