摘要:

An account of object relations theory (ORT), represented in terms of the procedural sequence model (PSM), is compared to the ideas of Vygotsky and activity theory (AT). The two models are seen to be compatible and complementary and their combination offers a satisfactory account of human psychology, appropriate for the understanding and integration of psychotherapy.

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1991.tb01669.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

This paper explores the contribution of unconscious and experiential factors in accounting for the high rates of depression, alcohol and drug abuse and suicide within the medical profession.The first part of the paper reviews the literature on motivations to study medicine and proposes that, for some doctors, a component of their decision is a response to unconscious drives to compensate for childhood experiences of parental impotence, or emotional neglect.The second part of the paper utilizes the theoretical framework of Kohut to argue that these childhood experiences may also result in the development of a narcissistic disturbance, and a vulnerable self‐esteem. A model is outlined of how this may contribute to the development of emotional distress and psychiatric illness through the creation of a state of dependence on patients, emotional detachment and the denial of personal vulnerability. It is proposed that preventative strategies will need to include changing the emotionally ‘abusive’ nature of medical education, which tends to exacerbate this pr

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1991.tb01670.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Looking at the onset of depressive states in linear terms, there is often a problem of distinguishing cause and effect: did the adverse life‐events cause the depression, or did the depression cause the adverse life‐events? If we abandon linear thinking and look at depression in systemic terms, the problem of cause and effect disappears, but it is replaced by another problem: is the patient/environment system characterized by homeostasis or change? Some depressed patients seem to be spiralling down towards disaster. Others seem to be stuck in a rut. In systems terms, can depression be at the same time an agent of change and an agent of stasis (or even homeostasis)? The paradox can be resolved if we postulate that the function of depression is to reconcile the individual to an involuntarily subordinate social role; depression which reconciles to a pre‐existing subordinate position has static properties; depression which mediates a switch to a subordinate position from a previously dominant position has properties of systemic c

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1991.tb01671.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

This paper discusses factors which have affected progress in the primary and secondary prevention of suicidal behaviour. An attributional model of helping and coping described by Brickman and his colleagues (1982) is used to suggest that the match or mismatch between attitudes and attributions of helpers and helped is critical in determining (a) whether or not people seek help when in a crisis, and (b) whether or not people respond to help when they receive it. The evidence for the efficacy of cognitive‐behavioural problem‐solving therapies is reviewed in the light of their ability to take account of matches or mismatches in attitudes towards helping and being hel

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1991.tb01672.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Social‐cognitive theories of depression predict that an individual is at more risk of becoming depressed if the individual's only dominant role or goal is disrupted by a life‐event. This paper reports the development of an instrument which assesses the individual's important roles and goals; preliminary data are presented from two samples (sample 1 of elderly people, sample 2 of younger adults) taken from the age‐sex registers of GP practices. The overall reliability of the questionnaire is good, and evidence was obtained for the predicted pattern of an overvalued role or goal being more likely to be correlated with depressive symptomat

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1991.tb01673.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

The research literature on stress has grown disproportionately to actual advances in the field. The authors review issues that may underlie this lack of progress within four general domains: (1) conceptualization and operationalization; (2) measurement; (3) design; and (4) analysis.

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1991.tb01674.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

The basic hypothesis of the literature on alexithymia, i.e. that alexithymia has a higher prevalence in psychosomatic than in neurotic (and delusional) patients, was empirically tested by means of the well‐validated Toronto Alexithymia Scale (TAS). Surprisingly, neurotic and delusional patients (N= 71) had significantly higher mean total scores on the TAS, compared with the psychosomatic group (N= 150); the normal control sample (N= 224) was, as predicted, the lowest scorer. This hierarchical distribution was confirmed for the first two factors of alexithymia: (1) difficulty in distinguishing between feelings and bodily sensations, and (2) difficulty in expressing feelings. The psychiatric group was, instead, the lowest scorer on the third factor (lack of fantasy life). A substantial cross‐validation of the above findings was achieved by comparing on the TAS three subgroups of the normal sample (symptom‐free, somatizing and ‘neurotic’ normal controls). The postulate of the non‐neurotic nature of alexithymia, along with its many psychopathological and technical corollaries, is completely contradicted by the prese

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1991.tb01675.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Book reviewed in this article:A Testimony of Her Times: Based on Penelope Hind's Diaries and Correspondence 1787–1838.BySarah Markham.Theory and Practice of Psychiatric Rehabilitation.Edited byF. N. Watts&D. H. Bennett.Variations on Teaching and Supervising Group Therapy.Edited byK. G. Lewis.AIDS Related Psychotherapy.ByM. Winiarski.Between Therapist and Client: The New Relationship.ByM. Kahn.Breaking the Silence: Art Therapy with Children from Violent Homes.ByC. Malchiodi.Dance Therapy and Depth Psychology: The Moving Imagination.ByJ. Chodorow.Essential Papers on Transference.Edited byA. Esman.Psychological Processes of Childbearing.ByJ. Raphael‐Leff.Counselling the Bereaved.ByR. A. Dershimer.Children of Divorce: Developmental and Clinical Issues.Edited byC. A. Everett.The Protective Shell in Children and Adults.ByF. Tustin.The Work and Play of Winnicott.BySimon Grolnick.Treatment of Rape Victims: Facilitating Psychosocial Adjustment.ByK. Calhoun&B. Atkeson.The Handbook of Medical Psychotherapy: Cost‐effective Strategies in Mental Health.Edited byK. Anchor.Schizophrenia Genesis: The Origins of Madness.ByI. Gottesman.Love's Executioner and Other Tales of Psychotherapy.ByI. Yalom.Working in Partnership: Clinicians and Carers in the Management of Longstanding Mental Illness.ByL. Kuipers&P. Bebbington.The Uses of Writing in Psychotherapy.Edited byP. K

ISSN:0007-1129    

DOI:10.1111/j.2044-8341.1991.tb01676.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY