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PubMed1992

[Elements of a neurophysiologic model of the unconscious].

The author sets forth a conception of an inborn reciprocally organized neuropsychological pre-program of the personality. In tender age it orientates the experience and the behaviour unconsciously and later its activity becomes conscious to one or another degree. Elements of this pre-program are a reciprocally organized system of the fundamental drives and emotions and adjacent structures. On the basis of this conception, the author makes a neuropsychological analyse of some para-adaptive personality reactions.

Drive↗
PubMed1992

[The body--a symbol of the unconscious?].

Based on Lacan's differentiation between the real, the imaginary and the symbolic it is shown that Moser's connection between psychoanalysis and therapy is almost exclusively concentrated on the body in the sphere of the imaginary. According to Bittner, when the body is regarded symbolically, it represents a highly emotional "transcription" of the unconscious.

Body Image↗
PubMed1992

Intestinal ischaemia in the unconscious intensive care unit patient.

This paper highlights the difficulties of diagnosing intestinal ischaemia in unconscious patients on an intensive care unit. We have analysed the clinical details and investigations of eight such patients in whom a preoperative diagnosis of intestinal ischaemia was made on clinical grounds. Intestinal ischaemia was confirmed at laparotomy in only four cases (50%). These patients showed no significant differences in any of the commonly accepted parameters of intestinal ischaemia from the four patients who had a negative laparotomy. In particular, all patients exhibited a metabolic acidosis with fever and a leucocytosis. There was a mean delay of 13.6 h between surgical opinion and laparotomy in the four patients with ischaemia, only one of whom was salvaged. There was no morbidity associated with the laparotomy in this small series. It is suggested that, in the intensive care setting, early laparotomy should be performed immediately the clinical suspicion of intestinal ischaemia arises.

Acute Disease↗
PubMed1992

[Conflict and counter-conflict--unconscious aspects in a cultural context].

Quarrel is considered to be a social form not only an affective relationship. Following the sociologist Georg Simmel the thesis is presented that quarrel does not destruct social order but constructs. Quarrel is a social form in the antagonism between family and culture. Described are characteristic courses of quarrels as well as unconscious strategies which are illustrated by family therapeutic examples. My contribution ends with the remark in the theory of culture about the connection between quarrel, the tragedy of individualization and the introversion of guilt. I propose not to avoid quarrels, but to cultivize them.

Child↗
PubMed2006

Implants will aid care of unconscious patients.

Use of implantable chips can make a big difference in care of patients with altered mental status. With unconscious patients, staff can wave a reader over their arm to get information about their medical history and current medications. Since the chip has an identification number, but not medical records themselves, federal privacy laws are not violated. Technology is relatively inexpensive and can be borne by insurance carriers.

Emergency Service, Hospital↗
PubMed2006

Electrocardiographical case. A man found unconscious.

A 25-year-old man was brought to the emergency room after being found unconscious. Electrocardiography (ECG) showed changes classical of tricyclic antidepressant (TCA) poisoning. These included sinus tachycardia, QTc prolongation, QRS complex widening, right axis deviation and positive R waves in lead aVR. This unique ECG highlights the importance of lead aVR, which often tends to be ignored. Treatment is started based on ECG findings.

Adult↗
PubMed2006

Prolonged unconsciousness in a patient with End-stage Renal Disease.

Patients with End-stage Renal Disease being immunocompromised; are prone to a variety of infections, sometimes, rare ones, more than the general population. This fact should alert the physicians to be more vigilant and have a broader scope when considering the etiology of infections in such patients. We report the case of a 65-year-old man who had a very stormy hospital stay secondary to cerebral nocardiosis with multiple brain abscesses, prolonged unconsciousness and neurological deficits. However, the patient was treated successfully, surgically and chemotherapeutically. He was discharged home in a good condition.

Aged↗
PubMed2007

What's fair? The unconscious calculus of our moral faculty.

This essay argues that much of the research in moral psychology has focused on moral performance, on what people do. The study of moral competence, in contrast, has largely been ignored. I use the analogy to linguistics as a model for exploring our moral competence, and suggest that we are endowed with a moral faculty that operates over the causes and consequences of actions. This moral faculty is endowed with principles and parameters that are universal. Acquiring a particular moral system entails setting the parameters. On this model, emotions such as empathy are consequences (as opposed to causes) of unconscious but principled moral evaluations.

Emotions↗
PubMed1992

Tympanometry for middle-ear effusion in unconscious ICU patients.

Eighty-six bilateral impedance audiometries were performed weekly in 35 unconscious ICU patients. Tympanometry showed the presence of middle-ear effusion in 43.3% of the examinations (80% of the patients). The incidence of effusion was significantly higher in patients older than 50 years, in intubated and mechanically ventilated patients and in the presence of microbial colonization of the upper airways. The acoustic reflex (AR) was characterized by increased threshold values in 23.8% of the examinations and was absent in 41.3%. Abnormal or absent ARs were usually associated with middle-ear effusion or tube malfunction.

Acoustic Impedance Tests↗
PubMed1989

[An early, on the borderline between dream and transference, unconscious fantasy of Freud on the psychoanalytic situation (1898). A contribution to psychoanalytic creativity].

Taking 24 hours in the life of Freud, the author shows how significant the interplay of dream, day-dream, unconscious phantasy and transference can be in solving scientific problems. This is documented by using the correspondence between Freud and Fliess on March 9/10, 1898, by taking Freud's dream of a botanical monograph, his day-dream of a glaucoma operation, his remarks on the "real" course of the day, and segments of self-analysis.

Austria↗
PubMed1989

Unconscious guilt as a cause of sexualized relationships.

The author summarizes 4 years of intensive psychotherapy with a patient who engaged in various forms of self-destructive behavior, including the sexual fondling of his 14-year-old stepdaughter. The author illustrates the important role that unconscious guilt may play in motivating a patient to engage in what ordinarily would be thought of simply as illicit drive-gratifying behavior. She describes the patient's reported childhood traumas and the therapeutic process of treatment, and gives examples of interpretations that facilitated the patient's efforts to gain control over his self-destructive behavior.

Adult↗
PubMed1988

Pediatric closed head injury: outcome following prolonged unconsciousness.

This report describes outcomes for a group of 26 children who remained unconscious longer than 90 days after traumatic brain injury. Twenty children regained consciousness; 11 are able to communicate. Five children can ambulate independently. In this series, children with the best recovery (IQ greater than or equal to 70) were predicted by minimal cerebral atrophy, demonstrated by computerized brain scan (CT scan) performed two months after injury (p = 0.001). In subjects over 12 years old, minimal CT atrophy predicted a good outcome with 89% accuracy.

Adolescent↗
PubMed1987

The use of intermittent and continuous recordings of jugular venous bulb oxygen saturation in the unconscious patient.

Monitoring clinical signs in unconscious patients provides only late information about cerebral deterioration. Ischaemia and hypoxia are the mechanisms of much of the damage. Cerebral blood flow (CBF) measurements provide direct evidence of ischaemia but are intermittent values for what may be an unstable situation. Continuous recordings of CBF and oxygenation are more likely to reveal harmful tendencies to ischaemia and hypoxia at an early stage than intermittent readings. We report our experience with intermittent and also continuous recording of the jugular venous bulb oxygen saturation (JVO2Sat) obtained by fibreoptic oximetry in a group of 10 head injured and 7 septic patients. Simultaneous measurements of CBF by an isotopic xenon clearance method were also made. The JVO2Sat has been suggested to be a reliable indicator of cerebral oxygenation, a low value being indicative of ischaemia. We discuss whether our findings support this statement. There are also variations in JVO2Sat with mean arterial blood pressure and intracranial pressure. These variations have important implications in the interpretation that can be made of one single value of JVO2Sat.

Adolescent↗
PubMed1978

The unconscious in France before Freud: premises of a discovery.

The influence of German culture on Freud has long been acknowledged, while his indebtedness to French psychological and medical tradtion has often been overlooked. The author presents a study of the emergence and evolution of the concept of the unconscious in nineteenth century French scientific discourse and its influence on Freud.

France↗
PubMed1987

Identification and its connexion with unconscious thought and melodic lines.

This paper deals with identification in relation to unconscious thought, as discussed by Freud in works written throughout his life, and its connexion with melodic lines. These ideas are reexamined in the context of the work of other authors and correlations are established between theory, clinical practice and psychoanalytic technique.

Depressive Disorder↗
PubMed1987

+Gz-induced loss of consciousness: a case for training exposure to unconsciousness.

+Gz-induced loss of consciousness (G-LOC) continues to be a threat to aircrew flying high-performance fighter aircraft. All avenues to prevent G-LOC, and to reduce the resulting incapacitation should G-LOC occur, must be explored. Research has begun to accurately quantify all aspects of the G-LOC phenomenon. The emerging pattern from this research indicates that, theoretically, G-LOC incapacitation could be significantly reduced. Comparison of G-LOC with LOC induced by acute arrest of cerebral circulation reveals that the G-LOC incapacitation could be reduced by as much as 17 s. Results also indicate that the relative incapacitation period (confusion and disorientation) following unconsciousness could be reduced by at least 9 s for an individual who has previously experienced G-LOC. This suggests that exposure to G-LOC during centrifuge training could provide this orientation to G-LOC and potentially reduce the incapacitation period should it occur inflight. This exposure may be likened to the current altitude-hypoxia training requirement for aircrew. Experience to date supports the contention that such training may be accomplished with an acceptable safety margin.

Adolescent↗
PubMed1987

Unconscious identification fantasies and family prehistory.

Discovery of the fact that a subject identifies in an obvious way with another is at first only the awareness of a present process: involuntary mimesis, obedience to early 'identifying designations' or simple imitation deliberately carried out. Much psychic work remains to be done before we can think of such phenomena as 'screen-identifications'. The psychoanalytic interpretation of these dynamic formations will lead to the resolution of genuine 'identification complexes' through the reconstruction of scenarios which I have named 'unconscious identification fantasies'. These fantasies stage characters from the infantile prehistory and family saga of a subject who may be compelled to live out in his behaviour, symptoms, dreams, or even sometimes delusions, episodes pertaining to the past existence of the 'ego's visitors' linked to the most archaic processes that constitute the personality.

Adult↗