Couple Psychoanalysis in the United Kingdom: Past,Present, and Future

ABSTRACT

The evolution of couple psychoanalysis in the United Kingdom is historically rooted in, and currently supported by, what might be called the Tavistock tradition, which principally derives from the work of Tavistock Relationships, a London-based organization combining clinical practice, training, and research. Practitioners working within this tradition draw on a range of psychoanalytic theories and differ in the ways they are applied in clinical practice and with different client groups, but they are united by their focus on relationship dynamics and how these can be affected by unconscious processes. This article charts how the main ideas and practices associated with the Tavistock tradition of couple psychoanalysis came into being, describes the conceptual building blocks that provide the platform for current training and practice, and identifies nodal points that might indicate directions of growth in the future.     

Ambivalence and Male Religious Experience: An Autobiographical Study

I argue that what are typically identified as “calls from God” to an office of sacred power are filled with various degrees and types of ambivalence. This ambivalence becomes manifest (or not) to the person experiencing a call at various points in their lifespan and it exists for a number of reasons. I seek to unveil the psychodynamics responsible for these feelings of ambivalence. I argue that the awareness of feelings of ambivalence can be correlated with the degree of one’s happiness—specifically in one’s sexual and mental health; this point is marshaled throughout the essay by autobiographical examples of men who experienced some type of divine calling. In addition to psychoanalytic resources, I apply postmodern autobiographical criticism to this autobiographical study; my autobiographical notes are written in italics.     

Searching for the facts in the clinical setting with couples

This paper describes a research proposal to examine whether or not the underlying analytic concepts behind the couple psychoanalytic psychotherapy model used at the Tavistock Marital Studies Institute in London are sufficiently coherent, both conceptually and clinically, to be used as the basis for a system of audit which respects the unique data produced in analytic psychotherapy. This 'psychoanalytic' system of audit is one which is characterized particularly by the use of the therapists' subjectivity, rather than attempts to be objective and gather data through such things as random controlled trials or generic outcome questionnaires. The paper describes the approach to the subject and the mix of qualitative and quantitative methods used. As the Tavistock Marital Studies Institute has a history of contact with Jungian analysts from the Society of Analytical Psychology, Jungian concepts are included in the model. The research is part of a professional doctorate in couple psychoanalytic psychotherapy at the Tavistock Marital Studies Institute in conjunction with the University of East London, entitled 'Conceptualizing audit in Couple Psychoanalytic Psychotherapy'.     

From the Balint method toward profession-related supervision

This paper focuses on Michael Balint's special application of psychoanalysis, originally conceived as a training of doctors. Then the attempt is made to discover indirectly, since Balint never described his method in context, what he thought mattered in terms of method. Besides Balint's own contributions, those of his own staff are also consulted as well as the cultural background of the Tavistock Clinic and the Tavistock Institute. Then the further developments of the Balint method in the German-speaking world are presented. At the center are the special features of the method: (a) the atmosphere, (b) the narrator's contribution, (c) listening and reactions of the members of the group, (d) the unconscious enactments in transference and countertransference and the mirror-phenomena, respectively. Furthermore, the respective central points of reference are discussed from the viewpoint of communication science: (a) case, (b) group, and (c) institution. In conclusion and based on these foundations, the characteristics of the application of the Balint method in the form of a particular profession-related supervision are presented.     

Factors influencing public awareness of autonomous vehicles: Empirical evidence from Brisbane

Growing concerns, regarding transport disadvantage and increased socioeconomic disparities, demand innovative ways to improve equity and make transportation systems smarter. One of the most anticipated developments within the field of smart mobility is driving automation systems. Autonomous vehicles (AVs) have the potential to improve accessibility, affordability, safety and efficiency of transport systems, but come with risks including the intensification of private vehicle travel. Understanding public awareness is an important step to determine whether motivation and intention to use AVs will impact on its potential. This paper aims to investigate factors influencing public awareness of AVs as a solution to transport disadvantage. The study applies an ordinal logistic regression analysis to analyse survey data collected from the residents of Brisbane (Australia). Our findings reveal that awareness is positively correlated within young and middle-aged adults, low-income residents, disability, public transport users, and those who feel unsafe on public transport, while an increase in the number of household vehicles is negatively correlated. The study provides insights into public awareness towards the potential benefits of AVs, and highlights potential opportunities and challenges associated with these expectations.     

Treatment manuals and the advancement of psychoanalytic knowledge: The Treatment Manual of the Tavistock Adult Depression Study

This paper has two aims: first, it seeks to understand the absence of treatment manuals in psychoanalysis. Secondly, it summarizes the treatment manual of the Tavistock Adult Depression Study, which describes the form of psychoanalytic psychotherapy whose effectiveness has been evaluated both in the Tavistock Adult Depression Study (TADS); and in the German Die Langzeittherapie bei chronischen Depressionen (LAC) Studie. Throughout the history of psychoanalysis, opinions about treatment manuals, empirical research and their antecedents have been deeply divided. After tracing the often polarized unfolding of these matters, the paper proposes that emotional and cognitive difficulties as well as scientific ones underpin their persistence. It is suggested that greater familiarity with them may lead to better combinations of outcome research and psychoanalysis: for example, the Tavistock manual seeks to match one account of the objects, aims, values, spirit and methods of psychoanalysis (as well as of connected forms of psychoanalytic psychotherapy); and also to meet what is required of treatment manuals by random allocation controlled trials. It has been a crucial element in the above studies of the outcome of long‐term psychoanalytic psychotherapies with chronically depressed patients. After describing the Tavistock Manual, the paper concludes suggesting that, if appropriately constructed, treatment manuals can make a contribution to the advancement of specifically psychoanalytic knowledge.     

Obsessive-Compulsive Disorder: Current Views

Obsessive-compulsive disorder has been of central interest to psychoanalysis since Freud's early papers, most particularly in the “Rat Man” case. This early literature spelled out with great clarity the presumed development, psychodynamics, and meaning of obsessional and compulsive symptoms. Unfortunately, since Anna Freud's 1969 review of the subject, virtually nothing has appeared in the psychoanalytic literature that has added to our understanding of the disorder or enhanced the very limited therapeutic influence of psychoanalysis in such cases. Meanwhile, there has been an avalanche of contributions from biological psychiatry and behavioral psychology that have propounded different theories of pathogenesis and have laid claim to significant therapeutic effectiveness. If psychoanalysis is to have credibility in this field, it will have to enlist itself in multidisciplinary research efforts directed toward enriching our knowledge about the psychodynamics and the biological substrate of this illness (more common than once believed) and the efficacy of our efforts to treat it.     

Can synaesthesia research inform cognitive science?

The renaissance of synaesthesia research has produced many insights regarding the aetiology and mechanisms that might underlie this intriguing phenomenon, which abnormally binds features between and within modalities. Synaesthesia is interesting in its own right, but whether it contributes to our knowledge of neurocognitive systems that underlie non-synaesthete experience is an open question. In this review, we show that results from the field of synaesthesia can constrain cognitive theories in numerical cognition, automaticity, crossmodal interaction and awareness. Therefore, research of synaesthesia provides a unique window into other domains of cognitive neuroscience. We conclude that the study of synaesthesia could advance our understanding of the normal and abnormal human brain and cognition.     

Learning and teaching the theories of Melanie Klein

I shall attempt to bring together here thoughts of experienced clinicians and teachers who have taught Melanie Klein's theories to child psychotherapists. However, most of the contributors have also taught Klein to clinical trainees in adult psychoanalytic work and to different groups abroad and, in some cases, to already trained psychotherapists or psychoanalysts. Klein's theories are introduced at different stages in the different child psychotherapy programmes in London. For instance, the students at the Tavistock are introduced to Klein's theories before they are necessarily in their own psychoanalysis, while other trainings introduce her theories in the introductory years of the clinical training.

William Halton is one of the longest-running teachers of Klein in the Tavistock Child Psychotherapy Training and brings his 'framework' culled from many years of experience. Maria Rhode has taught the Narrative to students at the Tavistock for many years. Elizabeth Spillius, psychoanalyst, writer and teacher, brings her experiences teaching Klein to non-Kleinians. Karen Proner teaches at the Tavistock, in Italy and the United States.

TEACHING MELANIE KLEIN William Halton 10 Lincoln Road London N2 9DL     

Working in the countertransference

Ferenczi (1988) described the procedure of mutual analysis, in which the patient and analyst switch roles for part of the time in the analysis. This procedure allowed patients in stalled analyses to make progress and enabled the analyst to overcome certain countertransference blocks but was ultimately rejected for certain drawbacks. Working in the countertransference is a modification of mutual analysis that retains some of its benefits and eliminates some of its drawbacks. In such work, the psychoanalyst's personality and psychodynamics become the center stage of the manifest content of the session; the analyst avoids interpretations of the transference and, instead, elicits the patient's detailed understanding of the analyst's psychodynamics. The analyst does not, however, generally volunteer his free associations or facts about his own life. This process allows deep work with patients with a predominance of projective identification. Working in the countertransference may be preferred in cases of severe psychopathology to other procedures for its lessening of the frequency, severity, and persistence of transference psychoses. The procedure is also a useful supplement to transference analysis with neurotic patients, for whom it can break through blocks caused by anxiety‐laden issues or countertransference impediments.     

A theory of consciousness

Consciousness is the subjective awareness of momentary experience interpreted in the context of personal memory and present state. I propose that two brain systems converge to create consciousness. The exogenous system sends information about multimodal external stimuli to basal dendrites in widely dispersed pyramidal cell ensembles in the cortex of the brain; this system produces synchronized fragments of sensations. The endogenous system distributes readout of representations of memories, activated in systems established by associative learning, diffusely to apical dendrites. Convergence of exogenous and endogenous inputs enhances cellular excitability, and fragmented sensations are thereby converted to fragments of perception. Local field potentials periodically modulate all cortical membrane potentials and facilitate synchronous discharge of these excited elements. Feedback between the cortex and the thalamus results in a cortico-thalamo-cortical reverberation, binding the fragments into a unified global percept. Sustained reverberation produces a resonating electromagnetic field of synchronized elements. The momentary content of information in the brain is this distributed coherence, which is negative entropy. Consciousness is a physical property of this field, producing the subjective awareness of this information.     

Restorying family therapy

This article describes a multi-systemic model of therapy developed by the author over the past decade and summarizes the main products of this project: Explication of key family systems notions, strategic family play therapy, multi-systemic therapy, and culturally-competent family therapy. The model incorporates beyond the family system, culture, wider ecosystems, psychodynamics, and the individual's neuropsychological, cognitive, and socio-emotional development. The model enables the therapist to design flexible multimodal interventions.     

Transcendence,transmission and transformation: the transcendent function in infant observation

Abstract: This article discusses the activation of the transcendent function as it operates through a series of complex parallel processes occurring within a Tavistock Model Infant Observation Group whose location is Palo Alto, California. We follow the observer, a seasoned female analyst, through her final two observations as she is caught initially in the central family complex that does not allow for a conscious ending to this three‐year observational period. Subsequently through the work of the transcendent function within the group, a discussion of the observer's ensuing paradoxical enactment takes place as we watch how this observer becomes able to help the family reach a termination not previously possible. Moving within a dynamic field that includes the infant observation group, the observed baby and his family, we experience the numinosity of the transformation that is activated. We will explore the ongoing encounter between the group mind, the observer and the observed as mutations within this dynamic field enable a genuine experience of mourning that has a profound effect on the observed baby and family.     

Strengthening the Strengths Perspective

Abstract

This article revisits the strengths perspective as conceptualized in social work practice. Although we find this perspective has value and utility for practitioners, we identify areas where the strengths perspective could be enhanced and augmented by integrating the contemporary relational approach exemplified by Paul Wachtel's cyclical psychodynamics. Specifically, we explore his concepts of therapeutic communication and use of language, including interventions that affirm client strengths such as reframing, searching for variations and exceptions, and reconceptualizing how transference impacts the therapeutic action. We illustrate our view with a case vignette, advocating that Wachtel's integrative approach provides a new context for psychodynamics in current social work practice.     

Constructing bridges and systemic connections: In brief dynamic therapy

The author outlines how the conceptual framework which underpins cyclical psychodynamics, a branch of relational psychoanalysis, provides an opportunity for a coherent integration of constructivist CBT principles and techniques and family systems theory within a model of brief dynamic therapy. Drawing upon Wachtel’s articulation of a more flexible notion of the internal world and one in which current interpersonal patterns are seen to shape the psyche and internal conflicts, the author goes on to identify ways in which attending to a client’s behaviour and the ways in which affective experience is expressed interpersonally can open the way to an integration of therapeutic features from constructivist CBT and family systems theory. The contribution that coaching a client in the ways in which they behave interpersonally in the context of both family and workplace relationships can make to therapeutic effectiveness is explored. These themes are illustrated with a case study.     

试论医学的社会意识

医学的社会意识是一个重要的理论概念,研究医学的社会意识的内涵和作用有重要的理论与实践的意义。同时,强化卫生决策者,医务人员和社会公众的医学社会意识,对于医学的正确发展和卫生事业的进步也同样是重要的。     

Implicit learning: news from the front

Can we learn without awareness? While the current consensus is most likely to be `no', there is, however, considerable ongoing debate about the role that consciousness plays in cognition and about the nature of consciousness itself. In this article, we review recent advances in the field of implicit learning, based on three perspectives: empirical findings (including neuropsychological evidence), methodological issues, and theoretical positions (including computational models). The overall picture that emerges is complex and reflects a field that is very much in flux: while it seems undeniable that cognition involves some form of unconscious processing, it is as yet unclear how to best separate conscious and unconscious influences on learning, and how to best think about the status of the `cognitive unconscious'. We suggest that implicit learning is best construed as a complex form of priming taking place in continuously learning neural systems, and that the distributional knowledge so acquired can be causally efficacious in the absence of awareness that this knowledge was acquired or that it is currently influencing processing, that is, in the absence of metaknowledge.     

Les cadres et les champs de l’intervention : vers une cartographie

The intervention is based on methodologies and theoretical conceptions of transformation processes. Intervention does not belong specifically to occupational psychology, but we will focus here on different approaches in this disciplinary field. First, the theoretical and methodological frameworks of ergonomics, psychodynamics, the activity clinical approach, psychosociology, socio-psychoanalysis, and systemic intervention will be presented. This mapping test will then seek to identify common fundamentals. It aims to highlight the contributions offered by these different attempts to model the intervention, which are often not well known to each other. Indeed, the plurality of approaches that can be mobilized constitutes an essential resource to support the confrontation with the challenges of reality in the course of the intervention and the challenges posed by “field” issues.     

The value of grandparents

This paper is a slightly revised version of a paper presented on 26 October 1989 as one of the Tavistock Open Lectures. The role of grandparents is discussed and the value of a supportive presence, both externally and internally, is emphasised, especially at birth and at times of mental illness. This concept is extended to the maternal or ‘grand’-maternal role adopted by agencies attempting to improve the quality of mental care, and its value is also visible in the transference in psychotherapeutic work.     

句法意识的发展及其与阅读理解关系的研究进展

句法意识是指个体反思句子结构形式的能力,是元语言意识的一个重要组成部分。本文介绍了句法意识的发展以及句法意识和阅读理解之间关系的研究进展,并对研究中存在的问题进行了总结。