By R. Will. Colorado School of Mines.

A fiber that contracts from a prestretched condition develops forces greater than that of a fiber contracting from resting length buy zoloft 25 mg with mastercard. Experiments with single muscle fibers indicate that there is a maximum speed of shorten- ing above which a muscle cannot shorten fast enough to keep up with the apparatus driving the shortening. The single muscle fiber experiments also show that when a muscle is forcibly stretched it can exert very large forces, up to a limit; excessive forces acting on the muscle can cause it to tear. Muscle cells convert chemical energy found in fatty acids and blood sugar glucose into movement and heat. Actin and myosin are protein molecules that are associated with motility in liv- ing systems. Relative translation between thick and thin filaments is re- sponsible for much of the change in length of a muscle during contrac- tion (Fig. According to the sliding filament theory of muscle contraction, myosin heads on the thick filaments (crossbridges) interact with actin-binding sites on the thin filaments. The crossbridges are pre- sumed to generate force only when they are attached to actin. Skeletal muscle must be stimulated by the central nervous system be- fore it contracts. Messages to activate a muscle travel from the brain to the nervous system and to individual muscle fibers. The amount of tension produced by a skeletal muscle depends on both the frequency of stimulation and the number of motor units involved in the activation. In the muscles of the eye, a motor neuron might control only two or three fibers because precise control is extremely important. On the other hand, in leg muscles more than 2000 fibers are controlled by a single neuron. Even when a muscle ap- pears to be at rest, some motor units in the muscle may be active. The contraction of the activated muscle fibers does not produce enough pull to cause movement but they do tense the muscle. Resting muscle tone stabilizes the positions of bones and joints and maintains body position.

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Freud (1963) describes the process of defecation (expul- sion) in the first year of life as a pleasurable activity that reduces tension buy zoloft 25 mg on line. However, by the second year of life the child must decide if he or she will let go of feces, at the love object’s request, or withhold them for purposes of autoerotic gratification, thus asserting self-will. If toilet training is par- ticularly punitive, the child when grown to adulthood may retaliate against authority figures through irresponsibility and obstinacy. The same punitive toilet training may cause a reaction formation in the adult, and a sense of orderliness may develop in the personality structure that encompasses col- lecting, possessing, and holding onto objects. This overcontrolled behav- ior may express itself through compulsive qualities (anal retentiveness) that involve frugality and parsimony. Freud (1963) further states that there are definitive commonalities that exist between an interest in money and defecation. Wherever archaic modes of thought predominate or have persisted—in ancient civilizations, in myth, fairy-tale, and superstition, in unconscious thought and dreams, and in the neuroses—money comes into the closest re- lation with excrement. We know how the money which the devil gives para- mours turns to excrement after his departure, and the devil is certainly noth- ing more than a personification of the unconscious instinctual forces.... It is possible that the contrast between the most precious substance known to man and the most worthless, which he rejects as ‘something thrown out,’ has contributed to the identification of gold with feces. In fact, fairy tales (which is explored later in this chapter) deal with the basic needs of maturation and development. Therefore, the whole of "Jack and the Beanstalk" deals with the growth and regression to earlier stages of a boy as he achieves puberty, while the golden goose can be seen as merely one phase of his development. In the phallic or Oedipal phase, pleasurable activities shift from the anal erotic zone to the genitalia (phallus). This is also a time when the child begins to exhibit sexual longing for the parent of the opposite sex. Freud termed the boy’s shift—from identifying with his father to becoming a ri- val while sexual wishes emerge toward the mother—the Oedipus complex. The equivalent situation for the girl, her desire to possess the father while renouncing the mother, was termed the Electra complex. My parents lovingly saved this letter and would retrieve it from its secret hiding place every so 73 Defense Mechanisms and the Norms of Behavior 2.

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Controversy exists regarding the etiology and sequence of depression in couples and whether the depres- sion or the couple disorder is primary (i discount zoloft 100mg mastercard. Jacobson, Dobson, Fruzettti, Schmaling, and Salusky (1991) found clinical samples with depressed individ- uals who were not dissatisfied with their marriages, and in these cases behav- ioral couple therapy was no more effective than other treatments for depression. Thus, it appears that couple dissatisfaction does affect depression, and couple therapy should be used in these cases to consolidate and extend the gains made in individual treatment (Alexander & Barton, 1995). Numerous theorists and clinicians have identified approaches to sub- stance abuse using CBCT methods (Fals-Stewart, Birchler, & O’Farrell, 1996; Noel & McCrady, 1993; Zweben, Pearlman, & Li, 1988, and O’Farrell, Choquette, & Henry, 1998). Approaches range from one partner observing the treatment of the abusing or addictive individual and using standard CBCT interventions with both partners, to involving extended community and family systems. In similar fashion, chronic pain (McGrath & Good- man, 1998), anxiety (Craske & Zoellner, 1995), and medical illness such as cancer (Carlson, Bultz, Speca, & St. Pierre, 2000) have been the focus of CBCT interventions, and a wide range of interventions have been used that are similar to those indicated above for substance abuse. Lichtenstein (1991) has described a method for using CBCT with couples who have chil- dren with disabilities. There is nearly universal agreement among clinicians of various theoret- ical orientations that family involvement of some type is useful for most cultural groups in the treatment of a variety of psychological or medical disorders, and it appears that directive CBCT-type interventions are very commonly used, although not always comprehensively or systematically. In addition, CBCT methods such as homework assignments may seem intu- itive, but they become effective therapeutic tools when they are applied me- thodically and in the appropriate context. Even more complex procedures such as systematic desensitization and paradoxical intervention can be taught to paraprofessionals and seasoned therapists alike, but perhaps the most important factor in applying CBCT methods to diverse problems is for clinicians is to use structured, precise interventions in order to increase their effectiveness. ETHICAL CONSIDERATIONS Couple therapy in general, and especially CBCT, raises particular ethical is- sues for clinicians. As indicated earlier, it is difficult to conceive of effective 128 THEORETICAL PERSPECTIVES ON WORKING WITH COUPLES couple therapy that does not include some focus on communication, prob- lem solving, behavior exchange, and exploration of attributions between partners. In addition, all forms of psychotherapy involve some potential risks, and the active, direct nature of CBCT requires special attention in order to attenuate any adverse consequences.

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