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Biomedical subjects

J Sandler

Publications and source records attributed to J Sandler.

At least 37 records · Page 2Linked to original sources

Phantasy and its transformations: a contemporary Freudian view.

Over the past fifty years changes have occurred in the theoretical positions of the Contemporary Freudian and Klein groups in the British Society, but fundamental differences remain. This paper considers the meaning of the term 'the unconscious', with particular reference to the censorship lying between consciousness and the Preconscious system--or, in the authors' model, consciousness and the present unconscious. The distinction between the present unconscious and the past unconscious is described. Emphasis is placed on the difference between phantasies in the present unconscious, which exist in the 'here-and-now' and those in the past unconscious, which are for the most part reconstructions based--among other things--on the analyst's theories of mental functioning and of child development. Thus, transference phantasies are phantasies in the present unconscious. The authors go on to emphasise the implications of the distinction between the present and past unconsciouses for analytic work, stressing the need for focus on phantasies and associated conflicts in the present unconscious before turning their attention to reconstruction of the past. Finally, they point to the concept of dialogue with one's introjects (internal objects) as represented in unconscious phantasy, to the stabilising function of (present) unconscious phantasy and to the need to interpret conflict and resistance.

Adult↗

Preventing relapse in obesity through posttreatment maintenance systems: comparing the relative efficacy of two levels of therapist support.

The present study compared the relative effectiveness of a therapist-supported maintenance condition with a minimal contact maintenance condition in preventing relapse following an obesity treatment program. Thirty-two subjects who completed an initial 12-week cognitive/behavioral plus aerobic exercise treatment program were matched on absolute weight loss and randomly assigned to one of two maintenance conditions. Subjects were assessed at pretreatment, posttreatment, and 3, 6, and 12 months following posttreatment using measures of weight, blood pressure, and depression. Three- and six-month follow-up results indicated that subjects who participated in the therapist-supported maintenance group continued to lose weight and/or maintained therapy-induced weight loss to a greater degree than control subjects. At the 12-month follow-up assessment therapist-supported subjects maintained therapy-induced weight loss better than the control subjects. These findings suggest that maintenance programs which provide continued contact emphasizing relapse prevention training may be an important adjunct in the maintenance of therapy-induced weight loss.

Adult↗

On internal object relations.

This paper gives an account of the author's attempts to come to terms with the concept of internal object relations, and to find an appropriate theoretical place for it within non-Kleinian mainstream theory. It is proposed that the internal object be regarded as a structure in the nonexperimental realm, being built up during development on the basis of the child's subjective perceptual and fantasy experiences. The internal objects in turn influence perception, thought, fantasy, current object relations, and transference. From the point of view of the clinician, the concepts of internal object and of internal object relation act as useful organizing constructs for both analyst and patient. Finally, the suggestion is made that internal objects can be regarded as the source of internal "presences" with which the person constantly unconsciously interacts.

Delusions↗

Psychoanalytic technique and 'analysis terminable and interminable'.

Some of the implications for psychoanalytic technique of the papers given at the plenary sessions of the Montreal Congress are considered. Emphasis is placed on the role of affects in development and in current psychic functioning. Motivation for unconscious wishes arises from many sources, and affects should not only be thought of as drive derivatives. There is a substantial gap between the (largely) implicit clinico-technical theories in the analytic work presented, which do in fact show great sensitivity to the patients' affects, and the formal 'official' general psychoanalytic theory used. This discrepancy in our theories should be faced. Freud's tripartite structural theory of the mind (the 'second topography') seems now to have limitations for clinical purposes.

Ego↗

Sex differences in weight loss among adults with type II diabetes mellitus.

The treatment of choice for Type II or non-insulin-dependent diabetes mellitus is a behavioral program for the management of weight. However, compliance with this lifelong dietary regimen is often poor. In the current investigation male and female adults with diagnosed Type II diabetes were randomly assigned to either a behavior modification, a cognitive modification, a cognitive-behavior modification, or a control group. Patients were evaluated in terms of weight, percentage of body fat, and glycosylated hemoglobin measures. Men lost significantly more weight than women and subjects in the behavior modification group lost more weight and demonstrated greater decreases in diabetes control than subjects in the cognitive-behavior modification, cognitive, and control groups. A significant interaction indicated that diabetic men may benefit more from behavioral weight reduction programs than diabetic women. Several explanations for these findings are considered.

Adult↗

The past unconscious, the present unconscious and the vicissitudes of guilt.

The concepts of present unconscious and past unconscious have been introduced in order to provide a useful theoretical schema for comprehending clinical psychoanalytic material. In the present paper these concepts, together with the notion of the second censorship, are made use of to provide a framework for understanding the way in which guilt feelings and the ideas associated with them are dealt with at different levels of consciousness. The technical approach linked with the theoretical ideas in this paper is described, with special reference to the relation between interpretation of the present and reconstruction of the past.

Child Development↗