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PubMed1978

[Penal responsibility and the unconscious conflict].

Although the same model of the delinquent's penal responsibility still exists in law as well as in psychiatry, it is rapidly giving way to the concept of personality. Moreover, the psychoanalytical model is currently being used. The sole point of reference used by the psychiatrist is his relationship with the delinquent. He thus constructs a "new history" for the delinquent. This psycho-dynamic approach to the delinquent makes us formulate two fundamental objections: 1) It often is forgotten that the Freudian topical approach and its instances of personality are metaphorical. Out of context, that is of a relationship in time and space, it becomes void of meaning. Thus, the use of psychoanalytical concepts is epistemologically inacceptable. 2) Psychoanalytical theory, on a par with all systems of thought, has constituted its own system of values. Thus, neurotic structures, being nearer to that of the expert himself, take a privileged position. To summarize, it is the author's purpose to show that intra-psychic conflicts cannot be reduced to inter-personnel conflicts, most of all not in the field of crime.

Forensic Psychiatry↗
PubMed1996

Aetiological considerations in the febrile unconscious child in the rainforest and arid regions of Nigeria.

An analysis of hospital admissions in two areas of Nigeria indicates that the burden of coma/convulsions with fever and malaria is higher in the rainforest region whereas that of bacterial meningitis (BM) and focal extracranial infection (FEI), mainly acute respiratory infections, is higher in the arid region. The burden of malaria has increased and chloroquine-resistant malaria has become a problem in clinical practice. There is the need to revise the current policy of initiation of treatment with chloroquine in severe malaria being practised in some centres; quinine would be a suitable alternative based on current trends. Co-existing infections, especially the association of other infections with BM, are an important feature in both wet and arid regions of Nigeria and point to the need for "routine" diagnostic spinal taps in order to minimise the chances of a missed diagnosis of BM.

Adolescent↗
PubMed2001

Freud and Klein on the concept of phantasy.

In summary, I think Freud's idea is that the prime mover of psychic life is the unconscious wish, not phantasy. The 'work' of making phantasies and the 'work' of making dreams are parallel processes in which forbidden unconscious wishes achieve disguised expression and partial fulfilment. For Freud himself, especially in his central usage, and even more for his immediate followers, phantasies are conceived as imagined fulfilments of frustrated wishes. Whether they originate in the system conscious or the system preconscious, they are an activity of the ego and are formed according to the principles of the secondary process. That is not the whole story, however, because phantasies may get repressed into the system unconscious, where they become associated with the instinctual wishes, become subject to the laws of the primary process, and may find their way into dreams and many other derivatives. For Freud and for French psychoanalysts particularly, there are the primal phantasies, 'unconscious all along', of the primal scene, castration and seduction, also capable of being directly incorporated into dreams and expressed through other derivatives. For Klein phantasy is an even more central concept than for Freud and it has continued to be used by her successors with only minor changes. In Klein's thinking unconscious phantasies play the part that Freud assigned to the unconscious wish. They underlie dreams rather than being parallel to them--a much more inclusive definition of phantasy than Freud's. The earliest and most deeply unconscious phantasies are bodily, and only gradually, with maturation and developing experience through introjection and projection do some of them come to take a verbal form. Freud's central usage, the wish-fulfilling definition of phantasy, is a particular type of phantasy within Klein's more inclusive definition. And, as in Freud's formulation, conscious phantasies may be repressed, but in Klein's formulation this is not the only or even the main source of unconscious phantasies. In Klein's usage, unconscious phantasies underlie not only dreams but all thought and activity, both creative and destructive, including the expression of internal object relations in the analytic situation. Finally, it is my tentative suggestion that conceptual and clinical focus on the concept of phantasy, especially unconscious phantasy, as in Britain and France, tends to involve a heightened awareness of the unconscious--hardly surprising, since unconscious phantasy is such a fundamental aspect of the unconscious. I have suggested that, although there are many individual variations, the structural model and the self-psychology, relational and intersubjectivist models tend to discourage focus on the dynamic unconscious.

Adult↗
PubMed1990

Acceleration-induced loss of consciousness. A review of 500 episodes.

Unconsciousness resulting from exposure to increased levels of head-to-foot (+Gz) acceleration stress (501 unconsciousness episodes) on a centrifuge in asymptomatic, healthy human subjects was investigated. A method for quantitatively measuring the kinetics of the unconsciousness and associated phenomenon was developed. In addition, a theoretical framework for describing the central nervous system (CNS) alteration resulting from acute reduction of blood flow was formulated to allow a method for defining unconsciousness phenomenon. The length of unconsciousness and the associated incapacitation was found to be dependent on the magnitude of the CNS insult resulting from reduced blood flow. The magnitude of the insult was determined by the onset and offset rates of the +Gz-stress and the length of time at increased +Gz. The incapacitation resulting from +Gz-stress included 11.9 seconds of absolute incapacitation (unconsciousness) and 16 seconds of relative incapacitation (confusion/disorientation) for 28 seconds of total incapacitation (period of time for lack of purposeful movement). Myoclonic convulsions were observed in approximately 70% of the unconsciousness episodes. The convulsions lasted 4 seconds and occurred following the return of CNS blood flow. The convulsions occurred after 8 seconds of unconsciousness and ended coincident with the return of consciousness. They occurred when the CNS insult was of greater magnitude. Memorable dreams occurred and were considered to occur during the terminal portion of the convulsion period. The dreams occurred with exposures having longer unconsciousness. The length of unconsciousness and incapacitation was affected by the wearing of an anti-G suit, with unconsciousness and incapacitation being reduced if the suit were worn. Performance of an anti-G straining maneuver resulted in an increased length of incapacitation by allowing the subject to get to higher levels of +Gz-stress and to sustain a greater amount of acceleration exposure. The results of this 11-year study of human unconsciousness provide a quantitative kinetic description of the phenomenon in healthy humans that is completely documented on videotape. These results should be of interest to neuropsychophysiologists investigating unconsciousness, convulsive activity, and dream phenomenon. They also provide the basis for future research aimed at solving +Gz-induced loss-of-consciousness problems in fighter-aircraft aviation.

Acceleration↗