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[The effect of neuroleptics in a attempt at understanding the vulnerability to schizophrenia].

Animal and human data suggest that neuroleptic drugs act by decreasing the special significance of some stimulations, especially those of importance for the subject. The two following hypotheses are therefore considered as a basis for the work presented in this paper: 1) the target of neuroleptic drugs is a neuro-psychological mechanism whose function is to focalize the subject on important stimulations and to involve the subject in responding; 2) schizophrenia vulnerability could imply an excessive and abnormal propensity to be over-involved, especially in existentially loaded problems. A careful clinical study of the mode of decrease, and sometimes of disappearance, of schizophrenic delusions under the influence of neuroleptic treatment confirms the hypotheses. Results are of interest for clinical treatment and for research.

Antipsychotic Agents↗

Visions of body and soul.

Inspiration for the Sacred Mirrors emerged after I had a series of mystical experiences that caused me to redefine my view of consciousness and the self. I saw the body as not just a solid isolated object in a world of separate forms and existential anxiety, but more like a manifestation of primordial energy of awareness that was everywhere present.... I wanted my paintings to visually chart the spectrum of consciousness from material perception to spiritual insight, and to function, if possible, as symbolic portals to the mystical dimension.... The obvious way was to present a believable and almost hyper-real portrayal of the physical body and then seduce the viewer into the stranger mystical dimensions.

Consciousness↗

A model of hypnotic intervention for palliative care.

The World Health Organization defines palliative care as "the active total care of patients whose disease is not responsive to curative treatment." One of the primary issues of palliative care for patients with advanced cancer is symptom control and quality-of-life issues. The purpose of the hypnotic model presented here is to improve the patient's total psychological, social, and spiritual well-being. There exists a need for a broad and inclusive model of mind-body interventions for palliative care. This is supported by the observation that symptoms related to psychological distress and existential concerns are even more prevalent than pain and other physical symptoms among those with life-limiting conditions. The following model integrates naturalistic, solution-oriented hypnosis within the framework of a situational 4-stage crisis matrix. The four stages of the matrix are: (1) The Initial Crisis, (2) Transition, (3) Acceptance, and (4) Preparation for Death. Hypnotic interventions are tailored to each stage in the crisis matrix.

Adaptation, Psychological↗

Status inequalities, perceived discrimination, and eudaimonic well-being: do the challenges of minority life hone purpose and growth?

Considerable prior research has investigated links between racial/ethnic status and diverse aspects of mental functioning (e.g. psychological disorders, quality of life, self-esteem), but little work has probed the connections between minority status and eudaimonic well-being. Derived from existential and humanistic perspectives, eudaimonia describes engagement in life challenges and is operationalized with assessments of purpose in life, personal growth, autonomy, environmental mastery, self-acceptance, and positive relations with others. Using Midlife in the United States (MIDUS), a national survey of Americans aged 25-74, plus city-specific samples of African Americans in New York City and Mexican Americans in Chicago, minority status was found to be a positive predictor of eudaimonic well-being, underscoring themes of psychological strength in the face of race-related adversity. Perceived discrimination was found to be a negative predictor of eudaimonic well-being, although such effects were gender-specific: it was women, both majority and minority, with high levels of discrimination in their daily lives whose sense of growth, mastery, autonomy, and self-acceptance was compromised.

Adult↗

[Traumatic stress severity].

Since 1980, a new outlook on stress was applied in connection with the changes in psychiatric concepts and the notion that a traumatic experience may cause specific psychological symptoms varying from the content and source of other psychiatric disorders. The understanding of the trauma, defined by the objective traits of the stressor, separated it from stress as defined by the subjective individual's decision. This was against the current theory of Selye in which the stress reaction is a homogenous entity as a whole, defined by a subjective evaluation of the event, independently of the objective traits. The paper examines new directions in the studies on the meaning of trauma for the person who survived it. According to these studies, the trauma and its consequences cannot be viewed solely in a narrow pathogenic and symptomatic frame. Modern directions of studies on stress led to a model integration of physiological, behavioural and psychological reactions and the trauma itself was to be seen in a cultural and historical context. Today's biopsychocultural model of understanding trauma consists in a complex of common actions from various systems and backgrounds. They comprise the following factors: physical (biological), intrapsychic, interpersonal (familial, social, religious, cultural), educational-professional, economical, political. These systems coexist in a time frame, in common relations and connections. They all affect the capability to evaluate danger, which gives different strategies of coping with oneself. Studies on PTSD give arguments for understanding of the full influence that a trauma can have on a person, and allow for an unlimited outlook on the traumatic situation--its biological, social and existential aspects.

Humans↗

Care of a child dying of cancer: the role of the palliative care team in pediatric oncology.

The last period of life of a child suffering from cancer is of crucial importance not only for the child himself but for his parents and relatives as well. The way the child dies will remain in the memory of his parents for ever. Multiple problems in management of dying child may arise during this last phase. Timely and sensitive discussion of such aspects of management as implementation of Do Not Resuscitate order, possible provision of fluids and parenteral nutrition, initiation of palliative sedation and management of depression is necessary and may help parents to better cope with this tragic situation. Palliative care team consisting of medical and psychosocial staff plays vital role conveying comprehensive and timely management of all these problems and providing all necessary assistance for parents and other involved during ones' last weeks, days, and hours of child's life. The palliative care team cannot avert approaching death but it is responsible for making it as peaceful and as free of suffering as possible. This is achieved by vigorous control of all physical symptoms in the dying child and by paying close attention to all existential, emotional, and social demands of both the child and his relatives.

Attitude to Death↗

Father-to-son sperm donation. A report of three cases.

Sperm donation is a common practice in assisted reproduction. In cases of azoospermia and negative results of testicular sperm extraction, it appears as the only solution. Sperm donation entails a complete genetic dissociation between husband and offspring, which brings psychological stress for the couple arising from ethical and existential dilemmas. Faced with such dilemmas, some couples prefer father-to-son donation as an alternative solution. Here, three cases of non-obstructive azoospermia are presented where intracytoplasmic sperm injection was performed with father-to-son sperm donation.

Fathers↗

Putting leaders on the couch. A conversation with Manfred F. R. Kets de Vries. Interview by Diane L. Coutu.

Much of the business literature on leadership starts with the assumption that leaders are rational beings. But irrationality is integral to human nature, and inner conflict often contributes to the drive to succeed. Although a number of business scholars have explored the psychology of executives, Manfred F.R Kets de Vries has made the analysis of CEOs his life's work. In this article, Kets de Vries, a psychoanalyst, author, and instead professor, draws on three decades of study to describe the psychological profile of successful CEOs. He explores senior executives' vulnerabilities, which are often intensified by followers' attempts to manipulate their leaders. Leaders, he says, have an uncanny ability to awaken transferential processes--in which people transfer the dynamics of past relationships onto present interactions--among their employees and even in themselves. These processes can present themselves in a number of ways, sometimes negatively. What's more, many top executives, being middle-aged, suffer from depression. Mid-life prompts a reappraisal of career identity, and by the time a leader is a CEO, an existential crisis is often imminent. This can happen with anyone, but the probability is higher with CEOs, and senior executives because so many have devoted themselves exclusively to work. Not all CEOs are psychologically unhealthy, of course. Healthy leaders are talented in self-observation and self-analysis, Kets de Vries says. The best are highly motivated to spend time on self-reflection. Their lives are in balance, they can play, they are creative and inventive, and they have the capacity to be nonconformist. "Those who accept the madness in themselves may be the healthiest leaders of all," he concludes.

Administrative Personnel↗

Hysterical personality and family: a clinical case.

Within the framework of family typology, the therapist can organize and orient his own observations, by confronting the characteristics of a particular family system, with the models of a "shared reality". Structural and organizational analysis of the family system, according to a general typology, can also be useful when the therapist has to deal with a defined and a not specific symptom or disease, and when a differential diagnosis is necessary for its pragmatic effects. This is often the case of hysteria, which according to many authors can show today various, confused shapes, as depression, general existential discomfort, anorexia and bulimia, and forms of exhibited addition. The authors present a clinical case, trying to point out how a "typology-oriented" observation of the family system, allowed the therapists to clarify an individual condition, otherwise difficult to understand.

Adult↗

Interactive typology of the hypochondriacal patient.

Many authors agree on the idea that the affective and behavioural characteristic of a certain type of family encourages the use of the body as a primary means of communication with others. This way of communicating has usually been acquired during childhood and later, in the adult life, it appears again in the different social contests. Some authors like Alby, Levy, Baker, Parker, Lipscombe, Marcelli, Bianchi and others focus on this type of family interaction and the single characteristic of the personalities of each family member. These authors describe some relationship patterns used by hypochondriac patient such as: avoiding unpleasant situations, blaming others, adopt a sick-role as a way of controlling the relationship between existential events and somatic symptoms; relationship with physicians and the need to confirm her/himself.

Anxiety↗

[Differential phenomenology of the paranoid psychoses in epilepsy].

First, the author makes reference to the psycho pathological and nosological questions associated with paranoid and schizophrenia-like psychoses in epilepsy and in particular to the non resolved problem of a distinction between these epileptic syndromes and the ones of schizophrenia. Starting from a phenomenological analysis of basic existential structures such as encounter or interpersonality, temporality and spatiality in a typical case of paranoid psychosis in epilepsy, the author tries to establish formal criteria which allow to distinguish these psychoses from schizophrenia. Thus it could be demonstrated that the structure of the encounter in the psychotic epileptic is quite conserved, both in what refers to the real and the delusional partner. His spatiality is characterized by the phenomenon of narrowness and his temporality by harassment, being necessary to underline the fact that, unlike what happens in schizophrenia, in the paranoid psychoses of epilepsy the space maintains its unity and the time its continuity. We could summarize the substantive difference between both types of paranoid psychoses with the following words: in paranoid syndromes in epilepsy what occurs is a change of state "within the world", while in schizophrenia it is a rather a modification of the "being-in-the world" itself or, with other words, it deals with a going out from the world constituted as community.

Adult↗

[Death experience. Antidote against fear to death].

Fortunately, anthropology has brought to our modern society a higher interest for mankind's cultural dimension and the values which each people employ in order to make sense out of the changes which occur during our lives. It is this cultural dimension which permits men to develop our innate capacities and to become humans. However, in order to achieve this, we need experiences which are codified and interpreted by a values system which each individual has made his/her own. Some of these experiences take place inside cultural mores constructed expressly so that they are useful for one's lifestyle; these are known as rites. A rite, therefore, is an experience which leaves an impression, which implies social and biographical changes, which provides meaning to human beings' universal interests. Nonetheless, since rites usually are organized by diverse religions, it is convenient, as we enter the 21st Century, to speak about Experiences which Activate Structures as means to approach, to come to grasp with, some of the great causes of anxiety in humans: death and insanity. These Experiences which Activate Structures allow us to subjectively experiment, to conquer our fears and to be more conscious of our here and our now. Workshops on the Living Integration of One's Own Death are included in this context as an appropriate forum through which to approach death with knowledge and serenity, inducing changes in our own lifestyle as well and helping us to overcome situations of existential blockage.

Death↗

An intersubjective developmental perspective on interactions between deaf and hearing mothers and their deaf infants.

Most research into interactions between mothers and their infants with hearing impairments focuses on mothers' and infants' behaviors separately, speculating about the interplay among these behaviors and their effects on child development. In the present article, an intersubjective developmental theory focusing on the development of the "interworld" between deaf and hearing mothers and their deaf infants is used to integrate and interpret the seemingly incoherent research on early mother-deaf child interaction. Inspired by Stern's work (e.g., Stern, 1985), the intersubjective developmental theory distinguishes four stages in the development of intersubjectivity: emerging (birth-2 months), physical (2-8 months), existential (8-13 months), and symbolic (13 months and older), each characterized by a different type of mother-infant interaction. The integration of research findings on early mother-deaf child interaction into these four developmental stages offers new perspectives that can advance research and resolve certain early-intervention issues.

Communication↗

[Adult health problems and coping at life turning points].

At important life turning points, middle-aged adults face many physiological changes (e.g., aging, changes in hormone levels) and alterations in family structure (e.g., children growing up and leaving home). In addition to facing these changes and their impacts, adults must also take on challenges in terms of self-concept, body image, life goals, and life meaning. Illnesses that commonly occur during this life stage include menopausal depression, substance abuse, and anxiety. Traditional treatment models are medical-oriented, but curative effects are limited and hospital visits still occur at high frequencies, resulting in increased medical expenses and disruptions in family life. The authors review the current literature on curative models in this area, and discuss the potential of a combination of physical therapy, cognitive, and existential-humanistic therapy to improve patients' physical strength, self-concept, self-esteem, and self-confidence in an effort to overcome physio-psycho-social disorders and to increase vitality.

Adaptation, Psychological↗

[Health care needs of cocaine users in Hungary: results of a qualitative study].

INTRODUCTION: There have not been any substantive collection of data on cocaine users in Hungary although there were numerous indications that a cocaine problem may exist. AIM: In the frame of the project entitled "Support Needs for Cocaine and Crack Users in Europe" the aim of the authors was to identify the qualitative characteristics of Hungarian cocaine users. STUDY GROUP AND METHODS: In addition to a quantitative study of 210 cocaine users, we selected nine subjects by random sampling and conducted problem-oriented depth interviews with them. Three of the subjects belonged in the party group (weekend use, social integration), three in the scene group (part of the marginal drug-using subculture) and three in the therapy group (undergoing treatment for drug use at the time of the study). The main thread of the interview covered the following main aspects: 1. Drug-using behaviour--reduction, termination or continuation of use; 2. Use of support services; 3. Experiences with addiction medicine services; 4. Support needs. RESULTS: The interviews decide to give up cocaine use when they perceive the disproportionately high costs of cocaine use on the basis of simple cost-benefit calculation. Apart from the existential costs, the main costs include sleep disorder, psychological and psychiatric symptoms and problems (depression, sensitivity, paranoid state, panic, anxiety, sexual disorders, etc.), symptoms reminiscent of serious cardiac disorders (chest pain) and interpersonal problems. They were able to reach professional help by chance, through friends. Cocaine users do not favour state health services, they are mistrustful of the handling of data. For this reason they prefer private doctors. They seek medical help not for detoxification but rather to prevent a relapse, generally for problems arising after withdrawal. Psychological help dominates in the assistance given. Heroin-dependent cocaine users seek help from the staff in the place where methadone treatment is given. Much depends in the management of abstinence on the degree of involvement in the subculture, emotional support, the attitude to work, the extent of disorders arising after withdrawal, and the quality of the personal relationship formed with the doctor. Most cocaine users require complex multi-disciplinary treatment. CONCLUSION: Cocaine use can be characterised along the dimensions of work, self-image, conspiracy, openness, criminality, basic drug, the negative or positive reinforcing function of cocaine: Dr. Jekyll and Mr. Hyde type, Carmen type, Pinocchio type. The Dr. Jekyll and Mr. Hyde type is characterised by a double life, the Carmen type is the prototype of the sovereign female placing the emphasis on sexuality, the Pinocchio type is a trouble-making, criminal risk-seeker. While some of those within the Dr. Jekyll and Mr. Hyde type are open to help and others do not seek help, the Carmen type is open and the Pinocchio type closed to help unless their legal interests require the opposite.

Cocaine-Related Disorders↗

[The child with a cancer diagnosis: revisiting the way of assistance policies].

This paper considers about the onco-hematologic assistance policies and their implications in caring for a child with cancer diagnosis and his/her family. It emphasizes that the existential changes of the child-family unit may be minimized by the policies that assure access to resources. The study shows how Non-governmental Organizations (NGOs) are inserted in the context. The conclusion is that the engagement of families as well of health professionals and institutions, both governmental and non-governmental, may contribute to the implementation of policies that enlarge the network of assistance to children who suffer from an onco-hematologic disease.

Adolescent↗

The changing psychological contract at work and employee burnout.

Today we stand in a vortex of technological, economic, and cultural changes that altered dramatically the world of labor and with it the psychological contract between employers and employees. While the effects of the changed contract at work are usually addressed from an organizational, social or economic perspective, the current article addresses it from a psychological perspective from which one noteworthy cost of the changed psychological contract is employee burnout. The article describes burnout, differentiates it from stress, and proposes an existential perspective to explain its underlying dynamic, using the results of a cross-cultural study of Israeli and American managers as an example. Recent studies on gender differences in management are used to point in the recommended for preventing employee burnout, despite the new psychological contract, namely--a democratic, egalitarian management style.

Burnout, Professional↗

[The free man (a model of mental health)].

The individual freedom is a basic value of mental health that must be aim of promotion and prevention. The human freedom is a mental unit faculty, attached to the reason, with a function distributed into three sequences (choice, self-control and action). The profile of the free man is described as the author of a personal life organized on a vital project and a wide existential temporality, with a very favourable arrangement to the own well-being and other people's. The social liberty can only be real in a free culture.

Freedom↗