Clinical Commentary

This paper describes a lengthy period of psychotherapy with a child. This treatment began only after a prolonged contact with other child and adolescent mental health services during which the child's difficulties, which had initially seemed to be ordinary behavioural problems, had proved puzzlingly intractable to a variety of interventions. Subsequent psychotherapy revealed a profound disorder of development which lay bath the Surface presentation. In a climate where Asperger's syndrome is often felt to be untreatable, this paper argues that some children, at least, can benefit from psychotherapy and can be helped towards real mental growth. Asperger's syndrome in children bears some striking similarities to narcissistic personality disorder as described in the adult psychoanalytic literature and this paper discusses some of the theoretical and clinical implications of the innate origins of Asperger's syndrome.     

Clinical Commentary

This commentary is slightly different from previous ones in that the clinical work presented took place some 20 years ago. This gave an opportunity, for those commentators who wished to, to take up how they think the work of a child psychotherapist might have changed in the intervening years.     

Clinical Commentary

Abstract

This paper is the narrative of a first-time father with a son born seven weeks early by Caesarean section. Against the anxiety and trauma of his infant's birth and his wife's illness, another inner darker drama is being relived. Michael shows all the wounds of a battered child. He asks two awesome questions - Will I be to my son as my father was to me? Will my son be to me as I was to my father? Fearful and at first unvoiced questions, the developing interviews gave them a voice. We respected Michael's sharing of the early and fearful days and nights when his infant first came home. We sometimes found it hard to empathize with his running away to hide in work, until we understood what he was hiding from. Most poignant was his struggle with his anger and hurt with his father and his desire to understand, ‘Why?’, so that he would not be like this to his son. We saw a sensitive revelation of life being born inside him anew, as he made contact with his real infant and his psychic infant within. Of particular interest was the therapeutic use of the research interview space and the interviewer.     

上睑凹陷临床治疗方法的进展述评

上睑凹陷指的是上睑区眶下缘处出现的凹陷,常常与眼睑皮肤松弛下垂同时发生,为上睑老化的临床表现之一。随着人们对眶区年轻化的日渐重视,整形美容医师对纠正上睑凹陷研究出多种治疗方法。我们搜集了关于上睑凹陷临床治疗方法的国内外文献,并综合比较,分析进展趋势。目前的国内外研究中可将治疗方法概括分为三大类：组织的重新定位;注射及填充;以及两种方法的联合应用。而两种方法的联合应用正逐渐成为当今临床的主要治疗趋势。     

Commentary

A critique and discussion of the six papers offered in this volume is provided. Links to prior traditions in outcome and process research from the past are made. In addition the author reviews the somewhat negative reception of clinicians to empirical research and indicates the opinion that such attitudes have been to the detriment of our scientific status and public trust.     

Commentary

Conclusion Self psychology has added several dimensions to working with difficult oral patients in group psychotherapy. Elucidation of selfobject transferences provides a new understanding of members' linkages to the therapist, to one another, and to the group-as-a-whole. The emphasis on the process of narcissistic injury and repair has shed light on subtle processes that precipitate provocative, self-defeating behaviors that are compatible with dynamic constellations subsumed under the rubric of oral character neurosis.Glatzer paved the way for further advances when she accurately began to explore many facets of these individuals' characteristic behavioral patterns and their underlying dynamics. She provided a sound treatment base, using available theory, for patients who had been previously thought to be unacceptable or untreatable in group psychotherapy.One of the challenges that lies ahead is development of satisfactory evaluation of our treatments. Unless we can begin to demonstrate that long-term treatment is necessary and that group treatment is cost effective, extended insurance support for these deserving individuals will disappear. If our dynamic formulations are accurate, these personality malformations are not amenable to brief interventions, although acute symptoms might be alleviated. In light of our current knowledge, significant change will only take place with extended treatment.     

Commentary

The social and intellectual climate of the late 1940s and early 1950s in America helped nourish humanistic, person-centered views of human behavior. During that time, psychologists such as Gordon Allport, Abraham Maslow, David McClelland, Harry Murray, and Carl Rogers emphasized the positive growth potential in human character. The psychiatrist Harry Stack Sullivan proposed that personality can best be understood within the context of interpersonal transactions, and he provided a practical, street-smart understanding of psychiatric symptoms that was quite an advance over the traditional medical and psychoanalytic viewpoints. These ideas, along with the concept of dimensionalizing traits rather than categorizing them, inspired my colleagues and I to conduct our cooperative work on the interpersonal circumplex, which culminated in the publication of my monograph. Interpersonal Diagnosis of Personality (Leary, 1957).     

Commentary

No abstract available for this article.