Psychoanalysis as a vocation

Psychoanalysis may be seen as caught between two different trends of disenchanted modernity: rationalization, which leads to the framing of our work as a professional discipline subordinate to the dictates of instrumental rationality, and self‐analysis, which frees us from the dictates of orthodoxy, inequality, and authority. But a further difficulty lies within the aspect of enlightenment, which has not only provided a greater role for our subjectivity but disguised relations of authority, conformity, and objectiflcation in our work. Psychoanalysis has objectified the other while idealizing its knowledge as objective, has paradoxically denied the very subjectivity that must serve as the source of the analyst's knowledge. However, the reaction against this condition, which may tend to produce counter‐ideals of not‐knowing and mutuality, must also be carefully deconstructed. Differences in the meaning given by different schools to the use of the analyst's subjectivity suggest that pluralism will make new knowledge demands on psychoanalysts. Analytic training should include the development of critical abilities that help to meet these demands within a context of education as a collaborative, democratic process. Knowledge itself can be used homeo‐pathically as an antidote to the old ideal of the knowing authority.     

Psychoanalysis as science

This work explores two “Copernican shifts” in the history of psychoanalysis. The first is Freud's recognition of the motives behind the constructions of psychic reality; the intrusion of the wish in the subject's perceptions. The author explores the roots of this recognition in the scientific tradition of Kant and Helmholtz, and suggests that these two predecessors were topical for Freud in their deviation from a theory of “immaculate perception”. The other theme of this work is what the author suggests is a contemporaneous “Copernican shift” in psychoanalytic theory. This shift consists in a recognition of the topicalness of the experience of reciprocity. Connections between this experience and the experience of the self are described, and implications for the theory of the psychoanalytic process are suggested.     

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.     

Creative Process Groups

Many nonverbal and artistic modes of expression have been used to communicate in counseling and education. This article investigates one mode of expression-the slide/tape show-as implemented in a group format in a college setting. The Creative Process Group, using the task of creating a slide/tape show, has group members (1) explore a relevant issue using an alternate means of expression, (2) experience a group creative process, and (3) learn about group dynamics and how individuals, including themselves, function in groups.     

Metacognition as a Moderator of Creative Ideation and Creative Production

Recent theoretical work has called for exploration of the moderating effects of cognitive factors on the relationship between creative ideation and creative production. The Cognitive-Creative Sifting model suggests skills in processing and transforming information influence the association. This study used the Runco Ideational Behavior Scale, Metacognitive Awareness Inventory, and Creative Behavior Inventory to test the moderating effect. Medium to large moderator effects (f² = .015 to f² = .041) were observed across previous theoretically proposed aspects of metacognition. A large, statistically significant moderator effect was observed for overall metacognition (f² = .031). Observed differences across subcomponents of metacognition paralleled theoretical connections between metacognition and creativity. Further studies are suggested using more diverse creativity measures, as well as tests for other cognitive sifters. Implications for educational practice, particularly regarding the creatively gifted, are offered.     

Psychoanalysis as medicine,psychoanalysis as religion

The author explores unfavorable comparisons between psychoanalysts and medical psychiatry, tracing the crisis in the mental health fields created by managed care. This current crisis is traced to an historical identification with the medical profession and a more recent dependence on third-party payments. He suggests reorganizing the profession as a religion or spiritual exercise as a way out of the crisis and as a way of revitalizing its practice.Richard A. Friedman, Ph.D., is a psychoanalyst in private practice in New York City, supervisor at the Psychoanalytic Psychotherapy Study Center, and a faculty member and training analyst at the New York Center for Psychoanalytic Training     

Creative Writing as a Medical Instrument

Listening and responding to patients’ stories for over 20 years as an emergency physician has strengthened my appreciation for the many ways that the skills and principles drawn from writing fiction double as necessary clinical skills. The best medicine doesn’t work on the wrong story, and the stories patients tell sometimes feel like first drafts—vital and fragile works-in-progress. Increasingly complex health challenges compounded by social, financial, and psychological burdens make for stories that are difficult to articulate and comprehend. In this essay, I argue that healthcare providers need to think like creative writers and the skills and sensitivities necessary to story construction deserve a vital space in medical education. A thorough understanding of story anatomy and the imaginative flexibility to work stories into open spaces serve as antidotes to the reductive nature of clinical decision making and have implications as patient safety and risk management strategies. The examples that I have selected demonstrate how thinking like a creative writer functions at the bedside, providing tools for clinical excellence and empathy. This approach asks that we re-imagine the importance of story in clinical care: from a vehicle to a diagnosis to its place as a critical destination.     

Alone Together: Solitude and the Creative Encounter in Art and Psychoanalysis

This paper examines aspects of solitude in relation to creativity and personal transformation, especially as it pertains to artists and their objects. It argues that solitude is a core feature of the human condition and that it is inseparable from relatedness. Both solitude and relationship are layered and dynamically interactive states. The paper also considers the relational needs that art objects serve for their creators and specifically addresses the uniqueness of women's solitude. Finally, a clinical case is presented to illustrate the interplay between solitude and relatedness in psychoanalysis.