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1/6. The unseen tears of children: a Chinese boy who vomited for 14 months.

    A Chinese boy in hong kong who vomited for 14 months after his father had gone abroad to work is reported. Despite the very obvious predicament and sadness, more than 30 doctors had failed to understand the patient. In their search for a disease to explain the symptom, they trapped both themselves and the patient in the symptom of vomiting. It is argued that this patient should have been understood not from the angle of the traditional medical model. Neither was the psychoanalytical model useful. Rather the communication model of hysteria is much more practical; the vomiting can be construed as the unseen tears of a boy entrenched helplessly in his predicament. These unseen and unrecognized tears had cost the patient 14 months of precious life.
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ranking = 1
keywords = communication
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2/6. Functional dysphonia in adolescence: two case reports.

    Reports of functional dysphonia in children and adolescents under 16 years of age are few. Approximately a dozen cases have been reported in the English literature over the past 35 years. Most of the articles appear in journals related to the fields of speech, hearing and communication with a few in the Otorhinolaryngologic journals. Published papers in psychiatric journals dealing with voice or speech disorders are virtually nonexistent. In children and adolescents the two most common varieties are the Whispering syndrome, which occurs predominantly in girls, and the Hysterical High Pitched voice seen mostly in boys. This paper discusses these two varieties of functional dysphonia and presents a case example of each.
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ranking = 1
keywords = communication
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3/6. Integrating systems theory and attachment theory: the use of radio communication to modify attachments in a patient with psychogenic vomiting.

    A case is presented that shows the usefulness of integrating systems theory and attachment theory in the formulation and treatment of a clinical problem. The 5 year old son of East Indian immigrants presented with persistent psychogenic vomiting associated with pathological family attachments. It was evident that the precarious family equilibrium was stabilized by the child's psychogenic vomiting. The therapeutic team suggested to the family that their problems might be more satisfactorily resolved if the mother and child maintained their link by two-way radio. Three weeks later the vomiting had ceased, the child no longer felt that he needed the radio and both parents had established new patterns of relating to their child, whose attendance and peer socialization at school showed marked improvement. To some extent the rapid resolution of the problems was facilitated by the cultural strengths of the family.
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ranking = 4
keywords = communication
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4/6. Hermeneutics and psychoanalytically oriented psychotherapy.

    Psychic or psychosomatic disorders--symptoms as well as the structures on the basis of which symptoms usually develop--include substantial impairment of communication. Psychogenic symptoms often seem incomprehensible and strange. psychotherapy then involves the figuring out of the meaning of a symptom and, at the same time, the effecting of change in the sense of an enhancement of communication. Here, philosophic hermeneutics can point the way for psychotherapeutic reflection. Hermeneutics, when applied to psychotherapy, is the art of understanding and of making understood when the means of understanding and agreement between persons is disturbed. The psychotherapeutic process itself is executed within a "hermeneutic circle." A short case presentation illustrates the hermeneutic technique.
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ranking = 2
keywords = communication
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5/6. Some guidelines for uses of hypnotherapy in pediatrics.

    Hypnotherapy has many uses in pediatrics, and its value, not only as a adjunct but also as a primary therapy for certain conditions, justifies its inclusion in pediatric training programs. suggestion and expectation have long been related to therapeutic outcomes in medicine, but not all physicians know how to apply them constructively and systematically in communication with patients. In pediatrics there is a tendency to overlook opportunities in which hypnosis might be the treatment of choice. Because children engage in imagination and fantasy easily without the cognitive inhibitions of adults, they are able to use hypnosis more readily than adults. More research into the imaginative skills of children may facilitate understanding of learning mechanisms and make it possible for professionals to prevent the loss of the natural imaginative capacities in children and, therefore, enhance the ability of mature members of society to use these skills. In addition to reduction of specific symptoms through hypnotherapy, children benefit by the sense of mastery which they acquire, a sense which is surely needed to overcome the feelings of hopelessness, loss of control, and depression induced by many diagnostic and therapeutic procedures in medicine.
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ranking = 1
keywords = communication
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6/6. Clinical application of a dysregulation model of illness and disease: a case of spasmodic torticollis.

    A case of spasmodic torticollis is described to demonstrate the clinical usefulness of a new theoretical model of somatic illness and disease. Based on a conception of the living organism as a self-regulating system, the model attributes somatic disorders to a variety of regulatory disturbances including deficits in affect regulation and in the ability to maintain a stable and cohesive self. Throughout the analytical treatment, attention was given to repairing deficits in the patient's self-organisation, and to elevating chaotic impulses and inchoate emotions from a primitive sensorimotor level of experience to a mature representational level where they could be valued for their signal function and modulated through imaginal activity and communication with others. Analysis of the patient's pathologic internal object relations modified his self-organisation, and enabled him to establish regulatory interpersonal relationships that complemented his enhanced self-regulatory capacities. These changes were accompanied by a gradual resolution of the patient's torticollis.
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ranking = 1
keywords = communication
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