Douglas H. Ingram

The vigor of metaphor in clinical practice.

ConclusionMy purpose in this paper has been to clarify how contemporary interpretations of metaphor, by blurring the boundary between the prose and the poetry of everyday discourse, enliven the psychoanalytic dialogue. This is not merely a matter of literary interest, but finds legitimization in linguistic research, neurobiology, infant observation, and psychoanalytic process research. An appreciation of the overlapping categories of everyday metaphor inaugurates a new kind of attentiveness for the psychoanalytic clinician and suggests an array of technical possibilities for participating in the clinical dialogue that may not have been previously recognized.

Psychoanalytic treatment of the obese person: Part III

This paper is an attempt to clarify some of the issues which face the psychiatrist in his efforts at treating the obese patient through analytic means. A thoroughgoing bias in Western culture impairs the psychiatric and non-psychiatric medical care of the obese person. Inconclusive evidence concerning the causal relation between obesity and chronic disease does not deter this cultural bias from exaggerating the role that obesity is thought to play in disease process. Whatever contribution it makes to physical illness, obesity remains a substantial social disability that is frequently associated with self-hate and feelings of ineffectiveness. Scientific investigations indicate that adiposity is determined by interactions of genetic and environmental influences acting at different levels of complexity within the organism. Hence, the adipocyte itself may influence existing fatness and retard weight reduction. Constitutional factors affecting the hypothalamus may contribute to obesity in certain individuals. Also, cortical effects determine maladaptive eating behavior and excessive adiposity. Poor eating habits which are associated with emotional conflict seem to strongly affect the development and continuance of obesity in most fat persons. The interaction among adipocyte, hypothalamus, and cerebral cortex remains unclear. The various treatments of obesity have been shown to be of little impact in helping overweight persons to sustain weight loss. Diet control, exercise, group psychotherapy, and behavior modification show slight benefit. Recent controlled studies dispute earlier claims that behavior modification is effective in achieving meaningful and lasting weight loss. Claims that intestinal bypass procedures are a useful treatment also require further supporting evidence. Psychoanalytic or intensive sustained psychotherapeutic treatment of the obese person emphasizes exploration of the entire personality. As long-neglected constructive forces are stregthened, weight loss may proceed. Psychoanalytic treatment is not indicated for obesity uncomplicated by neurotic distortions. In the presence of interpersonal problems and personal ineffectiveness, psychoanalysis has real utility. It is not clear that obesity is a major determinant of impaired physical or emotional health. Rather, the medical indictment of obesity seems to stem from the need to justify an intensely negative cultural bias. Casual disregard of this fact and of the complexity involving issues of etiology and treatment may signify inadequate appreciation in the psychoanalyst of the extent to which he participates in this cultural bias. The continuing failure of medical science to devise a means to help fat persons sustain weight loss to any meaningful degree has prevented the development of studies which would show if weight reduction truly does provide uniformly enhanced physical and emotional well-being...

How Clinicians Feel about Working with Spouses of the Chronically Ill

Clinicians who provide psychotherapy to spouses or partners of the chronically ill were solicited through listserves of psychodynamic and other organizations. The current report excluded those therapists working with spouses of dementia patients. Interviews were conducted with clinicians who responded. The interviews highlight the challenges commonly encountered by psychotherapeutic work with this cohort of therapy patients. A comparison is drawn that shows both overlap and distinctions between the experiences of those therapists engaging with spouses of chronically ill patients without a dementing process and those working with spouses of chronically ill patients who do suffer from a dementing process.

How clinicians feel about working in therapy with spouses of dementia patients.

Clinicians who provide psychotherapy to spouses or partners of persons with dementia were solicited through LISTSERVs of psychodynamically oriented organizations. Interviews were conducted with the 14 clinicians who responded. In the aggregate these clinicians provide psychotherapeutic service to scores of caregivers. The interviews highlight the challenges commonly encountered by psychotherapeutic work with this cohort of patients.

What is "psychodynamic psychiatry"?

Forrest, David V. Response to Michael H. Stone’s Article, “Disorder in the Domain of the Personality Disorders”: Invisible and Innominate Borderline Dynamics 677 Friedman, Richard C. and Downey, Jennifer I. About the Editors 1 Friedman, Richard C. and Downey, Jennifer I. Editorial: The Biopsychosocial Model 371 Friedman, Richard C. and Downey, Jennifer I. Psychodynamic Psychiatry and Psychoanalysis 5 Friedman, Richard C. Editor’s Introduction 543

The Hofgeismar lectures: a contemporary overview of Horneyan psychoanalysis.

Part I of this paper describes Karen Horneys theory of neurosis. In the 1930s, Horney repudiated Freuds view of female developmental psychology. She argued that cultural factors rather than anatomy or innate biological drives were the primary determinants not only of female development but of personality, as well. When genetic and environmental circumstances together lead to basic anxiety early in life, she believed a deep inner conflict emerges in the individual leading to the need for elaborating layers of rigidified protective defenses. She called this the neurotic process. This process can result in discrete symptoms of mental disorder as well as the more generalized problems of alienation from the persons real self and reliance on neurotic solutions. In Part II, the practical application of Horneys theory to clinical work is demonstrated in a case presentation of a notably timid and perfectionistic man. Part III points up elaborations of Horneys theories by later workers of her school, the American Institute for Psychoanalysis, and provides a history of her school within the broader context of American psychoanalysis. The authors emphasis on postmodern and narrativist elements of Horneyan psychoanalysis are illuminated, as well.

Psychodynamic Psychiatrists' Experiences of Being Stalked

Despite the estimated 15% likelihood that a psychiatrist will become the victim of stalking, there is little formal recognition of its prevalence or its impact on well-being. Through narrative accounts, ten psychiatrists with psychodynamic orientations speak of their experiences including how each managed the anxieties consequent to stalking. These include a variety of adaptive psychic operations as well as concrete actions to curtail stalking.

The language of psychoanalysis.

In this age of modern era, the use of internet must be maximized. Yeah, internet will help us very much not only for important thing but also for daily activities. Many people now, from any level can use internet. The sources of internet connection can also be enjoyed in many places. As one of the benefits is to get the on-line language of psychoanalysis book, as the world window, as many people suggest.

In memoriam. Andrew Keogh Ruotolo, M.D. 1926-1979.

Dr. Andrew K. Ruotolo, a devoted teacher on the faculty of the American Institute for Psychoanalysis and a member of the Institutes Board of Trustees, died of a heart attack on August 8, 1979. Dr. Ruotolo was 53 years old. He maintained an active practice in psychoanalysis and psychiatry in Westfield, New Jersey, for over 20 years. Among Dr. Ruotolos broad range of interests was a sustained curiosity about the psychodynamics of homicide. Steeped in the theories of Dr. Karen Homey, Dr. Ruotolo applied her concepts to the dynamics of murder and legal sanity in articles and, most recently, in a book Once upon a Murder. Years in the writing and based upon still more years of experience with alleged and convicted murderers, Once upon a Murder was published by Grosset and Dunlop on September 12, a month after its author had died. A graduate of Yale College in 1945 and Cornell Medical School in 1948, Dr. Ruotolo served as an intern at Martland Hospital in Newark and completed a residency in psychiatry at Worcester State Hospital in Massachusetts. He also served in the Korean War with the First Marine Division as a lieutenant in the Navy, senior grade. Dr. Ruotolo took his psychoanalytic training at the American Institute for Psychoanalysis. Subsequently, he joined the faculty of the Post Graduate Center for Mental Health but later accepted an invitation to return to the Institute. He also served as consulting psychiatrist for the Seton Hall University Counseling Center. He was a fellow of the American Academy of Psychoanalysis, a member of the Association for the Advancement of Psychoanalysis, of the New Jersey Medical Association, and of the American Medical Association. Esteemed for his teaching and clinical abilities, Dr. Ruotolo had a gift for conveying the value of nuance and symbolism both by the impact of his personal presence and by his utter devotion to the Horneyian concept. He loved to teach. Of the activities that thrilled his life, teaching at the Institute was one of those he enjoyed the most. He will be sorely missed.