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The nature and expression of anger and guilt in sons and daughters of Holocaust survivors were studied by a quantitative and qualitative analysis of relationship narratives. Findings are discussed in relation to the reciprocal overprotectiveness between the surviving parents and their children in the context of intergenerational communication of trauma.
1. Basal plasma and spinal fluid noradrenaline were increased in patients with primary hypertension and phaeochromocytoma compared with normotensive patients (P less than 0.01). 2. Patients with primary hypertension had more anger (P less than 0.01), anxiety (P less than 0.01) and guilt (P less than 0.05) than normotensive patients or patients with phaeochromocytoma. 3. The responses of noradrenaline and adrenaline concentrations were similar after mental and isometric stress in primary hypertensive and normotensive subjects. 4. However, after mental stress and isometric exercise there were increased responses of plasma noradrenaline and systolic blood pressure respectively, in patients with high anxiety and anger compared with those below the 50th percentile (P less than 0.05). 5. Increased central and peripheral neurogenic tone at rest and after stress in association with increased anxiety and suppressed anger appear to be pathogenic factors in some patients with primary hypertension and may not be a result of the blood pressure elevation.
Survey data from several countries indicate that many people believe that hypnosis may increase the accuracy of an eyewitness's memory; most experimental research, however, suggests that this belief is inaccurate. This study examined whether the belief could influence judgments of guilt and innocence in a simulated criminal trial. The results indicated that British undergraduates were more likely to find a male defendant guilty when told that the testimony against him had been elicited under hypnosis. Results concerning a nonhypnotic memory facilitation technique were found to be inconclusive, and the salience of hypnotically elicited testimony was ruled out as a contributory element.
This paper examines the important role of anniversary reactions in the psychological adjustment of seriously traumatized individuals. The clinical case study examines the impact of anniversary reactions on the posttraumatic symptoms and accommodation of a five-year-old boy. Unresolved conflict with the mother, an intense sense of guilt, and difficulty in self-identification were explored during subsequent sessions of psychoanalysis. The clinical significance of considering the possibility of anniversary reactions in children manifesting repetitive attempts of trauma mastering is discussed.
Women who lose an early pregnancy are shocked when they are first given the information that they have miscarried. Later they feel guilt and emptiness. Heideggerian interpretive phenomenology has been used with 13 women from southwest Sweden to uncover their lived experience of miscarriage. Women plan their future with a child during early pregnancy. When miscarriage occurs it is not a gore, an embryo, or a fetus they lose, it is their child. They feel that they are the cause of the miscarriage through something they have done, eaten, or thought. They feel abandonment and they grieve for their profound loss; they are actually in bereavement.
Hospice care is dedicated to alleviating the pain of dying people. In addition to physical, social, and psychological pain, religious or spiritual pain can add to the struggles of many patients. Religious pain is rooted in guilt leading toward punishment and experienced as fear. It is resourced through the positive teachings of the patient's religious legacy. Spiritual pain is rooted in shame leading a patient to abandon hope in God's love. It is resourced through bringing unconditional love to the patient's sense of self-hatred and inner criticism.
The author describes the phenomenology and clinical characteristics of survival guilt which can be found in many Vietnam veterans. This conflict, in its most acute presentation, typically resembles an agitated depression. The syndrome is characterized by the veterans' frequent dreams of their friends dying in battle, and by their avoidance of interpersonal intimacy because they fear the other party may abandon them or die. The section on treatment recommendations emphasizes the importance for psychotherapists to confront continuously the veterans' many self-destructive patterns of behavior. Psychotherapy should also address any false beliefs the veterans may entertain regarding the nature of their survival.
Men and women who have a family history of breast and/or ovarian cancer may be offered a predictive genetic test to determine whether or not they carry the family specific BRCA1/2 mutation. The sons and daughters of mutation carriers have a 50 per cent chance of inheriting a mutation, which will increase their risk of developing cancer. Little is known about at-risk men's feelings about the part they play in the transmission of BRCA1/2 mutations within their families. This study investigated high risk men's responses to BRCA1/2 predictive genetic testing. Seventeen in-depth interviews were undertaken with carrier (n= 5) and non-carrier men (n= 12). All men described genetic testing as a familial duty. It is observed that carriers and non-carriers mobilised differing explanations about their role in the aetiology of risk. It is noted that men engage in a form of narrative reconstruction in which they draw upon discourses of guilt and blame or fate and predestiny in an effort to present themselves as morally responsible or blameless. It is argued that narrative reconstruction enables these men to reconcile their genetic identity, self and family.
This paper suggests that humans have innate needs to be seen as attractive to others. These needs form the basis for shame and mediate evaluations of social standing (status), social acceptance and social bonds. Shame and humiliation are associated with attacks on, and losses of, social attractiveness. The internal experiences of shame are derived from submissive strategies where one seeks to signal to others awareness of loss of social standing and limit possible damage. However, it is suggested that shame and humiliation differ from each other in a number of ways. For example, in shame the focus is on the self, while in humiliation the focus is on the harm done by others. Variations in the defensive strategies of shame and humiliation (e.g. avoidance, escape versus aggression and revenge) can pose particularly difficult problems in therapy. A focus on the role of social attractiveness in shame also allows for important distinctions to be drawn between shame and guilt.
I have described paradoxical naughtiness due to guilt which occurs in some child patients during therapy and, if undetected and not interpreted, can escalate to destructive proportions. A clear conceptualization of the superego developmental line is crucial since it provides a framework for understanding the shifting superego transferences as played out by the child. The prohibitive and the loving superego transferences in turn provide the specific material for interpretations that lead to new identifications with the therapist's benign superego and at times eventual understanding of the child's internalization and distortion of parental superego functions from the past.
The soldiers who perpetrated atrocities during the Vietnam War are a group much less studied than the victims of violence during peacetime. These soldiers were catalyzed by war to express a darker side of their humanity, a side that our society often chosses to ignore. At some level their experiences relate to us all. In the future more young men and, probably young women, will be sent to war. Once they have been transformed by military training and the hellish conditions of war, society tends to forget them--to leave them wandering in a no man's land of their own tortured thoughts and feelings. We need to understand more about how such transformations of the self beset our returning soldiers. And, once this has happened, we need to know how to help them reintegrate into society and reconnect with others in a meaningful way. A psychotherpy that embraces the patient's need to express remorse is necessary in order to help these patients work through their guilt and self-hatred. These are the main objectives of treatment.
The highly condensed dream element trimethylamin is central to the dream of Irma's injection. After a brief review of the medical literature on timethylamine (TMA), it is suggested that two important meanings of this chemical and its properties lie in its disguised reference to disparaging views of women, as well as to Freud's homosexual connection to Wilhelm Fliess. Freud's misogynistic and homosexual impulses were stimulated by Fliess's recent surgical error committed while operating on Freud's patient Emma Eckstein. Evidence is presented that the collaboration between Freud and Fliess in performing an aggressive act toward a woman was for Freud an enactment of a childhood situation in which he and his nephew John had ganged up on John's sister Pauline. The later relationship between Freud, Jung, and Sabina Spielrein is seen as an additional reenactment of this childhood triangle. An examination of Freud's associations to and analysis of the Irma dream, as well as some of his later relationships with women, indicates that guilt and the wish to make reparation were also prominent themes in Freud's inner life.
A behavioural technique is described suitable for the treatment of patients with high levels of guilt who attempt to relieve their depression by risk-taking activities which reflect their individual wishes and fears, or who suffer anxiety due to unacceptable past behaviour. It is recommended as an alternative brief method of treatment to psychoanalysis and is based on the application of behaviour therapy to a patient's psychopathology. Three case histories are described to illustrate the principles of the technique.
Homosexuality in the male is commonly held to be the product of a specific family constellation consisting of a dominant mother and an ineffectual or hostile father. Prospective studies however, on boys with early effeminate behaviour, the majority of whom subsequently become homosexual, show that their closeness to the mother and distance from the father spring from their own needs. The physician should feel free to relieve parents of guilt for this condition.
The Mosher Guilt Scales, the Stanford Shyness Survey, and measures of anxiety, hostility, and self-esteem were administered to 54 college females in an effort to clarify the nature of the personality problems that beset shy and guilty persons in social situations. As was hypothesized, it was found that shy people also tended to be guilty. This complicates attempts to understand the nature of the problems with which shy and guilty persons must cope. In addition, it was found that both shy and guilty people tended to be high in trait anxiety, and low in hostility and self-esteem. Thus the profile of a shy, guilty person is that of an individual who is uncomfortable with her own feelings, actions, and beliefs across a variety of social situations.
The purpose of this discussion of teleological and deterministic concepts in clinical theory and treatment was not to offer definitive answers to a timeless philosophical problem. Indeed, a solution to the problem of free will in a deterministic science eludes even the greatest thinkers (cf. Howard and Conway, 1987). Following Feyerabend (1984), the purpose was instead to question one of the "general and lasting boundary conditions" (p.3)-causal explanations-introduced by Enlightenment-era philosophers of science to "protect" (p.3) science. I have attempted to demonstrate the logical inconsistencies of Klein's theory of etiology of infantile guild using both a teleological perspective that questions the assumption of causal explanations imposed on a scientific inquiry of human experience, and a deterministic perspective that affirms this assumption. When taken to their logical conclusions, both perspectives reduce to mutually irreconcilable theoretical and clinical absurdities. As as clinician I myself have chosen to work within a deterministic framework. I have found that perceiving the patient deterministically allows me to empathize with even the most unspeakable intrapsychic experiences. I share with my patient the antecedent conditions that efficiently cause our common experiences. It is this empathy for our share human condition-in al its transcendence, frailty, and profanity-communicated through interpretation that seems to give birth to the healing process (Goodman, 1991). This discussion doubtless also contains inconsistencies. Nevertheless, it contributes to the ongoing discourse of clinical theory and treatment because it draws attention to the enormous, yet still largely implicit, debt that clinical theory and treatment owe to philosophy. It is a great irony that the discipline that has historically put scientific inquiry in shackles also has the power to set it free. Whether teleology is the philosophical perspective to set clinical theory and treatment free, however, seems unlikely. In choosing to discuss Klein's theory of infantile guilt, I have taken seriously R.J. Rychlak and Rychlak's (1990) implicit support (cf. p.48) for a teleology that functions throughout the life span, et find it difficult to imagine both the unconscious and conscious minds with freely premising capacities-as if human being were actually two persons in one. One the other hand, reducing human beings to the status of Hobbesian machines-as the deterministic perspective seems to imply-presents a similarly unattractive alternative. To understand the nature of human suffering and the process of healing it, however, one thing is certain: A philosophical discourse of clinical theory and treatment must continue.
Three parking spaces clearly designated as reserved for people with disabilities were observed from 8:00 AM until 9:00 PM on Monday through Saturday of the second or third week in November for five consecutive years. During the seven weeks of observation, 962 drivers parked illegally in those three reserved spaces. Informal observations and previous research suggested that illegal parkers would be more likely to park in the least conspicuous parking spaces, and, as predicted, a significant monotonic relationship was found. Thus, the data generally agree with the prediction that illegal parkers in spaces reserved for people with disabilities are less likely to park in the more conspicuous parking spaces and are more likely to park in the least conspicuous parking spaces, suggesting a guilt gradient in this illegal parking.
A physician may feel guilt and sorrow if he contributes, though innocently, to a patient's death. One radiation therapist, whose famous patient died, finds a parallel to his own experience in the case of the opera composer Giacomo Puccini, who died while being treated for cancer by his well-meaning radiotherapist.