Therapy of a case of psychotic personality organization manifesting gender identity disorder.
The author relates his experience with a case of psychotic personality organization manifesting transsexualism spanning about 10 years. This paper presents the case and discusses the psychodynamics together with the course of therapy. The patient was a case of primary transsexualism who fell into hallucinatory-delusional states each time he seriously tried to become a woman. His transsexual wish was identification with his idealized grandmother image, for defense of his helpless and vulnerable self, and an attempt to reestablish his self which was facing a crisis of disintegration due to disorganization of his ego. Over about 4 years of psychoanalytic psychotherapy, the conflict between "becoming a woman" and "taking over as head of the house" was an integral issue. The psychotherapy was brought to a tentative conclusion by the patient giving up the idea of "becoming a woman" and deciding to "take over as head of the house".
Department of Psychiatry and Behavioral Science, Tokai University School of Medicine, Kanagawa, Japan.
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Hashimoto
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003702:Delusions / Q000628:therapy; D005783:Gender Identity; D006212:Hallucinations / Q000628:therapy; D006801:Humans; D008297:Male; D010554:Personality Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D011575:Psychoanalytic Therapy; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D014189:Transsexualism / Q000628:therapy
D014150:Antipsychotic Agents