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PubMed1982

Specific approaches and techniques in the treatment of gay male alcohol abusers.

An extended discussion of specific therapeutic approaches and techniques with homosexual male alcohol abusers, including dealing with low self-esteem, sober sex, getting high, getting "far out" sexually, double lives, second rate relationships, social bonding, and aging. In this paper, the bias of treatment approaches is toward individualized, interpersonal, holistic eclecticism: a combination of responsibility building therapy, awareness therapy, medical and neurophysiological approaches, strategic therapy, utilization of altered states of consciousness, and attitudinal change therapy.

Adult↗
PubMed2005

Compulsive buying--a growing concern? An examination of gender, age, and endorsement of materialistic values as predictors.

Compulsive buying is an understudied, but growing, dysfunctional consumer behaviour with harmful psychological and financial consequences. Clinical perspectives treat it as a psychiatric disorder, whereas recent proposals emphasize the increasing endorsement of materialistic values as a cause of uncontrolled buying (e.g. Dittmar, 2004b; Kasser & Kanner, 2004). The present research aims to improve understanding of compulsive buying through examining gender, age, and endorsement of materialistic values as key predictors in three UK questionnaire studies, which sampled individuals who had contacted a self-help organization and residentially matched 'controls' (N = 330), consumer panelists from a multinational corporation (N = 250), and 16- to 18-year-old adolescents (N = 195). The results confirmed previously documented gender differences, and showed that younger people are more prone to compulsive buying. The central findings were that materialistic value endorsement emerged as the strongest predictor of individuals' compulsive buying, and that it significantly mediated the observed age differences.

Adult↗
PubMed1999

Suppression and ritualistic behaviour in normal participants.

OBJECTIVE: Previous research has shown that normal and abnormal ritualistic behaviours do not differ in content. Rather, the differences between both categories of rituals pertain to characteristics such as frequency, intensity, discomfort and resistance. This study sought to investigate whether thought suppression is linked to these characteristics. DESIGN: Cross-sectional; questionnaires on thought suppression and rituals were administered to a sample of undergraduate students (N = 166). METHOD: Habitual suppressors (N = 20) and non-suppressors (N = 20), as measured by the White Bear Suppression Inventory, were selected and compared with regard to the characteristics of their rituals. RESULTS: Suppressors experienced their rituals as more intense, discomforting and resistance-provoking than did non-suppressors. There were no group differences in the content, frequency, and perceived senselessness of rituals. CONCLUSION: Although the cross-sectional nature of the present study precludes causal inferences, its findings are consistent with the view that chronic thought suppression may promote ritualistic behaviour. Clearly, the details of the link between thought suppression and rituals require further examination.

Adolescent↗
PubMed2001

Listening and speaking psychoanalytically--with what in mind?

In this paper, the proposition is developed that multi-model thinking with respect both to theories of mind and to theories of technique has always been implicitly present in psychoanalytic practice as a response to the demands of the clinical moment. But this has gone unnoticed and untheorized, in part because it is hidden in general considerations regarding tact, timing and (less discussed) variations in voice tone and also because our psychoanalytic practices, without our awareness but as adaptations to the clinical moment, do not always match our theories. The author offers reasons from the broad culture of psychoanalysis why this is so. He also offers a conceptualization and a strategy for raising the implicit and untheorized to heightened levels of awareness; he does this by highlighting the place of patient characteristics as the underpinning of theory variation and the place of a vast array of clinical possibilities as the backdrop of analytic listening. Clinical examples are used throughout.

Attention↗
PubMed2003

Repetition compulsion and self-psychology: towards a reconciliation.

The concept of repetition compulsion, which has never been fully acknowledged by Kohut and his followers, is re-evaluated in this article within the context of self-psychology. In line with the underlying principles of defensive contact-shunning on the one hand, and non-traumatic empathic failure on the other hand, the repetition can be seen as the twofold expression both of the wish for a new benign relationship and of the dread of traumatic, repeated disappointment. Therefore, early non-traumatic disappointments are initiated by the patient, and role-responded to by significant others. This way, the risk of disillusionment of full-blown expectations is avoided. The repetition compulsion, then, is a complex mechanism: preventive in one part, it protects the vulnerable self from potentially traumatising experiences; thus, it is operated in response to the danger signal of emotional cravings, once the latter are experienced as getting out of hand. Providing novel experiences, in its other part, it can lead to opening the road for change; such curative impact relies on lengthy working through in a safe, empathic, holding environment.

Compulsive Behavior↗
PubMed2003

Diagnosing a male hysteric: Don Juan-type.

The aim of this paper is to provide a clinical account of a male hysteric, Don Juan-type, taken from the early stages of treatment. The patient presented with a relationship problem but there soon emerged a form of compulsive sexuality or hypersexuality in his love relations that became a central feature of the clinical picture. This hypersexuality expressed itself in a compulsive need to stage, or to stage-manage, interpersonal scenaria of a sexual or sexualised nature. These scenaria, which were repeated in different variations and with different personnel, are seen by the author as a dramatisation of the primal scene with the patient taking up the position of the oedipal father. Explanations for the disappearance of male hysteria are given, including a new theory which claims that an imbalance in psychoanalytic theory itself led to the feminisation of hysteria. This critique allows certain forms of hypersexuality in men to be promoted as a form of hysteria, the most common example being Don Juanism-a form of compulsive sexuality that encompasses normative, conversion and character features. The paper also examines the male hysteric's developmental agenda. What the patient's compulsive sexual tableaux exposed was that he had never faced a separation that was not a triangular experience. This meant that his separations were experienced as two developmental agonies telescoped into one-separation (pre-oedipal) and exclusion (early oedipal). This combination, the author suggests, is so frightening in a particular group of men as to explain the choice of hysteria as opposed to some other choice of neurosis.

Adult↗
PubMed1999

Narcissistic resistances in the analytic experience.

The narcissistic resistances in the clinical experience and the supposed autonomy of the patient to reproduce the narcissistic stage are studied in this paper. The problem is examined through the analysis of a patient, who masturbated compulsively. The relationship between the symptom and the transference is investigated because the symptom related to specific behaviour from the object, and in order to understand the meaning of the phantasy that underlines the auto-erotic activity. It is pointed out that, in order for defensive activity to fulfil its sense of narcissistic refuge, an other (distinct from the subject) must carry out an essential function of support of the narcissistic defence. Narcissistic self-sufficiency is governed by a paradox, as it needs an object to demonstrate that it can subsequently dispense with this object. A second paradox occurs when the narcissistic subject can only succeed in dispensing with the object if the object gives some sign indicating that he is affected by such 'doing without'. In the analytical relationship, this type of defence manifests itself as narcissistic resistance. The analyst participates in the covering-up of the dependency that the defensive system has on the external object and this is a prerequisite for establishing the resistance.

Adult↗
PubMed1976

Alcoholics' perception of leisure.

The attitudes of alcoholics and a norm group toward leisure were compared. The alcoholics differed from the norm consistently in seeing themselves as having more leisure than they wanted, in being more work-oriented, in preferring highly structured free time, and in viewing leisure negatively.

Age Factors↗
PubMed1986

The MacAndrew Scale: clinical application and theoretical issues.

The research literature on the MacAndrew (MAC) Scale was surveyed to identify factors that influence the scale's usefulness as a screening device for alcohol misuse, and to explore the meaning of MAC Scale scores. Although the MAC Scale's ability to discriminate alcoholic and substance misuse groups from nonalcoholic psychiatric groups is well documented, the scale may not discriminate between alcoholics and antisocial individuals, or between patients with combined alcoholic psychiatric diagnoses and nonalcoholic psychiatric patients. Recommendations for future research and for the clinical application of the MAC Scale are provided.

Age Factors↗
PubMed2003

Alcohol craving predicts drinking during treatment: an analysis of three assessment instruments.

OBJECTIVE: The purpose of this investigation was to examine the utility of thee craving instruments to predict drinking during treatment. The three assessments used were the Penn Alcohol Craving Scale (PACS), the Alcohol Urge Questionnaire (AUQ) and Items 1-6 of the Obsessive subscale (OBS) of the Obsessive Compulsive Drinking Scale (OCDS). METHOD: The three instruments were administered during the course of a 9-month, double-blind, placebo-controlled trial of 100 mg/day of naltrexone, and a manual-based psychosocial intervention using the BRENDA manual conducted at the University of Pennsylvania's Treatment Research Center. Participants (133 men and 50 women at the initiation of the study) used these instruments to self-report craving on a weekly or biweekly basis. The weekly number of drinks was reported using the Timeline Followback interview. The data were analyzed with generalized estimating equations using craving scores at 1 week as the independent variable and number of drinks in the subsequent treatment week as the dependent variable. RESULTS: Each of the three scales predicted drinking during the subsequent treatment week. The PACS was the strongest predictor followed closely by the OBS and then the AUQ. Most important, craving as measured by the three scales was a stronger predictor of subsequent drinking than was drinking during the prior treatment week. CONCLUSIONS: Craving assessment provides a useful means of predicting drinking during treatment. Such information would be helpful in designing clinical trials and for many treatment modalities.

Adult↗