Defense Mechanisms

The model of ego development by Loevinger describes an epigenetic series of successive stages comprising increasingly complex styles of impulse control, interpersonal relationships, moral and cognitive reasoning. This model offers an opportunity to explore the structural premises young adults rely on solving their developmental tasks. Controls compared to patients show a significantly superior intrapsychic coping, awareness of social rules and knowledge of interpersonal relations.

BACKGROUND: Effective interventions for maltreated children are impeded by gaps in our knowledge of the etiopathogenic mechanisms leading from maltreatment to mental disorders. Although some studies have already identified individual risk factors, there is a lack of large-scale multilevel research on how psychosocial, neurobiological, and genetic factors act in concert to modulate risk of internalizing psychopathology in childhood following maltreatment. To help close this gap, we aim to delineate gender-specific pathways from maltreatment to psychological disorder/resilience.

From the perspective of the terror management health model (TMHM), expectancies as to whether a health behavior is likely to effectively protect one's health (i.e., response efficacy) and whether an individual is optimistic about the outcomes of his or her health risk assessment (i.e., health optimism) should have a more potent influence on health decisions when thoughts of death are conscious and the health risk domain is potentially fatal.

After giving an introductory outline of the phenomenology and theoretical aspects of the concept "love affair", the author proceeds to review a number of symptomatic love affairs arising in the lives of a series of female patients during the course of analytically oriented psychotherapy.. The material is presented in its general aspects and in the form of one detailed case history. In subsequent discussion the author attempts to explain the genesis of these love affairs in terms of phase-speciifc conflicts in the patient and certain iatrogenic aspects of the therapy.

Erotomania is reexamined by an in-depth study of eight patients. There appear to be two main varieties: the phantom lover syndrome, or fixed delusion elaborated around a person who does not exist, and erotomania proper, a recurrent tendency to believe that one is loved by a powerful, prominent man.

The roles of the archaic loving and hating introjects are traced in the early scientific romances and the life work of H.G. Wells. The preambivalent polarization of the early loving introjects of an archaic ego ideal (giving rise to utopian fantasies and, later, to promulgations of a new world state) and the early hostile introjects of an archaic superego (giving rise to fears of death and, later, to fears of cosmic dissolution) is represented in eschatological preoccupations with death, the Last Judgment, heaven and hell.

Although the erotic transference is believed to be universal, it is variable in its expression. Drawing on the distinction between transference resistance and resistance to the awareness of the transference, I have proposed that, in general, the erotic transference utilized as resistance is more common among women, while resistance to the awareness of the erotic transference is more common among male patients. Erotic transference as resistance poses different analytic problems from those posed by resistance to its awareness.

A survey within a defined area of the north-east of England (population of approximately 1.25 million) generated a number of patients with current or past erotomanic phenomenology. A casenote study was carried out on the 11 patients identified. Cases were classified in accordance with DSM-111-R criteria and an assessment was made of the extent to which each case fulfilled specific criteria for primary and secondary erotomania, as defined by previous authors. The response to treatment of both psychiatric syndrome and erotomanic phenomenology is described for each case.

In psychoanalytic theory, homosexual women are regarded as being possessed by violent hatred of the mother. They are held to identify with the male or the phallic and to display an absence of "normal" femaleness. Their attendant immaturity makes them incapable of love. The author takes issue with the assumption that normality is synonymous with mature, reciprocal heterosexuality. With reference to a case study of a homosexual woman, she traces the structure of a lesbian love relationship. The patient is the involuntary witness of sexual intercourse between the parents.

This paper describes how an erotic paranoid reaction, when linked to fantasies of benign conspiratorial persecution by the hospital and the milieu, might merge as the grandiose messiah-complex.