Psychotherapeutic Aspects Research Articles

Psychoanaliza dzieci według Melanii Klein

Participants of polemics connected with the psychotherapeutic aspect of psychoanalysis, discuss the most often about technique. Controversies considerable relating to psychological theory and philosophy, lying at bases of this technique, are treated as secondary. This approach creates conflicting directives of therapeutic technique, forges its ethical dimension and description of psychical life of individual, introduces in the area of culture notions and phenomena not dependent on the social control. Threats resulting from these should be counteracted by psychotherapist's theoretical and philosophical reflection.

Psychiatry, religion and cognitive science.

To see whether certain findings in cognitive science can serve to bridge the conceptual gap between psychiatry, particularly in its psychotherapeutic aspects, and religious/spiritual understanding. A brief review is given of certain basic differences between psychiatric understanding in its psychotherapeutic aspects, and much of Western religious/spiritual understanding. Reference is then made to certain findings in contemporary cognitive science which might challenge the implicit mind-body split of Western religious tradition and its parallel in psychotherapeutic practice. Attention is also drawn to elements in religious/spiritual tradition that run counter to this dualistic point of view. Much of contemporary religious/spiritual understanding, and of modern psychiatric understanding, especially in terms of psychotherapy, appear to exist in quite separate domains. Psychotherapy and the greater part of Western religious thinking, however, share a belief in the existence of a transcendent mind. Recent developments in cognitive science and certain spiritual traditions, challenge this implicit mind-body split, providing an opportunity for a renewed dialogue between psychiatry and religion and the possibility of collaborative research.

Perspectives of eating disorders from the Charité Hospital in Berlin.

Eating disorders have attracted steadily expanding clinical and scientific attention since second half of the 19(th) century and, particularly, after the core descriptions of anorexia nervosa had been delivered by Gull and Lasègue. In this review, we attempt to illustrate perspectives on eating disorders that have emerged since then from the work at the Charité Hospital in Berlin. It is shown that the professional fate of care for eating disorders has been tied closely to the maturation of the specialty of child and adolescent psychiatry and psychotherapy in the 20(th) century. From the early beginnings of Theodor Ziehen (1862-1950) heading the Psychiatric and Neurological University Clinic of the Charité Hospital in Berlin and being devoted to child psychiatry and psychology, the issue of eating disorders has been pursued at the Charité throughout the vicissitudes of time. After a ward for children suffering from mental illnesses was instituted by Karl Bonhoeffer (1868-1948) in 1921, child and adolescent psychiatry and psychotherapy has constituted itself first in terms of a division and finally as a separate department at the Charité Hospital. Over the years, quite a remarkable body of work on eating disorders has accumulated in this institution. It is emphasised that the value of contributions inherited appears not just of historical interest. The past has addressed psychotherapeutic, anthropological, biological, psychometric, neuropsychological, and transcultural aspects which continue to yield insights into the nature of eating disorders. Tasks and prospects ahead are based upon this background, and some of these are outlined briefly.

Late-life depression: psychopathology, medical interventions, and dental implications.

Late-life depression (LLD) initially occurs after age 65 years and is a major public health concern because the elderly who are at high risk constitute an ever-expanding segment of the population. LLD is a mental illness in which mood, thought content, and behavioral patterns are impaired, causing the individual distress, compromising social function, and impairing self-maintenance skills (eg, bathing, dressing, hygiene). LLD characterized by marked sadness or a loss of interest or pleasure in daily activities and may be accompanied by weight change, sleep disturbance, fatigue, difficulty in concentration, and a high suicide rate. Diagnosis of LLD is sometimes complicated by a denial of mood change and an inability to distinguish symptoms of a concurrent physical illness from those of a depressive etiology. The disorder is most frequently treated with antidepressant medications, and although older individuals have a recovery rate that is comparable with younger adults, they often take longer to recover, have more frequent relapses, and are more sensitive to the side effects of the drugs. Individuals undergoing treatment for LLD and those whose illness has not been diagnosed or treated often are seen with significant oral disease by the dentist. Dentists need to be cognizant of how to safely and compassionately provide care to those already receiving mental health services. They must also be familiar with the psychiatric symptoms of the disorder to effectuate a timely referral to a physician of those with occult or relapsing disease. LLD is frequently associated with a disinterest in oral hygiene, a cariogenic diet, diminished salivary flow, rampant dental decay, advanced periodontal disease, and oral dysesthesias. Many medications used to treat the disease magnify the xerostomia and increase the incidence of dental disease. Appropriate dental management necessitates a vigorous preventive dental education program, the use of artificial salivary products, antiseptic mouthwash, daily fluoride mouth rinse, and special precautions in administration of local anesthetics with vasoconstrictors and prescription of analgesics. Dentists who invoke appropriate precautions can usually provide a full range of services to individuals with LLD, thereby enhancing patient self-esteem and contributing to the psychotherapeutic aspect of management.

The psychopathology, medical management and dental implications of schizophrenia

Schizophrenia is a psychiatric illness characterized by thought disturbances, bizarre behaviors and cognitive impairments that may diminish a person's abilities in the areas of social relations, school or work and self-care. The onset of the disorder typically occurs between the late teens and mid-30s. Advanced dental disease is seen frequently in patients with schizophrenia for several reasons: the disease impairs these patients' ability to plan and perform oral hygiene procedures; some of the antipsychotic medications they take have adverse orofacial effects such as xerostomia; and these patients sometimes have limited access to treatment because of a paucity of financial resources and adequate number of dentists comfortable in providing care. The recent introduction of more effective medications has permitted the majority of patients to receive their psychiatric care from community-based providers rather than in the hospital. Consequently, dentists in the private sector also are being called on more frequently to care for these people. Dentists cognizant of the signs and symptoms of schizophrenia are likely to feel more secure in treating patients with schizophrenia and more confident when obtaining consultative advice from the patients' psychiatrists. Dentists usually can provide a full range of services to such patients, can enhance these patients' self-esteem and can contribute to the psychotherapeutic aspect of management. To effectively provide treatment to patients with schizophrenia, dentists must be familiar with the disease process so that they can communicate effectively with the patient, the treating psychiatrist and family members who serve as caregivers. In addition, dental treatment may need to be modified because of the patient's impaired ability to think logically, the local and systemic effects of psychiatric medications, and adverse interactions between these drugs and medications used in dentistry.

Major depressive disorder: Psychopathology, medical management and dental implications

Major depressive disorder, or MDD, is a psychiatric illness in which mood, thoughts and behavioral patterns are impaired for long periods. The illness distresses the person and impairs his or her social functioning and quality of life. MDD is characterized by marked sadness or a loss of interest or pleasure in daily activities, and is accompanied by weight change, sleep disturbance, fatigue, difficulty concentrating, physical impairment and a high suicide rate. In 2000, the World Health Organization, or WHO, identified MDD as the fourth ranked cause of disability and premature death in the world. WHO projected that by 2020, MDD would rise in disease burden to be second only to ischemic heart disease. The disorder is common in the United States, with a lifetime prevalence rate of 17 percent and a recurrence rate of more than 50 percent. MDD may be associated with extensive dental disease, and people may seek dental treatment before becoming aware of their psychiatric illness. MDD frequently is associated with a disinterest in performing appropriate oral hygiene techniques, a cariogenic diet, diminished salivary flow, rampant dental caries, advanced periodontal disease and oral dysesthesias. Many medications used to treat the disease magnify the xerostomia and increase the incidence of dental disease. Appropriate dental management requires a vigorous dental education program, the use of saliva substitutes and anticaries agents containing fluoride, and special precautions when prescribing or administering analgesics and local anesthetics. Dentists cognizant of these signs and symptoms have an opportunity to recognize patients with occult MDD. After confirmation of the diagnosis and institution of treatment by a mental health practitioner, dentists usually can provide a full range of services that may enhance patients' self-esteem and contribute to the psychotherapeutic aspect of management.

A model for an integrated psychotherapy service

A model psychotherapy service is proposed, integrated in the double sense of combining different psychotherapeutic modalities in a single psychological treatment service, and forging close links with general psychiatry. The four limbs of the service extend into supporting counsellors in general practice, providing psychotherapeutic input into the treatment of the severely mentally ill, managing patients with personality disorders, and supplying psychotherapeutic aspects of a liaison service. The advantages of this model in the current managerial climate are discussed.

Ambiguity: Spiritual and psychotherapeutic aspects

Ambiguity is treated here as one of the interfaces between spirituality and psychotherapy. The multiplicity of spiritualities and the characteristics of spiritual leaders are discussed, the latter contrasted with the tenets of traditional psychotherapy. Similar and integrative aspects of spiritual and psychotherapeutic sojourners are examined.

In the Patient's Best Interest:

Psychiatry and psychology have a joint responsibility to diagnose Anxiety from other health conditions. A cooperative treatment protocol has evolved between psychologists and psychiatrists called a split treatment model where the psychiatrist prescribes psychotropic medications and the psychologist focuses on the psychotherapeutic aspect of treatment. Two surveys reported in literature reveal that there has been a tacit acceptance of the split treatment model by both professions. Review of the medical legal literature does not discern any professional liability problems in the split treatment model. Data is presented on the unmet need in the treatment of anxiety which psychology and psychiatry must address.

Aspects of teaching psychotherapy to medical students.

Much concern has centered on medical students' failure to choose psychiatry as a career. Little of this discussion focuses on the challenges of treating psychiatric patients. Although all students of psychotherapy face difficult training, the medical students' preparation is unique, especially in experiencing, tolerating, and using countertransference. Understanding and caring for psychiatric patients (whether pharmacologically, psychodynamically, or otherwise) involves exposure to extremes of emotion. A therapeutic response demands skills quite different from those culled by the medical admission process and the preclinical years. Appropriate handling of consequent problems is hampered when some of the psychotherapeutic aspects of clerk-patient relations go unrecognized and when supervisors avoid discussion of the student's reactions as an integral part of the work. Without specific attention to these areas, many students feel inadequate or frightened in the clerkship. With supervisory aid, such unwelcome situations can be converted to diagnostic and therapeutic tools of great value.

Psychiatry in everyday medical practice.

The general practitioner's awareness of the psychotherapeutic aspects of every doctor-patient transaction would allow him more effectively to apply the principles of preventive psychiatry to his everyday medical practice. The experience of one physician's practice is drawn upon to demonstrate how some of Balint's techniques apply to cases in general practice. The categorization of presenting complaints into “no illness situation,” “unorganized illness,” or “organized illness” helps the physician to make distinctions between “traditional diagnosis” and “overall diagnosis.” This method is illustrated with several case examples showing how the physician helped the patient to move from a narrow physical focus to an exploration of broader emotional problems.

The effects of extending the CS-UCS interval on the effectiveness of the conditioning treatment for nocturnal enuresis

Previous studies of the “conditioning method” of enuresis treatment have confounded the effects of conditioning with those of nonspecific psychotherapeutic aspects of the procedure. The present study compared three groups of enuretic children: (1) under the conventional bell-light conditioning procedure; (2) under a similar procedure, but which involved a three-minute delay between wetting and alarm, and (3) under no-treatment conditions. Double-blind precautions were used. Results suggested that conditioning effects improvement over and above that effected by nonspecific influences. The findings are qualified by large variances in improvement, and by premature termination of the experiment.

Psychotherapeutic Aspects of Pentecostal Sects among West Indian Immigrants to England

groups during critical periods of history is a well-documented and substantiated phenomenon. This has been manifest in recent times in the various messianic sects of the more deprived socioeconomic and racial groups in the United States and in various nativistic movements among societies recently in contact with Western civilization.2t There is a large literature describing such phenomena in terms of their function in supporting both the structure of institutions and the individuals within a society in addition to fulfilling religious needs. By symbolically expressing customs and social relationships, ritual and belief have been viewed as supporting the individuals participating while reinforcing the values of the group. Underlining the value of sects many workers have pointed to the socio-economic roots of such sects, emphasizing their value for the poor and frustrated, particularly in times of social and economic upheaval. Thus for example, millenial ideas have been seen as compensations for the lack-lustre and impoverished existence of sect members or as satisfying the fantasy needs of oppressed racial minorities. These sociological and anthropological views emphasizing the integrative functions of religion, have been supplemented in recent years by the interest in the mental health potentialities of religious behaviour expressed by religious leaders, behavioural scientists and physicians.4 Some workers have in fact demonstrated parallels to psychotherapy in religious activities. Sargant examining the parallels of thought reform, religious conversion and psychotherapy, noted that they all facilitated change by producing excessive cortical excitation in individuals, leading to emotional exhaustion and states of reduced resistance

Control data for evaluating the efficacy of psychotherapy in habitual spontaneous abortion.

A spontaneous abortion is usually defined as the involuntary expulsion of the foetus before it is of viable age. A woman who has had three consecutive spontaneous abortions is called an habitual spontaneous aborter. The probability that a woman will abort a current pregnancy I call her abortion-probability. In the course of some uncontrolled studies it has been claimed that this probability can be reduced by psychotherapeutic means. For instance, Javert (1957) reported that, using an eclectic treatment, live births resulted from 81.2 per cent. of 154 pregnancies of women who had been habitual aborters. He attributed his success to the psychotherapeutic aspects of his regime.

Psychotherapeutic aspects of teaching emotionally disturbed children

Psychotherapeutic aspects of teaching emotionally disturbed children

Psychotherapeutic aspects of authority.

Psychotherapeutic aspects of authority.

Psychotherapeutic Aspects of Symptomatic Treatment

Psychotherapeutic Aspects of Symptomatic Treatment