PsychiatricTimes Members: Login | Register

|     

PsychiatricTimes SearchMedica Medline Drugs

Powered by SearchMedica

 
Risk Assessment
News
Current Issues
Blogs
Special Reports
CME
Conferences
Resources
Careers
Multimedia
About Us
 

Home »

Psychiatric Times. Vol. 25 No. 9
Pages: 1  2  
Next
Practicing 

Reconstructing One’s Past

By Jerry M. Lewis, MD

| August 1, 2008
Dr Lewis is chairman emeritus of the Timberlawn Psychiatric Research Foundation and clinical professor of psychiatry at the University of Texas Southwestern Medical School. He is also in private practice of individual, marital, and family therapies in Dallas.

Over 55 years ago, I graduated from the then almost new University of Texas Southwestern Medical School in Dallas and went off to Boston and the Brigham to be a straight medical intern. I had been married for 2 years, and my wife was pregnant with our first child—neither of us knew a soul in Boston. I was on duty for 36 of each 48 hours (except for 1 weekend a month) and was of little help to my wife, who was alone in a strange city and was facing the imminent birth of our first child. It was, in short, not an easy year. However, we made friends, and I was encouraged to stay on at the Brigham. We not only survived but, in a sense, flourished. Although from a developmental perspective, survival and growth are important markers of outcome, there is more to the ways in which those experiences changed us than those markers suggest.

One change concerned what was to become my career in psychiatry. In the Dallas of the early 1950s, psychiatry was overwhelmingly biologic. There were no helpful psychotropic drugs, and the prevalent treatment paradigms involved electroshock, insulin coma, and, for some, sleep therapy. In Boston, psychoanalysis was the clearly dominant ideology, and whether stated explicitly or accepted implicitly, it was based, in part, on the biblical injunction that knowing the truth shall set you free. As a psychoanalytic premise, however, the biblical injunction was understood as meaning that knowing the truth about oneself led to freedom from maladaptive behavioral patterns learned in childhood. This emphasis on truth and the search for insight attracted some of the very brightest of my fellow house officers in Boston and had a major impact on my evolving ideas about human psychology.

How much things have changed since those early days! My reading of the current understanding of what one discovers about oneself in many forms of psychotherapy is not necessarily the truth but rather a more useful reconceptualization of one’s personal past. The emphasis on truth has been replaced by that of utility. What, it is now asked, is the most helpful way of understanding one’s personal past?

This movement away from the search for truth as a guiding principle of many psychotherapeutic schools has been influenced during the past 50 years by multiple factors. In this essay I will discuss only 3: longitudinal studies, narrative theory, and neuroscientific advances, particularly those regarding memory.

Longitudinal studies suggest that many adults’ recollections of their pasts—especially childhood and family experiences—undergo changes throughout life. One “truth” is replaced by another. For some, the parents of childhood are recalled more sympathetically. For others, the recollections are much more critical. Some believe that the difference between those who are more sympathetic and those who are more critical is to be found in the present circumstances of those who are doing the recollecting.

We found support for this premise in a longitudinal study of young couples before and after the birth of their first child.1,2 In the findings relevant to this topic, the participants’ reports of their childhood relationships with each parent and the nature of their parents’ marriage were relatively stable from the prenatal period to 4 years after the birth of their first child. Having a child and parenting that child for 4 years did not appear to induce systematic changes in the recollections of their own childhoods. There was, however, one intriguing exception to this picture of relative continuity. A number of the female participants changed their recollections of their fathers from positive to negative. After 4 years of parenting, they no longer recalled their fathers as being as affectionate and supportive during their childhoods as they had been before the birth of their child. In searching to understand the correlates of these changed memories, we found a clear pattern, and it had to do not with the female participants but their husbands. The women who changed their recollections had husbands who were depressed, who helped little with parenting, and who were observed to be less sensitive to their children than other fathers.

Why, then, would the women with less available and helpful husbands change their recollections of their fathers in a negative way? One possible answer to this question was found in the marital satisfaction data. The women with depressed, unhelpful husbands did not report lower levels of marital satisfaction; rather they were maintained at high levels. One interpretation of our data was that the women’s more negative memories of their fathers served the function of minimizing (or denying) their husbands’ failure to be as helpful as needed. If this is all that can be expected of men, then I can no longer recall my father so positively!

Pages: 1  2  
Next
 

Join the Conversation

Want to join the conversation? If you're a healthcare professional, we'd like to hear your comments. Just sign in or register today to become part of our growing, online community.






 
TOPIC INDEX

Addiction Medicine
Alzheimer Disease
Anxiety Disorders
ADHD
Bipolar Disorder
Child & Adolescent Psychiatry
Dementia
Depression
DSM-5
Geriatric Psychiatry

 

Health Care Reform
Major Depressive
Disorder
OCD
Personality Disorders
Schizoaffective Disorder
Schizophrenia
Sleep Disorders
Somatoform Disorders
All Topics

 


 
FROM PHYSICIANS PRACTICE
Primary Care Can't Thrive Without Nurse Practitioners
Courtney H. Lyder, ND,  May 17, 2013
With a projected shortfall of primary-care physicians, it's time for alternate solutions to patient care. Nurse practitioners are one logical remedy.
VWhat Physicians Can Learn from the Allscripts EHR Lawsuit
Marisa Torrieri,  May 16, 2013
Lawsuit prompts question: What should physicians do to ensure they end up with a great EHR instead of buyer’s remorse?
Eight Ways ICD-9 Will Still Matter to Medical Practices
Brenda Edwards, CPC,  May 15, 2013
What should your medical practice do with your ICD-9-CM book after October 1, 2014? Keep it.
Seven Ways Technology Can Speed Up Patient Collections
Cheyenne Brinson,  May 15, 2013
Failing to adopt widely available billing and collections technology can cost medical practices big. Here's how to do it right.
Four Reasons Private Medical Practice is Becoming Extinct
Carol Stryker,  May 15, 2013
It’s becoming increasingly difficult for private medical practices to thrive. Here’s what’s driving the trend toward consolidation.
 

 

 
MOST POPULAR
  • Most Popular
  • Most Emailed
  • Most Recent
  • Developmental Psychopathology Comes of Age
  • Grief and Depression: The Sages Knew the Difference
  • The Moral Struggles of Practicing Psychiatrists
  • Update on Mental Health Benefits and Substance Use Disorder Services Under the Affordable Care Act
  • Psychiatry and the Myth of “Medicalization”
  • Grief and Depression: The Sages Knew the Difference
  • Synthetic Cathinones: Signs, Symptoms, and Treatment
  • Developmental Psychopathology Comes of Age
  • Psychiatry and the Myth of “Medicalization”
  • An Update on ADHD
  • Eco-Psychiatry: Why We Need to Keep the Environment in Mind
  • DSM-5: Where Do We Go From Here?
  • Suicidal Behavior: A Separate Diagnosis
  • New Insight Into the Neurobiology of Depression
  • Cultural Psychiatry and the 'No-Chicken' Doctor
Click here to subscribe to our newsletter
 
COMMENTS
  • Most Commented
  • Most Recent
  • Psychiatry and the Myth of “Medicalization”
  • Grief and Depression: The Sages Knew the Difference
  • Is it Time for a Treatment Manual to Complement DSM-5?
  • Diagnosis and its Discontents: The DSM Debate Continues
  • Lamotrigine for Major Depressive Disorder Is Inappropriate
  • Psychiatry and the Myth of “Medicalization”
  • Parity Laws: Powerful Weapon—or Pipe Dream?
  • The Moral Struggles of Practicing Psychiatrists
  • DSM-5 Won’t Solve the Overdiagnosis Problem—But Clinicians Can
  • NIMH vs DSM 5: No One Wins, Patients Lose
Click here to subscribe to our newsletter
 
CAREER CENTER

  •   Featured Jobs  
  •    Resources   
  • Psychiatry and Nurse Practitioner Opportunities
  • Associate Medical Director - Psychiatrist Delray Beach, Florida
  • Retiring Child Psychiatrist Seeks Replacement August 2010 or Before
  • Chairperson, Dept of Psychiatry Needed
  • FT Staff Psychiatrist - Excellent Benefits
  • BC Adult and Child Psychiatrits - PT and FT Positions Available
  • Managing Risks When Practicing in Three-Party Care Settings
  • 12 Tips for Making Your Practice Greener
  • Keys to Avoiding Malpractice: Standard of Care in Psychiatric Practice
  • Take This Job and Shove It
  • Merging Administrative and Academic Careers in Psychiatry
 
SearchMedica SEARCH RESULT

Find peer-reviewed literature and websites for practicing medical professionals

CME on Display
Evidence on Display
Guidelines on Display
Patient Education on Display
Clinical Trials on Display
Practical Articles on Display
Research and Reviews on Display
All "Display" results

CancerNetwork | ConsultantLive | Diagnostic Imaging | Musculoskeletal Network | OBGYN.net | PediatricsConsultantLive |
Physicians Practice | Psychiatric Times | SearchMedica | Medical Resources

© 1996 - 2013 UBM Medica LLC, a UBM company
Privacy Statement - Terms of Service - Advertising Information - Editorial Policy Statement - UBM Medica Network Privacy Policy