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PubMedDate not supplied

The role of primal scene and masochism in asthma.

Early investigators, such as French (1939), observed that asthma patients need to repress their sexual and aggressive impulses in an attempt to retain their mother's love. Early traumatic experiences (Brown and Goitein 1946), illness, primal scene, death in the family, miscarriage or birth of a sibling have all been mentioned as precursors of asthmatic attacks. These factors are also of considerable relevance in the case material presented here. Emphasized in this presentation, in addition to the above mentioned factors, are critical aspects of primal scene traumatic experiences and their role in the subsequent development of sadomasochistic character formation. This sadomasochism plays a considerable role in the later eruption of asthmatic symptomatology. The crucial factor in the asthmatic symptomatology arises from the effect of the traumatic experiences which are associatively linked to these sadomasochistic fantasies. Clinical material of an asthmatic girl with learning inhibitions and sleeping difficulties is presented. She demonstrates a clownish sadomasochistic type of behavior reflecting a disturbance in her object relationships. During the course of analysis, it was revealed that specific unconscious fantasies, associated with early traumatic experiences, played a predominant role in the development of her sadomasochistic attitudes. These, in turn, were linked to her asthmatic attacks.

Adolescent↗
PubMedDate not supplied

[Importance of catheterization of inferior petrous sinuses in surgical treatment of Cushing's in children and adolescents].

The authors present 12 cases of Cushing disease in children and adolescents. In childhood the course of this disease differs from that in adulthood. The predominating initial signs in children are growth stunting and arrest of sexual maturation. Radiological methods (sella X-ray, CT, NMR) are normal initially in most cases and the diagnosis is confirmed exclusively by hormonal investigations. ACTH determination of venous blood samples obtained by catheterization of the inferior petrous sinuses is essential not only for the diagnosis of pituitary adenoma but also for choice of proper surgical treatment. The optimal method is selective removal of the adenoma. In case of impossibility of this removal (anterior lobe hyperplasia) hemiphysectomy is suggested (with removal of the lateral part of the anterior lobe on the side of greater secretion of ACTH into the inferior petrous sinus. This method is possible only if before the operation catheterization of these sinuses was done and a significant difference of ACTH level was found between the right and the left sinus. This is the reason why this test is essential for selection of proper treatment. Anterior lobe hypophysectomy, bilateral adrenalectomy, X-ray hypophysis irradiation are unacceptable for children because of their maiming character making impossible further somatic development and sexual maturation of children.

Adolescent↗
PubMed1982

Obsessional phenomena and the development of imaginative competence.

Obsessional phenomena are discussed in the light of anxieties arising around the ages 8-12. Three cases of the disappearance of obsessional symptoms are then described. In one remarkable sequence of dreams preceded recovery; in another it was the establishment of a secure therapeutic bond; in the third it was falling in love. The capacity securely to differentiate between fantasy and reality is seen as an essential development element in the recovery from obsessionality.

Adolescent↗
PubMed1975

Implicit messages concerning menstruation in commercial educational materials prepared for young adolescent girls.

Interviews with young girls aged 9 to 18 revealed that commercial educational materials are an important source of information about menstruation. Although these materials are valuable educational supplements, they do not provide a complete, accurate, and realistic description of menarcheal changes and emphasize good hygiene rather than dealing with the young girl's emotional needs and anxieties. The authors stress the need for more research into the physiological, cognitive, and psychological changes during puberty and the obligation of parents, schools, and other social institutions to provide more comprehensive information to the maturing girl about the essential issues of pubertal development.

Adolescent↗
PubMed1991

The psychoanalytic treatment of a preschool boy with a gender identity disorder.

A three-year, nine-month-old boy began analysis by wishing he was a girl and pretending he was a superheroine. Over the course of almost five years, the cross-gender defense against fear of loss of the object, anal loss, and castration by the object reorganized in all libidinal phases through early latency. Developmental arrests seemed to occur during the anal rapprochement and oedipal phases that led to observable cross-gender strivings by two and a half years of age. The role of early childhood illness, narcissistic vulnerability, mother's childhood wish for a sister, the mother's adult wish for a daughter, a shared fantasy between mother and child, identification with the perceived power and beauty of mother and grandmother, pathological sibling rivalry that influenced identification with his sister, were demonstrated in his play during sessions. Interwoven in the background was the impact of an emotionally absent father, a dying grandfather, and an accident-prone uncle. This paternal matrix seemed to discourage budding masculinity and encourage feminine identifications. The analyst's approach and the child's responses to interpretation of the transference manifestations, cross-gender behavior, fantasies, and play are presented. Finally, the gradual resolution of the conflicted wish to be a girl was supplanted by the emergence of appropriate gender identification. A two-year followup appeared to confirm his postanalytic gender stance and continuing consolidation of stable gender development.

Anxiety, Castration↗