In _Psychoanalytic Therapy as Health Care_, a timely and trenchant consideration of the clash of values between managed care and psychoanalysis, contributors elaborate a thoughtful defense of the therapeutic necessity and social importance of contemporary psychoanalytic and psychodynamic approaches in the provision of mental health care. Part I begins with the question of where psychoanalytic treatments now stand in relation to health care; contributors offer explanations of the current state of affairs and consider possible directions of future (...) developments. Part II looks directly at the conundrums that have resulted from the attempt to integrate psychotherapy and managed care, with contributors examining the ethical and legal dimensions of confidentiality, privacy, and reporting to third parties. Part III opens to wider consideration of the experiences of psychoanalysts under health care systems throughout the world. Finally, Part IV demonstrates the relevance of contemporary psychoanalytic approaches to a variety of contemporary patient populations, with contributors focusing on the applicability of analytically oriented treatment to AIDS patients, seriously disturbed young adults, and inner-city clinic patients. Collectively, the contributors to _Psychoanalytic Therapy as Health Care_ convincingly refute the claim that psychoanalytically informed therapy is an esoteric treatment suited only to the "worried well." Drawing on a wide range of clinical and empirical evidence, they forcefully argue that contemporary psychoanalytic approaches are applicable to seriously distressed persons in a variety of treatment contexts. Failure to include such long-term therapies within health care delivery systems, they conclude, will deprive many patients of help they need - and help from which they can benefit in enduring ways that far transcend the limited treatment goals of managed care. (shrink)

Though the impetus for psychoanalytic and group analytic in-patient psychotherapy largely came from Britain, it is in Germany that this work has been supported, developed and researched to a greater extent than elsewhere. In _Psychoanalytic Therapy in the Hospital Setting_ Paul Janssen describes the different models which have been tried and evaluated and explains his own integrative model in detail, illustrating it with vivid clinical vignettes. The author also shows that in-patient groups are particularly effective in the treatment (...) of severe personality disorders, borderline conditions and psychosomatic illness. Not previously available in the English language, this book will be invaluable reading to psychiatrists, psychotherapists, nurses, social workers and anyone working in health care. (shrink)

In recent years, there has been a drive to develop briefer, more focal psychodynamic interventions, with the hope of satisfying the ever-increasing need for mental health support. This book outlines the principles and practice of Brief Psychoanalytic Therapy. An introductory chapter distils those aspects of psychoanalysis that provide a basis for the approach. This is followed by an overview of themes and variations in six forms of brief psychodynamic therapy. The remainder of the book is concerned less (...) with theory than with clinical practice. Treatment and Adherence Manuals detail the specifics of therapist orientation and technique, and a formal research study comparing the approach with Interpersonal Therapy is reported. Case histories of individual treatments unfolding over time are complemented by detailed examination of short sequences of patient-therapist dialogue from transcribed sessions. (shrink)

In his extensive description of the heuristic approach to psychoanalytic therapy, Peterfreund discusses the strategies used by both patient and therapist as they move toward discovery and deeper understanding.

In this paper I propose a model of the fundamental components of psychoanalytic psychotherapies that I try to explicate with contemporary theories of the Bayesian brain and the Free Energy Principle (FEP). I first show that psychoanalytic therapies require a setting (made up of several envelopes), a particular psychic state and specific processes (transference, free association, dreaming, play, reflexivity and narrativity) in order to induce psychic transformations. I then analyze how these processes of transformations operate and how they (...) can be enlightened by the FEP. I first underline the fact that psychoanalytic therapies imply non-linear processes taking time to unfold and require a setting containing high entropy processes. More precisely, these processes are characterized by an interplay between extension and reduction of free energy. This interplay also favors the emergence of new orders of subjective experience, which occur following states of disorder, according to a certain energetic threshold allowing the modification and improvement of mental functioning. These high entropy states are also characterized by random functioning and psychic malleability which favors the exploration of subjective experience in an original manner. Overall, the approach proposed in this paper support the dialogue between psychoanalysis and other fields of research while underlining how psychoanalytical theoretical and conceptual constructs can also be useful to other disciplines, in particular the neurosciences of subjectivity. (shrink)

The mind body problem in psychoanalytic theory and practice -- Philosophy and the mind-body problem, influences on psychoanalysis -- Psyche and soma in the work of Sigmund Freud : psychoanalytic foundations -- Psyche and soma in Klein and object relations : contemporary developments -- Psyche and soma in Kohutian, intersubjective, and relational theories -- Attachment theory and neuropsychoanalysis -- Conclusions.

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.2 (2004) 125-128 [Access article in PDF] Comparing Psychoanalytic and Cognitive-Behavioral Perspectives on Control Bruce N. Waller Keywords freedom, locus of control, psychoanalysis, self-efficacy, volition Cognitive behavioral research on locus of control and self-efficacy has produced an extensive body of empirical results that might prove useful to psychoanalytic researchers endeavoring to strengthen the empirical foundation of psychoanalytic therapy. Cognitive-behaviorists and psychoanalysts (...) share a common interest in the importance of perspectives and belief systems and their impact on individual freedom, and comparative research on therapeutic effectiveness could yield benefits for both therapeutic approaches.Locus of control and self-efficacy are central elements in cognitive-behavioral psychology, and they play an important role in cognitive-behavioral therapy. Although the psychoanalytic approach does not explicitly employ those concepts, psychoanalytic therapists are obviously concerned with problems of effective action and internal obstacles to action. Attention to these two perspectives and their overlapping interests offers potential benefits for both the cognitive-behavioral and the psychodynamic approaches to psychological research and therapy.One potential benefit is the development of useful tools for advancing empirically based research on psychoanalysis. As Lehrer (1999) states, it is advantageous to ground psychoanalysis in "firm empirical evidence whenever possible." Although there have obviously been significant positive steps in that direction (Singer 2003; Weiss 1995, 1988; Weiss and Sampson 1986), psychoanalytic researchers have recognized that one source of difficulty is in finding clearly measurable research objectives and hypotheses (Burgin 2002). Cognitive-behavioral research on locus of control and self-efficacy has produced an extensive body of research using clear measurement standards that could prove useful in the empiricist approach to psychodynamic theories. In particular, those cognitive-behavioral research findings might offer a means of extending empirical investigation of psychodynamic theory in a direction usually regarded as difficult to test empirically: the study of psychoanalytic effectiveness to "change your way of seeing" (Lieberman 1999). Shifting locus of control or efficacy expectations in specific domains (Bandura 1997) [End Page 125] would empirically confirm the effectiveness of psychoanalytic techniques. It might well be that some efficacy expectations are enhanced more effectively by psychodynamic processes than by cognitive-behavioral therapy, or that psychoanalysis is effective in enhancing some specific efficacy expectations but not others. This could potentially extend the empirical examination of psychoanalytic theory as well as provide a base of comparison with cognitive-behavioral therapy techniques.Although self-efficacy enhancement might be a fruitful empirical test for psychodynamic therapy, therapeutic intervention to modify locus of control potentially could be even more productive. Current research indicates that one's orientation toward locus of control is a relatively stable characteristic, although it can be modified (Holyrod et al. 1984; Rotter 1979; Sadow and Hopkins 1993). One reason for locus of control stability may be that the locus of control imposes a perspective on the conceptualization of all one's experiences: from a strong internal locus of control perspective I view failures and successes as largely my own doing, whereas from an external locus perspective even my most effective efforts are seen as events that were outside my control: "I guess it was just my time to do well on a math exam," rather than "My hard work for that exam really paid off." (Lieberman makes this phenomenon quite clear in his excellent discussion of transparency.) Although locus of control is not easily modified, it is important to find effective means of helping subjects to achieve such changes, because research shows that a strong internal locus of control is positively correlated with success in work, sports, studies, marriage, and psychological adjustment (Lefcourt 1981, 1992), as well as with better health care behavior and better health (Bandura 1977; Schorr and Rodin 1982; Schulz 1976; Schulz and Hanusa 1978; Wallston 1993). Those deeply enmeshed in an external locus of control enjoy less real freedom and suffer severe disadvantages.How does one effect a shift in such a basic orientation? Not easily. From a psychoanalytic approach, the key will lie in recognizing and reconceptualizing the beliefs that impede effective action. Cognitive-behaviorists are more likely to... (shrink)

RE-ISSUED WITH INDEX 'Therapy may be mad,' declares Rob Weatherill in this outspoken volume. Therapy here means particularly psychotherapy and counselling, but should be also taken to signify the universal logic of the post-modern therapeutic culture of well-being, happiness and enjoyment. More and more people want to believe in therapy who have lost belief in anything else. Counselling and therapy increasingly inform all human interaction. The dominant ethos is a holistic one. This book aims to refute, (...) primarily through the prism of modern psychoanalysis and key theorists like Baudrillard, Levinas, Lyotard, Paz, Steiner, Reiff as well as Žižek, the fashion for a return to a pre-Cartesian ideal of harmony and integration. On the contrary, there is something monstrous, something excessive, that Freud termed the death drive, at the heart of the Real upon which ordinary reality, so to speak, rests. Enlightenment thought, in which we in the West in particular are caught, is entirely incapable of going beyond the ideal humanist version of man – our last great illusion. (shrink)

In the nearly one hundred years that have elapsed since Freud’s publication of his pioneering work with “Little Hans,” psychoanalysis has transformed not only our clinical work with children, but has immeasurably enriched our understanding of normal child and adolescent development as well as developmental deviations and derailments. We have gradually come to understand childhood and adolescence as a complex tapestry of developmental themes, conflicts, and crises; sometimes discontinuous or discrete, at other times, harmonious and integrated, yet always occurring within (...) a transactional matrix of environmental influences and internal experience. In this transdisciplinary anthology, eight authors explore the changing terrain of child and adolescent psychoanalysis and psychoanalytic therapy. The contributions, which reflect theoretical and clinical heterogeneity, are both innovative and varied, and range from the highly abstract and theoretical to those that consider very specific dimensions of clinical process. Collectively, they make a compelling case for the continued relevance of psychoanalytic ideas in the treatment of children and adolescents. With insightful contributions by expert psychoanalysts, clinical social workers, and clinical psychologists, Psychoanalytic Approaches to the Treatment of Children and Adolescents: Tradition and Transformation is essential reading for child and adolescent therapists. Psychoanalytic Approaches to the Treatment of Children and Adolescents will increase your knowledge of: the function of play in normal development--and within the treatment relationship psychoanalytic theories and research investigations linking early object loss to depression the nature of adolescent depression the theoretical and clinical dimensions of a two-systems approach to understanding psychopathology and the clinical process the dynamic meaning and clinical management of drug and alcohol abuse, promiscuity, eating disorders, violence, and other self-destructive behaviors the complexities of treating children with neuropsychological deficits. (shrink)

There is mounting evidence that strong personal relationships and spiritual beliefs contribute to our well-being. In Divine Therapy, Janet Sayers employs a biographical approach to the lives and writings of a range of eminent psychotherapists and psychologists to illuminate the link between physical and mental well-being and the 'at-one-ness' provided by love, religious and mystical experiences.

The outcomes of psychoanalysis, as with other psychotherapies, vary considerably. _Psychoanalytic Treatment in Adults _examines the results of a longitudinal study of change during psychoanalysis, illuminating the characteristics of patients, analysts and analyses which can help to predict outcomes of treatment. Written by experienced psychologists and psychoanalysts, chapters in the book draw upon sixty case studies to consider how patients with very different analytic outcomes respond at both the beginning and end of their analysis. Psychoanalysts used a clinician report measure, (...) the Shedler-Westen Assessment Procedure, to describe a patient at the beginning of psychoanalysis and every six months until the analysis ended. This allowed the authors to learn about changes over analysis and, in turn, improved treatment planning and practice for the well-being of other patients. Chapters explore five outcomes: a negative therapeutic reaction; attrition when the patient drops out; attrition due to external events; mutual agreement between patient and analyst without maximum benefits; and mutual agreement between patient and analyst with maximum benefits. The findings from these chapters will be of interest to researchers and academics in the fields of psychoanalysis, psychotherapy, psychodynamic therapy, psychoanalytic education, psychiatry and psychology. The results should also help clinicians recognize potential problems early in analytic treatments so that they can work more effectively with patients. (shrink)

Structures of Subjectivity: Explorations in Psychoanalytic Phenomenology and Contextualism, is a revised and expanded second edition of a work first published in 1984, which was the first systematic presentation of the intersubjective viewpoint – what George Atwood and Robert Stolorow called psychoanalytic phenomenology – in psychoanalysis. This edition contains new chapters tracing the further development of their thinking over the ensuing decades and explores the personal origins of their most essential ideas. In this new edition, Atwood and Stolorow (...) cover the philosophical and theoretical assumptions of psychoanalysis and present a broad approach that they have designated phenomenological contextualism. This approach addresses personal subjective worlds in all their richness and idiosyncrasy and focuses on their relational contexts of origin and therapeutic transformation. Structures of Subjectivity covers the principles guiding the practice of psychoanalytic therapy from the authors' viewpoints and includes numerous detailed clinical case studies. The book will be essential reading for psychoanalysts, practitioners of psychotherapy, psychiatrists, psychologists, counselors, and social workers. It will also be of interest to scholars and students with an interest in psychoanalytic theory and practice, and its philosophical premises. (shrink)

A ubiquitous assumption of the psychotherapy landscape is the axiom that theory is an indispensable accompaniment of psychotherapy praxis. Yet a range of leading philosophers and spiritual masters tell a very different story, which can give us incisive and productive purchase on some of the central lacunae of modern psychotherapy practice. At least some existentialist and kindred philosophers maintain that the embrace of theory and scientism necessarily constrains, and at worst determines, what we can perceive and experience of the world (...) . This paper offers an account as to why a ‘modernist’ view of the role of theory is not only unsustainable, but also fundamentally antithetical to psychotherapy practice at its best. On this view, what is termed a ‘post-existential’ therapy praxis is the very antithesis of the kind of scientism that still dominates much psychotherapeutic thinking. The paper concludes with some speculatively sketchy comments about the place of what is labelled ‘the subtle’ and ‘the mysterious’ in therapy work and in human experience more generally—comments which are couched within what is here termed a ‘trans-modern’, New Paradigm cosmology. As we pass through what are arguably the death throes of Late Modernity, such a ‘post-theoretical’ approach to therapy practice is tentatively labelled as ‘post-existential’, as while it shares many features in common with what is termed ‘existential-phenomenological psychotherapy’, at the same time it also moves crucially beyond the latter both in its due recognition of the importance of psychoanalytic and postmodern thinking in challenging a naïve existential conception of human agency, and in its explicit openness to the trans-modern, the spiritual and the ineffable. (shrink)

In this provocative contribution to both psychoanalytic theory and the philosophy of science, Louis Berger grapples with the nature of "consequential" theorizing, i.e., theorizing that is relevant to what transpires in clinical practice. By examining analysis as a genre of "state process formalism" - the standard format of scientific theories - Berger demonstrates why contemporary theorizing inevitably fails to explain crucial aspects of practice. His critique, in this respect, pertains both to the formal structure of psychoanalytic explanation and (...) the technical language through which this structure gains expression. The pragmatic recommendations that issue from this critique are illustrated with respect to a number of perennial problem areas besetting analysis and cognate disciplines. In a discussion that encompases theories of affect, issues in family therapy, the nature of first-language acquisition, and the philisophical topics of free will and determinism, Berger shows that certain systems of representation _can_ describe the psychological realm adequately, and that such systems necessarily follow modern physics in rejecting naive assumptions about the separability of theory and practice. His proposals culminate in a "nonhierarchical" conception of psychoanalytic theory that assigns a separate status to the clinically pragmatic level of theorizing. In both his critique of contemporary analysis and his reconstructive proposals, Berger fuses into a highly readable argument a fascinating range of insights culled from epistemology, linguistics, physics, logic, computer science, history, and aesthetics. More impressively still, he demonstrates how an investigation of psychoanalytic theory can serve as a vehicle for examining pervasive epistemological issues in both philosophy and the social sciences. (shrink)

Are there common mechanisms that apply across different therapies that might explain their effectiveness? Many psychologists, psychotherapists and counsellors, whether clinicians or researchers, now recognize that one such key mechanism involves the transformation of meaning in the process of therapy. The purpose of this book is to show how the transformation of meaning is related to therapeutic change. Change in therapy can and should occur at a number of levels for improvement to be maintained, whether in behavior (...) class='Hi'>therapy, cognitive therapy or psychoanalytic therapy. The leading scientists and practitioners who have contributed to this book approach therapy from very different perspectives, but they together help to fashion a common framework for understanding the role of meaning in therapeutic change. (shrink)

The oceanic feeling -- The psyche's unitive trends -- Otto Rank's will therapy -- Erich Fromm's humanistic psychoanalysis -- The mystical in art and culture : Milner, Winnicott, and Ehrenzweig -- D.W. Winnicott's analysis of the self -- The cosmic narcissism of Heinz Kohut -- Hans W. Loewald and psychic integration -- Wilfred R. Bion's transformations of O -- James Grotstein and the transcendent position -- The personal monism of Neville Symington -- The ecstasies of Michael Eigen.

Psychoanalytic work with children is popular, but the sophisticated language used in psychoanalytic discourse can be at odds with how children communicate, and how best to communicate with them. _Dialogues with Children and Adolescents: A Psychoanalytic Guide _shows how these aims can be achieved for the most effective clinical outcome with children from infancy up to late adolescence. _Björn Salomonsson_ and _Majlis Winberg Salomonsson_ draw on extensive case material which reveals the essence of communication between child and (...) therapist. They enfranchise the patient of all ages as an equal participant in the therapeutic relationship. Presented in letter form the cases contain no professional terms. Only the final chapter contains theoretical commentaries applicable to each case. These terms and theories help to explain a child’s behaviour, the analyst’s technique and the background to the disorder. This is new creative development in child therapy and analysis which is written in a very accessible style. _Dialogues with Children and Adolescents_ will be essential reading for beginners in psychoanalytic work with children and will cast a fresh light on such work for more experienced clinicians. It will also appeal to the non-professional lay reader. (shrink)

Recent research on “psychotherapy” in Greek philosophy has not been fully integrated into thinking about philosophy as a way of life molded by personal relationships. This article focuses on how the enigma of Socratic eros sustains a network of thought experiments in the fourth century BCE about interpersonal dynamics and psychical transformation. It supplements existing work on Plato's Symposium and Phaedrus with comparative material from Aeschines of Sphettus, Xenophon, and the dubiously Platonic Alcibiades I and Theages. In order to select (...) and illuminate commonalities among all of these, it also draws critically upon Jacques Lacan's psychoanalytic technique and his numerous comparisons between Socrates and psychoanalysts. What emerges is a more complex and qualified but no less sincere appreciation for the ideal of reflective, cooperative aspiration toward Beauty portrayed in Plato's dialogues. (shrink)

Psychoanalytic practice and theory do not map together in any seamless ways. Nevertheless, the creative tension between the two is essential in the production of psychoanalytic knowledge. In this paper, I recount Emma’s psychoanalytic journey using a series of five vignettes from her four-year psychotherapy. When I met Emma, she had been unable to walk for six months. The reasons for her affliction were, at this time, mysterious. During her therapy, a transformative process took place reflecting (...) a movement from symptom to the symbolization of an inner receptive space. The insights that emerged from this psychic journey challenge the conceptualization of a simple linear progression from the pre-Oedipal to the Oedipal moment which is seen to structure subjectivity. I argue that the representation of a receptive inner space is a necessary precondition for thought – and this is especially so for women’s development of mind. This argument calls into question the centrality given to the Oedipus complex and the associated paternal function in the structuring of subjectivity in some psychoanalytic models of mind. I suggest these models sit too closely to patriarchal fantasies which underestimate the complex processes involved in entering the symbolic realm. (shrink)

The history of the relationship between pragmatism and psychoanalysis is both complex and fragmentary. On the pragmatist side, the engagement with Sigmund Freud’s thought – and with the psychoanalytic tradition more generally – tends to be cursory, nonlinear, and at times slightly adversarial. For instance, William James notoriously rejects the unconscious as a concept and develops a different theory of the subconscious. Similarly, Charles S. Peirce frequently refers to the unconscious dimens...

How we narrate our lives can affect us, for good or ill. Our narrative practices make an undeniable difference to our psychosocial well-being. All so-called "talking cures" – including traditional psychoanalytic and psychodynamic approaches to therapy and newer techniques – are motivated by this insight about the power of personal narratives. All therapies of the discursive ilk make use of narratives, in one way or another, as a means of enabling individuals to frame, or reframe, and to manage (...) their life circumstances in richer or new ways.Narrative Therapy, an important sub-class of talking therapies, breaks faith with more traditional psychodynamic approaches in adopting a... (shrink)

Unconscious Incarnations considers the status of the body in psychoanalytic theory and practice, bringing Freud and Lacan into conversation with continental philosophy to explore the heterogeneity of embodied life. By doing so, the body is no longer merely an object of scientific inquiry but also a lived body, a source of excessive intuition and affectivity, and a raw animality distinct from mere materiality. The contributors to this volume consist of philosophers, psychoanalytic scholars, and practitioners whose interdisciplinary explorations reformulate (...) traditional psychoanalytic concepts such as trauma, healing, desire, subjectivity, and the unconscious. Collectively, they build toward the conclusion that phenomenologies of embodiment move psychoanalytic theory and practice away from representationalist models and toward an incarnational approach to psychic life. Under such a carnal horizon, trauma manifests as wounds and scars, therapy as touch, subjectivity as bodily boundedness, and the unconscious 'real' as an excessive remainder of flesh. Unconscious incarnations signal events where the unsignifiable appears among signifiers, the invisible within the visible, and absence within presence. In sum: where the flesh becomes word and the word retains its flesh. Unconscious Incarnations seeks to evoke this incarnational approach in order to break through tacit taboos toward the body in psychology and psychoanalysis. This interdisciplinary work will appeal greatly to psychoanalysts and psychoanalytic psychotherapists as well as philosophy scholars and clinical psychologists. (shrink)

What does it mean to ‘drop out’ of therapy? Many definitions of ‘dropout’ have been proposed, but the most widely accepted is the client ending treatment without agreement of their therapist. However, this is in some ways an external criterion that does not take into account the client’s experience of therapy, or reasons for ending it prematurely. This study aimed to identify whether there were more meaningful categories of dropout than the existing dropout definition, and to test whether (...) this refined categorisation of dropout was associated with clinical outcomes. This mixed-methods study used a subset of data from the IMPACT trial, which investigated psychological therapies for adolescent depression. Adolescents were randomly allocated to a treatment arm (Brief Psychosocial Intervention; Cognitive-Behavioural Therapy; Short-Term Psychoanalytic Psychotherapy). The sample for this study comprised 99 adolescents, aged 11-17 years. 32 were classified as having dropped out of treatment and participated in post-therapy qualitative interviews about their experiences of therapy. For 26 dropout cases, the therapist was also interviewed. 67 cases classified as having completed treatment were included to compare their outcomes to dropout cases. Interview data for dropout cases were analysed using ideal type analysis. Three types of dropout were constructed: ‘dissatisfied’ dropout, ‘got-what-they-needed’ dropout, and ‘troubled’ dropout. ‘Dissatisfied’ dropouts reported stopping therapy because they did not find it helpful. ‘Got-what-they-needed’ dropouts reported stopping therapy because they felt they had benefitted from therapy. ‘Troubled’ dropouts reported stopping therapy because of a lack of stability in their lives. The findings indicate the importance of including the perspective of clients in definitions of drop out, as otherwise there is a risk that the heterogeneity of 'dropout' cases may mask more meaningful distinctions. Clinicians should be aware of the range of issues experienced by adolescents in treatment that lead to disengagement. Our typology of dropout may provide a framework for clinical decision-making in managing different types of disengagement from treatment. (shrink)

There is increasing recognition within psychoanalysis and related therapies that awareness of the body is important in understanding and treating patients. Psychic Threats and Somatic Shelters explores the ways in which adults and children become acquainted with the range of physical issues that arise within their psychoanalytic or psychological treatments. Nitza Yarom discusses in a practical and clinically focused way the large variety of physical outlets which today's person uses to shelter from the many troubles and restrictions that are (...) placed on everyday life. Her book is divided into two main sections: Somatic shelters, which explores the variety of physical symptoms encountered by patients, including problems with weight and eating; with sensation through sight, sound, smell and taste; in movement through hyper activity or rigidity and through the communication of physical pain. Embodied dialogue, in which the author updates the use of the basic technical principles of psychoanalysis to involve the body in the treatment including transference and counter-transference between analyst and patient. In Psychic Threats and Somatic Shelters the emotional communication of these body narratives are vividly demonstrated in the treatments presented, here the interaction in the consulting room is revealed in bodily resonance and its therapeutic effects. This book is written for psychoanalysts and psychotherapists, psychologists, body therapists, family therapists, social workers and art/movement therapists. (shrink)

Daniel is 35, successful, a high level professional and an accomplished academic - yet he is also a virgin, who fears that he will spend the rest of his life alone. More importantly, Daniel has existed in an emotional bubble all of his life, and has had no intimate friendships. In other words, he is not fully alive, and seeks psychotherapy because he is haunted by not understanding what is wrong with him. He is attractive to women, yet as soon (...) as a woman tries to get close to him, he runs away. Lacking an inner foundation, he fears that women will annihilate him, like his overbearing mother who abused him as a child. Quite simply, this book is an unprecedented achievement, taking the reader into actual psychoanalytic sessions and sharing with the reader Michael Shoshani Rosenbaum’s dialogues with Daniel, vividly illustrating his pain and struggle to transcend his existential plight. Furthermore, as the author of two sections of the book, Daniel himself provides a rare, insightful view from the other side of the couch, illuminating the challenge and change experienced within the other half of the therapeutic relationship. It is a compelling psychological adventure, fusing together the intimacy of the therapy with an account of the revolutionary changes that have occurred in the practice of psychotherapy and psychoanalysis over the last decades. Daniel is like no one else, and yet he is everyone, making this book a must for every person searching for self-knowledge, allowing the reader to identify with Daniel and his struggle to become human. (shrink)

The following paper, delivered as a lecture to the philosophy departments of a number of American universities in 1979, traces a parallel between Hegelian phenomenology and Freudian psychoanalysis. It stems from a project I have been working on for several years now entitled Erinnerungsversuch or "Essay in Remembrance. " In my studies of Freud and Hegel for that project I was struck by the importance of memory for their work, not only as a field of investigation but also as a (...) method of the investigation itself. Remembering and forgetting are the crucial events for both psychoanalysis and phenomenology, crucial yet maddeningly intertwined, so that while memory seems eminently subject to malfunction and even illness it remains the sole source of insight and cure. I therefore determined to extend the parallel as far as it would go-perhaps even farther-and the present paper is the result. I am of course aware that Hegel was not a psychotherapist, Freud not a systematic philosopher, and realize that if essays like this one may be excused at all it is only because they eventually grow silent and allow irreconcilable differences to reassert themselves. Yet there is a sense in which Hegel's creative recapitulation of the history of philosophy, seeking as it does to liberate philosophical thought from a crippling self-ignorance, amounts to therapy of spirit; and there is a sense in which Freudian therapy must shatter traditional prejudices in our thoughts about what the psyche or spirit is, by letting psychological phenomena show themselves as they are. I have tried to make the parallel as concrete as possible, shunning Freud's metapsychology and turning instead to one of his earliest accounts of psychoanalytic praxis, eschewing sweeping remarks about Hegel's "system" and concentrating on just a few pages from the Phenomenology. Readers trained in philosophy will know that a few pages of Hegel are bound to contain labyrinths. I hope that my psychologist-readers will overlook the oversimplified presentation of Freud-which results partly from the lecture form-and will forgive my unwillingness to make Hegel's thought seem less demanding than it is. Finally, if I am right, the Freud-Hegel parallel with respect to memory tells us a good deal not only about this fascinating faculty but also about that singular creature who is so ardent to remember and so prone to forget. (shrink)

In various documents the view emerges that contemporary biotechnosciences are currently experiencing a scientific revolution: a massive increase of pace, scale and scope. A significant part of the research endeavours involved in this scientific upheaval is devoted to understanding and, if possible, ameliorating humankind: from our genomes up to our bodies and brains. New developments in contemporary technosciences, such as synthetic biology and other genomics and “post-genomics” fields, tend to blur the distinctions between prevention, therapy and enhancement. An important (...) dimension of this development is “biomimesis”: i.e. the tendency of novel technologies and materials to mimic or plagiarize nature on a molecular and microscopic level in order to optimise prospects for the embedding of technological artefacts in natural systems such as human bodies and brains. In this paper, these developments are read and assessed from a psychoanalytical perspective. Three key concepts from psychoanalysis are used to come to terms with what is happening in research laboratories today. After assessing the general profile of the current revolution in this manner, I will focus on a particular case study, a line of research that may serve as exemplification of the vicissitudes of contemporary technosciences, namely viral biomaterials. Viral life forms can be genetically modified (their genomes can be rewritten) in such a manner that they may be inserted in human bodies in order to produce substances at specific sites such as hormones (testosterone), neurotransmitters (dopamine), enzymes (insulin) or bone and muscle tissue. Notably, certain target groups such as top athletes, soldiers or patients suffering from degenerative diseases may become the pioneers serving as research subjects for novel applications. The same technologies can be used for various purposes ranging from therapy up to prevention and enhancement. (shrink)

Suicidality, a significant problem in New Zealand for the past decade or so, has invited a substantial body of research into causes and prevention. However, given the effort, the prevention results do not appear to be sufficiently convincing when coroners’ views are considered. This paper focuses on two mainstream therapeutic approaches towards persons with borderline personality disorder, in which suicidal behaviour is a prominent feature demanding understanding and active attention. It is argued that dialectical behaviour therapy and psychoanalytically informed (...) therapies are lacking on two accounts. Firstly, the philosophical and methodological underpinnings of both approaches perpetuate what Heidegger refers to as the compound misunderstanding of ourselves as human beings. Secondly, what this translates into is a practice which forgets the human order and misunderstands the experience of the singular human present in despair. As an alternative approach towards dealing with suicide in practice, the author presents concepts central to Heidegger’s phenomenology of human existence and discusses how these may inform and enhance the treatment of suicidal patients. Indo-Pacific Journal of Phenomenology , Volume 7, Edition 2 September 2007. (shrink)

Freud saw the dream as occupying a very important position in his theoretical model. If there were to be problems with his theoretical account of the dream then this would impinge upon proposed therapy and, of course, education as the right balance between the instincts and the institution of culture. Wittgenstein, whilst stating that Freud was interesting and important, raised several issues in relation to psychology/psychoanalysis, and to Freud in particular. Why would Wittgenstein have seen Freud as having some (...) important things to say, even though he was sharply critical of Freud's claims to be scientific? The major issues to be considered in this paper are, in Section 1, the scientific status of Freud's work—was it science or was it more like philosophy than science; the analysis of dreams; rationality, and dreams and madness. Section 2 considers Freud and education, including the indignity of Freud's notion of ‘the talking cure.’ Section 3 considers psychoanalytic explanations not as theory but as a manner of speaking: ‘une façon de parler.’. (shrink)

_What is This Thing Called Love?_ provides a clear how-to guide for carrying out psychotherapy with couples from a psychoanalytic perspective. The book draws on both early and contemporary psychoanalytic knowledge, explaining how each theory described is useful in formulating couple dynamics and in working with them. The result is an extremely practical approach, with detailed step-by-step instructions on technique, illuminated throughout by vivid case studies. The book focuses on several key areas including: An initial discussion about theories (...) of love. Progression of therapy from beginning to termination. Transference and countertransference and their unique manifestations in couples therapy. Comparisons between couples therapy and individual therapy. Step-by-step instruction on technique. _What is This Thing Called Love?_ is enlivened with humour and humanness. It is crucial reading for psychoanalytic therapists, psychologists, psychiatrists, couples therapists and students who want to learn about--or augment their skills in--this challenging modality. (shrink)

_Winner of the 2010 Goethe Award for Psychoanalytic and Psychodynamic Scholarship!_ This book builds a key clinical bridge between attachment theory and psychoanalysis, deploying Holmes' unique capacity to weld empirical evidence, psychoanalytic theory and consulting room experience into a coherent and convincing whole. Starting from the theory–practice gap in psychoanalytic psychotherapy, the book demonstrates how attachment theory can help practitioners better understand what they intuitively do in the consulting room, how this benefits clients, and informs evidence-based practice. (...) Divided into two sections, theory and practice, _Exploring in Security_ discusses the concept of mentalising and considers three components of effective therapy – the therapeutic relationship, meaning making and change promotion – from both attachment and psychoanalytic perspectives. The second part of the book applies attachment theory to a number of clinical situations including: working with borderline clients suicide and deliberate self-harm sex and sexuality dreams ending therapy. Throughout the book theoretical discussion is vividly illustrated with clinical material, personal experience and examples from literature and film, making this an accessible yet authoritative text for psychotherapy practitioners at all levels, including psychoanalysts, psychiatrists, clinical psychologists, mental health nurses and counsellors. (shrink)

First published in 1996, _The Embedded Self_ was lauded as "a brilliant and long overdue rapprochement between psychoanalysis and family therapy conceived by a practitioner trained and experienced in both modalities of treatment." Mary-Joan Gerson’s integrated presentation of psychodynamic and family systems theory invited therapists of either orientation to learn the tools and techniques of the other, to mutual benefit. Firmly grounded in detailed case presentations, her focus on family therapy examined its history, organizing concepts, and developmental approaches, (...) and addressed practical questions of diagnosis, clinical interaction, and referrals. A dozen years later, the psychoanalytic community is more open to integrating perspectives, and the growth of analysts working with couples and families necessitates an update of the material presented in _The Embedded Self_. Similarly, the family therapy community has deepened its interest in individual dynamics within systemic patterning. From a new and revised perspective on the possibilities of integration, Gerson covers the latest research in neuroscience and the transmission of affect within intimate relationships, with a new chapter on attachment theory and emotionally focused therapy. Sections on narrative therapy and psychoanalytically-oriented family therapy are expanded as well. _The Embedded Self_ was a sterling introduction to family systems theory and therapy, and enhanced the work of analysts and family and couples therapists alike. The second edition proves no different in its context but wider in its scope, further enhancing the work of the family therapist interested in individual dynamics, and preparing the psychodynamically-oriented therapist who seeks to extend her craft from the dyad to the triad, and beyond. (shrink)

Mimetic theory draws support from diverse disciplines in the humanities and social sciences. But arguably Girard would have even more influence if his theory had stronger life data, and one field well positioned to provide such input is psychology. Girard distinguished his thinking from Freud, while critiquing the psychoanalytic tradition more generally, in Book III of Things Hidden since the Foundation of the World1—a work taking the form of an extended dialogue with two psychiatrists. One of these, Jean-Michel Oughourlian, (...) has begun to develop the Girard-inspired practice of "interdividual psychology."2 In Girard's own hands, albeit to a limited degree, mimetic theory has been applied to mental health issues.3... (shrink)

Objects of Hope brings ranging scholarship and refreshing candor to bear on the knotty issue of what can and cannot be achieved in the course of psychoanalytic therapy. It will be valued not only as an exemplary exercise in comparative psychoanaly.

The problem -- Fearless speech -- Talking versus writing -- The critical method -- Reasons and causes -- Elucidations -- Back to the rough ground -- The self and images -- A non-foundational therapy.

In this paper it is suggested that Freud's 'tally argument' (Grunbaum 1984) is not best interpreted as a risky claim concerning the efficacy of psychoanalytic therapy, but as a risky claim concerning the implications of theoretical psychoanalytic explanations of the efficacy of psychoanalytic therapy. Despite the fact that Freud never empirically established that these implications hold, the 'tally argument' does draw attention to a critical distinction that is too often neglected in contemporary empirical studies of (...) psychoanalysis and other forms of psychotherapy: between empirical evaluations of the efficacy of psychotherapy and empirical evaluations of theoretical explanations of the efficacy of psychotherapy, and the different forms of comparative enquiry relevant to each. It is argued that the contemporary neglect of this critical distinction, in conjunction with the common negative conception of placebo control treatments in psychotherapy research, has led to the epistemic impoverishment of experimental studies of the various professional psychotherapies. In consequence, although there is good empirical evidence for the efficacy of psychoanalysis and other forms of professional psychotherapy, there is no good empirical evidence for theoretical psychoanalytic explanations of the efficacy of psychoanalysis, or for traditional theoretical explanations of the efficacy of other forms of professional psychotherapy. (shrink)

Both a method of therapy and an exploration of psychic reality, free association is a fundamental element of psychoanalytical practices that refers to the way a patient is asked to describe what comes spontaneously to mind in the therapeutic setting. This paper examines the role of free association from the point of view of psychoanalysis and neuroscience in order to improve our understanding of therapeutic effects induced by psychoanalytic therapies and psychoanalysis. In this regard, we first propose a (...) global overview of the historical origins of the concept of free association in psychoanalysis and examine how Freud established its principles. Then, from Freud’s distinction between primary and secondary processes, we proceed to compare the psychoanalytic model with research originating from cognitive psychology and neuroscience. The notions of entropy and free energy appear particularly relevant at the intersection of these different domains. Finally, we propose the notion of symbolizing transmodality to describe certain specificities of symbolization processes within free association and we summarize the main functions of free association in psychoanalytic practices. (shrink)

At a colloquium in Bonneval, Lacan criticized Merleau-Ponty for his inability to account for the unconscious. For this reason he concluded the latter’s philosophy was fundamentally incompatible with psychoanalysis. This argument set the tone for scholars who studied the relationship between phenomenology and psychoanalysis. J. B. Pontalis, for example, famously argues that Merleau-Ponty misuses the term unconscious. According to Pontalis, Merleau-Ponty equates the unconscious with a “horizon” of possible experience: a moment of experience that is currently in shadow but can (...) be brought to light.1 Psychoanalytic therapy does, in part, treat the unconscious as a territory that can be colonized by language... (shrink)

Transference, as well as counter-transference are both central to the praxis of psychoanalytical therapy. They emerge from the encounter with the patient who is caught in libidinal conflicts (Freud) and in the imaginary chain of signifiers (Lacan). Affective effects stemming from transference must, therefore, be taken into account in order to clarify their unconscious connection to the symbolic as well as to the real. Phenomenologically speaking, this corresponds to an original dimension of being-affected, a dimension prior to any sort (...) of interpretation. It aims at liberating desire (désir) by making jouissance possible as an act that does not lead to a hypostasis of the law (Phallus). (shrink)

In the first collection of his essays to be published, Jeremy Holmes discusses the wider application of psychotherapy within psychiatry and suggests that psychoanalysis needs to escape from its esotericism by taking into account contemporary advances in cognitive science, family therapy and the realities of psychiatric work in a public health setting. Illustrating his arguments with literary as well as clinical examples, he emphasizes the importance of creativity in psychotherapy and the connections between the artistic and psychotherapeutic impulse.

Summary This paper starts with a short review of recent developments in psychotherapy process research and analyzes that a medical, or better, technical approach in process research – using words such as ‘intervention’, ‘effect’ and ‘outcome’ – is gradually acknowledged as only one side of psychotherapy; the other, more human or ‘humanistic’ side, is ‘conversation’, described by prominent authors as ‘low technology’. Conversation analysis cannot study psychotherapy as a whole. Sessions are subdivided into ‘situations’. What are situations? I make a (...) proposal to answer this question by three components: open up, select and control options. Then, 11 transcribed extracts from psychoanalytical therapy sessions are used to describe three types of situations and the special kind of requirements they demand from a therapist. Obviously, such situations appear during a session, they can be handled if therapists are sensitized for certain difficulties to arise. Shift-of-situation and double meaning are new observations in this approach to define the situational gestalt and train ‘seeing’ it. (shrink)

Three-way baby making is not new: genetic surrogacy existed in Biblical times and donor insemination was recorded in Britain over 200 years ago. However, the gift of gametes between women breaks all social conventions. This paper examines the phenomenon of gamete-donation questioning whether a ‘gift’ of such magnitude can ever be ‘free’ (as the Human Fertilisation & Embryology Authority advocates), or a ‘true’ gift (in Derridian terms). Exploration of this unprecedented ‘gift’ from a psychoanalytic approach is supplemented by an (...) interdisciplinary one, drawing on the gift literature in philosophy, anthropology, ethnography and socioeconomics, as well as neonatal research and reproductive medicine. Critics note the dearth of analyses that take seriously the psychological ramifications of contemporary treatments, protocols and expectations in reproductive medicine. Based on psychoanalytic therapy within a clinical practice devoted to reproductive issues, the author argues that institutionalised asexual reproduction alters unconscious conceptualisations of the act of procreation – converting the passionate intimacy of primal scene into a clinical coupling of gametes in a mechanised arena. The author argues that, too charged to contemplate, the gamete's transcendent quality and blurring of elementary personae/res distinctions leads protagonists, including professionals, to defensive commodification. Multiple emotional meanings are ascribed to gifted gametes by each in the triangle of donor, recipient and offspring, illustrated here with verbatim material. This article addresses some of the far-reaching socio-political consequences for class, race, age, gender and sexuality of asexual reproduction, related to selection procedures and uneven global and local distribution of fertility treatment and its cost in financial, physical, practical and emotional terms. Similarly, feminist unease over (patriarchal) reproductive control and gatekeeping policies are considered, as well as ethical concerns over genetic manipulation, pre-implantation screening, sex selection, selective foetocide and potential exploitation of transnational donors and surrogates. (shrink)

Sublimation is usually defined as a defense-mechanism that desexualizes the sexual instincts. This desexualization then results in socio-cultural activities and psychic health. That means that sublimation is a crucial concept for psychoanalytic thinking, because it seems to connect the Freudian metapsychology with both applied psychoanalysis and psychoanalytic therapy. However, in this article I argue that within Freud's theory sublimation is an empty and redundant concept. It is a redundant concept as far as it 'explains' the socio-cultural tendencies (...) of human beings, since these tendencies can be easily understood as the outcome of other defense-mechanisms, such as repression and identification. For that matter, Freud's only example of the sublimation process — found in Leonardo da Vinci and a Memory of his Childhood — is in fact no sublimation, but a classic example of repression followed by symptom-formation. Secondly 'sublimation' is an empty concept with regard to the psychoanalytic therapy, because in that context it is used to explain something that simply never happens, at least according to Freud, namely a perfect recovery and a completely 'terminable' analysis. (shrink)