PubMed · 4444631
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D Lonie. 1974-11-16. Playing.. https://doi.org/10.5694/j.1326-5377.1974.tb71132.x
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Under the sway of the oedipal imperative, the Isakower phenomenon has long been regarded as a regressive perceptual defense against castration anxiety accompanying incestuous wishes, often stimulated by primal scene exposure-fantasy. Clinical material from the psychoanalytic psychotherapy of a borderline patient with object constancy deficits is offered to support a reconceptualization of the Isakower phenomenon: Following annihilatory rage and the destruction of extant inner objects, resulting in a regression to the "drive organization of memory," the face-breast imagery within the Isakower phenomenon arrives as a hallucinatory alternative to unbearable aloneness.
One hundred and twenty-three male children, aged one to ten years, were studied to determine the influence of premedication on changes in patterns of behaviour following hospitalization for repair of inguinal hernias. Four comparable groups were selected for premedication regimen: (1) A control group without premedication; (2) oral trimeprazine tartrate 2 mg/kg, methadone 0.1 mg/kg and droperidol 0.15 mg/kg; (3) oral midazolam 0.45 mg/kg; (4) intramuscular midazolam 0.15 mg/kg. Standard inhalational anesthesia was used and caudal blocks employed for analgesia. The parents returned a questionnaire at two weeks. Changes in behaviour were reported in 78% of the children and overall, premedication showed little benefit. However, midazolam premedication was associated with a significantly lower incidence of night-time crying and awakening, compared with no premedication. Only for night-time crying and day-time toilet training did age below five years prove to be a significant contributing factor.