Biomedical subjects

G A Awad

Publications and source records attributed to G A Awad.

15 recordsLinked to original sources

PubMed1992

A fantasy penis: its development, multiple meanings and resolution.

A 30-year-old single woman came to analysis because of anxiety, guilt and a sense of being bad. After two years of analysis that focused primarily on her relationship with her family members, an unconscious fantasy of having a penis was uncovered. The origin of the fantasy was traced to the narcissistic crisis and the birth of her brother, and as an attempt to regain the loss of mother's love. However, other meanings were added during subsequent developmental stages; namely, the fantasy penis was an umbilical cord that connected her with her mother, it bestowed power and licence to do whatever one wants and was a shield against father's subtle breach of the oedipal fantasies. The resolution of the fantasy passed through a stage of losing the penis and ending up with 'nothing' before a vagina could be experienced as a natural way to be.

Adult↗

PubMed1991

Male adolescent sexual offenders: exhibitionism and obscene phone calls.

Clinical assessment of 19 male adolescent sexual offenders who had committed exhibitionism or telephone scatologia showed that the majority were maladjusted, had committed numerous sexual offenses and came from multi-problem families. Several of them appeared to be sexually deviant, although they did not meet DSM-III-R criteria for a diagnosis of paraphilia. Anti-social traits, sexual deviance in the family, homosexual conflicts, repressed sexuality and sexual deviance were considered to be contributory factors.

Adolescent↗

PubMed1991

Therapeutic management of sexual abuse allegations in custody and visitation disputes.

Our experience is that in many cases, trying to assess the "truthfulness" or "falseness" of sexual abuse allegations that occur in the midst of custody and access disputes may not be possible. Instead therapeutic management of such cases is advocated. A case is presented in which sexual abuse was suspected because the recanting child displayed sexualized symptoms. Following a thorough assessment, which indicated that the child was abused, but could not confirm who the offender was, both the child and the mother were seen in psychotherapy on a regular basis. The father used counselling to achieve rights for visitations. The building of a therapeutic relationship allowed us to experiment with the situation to where we felt we could identify the potential offender who had to be kept away from the child. In addition, the therapeutic relationship enables this family to come to us to resolve their disputes rather than use the judicial system.

Adult↗

PubMed1991

Adolescent female firesetters.

A retrospective study of the charts of 13 female adolescent firesetters revealed severe family and individual pathology. The parents had a history of separation, violence, alcohol and/or drug abuse, and inability to take care of the children. The girls had a long history of serious behavioural problems. Four girls had set one fire, six had set several fires within a period of a few days, three had a long-standing history of setting fires. The girls showed a lack of remorse or concern for their behaviours.

Adolescent↗

PubMed1991

Unconscious fantasies: from the couch to the court.

No single unifying theory exists that explains the plethora of behaviors that bring individuals before the courts on a daily basis. No biological, social, or familial model for criminal behavior is without limitations, or exempt from controversy and criticism. We suggest, however, that it is appropriate, and often necessary, for the psychiatric expert to advance lucid, intelligible, and simplified psychodynamic formulation, either alone or in conjunction with another explanatory model of criminal behavior, to assist the court in its understanding and disposition of a given case. In some cases, apparent criminal behaviors result when unconscious motivating factors, particularly unconscious fantasies, find expression in conscious life. In this article, we consider the etiologic role of unconscious fantasy in certain seemingly inexplicable criminal behaviors. The concept of unconscious fantasy is explained and a detailed case description and formulation are provided in order to illustrate the central role of unconscious fantasy in some of these behaviors. Recommendations are offered for the manner in which psychodynamic formulation should be presented in reports and in courtroom testimony through reference to the author's experience.

Adult↗

PubMed1989

Adolescent child molesters: clinical observations.

Clinical assessments of 29 male adolescent child molesters referred to the Toronto Family Court Clinic showed that many were socially isolated, had chronic learning problems and had been maladjusted prior to committing their sexual offenses. The roles of drug and alcohol abuse, past sexual victimization, antisocial traits, disinhibition, peer-group influence, psychopathology and sexual deviance, alone or in various combinations, as causal factors for these boys' sexual offenses are discussed in view of previous studies and illustrated by case vignettes.

Adolescent↗

PubMed1988

Assessment, management, and treatment planning for male adolescent sexual offenders.

Adolescent sexual offenders are considered as a part of the larger group of emotionally disturbed youngsters. For purposes of clinical management, areas of overlap between the two groups are identified and issues specific to sexual offenders are delineated. Ethical issues, preventive interventions, the risk of recidivism, and the special problems presented by incestuous offenders are discussed.

Adolescent↗

PubMed1988

The court as a catalyst in the treatment process.

The role of the Court in the treatment process varies. In some cases it can work as a catalyst. We present the treatment of a family with a mother whose involving psychosis kept her daughter from attending school, and show how the power of the Court can be useful.

Adult↗

PubMed1987

A critique of the principles of the Young Offenders Act.

A unique feature of the Young Offenders Act is a section on the Principles of the Act. The principles clearly focus on the responsibility of young offenders, their legal rights, and the protection of society. The focus on the due process of the law is a welcome addition to the Juvenile Justice system. However, these principles do not recognize any other rights for adolescents, downgrade the importance of their needs, and do not take into account the cognitive, psychological and social functioning of adolescents. In addition, the principles implicitly reverse those important principles that have guided our society and the clinical process for more than a century; namely, a shift from a "therapeutic state" to a "legalistic state", the roles of institutions in our society, and the adultomorphization of adolescence.

Adolescent↗

PubMed1987

The assessment of custody and access disputes in cases of sexual abuse allegations.

Sexual abuse allegations directed at one parent can arise in the context of custody and access disputes. The role of the clinician, when such allegations occur, is to provide an assessment of the total situation, taking the allegations into account. To assess the probability that sexual abuse has occurred involves a thorough assessment of the accuser, the accused, the accusation, the child, and different family subsystems. Particular attention should be paid to interviewing the young child with detailed focus on the interviewing process, how the interviews are reported and what conclusions may be drawn from them. Following a thorough assessment, the clinician may reach one of three conclusions: that the sexual abuse has probably occurred, has probably not occurred, or is unsure. A strong caution is given against becoming entangled in an endless process of trying to find out whether the allegations are true or false. Whatever conclusions are reached are but one factor in the recommendation regarding custody and/or access. Ultimately the recommendation will be made according to the best interests of the child, taking into account the child's relationships and attachments, as well as the sexual abuse allegations.

Canada↗

PubMed1986

Male adolescent sexual offenders: the offender and the offense.

A group of male adolescent sexual offenders were divided into three groups: Courtship Disorders (Exhibitionism, Toucherism and Obscene Phone Calls), Sexual Assaults, and Pedophilic Offenses. Group I offenders tended to come from a less disorganized family background, were better adjusted to school and in the community and were seen by clinicians as less seriously disturbed than the adolescents in the other two groups. In addition, these adolescents did not experience the offense as a sexual act. Group II offenders (Sexual Assaulters) came from a more disturbed family background characterized by a high rate of long-term parent-child separations, committed more violent offenses and had a higher frequency of intellectual functioning in the Borderline Range of Intelligence. Group III offenders (Pedophilic Offenses) were Canadian born, had witnessed physical violence between their parents, were described as having been infants who did not enjoy being cuddled and had siblings who were truant. This study suggests that classifying adolescent sexual offenders along the line suggested in adult literature seems to be justified.

Adolescent↗

PubMed1978

Basic principles in custody assessments.

The paper discusses some of the principles of custody assessments in divorce proceedings. It is felt that such assessments should be undertaken only upon the request of the judge or both lawyers. The assessment should be extensive and should include collecting and collating all available data obtained through interviews or letters. The report should include historical material, the formulation, and the reasons for the recommendations. Clinically, the important issue is to decide under whose care the child's growth and development is enhanced. Factors that help in this decision include the emotional ties between the parent and the child, the capacity of each parent to provide physically and emotionally, the preference of the child, and the need for continuity. The psychiatric and moral "fitness" of parents is critically reviewed. It is maintained that no parent should be given an inherent preference in custody rulings. Finally, it is argued that access should be expected after divorce and should be changed or eliminated only under strict conditions.

Adult↗

PubMed1976

Father-son incest: a case report.

A case of father-son incest is presented. There were three sexual involvements over a period of 6 weeks that ranged in activity from genital fondling to anal penetration. The father was the initiator of the activity and was drunk during each of the episodes. The son passively submitted while the mother denied the activity when told about it after the first episode. The marital situation had deteriorated over the years to an almost complete breakdown of communication. The father had been struggling with latent homosexuality for a long time, and the alcohol triggered the incidents. There was no evidence of any special relationship between father and son, except for the acting-out behavior and the challenging of parental authority by this particular son. Short term, behavior-oriented marital sessions helped to improve the situation at home.

Father-Child Relations↗

PubMed1976

A female fire-setter: a case report.

A case of a 12 1/2-year-old female fire-setter is presented. The symptom was the result of long term developmental problems precipitated by the onset of puberty. Psychoanalytically oriented individual psychotherapy combined with marital and family therapy were the modes of treatment. The continuous struggle to establish a therapeutic alliance with an early adolescent is discussed. A patient whose main mechanisms of defense are repression, suppression, denial, and projection presents a challenge for the therapist.

Age Factors↗

PubMed1975

Psychiatric consultations in a pediatric hospital.

The authors conducted a study of 30 hospitalized children who were referred for psychiatric consultation and 60 hospitalized children who were not. They studied the medical charts of these children and administered a questionnaire including a checklist of behavioral symptoms to their parents. More psychopathology was found in the children referred for consultation, but about 20 percent of the children not referred also showed a high degree of psychopathology. Factors found to be associated with referral for psychiatric consultation were older age, longer hospital stay, many previous hospitalizations, and ambiguous diagnoses.

Age Factors↗