The author's reflections within this paper revolve around the significant difficulties in accepting an unrelenting and distressing reality for both the patient and the analyst, compounded by the rapid and violent unfolding of external circumstances that ultimately demanded a change in the therapeutic setting. Deciding to maintain the sessions via phone highlighted specific obstacles regarding the lack of visual input and the resulting discontinuity. Much to the analyst's surprise, the analysis also inclined towards exploring the implications of certain autistic mental territories which, up to that juncture, had been impervious to verbal communication. In contemplating the import of these alterations, the author explores how, for analysts and patients alike, adjustments to the frames of our daily lives and clinical procedures have allowed previously undifferentiated aspects of the personality to surface, having previously been concealed within the context of the setting.

In this collaborative effort, a volunteer, community-based organization, A Home Within (AHW), details its provision of pro-bono, long-term psychotherapy services to foster youth, both current and former. A brief description of the treatment method is presented, along with an account of the treatment delivered by a volunteer AHW. Finally, reflections on the broader societal impact of our psychoanalytic work are offered. A comprehensive psychotherapeutic approach with a young girl in pre-adoptive foster care showcases the impact of psychoanalytic treatment on foster youth, often neglected by overburdened, under-resourced community mental health systems in the United States. This open-ended psychotherapy provided an unparalleled opportunity for this traumatized child to work through past relational trauma and develop more secure attachments. Employing both psychotherapeutic analysis and a wider societal context perspective from this community-based program, we further investigate the case.

The paper critically examines psychoanalytic dream theories through the lens of empirical dream research. In this text, the psychoanalytic discourse on dream functions is summarized, encompassing aspects such as dream's role in maintaining sleep, the concept of wish fulfillment, the compensatory aspect of dreams, and the distinction between latent and manifest content. These research questions have been examined within the context of empirical dream research, and the findings offer the possibility of providing insights into psychoanalytic theories. The paper examines both empirical dream studies and their conclusions, as well as clinical dream analysis within psychoanalysis, concentrated largely in German-speaking nations. Major psychoanalytic dream theories and contemporary approaches are analyzed in light of the results, revealing influential developments stemming from these insights. The paper, in its concluding remarks, seeks to develop a new theory of dreams and their functions, integrating psychoanalytic principles with research methodologies.

The author strives to reveal how an epiphany within a reverie, during a session, can offer surprising insights into the essence and possible portrayal of the emotional flow present in the lived experience of the analytic encounter. Reverie serves as a critical analytical resource, particularly when the analyst is engaging with primordial mental states, tumultuous with unrepresentable feelings and sensations. This paper details a hypothetical toolkit of functions, technical applications, and analytical impacts of reverie within the analytic process, exploring analysis as a means of transforming the nightmares and anxieties that plague the patient's mind through the act of dreaming. The author carefully examines (a) reverie's utilization as a measure of analysability in initial consultations; (b) the particularities of 'polaroid reveries' and 'raw reveries,' two distinct types of reverie, as labelled by the author; and (c) the potential manifestation of a reverie, notably in cases of 'polaroid reveries,' as discussed by the author. Hypothetical reverie applications, explored by the author in the context of analytic life, take form as living portraits of these diverse uses. These sketches delve into archaic and presymbolic psychic functions.

Bion's critique of linking strategies seemed profoundly influenced by his former analyst's advice. In a lecture on analytical technique from the preceding year, Klein's expressed wish was for a book to be written, detailing the critical process of linking [.], an essential element of the art of analysis. Bion's 'Attacks on Linking', later subjected to further scrutiny in 'Second Thoughts,' has emerged as one of his most famous works and, barring Freud's publications, is arguably the fourth most frequently cited article across the breadth of psychoanalytic literature. Bion's concise and scintillating essay introduces the enigmatic and captivating idea of invisible-visual hallucinations, a concept that has not, subsequently, been extensively explored or debated by other scholars. Consequently, the author advocates for revisiting Bion's work, commencing with this particular concept. In an effort to establish a clear and distinct definition, concepts of negative hallucination (Freud), dream screen (Lewin), and primitive agony (Winnicott) are juxtaposed. In summary, the hypothesis posits that IVH might exemplify the source of all representations; specifically, a micro-traumatic inscription of the stimulus's trace (but capable of transitioning to a true trauma) woven into the psychic texture.

Clinical psychoanalysis's understanding of proof is examined in this paper, re-evaluating a Freudian claim on the link between successful therapy and truth, known as the Tally Argument, a concept coined by philosopher Adolf Grunbaum. I reiterate, with emphasis, criticisms of Grunbaum's reworking of this argument, highlighting the profound extent to which he has misconstrued Freud's meaning. Milademetan manufacturer Subsequently, I present my own understanding of the argument and the rationale supporting its central assumption. Following the discussion, I will present three distinct proof methodologies, each furthered by analogous examples found in comparative academic domains. Laurence Perrine's 'The Nature of Proof in the Interpretation of Poetry' serves as a framework for my exploration of inferential proof, emphasizing the role of a strong Inference to the Best Explanation in supporting an interpretation. Psychoanalytic insight, a suitable illustration of apodictic proof, is a consequence of my discussion, instigated by mathematical proof. Milademetan manufacturer Eventually, the holistic framework of legal argumentation motivates my investigation into holistic evidence, a dependable approach to verifying epistemic conclusions through therapeutic results. Psychoanalytic truth can be significantly corroborated by these three kinds of verification.

This paper demonstrates how the philosophical ideas of Charles Sanders Peirce are applied by prominent psychoanalytic theorists, including Ricardo Steiner, André Green, Björn Salomonsson, and Dominique Scarfone, in order to clarify psychoanalytic issues. Peirce's semiotics, according to Steiner, addresses a conceptual void within the Kleinian tradition, specifically concerning the gap between symbolic equations, which psychotic patients experience as factual representations, and the process of symbolization. Green's argument against Lacan's linguistic model of the unconscious finds support in the suggestion that Peirce's semiotic system, encompassing icons and indices, offers a superior conceptualization of the unconscious compared to Lacan's linguistic approach. Milademetan manufacturer In one of Salomonsson's articles, Peirce's philosophical framework is successfully demonstrated to illuminate clinical practice. It challenges the notion that words hold no meaning for infants in mother-infant therapy; a different Salomonsson paper presents compelling implications of Peirce's conceptions for understanding Bion's beta-elements. While Scarfone's final paper delves into the establishment of significance in psychoanalytic theory, our inquiry will be restricted to how Peirce's concepts function within the model presented by Scarfone.

Studies have demonstrated the efficacy of the renal angina index (RAI) in the pediatric population for anticipating severe acute kidney injury (AKI). In this study, we aimed to evaluate the Risk Assessment Instrument (RAI)'s ability to forecast severe AKI in critically ill COVID-19 patients and propose a tailored modification, mRAI, for this population.
A prospective cohort analysis of all COVID-19 patients admitted to the intensive care unit (ICU) of a tertiary hospital in Mexico City and requiring invasive mechanical ventilation (IMV) was undertaken between March 2020 and January 2021. AKI was classified according to the standards outlined in the KDIGO guidelines. The RAI score was calculated for all included patients, employing the Matsuura method. All patients, having reached the peak score for the condition via IMV, demonstrated a score directly correlating to the creatinine (SCr) delta. A noteworthy result, 24 and 72 hours after being admitted to the ICU, was severe AKI (stage 2 or 3). Factors associated with severe acute kidney injury (AKI) were investigated via logistic regression. This data was then used to develop and compare different versions of a modified Risk Assessment Instrument (mRAI).
An examination of the practical value of both the RAI and mRAI scores.
A staggering 30% of the 452 studied patients experienced severe acute kidney injury. The RAI score, at baseline, was linked to AUC values of 0.67 and 0.73 at 24 and 72 hours, respectively, when using a 10-point cutoff for predicting severe acute kidney injury. A BMI of 30 kg/m², as determined by multivariate analysis, after controlling for age and sex, was observed.
The presence of a SOFA score of 6 and the Charlson comorbidity index were found to be risk factors in the emergence of severe acute kidney injury. The calculation of the new mRAI score involves adding up the conditions and multiplying this combined value by the SCr level.