Life-threatening illness in the analyst.

The literature on practicing throughout a life-threatening illness is reviewed and important differences about attitudes toward self-disclosure are understood by noting a division between two perspectives on transference: "one-body" and "two-body" views. The analyst's use of self-disclosure is informed by the prominence given the interpretation of transference as against that given the patient's needs in the collaborative relatedness supporting the therapeutic alliance. Themes and illustrative clinical vignettes are presented from the author's own experience practicing during such an illness. Three phases of working during illness are delineated, each somewhat different regarding the analyst's state, and hence patients' needs and reactions. Recommendations are made regarding conditions that make it possible to work effectively during a life-threatening illness. The analyst needs help from his or her own analyst to make the clinically and sometimes ethically appropriate decisions about practice; while this is important in instances in which the analyst recovers, it is essential should the analyst become terminal and face more certain death.

A new view of developmental research for psychoanalysts.

Three major epistemological perspectives in psychoanalysis are summarized, and the developmental research relevant to each is described. Not all research is useful for all psychoanalytic perspectives. The most historically recent of the three perspectives, exemplified by Winnicott, others in the British Independent Group, and the "relationists" in the United States, who focus on the experiential immediacy of the analyst-analysand interaction and emotions, presents new problems and challenges for meaningful dialogue with the developmental researcher. Research in extrapsychoanalytic disciplines has traditionally been posed as authoritative for the grounding of psychoanalytic "truth," and, unlike the earlier perspectives, this view explicity rejects any truth deriving from authority outside the psychoanalytic process itself. To illustrate how developmental research inquiry would be different for each epistemological perspective in psychoanalysis, the same study of infant development is described in three different ways as relevant to each perspective. Child development research has been changing as a field in ways parallel to psychoanalysis, each undergoing fundamental changes that encourage a new integration.

Effect of indigenous arbuscular mycorrhizal endophytes on the development of six wild plants colonizing a semi-arid area in south-east Spain.

The effect of arbuscular mycorrhizal fungi (AMF) an six plant species that frequently grow in areas of Mediterranean climate in south-east Spain was studied. In semi-arid soils, the most abundant AMF was Glomus aggregation Schenck and Smith, followed by Glomus mosseae (Nicol. and Gerd.) Gerd. and Trappe. The vascular plant species studied were Dittrichia viscosa (L.) W. Greuter (Asteraceae); Dactylis glomerata L., Piptatherum miliaceum (L.) Cosson, and Slipa tenacissima L. (Poaceae); Retama sphaerocarpa (L.) Boiss., and Ulex parviflorus Pourret (Fabaceae). Legumes were studied with single and dual symbiosis (Rhizobium and AMF). In a greenhouse experiment, inoculated plants developed better than noninoculared controls, as shown by dry weight and tissue N and P content. Plants inoculated with G. aggregation grew better than plants inoculated with G. mosseae. For this reason G. aggregatum was chosen for a field experiment, in which this AM fungus increased shoot dry mass, shoot length, and percent survival after transplantation. The effects of soil microorganisms on development, survival and fertility of native plants, their influence on the effects of the erosion, and their importance in plant repopulation programmes are discussed.

Conditions for the relevance of infant research to clinical psychoanalysis.

There is increased pluralism within psychoanalysis today, and the practice of psychoanalysis rests on many different theories and distinctly different epistemologic perspectives about the nature of the truth, the position of the observer-analyst in the process, and the phenomena to be observed. The relevance of developmental observation research to clinical psychoanalysis will vary with the epistemological perspective of the practitioner, and to be relevant the perspective of the researcher must 'match' that of the clinician. Additionally, its relevance is conditioned by what is considered 'empirical' data, i.e. whether the data are defined behaviourally or by empathic judgements of an observer. Three broad categories of psychoanalytic perspectives are discussed: empirical-natural science, hermeneutic-empirical, and hermeneutic-constructivist. A patient in analysis is described, with details of two sessions. Three imaginary consultants, each representing one of the major epistemological clinical perspectives, comment on the material to demonstrate the relationship among technique, epistemology, and the ways infants and developmental observation research may be relevant (or not relevant).

Early state organization and follow-up over one year.

Evaluations of state organization at 36 weeks postconceptional age (PCA) were conducted in the special care nursery on 24 low birth weight preterm neonates who were subsequently assessed on three dimensions of outcome at 1 year postterm. Half the subjects (N = 12) had been cared for in an alternative supportive nursery from 32 to 36 weeks PCA; the other half had remained in the regular intermediate care nursery. Although subjects from the alternative nursery demonstrated superior state organization before nursery discharge at 36 weeks PCA (p less than .05), they were not superior on any outcome measures at 1 year postterm. Subjects demonstrating superior state organization within their nursery group were compared with subjects demonstrating inferior state organization within their nursery group. Significant differences in 1-year outcome were found between these two groups of good and poor neonatal state organizers on gross morbidity, on the Bayley motor scale, and on a measure of recovery of state organization observed in the Strange Situation (p less than .05).

Osmotic disequilibrium causing ascites during chronic hemodialysis.

UNLABELLED: Ascites formation is a recognized complication of chronic hemodialysis (CHD). The cause is an enigma after tumors, tuberculosis, and heart, liver, and pancreatic diseases are excluded. A 55-year-old patient who developed intractable ascites about 6 months after starting CHD was studied. The premise was that osmotic disequilibrium during HD may be the causative factor. Other causes of ascites were excluded. The study method relied on determining simultaneous serum and ascites osmolality (Sosm and Aosm) at the start and finish of a standard 4 hour HD session. THE RESULTS: Sosm and Aosm at the start averaged 310 and 309 mosm/L, respectively. At the end, Sosm averaged 285 and Aosm averaged 301 mosm/L, giving a 16 mosm concentration gradient. Two days later, Sosm and Aosm were equal again. It is concluded that the osmotic gradient at the end of 4 hours of HD favors movement of water from the intravascular space into the ascitic fluid space until osmotic equilibrium is once again achieved.

Parenting a damaged child: mourning, regression, and disappointment.

This paper is an examination of the long-term parenting experiences of parents who have given birth to CNS damaged infants. In particular, the focus is on the mourning, regression, rage, and depression that frequently attend these parents throughout their lives and can become pathological and pathogenic interferences with the provision of good-enough parenting. Several clinical vignettes were presented, each of which illustrated the usefulness of different psychoanalytic clinical theories about normality and pathology of parenting and parent-child interaction. The now-classical contribution of Solnit and Stark (Mourning and the Birth of a Defective Child, 1962) is reviewed along with Benedek's and others' psychoanalytic theories about normal parenting. The thinking of these writers is within the framework of structural/libidinal theory and seems to be useful in describing certain parenting problems that concern the mourning and regressive aspects of parenting. However, it was proposed that some of the adaptive coping and pathology encompassed by Solnit and Stark's explanations is not comfortably illuminated by the structural clinical theory of conflict and drives. Freud's discussion (1917) compares mourning and melancholia, which he differentiated as related but dynamically distinct clinical phenomena. This work is briefly recalled as an earlier point in theory building where structural theory was not sufficient to explain clinical depression and rage that exceeds normal mourning (as in Freud's melancholia). It is felt that an additional theoretical perspective on parenting provided by self psychology can fill in some of the gaps left by structural theory explanations. The self psychology perspective is particularly helpful with understanding the rage, ambivalence, and chronic depression often experienced by parents of damaged children. According to this perspective, the damaged child is a disappointing selfobject for the parent, and the parent's self organization will give him the resources to cope adaptively or to develop narcissistic pathology. Three types of intrapsychic problems for a parent are described: mourning the lost object, the fantasied perfect child; experiencing and recovering from regression to early identifications with his own parents; withstanding tension and regulating one's self (experiencing chronic depression and rage) when confronted with a great disappointment in a selfobject (represented by the damaged child). It is important when designing intervention strategies in a hospital or pediatric clinic setting to clarify which type of problem is the major focus of the parent's struggle.(ABSTRACT TRUNCATED AT 400 WORDS)