[Schizophrenia as dialectic of psychotic forms and psychological contents].
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Biomedical subjects
Publications and source records attributed to G Benedetti.
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This article is a survey of the present stage of development of perinatal psychology. The author discusses critically the results of the international literature on this topic according to his own psychiatric experience. He stresses how the methodology of the research lies in the dialectics of psychodynamic understanding and the point of view of the psychobiological sciences.
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1. The author tries to consider at first the development of psychotherapy in shizophrenic patients in a historical review which sees the present emerge from the fusion of three main tendencies of thinking. 2. He then traces the actual stage of his own thirty-year evolution of work and shows, how schizophrenic symptoms can be turned into special forms of communication in Psychotherapy. 3. Psychotherapy in schizophrenia seems to be, by this aspect, the place where the contributions of psychoanalysis, by Freud, of analytical psychology, by Jung, of Daseinsanalyse by Binswanger and of the American transactionalism join in operational patterns of the psychiatric communication.
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The work of the author and others in the field of psychotherapy of schizophrenia is said to have demonstrated that understanding the patient requires a special therapeutic relationship which is different from that in the psychoanalysis of neurosis because it implies an intrapsychic process that can be described as follows: Parts of the ill personality are introjected by the psychotherapist and parts of his personality are adopted by the patient, as shown by the fact that the dreams and the unconscious fantasies and striving of the therapist reflect the anxieties of the patient, and the dreams of the latter are structured by the inner movements of the former, as if there were a partially shared identity between them both. This phenomenon is called "identification." The psychotherapy of schizophrenia reveals realms of existence in which understanding is not only a function of personality, but also a transformation of personality by the act of being near the patient.
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1. The kinetics of the plasma disappearance of bilirubin (2 mg/kg intravenously) were studied in 106 patients with Gilbert's syndrome and in 13 normal subjects. 2. All patients had significant decreases in hepatic bilirubin clearance and transfer rates from plasma to liver, resulting in increased values for plasma retention at 4 h. The calculated value for unconugated bilirubin production was normal in 40% of patients and increased in the remainder. 3. In 29 of the Gilbert's patients their bromosulphthalein kinetics were studied 1 week before the bilirubin test. These results were essentially normal and it was concluded that the hepatic clearance mechanisms for bilirubin and bromosulphthalein are different. 4. In 10 patients the bilirubin transport maximum (Tm) was found to be low whereas the relative storage capacity (S) was normal. Phenobarbitone treatment in four patients resulted in an increase in Tm, and S decreased in two patients and remained unchanged in the other two. 5. These results support the hypothesis that there are several variants of Gilbert's syndrome and that the bilirubin tolerance test is a useful diagnostic test.
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The instrumental construction of 5 basic dimensions of ego-consciousness (ego-vitality, -activity, -consistency, -demarcation, -identity) is presented as a means of synopsis the clinical polymorphism of schizophrenic experience and behaviour. Such consideration leads to the insight how deep in their basic feelings of vitality the schizophrenic person may be endangered. From that a body-oriented therapy is conceived, which is presented in datail. The commentary of G. Benedetti points out, how in different therapeutic approaches a common basic attitude of the therapist and a unifying synthetic relationship between therapist and patient can be seen: in duality, empathic sharing of psychotic experience, symbolic realization the narcissistic deficit is overcome. The resynthesis of the ego starts from the present experience rather than from analytical interpretative historical reconstruction.
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Transference as well as counter transference is necessary within the therapy of neuroses; but with the relation between doctor and patient in psyotherapy certain components form processes of identification and counter identification between those two partners of the therapeutic event. Way, meaning and form of these processes leading to a new creation of identity in the patient are discussed in the following study. The nature of psychotherapy of schizophrenia as well as some theoretical aspects are lightened.
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This paper presents the psychodynamic investigation of a case of schizophrenia, which developed on the basis of a LSD-psychosis. It is a contribution to a treatment of schizophrenia, in which the coexistence of biological and psychological factors is taken into consideration. Biological premises do not invalidate the psychological understanding of many symptoms. Psychodynamic experience permits the psychiatrist to encounter the patient adaquately, even if the possibility for a long psychotherapeutic treatment is absent.