Family Dynamics and Drug Overdoses*

ABSTRACT: In a study of 40 patients who had taken an overdose, and with the relatives of 18 of these subjects, a pattern of family factors that appeared relevant to the choice of drugs was found. These family factors included: (a) a specific expectation that the person would use drugs; (b) an identification with another suicidal family member; (c) a high level of oral preoccupation and oral fixation; (d) trauma in the life history associated with food or orality; and (e) a direct participation of other family members in the suicidal act. The direct study of family interactions in evaluating suicidal potential is recommended for its unique diagnostic and therapeutic implications.     

Curious bedfellows: Psychoanalytic understanding and old age psychiatry

SUMMARY

The author outlines an approach to assessment, or as she prefers to call it, psychoanalytic consultation, in the Health Service. This involves giving the patient an experience of the analytic process, which they can then assess in a way, while the assessor gains information about a number of categories that can be thought of hierarchically, which inform the advice given the patient and the referrer about management and treatment. The safety of the patient is paramount, as psychoanalytic psychotherapy is a powerful and disruptive treatment. However it is argued that, on the whole, ‘suitability for psychotherapy’ should be on the basis of exclusion rather than involving the patient passing a sort of ‘suitability test’. The latter may enable public psychotherapy services to deny the incompleteness of what they are able to offer.