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At least 73 records · Page 4Linked to original sources
PubMed1982

Appetite perversions and taste changes triggered or abolished by radiotherapy.

Special questioning of 819 oncology patients whose treatment included radiotherapy has revealed 147 instances where local tumour radiation--apparently regardless of tumour type, site, or volume radiated-has either triggered (97 cases) or abolished (50 cases) an isolated appetite perversion. Both effects typically occur when a dose of about 500-1500 cGy has been reached and at a stage when little, if any, tumour regression is evident. No correlation can be seen with anorexia or with the usually recognised side effects of radiotherapy. Spontaneous return to normal is quite common in cases triggered by tumour treatment, but rare in cases starting before diagnosis. The latter may cease when the tumour is treated. The explanation for these highly selective and rapidly reversible aversions or cravings is totally obscure, but questioning large numbers of patients has provided certain clues, including frequent descriptions of an underlying change in taste or odour and also close links with two other equally unexplained phenomena--(1) alcohol intolerance in tumour patients and (2) the cravings and aversions of pregnancy.

Adult↗
PubMed2002

Intensity-modulated radiation therapy: the inverse, the converse, and the perverse.

Intensity-modulated radiation therapy (IMRT) is a refinement of current radiotherapy techniques rather than a major breakthrough. The term IMRT includes several different techniques that all share with classical arc therapy the principle of using multiple fields to reduce the dose to normal tissues, but integrating to a higher dose throughout the tumor volume itself. This paper reviews not only the putative upside but also the downside of the development of IMRT. Theoretical, practical, and cost considerations, both positive and negative, are discussed. There are several issues to be considered, but the most important perversely predict a significant increase in radiation-induced neoplasms, resulting not only from larger volumes of tissue exposed to more modest but still mutagenic doses, but also from a significant increase in total body dose from leakage, because the beam is typically on for a considerably longer period of time than is conventional. A plea is made for radiation oncologists to maintain a strong biologic and cellular orientation as oncology rapidly becomes more molecular in its orientation.

Humans↗
PubMed1995

Present dangers and future threats: some perverse incentives in the NHS reforms.

The NHS reforms have come to mean all things to all men (and women). Identifying a market oriented purchaser-provider split as the conceptual heart of the reforms is still, however, useful. There are important perverse incentives in and around the NHS that are associated with the reforms; furthermore, many reactions to the resulting problems are paradoxical and often counterproductive. Hitherto most criticism of the reforms from the health policy and management community (as opposed to the professions and the public) has been tactical rather than fundamental. There are serious problems for the NHS associated both with the NHS market and with current, often tacit, strategies for the future of the service.

Community Health Services↗
PubMed1991

Sadomasochism, sexual excitement, and perversion.

Sadomasochism, an ingredient of infantile sexuality, is an essential part of normal sexual functioning and love relations, and of the very nature of sexual excitement. Sadomasochistic elements are also present in all sexual perversions. Sadomasochism starts out as the potential for erotic masochism in both sexes, and represents a very early capacity to link aggression with the libidinal elements of sexual excitement. Sexual excitement may be considered a basic affect that overcomes primitive splitting of love and hatred. Erotic desire is a more mature form of sexual excitement. Psychoanalytic exploration makes it possible to uncover the unconscious components of sexual excitement: wishes for symbiotic fusion and for aggressive penetration and intermingling; bisexual identifications; the desire to transgress oedipal prohibitions and the secretiveness of the primal scene, and to violate the boundaries of a teasing and withholding object. The relation between these wishes and the development of erotic idealization processes in both sexes is explored in the context of a critical review of the pertinent psychoanalytic literature.

Adult↗
PubMed2001

The countertransference: erotic, erotised and perverse.

The author begins by drawing attention to the dearth of psychoanalytic theory on the sexual countertransference, which he attributes largely to embarrassment associated with the personal superego and to fear of censure by the psychoanalytic community. After a review of the relevant literature, he points out that the term 'countertransference' arose in the context of misbehaviour by the early analysts and that the countertransference was originally seen as something to be controlled and suppressed, partly for the sake of the reputation of psychoanalysis. Theoretical and normative reasons are adduced for the disappearance of sexuality from psychoanalytic scenarios, and the wish for sexual contact with patients is discussed. While it may be deemed perfectly normal for an analyst to have erotic feelings towards patients of either sex, psychopathology is, in the author's view, involved only if he acts out. Clinical illustrations are given of manifestations of the sexual countertransference in its erotic, erotised and perverse forms, which the author considers it important to distinguish. He concludes that the relative absence of theory on the subject means that not enough clinical use is made of the sexual countertransference, which he sees as of great potential value to therapist and patient alike.

Adult↗
PubMed2002

The "polymorphously perverse" psychopath: understanding a strong empirical relationship.

The relationship between psychopathy and sexual offending has been empirically established, but it is little understood. The author proposes nine explanations to provide a conceptual basis for this empirical relationship: (1) search polygyny, (2) callousness and a lack of empathy, (3) a lack of attachment or bonding, (4) sensation seeking as a product of chronic cortical underarousal, (5) grandiosity, (6) entitlement, (7) a predominance of part-object relations, (8) a high frequency of predatory violence, and (9) the leaving by consensual sex partners when the psychopathy is identified. These explanations, constructed from anthropological, psychobiological, attachment, psychoanalytic, and aggression research, find some direct and indirect empirical support in the extant literature. They contribute to understanding the "polymorphously perverse" sexuality of the psychopath.

Antisocial Personality Disorder↗
PubMed1992

The perversion of mothering: Munchausen syndrome by proxy.

Munchausen syndrome by proxy, in which a seemingly caring and concerned mother is simultaneously harming her child, can best be understood in terms of the mother's need for a relationship with a physician that is rooted in a profound sense of early abandonment. This understanding broadens the definition of perversions. The infant in this sadomasochistic interaction is dehumanized and is used as a fetishistic object to control the relationship. The author's literature review and case report provide the basis for his exploration of the historical, cultural, and psychological factors that both contribute to the development of the syndrome and conspire to deny its reality.

Adult↗
PubMed1992

Psychic change and developments in the theory of technique in adolescent analysis: the handling of perverse levels of transference.

The paper presents some of the characteristics of the analytic process in an adolescent with homosexual behaviour. The technical peculiarities of this kind of treatment are compared with those of adult patients with similar pathologies. The difficulties arising from complex acting-out behaviour in which the family take an active part, the role of secrecy, and the handling of the erotization of the transference through the verbal interchange are discussed on the basis of the clinical material presented. The characteristics of a strongly split transference, with a dissociated perverse level, imply specific difficulties in maintaining a workable analytic setting; the strategic choices with which the analyst is faced to be able to attain it, and its clinical implications are discussed.

Adolescent↗
PubMed1992

Addiction as a form of perversion.

Psychoanalytic treatment of addiction is often ineffective because therapists fail to recognize addiction as a discrete disorder. The author reviews psychoanalytic theories of addiction and presents an alternative concept comprising biological, behavioral, and psychological characteristics. She compares the structural similarities between addiction and perversion and describes the use of the addictive substance as a fetish object. Finally, she discusses the implications of psychoanalytically oriented treatment and advocates a multimodal treatment approach.

Behavior, Addictive↗
PubMed1986

Identification and its vicissitudes as observed in the perversions.

This paper aims to contribute to the clarification of the different meanings of the concept of identification and the different processes involved in the making of an identification, by considering the perversions as disorders of internalization. The different forms of internalization are regarded as lying along a continuum of which identification is at one extreme and involves the incorporation of (part of) the object-representation into the self-representation. The pervert is shown to be unable to carry out the process of identification because he is fixated at an early developmental phase which I refer to as the 'core complex': instead of identification he has to make use of 'stimulation' in which the subject unconsciously models himself on (parts of) the object. The crucial role the body plays in these dynamics is considered. Exploration of these issues highlights how, in order for identification to take place, the issues of the core complex need to be adequately resolved in the course of normal development.

Aggression↗
PubMed1993

A fundamental dilemma of psychoanalytic technique: reflections on the analysis of a perverse paranoid patient.

The work refers to the general topic of the traumatic effects of transference in the analytic situation. The author defines the fundamental dilemma of interpretive technique as the technical difficulty, sometimes insurmountable, faced by the therapist in the treatment of severely ill patients, particularly in the case of narcissistic, self-centred disorders, where the interpretive action itself often produces negative side effects that are not countered by the curative effect of the insight achieved through interpretation. In a brief theoretical introduction, this dilemma is described as a longstanding problem in psychoanalysis that has been systematically concealed by the protracted discussion on the subject of 'analysability' and which has still not been resolved by the theory of technique. Clinical case material on a perverse patient is then presented to illustrate the dilemma described and to demonstrate some general strategies by which it may be overcome.

Adult↗
PubMed1996

Ladies of fashion: pleasure, perversion or paraphilia.

The author considers the reasons why interest in fashion is important in female development. Freud's comment that 'all women are clothes fetishists' and his explanation that a woman uses clothes to show that 'one can find in her everything that one can expect from women' are amplified and challenged by other authors and psychoanalytic evidence. Caper's (1994) focus on the erotic meaning of his patient's clothing is contrasted with the use ego-psychologists have made of 'appropriate' clothing and grooming as markers of mental health and intact functioning. A case of a woman who had a shopping symptom is considered. The roots of the symptom in her fantasy life, its replacement of genital satisfaction, its precursors in interactions with her parents and its use in enacting sado-masochistic fantasies is elaborated in the case material. A second case briefly illustrates the role ascetic refusal of clothing may play in some women's psychic lives. Use of clothing as a way of displaying the body, as an indicator of economic power, as an incitement to envy, and as a sexual enticement is discussed. Examples of understanding of the psychological aspects of interest in clothing are drawn from art, anthropology, sociology, political science and philosophy. The paper concludes with the idea that clothing and shopping for clothing can range from normal pleasure to paraphilia and leaves open the question whether it can be a perversion. Focusing on clinical material about shopping for fashionable clothing, the author shows how shopping can become central in some women's lives as it is important in many. It considers the boundaries between source of pleasure, paraphilia and sexual fetish as they are exemplified in women's attitudes towards clothing and their use of it.

Adult↗
PubMedDate not supplied

Male homosexuality: perversion, deviation or variant?

Male homosexuality has complex determinants: biological, psychological, social, cultural and situational factors may be relevant, either inhibiting hetereosexuality or leading towards homosexuality. Environmental factors seem paramount, particularly significant early relationships, usually within the family. Especially implicated are the personalities and interaction of the parents, recent interest being especially in the father's role. Also relevant is the family as a complex social system and the modes of communication within it, both verbal and non-verbal. Social research and sociopolitical pressures have helped to liberalize attitudes to homosexually 'deviant' behaviour but have not added significantly to its understanding. Many factors are involved in determining whether homosexual men seek therapy and reach a particular therapist. These factors relate to the patient's and therapist's personalities; to different therapeutic philosophies and therapeutic goals; and to the formal and informal referral networks in society.

Freudian Theory↗