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What Supports Supportive Therapy?, Peter N. Novalis, M.D., Ph.D.

Jefferson Journal of Psychiatry

Think of 1896, the year Jacob Freud died, kindling a depression in his son Sigmund which led to The Interpretation of Dreams. To a raucous convention in Chicago, William Jennings Bryan declaimed against the gold monetary standard: "You shall not press down upon the brow of labor this crown of thorns, you shall not crucify mankind upon a cross of gold" (I). Years later the monetary gold standard was abandoned during the New Deal, but Freud's newly mined "pure gold of analysis" continued to be an object of adulation and emulation, despite Freud's prediction that its …

Pharmacologic Treatments Of Cocaine Dependence, Michael B. Knable, D.O.

Jefferson Journal of Psychiatry

The rapid escalation of cocaine abuse in the United States in the 1980's has generated a host of interesting hypotheses on various aspects of this problem. After a succinct discussion of epidemiologic, clinical, and neuro-pharmacologic aspects of cocaine abuse, a survey of the current literature on psychopharmacologic management of dependence is offered. While several agents have emerged as useful adjunctive treatments for abstinence syndromes it is important for the clinician to remember that there is not official approval for such treatments. Additionally, psychotherapeutic maneuvers, which remain the major tools in treatment of addicts, should not be overlooked when an experimental …

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor Volume 7, Number 1, 1989 for Jefferson Journal of Psychiatry

Seasonal Affective Disorder: Sad Or Fad?, J. Thomas Pichot, Md, Peter S. Jensen, Md

Jefferson Journal of Psychiatry

Seasonal affective disorder (SAD) and phototherapy have recently been the subject of a great deal of interest in the psychiatric literature. First described in 1984 (I), SAD is now defined as "a cyclic illness characterized by recurrent episodes of fall/winter depression alternating with periods of spring/summer euthymia (normal mood) or hypomania (mild elation and behavioral activation)" (2) . Recent findings indicate that there may be at least two additional patterns of seasonal depressions, one characterized by annual summer depressions with euthyrnic, hypomanic or manic symptoms in the winter, and the other characterized by depressive episodes occurring in both winter and …

Brief Remarks On Some Linguistic Features Of "Empathy" And "Sympathy", Emanuel E. Garcia, Md

Jefferson Journal of Psychiatry

The use of words by an individual or culture is subject to the very same psychological forces that drive man's other activities . Hence, the history of a word's usage becomes a telling record of the mental processes of its creators and users, both conscious and unconscious. Etymology, as Freud has observed in his dreambook (1900), contributes significantly to our understanding of the deeper layers of the psyche . Let us take the word "rival," for example, and see how we may make use of etymological data. It is derived from the Latin "riva lis," I which originally meant "one …

Mechanisms And Therapeutic Implications Of Neuroleptic Atypicality, Daniel C. Javitt, Md

Jefferson Journal of Psychiatry

Neuroleptics have proven effective for the overall treatment of schizophrenia. The neuroleptic therapy of schizophrenia, however, has been limited by tardive dyskinesia and by the relative inability of neuroleptics to ameliorate the negative symptoms of schizophrenia. Intensive research has been conducted to identify atypical neuroleptics which would not cause TD and which would have relatively greater efficacy in treating negative symptoms. Based upon animal models of TD and negative symptoms, four neuroleptics have been identified which may have these properties: clozapine, thioridazine, sulpiride, and molindone. Clinical studies of TD suggest that these four potentially atypical agents may have lower dyskinetic …

Countertransference And Inpatient Psychiatry: Theoretical And Clinical Aspects, Edward Kim, Md

Jefferson Journal of Psychiatry

Few aspects of psychiatric training are more troubling to beginning residents than the emerging awareness of their own countertransferences. This is often viewed with a mixture of disgust and embarassment as a sign of incompetence and lack of professionalism. Conflicting views on the origins of, and appropriate responses to countertransference further add to the difficulty and anxiety of psychiatric training. The frustration and sense of helplessness which often accompany these feelings can lead to disillusionment and various degrees of acting out which ultimately compromise patient care and resident education. Ironically, the feeling of being overwhelmed by countertransference can often occur …

Com Outlook Fall 2011, College Of Osteopathic Medicine

COM Outlook

No abstract provided.

A Silent Storm: Hepatitis C In Pakistan, Noureen Jiwani, Raisa B. Gul

School of Nursing & Midwifery

No abstract provided.

Poor Women With Sexually Transmitted Infections: Providers’ Perspectives On Diagnoses, Genevieve R. Cox

Sociology

This article presents results from a study of health care providers, mainly nurses and nurse practitioners, who routinely diagnose sexually transmitted diseases (STDs) in rural low-income populations in West Virginia (WV). A qualitative analysis of eighteen semi-structured interviews reveals that providers who consistently work with low-income populations believe patients undergo a negative change in self-image in response to a chronic STD diagnosis. Providers express concerns about a number of issues related to low-income, rural women’s access to sexual health care and see the need for more sexuality education, more funding for free and reduced cost clinics, and more available health …

Smart Rehabilitation For The 21st Century: The Tampa Smart Home For Veterans With Traumatic Brain Injury, Jan Jasiewicz, William D. Kearns, Jeffrey Craighead, James L. Fozard, Steven Scott, Jay Mccarthy

Rehabilitation and Mental Health Counseling Faculty Publications

No abstract provided.

Pediatric Telebehavioral Health In Rural Primary Care: An Electronically-Mediated Warm Handoff, J. A. Correll, Jodi Polaha

ETSU Faculty Works

No abstract provided.

Male Gender Preference, Female Gender Disadvantage As Risk Factors For Psychological Morbidity In Pakistani Women Of Childbearing Age - A Life Course Perspective, Farah Qadir, Murad M. Khan Dr., Girmay Medhin, Martin Prince

Department of Psychiatry

Background: In Pakistan, preference for boys over girls is deeply culturally embedded. From birth, many women experience gendered disadvantages, less access to scarce resources, poorer health care, higher child mortality, limited education, less employment outside of the home and circumscribed autonomy. The prevalence of psychological morbidity is exceptionally high among women. We hypothesise that, among women of childbearing age, gender disadvantage is an independent risk factor for psychological morbidity. Methods: A cross-sectional catchment area survey of 525 women aged 18 to 35 years living in Islamabad and Rawalpindi. The effect of gender disadvantage was assessed as a latent variable using …

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor for Volume 6, Number 2, 1988 issue of Jefferson Journal of Psychiatry

In The Beginning...Phylogeny In Freud's Overview Of The Transference Neuroses: A Review-Essay, Emanuel E. Garcia, Md

Jefferson Journal of Psychiatry

A PHYLOGENETIC FANTASY

I. Grubrich-Simitis, editor

A. Hoffer and P. T. Hoffer, translators

Harvard University Press, Cambridge, Mass.

1987

Book Review: A Portrait Of The Analyst, Michael B. Knable, D.O.

Jefferson Journal of Psychiatry

A MIND OF HER OWN: THE LIFE OF KAREN HORNEY

Susan Quinn

New York , Summit Books

Book Review: Lessons Of War, Ronald J. Koshes, Md

Jefferson Journal of Psychiatry

MILITARY PSYCHIATRY: A COMPARATIVE PERSPECTIVE

Richard A. Gabriel, editor

New York, The Greenwood Press 1986, 170 pages

Dysmorphophobia In A Diastrophic Dwarf: A Psychiatry-Dermatology Liaison Approach, Donald J. Kushon, Md

Jefferson Journal of Psychiatry

This is a case study of a 30-year-old male diastrophic dwarf who complained of hypertrichosis on his back and nose of 3 years duration. He had no previous psychiatric history, and although the distortion he described on his back was not apparent to others, there was a minimal amount of dark hair growth on his nose. He had unresolved conflicts concerning his disproportionate arms and legs and had sought surgical correction for many years from many orthopedic surgeons to no avail. After a diagnosis of dysmorphophobia was made by a psychiatric consultant, weekly visits with the dermatologist were arranged for …

The Potential Role Of Psychiatry Residents' Councils, J. Thomas Pichot, Md

Jefferson Journal of Psychiatry

There are numerous books and articles within the scientific literature that deal with issues of training psychiatry residents and the characteristics of that milieu. Those authors that deal primarily with stress usually discuss the sources of the stress and the resultant behavioral changes that are manifested by the trainees. Typically, are relatively small portion of the discussion is devoted to how these problems are, or might be, addressed. This paper, while not itself intended to be an overview of stress in residency; will concentrate on a literature review of some specific aspects of the residency training process, primarily role definition …

The Physical Examination In Psychiatry, Scott Patten, Md

Jefferson Journal of Psychiatry

The physical examination is a neglected aspect of the psychiatric assessment. For example, a survey of ninety-eight practicing psychiatrists, conducted by Patterson (1) in 1978, found that none of them routinely performed physical examinations on their patients. More than one-half of these psychiatrists reported that they no longer felt competent to do so. One situation in which psychiatrists do often perform physicals is while admitting patients to hospital. However, the quality of these examinations is often poor (2 ,3).

An indifferent attitude toward the physical examination has persisted in psychiatry despite numerous publications emphasizing the importance of medical assessment (2-8). …

Some Comments On The Concept Of The Ego-Ideal, Gurmeet Kanwal, Md

Jefferson Journal of Psychiatry

In a review of the literature on the ego-ideal my impression has been that this concept has been placed in the position of a stepchild of the structural model of the mind, falling somewhere between the ego and the super-ego, and yet remaining loosely linked to both. Authors such as Jacobson (1954), Hartmann and Lowenstein (1962), Sandler (1963), and Schafer (196 7), have regarded the ego-ideal as a substructure of the super-ego. Others like Annie Reich (1953, 1954), Lampl de-Groot (1947), Peter Bios (1972), and Chasseguet-Smirgel (1975), have tended to view the two as being separate structures.

The purpose of …

In Response: The Usefulness Of Neutrality, Paul A. Dewald, Md

Jefferson Journal of Psychiatry

The term "neutrality" as used in psychoanalysis has multiple meanings, each carrying major emotional significance. In that sense "neutrality" is a term which evokes the metaphor of the "Six Blind Men and the Elephant."

In her paper, "The Usefulness of Neutrality," Julia Jones Zawatsky uses the term to express a variety of issues related to a complex and difficult clinical situation. Neutrality includes the therapist taking an equidistant position from the various forces involved in the compromise formation used to solve psychic conflict. She also uses the term to acknowledge the multiple facets of the therapist's conscious and unconscious …

A Psychiatric Perspective On Erectile Dysfunction, Syed Ahmed, Md

Jefferson Journal of Psychiatry

Erectile impotence is a common family health problem, with exact incidence unknown, that adversely affects both men and their female partners. It is classified as "inhibited sexual excitement" in DSM-III and is defined as the inability to attain or maintain a penile erection until completion of the sexual act. It had been stated formerly, without supporting evidence, that 90% of erectile disorders were "psychogenic. " Today, however, only about one-third are so classified (1). In Kinsey's (2) series, the prevalence of impotence was less than 2% until the age of 40 years; it increased to 6-7% at age 55 …

Bioethical Issues In The Management Of Gender Dysphoria, George R. Brown, Md

Jefferson Journal of Psychiatry

The term "gender dysphoria" ( I) describes a heterogeneous group of individuals who express varying degrees of dissatisfaction with their anatomic gender (hence "gender dysphoria"), and the desire to possess the secondary sexual characteristics of the opposite sex. Only a minority o f these patients can be considered on the extreme end of a spectrum of subjective dissatisfaction with assigned anatomy and societally sanctioned gender role (i.e., "transsexual"). The number of such patients presenting to psychiatric clinics has greatly increased subsequent to the 1966 publication of Harry Benjamin's seminal work, The Transsexual Phenomenon (2), and extensive media coverage of individual …

Accepting Dependence, Julia Zawatsky, Md

Jefferson Journal of Psychiatry

There is an increasing emphasis on short term treatment in Psychiatry. Short term treatment may not provide the time necessary to permit the regression and foster the dependence necessary for successful treatment.

Supervising Residents Treating Multiproblem Patients: Transformations Of Therapeutic Narcissism, Susan J. Olson, Md, Valerie A. Westhead, Md, Jean M. Goodwin, Md, Mph

Jefferson Journal of Psychiatry

While much of the literature on psychotherapy supervision focuses on teaching psychotherapeutic techniques, most residents and supervisors realize that there is another agenda: making the often drained and narcissistically injured therapist feel better. The beginning therapist's self-esteem is especially vulnerable to injury because most psychiatric residents have "heavily committed themselves to a field of endeavor for which ... they are relatively untested" (I). Coupled with this, they are often assigned the most difficult and demanding patients, those with narcissistic disorders who are unable to soothe themselves. Both Searles (2) and Balint (3) describe the barrage of counter transferences usually experienced …

Book Review: The Soft Voice Of Reason, Emanuel E. Garcia, Md

Jefferson Journal of Psychiatry

FREUD AS AN EXPERT WITNESS

K. R. Eissler

Madison, Connecticut, International Universities Press 1986, 449 pages.

Book Review: Adapting Psychotherapy For An Underserved Population, Lorna Clark-Rubin, Md

Jefferson Journal of Psychiatry

PSYCHOTHERAPY IN THE COMMUNITY:A PSYCHOANALYTICALLY BASED GUIDE TO THE TREATMENT OF THE ADULT

Eric Lager, M.D., Israel Zwerling, M.D.with Joseph Slap, M.D., Samuel Bullock, M.D. Warren Smith, M.D.Warren H. Green, Inc., St. Louis

1983. pp. 190.

Developmental Stages Of Learning Psychotherapy, Duncan B. Clark, Phd, Md

Jefferson Journal of Psychiatry

The contradictory philosophies of the major schools of psychotherapy present a dizzying array of alternative approaches for the psychiatry resident. The academic efforts that have been made to synthesize differing approaches to psychotherapy have not met with widespread acceptance. Part of the reason why such a synthesis has been slow in coming may be found in the stages of development the practitioner goes through in learning psychotherapy. The concepts of developmental psychology discussed by Chandler (7) in describing the adolescent's confrontation with relativism and "epistemological loneliness" can help us understand some of the cognitive problems faced by the psychiatry resident. …

A Brief Note On A Psychotherapeutic Technique Described By Glover And Its Application During Psychiatric Residency, Emanuel E. Garcia, Md

Jefferson Journal of Psychiatry

Few would dispute the existence of a general tendency to blame psychological ailments on physical problems. For example, we often attribute changes in mood to the somatic effects of the weather, irritability to diet, apathy to physical exhaustion, etc. How many of us can deny at some time having attempted to explain to our spouses that an outburst of temper was really the fault of our indigestion, let us say? Of course, our spouses are rather skeptical. And as psychiatrists we too preserve a skepticism towards the explanations of this kind which our patients so often provide. This is not …