Sleep-related experiences [Watson, D. . Dissociations of the night: Individual differences in sleep-related experiences and their relation to dissociation and schizotypy. Journal of Abnormal Psychology, 110, 526–535] refer to a host of nocturnal altered-consciousness phenomena, including narcoleptic tendencies, nightmares, problem-solving dreams, waking dreams, and lucid dreams. In an attempt to clarify the meaning of this construct, we examined cross-sectional and longitudinal associations of sleep-related experiences , altered-consciousness tendencies , psychological distress, childhood maltreatment , and life stress in young adults. Both (...) types of SREs were found to be distinguishable from altered-consciousness tendencies. Transliminality emerged as a longitudinal predictor of both general SREs and lucid dreams. Psychological distress and an increase in life stress predicted an increase in general SREs over a 3-month interval. We conclude that transliminality is a general altered-consciousness trait that accounts for some of the individual differences in sleep-related experiences, and that general sleep experiences are an outcome of psychological distress and life stress. (shrink)

Emerging action perspectives on psychopathology depict individuals as actively shaping those environmental conditions that then impact on their risk for psychopathology, resilience in the face of it, and successful recovery from it. This view, although having important implications for research and clinical practice, has yet to be articulated in terms of its underlying philosophical framework. To begin to address this challenge, we situate action theory in the context of the writings of Deleuze and Guattari, who, in their seemingly anti-psychiatric series (...) entitled Capitalism and Schizophrenia, argue for the central role of human agency as a fundamentally active force in determining subjective life. Within this context, they propose an alternative approach to the current deficit focus of much psychopathology research, replacing the notion of deficit with a fundamentally productive notion of desire (what they call “desiring-production”). After our exposition of this philosophical perspective on human agency, implications of this approach for action-informed research and clinical practice are discussed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Introducing a “Deleuze Effect” into PsychiatryLarry Davidson (bio) and Golan Shahar (bio)Keywordsdesire, intentionality, psychopathology, agency, action theory, desiring-production, active and reactive forcesYou have to keep small rations of subjectivity in sufficient quantity to enable you to respond to the dominant reality.(Deleuze and Guattari 1987160)We are very pleased with the variety of responses our article has generated thus far and hope that it continues to provoke dialogue. That was, we (...) think, our in tent—should we be allowed to hold on to any such “thing” as an intention. We also take the diversity of these responses to reflect one of our key challenges in using Deleuze’s thought to reform (as op posed merely to inform) psychiatric practice: How to make a radical philosophy accessible enough to a broad enough audience for it to bring about substantive, real change in an existing culture in the hic et nunc, the here and now. That is why we chose the quotation above from Mille Plateaux. Even Deleuze (with Guattari) encourages us to keep “small rations” of subjectivity at hand if we are interested in responding to the “dominant reality.” And that has been our main agenda; to engage with the dominant reality of deficit-based psychiatric theory and practice to overturn it, or, in Clegg’s terms, “explode” it from within.In this regard, we certainly agree with Evangelista and Clegg that much more remains to be done, both in developing our position and in exploring its implications for practice. We view our “Deficit to Desire” paper as simply a first step in this direction (e.g., Shahar and Davidson, in press). We thought it necessary first, as we wrote in the original paper, to articulate the theoretical underpinnings of an action model for clinical understanding and practice “at a philosophical level of discourse on the one hand, but also in such a way that they provide a concrete, substantially different point of departure for empirical studies of psychopathology, on the other.” But why is this important, and what implications does it have for our response to these three thoughtful commentaries?A first implication is that our primary aim is not to provide a comprehensive exposition of Deleuze’s thought. In our opinion, even attempting to give a comprehensive exposition of Deleuze’s thought would actually go directly against its main thrust, which we view as to ignite and propagate ever new and creative lines of flight which carry desiring-production into “a small plot of new land at all times” (Deleuze and Guattari 1987, 161). “Experiment,” entreats Deleuze, “don’t interpret” (Deleuze and Guattari 1987, 139). We would guess, in fact, that Deleuze no more wanted to [End Page 243] produce Deleuzeans than Kierkegaard wanted disciples going around the Danish countryside after his death spreading the word that Kierkegaard did not want disciples going around the Danish countryside after his death (one of our favorites among his many ironies). So although we agree that there is much more in Deleuze’s thought than what is contained in our paper, we think that to some degree it misses its point. In Deleuzean fashion, we want to use the “Deleuze effect” to bring radical change to psychiatry (and we appreciate the irony of that too). Although both Evangelista and Clegg seem to welcome this effort, despite their misgivings, Weiner clearly is worried. Weiner also seems to have had the most intimate experience of the psychiatric system—that is, is most familiar with the world we are trying to change—so we focus in particular on his very understandable concerns.It also happens to be the case that focusing on Weiner’s concerns brings us immediately back to the nature of the effect we were hoping to have. Weiner explains that people with serious mental illnesses are “oppressed from within” and that their affliction seems to be coming “from a seemingly autonomous place” that is “within us, but not ultimately of us.” We could not agree more, and appreciate the lucidity and eloquence with which he makes this astute and important point. Several years ago, one of us even attempted a Husserlian-inspired analysis of how a person... (shrink)

In contrast to the fruitful relationship between psychoanalysis/psychoanalysts and the humanities, institutionalized psychoanalysis has been largely resistant to the integration of psychoanalysis with other empirical branches of knowledge, as well as clinical ones [primarily cognitive-behavioral therapy ]. Drawing from two decades of theoretical and empirical work on psychopathology, psychotherapy, and psychoanalysis, the author aims to show how a reformulation of object relations theory using psychological science may enhance a clinical-psychoanalytic understanding and treatment of suicidal depression, which constitutes one of the (...) most formidable health challenges of our time. Specifically, he rewrote the notion of Melanie Klein positions—primarily the depressive position—using extant knowledge of structure of emotions, the centrality of mental representations of the future and the toxic nature of criticism-based emotions. This reformulation enables a dialog between clinical psychoanalysis and other therapeutic schools of thought and sheds light on the understanding and treatment of suicidal depression. (shrink)

We suggest that the network approach to comorbidity (Cramer et al.) is best examined by using longitudinal, multi-measurement, intra-individual data. Employment of time-series analysis to the examination of the generalized anxiety disorder and major depressive disorder comorbidity enables a detailed appreciation of fluctuations and causal trajectories in terms of both symptoms and cognitive vulnerability.