A technique for controlling behavior in natural life settings

A behavior control technique is presented, consisting primarily of having a patient give up some portion of his reinforcers (usually money) with the understanding that he must behave in therapeutically prescribed ways in his natural environment to re-earn the reinforcers. The critical features and requirements of the technique are discussed, various applications are suggested, and implications for research are drawn.     

Secondary Revision: On Rethinking the Analytic Process and Analytic Technique

The author relates aspects of his own personal history and professional development in an effort to explain the changes in his way of thinking and working as an analyst that have evolved over the past thirty years. He also includes some of his current thinking on the questions of countertransference, the uses of memory, and contemporary analytic technique.     

Bion's Notes on memory and desire – its initial clinical reception in the United States: A note on archival material

While Bion's 1967 memory and desire paper reflected a crucial episode in his clinical thinking during his epistemological period, it was also central to his evolution as a Kleinian psychoanalyst who worked with seriously disturbed adult patients. The author explicates and contextualizes these claims with a new archival document, the Los Angeles Seminars delivered by Bion in April 1967, and the full‐length version of Notes on memory and desire. Bion here instigated a radical departure from years of theory‐laden work when he made his clinical work and ideas accessible to a new audience of American Freudian analysts. While this new group was keenly interested to hear about Bion's clinical technique with both borderline and psychotic patients, there were varied reactions to Bion's ideas on the technical implications of the analyst's abandonment of memory and desire. Both the Los Angeles Seminars and Notes elicited responses ranging from bewilderment, admiration to skepticism amongst his audience of listeners and readers. These materials also however allow for a more complete and systematic presentation of important ideas about analytic technique – and while his ideas in this domain have been long valued and known by many psychoanalysts, this contribution stresses the crucial aspect of the reception of his ideas about technique in a particular American context. American analysts gained a much more explicit idea of how Bion worked analytically, how he listened, formulated interpretations and factored in the analyst's listening receptivity in the here‐and‐now. The author concludes with a consideration of the importance of Bion's American reception in 1967.     

What is “Good” Technique? How to Teach it? Personal Reflections on Psychoanalytic Training

There is an intense interest in the interactional process across the varying psychoanalytic schools of thought. The analytic relationship itself, in all of its complexity, is the vehicle for our work. These advances raise the question of what we mean by technique these days, a question that has implications for analytic training and supervision. In this paper, the author reflects back on his analytic training experience, specifically at how two of his supervisors regarded technique, how it was taught, and the various ways in which it was communicated. In looking back at these supervisory experiences, the author examines how these teaching analysts embodied some of what they had to teach. The author shows what was mutative across these training experiences in terms of what was needed in order to grow—what facilitated his own development as an analyst and contributed towards the cultivation of his own style.     

Lacan1

Jacques Lacan belonged to the second generation of French psychoanalysts which, thanks to the arrival in France of Rudolf Loewenstein, was the first to benefit from a training analysis of sufficient quality and duration. Lacan left the Société Psychanalytique de Paris and the International Psychoanalytic Association in 1953, following a controversy over the short sessions he gave his patients. For Lacan, the anxiety of being absorbed by the object is the principal anxiety from which the anxieties of separation, castration or fragmentation are derived, which may explain why he did not keep his patients for a sufficient length of time. Lacan transformed his difficulty into an advocated technique, which he justified by making a critique of the classical technique. He founded his own international psychoanalytic association, in which selection only occurs when the analyst is already at a very advanced stage in his career (‘the authorization of an analyst can only come from himself’). We are indebted to Lacan for having drawn the attention of analysts to the role of language, and especially of words with a double meaning, in the genesis of interpretation, but his theory of language, founded on the assimilation of psychoanalysis to structural linguistics and anthropology, has collapsed. Many of Lacan's other theoretical contributions, such as the renewed interest in the après‐coup, the place of mirror relations in narcissism, the distinction between what he calls jouissance and the orgasm, or between the ‘real’ and reality, have been gradually integrated by analysts who accept neither his technique nor his laxity in training.     

Effects of self-reinforcement on the demanding behaviors of a paranoid personality: A case report

Describes the extinction of the demanding behaviors of a nine-year-old boy by placing the responsibility for behavioral reinforcement directly under his own control. The therapist assumed that the behavioral pattern of the paranoid personality is characterized by an overdependence upon environmental reinforcers and therefore used the self-management technique, allowing the student the opportunity to gain independence from his classroom environment while meeting his need for positive feedback.     

Paul Gray's narrowing scope: a "developmental lag" in his theory and technique

A cental thesis of Paul Gray's work is that a "developmental lag" pervades modern psychoanalysis in its failure to assimilate and apply knowledge gained about the role of the unconscious ego in intrapsychic life. But Gray himself, it is proposed, has become a victim of a new "developmental lag," of his own construction. As he somewhat single-mindedly pursued the ramifications of his "developmental lag" concept, Gray may have foreclosed on some noteworthy ideas developing around him. The most important example is his claim--herein refuted--that proper interpretive technique can avoid being infused with transference. He also seems to have rejected the theoretical importance of the internalization of the analyst and the clinical usefulness of countertransference. While emphasizing defense analysis, he ignores defenses such as splitting, denial, and disavowal as substantive problems for his technique of close-process attention. Gray's "undoing" of the rapprochement between "ego analysis" and "id analysis" by viewing the matter as an either-or proposition undermines the very real value of his contribution to the field.     

Boole's annotations on ‘the mathematical analysis of logic’

George Boole collected ideas for the improvement of his Mathematical analysis of logic(1847) on interleaved copies of that work. Some of the notes on the interleaves are merely minor changes in explanation. Others amount to considerable extension of method in his mathematical approach to logic. In particular, he developed his technique in solving simultaneous elective equations and handling hypotheticals and elective functions. These notes and extensions provided a source for his later book Laws of thought(1854).     

Elements of analytic style: Bion's clinical seminars

The author finds that the idea of analytic style better describes significant aspects of the way he practices psychoanalysis than does the notion of analytic technique. The latter is comprised to a large extent of principles of practice developed by previous generations of analysts. By contrast, the concept of analytic style, though it presupposes the analyst's thorough knowledge of analytic theory and technique, emphasizes (1) the analyst's use of his unique personality as reflected in his individual ways of thinking, listening, and speaking, his own particular use of metaphor, humor, irony, and so on; (2) the analyst's drawing on his personal experience, for example, as an analyst, an analysand, a parent, a child, a spouse, a teacher, and a student; (3) the analyst's capacity to think in a way that draws on, but is independent of, the ideas of his colleagues, his teachers, his analyst, and his analytic ancestors; and (4) the responsibility of the analyst to invent psychoanalysis freshly for each patient. Close readings of three of Bion's 'Clinical seminars' are presented in order to articulate some of the elements of Bion's analytic style. Bion's style is not presented as a model for others to emulate or, worse yet, imitate; rather, it is described in an effort to help the reader consider from a different vantage point (provided by the concept of analytic style) the way in which he, the reader, practices psychoanalysis.     

Martin Mayman's early memories technique: bridging the gap between personality assessment and psychotherapy

In this article, we describe Martin Mayman's approach to early childhood memories as a projective technique, beginning with his scientific interest in learning theory, coupled with his interest in ego psychology and object relations theory. We describe Mayman's contributions to the use of the early memories technique to inform the psychotherapy process, tying assessment closely to psychotherapy and making assessment more useful in treatment. In this article, we describe a representative sample of research studies that demonstrate the reliability and validity of early memories, followed by case examples in which the early memories informed the therapy process, including issues of transference and countertransference.     

Ferenczi's fatal illness in historical context

In August 1932, Ferenczi was already manifesting symptoms of his fatal illness, pernicious anemia. This was diagnosed between September 20 and October 2 of that year, less than a month after the Twelfth International Psychoanalytic Congress in Wiesbaden. Despite seemingly successful treatment with injectable liver extract, he underwent an acute psychotic episode in March 1933, triggered by the neurological symptoms of his illness. These facts substantiate the subsequent claim of Freud and Jones that Ferenczi suffered from paranoia near the end of his life, but they do not support the commonly-held view that the writings and experiments in psychoanalytic technique of his last five years were symptomatic of a progressive mental illness.     

PHILIP LEVY AND THE G INDEX — A FINAL REPLY

Levy's argument using double extended matrices is shown to be without basis. Such a technique, it is pointed out, cannot properly be used in R technique to eliminate factors of means since it represents the double scoring of items—not persons, as would be required in his illustration.     

“There Was a Child Went Forth” Commentary on Paper by Steven Stern

In this discussion of Stern's rich and thoughtful contribution to the dialogue between unified- and multiple-self theories, I refer to his earlier conceptualization of repeated and needed relationships. I thus highlight how his current model strikes me as shifting his emphasis toward identificatory factors, both in development and in clinical process, and away from the working through, or negotiation of, repetitions of relational configurations. Through Stern's clinical examples, I engage dialogue about how his construct of an “intersubjective self” relates to the qualities of multiplicity he accounts for in his theory. And I consider the implications for clinical technique of favoring identificatory influences over the analyst's living through the experience of transference repetitions with the patient and thereby introducing ameliorating responses from within, rather than from a stance more external to, embeddedness in transference–countertransference repetitions.     

Technique as a Case-Specific Problem: Reply to Commentaries

Seligman's appreciative response to the discussions of his paper is most concerned with the issues raised in Leon Kleimberg's critique of his “modifications of technique.” The dialogue between Kleimberg's and his point of view, with the latter echoed as it in Case and Dent's and Frosch's, reflects a number of key convergences and divergences between the American relational perspective and the British Independents'. Both approaches rely on a fundamentally dyadic perspective that stresses how the analyst's work is fundamentally shaped in response to the patient's internal objects. At the same time, although he is sympathetic to Kleimberg's concerns, he questions the idea of technique as a fixed set of uncontaminated practices. Instead, he endorses the North American relational idea that whatever the analyst does in the name of “technique” cannot be extricated from the transference-countertransference in which it is implicated. From this point of view, technical decisions are most likely to be experienced by the patient, and very often by the analyst, as inevitably reflecting one aspect of another of the patient's internal object world from within the phanstasmatically organized matrix of each analytic relationship. In addition, he is concerned that analysts' rigidly adhering to “technical” positions will reduce their likelihood of being effective with the widest range of patients, an increasing number of whom may not accept the traditional analytic practices. The mentalization concept, although not guiding his decisions in the case, is useful in describing many such situations.     

B.F. Skinner and the auditory inkblot: The rise and fall of the verbal summator as a projective technique

Behaviorist B.F. Skinner is not typically associated with the fields of personality assessment or projective testing. However, early in his career Skinner developed an instrument he named the verbal summator, which, at one point, he referred to as a device for "snaring out complexes," much like an auditory analogue of the Rorschach inkblots. Skinner's interest in the projective potential of his technique was relatively short lived, but whereas he used the verbal summator to generate experimental data for his theory of verbal behavior, several other clinicians and researchers exploited this potential and adapted the verbal summator technique for both research and applied purposes. The idea of an auditory inkblot struck many as a useful innovation, and the verbal summator spawned the tautophone test, the auditory apperception test, and the Azzageddi test, among others. This article traces the origin, development, and eventual demise of the verbal summator as an auditory projective technique.     

Independent control of a pre-school child's aggression and peer interaction by contingent teacher attention

This study demonstrated the existent role of contingent teacher attention in maintaining a preschool child's aggression to his peers, as well as an imposed use of contingent teacher attention to increase his low peer interaction. Aggression and peer interaction were analyzed independently as two baselines of multiple baseline design; each was subjected to at least one reversal. The multiple baseline design was used to examine three possibilities: (1) that the high rate of aggressive behavior was in itself impeding the emergence of peer interaction; (2) that contingent teacher attention could be used to maintain a reduced rate of aggressive behavior; and (3) that a similar use of teacher attention could maintain an increased rate of peer interaction. The technique of largely ignoring the subject's aggressive behavior and attending instead to whatever child he was attacking decreased his aggressive behavior to an acceptable rate. Two reversals of this technique displayed experimental control, each recovering the high baseline rate of aggression. After the aggressive behavior was decreased for the final time, teachers attended to the subject only when he was involved in social interaction with peers, and they thus increased his social interaction to a high rate. Later, they withdrew their attention for social interaction and reversed the effect and finally then recovered it.     

When Interpretation Derails the Patient: The Negative Impact of Certain Misuses of the Concept of the Unconscious

Alternatives to classical psychoanalytic theory and technique have existed in the form of various "deviant" schools, all of which have found that contemporary conflict theory fails to achieve good results with the patients they treat. While the principles of interpersonal, self-psychological, intersubjective and relational schools are reasonably well known through the psychoanalytic literature, the opportunity to examine detailed analytic accounts by classical analysts has only recently become possible. The publication of full case reports has recently become a feature of the traditionally based psychoanalytic journals. This paper makes use of a recent volume of the Psychoanalytic Quarterly to examine the interpretations made during a lengthy analysis of a male patient struggling with his ambivalence about marrying his fiancée. The analyst repeatedly attributes his patient's reluctance to marry and negative feelings about his fiancée as determined by his unconscious conflation of his mother and his fiancée. The author attempts to demonstrate the derailment of the patient by these interpretations. They prevent him from solidifying his own judgment and, in so doing, prevent him from taking suitable action. An alternative approach to the material of the case is presented, including very different interpretations that would, in the author's opinion, liberate the patient rather than derail him from achieving his life goals.     

The patient's perception of the analyst: the hidden transference.

Just as the person of the analyst becomes a nidus for the manifestations of transference, so does the analyst's technique. When the patient misperceives person and technique, identifying the transference is not difficult. More complicated are those situations in which the patient's perception of the analyst and of his or her technique is congruent with the analyst's self-representation, or when the patient uses reality aspects of the analysis and the analyst as a resistance. Clinical material from the analysis of three patients is used to illustrate this.     

The Superego and the Two-System Model

The authors note that Freud's clinical struggle with the sadomasochism of his patients led directly to his theory of the superego, which in turn affected his ideas on sadomasochism. The authors use their dual-track model of two systems of self-regulation—the “closed,” sadomasochistic, omnipotent system and the “open,” competent, loving, reality-attuned system—to trace the origins, development, and functions of the “closed” and “open” superego. They suggest that the application of this model will help restore the importance of the superego in psychoanalytic theory and technique, and they provide clinical illustrations from the analysis of an older adult.     

Receptivity,or Going on (Not) Being: Commentary on Paper by Robert Grossmark

“The treatment hinged on my being able to live with him in this ongoing non-existence and know it and tolerate it, and expect no more,” writes Dr. Robert Grossmark about himself and his patient, Kyle (pp. 637–638). This is a key sentence, outlining the core of the enlightening analytic work done. I comment on the linkage between living the ongoing nonexistence and going-on-(not)-being, then reflect about the distinction between what I call the “outward” technique, which is everything Grossmark describes about treating Kyle, and the “inward” technique, which is all that occurred within him, in an inner, hidden, powerful, unconscious dialogue with the patient, and which is only hinted at. In this context, with patients like Kyle, who bring to the analyst physical sensations and actions for dreaming, the analyst's corporeality, by which I mean his experience of his body and his capacity to connect it to emotion, thereby lending it meaning, has a critical importance. I bring, in a nutshell, references to several psychoanalytic writers about the subject of corporeality in analytic treatment and use a vignette from an analysis to demonstrate the point.