Cold hard death, cold hard doctors.
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Biomedical subjects
Publications and source records attributed to F W Furlong.
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During the past century various theories of mental functioning that rest on a deterministic view of man have gained dominance. However, a review of psychodynamic writing shows that there has remained a need for some concept of autonomy and inner direction, as represented by the concepts of ego autonomy and behavioral self-control. In fact, some studies of mental health and psychotherapy can be interpreted as supporting the existential view that the experience of "freedom" and "choice" is a genuine phenomenon. Although concepts of behavioral self-control may reconcile these contradictions, the author concludes that no theories of mental functioning have entirely dealt with the paradoxes of autonomy, inner direction, and choice.
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The past decade has seen the emergence of popular "new psychotherapies" such as Gestalt Therapy, Transactional Analysis, and Primal Therapy, each with substantial followings. This paper puts forward a hypothesis about what these divergent systems may possess in common. Certain aspects of these therapy systems, in particular the induction of new patients and trainees, are examined in terms of Paul Tillich's concepts of the universal necessity of a rationale for courage. The significance of Tillich's analysis of courage for various historical movements is reviewed. In each system an element of unconditional commitment to a particular world view is required, as evidenced in the writings of the proponents of these systems, for the patient to be accepted into the particular system. These theoretically divergent systems possess, in common, a factor of an initial commitment to and induction into a collective belief system comparable to what Tillich describes as "the courage to be as a part".
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In a double-blind study, three depressed subjects received thyrotropin-releasing hormone (TRH) on three successive days, and one subject similarly received placebo; all subjects were then given ECT. Two of the patients given TRH responded to ECT. One patient's reaction is of special significance because of her response to ECT, diminished thyroid-stimulating hormone response to TRH, increased growth hormone and prolactin response to stress, and antidepressant effect of TRH. These findings raise the possibility that previous conflicting reports about TRH's antidepressant effects stem from the combined study of endocrinologically distinct depressive subgroups and strongly suggest that there may be a specific subgroup that is responsive to TRH.
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