Don D. Jackson

An episode of sleepwalking.

There does not appear to be a voluminous literature on somnambulism. Except for a monograph (7) there are generally scattered comments on the topic usually included in discussions of hysterical phenomena. Ferenczi (4), for example, suggests that there are similarities between somnambulism and posthypnotic commands. He uses as an example a patient whose father used to awaken him with a stern command of “Get up.” Later when he was employed as a tailor by a domineering employer he began having somnambulistic attacks where he would awaken, remove his night shirt and begin sewing motions. Ferenai speaks of the need to comply which is similar to posthypnotic commands. He does not discuss preoedipal and oedipal factors. Sadger (7), who has written the most complete work on the subject, presents several cases of sleepwalking and moon waliing, but the cases were superficially studied and he does not discuss dynamics. Fenichel (3) outlines the dynamics of somnambulism in a fairly satisfactory fashion. He emphasizes that the sleepwalker is running away from the bed which is felt as a place of temptation or is walking toward a place of protection. Fenichel believes that the somnambulistic state is a mixture of the hypnotic spell and the hysterical dream state. Abraham (l), in a discussion of the subject included in a paper on hysterical states, makes the point that anxiety attacks stand in close genetic relationship to dream states, and that his patients with dream states and somnambulism had anxiety attacks but not hysterical motor attacks. In general, then, ps’ychoanalysts agree on the relation of sleepwalking to hysteria and to phenomena such as posthypnotic suggestion. The infantile prototype of the somnambulistic state may be feigning sleep in order to witness the primal scene, and the need to repress the feelings aroused as well as the attempt to stay asleep. In the clinical material presented in psychoanalytic literature, there is a frequent association of somnambulistic spells and enuresis. In addition to the aggressive and sexual aspects of urination, in some cases it may be the fact the child is picked up and taken to the toilet, often while still asleep, that helps condition the link between urination and the desire to be with the mother, beside the obvious fact that both oedipal wishes and excretory

Conjoint Family Therapy

The paper presented here is a product of the Family Therapy in Schizophrenia Project of the Palo Alto Medical Research Foundation, and thus reflects the ideas and experience of the entire project staff and associated therapists.1 In it we should like primarily to report some observations based on this particular experiment in conjoint family therapy with schizophrenics—that is, in treating the identified patient and other members of his family together as a functioning natural group. We shall have little to say about the work of others, except by way of acknowledging and illustrating a growing trend toward this form of treatment. There is still only a limited amount of such work being done, and less published, so perhaps the best way to introduce something that is bound to be somewhat new and strange is to have the reader accompany us on our own voyage of exploration and discovery, in part. As we go, we shall also attempt to formulate more systematically what we ourselves have been learning along the way.

Filming of psychotherapeutic sessions as a personal experience

When I was asked to write of my experiences in being filmed for psychotherapeutic study, I first thought back on the total amount of experience I had. This, it would seem, is approximately six half-hour films of initial interviews with patients (largely psychotic), approximately two hours of therapy sessions with psychotic patients, twenty-five minutes of an hour long film on psychiatry during which a “stranger” was interviewed, and three half-hour RV films as a member of a three-man panel. The outstanding feature of the therapy filming experiences was my own reaction to the finished production. I did not feel well acquainted with the individual upon the screen who was masquerading as I. The voice I had become somewhat used to because of listening to hours upon hours of tape-recordings; however, the appearance was another matter. Even after six years, I am still not entirely comfortable with the recognition of myself as a psychotherapist when my image is splashed upon the screen for the instruction and criticism of psychiatric residents.