The Levels Hypothesis: A Re-Examination and Reorientation

The levels-hypothesis appears to be derived from psychoanalytic theory, and in its most popular interpretation is concerned with levels of consciousness. However, it is argued that a gradient of consciousness has no application to projective techniques, essentially because there are no principles of differentiation. It is for this reason that the studies which have been done have concerned themselves with such concepts as pathology, concepts which have a tenuous relation to the original levels-hypothesis. The paper has proposed that consciousness in the sense of awareness can more meaningfully be applied to projective material, and that when it is used in this sense a levels-hypothesis can be derived which is both testable and has an adequate rationale.     

Erotized transference reconsidered: expanding the countertransference dimension

A reconsideration of the erotized transference from a contemporary perspective has been presented utilizing detailed case material provided by Stoller. The main thesis is that this type of transference, traditionally conceived as a product of a particular kind of patient often felt to be borderline, is better understood as arising in a specific intersubjective context involving both participants in the psychoanalytic situation. The focus is on the intricate interaction of analyst and patient, recognizing that either may serve as a selfobject for the other. This view assumes a more expanded countertransference role than recognized in the earlier literature. The psychoanalytic situation can be erotized by either or both participants. A corollary thesis is that the details of a patient's fantasy should also be viewed as codetermined and that imbedded within it might be the patient's subjective experience of the psychoanalytic interaction. Alluded to peripherally is that the erotized transference in the interaction between male analyst and female patient is, in part, a manifestation of traditional roles assumed in situations involving a male authority figure in close engagement with a female who perceives herself as relatively powerless. This issue has recently received considerable attention from writers who have addressed themselves to the important gender issues in psychoanalysis.     

Developments in cognitive neuroscience: II. Implications for theories of transference

An integration of psychoanalytic theory with contemporary developments in cognitive neuroscience offers a useful perspective on long-standing controversies about the nature of transference, and a better understanding of the precise mechanisms by which transferential processes occur. Contemporary psychoanalytic views of transference are reviewed, and the many processes that constitute transference are described. Two issues that have emerged in different guises for several decades-the role of the analyst in eliciting transference, and the nature of "real" and "transferential" components of the therapeutic relationship-are reconsidered in the light of concepts such as connectionist networks. Although a useful analytic stance is one that allows the patient's enduring dynamics to dominate the analytic field, it is suggested, anonymity is neither a cognitive possibility nor the driving force behind most transference reactions, and the distinction between "real" and "transferential" perceptions is one of therapeutic interest, not of mechanism. Certain features of the analytic situation make some dynamics more likely than others to enter the treatment relationship, notably those related to authority, intimacy and attachment, and sexuality. Transference reactions are best understood as constructed from a combination of the patient's enduring dispositions to react in particular ways under particular conditions; features of the analytic situation and of the analyst; and interactions between patient and analyst. These reactions do not unfold ineluctably from the patient's mind in the consulting room, nor are they cognitive constructions of the patient-analyst dyad or co-constructions of relatively equal partners exerting their influence on the analytic field.     

Some observations on the psychoanalytic process

The author's aim is to delineate the psychoanalytic process and to distinguish it from the psychoanalytic situation, the transference neurosis, "insight," and psychoanalytic technique in general. Freud's 1913 views provide the basis for a concept of the psychoanalytic process centered on the recognition and interpretation of resistances and on the patient's reactions to the analyst's interventions. This clinically observable "unit" of the process is described and compared with Bernfeld's "facts of observation." The proposition is advanced that the process does not come to an end with the termination of analysis. It continues postanalytically in the form of the patient's more objective and more effective capacity for self-observation. The paper closes with a warning about the "pitfalls of perfectibilism" and with a plea for the elevation of the not-so-good analytic hour.     

The application of psychodynamic methods within the framework of behavior therapy

Behavior Modification has gone a long way since its start as a reaction to the traditional psychiatric and psychotherapeutic methods. It is no longer a monolithic term, as it includes a variety of theoretical and conceptual positions, different methodological approaches and many therapeutic techniques. It is the aim of this paper to demonstrate that due to the changes behaviorism has gone through, it is no longer an alien discipline to psychoanalysis as it has been in the early days of the movement. Therefore, an integration between the two approaches is currently possible in a relatively smooth and conflict- free manner. There are several varieties of integration between the two approaches. The suggested combination is an elaboration of Kaplan's method, which is behaviorally-oriented, but utilizes psychoanalytic concepts and techniques pragmatically at times when the behavioristic treatment program has come to a stalemate because of the patient's resistances. This approach seems to be especially coherent and efficient;it has proven to be successful in avoiding the pitfalls which were the cause of skepticism with respect to the integration of the two types of treatment — behavior therapy and psychodynamic therapy. Vignettes from behavioral-cognitive treatment of test anxiety and combat reaction (post-traumatic stress disorder) will be presented in order to demonstrate the suggested method.     

The analyst's theory: A third source of countertransference

The author asserts that the analyst's theory, personal and/or academic, is an important source of countertransference which complicates our traditional understanding of the analyst's emotional responses as being constructed from a mix of his transferences and the patient's effects on him. From this perspective, theory - because it has no intrinsic relevance to the essential phenomena of individual analytic processes - may be a confounding, as well as a necessary, factor in clinical work. Although the analyst's theory might be conceptualized as a component of his personality that shapes his emotional reactions to a patient, the author believes that there is a valuable increment of conceptual clarity and additional clinical utility to thinking about a more direct role of theory in the process of countertransference formation. He uses aspects of the clinical analysis of narcissistic resistances to illustrate how some theories might predispose an analyst to confounding unconscious enactments by generating either positive or negative countertransferences which can be used defensively by the patient and/or analyst. He also illustrates how, in some contexts, an analyst's theory might attenuate potentially informative countertransference reactions and interfere in this way with the analyst's apprehension of the patient's psychic functioning. Finally the author addresses the importance of 'fit' between an analyst's working theory and a patient's psychopathology, and considers implications of his ideas for psychoanalytic training and practice.     

States of identity: a perspective drawing upon Fordham's model and infant studies

This paper examines the Jungian concept of identity and distinguishes it from projective identification and participation mystique which also refer to non-differentiation between self and object but involve projective mechanisms. Clinical work by Fordham and a psychoanalytic infant observation are used to illustrate early perceptual operations defined by experimental researches. These operations are understood to be expressions of the primary self which manifest themselves before the structuring necessary for normal projective identification. This paper attempts to describe an intersubjective experience between mother and baby that allows for their separate ways of relating, but does not depend on projective mechanisms that can exist only after there has been adequate development.     

Basic Considerations in the Application of Therapy and Education to Parent Groups

This article presents a couples group therapy treatment approach that uses analytic object relations concepts such as transference/countertransference, projective identification, containment, and the holding environment. Object relations theory is seen as the most useful theory with which to view couple interaction because it is based on a two-person psychology and focuses on the impact of relational systems on the development of the person. This includes the idea that the person grows within the attachment to another person. Group therapy is seen as a more effective treatment approach because the group is a resilient holding environment that provides an avenue in which projective identifications can be understood and contained, power can be redefined, isolation of the couple can be decreased, and the couple's responses can become more versatile. The model described is illustrated with clinical vignettes from an open-ended couples group.     

‘If I leave home,who will take care of mum?’ Intergenerational transmission of parental trauma through projective identification

Using the construct of projective identification and integrating it with the body of literature on intergenerational transmission of unsymbolized parental trauma, I describe the case of an adult daughter that illustrates intergenerational transmission of unsymbolized parental trauma. It is suggested that the daughter has unconsciously identified with the disavowed feelings of anxiety projected into her by her mother. The daughter’s projective identification of her mother’s unresolved past traumas prevent her from leaving the parental home for the first time, despite being 35 years old. In turn, it is thought that the mother’s unconscious grasping onto her daughter is an attempt to avoid the confrontation of her own unprocessed fears implanted into her by her own mother, thus linking three generations of disavowal. As a way of extending the exiting theory, it is proposed that when there are long-term and inexplicable experiences of anxiety that coalesces around the intergenerational transmission of parental trauma, the term ‘intergenerational transmission of traumatic anxiety’ can be used to describe it.     

The patient's experience of validation in psychoanalytic treatment

The importance of the patient's experience of validation is not a new one in psychoanalytic thinking, and can be traced throughout the literature. However, its role as an essential aspect of the psychoanalytic process, particularly in working with intrapsychic conflict, has traditionally been underappreciated. It is argued that validating interventions have an important role in psychoanalytic treatment, and that they often serve to open up, rather than foreclose, the analysis of transference. Marsha Linehan's conceptualization of the role of validation in Dialectical Behavioral Therapy provides a unifying framework for a more extensive psychoanalytic consideration of validation. After a review of the psychoanalytic literature, a number of conceptual issues are discussed that have complicated thinking about validation from a psychoanalytic perspective. Two clinical examples are presented, one from the author's psychoanalytic practice and one from his own analysis. Both illustrate how active validation by the analyst can play an essential facilitating role in the psychoanalytic process.     

Addictions and the Quest to Control the Object

Most patients come into psychoanalytic treatment engaged in some form of repetitive, destructive behavior that is an externalization or projection of their internal struggles. One form of this object relational acting-out is the addictions, be they to alcohol, gambling, drugs, sex, procrastination, or other variations. The patient's experience is a "must do-can't stop" one that leaves them both desperate and relieved. Patients come to us wanting help in refraining from these addictive patterns. Sometimes, they are attending a 12-step program or are in a day treatment recovery program but need additional assistance in remaining free from their addictive behaviors. Others seek out psychoanalytic treatment while still involved in their addiction, but wish to stop the behavior and build a more positive plan for their lives. This paper examines the deeper object relational issues that lie behind the addictive process. The transference is often colored by acting-out, by sadomasochistic dynamics, by projective identification, and by fantasies of persecution and loss. Case material is used to explore these specific problems as well as the patient's general difficulties with paranoid-schizoid and depressive functioning.     

The scientific status of psychoanalytic clinical evidence (I)

The main source of evidence for psychoanalytic theory comes from the clinical situation. Yet recent empirical studies in verbal conditioning and the social psychology of persuasion indicate that psychoanalysts and therapists of other schools are speciously validating their own theories by unwittingly influencing their patients’ behavior. In the light of this evidence it is small wonder that psychoanalysts consistently ‘validate’ psychoanalytic theory in their clinical practice while therapists of other schools ‘validate’ their own theories in their clinical practice. Although Freud was not unaware of the problems of ‘suggestion’ and the conflicting evidence of rival schools of psychotherapy, he never met these problems successfully. Contemporary psychoanalysts have added little to Freud's original position. One recent attempt, by Fritz Schmidl, to formulate new criteria for the correctness of psychoanalytic clinical interpretations, does not completely escape the problem of suggestion and has new problems of its own.     

Validity Rates of the Personality Assessment Inventory and the Minnesota Multiphasic Personality Inventory–2 in a VA Medical Center Setting

This paper presents some notions regarding the all important question of projective stimulus ambiguity. It is suggested that in spite of the observation that TAT stimulus ambiguity has been the most studied, the problem of stimulus ambiguity must be considered a vital problem in relation to projective tests as a whole. Findings specific to an extended DAP (involving the inclusion of a self-portrait) are reported and the relevance of these findings to the problem of stimulus ambiguity is discussed.     

主题统觉测验中国修订版(TAT-R,C)的编制与常模

主题统觉测验是一种与罗夏测验齐名的人格投射技术。但由于原版测验图片不适用中国被试,而且操作复杂,评分缺乏客观性,信度、效度不理想,更无标准化常模,所以在临床实践难以推广,在国内尚未系统研究。 为改进原版测验缺陷,首先修订了新的适合中国文化模式的工具,把原有的无结构投射法修改为联想—选择法投射,使修订版测验简单、易行。并且经研究验证,修订版(TAT-R,C)测验具有一定的信度效度,并建立了标准化常模。     

The Meaningfulness of Helping Others: Loren Eiseley's “The Star Thrower”

Freud and Klein describe projective processes—projection, projective identification, and the repetition compulsion—that cause interpersonal distortions not only in the psychotherapy relationship but in adult intimate relationships as well. Winnicott's theory of the use of an object describes a way of relating that is free of the distortions of projection, opening up the possibility of differentiation between intimate partners. Two case examples illustrate how addressing projective processes assisted one patient in extricating herself from a psychologically abusive relationship and helped a couple in treatment to move from object relating to object use. It is argued that the use of these psychoanalytic theories has an important role within a modern relational social work practice.     

Relationships among projective and direct verbal measures of achievement motivation

The present study was undertaken to explore ways projective arid nonprojective verbal measures of achievement motivation elicit comparable and dissimilar responses in a "Third World" sample of entrepreneurs as a test of McClelland's theory of economic growth. Results were generally consistent with the theory of achievement motivation, and suggested that high scores on n Ach were associated with high rates of industrial and agricultural output; low scores were associated with static or declining business. TAT measurement was the best predictor in that it correlated 0.68 and 0.48 with agricultural and industrial production. Results further lend support to past findings: namely, that Various achievement measures appear to be measuring dissimilar constructs.     

Psychoanalytic observation

The recent focus on empathy as the essential activity in psychoanalytic data gathering has underemphasized the complexity of psychoanalytic observation and has failed to identify what truly makes it unique among modes of psychological investigation. It is a process that includes introspection and empathy. However, it also includes the analyst's observation of the patient's behavior, and particularly verbal behavior, in a way that is not necessarily empathic. The psychoanalytic use of introspection and behavioral observation together, as they are modified by the analysand's free association and the analyst's evenly hovering attention, provides a unique method of data gathering. The transient, mutually related regressions of analyst and analysand which partly constitute the analyzing instrument modify the field of observation available to both, providing better access to derivatives of the analysand's unconscious mental functioning. This more complex concept of psychoanalytic observation, as opposed to that in which empathy is predominant, has important implications for psychoanalytic training, clinical work, and theory.     

A Picture Book of Internal Events: The Colours of Rage and Love

The views on countertransference in psychoanalytic theory and practice have undergone a change within the last fifty years. From being considered an impediment to analysis, countertransference is today looked upon as an important potential for a tentative understanding of what is unconsciously communicated from the analysand to the analyst. This implies that the analyst is susceptible to the unconscious interaction in the transference and the countertransference, and that he/she becomes conscious as quickly as possible of what is taking place. This applies especially to erotic feelings which are often intensified in analyses with patients with a serious psychopathology, as well as in analyses with patients in regressive phases where projective identification is the dominant factor used as a defence and a communication. Opinions differ as regards the question of how to deal with such a situation, especially whether it is right to be candid about the analyst's countertransference feelings towards the analysand, something most would caution against. In an example from an analysis, the analyst describes how he was influenced by an unconscious erotic countertransference. After three years of therapy with a patient with a serious psychopathology, he developed ?motherly” feelings, which he interpreted as reflecting a child's longing for closeness and physical contact. The result was that a few times, he ?forgot” to indicate the end of the session, which was then prolonged, and also that he embraced her on several occasions before she left the session. One year later, he had intense sexual fantasies and dreams about the analysand, which he experienced as both enticing and alarming, and as an impediment to the analysis. He soon became aware of the element of projective identification in the interaction, and by interpreting the analysand's unconscious communication, he regained his ability to maintain an analytic attitude and clear boundaries.     

On psychoanalytic autobiography

This article considers how one might define ‘psychoanalytic autobiography’, using statements from theorists of ‘life-writing’ and extracts from autobiographers (some of them psychoanalysts), together with their own commentaries on the genre. The focus is less on content and more on the nature of the art form, with a view to noting analogies with the psychoanalytic process. These analogies are to be found, in particular, in the qualities of transference dialogue; in the art of transformative or communicative projective identification; and in the contrast between self-indulgent and constructive types of memory. Psychoanalytic autobiography is seen as a mode of remaking the self – not omnipotently but through exploratory self-analysis, frequently following the familiar pattern of loss and rediscovery. It entails a special imagined relationship with the unknown reader, and a sense of being guided by a detached observational eye equivalent to that which Bion terms the ‘third party’ in a psychoanalytic situation.