The role of ethical principles in health care and the implications for ethical codes.

A common ethical code for everybody involved in health care is desirable, but there are important limitations to the role such a code could play. In order to understand these limitations the approach to ethics using principles and their application to medicine is discussed, and in particular the implications of their being prima facie. The expectation of what an ethical code can do changes depending on how ethical properties in general are understood.

A brief history of the International Psychoanalytical Association.

Originally prepared as part of the background material for an International Psychoanalytical Association Symposium devoted to a critical consideration and review of the structure and functioning of the IPA in 1988, this paper uses sources within the IPA's Archives to trace the key developments in their history since their foundation in 1910. An addendum provides some details of similar developments from 1985 to the present.

Creativity and the third age.

The paper discusses aspects of the creative process in the elderly and, indeed, in the old. After a definition of the third age, the writer goes on to discuss the nature and aims of creativity. Particular attention is paid to the roles of sexuality, regression in the service of the ego, narcissism, sublimation, the depressive position and reparation.

Neglected fathers in the aetiology and treatment of sexual deviations.

Current researches in sexual deviations have rightly stressed deficiencies and faults in the mother/child relationship, fears of annihilation and an inability to achieve separation and independence. As a result of this the role of the father in the patient's family structure and in their psychotherapies and psychoanalyses has been somewhat neglected, also because the fathers are usually described as cold, distant, uninvolved, etc. The author believes that the obliteration of the father figure, whether accidental or deliberate, is an important part of the psychopathology.

[The psychoanalytic movement during the years of the war (1939-1941) according to the archives of the I.P.A].

This is an overview of the activities and developments within the twelve component Societies of the International Psychoanalytic Association from the outbreak of the Second World War to its end in 1945. The author describes how the war had deeply affected the activities of the societies within Europe, as compared with other parts of the world. He notes how in the United States of America psychoanalysis was in a comparatively bouyant state, to some extent owing to migration of psychoanalysts from Europe, whilst in South America and Australia new societies were formed.

Toward a unified conception of the origins of sexual and social deviancy in young persons.

This paper is based on the empirical evidence that social and sexual deviancy in young persons often succeed on one another, alternate repeatedly, or occur concomitantly. The role of the superego and the relationship of acting out and symptomatic acts to both conditions are explored. States of excitement, tension, and discharge in young persons are described.

Do patients who move to a new town consult their doctor more often?

A study was conducted to measure any difference in the consultation rate of patients from two new town housing estates compared with patients from the rest of the practice. Patients from the new estates consulted 15% to 20% more than those in other areas, but newly registered patients showed no difference compared with the indigenous population. It is suggested that patients who chose to move to new town rented accommodation bring with them a more casual attitude to the general medical services.

From denial to self-awareness: a 20 years' study of a case of childhood delinquency evolving into adult neurosis.

This is a study of the evolution of delinquency into adult neurosis in a girl whose analytic psychotherapy began in pre-puberty. With some interruptions the treatment was extended over nearly 20 years. The antisocial tendency, which was serious enough to lead to appearance in juvenile courts, continued until late adolescence when the first signs of a fully fledged neurosis made their appearance.

On some positive aspects of the negative therapeutic reaction.

The development of the concept of the Negative Therapeutic Reaction (N.T.R.

An outbreak of hepatitis B from tattooing.

An outbreak of 34 cases of hepatitis B not all of them notified, is described. 31 was tattooed by one artist; 3 were secondary infections. All primary infections occurred in males aged 16-28 years.

The differential diagnosis of homosexuality.

The treatment of homosexuality presents serious difficulties owing to its multifactorial aetiology and variety of psychopathological views. It is suggested that the combined use of psychiatric and psychoanalytic models can contribute to the establishment of a satisfactory differential diagnosis. Out of the innumerable clinical types seen in practice and described in the literature, three major groups can be isolated.

Object choice and actual bisexuality.

Actual bisexuality is to be distinguished from homosexuality in a latent state and from conscious bisexual fantasies. Contemporary social changes have caused an increased demand for help for those men and women capable of engaging in protracted heterosexual and homosexual relations. Among such people narcissistic and borderline states are common.