IMMUND: an Early Stage Diagnostic and Therapeutic Frame for Neurodegenerative Diseases and Multiple Sclerosis based on Immunological Markers

For neurodegenerative diseases, the impact of immunological markers is one of the modern research areas. It has been observed that neuroinflammation increases the cellular precipitation of some of the key proteins associated with neurodegenerative diseases. Therefore, the possibility of functional loss can be enhanced due to neuroinflammation which leads to the initiation of any related diseases. In this regard, autoantibodies, which are known for their autophagy nature, can be considered as key elements for early diagnostic as well as early therapeutics. In this article, we have proposed a comprehensive framework to unveil the diagnostic as well as the therapeutic possibility of the autoantibodies which are largely associated with Mild-Moderate Alzheimer's Disease, Early-Stage Parkinson's Disease, and Multiple Sclerosis. Here, we have introduced a new concept of average p-value where multiple p-values of an autoantibody in a singular disease have been considered as a multi-occurrence of that sample in cellular systems. Also, multiple proteins from a single protein family under a differentially expressed range have been prioritized. As a result, the top ten autoantibodies have been selected for further study and also considered as diagnostic markers. Interestingly, most of the selected autoantibodies are either cytokines or immunoglobulins. Subsequently, we have performed an evolutionary sequence-structure space study to identify the druggable structural facet for the selected autoantibodies. To make the therapeutic perspective more robust, we have introduced the concept of protein moonlighting. Hence, it provides more robustness in therapeutic identification. Finally, two autoantibodies i.e., Q9NYV4 and P01602 are identified as a novel marker.

Boundary violations

Professional boundaries can be described as the ‘edge’ or limit of appropriate behaviour by the practitioner in the clinical setting. The therapeutic frame comprised of this set of boundaries allows the clinician and the patient to interact in a safe and productive way. These boundaries can be violated by sexual contact between the practitioner and the patient or by nonsexual overinvolvement. The mental health clinicians who transgress boundaries may do so for different reasons, and there are varied characterological and symptomatic clinical pictures that lead to boundary violations. Detailed evaluation of each individual case is necessary to determine if the clinician can be rehabilitated or not. Rehabilitation generally involves psychotherapy, monitoring, practice limitations, continuing education, and supervision. The digital era has brought about new forms of boundary violations involving cyberspace and the relative ease with which information about patients can be accessed.

“Sometimes you have to pop them”: Conflict and Meaning-Making in a Parenting Class

Parenting education is designed to address problems associated with childhood poverty, but such programs have had limited success. This ethnographic study of a parenting class serving low-income African American mothers examines tensions between parents and instructors over the use of physical force in disciplining children or in resolving conflicts more broadly. The article uses the concept of cultural frames to analyze how parents and instructors understood the issues at stake, showing significant differences between the frame the instructors used (discouraging all forms of force) and that of the parents (who saw force as sometimes necessary and effective). The instructors' therapeutic frame positioned children as vulnerable and prioritized self-esteem and positive relationships, and it did not resonate with parents, whose protective frame emphasized their responsibility to keep children safe in a dangerous world. This study examines interactions between parents and instructors to show that when frames come into conflict in social settings, collective affirmation of a particular frame can be a source of resistance and solidarity, thus raising questions about the potential of anti-poverty interventions that do not pay attention to context or meaning making.

The Yale Manual for Psilocybin-Assisted Therapy of Depression (using Acceptance and Commitment Therapy as a Therapeutic Frame)

The Yale Manual for Psilocybin-Assisted Therapy of Depression provides researchers and therapists with methods, structure, and areas to consider regarding the use of psychedelic- assisted therapy in the treatment of Major Depressive Disorder (MDD). In particular, this manual illustrates a mode of utilizing Acceptance and Commitment Therapy (ACT) as a therapeutic framework for psilocybin-assisted therapy of depression.

The analyst as “boundary artist”: how does Winnicott’s theoretical and clinical work affect our perception of boundaries in the therapeutic relationship?

Winnicott positioned his psychoanalytic style as distinct from Freudian and Kleinian theory, while his clinical practice was viewed by many as too enigmatic from which to establish a suitable theoretical framework. This article explores the role of boundaries within his practice and discusses whether he could be considered a “boundary artist” in the analyst’s chair. Winnicott’s underlying philosophy and clinical approaches are examined in relation to the analyst’s intrapsychic boundaries and the permeable border between the roles of analyst and analysand—particularly with regard to his notion of transitional space. Despite Winnicott exhibiting narcissistic tendencies that may have blurred the boundaries of the therapeutic frame, this critique demonstrates how he used his unique skill set to ensure boundary crossings could benefit the therapeutic process whilst avoiding harmful violations. Additionally, we will also consider the more problematic implications of Winnicott’s practice on modern relational psychotherapy.

The Case of "Rosa": Reflections on the Treatment of a Survivor of Relational Trauma

In this article, I respond to commentaries by Karen Riggs Skean (2018) and Shigeru Iwakabe (2018) on my presentation of the case of "Rosa," (Vigoda Gonzalez, 2018), a survivor of chronic relational trauma. In her insightful response, Riggs Skean (2018) elaborates on the interplay between language switching and the therapeutic frame, the suitability of Accelerated Experiential Dynamic Psychotherapy (AEDP; Fosha, 2000) for the treatment of trauma, and the short-term nature of the work with this particular client. Iwakabe (2018), an AEDP clinician and researcher, offers insights and reflections on the areas of language switching, emotional change process, and corrective emotional experiences, and poses evocative questions regarding the development of clinical skills relevant to affect-focused therapies. In the following response I consider these thoughtful commentaries and provide feedback with the hope to spur the dialogue regarding the flexible adaptation of treatment approaches to our clients’ psychological needs.