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The words we work with that work on us: clinical paradigm and cumulative relational trauma
Authors:Birgit Heuer
Abstract:This paper addresses a gap between analytic clinical theory and practice which emerges when examining the words we work with via textual and narrative research of case histories. Both subject matter and methodology fit with the remit of conceptual research in psychoanalysis, currently ranging from inductive to nomothetical approaches. Research of clinical language reveals an implicit account of human nature and the world which undergirds clinical practice. Based in the critical philosophy of the previous century, this is termed clinical paradigm. Such implicit views are induced rather than explicitly taught during analytic training, and need to be spelled out in order to become available to discourse and difference of opinion. Textual research shows these implicit pre‐clinical attitudes to be inherently pessimistic and thus too similar to the views of self and others found in cumulative relational trauma. Moreover, clinical accounts tend to normalize subtly antagonistic forms of relating, recently recognised as micro‐trauma. Importantly, this contravenes the agapic orientation of our theories and ethics. Paradigmatic reflection as a form of professional individuation addresses this gap. This includes a more optimistic outlook which can be traced through the philosophical implications of quantum theory.
Keywords:clinical language  clinical optimism  clinical paradigm  conceptual research in psychoanalysis  cumulative relational trauma  micro‐trauma  langage clinique  optimisme clinique  paradigme clinique  recherche conceptuelle en psychanalyse  traumatisme relationnel cumulatif  microtraumatisme  klinische Sprache  klinischer Optimismus  klinisches Paradigma  konzeptuelle Forschung in der Psychoanalyse  kumulatives relationales Trauma  Mikrotrauma  linguaggio clinico  ottimismo clinico  paradigma clinico  ricerca concettuale in psicoanalisi  trauma relazionale cumulativo  micro‐trauma  к  л  и  н  и  ч  е  с  к  и  й   я  з  ы  к    к  л  и  н  и  ч  е  с  к  и  й   о  п  т  и  м  и  з  м    к  л  и  н  и  ч  е  с  к  а  я   п  а  р  а  д  и  г  м  а    к  о  н  ц  е  п  т  у  а  л  ь  н  ы  е   и  с  с  л  е  д  о  в  а  н  и  я   в   п  с  и  х  о  а  н  а  л  и  з  е    к  у  м  у  л  я  т  и  в  н  а  я   о  т  н  о  ш  е  н  ч  е  с  к  а  я   т  р  а  в  м  а    м  и  к  р  о  ‐т  р  а  в  м  а    lenguaje clí  nico  optimismo clí  nico  paradigma clí  nico  investigació  n conceptual en psicoaná  lisis  trauma relacional acumulativo  micro‐trauma                                                                          
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