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Læknablaðið - 01.06.1961, Síða 52

Læknablaðið - 01.06.1961, Síða 52
80 LÆKNABLAÐIÐ whole human heing, his liabili- ties and liis assets, and by look- ing for what is in the back- ground, subtle and covert, can we ohtain a more comprehen- sive basis for making more ac- curate diagnoses and prognoses regarding future growing possi- bilities in human beings. To elahorate and support my main thesis with two more ex- amples: a woman on whoni I had a twenty-six j'ear follow- up, and a man with a twenty- four jrear follow-up. I cite thcse two examples hecause of tlie length of conlinuous ohserva- tion, because the prognosis looked poor in hoth, particularly hecause of the severity of their illness, its duration and hecause their pliysical and psychological heredity and endowment were poor. Assets, all in all, seemed lo be limited. Lucile, age 19, attempted sui- cide hy gas in 1931. The hospi- tal staff could not agree whether tlie diagnosis was simple schizo- plirenia or a psychotic depres- sion. I worked with her ahnost daily throughout the year. She left the hospital about tliree months after I did, after hospi- talization of fourteen montlis. In 1935 she was again in a mental liospital down soulh. This episode followed a severe illness of her mother on whom she was morbidly dependent. In 1938 and 1939, for about one and a lialf years, I saw her once a week as a private patient witli steady improvement. In 1939 I saw lier sister after she — her sister —- made a suicidal at- tempt. The sister made a social recovery. In 1945 her sister was again in a psycliiatric hospital with what looked like either a psychotic depression or an early schizophrenia. In 1954 her husband had to perman- ently liospitalize her. She now clearly showed the picture of schizoplirenic deterioration. In 1940 Lucille’s’ hrother died of a coronary thrombosis at 33. Her father had died of a coron- ary thrombosis at 38 when she was a little girl. Also in the early 40’s her j’oungest hrother, at about age 19, was diagnosed as a psycliopathic personalitj7 and committed to a mental hos- pital in North Carolina. In 1943 her mother died in a diabetic coma. Lucille took this experi- ence very well. From 1938 on slie was self- supporting and in late 1945 when I last saw her she was holding quite a responsible joh as office manager in a large factory. On this last occasion she came to see me about an emotional involvement with a married man. She liad quite some insight into the neurotic nature of her difficulty. She had liad other such experiences and knew tliat they were sick. Sev-
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