ABSTRACT
The treatment of psychic abnormality and madness which we find in Shakespeares works is in itself of great interest to the psychiatrist as representing what he sees everyday in the clinic. He has described in Ophelias madness something which has not been as adequately reproduced anywhere else: the phenomenon of becoming de-ranged in the exact meaning of the word- the de-rangement of the self from its former state. The de-rangement of the psysiognomy preceeds the cristalization of the delusion and we have followed the tracks of Ophelia's course into her madness, which is quite specifically structured.
El tratamiento de la anormalidad psíquica y la locura que encontramos en las obras de Shakespeare es en sí misma de gran interés para el psiquiatra ya que representa lo que él observa en su práctica clínica diaria. Él ha descrito en la locura de Ofelia algo que no ha sido tan adecuadamente reproducido en parte alguna: el fenómeno de llegar a descarrilarse en el sentido propio de la palabra -el descarrilamiento de sí- misma de su estado anterior. El descarrilamiento de la fisiognomía precede a la cristalización del delirio y hemos seguido la ruta del curso de Ofelia hacia la locura, locura que está específicamente estructurada.
Subject(s)
Humans , Delirium , Mental Disorders , Psychiatry in LiteratureABSTRACT
Blankenburg applied Husserl's phenomenolgy to patients with hebephrenic schizophrenia which no longer have a sense for what is sociable suitable. These patients lose a sense for things that are evident in every day common sense. Blankenburg debates with Jaspers and Binswanger about the role of intuition and phenomenological method in hebephrenia. He returns to a Husserlian approach of genetic phenomenology to uncover the loss of natural evidence in the formation of attenuated schizophrenia. Phenomenological philosophy can help clarify the concepts at the heart of schizophrenia and thus has practical relevance. Philosophical thinking and a more patient-centered approach to psychiatry should be integrated into the research of psychiatrists.
Blankenburg aplicó la fenomenología de Husserl en pacientes aquejados de esquizofrenia hebefrénica que ya no poseen un sentido para lo que es socialmente adecuado. Estos pacientes pierden el sentido para las cosas que son evidentes para el sentido común cotidiano. Blankenburg debate con Jaspers y Binswanger acerca del papel de la intuición y el método fenomenológico en la hebefrenia. Él retorna a la fenomenología genética para develar la pérdida de la evidencia natural en la formación de la esquizofrenia atenuada. La filosofía fenomenológica puede ayudar a clarificar los conceptos en el corazón de la esquizofrenia y así conseguir relevancia práctica. El pensar filosófico y un acercamiento en psiquiatría más centrado en el paciente se debe integrar a la investigación de los psiquiatras.
Subject(s)
Humans , Schizophrenia, Disorganized , Social BehaviorABSTRACT
Psychoanalysis was originated from the cathartic method first practiced by Breuer and then by Freud. There are no hard data that can explain why Freud took so long in using it and why he associated it regularly with hypnosis rather than apply as the exclusive psychotherapeutic tool. It is argued that its creation was closely related to the concept of catharsis, as Aristotle understood it, that is to say, as the emotions that the audience discharge when attend a tragedy. The friendship and partnership between Breuer and Freud ended in a bitter breakup, delaying Freud's intellectual development. It is postulated that the breakdown was the result of an unresolved Oedipus complex of Freud in relation to an ambivalent father figure: a persecutory, tyrannical, angry one, that represented Breuer, and a good, sublimated, idealized one, that personified Freud's close friend Wilhelm FlieB.
El psicoanálisis nació a partir del método catártico practicado primero por Breuer y luego por Freud. No se tienen datos para saber porqué Freud demoró tanto tiempo en utilizarlo y también se desconoce porqué lo asoció regularmente a la hipnosis en lugar de aplicarlo como psicoterapia única. Se plantea que su creación estuvo estrechamente vinculada al concepto de catarsis desarrollada por Aristóteles, es decir, la descarga de emociones que los espectadores experimentan cuando acuden a presenciar una tragedia. La amistad y el trabajo conjunto entre Breuer y Freud terminaron en una áspera ruptura, la que retrasó el desarrollo intelectual de Freud. Se postula que el quiebre fue producto de un complejo de Edipo no resuelto de Freud en relación a una figura de padre escindida entre un objeto interno persecutorio, tiránico, rabioso que proyectó en Breuer, y otro bueno, sublimado, idealizado que desplazó en la persona de su amigo íntimo Wilhelm FlieB.
Subject(s)
Humans , Catharsis , Oedipus Complex , PsychotherapyABSTRACT
The philosopher Jean-Paul Sartre carried out an ontological analysis of the underlying assumptions of Freud. He rejected the notion of the unconscious and replaced it by the conscious and added the concepts of freedom, original choice, and bad faith, to better understand the neurosis. These neurosis results from bad faith projects freely chosen but not genuinely assumed. In proposing the Existential psychoanalysis he contributed to a deepening of the theory and practice of Freudian psychoanalysis. Sartre's outline has been little studied and deepened. Binswanger, Heidegger, Ricoeur, and Boss have sought to continue the footsteps of Sartre albeit indirectly, supported by their respective metaphysical conceptions. Martín-Santos has been an exception and his contribution was focused on the basics of existential psychotherapy. We don't still have studies written by psychiatrists who creatively take advantage of the insights of Sartre and his detractors.
El filósofo Jean-Paul Sartre sometió a un análisis ontológico los supuestos implícitos de Freud. Rechazó la noción de inconciente y la sustituyó por el de conciencia y agregó los conceptos de libertad, elección originaria y mala fe para entender mejor las neurosis. Éstas resultan de proyectos de mala fe libremente escogidos aunque no asumidos. Al proponer el Psicoanálisis existencial intentó contribuir a una profundización en la teoría y práctica del psicoanálisis freudiano. Su esbozo ha sido poco estudiado y profundizado. Binswanger, Heidegger, Boss y Ricoeur han buscado proseguir los pasos de Sartre aunque de manera indirecta, apoyados en sus respectivas metafísicas. Martín-Santos ha sido la excepción y su aporte se centró en los fundamentos de la psicoterapia existencial. Todavía faltan análisis de psiquiatras que aprovechen creativamente las intuiciones de Sartre y sus detractores.
Subject(s)
Humans , Philosophy , Psychiatry , Psychoanalysis , Neurotic DisordersABSTRACT
There is no question about the negative effects of child sexual abuse. Freud's seduction theory asserts that psychoneuroses in adults are caused by reactivation of forgotten recollections of gross sexual abuse (involving the genitals) that had taken place prior to the age of 8 to 10 years. His contribution consisted in the discovery of specific events, prior to puberty, which were indispensable to the formation of psychoneuroses. If an adult patient recalled an infantile sexual experience, Freud assumed the interference of a pervert: a child was sexually innocent unless it had been traumatized. But Freud's technique of clinical exploration had not attained adequate reliability and was not immune to prejudices. Freud himself dropped his mechanical, static theory that presupposed a single type of accidentally occurring trauma prior to puberty, allowing him to develop his new drive and fantasy theory.
Subject(s)
Child , History, 19th Century , History, 20th Century , Humans , Child Abuse, Sexual/history , Child Abuse, Sexual/psychology , Freudian Theory/history , Unconscious, Psychology , Incest/history , Incest/psychology , Mental Disorders/etiology , Paternal Behavior/history , Paternal Behavior/psychologyABSTRACT
The advance in the understanding of depressive disorders has been spectacular in all areas. However, the psychopathological analysis of his clinical features has remained stagnant since the advent of DSM-III. Kurt Schneider was concerned with particular care of their study and his contributions are still valid although much of his work remains unknown by the present world psychiatry. His main contributions concern the fields of methodology, conceptualization and description. He distinguishes different clinical entities: endogenous, basic, background, endoreactive, reactive, and existential depression and finally the depressive personality. Any progress on the psychopathology of depression requires a thoroughly deepening in his research.
El avance en el conocimiento de los trastornos depresivos ha sido espectacular en todaslas áreas. Sin embargo el análisis psicopatológico de sus cuadros ha permanecido estancado desde la aparición del DSM-III. Kurt Schneider se preocupó con especial cuidado de su estudio y sus contribuciones todavía están vigentes aunque en gran parte permanecen desconocidas. Sus principales aportes se dan en los campos de la metodología, conceptualización y descripción. Él distingue distintas entidades: depresión endógena, de base, de trasfondo, endorreactiva, reactiva, existencial y personalidad depresiva. Cualquier avance en la psicopatología de la depresión requiere por necesidad una profundización en sus investigaciones.
Subject(s)
Humans , Depression/history , Psychopathology , Depressive DisorderABSTRACT
An accomplished film can help to disentangle the basic dilemmas that harass the psychic existence of human beings. The film Mother and Daughter shows special sensitivity to the relationship between a mother and her daughter having as basic conflict the missing father. But this lack of father appears disguised and even denied putting in its place the abandonment of the child by her teenage mother at birth and the intense emotions felt by both because of this traumatic abandonment. While the anger seems to be directed to the mother and the feelings of guilt toward the child, a more thorough analysis shows that both emotions are referred to the absent father. The daughter tries to repair her depression unsuccessful giving birth to a baby but at the expense of her own life.
Una obra cinematográfica lograda consigue penetrar en los dilemas centrales que acosan a la vida psíquica de los seres humanos. La película Madre e hija expone con especial sensibilidad la relación entre una madre y su hija teniendo como conflicto básico la ausencia del padre. Pero esta carencia de padre aparece disfrazada y aún negada poniendo en su lugar el abandono de la hija por su madre adolescente al momento de nacer y las intensas emociones que embargan a ambas a causa de este traumático abandono. Mientras la rabia parece estar dirigida a la madre y los sentimientos de culpa hacia la hija, un análisis más acabado muestra que ambas emociones están referidas al padre ausente. La hija intentará reparar infructuosamente su depresión engendrando una bebé pero a costa de su propia vida.
Subject(s)
Humans , Depression , Mother-Child Relations , Art , Motion Pictures , Child, AbandonedABSTRACT
A work of art in its own and distinct way from the scientific, illuminates the deep riddles of human existence. The movie Thins you can tell just by looking at her points to the depression that is generated following a filicide, depression which reproduces the original depression of a woman who has defended since her childhood against her raging and murderers jealousy towards her mother. That is, the present depression works through the internal depression. The externalization of her internal conflict in a tramp plastically displays the more primitive mechanisms of the mind of the protagonist and the way she tries to defend herself and solve her problems. The male figure appears as secondary to the importance of women in this internal depression.
La obra de arte ilumina de manera propia y diferente a la científica los enigmas profundos de la existencia humana. La película Cosas que usted puede decir con solo mirarla a ella apunta a la depresión que se genera a raíz de un filicidio, depresión que se reproduce la depresión primaria de una mujer que se ha defendido desde su infancia de su envidia rabiosa y asesina hacia su madre. Es decir la depresión actual vuelve a elaborar la depresión interna. La exteriorización de su conflicto íntimo es una vagabunda muestra plásticamente los mecanismos más primitivos de la mente de la protagonista y el modo como ella intenta defenderse y resolverlo. La figura del varón aparece como secundaria a la importancia de la mujer en esta depresión interna.
Subject(s)
Humans , Motion Pictures , DepressionABSTRACT
Severely depressed patients may have delusions of guilt and sinfulness, and persecution. They believe they are being singled out for their past mistakes and that everyone is aware of their errors. A minority of depressed persons have fleeting genuine affective auditory or visual hallucinations with extremely unpleasant content along the lines of their delusions. The insights into the human psyche contained in Greek tragedy are profound. There is much to learn from the psychological assumptions of Aeschylus, Sophocles, and Euripides, because their views are different to modern ones. Orestes is characterized by a virtually psychotic fear of persecution, the consequence of guilt over his matricide. It may be argued that he suffered from a depressive disorder with psychotic features.
Los pacientes que sufren de una depresión grave pueden presentar delirios de culpa, pecado y persecución. Ellos están convencidos que son estigmatizados por sus faltas anteriores y que todo el mundo sabe de sus errores. Una minoría de personas deprimidas tiene alucinaciones visuales y auditivas auténticas pero pasajeras de naturaleza afectiva con contenidos extraordinariamente desagradables que están en concordancia con sus delirios. La riqueza del conocimiento sobre la psiquis humana que está encerrada en la tragedia griega es particularmente profunda. Hay mucho que aprender de los supuestos de Esquilo, Sófocles y Eurípides porque sus visiones son muy diferentes de las modernas. Orestes se caracteriza por exhibir un temor psicótico de persecución a consecuencia de su culpa por su matricidio. Se puede plantear que él sufrió de un trastorno depresivo con rasgos psicóticos.
Subject(s)
History, Ancient , Delirium , Depression , Greek World , Depressive Disorder , Mythology/psychologyABSTRACT
Background. Edmund Husserl 's Phenomenological psychology is a discipline set to play an important role in the empirical phenomenological psychopathology. Objective. To focus on the basic philosophical and psychological assumptions of Phenomenological psychology Method. To inquire into Husserl's interpretations on the nature of Phenomenological psychology in order to understand the presuppositions of phenomenological psychopathology in psychiatry Results. Phenomenological psychology is described as an a prioric, eidetic, intuitive, purely descriptive, and intentional science of the psychical, which remains entirely within the realm of the natural attitude Conclusions. Phenomenological psychology is destined to supply the essential insights needed to give meaning to the research presented under the title of psychopathological phenomenology.
Antecedentes. La Psicología fenomenológica de Husserl es una disciplina destinada a jugar un papel importante en la psicopatología fenomenológica empírica. Objetivo. Centrarse en los supuestos filosóficos y psicológicos de la Psicología fenomenológica Método: Investigar las interpretaciones de Husserl acerca de la naturaleza de la Psicología fenomenológica para comprender los presupuestos de la psicopatología fenomenológica en psiquiatría. Resultados: La Psicología fenomenológica es una ciencia apriórica, eidética, intuitiva, puramente descriptiva e intencional de lo psíquico, que permanece dentro de la actitud natural. Conclusiones: La Psicología fenomenológica está destinada a proporcionar los conceptos esenciales necesarios para dar un sentido a la investigación que se presenta con el título de Fenomenología psicopatológica.
Subject(s)
Humans , Philosophy , PsychopathologyABSTRACT
Background. In a two-parts article an attempt is made to apprehend the mood disorder that Nietzsche suffered from the last year of his lucid life, and to determine the profound relationship between his creativity and his elation. Method. To give a detailed description of his major affective outbreaks and emotional symptomatology during 1888. Results. What most characterizes his last year is in particular, typical not impairing organic euphoric changes culminating in dementia in 1889. Conclusions. He was exceptionally productive as well as moderately stable from January 1888 until his deteriorating process of January1889. A thoroughly investigation of his outstanding creativity during that year shows that his mood disorder never interfered seriously with the core concepts of his philosophical work and his Weltanschauung.
Antecedentes. Este artículo en dos partes intenta captar el trastorno del humor que sufrió Nietzsche el último año de su vida lúcida, y determinar la profunda relación entre su creatividad y su euforia. Método. Dar una descripción detallada de sus quiebres afectivos y su sintomatología emocional durante 1888. Resultados. Lo que caracteriza de mejor manera su último año es en particular, cambios eufóricos orgánicos que no lo inmovilizaron y que culminaron en la demencia de 1889. Conclusiones. Él estuvo moderadamente estable así como excepcionalmente productivo desde enero de 1888 hasta su proceso degenerativo de enero de 1889. Un análisis detallado de su creatividad notable durante ese año muestra que su trastorno afectivo nunca interfirió seriamente con los conceptos nucleares de su trabajo filosófico y su Weltanschauung.
Subject(s)
History, 19th Century , Affect , Mood DisordersABSTRACT
Background. This article attempts to evaluate the mood disorder that Nietzsche suffered from the last year of his lucid life. Method. In a two-part series, a detailed description of his daily life and his mental symptomatology during 1888 is given. Results. He was moderately stable as well exceptionally productive from January 1888 until he rushed in madness in January 1889. Conclusions. A meticulous analysis of his own creativity over this year shows that his emotional illness supplied material peculiar to his nature for his philosophy.
Antecedentes: Este artículo intenta evaluar el trastorno del humor que sufrió Nietzsche el último año de su vida lúcida. Método: En una serie de dos artículos se entrega una descripción minuciosa de su vida cotidiana y sintomatología mental durante 1888. Resultados: Él estuvo moderadamente estable así como excepcionalmente productivo desde enero de 1888 hasta que se precipitó en la locura en enero de 1889. Conclusiones: Un análisis detallado de su propia creatividad durante ese año muestra que su trastorno del humor proporcionó material peculiar a su esencia para su filosofía.
Subject(s)
Affect , Euphoria , Mood Disorders/historyABSTRACT
Background. Practice and research in the field of biological psychiatry requires us to assume certain positions on several philosophical issues. Objective. To focus on the basic philosophical assumptions of modern biological psychiatry. Method. To inquire into Ortega y Gasset's interpretations of the nature of man and science in order to understand the presuppositions which biological psychiatry itself can never justify scientifically. Results. Biological psychiatry allows only the insigths of what its kind of representation has admitted in advance as a possible object, i.e., brain function, gene expression, neurotransmitter. On the contrary and according to Ortega: "The man is not his body that is a thing, neither his soul that is also a thing, a subtle thing: the man is not at all a thing, but a drama: his life" Conclusions. Ortega can help us to apprehend the level of understanding peculiar of the current biological psychiatry better because his "new level is a deeper stratum of the philosophical problems".
Antecedentes: La práctica e investigación en el campo de la psiquiatría biológica exige que asumamos posiciones en varias cuestiones filosóficas Objetivo: Centralizarse en los supuestos filosóficos básicos de la psiquiatría biológica moderna Método: Investigar las interpretaciones de Ortega sobre la naturaleza del hombre y la ciencia para comprender los presupuestos que la psiquiatría biológica no puede justificar científicamente Resultados: La psiquiatría biológica permite visualizar sólo aquello que su tipo de representación ha aceptado antes como objeto posible, ej., función cerebral, expresión génica, neurotrasmisores. Por el contrario y de acuerdo a Ortega: "El hombre no es su cuerpo, que es una cosa, ni su alma, que es también una cosa, una sutil cosa: el hombre no es en absoluto una cosa, sino un drama: su vida" Conclusiones. Ortega ayuda a captar mejor el estrato de comprensión propio de la psiquiatría biológica porque su "nuevo nivel está en un estrato más profundo de los problemas filosóficos".
Subject(s)
Humans , Biological Psychiatry , Philosophy, Medical , Mental Disorders/etiologyABSTRACT
Professional responsibility provides the groundwork for medicine since the existence of the Hippocratic Oath. Physicians must be prepared to justify their decisions and actions, based on scientific issues but also considering the underlying professional responsibilities. Ethical theories form a major part of such justification. A number of competing ethical theories may be identified. The maximal, minimal and excellence ethical theories agree with our experience with moral uncertainties. But veracity ethics is a new form of answering moral questions. Clinical situations are unavoidably conflictive. Lucid understanding of the necessary character of these conflicts leads to self-recognition and the itinerary of veracity ethics runs from misunderstanding to recognition. The self-awareness that veracity offers to physicians is difficult and painful due to the narcissistic humiliation that it inflicts on them.
Subject(s)
Humans , Ethical Theory , Ethics, Medical , Liability, Legal , Morals , Physician-Patient Relations , Professional Role , Psychoanalytic Theory , Social ResponsibilityABSTRACT
This is an attempt to evaluate the mental disorder that the novelist Virginia Woolf suffered, and to determine the relatioship between her creativity and her insanity. What mostly characterizes her illness is the presence of typical phases of severely impairing depression and significant hypomania, culminating in suicide at the age of 59. This is a convincing life history of a bipolar II disorder, although the «broad bipolar spectrum¼ is less easy to define operational than bipolar disorder I. She was moderately stable as well as exceptionally productive from 1915 until she committed suicide in 1941. Virginia Woolf created little or nothing while she was unwell, and was productive between attacks. A detailed analysis of her own creativity over the years shows that her illnesses were the source of material for her novels.
Subject(s)
History, 19th Century , History, 20th Century , Bipolar Disorder/history , Creativity , Famous Persons , Literature/history , Bipolar Disorder/psychology , Greece , PedigreeABSTRACT
Only recently, bioethics has crystallized into a full-fledged discipline. The aim of this article is to analyze whether Freud is competent to deal with bioethics. Freudian psychoanalysis is reviewed as a global theory that touches culture as a totality. And it is by way of a global theory of culture that Freud takes up the phenomenon of morality. Freud gives not an alternative answer to unchanged questions in bioethics, but delivers a new manner of asking moral questions. The ground rule establishes the conditions for treatment. And secondly, it is a radical elimination of any position of moral existence. Ethics is simply bracketed (put in parenthesis) in the sense that in its regard no position is taken either for or against. What is at stake is self-recognition and Freudian itinerary runs from misunderstanding to recognition. If Freud offers a technique, it is not included in the cycle of techniques of domination; it is a technique of veracity.
Subject(s)
Humans , Bioethics , Ethical Theory , Ethics, Medical , Psychoanalysis , Physician-Patient Relations , Truth DisclosureABSTRACT
Background: Since about 1970 biomedical ethics crystallized into a full-fledged discipline. The so called ½ethical turn¼ is a fundamental conceptual challenge for the field of medicine and has generated heated controversy. Today, the ancient psychotherapeutic framework is under the severest strain in its long history. Aim: To review the relationship between psychotherapy and the conceptual shift in moral theory. Material and method: To forge a new model for the patient-physician relationship, speech acts and nature of man derived from a ½pragmatic turn¼ of bioethics. Results: Research findings suggest that behavior, cognitive and psychodinamic psychotherapies are speech-acts constituted by a hierarchy of subordinate acts distributed on three levels: the level of the locutionary act, the act of saying; the level of the illocutionary act (or force), what we do in saying; and the level of the perlocutionary act, what we provoke by the fact that we speak. Conclusions: Advances in linguistic research have led to a more sophisticated understanding of how psychotherapy affect ethical issues. These developments point towards a new era of psychotherapeutical theory and practice in which specific modes of psychotherapy can be designed to target specific dilemmas of medical ethics.
Subject(s)
Humans , Bioethics , Psychotherapy , Ethics, Medical , Psychotherapy/ethics , Physician-Patient RelationsABSTRACT
El Análisis Existencial nos obliga a comenzar a ver y pensar desde el principio, de tal modo que permanezcamos en lo que inmediatamente percibimos y no nos perdamos en abstracciones, derivaciones y explicaciones científicas, alejadas de la realidad inmediata de los fenómenos dados. En este sentido, el hombre es fundamentalmente afuera en el mundo y con las cosas que encuentra. La palabra alemana "Dasein" designa mejor que "existencia" al ser humano exclusivamente: como ser-en-el-mundo. Mientras no comprendamos la naturaleza esencial del hombre como siendo de un carácter develador-de-sentido, permaneceremos incapaces de entender cómo puede un psicoterapeuta curar a un paciente, ni siquiera cómo puede entrar en una relación así llamada psicoterapéutica