CL 732, Disorder of Adulthood II:
The relevance of neuroscience to clinical practice

Fall 2009

Joseph Palombo

 

Goals

1. To familiarize students with the emerging knowledge in the neurosciences;
2. To discuss the relevance of this body of knowledge for theories of development, psychopathology, and
treatment; and
3. To delineate the major controversies this new paradigm raises.

 

Objectives

1. To examine the problems inherent in attempting to integrate two disparate disciplines;
2. To reconceptualized the nature and dynamics of some types of psychopathology;
3. To discus the implications for treatment interventions
The distinction between diseases of “brain” and “mind,”
between “neurological” problems and “psychological” or
“psychiatric” ones, is an unfortunate cultural inheritance
that permeates society and medicine. It reflects a basic
ignorance of the relation between brain and mind
(Damasio, 1994, p. 40).

 

Assignments

Following a long tradition, at the beginning of each class, following the first one, members of the class will take turn summarizing the content and discussion of the previous class. This summary cannot be longer than 10 minutes. If the class has more than seven members, some of you may
choose a partner with whom to share in the presentation.

Since this will be a difficult class for many of you, you may do one of the following to fulfill the written requirements for the course:

1. Submit your class notes, clearly written out and properly formatted, with comments on what has helped you and what you found difficult about every class.

2. Submit, by mid-term, a one page proposal of a topic on which you would like to write a 15 page paper. I will review the proposal and discuss it with you.

This paper is due on the last day of class for the semester, Saturday, January 26, 2010.

This bibliography is provided for reference and further study.

 

Course outline and reading list

Class 1. Introduction: The relevance of neuroscience to clinical practice

a. DSM & PDM

DSM-IV. (1994). Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition. Washington, DC: American Psychiatric Association.

PDM. (2006). Psychodynamic Diagnostic Manual (PDM). A collaborative effort of the American Psychoanalytic Association, International Psychoanalytic Association, Division of Psychoanalysis (39) of the American Psychological Association, American Academy of Psychoanalysis and dynamic Psychiatry, and National Membership Committee on Psychoanalysis in Clinical Social Work. Silver Springs, MD:
Alliance of Psychoanalytic Organizations.

b. Freud’s project revisited

Schore, A. N. (1997). A century after Freud's Project: Is a rapprochement between psychoanalysis and neurobiology at hand? Journal of the American Psychoanalytic Association, 45(3), 807-840. PEP

c. Kandel’s proposal

Kandel, E. R. (1998). A new intellectual framework for psychiatry. American Journal of Psychiatry, 155(4), 457-469.

Kandel, E. R. (1999). Biology and the future of psychoanalysis: A new intellectual framework for psychiatry revised. American Journal of Psychiatry, 156(4), 505-524.

d. The Paradigm: A Neuropsychodynamic Perspective

i. Evolutionary perspective

Mayr, E. (2001). What Evolution Is. NY: Basic Books. [Elementary text on evolution, recommended reading]

Strenger, C. (2006). Freud's forgotten evolutionary project. Psychoanalytic Psychology, 23(2), 420-429. PEP

ii. Systems approach

Miller, M. L. (2004). Dynamic systems and the therapeutic action of the analyst. In J. Reppen, J. Tucker & M. A. Schulman (Eds.), Way Beyond Freud: Postmodern psychoanalysis observed. London: Open Gate Press.

 

Development

Class 2. Of brains and selves: The making of minds

a. The Brain and its functions

i. Brain development: Interaction between endowment and environment

ii. Brain anatomy: The hemispheres, the four lobes, and the limbic system

Bloom, F. E., Beal, M. F., & Kupfer, D. J. (Eds.). (2003). The Dana Guide to Brain Health. New York: The DANA Press. [Excellent guide, highly recommended]

Plizzka, S. R. (2003). Neuroscience for the Mental Health Clinician. NY: Guilford Press. [For the sophisticated mental health practitioners]

Ratey, J. J. (2001). A user's guide to the brain: Perception, attention, in the for theaters of the brain. New York: Pantheon Books. [You can read selectively and get a great deal out of this book]

iii. The neuron: neurotransmitters, neuronal networks, mirror neuron:, Imitation, Theory of Mind, and empathy

Decety, J., & Jackson, P. L. (2006). A social -- neuroscience perspective on empathy. Current Directions in Psychological Science, 15(2), 54 -- 58.

Iacoboni, M. (2008). Mirroring People: The new science of how we connect with others. New York: Farrar, Straus, Giroux.

Rizzolatti, G., & Craighero, L. (2004). The Mirror-Neuron System. Annual Review of Neuroscience, 27, 169-192.

b. The sense of self: The self as an embodied person

i. The sense of self cohesion: The context, social communication, Mindsharing, Theory of Mind, Emotional communication

ii. Coherent self-narratives: Personal and shared meanings, Central coherence, Relevance Theory

Palombo, J. (2001). Learning disorders and disorders of the self in children and adolescents. NY: W.W. Norton. Chs. 1-6. [Discusses the impact of neuropsychological deficits on the development of the sense of self].

Siegel, D. J. (1999). The developing mind: Toward a neurobiology of interpersonal experience. NY: Guilford Press. [Very popular, very readable, and informative book]

Solms, M., & Turnbull, O. (2002). The brain and the inner world: An introduction to the neuroscience of subjective experience. NY: Other Press. [An update of Freud’s project for a neurology for psychologists]

 

Psychopathology: Disorders of the self

Class 3. Neurons, neurotransmitters, and neurobehavioral disorders

a. Depression and the neurotransmitter system, demoralization and depletion states

Palombo, J. (1985). Depletion states and selfobject disorders. Clinical Social Work Journal, 13(1), 32-49.

b. Schizophrenia

 

Class 4. Hemispheric specialization and social communication

a. Left hemisphere: Language-based disorders, i.e., dyslexia

Pally, R. (1998a). Bilaterality: Hemispheric Specialisation and Integration. International Journal of Psycho-analysis, 79, 565-578. PEP

Palombo, J. (2001). Learning disorders and disorders of the self in children and adolescents. NY: W.W. Norton. Ch. 7.

b. Right hemisphere: Disorders of social interaction: i.e., nonverbal learning disabilities

Palombo, J. (2001). Learning disorders and disorders of the self in children and adolescents. NY: W.W. Norton. Ch. 10 and 11.

 

Class 5. The Frontal Lobe: Attention and self-regulation

a. ADHD and Executive Function Disorders: Inhibition and working memory

Damasio, A. R. (1994). Descartes' error: Emotion, reason, and the human brain. New York: G.P. Putnam's Sons. Ch. 1-3.

Goldberg, E. (2001). The executive brain: Frontal lobes and the civilized mind. NY: Oxford University Press. [Readable account of the research on frontal lobes and executive functions]

Palombo, J. (2001). Learning disorders and disorders of the self in children and adolescents. NY: W. W. Norton. Ch. 8-9.

Palombo, J. (In Press). Executive Function Disorders and Self-Deficits: A clinical perspective. In Nina Heller and Alex Gitterman, Mental Health and Social Problems: A Social Work Perspective. Routledge

b. Attachment disorders: Mutual regulation, self regulation and the orbitofrontal regions

i. Secure attachments
ii. Insecure avoidant attachments
iii. Insecure ambivalent attachments
iv. Disorganized/disoriented attachments

Amini, F., Lewis, T., Lannon, R., Louie, A., Baumbacher, G., McGuinness, T., et al. (1996). Affect, attachment, memory: Contributions toward psychobiologic integration. Psychiatry, 59(3), 213-239.

Applegate, J. S., & Shapiro, J. R. (2005). Neurobiology for Clinical Social Work: Theory and Practice. NY: W. W. Norton. [Focuses on attachment theory]

Fonagy, P. (2001). Attachment theory and psychoanalysis. New York: Other Press.

Palombo, J., Bendicsen, H., & Koch, B. (2009). Guide to Psychoanalytic Developmental Theories. New York: Springer. Ch. 15-18

 

Class 6. The Limbic System: Emotions, anxiety and the memory system

a. Theories of affect and the fear system

Pally, R. (1998). Emotional Processing: The Mind-Body Connection. International Journal of Psychoanalysis, 79, 349-362. PEP

Pally, R. (1997). Memory: Brain systems that link past, present and future. International Journal of Psycho- Analysis, 78, 1223-1234. PEP

Panksepp, J. (2001). The long-term psychobiological consequences of infant emotions: Prescriptions for the Twenty-First Century. Infant Mental Health Journal, 22(1-2), 132-173.

b. Panic disorders, Anxiety disorders, phobias, and the amygdala

c. Trauma: PTSD, Bereavement, and the memory system

LeDoux, L. (1996). The Emotional Brain: The mysterious underpinnings of emotional life. New York: Simon & Schuster. [Excellent discussion of the brain’s fear system]

d. The special case of OCD

 

The Treatment Process

Class 7. The human dialogue and rewiring the brain I

a. Mindsharing: Empathy and the provision of complementary functions

b. Definition of mindsharing

i. Empathy

ii. Complementary functions: Selfobject functions, regulatory functions, and adjunctive functions

Palombo, J. (2008). Mindsharing: Transitional Objects and Selfobjects as Complementary Functions. Clinical Social Work Journal, 36, 143-154.

c. The psychodynamics associated with brain-based dysfunctions.

d. Psychotherapy as a new form of learning: Implicit relational knowing

Cozolino, L. (2002). The neuroscience of psychotherapy: Building and rebuilding the brain. N.Y.: W. W. Norton.

Stern, D. N. (1998). The process of therapeutic change involving implicit knowledge: Some implications of developmental observations for adult psychotherapy. Infant Mental Health Journal, 19(3), 300-308.

Stern, D. N. (2004). The present moment in psychotherapy and everyday life. N. Y.: W. W. Norton.

 

Class 8. The human dialogue and rewiring the brain II

a. The transference/countertransference configuration and its three components:

i. The concordant positions and responses:
ii. The complementary positions and responses:

(1) Defining transference

Levin, F. M. (1997). Integrating some mind and brain views of transference: The phenomena. Journal of the American Psychoanalytic Association, 45(4), 1121-1151. PEP

(2) Differentiating transference from nontransference
(3) Explanation and interpretation: What is the mutative vehicle for change?
(4) Countertransference

b. The disjunctive positions and responses.

Palombo, J. (2008). Self psychology theory. In B. A. Thyer (Ed.), Comprehensive handbook of social work and social welfare: Human behavior in the social environment (Vol. 2, pp. 163-205). New Jersey: John Wiley & Sons.

 

 

 

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