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Biomedical subjects

L Wurmser

Publications and source records attributed to L Wurmser.

At least 19 recordsLinked to original sources
PubMed1985

Denial and split identity: timely issues in the psychoanalytic psychotherapy of compulsive drug users.

Quite generally, psychotherapy and psychoanalysis are under great pressure today to account for what they are doing, to prove their scientific validity and their therapeutic efficacy. Those of us who use clinical experience in conducting their practice in ways which seem optimal, as judged both by them and by their patients, are increasingly challenged to respond to a canon of scientific method and validity that claims its brief for truth. What I am going to say will not live up to such high standards of proof, but will simply reflect my clinical experience: what helps and what fails with most patients that come to me, often after a string of previous treatment failures. What I am going to say claims practical usefulness, not ultimate scientific truth. I would like to highlight a number of issues that have proven themselves as of special importance for the long term treatment of substance abuse dependent patients. The first is the role various forms of denial play and how these might best be approached. Multiple layers of denial entail usually some form of split identity--rapid alternations from one part identity to the other. Then I shall briefly study the role of impulsivity and of various forms of impulsive action. These topics of denial, split identity and impulsive action dictate some reflexions on attitude and technique necessary for the long term psychotherapy of patients with prominent problems of substance abuse and impulsivity. I shall conclude with some more general recommendations for the future of psychotherapy with substance abusers.

Adult↗
PubMed1984

More respect for the neurotic process: comments on the problem of narcissism in severe psychopathology, especially the addictions.

In dealing with and writing about psychopathology and psychodynamics, there has been in the past 20 years an increasing shift towards stressing their closeness to the psychoses and emphasizing the archaic nature of the inner processes. With that there has developed a special regard for a "defect psychology." This change has had momentous implications for the attitude towards patients and the treatment approach. The discussions about such changes center on the concept of narcissism. The paper advocates, in contradiction to these moves, the continued use of the model of conflict theory and, hence, a consistent focus on the defenses in psychotherapy and psychoanalysis, with all that this specifically entails for the treatment and understanding of the addictions, as illustrated by four case vignettes.

Adolescent↗
PubMed1977

A defense of the use of metaphor in analytic theory formation.

This study of psychoanalytic theory formation is based on the epistemology of Cassirer and Langer. It postulates the need of all sciences to operate with symbols of various levels of abstractions, including, in a very prominent way, metaphors. There is not just one scientific method. The current wave of criticism against psychoanalytic theory from within and without, and especially of its use of metaphor in theory formation, is based on a philosophy of radical empiricism which cannot do justice to the science of psychoanalysis.

Humans↗
PubMed1976

Therapeutic effects of methadone and 1-alpha-acetylmethadol.

Many heroin addicts prefer methadone maintenance treatment to 1-alpha-acetylmethadol(LAAM) because of the "rush-like" effect of methadone. Although there have been no observable differences in the safety and effectiveness of the two drugs, LAAM appears to lead to a more stable, consistent physiological state. The authors report on two patients who had ego defects characterized by severe mood swings. Both patients preferred LAAM to methadone because of its stabilizing effect and smoother action.

Adult↗