ABSTRACT
I. Hospitalizations: For what? (Reactions to these at dierent libidinal phases suggest unresolved traumas)
II. Major Illnesses-For example, diabetes, hypertension, heart, gastrointestinal, respiratory, kidney, liver, thyroid, cancer, immunological, sexually transmitted disease (ese cause loss of control and may lead to variety of compensatory defenses such
as avoidance and counterphobic behavior.) III. Current Medications IV. Accidents/Injuries
V. Operations (e libidinal phase during which these occurred may suggest unresolved trauma.)
VI. Psychophysiological Problems-For example, irritable bowel, stress-induced ulcers, bulimia, severe headaches, psoriasis, neurodermatitis, palpitations, syncope, tics, impotence, anorgasmia, hyperventilation [asthma] (ese can indicate decreased ego strength and conflicts over control of emotion.)
VII. Pregnancy, Menstrual, and Abortion History (looking for traumatic emotional states); use of contraception (reflects judgment, executive function, and unconscious conflict)
VIII. [Review of Systems-For example, HEENT, CV-Resp, G-I, Hem, Ortho, G-U, Allergies, Neuro]4
I. Who Raised and at What Ages A. Looking for nature of separations during dierent libidinal phases B. Looking to understand the kind of conflicts experienced with which people II. Patient’s Age at Trauma-For example, divorce, deaths, nancial straits, separa-
tion; childhood illnesses, operations, accidents III. Parents’ Characters and Psychiatric Symptoms A. Was either parent hospitalized or treated for emotional problems? Type of
Rx? B. Nature of parental relationship and family structure, before and during high
school C. Any parental alcoholism/drug abuse? Eect on patient: especially identifica-
tion with the aggressor or disidentification IV. Nature of and Closeness in Relationship With Each Parent and Siblings. If more
than two siblings, was there an auxiliary parent? Nature of those relationships? A. Loving/caring/empathic B. Sadomasochistic C. Sexually abusive D. Competitive E. Combative/physical F. Argumentative G. Disrespectful H. Idealized I. Inhibited J. Cold/distant V. Nature of Discipline (especially restrictions and corporal punishment, and from
whom; reaction to it) A. Severe beatings that led to breakdown in affect regulation
B. Look for avoidance of conflict experienced as trauma and later defended against with minimization reaction formation and rationalization
VI. Patient’s Social Development (in grammar and high school; play history; parents’ attitudes toward work and play)
A. Problems with separation from the home B. Looking for persistent narcissism (the “Adulteen”5 who has never grown up) VII. Attitude of Parents During Adolescence (to dating, cigarettes, alcohol, drugs,
privacy [masturbation], and sex; how conicts were resolved) VIII. Superegos of Parents (their ideals for patient; have they been reached?) A. Look for identification with parents’ superego B. Look for disidentification from parents’ superego but identification with parents’
unconscious anti-authoritarian wishes6 IX. Patient’s Symptoms (child and adolescent) A. Phobias, obsessions, conversions, depressions, clinging, isolation, excess ght-
ing, argumentation, oppositionality, hallucinations (monsters), sleep disturbance, enuresis-At what age slept alone?
