Listeriosis of the central nervous system in children beyond the neonatal period

Observations on three children with neurolisteriosis (one case of meningitis, two cases of meningoencephalitis, each Serovar 4 b), show that even after the neonatal period, listeriosis must not be ignored in the process of diagnosis and therapy. It is the bacteriological examination of the cerebrospinal fluid, together with the blood culture, and not clinical symptoms and serology that guarantee a timely diagnosis and therapy (ampicillin and gentamicin).     

Insight and the analytic dyad

Insight reflects the unitary nature of psychic activity in contrast to the fragmentation created in abstracting categories for the purpose of study and discussion. The unique analytic clinical dyad offers a structure in which intrapsychic fragments can be actualized and integrated. As a result, the analyst's contribution is more crucially one of exploration than of revelation. Whatever the area of examination, past or present, the link to analytic immediacy offers the opportunity to make meanings meaningful, to convert known facts to psychic truths. The analyst's clinical task requires his private self-analysis as part of the collaborative exploration of how the patient's mind works. Higher level ego functioning, including acutely active remembering, is at times transiently loosened in order for the analyst to share in the clinical work of discovery. The words the analyst uses to communicate his understanding convey only approximate manifest meanings, though they structurally reveal deeper messages of importance to the patient. These verbal approximations help stimulate self-reflection in the analysand as a step in the process of gaining insight.