Organizational Structure and the Establishment of Psychoanalytic Identification: Commentary on Paper by Randall Lehmann Sorenson

This commentary addresses two themes: parallels between religious and psychoanalytic education and the question of group survival in a world of competitive groups, whether religious (“strict” vs. “weak”) or psychoanalytic (differing psychoanalytic approaches). “Strict” religious education involves teaching both critical thinking and identification with the particular religion. This blend of critical thinking and identification with psychoanalysis is crucial in psychoanalytic education. We want to graduate students who see themselves as psychoanalysts rather than as being “interested” in psychoanalysis. This goal is accomplished when students have close, positive experience with personal analysts, supervisors, and teachers who are strongly committed to psychoanalysis but in a manner that encourages students to think critically and find their own psychoanalytic perspective. With regard to the second theme, I discuss how our narcissistic commitment to one or another psychoanalytic model interferes with open integration of new insights. Individual analysts privately integrate competing ideas in their own idiosyncratic ways. When these individuals publicly represent competing psychoanalytic groups, however, they tend to emphasize differences among these groups. They then find ways to appropriate new ideas as extensions of their own evolving tradition. In this way, a theoretical school is able to integrate new developments while preserving its own identity.     

Beyond illusion: Psychoanalysis and the question of religious truth1

In this paper the author critically examines the nature of the positive, reconciliatory attitude towards religion that has become increasingly prevalent within psychoanalytic thinking and writing over the past 20 years. She shows how this positive attitude rests on a change in the nature of the prototype of religion and its reassignment to the realm of illusion, thus making irrelevant an issue most central both to psychoanalysis and to traditional Judeo‐Christian belief ‐ the passionate search for truth. The author demonstrates how the concern with truth, and specifically with the truth of religious claims, lies at the basis of the opposition between psychoanalysis and religion but, paradoxically, also provides the common ground for dialogue between the two. She argues that, as Freud developed his ideas regarding the origin of conviction in religious claims in his Moses and monotheism (1939), the nature of this common ground was expanded and the dialogue became potentially more meaningful. The author concludes that meaningful dialogue emerges through recognition of fundamental differences rather than through harmonisation within a realm of illusion. In this light, the present study may also be seen as an attempt to recognise fundamental differences that have been evolving within psychoanalysis itself.     

Regression,Self State Work,and the Developmental Perspective: The Application of Diverse Theoretical Perspectives to Working with Trauma

This paper explores the ways in which the author makes use of ideas associated with diverse theoretical perspectives in working with patients who have suffered trauma. A detailed vignette contributed by Dr. Rina Lazar serves as a point of departure for the author’s consideration of how theories of regression and self-states inform a developmental perspective, and are applied in the clinical psychoanalytic situation.     

Mutual Regulation,Mentalization, and Therapeutic Action: A Reflection on the Contributions of Ed Tronick to Developmental and Psychotherapeutic Thinking

This article celebrates Ed Tronick’s contribution to psychodynamic developmental psychology. Tronick’s ideas have implicitly and explicitly influenced late 20th-century and early 21st-century psychoanalytic thinking, and his contribution is here acknowledged in relation to the work on the developmental ideas concerning mentalizing. Tronick’s (1989, 2007) mutual regulation model (MRM) is outlined and examined from the point of view of the attachment-theory-based mentalization model of interpersonal interaction and psychopathology. The article identifies common ground between clinical implications of Tronick’s MRM and the mentalization model as independent but complementary ways of expanding ideas originating in attachment theory, and highlights ways in which the MRM provides greater clarity for several concepts which are frequently used in writings about mentalizing such as the background of safety and the holding environment.     

The ecological imagination

This paper offers a psychoanalytic exploration of meaning within the concept of ecology. From a starting point in the experience of primal anxiety, originating in the work of Freud, Jung and Klein, links are made to cultural themes through a developing comparison of case studies in literature, mythology, the public sphere and clinical practice. It is argued that the application of psychoanalytic ideas to environmental concern has validity. The idea emerges that individual and public attitudes to our environment might be open to positive change through an appreciation of the concept of early anxiety, currently available to us in work of the imagination.     

Supervision and Analysis at a Crossroad: The Development of the Analytic Therapist: Discussion of Papers by Joan Sarnat and Emanuel Berman

This discussion of papers by Sarnat and Berman on psychoanalytic supervision explores the complex nature of the contemporary psychoanalytic supervisory relationship. It considers how developments in psychoanalytic theory and practice, reflecting relational, intersubjective, attachment, and field theory influences over the past 30 years, have changed the ways in which many analysts practice and theorize supervision. Contemporary supervisors attend not just to the patient being presented, or to the therapeutic dyad, but to the supervisory relationship itself as part of the clinical/supervisory frame of reference. Similarities and differences between therapy and supervision are considered.     

Childhood and Trauma

In this paper, I follow the evolution of the concept of trauma within psychoanalytic theory, and some of the effects of this evolution. Starting out from the point where Freud gives up the theory of trauma as the cause of neurosis in 1897, and the alleged reasons for such a change, I analyze the theoretical and clinical consequences of this change within psychoanalysis. I proceed to develop Ferenczi's ideas on trauma, their relevance to present-day psychoanalytic theorizing and practice, as well as for the understanding of the psychic processes in children, tracing the development of some of these ideas in contemporary psychoanalytic thinking.     

TRANSFERENCE‐FOCUSED PSYCHOTHERAPY AND MENTALIZATION‐BASED TREATMENT: BROTHER AND SISTER?

Transference‐focused psychotherapy and mentalization‐based treatment are new psychoanalytic treatment forms for borderline patients. How do these forms of treatment differ and how are they alike? What interventions do they yield in clinical practice? In the past few years two methods of psychoanalytic treatment for borderline patients have been developed: transference‐focused therapy and mentalization‐based treatment. This paper explores the similarities and differences between them, with a special focus on how the different theories lead to different interventions in clinical practice. TFP takes the central problem to be the disorder in object relations, while MBT focuses on the self as agent. Further differences concern notions of the role of aggression, the presence of mental representations and the position of the therapist. Interventions formulated by therapists of both frames of reference in response to some therapy fragments differed substantially. Both theories share a desire to develop a psychoanalytical technique suitable for borderline patients, and both stress the central importance of the handling of the transference and of working in the here‐and‐now, as well as the necessity for effect research.     

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.     

Reclaiming the rubbish: A study of projective mechanisms

Projection is a defence mechanism involving the expulsion of unwanted or unbearable parts of the personality, which are then located in others and thereby disowned. My aim in this essay is to explore the development of theoretical ideas about projection, and how they have affected contemporary theories of psychoanalytic practice. I shall illustrate the application of some of these ideas using two case examples.     

Unformulated experience,dissociation, and Nachträglichkeit

The paper is divided into two parts. The first part is an interpersonal/relational psychoanalytic account of some relationships between dissociation, time, and unformulated experience. Trauma, and the dissociation to which trauma leads, freezes time, which makes it impossible to formulate certain kinds of new experience. Instead, potential new meanings remain unformulated. The route of clinical access to frozen time is the interpersonal field: to thaw time and allow new experience, the ways in which the interpersonal field is itself frozen need to be addressed. A clinical illustration of these ideas is offered. The second part of the paper presents and explores a point of confluence between the views in Part 1 and certain aspects of French psychoanalysis, with particular reference to the concept of Nachträglichkeit in the work of Jean Laplanche and Haydée Faimberg.     

The French model of psychoanalytic training: Ethical conflicts1

Research on psychoanalytical education within the IPA may be clarified by reflecting on the ethic behind each of the three main models (Eitingonian, French and Uruguayan). In fact, the ethic underpinning psychoanalytical education, whatever the model, is confronted by irreducible conflicts between transmitting psychoanalysis by means of analytical experience or by means of academic teaching. Transmission by experience is essentially based on the ethic of psychoanalytic practice, which is difficult to regulate through institutional standards, whereas the academic aspect can be evaluated by objective and public criteria. The importance of both aspects and their relative weight in the training process depend on the conception of psychoanalysis underlying each model. This paper will look primarily at the French training model, the essentially analytical aspects of which favour the transmission of the very ethical foundations of psychoanalytic practice itself: the application of the method both as a working tool and as a tool of evaluation. It presupposes expanding the observation and analysis of transference beyond the framework of treatment to that of supervision. From this analysis, the paper will attempt to demonstrate how the French model proposes dealing with the inevitable conflicts between transmission by means of analysis and training by means of apprenticeship.     

Catalysts for psychic change: Perspectives from contemporary psychoanalysis

This paper was given as the inaugural ‘Ellen Noonan Counselling Lecture’ on 3 July 2007, at Birkbeck College, University of London, and I have retained some of the spoken style of the original lecture. Since the 1960s, psychoanalytic models of change and growth have in themselves undergone radical changes. The aims of psychoanalytic and psychodynamic work are now less tied to a model of ‘health’ or ‘normality’ and more linked into processes that enable people to keep developing throughout life. The lecture examines some of the new theories of psychic change and growth from the contemporary Independent, Lacanian and post-Kleinian schools of psychoanalysis and, using clinical illustrations, explores the implications of these new theories for psychodynamic practice.     

Psychic phenomena and early emotional states

This paper examines the relationship between severe early trauma and the development of psychic intuition. A case presentation with extensive dream work helps to illustrate this connection by exploring the psychological meaning of one patient's acute receptivity to unconscious communications. The paper includes a historical overview of Freud's attitudes toward occultism, as distinct from later psychoanalytic views, including those of Wilfred Bion. Many of Bion's views have more in common with Jung's perspective than with Freud's, with particular reference made to spiritual and religious differences. Bion clearly states that Freud and psychoanalysts have focused on phenomena, not on noumena, which Bion considers to be the essence of the psychoanalytic point of view.     

Ferenczi and Winnicott: Searching for a “Missing Link” (of the Soul)

The aim of this paper is to present the close link between Ferenczi's and Winnicott's theoretical, clinical and therapeutic thought, indicating how this link has become something of a “missing link” in the history of psychoanalytic ideas, an implication which we retain, in part, to this day. In the first part entitled “Who's speaking to whom?”, I aim to explore the contents of the most essential parts of their messages, stressing the similarities and differences between them, and citing the most important authors whom they address (Freud for Ferenczi, Klein for Winnicott). In the second part, I aim to tackle the general direction underlying both their work and their lives, concentrating specifically on “the maternal”, and examining the repercussions of this aspect on psychoanalytic technique and practice. In the third part, as a kind of “Parting”, I will present further brief conclusions on the relevance and significance of their thoughts in modern day psychoanalysis, defining Ferenczi and Winnicott as “founders of future discursiveness”.     

Grounded Theory methods in child psychotherapy research

This article considers the place of qualitative research in psychoanalysis and child psychotherapy. It discusses why research methodology for many years occupied so small a place in these fields, and examines the cultural and social developments since the 1960s which have changed this situation, giving formal but also qualitative methods of research much greater significance. It reflects on the different pressures to develop explicit research methods which arise both from outside the psychoanalytic field, as a condition of its continued professional survival, and from within it, where its main aim is the development of fundamental psychoanalytic knowledge. It suggests that the conduct of mainly quantitative research into treatment outcomes is largely a response to these external pressures, whilst the main benefits to be gained from the development of qualitative research methods, such as Grounded Theory, are in facilitating the knowledge-generating capacities and achievements of child psychotherapists themselves. The paper describes Grounded Theory methods, and explains how they can be valuable in the recognition of hitherto unrecognised meanings and patterns as these are made visible in clinical practice. Finally, it briefly describes three examples of completed doctoral studies, all of which have added significantly to the knowledge-base of child psychotherapy, and which demonstrate how much can be accomplished using this method of research.     

Psychoanalysis and the Body–Mind Problem

In this paper I have tried to clarify some of the differences between on the one hand ordinary doubts and uncertainties that are part and parcel of the psychoanalytic process, and on the other hand the sort of doubt that Socrates called 'aporia', that is, philosophical and conceptual. I have described one point at which philosophical doubt may creep into psychoanalytic thinking on body/mind issues. I presented a psychoanalytical model of the mind, based largely on Bion and Anzieu, in which mind is seen to be emergent from a body–mind nexus, to which we may, under pressure, regress. I elaborated this by reference to an example of my own somatisation, and to Anzieu's theory of a skin ego. Finally I made some comparisons between philosophical solutions to anxieties arising both in the mind/body area and in general epistemology, and psychoanalytic approaches to similar anxieties in life.     

Is transference the ‘total situation’?

This paper examines through the detailed explication of analytic material the author's experience of a psychoanalytic and a Jungian way of understanding the interactions between him and his patient. This comparative approach considers where the differences lie with respect to timing and content of interpretations and where the differences are essentially tactical rather than theoretical.     

A third language in therapy: deconstructing sameness and difference

The paper draws on recent research and the first author’s personal story to show what happens when the language difference between therapist and client is brought to mutual awareness in the therapy room. Individual lived experiences of migrant psychotherapists and counsellors and the issues that arise in therapy practice when the practitioners use their second language as the means of communication with clients are explored. The notion of a third language – a dynamic communication system that is a result of developing a professional identity through a second language – is introduced. Unlike the psychoanalytic third, it is often conscious and may be used either defensively or purposefully as a concrete third point of reference in the intersubjective encounter. The paper explores how the concept of a ‘Third Language’ can be used as a tool to negotiate perceived sameness or difference in therapeutic encounters and to build a common language with a client, both literally and metaphorically. The study featured in the paper has implications for practice, theory and research.