Brief psychotherapy for unresolved grief in an 82-year-old-man

This man experienced in old age the torment that occurs when early fantasies that underly anxieties are enacted in real life. His elderly wife, when she became confused, ordered their son to drive him from the marital home. When the wife died, the son kept the news from the husband until after the burial. These acts created in reality the fantasy of a reversed oedipal situation, with the son succeeding as a competitor for his father's wife. If the father had resolved his own oedipal strivings satisfactorily, presumably he would not have feared such competition. But there seemed to have been some early environmental failure that had prevented him from integrating in the process of maturation his own wishes for his mother and his fears of his father. Yet, despite the patient's advanced years, the early failure situation seemed to fade as he used the therapy not only to work through his grief, but also as an opportunity to experience anew in the transference a more facilitating environmental adaptation to his needs.     

Leon H. Levy (1925–2010).

Leon H. Levy died on August 24, 2010, in Richmond, Virginia, at the age of 84. Leon was an extraordinary scholar, teacher, and visionary. He graduated with a bachelor’s degree in psychology from Antioch College in l950 and a doctorate in psychology from Ohio State University in 1954. He was a faculty member at Indiana University, Bloomington, for 24 years, serving as the director of clinical training from 1969 to 1978. In 1978, Leon became chair of the Psychology Department at the University of Maryland, Baltimore County (UMBC) and served in that position until his 1996 retirement. He was the principal figure in creating and launching UMBC’s highly successful doctoral program in Human Services Psychology (HSP) and was graduate program director from its inception in 1984 until his retirement. His striking effectiveness in two concurrent leadership roles continues to amaze his successors. Leon was also an innovator in the professional preparation of psychologists. Leon was the recipient of numerous national Public Health Service grants and published more than 60 scholarly articles. Leon is survived by his wife Sandra M. Levy, a psychologist and priest associate at St. John’s Episcopal Church in Richmond, Virginia; his children Paul, Judy, and Claire Levy; and his step-sons Brian and Kevin Esterling. We join his family in mourning his passing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

John E. Exner Jr. (1928-2006).

Presents an obituary for John E. Exner Jr. Many psychologists bounce around a bit before they lock in on the specialty that becomes the focus of their professional life. That was not the case with John Exner. He first laid hands on a set of blots from the Rorschach Inkblot Test in 1953, and his fascination with the instrument anchored his career from then on. Through five decades, 14 books, more than 60 journal articles, and countless workshop and conference presentations, John Exner and the Rorschach became synonymous. John Exner died on February 20, 2006, at age 77, after a courageous fight with leukemia. He is survived by his wife of 55 years, Doris, five children, and 10 grandchildren. Doris was the administrator of Rorschach Workshops since its inception. John chronicled their lifelong love in a series of poems in the dedication section for many of his books. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

John Porter Foley, Jr. (1910–1994): Obituary.

Memorializes John Porter Foley, Jr., who was known for his early work on the conditioned responses in primates and abnormal behavior of humans, and later for his work in industrial psychology. Foley's interest in evaluation and training led him to a position as the Director of the Psychological Corporation's Industrial Division, and later to the establishment of his own consulting organization, J. P. Foley and Associates. Foley's work also included collaborations on testing research with his wife, Anne Anastasi, a former president of the American Psychological Association. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Computer based nursing documentation means to achieve the goal

New functions have been integrated in the Giessen Hospital Information System WING to support the classification of all intensive care patients into the Therapeutic Intervention Scoring System (TISS). The use of those functions has been pushed when health insurance bodies demanded evidence for the correct classification of ICU beds. This article presents an overview on this development from the start in just one intensive care unit to the complete coverage of six intensive care units and three intensive monitoring units with a total of 109 beds. For those units complete TISS data has been documented for more than a year now at a detailed level. On average 14 interventions have been recorded per patient and day, accumulating to a database with more than a million entries. We describe the experiences made during introduction and the different front-end applications we used to achieve the goal. Results gained from the huge database and their implications for our future work are discussed. TISS documentation is now an established routine on every intensive care unit of our University hospital. It has been implemented without major financial or manpower investments and no specific intensive care information system has been needed. Establishing this type of basic care documentation made nurses aware of their activities, so that now they consider electronic care documentation to be in their very own interest. The next goal has been set by nurses themselves, they want to establish intervention based care documentation on normal wards as well. We think that step by step we will thus be able to achieve a more complete electronic patient record.     

John Watson Murray Rothney (1906–1987).

Presents an obituary for John Watson Murray Rothney, who died in Roswell, New Mexico, on July 1, 1987, after a lengthy illness. He was one of the early and continuing influential persons in guidance, counseling psychology, and counselor education and was particularly famed for his longitudinal research in school counseling. He attributed his early interest in longitudinal research to W. F. Dearborn with whom he worked on the Harvard Growth Studies involving 2,000 school children in the early 1930s. He also worked on the Dartmouth Study on Vision and Motivation in the late 1930s. John Rothney was deeply committed to education, to the University of Wisconsin, to his family, to his colleagues, and to his students. He was highly respected and left his mark and influence on all individuals and institutions that had the good fortune to experience involvement with him. He is survived by his wife, Ruth, two sons, Jim and Scott, and two grandchildren. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bj?rnstjerne Bj?rnson, a wife of a cotter and a physician. The lawsuit against physicians 1907

The Norwegian poet and Nobel Prize laureate in literature Bj?rnstjerne Bj?rnson (1832-1910) lived for the last 35 years of his life on his estate Aulestad, near Lillehammer. The wife of a cottar at a nearby farm, a servant to his wife Karoline, fell ill in November 1906 with an incarcerated hernia and was sent to the local hospital by Bj?rnson's physician. On arrival at the hospital the doctor in charge found her too ill to operate on. She died a few hours after an operation the next day of peritonitis and a gangrenous intestine. Bj?rnson found this inexcusable. Because of a session with the Nobel Peace Prize Committee, he left his son Erling to attack the hospital in a press article. This led to a lawsuit in which the doctor was accused of irresponsibility and incompetence. After several court sessions the case was dropped on 7 July 1907. This was probably the first case in Norway raised against doctors for irresponsible and incompetent treatment of a patient with death as the result.     

Review of Trauma and human existence: Autobiographical, psychoanalytic, and philosophical reflections.

Reviews the book, Trauma and human existence: Autobiographical, psychoanalytic, and philosophical reflections by Robert Stolorow (see record 2007-07947-000). The author discribes his book as a “project (that) has occupied (him) now for more than 16 years” (p. 45) starting six months after the tragic death to metastatic cancer of his 34-year-old wife Daphne (“Dede”) Stolorow, on February 23, 1991. His book exemplifies a value, deeply shared by the author and his late wife, that of “staying rooted in one’s own genuine painful emotional experiences” (p. 46). The volume is very dense (50 pages of text, total), the product of 16 years of intense and sensitive reflection. It condenses in very short order the history of his intersubjective perspective on developmental trauma, (the outcome of invalidating malattunement in the “parent–child mutual regulation system” lending to unbearable affect states in search of a “relational home”), his theory of the phenomenology of trauma (the shattering of “absolutisms of everyday life”), trauma’s temporality (trauma freeze frames the past and the future into an eternal present), and, finally an analysis of the ontological or universally constitutive aspect of trauma in our lives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Withholding medical care as a physical injury--homicide from the viewpoint of the physician

Limitation and termination of intensive care and in particular life support in patients who do not have a chance to recover from their illness has become a widely accepted approach in intensive care medicine. In well defined situations, life support can be withheld or withdrawn without the risk of becoming a criminal case. Frequently, the physician must base his/her decision on the presumed will of the patient which can be difficult to assess. Existing guidelines of the Society of physicians of Germany, which are partly preliminary, are helpful for the decision process of the physicians as well as of the relatives of the patients.     

Postvasectomy residual sperm pregnancy

A pregnancy occuring within a few months after a successful vasectomy is sometimes attributed by a skeptical physician to sexual involvement by the spouse with a nonvasectomized man. This assumption may be unjustified because of the fact that after a vasectomy, some residual sperm which are viable enough to cause pregnancy could remain stored distal to the site of occlusion. The Maternal and Child Health Center of Taiwan documented a case history of a 32-year-old father of 2 who impregnated his wife approximately 38 days, and at least 9 ejaculations, after a successful vasectomy. The patient had no urogenital abnormalities and had an uneventful vasectomy procedure. He resumed intercourse with his wife 8 days after vasectomy and returned for 5 semen tests during the year after vasectomy. The patient's 28-year-old wife had her last menses 24 days after the vasectomy, and pregnancy test 57 days after the vasectomy confirmed the suspicion of pregnancy. Vacuum aspiration terminated the pregnancy 2 days later. There was no doubt or question at all that the patient was his wife's only sexual partner. The authors concluded that based on examination of several thousand postvasectomy semen specimens, the distribution of the biologic limits for residual sperm viability is an asymmetrical distribution skewed to the right, suggesting that the limits may even exceed 38 days for some individuals. Thus physicians should be careful in evaluating a pregnancy which occurs a few months after a successful vasectomy.     

Human growth hormone transgene expression increases the biomechanical structural properties of mouse vertebrae

Delusions of pregnancy in men have been reported rather infrequently. This case report is of a male schizophrenic patient who developed a delusion of pregnancy on two successive occasions each time when his wife became pregnant. The authors view briefly various aetiological hypotheses of delusions of pregnancy and whether the couvade phenomenon had any role in the origin of this delusion.     

Pressure transducers as a source of bacteremia after open heart surgery. Report of an outbreak and guidelines for prevention

During four weeks in 1974, eight (26 percent) of 31 intensive care unit patients who had undergone open-heart surgery developed symptomatic Pseudomonas cepacia bacteremia in the intensive care unit one to three days after the open-heart surgery. An investigation demonstrated that operating room pressure transducers were being contaminated during cleaning with a detergent that contained P cepacia at the rate of 10(4) organisms per milliliter and that the organisms were transmitted to patients after open-heart surgery as a result of one to three days of contact with transducer-monitoring lines used in the operating room and brought to the intensive care unit with the patient. Pressure-transducer contamination, a frequently unappreciated but preventable cause of nosocomial bacteremia, can be minimized by sterilizing transducers between use on different patients by paying strict attention to aseptic technique when setting up, calibrating, and using monitoring systems; and by changing transducers, tubing, and monitoring fluid for each monitored patient at regular intervals.     

Quality of life after intensive care

The outcome of intensive care is related to patient selection and case-mix. Especially when assessing QOL, the results should be interpreted in the context of age and the cause of intensive care admission. Only a few QOL studies so far have databases which are large enough to characterize the outcome in specific patient groups. The influence of preexisting chronic diseases should be taken into account as well. A far more difficult issue is how to screen for differences in socioeconomic background. Problems in physical functioning seem to be common among ICU patients in general, but among younger patients the psychosocial problems are also dominant. While the QOL after intensive care as compared with reference values may be better perceived among older patients, the previously healthy and younger ones tend to experience more limitations. The reason for intensive care presumably has impact on the pattern of convalescence. A better understanding of the natural history of recovery from critical illness may help to identify those patients who need more intensive rehabilitation.     

John Walter Thibaut (1917–1986).

John Thibaut died on February 19, 1986, after a five month bout with lung cancer. Characteristically, he lived his last months with dignity and with deep love for his wife and children. With an extensive circle of students, colleagues, and friends he was one of the most loved and respected figures in psychology. Professionally, he had made major contributions to his science and university and had received recognition through election to the American Academy of Arts and Sciences (1978), receipt of the Distinguished Senior Scientist Award from the Society for Experimental Social Psychology (1981), and receipt of the Distinguished Scientific Contribution Award from the American Psychological Association (1983). (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Valuing a practice for a partnership

The hot topic from Capitol Hill in Washington to Capitol Hill in Jefferson City is health care reform. President Clinton started the ball rolling during the campaign in 1992 by including health care reform in his platform. He continued the effort after his election by appointing his wife, Hillary, to chair a task force to present an outline for federal legislation. Since the package was presented to Congress, there has been much discussion, lobbying, and rumoring about the implications of health care reform and what it could mean to all of us as dentists. On the home front, Governor Carnahan has introduced legislation in Missouri to reform the health care system. This effort is known as the Missouri Health Assurance Plan (H.B. 1622). Missouri Dental Association members are vitally concerned about the impact of health care reform on their practice, their taxes, their relationship with their patients and employees, and on their ability to seek out health care services since each member is also a consumer of health care. This article represents answers to some of the questions being asked by MDA members in order that they might be more aware of the activities by the MDA, the ADA, and other levels of organized dentistry relating to health care reform.     

A Recent Court Experience.

Because of the recent interest in the testimony of the psychologist as an expert witness, I would like to share a recent court experience with APA members. A patient murdered his estranged wife during the time he was being evaluated for treatment at the Hamm Memorial Psychiatric Clinic, a privately endowed community clinic. He was seen once in May, 1955, by the psychiatric social worker and the psychiatrist; but he did not return until November of the same year, at which time he again saw the psychiatrist, who referred him to me for psychological evaluation. Eight days after I saw him, he shot and killed his wife. The entire psychiatric team was subpoenaed by the defense attorney to testify in the Ramsey County District Court as to the patient's mental condition prior to and at the time of the murder. In addition, the defense attorney requested that the psychiatrist, as well as myself, evaluate him in the jail as to his mental condition subsequent to the murder. The first professional member called to the witness stand was the psychiatric social worker, who was questioned rather briefly as to her impressions of the defendant at the time he was first referred. I was called to testify immediately afterwards and was subjected to questioning and cross-examination for a five-hour period. One hour was spent in qualifying me as an expert in terms of education, experience, academic appointments, and the like. The remainder of the time was devoted to an analysis of the psychological tests, as well as my clinical opinions as to the psychological condition of the patient. No attempt was made by the prosecuting attorney to harass me personally, although he would occasionally intersperse such comments as, "You are not a qualified psychiatrist, are you?" or, "You do not have an MD degree, is that right?" At the same time, he did not raise objections when the defense attorney asked for my diagnostic impression or opinion as to whether or not the patient knew right from wrong at the time of the shooting. Following my testimony, the psychiatrist was called to the witness chair and gave essentially the same picture based on his evaluation of the patient. The jury deliberated six hours and the defendant was found guilty of murder in the first degree which carries a mandatory sentence of life imprisonment. An informal polling of the jurors after the trial by the attorney for the defense revealed that the jury at no time questioned my expertness and fully accepted me as a professional member of the community. The majority agreed that the patient was psychotic but apparently did not feel he was insane. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contributions of ethics to the practice of intensive care

Intensive care, one of the greatest achievements of modern medicine, is not without its problems. In what sense could ethics contribute towards an intensive care medicine which would be humane and respectful of what it means to be sick? After having presented a phenomenology of what it means to be sick and in intensive care, the author proposes an ethical framework which could guide the decision-making of physicians specialized in the field. This framework has three levels. Level one deals with the basic values of benevolence and autonomy which are those of medicine itself. Level two deals with the implementation of these values, which bioethics sees as conflicting. Implementation is achieved by "conversation" between the physician and the patient. Finally, the physician is invited to question his or her own attitude towards the unavoidable dilemmas created by the paradoxes and contradictions of modern medicine.     

Dementia: supporting the patient and the carer

This article illustrates the many skills required of a community psychiatric nurse in caring for a patient with dementia while also providing support for the carer. A four-year case study shows how early intervention and continued support enabled the patient to remain living in the community with his wife, which is what they both wanted.     

Nutrient Intake Report: a coordination of patient dietary assessment between physicians and registered dietitians

The Nutrient Intake Report (NIR) is based on a 7-day dietary recall questionnaire used previously in research for dietary assessment and adapted for clinical use. Used to provide information and counseling as part of total patient care, the NIR acts as a cornerstone for dietary education and interaction between physician, registered dietitian, and patient. The NIR is ordered by physicians or registered dietitians, scanned and assessed by a registered dietitian, and incorporated into the laboratory section of the medical record. It documents the patient's dietary intake in the context of his or her diagnosis and general health status. The NIR also opens a dialogue between physicians and registered dietitians. Incorporation of the NIR into the medical record makes the work of the registered dietitian available to other health practitioners, which is welcome in an era when licensing and reimbursement are contingent on systematic documentation of dietary assessment and its role in patient care.