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Refusing the cure: Sophocles's Philoctetes and the clinical problems of self-injurious spite, shame and forgiveness.

Sophocles's Philoctetes (409 BCE) is a dramatic masterpiece unfamiliar to most analysts. The play presents a complex portrait of self-injurious spite of heroic dimensions as it touches on issues of intense shame, feelings of helplessness and the refusal of forgiveness. Sophocles's protagonist, Philoctetes, is a man who, like some of our patients, refuses to be healed. He intends, through his continued sickness and misery, to exact revenge against those who mistreated him. These are recognizable clinical issues, playing roles in every psychoanalytic treatment, issues that may assume a special importance in protracted, stalemated or aborted analyses. There are patients who damage the analyst by damaging the analysis they are in, a malevolent project often undertaken in revenge for wrongs suffered during childhood. This paper links Sophocles's drama to these vitally important clinical considerations through the discussion of a particular case.

Drama↗

A Streetcar Named Desire--psychoanalytic perspectives.

Tennessee Williams expressed in A Streetcar Named Desire aspects of his own psychic conflict that erupted after he reached sudden success with the play's predecessor The Glass Menagerie. Interpretations are suggested about those psychic conflicts and their emotional and behavioral manifestations through an analysis of both the play and the author's life history. In particular, the playwright's childhood experiences within a troubled family, his painful relationships with a rejecting, abusive father and an unhappy, controlling mother, and his helpless witnessing of the suffering inflicted upon his beloved sister are linked to the contrasting themes, characters, and action in both dramas.

Conflict, Psychological↗

Hamlet as process: a novel approach to using literature in teaching psychiatry.

Psychiatrists have made many forays into literature for the purposes of theory building, clinical understanding, and teaching. Given how fascinating and fruitful such inquiries can be, one wonders why they have had a mostly episodic place in teaching. I submit that at least some limitations resulted from an emphasis on what I would loosely call "content" and, related to it, on comprehensive "formulations" of a single literary character. This paper argues instead for a shift in focus onto "process" and situations created by particular interactions between the characters. Rather than pursue "the psychology of the individual characters; what they are like, what makes them what they are, what intentions, often apparently not conscious, seem to motivate their actions and attitudes" (Silberger 1973), I would look instead at what characters do (what they say, what they appear to emote and think) in response to each others' speech and imputed feelings and designs. The give-and-take entailed in the collision of their wishes, needs, and pasts at specific points in the evolution of the plot, and their reciprocal (mis)perceptions and (mis)interpretations, is especially relevant to understanding and teaching what is often thought to be the most complex aspect of being/becoming a psychiatrist, namely, comprehending and managing the emotional valences of the therapist-patient relationship. While such interactions are often explicit in, or can be adduced from, novels, short stories, or poems, the one form to which they are intrinsic is drama.

Communication↗

Student theatre as a means of promoting communication, self-development and creativity.

In the process of producing plays in a student drama and theatre workshop at the Hebrew University of Jerusale, certain educational principles and techniques have been utilized. These principles appear to promote inter-group communication, as well as self-development and creativity and to provide a vital educational technique in the teaching of literature.

Affective Symptoms↗

Theatre and community: 'the Tent of Joseph'.

The rationale of community theatre is discussed and its mental health and social goals set forth; these are the mobilisation of creativity through the construction of an original community drama and, impelled by this and its performance, activity for community organisation. An original project in Israel and its first stages of implementation are reported and analysed.

Adolescent↗

Television documentaries lifting hospital, medical center profiles.

The nation's hospitals and medical centers are enjoying the legacy of TV audiences' addiction to medical dramas. Cable television has met the challenge with documentary coverage of real live hospitals. The medium offers many benefits and few disadvantages for those marketing managers with the courage to welcome camera crews. Lynn Hopkins Cantwell is director of public relations and marketing for Children's National Medical Center, Washington, D.C., which was covered in a seven-instrument "Lifeline" documentary for the Discovery Channel. James G. Gosky is director of communications for The MetroHealth System, Cleveland, which was the subject of two installments of "Trauma: Life in th ER," produced for the Learning Channel. These marketing pros describe the myriad details they faced when their respective hospitals went "on camera." Among the key factors were good communications with all constituents, attention to detail, and follow-up.

District of Columbia↗

[The maniac-depressive psychosis in the Opera].

There's a brief mention on the origins of the operatic genre, to get then completely into the madness in the opera, describing a close relation between the sung drama and Psychiatrics studying mind sufferings which might have or not a characteristic anatomical substractum. There's a special focus in the illness of certain opera characters.

Bipolar Disorder↗

The promised planet: alliances and struggles of the gerontocracy in American television science fiction of the 1960s.

American science fiction television series of the 1960s dramatized the complex conflicts raging throughout society in simple, allegorical terms. The power struggle between the older and younger generations that pervaded many of the conflicts and social reform movements of this era was explored in the four most imaginative and acclaimed science fiction television series of the 1960s: The Twilight Zone (1959-1965), The Outer Limits (1963-1965), Star Trek (1966-1969) and Lost in Space (1965-1968). Each show presented the mature male as the bearer of culture, the holder of power and the keeper of the scientific mysteries, but instead of a standardized response to the problem of the 'generation gap' and the ever-increasing polarization of American society along generational lines, these dramas offered both pessimistic and optimistic views of the outcome of contemporary intergenerational social strife.

Aging↗

Making the connections: AIDS and water.

OBJECTIVE: Acknowledging AIDS as a crosscutting development issue, a Zambian rural water supply project that provides safe accessible water to rural communities embarked on a new initiative to mainstream AIDS into the water sector. SETTING AND PARTICIPANTS: The work of providing safe water takes the predominantly male workforce away from their spouses and families, into the rural villages of Zambia's Eastern Province, for long periods of time. With an HIV prevalence rate of 16.1%, the risk of HIV exposure exists for both employees and rural villagers. AIDS mainstreaming activities were designed to target both groups. INTERVENTION: An AIDS mainstreaming strategy was developed by identifying components that could be influenced in the external domain (the organization's usual work) and the internal domain (the workplace). Basic questions were addressed such as: how does AIDS affect the organization, how might the usual work aggravate susceptibility to HIV infection, and where is the comparative advantage? OUTCOMES: A workplace program including peer education, employee health education (including condoms) and a workplace policy was established for employees. For the target population, a series of five messages connecting safe water and AIDS was developed and disseminated through educational drama, community meetings and trainings, and integrated into the regular water, sanitation and hygiene activities. CONCLUSIONS: As an efficient utilization of resources that makes a broad impact, AIDS mainstreaming does not change the sector's mandate but takes advantage of the extensive geographic coverage and natural distribution system of water projects to disseminate AIDS information and make linkages with AIDS partners.

Acquired Immunodeficiency Syndrome↗

Acting the part.

The implementation of two key policies highlighted the need to support nurses and midwives to challenge colleagues effectively. To overcome the difficulties this presented, an innovative training package using drama provided participants with practical tips and a safe environment to practise newly developed skills. The programme was well evaluated but further work needs to be undertaken to evaluate its impact upon practice.

Drama↗

[Hofmannsthal and the gliding out of this world].

In the sphere of language, Hugo von Hofmannsthal was already in his childhood talented by nature. His first poems and essays he wrote when he was 17 years old, his first drama ("The Death of Tizian") in his 18th year. From the beginning he followed the great tradition of the theatre of Vienna. His lyrical creations end already before he turned 30 years. At this time the dramatist begins with the reception of the medieval mystery plays, Calderon and the greek-oriental myths. The phenomena of gliding-out-of-the-world are found before this time, in the period of his very own spiritual conceiving. They show a remarkable inclination to abandon the world of reality (Wirklichkeit, koinos kosmos): gliding into the world of dream and trance, of phantastic tales, of magic and demonia, of depersonalization and dilusion, of dying and of death (idios kosmos). These tendencies vanish when Hofmannsthal turns to more conventional topics.

Attitude to Death↗

Addressing the oedipal dilemma in Macbeth.

Macbeth has been viewed as a play about the oedipal crime of patricide. This paper elaborates on this approach by elucidating the oedipal and preoedipal themes in the roles played by women in the drama, particularly in Macbeth's relationships with Lady Macbeth and with the weird sisters. Differences between Macbeth and Macduff's responses to the oedipal dilemma are also defined. An understanding of these themes provides the context for understanding the underlying hostility toward women implicit throughout the play.

Drama↗

Oedipus and insight.

Insight is a core concept in psychoanalytic theory. The Oedipus myth has been a central metaphor in the evolution of psychoanalytic theory, particularly the psychoanalytic theory of development. Similarly, Sophocles' drama, its relation to the myth, and its repeated reinterpretation throughout the ages provide a valuable metaphor for our understanding of the role of insight in psychoanalysis and in development. We may have underestimated the importance of insight in normal development while oversimplifying its significance as an agent of therapeutic change.

Drama↗

Multisectoral strategy for AIDS prevention at community level.

In north-east Thailand a five-act drama is broadcast on the village sound system to catalyse involvement in planning and carrying out AIDS prevention activities. Each community's own suggestions for an effective strategy are presented to the relevant government and nongovernmental agencies for endorsement and support.

Community Health Services↗

Making health messages interesting.

In Afghanistan a radio drama serial carrying messages vital to the well-being of the population, backed up by more detailed information in reinforcing radio programmes and a cartoon magazine, is proving effective in increasing people's knowledge of immunization and other subjects.

Adult↗

Audience as analyst: Dennis Potter's The Singing Detective.

Author Dennis Potter has written an exceptional psychoanalytically informed television series in The Singing Detective. Potter succeeds by echewing the usual portrayal of psychoanalysis in cinema and television as a therapy which the viewer observes but instead creates, by means of the content and structure of the series, a production that forces the audience into a role of analyst. The story of the current life and the childhood of the protagonist, Philip Marlow, has depth and context which allows the audience to examine the personality of Marlow, including character pathology and traits, sexuality, fantasy, dreams, and delusions from several metapsychological viewpoints. Potter allows the audience to use the dynamic, genetic, topographic, and, most unusual in drama, structural viewpoints. The audience can experience aspects of an analyst's experience, including the process of formulating and evaluating over time analytic hypotheses and coping with emotional reactions to the material which at times has transferencelike qualities.

Arthritis, Psoriatic↗

Hitchcock's "Vertigo": the collapse of a rescue fantasy.

The author presents an interpretation of Hitchcock's 'Vertigo', focusing on the way in which its protagonist's drama resonates with the analyst's struggle with deep unconscious identifications, with the impossibility of maintaining detached objectivity or guaranteeing one's role as a reparative good object and with the dangers of grandiosity, omniscience and illusory control. The protagonist's 'countertransference love' crystallises around a rescue fantasy in which he is Orpheus striving to bring Eurydice back from Hades, or a Knight determined to behead an obscure Dragon endangering Beauty. Initially these key roles are sharply differentiated, through splitting and disavowal, which deprive the participants of their conflictual three-dimensionality. Eventually, however, the valiant Knight turns out to be as helpless and lonely as his Beauty, and in the final scene as ruthless and lethal as the Dragon. This interpretation is compared to numerous other views of the film offered in the literature. The survey and comparison of the various views leads to fundamental issues in the psychoanalytic study of art. Interpretations can be seen as unavoidably coloured by the (counter)transference of viewers. It is suggested that a film has no hidden true meaning, and a new individual significance emerges in the transitional space opened up by each viewer's encounter with the emotional universe of the film. A defensive emphasis on the pathology of artists and their work may alienate us from art, and blind us to ways in which we could learn from it personally and professionally.

Drama↗

Ecopolitical battles at the Tarai frontier of Nepal: an emerging human and environmental crisis.

"In Nepal, the drama of human and environmental ills is increasingly being played out in the form of peasants' ecopolitical battles over common land access and control, such as in the Tarai frontier, a region bordering the Gangetic Plain of India. This is a complex battle, pitting peasants' day-to-day survival against environmental security on one front, and against the Nepalese State and its dominant class interests on the other. This article critically dissects this raging battle to gain a clear understanding of its complexities as well as its diverse roots."

Asia↗