The psychodynamics of transference--a virtual reality model.

Objective: Virtual reality is not only being utilized increasingly as an enhancement for diagnosis and treatment of psychiatric illness, but it also can be used to model theories, generate hypotheses, and provide a new context for teaching psychodynamic therapy. Here we describe the use of an online virtual world--Second Life--as a heuristic tool for understanding and teaching a key psychoanalytic concept, transference.

Methods: Using an extended vignette to illustrate the results of the modeling process, we explore teaching the vicissitudes of object relationships by means of analogs in virtual reality.

Medical professionalism: a tale of two doctors.

The AMA's social media guidelines provide physicians with some basic rules for maintaining professional boundaries when engaging in online activities. Left unanswered are questions about how these guidelines are to be implemented by physicians of different generations. By examining the issues of privacy and technological skill through the eyes of digital natives and digital immigrants, the challenges associated with medical e-professionalism become clear.

Crime and hate in virtual worlds: a new playground for the ID?

Virtual worlds offer the potential for friendship, compassionate listening and support, and even love for 15 million users worldwide. But virtual analogs of crimes such as rape, murder, and pedophilia also exist within these worlds. The writings of Freud and Winnicott provide one model for understanding what may motivate these virtual crimes and how to think about them clinically.

The Role of Psychiatry in the Management of Acute Trauma Surgery Patients.

BACKGROUND: Trauma is a leading cause of death and disability in the United States, with high prevalence and recidivism in individuals with psychiatric and substance abuse disorders. Half of these disorders go undiagnosed by the trauma team, resulting in adverse public health and economic consequences. METHOD: In a 16-week pilot study in the emergency department of an inner-city tertiary care hospital, a psychiatrist was integrated into the trauma surgery team by responding to all traumas and rounding with the staff 1 shift per week (March 1, 2000, through June 31, 2000).

Celebrity Patients, VIPs, and Potentates.

BACKGROUND: During the second half of the 20th century, the literature on the doctor-patient relationship mainly dealt with the management of "difficult" (personality-disordered) patients. Similar problems, however, surround other types of "special" patients. METHOD: An overview and analysis of the literature were conducted.