Critical incident debriefing in groups: a group analytic perspective

This paper looks at providing critical incident debriefing in groups. It outlines key group analytic concepts that are relevant to debriefing, including mirroring, group dynamics and supervision. It details how these concepts, along with the facilitator's and supervisor's free-floating attention, can help in thinking about the group and the organizational impact on the individual and the group. Using examples of debriefing, suggestions are made about how to use these concepts within the debriefing session and the impact of the dynamics of the organization on the debriefing.

The paper emphasizes the importance of supervision for debriefers and how the dynamics of the debriefing and the organizational context can be mirrored in the supervision. It illustrates the interplay between the individual, the group and the organization through commentary on vignettes, which include a debriefing session and the subsequent supervision session for debriefers.     

Reflections on Klein's radical notion of phantasy and its implications for analytic practice

Analysts may incorporate many of Melanie Klein's important contributions (e.g., on preoedipal dynamics, envy, and projective identification) without transforming their basic analytic approach. In this paper I argue that adopting the Kleinian notion of unconscious phantasy is transformative. While it is grounded in Freud's thinking and draws out something essential to his work, this notion of phantasy introduces a radical change that defines Kleinian thinking and practice and significantly impacts the analyst's basic clinical approach. This impact and its technical implications in the analytic situation are illustrated and discussed.     

High-Risk,High-Gain Choices: Commentary on Paper by Philip A. Ringstrom

In this commentary building on Philip Ringstrom's paper, I address how improvisation, an unpremeditated spontaneous activity emerging within an interactive context, can be analytic even when not shaped consciously by the analyst's reflective capacity and therapeutic judgment. A microanalysis of the nonverbal dimensions of the analytic exchanges that Ringstrom offers is used to illustrate how affective experience can be attended and coconstructed on a subsymbolic process register carried on kinesthetic, somatic, and acoustic dimensions that may or may not be transduced to symbolic expression for mutative analytic impact to have occurred. The metaphor of jazz is added to the metaphor of improvisational theater to help elaborate this view.     

On the Importance of Being (Earnestly) Hybrid—Or,Qualms of a Quasi-Postmodernist: Commentary on Paper by Susan Fairfield

Dr. Fairfield makes a strong case that contemporary analytic theorists fail to live up to their apparent aspiration to present a thoroughgoingly postmodern conceptualization of the self. She argues instead in favor of a “hybrid” model—one that includes a dollop of modernism in the postmodernist brew. In this commentary, I critique the theorizing process inherent in psychoanalytic postmodernism, and then comment on and give a clinical example involving the self's “configurality.” I argue that we need to embrace the challenges of postmodernism without so privileging this position that we let it loosen our grasp of the realities of everyday clinical experience that might cause us to question postmodernism's tenets or values. Moreover, we must not assume that we can gauge the full impact of our “model of subjectivity” on the therapeutic process by knowing what we think we think.     

Crossing Boundaries: Commentary on Paper by Sarah Hill

This commentary focuses on two aspects of Hill's presentation. First, it addresses the critical role of repetition compulsion in carrying into analytic enactments the patient's early, unsymbolized traumas. This discussion addresses, furthermore, Hill's reference to her early, preverbal, experience with an African nanny, as this resonated with some of the author's personal experiences. It is suggested that, particularly in American culture, the identities of white children who experience extended care by black nannies must be regarded as multiply determined, race being a critical determinant. How this aspect of white identity is negotiated in a culture bounded by established racial dichotomies is regarded as critical to analytic inquiry, regardless of the racial makeup of the analytic dyad.     

The Analyst as Comic and the Comic in Analysis: Reply to Commentary

This discussion elaborates aspects of the use of humor and jokes in clinical psychoanalysis. The use of humor, like dreams or other symmetrical processes, facilitates the patient's development of the capacity to symbolize unconscious experience and mitigates the need to evacuate unconscious experiences and fantasies into the external world. In focusing on specific clinical interventions I highlight three dimensions of the process: the concept of coconstruction in the emergence of humor in the psychoanalytic relationship, the authority of the patient's psychopathology and affective and cognitive development, and the analyst's willingness to take the risks of self-exposure and possibly hurting the patient implicit in the use of humor and jokes in the analytic relationship. Different forms of humor are described in relation to the different clinical situations, including mutually created jokes, caricatured enactments, cartoonlike images, and self-depreciating commentary on the analytic process. In using jokes and humor in psychoanalysis we introduce the possibility of pleasure within an intense, intimate moment which allows for the transformation of unacceptable aspects of both patient and analyst as they become joined within a broader human experience.     

The Coparticipant Field: Commentary on a Paper by Juan Tubert-Oklander

Psychoanalytic field theory is integral to relational praxis. In his study of the analytic field and its interpersonal complexities and relational intricacies, Tubert-Oklander emphasizes its clinical promise. Tubert-Oklander's field orientation, however, is a conservative and limited one. This commentary proposes a new, more radical coparticipant theory of analytic praxis.

As a unique form of clinical participation, coparticipant inquiry is marked by an emphasis on patients' and analysts' relational mutuality, coequal analytic authority, and dyadic uniqueness. Coparticipant inquiry represents both a one-person and two-person psychology—an integral of classical individualism and the social emphasis of the interpersonal/relational viewpoint. Coparticipant analysis calls for a new, multidimensional concept of the self that reconciles the seeming paradox that we are simultaneously communal and individual beings—from birth embedded in a series of social field, yet always uniquely individual. This psychoanalytic dialectic between personal, nonrelational selfic “I” processes and an interpersonal “me” pattern brings into relational play such concepts as will, self-determination, and agency. Coparticipation promotesatechnically freer, more self-expressive, and spontaneous inquiryandemphasizesthecurativeimmediacyofnewrelationalexperience.

I have believed for a long time that human

nature is a reciprocity of what is inside the skin

and what is outside; that it is definitely not

“rolled up inside us” but our way of being one

with our fellows and our world. I call this field

theory.

—Gardner Murphy     

Between Subjects: Commentary on Paper by Robert P. Drozek

This commentary on Drozek's paper outlines its key points under 10 headings, looking at various aspects of the intrapsychic and intersubjective elements involved in understanding motivation. There is discussion of issues of autonomy and dignity based upon Kant's philosophy that underpin the paper's assumptions about unconditional valuing of the other as a universal element of intersubjective motivation. In the commentary attention is paid to the role of desire in motivation, as well as some of the psychoanalytical literature on motivation, including papers by Sandler, Loewald, and Winnicott, some aspects of which connect up with the paper's theses. At various points, some of the clinical relevance of the paper's proposals are brought to light, in particular how the patient may be in a position to use the analyst's interventions as a source of intersubjective motivation.     

The Russian Cusanus: S. L. Frank and the Russian reception of Nicholas of Cusa

During the intense philosophical and theological renaissance of the Russian Silver Age, the German Cardinal Nicholas of Cusa (1401–1464) received a unique appraisal in the work of Semyon Liudwigovich Frank (1877–1950), hailed by some as ‘the greatest Russian philosopher’. This paper will show that five of Frank's central philosophical arguments can be traced directly to Cusa's writings. Once these key arguments are taken together with Frank's own comments about Cusa, it can be concluded that Frank saw himself as Cusa's modern successor, presenting his ideas in a different intellectual context. In this sense, we can speak of Frank as the ‘Russian Cusanus’. The arguments in question include Cusa's docta ignorantia, our knowledge of being, the recognition of absolute being as ‘non-other’, the identity of possibility and actuality in the absolute, and finally the coincidentia oppositorum.     

Arrested Histories: A Response to Françoise Davoine

This commentary examines the psychoanalytic drama narrated by Françoise Davoine in terms of the dream at its crossroads: a site within the analysis (and its dramatic narrative) in which the dead and the living change places and the untold stories of the patient's and analyst's mothers begin to emerge. Davoine's narrative recounts the emergence of a language in which the hidden stories become entangled with each other as well as the breakdown of signification in which an uninscribed history appears on the scene. Ultimately the analysis turns around an arrest of signification, a form of madness that reveals the violent history at the heart of the exchanges enacted in the analytic encounter. This is also the point, I suggest, at which the possibility of a new relation to history and a new form of address open up.     

The Radical Cure: Commentary on Paper by Eyal Rozmarin

This commentary on Eyal Rozmarin's paper “To Be Is to Betray” considers the place of history in the psychoanalytic encounter. Examining texts by Adorno and Ferenczi, the author cautions against “radical cures” that conflate political values with analytic ones.     

Does She Do or Does She Don't?: Reply to Commentary

This reply clarifies the ideas originally presented in “Beyond Milk and the Good Breast: Reconfiguring Psychoanalytic Dyads” (PD 9/5, 1999) in response to Steven Reisner's commentary. It faults Dr. Reisner's reading of Lacan and Kristeva, as well as his use of male-gendered metaphors to transform my clinical material into a different analytic treatment. I conclude that, by arriving at such differing conclusions regarding theory and clinical treatment, he inadvertently proves, and enacts, the basis of my argument: that the gender of the analyst is an important variable that affects psychoanalytic formulations, treatment, and outcome.     

The Particularities of Form: Reply to Commentary

In this brief reply to Bollas's commentary on our paper about his work, the cycles of intersubjective dialogue endlessly sustaining should be apparent. We begin with an example of the form—content distinction and attempt to use it as a springboard for further disentangling some of the nuances of Bollas's intersubjective theorizing. Bollas's emphasis on form over content as a means of conceptualizing the analyst's contribution to the analytic process is indeed compelling. We all know from both sides of the couch the profoundly different meanings and messages that an analyst's mien invites: whether she's abrupt, verbose, meditative, tranquil. Yes, the medium is the message, and, thus, whether the analyst conveys a message through the effects of form that Bollas points out, such as “We have all the time you need for the nuances of unconscious figuring” versus “This is hot—we hafta figure it out now” surely does have an effect on the psychic material produced in the analytic process. We go on to add to Bollas's discussion of form by considering the particularities of form and how these too affect the analytic process.     

Are waves of relational assumptions eroding traditional analysis?

The author designates as ‘traditional’ those elements of psychoanalytic presumption and practice that have, in the wake of Fordham's legacy, helped to inform analytical psychology and expand our capacity to integrate the shadow. It is argued that this element of the broad spectrum of Jungian practice is in danger of erosion by the underlying assumptions of the relational approach, which is fast becoming the new establishment. If the maps of the traditional landscape of symbolic reference (primal scene, Oedipus et al.) are disregarded, analysts are left with only their own self‐appointed authority with which to orientate themselves. This self‐centric epistemological basis of the relationalists leads to a revision of ‘analytic attitude’ that may be therapeutic but is not essentially analytic. This theme is linked to the perennial challenge of balancing differentiation and merger and traced back, through Chasseguet‐Smirgel, to its roots in Genesis. An endeavour is made to illustrate this within the Journal convention of clinically based discussion through a commentary on Colman's (2013) avowedly relational treatment of the case material presented in his recent Journal paper ‘Reflections on knowledge and experience’ and through an assessment of Jessica Benjamin's (2004) relational critique of Ron Britton's (1989) transference embodied approach.     

The Floating “I”—An Experience of Shifting Form: Commentary on Paper by Anne Sweetnam

The author offers a subjective reading of the clinical segment of Annie Sweetnam's paper. For clinical writing to have a lively impact, the form must be effective. This commentary focuses on how shifts in the written form convey shifting internal states of the patient and analyst and how the form then draws the reader into the emotional field within the transference–countertransference.     

When actions speak louder than words: Verbal and nonverbal wrangling in the therapeutic arena commentary on paper by F. Diane Barth

Patients’ use of language in the analytic setting can undergo extreme and sometimes surprising fluctuations. Seemingly articulate and engaging patients retreat to the concrete in their use of words, disconnecting verbal expression from one's internal experience. Are these fluctuations indications of limitations in the patient's capacity to put experience into language, or are they indications of the emergence of otherwise unacknowledged aspects of self into the treatment arena? Shifts in the use of language (both patient's and therapist's) can be opportunities to question the work of the analysis. Whether one uses these moments to expand the boundaries of the analytic technique or to expand the boundaries of the analytic relationship—or both—is the question posed in this commentary.     

End notes: two unpublished presentations by Michael Fordham

Following the publication in this journal of two of Fordham's unpublished papers selected by James Astor (2010, 55, 5), the editors have asked me to select a further two. I have chosen two clinical pieces, one clinical notes and the other notes that refine his previous thinking, which Fordham wrote at the end of his life. Both are examples of the way Fordham continued throughout his analytic work to turn to patients as his primary source of learning. Fordham presented the first piece, ‘A case study’, to Parkside Clinic in 1988. Its subject is his last child patient, a nine‐year‐old boy with behaviour problems that destroyed the analytic frame. The second is clearly for an SAP (Society of Analytical Psychology) audience and written probably around 1992–93. It is titled ‘Some comments on transference and countertransference’ and contains material from the patient who has become known through papers in this journal as ‘K’. The two pieces are presented together within a commentary rather than separately with footnotes, in order to provide some context for Fordham's thinking in his late years.     

INTUITING THE TRUTH OF WHAT'S HAPPENING: ON BION'S “NOTES ON MEMORY AND DESIRE”

Bion's “Notes on Memory and Desire” (1967a) is an impossible paper that this article's author has struggled with for decades. He views the paper, only two and a half pages in length, as a landmark contribution. Despite its title—and its infamous dictates to resist the impulse to remember past sessions and desire for “results”—the paper is not, most importantly, about memory and desire. It proposes a new analytic methodology that supplants awareness from its central role in the analytic process and, in its place, instates the analyst's (largely unconscious) work of intuiting the (unconscious) psychic reality of the present moment by becoming at one with it. This article's clinical examples, provided from the author's own work, illustrate something of his ways of talking with his patients.     

On shame,countertransference, and analytic style

Some analysands experience a restricted space in the analytic situation with special counter-transferential consequences. The author discusses how shame is involved in these situations, and projected on to the analyst. This leads to an important choice of direction for the analyst regarding counter-transference acting out or conditions for a real analytic situation. Shame plays a special rôle in these choices of direction. The author illustrates the problem with a clinical vignette and shows how integration of shame is accomplished clinically, and continues with a discussion of the connections between the analyst's analytic style, his own communicative style as a defense against shame and the analytic styles of different analytic “schools”. A discussion of Liberman's concept, of “asymmetrical dialogue” and its connection with countertransference acting out and analytic styles, forms a conclusion to the paper.