Searching for the enriching sense of otherness: The psychoanalytic psychotherapist as a meaning-bearing other

Abstract

This paper is a theoretical and clinical examination of the patient's search for the otherness of the therapist as a prerequisite for change and development in relational psychoanalytic psychotherapy. A basic assumption is that being in a relationship as well as being a personal self, is to be understood, as being with a “meaning-bearing other”; that is, someone who allows for the possibility of meaningful thoughts and feelings, either through an actual communicative presence or as a consciously, prereflective, or unconsciously imagined communication partner. The term “meaning-bearing other” is used to differentiate distinct, although often synchronic, modes of relatedness. The need for intersubjective “depth”—that is, to discover the otherness of the other, and for oneself to be recognized as an experiencing subject—is regarded as a main motivational force. Winnicott's, as well as Sullivan's developmental approaches, Mitchell and Aron's views on psychoanalytic interaction, and Heidegger and Gadamer's phenomenology and hermeneutics are used as theoretical points of reference for the present discourse. The theoretical points of view are examined and discussed through excerpts from twice-a-week psychotherapy with a six-year old girl.     

Notes towards a psychoanalytic understanding of the couple relationship

In this paper an attempt is made to demonstrate how a particular orientation to contemporary psychoanalytic concepts may be useful to an understanding of the nature of the marital, or couple, relationship. The unconscious forces which may attract two people to each other, which may influence the patterns of their interaction and which may result in psychic stagnation or development are outlined. The second part of the paper addresses the nature of the therapeutic relationship with the patient couple. A hypothesis is offered regarding possible diagnostic criteria for choosing whether to work with a couple presenting for couple psychotherapy employing one psychotherapist or two psychotherapists working as a co-therapy pair. (The usual practice of myself and my colleagues at the Tavistock Institute of Marital Studies is to see our patient couples with a co-therapist partner).     

The psychoanalytic process and the development of insight in child analysis: a case study

This paper describes a segment of the analysis of an aggressive latency-age child. The data demonstrate the relationship between the establishment of a psychoanalytic process (the analysis of transference, defense, and resistance), the development and nature of insight in the child, and the resulting therapeutic change. Examination of the process shows that the therapeutic gains were a result of insights acquired by the child, particularly his awareness of painful affects that had been warded off. This case is compared with Bornstein's treatment of a phobic child who manifested severely "out-of-control" behavior.     

The effects of the introduction of medication on the psychoanalytic process: a case study

The past fifteen years have seen a marked change in the attitude of psychoanalysts toward the use of medication in psychoanalysis, yet few detailed case studies have appeared in which the effects of the introduction of a medication on the psychoanalytic process have been studied. A plea for fluoxetine (Prozac) as a weight-loss aid, from a female patient whose analysis had progressed satisfactorily, set in motion a remarkable series of events. Her mood brightened, she rapidly lost weight, and she ultimately realized that she had the fantasy of being impregnated, all of which represented the reenactment of crucial childhood experiences. The most significant change in the psychoanalytic process was a newfound ability to experience critical thoughts and feelings, which previously had been prohibited by her harsh superego. At first both patient and analyst believed that the medication had "softened" her superego, but reexamination of the data revealed that most, if not all, of the changes could be attributed to the transference meaning of the collaboration rather than to the effects of the drug.     

Isakower-like experience on the couch: a contribution to the psychoanalytic understanding of regressive ego phenomena

Since Isakower's original contribution of 1938, Isakower phenomena have been viewed as primitive experiences involving maternal breast, womb, and face imagery. This clinical report harks back to the less well-known hypothesis with which Isakower concluded his paper: he suggested that these perceptual experiences are related to childhood oedipal masturbatory fantasies at the time of going to sleep. In this paper four Isakower-like phenomena experienced by a patient on the couch are reported in the dynamic context in which they occurred. It is argued that these phenomena constitute a type of regressive ego experience that defends against oedipal conflict.     

The case against neuropsychoanalysis: On fallacies underlying psychoanalysis' latest scientifi c trend and its negative impact on psychoanalytic discourse

The authors offer a critical examination of the claims of the proponents of the growing neuropsychoanalytic trend, that neuroscientifi c fi ndings are relevant and important for the development and justifi cation of psychoanalytic theory and practice. They bring to light some of the intuitions that have led to the popularity of the neuropsychoanalytic claims and the fallacies that underlie these claims and intuitions. They argue that it is crucial at this time to articulate the case against the neuropsychoanalytic trend because, underlying the debate over the relevance of neuroscience to psychoanalysis, there lies a struggle over the essential nature of psychoanalytic theory and practice. Relying on a biologistic perspective, whereby only what is biological is real, this new trend in effect offers a vision of psychoanalysis that limits the signifi cance of the unique psychoanalytic concern with the understanding of meanings and the role of discourse in discerning and justifying these meanings.