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PubMed1981

The child's accusation of sexual abuse during a divorce and custody struggle.

A single case report is presented in which the children, after a marital separation of their parents, accused the father and paternal grandparents of sexually assaulting them during the time the parents and children were still living together. The case illustrates the dilemmas that their allegations created for the therapist who was responsible for the children's evaluation during the custody suit. The therapist's efforts to resolve these dilemmas are described, and the case is discussed in terms of the literature on folie á deux.

Child↗
PubMed1978

An analysis of the first 200 legal abortions at the Johannesburg General Hospital.

A retrospective study was made of the first 200 terminations of pregnancy at the Johannesburg General Hospital since the promulgation of the Abortion and Sterilization Act of 1975. The indications for termination of pregnancy, the ages, marital status and parity of the patients, the procedures and their complications are analysed. Psychiatric factors were cited in 76% of cases. Further indications were rubella infection in the first trimester of pregnancy, medical, genetic and legal factors. The use of intra- and extra-amniotic prostaglandin administration is compared.

Abortion, Legal↗
PubMed1982

Epidemiologic differences between sexual and physical child abuse.

Sexual and physical child abuse are assumed to differ; however, these differences have not been well characterized epidemiologically. Furthermore, despite assumed differences, these types of abuse are often analyzed as one entity. This can have significant effects on assessment of risk and recommendations for intervention. We compared 735 cases of sexual abuse and 3,486 cases of nonsexual physical abuse confirmed by the Georgia Department of Protective Services. Sexual and physical child abuse cases differed in age, sex, and relationship of perpetrators and victims; demographic and socioeconomic characteristics of families at risk; and morbidity and mortality caused by the event. The most important recommendation based on these findings is that epidemiologically distinct forms of child abuse must be analyzed separately before intervention measures are proposed.

Adolescent↗
PubMed1982

The formation and shaping of the Oedipus complex: clinical observations and assumptions.

Freud maintained that the Oedipus complex as a development landmark could be conceptualized as taking place only at the time of the phallic phase. Freud's theory is that it is the culmination of a very long process whose primary result, in developmental terms, was that the ego now had to act as an organizing and unifying agent of all of one's past, while at the same time adding a new agency of the mind which he called the superego. With the resolution of the Oedipus complex, infantile sexuality would begin to be left behind. Since Freud, there have been a number of developments and controversies related to the Oedipus complex. The confusion which has arisen is that some of us use the insights we have gained about pre-oedipal life as themselves holding the answers to many of the psychopathologies we meet with clinically. My own view is that unless these insights about pre-oedipal life become part of a development framework, culminating in the Oedipus complex and, through its resolution, in the internalization of the superego, then we miss something which is fundamental in our understanding and in our efforts to undo psychopathology. For Freud, the relationship between sexuality and the Oedipus complex was inseparable. The assumption I put forward about the Oedipus complex is that the image of one's own body which has been organized by the end of the phallic-oedipal period determines the form of the oedipal resolution, and remains central to one's later sexual life and psychopathology. If, in our clinical work, we avoid the meaning of genital sexuality and the meaning of the sexual body image, but interpret mainly those aspects of the patient's life which are pre-oedipal (and therefore non-incestuous), then we lose the chance of creating the possibility of the patient having an active relationship to his sexual/genital body, and the patient loses the chance of ever feeling himself to be the owner of his own sexuality.

Adolescent↗
PubMed1978

The role of attention in depersonalization.

Episodes of depersonalization function to keep disturbing preconscious thoughts from becoming conscious. The symptom is conceptualized as a compromise between the wish to be "only dreaming" and the need to maintain a waking state in contact with perceptual reality. Restriction of attention is identified as the central mechanism by which the compromise is effected. On this basis an explanation for the alteration in the sense of reality is suggested. Material from a case is given to support these ideas. The author speculates that early efforts to deal with traumatic experience at a time when the distinction between sleeping and waking states is not secure may lead to the symptom choice of depersonalization.

Adult↗