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At least 793 records · Page 44Linked to original sources
PubMed1989

Pains and gains: a study of forced terminations.

The forced termination of psychoanalysis, such as occurs when the analyst makes a geographic move, uniquely disrupts the analytic setting. This paper recounts the author's experience of terminating a full-time private practice of psychoanalysis and psychoanalytic therapy for such a move. The limited literature on the subject is reviewed with a focus on the use of technical variation in the forced termination situation. The author delineates three areas of interaction with patients where technical variation proved in her experience to be of value: dealing with countertransference and counter-reaction, providing information about the move, and the consideration and process of referral for continued therapy. As opposed to what would be predicted from a classical psychoanalytic perspective, the use of such technical maneuvers seemed to facilitate rather than impede analytic work. These variations in technique served at crucial times to maintain the analytic alliance, to preserve the patient's capacity to recognize and make use of transference, and to provide avenues for resolving past traumas in the transference and the actual loss of the analyst. The concept of the analyst as a new or useable object is proposed as providing a theoretical framework for understanding these observations.

Adaptation, Psychological↗
PubMed1989

Understanding negative hallucination: toward a developmental classification of disturbances in reality awareness.

Negative hallucinations are explored from a psychodynamic viewpoint in four cases of neurosis. Next, shifting to the level of clinical theory, negative hallucinations are contrasted with five better-studied disturbances in reality awareness. It is noted that all six function as screen phenomena, and all occur in everyday contexts. These and other phenomenological issues lead to an assertion that negative hallucinations are regressive perceptual phenomena, similar in form to both preconscious perceptions and infantile amnesia. Finally, developmental considerations are used to derive a coherent hierarchy of disturbances in reality awareness.

Adult↗
PubMed1991

Sadomasochism in the perversions: some thoughts on the destruction of reality.

The author summarizes and develops some of her viewpoints on the perversions (outlined in several of the books and articles she has written). For her all the perversions, whatever their content, develop against an anal sadomasochistic backdrop. Their aim is to destroy reality. Reality, from a psychosexual perspective, may be defined as resulting from the existence of the father separating the mother and the child. This may be formulated in another way: reality is recognition of sexual and generational differences. Or, yet again: mother and father have a procreative sexuality, whereas the child does not. This leads to the idea that the destruction of reality is equivalent to destruction of the paternal universe. Clinical case illustrations are provided, one of which centers on the assassination of an old man who, besides representing a paternal oedipal image, also represents reality itself. This case illustrates in concrete form the murder of the father, and hence of reality, accomplished by the pervert when he eradicates the paternal dimension of psychosexuality by regressing to the anal sadomasochistic dimension.

Fantasy↗
PubMed1993

What is sublimated in sublimation?

Sublimation has always been an elusive idea in psychoanalytic thought. This is because psychoanalysis is most systematic as a clinical psychology, while sublimation signifies an obverse of neurosogenesis. Nevertheless, the idea of sublimation remains a concern of psychoanalysis inasmuch as sublimation entails a version of socialization and cultural experience that answers to various principles of psychoanalytic theory. For reasons developed here, the creation and experience of art figure prominently in reflections on sublimation. Clinical material from the analyses of several artists is presented to demonstrate how neurosis takes a toll of sublimation and how sublimation takes a toll of the analytic process. Sublimatory experiences are then reconstructed from the devices of art. Two achievements of sublimation are especially noted: reduction of the ordinary instrumental functions of affects, and heightened consciousness of endopsychic processes.

Creativity↗
PubMed1994

The uses of the past and the actualization of a family romance.

This paper elaborates an aspect of the therapeutic experience of analysis that pertains to the examination of the past as it influences a patient's view of his self-worth and relationship to the world. It is complementary to the usual view of psychoanalytic process that involves analysis of transference resistance, revelation of transference, and the discovery of its genetic roots. I propose an additional therapeutic aspect of the reexperience of the past in which the changed representation of patient as child is validated by a new object, the analyst, who is experienced as a benevolent witness to the past and as a benevolent presence in the past, thereby consolidating the change and influencing the patient's adult self-representation. This therapeutic effect is more likely to be of significance in patients who have experienced parental loss or significant deprivation in childhood. Segments of the analysis of a patient illustrate this point. The patient described "listening to himself with compassion for the child he had been" and being listened to by me in the same way. He became thereby "tolerant and empathetic with the child he had been." The more general implications of this as a vehicle for change in psychoanalysis are discussed. Of ancillary interest was the patient's research into his past and ultimately his actualization of a family romance fantasy with a particular ironic twist.

Adult↗
PubMed1995

Transferences of deception.

Three characteristic transference configurations are identified that frequently emerge in the analyses of patients for whom deception and inauthenticity are central themes. These configurations are labeled (1) imposturous, (2) psychopathic-paranoid, and (3) psychopathic-unreal. Patients who develop these transferences have actively split the object world along two distinct axes. The first split has occurred along the lines of pleasure and unpleasure. The second divides objects along the lines of the experience of reality, with some objects felt to be charged with exaggerated, painful meaning, and others felt to be devoid of meaning and affect. This split, which arises as a way of managing painful object relations, is then woven into fantasy and defense at many developmental levels. Material from the analyses of two patients is presented to demonstrate the interplay of the three transference configurations, the fantasies that underlie them, and the clinical importance of analyzing the second split.

Adult↗
PubMed1992

Cerebral blood flow and mental processes in schizophrenia.

The patterns of cerebral blood flow associated with three syndromes of schizophrenic symptoms are compared with the loci of cerebral activation in normal subjects during the performance of mental processes implicated in the three syndromes. The psychomotor poverty syndrome, which has been shown to involve a diminished ability to generate words, is associated with decreased perfusion of the dorsolateral prefrontal cortex at a locus which is activated in normal subjects during the internal generation of words. The disorganization syndrome, which has been shown to involve impaired suppression of inappropriate responses (eg in the Stroop test), is associated with increased perfusion of the right anterior cingulate gyrus at a location activated in normal subjects performing the Stroop test. The reality distortion syndrome, which evidence suggests arises from disordered internal monitoring of activity, is associated with increased perfusion in the medial temporal lobe at a locus activated in normal subjects during the internal monitoring of eye movements.

Adult↗
PubMed1994

How to assess thinking skills in cancer patients.

This article emphasizes the importance of health care professionals assessing and working with the way cancer patients think. Health care professionals can help cancer patients think more effectively about the organic manifestations of their disease, problems that arise from the cancer experience, and problems unrelated to cancer, but which negatively influence their lives. Nine thinking skills areas are identified and described. Skills that health care professionals can use to assess patients' thinking, and to gain insight into their own thinking, are reviewed. In addition, suggestions are made for how patients can be helped to overcome thinking skills weaknesses and build their strengths so that they can optimize their chances of quality life.

Adaptation, Psychological↗
PubMed1994

Breaking bad news--a flow diagram.

Breaking bad news is neither an easy nor a popular task. Properly handled, however, it can be given in a positive way that the individual can both accept and understand. There may be a range of emotions and concerns following the telling of bad news. These need to be explored and worked through with each individual. This flow diagram describes the steps in this important process.

Adaptation, Psychological↗
PubMed1997

Disorientation in chronic psychiatric patients.

OBJECTIVE: To explore the effect of chronic institutionalization on cognitive performance in chronic psychiatric patients with emphasis on age disorientation, a phenomenon that was found in previous research to occur in up to 25% of chronic schizophrenic patients. METHOD: One hundred and ten chronic psychiatric patients, forming 4 main groups--schizophrenic patients, nonschizophrenic patients, institutionalized, and noninstitutionalized--were examined for age disorientation (inability to give one's chronological age correctly on request), and their Minimental State scores (MMSE) were compared across the 4 groups. RESULTS: Twelve out of 43 patients (26%) who were institutionalized according to our definition were age-disoriented and had significantly lower MMSE scores than the other 3 groups. The chronic, noninstitutionalized schizophrenic group and the other chronic psychiatric patients, whether they were institutionalized or not, were negative for this phenomenon. One of the 12 age-disoriented patients was age delusional, and 5 of the 12 had a total MMSE score consistent with dementia (21 or lower). CONCLUSION: Age disorientation is a specific phenomenon that characterizes a subgroup of chronically ill and institutionalized schizophrenic patients. It is unlikely that chronicity per se or prolonged hospitalization alone will lead to cognitive impairment.

Adolescent↗
PubMed1987

Application of expanded polytetrafluoroethylene (ePTFE) tubing to the study of human wound healing.

Wounds are a part of daily life. They range from minor nicks and cuts to the incisions of major surgery. In the sequence of evolution the process of healing arose long before modern science. The events which we are beginning to unravel have occurred routinely for a very long time despite our lack of understanding. We have learned how to nurture healing, but how to modify healing in a positive sense is only an approaching reality. Standardized tests of human healing are a necessary part of future research in wound healing. In the Wound Healing Laboratory we have used tubes of expanded polytetrafluoroethylene (ePTFE) as a tissue-sampling device in small, experimental, needle-stick wounds. Ingrowth into ePTFE is influenced by surface and structural characteristics. These are held constant, and "normal" values can be established and used as a base with which to study effects of various clinical states on healing in humans.

Biocompatible Materials↗
PubMed2001

Theory of mind, causal attribution and paranoia in Asperger syndrome.

Theory of mind (ToM) deficits are central to autistic spectrum disorders, including Asperger syndrome. Research in psychotic disorders has developed a cognitive model of paranoid delusions involving abnormal causal attributions for negative events. Possible aetiologies of these include deficits in social reasoning, specifically ToM. The present study investigated this attributional model of paranoia in Asperger syndrome. Participants diagnosed with Asperger syndrome scored significantly higher on a measure of paranoia and lower on a measure of ToM, compared with the control group. They did not differ in self-concept and causal attributions, contrary to the attributional model of paranoia. A regression analysis highlighted private self-consciousness as the only predictor of paranoia. The theoretical and clinical implications of these findings are discussed.

Adolescent↗
PubMed2006

Mental disorders and the symbolic function of therapeutic rites in the Réunion Island Hindu environment.

This article describes two therapeutic rituals in the Hindu milieu on Réunion Island--walking on fire and piercing parts of the body in the Feast of Cavedy--to underscore the cultural representation of madness and the symbolic function of these rites in treatment. Madness is considered to be the result of a rupture of genealogy through denial of the founder, and of psychic-somatic unity, which leads the afflicted person to develop a fantasy of immortality. The two therapeutic rituals aim at reestablishing the debt to the founding ancestor by the symbolic reactualization of the original chaos, and at restoring the genealogy through a relationship between the penitent and the officiant, which brings the subject to accept his human condition as a mortal being.

Adult↗
PubMed1990

Insight.

Explore the source record for details and available documents.

Awareness↗
PubMed1991

The idealisation of therapy: fantasy versus reality in clinical practice.

In this paper, object-relations theory is used to illuminate problems encountered in the psychotherapeutic management of severely disturbed psychiatric patients. The hazards of idealisation of the psychiatrist by the patient are reported in four case histories. Attention is drawn to the subsequent breakthrough of negative feelings where idealisation had been unrecognised or unwittingly encouraged. Some implications for the more successful management of the transference in patients such as these are discussed.

Adult↗
PubMed1992

Déjà vu experiences and reduplicative paramnesia.

A schizophrenic patient with different forms of experiences of inappropriate familiarity is described. The authors discuss traumatic experiences as aetiological factors in déjà vu experiences and reduplicative paramnesia. Finally, the differential diagnostic problem in psychotic and dissociative phenomena is stressed.

Adult↗