Introduction: Neurobiological systems engineering models are useful for treating patients. We show a model of “high opioid tone” autism and present a hypothesis about how autism is caused by administration of opioids during childbirth.Main Symptoms: Clinical diagnosis of autism in a 25 year old man was confirmed by a Social Responsiveness Scale self-rating of 79, severe, and a Social Communications Questionnaire by the patient's father scoring 27. Cold pressor time was 190 seconds—unusually long, consonant with the high pain tolerance of (...) autism.Therapeutic Intervention and Outcomes: At naltrexone 50 mg/day SRS fell to 54 and SCQ-−2–9; both non-significant. CPT fell to 28, repeat 39 s. Improved relatedness was experienced ambivalently, understood as feelings never before experienced—causing pain. Non-compliance with naltrexone was followed by cutting open his palm and drinking alcoholically. Transference focused psychotherapy has helped him remain naltrexone—compliant while he works on issues of identity and relatedness.Conclusion: The model suggests studies that could be conducted to both prevent and treat this form of autism. (shrink)

The neuropsychoanalytic approach solves important aspects of how to use our understanding of the brain to treat patients. We describe the neurobiology underlying motivation for healthy behaviors and psychopathology. We have updated Freud’s original concepts of drive and instinct using neuropsychoanalysis in a way that conserves his insights while adding information that is of use in clinical treatment. Drive (Trieb) is a pressure to act on an internal stimulus. It has a motivational energic source, an aim, an object, and is (...) terminated by the satisfaction of a surge of serotonin. An instinct (Instinkt) is an inherited pattern of behavior that varies little from species to species. Drives are created by internal/ventral brain factors. Instincts require input from the outside that arrive through dorsal brain structures. In our model unpleasure is the experience of unsatisfied drives while pleasure if fueled by a propitious human environment. Motivational concepts can be used guide clinical work. Sometimes what had previously described psychoanalytically as, “Internal conflict,” can be characterized neurobiologically as conflicts between different motivational systems. These motivational systems inform treatment of anxiety and depression, addiction in general and specific problems of opioid use disorder. Our description of motivation in addictive illness shows that the term, “reward system,” is incorrect, eliminating a source of stigmatizing addiction by suggesting that it is hedonistic. Understanding that motivational systems that have both psychological and brain correlates can be a basis for treating various disorders. Over many papers the authors have described the biology of drives, instincts, unpleasure and pleasure. We will start with a summary of our work, then show its clinical application. (shrink)

This essay concerns Heidegger’s assertion that the biography of the poet is unimportant when interpreting great works of poetry. I approach the question in three ways. First, I consider its merits as a principle of literary interpretation and contrast Heidegger’s view with those of other Trakl interpreters. This allows me to clarify his view as a unique variety of non-formalistic interpretation and raise some potential worries about his approach. Second, I consider Heidegger’s view in the context of his broader philosophical (...) project. Viewed this way, Heidegger’s decision to neglect the poet’s biography seems quite reasonable and consistent with his inquiry into the being of language. Finally, I consider Heidegger’s suggestion that Trakl is a kind of mad genius. I recast this paradigmatic figure in terms of what I call the ‘wretched prophet’ and consider some ways in which its appeal sheds light on the crisis of modernity and the aestheticization of politics. (shrink)

Recent scholarship has adduced convincing evidence that, underlying the late medieval and early modern discourse on witchcraft and diabolism, there lay not only popular folkloric and religious beliefs, but also real practical activities by which individuals made manifest their malicious intent toward others, as well as subjective experiences of interaction with supernatural entities, some of which were interpreted as the Christian Devil. This hypothesis raises a number of hermeneutic questions concerning how the social and material conditions predicating concrete acts of (...) maleficium related to practitioners' social psychology and moral self-construction. Through the interpretive frame of Friedrich Nietzsche's antithesis of 'master' and 'slave' moralities, this paper argues that the Christian theological and cultural context of early modern Europe primed individuals to experience the constraints and stresses of everyday life in vividly moralized terms, and to strategically negotiate their own personal advantage by realigning themselves within this moral order. (shrink)