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Lazar, N.D. (1973). Nature and Significance of Changes in Patients in a Psychoanalytic Clinic. Psychoanal Q., 42:579-600.

(1973). Psychoanalytic Quarterly, 42:579-600

Nature and Significance of Changes in Patients in a Psychoanalytic Clinic

Norman D. Lazar, M.D.


Changes in the psychoanalytic patients at the Columbia University Psychoanalytic Clinic for Training and Research are described. Included are statistical data on the reduced number of applicants for treatment and on changes in psychopathology and diagnostic categories. There has been a shift from symptom neuroses to character disorders and it is suggested that there is an increasing number in the latter group with multiple features of infantility in ego organization and indications of early fixations. Literature on the relationship between changes in society and changes in psychopathology is reviewed, indicating considerable agreement as to the manifestations of the latter. The presenting features of the changes in psychopathology are described with speculation about some of the underlying psychoanalytic factors, especially the role of primitive, pregenital aggressive drives. There is brief consideration of some of the technical problems in the psychoanalytic treatment of the patients described.

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