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Results for “Reality Testing”

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At least 1,009 records · Page 56Linked to original sources
PubMed1987

The psychological impact of ambulatory peritoneal dialysis on adults and children.

The most common medical complication causing patient and spouse reaction remains peritonitis. Psychological difficulties include different levels of problems with body image distortion and major role reversal issues with resulting significant marital discord, especially in our diabetic patients. Contrary to patients on maintenance hemodialysis and IPD, no patients were noted to become pathologically depressed although adjustment problems manifested as depression were seen. The increasing role of technology in treatment means that greater attention should be paid to how patients relate psychologically to the application of what can seem to be overpowering or even fearsome technical means. Appropriate evaluation and selection of candidates for CAPD can enable these chronically ill persons to better control and adapt to the critically necessary procedure of dialysis. In the words of a 55-year-old gentleman on CAPD for three years: "It is unbelievable how much freer and fitter I feel since being on CAPD. I have had several holidays and can drive 200 miles on my own without difficulty. The main advantage to me is that CAPD has restored my independence. I feel well enough to enjoy life--the best criterion for judging any treatment."

Adaptation, Psychological↗
PubMed1987

["Relations and gestalt" (Wyss)--autism and physiognomic gestalt change in malignant schizophrenias].

Reality is what makes it possible to exist as a human being; every form of psychosis is characterized by a loss of reality. Human reality is the social reality of one's fellow-creatures. It is always rooted in the corporeal, the soma which is the manifestation within the individual of the unity of physis, bios, and mind. This complex manifestation (or gestalt in a broader sense) is unstable. It must be maintained by means of a constant supply of emotional stimuli, which is aesthetically mediated by communicative intercourse. Schizophrenia signifies the rupture of interpersonal relationships, a breakdown in the process of emotional refuelling. A marked diminution of clear contours in physiognomic manifestations also has somatically perceivable consequences in the case of the chronically ill. Not only does gestalt thus help form the basis of relationships; relationships, for their part, are instrumental in shaping gestalt.

Autistic Disorder↗
PubMed1979

Problems in the assessment of analyzability.

As additional studies of assessment of analyzability have been reported, research has proven very difficult and provided little clarification. This paper reviews the literature, particularly of the last twenty-five years, from the viewpoint of identifying the nature of the problems in developing useful methods of study. Some approaches to these problems, which might provide increased understanding as well as a clearer definition of some inherent limitations, are discussed.

Affect↗
PubMed1986

Identification and its vicissitudes as observed in psychosis.

I have described the mechanisms that operate in psychotic identification. One mechanism is psychotic introjection, characterized by a refusion of 'all good' self and object representations. This re-fusion threatens the destruction of the self as a consequence of the defensive blurring of these self and object representations. The second operative mechanism is projective identification, which I have defined in comparison with and in contrast to projection. Projective identification threatens the destruction of the relation with the object. The case I have described in detail illustrates these psychotic identifications, the development of psychotic transferences wherein the patient cannot differentiate herself and her thinking from the therapist and his thinking, and the struggle around a sense of personal identity at a point of resolution of the psychotic transference. This case also illustrates that an integrated self includes two types of self-representations: those centred on self differentiation and those which reflect the observing functions of the parental images internalized into the self.

Adult↗
PubMed1986

Circadian variations of systolic time intervals.

In order to test the reality of a circadian evolution of systolic time intervals, an experiment was conducted on six subjects resting in a supine position for 24 h. Heart rate (HR), systole (S), diastole (D), presystole (PS), isovolumetric contraction time (IVCT), normal and corrected ventricular pre-ejection and ejection time (LPEP, LPEPc, LVET, LVETc) were computed by electric rheoplethysmography every 3 h in supine and sitting positions. Evidence of the existence of a circadian rhythm was clear in supine subjects; especially LPEP and LVET acrophases were, respectively, 4.03 +/- 2.36 h and 4.31 +/- 1.15 h. In sitting subjects, a circadian rhythm was evidenced for IVCT, LVETc and LPEP/LVET, and on the difference of resting-sitting for PS, IVCT and LPEP, suggesting a decrease in orthostatic tolerance at the end of the night. However, values for characteristics of circadian rhythms (mean, amplitude, phase) strongly depend upon experimental conditions (position, activity, diet). A phase difference between systolic times and HR was also observed. This phenomenon was due to an advance in phase of D relative to S. Finally, all these results show that it is always necessary to take circadian factors into consideration during cardiovascular studies, especially for the preparation of protocols and the interpretation of results.

Adult↗
PubMed1986

Suddenly finding it really matters: the paradox of the analyst's non-attachment.

Psychological discoveries of a certain kind give rise to a particular sense of shock. When we are forced to look afresh at something whose importance we think we already know, we may find it has new and unexpected significance. Our previous understanding, genuine as it was, comes to seem rather shallow. Psychoanalysts must be open to such experiences, and I illustrate this with episodes from the history of psychoanalysis and with clinical examples. 'What really matters about this analysis?' is a question for which patient and analyst must each seek an answer, and both must allow it to take them by surprise. There is a parallel between the patient's need to give up his established ways of coping and the analyst's need not to cling on to his familiar ways of understanding. The paradox of non-attachment is that our understanding can only develop if we are not anxious to hold on to it. I relate this clinical observation to the idea of non-attachment as found in spiritual tradition, and I draw on the work of Bion and Matte Blanco to locate these ideas within psychoanalytic theory.

Fantasy↗
PubMed1986

[Behavior medicine intervention strategies in nursing home patients with manifestations of dementia of multiple origins].

The present study is an attempt to throw light on the possibilities and scope of different therapeutic applications concerning geriatric patients. Guide-lines are presented for the absolving of general animation programmes as well as also a specific "training in realism, orientation and memory" to modify the symptoms of chronic brain syndromes. First results show that with both intervention strategies a better integration of demented patients is possible in the department. Furthermore some improvements in the cognitive area can be attained by means of selective training.

Aged↗