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Work-related stress
Published in Janet Thomas, Understanding and Supporting Professional Carers, 2021
Splitting sometimes helps workers to cope with fear of distressing illness. Oncology is regarded as a highly stressful specialty. Often patients have to be given bad news. Cancer strikes fear into our hearts because sufferers may have to undergo surgery and unpleasant treatment, and in many cases the treatment is unsuccessful and the patient may die. Doctors and nurses find it hard to face cancer, too, but if they focus on the patients they avoid having to think about their own vulnerability. They tend to block out or split off their own fear of the disease.
Chronic Catathymic Homicides
Published in Louis B. Schlesinger, Sexual Murder, 2021
Meloy refers to other defense mechanisms indicative of borderline personality such as splitting (“either he or I must die”). Splitting may occur during alternating emotional states toward himself and the victim. In addition, defenses of primitive idealization and devaluation are also used by these offenders. Such opposite notions are similar to splitting and are typical in individuals who fall within the borderline spectrum but who have pronounced narcissistic traits characterized by a sense of entitlement along with severe dependency. Frequently, such offenders have a wish to be admired and, at the same time, to be taken care of. They are vulnerable to slight criticisms or narcissistic injuries.
Introduction Part 2
Published in Paul Ian Steinberg, Psychoanalysis in Medicine, 2020
Mechanisms of defense are unconscious attempts to reduce anxiety and other painful feelings. Too heavy reliance on what are called more primitive mechanisms of defense is typical in more disturbed personalities. These defenses, including projection, projective identification, splitting, and denial, interfere with an individual’s capacity to test reality. For example, in projection and projective identification, an aspect of the self is not acknowledged as being part of the self, but is experienced as part of someone else. In splitting, two aspects of one’s perception of another person, for example, are kept separate in the mind. The individual who is splitting may respond at some points to the other person as if the other person is entirely characterized by one part of the split, for example, a tendency towards openness and generosity. At other points, the individual who is splitting may respond to the other person as if he is entirely characterized by the other side of the split, for example, a tendency towards caution about money and relationships. The external reality of the other person, as it were, may be that under some circumstances, he is inclined to be generous and open, but when feeling threatened, he may be more cautious. Rather than perceiving the whole of the other individual, the patient who relies on splitting may only perceive part of it at a time, and react to that part.
Opportunities for enteral drug delivery for neonates, infants, and toddlers: a critical exploration
Published in Expert Opinion on Drug Delivery, 2022
Nicole Sheena Kaneria, Catherine Tuleu, Terry Ernest
Lipophilic base suppositories are known to melt at temperatures from 30°C. This poses logistical difficulty (need for refrigeration) in their usability in LMICs where temperatures are often above this [49]. Rectal formulations can be restricted with dose flexibility. As can be seen from Table 5, some formulations require splitting of the suppository yet split lines nor proper instructions on how to do to ensure accurate dosing are present. Splitting would also mean the size and shape of the formulation is altered, risking their proper and comfortable insertion [27]. The 2013 EMA Guideline [31] considers shape and size of the formulation an important factor: The age and size of the child should be considered for an appropriate size (diameter and length) of the formulation (and lengths for any required rectal tube delivery device [27]). It is also not recommended for suppositories to be cut for achieving smaller doses unless designed to do so as possible inhomogeneous drug distribution and unreproducible cutting are potential causes for dosing error. The 2006 EMA Reflection paper [27] advises for manufacturers to provide information on drug dispersion uniformity of the product. Doliprane, a paracetamol suppository shows advancement in this regard. The 100 mg dose (for 3–8 kg children; ~term neonate-1 year), has a single score line enabling accurate homogeneous 50 mg doses if required. To the knowledge of the authors Doliprane (Sanofi) may be the only suppository containing a score line.
Relationships, Emotions, and Defenses Among Patients with Substance Use Disorders, Assessed with Karolinska Psychodynamic Profile: Possibilities to use Intensive Short-Term Dynamic Psychotherapy in Substance Abuse Treatment
Published in Alcoholism Treatment Quarterly, 2019
Elisabeth Punzi, Karin Lindgren
Disturbing emotions and relational difficulties might be mitigated by defense mechanisms. Defenses are cognitive, emotional, and interpersonal strategies that keep overwhelming emotions from awareness (Coughlin, 2016). Defenses thus mitigate anxiety but simultaneously exclude adaptive emotion regulation and thereby hinder symptom reduction. Defenses might be classified as primitive or mature (Kernberg, 1992; Perry & Bond, 2012). When primitive defenses are habitual, emotional and relational development is hindered (Kernberg, 1992; Ramos, 2004). Turning against the self is one example of a primitive defense that mitigates emotions while increasing suffering. In turning against the self, aggression toward others is not permitted because aggression is connected to painful experiences of loss of love. Instead anger is turned toward oneself, for example, in form of self-contempt or physical self-attacks (McWilliams, 2011; Perry & Bond, 2012). Splitting is another primitive defense in which intense positive and negative emotional reactions, and contradictory experiences of self and others, are separated and thus become difficult to identify and handle. Primitive defenses tend to occur in individuals with SUD, and the patients’ defenses need to be assessed so that treatment can be planned according to the needs and capacities of each patient (Aleman, 2007b; Beveridge, 2008; Director, 2002; Evren et al., 2012).
Psychodynamic Analysis of Racialized Interactions: The Get Out Case Study
Published in Smith College Studies in Social Work, 2019
Brian Rasmussen, Ann Marie Garran
At this point it is reasonable to ask: How do the white people in the film manage incongruent and incompatible perceptions of black people? Why would these racist white people want to inhabit black bodies, the same people that are culturally devalued? One answer lies in understanding Klein’s thinking about the defense of splitting. A central mechanism to ward off anxiety and control danger, splitting is thought to originate in our earliest days and to continue, to varying degrees, throughout the lifespan. Splitting keeps separate perceptions of good and bad, whether internal or external (Segal, 1974). For instance, a parent that is at one time frustrating may evoke the rage of a toddler who during those moments would see this person as “all bad”. This state would likely not last long as soon the child will revert back to viewing the caretaker as “all good”. It is important for the child to keep these psychic states separate. However, idealization is thought to intensify the split between good and bad (Clarke, 2003). Over time the child gradually begins to internalize a more mature view of self and others, accepting that we are all a varying mix of both – corresponding to Klein’s idea of the depressive position. Frosh (1989) and Rustin (1991) have argued that splitting operates as a defense to keep separate positive and negative attitudes and perceptions of others and creating rigid categories of others, underscoring racist dynamics.