[Spontaneous rupture of the liver following caesarean section: a rare complication of an eclamptic liver].
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Biomedical subjects
Publications and source records attributed to H Bruch.
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The reciprocal interaction between psychotherapy and theoretical assumptions is illustrated through observations of anorexia nervosa. Traditional psychoanalysis, with its emphasis on interpretation of unconscious processes, was found to be rather ineffective, whereas an approach evoking active participation on the part of the patient led to better treatment results. The experience of being listened to appeared to be of utmost importance. The characteristic deficits in self-concept and body awareness could be related to a paucity or an absence of confirming responses in the early mother-child interactions. This concept reinforced the focus on encouragement of initiative and autonomy during therapy.
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I should like to make a personal remark before offering this very brief sketch of Frieda Fromm-Reichmann's life and activities. When I started to put my notes together I experienced an extraordinary bewilderment: she had died on April 28, 1957. I had a reaction of disbelief--it can't possibly be a quarter of a century, because her influence has remained so active and alive, not only in the people who had actually known her but also in many younger colleagues, who have a sense of personal relationship to her.
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The differentiation of the distinct clinical syndrome of anorexia nervosa from atypical cases is based on the following distinguishing features: a relentless pursuit of thinness; an almost delusional disturbance of body image; an inability to correctly identify hunger from other bodily or tension states; a lack of an identity awareness; and a paralyzing sense of ineffectiveness. This sense of ineffectiveness, pervasive of all thought and action, is connected with the perception of the self as acting only in response to the demands of others and is camouflaged by negativism and defiance. The core developmental issues of being unable to experience the control over one's own body and of lacking the conviction of living one's own life are based on the severe deficits in autonomy and initiative, originating from the distortion and mislabeling of feelings, sensation and moods in early childhood. The treatment process focuses on evoking awareness in these patients of their impulses, feelings and needs as originating within themselves as an essential step in the development of a sense of competence and self-esteem.
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Eight physiologic parameters were correlated with global ratings of affect intensity in four psychotherapeutic interviews with one patient. Highly significant covariation of affect with five of the eight physiologic parameters was obtained. It was concluded that affect intensity may be a useful psychologic parameter in studying psychophysiologic relationships in psychotherapy.
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