Search PubMed⌕ Search

Biomedical subjects

B Dorfman Lerner

Publications and source records attributed to B Dorfman Lerner.

6 recordsLinked to original sources
PubMed1986

[How to accompany a suicidal patient].

In this paper the author offers the prospective T.C. an orientation for the treatment of patients who have intended suicide. After examining general questions such as who and when people commit suicide, she presents an "Assessment of self-destructive potentiality" by Tabachnik & Farberow as a guide to the best prevention of the suicidal act. The metapsychological view of Freud as regards the repressed homicidal motivation in suicide is complemented by the views of Garma and Abadi. In respect to the process of accompaniment in these cases, the author suggests the appearance of four phases (simultaneous or in succession) that are: 1. the presence and the regard in which what is important for the patient is that the T.C. is there and affectionately regards him; 2. the listening, in which the T.C. provides facilities for the patient to speak; 3. the key word, in which "I comprehend" is the privileged T.C. expression; and 4. the dialogue. Within phase 3. discrimination can be made between different psycholinguistic aspects of the key expression, such as: a) its constituting aspects; b) its catarctic or economic aspect; c) its meaning a recognition of the patient's identity; and d) the emergence of hope. Also, as suicide is the end point of different psychopathologies, a brief indication of possible T.C. responses is given. In all these, the principal aim is to help the patient to elaborate a new life project. A clinical successful example shows how three T.C. were included in the treatment of a suicidal patient to accompany her in the recognition and tolerance of her own and others' aggressive feelings. Some philosophical considerations are added.

Humans↗
PubMed1984

[A new research method in psychiatry: the therapeutic companion].

In this paper, the profile of the therapeutic companion (T.C.) is drawn. This is a person, not necessarily a psychologist, who has been especially trained to cooperate in a psychiatric therapeutic equipment from a complementary position to the therapist in charge (T. Ch.). His function is to accomplish the therapist's instructions which mainly aim to contain the patient's anxiety and to give him pertinent responses to this symptomatic behavior. The link T. C.-T. Ch. is examined; a fluid communication between the parties and permanent supervision of the T.C.'s work is strongly recommended for a satisfactory therapeutic work. The indications for the inclusion of the T. C. comprise psychotic decompensations in border-line patients, acute psychosis and suicidal or aggressive behavior toward others. Special emphasis is laid on the research possibilities of this procedure: "natural" observations can be made and corroboration of hypothesis about therapeutic conduct can be attained. In respect to the number of T. C. to employ in each case. It depends on the patient's pathology. Not always, though, the theoretical convenience of only one T. C. all the time for some cases is feasible, due to the emotional strain of the task. The probability of a betterment of the therapeutic efficiency, together with the diminishment of time and cost of internment are some of the advantages of this approach.

Humans↗
PubMed1982

[Defusion].

Explore the source record for details and available documents.

Defense Mechanisms↗
PubMed1981

[Reflections on cotherapy as a teaching instrument in an institution].

In this paper I intend to present the different aspects of cotherapy as a teaching function beginning by the definition of the concept and its two meanings: the large one (the totality of means implemented in the treatment of a patient, (P.) and the narrow one (therapy session with two therapists who are present simultaneously). Then I carry on to the need of a basic agreement in therapeutic ideology and of permeability in the therapeutic team (T.T.) for mutual suggestions. I point to the advantages of the inclusion of the inexperienced therapist in the sessions, taping and observation through the Gesell chamber for the formation of therapists. Next there is a division of the treatment period in three stages; pre-session (the stage previous to the initiation of cotherapy for the first time and from then on previous to each one of the following sessions), the session (in which a therapeutic, a teaching and an intrapersonal period are differentiated and the post-session (in which the above mentioned periods are made explicit, are thought over and the therapeutic project is constantly adjusted. The advantages of the cotherapy for the P. are also mentioned. They are: a) betterment of the contention of the P. when his anxiety expresses itself in inadequate acting outs or is manifested in a very noisy manner; b) useful strengthening of the therapeutic action and of the making of limits: the fact that two therapists coincide in their view gives to their words more credibility and authority; c) the fact that there are two therapists instead of one makes the duplication superior to the sum of the same two therapists taken separately respect ot the offer of more information, models, views; d) a greater possibility of dramatizing roles due to the different personalities of therapists (roles that can be maintained by each therapist beyond the session period with the P.), facilitating in that way a better understanding by the P. of therapeutic interventions: e) unlike what happens with individual therapy, cotherapy allows the passage of a situation in which the third person is only included in fantasy to another in which the third one is included in the actual reality facilitating then a larger interplay between projections-introjections and its further comprehension by the P. Amongst its disadvantages there could be named: a) lack of intimacy as experienced by therapists and/or P.; b) risks of ill doing due to a T.T. wrongly combined; c) possibility of development of a "co-transference neurosis" that should require supervision by a third therapist; d) high cost to the institution. The advantages are, nevertheless, superior to the disadvantages so cotherapy is recommendable in any institution in which therapists are trained.

Humans↗
PubMed1981

[Concept of external reality in Freud's works].

Three main functions of external reality (E.R.) relative to the subjecto may be mentioned. a) it is a source of stimulae that promote the structuring of te psychic apparatus. In this sense, E.F. is the place where this apparatus is charged and where it is discharged (specific action). b) it is a vehicle of gratification or frustration of necessity (Anaké). The satisfaction of necessity is gratifying, the lackof it is frustrating. c) it is the instance that heals or makes a person ill acording to its possibility of gratifying or frustrating the subject respectively. If we first take point a), we can examine the relationship between E.R. and internal (psychic) reality along the process of internalization of normal and pathologic experience. The author thinks Freud considers frustration as structuring of the psychic apparatus as long as it does not satisfy the person's needs or opposes the accomplishment of his desire. This complels the subject to recognize the existence of the external object. Also, whenfacing the external object the subject discovers his own self. Coinciding with this reognitions he tries to defend himself against it. In normal circustances the image of the external world is built by means of successive projections and introjections. The more sane the subject, the more faithfully and without distortions will he incorporate the external images. To be structuring, the frustrations must be encountered in adequate dose. If it is excessive there will be a distortion of the image due not only to projection but also to the defusion of instincts (defusion that takes place in the process of introjection of external figures). These distorted images of the external world coexist with various fantsies. But these fantasies are also marked by E.R. Even when the individual history of a subject does not give accont of this reality, there is a "filogenetic endowment" of fantasies that always recognize an external origin: they are the prehistoric fantasies. This hypothesis of the original fantasies is similar, in respect to their ontogenetic origin, to the innate ideas of Descartes and it is coherent with Freud's empirical point of view of those fantasies being perceptions in a filogenetic past. In this way Freud tries to give account both of the idealistic and the empiricist points of view about perception. If in genetic matters the interaction with the external world is primordial, in epigenetic matters Freud goes away from empericism of perception to propose the hypothesis of an internal reality, that differs from empericism of perception to propose the hypothesis of an internal reality, that differs from external material reality. But even in the psychotic process, in which the psychological reality is far apart from E.R., the former gets influenced by the latter...

Dreams↗