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Biomedical subjects

M T Notman

Publications and source records attributed to M T Notman.

At least 19 recordsLinked to original sources
PubMed2002

The hormone replacement therapy controversy.

The issue of hormone replacement treatment for menopausal symptoms, osteoporosis, various cardiac problems, and other disorders has received a great deal of attention. Recent data concerning the benefits and risks have changed ideas about indications and contra-indications. In this paper we will consider the multiple factors that determine an individual woman's decision about taking or continuing to take hormone replacement therapy, not only the medical indications. We will discuss the established benefits of replacement therapy, conditions for which the benefits are not established, areas of controversy, risks of treatment, and factors underlying the decisions about undergoing the treatment.

Adult↗
PubMed2001

Psychiatrist-patient boundary issues following treatment termination.

OBJECTIVE: Psychiatrist-patient relationships after termination of treatment are fraught with complexities and are the subject of ongoing debate. The authors discuss the issue of boundary violation allegations that arise after treatment has ended, with the goal of explicating how these issues have been handled in psychiatric discussions as well as in broader sociolegal settings. METHOD: Clinical illustrations and legal cases are used to illustrate how legal and administrative bodies have dealt with posttermination boundary issues. RESULTS: Courts and regulatory bodies have tended to use the psychoanalytic concept of transference to decide issues in which there has been a complaint of impropriety-be it romantic, financial, or social in nature-arising after termination of treatment. However, a multitude of treatment approaches are currently employed in psychiatry, and often their practitioners either do not use the concept of transference or deny its validity. If the concept is used, it is often present in many settings outside therapy. CONCLUSIONS: The concept of transference is subject to continuing debate and modification within psychoanalysis, and its use in judicial or quasijudicial settings raises questions about whether it meets standards of scientific acceptance. Using the concept of transference to decide posttermination issues results not only in confusion but also has the potential for many adverse consequences for practitioners and the profession.

Adult↗
PubMed1989

Depression in women. Psychoanalytic concepts.

I would now like to summarize the relationship between concepts about depression and formulations of feminine development and personality. What are women's vulnerabilities? 1. The particular vicissitudes of feminine development result in differences, in attachment and anxiety about loss of love and abandonment as part of the normal constellation of feminine personality. These derive, in part, from the difference in the process of separation-individuation and differentiation in women as compared with men. 2. The normal feminine personality includes responsiveness and/or dependency in relation to others and greater anxiety about loss of love. This sensitivity is important in the regulation of and fluctuations of self-esteem. 3. The pathways for development of aggression and its fate includes the powerful effect of social customs that prescribe passivity with consequent likelihood of helplessness and the relatively fewer pathways for activity and active mastery. 4. Problems of self-esteem, including those resulting from the recognition of aggression and also the development of an ego ideal that values sacrifice and service. Devaluation of the female body contributes. 5. Problems of identification with a devalued person as a woman--the mother--who is sometimes also depressed. 6. Sex-role stereotypes and life conditions that support devaluation, subservience, and helplessness and limit opportunities.

Depressive Disorder↗
PubMed1988

Anxiety, depression, and menstrual symptoms among freshman medical students.

Based on data from a larger longitudinal study of medical students and physicians, this study establishes the incidence of some menstrual symptoms in a nonclinical population of 82 healthy, female, first-year medical students and investigates the correlation of self-reported anxiety and depression scores with these symptoms. Findings show that nearly half reported the frequent occurrence of at least one menstrual symptom that appeared to cause discomfort but did not interfere with performance. The data suggest an association between anxiety and depression scores and certain self-reported menstrual symptoms in this population. The study suggests the need for further investigation of the nature of the relationship between dysphoric moods and menstrual symptoms in healthy women.

Adult↗
PubMed1987

Psychotherapy with the substance-dependent physician: pitfalls and strategies.

Psychotherapy with substance-dependent physicians presents special problems. Accurate assessment and effective response is rendered difficult due to underrepresentation or denial by the patient and countertransference impediments to recognition and limit setting by the therapist. Case examples illustrate problems, pitfalls, and therapeutic strategies.

Adult↗
PubMed1986

Pregnancy, developmental crisis and object relations: psychoanalytic considerations.

The psychoanalytic literature until recently was focused on the task of understanding and conceptualizing motherhood as 'not secondary' (to the girl's wish for the penis) but the central organizer of the woman's sexual drive. Pregnancy was viewed as a developmental crisis but little had been written on the internal shifts and realignments in the mental organization of the woman during pregnancy. Material from the analyses of three women during their first pregnancy is discussed and some theoretical conclusions are offered.

Adult↗
PubMed1984

Factors influencing first-year medical students' perceptions of stress.

This preliminary report from an ongoing longitudinal study of students at both Tufts and Harvard medical schools examined the relationship between premedical school demographic and stress variables and the numbers and types of stresses reported by students in open-ended interviews conducted during their first year of medical school. Analyses showed that the general categories of "medical school stresses" and "social stresses related to medical school" accounted for about two-thirds of the total number of stresses mentioned. The overall distributions of stresses across general categories were remarkably similar in all student groups studied, although significant differences were found between students from different background groups on a number of the specific types of stress. No significant differences were found between groups as to those reporting a high total number of stresses. There did appear to be differences in the degree to which students felt affected by the stresses they reported, suggesting the need for additional data on the meanings of different stresses for different students and the ways in which they cope with them.

Adult↗
PubMed1982

A follow-up study of rape victims.

Of 130 women initially seen in a general hospital emergency room after being raped, the authors were able to interview 41 of the women 1-21/2 years after the rape. Half of the women continued to fear being alone and three-quarters reported still being suspicious of others. Many also felt restricted in their daily lives and had self-reported episodes of depression and sexual problems, which they attributed to the rape; none had a history of mental or emotional disturbance. The authors recommend that short-term, issue-oriented therapy be made available for all rape victims, as well as resources for the treatment of long-term symptoms.

Adaptation, Psychological↗
PubMed1981

To marry or not to marry: a choice.

The authors discuss the reasons for decisions to remain single or to marry, particularly for women today. They consider aspects of the life experience of single women and provide a developmental context for women's choices. The authors discuss the impact of marriage on women's lives and point out that marriage increases stress for women. The changing role of women in society and increased reproductive control have given women greater choice about the direction of their lives, including more freedom to make deliberate decisions about marriage.

Adult↗
PubMed1981

Women in academic psychiatry: politics and progress.

The progress of women in academic psychiatry depends in part on the social and institutionalized administrative patterns expressed through faculty attitudes, hiring practices, and other conditions of the field as they are currently structured. As the numbers of women increase, their specialness will decrease, and accommodations to particular needs and variations may become accepted as part of the system. This success in modifying the system will be self-perpetuating, proportional, and appropriate, leading to more participation of women in academic psychiatry.

Career Mobility↗