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Biomedical subjects

J D Noshpitz

Publications and source records attributed to J D Noshpitz.

11 recordsLinked to original sources

Self-destructiveness in adolescence.

This study is an attempt to formulate the dynamics of the group of adolescents involved in major drug use and other antisocial behavior. As consultant to a drug rehabilitation center for teenagers, the author has had occasion to interview and evaluate a large number of youths whose lives had taken such a turn. Certain aspects of the life style and behavior patterns of these young people show striking similarities. In particular, their behavior evidences the presence of a central self-destructive moiety which can be likened to a negative ego ideal; this acts to shape and to direct their lives. This element in the character structure of these patients is described in clinical and theoretical (developmental) terms, with special address to: a chronic low-grade sense of inner malaise, a tendency to self-blame for whatever goes wrong for family and close friends, feelings of alienation from the larger society around them, behavioral provocativeness in the service of seeking the relief that punishment brings, recurrent gestures of self-mutilation, frequent involvement with cults of devil worship, a record of multiple antisocial acts punctuated by numerous arrests, and repeated suicidal gestures and attempts. The origins of the negative regulatory superego elements which make for this type of psychopathology are explored.

Adolescent

Self-destructiveness in adolescence: psychotherapeutic issues.

In sum, then, the psychotherapy of self-destructive adolescents involves an assessment of the degree to which the patient's behavior is dominated by a negative ideal. If that seems like a central mechanism, than the therapist must seek ways to bring this to awareness, to confront the patient with the presence and the activity of such a component of the self, to sensitize the patient to the way this expresses itself in his everyday behavior, and to rally the patient to the twin tasks of facing this and consciously opposing it, and of working to discern its origins and what happened to introduce it into his life. Generally speaking this is an aspect of personality that patients tend to repress and to maintain in repression. They may do this by denial, evasion, or hyper-emotionality, by regarding this part of the self as a source of pleasurable excitement, or by using its effects to drive away the therapist or to convert the therapy into yet another site for the attainment of pain, frustration and failure.

Acting Out

Learning disabilities as a childhood manifestation of severe psychopathology.

The severity and nature of psychopathology in a group of learning disabled children was investigated. Compared to children in a normal control group, those in the learning disabled group manifested a significant degree of emotional maladjustment. They also exhibited disturbances in areas of ego functioning generally thought to be impaired in those with borderline personality organization. No linear relationship was found between severity of pathology and degree of underachievement.

Affective Symptoms

Narcissism and aggression.

Many of the phenomena we associate with violence and rage seem to be connected with narcissistic wounding. In this study, the narcissistic dimension of personality is regarded as a phylogenetic derivative of a territorial instinct. The establishment of a self-territory is experienced as a form of personal space, and an effort is made to distinguish various regions in this space. In particular, there is envisaged a narcissistic core consisting of the multiplicity of affiliations to which a given person belongs. These include gender identity, body self, religion, patriotism, lineage, profession, and other such self-defining attachments. In addition, there is a periphery to this space, a point of contact with the boundaries of others where much vulnerability can develop in people with narcissistic problems. It is in connection with such vulnerabilities and the immense reactivity to the invasion of core narcissistic territory that the nature of violence in interpersonal reactions needs to be studied.

Aggression

A narcissistic reaction in a six-year-old girl with a seizure disorder.

A six-year-old girl with a three-year history of seizures came to psychotherapy because of a progressively worsening behavior disorder. She was adjudged to have a severe reactive narcissistic disorder in response to her uncontrollable seizures. During the complex clinical course of her combined conditions, two different styles of psychotherapy were employed. Their relevance to the psychotherapy of the narcissistic conditions of childhood is explored.

Child