The Woman Patient: Aggression, Adaptations, and Psychotherapy

319 Pages·1982·6.55 MB·English

by  Carol C. Nadelson M. D.

THE WOMAN PATIENT
Volume 3
Aggression, Adaptations,
and Psychotherapy
WOMEN IN CONTEXT: Development and Stresses
Editorial Matina Homer, Radcliffe College
Board: Martha Kirkpatrick, University of California at Los Angeles
Claire B. Kopp, University of California at Los Angeles
Carol C. Nadelson, Tufts University School of Medicine
Malkah T. Notman, Tufts University School of Medicine
Carolyn B. Robinowitz, American Psychiatric Association
Jeanne Spurlock, American Psychiatric Association
THE WOMAN PATIENT
Volume 1: Sexual and Reproductive Aspects of Women's Health Care
Edited by Malkah T. Notman and Carol C. Nadelson
Volume 2: Concepts of Femininity and the Life Cycle
Edited by Carol C. Nadelson and Malkah T. Notman
Volume 3: Aggression, Adaptations, and Psychotherapy
Edited by Malkah T. Notman and Carol C. Nadelson
BECOMING FEMALE: PERSPECTIVES ON DEVELOPMENT
Edited by Claire B. Kopp
WOMEN'S SEXUAL DEVELOPMENT: EXPLORA TIONS OF INNER SPACE
Edited by Martha Kirkpatrick
WOMEN'S SEXUAL EXPERIENCE: EXPLORA TIONS OF THE
DARK CONTINENT
Edited by Martha Kirkpatrick
THE WOMAN PATIENT
Volume
3
Aggression, Adaptations,
and Psychotherapy
EDITED BY
MALKAH T. NOT MAN, M. D.
AND
CAROL C. NADELSON, M. D.
Tufts University School of Medicine
Boston, Massachusel/s
PLENUM PRESS· NEW YORK AND LONDON
Library of Congress Cataloging in Publication Data
Main entry under title:
Aggression, adaptations, and psychotherapy.
(The woman patient; v. 3) (Women in context)
Bibliography: p.
Includes index.
1. Aggressiveness (Psychology). 2. Women-Mental health. 3. Women-Crimes
against. 4. Psychotherapist and patient. I. Notman, Malkah T. II. Nadelson, Carol C. III.
Series. IV. Series: Women in context. [DNLM: 1. Delivery of health care. 2. Genital
diseases, Female. 3. Women. WP 100.3 W872 1978J
RC451.4.W6A37 616.89'0088042 82-5325
AACR2
ISBN 978-1-4684-4096-6 ISBN 978-1-4684-4094-2 (eBook)
DOI 10.1007/978-1-4684-4094-2
©1982 Plenum Press, New York
Softcover reprint of the hardcover 1st edition 1982
A Division of Plenum Publishing Corporation
233 Spring Street, New York, N.Y. 10013
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means. electronic, mechanical, photocopying, microfilming,
recording. or otherwise, without written permission from the Publisher
Contributors
E. P. Benedek, M.D . • Clinical Professor of Psychiatry, University of
Michigan Medical Center; Director of Research and Training,
Center for Forensic Psychiatry, Ann Arbor, Michigan
Karen A. Cohen • Program Coordinator for Health Education, Capital
Area Community Health Plan, Albany, New York
G. A. Farley • Private practice, Ann Arbor, Michigan
Susan M. Fisher, M.D . • Lecturer, Department of Psychiatry, Univer
sity of Chicago School of Medicine, Chicago, Illinois
Rochelle Friedman, M.D . • Psychiatrist, Massachusetts Institute of
Technology, Cambridge, Massachusetts; Clinical Associate in Psy
chiatry, Massachusetts General Hospital, and Clinical Instructor in
Psychiatry, Harvard University School of Medicine, Boston, Mas
sachusetts.
Abraham Genack, M.D., Ph.D . • Department of Psychiatry, Harvard
Medical School and Mount Auburn Hospital, Boston; Medical Di
rector, Metropolitan Beaverbrook Mental Health and Retardation
Center, Watertown, Massachusetts
Stuart T. Hauser, M.D., Ph.D . • Associate Professor of Psychiatry,
Harvard Medical School, Boston, Massachusetts
Astrid N¢klebye Heiberg, M.D . • Associate Professor, Psychiatric Insti
tute, University of Oslo, and Deputy Minister of Health, Norway
Berit He[(je, D.D.S . • Department of Oral Surgery and Oral Medicine,
University of Oslo, Norway
Elaine (Hilberman) Carmen, M.D . • Associate Professor, Department of
Psychiatry, University of North Carolina School of Medicine,
Chapel Hill, North Carolina
Irving Hurwitz, Ph.D . • Associate Professor, School of Education, Bos
ton College, Chestnut Hill; Consultant Division of Child Psychia
try, New England Medical Center, Boston, Massachusetts
v
vi CONTRIBUTORS
Lewis A. Kirshner, M.D . • Assistant Professor of Psychiatry, Harvard
Medical School, Boston; Harvard Community Health Plan, Welles
ley, Massachusetts
Gerald L. Klerman, M.D . • Professor of Psychiatry, Harvard Medical
School and Director, Stanley Cobb Psychiatric Research Laborato
ries, Massachusetts General Hospital, Boston, Massachusetts
Harriet E. Lerner, Ph.D . • Staff Psychologist, The Menninger Founda
tion, Topeka, Kansas
Don R. Lipsitt • Associate Professor of Psychiatry, Harvard Medical
School and Mount Auburn Hospital, Cambridge, Massachusetts
Mirjam Mathe, M.D . • Assistant Clinical Professor of Psychiatry, Al
bert Einstein College of Medicine; Clinical Director, Outpatient
Child Psychiatry, Soundview Throgs Neck Mental Health Center,
New York
Barbara S. McCrady, Ph.D . • Butler Hospital, Brown University, Prov
idence, Rhode Island
Jean Baker Miller, M.D . • Clinical Professor of Psychiatry, Boston
University Medical School, Boston; Director, Stone Center for De
velopmental Studies and Services, Wellesley, Massachusetts
Carol C. Nadelson, M.D . • Professor and Vice-chairman, Director of
Training and Education, Department of Psychiatry, Tufts Univer
sity School of Medicine-New England Medical Center Hospital,
Boston, Massachusetts
Theodore Nadelson, M.D . • Clinical Professor of Psychiatry, Tufts Uni
versity School of Medicine; Chief of Psychiatry, Boston Veterans
Administration Medical Center, Boston, Massachusetts
Malkah T. Notman, M.D . • Clinical Professor, Department of Psychia
try, Tufts University School of Medicine-New England Medical
Center Hospital, Director, Women's Resource Center, and Direc
tor of Psychotherapy, Boston, Massachusetts
Cynthia R. Pfeffer, M.D . • Assistant Professor of Psychiatry, Cornell
University Medical College; Chief, Child Inpatient Unit, The New
York Hospital-Cornell Medical Center, Westchester Division, White
Plains, New York
Nancy Rudes, M.S.W . • Private practice, New York
Earle Silber, M.D . • Supervising and Training analyst, Washington
Psychoanalytic Institute, Washington, D.C.
CONTRffiUTORS vii
Veronica Tisza • Lecturer, Department of Psychiatry, Harvard Medical
School; Consultant, Department of Child Psychiatry, Massachu
setts General Hospital, Boston, Massachusetts
Myrna M. Weissman, Ph.D . • Professor of Psychiatry and Epidemiol
ogy; Director, Depression Research Unit, Yale University School
of Medicine, Department of Psychiatry; Connecticut Mental Health
Center, New Haven, Connecticut
Joan J. Zilbach, M.D . • Associate Clinical Professor of Psychiatry, Tufts
University School of Medicine; Lecturer, Harvard Medical School;
Senior Psychiatrist and Co-director, Family Therapy and Research
Program, Judge Baker Guidance Center, Boston, Massachusetts
Preface
This volume continues some of the issues raised in Volume 2 and fo
cuses more closely on therapeutic intervention. The theoretical discus
sion of aggression provides a background for the presentation of pat
terns of aggression and violence affecting women, as well as possible
connections between physical and emotional symptoms and indirect
expressions of aggression. The section on aggression against and by
women is an extension of some of the content of The Woman Patient,
Volume 1 (e.g., the chapter on rape). Theoretical and clinical views
that are not often linked in this fashion are included here because we
are interested in understanding the development of a self-concept that
incorporates the constructive aspects of "aggression" as well as an un
derstanding of violence. In this context, loss, abandonment, delin
quency, and child and adolescent suicide are also extensions of these
issues.
The chapters that follow address aspects of symptom formation
and concepts of illness. There is, as yet, no definitive explanation for
why women experience certain illness patterns more or less than men.
Current considerations have been reviewed, but these do not answer.
They are a beginning on which we must build. It is apparent that any
discussion of these subjects better elucidates the complexity if it in
cludes an intermingling of general problems with concrete symptoms.
Those specific problems that are usually thought of as psychological
such as depression, and behaviors (such as substance abuse) provide
a focus for understanding wider issues.
In the section on psychotherapy, the relationship between the
woman patient and her therapist in analytic therapy is discussed gen
erally as well as specifically with regard to women's relationships to
their families.
As in the previous volumes in this series, we hope to raise ques
tions and stimulate thought rather than to provide any kind of jefin
itive answers to many of the questions raised.
We would like to thank all of the contributing authors for their
ix
x PREFACE
hard work, patience, and tolerance during the process of writing and
rewriting; our families for their support; and our editor, Hilary Evans,
for her continual enthusiasm and help.
CAROL C. NADELSON
MALKAH T. N OTMAN
Boston, Massachusetts
Contents
Aspects of Aggression and Violence
Chapter 1 • Social Change and Psychotherapeutic Implications 3
CAROL C. NADELSON and MALKAH T. NOTMAN
Chapter 2 • Aggression in Women: Conceptual Issues and 17
Clinical Implications
CAROL C. NADELSON, MALKAH T. NOTMAN, JEAN
BAKER MILLER, and JOAN ZILBACH
Chapter 3 • Women and Violence 29
E. P. BENEDEK and G. A. FARLEY
Chapter 4 • Wife Abuse: Culture as Destiny 47
ELAINE (HILBERMAN) CARMEN
Chapter 5 • Incest 65
VERONICA TISZA
Chapter 6 • The Adolescent Girl in a Group Home 83
MIRJAM MATHE and NANCY RUDES
Chapter 7 • Juvenile Delinquency in Girls 95
SUSAN M. FISHER and IRVING HURWITZ
Chapter 8 • Childhood and Adolescent Suicidal Behavior, with 115
an Emphasis on Girls
CYNTHIA R. PFEFFER
Symptom Formation and Illustrative Symptoms
Chapter 9 • The Organic-Functional Controversy 133
THEODORE NADELSON
Chapter 10 • The Painful Woman: Complaints, Symptoms, and 147
Illness
DON R. LIPS ITT
xi