What Organizational Consultants Do and What it Takes to Become One: Commentary on Papers by Kenneth Eisold and Marc Maltz

Relative to traditional professions like psychotherapy, organizational consulting includes more diverse practitioners and practices but far fewer formal requirements for entry or standards for practice. To define better boundaries around and within the field, I highlight the importance in Kenneth Eisold's and Marc Maltz's case material of distinguishing between organizational consultants and psychoanalysts and between different types of consultants in terms of their professional roles, services provided, and associated skills and knowledge. I underscore the value consultants bring to their clients when they are able to help diagnose and address performance issues that are at once social and operational, interpersonal and organizational, and unconscious and conscious.     

Search Yourself: Commentary on Paper by Kenneth A. Frank

This commentary has as its point of departure essential questions about selfhood, self-knowledge, and therapeutic action. Frank's contemporary redefinition of “mutual analysis” and its impact on the clinical surround are examined, with a special emphasis placed on the willingness of the analyst to change and grow. The vital role and theme of the analyst's emotional honesty are explored with an eye toward the clinical impact of contextualism, psychoanalytic complexity, and the personal attitudes that inevitably permeate the analytic relationship and its trajectory. This commentary, in concert with Frank's paper, encourages clinicians to embrace a more collaborative, mutually analytic posture in their clinical endeavors.     

Commentary on Papers by Burton and Bonovitz

The author probes bastions in Noelle Burton’s and Christopher Bonovitz’s patients’ unsymbolized experience. Bonovitz and his patient were involved in a mutually created phallic collapse, one in which they are unable to use their minds aggressively and vitally to make sense of things together. Bonovitz gained purchase on a set of conspiratorial feelings he had held toward his two analysts, feelings that were enacted with his patient. For Burton and her patient there was a different kind of bastion in which Burton’s wish to know her patient couldn’t be experienced as something other than impingement. The author argues the value of our openness to reverie not only when patients’ have poorly developed capacities for verbalization and symbolization but more generally as a clinical sensibility to cultivate with all patients.     

Psychoanalysis and Nature: Commentary on Papers by Bodnar and Santostefano

This is a response to papers by Sebastiano Santostefano and Susan Bodnar. The response argues that the psychoanalytic view of constitutive conflict makes any assimilation of analysis and ecology very problematic. Patients may benefit from being in pleasant surroundings outside urban areas, but this is not psychoanalytic work. Psychoanalysis would entail them coming to understand why they are fueled by desires they do not recognize as their own. It would entail them working through how these desires have come to belong to them. Calling these desires natural or unnatural is not helpful, and it may be pernicious.     

Plea for a Measure of Imagination: Commentary on Paper by Harvey Peskin

In responding to Harvey Peskin's important paper, “Man Is a Wolf to Man,” I further deconstruct his proposition “what therapeutic neutrality is to psychic reality, the therapeutic witness is to the recovery of social reality.” This statement calls into question two principles of the orthodox Freudian canon, one theoretical and one technical. Beyond the stimulus barrier, traumatic reality collapses psychic reality, conscious and unconscious fold into one another, reality and fantasy merge, and nightmares are made flesh. In attempting to impose psychic reality on a traumatic experience, then, classical psychoanalysts disavow a significant portion of human experience. Technically, the analyst's neutrality or failure to acknowledge the significance of historical reality condemns the survivor to further dehumanization as her dehumanizing experiences go unmarked in treatment. Peskin contends that the need to have experience validated, to have a witnessing analyst before an interpreting one, arises not only in matters of extreme traumatization but in everyday life. Illustrating the importance of this claim with an example from my own life, I propose that extreme traumatization takes a different kind of therapeutic engagement, one that is beyond professional obligation; a moral imperative that requires imagination when recognition is not enough. I add a further caveat that in cases of extreme traumatization, rather than privileging a search for psychic reality or even historical reality, some contemporary analysts privilege an exploration of the treatment relationship, failing to recognize that in such cases historical reality must initially take precedence over an emphasis on the intersubjective.     

Whiteness Uncovered: Commentary on Papers by Melanie Suchet and Gillian Straker

In this discussion of papers by Gillian Straker and Melanie Suchet, the author draws some links between the two papers in the interest of expanding analysts' understanding of the nature of whiteness as part of a racist discourse.     

The Laborers in the Vineyard: Putting Humor to Work

This article focuses on Jesus?? parable popularly known as ??The Laborers in the Vineyard?? (Matt. 20:1?C16). I propose that a psychoanalytic reading of the parable offers insights that are missing or overlooked in more traditional readings. In support of this proposal, I discuss the interpretation of the parable by Richard Q. Ford (1997) and his emphasis on the critical role of the listener in effecting the reconciliation of disputing parties; and then turn to Freud??s analysis of beggar jokes (Freud 1905/1960) to explore the generosity vs. envy issue to which the landowner alludes in his response to the complaining workers. I also employ Freud??s view that humor (Freud 1927/1963) reflects the superego??s comforting side to suggest that humor may assist in the effort to get the disputing parties to listen to one another and even perhaps to resolve their differences.     

We: Commentary on Papers by Trevarthen,Ammaniti & Trentini,and Gallese

In my discussion of papers by Trevarthen, Ammaniti & Trentini, and Gallese, I situate their work within an emerging paradigm of intersubjectivity. This new model finds philosophic grounding in the work of the phenomenologists (Husserl, Merleau-Ponty, Nancy) as it draws from the multiple sources that come together to comprise the new field of cognitive and affective neurosciences. These papers hold the potential to make relational psychoanalysis more relational by providing new foundations for rethinking the biological, developmental and clinical. What emerges is an intersubjective theory based in motor action and perception that serves as the embodied basis for human culture and community, a shared “we” space of basic human affinity. I extend this conception into the analytic setting with a brief introduction to enactive participation in clinical process.     

Context Matters: Commentary on Papers by Aschieri,Chudzik, Evans,and Fantini

This article discusses articles by Aschieri, Chudzik, Evans, and Fantini (this issue) that address cultural considerations in Therapeutic Assessment (TA). The importance of the cultural context in which a TA is conducted is highlighted. Among the themes highlighted are the conceptualization of psychology, and more specifically psychological assessment, as a culture in and of itself and the importance of shame (Aschieri), the way the cultural values influence the practice of assessment (Chudzik), the importance of understanding the meaning of one's experience within their culture (Evans), and the role of subcultural differences (Fantini). The role of culture is seen as an important variable across these articles that explore varied conceptualizations and influences on assessment psychology. Cultural sensitivity and responsivity is seen as a crucial factor in the avoidance of misalliances. The articles in this special section are viewed as important contributions to the TA literature and demonstrate how the TA paradigm can help assessors overcome potential cultural influences that could affect the benefit of a psychological assessment.     

Dances of Desire: Commentary on Papers by Dianne Elise and Jonathan H. Slavin

The richness and creativity of early classical work with dreams became narrowed through doctrinaire obedience to Freud's brilliant hypotheses. Interpersonal psychoanalysis, though originally little interested in problems of mind and private mentation, may be well suited, in part due to its lack of a comprehensive dream theory, to a clinical approach to dreams that is relatively open‐minded, pluralistic, complexly layered, collaborative, and playful. Multiple possibilities for the meanings of dreams and multiple ways of approaching dreams in analytic therapy are suggested. Although many therapists for complex reasons shy away from working on dreams, an interpersonal approach recognizes that several wishes of both patient and analyst may be significantly fulfilled in the pleasures of working together on dreams. If it is mindful of what is unfortunately a growing tendency to project into all dreams a single‐minded preoccupation with transference and countertransference, and if it respects the world of dream imagery in its own right, interpersonal psychoanalysis can make a genuine contribution to our understanding of dreams and dreams can lend an important dimension to interpersonal concepts. Several clinical examples are presented in an effort to highlight an approach that “stays with the image”; and allows the dream images to make their way into the psychoanalytic dialogue.     

New Windows on Understanding Addictive Vulnerability: Commentary on Papers by Lisa Director and Noelle Burton

The author discusses papers by Director and Burton, placing their work in a context of contemporary psychoanalytic models for understanding addictive behavior. Whereas early psychoanalytic models stressed drive theory and a topographic model of the mind, the contemporary models discussed here emphasize themes of dissociation—integration, helplessness—omnipotence, self-organization, and relational therapy. The author considers how these modern themes resonate with psychoanalytic formulations of addictive vulnerability that have considered disturbances in affect recognition/tolerance, self-esteem, relationships, and self-care. The author concludes by suggesting that the dyadic paradigms advanced by Director and Burton likely have implications for psychodynamic group treatments.     

Disruption and Desire Discussion: Commentary on Papers by Dianne Elise and Jonathan H. Slavin

Dr. Slavin's and Dr. Elise's paper are discussed, with reference to clinical theory.     

For There is Work to be Done: Poetry and Commentary

Poetry illuminates the work of health care professionals well beyond procedure guidelines, clinic schedules or best practice policy. Poems and commentary from the perspective of a nurse, an emergency medical technician and two physicians are accompanied by an exploration of the meaning of work and the role of medical humanities.     

The Wisdom of Sharing a Frame: Commentary on Papers by Anthony Bass and Ilana Laor

In this discussion I agree with Anthony Bass, who shows how the analytic frame has properties that involve both the process and the structure, and I suggest replacing the term structure with the term constraints. Bass considers analytic frames as contexts: Different frames organize different contexts of experience. He says that the frame is cocreated by patient and analyst and evolves over time. I think that Dafna's case presented by Ilana Laor is a good example of this aspect. I agree with Laor, who shows how the frame reflects the negotiation process between patient and analyst, emphasizing that this process itself is therapeutic. Following Bass I emphasize that a polarization between stability versus flexibility should be replaced by the dialectic between stability and flexibility. I conclude wondering how Bass's and Laor's “wisdom” regarding flexibility and elasticity can be passed over to younger psychoanalysts who are beginning their clinical work.     

Psychotherapy Research and Psychoanalytic Practice: Commentary on Papers by Lester Luborsky and Hans H. Strupp

I discuss the views of Lester Luborsky (quite optimistic) and of Hans H. Strupp (less so) concerning the accumulating evidence for the favorable impact of psychoanalytic therapy research, as it has grown over recent decades, in shaping clinical psychoanalytic activity. I offer my perspectives on their views of the issues of (a) the effectiveness of psychoanalytic (psychodynamic) therapies vis-à-vis the varieties of nonanalytically based therapies; (b) long-term (time-unlimited) vis-à-vis short-term (time-limited) therapy, (c) the call for empirically supported treatments (ESTs), (d) the call for randomized clinical trials (RCTs), (e) the trend toward “manualization” of therapy approaches, and (f) the light that all these considerations can cast on the extent to which, and how, psychoanalytic therapy helps.     

Originality,Dread, and Object Usage: Commentary on Papers by Sarah Mendelsohn and Deborah Dowd

Both Deborah Dowd and Sarah Mendelsohn capture the fraught experience of staying near a patient’s dread. I discuss dread as an engagement with unrepresented trauma. With each case I interpret a critical clinical moment as an instance of Winnicott’s object usage, by which the patient leaves omnipotence and finds externality. I introduce a crucial meaning of object usage that I find only implicit in Winnicott’s text: Not only must the analyst survive the patient’s destructiveness, but the analyst also must be disrupted by the patient’s unrepresented trauma. Their patients’ experience of this disruption positions each of these analysts as an other who can be used.