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Biomedical subjects

E R Shapiro

Publications and source records attributed to E R Shapiro.

At least 19 recordsLinked to original sources
PubMed1998

The healing power of culture stories: what writers can teach psychotherapists.

The personal narrative as the shared story of one's life in cultural context is increasingly being viewed by psychotherapists as a useful way to support the work of healing. This article uses the life course narratives of creative writers, especially those who write from outside the margins of the dominant culture, as shared resources for growth. The article focuses on Isabel Allende's book Paula, which tells the story of how the experienced her daughter's death as both a shattering below and a life-expanding opportunity to revisit her lifelong storehouse of relationships and cultural resources. Out of these narratives, she drew new strengths and insights that helped her cope with her loss and create a new relationship with her daughter's spirit. The article suggests how psychotherapists concerned with honoring the complexity of culturally diverse life stories can learn to use personal narratives as resources for healing, for ourselves and with others.

Adaptation, Psychological↗
PubMed1996

Family bereavement and cultural diversity: a social developmental perspective.

This article offers an integrative, interdisciplinary model of bereavement as a family developmental process that unfolds in cultural context. A critique of cultural assumptions highlights the culture-bound nature of prevailing North American practices, which view grief as an isolated individual experience and emphasize detachment from the dead as a way to promote recovery. Death and grief precipitate two kinds of family change, both guided by culture yet uniquely experienced and interpreted by individual families: 1) recreating the family without a key family member, but capable of coping with both existing and new tasks; and 2) incorporating the death into an ongoing but irrevocably altered family life-cycle developmental process. In supporting family change after a death, family therapists need to collaborate with grieving families in examining the goodness of fit between their unique circumstances and the bereavement expectations of their community and culture. Four case examples are presented, two of which will apply this social developmental model to emphasize transformations of attachment to the deceased--rather than detachment--that will support the ongoing family development of grieving families.

Acculturation↗
PubMed1996

Exile and professional identity: on going back to Cuba.

The author tells the story of her lifelong attempts to create a coherent, complex cultural identity from her family's multiple diaspora legacies, and the impact of these struggles on her personal and professional development. She emphasizes the intergenerational conflicts created by the sociopolitical circumstances of her generation's Cuban immigration experience, and progressive attempts to include her Cuban identity in her sense of self. An unexpected lesson in the politics and history of psychoanalysis, itself an immigrant movement that abandoned its social conscience to survive in exile, catalyzed a return to Cuba and a greater inclusion of its social values in her personal and professional lives.

Career Mobility↗
PubMed1995

Grief in family and cultural context: learning from Latino families.

The following article offers an integrative theory of family development in sociocultural context, which critically examines the goodness of fit between the grief experiences of culturally diverse families and prevailing North American grief practices. This model suggests that many Latino families, even when they are themselves from a variety of national backgrounds with somewhat different sociopolitical histories and cultural practices, offer an approach to death and grief that can enhance developmental outcomes in family bereavement. These qualities include a focus on family and extended family relationships as developmental resources; an appreciation of the spiritual and psychological continuity between the living and the dead; and an appreciation of the need to keep working on relationships, even after a death, so as to create new, more optimal shared understandings of family past, present, and future. The bereavement story of the Ruiz family, who migrated from rural Puerto Rico to the United States, serves to illustrate the ways that integration of Latino family experience into mental health models of grief can help expand understanding and improve bereavement outcomes for all families.

Cross-Cultural Comparison↗
PubMed1987

Disguised countertransference in institutions.

The manifest reason for the hospitalization of psychiatric patients is that someone decides that they are in danger of suicide or homicide, or that they are unable sufficiently to care for or manage themselves. From another perspective, however, hospitalization can be understood as a consequence of limitations on the part of the family, the community, or the therapist in managing the affects generated in relation to these patients' behavior and communications. In other words, it is possible that patients may be hospitalized primarily because people in their lives (and often they themselves) cannot stand their own reactions to them and to their behavior. A less readily recognizable aspect of the institution, then, may be its use as a place to lock away unacknowledged, or at best uninterpreted problems of unbearable human responses to patients' psychopathology. In therapeutic relationships, where these issues are condensed, such responses are termed countertransference. The connections between individual relationships and institutional behavior are complex and inevitably contentious. In this paper, we suggest that a study of these connections may reveal disguised elements and illuminate some of the parameters of the complex phenomenon of countertransference.

Countertransference↗
PubMed1978

The psychodynamics and developmental psychology of the borderline patient: a review of the literature.

The author reviews the psychodynamics and developmental psychology of the borderline patient as described in the literature on intensive therapy, early mother-child interaction, and family interaction. Focusing on the borderline patient's characteristic difficulties in intimate relationships, he describes the patient's use of splitting and projective identification as seen in the characteristic transference-countertransference interaction in intensive therapy. These primitive defensive mechanisms, which are also utilized by family members, appear to contribute to a failure of empathic responses both during the child's early development and in the family interactions during his adolescence. The author concludes that conceptual attempts to relate adult and child phenomena, although highly speculative, create new and useful perspectives for the treatment of the borderline patient.

Adolescent↗
PubMedDate not supplied

Treatment of invasive external otitis with cefsulodin.

Thirteen patients with invasive infections of the external ear were treated with cefsulodin sodium. Eleven were elderly diabetic patients with malignant external otitis, and two were nondiabetic adults with cellulitis or chondritis of the external ear. Four of 11 patients with malignant external otitis had extensive disease, with progression of infection to the petrous apex, medial base of the skull, or parapharyngeal soft tissue. Eleven patients had granulation tissue in the external auditory canal, and three presented with cranial nerve palsies (V, VII, IX, X). Pseudomonas aeruginosa was isolated from all patients. Minimal inhibitory concentrations of cefsulodin for the strains isolated were 1.56-6.25 micrograms/ml (mean, 3.37 microliter/ml) and minimal bactericidal concentrations were 1.56-25 micrograms/ml (mean, 5.59 micrograms/ml). Duration of therapy was from one to 12 weeks. Nine patients had a positive clinical response, three had recurrent disease after initial improvement, and one was lost to follow-up. A positive response was correlated with a longer duration of therapy and less extensive disease; complications were minor. Cefsulodin appears to be an effective agent for the treatment of selected patients with invasive external otitis.

Adult↗