The Penn Psychoanalytic Treatment Collection: a set of complete and recorded psychoanalyses as a research resource

From a set of seventeen complete and tape-recorded psychoanalyses, a sample of findings is presented: (a) the level of agreement of two clinical judges on the psychological health of these patients is adequate for the late sessions, but not for the early sessions; (b) the amount of change during psychoanalysis appears to be similar to that in the Menninger Foundation Psychotherapy Research Project; (c) psychiatric severity measures from the early sessions can yield a significant level of prediction of the later benefits from psychoanalysis. Finally, further research uses of this collection of psychoanalyses are suggested.     

The American Psychoanalytic Association: a decade of change

The American Psychoanalytic Association in the last decade has undergone the most extensive organizational changes in its history. Efforts at inclusion, outreach, and democratization have halted a decline in candidates, active members, and cultural influence and led to a vibrant, growing organization, as new professional groups have gradually been included in the association's training programs. The goal of increasing training opportunities for minority candidates has only partially been achieved. A recent effort to offer affiliate status to psychotherapists and students has begun, though with modest results. Alliances with otherpsychoanalytic groups have led to creation of the Psychoanalytic Consortium and steady progress toward external accreditation of institutes and licensure of psychoanalysts. In the interest of unification there is a need to develop pathways of affiliation and membership for independent institutes and societies that desire to join the association. Democracy has in large measure already been enhanced at the national level. Deliberations are now transparent, and an invigorated Executive Committee willingly shares power with the Executive Council. Candidates now are deeply involved in the governance of Board and Council and their committees. But only when all members and candidates enjoy full voting rights and all members are able to serve as officers and Executive Councilors will the decades-long effort to democratize the association be concluded.     

A Psychoanalytic Contribution to Psychic Vampirism: A Case Vignette

The American Journal of Psychoanalysis -     

Discussion: Application of Psychoanalytic Developmental Understanding to Three Early Intervention Programs

Discussion is made of the application of psychoanalytic developmental understanding to three early intervention programs. One program that was highly ambitious in its aim of preventing aggressive behavior in children attending elementary school was effective but may have attempted to achieve too much. One, involving an assistance program in a public school for boys who had lost their fathers, was extremely successful in helping the boys to express and deal with their feelings verbally rather than through undesirable behavior. The third program provided services for very young children that developmentally were extremely useful to them. Discussion is made of the value of these programs not only to the children involved but also to the teachers and mental health care personnel who worked with them.     

Adult Attachment Interview and Psychoanalytic Perspective: A Single Case Study

In this single case study we present a female patient diagnosed with a narcissistic personality disorder and a borderline organization. The interplay between attachment and psychoanalytic perspective will be focused. The analyst describes his impressions of the initial interview with the patient and essential steps during treatment. The patient was interviewed with the Adult Attachment Interview and classified as “insecure preoccupied” with an “unresolved state of mind” concerning loss and abuse. The analyst was asked to comment the AAI's essential characteristics of this patient. We discuss converging and diverging aspects of clinical and attachment interpretation in this single case.     

A Relational Psychoanalytic Model for Case Management: A Literature Review

Abstract

Relationship building is critical in case management with the seriously mentally ill. A theoretical framework, such as relational psychoanalytic theory, with a strong integrative emphasis provides a structure for the complex interplay of internal and external factors/forces in case management. The purpose of this paper is to provide a literature review in the area of case management: relational psychoanalytic theory, relationship building and psychodynamic theory. The review concludes outlining the appropriateness of this theoretical framework for case management.     

Psychoanalytic Interpretation of Superego Functioning Following CS Readministration Procedures: Case Illustration

The Comprehensive System (CS; Exner, 2003) has specific procedures to address brief Rorschach protocols when the first administration yields fewer than 14 responses. These procedures involve the assessor's asking the client to retake the test by providing more responses on the second administration than the first administration. The request carries with it an implicit criticism of the client's initial effort and a mandate to improve performance on retake. The retake request, with its ambiguously worded demand for improved performance, engages the client's superego (i.e., the client feels judged) and makes it possible to study superego manifestations (e.g., guilt, shame) on the Rorschach test, using a model of (a) brief first record, (b) retake directive, and (c) second administration. We present a case that illustrates a clinical strategy, modeled on a psychoanalytic understanding of the CS retake procedure, for studying the client's superego functioning under retest conditions.     

On the Psychoanalytic Treatment of the Depressive Personality

In order to discuss the depressive personality we have first to distinguish between this clinical entity and other types of depressive psychopathology that might also be chronic. The character traits and psychodynamics of the depressive personality confirm that there is a special group of patients, who belong to a depressive disorder continuum. The particular technical problems that depressive personality present are: (1) the inability to enjoy anything and the consequences of this on the therapist's experience and interventions, and (2) the negative therapeutic reaction which threatens the analytic process and the therapist's competence. If we combine transference/extratransference interpretations with an "empathetic understanding" approach to systematic confrontation and interpretation, we can therefore justify the need for a slightly modified psychoanalytic technique in the treatment of the depressive personality.     

Psychoanalytic developmental theory: a contemporary reconsideration

Psychoanalytic developmental theory has never enjoyed a broad consensus among psychoanalytic thinkers. In today's postmodern era, its relevance and basic premises are even more in question as a legitimate part of psychoanalytic theorizing. Part of the problem has been (1) the serious errors perpetrated historically in the name of psychoanalytic developmental theory and (2) its current state of disarray in the wake of piecemeal efforts to rectify these errors. Nonetheless, its presence is discernible in every psychoanalyst's theory and clinical work, whether or not it is acknowledged or brought into a cohesive theoretical frame. The point of view of "intersubjective ego psychology" (Chodorow 2004), embraced by a growing number of analysts interested in development, offers a more flexible and inclusive paradigm for psychoanalytic developmental thinking in order to preserve its rightful place in contemporary psychoanalysis.     

How Psychoanalytic Thinking Lost its Way in the Hands of Men: The Case for Feminist Psychotherapy

A feminist stance is adopted to challenge the androcentric nature of many of the concepts which lie within the tradition of male psychoanalytical thinking. Such thinking steadfastly refused, and largely still refuses, to acknowledge the social reality and consequences of women's experience of living in a patriarchal society. It is argued that psychoanalytical theory has construed women as inferior and is wholly revealing of what men expect and want women to be. Any psychotherapy based solely within that tradition thus plays its part in the oppression of women. Two concepts from analytical psychotherapy, transference and counter-transference, are used as specific examples, and some contrasting researches advanced by feminist psychotherapy are outlined.     

The Meaning of Empirically Supported Treatment Research for Psychoanalytic and Other Long-Term Therapies

Two ways of evaluating the implications of empirically supported treatment research for psychoanalysis and other long-term therapies are considered. The first involves the comparison of the relative benefits of various psychotherapies; the second involves the comparison of short-term and long-term psychotherapies. The major findings are that (a) each of the different types of psychological treatments shows benefits, (b) the amount of benefits from each type of therapy shows mainly nonsignificant differences, (c) these nonsignificant differences are especially evident when the researcher's therapeutic allegiance is taken into account, (d) both short-term and long-term treatments show some positive benefits for some patients, and (e) there is a tendency for longer treatments to show more lasting benefits. The main gap in research studies consists of a lack of comparative studies of psychoanalysis versus other treatments. This review highlights the virtue of “methodological pluralism,” which means here applying to the same data a variety of methods for comparing psychotherapies with one another and for comparing long-term and short-term psychotherapies.     

The Quest for a Unified Psychoanalytic Theory: A Retreat from Uncertainty

There has been a historical shift in psychoanalysis from an earlier time of certainty to our present state of uncertainty with the coexistence of multiple theories competing for our attention. We realize retrospectively how entrenched groups ruled our institutions by maintaining faith in their authority as the keepers of “pure” psychoanalysis. Despite struggles between competing ideologies, there has been progress in integrating clinical theories. As no psychoanalytic theory or technique has been proved superior, we advocate an inclusive approach with all psychoanalysts keeping an open mind about the value of competing theories. This integration of disparate theories has led to a resurgence of interest in psychoanalytic training. Examples are given of some of the difficulties encountered when competing ideas are introduced in psychoanalytic groups.     

Psychoanalytic aesthetics: a defense and an elaboration

Psychoanalysis provides a middle ground that synthesizes opposing views in aesthetics. The opposition in question is between those who would assign primary importance to form in art and those who would assign it to content. Psychoanalysis can offer a psychological elaboration of the aesthetics of catharsis first set out by Aristotle. And it is in this tradition that psychoanalytic theory should be placed. Although Freud emphasized the thematic, emotional, and pleasure yielding aspects of the aesthetic experience, an elucidation of the aesthetics of form is inherent in and consistent with the basic findings of psychoanalysis.     

ARTICLE WITHDRAWN: The Social Determinants of Psychoanalytic Therapy

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A Mixed Bag: The Realities of Psychoanalytic Practice

For a variety of reasons, psychoanalytic training is done in somewhat of a vacuum. It teaches a theory and a way of practicing that does not always translate well to day-to-day private practice work. The clinical realities of psychoanalytic practice prove the psychoanalytic method to be one that provides help to a wider audience than classical psychoanalytic training programs might suggest. The psychoanalytic approach offers the analyst many special opportunities to work with and help a wide variety of patients. Analysts who accept both the limitations as well as the wide application and broad benefits of the psychoanalytic approach may have a more fulfilling experience than their training experiences might foster. At the same time, the analyst's level of therapeutic skill, the patient's diagnosis, and many multiple external factors create different limitations in the practice and outcome of psychoanalytic work. Extensive case material is used to show the broad range of patients who are helped by the psychoanalytic method. The clinical material also shows the less than perfect, but often good enough outcomes of these difficult cases with often severely disturbed patients.