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Anorexia nervosa and Turner's syndrome.

Publications about Turner's syndrome and anorexia nervosa are extremely rare. All of them, including a new case, are listed up and discussed under psychodynamic aspects. The conclusions drawn from these 21 cases might be essential for genetic counseling, hormonal treatment and psychotherapy in Turner's syndrome. (1) There is a connection between the beginning of the hormonal treatment and the onset of anorexia nervosa in Turner's syndrome. The anxiety during hormonal treatment is due to sexual feelings and the confrontation with the gender role. As the manifestation of anorexia nervosa ought to be taken into account the beginning of a hormonal treatment should be decided in individual context. (2) The early childhood of girls with Turner's syndrome is striking with respect to psychosocial constellations. Short stature and other deficits mean narcissistic wounds. Therefore understanding and affectionate parents are most important to them as they particularly suffer from conflicts with the family.

Adult↗

The phallic child: its emergence and meaning in a clinical setting.

The nature of the drive toward forming and maintaining intense attachments with other human beings has been examined in the light of case material from the play therapy sessions of a ten-year-old boy. The primary question addressed concerns the relationship of the attachment drive to other drive systems. Freudian theory, object relations theory, and attachment theory present competing paradigms for understanding the relationship between the drives. The Freudian paradigm sees human attachment as derivative from other drives, especially the sexual drive. In developing his attachment theory, Bowlby broke from the classical Freudian view. He postulated attachment as a primary and autonomous drive. Object relations theory, by contrast, sees sexuality as one manifestation of a more fundamental drive that is intrinsically relationship seeking. Each of these traditions has contributed to our understanding of human reality. A careful examination of the clinical material, however, strongly suggests that a drive toward relationship is intrinsic to libidinal energy. It is therefore concluded that the understanding of the relationship between the drives based on object relations theory provides us with the most adequate framework within which to understand the clinical material.

Adoption↗

Adolescent sexual offenders: a self-psychological perspective.

Following a request for assistance in formulating a treatment philosophy for adolescent sexual offenders, a qualitative study of seven adolescent offenders was designed with a view to elaborating pre-offense, and post-offense dynamics. The point of departure was the hypothesis that sexual offending had relation to object relations. It was further hypothesized that offenders' object relations and self-development had been disfigured in childhood and adolescent development. The developmental theories of Mahler, Stern, Winnicott, and Kohut were reviewed in order to shed light on the connection between disfigured self-development and sexual offending. Mahler's work suggested that anomalies during the separation-individuation process were heavily implicated. Winnicott's thinking on transitional functioning in potential space and his employment of the concepts of the true self and false self were especially useful. These bodies of work were assimilated to Kohut's theory of self development in which three nuclear sectors of the self, namely, the grandiose-exhibitionistic sector, the idealizing-voyeuristic sector, and the twinship-alterego sector, gradually coalesce and cohere through the moderating influence of parental empathy with the child's developmental tasks. Where such empathy is unforthcoming, or when the normal parental functions are obliterated by traumatic experiences of abuse, unmoderated needs for exhibitionism and voyeurism continue through childhood, adolescence, and adulthood. Victims of sexual offending were hypothesized to perform functions of restoration and preservation of a chronically weak and threatened self. The sample's interview transcripts were qualitatively analyzed and aggregated. Analysis suggested that, indeed, offenses appeared to have been motivated to preserve a weakened sense of self and that the thoughts and perceptions surrounding the offenses resonated with expressions of problematic separation from parental objects. In addition, it was noted that in the post-offense period, offenders had become subject to close supervision, or proctoring, from both formal and informal systems. In close supervision, offenders tended to rapidly crystallize a foreclosed, negative, deviant sexual identity in defense of unmoderated narcissism. Other observations were that intrafamilial offending was consistent with enmeshment in the family, adjudication and apparent treatment readiness, while extrafamilial offending was consistent with exclusion from the family, no adjudication and resistance to treatment.

Adolescent↗

A variation on Freud's theme in "A child is being beaten"--mother's role: some implications for superego development in women.

Clinical material is presented leading to a discussion of beating fantasies which varies from Freud's model. Analysis shows that the fantasied role girls assign to mother as the punisher in the oedipal drama is equivalent to the fantasied role boys ascribe to father as castrator. For both sexes, castration anxiety spurs the internalization of parental prohibitions, the repression of oedipal wishes, and the subsequent structuralization of the superego. Mother establishes the "oedipal law" for the girl analogously to father's doing the same for the boy. The role that such fantasies play in the formation of the female superego is examined.

Adolescent↗

Vicissitudes of adolescent development and its relationship to young adulthood.

Present day psychoanalysis of adolescents is separate from that of adults. It must include an adolescent-young adult period. Knowledge of interactional family influences, that is, power demands with limited communication, plus frequent divorce, make special demands. Internalizaton of the therapist helps neutralize some of the comflict. This is a period when only a piece of the therapeutic work can be achieved and can satisfy neither parents nor adolescents.

Adolescent↗

Adolescent personality development: three phases, three courses and varying turmoil. Findings from the Toronto Adolescent Longitudinal Study.

The Toronto Adolescent Longitudinal Study was launched in 1977 to examine personality development in a non-clinical sample of children from ages ten through 19 over an eight year period. Following a description of their conceptualized model of personality and of the nature of the study, the authors summarize their findings which suggest new perspectives in three areas of adolescent personality development: 1) the subphases of adolescence, 2) the routes of passage through which adolescents proceed, and 3) adolescent turmoil.

Adolescent↗

The psychology of women: a psychoanalytic review.

Freud's psychoanalytic views of female development emphasized the importance of penis envy and the Oedipus complex. Resolution of the Oedipus complex resulted in a "neurotic" solution, a "masculinity complex" or a normal feminine attitude involving acceptance of anatomic inferiority, passivity, masochism and narcissism. Modern psychoanalytic views have rejected or reformulated many of these theories. Penis envy is seen as a normal phase of development which is resolved in most women. Women have been found to develop strong, albeit different, super ego structures. The female character triad has been questioned and the role of environmental factors emphasized. Efforts continue to develop a comprehensive well-integrated view of female psychology.

Female↗

Male adolescent rites of passage: positive visions of multiple developmental pathways.

Unlike the separation-based, stereotyped views of boys' developmental movement into adulthood, this paper will argue that there are more modern and relational models, as well as multiple pathways, for young males to journey through such rites of passage. Indeed, it will be suggested and supported by both qualitative and quantitative data that the more classic models depend on a "boy code" of traumatic separation from mother and the feminine, a process that is not only negative rather than positive in its developmental trajectory, but also likely to create a premature traumatic separation, leaving boys at risk for emotional maladjustment, everyday sadness, increased incidence of depression and the potential for violence toward the self, suicide, as well as violence toward others. More-positive visions and versions of male rites of passage will be posited and described. The definition of emotional "resilience" during this significant period will be re-addressed as one of "healthy vulnerability," sustained through connection to loving adults, rather than a classic belief in stoicism and release from relational ties. Attachment theory will be brought to bear and the desperate yearnings of adolescent males not only for connection to adult mentors, but also for non-romanticized friendships with adolescent females, will be discussed. Finally, the understanding and substitution of these new, more positive, developmental pathways will be linked to the prevention of violence.

Adolescent↗