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PubMed2005

Countertransference in the Context of the Fourth Basic Assumption in the Unconscious Life of Groups.

The treatment of choice for traumatized and difficult patients is psychoanalysis or psychoanalytical therapy followed by intensive group analysis for an unlimited period of time. The group is able to help the analyst make therapeutic use of inevitable difficulties in countertransference processes. Also, traumatized and difficult patients are likely to create the basic assumption of Incohesion: Aggregation/Massification, and to personify the roles associated with it. These processes can be used in order to provide such patients with appropriate therapeutic attention involving both containment and holding, and interpretation. Extensive clinical data from psychoanalysis and group analysis are used to illustrate both this clinical approach and the author's theory of Incohesion.

Journal Article↗
PubMed1990

Visual masking and unconscious processing: differences between backward and simultaneous masking?

Visual masking procedures are considered to have great potential for studying information processing that occurs outside of consciousness. Unfortunately, effects that indicate processing of masked word stimuli have been both difficult to obtain and, once obtained, difficult to replicate. The present seven experiments failed to obtain an effect of lexicality (word vs. nonword targets) on detection that was recently reported by Doyle and Leach (1988). Whereas Doyle and Leach had used backward binocular masking, most of the present experiments used simultaneous dichoptic masking. Doyle (1990) recently suggested that the effect of lexicality on detection (coupled with an effect of knowledge of results, which was also not obtained in the present research) could explain why Greenwald, Klinger, and Liu (1989) found no evidence for detectability of masked words that were nevertheless analyzed semantically. The differences of the present findings from those of Doyle and Leach (1988) not only confirm the uncertainty of generalizing across masking procedures, but also indicate that Greenwald et al.'s "detectionless processing" interpretation remains viable.

Adult↗
PubMed1992

Left or right, up or down: a case for positioning of unconscious head-injured patients.

Nursing care activities have been proved to cause increases in intracranial pressure (ICP) which could be detrimental to the patient's health. Because positioning is one of the activities that causes the greatest pressure changes it was evaluated in this study. Cumulative increases also occur when nursing care activities are carried out in quick succession. The analysis of the data and literature suggest that the backrest position with the head of the bed elevated 30 to 45 degrees is the best position for a patient with increased ICP. If further research should prove that this position has a negative influence on the cerebral perfusion pressure, these recommendations will have to be revised.

Clinical Nursing Research↗
PubMed1991

Tube feeding and the permanently unconscious: the Supreme Court's decision in Cruzan.

In the recent case of Cruzan v. Director, Missouri Department of Health, a majority of the United States Supreme Court voted to affirm a Missouri decision rejecting the request of guardians for removal of tubes used to provide nutrition and hydration to a woman in a persistent vegetative state. This article analyzes the Court's decision, focusing specifically on the concurring and dissenting opinions in the case, and discusses the implications of this decision for the states.

Adult↗
PubMed2000

[Cholinergic syndrome with unconsciousness in amanita poisoning].

HISTORY AND ADMISSION FINDINGS: A 41-year-old patient was found in his flat in a state of coma. After emergency treatment his vital signs were stable and he was transferred to an acute hospital with possible cannabis intoxication. The patient, a hobby gardener, was previously well and had an adversion to the use of any chemical substances. The main symptom showed a cholinergic syndrome with deep coma. We assumed plant ingestion because of the clinical picture and history. INVESTIGATIONS: The laboratory results were within normal limits apart from a slight rise of the serum creatinine kinase level. The electrocardiogram showed a bradycardia. A drug-screening could not be performed. TREATMENT AND COURSE: The differential diagnosis of plant alkaloids or mushroom toxins were considered due to possible plant ingestion and a cholinergic syndrome. Later the toadstool (Amanita muscaria) was found. After treatment oft the cholinergic syndrome with high doses of atropine primary poison elimination was performed. 24 hours later the patient awoke from his coma. Visual hallucinations persisted for a few days. No organic damage due to the intoxication was found. CONCLUSION: Toxic mushroom ingestion can produce a variety of clinical pictures. Most commonly an anticholinergic syndrome is found, but this was not the case in this patient. The effect of the poison depends on the amount and the preparation, so that no reliable outcome prediction can be made. The drug "poisonous mushroom" is legal and hallucinogenic substances are trendy. As a result clinical signs like those described here will have to be expected in the future.

Adult↗