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Archive for February, 2007

“What Makes Psychiatry and Psychology Unique? An Argument for the Retention of the Narrative in Our Work.”

Wednesday, February 28th, 2007

“What Makes Psychiatry and Psychology Unique? An Argument for the Retention of the Narrative in Our Work.” By Herbert Peyser (Click Here to read)

Books For the Bereaved

Wednesday, February 28th, 2007

I appreciate all the suggestions of a book for someone who has lost a wife of 32 years. lso for the kind, personal nature of the replies.

Alan

The most frequent suggestion was Joan Didion’s book, The Year of Magical Thinking, written on the death of her husband.
(more…)

Symonds Prize at Studies in Gender and Sexuality: Winner and New Contest

Tuesday, February 27th, 2007

Symonds Prize at Studies in Gender and Sexuality: Winner and New Contest
The Editors of Studies in Gender and Sexuality proudly announce the winner of the first Symonds Prize: Meg Jay, PhD, “Melancholy Femininity and Obsessive-Compulsive Masculinity: Sex Differences in Melancholy Gender,” Vol. 8, # 2 (2007).

They also announce the second annual competition for the best essay on a topic related to issues of gender, sexuality, or both. The essay may engage clinical or theoretical questions. The writer may be new or seasoned. The topic may be cutting-edge or devoted to any of the time-honored problems in psychoanalysis. Examples of topics include but are not limited to:

Gender in the work place, everyday life, and politics

Sex and gender in clinic and in culture

Gender and sex in contemporary cinema or theater, literature or art

Sex and food

Gay marriage and civil union

Race and gender in clinical and cultural representation

The materiality of sex: from sex toys to who does what with whom

Seduction and consent

Gender and sexuality in disability or illness

Gender and prisons

A cultural studies approach to pornography

A cultural studies approach to recent television (“The Real World,” “The L Word”…)

Torture, war crimes, and gender (Abu Ghraib, Rwanda…)

Gender, sexuality and the history of psychoanalysis

Abortion politics and rights

In the spirit of the journal’s mandate, we are interested in essays that vary in form and content. Submission could include papers that are multidisciplinary. We are open to orthodoxy and heterodoxy. Even to their combinations.

The contest will be judged by members of the journal’s Editorial Board. The winner of the Symonds Prize will receive $500, and the essay will be published in the journal.

Now in its seventh year of publication, SGS ( http://www.analyticpress.com/sgs.html) has served as an interdisciplinary forum for reexamining gender and sexuality. It was launched with paradigm-stretching articles on male and female homosexuality and bisexuality; femininity and the place of desire; postmodern gender theory; and the erotic transference. Since then, SGS has been at the leading edge of sex and gender theory. It has explored many clinical, developmental, and cultural topics – boyhood homophobia; bisexuality; infertility; gender jokes, transsexual and transgender categories of identity and experience – and ranged into the visual arts, cinema, and popular culture.

Submissions (title page to list author’s name and contact info; manuscript to list only title on first page and as running head) should be sent to:

Martha Hadley, Ph.D.

Executive Editor

What Makes Psychiatry and Psychology Unique? An Argument for the Retention of the Narrative in Our Work” By Herb Peyser

Monday, February 26th, 2007

Paper presented to New York Psychoanalytic Institute Click here to read

About That Mean Streak

Tuesday, February 13th, 2007

My Letter to the Editor appeared in today’s New York Times, as follows:

To the Editor:

Re “About That Mean Streak of Yours: Psychiatry Can Do Only So Much” (Feb. 6): The examples Dr. Richard A. Friedman uses to promote his view that some people “can be mean or bad just like anyone else” give psychiatry a bad name.

Psychoanalytically oriented psychotherapy, in my experience, can help a person understand the roots of meanness, and only with such understanding is there hope for modulated change. I would ask Dr. Friedman what he means when he says that one patient had “all the benefits of an upper-middle-class upbringing?” And how did the psychotic patient happen to have the home phone number of a female resident? The vignettes do not substantiate his thesis.

Jane S. Hall
New York

The writer is the founder of the New York School for Psychoanalytic Psychotherapy.

These types of arguments and articles unfortunately reflect poorly not only on psychiatry but on all mental health workers. As a psychoanalyst with a social work background I have treated many people whose so called “mean streaks” are wrecking their lives. Psychoanalytically-oriented work provides a deeper, broader look at why people react in “mean” ways. This off-putting attitude is a symptom of anxiety about closeness and intimacy that has become characterological and though adaptive in one way, also extremely injurious. We must speak up in support of our field and to educate the public.

Is this the end of the scholarly journal? Article in Christian Science Monitor

Monday, February 12th, 2007

Is this the end of the scholarly journal?

Publishing research to blogs and e-books is so easy, some are wondering if peer-reviewed journals are on their way to obsolescence.

Click Here: Gregory M. Lamb | Staff writer of The Christian Science Monitor

This article raises a question about the future of print peer reviewed scientific journals. My sense is that there will be a place for quality peer reviewed journals in psychoanalysis.

Proust and the Love of Longing by Arlene Kramer Richards and Lucille Spira

Thursday, February 8th, 2007

Chick here for: Arlene Kramer Richards and Lucille Sprira on Proust and the Love of Longing

This work in progress is an attempt to learn something from a great artist
and commentator on human nature that will be applicable to clinical work
with analytic patients. We would be especially glad to hear from readers
how the ideas about loneliness and aloneness being valued over fulfillment
accord with their clinical observations. Case vignettes would be especially
welcome.    Arlene  

 

Talk Therapy Works for Panic Disorder

Tuesday, February 6th, 2007

Janice Lieberman has written in to call our attention to an important study by Barbara Milrod (an IPA member) and an article in today’s New York Times — “In Rigorous Test, Talk Therapy Works for Panic Disorder” by Benedict Carey.

Leon Hoffman on “Avoiding the ‘alphabet soup’ maze: Parents with difficult children”

Monday, February 5th, 2007

There have been many reports in the press recently about families with
children who have developmental, emotional and/or behavioral difficulties.
These articles help other parents recognize that they are not alone with
their angst and frustrations. Among the many issues addressed in these
reports are that psychiatrists and other mental health professionals are
unsure as to how best treat children with complex disorders, and whether
the use of several psychotropic medications simultaneously are indicated.

Unfortunately, much too often parents are faced with a dilemma as to
how to proceed because, to quote one parent, “they hear an alphabet soup
of labels that seem to change as often as a child’s shoe size.” Most often
categorizing a child with a standard diagnostic label does not do justice
to
the child or the family in trying to determine the best therapeutic course
to
follow. Too many of us have been led to believe that if we only made the
“right” diagnosis we could find the “right” medication or combination of
medications for the child. A current example is the ubiquity with which the

diagnosis of bipolar disorder is made in children with a variety of
disruptive
and/or mood symptoms. These children are often very quickly prescribed
mood stabilizers. This approach has many pitfalls.

So what are parents to do when faced with complex behavioral and/or
emotional situations with their children? Whenever parents bring their
children to mental health professionals, the parents will feel frightened,
anxious, puzzled; they may not even be able to know what questions to
ask, especially if they are worried or if it’s their first contact with a
professional.

In such a state, how can parents judge the value of the professional’s
assessment?

With the helpful guidelines that follow.

If, from the very first contact, the mental health professional  enters into a collaborative relationship with the parents – that professional and parent will work jointly to determine the best course to follow for the child- the parents should feel assured they are in good hands.

Parents should see evidence that the mental health professional will be assessing five eneral areas of the child’s behavior.

First, the professional needs to understand how the parents view the child’s symptoms. This includes how the child’s symptoms affect the family and how do family interactions affect the child. Second, the professional needs to assess how the child experiences his or her symptoms. It’s critical to the treatment to understand how the child interacts with people around him or her: with the parents, siblings, relatives, other children, other
significant adults, and in school; as well as, how others interact with him or her. In other
words the parents and professional together try to understand how the child’s
social development has proceeded.

In addition to an assessment of the child’s emotional and social development, the
child’s sensory, motor, and cognitive development need to be evaluated. This
includes understanding the nature of the child’s responses to sensory stimuli
(appropriate, under-reactive, over-reactive); fine motor and gross motor development;
language development; memory; fund of knowledge; ability to understand social
situations; and changes in school performance.

With these assessments accomplished, the professional in collaboration with
the parents is ready to come up with a diagnosis. By that I do not mean simply
a specific label, such as ADHD or bipolar or depression, based on the number
and frequency of particular symptoms. Rather I mean, as those of us who
work intensively with children and their families use the term, “diagnosis,” in
a broad sense, how do we understand the child’s symptoms in terms of his or her
current state of development, his emerging personality pattern, and with his
particular family structure.

In trying to understand the child, we try to ascertain whether the problem concerns mainly the child’s feelings (is it mainly depression or anxiety)? Or does the problem relate mainly to the child’s sensory, motor, and/or cognitive development with emotional reactions secondary to those problems? Or is the problem is mainly what’s called an “externalizing” kind of problem?

In other words, does the child express his problems primarily through action rather than through expressing subjective distressful feelings, particularly with words? Whether there is a problem with the child’s ability to differentiate his or her fantasy life from the rest of his experience? Whether the child experiences a conflict within him or herself or does he or she only feel a conflict with other people? Whether there is a mixture that is hard to tease apart?
And, how do the child’s problems impact on and interact with the family’s feelings and functions?

And here’s the most important guideline. Parents need to remember that a diagnostic assessment is always a “work in progress.” As time and treatment evolve, both parents and mental health professionals always need to be sensitive and allow for modifications and changes in direction.

Only after such a comprehensive evaluation can one understand the adaptive and maladaptive patterns in the child and family and implement a treatment plan which always has to include supportive work with the parents. Together, parent and professional have to decide the specifics that are best for the child at “this” particular time. The possibilities include psychotherapy, a variety of remediation interventions, special classes or schools, pharmacotherapy, or some combination of these and other modalities of treatment. The comprehensive approach I am describing requires time and adequate resources.

Unfortunately, in today’s climate of limited insurance benefits and the ascendance
of the psychopharmacological revolution, too many of our children visit a child
psychiatrist once or twice and are quickly diagnosed to have a “disorder,” resulting
in the “need” for powerful psychotropic medications. Certainly some children require
psychotropic medications and/or mood stabilizers. However, without an adequate
comprehensive evaluation and without comprehensive ongoing care, families and
children may enter into the “alphabet soup” maze where one diagnostic label after
another is followed by a trial of one medication after another. And more than ever,
the climate of the nation’s health care complex is short shifting health care for our
children. We should be mindful and be attentive to just how our children are cared for.

Leon Hoffman, MD
Chief Psychiatrist, West End Day School, NYC
Board Certified Child and Adolescent Psychiatrist, Certified Child and
Adolescent Psychoanalyst

Leon Hoffman, MD
Director, Pacella Parent Child Center of
The NY Psychoanalytic Institute & Society
167 East 67th Street
NY NY 10021
212.249.1163
917.767.6575
73542.334@compuserve.com

http://www.theparentchildcenter.org/

Two book reviews of interest

Friday, February 2nd, 2007

“Freudian whip: Latest bio offers unflattering look at lauded psychoanalyst” by John Cruickshank. Chicago Sun-Times, January 21, 2007. [A review of FREUD: INVENTOR OF THE MODERN MIND by Peter D. Kramer, HarperCollins, 224 pages, $21.95.]

“Freud’s Will to Power” by Ronald W. Dworkin. The New York Sun, November 29, 2006. [A review of FREUD: INVENTOR OF THE MODERN MIND by Peter D. Kramer, HarperCollins, 213 pages, $21.95.]