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.     

Worry: A critical analysis of some theoretical approaches

Abstract

It is suggested that worry has not been given serious academic attention due to problems of definition, and a prevailing belief that it is an unnecessary addition to the theorists vocabulary given the term “anxiety”. However, an increasing awareness of the importance of cognitive factors in emotional disorders makes the study of worry a necessary endeavour. Furthermore, inclusion of worry in DSM III-R as the principle diagnostic index of Generalised Anxiety Disorder has given the term clinical credibility. Three theoretical approaches to the subject of worry are considered: the test anxiety literature, which has focused on the effects of worry on performance, and two largely clinical accounts, a tripartite theory of worry and anxiety proposed by Borkovec, Metzger, and Pruzinsky (1986), and the model of anxious apprehension proposed by Barlow (1988). All approaches are critically evaluated, and suggestions made for future formulations.     

The EEG as confirmatory evidence of brain death: Previous and current approaches

The role of EEG in confirming the clinical diagnosis of isolated brain death has undergone evolutionary changes since the original recommendations concerning its use. Accumulated evidence now supports that approach that the EEG can be used not only as a confirmatory test for brain death, but one which considerably facilitates making the diagnosis. Using the EEG, brain death can often be identified with absolute certainty within just a few, rather than the previously recommended 24 or more hours after a known precipitating event. Guidelines to this effect have now been established.     

Seeking an ethical and legal way of procuring transplantable organs from the dying without further attempts to redefine human death

Because complex organs taken from unequivocally dead people are not suitable for transplantation, human death has been redefined so that it can be certified at some earlier stage in the dying process and thereby make viable organs available without legal problems. Redefinitions based on concepts of "brain death" have underpinned transplant practice for many years although those concepts have never found universal philosophical acceptance. Neither is there consensus about the clinical tests which have been held sufficient to diagnose the irreversible cessation of all brain function – or as much of it as is deemed relevant – while the body remains alive.     

Author's commentary: A holistic and meditative approach to the dying process

Abstract

At face value, the phrase “a good death” may present the ultimate oxymoron. To fully comprehend the goal of comeditation one must understand the fundamental needs of the dying. Comeditation's prescribed meditative and breathing techniques are adaptable to any philosophy and state of health, even for those who have never mediated before. The caregiver's opportunity to relate intimately with the consciousness of the dying in the last days leads to a sense of peace rather than remorse in the bereavement period. (Ruth Buczynski, president, National Institute for the Clinical Application of Behavioral Medicine)     

Dreams of passage:: An object-relational perspective on a case of a Hindu death ritual

By examining the case of a death ritual in a Surinam-Hindu community in the Netherlands, the authors want to demonstrate the usefulness of object-relations theory in the study of religion. Because it focuses on the dynamic interaction between individual and culture, this psychological theory embraces a truly cultural-psychological approach. D.W. Winnicott's idea of ‘transitional phenomena’ is central in this respect. Cultural activities, such as participating in rituals and myths, are said to have a transitional function, when they sustain identity formation and coping with crises. Based on Arnold van Gennep's famous term ‘rites of passage’ as well as on the psychoanalyst Geza Róheim's insights into rites and myths of passage, the new term rêve de passage (dream of passage) is coined. Dreams may also have a transitional function in situations of crisis and change. As an example, we discuss the dream of one of the mourners in the case discussed. By using cultural meanings from her social and religious context—in particular, the notion of the mahapatra—the dream helps the mourner to cope with a difficult situation and to make the transition back to ordinary life. The article concludes that the concept of rêve de passage, as developed within the object-relational framework, is a promising tool for dream research in both religious studies and anthropology.