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Self, identity, and subjective experiences of schizophrenia: in search of the subject.

Schizophrenia is an I am illness--one that may overtake and redefine the identity of the person. This essay explores concepts of personhood and subjectivity from social science that are useful in understanding the experiencing subject in schizophrenia. Relationships between the self and sickness have not been investigated adequately with reference to their influence on prognosis. Chronicity is conceived of as a loss of self and of positive social roles and identity. Methods for the study of self and identity in relation to schizophrenia include analysis of illness-identity representations made by persons with schizophrenia.

Adaptation, Psychological↗

A clinical interpretation of attitudes and behaviors associated with celebrity worship.

The phenomenon of celebrity worship is currently conceptualized as an abnormal type of parasocial relationship, driven by absorption and addictive elements and which potentially has significant clinical sequelae. The authors hypothesize that the three increasingly extreme sets of attitudes and behaviors associated with celebrity worship also partly reflect the three domains of personality discussed in Eysenckian theory. Specifically, celebrity worship for entertainment-social reasons may reflect extraversion personality traits; intense-personal attitudes and behaviors toward celebrities may reflect neuroticism traits; and celebrity worship of a borderline-pathological nature may reflect psychoticism traits. To test this idea, the authors administered the Celebrity Attitude Scale and the Abbreviated Form of the Revised Eysenck Personality Questionnaire to large convenience samples of students (N = 317) and community (N = 290) respondents. Results indicate that celebrity worship is not an uncommon phenomenon. Further, correlational analyses supported predictions and suggest that Eysenckian domains of personality may promote or hinder a person's progression along the continuum of behaviors associated with celebrity worship.

Adolescent↗

Ego functions and ego development: defense mechanisms and intelligence as predictors of ego level.

This study considers the contribution of two ego functions--intelligence and defense mechanisms--to ego developmental level. Two independent assessments of ego level were related to IQ and defense mechanism use in a sample of 89 young adults. Whereas IQ and defense were themselves found to be unrelated, both variables predicted ego level: The relation with IQ was linear, whereas the relation with defense was curvilinear. In addition, the relation between defense and ego level varied as a function of IQ level. At low levels of IQ, stronger use of Denial and Projection was associated with higher ego levels. At high IQ levels, strong use of Denial was associated with lower ego levels, whereas moderate use of Projection was associated with higher ego levels.

Adult↗

Individuation: from fusion to dialogue.

Growing interest in concepts of fusion and individuation within a number of different theoretical systems of psychotherapy suggests an emerging shift in perspective in the conceptualization of psychopathology and psychotherapy. This shift may represent a first step in the integration of individual and relational dynamic theories. A theoretical framework for the exploration of processes of fusion and individuation is presented, with suggested applications for the study of problems experienced by adult couples. The process of individuation from fusion to dialogue is outlined in the description of four modes of relationship. In this context, the paper suggests ways in which a variety of problematic relational patterns seen in couples may be viewed as reflecting the partners' struggles to move from fusion to dialogue.

Denial, Psychological↗

Personality.

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Achievement↗

The feeling of professional identity in an integrated psychosomatic approach.

Apart from the efficacy of an integrated psychosomatic approach there emerge problems with the psychosomaticist's feeling of professional identity which are delineated and discussed in the light of the authors' experience. For many years they took part in institutionalizing an approach combining internal and psychological medicine on the basis of a psychoanalytic orientation in a ward setting and an outpatient clinic for hypertensives which were both attached to a university hospital. The core conflict of professional identity in an approach like this is concerned with educational incompatibilities in the different fields, frictions of daily routines, and institutional tensions arising from controversial theoretical backgrounds and faculty policies. Different cognitive and action styles, varying attitudes concerning matters of timing and different necessities of empathy versus distance must be integrated like other polarities. Discussions about the favors of an integrated psychosomatic approach tend to underestimate the outlined problems of professional identity.

Adaptation, Psychological↗

The psychiatry internship and the development of professional identity.

Advocates of the psychiatry internship believe the experience fosters professinal maturity. The authors examined the maturing process of 10 psychiatry residents during their internship year. Changes in the interns' professional identity including expectations of self and others are described and seen as a goal of the experience. The authors outline danger signals of poor professional development and suggest interventions to help interns resolve conflicts.

Attitude of Health Personnel↗

The resolution of a transsexual wish in a five-year-old boy.

The brief truncated psychoanalytic treatment of a transsexual boy described in this paper demonstrates the development of transference reactions and their subsequent resolution. The analytic situation allowed this young patient to live out again his relationship with his parents in his relationship with the analyst, to recover from wishing to be a member of the female sex, and to work through his conflicted symbiosis with his mother. Carlos became able to individuate and disidentify from her into a separate male child, in order to be able to identify with, and accept, his own biological and psychological maleness. It is to be hoped that our success with this patient will encourage others to treat and study children suffering from gender identity problems via the psychoanalytic approach.

Anxiety, Castration↗

A family's coming to terms with Alzheimer's disease.

Findings of a qualitative analysis of several members of a family in which one member has Alzheimer's Disease (AD) support the notion that differences in how each family member defines and makes meaning of the situation have consequences for the family as a unit. Ten in-depth individual and dyadic interviews of five available family members were conducted during a period of 18 months. Data support the finding that each member of the family experienced a similar process of coming to terms with changes in the person who has AD. This process consisted of three stages: identifying how the person with AD was the same as he was before, as well as how he was different, prior to disease onset; redefining the identity of the person with AD; and rewriting one's relationship with the person with AD. This study supports both Knafl's and Deatrick's concept of family management and Patterson's concept of family meaning.

Adaptation, Psychological↗