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The authors review recent and current literature on the relationship between psychological factors and cancer. They discuss the roles of predisposing personality patterns and emotional stress in the development, site, and course of cancer; the influence of awareness of terminal illness on the behavior of cancer patients; and the management of psychiatric symptoms in these patients.
This paper examines the coming out process within an adult developmental context. Therapeutic issues which surface for the young adult lesbian client include separation from parents, development of social support, exploration of career/vocational goals, and the establishment of intimate relationships. Intervention strategies are suggested which facilitate the coming out process and help the client integrate her sexual orientation within her emerging adult identity.
This paper seeks to import a more complex understanding of gendered subjectivity into discussions of young people and homosexuality, and is based on an Australian national survey (n=749) of same-sex attracted youth (SSAY) aged between 14 and 21. Results revealed significant gender differences with regard to patterns of sexual attraction, behaviour and identity labels among participants. For the young men in the study, there was more congruence between feelings of gender a-typicality, same-sex attractions and same-sex behaviours. Overall, young women displayed more fluidity with regard to their sexual feelings, behaviours and identities. Young women were more likely to be engaged in private explorations of lesbianism, concurrent with participation in heterosexual sex and relationships. Young women were also grappling with more limited and emotionally risky opportunities for sex with other girls who were already known to them as friends. The invisibility of lesbianism as an identity or practice led to confusion about what feelings meant for the future in the arena of lived experience. The paper concludes that more research is needed into the impact of gender on the development of young people's experiences of homosexuality, particularly the manner in which invisibility and lack of social acceptance of a full spectrum of sexual diversity may disadvantage young women's emotional health and well-being.
Material from interviews with 35 premenarcheal and postmenarcheal girls suggests that menarche is an emotional event related to the adolescent girl's emerging identity as an adult woman, her newly acquired ability to reproduce, and her changing relationship with her mother. However, our culture tends to ignore the affective importance of menarche and instead conveys the view that it is a hygienic crisis. The authors suggest the need for developing a socially and culturally appropriate substitute to serve the emotional function that more primitive societies have met with social rituals, thus meeting the psychological needs of the young adolescent girl.
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The antecedents and consequences of variations in girls' physical development are reviewed. Girls' development is highlighted because research on antecedents addresses genetic and environmental influences on menarcheal age variations, and because findings on the behavioral consequences of tempo variations have been less consistent for girls than for boys. Implications for adolescent health care are considered, particularly for the early maturing girl.
This study demonstrated reinforcement control over pronounced feminine behaviors in a male child who had been psychologically evaluated as manifesting "childhood cross-gender identity". The clinical history of the subject paralleled the retrospective reports of adult transsexuals, including (a) cross-gender clothing preferences, (b) actual or imaginal use of cosmetic articles, (c) feminine behavior mannerisms, (d) aversion to masculine activities, coupled with preference for girl playmates and feminine activities, (e) preference for female role, (f) feminine voice inflection and predominantly feminine content in speech, and (g) verbal statements about the desire or preference to be a girl. The subject was treated sequentially in the clinic and home environments by his mother, trained to be his therapist. The mother was taught to reinforce masculine behaviors and to extinguish feminine behaviors, by using social reinforcement in the clinic and a token reinforcement procedure in the home. During this treatment, his feminine behaviors sharply decreased and masculine behavior increased. The treatment effects were found to be largely response-specific and stimulus-specific; consequently, it was necessary to strengthen more than one masculine behavior and weaken several feminine behaviors, in both clinic and home settings. A multiple-baseline intrasubject design was used to ensure both replication and identification of relevant treatment variables. Follow-up data three years after the treatment began suggests that the boy's sex-typed behaviors have become normalized. This study suggests a preliminary step toward correcting pathological sex-role development in boys, which may provide a basis for the primary prevention of adult transsexualism or similar adult sex-role deviation.
The Authors, taking Andry's hypothesis about the pathogenetic role of the deprivation of father-image during infancy in structuring an inadequate, too rigid or incoherent Super-Ego, assume that could be a possible factor in explaining the social misadaptation of adolescents with prolonged experiences of institutionalisation. The test group, consisted of 163 adolescents and pre-adolescents released from three state institutions in Modena, in the period 1966-1973, it seems to confirm, through the indexes of the socialisation in the family, scholastic and work groups after releases from the institutions, as well as through those of social misadaptation and antisociality, the Author's hypothesis interpreting the social misadaptation as one of the manifestations of the difficulties encountered by adolescents in the adaptation process. These difficulties depend a great deal on a surplus of pathological defenses arising from retarding of the consolidation of the Ego and from developing a negative Ego-Ideal. The deprivation of valid parental images for introjective identifications during latency or adolescence seems a very important factor in influencing these structures of personality.
Few topics in sexology elicit such a diversity of opinions and emotions as the question of etiology of homosexuality. Views frequently carry with them implicit or explicit messages concerning the psychologic health of this sexual orientation. Theories of sexual development usually portray adolescence as a critical time in the life course because of changes in: 1) anatomy and physiology; 2) psychologic functioning: the reawakening, renewal, and reliving of previously established sexual relations and drives; and/or 3) social conditions: an increased exposure and adherence to societal messages concerning appropriate and inappropriate social and sexual behaviors and relationships. This paper provides a brief overview of several major theories--evolutionary biology, psychoanalysis, and social processes--as they relate to the development of sexual orientation. In addition, an ethologic perspective that synthesizes various etiologic theories, as they relate to homosexuality during adolescence, is briefly reviewed. In these discussions, the issue of whether homosexuality is a normal or abnormal developmental state during adolescence is also addressed.
This paper presents an ideal-typical model of homosexual identity development that describes how committed homosexuals (i.e., women and men who see themselves as homosexual and adopt corresponding lifestyles) recall having developed perceptions of themselves as homosexual. The model consists of four stages: sensitization, identity confusion, identity assumption, and commitment. Often-repeated themes in the life histories of lesbians and gay males, clustered according to life stages, provide the content and characteristics of each stage.
Human sexuality goes through many stages from birth onward before reaching adult meaning and expression. Apart from the physical aspects, sexuality involves complex cognitive and social-emotional developmental processes including capacity for intimacy, affiliation, communication, mutual respect and responsibility. A variety of risks may affect sexuality development at any stage and facet of it. To support healthy sexuality functioning in the female adolescent, physicians need to identify early risk markers, some of which are biological and others intrapsychic or sociocultural. Identification should lead to preventative action in support of the adolescent.
This paper offers a new theoretical and clinical look at the death drive in connection with the preservative drive. The author elaborates the flaws she sees in Freud's Beyond the Pleasure Principle (1920) and reformulates the transition between Freud's first drive theory and his second one within an implicit object relations theory. Simultaneously with this revised version of drive theory, a structural theory for the realm of healthy self- and object preservation and for pathological or deadened self and object parts is developed, including the devastating effects of trauma. Clinical material from an extended psychoanalysis shows how these concepts can help us understand these patients' absence and "deadness" and rethink the technical challenges they provide.
The sense of shame seems to vanish for more than a decade now, manifested e.g. by an increasing tolerance toward the naked female body. However, it is supposed that shame has still its significance especially during female puberty. Psychological considerations referring to shame and to the puberty of girls are reported and the significance of feeling ashamed in this salient segment of female development is delineated. Finally a concept is proposed within which the feeling of shame is understood as a possibility to create accordance between the positive aspects of being ashamed and the tendency of going beyond the borders of shame usually guaranteed by social rules.
Characteristics by which to classify a woman as authentically transsexual are offered from earlier investigations and supplemented by findings from recent work with this type of patient. Developmental issues are discussed and six psychodynamic accompaniments listed. A case demonstrates how to identify the true female transsexual and how to understand her psychological processes.
This paper considers Brenner's (1975, 1979, 1982) modification of Freud's theory that anxiety is the only signal affect. Brenner introduced the notion that castration depressive affect also can trigger psychic conflict, defense, and symptom formation. Clinical material from the first year of treatment of a three-year-old boy who suffered a regression in daytime bladder control is presented. The focus is threefold: First, to show that the often cited but poorly studied symptom of regression in bladder control may be an indicator of the child 's struggle with the three calamities of childhood (object loss, loss of love, and castration); second, to present data that support the importance in early symptom formation of both anxiety and depressive affect tied to the ideation of castration as well as of object loss; third, to suggest that vulnerability to castration depression is a concept more pertinent to the stage presently labeled the phallic-narcissistic phase, rather than to the oedipal phase of development. The discussion addresses the importance of castration depressive affect as a concept in guiding therapeutic intervention. Vulnerability to castration depressive affect is postulated to be more prominent in the phallic-narcissistic phase because phallic self representation is not yet consolidated.
This paper explores changes in the recent psychoanalytic theory regarding the preconditions and structural characteristics of sexual love. In briefly reviewing Freud's contributions and subsequent developments regarding infantile sexuality and the perversions, the oedipal constellation, superego development and mass psychology, a common frame is provided for the description of the love life of the sexual couple. In this context, this paper also explores how contemporary psychoanalytic formulations may help to clarify certain conflicts between conventional morality and the psychological reality of the couple in love.
Observations of a girl's development are presented to demonstrate the role of the transitional object in coping with the normal strains implicit in the separation-individuation thrust and in the anal-urinary and early sexual stages of development. When at eighteen months a separation experience led to a serious preoedipal castration reaction, the transitional object no longer was capable of serving its ordinary function and was replaced by a fetishistic object.
This paper touches on two issues that have been disputed by child analysts: the genesis of the transsexual symptom complex, and the question of transference neurosis in child analysis. My observation, as reported previously (Loeb and Shane, 1980) and shown in the present case, is that the transsexual symptom complex can develop out of intrapsychic conflict and can be resolved in a fully developed transference neurosis. In the analysis of a four-and-a-half-year-old boy with transsexual symptoms, I was abstinent--not benevolent or supportive--and both positive and negative transference feelings developed into a full-blown transference neurosis. Then, as I interpreted its elements, we worked through his conflicts, which manifested themselves as acting out of his identification with his aggressive, seductive, and castrating grandmother. As he came to understand his conflicts, the boy's transsexual symptoms vanished.