The empirical foundations of psychoanalytic approaches to psychological testing

The view that psychoanalytic approaches to psychological testing lack empirical foundations is disputed by systematically examining the ways in which psychoanalytic theory expands the sources of data available to the psychological tester at each step in the assessment process. The contention is made that it is unscientific to restrict the concept of what constitutes scientific rigor to formal experimentation with statistical analysis.     

The wonderful adventures of Nils: or Taking leave of childhood

The relationship between neuroscience and psychoanalysis is studied by taking “the new mechanism of neuroscience” under scrutiny. That new trend stresses that neuroscientific explanations are mechanistic explanations in particular. Since the issue of psychological mechanisms lies at the core of psychoanalysis, it is crucial to study the relationship between neural and psychological mechanisms. The authors argue that neuroscience cannot verify psychoanalytic theories. However, by combining neuroscientific and psychoanalytic (psychological) viewpoints, it will be possible to approach a more holistic picture of psychological phenomena, here suggested by a new conception of defense mechanisms.     

The impact of theory on psychological testing: how psychoanalytic theory makes diagnostic testing more enjoyable and rewarding.

Systematically applying psychoanalytic theory to psychological testing cultivates a practical, useful, and enjoyable experience of test administration, test scoring, and test interpretation. Furthermore, by grounding psychological testing in psychoanalytic theory, testing becomes rewarding because there is a lively clinical interplay between testing and psychotherapy. These potential sources of enjoyment and skill for the psychological examiner are explored, and several clinical examples are given for illustrative purposes. The need to appreciate the impact of a given theoretical frame of reference is highlighted.     

Challenges of patient‐led mental health services to psychoanalytic clinicians

This paper considers implications to psychoanalytic psychotherapy of the British Government's decision to implement a patient choice agenda for state‐funded mental health services in England and Wales. It places the patient choice agenda in the context of consumerist society and argues that the complex nature of psychoanalytic psychotherapy leaves it more vulnerable than other psychological therapy modalities to compete in the current reality of ‘consumer’‐led public mental health, which, in turn reflects a profoundly changed social context from that to which psychoanalysis traces its roots. Unless psychoanalytic clinicians recognize and find ways to adjust to this context they will jeopardize the survival of psychoanalytic psychotherapy in an increasingly market‐orientated model of mental healthcare provision in the public sector, eager to promote more ‘consumer friendly’ psychological therapy models.     

Psychoanalytic observation

The recent focus on empathy as the essential activity in psychoanalytic data gathering has underemphasized the complexity of psychoanalytic observation and has failed to identify what truly makes it unique among modes of psychological investigation. It is a process that includes introspection and empathy. However, it also includes the analyst's observation of the patient's behavior, and particularly verbal behavior, in a way that is not necessarily empathic. The psychoanalytic use of introspection and behavioral observation together, as they are modified by the analysand's free association and the analyst's evenly hovering attention, provides a unique method of data gathering. The transient, mutually related regressions of analyst and analysand which partly constitute the analyzing instrument modify the field of observation available to both, providing better access to derivatives of the analysand's unconscious mental functioning. This more complex concept of psychoanalytic observation, as opposed to that in which empathy is predominant, has important implications for psychoanalytic training, clinical work, and theory.     

Foundations of psychoanalysis reconsidered

Grünbaum's approach to psychoanalysis suffers from several difficulties. It imposes a standard of logical reductionism and methodological purity that not only violates the nature of psychoanalytic knowledge, but imposes an invalid standard of verification and scientific confirmation. It utilizes a brand of dichotomous reasoning that forces psychoanalytic propositions into artificial positions that do not reflect the actuality of analytic practice. It imposes a standard of verification that is impossible for psychoanalysis, along with all forms of psychological knowledge, to reach. It visualizes psychoanalysis as encompassing only one form of knowledge of human psychic life, forcing it into a model that eliminates other aspects of the psychoanalytic process, so that psychoanalysis is subjected to criticism only on one dimension among several--a kind of psychoanalytic straw man. The psychoanalysis that is so impaled often is difficult for the psychoanalytic practitioner to recognize. To the extent that Grünbaum's skillful and highly informed criticism of the philosophical bases of psychoanalysis encounters these difficulties, the value of his argument falls short of providing a useful basis for advancing psychoanalytic knowledge and particularly for promoting the quest for pertinent standards of validation within psychoanalysis.     

Sollen Psychoanalytiker Psychotherapeuten ausbilden?

With respect to the radical changes in psychotherapeutic education as a consequence of the Law for Psychotherapy that has been put into force, the author elaborates on political, medical and strategic aspects. It is of special interest whether psychoanalysts having had the “monopoly” of training in depth psychological therapy should further take responsibility for the training in and the development of this method. Meanwhile, other therapeutic schools are claiming depth psychological psychotherapy for themselves and they deny the essential role of psychoanalysis as a foundation of it. In addition, the psychoanalytic institutes themselves do not agree on this issue. A further aspect of the question is that of marketing strategies: in order to survive, it is for psychoanalytic institutes at a time of lessening interest in standard psychoanalytic training important to offer training in depth psychological therapy with its comparatively less expensive and less extensive curriculum. But the essential question remains: should psychoanalysts train psychotherapists and take responsibility for an independent depth psychological therapy, or not? The author calls for a separate profound education in depth psychology taught by psychoanalysts in order to maintain a positive atmosphere for psychoanalysis e.g. in clinical institutions. He agrees with the IPV that this would help to solve “the crisis of the psycho analysis”. Finally, some of the most important, unsolved questions referring to a separate and profound education in depth psychology are presented and possible solutions are offered. It is of crucial importance to take up again the discussion within the psychoanalytical associations and to adjust their medical as well as political attitude to the new ways depth psychology is taught at psychoanalytical institutes.     

Intersubjektivit?t und psychoanalytische Identit?t

The psychoanalytic identity is the result of identification with a psychoanalytic introject. It protects against the fears to which everyone who is attempting to illuminate the unconscious is exposed. In this paper the substantive issues of identity are discussed as a psychoanalyst who is a support for the work by providing concepts for the understanding of the unconscious. Using the example of the intersubjective wend in psychoanalysis it will be examined how these contents have changed under the influence of intersubjectivity. The notion that psychological development also occurs in psychoanalysis in unmistakable interpersonal contexts implies removing the restraints imposed by commitment to the technical rules and normative expectations. The intersubjective view of psychoanalysis therefore demands from the psychoanalyst an identity which is fundamentally different from that of the classical psychoanalyst. Processing the associated fears places the psychoanalytic identity at a more mature stage.     

A MOLE LEAVES HIS HOLE

This paper uses the example of setting up a community-based adolescent psychotherapy and counselling service to explore the difficulties and anxieties that can arise when psychoanalytic practitioners venture out of the consulting room to become involved in planning and organizing services. Emphasis is placed on the complications of such a task in a climate of rapid change, when levels of anxiety, fuelled in many different ways, can threaten the viability of the task one is engaged in. The author argues that in a political climate that is generally not very supportive of psychoanalysis, it is possible none the less for psychoanalytic ideas to have an important impact on how psychological services can develop, and this in itself can challenge many of the preconceptions about psychoanalytic practitioners that one can be confronted with when one leaves the comfort of the consulting room.     

A tempest, a birth, and death: Freud, Jung, and Shakespeare’sPericles

This essay applies a Freudian psychoanalytic and Jungian archetypal narrative analysis to Shakespeare’s first and oft-criticized romance. The author argues that key structural and thematic elements ofPericles are best illuminated when viewed through a psychological interpretative lens, and that the play is best comprehended when examined in the context of its associative, rather than linear, richness. Masculinity and femininity, central themes of the narrative, are explored both in relation to the Oedipal complex and psychological individuation.Pericles also provides an excellent basis to examine key differences between Freud’s and Jung’s approach, particularly Jung’s widening of the primarily sexual psychoanalytic approach to encompass broader archetypal meaning.     

PSYCHOANALYSIS AND COGNITIVE BEHAVIOUR THERAPY ‐ RIVAL PARADIGMS OR COMMON GROUND?3

The author suggests that contemporary enthusiasm for cognitive‐behavioural therapy reflects our longing for swift, rational help for psychological suffering. Competition for funding threatens the psychoanalytic presence in the public sector. The psychoanalytic and cognitive‐behavioural models are contrasted, and the relative richness of the psychoanalytic paradigm outlined. The author suggests that a cognitive model is commonsensical, but less complex, with less potential explanatory and therapeutic power. She discusses how the analytic stance is always under pressure to ‘collapse’ into simpler modes, one of which resembles a cognitive one. This also occurs inevitably, she argues, when attempts are made to ‘integrate’ the two models. Cognitive and ‘integrated’ treatments nevertheless have the advantage that they are less intrusive and hence more acceptable to some patients. Selected empirical process and outcome research on cognitive and psychoanalytic therapies is discussed. Brief psychotherapies of either variety have a similar, modestly good outcome, and there is some evidence that this may be based more on ‘dynamic’ than ‘cognitive’ elements of treatment. Formal outcome studies of more typical psychoanalytic psychotherapy and of psychoanalysis itself begin to suggest that these long and complex treatments are effective in the more comprehensive ways predicted by the model.     

Conceptualizations of the psychoanalytic process

A demonstrable psychoanalytic process involves elaborate and sustained intrapsychic experiences and phenomena for both analysand and analyst. It also includes a complex and at times subtle interpersonal relationship in which each participant is actively sensitive and responsive to verbal and nonverbal input from the other. These interpersonal experiences stimulate further intrapsychic responses which in turn may have further interpersonal effects. Within the framework of the psychoanalytic situation, these combined intrapsychic and interpersonal responses lead first to facilitative and ultimately to definitive changes in the patient's psychological organization and function. A method for demonstrating a psychoanalytic process is described.     

Blurring Boundaries or Why Do We Refer to Sexual Misconduct With Patients as “Boundary Violation”

I argue for the notion that we reserve the term boundary for the psychic realm because the psychic boundaries of psychoanalysis are so fundamentally complex, dense, and intrinsically confusing that bringing in the realm of behavioral ethical violations is actually unnecessarily vague and mystifying. The notion of a psychological boundary as a term in psychoanalytic work is a fragile, metaphoric construction that allows us to explore fantasy, affect, symbols, and elements of shared and unique realities. Psychoanalysis hinges on a social compact by patients and analysts to open up otherwise forbidden territory offered through this metaphoric construction. Rather than conflate forensic vocabulary (“violation”) with a central psychic concept for conducting psychoanalytic work (“boundary”), I suggest that we refer to ethical misconduct in more straightforward conventional terms such as misconduct (behavioral referents) or with specific psychological understandings of the many determinants of this behavior that we have available to us as psychoanalysts.     

Object-Relations and Cultural Narratives in the Analysis of Racism: Theorizing Subjectivity After Klein and Lacan

This paper discusses two approaches to racism in the psychoanalytic literature—one based on Kleinian object-relations, and another based on Lacan’s theory of language as central to subjectivity. It is argued that the Kleinian method relies on drawing parallels between object-relations at the psychological level and social relations in the external world, and this limits its understanding to a narrow catalogue of psychoanalytic concepts. A Lacanian/post-Lacanian approach begins from the structure of cultural narratives and is more sensitive to social variations. Using examples from anthropology, it is argued that both theories are crucial for a robust analysis of racism.     

Psychoanalysis as a creative shaping process2

The author first explains the concepts of creativity, play and aesthetic experience. He then outlines the psychoanalytic process as a creative one that shapes reality. Making a link between psychoanalysis and the humanities, he demonstrates that creative play is a fundamental aspect of the human experience of reality. Aesthetic experiences during the psychoanalytic process are comparable to the play by which children structure their world and artists' activity in following their urge to shape. Furthermore it is shown that creative actualisation testifies to a quasi‐biological need for coherence and structure. Through modern hermeneutics, the truth claims of aesthetic shaping can be established in epistemological terms. The basic principles of hermeneutics‐historicity, linguisticity and communicative experience‐find their psychoanalytic counterparts in memory, representational shaping and transference‐countertransference. Psychoanalysis is demonstrated to be simultaneously a science and an art. On the basis of a case history, aesthetic experience is shown to constitute a specific and unique form of access to psychic reality. Aesthetic experience and creativity do not only aid recovery from ‘bad psychological states’, they are also indispensable for the entire understanding of internal and external reality. It is possible to develop this understanding through a creative psychoanalytic attitude.     

FROM FREUD TO FEMINIST PERSONALITY THEORY: GETTING HERE FROM THERE

After a discussion of the impact of psychoanalysis on psychological thinking about personality theory and the changes that have been taking place within psychoanalytic theory about women, eight criteria arising out of feminist therapy theory are stated. These criteria represent suggested minimum conditions that a woman-based theory of female development and personality needs to fulfill. Freudian theory, current psychoanalytic theory, and several feminist theories are then evaluated in light of the stated criteria. The author concludes that feminists have arrived at some degree of general agreement about personality theory, although they have often arrived at their specific approaches via diverse theoretical routes.     

DESIRE ON AND OFF THE COUCH

The concept of desire is potentially useful and underutilized for elucidating and understanding psychoanalytic material and informing psychoanalytic technique. It can be employed as a lens for viewing and clarifying diverse clinical phenomenon and other mental productions. One way of defining desire as a conceptual framework as applied to psychoanalytic theory is to refract it into three components: (1) love (emotional desire), (2) sex (physical desire), and (3) passion (other manifestations of desire). These different aspects of desire are manifest in and of themselves and as enhancements of one another. Focusing on each of them as manifest in the transference/countertransference relationship in analysis can facilitate a patient becoming more aware of psychological conflicts and working them through in analysis. This paper presents and discusses a case study in which these different aspects of desire are employed and analyzed.     

You Can Get Here From There

This paper is a review of my development from psychology intern and research assistant to the psychoanalytic tester and theoretician David Rapaport at the Menninger Clinic in the 1940s, through my career in psychological testing, my psychoanalytic training in the Western New England Institute, and my working successively at the Austen Riggs Center, Yale Department of Psychiatry, Yale Student Mental Health Center, Cornell Department of Psychiatry, and eventually private practice in New York City. During this period, I rose to the academic rank of Professor and the analytic position of Training Analyst. I have written extensively: first on testing, then more or less in turn on psychoanalytic ego psychology, action language for psychoanalysis, feminist issues, narrative in psychoanalysis, and the contemporary Kleinians of London. This memoir traces the intellectual continuity that characterizes these writings and my continuing development as a psycho-analyst—my first ambition and great love.     

Administration of the thematic apperception test: Contributions of psychoanalytic psychotherapy

Psychodiagnosis has given more to than it has received from psychotherapy. Some psychological tests may benefit from the wisdom accrued and embodied in the psychoanalytic situation. Using the well known projective instrument, the Thematic Apperception Test (TAT), guided by the intent to make the use of the test more consistent with the psychoanalytic situation and contemporary projective theory, it is suggested that the basic TAT instruction be modified and that greater attention be paid to an explicit theoretical rationale by which the cards are selected and presented. Inviting the patient to collaborate in a self-interpretation of the TAT can serve as an assessment of the patient's capacity for introspection and the development of the working alliance. It is further suggested that psychoanalytic developmental theory can function as an epigenetic organizer of the patient's TAT protocol.This research was supported by the Veterans Administration. The author is grateful for the inspirational and thoughtful comments of Drs. Marvin Acklin, Murray Tieger, and Edwin Wagner.