Atromid.S* (clofibrate) to lower blood lipids safely and effectively Indications ATROMID-S is indicated where reduction of blood lipids is desirable; e.g., patients with hypercholesterolemia and! or hypertriglyceridemia. Contralndlcations While teratogenic studies have not demonstrated any effect attributable to ATROMID-S, its use in nonpregnant women of childbearing age should only be undertaken in patients using strict birth control measures. If these patients then plan to become pregnant, the drug should be withdrawn several months before conception. The drug should not be given to lactating women. ATROMID-S is not recommended in children since, to date, an insufficient number of cases have been treated. ATROMID-S is not recommended for patients with impaired renal or hepatic function. Warning Caution should be exercised when anticoagulants are given in conjunction with ATROMID-S. The dosage of the anticoagulant should be reduced by one-third to one-half (depending on the individual case) to maintain the prothrombin time at the desired level to prevent bleeding complications. Frequent prothrombin determinations are advisable until it has been definitely determined that the levels have been stabilized. For PRECAUTIONS and ADVERSE REACTIONS, see scientific brochure. Dosage and Administration For adults only: One capsule (500 mg) four times daily. Availability No. 3243 Each capsule contains 500 mg clofibrate N.F. in bottles of 100 and 360. Further information, references, and scientific brochure available on request.
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AYERST LABORATORIES, division of Ayerst, McKenna & Harrison Limited, Montreal, Canada Made in Canada by arrangement with IMPERIAL CHEMICAL INDUSTRIES LTD. Reg'd.
my grandfather earned in 5. My grandfather swam in a pond; I have an ornately decorated swimming pooi in my garden, but so does everybody else in Bridle Boulevard. Grandfather was proud of his matched pair of greys and his carriage. I have two cars, but who doesn't? How do you measure success? I belong to three clubs, which I visit not more than once or twice a year; I have a three-quarter ton yacht, which would be tied to the dock all summer long, were it not for the energies of my son and his friends; I have a farm. A farm - that's the real index of success - 80 ha of land, about 20 ha more than my grandfather ever owned. I love that farm with almost the same love that my grandfather had for his land,
but I can't live there and enjoy it like my grandfather did. I just visit it on occasional weekends and hire someone to live there, to work the land and to enjoy it. Who am I, the world-renowned and famous Dr. Quigley, travelling in the loneliness of a crowded bus? Only the resident knows me, and he remains seated. I got off the bus at the next stop, crossed the road and took a bus home. "Can I borrow your car Mary?" I asked my wife, puzzled by my unexpected return. "Certainly, dear, what are you going to do?" I paused for a minute, watching the sun dancing on the rippling surface of our swimming pool. "I thought I would go back to Quigley to get a haircut."E
Musings on friendship JOEL PARIS FRCP[C]
Much has been written about love, little about friendship. Is that because, problematical as it is, there are fewer barriers to falling in love than to becoming a friend? People seem just as anxious as ever to pair up heterosexually, and it is a common observation that friends see less of each other if one of them falls in love. In marriage, a friend can be a threat, either because of the jealousy of the spouse or because of the spectre of a sexual triangle. It was not always so. There are those who believe that romantic love in its present form dates only from the time of the troubadours. Certainly in Shakespeare's time friendship was passionate, and it is only a reflection of ourselves that we see homosexuality in Shakespeare's sonnets. Men were not afraid to use the word "love" to each other, and we can assume that they were not afraid to feel it. Ask someone today if he has a close friend; he will usually say yes, but what he often means is people he sees not too often, and only at appointed times. Couples can be friends only if all four persons like each other, which is difficult enough with two! The kind of friendship the Elizabethans knew seems to have become a rarity. What determines the choice of a Reprint requests to: Dr. J. Paris, 517 Pine Ave. W., Montreal PQ, 113W 2L8
friend? As in love, one is often struck by the attraction of opposites. The need for a friend or a lover involves a desire to compensate for a missing part of oneself. Reik1 has eloquently described the self-dissatisfaction that precedes falling in love. Since every commitment in life involves a renunciation, no one can experience all potential aspects of his personality. The gap is filled by narcissistic identification with the other, a vicarious living out of the embryonic aspects of oneself. But exactly because the friend is what one is not, he is envied. As Reik points out, this envy becomes unconscious in love, but can re-emerge when the other proves disappointing. And in friendship, envy is less likely to be submerged in a haze of romance. On the whole, it is easier for women to be constant in friendship. Only observe the promiscuity of the male homosexual as opposed to the relative stability of lesbian relationships. One could conjecture that woman's biological function of nurturance over an extended period spills over from her children to her husband to her friends. In men, friendship is too often spoiled by envy and ambition. Men will bond together in a common cause, and perhaps the biological heritage of a hunting band1 acts as an adhesive. But without a common struggle, the ties become too easily frayed. A man
CMA JOURNAL/MAY 21, 1977/VOL. 116 1189
t
.
.4
...
Friends will be needed ...
who moves to a higher position may hated aspects of oneself onto him. There is always an element of fanabandon his old comrades; two men who, while young, fought together tasy in a strong friendship. The friend against the conservatism of the old may is invested with qualities no one perpart company when they sense there is son could have, with one's suppressed power to be had-and possibly not grandiosity, with the lost and searchedenough for both. Or the competition for goodness of parents, siblings and may be over the opposite sex; friends previous friends. The charismatic permay part if one is more successful in son especially attracts others; as Freud4 winning the love of women. If both pointed out, narcissism is irresistible are unsuccessful their common failure because we had it once and yearn to have it again. But the illusion created will bind them together. If friendship begins between equals, by the most impressive people is easily they may not remain equal. Or once shattered, so that they either make use the needed qualities of the friend are of an easy promiscuity, such as in incorporated, he may be outgrown and large groups, or learn to become aloof discarded. In a relationship of master and unapproachable. If two narcissistic and disciple, the ultimate outcome is people become friends, the d6nouement uncertain. Unless the superior party is is inevitable. Friendship can survive generally interested in nurturing the only if neither party feels destroyed by other and encouraging him to grow in the victories of the other. The ability to genuinely rejoice in his own way, feelings of revolt will inevitably emerge. If these feelings are another's good fortune is related to true suppressed by an exaggerated loyalty, empathy, the capacity to feel what the relationship may still survive, but someone else feels without losing one's at the disciple's expense. That is, un- own boundaries. The hostility that less he has the good fortune to see his erupts between formerly good friends master die while he himself is still may be because the friend was never young! It is rare for great charismatic valued for himself, but as a fantasy; leaders to have truly creative disciples; the former friends never knew each the leader is just too sure that he is other at all. In the psychiatric patient the capacright. What is tragic in friendship is that ity for friendship is of profound proghostility is more likely to break out nostic significance. Borderline patients the more deeply the friends identify may oscillate between periods of withwith each other. As Hoffer3 has pointed drawal and a passionate merger with out in a social context, the need for the other. Schizoid patients maintain reassurance about oneself is most a stable and rigid boundary with the strongly directed toward those whose world; friendship is impossible because views differ only a little from one's a destructive and profoundly envious own. Thus the falling out of friends hostility is unleashed by closeness. A over relatively small political differ- narcissistic personality cannot maintain ences. Close identification with a friendship because his need for adfriend may lead to a projection of the miration prevents him from feeling 1190 CMA JOURNAL/MAY 21, 1977/VOL. 116
empathy. In general, as Rangell5 has described, those who lack a secure identity of their own fear the loss of boundaries with another person. But it is not on1.' in the diagnosable patient population that friendship is a problem. Social conditions have exacerbated the difficulties in the path of good friends. A high rate of social and geographical mobility means that the best of friends will be forced to separate and prepare to do so even from the beginning of the relationship. The superficial camaraderie of Americans is an adaptation to a life in which longterm friendships are unlikely. At the ultimate point, encounter groups meet for a weekend and part. Although a therapist is not a friend, it is probably not an accident that psychotherapy flourishes in highly mobile urban environments and has never caught on in the more traditional communities. Perhaps in the future there will be fewer lifelong friendships, just as there are fewer lifelong careers and lifelong marriages. But as long as it is the human condition to be incomplete in oneself, friends will be needed. Sexual love cannot replace friendship; no one person, no matter how well loved, can fill all the empty spaces. Rather friendships, by compensating for the deficiencies of the beloved, make it easier for love to endure. References REIK T: On Love and Lust, New York, Grove Press, 1957 TIGER L: Men In Groups, New York, Random House, 1969 HOFFBa E: The True Believer, New York, Harper & Row, 1957 Fawn S: On Narcissim - An Introduction, in Collected Papers, vol IV, London, Ho&arth, 1925, p 30 5. RANGELL L:On Friends.p. I Amer Psychoan Assoc 11: 3, 1963
1. 2. 3. 4.
.
*
0
AYERST LABORATORIES, division of Ayerst, McKenna & Harrison Limited, Montreal, Canada Made in Canada by arrangement with IMPERIAL CHEMICAL INDUSTRIES LTD. Reg'd.
my grandfather earned in 5. My grandfather swam in a pond; I have an ornately decorated swimming pooi in my garden, but so does everybody else in Bridle Boulevard. Grandfather was proud of his matched pair of greys and his carriage. I have two cars, but who doesn't? How do you measure success? I belong to three clubs, which I visit not more than once or twice a year; I have a three-quarter ton yacht, which would be tied to the dock all summer long, were it not for the energies of my son and his friends; I have a farm. A farm - that's the real index of success - 80 ha of land, about 20 ha more than my grandfather ever owned. I love that farm with almost the same love that my grandfather had for his land,
but I can't live there and enjoy it like my grandfather did. I just visit it on occasional weekends and hire someone to live there, to work the land and to enjoy it. Who am I, the world-renowned and famous Dr. Quigley, travelling in the loneliness of a crowded bus? Only the resident knows me, and he remains seated. I got off the bus at the next stop, crossed the road and took a bus home. "Can I borrow your car Mary?" I asked my wife, puzzled by my unexpected return. "Certainly, dear, what are you going to do?" I paused for a minute, watching the sun dancing on the rippling surface of our swimming pool. "I thought I would go back to Quigley to get a haircut."E
Musings on friendship JOEL PARIS FRCP[C]
Much has been written about love, little about friendship. Is that because, problematical as it is, there are fewer barriers to falling in love than to becoming a friend? People seem just as anxious as ever to pair up heterosexually, and it is a common observation that friends see less of each other if one of them falls in love. In marriage, a friend can be a threat, either because of the jealousy of the spouse or because of the spectre of a sexual triangle. It was not always so. There are those who believe that romantic love in its present form dates only from the time of the troubadours. Certainly in Shakespeare's time friendship was passionate, and it is only a reflection of ourselves that we see homosexuality in Shakespeare's sonnets. Men were not afraid to use the word "love" to each other, and we can assume that they were not afraid to feel it. Ask someone today if he has a close friend; he will usually say yes, but what he often means is people he sees not too often, and only at appointed times. Couples can be friends only if all four persons like each other, which is difficult enough with two! The kind of friendship the Elizabethans knew seems to have become a rarity. What determines the choice of a Reprint requests to: Dr. J. Paris, 517 Pine Ave. W., Montreal PQ, 113W 2L8
friend? As in love, one is often struck by the attraction of opposites. The need for a friend or a lover involves a desire to compensate for a missing part of oneself. Reik1 has eloquently described the self-dissatisfaction that precedes falling in love. Since every commitment in life involves a renunciation, no one can experience all potential aspects of his personality. The gap is filled by narcissistic identification with the other, a vicarious living out of the embryonic aspects of oneself. But exactly because the friend is what one is not, he is envied. As Reik points out, this envy becomes unconscious in love, but can re-emerge when the other proves disappointing. And in friendship, envy is less likely to be submerged in a haze of romance. On the whole, it is easier for women to be constant in friendship. Only observe the promiscuity of the male homosexual as opposed to the relative stability of lesbian relationships. One could conjecture that woman's biological function of nurturance over an extended period spills over from her children to her husband to her friends. In men, friendship is too often spoiled by envy and ambition. Men will bond together in a common cause, and perhaps the biological heritage of a hunting band1 acts as an adhesive. But without a common struggle, the ties become too easily frayed. A man
CMA JOURNAL/MAY 21, 1977/VOL. 116 1189
t
.
.4
...
Friends will be needed ...
who moves to a higher position may hated aspects of oneself onto him. There is always an element of fanabandon his old comrades; two men who, while young, fought together tasy in a strong friendship. The friend against the conservatism of the old may is invested with qualities no one perpart company when they sense there is son could have, with one's suppressed power to be had-and possibly not grandiosity, with the lost and searchedenough for both. Or the competition for goodness of parents, siblings and may be over the opposite sex; friends previous friends. The charismatic permay part if one is more successful in son especially attracts others; as Freud4 winning the love of women. If both pointed out, narcissism is irresistible are unsuccessful their common failure because we had it once and yearn to have it again. But the illusion created will bind them together. If friendship begins between equals, by the most impressive people is easily they may not remain equal. Or once shattered, so that they either make use the needed qualities of the friend are of an easy promiscuity, such as in incorporated, he may be outgrown and large groups, or learn to become aloof discarded. In a relationship of master and unapproachable. If two narcissistic and disciple, the ultimate outcome is people become friends, the d6nouement uncertain. Unless the superior party is is inevitable. Friendship can survive generally interested in nurturing the only if neither party feels destroyed by other and encouraging him to grow in the victories of the other. The ability to genuinely rejoice in his own way, feelings of revolt will inevitably emerge. If these feelings are another's good fortune is related to true suppressed by an exaggerated loyalty, empathy, the capacity to feel what the relationship may still survive, but someone else feels without losing one's at the disciple's expense. That is, un- own boundaries. The hostility that less he has the good fortune to see his erupts between formerly good friends master die while he himself is still may be because the friend was never young! It is rare for great charismatic valued for himself, but as a fantasy; leaders to have truly creative disciples; the former friends never knew each the leader is just too sure that he is other at all. In the psychiatric patient the capacright. What is tragic in friendship is that ity for friendship is of profound proghostility is more likely to break out nostic significance. Borderline patients the more deeply the friends identify may oscillate between periods of withwith each other. As Hoffer3 has pointed drawal and a passionate merger with out in a social context, the need for the other. Schizoid patients maintain reassurance about oneself is most a stable and rigid boundary with the strongly directed toward those whose world; friendship is impossible because views differ only a little from one's a destructive and profoundly envious own. Thus the falling out of friends hostility is unleashed by closeness. A over relatively small political differ- narcissistic personality cannot maintain ences. Close identification with a friendship because his need for adfriend may lead to a projection of the miration prevents him from feeling 1190 CMA JOURNAL/MAY 21, 1977/VOL. 116
empathy. In general, as Rangell5 has described, those who lack a secure identity of their own fear the loss of boundaries with another person. But it is not on1.' in the diagnosable patient population that friendship is a problem. Social conditions have exacerbated the difficulties in the path of good friends. A high rate of social and geographical mobility means that the best of friends will be forced to separate and prepare to do so even from the beginning of the relationship. The superficial camaraderie of Americans is an adaptation to a life in which longterm friendships are unlikely. At the ultimate point, encounter groups meet for a weekend and part. Although a therapist is not a friend, it is probably not an accident that psychotherapy flourishes in highly mobile urban environments and has never caught on in the more traditional communities. Perhaps in the future there will be fewer lifelong friendships, just as there are fewer lifelong careers and lifelong marriages. But as long as it is the human condition to be incomplete in oneself, friends will be needed. Sexual love cannot replace friendship; no one person, no matter how well loved, can fill all the empty spaces. Rather friendships, by compensating for the deficiencies of the beloved, make it easier for love to endure. References REIK T: On Love and Lust, New York, Grove Press, 1957 TIGER L: Men In Groups, New York, Random House, 1969 HOFFBa E: The True Believer, New York, Harper & Row, 1957 Fawn S: On Narcissim - An Introduction, in Collected Papers, vol IV, London, Ho&arth, 1925, p 30 5. RANGELL L:On Friends.p. I Amer Psychoan Assoc 11: 3, 1963
1. 2. 3. 4.
