Further evidence for the case against neuropsychoanalysis: How Yovell,Solms, and Fotopoulou's response to our critique confirms the irrelevance and harmfulness to psychoanalysis of the contemporary neuroscientific trend

In their paper “The case for neuropsychoanalysis” Yovell, Solms, and Fotopoulou (2015) respond to our critique of neuropsychoanalysis (Blass & Carmeli, 2007), setting forth evidence and arguments which, they claim, demonstrate why neuroscience is relevant and important for psychoanalysis and hence why dialogue between the fields is necessary. In the present paper we carefully examine their evidence and arguments and demonstrate how and why their claim is completely mistaken. In fact, Yovell, Solms, and Fotopoulou's paper only confirms our position on the irrelevance and harmfulness to psychoanalysis of the contemporary neuroscientific trend. We show how this trend perverts the essential nature of psychoanalysis and of how it is practiced. The clinical impact and its detrimental nature is highlighted by discussion of clinical material presented by Yovell et al (2015). In the light of this we argue that the debate over neuropsychoanalysis should be of interest to all psychoanalysts, not only those concerned with biology or interdisciplinary dialogue.     

Editorial

Abstract

This paper will examine the current crisis in psychoanalysis in terms of the profession's decline, the apparent lack of patients, the ongoing debate over what constitutes psychoanalysis versus other therapies, and the lack of clinical focus in those debates. The concept of analytic contact will be introduced, and clinical material is used to showcase this concept as a bridge from the circular political debates to a more meaningful examination of what is psychoanalytic. In addition, case material will explore how patients tend to fight off the establishment of analytic contact in favor of safer, less threatening modes of relating. The author suggests that most patients fight off analytic contact and try to shift the treatment into something less analytic. It is up to the analyst to detect this, interpret it, and notice any countertransference collusion that may occur. Although the state of psychoanalysis as a profession is less than stellar in the eyes of the public, and the profession is apt to sabotage itself with endless debates about what constitutes true analytic work, the end is not necessary near. This paper proposes analytic contact to be the more useful focus of research and productive area of clinical exploration. If the decline of our field is to turn around, it will be on the clinical battlefront, not in terms of the theorizing among disagreeing groups of territorial analysts afraid of losing their political high-ground. The concept of analytic contact assumes that a deep exploration of intrapsychic phenomena, conflicts, and defenses, all within the realm of the transference, is the best clinical method of helping the mentally troubled individual. This genuine chance of change is best administered by a trained psychoanalyst. This simple idea is something the profession has contaminated with its often pointless arguments over frequency, analyzability, couch, and so forth. The clinical material will show that what happens in the room between analyst and patient is what best defines the true psychoanalytic treatment.     

Asperger syndrome: How does it relate to non‐verbal learning disability?

The syndrome of non‐verbal learning disabilities (NLD) is associated with prominent non‐verbal deficits such as reduced perceptual and spatial abilities, against a background of relatively intact verbal abilities. Asperger syndrome is one of the several developmental disorders for which Byron Rourke has claimed that almost all the signs and symptoms of NLD are present. This study investigated the claim utilizing a battery of neuropsychological tests that were found to be sensitive to NLD in the original learning disordered populations used to describe the syndrome. Children aged between 8 and 14 were recruited to form two groups: (1) children with Asperger syndrome (N=14) and (2) normal healthy schoolchildren (N=20). By contrast to the main principle outlined in the NLD model, children with Asperger syndrome did not display a relative difficulty with spatial‐ or problem‐solving tasks; indeed, they displayed significantly higher performance on some non‐verbal tasks in comparison with verbal tasks. It was only in relation to their high levels of psychosocial and interpersonal difficulties, which are also predicted on the basis of their psychiatric diagnosis, that the children with Asperger syndrome were clearly consistent with the NLD model in this study. These results raise questions about the relevance of the syndrome of NLD for children with Asperger syndrome.     

Social functioning using direct and indirect measures with children with High Functioning Autism,nonverbal learning disability,and typically developing children

Social perception is an important underlying foundation for emotional development and overall adaptation. The majority of studies with children with High Functioning Autism (HFA) or nonverbal learning disabilities (NLD) evaluating social functioning have used measures of parent and/or teacher ratings. The present study utilized parent and teacher ratings of behavior as well as executive functioning in addition to direct measures of social perception. Three groups participated in this study (control [n = 38] HFA [n = 36], NLD [n = 31]). Results indicated that the HFA group experienced the most difficulty understanding emotional cues on the direct measure while both the HFA and NLD groups experienced difficulty with nonverbal cues. Significant difficulties were reported on the parent rating scale for sadness and social withdrawal for both clinical groups. Executive functioning was found to be particularly problematic for the clinical groups. The direct social perception measure was highly correlated with the measures of executive functioning and reflects the contribution that executive functions have on social functioning. These findings suggest that the clinical presentation on behavior rating scales may be very similar for children with HFA and NLD. Moreover, it appears that measures of executive functioning are sensitive to the clinical difficulties these groups experience. The findings also suggest there is a commonality in these disorders that warrants further investigation.     

The Experience of Another Body on Our Body in Psychoanalysis: Commentary on Paper by Jon Sletvold

The current challenge of complexity requires that we overcome the mind–body dichotomy in order to find a more holistic way to explore human experience. Contemporary relational psychoanalysis tries to get past the overemphasis placed on language, and to include the development and promotion of a greater awareness of the bodily experience of the patient and analyst, with respect to their “bodies as they relate to each other.” We especially agree with Sletvold about the notion that psychoanalysis has a great deal to learn from the performing arts in terms of engaging in emotional communication and therefore of training the body to express emotions. This is true in particular for the “arts of time”: music, dance, acting. Unlike Sletvold, we keep the relational standpoint as a point of departure rather than as a point of arrival of processes. According to us, imitation is not the result of induction; rather it is a process whereby we discover and rediscover, that is, we find again the remains of the effects of another body on our body. In clinical praxis we should learn how to allow an ongoing dialectic between the implicit and the explicit. Finally, we underscore that we find the training program proposed by Sletvold original, innovative, and stimulating.     

The uses of moral ideas in the mastery of trauma and in adaptation, and the concept of superego severity

The power of moral ideas, here equated with superego strength, has been explained in increasingly complex terms over the course of the development of psychoanalysis. At first regarded mainly as useful in opposing oedipal instinctual demands, morality came to be seen also as opposed to aggressive wishes while at the same time capable of gratifying aggressive and libidinal forces. In this paper, I discuss the contribution to the strength of morality that comes from the effects of painful ("traumatic") experiences and from the use of moral ideas for social, adaptational purposes. In addition I consider the possibility that unchanging moral ideas can have changes in function in clinical work. A case is presented to illustrate these points.     

PSYCHOANALYSIS AS APPLIED AESTHETICS

The question of how to place psychoanalysis in relation to science has been debated since the beginning of psychoanalysis and continues to this day. The author argues that psychoanalysis is best viewed as a form of applied art (also termed applied aesthetics) in parallel to medicine as applied science. This postulate draws on a functional definition of modernity as involving the differentiation of the value spheres of science, art, and religion. The validity criteria for each of the value spheres are discussed. Freud is examined, drawing on Habermas, and seen to have erred by claiming that the psychoanalytic method is a form of science. Implications for clinical and metapsychological issues in psychoanalysis are discussed.     

Pluralistic approaches to the study of process and outcome in psychoanalysis. The LAC depression study: a case in point

Approaching process and outcome in psychoanalysis is a topic that touches on ambitious and complex epistemological and methodological issues. As discussed in the first part of the paper, in keeping with challenging epistemic considerations, it would seem appropriate to describe the specificity of psychoanalysis as a specific scientific discipline of the unconscious (spezifische Wissenschaft des Unbewussten, see LIT). Psychoanalysis, over its more than 100-year history, evolved a range of highly advanced research methods for investigating the specific object of its research, namely unconscious conflicts and fantasies. Hence, like many other scientific disciplines, contemporary psychoanalysis comprises a plurality of theories, methods of clinical treatments as well as a plurality of research topics. This position is discussed with reference to a model illustrating different forms of clinical and extra-clinical research in psychoanalysis. A major, ongoing comparative study of outcomes of psychoanalytical and cognitive behavioural, long-term treatments of chronically depressed patients, the so-called LAC-study, serves to illustrate the richness of contemporary research in psychoanalysis.     

Smaller splenium in children with nonverbal learning disability compared to controls,high-functioning autism and ADHD

The current study investigated morphological differences in the corpus callosum in children ages 8 to 18 years old with nonverbal learning disability (NLD; n = 19), high-functioning autism (HFA; n = 23), predominantly inattentive ADHD (ADHD:PI; n = 23), and combined type ADHD (ADHD:C; n = 25), as well as those demonstrating typical development (n = 57). Midsagittal area of the corpus callosum and five midsagittal anterior-to-posterior corpus callosum segments were examined using magnetic resonance imaging. Controlling for midsagittal brain area and age, no group differences were found for total corpus callosum area. This finding indicates that higher functioning children on the autistic spectrum do not have smaller corpus callosi as has been found in previous research with heterogeneous samples. Following segmentation of the corpus callosum, the NLD group was observed to have significantly smaller splenia compared to all other groups. Smaller splenia in the NLD group was associated with lower WASI PIQ scores but not WASI VIQ scores. Children with HFA were observed to have larger midbody areas than children with NLD and neurotypically developing children. Children with HFA and NLD demonstrated behavioral symptoms of inattention and hyperactivity similar to the ADHD groups indicating that corpus callosum differences seen in the NLD and HFA groups are not related to these behaviors.     

What are symbols symbols of? Situated action,mythological bootstrapping and the emergence of the Self

This paper addresses the question of how symbols should be understood in analytical psychology and psychoanalysis. The point of view examined focuses on the recent turn to more cognitive and developmental models in both disciplines and briefly reviews and critiques the evolutionary and cognitive arguments. The paper then presents an argument based on dynamic systems theory in which no pre-existing template or structure for either mind or behaviour is assumed. Within the dynamic systems model the Self is viewed as an emergent phenomenon deriving from the dynamic patterns existing in a complex system that includes the physiological characteristics of the infant, the intentional attributions of the caregiver and the cultural or symbolic resources that constitute the environment. The symbol can then be seen as a discrete, and in important ways an autonomous, element in the dynamic system. Conclusions are drawn for further research into the nature of the symbol with implications for both theory and practice in analytical psychology and psychoanalysis.     

The analytic setting today: using the couch or the chair?

This paper re‐visits Murray Jackson's 1961 paper in the Journal of Analytical Psychology, ‘Chair, couch and countertransference’, with the aim of exploring the role of the couch for Jungian analysts in clinical practice today. Within the Society of Analytical Psychology (SAP) and some other London‐based societies, there has been an evolution of practice from face‐to‐face sessions with the patient in the chair, as was Jung's preference, to a mode of practice where patients use the couch with the analyst sitting to the side rather than behind, as has been the tradition in psychoanalysis. Fordham was the founding member of the SAP and it was because of his liaison with psychoanalysis and psychoanalysts that this cultural shift came about. Using clinical examples, the author explores the couch/chair question in terms of her own practice and the internal setting as a structure in her mind. With reference to Bleger's (2013) paper ‘Psychoanalysis of the psychoanalytic setting’, the author discusses how the analytic setting, including use of the couch or the chair, can act as a silent container for the most primitive aspects of the patient's psyche which will only emerge in analysis when the setting changes or is breached.     

Infantile sexuality and Freud's legacy

The topic of sexuality and infantile sexuality, though less frequently discussed by psychoanalysis in recent decades, has received renewed attention for some years. The intention of this paper is to share some reflections around the role of infantile sexuality in our thinking, how we encounter it in our work with patients and in clinical material. Through reference to questions put forward by Freud (1905) in Three Essays, this paper takes into consideration some areas of the debate that has developed on the subject of infantile sexuality, starting from Freud's original intuition, including various hypotheses on the genesis of the sexual drive. The author will concentrate on two specific points. Firstly, how infantile sexuality – as a permanent dimension of the subject's existence – unfolds in the relationship and is deeply influenced by it. And that is how in childhood and adolescence, infantile sexuality ushers in parental sexuality – just as, in the case of our patients, infantile sexuality ushers in the analyst's sexuality. The second point pertains to the temporal dimension within which infantile sexuality is inscribed. The hypothesis that the author proposes is that infantile sexuality may be understood in the specific time of psychoanalysis [Nachträglichkeit], distinct and different with respect to the linear, evolutionary dimension.     

SPONTANEOUS “CURES”: NORMAN REIDER'S FORGOTTEN PAPER,PART II

Part I of this paper combined an introduction to Norman Reider's original 1955 paper with a republication of the paper itself. Part II is a discussion of the complexities of a comparison of past and present psychoanalytic literature. The concept of enactment is proposed as one of many possible alternative views in considering Reider's notion of spontaneous “cures.” A careful consideration of these spontaneous cures within the ordinary ups and downs of any psychoanalytic treatment sheds important light on our continuing confusion about how we define the term cure, and therefore about the nature of change during psychoanalytic treatment. This alternative perspective is only one of many plausible ones for present‐day readers. The purpose of this republication is not to propose an explanation for “what really happened” with Reider and his patients; rather, it is to reconsider the fallacy of evaluating his paper outside its historical context and thereby failing to appreciate his courage in presenting what at the time were radical views. Questions about the complexity and confusion regarding cure and change require reexamination of the neglect of epistemology on the part of psychoanalysis in prolonging the confusion about distinguishing psychotherapy and psychoanalysis.     

Restarting the Imagination,Refinding the World: A Discussion of “Activating Lifeness in the Analytic Encounter” and “‘What If’ Dimensions of the Analytic Field”

Quite different in focus and intent, these two papers address, each in their own ways, an emerging current running through contemporary psychoanalysis. In her paper, Peltz (this issue) outlines the contours of a paradigm shift, in which the question of dehumanization come to the fore. Peltz highlights the importance of a kind of engagement and posture that she describes in terms of the vitalizing presence of the analyst. In exploring what he calls the “what-if” dimension of the clinical field, Cartwright (this issue) re-conceptualizes the imagination in terms of how it frees us up for renewed experience of the vitality of objects. Both papers draw attention to the importance of catalyzing a renewed perceptual engagement with the world of objects in an age of detachment and psychical disenchantment.     

Feminism and Family Therapy

Feminism has had a profound effect on contemporary culture and on thinking in most academic fields, including psychoanalysis. Interestingly, until very recently it had made virtually no impact on the theory and practice of family therapy. This paper proposes an explanation for this peculiar phenomenon and argues that family therapy has been considerably handicapped by its insularity from the feminist critique. Utilizing feminist scholarship in psychoanalysis, history, and sociology, the paper analyzes the structural contradictions in family life that family therapists have essentially ignored and then outlines their clinical implications. Key points in the discussion include the argument that systems theory is an inadequate explanatory matrix from which to build a theory of the family, that the archetypal "family case" of the overinvolved mother and peripheral father is best understood, not as a clinical problem, but as the product of a historical process two hundred years in the making, and that power relations between men and women in families function in terms of paradoxical, incongruous hierarchies that reflect the complex interpenetration between the structure of family relations and the world of work. This conceptual model then provides the basis for an analysis and critique of sexual politics as they emerge in the prototypical clinical situation.     

The soul of psychoanalysis in the modern world reflections on the work of Christopher Bollas

The paper begins with the claim that psychoanalysis faces a dilemma in locating itself in a contemporary world that devalues experiences of interiority, depth, and embeddedness in personal history. Psychoanalysis's coming to terms with this modern world—reflected in contemporary relational paradigms and emphases on interaction, authority, and epistemology—is essential yet tends to replace an outdated conformity with an updated one, in which what is offered to analysands may become limited and the soul of psychoanalysis lost.

Bollas's work attempts to reinspire psychoanalysis. This paper explores his contributions and the tensions within them and develops several points about how psychoanalysis can maintain a worthwhile self—for itself and for its analysands—in the modern world. Among the issues discussed are the sense in which an endogenous motivational core associated with an emphasis on interiority may be compatible with a relational paradigm and how the notion of personal idiom is a rich and fruitful one, but that the cultural field deserves a more fundamental place than it is given by Bollas. The problem of authority and exploitation, within and outside the consulting room, is also taken up, and it is argued that psychoanalysis should be conceived as a moral discourse in which the analyst's self‐subverting (but not diminished) authority is essential.     

Heidegger and Post-Cartesian Psychoanalysis: My Personal,Psychoanalytic, and Philosophical Sojourn

The dual aim of this article is to show both how Heidegger's existential philosophy enriches post-Cartesian psychoanalysis and how post-Cartesian psychoanalysis enriches Heidegger's existential philosophy. Characterized as a phenomenological contextualism, post-Cartesian psychoanalysis finds philosophical grounding in Heidegger's ontological contextualism, condensed in his term for the human kind of Being, Being-in-the-world. Specifically, Heidegger provides philosophical support (a) for a theoretical and clinical shift from mind to world, from the intrapsychic to the intersubjective; (b) for a shift from the motivational primacy of drives originating in the interior of a Cartesian isolated mind to the motivational primacy of relationally constituted affective experience; and (c) for contextualizing and grasping the existential significance of emotional trauma, which plunges us into a form of Being-toward-death. Post-Cartesian psychoanalysis, in turn, (a) relationalizes Heidegger's conception of finitude, (b) expands Heidegger's conception of relationality, and (c) explores some ethical implications of our kinship-in-finitude.     

Harsh Conditions/Loving Work: Relational Psychoanalysis Expands Its Reach: Commentary on Panel

In these three essays Lazar, Swartz, and Doñas deconstruct a clinical moment that was, in their view, braided with the sociopolitical, as well as with the relational and the intrapsychic. In these bruisingly original discussions, the authors demonstrate how they held the tension between the intimate and the global, and how relational psychoanalysis remains an arduous practice but is also a gift.     

Couple Psychoanalysis in the United Kingdom: Past,Present, and Future

ABSTRACT

The evolution of couple psychoanalysis in the United Kingdom is historically rooted in, and currently supported by, what might be called the Tavistock tradition, which principally derives from the work of Tavistock Relationships, a London-based organization combining clinical practice, training, and research. Practitioners working within this tradition draw on a range of psychoanalytic theories and differ in the ways they are applied in clinical practice and with different client groups, but they are united by their focus on relationship dynamics and how these can be affected by unconscious processes. This article charts how the main ideas and practices associated with the Tavistock tradition of couple psychoanalysis came into being, describes the conceptual building blocks that provide the platform for current training and practice, and identifies nodal points that might indicate directions of growth in the future.     

The session of the two dreams

Abstract :  Through the discussion of the clinical material the author tries to show how numerous aspects of traditional Jungian analysis are close to several theoretical and clinical developments of Relational Psychoanalysis. A short introduction about relational psychoanalysis is given. The relational aspects of Jungian theory and praxis are underlined. If we refer to these theoretical constructs, it becomes possible to work in an original way and think of the clinical setting as different from the classical Freudian one, without abandoning Jungian tradition.