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PubMed1996

From "nothing" to "something" to "everything": bisexuality and metaphors of the mind.

Psychoanalytic understanding of female sexuality has continued to evolve since Freud presented it as a central and abiding question in psychoanalytic theory. This paper is an attempt to demonstrate that much of what we have learned and added to our theory is based in part on the classical thinking which remains a foundation of psychoanalytic wisdom about human sexuality in general, male and female. And this foundation rests on the cornerstone of the human longing for completeness, for "everything"--a bisexual core. A clinical case, the basis of psychoanalytic data, demonstrates, primarily through the analysis of a dream, the neurotic derailments that follow upon a disavowal of the need for the little girl to identify with the metaphorical representation of male genitalia. The theoretical underpinnings of this perspective are presented as well as a correction of a common misreading of Freud's ideas about anatomical "bedrock."

Dreams↗
PubMed1994

Marital conflict and child adjustment: an emotional security hypothesis.

An emotional security hypothesis that builds on attachment theory is proposed to account for recent empirical findings on the impact of marital conflict on children and to provide directions for future research. Children's concerns about emotional security play a role in their regulation of emotional arousal and organization and in their motivation to respond in the face of marital conflict. Over time these response processes and internalized representations of parental relations that develop have implications for children's long-term adjustment. Emotional security is seen as a product of past experiences with marital conflict and as a primary influence on future responding. The impact and interaction of other experiential histories within the family that affect children's emotional security are also examined, with a focus on parent-child relations.

Adolescent↗
PubMed1991

Investigation and treatment of a multiple limb birth.

We report a baby born with three fully developed normally functioning legs. The third leg was attached to the baby's sacrum via an iliac bone at the site of a spina bifida. A primitive perineum was present. Innervation of the limb was via a sacral hiatus with a myelomeningocele. A rudimentary peritoneal sac was found at operation containing a blind loop of bowel suspended by a mesentery. The additional leg was found to have no cortical representation using somatic evoked potentials although lumbar responses were normal. Magnetic resonance imaging demonstrated a bifid spinal cord in the lumbo-sacral region. Associated abnormalities were a haemangioma of the L orbit and a vascular mass in the cerebellum.

Abnormalities, Multiple↗
PubMed2000

Childhood maltreatment and malevolence: quantitative research findings.

This article examines the quantitative research literature that focuses on the object relations sequelae of childhood maltreatment. A review of 12 studies indicates strong support for a relationship between childhood maltreatment and a malevolent object world. This relationship holds despite variations in methodology across studies, including differences in sampling and measurement techniques. This paper defines the construct of malevolence, and proposes that malevolent representations are a central feature of the experience of childhood maltreatment. Implications for diagnosis and treatment are considered, and directions for future research are outlined.

Child↗
PubMed1992

Malevolent object representations in borderline personality disorder and major depression.

To study malevolent representations, earliest memories were reliably coded on scales of affect tone. Ss were diagnosed with borderline personality disorder: 31 without and 30 with concurrent major depression. Nonborderline comparison subjects had either major depressive disorder (n = 26) or no psychiatric diagnosis (n = 30). Borderline subjects were discriminated from comparison subjects by their more malevolent representations; they more frequently produced memories involving deliberate injury; and they portrayed potential helpers as less helpful. Results suggest the diagnostic significance of malevolent representations, which need to be explained by any theory of borderline personality disorder.

Adolescent↗
PubMed2002

A psychoanalytical approach to integrating family and individual therapy in the treatment of adolescents. A case study.

An integrated model of object relations family therapy and a self psychology-oriented individual therapy is presented in the form of a case study of an adolescent. The therapy strives to create and negotiate a balance between deconstructing the family's defensive delineations of the adolescent and helping him to form new building blocks of self-representation. The integrated model both highlights and adeptly addresses the unavoidable adolescent issue of conflicted loyalty between self and family as reflected in the adolescent's internal and external psychological world.

Adolescent↗
PubMed1987

The development of time sense: from object constancy to adolescence.

A developmental line of time sense during the oedipal phase and latency is described. Subjective time sense is seen as constantly evolving, shaped by the emergence of cognitive capacities, significant emotional themes, and environmental influences. Temporal development during these phases is unique because the capacity to tell objective time is present for the first time. Significant emotional influences are the Oedipus complex, infantile neurosis, and superego formation. The concepts of Mother Time and Father Time are presented as useful descriptors of the child's intrapsychic representation of the chief environmental effectors of temporal organization. Clinical examples demonstrate that the development of time sense can be unaffected, impeded, or incorporated into psychopathology.

Child↗
PubMed1997

Lengths of hamstrings and psoas muscles during crouch gait: effects of femoral anteversion.

Recent studies of muscle lengths measured by means of gait analysis data and musculoskeletal models have suggested that in many cases of crouch gait in patients with cerebral palsy, the hamstrings are of normal length and the psoas muscles are short. In these studies, however muscle lengths were calculated by applying kinematic data from a child's joint to a normal adult model. Children with cerebral palsy and other disorders generally do not have normal bone architecture but instead have muscle attachment points and muscle paths altered by osseous deformities. In this study, we explored the consequences of using normal adult musculoskeletal models to calculate hamstring and psoas lengths for children with cerebral palsy. Specifically, for a group of subjects with cerebral palsy who walk with a crouch gait, we investigated the changes in muscle lengths that arise when a patient-specific representation of clinically measured femoral anteversion was added to a model of normal musculoskeletal geometry. The calculation of psoas muscle length was found to be very sensitive to femoral anteversion whereas the calculation of hamstrings length was found to be relatively insensitive to this osseous deformity.

Adolescent↗
PubMed2004

Relations between young children's responses to the depiction of separation and pain experiences.

This study examined relations between young children's representations of separation and pain experiences in 60, 4- and 5-year-old children. Separation representations were assessed with the Separation Anxiety Test (SAT) and pain representations were assessed by examining responses to pictures of children about to experience pain in the presence of parent figures. Results showed that representations of separation and pain experience were systematically related and the patterns were not accounted for by the child's ability to differentiate emotional states, language ability, or reports of emotional regulation. These findings are consistent with Bowlby's (1982) concept of secure base behaviour in response to a variety of distress, and support the hypothetical construct of an internal working model of attachment which organizes children's behaviours, thoughts, and feelings in response to both separation experience and painful events.

Adult↗
PubMed1998

Maternal identification: a description of the process in real time.

This research, using the method of microanalysis, explores the to-and-fro activity of the self- and object representational world of mothers as they observe their children. Under examination is a "moment" usually lasting not more than 5-20 seconds that was selected by the mother as outstanding to her during the time she was observing her child. A microanalytic interview technique was developed in which the mother is asked about everything she experienced about "the moment," including what she was feeling, imagining, doing, perceiving, and remembering. At brief intervals she was asked to indicate on a scale where--on herself or her child--her experience was centered. These data were organized in terms of tracking the locus of the mother's perspective: from dwelling in her own mind (self-representation) to inhabiting that of her child (object representation). Results indicate that these representational shifts occurred frequently, usually every one to three seconds, and that there were significant individual differences among the mothers.

Child, Preschool↗
PubMed2026

Preserving the Pineal Gland in Perinatal Mouse Brain Preparations.

The pineal gland, a neuroendocrine structure that secretes melatonin, forms from an anlage at the dorsal midline in the embryonic forebrain. At embryonic day (E) 14.5 in the mouse, a pineal diverticulum is seen out-pouching from the roof of the diencephalon between the paired telencephalic vesicles. This diverticulum is in close contact with overlying cartilage, meningeal, and vascular tissue. It is easily lost when the cranial vault is opened to extract the brain at late embryonic/ early postnatal stages. Despite its important neuroendocrine role, the early development of the pineal gland and the signaling mechanisms that regulate this process remain poorly understood, partly due to the difficulty of preserving this structure intact during embryonic stages of mouse brain development. This article presents an innovative dissection procedure that preserves the pineal gland while maintaining its structural integrity and its attachment to the roof of the diencephalon during brain isolation from embryonic stages through postnatal day (P) 7. The procedure is demonstrated using an E18.5 mouse brain and is therefore suitable for downstream applications requiring preservation of tissue architecture, including in situ hybridization, immunohistochemistry, and spatial transcriptomics. The protocol may also be used to isolate the developing pineal gland, thereby improving pineal-specific representation in transcriptomic and proteomic analyses, which is otherwise challenging because of its small size.

Animals↗
PubMed1985

Proprioceptive influences on auditory and visual spatial localization.

We evaluated the influence of proprioceptive information about arm position on the perceptual localization of auditory and visual targets attached to the hand. Our approach was to distort the perceived position of the restrained arm by means of mechanical vibration of the biceps brachii muscle; such vibration elicits compelling apparent extension of the stationary forearm (Goodwin, G. M., D. I. McCloskey, and P. B. C. Matthews (1972) Science 175: 1382-1384, Brain 95: 705-748), and subjects report changes in the apparent directions of the auditory and visual targets attached to their hand. These changes are in the same direction and plane as apparent arm motion and their onsets are coincident with or lag slightly behind the experienced displacement of the arm. While visual motion is being experienced, a subject's eyes remain steadily fixating the target light. The pattern of findings demonstrates that proprioceptive information about limb position can influence the central representation of gaze and auditory localization can be similarly influenced. The biasing of auditory localization indicates that identical patterns of arrival time and intensity cues at the two ears can give rise to the perception of sounds in widely disparate spatial positions in relation to the head and body, depending on the proprioceptive representation of the direction of the sound source.

Adolescent↗
PubMed2005

The impact of social environments on the effectiveness of youth HIV prevention: a South African case study.

Few would disagree that 'social context' shapes the effectiveness of HIV-prevention programmes. However much work remains to be done in developing systematic conceptualisations of HIV/AIDS-relevant aspects of social environments in vulnerable communities. This paper contributes to this challenge through a case study (44 interviews, 11 focus groups with 55 people and fieldworker diaries) of the impact of social context on a participatory peer education programme involving young people in a peri-urban community in South Africa. Three interacting dimensions of context undermine the likelihood of effective HIV-prevention. Symbolic context includes stigma, the pathologisation of youth sexuality (especially that of girls) and negative images of young people. Organisational/network context includes patchy networking amongst NGOs, health, welfare and education representatives and local community leaders and groups. This is exacerbated by different understandings of the causes of HIV/AIDS and how to manage it. These challenges are exacerbated in a material-political context of poverty, unemployment and crime, coupled with the exclusion of young people from local and national decision-making and politics. HIV-prevention initiatives seeking to promote health-supporting social environments should work closely with social development programmes to promote young peoples' social and political participation, increase opportunities for their economic empowerment, challenge negative social representations of youth, and fight for greater recognition of their sexuality and their right to protect their sexual health.

Adolescent↗
PubMed1993

Parental and relationship representations and experiences of depression in college students.

Young adults' descriptions of their parents and their relationships with their parents were used to reexamine the relations between object representation and depressive experience. One hundred eight students completed (a) four open-ended descriptions, including two written descriptions of the parents (mother and father, separately), and two written descriptions of the relationships with the parents; and (b) the Depressive Experience Questionnaire. Each of the four open-ended descriptions was rated on seven scales. Factor analysis yielded four distinct factors from the 28 dimensions of the descriptions. These factors were related to: (a) the degree of elaboration and investment, (b) the structural level of the descriptions, (c) the affective tone of the description of the father, and (d) the affective tone of the description of the mother. Significant differences and interactions were found regarding the interplay between the specific significant other represented (father or mother) and the specific framework of representation (parent description or relationship description). Measures derived from parents' and relationship descriptions significantly predicted depressive experiences of self-criticism and dependency. The results indicate the advantages of a joint exploration of the representation of distinct significant others (mother and father) and the use of two modes of relatedness (describe parent and describe relationship with parent) in the process of personality assessment.

Adolescent↗
PubMed1983

The structural theory and the representational world: developmental and biological considerations.

Although the intriguing question of whether the division into two viewpoints within the structural theory is a theoretical convenience or whether it mirrors fundamental psychobiological truths is not capable of full resolution at the moment, fortunately that resolution is not required for our usual clinical purposes. I believe that analytic work presents us with data readily conceptualized now from one, now from the other, viewpoint, so that analytic understanding benefits from the analyst's shifting his frame of reference from moment to moment in listening and associating to the patient's material. I believe that in every event within the analytic situation or in a person's life, our understanding is deepened and made more complete by approaching the phenomena from both vantage points, bearing in mind that the same ego we conceptualize as testing, assessing, and evaluating emergent drives is also assessing the congruence or discrepancy between the wished-for and perceived states of the representational world. These processes are occurring both in the analysand and in the analyst who is attempting to resonate with and understand the intrapsychic functioning of his patient. They constitute two observational vantage points within the structural theory, organizations of motives (Friedman, 1980) either of which may offer the most immediate access to understanding a particular segment of clinical material. I believe our understanding is most often deepened, however, by subsequent scrutiny in the light of the other model. I have tried here to supplement my previous exposition of a representational world point of view (J.G. Jacobson, 1983) by providing some of its developmental, ethological, and psychophysiological landmarks and underpinnings.

Animals↗
PubMed1994

Goal-directed linear locomotion in normal and labyrinthine-defective subjects.

When a subject is walking blindfolded straight ahead towards a previously seen target, the brain must update an internal representation with respect to the environment. This study examines whether the information given by the vestibular system is necessary for this simple path integration task and gives a quantitative description of locomotor behaviour during the walk by comparing ten normal and seven bilateral labyrinthine-defective (LD) subjects. Each subject performed 20 blindfolded walks (EC) and ten walks with eyes open (EO) towards a target attached to the floor 4 m in front of them; these walks were made at different velocities. The positions of head, trunk and feet were recorded using a 3D motion analysis system. No significant difference was found between normal and LD groups in terms of the distance error of reaching the target, while LD subjects showed a larger lateral error. Path curvature, expressed as the standard deviation of the angle between the direction of one step and straight ahead, was found to be significantly larger for LD subjects in the EC condition, demonstrating their instability when walking without vision. Mean walking velocity was lower for LD subjects than for normal subjects in both EC and EO conditions. Both groups walked faster with eyes open; LD subjects increased their velocity by increasing step length, normal subjects by increasing step frequency. Head stabilisation in the frontal plane during locomotion was not significantly different between LD and normal subjects, whereas both head and trunk rotation were slightly larger in LD subjects during blindfolded walking. The results show that bilateral LD subjects are able to perform linear goal-directed locomotion towards memorised targets. Thus, the vestibular system does not appear to be necessary for active linear path integration.

Acceleration↗
PubMed1997

[Large cystic neurinoma: a case report].

We report a case of large cystic acoustic neurinoma. A 52-year-old male was admitted to hospital with a history of progressive dysphagia, gait disturbance and diplopia for 2 months. On admission, neurological examinations revealed Bruns' type nystagmus to the left side, hypesthesia in the distribution of the second and third divisions of the left trigeminal nerve, and partial paresis of cranial nerves IX, X, and XII on the left side, and truncal ataxia. A pure-tone threshold audiogram indicated the presence of 32 dB hearing loss in the left ear. Speech discrimination was 80%. Caloric vestibular responses were absent on the left side. Skull radiographs with polytomographs of the internal auditory canal (IAC) were normal. Bony changes in the IAC were not found by high-resolution bone-window computed tomography (CT) scan. A plain CT scan revealed a large low-attenuated cystic mass in the left cerebellopontine angle (CPA), which was associated with displacement of the fourth ventricle. An enhanced CT scan demonstrated a thin rim-enhancement in the cyst wall. Magnetic resonance imaging (MRI) scans disclosed a large rim-enhanced cystic mass extending superiorly into the tentorial incisura and inferiorly into the foramen magnum. At surgery via a left suboccipital approach, a large cystic mass was found at the left CPA arising from the VIIIth nerve, and compressing the Vth, VIth, VIIth and lower cranial nerves. The cyst was filled with a xanthochromic fluid and was firmly attached to the internal auditory meatus (IAM). However no tumor extension into the IAM was confirmed. The tumor was excised completely. The postoperative course was uneventful, except for impairment of the VIIth and VIIIth nerves. At 6 months after the first operation, the facial nerve had improved up to grade III (Hause-Brackmann stage). Histological examinations revealed a typical benign acoustic neurinoma with predominant representation of Antoni B tissues. The cyst wall contained numerous abnormal sinusoid and telangiectasia-like vessels which showed occasional thromboses. The vessel walls displayed endothelial proliferations and were frequently hyalinized. Hemosiderin deposits and hemosiderin-containing phagocytes were also found near these vessels. Myxoid degeneration and necrosis were evident in vast areas. These degenerative changes appeared to be the principal causes of the large cystic formation. 16 cases including our case have been reported. The broad characteristics of the clinical symptoms and radiological findings of these tumors are discussed.

Humans↗
PubMed2006

Interprofessional collaboration with service users in the development of cancer services: the Cancer Partnership Project.

Patient and Public Involvement (PPI) is a cornerstone of UK National Health Service (NHS) policy. The Cancer Partnership Project (CPP) is the leading national PPI initiative in cancer care. The CPP espouses a "partnership" model, with a "Partnership Group" - collaborative service improvement groups formed of NHS staff and service users - in each of 34 cancer networks in England. These groups aim to enable service users to influence local cancer service development and thereby improve the effectiveness of services. We interviewed 59 cancer service users and NHS staff in a reflective evaluation of CPP. Groups were active and visible in 30 networks, their main activities being: providing an accessible source of consumer opinion; prolific networking and representation; patient information and communication projects; and lobbying for service improvements. The groups exhibited some significant tensions. The motivations of professional staff varied markedly, and "obligatory" involvement as part of a person's job was counter-productive when not coupled with a "personal" belief in the value of PPI. Other controversial areas were the disclosure by patients' of personal health and treatment experiences, and emotional attachment to the group. It was concluded that partnership groups represent a useful PPI model, but more attention generally should be paid to the complexities of PPI and timescales required for meaningful cultural change.

Adult↗