;&2-5.2! First results of the dream experiments revealed that patients confronted with dream words in contrast to so-called neutral words (taken from an all-purpose story) showed differential activation of the precuneus, the ventro-lateral pre-frontal cortex (VLPF), and the anterior cingulate gyrus, among others. These three brain areas are known to be involved in self processing operations (experience of self agency), generation of basic causal explanations, and regulating emotions (see also below), where the ACC is also known for its conflict monitoring feature. In the course of therapy it could be shown that the recognition or rather re-sounding of initially significant dream content at the beginning of therapy activated specifically the precuneus and the left parietal lobe, which did not substantiate after one year of therapy. The disappearance of these areas—which are involved in attention processes but are also significant to emotional processing by the self—at T2 allude to the supposition that possibly the dream content has lost its special importance and is experienced now in the same manner as the neutral story. As for the OPD part of FRED, it consists of three conditions in the fMRI scanner, which are repeated six times each. In condition 1 four subjectively confrontational (conflict-oriented) statements extracted from the previously conducted OPD interview (relational axis II) are presented consecutively in the fMRI scanner on a screen. In condition 2 subjects see four statements of an all-purpose situation presented in the same manner, and finally condition 3 is composed of four relaxation statements. Analysis of the fMRI brain scans contrasting the different conditions (dysfunctional sentences > traffic + relaxation) revealed specific activation patterns again in the precuneus, and above that of the posterior and anterior cingulate gyrus, medial prefrontal cortex (MFC), occipital cortex and the left hippocampus for condition 1 (dysfunctional sentences). The occipital cortex and precuneus are important brain structures for primary visual processes (occipital c.) and visual-spatial imagery (precuneus). But besides this the precuneus is also known to be an important brain area for episodic memory retrieval and self-processing operations, i.e., for first person perspective taking and experience of agency. The cingulate gyrus being an important part of the limbic system helps regulate emotions and pain and constitutes an important feature of memory just like the hippocampus, which is aligned for memory formation, specifically long-term memory (episodical biographic). The MFC is postulated to serve as an online detector of information processing conflict (Botvinick, Cohen & Carter, 2004) but also has a regulative control function of affective signals (Critchley, 2003; Matsumoto, Suzuki & Tanaka, 2003; Posner & DiGirolamo, 1998; Roelofs, van Turennout & Coles, 2006; Stuphorn & Schall, 2006). In a single case study it could also be shown that MFC activation could no longer be detected after one year of psychotherapy, suggesting that the conflict impact has diminished in the course of therapy @)15-1.*$#! While it is the first study of its kind, the study has its limitations. The sample size is relatively small, which is due for one to the longitudinal design of the study and for the other to the fact that investigating in an fMRI environment limits possible candidates. The strength of the study is the naturalistic design. The study scientifically follows chronically depressed patients in the course of their long-term psychoanalytical therapy, where changes in brain functions are investigated on ‘real’ patients undergoing psychotherapies realized in the offices of ‘real’ psychotherapists associated with a high external validity of the findings. A comparison to a non-depressive control-group is still lacking. G$#.1/.\!! Tamara Fischmann fischmann@sigmund-freud-institut.de Marianne Leuzinger-Bohleber m.leuzinger-bohleber@sigmund-freud-institut.de
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