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Biomedical subjects

J V Fisher

Publications and source records attributed to J V Fisher.

17 recordsLinked to original sources
PubMed2000

A father's abdication: Lear's retreat from 'aesthetic conflict'.

The author explores the potential contribution of Shakespeare's 'King Lear' to psychoanalytic thinking, linking a reading of the play focused on the emotional tensions inherent in the parental function of endowing ('heriting') the next generation with the developmental struggle characterised by Donald Meltzer as the 'aesthetic conflict'. Following Meltzer's definition of passion as the 'consortium' of Bion's emotional links, love, hate and the urge to know (L, H and K), the author develops an understanding of 'aesthetic conflict' linked with the tension inherent in that constellation. It is suggested that L and H split off from each other and from K become attempts to possess and control, while K split off from L and H becomes an attack on dreaded emotional links, oscillating between attempting to ignore them and attempting to overcome them. The author suggests an affinity between Bion's K link and what in 'King Lear' is pictured as a capacity to 'see feelingly' in the context of the struggle to give the object its freedom. This way of characterising 'aesthetic conflict' is linked with a fresh look at weaning as a lifelong developmental process, which in turn leads to a reconsideration of the psychoanalytic models of the dynamics of mourning.

Conflict, Psychological↗
PubMed1978

Three approaches to the recognition of affective disorders in family practice: clinical, pharmacological, and self-rating scales.

No single approach to the recognition of affective disorders worked in a ten percent sample of a family practice population, screened in the summer of 1975. Among 298 adults followed prospectively for two years, about six percent developed an affective disorder (3.8 percent anxiety, 1.9 percent depression, and 0.4 percent episodes of both). The sex ratio was predominantly female (2.7:1). Most of the cases were recognized by clinical problem lists, but 23 percent of the cases would have been missed without a computerized search of prescribed drug profiles. Self-rating tests (Zung for depression and Reeder for anxiety) performed poorly at predicting cases prospectively, and unimpressively in retrospect. The burden of these disorders is considerable, with a prevalence in this population of at least 19 percent. Of these cases, 22 percent had "mixed" episodes of depression, anxiety, and combinations seen at various visits. Criteria for diagnosis need to be clarified for more precise diagnosis, proper medication, as well as better estimates of incidence and patient load.

Adult↗
PubMed1977

Developing behavioral science for a family practice residency.

The development of behavioral science in a family practice residency has first to be structured around a statement of purpose and adequate goals. These goals can only be implemented when the purely custodial function of the medical profession is rejected and the ethical responsiblity of the physician to society is allowed to direct the role innovations that must be incorporated. It is the person of the physician as a diagnostic and therapeutic tool that must be cultivated. The curriculum presented has included behavioral science conferences, a one-month behavioral science rotation, a two-month orientation program, behavioral science clinical attendings, and a personal counseling program for each resident throughout the three years of training. To be complete, such a program requires the further refinement of behavioral objectives that allow reliable evaluation and redefinition by residents and faculty.

Behavioral Sciences↗
PubMed1976

A diagnostic formula for alcoholism.

Clinical pathologies with unusually high morbidities in alcoholic populations were analyzed to determine their capacity to diagnose alcoholism. On the basis of five systemic variables it was possible to diagnose correctly nearly 75% of alcoholic and matched control subjects.

Age Factors↗
PubMed1976

Management of the psychotic patient by the family physician.

The management of psychotic illness has taken some new directions since 1950. One of the effects of these changes is increased responsibility for care of psychotic patients within their own community. Family physicians are expected to play a significant part in the pre-hospitalization and after-care for these patients and their families. A training program to equip the family physician to give such care should provide the physician with: (1) skills to detect incipient psychotic illness and the ability to intervene at this stage; (2) a working knowledge of the psychoactive drugs; (3) awareness of the available community resources and the ability to mobilize them to provide a network of support for the psychotic patient and his family; and (4) an understanding of family dynamics and behavior. A training program which encompasses these essential elements will allow the family physician to provide the type of care that his patients/families and his community expect of him.

Community Mental Health Services↗
PubMed1976

The post-suicide family and the family physician.

It is estimated that there are 750,000 people each year who are intimately affected by suicide. Prominent among these are the family survivors and their family physician. This paper offers a time frame which divides the period following the suicide into three phases: Immediate (the first ten days after the suicide); Intermediate (after the first ten days through the first year); and Extended (from the first year until restitution occurs). It identifies the chief emotional reactions which occur in each phase, explores their psychodynamic origins, and proposes suggestions for appropriate management during each of the three periods. The goal of this plan of management is to enable the family physician to function in a supportive emphatic, and restorative manner for the post-suicide family.

Depression↗
PubMed1975

Physicians and alcoholics. The effect of medical training on attitudes toward alcoholics.

The over-all ratings assigned by first- and second-year medical students and housestaff (residents and interns) to alcoholics on a 16-adjectivee bipolar semantic differential measure differed significantly. Mean ratings by the housestaff were lowest and the ratings by the second-year students were lower than those of the first-year students on 5 of the 6 adjective pairs on which the groups differed significantly.

Alcoholism↗