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PubMed1984

An essay on contemporary dynamic psychiatry.

Psychodynamic theory is less well understood than one would wish, especially because of the centrality of dynamic theories in understanding a host of psychiatric disorders. The key psychodynamic notion is that psychiatric symptoms can be explained as manifestations of an unconscious purpose or strategy. The theoretical term that best encompasses this notion is "intentionality", a theoretical option that has, in many psychiatric circumstances, the greatest predictive and explanatory powers. Other more or less loosely related dynamic theories are the theory of the Oedipus complex, developmental theory, the theory of transference and the extraclinical theory. New theoretical paradigms are currently competing for explanatory priority, a development which reflects a healthy maturity in psychodynamic science, and which may mean that a new and superordinate theoretical paradigm is about to emerge. At a time of theoretical ferment it is particularly important that the theoretical underpinning of dynamic psychiatry be clearly explicated and the author claims that theoretical role for intentionality.

Countertransference↗
PubMed2002

[From taboo to self-actualization--acceptance problems and learning processes in working with mentally handicapped patients].

The article introduces the topic of "sexuality and people with developmental disabilities". It presents the historical stages of development and the institutional framework of the work with people with disabilities in Germany. Six criterions and standards respectively, are pointed out, that help to determine whether institutions support or hinder sexual self-determination. These standards are formulated as rights in the sense of the basic human rights.

Adolescent↗
PubMed1977

The syndrome of abuse dwarfism (psychosocial dwarfism or reversible hyposomatotropism).

In abuse dwarfism the behavioral signs include some or all of the following: (1) a history of unusual eating and drinking behavior, reversible on change of domicile, such as eating from a garbage can and drinking from a toilet bowl, stealing food, alleged picky eating and rejecting food at the table, polydipsia and polyphagia, possibly alternating with vomiting and possibly also with self-starvation; (2) a history of such behavioral symptoms as enuresis, encopresis, social apathy or inertia, defiant aggressiveness, sudden tantrums, crying spasms, insomnia, eccentric sleeping and waking schedule, pain agnosia, and self-injury, all occurring only in the growth-retarding environment; (3) retarded motor development, with improvement on removal of the child from the domiclle of abuse; (4) retarded intellectual growht, reversible on change of domicile by as much as 30 to 50 IQ points; and (5) a history of pathologic family relationships, including unusual cruelty and neglect, either somatic or psychic or both.

Adolescent↗
PubMed2005

Working with nonheterosexual youth to understand sexual identity development, at-risk behaviors, and implications for health care professionals.

This article outlines special issues related to being a nonheterosexual youth. Information is presented on the sexual development of homosexual youth and their unique challenges. Included are data about the average age of initial awareness and self-identification of gay, lesbian, bisexual, transgendered, and questioning youth. The average age of awareness of homosexual orientation is between 10 or 11 years, while the average for identifying or self-labeling is ages 13-15. This age range is consistent across studies. The special issues related to a unique sexual development, prejudices associated with being a nonheterosexually oriented youth, typical behavioral outcomes of dealing with discrimination, and major health concerns for this at-risk population are identified. Finally, implications for health care professionals working with these adolescents are outlined.

Adolescent↗
PubMed2004

["W. Bölsche's precious book". Freud and German evolutionism in the beginning of the 20th century].

Wilhelm Bölsche (1861-1939) is the author of a poetic history of the evolution of love entitled Das Liebesleben in der Natur (1898-1903). This work, inspired by the writings of biologist Ernst Haeckel, was greatly successful in Germany at the beginning of the 20th century. Freud kept a copy of the three volumes in his London library and cites the text in his lectures on an Introduction to psychoanalysis. Bölsche develops an Entwicklungsgeschichte (history of evolution) of the distinguishing sexuality of several types of love (oral, anal and urinary). In addition, he describes the "zoological reactionary" homosexual and ties this sexual behaviour to the history of the development of anal sexuality. This paper will address an excerpt on this topic from Bölsche's text that has been translated for the occasion. The task at hand is to prepare the ground for a study of German evolutionism, both popular and scientific, and its ties to psychoanalysis.

Austria↗
PubMed1979

On the concept and consequences of the primal scene.

The concept of the primal scene is in need of redefinition and clarification. The primal scene is not identical with its regressive transformations or later derivatives. Because of the different implications for normal development and for psychopathology, the primal scene as a universal fantasy should be differentiated from the primal scene as real experience. The effects of exposure to the primal scene are considered in relation to the developmental level of the child, other problems in the parent-child relationship, and cultural attitudes.

Age Factors↗
PubMed2002

The early oedipal situation: developmental, theoretical, and clinical implications.

The Oedipus complex is typically thought to begin in the phallic phase, when the child's relationship to the parents as a couple achieves central prominence. In contrast, the author views the appearance of oedipal conflicts in the phallic phase as the end point of a line of development of triangular relatedness that began in infancy. An aspect of the Kleinian view of the oedipal situation--that awareness of the parents as a couple begins in the preoedipal period--deserves serious consideration. A patient is presented for whom the working through of early oedipal issues in the transference-counter-transference permitted recovery from withdrawal into a fantasy world.

Child↗
PubMed1996

Rearing piglets in a poor environment: developmental aspects of social stress in pigs.

Effects of rearing conditions on the development of social relationships were investigated in female pigs. For that purpose, one group of piglets was reared in a poor environment (i.e., a commercially used indoor 4.2-m2 standard farrowing crate) and the other in an enriched environment (i.e., 0.5-ha outdoor pasture with half-open farrowing crates). After weaning, all piglets were housed in pairs under standard conditions. Dominant and subordinate individuals were distinguished within pairs and social relationships between members of a pair were studied in adulthood. The results show that pairs reared in a poor environment behave more aggressively. The subordinates of these pairs also develop symptoms indicative of chronic social stress exposure: i.e., they show a delayed onset of puberty, a smaller daily weight gain, and elevated basal cortisol levels that are also higher 5 h after an acute restraint stressor (tethering stress). No such deviations were found in subordinates reared in an enriched environment. It is concluded that rearing piglets in a poor environment may facilitate the development of social stress in adult (subordinate) pigs. Two underlying mechanisms may be proposed: a) deteriorated social skills lead to increased social stress, or b) a failure to cope with stressors in general, and the stress of being subordinate in particular, occurs in animals reared under poor conditions.

Aggression↗
PubMed1997

Relationship between sexual abuse, gender, and sexually inappropriate behaviors in seriously mentally ill youths.

OBJECTIVE: To examine gender differences in sexual abuse histories and in the development of inappropriate sexual behaviors in a sample of seriously mentally Ill youths. METHOD: A retrospective chart review was completed for all patients from 1987 through 1992 at a tertiary care public sector psychiatric hospital for youths (N = 499). Subjects were categorized by gender, sexual abuse status, and whether they had sexually reactive or victimizing behaviors. RESULTS: Girls were more likely to have been sexually abused, and their abuse histories were more severe. Sexual behavior problems in girls were almost exclusively associated with sexual abuse, whereas 29% of boys with victimizing behaviors had no sexual abuse history. Among sexually abused youths, boys were more likely to display victimizing behaviors, whereas both genders displayed similar rates of sexually reactive behaviors. Of the 19 girls who displayed victimizing behaviors, 95% were chronically sexually abused and one third had also received a major injury due to physical abuse. CONCLUSIONS: Boys appear to have a lower threshold of abuse exposure required to develop sexually inappropriate behaviors and are significantly more likely to display victimizing behaviors. Conversely, victimizing behaviors in girls may require a catastrophic maltreatment history. These gender differences should be incorporated into treatment interventions directed at sexual abuse victims.

Adolescent↗
PubMed1992

The Pre-Adult Health Decision-Making Model: linking decision-making directedness/orientation to adolescent health-related attitudes and behaviors.

In light of the broad consequences of the acquired immunodeficiency syndrome (AIDS) epidemic, as well as the increased rates of sexually transmitted diseases (STDs), pregnancy, and alcohol and drug abuse among adolescents, there is a great need to understand how adolescents make health decisions. This paper presents a model for adolescent health behavior, the Pre-Adult Health Decision-Making Model (PAHDM), which takes into account the differential information processing from peer sources, parent sources, or through critical or reflexive self-analysis. Also presented is a review of the large corpora of psychological and sociological literature on adolescent development, adolescent health behaviors, and, more specifically, AIDS and other STDs as a public health problem. The need for additional research in the area of adolescent health decision-making, and for a health behavior model that is specific to the "lifeworld" of the adolescent, is stressed.

Acquired Immunodeficiency Syndrome↗
PubMed1990

A qualitative analysis of adult incest survivors' responses to sexual involvement with therapists.

Six women who had histories of incest and had been sexually involved with therapists participated in qualitative research employing semi-structured, open-ended interviews. Transcribed interviews were content analyzed for recurrent regularities in topics, themes, events, and dynamics. Following content and cluster analyses of interviews, three overall themes emerged that appeared most salient in attempting to understand the development and maintenance of therapeutic relationships in which incest survivors experienced additional abuse. The themes were (1) early environment that prohibited the development of a sense of "personhood" in incest survivors, (2) repeated experiences of depersonalization inside and outside of therapy that reinforced a state of non-personhood, and (3) adoption of a "surrender pattern" to cope with violations, including therapist violations.

Adolescent↗
PubMed2001

The mother-daughter love affair across the generations.

The relationship between mother and daughter is the basis for all love relationships throughout life. Through the eyes and hands of the mother, the intimate and caring nature of love is transmitted from generation to generation. Mother-daughter love is also the beginning of heterosexual love and of sensual pleasure. However, sexuality separates and alienates mother and daughter. As a consequence, the daughter's identification with the mother becomes the most important transmitter of love. We review psychoanalytic studies of the development and fate of the mother-daughter love relationship, with particular attention to the change of the daughter's early love for the mother to identification with the mother and falling in love with a man, and to the significance of sexuality in this developmental process.

Adolescent↗
PubMed1987

A sociological approach to counseling homosexual clients and their families.

Stigma lies at the root of many problems typically experienced by homosexual clients and their families. Sociological theory and research shed light on the dynamics of stigma and its consequences, both for the stigmatized population and for their heterosexual families and associates. This article summarizes key sociological research on the nature and development of sexual orientation. It considers the dynamics of homophobia and its implications for homosexual youngsters and their families. It offers practical tips for helping clients to understand their own or a family member's homosexual orientation, for coping with stigma, for reconciling issues of religion and morality, and for determining lifestyle. Suggestions for therapist office materials are also included.

Attitude↗
PubMed1984

Issues in the psychiatric diagnosis and management of impotence.

The evaluation and management of impotence has received increasing attention in recent years, largely because of the development of new techniques of diagnosis and treatment discussed in the present review. The author reviews the role of psychiatry in (a) understanding psychogenic impotence, (b) differentiation of psychogenic from organic impotence and (c) developing the rationale and methods of the newer treatment modalities. The impact of the availability of surgical penile prosthesis implantation on the role of psychiatry in evaluating impotent subjects is discussed. The author indicates that much remains to be learned about the indications for surgical versus psychological treatment of impotence, and about the effectiveness of psychological interventions.

Behavior Therapy↗
PubMed1981

[Sexual development -- sexual advice -- sexual education -- Paedagogico-psychological aspects in gynaecological practice (author's transl)].

Sexuality of man is conceived as a psycho-physical phenomenon, and in gynaecological practice particular attention must be given to psychogenic components, whenever it comes to disorders of sexual organs and functions. It is also desirable and necessary to attend to patients not only in terms of medical findings and their communication. They also should be offered advice and recommendations. Fears and anxiety should be taken from them regarding their own sexual behaviour and experience and partnership relations. Findings obtained from empirical studies into sexual development together with results of an analysis of expectations and attitudes of gynaecological patients. -- Recommendations are given on how to brief patients, with particular reference being made to group briefing. -- Conclusions are suggested for training and upgrading of gynaecologists under the auspices of the Society of Gynaecology and Obstetrics.

Adolescent↗
PubMed1993

Effects of day care on preschool sex-role development.

Affiliative, aggressive, and problem-solving types of behavior were analyzed in middle-class preschoolers, 53 boys and 52 girls, grouped by length of time in day care. Boys were observed to be significantly more aggressive toward peers, but no differences between boys' and girls' aggressive or affiliative ratings were attributable to differential effects of time of entry into day care.

Child Day Care Centers↗
PubMed1976

Parental mislabeling of female genitals as a determinant of penis envy and learning inhibitions in women.

A survey of sex education literature confirms parents' self-reports regarding sex information imparted to their children. With relatively few exceptions, young children (and even teenagers) are taught that "boys have a penis and girls have a vagina," without further linguistic distinctions made regarding the sensitive external genitals of the female child. It is suggested that this incomplete, undifferentiated, and often inaccurate picture of female genitals prevents the growing girl from achieving pride in femininity, and may lead to anxiety and confusion regarding her sexuality. A case is presented in which the failure to label the girl's external genitals was a contributing factor to penis envy, as well as to conflicts about "looking" which led to symptomatic learning inhibitions. It is suggested that the ubiquity of the female "castration complex" may not stem primarily from the fact that the clitoris is a smaller (and thus inferior) organ compared to the penis. Rather, the girl's feeling of being "cheated" may reflect parental failure to explicitly acknowledge that the vulva (especially the clitoris) is an important aspect of "what girls have." Because visible and sensitive aspects of the girl's genitals are not labeled for her, the girl may feel that she does not have "permission" to develop into a sexually responsive and complete woman. As in the case presented, penis envy may be a symptom expressing the wish to have one's female sexuality "validated," but which also serves to block this forbidden wish by inhibiting sexual responsiveness and pride in femininity.

Achievement↗
PubMed1995

Has sexuality anything to do with psychoanalysis?

This paper, prepared as a Sigmund Freud birthday lecture for the Anna Freud Centre, takes the opportunity to clarify and to debate some of the misunderstandings surrounding the meaning and significance of sexuality in psychoanalysis. The author departs from twin observations he has made in the last ten years: direct discussion of sexuality seems to have become marginalised and restricted to specialised papers in psychoanalytic journals. Attempting to question and understand this trend the author recalls that Freud placed sexuality at the centre of psychic development, psychoanalytic theory and clinical work. The contemporary and fashionable focus on object relations, pregenital fixations, borderline pathology and theories and techniques drawn from observations of child development have obscured, the author argues, the meaning and importance of sexuality in psychoanalytic theory and practice. A condensed review of Freud's ideas about sexuality and a re-evaluation of them is aimed at restoring the importance of genital sexuality and the Oedipus complex to their central place. For this author today's sexuality is not Freud's sexuality.

Adult↗