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The past fifteen years have seen a resurgence of interest in the psychology of female development, impelled by factors both intrinsic and external to psychoanalysis. Within psychoanalysis, increasingly sophisticated formulations regarding ego development and object relations have modified and elaborated drive-oriented conceptualizations of psychosexual development. In addition, the recent focus upon narcissistic and borderline adult pathologies has led to a closer examination of the earliest phases of life, with emphasis upon early mother-child interactions and the nature of early identifications, narcissistic development and the formation of gender identity. The social and cultural changes reflected in the women's movement resulted in widespread charges that Freudian doctrine concerning female development was denigrating and phallocentric; in responding to this challenge, psychoanalytic theorists were stimulated to reconsider established hypotheses that viewed femininity as a secondary, defensive formulation. In addition, new discoveries and reinterpretations relating to fetal development and the physiology of the female orgasm challenged traditional conceptions about the masculine nature of libido. These various strands of developing knowledge and interest intersect in the area of early female development and make it a focal point from which to investigate and resolve major issues in psychoanalytic thinking. As inconsistencies and errors in the classical formulations about female psychosexual development are discovered, and reformulations made through closely detiriled observations based on current theoretical assumptions, they in tum illuminate issues in ego psychology, object relations and narcissistic development, and enlarge the entire body of psychoanalytic theory.
There are many textbooks which give detailed descriptions of the causes, clinical features and treatment of disease. There are a number of books devoted to clinical methodo logy which tell the student the questions which he must ask and describe the physical signs that he should seek. The authors of these books rarely devote more than a page or two to a job description and advice on how to acquire clinical skills. Although a sound knowledge of the facts is essential, a good doctor differs from a bad doctor more by his attitude and craftsmanship than by his knowledge. These important matters receive scant attention in the textbooks because the authors regard them as part of the spoken tradition which is taught at the bedside or in the clinics and is absorbed by watching clinicians while they are dealing with patients. The image of the doctor who greets patients with his pen poised over a prescription pad, and the calls for holistic medicine, imply that a number of students do not pick up the relevant attitudes and skills on the way. That this feeling is shared by the profession itself is suggested by the forma tion of a society to promote the treatment of the whole patient, and another for the promotion of humanism in cardiology. Good doctors have been treating the whole patient humanely since the profession was founded, and I find it shocking that it is thought that such societies are necessary."
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