Friday, February 23, 2007

Ego Psychological Theory of Medical Hypnotherapy 1 - Why study history?

Ego Psychological Theory of Medical Hypnotherapy (Review of Erika Fromm's work)

Why study history?

One of the advantages to the study of the history in any discipline is that it helps a researcher gain perspective and integration that would not be possible by any other means. The perspectives acquired by knowledge of the past are greater and more informed than perspectives acquired by the present alone.

Knowledge of the history of psychology in this case will make it possible to understand influences, developments, and relations such that our total perspective is much more informed, inclusive, and whole. Taking into consideration the vast knowledge and perspective gained from the study of the history of a discipline, does away with the need for any other justification.

Interest in the history of psychology has been rising since the 1960’s. Before that time, works on the history of psychology were limited to the interests and endeavors of a few individuals.

Boring’s (1929) classic, A History of Experimental Psychology and Roback’s (1961), History of Psychology and Psychiatry are examples of books written on the history of psychology that are a collection of names or anthologies. Courses in the history of psychology became more popular in graduate studies since Boring’s text (Vinney, 1993).

History and Systems courses use texts such as the aforementioned to convey facts and other information. Unfortunately, these texts lack any cultural context which would provide the student with a more comprehensive understanding of how events, history and people are interrelated. In the study of psychology, the cultural and historic context seems to be forgotten or dismissed as being of less significance.

The training of psychiatrists and psychologists revolves around facts and information and does not provide the historical constituents of any given theory within a cultural context. Hence, psychologists may not obtain the knowledge of those who came and contributed before them. Consequently, history all too frequently reveals that our discovery is only a rediscovery of something that was known long ago.

Psychiatrists and Psychologists who do not study the history of their discipline may erroneously believe at some point that they have developed new theories, techniques and methods in their practice and not recognize the evolvement of their presume original psychological thought.

Studying history provides a basis for the awareness of the errors of our predecessors, it also helps us keep our thinking straight. As Henle (1976) warns “If we cling to our ignorance of history, error crushed to earth, will rise again, and we will have to go on solving the same old problems again and again”.

Historical research has significant implications for psychological research. The origins of psychology must be understood in order for researchers to place their theories and research into appropriate contexts. It is essential to know and understand psychological accomplishments, contexts, and past trends in order to gain perspective on our present and future directions.

“The chief reasons for studying the history of psychology have to do with the development of necessary perspective” (Wertheimer, 1980, p. 20). Sigmund Freud stated in his book, The Future of an Illusion, “ the less we know about the past and the present, the more insecure must prove our judgment of the future” (Freud, 1957, p. 5).

Again emphasis is made on the importance of the study of history to our comprehensive understanding of the present and to better guide us in future decision.
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Wednesday, February 21, 2007

خارج الدائرة


عندما نختصر المسافات عبر الطرق الجانبية

تتكون منازل من الألفة بيننا وبين وجوه عابرة

.. تقف خلف وهم الأنتظار

في المرات الأولي تمشي مترددا ،
.
وبعد ذلك تبتسم وأنت تعبر

بعدما تدرك جيدا أن المشهد قد تغير كثيرا

وأنك لا تنتمي لهذه "الرقعة" من الأرض

وأن الشر أصيل ، عدا وجوه قليلة باسمة
.
كأننا كبرنا قليلا
.
:لنقول للأصدقاء الطيبين الذين عبروا بغير كلام

.... وداعا .. و إلي لقاء

Tuesday, February 20, 2007

سمو الذات حنو الأنا ... قصيدة بقلم د.عصمت النمر


سمو الذات
حنو الأنا
***

(1)

....هذه النافذة
هذه السماء المجلوة لم يعد لها سوى الرؤى السوداء

هذا الهواء سلبه خريف الأنا سمائه

فأصبح كالأنعكاس الباهت

تؤلف ذاتا فاسدة المذاق

أوراقها جافة ترحل بالألاف الى أعلى

تهوى ككهوف خاوية

صارت مدينة الذات كريهة

وأصبحت الأنا بلهاء

ترتدى الحاجز الواقى
نحو خواء بلا نهاية

************

(2)


ذات_ لم تكتمل هيجانا

تجمع الأنا ثم تفرقها فى السماء

وتتراكم مدنا سوداء فى الأفق

صارت مدن الذات كريهة

وابراجها ذاوية

تقف بلا حراك ممتقعة اللون على مسار القصيد

تطارد الاوراق الجافة,وتخلف البقع على الهواء

تتراكم فى خبايا السقوط الشاحب

لا مكان يذهبون اليه الا براقعهم

لا أنا لهم سوى المقاعد الخاوية

*************

ذات_تنكر

..

ذات فى ثيابها المطرزة

تخطر فى مشيتها
يرقصها الحواه على أطراف عصيهم

*****************

ذات_حصار

..

ايها الذات المستريبة

ترجلى

قل لى : كيف تقيم علاقة مابين ورد ة تكثف الحس

والأنا المستضام

***************

ذات_أنتظار

..

وجه جامدا ، ينتظر :لا أحد

لا يجد سوى اليباب

ممتلئا بذات

*****************

ذات_تداخل

..

ذات توشك أن تبدأ

ذات توشك أن تهل

ونأى عن لا شيئ

ودنو من لا شيئ

شيئ يطمس السمو

ويفخم اليباب

للوصول الى وجه ترابى

*******************

ذات _مملكة مقطوعة الرأس

..


المثقفون يلعبون

بأعواد الثقاب

لأن العالم الذهنى ياسادة

حالما يكون وحده-ذات

ينشئ للأنا

نصبا تذكاريا ملفق

************


ذات- سنديانة

..

-قندس ينقلب فيصبح أسفنجة,لا يتحرك بل يغطس بطيئا في الذات_*

حمار ينقلب جاموسة ثم سمكة قرش تندفع نحوك لتنهش _*

فى حين تشد الثعابين الملكية بنوع من العصر

على تجويف صدرك حد الأختناق

***

ذات_جلد

..

مناخير ملتهبة,رقاب متوترة,شفاة مختلجة

تطلق خوارات هائلة كأن فى نهايتها مزامير

عصمت النمر

Saturday, February 17, 2007

Psychopathic Personality ... الشخصية السيكوباتية





"I do wish we could chat longer, but... I'm having an old friend for dinner. Bye."

Hannibal Lecter


الشخصية السيكوباتية... هانيبال لكتر كنموذج تخيلي


Individuals with psychopathic personality disorder (P103. PDM) are found throughout the borderline range of severity.

We can place psychopathy, with great comfort, within the range of borderline personality and psychosis. Absence of guilt and fear of punishment, would place the psychopath out of the neurosis arena.

Because of his attention scale and organization, it will be safe to consider the psychpath a borderline patient when staring the treatment.

Attention is a cognitive function and cognition is a function of the ego, the GRO is not an ego function due to the fact that for the subject with deformed super-ego the GRO usually fades into the background of awareness.

Borderline patients typically manifest difficulty in the integration of object representations - which are unstable and vulnerable to fragmentation. According to Mahler (1972, 1975), the inconsistencies experienced during the phase of separation-individuation of emotional abandonment or overprotectiveness by the caregiver lead to further deficits in the patient’s organization of their internal world.

“For the borderline personality, the choice in close relationships is between attachment that symbolizes engulfment and loss of identity, and separation that evokes feelings of loss and abandonment” (Copeland, 1986, P. 158).

The borderline transference is characterized by boundary diffusion, splitting (Kernberg, 1975), panic states (Buie & Adler, 1982), and a loss of or fragmentation of self- and object representations (Giovacchini, 1979).Psychotic patients have poorly developed object representations which are the basis for their transference (Modell, 1968).

They barely differentiate between internal representations of the self and that of others (Blatt & Wild, 1976; Jacobson, 1973).

The psychotic’s unstable perception of others is influenced by the activation of un-integrated introjects (Volkan, 1976). The psychotic may perceive the therapist based on internal images that are frightening, distorted, fragmented, bizarre and may at other times view the therapist in an unrealistic idealized manner (Blatt, Schimek, & Brenneis, 1980; Smith, 1977).

Burnham, Gladstone, and Gibson (1969) call the psychotic transference the need-fear dilemma. In order for the psychotic to define himself as a person he needs others. But the psychotic fears that he will be swallowed up, lose bis own boundaries and merge with the object if he makes contact with “the other” (Erickson, 1984).

The psychotic behaves in this same manner in his relationship with the therapist.


Case Illustration: Hannibal Lecter


Hannibal Lecter Diagnostic Profile:


A- Personality Patterns


Dr. Lecter had a severe personality disorder with a decreased response of anxiety which causes the psychopaths to not be anxious or afraid of punishment when they perform a reprehensible action. His Omnipotent control is the primary defensive operation with s strong element of projective identification to exert power and to distract others from seeing his sexual perversions.


B- Profile of mental functioning

1) Capacity for Regulation, Attention, Learning
Dr. Lecter fictitious character shows a tremendous ability for regulation, learning, and attention to details within the apparent impulsivity which appears every time there is a promise of instantaneous reward. He always provides well organized and unexpected responses and maintains his focus.


2) Capacity for relationships
Dr.Lecter shows no capacity for intimacy and trust. Dr. Lecter seems to have inborn tendencies toward aggressivity and pleasurable excitement. He seems to have a fundamentally superior picture of himself with no expectations of tolerance for criticism.


3) Affective experience, Expression, and Communication
The affinity to draw attention of Dr.Lecter could be due to the inverted T pike of the EEG which appears in more details with the thermodynamic brain wave changes of the EEG Biofeebackreadings. There is nothing unconscious about his manipulative behavior. It is shameless and he hides any sign of weakness.


4) Defensive patterns and capacities & capacity to form internal representations
Omnipotent control is Dr.Lecter primary defense. He also use projective identification, many dissociative processes and acting out. His need to exert power takes over all other aims.

The clinical picture of psychopathy matches to a great extent the concept of de-automatization. De-automatization is “an undoing of automatization... directed toward the environment (Gill & Brenman, 1959, p. 178). Occurring outside of conscious awareness in the normal waking state, a person develops automatized or usual ways of thinking, perceiving or acting in regards to realistic demands. The evil doing of a psychopath is intentional, organized, and purely arousal for his/her own satisfaction.


5) Capacity for differentiation and Integration
Dr.Lecetr had no ability to differentiate between internal stimuli and external forces within the fabric of law and order.


Diagnosis and Treatment


Careful assessment should be done to decide whether the patient is treatable or not. (Using Kernberg's structural interview technique).


We should differentiate between psychopathic personality and paranoid personality where psychopathic patient has no guilt, his defenses are fundamentally psychopathic with some dissociative defenses, less responsive to therapy, and his distrust of others is based on omnipotent triumph.


The therapist should covey a powerful presence, behaving with integrity and accept that what motivates the patient has more to do with what behaviors make him look powerful than other evaluative criteria.


Uncompromising honesty by the therapist should not take the form of disclosure or moralization. It should persistently addresses reality, expressing the therapist's negative feelings toward the patient.


Nancy McWilliams suggests; over the course of treatment, if we analyze the patient's omnipotent control, projective identification, and domination by envy, the patient will change.


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