Remembered childhood artifacts. Windows to the past.

This paper explores how working with memories of childhood songs, pictures, poems, and stories can facilitate and deepen the analytic process. These artifacts are special metaphors for networks of repressed memories, in many respects like dream images. But unlike dream images and other early memories, they exist in the real world and can be verified. They provide the child with a scaffolding upon which to build a version of reality, putting conflictual situations into words, melodies, and images, and organize representations of relationships and affect that remain internally alive and can be reworked in unconscious fantasy. Three clinical examples illustrate how such associations enable the analysand to express ways in which the present, including the transference, is linked with the past.

Beginning careers in academic psychiatry for women--"Bermuda Triangle"?

OBJECTIVE: The proportion of women in leadership positions in academic psychiatry has not kept pace with the increase in the number of women entering the field. This study examines differences in career activities between women and men who graduated from the Yale University psychiatric residency training program and explores whether these differences can be explained by preresidency expectations, residency experiences, or training immediately after residency. METHOD: Departmental educational records of the Yale residency program were reviewed to determine professional interests expressed before psychiatric residency and training focus during residency for 355 residents in the 1970-1983 graduating classes. A 1984 follow-up study focused on their postresidency career activities. Differences in preresidency interests and experiences, training activities, and career paths between all female and male graduates and between women and men who chose academic careers were examined. RESULTS: After residency, the female graduates' marital status differed from men's--more had never married or were divorced. Women's professional activities diverged from men's; their practice pattern was different, they spent more hours teaching, and they had fewer publications in peer-reviewed journals. This divergence was not accounted for by differences in pretraining interests or in training focus during residency. The authors present possible explanations. CONCLUSIONS: Further research is indicated to determine the underlying causes of career differences between women and men in psychiatric practice and academia so that effective strategies for correcting the present inequality of women in senior faculty positions can be implemented.

Four-year evaluation of a psychiatric clerkship: 1982-1986.

The authors describe a psychiatric clerkship organized to achieve goals relevant to all medical students, regardless of their future specialty choice. The clerkship had been in place for 8 years in 1986, and standardized program evaluations were available for 4 years. A survey of the diverse clinical settings used for the clerkship showed that each had unique strengths and weaknesses but that each could meet the core goals of the clerkship, indicating that this clerkship design would also be feasible in a smaller department with any one or two of the settings available.

Topsy--living and dying: a footnote to history.

This paper explores the significance of Marie Bonaparte's book, Topsy: The Story of a Golden Haired Chow. The manifest importance of Topsy has been attached to the fact that the Freuds translated it out of gratitude to Bonaparte and because of their love for dogs. Another level of significance emerges when the book is placed in historical context. Topsy elucidates the relationships between Marie Bonaparte, Sigmund Freud, and Anna Freud. It reflects Bonaparte's feelings about Freud's illness and is part of an ongoing dialogue with him. The persistent misplaced emphasis on the "dog story" has obscured the more profound issues. The author suggests that the conflicting needs to appreciate transience and to avoid mourning may account for both the importance of the book and for its obscurity.

Anorexia nervosa masking the diagnosis of spinal meningioma: a case report.

A case report of an adolescent female with signs and symptoms of both anorexia nervosa and high thoracic spinal cord meningioma is presented. Similarities in the presentation of both conditions are discussed, with emphasis on the early diagnosis of anorexia nervosa masking and delaying diagnosis of the thoracic meningioma. The contribution of the family and doctor-patient relationship in delaying the diagnosis are discussed. Pertinent literature is also reviewed.