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Biomedical subjects

J Sandler

Publications and source records attributed to J Sandler.

At least 55 records · Page 3Linked to original sources

Reflections on some relations between psychoanalytic concepts and psychoanalytic practice.

This paper adopts the standpoint that psychoanalytic theory has been in a state of continuous organic development from the beginning, with states of theoretical strain being generated with each new advance in theory. The meaning of concepts becomes stretched, and psychoanalysts develop implicit theories, concepts and definitions that differ from the 'official' or 'public' formulations. While flexible concepts play an important part in psychoanalytic theory, it should be accepted that each may have a number of dimensions of meaning, and that these dimensions may differ from one psychoanalyst to another. Research should be directed towards making explicit the implicit concepts of practising psychoanalysts, and it is suggested that this process will result in the accelerated development of psychoanalytic theory. The essentials of that theory must be those aspects which relate to the work the psychoanalyst has to do, and therefore its main emphasis needs to be clinical. In the second part of the paper, the expansion of the concept of transference with the introduction of defence analysis is discussed, with particular reference to the class of object-related defences, which involve some combination of identification and projection. It is argued that major changes in technical emphasis brought about the extension of the transference concept, which now has dimensions of meaning which differ from the official definition of the term. Finally, three areas among many in which there is a significant distance between theory and practice are discussed. The public and official theories relating to drives, conflict, and internal object-relationships and transference are discussed, and suggestions made in regard to possible developments which might lessen the gap between the public theories and the implicit private clinical formulations of the practising psychoanalyst.

Conflict, Psychological↗

Effectiveness of a modified version of airflow therapy: case studies.

Utilizing airflow therapy, Schwartz (1976) has claimed an 89% success rate with stutterers following treatment and an 83% success rate at one year follow-up. Such claims have yet to be documented in the scientific literature. The purposes of this study were: (a) to investigate the effectiveness of a modified version of airflow therapy; (b) to examine the relative importance of its two main components--passive airflow and elongation of the first vowel spoken. The speech of two adult male stutterers with a lengthy history of stuttering, was assessed with spontaneous speaking and reading tasks. Results indicated marked improvement in both subjects' speech on the reading task was maintained at follow-up 10 weeks later. For spontaneous speech, results were generally weaker and less durable. Effects of the two treatment components were cumulative and did not allow determination of any differential effectiveness between components. Implications of these findings were considered and directions for future research discussed.

Adult↗

Effect of somatostatin-induced suppression of postprandial insulin response upon the hypertriglyceridemia associated with a high carbohydrate diet.

In an attempt to define the relationship between plasma insulin and triglyceride concentrations, we have studied the effect of suppression of the postprandial insulin response upon the secretion and plasma concentration of very low density lipoprotein (VLDL)-triglycerides. Eight nondiabetic subjects with a wide range of fasting plasma triglyceride levels (100-358 mg/dl) were studied during three dietary periods: base line, high carbohydrate (80% calories), and high carbohydrate (80% calories) with a daily intravenous infusion of somatostatin (SRIF) (1.3 micrograms/min) between 800 and 2,100 h. The significant increase in postprandial insulin response observed during high carbohydrate vs. base line was completely abolished during high carbohydrate-SRIF. However, plasma triglyceride levels rose in all subjects during each high carbohydrate period (with/without SRIF) vs. base line and the mean values reached during each period were the same (476 +/- 165 vs. 482 +/- 152 mg/dl, respectively). The secretion of VLDL-triglyceride into plasma was higher in four subjects, the same in two subjects, and lower in one subject during high carbohydrate-SRIF vs. high carbohydrate alone. The mean production rate of VLDL-triglyceride (mg/kg per h) was 25.6 +/- 4.9 during the high carbohydrate and 40.9 +/- 28.1 during the high carbohydrate-SRIF periods. These values were not significantly different. Postprandial glucose levels were slightly increased during high carbohydrate-SRIF, but overnight glucose concentrations were not affected. Plasma FFA levels were not different during the two high carbohydrate periods. Plasma glucagon levels did not appear to affect the results either. This study indicates that postprandial hyperinsulinemia during a high carbohydrate diet is not necessary for induction of hypertriglyceridemia.

Adult↗

The treatment of adult obesity through direct manipulation of specific eating behaviors.

The present study investigated the effects of three different conditions on weight loss in adult obese subjects. The three conditions were: (1) Monitoring-Contract (MC) in which subjects were reinforced by the return of a valued possession for changes in eating habits; (2) Monitoring (M); and Attention-Placebo (AP). Subjects in the MC group lost significantly more absolute weight and a significantly greater percentage of weight at the end of treatment than did the subjects in the M and AP groups. These changes were still manifested at a 2 month and a 6 month follow-up. The long-term advantages of a weight reduction program which focuses on a gradual and systematic weight loss through changes in eating habits are discussed.

Adolescent↗

Character traits and object relationships.

Character traits have in the past been viewed as "discharge" phenomena and compromise formations. Many traits can be better understood, however, as devices for evoking particular types of response in others in order to actualize the wished-for relationships existing in unconscious fantasy. Moreover, some "evocative" character traits create the unconscious illusion of the presence of the love objects. The concept of unconscious illusion can also be used to clarify the notion of "introject," which may be understood as an illusory object perceived outside normal consciousness.

Character↗