Biomedical subjects
Publications and source records attributed to M V Seeman.
The total population of a community schizophrenia registry sample yielded information about the relative lifetime frequency of hallucinations in women and men. Whereas hallucinations in non-auditory modalities were equally distributed between the two sexes, auditory hallucinations were significantly more common in women. These results will be considered in relation to the existing literature on hallucinations and gender.
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Is long term psychiatric care superfluous? Can it be provided by non medical therapists? This paper examines this question from the perspective of one patient who was in therapy for 20 years.
Schizophrenia is a continuing and relapsing disorder that begins in early adulthood and lasts indefinitely. Effective treatment, therefore, needs to be long-term and comprehensive. The physician must be able to control disabling symptoms while minimizing the side effects of neuroleptic medication. The lifetime risk remains of depression and suicide, paranoid crisis, social distress and frequent rehospitalization. It is a medical responsibility not only to look after the schizophrenic patient's health but also to coordinate social and emergency services, improve the quality of life, support the family and anticipate problems in offspring. At the time, the physician needs to consider the welfare of the community in which the schizophrenic patient lives.
Five women with excessive and irrational jealousy of their spouses have long defied my therapeutic efforts and have prompted me to explore the sources and the ramifications of conjugal jealousy. This paper presents my experiences and the formulations that have emerged from them.
Four dreams are reported in which associations leading to previously unacknowledged material were elicited by asking about names. Inquiry into names and distortions of names (rhymes, puns, contractions, initials, visual symbols) is a useful technique in the provocation of emotionally-laden connections. A possible explanation lies in the parallel between naturally occurring name transformations and the dream work of regression, displacement, condensation and symbolization.
Marital therapy has developed techniques which do not, for the most part, rely on the individual psychiatric diagnosis of the 2 partners. When both spouses suffer from Borderline personality disorders, the standard techniques do not seem to apply, are difficult to put into effect and the results of therapy are poor. The authors illustrate their experience with the description of a 3 month trial of marital therapy involving a borderline couple. The outcome suggests the need for careful individual and interactional diagnosis prior to marital therapy. Specific psychotherapeutic techniques should be tested for use with Borderline marriage partners.
Erotomania is reexamined by an in-depth study of eight patients. There appear to be two main varieties: the phantom lover syndrome, or fixed delusion elaborated around a person who does not exist, and erotomania proper, a recurrent tendency to believe that one is loved by a powerful, prominent man.
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Thirty patients with a hospital diagnosis of schizophrenia were randomly assigned upon discharge to either 1) a specialized aftercare clinic of 2) to private psychiatrists. At the end of six months, the clinic patients had spent significantly less time as hospital readmissions and were significantly more occupied (i.e. employed or in school) than the private patients. It seems possible that attendance at clinic provides group pressure to maintain drug compliance and may thus work to reduce rehospitalization. It is also likely that the network of clinic paramedical and volunteer staff, by its flexibility and availability, aids the patient's transition into employment.
It is possible, albeit reductionistic, to consider the many dysfunctions of reality testing found in schizophrenia as manifestations of a defective time sense. This perspective on schizophrenic discourse, for instance, permits a new grasp of "schizophrenic logic" and a novel approach to therapeutic interpretation. The present paper describes the use of time-related interventions in the psychotherapy of a schizophrenic patient. Several aspects of time sense are outlined. Under each heading are examples from the psychotherapy of Carrie, demonstrating her idiosyncratic notion of that particular temporal concept. Interpretations are aimed at clarifying the cognitive assumptions underlying the patient's expressions.
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Abandonment in love brings with it considerable psychiatric casualty. Although time usually heals, it may also reinforce psychopathologic attitudes. The main task of psychotherapy is to offer an explanation, stretched over time, which is emotionally acceptable, protects self-esteem, and diminishes the fear of new alliances.
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