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Biomedical subjects

L Havens

Publications and source records attributed to L Havens.

At least 19 recordsLinked to original sources
PubMed2000

Making a future.

Explore the source record for details and available documents.

Decision Making↗
PubMed2000

Success in life for older adolescents with cerebral palsy.

In this article, the psychosocial themes emerging from an exploratory qualitative study are reported. Using a constant comparative method, the authors describe how older adolescents with cerebral palsy defined success in life and the factors they viewed as helping or hindering their success. Participants were 10 adolescents with cerebral palsy between 18 and 20 years of age who took part in a semistructured interview exploring their perceptions of success. For these adolescents, success meant being happy in life. Three key psychosocial factors were related to success in life: being believed in, believing in yourself, and being accepted by others (belonging). The findings are useful in guiding the design of services to meet the life needs of individuals with disabilities.

Adolescent↗
PubMed1999

A symposium on psychotherapy in the age of managed care.

This article is based upon a symposium presented at Vanderbilt University Medical Center on the Department of Psychiatry's 50th anniversary (September 20, 1997). The panel of psychotherapy scholar-clinicians discusses issues including: whether or not managed care and psychotherapy are compatible; the relevance of the Consumer Reports' psychotherapy study to MCOs' emphasis on brief therapy; how MCOs impact upon the therapist-patient relationship; the effects of MCOs on the psychotherapist's personal and professional identity; and training psychotherapists in the era of managed care. The paper is dedicated to Pietro Castelnuovo-Tedesco, M.D., Vanderbilt's Blakemore Professor of Psychiatry, who died on January 24, 1998.

Humans↗
PubMed1994

Psychotherapeutic management techniques in the treatment of outpatients with schizophrenia.

Successful outpatient treatment of schizophrenic disorders largely depends on the patient's ability to form a treatment alliance with mental health professionals. However, even in the context of competent pharmacotherapy, symptoms of schizophrenia often persist under this alliance. The authors review five common syndromes occurring during the course of treatment of patients with schizophrenia that interfere with the therapeutic alliance: paranoia, denial of illness, stigma, demoralization, and terror from awareness of having psychotic symptoms. Mental health clinicians can use specific psychotherapeutic management techniques for these symptoms. Examples of these techniques include "sharing mistrust" for paranoid patients, providing patients who deny their illness with alternate points of view, making admiring and approving statements to demoralized patients, and normalizing experiences of stigmatized patients. The techniques do not require advanced psychotherapy training and can be used, with ongoing supervision, by bachelor's-level mental health workers.

Adult↗
PubMed1993

The treatment of paranoid phenomena: the development of the self.

The two main problems of patients suffering from paranoid phenomena are discussed from a treatment perspective. These two problems arising from "having trusted too much" and having lost "ownership of the self" result in the classic projections and loss of initiative commonly seen in paranoid psychopathology. Clinicians must first ward off the patients' projections and help patients work toward a position of "healthy skepticism." This article shows: (1) the specific role of narcissism, its structures and processes, as they contribute to the internal changes needed to achieve this goal; (2) how clinicians can rekindle important sources of initiative and aspiration within the patient. Selfobject relationships, the agency of the ego ideal and the role of the affects of hope and affection, along with such specific interventions as "performative statements," have been offered as helpful tools for clinicians who work with paranoid patients.

Adult↗
PubMed1991

Paranoid phenomena and pathological narcissism.

Paranoid phenomena can be seen to arise from pathological narcissism. As a result of certain kinds of trauma to the ego-ideal and/or losses of important self-object relationships, the self becomes dislodged from internal agencies and representations. Narcissistic cathexis of the self to these internal psychic structures loosens and hope, aspiration, affection and will become markedly diminished. Meaningful goals and choices become impossible to adopt and make. The paranoid patient is internally at "loose ends"; he is lost. Tragically, being gripped by the paranoid condition and its manifest delusional system is the only kind of security that the paranoid patient knows. No wonder it is so hard to give up. The vulnerability to paranoid phenomena may be seen to be a result of past experiences of subversion of "selfhood." In significant ways, the patient vulnerable to paranoid phenomena has not been adequately attended nor adequately "left alone." The self can be seen as arising out of crucial mother-infant exchanges that are paralleled by interactions between developing internal psychic structures. Out of these "reflections," the self is born. The narcisstic cathexis of self to the ego, superego and ego-ideal is the result of self-expression. If full self-ownership has not been possible then self-expression is vulnerable. Given these understandings of the relationship between paranoid phenomena and pathological narcissism, treatment will focus on reducing the threats to selfhood, refinding the self, and reestablishing ties to internal sources of affection, initiative and aspiration.

Ego↗
PubMed1986

A theoretical basis for the concepts of self and authentic self.

Concepts of self of Grossman, Kohut, and Kernberg are briefly summarized and some limitations suggested. The author proposes a theoretical basis of the concepts of self and authentic self parallel to superego development and the concept of ownership of impulses and values.

Defense Mechanisms↗
PubMed1979

Explorations in the uses of language in psychotherapy: complex empathic statements.

I have suggested (1978) that the language occurring to us in personal and psychotherapeutic speech reflects our distance from one another, and that the empathic position in particular evokes emotional reverberations and spontaneous verbal accompaniments which serve to identify that position. I have also suggested some prototypic forms of this spontaneous empathic speech. A clinical anecdote and two observations will illustrate these points and prepare for the discussion of more complex empathic forms.

Attitude of Health Personnel↗
PubMed1978

Explorations in the uses of language in psychotherapy: simple empathic statements.

I submit these ideas with hesitation. They seem to rest on a particular assumption widely at variance with contemporary practice and itself difficult to state. The prevailing assumption has been that the content of a person's mental life, symptoms, or experience lay in that person's mind, and that by asking questions, listening, in various ways making ourselves receptive, we could penetrate that mental life. In this traditional manner of thinking, the language of penetration has been secondary to the material being reached. In contrast, I suspect that the language of investigation and therapy is as important as the matter being investigated or treated--that in fact the two bear a symbiotic relationship to each other.

Adult↗