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Biomedical subjects

W W Meissner

Publications and source records attributed to W W Meissner.

At least 37 records · Page 2Linked to original sources
PubMed1994

The artist in the hospital: the van Gogh case.

As a result of psychotic crises, Vincent van Gogh was hospitalized several times during a period of about a year and a half from December 1888 to May 1890. The author focuses on van Gogh's intense intrapsychic struggle during this relatively brief but critical time. He discusses how van Gogh's painting not only reflected his struggles but also enabled him, for a time, to stave off the hopelessness and despair that eventually overwhelmed him, culminating in his suicide. After reviewing possible factors in the artist's illness, the author agrees with others that the most persuasive explanation involves epileptic underpinnings.

Art↗
PubMed1993

Treatment of patients in the borderline spectrum: an overview.

My purpose here has been to provide no more than a brief overview of an approach to the therapy of borderline patients in the framework of a spectrum view of this complex pathology. While the perspective, generated within a tripartite framework of alliance, transference, and countertransference, allows the therapist a sense of orientation and direction in pursuing the therapeutic work with these patients, it can provide little more than guidelines, a theoretical context for thinking about the therapeutic vicissitudes that challenge and frustrate all of us. Within this perspective, I would emphasize the importance of flexibility. The complexity of therapeutic interactions and the wide scope of variation, seen not only in the borderline spectrum itself but in individual patients, calls for an unusual degree of flexibility and therapeutic adaptability to the immediate demands of the ongoing therapeutic interaction. If therapists, as they are being buffeted about by the storms and unsuspected undercurrents of the therapeutic ocean, can at least keep their bearings and know when they are being pulled out of their therapeutic role and function, their ability to deal with and help their patients will be immeasurably enhanced. I would hope that these few guidelines would provide a workable compass for the task.

Borderline Personality Disorder↗
PubMed1993

Vincent: the self-portraits.

The self-portraits of Vincent van Gogh are examined in the context of his tragic life experience, ending in psychosis and suicide. The self-portraits are seen as repeated and unresolved efforts at self-exploration and self-definition in an attempt to add a sense of continuity and cohesion to a fragile and fragmented self-experience. The portraits are painted in mirror perspective; Vincent's search for identity is thus seen as mediated by the dynamics of the mirroring phenomenon. Further implications are explored in terms of processes of projection and introjection and their role in self-consolidation.

Ego↗
PubMed1992

The concept of the therapeutic alliance.

Certain conceptual aspects of the therapeutic alliance are considered. Although therapeutic alliance, transference, and the real relation are intermingled and intertwined in the actuality of the analytic relationship, they remain distinguishable and open to differentiating analysis. The distinctions between the therapeutic alliance and transference, and between alliance and the real relation, are explored and their differences clarified, including the difference between therapeutic misalliances and transferences. Some of the component dimensions of the therapeutic alliance are explored, including empathy, the therapeutic framework, responsibility, authority, freedom, trust, autonomy, initiative, and ethical considerations including values and confidentiality. Further exploration of these and other dimensions of the therapeutic alliance is called for, especially the extension of these dimensions to their practical clinical application.

Empathy↗
PubMed1991

The phenomenology of religious psychopathology.

Patients with firmly established belief systems frequently enter analysis. The analyst must determine the extent to which neurotic and therefore analyzable components are involved in the patient's beliefs as such, as opposed to how the beliefs are embraced and adhered to as expressions of personal neurotic symptom formation or character pathology. The author discusses typical patterns of neurotic religious involvement as they are expressed clinically in hysterical, obsessional, depressive-masochistic, narcissistic, and paranoid modes and styles. He illustrates the manifestations of these patterns with clinical examples drawn from psychoanalytic experience.

Adult↗
PubMed1990

Foundations of psychoanalysis reconsidered.

Grünbaum's approach to psychoanalysis suffers from several difficulties. It imposes a standard of logical reductionism and methodological purity that not only violates the nature of psychoanalytic knowledge, but imposes an invalid standard of verification and scientific confirmation. It utilizes a brand of dichotomous reasoning that forces psychoanalytic propositions into artificial positions that do not reflect the actuality of analytic practice. It imposes a standard of verification that is impossible for psychoanalysis, along with all forms of psychological knowledge, to reach. It visualizes psychoanalysis as encompassing only one form of knowledge of human psychic life, forcing it into a model that eliminates other aspects of the psychoanalytic process, so that psychoanalysis is subjected to criticism only on one dimension among several--a kind of psychoanalytic straw man. The psychoanalysis that is so impaled often is difficult for the psychoanalytic practitioner to recognize. To the extent that Grünbaum's skillful and highly informed criticism of the philosophical bases of psychoanalysis encounters these difficulties, the value of his argument falls short of providing a useful basis for advancing psychoanalytic knowledge and particularly for promoting the quest for pertinent standards of validation within psychoanalysis.

Follow-Up Studies↗
PubMed1987

A view of aggression in phobic states.

This article attempts to apply a theory of aggression as motivation to overcome obstacles to the understanding of phobic states and their formation. The role of aggression in the genesis of phobic conditions is discussed, and the traditional analytic view of aggression as instinctual drive is contrasted with a motivational approach. The motivational view offers the advantage of a clearer understanding of the stimulus contexts, representational connections, and both real and imaginary object connections that are lacking in the more traditional understanding of aggression as a biological drive.

Adult↗
PubMed1986

Can psychoanalysis find its self?

There is a place for the theory of the self in psychoanalysis. To justify that claim, I return to an era in the development of psychoanalytic thinking about the self that preceded Kohut's formulations and that has set itself on a course of evolving a concept of the self more congruent with extant structural theory. I try to articulate the potential role of such a self-concept in connection with the issues of personal agency and subjectivity, complex personal qualities, areas of the complex interaction and integration of intrapsychic structures, object relations, narcissism, and internalization. The intent of this discussion is to facilitate the further development and articulation of the psychoanalytic theory of the self, particularly in terms of its integration with structural theory, to promote clearer thinking and more effective clinical efforts.

Aggression↗
PubMed1985

A case of phallic-narcissistic personality.

A case of phallic-narcissistic personality is presented to demonstrate the intermingling of oedipal and narcissistic transferences and to suggest a therapeutic rationale for the analytic treatment of similar cases. The therapeutic approach to dealing with the narcissistic configurations involves: Empathic and receptive listening to the patient's material relating to and reflecting narcissistic motifs. This early objective extends only to gaining access to the detailed scope of the narcissistic material in its multiple aspects. Clarifying and identifying the relevant narcissistic configurations, both superior and inferior aspects, so that the patient becomes increasingly aware of their pervasive influence, and increasingly able to identify the respective motifs. Interpretively linking the narcissistically inferior and superior configurations into a common gestalt, so that the patient comes to understand that these opposing aspects are mutually linked, defensively interconnected, and reciprocally reinforcing. Identification and interpretation of interlocking patterns of projection and introjection, particularly as they reflect and express narcissistic configurations. Modification of patterns of projection and introjection through the medium of the ongoing interaction (partly interpretive, partly extra-interpretive) that characterizes the relationship between analyst and patient. Patient projections are thus modified and replaced by more autonomous and adaptive introjections derived from the analytic relation that facilitate the alteration of pathogenic narcissistic formations.

Adult↗
PubMed1984

Clinical differentiation of borderline syndromes from the psychoses.

The discrimination of borderline syndromes from the psychoses is often a difficult task clinically. The problem most often arises in the acute setting in which a crisis has arisen--the typical example being that of acute hospitalization. The clinician's task is to assess the patient's apparently psychotic symptoms and behaviors to determine whether they are the manifestations of an underlying psychotic process, or whether they reflect a more or less transient regression from a somewhat higher level of habitual functioning. Some discrimination between these categories is possible even in the acute presentation, since borderline patients only exceptionally demonstrate Schneiderian first-rank symptoms or any other discriminating indices of psychosis. While the differentiation may be clear cut between the psychotic and the higher-order, better functioning borderline, there may be less precision in discriminating between the lower-order borderline forms or transient borderline states and psychoses. We have focused on this area of differentiation in this study. The discriminating indices are both short- and long-term. The differentiation cannot be adequately made without longer-term evaluation of the patient. Nonetheless, on a short-term basis, evaluation of the patient's behavior can point the diagnosis in one direction or other. The presence of a clear precipitant; the presence of intense (often verbalized) anger; the patient's attempts to engage the therapist in an intense, dependent, clinging and demanding relationship, usually in manipulative fashion; the partial, fragmentary, often circumscribed and ego-alien quality of the patient's psychotic productions; the marked tendency to act-out feelings, particularly anger, in a way that gains increased attention and concern from doctors, family, friends, or hospital staff; the persistence of some degree of reality testing and areas of significant realistic functioning; the transient nature of regressive manifestations and the ready reversal of regression in structured environments and with appropriate therapeutic management, particularly adequate limit-setting--all point toward a borderline diagnosis. Moreover, these factors carry an accumulative weight so that the more of these factors that can be validated, the more secure the diagnosis of borderline psychopathology. On a longer-term basis, beyond a few days, one would expect the above indices to be better discriminated. In addition, there is greater opportunity to study patterns of patient behavior--both his interaction with staff and other patients and with the therapist.(ABSTRACT TRUNCATED AT 400 WORDS)

Borderline Personality Disorder↗
PubMed1981

The schizophrenic and the paranoid process.

Data are presented in support of an understanding of schizophrenic and paranoid processes as operating relatively independently in the formation and deformation of human personality. The schizophrenic process derives from a genetically determined diathesis in combination with a range of factors involving environmental stress. The effects of the schizophrenic process in the organization and integration of internal structure and the differentiation of psychic functions are found at multiple levels, including negative consequences for the integration between cognitive and affective capacities, between conceptual and perceptual functions, and in the integration and stabilization of psychic structures. The schizophrenic process is envisioned as having disorganizing and disruptive effects on different levels of psychic organization, including the levels of the organization of cognitive processes, the formation and integration of representational systems (both self and object, and the structural integration of the self-system. In contrast, the paranoid process is thought to operate in the shaping and internal patterning of the personality organization, particularly by way of crucial forms of internalization. The interaction of introjection and projection shapes the individual's self-organization and contributes to the quality of interaction with significant objects. The impact of the paranoid process in both its positive function of contributing to the building up and integration of a meaningful and constructive sense of self and capacity for psychological functioning, as well as its deviant forms of expression in the development of paranoid pathology, is discussed. Although the schizophrenic and paranoid processes operate relatively independently, their interaction and intermingling contributes to the spectrum of forms of psychopathology that characterize the schizophrenic spectrum.

Cognition↗