Psychoanalytic Couple Therapy: Classical Style

In this essay, the core concepts of psychoanalysis are set forth as the context for the application of classical psychoanalytic theory to the practice of couple therapy. Infantile sexuality and aggression are shown to have a powerful role in the interpersonal lives of family members. The repetition compulsion structures marital interaction and intergenerational dynamics. The intrapsychic emphasis of classical ego-psychology is viewed in the interpersonal arena, and the author suggests adding to the Oedipus and Narcissus myths a myth that resonates with this shift in emphasis. In introducing the “Pygmalion–Galatea process,” the author captures the universal attempt to change the psychic dynamics of the other or others. This ultimately mutual process begins with the infant's mirroring of its caretakers—which includes language acquisition. Much of human interaction is fueled by subsequent attempts to create others in our own images of them and by their reactive compliance or resistance to that dynamic. Three case illustrations are presented to show how these phenomena manifest themselves in marital interaction and in dreams.     

Group Processes in Family Therapy: a Psychoanalytic Approach

This paper describes a model of family therapy that draws on experiences and theories of psychoanalysis as applied to individuals and groups. It suggests concepts that help to understand and work with the family as a system. A brief example is given to illustrate the effort to engage with the patients' immediate feelings in the session in relation to each other and the therapist.     

The Dream and the Image: Creative Transformations in Psychoanalytic Space

The American Journal of Psychoanalysis - Psychoanalysis is a transformational process through which meanings become visible and foreclosed identity may be further constituted. Winnicott (1971)...     

Psychoanalytic Theory and the Rorschach (Book)

The purpose of this study was to explore how Mexican American adolescents (N = 120) would perform on the MMPI-A given that Hispanic adolescents were seriously underrepresented in the national norming sample during the development of the MMPI-A. The participants completed the MMPI-A, a short demographic questionnaire, and a 5-item version of the Acculturation Rating Scale for Mexican Americans. Results indicated that the present sample of Mexican American adolescents' performance on the Validity, Clinical, and Content scales differed minimally from the national norming group's performance, and their performance varied as a function of their levels of acculturation and socioeconomic status. Implications of these data are discussed.     

Medicating Patients in Psychoanalytic Therapy: Implications for Introjection,Transference, and Countertransference

If a patient comes for psychotherapy or psychoanalysis, why medicate him with psychotropic drugs? The answers to this question are explored and addressed from several points of view. The central hypothesis of this paper suggests that most of the reasons for medicating patients have to do with therapist's unresolved countertransference issues. Furthermore, medicating a patient may have deleterious effects on his introjected sense of self, and impacts the transference relationship in a significant way. The issues surrounding medication as adjunctive therapy are elucidated and clarified in terms of rationale, efficacy, and the impact on the psychotherapeutic relationship. Psychoanalytic solutions are offered and discussed.     

Chronic Eating Disorders in Therapy: Clinical Stories Using Family Systems and Psychoanalytic Approaches

This paper presents three pieces of work, all focused around a person presenting with a long history of disordered eating patterns. One treatment was a couple therapy, one a family plus individual therapy and the third a purely individual therapy. The three different psychotherapies demonstrate an approach which uses psychoanalytic as well as family therapy thinking and techniques. The material is offered to show examples of the clinical practice within which individual and couple or family therapy constitute a range of psychotherapeutic responses to people and, in particular, to people with eating disorders. The context of the therapy is described in some detail as it accounts for many features of the treatments, for example, that they are justified within the institution by having been subject to empirical investigation. A metaphor, that of the medieval castle, is offered as an evocation of the experience of the person that is relevant in the practice of both individual and family therapy.     

Low-Income Families With Potential Adolescent Gang Involvement: A Structural Community Family Therapy Integration Model

The purpose of this article is to propose a community structural intervention for low-income families who present to therapy with the concern of an adolescent at risk for gang involvement. Families are affected by multiple interacting systems. In congruence with systems theory, changing a part of the system will essentially affect the interrelated parts of the system. The proposed intervention utilizes structural family therapy and community family therapy as a model to impact change at the family system, its interrelated systems, and the system at which the family is embedded.     

Psychoanalytic Models of the Mind for Couple and Family Therapy

This paper describes an object relations theory of mind that highlights the interactive origin of psychic function and the beginnings of mental structure in the infant's relationships within the family group. Based on this model, psychoanalytic family and couple therapy employs the interactions between family and therapist to detect and work with developmental failures in holding and containment, skewed family projective identification, and attacks on linking, which characterize pathological and traumatized families. The coming together of transference generated by the family as a group and the therapist's countertransference are the fulcrum on which such therapy turns. An extended vignette of a session is used to illustrate the application of object relations theory to the therapeutic process of family therapy.     

Recent Developments in Psychoanalytic Child Therapy Edited by Joseph Weinreb

This article provides an annotated summary of 26 different procedures potentially useful in analyzing group therapy process, and includes an overview of therapeutic themes, research issues and clinical implications. The goal is to familiarize clinicians and researchers with the range of standardized and semistandardized procedures available for studying group interactions that have appeared in the literature during the past several decades. The authors concentrate on observer rating systems and do not systematically review self-report instruments. It is argued that the application of objective rating systems may foster greater understanding of group therapeutic interactions than is generally possible through normal clinical observations.     

Function(s) of Religion in the Contemporary World: Psychoanalytic Perspectives

With respect to our psychoanalytic frame of reference allowing us to study the extent of the hypotheses concerning the religious phenomenon as formulated by Sigmund Freud and Jacques Lacan, in the context of a cross approach between the accuracy of the concept of conversion and of psychic mechanisms or phenomena at stake within conversions, and based on the testimonials of subjects acknowledging themselves in the experiment of conversion, we try to understand if and how religion is anchored in our cultural era through subversive effects it may have on the subject.     

Sexual Contact Between Psychologists and Their Former Therapy Patients: Psychoanalytic Perspectives and Professional Implications

Data was analyzed from the semi-structured interviews of 6 heterosexual male psychoanalytic psychotherapists who by self-report had not engaged in a post-termination sexual involvement. The focus of each interview was to elicit the participants' views about sexual contact between psychotherapists and their former therapy patients, as well as their related attitudes towards Standard 4.07 of the APA Ethics Code (1992). The results suggested great disparity of opinion regarding what might constitute acceptable, ethical behavior in this domain. Nonetheless, all the clinicians agreed that the potential for harm resulting from post-termination sexual involvements was great, They all shared the beliefs that transference did not resolve with termination, that professional responsibilities continued after treatment ended, and that power differentials between therapist and patient lingered, perhaps in perpetuity. However, it was determined to be premature to replace the current Standard 4.07 with an absolute prohibition against sexual involvements between therapists and their former patients.     

Freud's Views and the Contemporary Application of Hypnosis: Enhancing Therapy Within a Psychoanalytic Framework

Freud's theoretical writings on hypnosis are reviewed and reasons for his abandoning of this clinical tool are suggested. Clinical hypnosis is an altered state of consciousness which has its own felt reality and does not bypass the ego. In fact, many of the essential characteristics of hypnosis are ego functions. Functions such as focused or free-floating attention, deep absorption, enhanced memory, imagery, ego-receptivity, ego-activity, defenses, and the capacity for self-observation all remain intact in hypnosis. This view is contrasted with Freud's early uses of hypnosis which were not informed by his later psychoanalytic discoveries. Clinical material is presented which illustrates how the conversion from a psychoanalytic psychotherapy to a hypnoanalysis resolved a therapeutic impasse and allowed for a productive treatment. Fromm's view of hypnosis, as a special form of adaptive regression in the service of the ego is clinically illustrated. It is postulated that the altered state of hypnosis facilitates an increased ego mobility. It is the psychic mobility of hypnosis which facilitates the vacillation between primary and secondary process thinking; the experiencing ego and the observing ego, and conscious and unconscious experience. It is largely the ego-mobility and available memory in hypnosis that account for its advantages as compared to non-hypnotic treatment. Relational and self-psychological components of hypnosis are also proposed.     

The Importance of Gender in the Psychoanalytic Relation (Discussion)

Abstract

The Importance of Gender in Psychoanalytic Relations (Discussion). Int Forum Psychoanal 1992;1:32-36. Stockholm. ISSN 0803-706X

Patients assimilate the analyst's gender, appearance, age and the prevailing cultural climate into the transference. Differences in gender between analyst and patient may stir up a variety of social conventions, stereotypes and characterological ways of relating to same or different gendered people. Analytic inquiry must focus on the patient's invariant organizing principles, the themes along which a person organizes his or her experience. Two papers presented at the August, 1991 meetings of the International Federation of Psychoanalytic Societies, that addressed the effect of the gender of each of the participants in the analyst-patient relationship are discussed.     

Identity and Therapy in the Black Community

Counselors working in the black community must understand the special problems of black people in discovering and affirming their identity. Black Power, proclaiming the integrity of the black community, has special relevance for black people in search of an identity. Counselors cannot ignore the new self-awareness which many black clients bring to counseling. An approach to counseling black clients is suggested, and some techniques are reviewed that may facilitate their full freedom. The role of the white counselor may be one of supervisor of lay therapists in the black community or change-agent and interpreter in the white community.     

Evaluating Marital Therapy: A Hospital and Community Study

The study investigated the application of marital therapy using three contrasting clinical approaches: conjoint treatment, couples groups, and treating the partner alone. Thirty-six couples comprised the research sample, with eighteen couples being treated in each of two NHS treatment settings. The duration of the treatment was ten weekly sessions each lasting one hour, and couples were followed up six months after termination. Outcome evaluations included marital satisfaction, sexual adjustment, and an assessment of target problems. The analysis of the results showed no significant difference between groups at the post-treatment and follow-up assessments. There was, however, a significant difference in the rates of change between experimental groups. The implications of these results are discussed.