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Biomedical subjects

M Viederman

Publications and source records attributed to M Viederman.

At least 37 records · Page 2Linked to original sources
PubMed1986

Personality change through life experience. (I): A model.

This paper offers a model for understanding personality change through life experience. The elements that led to the change in the patients described include a defective self-representation and a motivation to achieve an ideal self-representation; a decision to test the self-representation through an action in real life; the felicitous presence of an important object who contributed to the consolidation of a new self-representation in the context of the test; and identification with this object. The contributions of Hartmann, Hendrick, and White offer a theoretical substrate for understanding such change. The special importance of crisis, the potential for the development of psychopathology under other circumstances, and the personality characteristics of patients amenable to change are discussed.

Adult↗
PubMed1983

Meaning as an intervening variable.

In this paper, the author emphasizes the practical importance for the internist of determining the underlying content of the patient's fantasies about his illness and its treatment. These fantasies are often the cause of the anxiety and depression that accompanies physical illness and may be quite divorced from the reality of the situation. When the particular fantasies are elicited, the physician will be in a position often to directly reassure the patient about unrealistic concerns. By communicating his understanding, the physician increases the power of the patient's bond to him and is in a position to substantially alleviate emotional distress that stems from physical illness.

Adaptation, Psychological↗
PubMed1983

The psychodynamic life narrative: a psychotherapeutic intervention useful in crisis situations.

The Psychodynamic Life Narrative is a psychotherapeutic maneuver used during the first few sessions of a consultation with a patient in a crisis situation. By establishing a powerful bond between physician and patient, it offers the possibility of a rapid relief of dysphoric symptoms. In some situations, it may be useful in mobilizing a recalcitrant patient to accept psychotherapy or, in the case of the physically ill, to accept diagnostic procedures and treatments previously refused. It is most effective in patients whose general adaptation has been stable and whose psychological homeostasis has been disrupted by a life event of real and symbolic significance. Though the psychodynamic life narrative was first explored as a therapeutic maneuver in the treatment of depression in the physically ill (Viederman and Perry 1980), for reasons which will be described below, it has applicability to other situations of crisis--in some cases crises that have occurred in the distant past and left residual symptoms. This maneuver is not presented as a substitute for long-term psychotherapy or psychoanalysis where this is required and possible, and has distinct disadvantages where these treatments are contemplated. However, in some situations it may lead to significant change, particularly in the area of self and object-representations.

Adjustment Disorders↗
PubMed1982

Children of dialysis patients.

The authors interviewed and administered projective drawing tests to 14 children of dialysis patients in order to understand the children's fantasies about their parents' illness and treatment. They uncovered latent aggressive feelings toward the sick parent among a majority of the children and found that many children defended themselves against these feelings by identification with the sick parent or by pseudomature behavior (reinforced by the parent). The authors believe that the dialysis of a parent has a profound impact on the development of these children and stress the need for further investigation.

Adolescent↗
PubMed1981

Adaptation of residents to consultation-liaison psychiatry. I. Working with the physically ill.

When working with hospitalized physically ill patients, psychiatry residents may impose a pseudoanalytic, rigidly biological, or overly sympathetic approach. These approaches often fail to address the special requirements and altered psychological state of the physically ill. To have a therapeutic impact on such patients, the psychiatrist needs to assume an engaging, more spontaneous "therapeutic stance" and deviate from anonymity, abstinence, and neutrality. In learning how these deviations are dictated by the therapeutic intent by the patient's character style and psychodynamics, the resident acquires a model of influence useful in other areas of psychiatry.

Adaptation, Psychological↗
PubMed1981

Adaptation of residents to consultation-liaison psychiatry. II. Working with the nonpsychiatric staff.

When working with the staff in a general hospital, psychiatry residents may be overly competitive, solicitous, or detached. These defensive reactions often arise because of the special challenges of performing a consultation, including the skepticism about the value of psychiatry and the demeaning or unrealistic expectations about what the psychiatrist can do. Furthermore, the psychiatry resident feels even more challenged if the attitudes and behavior of the staff must be changed for the patient's benefit. To affect this influence on the staff the psychiatry resident may need to assume a "liaison stance." This stance involves not only establishing a collegial alliance but also using modified therapeutic maneuvers to alter staff behavior. By applying psychodynamic knowledge to understand and potentially to influence the staff, psychiatry residents, as participant observers, can feel less helpless and frustrated by difficult liaison situations.

Adaptation, Psychological↗
PubMed1980

Use of a psychodynamic life narrative in the treatment of depression in the physically ill.

Depression, unlike grief, is a maladaptive response to the crisis of illness. This crisis has certain characteristics: (a) psychic disequilibrium with confusion and uncertainty; (b) regression with intensified transferences; and (c) a tendency to examine the trajectory of one's life. This situation makes the patient not only more vulnerable but also more responsive to intervention. These characteristic reactions of illness can be considered in designing a therapeutic maneuver to treat depression. Three cases are used for illustration. In each case a depressed patient was presented a statement that placed his physical illness in the context of his life trajectory and demonstrated the psychodynamic logic of his depression. We call this intervention a "psychodynamic life narrative." The therapeutic effect of such a narrative and the type of patient most likely to benefit from such an intervention are discussed.

Adolescent↗
PubMed1976

The influence of the person of the analyst on structural change: a case report.

This paper attempts to demonstrate how values and attitudes of the analyst are inevitably communicated through the interpretative process and how they lead to structural change. Details of the analysis of a woman with a defective feminine self-representation are presented. A transference fantasy of the analyst's wife led to a fantasied ideal object with subsequent identification and modification of structure.

Attitude of Health Personnel↗
PubMed1975

Psychogenic factors in kidney transplant rejection: a case study.

The author examines the influence of psychic factors on kidney transplant rejection in a patient who suffered emotional trauma. As an adolescent, this man had reacted to the death of his father with an incomplete mourning response and had coped with the loss through identification and a search for surrogates. The death of a paternal surrogate immediately preceded the transplant rejection. The author emphasizes that the establishment of a causal relationship between a somatic event and a psychic antecedent is facilitated by demonstrating that a latent conflict has been evoked symbolically by an external event. Further research into such correlations could significantly enhance our understanding of disease processes.

Adaptation, Psychological↗