ABSTRACT
The need to create order out of chaos is a driving force, ethologicalty determined, and part of the human condition. Narrative, especially autobiography and self narrative, helps us sort out myriad fantasies, events, and images, weaving them into a cohesive whole that eventually promotes self-awareness. The narratives of Virginia Woolf, St. Augustine, and Samuel Beckett are briefly described. Attachment theory and current research demonstrates that secure attachment is a first step in the socialization process and helps put one's life in perspective. The therapeutic use of narrative is demonstrated by three clinical vignettes of patients with various psychiatric disorders who had successful therapeutic outcomes.
Subject(s)
Mental Disorders , Psychoanalysis , Humans , Narration , Psychotherapy/methodsABSTRACT
There are relatively few investigations of the emotion expressivity of children at risk for the later development of schizophrenia and schizophrenia-spectrum disorders. Using data from the New York High-Risk Project, we compared children's emotional expressivity during a semi-structured videotaped interview. Data were coded for 173 child subjects: 61 with schizophrenic parents (HRSz); 54 with affectively ill parents (HRAff); and 58 with psychiatrically "normal" parents (NC). A child's affective responses were rated for the presence of discrete positive, negative, or neutral emotions by coders naive to group membership. Responses were also rated for anxiety, flat affect, inappropriate affect, and emotional withdrawal/disengagement. Compared with the two other two groups, HRSz children displayed significantly more negative affect in response to questions regarding their most negative experiences and, when questioned about their self-concept, they displayed significantly less positive affect. Both HRSz and HRAff children showed more inappropriate affect than NC children. Significantly more HRSz children were rated as demonstrating a lack of emotional engagement. Children making inappropriate displays of positive affect while discussing a negative topic were most likely to manifest a psychiatric disorder as an adult. These findings suggest that inappropriate affect may be a nonspecific indicator of risk for psychopathology. Emotional withdrawal in childhood may be a potential indicator of risk for schizophrenia.
Subject(s)
Personality Disorders/diagnosis , Personality Disorders/psychology , Borderline Personality Disorder/diagnosis , Borderline Personality Disorder/psychology , Child , Diagnostic and Statistical Manual of Mental Disorders , Female , Friends/psychology , Humans , Interpersonal Relations , Male , Object Attachment , Peer GroupSubject(s)
Life Change Events , Object Attachment , Psychoanalytic Theory , Adaptation, Psychological , Adult , Aged , Aged, 80 and over , Art Therapy , Child , Child Abuse, Sexual/diagnosis , Child Abuse, Sexual/psychology , Child Abuse, Sexual/therapy , Child, Preschool , Conversion Disorder/diagnosis , Conversion Disorder/psychology , Conversion Disorder/therapy , Crisis Intervention , Dreams , Early Intervention, Educational , Female , Humans , Male , Mother-Child Relations , Psychoanalytic Therapy , Reactive Attachment Disorder/diagnosis , Reactive Attachment Disorder/psychology , Reactive Attachment Disorder/therapy , Repression, Psychology , Resilience, Psychological , September 11 Terrorist Attacks/psychology , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/therapyABSTRACT
The etiology of the Autistic Spectrum Disorders is discussed with a focus on Asperger's disorder. The manifestation of the triad of social impairment, communication impairment, and restricted repetitive behaviors and interests is discussed in terms of the various symptom phenotypes comprising these three domains. Clinical case material is used to illustrate how the treatment modality utilized should be fitted to an individual child's needs. A multimodal treatment plan is considered optimal in order to achieve a successful therapeutic outcome.
Subject(s)
Asperger Syndrome/therapy , Autistic Disorder/therapy , Adult , Asperger Syndrome/diagnosis , Asperger Syndrome/psychology , Autistic Disorder/diagnosis , Autistic Disorder/psychology , Child , Child Development Disorders, Pervasive/diagnosis , Child Development Disorders, Pervasive/psychology , Child Development Disorders, Pervasive/therapy , Child, Preschool , Combined Modality Therapy , Diagnostic Errors , Diagnostic and Statistical Manual of Mental Disorders , Humans , Male , Models, Psychological , Neuropsychological Tests , Psychiatric Status Rating Scales/statistics & numerical data , Psychotherapy/methods , Schizophrenia/diagnosis , Selective Serotonin Reuptake Inhibitors/therapeutic useABSTRACT
Psychiatric education in the United States has undergone vast changes during the past 40 years, from a classical psychoanalytic model to an evidence-based neurobiological paradigm. Training standards, set by the Accreditation Council for Graduate Medial Education, have brought more scientific rigor to the training of young psychiatrists, but the danger of losing the psychotherapeutic skills provided in the past by long-term psychodynamic supervision is of concern to many psychiatric educators. A model for evaluating competence in psychodynamic psychiatry is discussed and postgraduate psychoanalytic training is encouraged.
Subject(s)
Physician Executives , Psychiatry/education , Psychoanalysis/education , Teaching , Adolescent , Adolescent Psychiatry , Adult , Behavior Therapy/education , Child , Child Psychiatry/education , Clinical Competence , Combined Modality Therapy , Education, Medical, Graduate , Humans , Internship and Residency , Organization and Administration , United StatesABSTRACT
The notion that professional women can "have it all"--career and children--has been disputed in the current popular literature. A brief review of recent findings presents evidence that many couples successfully manage the dual challenge of work and family. Clinical vignettes from a group of professionals/mothers are presented with suggested "rules" for success. We have come a long way from the days when it was taken for granted (mostly by our grandfathers) that women's place is only in the home.
Subject(s)
Employment , Mothers/psychology , Women, Working , Achievement , Female , Humans , Mother-Child RelationsABSTRACT
The need to create order out of chaos is a driving force, ethologicalty determined, and part of the human condition. Narrative, especially autobiography and self narrative, helps us sort out myriad fantasies, events, and images, weaving them into a cohesive whole that eventually promotes self-awareness. The narratives of Virginia Woolf, St. Augustine, and Samuel Beckett are briefly described. Attachment theory and current research demonstrates that secure attachment is a first step in the socialization process and helps put one's life in perspective. The therapeutic use of narrative is demonstrated by three clinical vignettes of patients with various psychiatric disorders who had successful therapeutic outcomes.
