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Biomedical subjects

R C Lane

Publications and source records attributed to R C Lane.

8 recordsLinked to original sources
PubMed2001

The relational treatment of dissociative identity disorder.

The intent of this paper is to review the literature pertaining to the transference and countertransference components in the treatment of dissociative identity disorder. Aspects of transference and countertransference are presented and discussed within the relational psychoanalytic model. The functions of empathy, enactment, projective identification, and transitional objects are reviewed. Specific attitudes in the transference and countertransference are illuminated and major transference themes are discussed. Finally, a case vignette illustrates some of the central issues involved in the treatment of dissociative identity disorder.

Countertransference↗
PubMed1998

Identity confusion, bisexuality, and flight from the mother.

This paper deals with the effects of an oral-sadistic annihilating mother on her male and female offspring. The all-powerful nature of these mothers, and the corresponding helplessness of the fathers, produce in their offspring a sense of identity confusion, a struggle with their bisexuality, and a need to distance themselves from their mother. Everything unwanted in the mother is externalized onto and into the child, particularly suffering and pain, which are necessary for the maintenance of the (pathological) mother-child relationship. Positive movement (i.e., success) on the child's part threatens the balance of this relationship, is perceived by the child as a hostile and destructive triumph over the mother, and causes the Negative Therapeutic Reaction in therapy. The child's inherent masochism acts to preserve the early infantile omnipotence and leads to his/her assumption of all responsibility for the mother's affective states. The child's self-destructiveness also functions as a release for unconscious aggression toward the mother, due to the lack of boundary differentiation between the two.

Anxiety Disorders↗
PubMed1998

Directions in psychoanalysis.

This article is intended to familiarize the general practitioner with the important concepts in the practice of psychoanalysis. It provides an overview of the development of the field of psychoanalysis, considering it as theory of personality, as an explanation of psychopathology, and as a research procedure. It also explores psychoanalysis as a method of treatment and presents an outline of the knowledge and training necessary to become a psychoanalyst. A consideration of the analytic process includes a review of the postulates that govern its application--the analytic process, the therapeutic dyad, and psychodynamic interventions. Historical and political issues are examined, including the spread of psychoanalytic theory, the various contributions of important psychoanalytic thinkers, a review of the struggle of nonmedical psychoanalysts to break the one-time monopoly held by medical psychoanalysts, and the ongoing love-hate relationship between clinical practitioners and academic psychologists. In addition to providing this background material, this article explores the issues currently facing the field of psychoanalytic thought--the need for integration of the structural and relational perspectives and the outlook for the future of the discipline.

Forecasting↗
PubMed1996

Effect of intramuscular intraoperative pain medication on narcotic usage after laparoscopic cholecystectomy.

The purpose of this randomized, double-blind, clinical trial was to determine whether intraoperative, intramuscular (IM) injections of meperidine or ketorolac would improve postoperative pain relief in patients undergoing elective laparoscopic cholecystectomy. A total of 125 patients were entered into five study groups: 1) (N = 23) control placebo; 2) (N = 31) meperidine 100 mg IM intraoperative preprocedure; 3) (N = 20) meperidine 100 mg IM intraoperative postprocedure; 4) (N = 25) ketorolac tromethamine 60 mg IM intraoperative preprocedure; 5) (N = 26) ketorolac tromethamine 60 mg IM postprocedure. All groups were analyzed by comparing the amount of pain medication received in the recovery room, the time until first oral pain medication was requested, the overall amount of pain medication used in the first 24 hours, the percent requiring IM medication, and the pain score ratings from each group. There was decreased pain medication usage in the recovery room in all groups compared to control (P < 0.05). Group 4 had a longer painfree interval than meperidine groups or control. Both Groups 4 and 5 had decreased postoperative narcotic usage. Finally, the analogue pain scores showed that both ketorolac groups had significantly less postoperative pain compared to control, whereas the meperidine groups showed no improvement in postoperative pain relief. Intraoperative ketorolac given preprocedure or postprocedure significantly improved postoperative pain management and facilitated the transition to oral pain medication.

Adolescent↗
PubMed1995

The revenge motive: a developmental perspective on the life cycle and the treatment process.

In this article, vengeance and other manifestations of aggression and hostility are differentiated, then the developmental origins and later manifestations of the revenge motive through the life cycle are traced. Consideration is given to each phase of the life cycle, each of which may impart its distinctive stamp onto the patient's desires for revenge. Consistent with this developmental perspective, it is pointed out that desires for revenge may have important adaptive functions, helping the patient contain anxieties associated with developmental tasks that have not been mastered. A brief case example is used to illustrate how unresolved problems from various developmental stages may lend a particular coloration to the patient's later vengeful motives. Also provided is another case history of an early adult homosexual woman. The article is concluded with a set of technical recommendations for working with such patients in psychotherapy and psychoanalysis.

Adolescent↗
PubMed1991

The addiction to negativity.

In this paper, we have described a type of resistance that has attracted increasing psychoanalytic attention in recent years. Patients exposed to intense negativity during early life may develop an addiction to negative experience as adolescents and adults, and this may constitute a central organizing feature of their personality. In almost all patients, however, some moments of negativity may be observed. We have traced the developmental origins of an attachment to negativity, drawing especially on psychoanalytic investigations of preoedipal pathology. Manifestations and derivatives of early negativity include anhedonia, attachment to physical pain, fear of success, masochism, deprivation of self and others, and negative voyeurism. In discussing the dynamic functions of negativity, we place particular emphasis on two motives: the patient's desires for revenge against early objects that have been a source of deprivation and frustration; and the defensive function of negativity in helping to express as well as ward off dangerous wishes to merge with the object. Deviant forms of autoerotism are likely to be used by these patients to deal with the reactivation of early experiences of neglect and rejection. When negativity is used as a defense or method of relating to others it can lead to a severe disruption of the psychotherapeutic relationship. We have reviewed suggestions for the management of extreme negativity in treatment. Resolution of the therapist's countertransference reactions, especially induced feelings of frustration, rage, and helplessness, is crucial. Emphasis also has been placed on the patient's desires for revenge against self and object, and the manner in which these may be understood and eventually resolved. Only when patient and therapist begin to investigate the adaptive functions of extreme negativity can this pathological symptom be resolved and the patient's awareness of self and sense of autonomy be enhanced.

Adolescent↗