Research
Thesis PhD:
Soerensen, Barbara Maria Desombre (2024). An unconscious fantasy of a private world: explaining psychosis through an integrative psychodynamic theory. Macquarie University. Thesis.
https://doi.org/10.25949/27236574
This thesis proposes that the causation of psychosis can be explained by developing an integrative dynamic theory, which includes the integration of seven crucial factors: a theory of affect based recent advances in affect theory as informed by neuroscience and modern attachment research; a theory of unconscious thinking accounting for the influence of unconscious fantasy on the interpretation of attachment experiences; a theory of anxiety based on current research in bio-physiology; a theory of structural differences in the borderline and psychotic organisation; a theory of unconscious conflict and fantasy in accordance with current attachment research and affect theory; a theoretical explanation of the turn from factual reality to fantasy; a theory of unconscious conflict between affiliative and antiaffiliative motivations in relation to the construction, understanding, and validation of one’s subjective experiences. By integrating these theoretical ideas in a novel manner, this thesis delineates a psychodynamic theory that is capable of explaining psychosis.
The thesis further proposes that the most coherent theoretical formulation of the causation of psychosis postulates an unconscious fantasy of a private world, which is an expression of the dominance of the aggressive, antiaffiliative motivational structure in relation to the construction and validation of one’s subjective reality. The psychotic person thereby understands and explains their internal experiences through the delusions they have created within the unconscious fantasy of a private world. This thesis demonstrates that an unconscious fantasy of a private world is a distinctive feature of psychosis, which makes it possible to construct and make sense of reality without needing validation from the outside world.
Published Article:
Sorensen, B., Abbass, A., & Boag, S (2019). ISTDP and its contribution to the understanding and treatment of psychotic disorders. Psychodynamic Psychiatry, 47(3), 291-316.
https://doi.org/10.1521/pdps.2019.47.3.291
In this article, we review Davanloo’s metapsychology of the unconscious and how it can contribute to the current psychodynamic understanding and treatment of psychosis. In this framework, current attachment and emotions become connected with unconscious conflict-laden feelings about early attachment trauma at the core of the unconscious conflict. These conflict-laden feelings mobilize unconscious anxiety and defenses, which are alongside or, in and of themselves, constitute the entire picture of psychosis. Those patients with low emotional capacities are provided specific therapeutic techniques to bolster anxiety tolerance while those more defended patients are offered means to begin to accept and experience the feelings they have about present and past adverse experiences including those caused by psychosis itself. Case and case series research have shown this model to be clinically effective and cost effective as an adjunct to care. Case vignettes will describe the assessment of capacities and treatment frame for patients with a history of psychosis. Davanloo’s metapsychology of the unconscious offers an important contribution to the current psychodynamic understanding of psychosis by considering the role of attachment, emotions and unconscious conflict and addressing these through specific psychodynamic interventions.
Thesis MRes:
Sorensen, Barbara Maria Desombre (2016). ISTDP and psychosis: an investigation into the role of unconscious conflict and emotions. Macquarie University. Thesis.
https://doi.org/10.25949/19432664.v1
This thesis investigates how Dr Davanloo’s metapsychology of the unconscious with its extension to psychosis can contribute to the current psychodynamic understanding of psychosis. This thesis proposes that Dr Davanloo’s metapsychology of the unconscious offers an important contribution to the understanding of psychosis by considering the role attachment and emotions without neglecting the impact of unconscious conflict and fantasy.
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