Psychiatry Commons^™

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor, Volume 6, Number 1, 1987.

A Personal Journey, Shimon Waldfogel, Md

Jefferson Journal of Psychiatry

MAUS A SURVIVOR'S TALE

Art Spiegelman

New York Pantheon Books 1986.

Obsessive-Compulsive Disorder Reconsidered, Christopher J. Mcdougle, Md

Jefferson Journal of Psychiatry

OBSESSIVE-COMPULSIVE DISORDERS: THEORY & MANAGEMENT

Edited by Michael A. Jenike, Lee Baer, William E. Minichiello

Littleton, Mass, PSG Publishing Company, In c.1986. 196 pages, $24.50

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 …

Brief Communication: A Resident Elective Abroad, P. Conlon, M.B.

Jefferson Journal of Psychiatry

Elective study abroad during a residency is unusual, although this is not uncommon for medical students and fellows. There may be several reasons for this. Resident training programs are structured to last three or four years in North America and traditionally are under the auspices of specific university departments. This is a relatively short period of training compared to European countries, and consequently there tends to be less flexibility, and therefore less mobility, in training. Residencies also tend to be a combination of education, training and service requirements, and as programs have a specific allocation of positions for each year …

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 …

The Use Of Maintenance Electroconvulsive Therapy For Relapsing Depression, Ted A. Matzen, Md, Ronald L. Martin, Md, Tim J. Watt, Md, Douglas K. Reilly, Md

Jefferson Journal of Psychiatry

It is generally accepted that electroconvulsive therapy (ECT) is an effective treatment of major depressive episodes in patients with both unipolar and bipolar affective disorders (1). Yet, repeated relapse of depression occurs in some patients, even with vigorous maintenance therapy on antidepressant drugs (2-4). This often necessitates rehospitalization for ECT. In past decades, several authors suggested that periodic outpatient ECT was efficacious as a maintenance therapy (5-7). Recently, maintenance ECT was recommended by Fink (8), and Maletzky (9), but barely mentioned in two reviews (10,11), and discouraged in another (12) . However, a recent nationwide survey has disclosed that such …

The Effect Of Acute And Chronic Ethanol On Dopamine Turnover In The Caudate Nucleus Of The Rat, Rif S. El-Mallakh, Md

Jefferson Journal of Psychiatry

It is generally believed that acute and chronic ethanol (EtOH) administration alters the activity of catecholamines in the brain, however, the specific effects of EtOH on the dopaminergic system are disputed (I). Acute EtOH administration has been variously reported to decrease (2,3), increase (4,5), and cause no change (6 ,7) in dopamine (DA) synthesis and turnover. Likewise, chronic EtOH treatments have been reported to decrease (2,8) and increase (9, 10) DA synthesis and turnover. Many of these apparently conflicting results are explained by the use of different animal models (rat (2, 3,6,7,10), rabbit (6), and mouse (4,5,9)), different methods of …

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 …

Presentation And Differential Diagnosis Of Hyponatremia In A Schizophrenic Adult Male, Michael J. Sedlacek, Md

Jefferson Journal of Psychiatry

The diagnosis o f hyponatremia can prove to be a challenging task since initial symptomatology may mimic psychiatric illness. Accurate diagnosis and subsequent treatment is essential as this disorder can progress to seizures, coma and death if not recognized. Neither the true incidence nor the etiology of hyponatremia in the schizophrenic population has been established, but a definite association has been shown to exist. A recent retrospective study involving over 20,000 hospital admissions found a 5.8% incidence of hyponatremia in the schizophrenic population as compared with a 0.36% incidence for all admissions (1). The following case illustrates the features of …

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 …

Editor's Column, Gregory B. Sullivan, Md

Jefferson Journal of Psychiatry

An exhibition of paintings of the American Old West caught my attention one afternoon, after I had wandered across the street from our affiliate V.A. outpatient clinic to the Pennsylvania Academy of the Fine Arts. A popular theme among these romanticized views of the American frontier was the image of the trapper; alone, silent figure working at the nation's interface with the unknown. Several paintings depicted a custom known as the rendez-vous, a semi-annual occurrence wherein the trappers gathered eastward to river outposts in order to socialize, trade information and hand-made maps, restock supplies, and display for sale the …

Resident Editorial Board

Jefferson Journal of Psychiatry

List of Resident Editorial Board for Volume 6, Number 1, 1998 of Jefferson Journal of Psychiatry.

Letters To The Editor

Jefferson Journal of Psychiatry

Letters to the Editor.

In Response: Should Psychotherapy Be Taught To Psychiatric Residents?, Robert Michels, Md

Jefferson Journal of Psychiatry

The debate discussing whether psychotherapy should be taught to psychiatric residents (1) reflects the change, growth, and maturation of the profession. A theme that virtually defined psychiatric practice only a few decades ago is viewed by some as ready for discard while others still see it as essential. Of course, this isn't the first time. Eighty years ago some argued that the intellectual excitement and therapeutic promise of psychoanalysis was more than ample reason to discard the sterile and clinically nihilistic concern with constitutional neuropathic diatheses that marked 19th century psychiatry. Fortunately, wiser heads prevailed.

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: Towards A Practical Guide To The Therapy Of The Borderline Patient, Gregory B. Sullivan, Md

Jefferson Journal of Psychiatry

EFFECTIVE PSYCHOTHERAPY WITH BORDERLINE PATIENTS:CASE STUDIES

Robert J. Waldinger, M.D .John G. Gunderson, M.D.

New York, Macmillan 1987, 232 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.

The Witness, Paul D. Zislis, Md

Jefferson Journal of Psychiatry

I want to tell you a story. Why? I don't know. Perhaps so that you will understand. Perhaps so that I will understand. It is a story of the present. It is a story that allows a little comprehension of the past. And it is a story that reveals glimpses of the future.

First this preface:

For years I have been drawn as if by a magnet to the subject of the Holocaust. I have read much about it, spoken to some who survived it, seen films on it, visited museums concerned with it. I have seen the faces …