The case of Peter and Susan: The psychotherapeutic treatment of an acute psychotic episode at the Arbours Crisis Centre

The case of Peter and Susan is an example of multiple crisis intervention at the Arbours Crisis Centre in London. Both were treated by psychoanalytic psychotherapy together with intensive interpersonal support in a live-in therapeutic milieu, with successful results.An extended discussion about the work of the Arbours Association in London will be published by Human Sciences Press as a chapter entitled, An Alternative Sanctuary: The Arbours Crisis Centre, in the forthcoming book,Healing Human Systems, edited by U. Reuveni and R. & J. Speck. For further information about the Centre write to: The Arbours Association, 41a Western Park, London N.8.     

Divorce in the kibbutz: Affective responses to separation

This article is part of a comprehensive research project in which the central characteristics of the process of divorce in the kibbutz were examined. It appears that the framework of the kibbutz, free as it is from socio-economic pressures and boundary factors not directly connected with the marital relationship as such, provides an excellent and perhaps unique opportunity to investigate the pure emotional effects of the marital breakup.     

Shame and fragmentation in the marital dyad

The paper outlines an expansion of object relations theory to account for fragmentation and shame. This expansion promotes a better psychodynamic perspective on the type of marital conflict escalation that occurs when each spouse turns to the other for empathic receptiveness while that other is also in a disorganized and vulnerable state of mind. Escalation occurs when spouses have different needs for safety and optimum distance and when the shame generated by continued exposure of these needs is not acknowledged. Clinical precepts promoting a focus on fragmentation and acknowledgement of shame are elaborated.     

Do women and men receive different care for sore throats?

Several studies have shown differences in the rates at which women and men receive treatment for several common medical problems, especially heart disease. The reason for these differences and the extent to which men and women receive different treatments for other problems is unclear. The purpose of the current study was to determine whether there are differences in the rates men and women receive antibiotic therapy for pharyngitis (sore throat), whether these differences are related to differences in disease severity or comorbidity across the sexes, and whether these differences could be due to prejudice against women by male clinicians. This was a retrospective analysis of data at two university student health services in Pennsylvania and Nebraska. Male clinicians did not prescribe antibiotics at significantly different rates for male and female patients, but female clinicians prescribed antibiotics more frequently for their male patients.The original data collection was supported in part by a grant from the National Library of Medicine, LM-04321.Presented in part at the Annual Meeting of the Society for Medical Decision Making, Portland, Oregon, October, 1992, and at the Third Primary Care Research Conference, Atlanta, Georgia, 1993.We thank Jane Kreisberg and Linda Rizjis for coordination of the collection of the original data, Linda Gray for help with data entry, and Cheryl Kull and Mary Martino for secretarial support. We are grateful to all the physicians who participated in the original study.     

Applying developmental previewing to the principles of family therapy

This paper discusses the application of principles of infant psychiatry to the diagnosis and treatment of multigenerational family conflict. Using a technique referred to as previewing, the therapist can focus on the interpersonal meaning that the infant's development precipitates in the family and determine how the parents' relationships with the infant replicate their relationships with their own families of origin. The therapist may then use these insights for overcoming conflict and for acclimating parents to new developmental skills in an optimal manner. Specific suggestions for how parents may promote more adaptive patterns of interaction with the infant using previewing are offered.     

Effects of medical resonance therapy music on patients with psoriasis and neurodermatitis—A pilot study

Stress medicine has shown that emotional disharmony can be a substantial factor for skin diseases. The harmonisation of the emotional status and a corresponding reduction of stress hormones by the Medical Resonance Therapy Music^® (MRT-Music) as shown in other studies (1,2,3,4) inspired us to investigate its benefits for patients with psoriasis vulgaris and neurodermatitis (neurodermatitis constitutionalis atopica). Over a period of 14 days we measured the parameters of blood pressure, heart rate, stimulus to scratch and the degree of sickness in two, respectively four groups of 68 patients in total: two experimental groups (psoriasis/neurodermatitis) and two control gropus. All patients received the normal treatment of our hospital, the experimental groups were additionally treated with 3 × 30 minutes of MTR-Music per day, while the controls were asked to somehow relax during this time. In the experimental groups the measurements showed to somehow relax during this time. In the experimental groups the measurements showed a reduction of blood pressure and heart rate and revealed an enhanced reduction of the stimulus to scratch and an enhanced reduction in the degree of sickness. Interestingly the effects of MRT-Music were stronger with the psoriasis patients than with the neurodermatitis patients. The results of this pilot study convinced us to offer the treatment with the Medical Resonance Therapy Music to all our patients.     

Nonsuicidal Self‐Injury Is Predictive of Suicide Attempts Among Individuals with Mood Disorders

Nonsuicidal self‐injury (NSSI) prior to age 18 was evaluated as a risk factor for adulthood suicide attempt (SA). Archival data from 222 mood‐disordered participants were analyzed using multivariate Cox proportional hazards analysis. Participants with a youth SA were excluded. The hazards of SA among adult participants with a history of youth NSSI were twice than those of mood‐disordered participants without youth NSSI (hazard ratio = 2.00, 95% confidence interval = 1.16–3.44, p = .01). Moreover, participants who had both youth and adult NSSI attempted suicide significantly earlier than participants who began NSSI as an adult. Youth NSSI is associated with persistent, elevated SA risk in adulthood.     

Willingness of Mentally Ill Individuals to Sign Up for a Novel Proposal to Prevent Firearm Suicide

The study goal was to determine whether a significant number of high suicide risk individuals would confidentially put their own names onto a list to prevent future gun purchases. An anonymous written survey was administered in an inpatient psychiatric unit and two outpatient psychiatric clinics at an academic medical center. Two hundred forty individuals were approached to fill out the survey, of whom 200 (83.3%) did so. Forty‐six percent of participants stated that they would put their own name onto the list. This novel suicide prevention proposal, a Do‐Not‐Sell List, would appeal to many people at high risk for suicide.