The psychoanalytic treatment of a preschool boy with a gender identity disorder.

A three-year, nine-month-old boy began analysis by wishing he was a girl and pretending he was a superheroine. Over the course of almost five years, the cross-gender defense against fear of loss of the object, anal loss, and castration by the object reorganized in all libidinal phases through early latency. Developmental arrests seemed to occur during the anal rapprochement and oedipal phases that led to observable cross-gender strivings by two and a half years of age. The role of early childhood illness, narcissistic vulnerability, mother's childhood wish for a sister, the mother's adult wish for a daughter, a shared fantasy between mother and child, identification with the perceived power and beauty of mother and grandmother, pathological sibling rivalry that influenced identification with his sister, were demonstrated in his play during sessions. Interwoven in the background was the impact of an emotionally absent father, a dying grandfather, and an accident-prone uncle. This paternal matrix seemed to discourage budding masculinity and encourage feminine identifications. The analyst's approach and the child's responses to interpretation of the transference manifestations, cross-gender behavior, fantasies, and play are presented. Finally, the gradual resolution of the conflicted wish to be a girl was supplanted by the emergence of appropriate gender identification. A two-year followup appeared to confirm his postanalytic gender stance and continuing consolidation of stable gender development.

Adverse reactions to hypnotherapy in obese adolescents: a developmental viewpoint.

Hypnotherapy is a method of treatment for resistant obesity. This study was undertaken to ascertain the efficacy and/or risks it holds for adolescents. All tended to see hypnosis as a quick solution to longstanding problems. Other forms of weight control therapy had been unsuccessful. Untoward reactions occurred in many teenagers. These included: dissociated state, depersonalization, anxiety and fears. Patients who were not in a deep state of hypnosis were disappointed and viewed this as another failure experience. The severe side effects were observed in those patients in the earlier developmental phases of adolescence.