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A case of premenstrual distress: bisexual determinants of a woman's fantasy of damage to her genital.

Case material is used to illustrate specific clinical application of the concept of primary femininity. Some contemporary contributions to the psychoanalytic theory of female psychosexual development are presented as complementary with, rather than contradictory to, more familiar, longstanding formulations that emphasize phallic strivings in women. In the clinical example reported, a fantasy of genital damage underlay a woman's premenstrual distress. Aspirations and concerns related to both aspects of her fundamental bisexuality participated in symptom formation and had to be investigated in order to achieve symptom relief. As the analytic work unfolded, it could be seen that the patient's awareness of her feminine aims served to keep her masculine aims out of awareness, and vice versa.

Adult

The clinical and forensic psychiatric issues of retifism.

The literature on the etiological theories, clinical manifestations and treatment of retifism (foot fetishism) and fetishisms in general are briefly reviewed. The case of a 27 year old married male foot-fetishist is presented with emphasis on the psychosexual development leading to the specific sexual deviation. The specific behavioural treatment consisted of covert aversive conditioning using self-reports of sexual urges and psychophysiological monitoring as objective measures of therapeutic change. The theoretical basis for the therapeutic response is discussed.

Adult

Development of sexuality in female children and adolescents.

Female sexuality (meaning sexual desire, excitement and orgasm) has been of considerable interest in psychiatry. Women's efforts to define and legitimize their own experience of their sexuality have increased in the past 25 years. However, the integration of these new views into the body of psychiatric (especially psychoanalytic) theory has not occurred very actively or successfully. Very little is known about the development of sexuality in childhood and adolescence. This paper looks at various behaviours, interests and events in women's lives that might reveal something about the development of their sexuality. The literature on female masturbation is reviewed and some sex differences high-lighted. The literature on interest in babies, the wish to have babies, and menarche is explored for possible associations with sexuality. Rather than sexuality being a central organizer of experience, it seems quite possible that experience is an organizer of sexuality. Therefore, to better understand female sexuality we need to consider the impact of experiences during childhood and adolescence.

Adolescent

Psychosocial and erotic development in cross-gender identified children.

This article reviews certain aspects of psychosocial and erotic development in cross-gender identified children. Consideration is first given to the hypothesis that cross-sex affiliation preference and its attendant social ostracism is one factor that accounts for the presence of behavioural psychopathology in cross-gender identified boys. Next, the strong relation between patterns of childhood sex-typing and later sexual orientation is discussed. It is concluded that more attention should be given to the study of erotic development in its own right.

Adolescent

Adolescent female firesetters.

A retrospective study of the charts of 13 female adolescent firesetters revealed severe family and individual pathology. The parents had a history of separation, violence, alcohol and/or drug abuse, and inability to take care of the children. The girls had a long history of serious behavioural problems. Four girls had set one fire, six had set several fires within a period of a few days, three had a long-standing history of setting fires. The girls showed a lack of remorse or concern for their behaviours.

Adolescent

Proportion of unmarried siblings of homosexual and non homosexual gender-dysphoric patients.

Among the siblings of homosexuals, a lack of sexual and romantic interest in women may be independent of erotic feelings for men. This study investigated the sexual histories of siblings of gender-dysphoric outpatients. The patients were classified into three groups: non homosexual males, homosexual males and homosexual females. Their siblings consisted of 301 brothers and 284 sisters over the age of 25. Logistic regression showed that the brothers of the homosexual male patients were significantly less likely to have been married, either legally or common-law, than the brothers of the other gender-dysphoric groups, even with age and relative birth order taken into account. This finding suggests that the low propensity for long term heterosexual relationships seen in homosexual male gender-dysphoric patients also tends to appear in their brothers.

Adult

A study of the married bisexual male: paradox and resolution.

Men who live in conventional marriages and at the same time have significant love-sex relationships with members of their own sex are largely an invisible group in our society. However, there is evidence to suggest that they are not rare, only rarely identified. How these men perceive themselves, reconcile the ordinary aspects of their lives with their atypical sexuality, and conduct themselves in marriage and family life are the focus of this study. Particular attention is paid to two major paradoxes in their lives: the contradiction between their heterosexual public identity which places them comfortably in the mainstream of society and their stigmatized and forbidden homosexual desires and behavior; and the ethical issue of deceiving their wives as well as others to whom they are intimately related. Sixty men drawn from a non-clinical population presented their life stories in extended tape-recorded interviews. These men show great variations in their patterns of psychosexual development as well as in their accoMmodations to marriage and do not fit readily into simple categories. Most of them have found fulfillment and have no wish to change the pattern of their lives. In part, the study contrasts the more successful with the less successful marriages. A major conclusion is that some men are able to express with minimal conflict their homosexual and heterosexual impulses within the framework of a conventional marriage.

Adult

The life course of gay and lesbian youth: an immodest proposal for the study of lives.

The authors raise questions about several fundamental assumptions and methods regarding study of the development of gay and lesbian youth. Primary among these are the validity of reliance on respondents' recollections regarding their childhood and adolescent experiences; inferences about developmental processes and outcomes made on the basis of cross-sectional samples; the time-specific, cohort-bound nature of many previous constructs and findings; and the persistent search for continuities between childhood gender behavior and adult sexual orientation. In consequence, the emerging body of theory is largely a developmental psychology of the remembered past. Strategies are suggested for longitudinal, prospective research on homosexual adolescents, shifting attention from child-based, "causal" models to those of adolescent and adult-centered perspectives. Aimed at understanding life changes and the developmental processes and course of negotiating them, longitudinal methods will more accurately reflect current experiences of gay and lesbian youth coming of age in a unique historical context. Findings from studies of the life course have direct implications for modification of current developmental theories, particularly those that can inform gay and lesbian-sensitive clinical services for all age groups.

Adaptation, Psychological

'The main thing is being wanted': some case studies on adult sexual experiences with children.

Pedophilia is always considered by mainstream society as one form of sexual abuse of children. However, analysis of the personal accounts provided by pedophiles suggests that these experiences could be understood differently. This paper attempts to document some aspects of the pedophiles' construction of their sexuality, to provide illustrations of how these individuals understand themselves.

Adult

Boy-lovers and their influence on boys: distorted research and anecdotal observations.

A wide experience with boy-lovers has convinced the author that one can often learn more about them from reading some excellent novels than from so-called scientific studies. All too often research is unreliable because (1) it assumes pedosexual activity is a positive indicator of pedophilia; (2) no distinction is drawn between pseudo-pedophiles and real pedophiles; (3) no difference is recognized between boys and girls as partners; and (4) it is highly distorted by bias. Representative samples for research cannot be drawn from members of boy-love organizations. The incidence of violence is very low in pedophile contacts with boys. The influence can be strong in lasting relationships; it can be either wholesome or unwholesome. Within a relationship, sex is usually only a secondary element, although it can be important in sexual instruction and education. The impact of the law, the hostility of parents and the problem of the partners' inequality are discussed.

Adolescent

The process of recovering from anorexia nervosa.

The authors describe the process of recovering from anorexia nervosa as it is revealed by 13 women who have recovered from the illness. Emphasizing the patient's perspective, the paper reviews the perceived causes of the disorder, helpful and harmful therapy-related and life experiences, features hardest to change, the defensive function of anorexia nervosa and residual traits. Generally, the movement toward health entails forming a therapeutic relationship in which the anorexic can identify and express feelings, experience the empathic, nonjudgmental understanding of another person, separate from a pathological family system, resolve hostile dependent attachment to parents, assuage primitive guilt, and engage in the trials of adolescent psychosexual development to enter adulthood with the beginnings of a firm, cohesive sense of self.

Adult

Development of internal body image from childhood to early adolescence.

The study aimed at providing a psychogenetic characterization of the developmental patterns through which the graphic representations of the inside of the body progress, and at testing the developmental hypothesis of a progressive integration of genital parts into the internal body image. The drawings of the inside of the body by 360 children of both sexes and of age 5 to 10 yr., and by 213 early adolescents, boys and girls of ages 11 to 14 yr., were analyzed on the basis of a series of qualitative and quantitative criteria. The relationship between age and type of drawing corresponds to expectations in children and appears less linear for early adolescents. Further, data support the developmental process of integration of genitals into the body image and show differential aspects in boys and girls.

Adolescent

Family perception of rapists and pedophiles.

Previous research indicates that sex offenders were more likely to have been reared in dysfunctional families and to have identified less with their parents than were individuals in most comparison groups. It is unclear whether such failure to identify may be related to the perceived parenting styles and attitudes of the sex offenders' parents. 16 rapists, 18 pedophiles, 9 general offenders, and 11 college students completed the Children's Report of Parental Behavior Inventory to assess perceived parental communication patterns and attitudes. It was predicted that rapists and pedophiles would perceive their parents as (1) having been more rejecting, (2) as having exerted more control while encouraging less autonomy, and (3) as having provided harsher discipline than would individuals in comparison groups. Results supported the first two predictions.

Adult

Case report of a female-to-male transsexual homicide offender.

A 22 year old female-to-male half-Aboriginal transsexual had been exposed to gross neglect and violence, separation and inconsistent cultural supports during childhood. Her mother had also been convicted of homicide in a context of alcohol and violence. Transsexual identification, antisocial behaviours, self mutilation, substance abuse and unmet dependency needs were evident from childhood or early adolescence. The killing was a confrontational peer group stabbing in a brawl under influence of alcohol--the male mode of homicide. This is the first known case in world literature of a female-to-male transsexual guilty of homicide.

Adult

Alpha rhythm and the pineal gland.

Alpha rhythm is classically described as a bilateral posterior rhythm of substantially constant frequency in the range of 8-13 Hz which is enhanced by mental relaxation and blocked by attention. Since the full expression of alpha rhythm has been shown to occur coincident with puberty, it is possible that the establishment of alpha rhythm is subject to neuroendocrine influences which govern psychosexual maturation. There is ample evidence to indicate that the pineal gland is implicated in cerebral maturation and psychosexual development. Nocturnal plasma melatonin levels have been shown to decline progressively throughout childhood reaching a nadir at puberty. Since administration of melatonin has been reported to block alpha rhythm, it is proposed that the progressive decline in melatonin secretion during childhood facilitates the maturation of the alpha rhythm. Consequently, the presence of alpha rhythm could be used as a neurophysiological marker for the activity of the pineal gland and disorders associated with absent or delayed maturation of the alpha rhythm such as autism, dyslexia, personality disorders, epilepsy, Tourette's syndrome, and schizophrenia might be related to disturbances of pineal melatonin functions in early life. Moreover, since the EEG patterns associated with cerebral immaturity (i.e., slowing, absence of alpha activity) are more pronounced in the left hemisphere, this hypothesis implies differential influence of the pineal gland on hemispheric maturation potentially accounting for the vulnerability of the left hemisphere to cerebral insults.

Alpha Rhythm

[Psychodynamic theory of childhood psychoses].

A review of the different concepts of childhood psychoses is made. Margaret Mahler's observations of normal and psychotic children concerning their relationship with their mothers during their first years of life are reviewed. Through the discussion of the concepts that Mahler has reached, understanding the dynamics of growth and their alterations, we obtain a clear understanding of the defects in psychological functions observed in the psychoses, including early infantile autism (Kanner) and symbiotic psychosis (Mahler). A correlation of events occurring at different levels of growth: object relations, cognitive growth, psychosexual development, growth of anxiety, etc., is attempted.

Child

[Psychodynamics of ideological democracy].

In order to understand "ideological democracy" and its consecuences for therapy it is important to study the ideology of group members from the psychodynamic standpoint. Ideology is understood as a system of rules to interpret reality, although from a theoretical point of view, we contend reality itself is free from ideology. Ideology is thus defined as a cognitive system, stemming from emotional matrices of the psychosexual development of personality. The understanding of how the members of the Therapeutic Community attain "ideological democracy" is, to our mind, essential in order to be able to attain therapeutic goals. After a brief introduction the paper deals with ideology and its relationship with different personality structures: hysteric, phobic, psychopatic, depressive, paranoid and schizoid. Several common mechanisms for building ideology are set forth. The final conclusion is that such an analysis helps to ascertain the best strategies for community therapy.

Colombia