Save Your Marriage
Although dermatologists have more of a consultative role, they maintain a high level of patient contact. They establish long-term relationships with their many patients whose chronic skin conditions require multiple follow-up appointments over the course of several years. Patients appreciate their dermatologists for their equal emphasis on preventive medicine and immediate treatment of acute skin diseases. While dealing with the current problem at hand, dermatologists also make sure to educate their patients on the importance of skin cancer prevention staying out of the sun, using sunscreen, and watching their own suspicious moles. Many patients do not realize that mole self-checks are just as important as monthly breast self-examinations.
Anna Schonleben was born near Bayreuth in Bavaria and orphaned when only five years old. She was then passed from one family member to another until she was sponsored by a wealthy guardian who paid for her to be educated. At 15 she was married off to a 27-year-old lawyer Herr Zwanziger, but it was not a happy marriage, because her husband was an alcoholic and could not get work, and Anna's giving birth to two children only made matters worse. Her answer to the family's need for income was somewhat unconventional but it was one way she could cash in on her undoubted good looks and ability to hold an educated conversation she became a high class call-girl, confining her client base to judges and other men in powerful positions.
As the result of migration, some Colombian families tend to present marital conflicts, difficulties in communication with their teenage children, and symptoms of posttraumatic stress disorder. Alcoholism tends to be common in males depression occurs frequently in women (Leon 1993). Colombians also show frequent symptoms of somatization, resulting from postmigration stress. Escobar (1987 Escobar et al. 1983) documented higher somatization indexes among Colombian patients with major depression compared to North American patients.
Adaptation to life in the United States has not been easy for Dominicans. They face problems of unemployment, underemployment, poor housing, lack of knowledge of English, and lack of adequate health services. This difficulty in adjustment is most predominant among professional male immigrants, because they often can only obtain nonskilled employment, usually in New York's garment district. Dominican males have one of the highest unemployment rates in New York City (Rodriguez et al. 1995). Migration has disrupted family units, separating spouses from each other and parents from children. The result has been high divorce rates, as well as high levels of stress and depression (Cosgrove 1992).
Summary Epilepsy and the Family A New Guide is an update of a classic handbook for people with seizure disorders and their families. The author wrote this book to educate people with epilepsy, but he cautions the reader not to use this as a substitute for medical advice. Using references to actual cases, the author provides coping strategies for the practical and emotional challenges that epilepsy brings to the family. The author devotes chapters to special issues, such as (1) marital problems, (2) sexual activity, (3) childbearing and inheritance, (4) personality changes and violence, (5) treatment options, and (6) what to do when a seizure occurs. This new guide (1) addresses questions that adults with epilepsy may not ask their physicians (2) provides chapters tailored to the special needs of spouses, parents, children, and siblings of people with epilepsy and (3) discusses some medical conditions that can cause seizure disorders in children and adults, while addressing the issue...
With epilepsy from an eclectic perspective as well as the discussion of possible neural mechanisms of behavior, diagnostic considerations, and the use of multidisciplinary management of patients having nonepileptic events. Chapters nine through eleven deal with the importance of the appropriate selection of antiepileptic drugs, the treatment of psychiatric comorbidity with reference to the selection of appropriate psychotropics, and the importance of family therapy in people with epilepsy. Chapter twelve is a first person account of epilepsy which reflects the wide range of psychosocial and treatment issues encountered by those with epilepsy. In the preface, emphasis was placed on viewing quality of life as a measurable treatment outcome in the care of patients with epilepsy, understanding the economics of epilepsy and health care reforms, and addressing stigmas forced on people with epilepsy.
Mary Blandy was an unlikely poisoner. She was so incompetent that she left a trail of evidence that led quickly to her downfall. It may be that she was at first duped into poisoning her father by Captain Cranstoun, the man who wished to marry her. Mr Blandy had advertised the fact that his daughter was relatively rich (it transpired that he had been exaggerating), but was apparently not amenable to Mary's choice, or indeed her previous choices, for marriage. The son of a Scottish peer, Captain Cranstoun was not rich and was probably penniless. Furthermore, it appears that he was already married. After failing to persuade Mary to marry him secretly, he convinced her to administer a potion to her father that would make him more amenable to their marriage. At first it seemed to work, but when Mary discovered that Cranstoun also had a mistress in London he tried to persuade her to poison her father. He sent her a present of Scottish pebbles and some 'white powder' to clean them with.
Oppositional defiant disorder (ODD) A behavior disorder characterized by uncooperative, defiant, negative, irritable, and annoying behavior toward parents, teachers, and other authority figures in children and teens. Oppositional defiant disorder (ODD) is reported to affect between 2 and 16 percent of children and adolescents in the general population, usually appearing by age eight. ODD is more common in boys than in girls and may be more common among those children whose parents are having marital problems. Oppo-sitional defiant disorder often coexists with other mental health disorders such as mood disorders, anxiety disorders, conduct disorder, and attention Treatment may include individual therapy, family therapy, peer group therapy, or medication. Family therapy Family therapy is often focused on making changes within the family system, such as improving communication skills and family interactions. Parenting children with ODD can be very difficult and trying for parents....
Pediatrics offers many different avenues in which a physician can find his or her personal niche long-term health issues, acute critical care, and specialties that emphasize anything from physiology to psychosocial skills. A career in pediatrics also provides balance, because you continually educate both children and their parents. By building long-term relationships, pediatricians get to see kids when they are doing well, not just when they are sick. In the same day that you meet an infant who may not be growing properly, you will also give words of encouragement to a teenager, inspiring him to set goals for his future, and talking to him about sex, drugs, and rock 'n roll.
What exactly is psychotherapy It is a systematic method of treatment in which the psychiatrist and the patient discuss troubling feelings and problems during regularly scheduled meetings. Together, they find solutions to the underlying roots of these issues. There are many types of psychotherapy, such as those that help patients explore past relationships, discuss repressed feelings, or change thought patterns or behaviors. For most people, psychotherapy conjures up images of Sigmund Freud and classic psychoanalysis. This intensive form of individual psychotherapy involves four or five sessions per week over the course of several years. Psychoanalysts help patients recall and examine past events and memories to help them better understand their present behavior. Other commonly used forms of talk therapy include psychodynamic psychotherapy, behavioral therapy, cognitive therapy, and couples and family therapy.
In a few families, the conflict between siblings is so severe that the help of a mental health professional may be required. Signs that a family may need outside help in solving the problem include conflict that is causing marital problems, creates a real danger of physical harm, or that is hurting a child's self-esteem or psychological well-being.
Through long-term relationships with their patients, radiation oncologists assess for clinical stability or signs of recurrence and manage any long-term sequelae of treatment. This is particularly important as these late effects can become manifest weeks to years down the line, and may even include iatrogenic (radiation-induced ) secondary tumors. Your familiarity with radiation's true long-term effects on many organ systems will allow you to identify and medically intervene when necessary.
Because of the cultural value of machismo, which among other elements describes males as preoccupied with sexual conquest and domination over other males who threaten the family, Latinas may have difficulty trusting male providers with very personal issues, especially those related to marital conflict and sexuality. However, if rapport is established, a male provider, especially a Latino, can be well positioned to model for Latino families that being male does not require subordination of others. Male therapists must be attentive to when the gender difference interferes with the Latina patient's openness and must maintain a demeanor that is sufficiently formal so that it cannot be interpreted as flirting or sexualized behavior.
In the fourth major adjustment strategy, the neurotic projects inner conflicts onto the outside world, a process Horney called externalization. Externalization refers to the tendency to experience internal processes as if they occurred outside oneself and, as a rule, to hold these external factors responsible for one's difficulties (Horney, 1945, p. 115). It includes the defense mechanism of projection, as traditional psychoanalysis understands it, in which our own unacceptable tendencies (such as anger or sometimes ambition) are perceived as characteristic of other people but not ourselves. In one case study, for example, a woman was interpreted to have selected her ambitious but narcissistic husband because she could externalize onto him power, competence, and a capacity for success that she could not see in herself (Horwitz, 2001). This defensive choice by the self-effacing wife, combined with the husband's own expansive and narcissistic solution to conflict, led to considerable...
Various kinds of adult attachment resemble infant attachment styles. A person who falls in love, marries, and stays in a stable relationship throughout adulthood exemplifies secure attachment. Another, who is hesitant about love, marries, but divorces not long after and thereafter avoids long-term relationships illustrates an avoidant attachment style (Klohnen & Bera, 1998). Insecure attachment, too, occurs in adulthood as well as infancy. Michael Sperling describes desperate love in some college students as a style of love with high anxiety and the desire to be extremely close to the loved one this corresponds to insecure attachment in infancy (Sperling & Berman, 1991).
One of the most important findings to emerge from Barratt's research is that impulsiveness must be considered in the context of other personality variables. To illustrate, let us consider his current area of interest, impulsive aggression. Impulsive people are not necessarily more aggressive than nonimpulsive people, but impulsive, angry people are likely to lash out unexpectedly. I once saw a client who fit Barratt's description like a glove. John, as I'll call him, had some problems with his impulsivity, but he was a hardworking, generally stable man. His most serious flaw was his quick temper. It was a constant struggle to keep a lid on his anger, but in most situations he was quite successful in doing so. The one important exception was any discussion with his wife in which she conveyed even the smallest hint of criticism. Whenever they would begin to talk about a problem, John would feel his anger intensifying almost immediately. He would try to remain calm, but he was like a...
They also wondered why clitorises have such trouble provoking orgasm. They assumed that if clitorises worked properly like penises, they should just do their job of promoting marital satisfaction without so much copulatory effort. cortex (the brain's cognitive center). The clitoris is only the tip of the psychological iceberg in female choice. Having a mate with a large penis is not enough. To be fair, the penis is not just an insensate stimulator either. It is also a mechanism for male mate choice. If it is happy, its owner may be more likely to stay in a long-term relationship with a woman.
Transactional supercausality explains the cat paradox, Fig. 13.3, by interlacing contingent emitters and absorbers across space-time in a hand-shaking, to form a complex subquantum system whose outcomes are naturally distributed according to the wave amplitude because they are the result of bifurcations of offer and confirmation waves dependent on their relative amplitudes. Reduction of the wave function corresponds to a particular matching of emitter and absorber for one exchanged wave-particle. Determining which part of the wave function a particle appears in is converted into the combinatorial one of which emitter and absorber pair are matched up. One can model the transition from many-to-many to one-on-one in terms of a nonlinearity in which pairs become mated in sequence. However, this process cannot be resolved causally, based on initial conditions because of the hand-shaking, leaving a loophole that only the anticipatory mind and not computation per se can resolve. The many...
Both of Jung's parents were the youngest of 13 children, a situation that may have contributed to some of the difficulties they had hi their marriage. Jung's father, Johann Paul Jung, was a minister in the Swiss Reformed Church, and his mother, Emilie Preiswerk Jung, was the daughter of a theologian. In fact, eight of Jung's maternal uncles and two of his paternal uncles were pastors, so both religion and medicine were prevalent in his family. Jung's mother's family had a tradition of spiritualism and mysticism, and his maternal grandfather, Samuel Preiswerk, was a believer in the occult and often talked to the dead. He kept an empty chair for the ghost of his first wife and had regular and hithnate conversations with her. Quite understandably, these practices greatly annoyed his second wife.
At Leytonstone, Chapman met 39-year-old Mary Isabella Spink, the estranged wife of a railway porter. During their marriage they had had two children, Shadrach, the eldest, had been taken by his father, and William, born after they separated, was living with his mother. When Mary met Chapman, William was about five years old. Mary told Chapman that there was a furnished room to let in the house where she lodged in Forest Road, and he went to see it and decided to take it.
It is clear that certain barriers within the surgical profession end up discouraging women from entering. Many women are discouraged by the long hours, family sacrifices, and male-dominated operating room. Also, performing routine and emergency surgery on patients at all hours of the day and night does not lend itself well to being an available parent. Compared to other specialists, female surgeons are more likely to be single (but their divorce rate is equal to that of their male colleagues). And, because of strong professional aspirations and interests, they are also less likely than others to have children, or, if they do, more likely to have full-time childcare.12 Moreover, the military nature of a surgical residency degradation, humiliation, and rigid chain of command is especially unappealing. On a lesser note, many medical students and residents have observed that female scrub nurses
Perhaps even more importantly for long-term relationships, there was no television to keep your sexual partner amused after the first blush of romance faded. If they were bored in the relationship, there was no vicarious entertainment to be had. They either had to put up with your boring old self, or find a new lover. During the Holocene, when long-term monogamy thrived, people worked much harder and longer hours doing their planting, herding, trading, and career-climbing. There were fewer hours of leisure to fill, and more ways to fill them without talking to one another. Historically, humans did not begin to put up with lifelong marriage until they could no longer live off the land, property inheritance became the key to children's survival, and couples had economic incentives to continue cooperating long after they were no longer on speaking terms. During prehistory, there were fewer economic incentives to stay together, fewer distracting entertainments to replace lost romance, and...
Descutner and Thelen gathered evidence that demonstrates that people with high scores on their scale do have a number of intimacy problems. Compared to low scorers, they acknowledge that others find it difficult to get to know them, they have had fewer relationships lasting more than a couple of months, they are less satisfied with the quality of their dating relationships, they feel uncomfortable at the prospect of getting close to others, and they do not expect to feel satisfied once they enter a long-term relationship or marriage. Given these problems, it is not surprising that people with a fear of intimacy are significantly lonelier than their counterparts. If you did receive a high score on this test, it probably is the case that you could improve your relationships and your overall satisfaction with life by working on your communication skills. Psychologist Spencer Rathus has made a number of recommendations for those who wish to increase their ability to be emotionally...
Individual psychotherapy uses cognitive-behavioral approaches to improve problem-solving skills, communication skills, impulse control, anger management skills, and stress management skills. Family therapy is often focused on making changes within the family system, such as improving communication skills and family interactions, as well as increasing family support among family members. Peer group therapy is often focused on developing and using social skills and interpersonal skills.
Considering adoption should be stable, sensitive, and be able to give a child love, understanding, and patience. An adoptive parent may be married or single, childless or already a parent. It is possible to adopt even if a person has been divorced, has had marital problems, received counseling, or has a disability if the person can still care for a child. Agencies usually ask for proof of marriage, divorce, or death of a spouse, and applicants are generally asked to have a physical examination to document that their health permits them to care for a child.
Human males are generally not as choosy about short-term affairs as females. There is very little opportunity cost to short-term mating for men. It does not exclude other sexual options. But men get much choosier about medium- and long-term relationships, because their opportunity costs increase dramatically. If they are in a sexual relationship with one woman, it is very difficult to sustain a sexual relationship with another woman. They cannot give both their full attention. They must make choices sexual Evolutionary psychologists such as Doug Kenrick have good evidence that when it comes to choosing sexual partners for long-term relationships, men and women increase their choosiness to almost identical levels. They also converge in the features they prefer. Kenrick found that for one-night stands, women care much Women quickly learn the difference between male short-term mating and long-term commitment. They know it is generally easy to get a man to have sex, but hard to get him to...
Adlerian therapy aims to change thinking, emotion, and behavior through progressive stages (see Table 4.4). Because Individual Psychology believes all personality failures result from a lack of social interest, Adlerian therapy aims to foster the individual's social interest, that is, to take over a maternal function (Ansbacher & Ansbacher, 1956, p. 1 Willis approach appeals to some feminists because it emphasizes freedom and purposeful-ness, and in addition because Adler often emphasized the importance of gender equality (Morris, 1997). In stressing the social nature of the human, Adlerians have also been highly involved in family therapy (Dinkmeyer & Dinkmeyer, 1989 Sherman & Dinkmeyer, 1987).
A psychiatric evaluation revealed a woman who seemed in no distress and did not look ill, though she said she had been ill all her life. The patient had grown up in a home with marital discord and described her mother as cold and distant, her father as loving. His death, approximately 10 years before, had occurred just before a marked increase in all her complaints and a downhill course that involved multiple hospitalizations and surgeries. Although she was now divorced, she remained locked in an emotional battle with her ex-husband.
Like great detectives, endocrinologists make use of an extensive array of diagnostic testing. They study ACTH stimulation tests, dexamethasone suppression tests, bone densitometry, and thyroid function panels. Aside from cases of diabetic ke-toacidosis, adrenal crisis, and thyroid storm, there are few endocrine emergencies. This allows the clinician ample time to think about and prepare appropriate treatment regimens. Endocrinologists enjoy long-term relationships with their patients, who are typically on the younger side. As part of their patients' therapy, they often have to address the behavioral and psychosocial aspects of endocrine disease. For instance, patients with poorly controlled diabetes need to be taught (and encouraged) to modify their lifestyle, comply with their medication schedule, and use home glucose monitoring. Although much of their time is spent in the clinic setting, endocri-nologists also serve as inpatient consultants for endocrine emergencies and diagnos
Responsible for filtering out impurities from the blood. As part of their diagnostic workup, they analyze acid-base studies, electrolyte panels, and urine collections. In this highly intellectual specialty, they treat all types of diseases of the renal system, such as infection, kidney stones, alkalosis acidosis, autoimmune disorders, renal artery stenosis, and cancer. The nephrologist must understand how systemic diseases like hypertension and diabetes affect the kidneys, as well as be able to identify renal toxic effects of any medication. Long-term relationships are formed with patients who require chronic dialysis, and life-saving interventions such as acute hemodialysis are often provided within the intensive care setting. Nephrol-ogists also treat postrenal transplant patients and manage the complications of chronic immune suppression secondary to posttransplant medical therapy.
Relapse is an essential component of the dependency syndrome. Most patients relapse several times early in the course of treatment and recovery, but relapse can occur at any time. Patients are most likely to relapse when confronted with illness or psychosocial stressors (e.g., marital problems, job loss). Relapse does not necessarily indicate lack of motivation or compliance, especially with patients who have expended much effort, money, and time in attempting to recover. Relapse may mean that treatment was incomplete or otherwise ineffective or that a contingency had not properly been anticipated. Most relapses arise from the loss of vigilant preventive maintenance by the patient or the physician.
Consider how someone would feel about finding out that they had the karyotype and gonads of a male even though they seemed to be anatomically female. How would you feel if you found out that your karyotype or gonads were not those expected for the sex that you appear to be If you discovered that the person you were married to had the same set of sex chromosomes you have, even though their anatomy is that of the opposite sex, what would you think of laws declaring your union homosexual and your marriage invalid under the law Would it change your perceptions of yourself and how you fit into the world What would you think of the Parisian model's situation if she had simply said, that's ridiculous, and went ahead with marrying her fianc Alternatively, how would you feel if the model had compliantly responded to the doctors by taking up male attire and going in search of a woman to marry Consider why you have the reactions you have and what your justifications are, and think about how you...
Strong evidence indicates that Mexican Americans, as a group, tend to maintain traditional values about the role of the family in life (Montiel 1973). This evidence includes population figures that show higher numbers of intact families and focused studies that show continued allegiance to specific values. Among the areas that merit assessment are
Destmy does not mean preordamed or foredoomed. It is our destination, our terminus, our goal. Within the boundaries of our destiny, we have the power to choose, and this power allows us to confront and challenge our destmy. It does not, however, permit any change we wish. We cannot be successful at any job, conquer any illness, enjoy a fulfilling relationship with any person. We cannot erase our destmy, but we can choose how we shall respond how we shall live out our talents which confront us (May, 1981, p. 89).
As physicians who treat the mentally ill, psychiatrists have some of the most rewarding long-term relationships with their patients. This is an interdisciplinary specialty, well-suited for doctors who wish to use the broadest of all skills psychosocial, scientific, and clinical. Historically, psychotherapy has always formed the core of psychiatry. But with remarkable advances in neuroscience and drug therapy, this field of medicine has shifted to a more biological-based approach. Now, psychiatrists draw on the latest research in brain imaging, genetics, and psy-chopharmacology to treat many debilitating disorders.
In the primary care setting, patients sometimes complain of anxiety symptoms that do not meet diagnostic criteria for an anxiety disorder. These patients usually report brief or intermittent anxiety in the setting of stresses such as bereavement, serious illness, marital discord, or financial embarrassment. The patients are often anxiety-prone individuals and describe themselves as worriers at baseline. Treatment of subsyndromal anxiety includes emotional support and medications to control symptoms (see below).
Savving Your Marriage
Do you need to save your troubled marriage? Save Your Marriage and Develop a Lifelong Love. If you are having trouble in your marriage, you are not alone.