Should supportive measures and relational variables be considered a part of psychoanalytic technique? Some empirical considerations

This article presents some quantitative findings from a survey of 89 psychoanalysts (all members of the American Psychoanalytic Association or the International Psychoanalytical Association) about their own experiences in analysis. A comprehensive questionnaire was used to collect retrospective data about (1) how participants felt they benefited from their analyses and (2) how they remembered their analysts’ technique, personality, and style of relating. A correlational analysis found that, according to our participants’ ratings, the most beneficial analyses were associated with having a caring and emotionally engaged analyst who possessed positive relational and personality qualities, used supportive techniques in addition to classical techniques, and pursued therapeutic as well as analytic goals. Outcomes rated as successful were also associated with experiencing a good ‘fit’, a good working relationship, and a positive therapeutic alliance. Our results support the call for an expanded view of acceptable analytic technique (e.g. Schacter and Kächele, 2007) .     

Can research influence clinical practice?1

After briefly reviewing the unfavourable reception accorded empirical research by parts of the psychoanalytic community, as well as some of the benefits to clinical practice of analysts being involved in research activities, the author examines whether the findings of process and outcome research in psychotherapy and psychoanalysis can help identify the most appropriate forms of intervention for producing therapeutic change, given the specific condition of the patient and the relationship that the individual establishes with the analyst. He argues that research findings can influence clinical practice on various levels and in different areas, and goes on to examine a number of related issues: the specificity of therapeutic interventions versus the relevance of common curative factors; the dyadic conception of technique and ways of understanding the therapeutic action of the treatment alliance; and the strategic or heuristic conception in psychoanalytic therapy. Finally, the author presents clinical material with the aim of illustrating how the knowledge acquired through research can be applied to psychoanalytic treatment.     

The canary in the mind: on the fate of dreams in psychoanalysis and in contemporary culture

Dreams have been central in the birth and evolution of psychoanalysis. This paper explores the remarkable story of the relationship between dreams and psychoanalysis as a modern version of the long history of dreams in most healing traditions. But psychoanalysis seems to have turned away from dreams as central inspiration in a way parallel to the general culture’s turn away from dreams and the reality of inner life. Yet modern postindustrial culture is transfixed by a version of “dream life” in ways just beginning to be understood (e.g., in the transformation of ancient interest in the inner screen to the external screen). Working with dreams in psychoanalytic psychotherapy was a creative and revolutionary act for our forebears. It is even more so today, in ways that are discussed in this paper.Dr. Paul Lippmann is training and supervising analyst and faculty member at the William Alanson White Institute and faculty member of the NYU Postdoctoral Program in Psychotherapy and Psychoanalysis. He is also Director of the Stockbridge Dream Society.     

How Does Change Occur Within the Psychoanalytic Encounter?

On November 6, 2002, Dr. James Fosshage delivered the following talk at a Clinical Training Conference held at the Blanton-Peale Institute. The Clinical Training Conference at Blanton-Peale provides experiential and conceptual resources to support the therapist-in-training in the context of his/her professional identity. The training conference is attended by candidates of all phases of the Psychoanalytic Program, the Pastoral Psychotherapy Program, and the Marriage and Family Program, as well as faculty members, administrators, staff, and interns of the institute. The residents were asked to review three articles written by Dr. Fosshage in preparation for his presentation: Toward Reconceptualising Transference: Theoretical and Clinical Considerations, International Journal of Psycho-Analysis (1994) 75 (2): 265–280; Countertransference as the Analyst's Experience of the Analysand: Influence of Listening Perspectives, Psychoanalytic Psychology (1995) 12 (3): 375–391; and Listening/Experiencing Perspectives and the Quest for a Facilitating Responsiveness, Conversations in Self Psychology: Progress in Self Psychology, (1997) 13: 33–55.     

The Play Relationship and the Therapeutic Alliance

Abstract

This article examines the function of play in normal development and within the treatment relationship in both child and adult psychotherapy. Noting its developmental function and the natural role that play has as a mode of communication with children, the author emphasizes the centrality of play in the construction of the therapeutic alliance. The therapeutic alliance is characterized here as a libidinal attachment, a new object relationship through which developmental experiences involving play may be revivified and, ultimately, may lead to the forging of more enduring and successful adaptations. Two detailed clinical vignettes furnish illustrations of the ways in which play themes and scenarios develop in therapy, and how their association to the therapeutic alliance and transference relationship may be understood and interpreted.     

Introduction

Many clinicians interested in group and psychoanalytic thought have followed idiosyncratic and personally constructed modes of preparation. Formal training programs tend to differ in terms of emphasis on degree of previous analytic experience, quantity of supervision, number of courses, requirements to have personal analytic group therapy, as well as length of time required to lead an analytic group. The process of psychoanalytic clinical work seems to have been temporarily idealized but essentially resisted by long ingrained North American pragmatic and spiritual value systems. This has resulted in what has amounted to a 50 year flirtation, rather than identification, with Psychoanalysis by American professional culture. The depth of curative experience for patients and the intensity of clinical acumen for practitioners make an analytic perspective important to maintain.      

Reaction to Mortality: An Interdisciplinary Organizing Principle for the Human Sciences

Ernest Becker's theory about death denial is one example of depth psychological theory. Because very important features of Becker's theory have now successfully and singularly met the rigorous empirical testing of Terror Management Theory (TMT), it must be concluded that the theory of death denial stands apart from and above alternative depth psychological theories in explaining human behavioral and attitudinal motivation. Nevertheless, TMT only touches the surface of Becker's theory in the round. This essay looks at how Becker's wider theories of death denial are applied to (1) personal psychological, (2) social psychological, (3) political, and (4) spiritual aspects of human experience and suggests that what Becker has given us is an organizing principle, a theory of considerable integrative, explanatory, and interpretive power, for a broadly interdisciplinary social science of human behavior.     

What kind of discipline is psychoanalysis?

Current controversies involving clinical, conceptual and empirical research shed light on how psychoanalysis confronts its nature and its future. Some relevant debates in which Wallerstein, Green, Hoffman, Eagle and Wolitzky, Safran, Stern, Blass and Carmeli, and Panksepp have participated are examined regarding the characteristics of their argumentation. Agreements and disagreements are explored to find ways that could have allowed the discussion to progress. Two foci are highlighted in these debates: (a) whether a clinical common ground exists in psychoanalysis and what kind of procedure could contribute to further clarification; (b) complementation of in‐clinical and extra‐clinical evidence. Both aspects are scrutinized: the possibility of complementing diverse methodologies, and the nature of the shared clinical evidence examined in clinical discussion groups such as those promoted by the IPA Clinical Observation Committee. The importance of triangulation and consilience is brought to bear regarding their contribution to the robustness of psychoanalysis. So as to strengthen a critical perspective that enhances the discipline's argumentative field, psychoanalysis should take into account arguments from different sources according to their specific merits. By doing this, psychoanalysis increases its relevance within the current interdisciplinary dialogue.     

Discomfort in the community. The place of psyche: Between zōē and bios

In this paper, the author considers the treatment of people diagnosed with a psychosis or borderline personality disorder in therapeutic communities from a psychoanalytic perspective, with a particular focus on the work of Jacques Lacan and of André Green. He discusses two key questions. First, how are these patients to recover life? – not just in the biological sense but in terms of subjectivity. Secondly, is it ever really possible to build relationships with them? In relation to this second question, the author emphasizes the importance of the training and supervision of practitioners, as well as their own analysis. Therapeutic communities, above all, he argues, can provide structure and security in a society which is increasingly fragmented and unstable.