Destruction reconceived: On Winnicott's ‘The Use of an Object and Relating through Identifications’

‘The Use of an Object and Relating through Identifications’ is a landmark contribution that I find very difficult to write about because so much of what lies at its core is merely suggested. It is necessary for the reader not only to read the paper, but also to write it. In my reading/writing of the paper, the mother becomes real for the infant in the process of his actually destroying her as an external object (destroying her sense of herself as an adequate mother), and his perceiving that destruction. She also becomes a real external object for the infant in the process of his experiencing the psychological work involved in surviving destruction, a form of work that does not occur in the world of fantasied objects. The analyst or mother may not be able to survive destruction. It is essential that the analyst be able to acknowledge to himself his inability to survive and, if necessary, to end the analysis because of the very damaging effects for both patient and analyst of prolonged experience of this sort. The author presents clinical discussions of analyses in which the analyst survives destruction and is unable to survive destruction.     

Clinical concepts

In this section authors have written about the Winnicottian concept that they value most in their everyday working lives. This provides a valuable insight into the ways in which Winnicott's work is being used as a springboard for new ideas, as well as enlightening familiar ground. It is striking to see how the original Winnicottian idea takes on new form as it is taken up by new generations of clinicians. Despite the absence of a Winnicottian training school, his pervasive impact continues to influence current theory and practice.     

The good,the bad and the uncertainty: Trainees' perceptions of the personal development group

Background: Views about the purpose and role of personal development groups (PD group) in the counsellor training process are varied. Some argue they enhance self‐awareness, self‐exploration, the ability to be congruent and, ultimately, that they make for better practitioners. Others argue there is no clear evidence for such benefits and that they can actually be damaging to trainees. Aims: This study aimed to explore the beliefs of 25 trainees enrolled on counselling diploma or counselling psychology doctoral courses. It looked in particular at their perceptions of the purpose of PD groups and their expectations regarding support, difficulties and the scope of their participation. Method: Data was collected using open‐ended questions in an anonymous survey and was subjected to a thematic analysis. Results: Trainees appeared to hold mixed – and sometimes conflicting – views about the PD group. For some it was a positive endeavour that facilitated learning about self and clients, and helped in the processes of developing counselling skills and keeping the training group healthy. For others it was a feared space, which could elicit negative emotional experiences, and impact negatively on both learning outside of the PD group and the health of the group itself. Still others were unclear about its purpose. Hope/idealisation (of the process, the facilitator and course tutors) were also evident in the trainees' responses. Implications: Implications of these findings for counselling training are discussed.     

Kant, Quasi-Realism, and the Autonomy of Aesthetic Judgement

Aesthetic judgements are autonomous, as many other judgements are not: for the latter, but not the former, it is sometimes justifiable to change one’s mind simply because several others share a different opinion. Why is this? One answer is that claims about beauty are not assertions at all, but expressions of aesthetic response. However, to cover more than just some of the explananda, this expressivism needs combining with some analogue of cognitive command, i.e. the idea that disagreements over beuaty can occur, and when they do it is a priori that one side has infringed the norms governing aesthetic discourse. This combination can be achieved by reading Kant’s aesthetic theory in expressivist terms. The resulting view is a form of quasi‐realism about beauty. The position has its merits, but cannot ultimately explain the phenomena which motivate it. This conclusion generalises to quasi‐realism about other matters.     

Training social cognition: from imitation to Theory of Mind

Evidence for successful socio-cognitive training in typical adults is rare. This study attempted to improve Theory of Mind (ToM) and visual perspective taking in healthy adults by training participants to either imitate or to inhibit imitation. Twenty-four hours after training, all participants completed tests of ToM and visual perspective taking. The group trained to inhibit their tendency to imitate showed improved performance on the visual perspective-taking test, but not the ToM test. Neither imitation training, nor general inhibition training, had this effect. These results support a novel theory of social cognition suggesting that the same self-other discrimination process underlies imitation inhibition and perspective taking. Imitation, perspective taking and ToM are all pro-social processes--ways in which we reach out to others. Therefore, it is striking that perspective taking can be enhanced by suppressing imitation; to understand another, sometimes we need, not to get closer, but to pull away.     

Terrorism and the Uses of Terror

“Terrorism”' is sometimes defined as a “form ofcoercion.” But there are important differences between ordinary coercion and terrorist intimidation. This paper explores some of those differences, particularly the relation between coercion, on the one hand, and terror and terrorization, on the other hand. The paper argues that while terrorism is not necessarily associated with terror in the literal sense, it does often seek to instill a mental state like terror in the populations that it targets. However, the point of instilling this mental state is not necessarily coercive or intimidatory: one can try to instill terror as an act of punishment, or as an expressive or therapeutic act, or because one values the political consequences that might follow, or because one thinks terror is preferable, from an ethical point of view, to the inauthentic complacency that characterizes the targeted population at present. Though this paper asks questions about the definition of “terrorism,” these questions are not asked for their own sake. The quest for a canonical definition of “terrorism” is probably a waste of time. But asking questions which sound like questions of definition is sometimes a fruitful way of focusing our reflections on terrorism and organizing our response. This revised version was published online in June 2006 with corrections to the Cover Date.     

Incorporating a developmental perspective in doctoral training: survey of clinical child psychology training programs and introduction to the special section

Examined the degree to which clinical child programs incorporate and integrate developmental theory into their training, and introduced the contributions of 6 leaders in the field to this special section. Fifty-one clinical child doctoral programs responded to the survey. Results indicate that 3 types of training programs are operating: (a) child emphasis (n = 7), which do not have a formal clinical child training program but do have a faculty member who has child research interests; (b) clinical child (n = 37), which have a group of faculty members with specific child research and clinical interests and a formalized program of study; and (c) developmental-clinical programs (n = 7), which are similar to clinical child programs but require a substantive amount of developmental psychology course work and endorse a developmental psychopathology perspective. Findings reveal that clinical child programs have become increasingly differentiated and specialized over the past 20 years, but, with the exception of developmental-clinical programs, most programs are still neglecting to incorporate developmental theory into training. This issue, as well as concerns about the future direction of clinical child doctoral training is addressed in this special section on the Importance of Incorporating Developmental Theory Into Clinical Child Training.     

Being a psychoanalyst: An everyday audacity1

This paper is the work of fi ve psychoanalysts who came together as a group in order to refl ect on their work as analysts. How are we analysts to identify the unconscious resistances that may sometimes hold us back from offering psychoanalysis to some patients? Do these resistances sometimes hamper the inner freedom that we require in order to maintain a psychoanalytic focus once that process is under way? How do we manage from time to time to overcome these resistances or, better, make use of them in order to develop our understanding of the unconscious dynamics that create the link between analyst and patient? The authors discuss these issues with particular reference to clinical situations taken from classic psychoanalytic treatment cases during which the analyst had to fi nd within him‐ or herself the audacity to be a psychoanalyst. Each clinical situation is different: preliminary interviews, in the course of the actual treatment, issues that emerge in the training of candidates. One of the signifi cant features of this group lies in the fact that the participants are at different stages in their development as psychoanalysts (student, associate member, full member, training analyst). This means that their experiences complement one another and encourage a discussion of issues such as how psychoanalysis can be passed on, and the relationship between supervisor and supervisee.     

Observing groups as seen from both sides of the looking glass

Conclusion This paper attempts to make a contribution to an area of the literature on group therapy about which very little has been published—the effects of the therapy group upon the observing group and the dynamics of the observing group as an entity in itself. Although work on which this paper is based took place in training institutions where education is the primary function, it is important to emphasize that education and personal change are interrelated. Psychotherapeutic activity takes place spontaneously with the observers and needs to be constructively utilized. This wealth of process and reaction is an untapped training opportunity for the observing group. The challenge of method, personal reactions, and group process responses are all opportunities for its members to both learn more as therapists and mature as individuals. At this juncture, we are trying to establish ways of     

Meditation focused on self-observation of the body impairs metacognitive efficiency

In the last decade of research on metacognition, the literature has been focused on understanding its mechanism, function and scope; however, little is known about whether metacognitive capacity can be trained. The specificity of the potential training procedure is in particular still largely unknown. In this study, we evaluate whether metacognition is trainable through generic meditation training, and if so, which component of meditation would be instrumental in this improvement. To this end, we evaluated participants’ metacognitive efficiency before and after two types of meditation training protocols: the first focused on mental cues (Mental Monitoring [MM] training), whereas the second focused on body cues (Self-observation of the Body [SoB] training). Results indicated that while metacognitive efficiency was stable in MM training group, it was significantly reduced in the SoB group after training. This suggests that metacognition should not be conceived as a stable capacity but rather as a malleable skill.     

Lessons Learned Conducting Dialectical Behavior Therapy via Telehealth in the Age of COVID-19

Given the severity and suicide risk of patients typically treated by Dialectical Behavior Therapy (DBT) and the absence of guidelines regarding delivery of DBT via telehealth, it is crucial that the DBT treatment community gather and rapidly disseminate information about effective strategies for delivering DBT via telehealth. The current study surveyed DBT providers (N = 200) to understand challenges and lessons learned as they transitioned to conducting DBT via telehealth during the COVID-19 pandemic. Open-ended responses to challenges and lessons-learned were coded. Most frequently noted challenges were Therapy-Interfering Behaviors and elements related to the provision of Individual Therapy and Skills Training Group. The majority of providers offered advice for implementing group skills training, avoiding or overcoming therapist burnout, and emphasized continued adherence to treatment principles, even in the context of this new treatment modality. Overall, this qualitative study marks a starting point on identifying best practices delivering DBT via telehealth for which it is anticipated that clinical recommendations in this area will evolve, informed by clinician, researcher, and consumer input.     

In Defense of Ambivalence and Alienation

In this paper, I argue against certain dogmas about ambivalence and alienation. Authors such as Harry Frankfurt and Christine Korsgaard demand a unity of persons that excludes ambivalence. Other philosophers such as David Velleman have criticized this demand as overblown, yet these critics, too, demand a personal unity that excludes an extreme form of ambivalence (“radical ambivalence”). I defend radical ambivalence by arguing that, to be true to oneself, one sometimes needs to be radically ambivalent. Certain dogmas about alienation are even more entrenched. Allen Wood’s entry on “alienation” in the Oxford Companion to Philosophy begins as follows: “A psychological or social evil, characterized by one or another type of harmful separation, disruption or fragmentation, which sunders things that belong together.” I think that it is not true that self-alienation is necessarily “harmful.” I argue that radical ambivalence is a form of self-alienation. Thus, because faithfulness to oneself sometimes requires radical ambivalence, to be true to oneself, one sometimes needs to be alienated from oneself.     

Learning the unlearnable: the role of missing evidence

Syntactic knowledge is widely held to be partially innate, rather than learned. In a classic example, it is sometimes argued that children know the proper use of anaphoric one, although that knowledge could not have been learned from experience. Lidz et al. [Lidz, J., Waxman, S., & Freedman, J. (2003). What infants know about syntax but couldn't have learned: Experimental evidence for syntactic structure at 18 months. Cognition, 89, B65-B73.] pursue this argument, and present corpus and experimental evidence that appears to support it; they conclude that specific aspects of this knowledge must be innate. We demonstrate, contra Lidz et al., that this knowledge may in fact be acquired from the input, through a simple Bayesian learning procedure. The learning procedure succeeds because it is sensitive to the absence of particular input patterns--an aspect of learning that is apparently overlooked by Lidz et al. More generally, we suggest that a prominent form of the "argument from poverty of the stimulus" suffers from the same oversight, and is as a result logically unsound.     

A feminist psychotherapeutic approach to working with women who eat compulsively1

Feminist psychoanalytic theorists argue that eating problems demonstrate ways in which conscious and unconscious gendered feelings about women are split off and projected on to their bodies. As such, they are complex ways in which women attempt to negotiate and express their identities within their paradoxical social position in contemporary western society. They are not just consumers but also objects of consumption. This paper explores material from a feminist psychodynamic therapy group for women with a variety of eating problems, focusing on how interweaving both discursive and unconscious approaches to understanding the gendered function of weight can facilitate change. Feminist psychodynamic therapists work with the concept that the body is an interface between conscious and unconscious mind within both an internal and a social world. This framework enables the client to understand the connections between socially constructed frameworks of femininity, emotions and bodily sensations, rather than to act on them through some form of bodily abuse. This approach is based on my adaptation of Susie Orbach's (1978) ‘Fat is a Feminist Issue’ therapeutic model for working with compulsive eaters. While arguing that a feminist psychoanalytic framework is crucial in this type of work, I suggest that it is essential to combine this with cognitive and behavioural therapeutic interventions in order to provide a pedagogic structure in which food, eating and body size come to be seen as meaningful.     

Turning psychology against militarism

This paper draws on material, mostly from outside psychology, which illustrates the deep rootedness of militarisation in modern culture and the numerous ways in which it permeates civic society. Children, boys especially, learn to value armed conflict. War games are now more realistic, and the distinction between gaming and military training has become blurred. War and deadly weapons are portrayed in unrealistic ways that hide their actual effects. Just war theory, widely subscribed to, justifies armed conflict by proposing that under certain conditions, war can be just with moral rules that apply to the fighting. Many psychologists have worked for the military in one way or another, implicitly or explicitly promoting militarism, and the changing nature of war and armaments is providing further temptations for psychologists to do so. Psychology has been ambivalent about militarism. Peace psychology has not taken an unambiguous position on it, often speaking disparagingly of the absence of war in the absence of social justice, referring to it as “negative peace.” Feminists, often very clear in their opposition to militarism, have sometimes advocated for women to have greater acceptance in the armed forces. The paper concludes by arguing for a more clearly identified Psychology Against Militarism. Community psychology should take a lead in advocating for Psychology Against Militarism because militarism is a good example of how the exercise of power, wreaking widespread harm on us all but especially on those who are already relatively powerless, is collectively legitimised, and hence how we become complicit in supporting it.     

Considerations for the Use of Sentence Completion Tests

Often, sentence completion tests are administered to clients without a clear sense of the clinical questions to be investigated, and, therefore, the appropriate sentence completion instrument to be used. The multitude of forms that have evolved in the last fifty years have made it difficult for clinicians to make informed decisions about which form to use and for what purpose. This article presents ten general guidelines or considerations for the effective use of this popular but sometimes misused psychological assessment method. Practitioners are urged to consider such issues as oral versus written presentation of items, item content in terms of positive or negative stimulus pull, the structure of sentence stems, the original purpose of a given test in regard to intended population and theoretical orientation of the author, and the empirical validity of tests.     

Incorporation of an invasive object

The author discusses the experience of 'being invaded' that is sometimes communicated by certain severely disturbed patients. The complaint can sometimes be couched in terms of bodily suffering and such patients may state that they have the experience of a 'foreign body' inside. It is suggested that these patients have suffered severe early failure of containment of their projections, while at the same time they have incorporated primitive characteristics of the object that have been powerfully projected into them. An object that invades in this way, it is suggested, experiences a compulsive need to expel unbearable states of mind using others as a repository. The infant incorporates these violent projections as part of his own mental representational system, and normal identifi cation processes are disrupted. There follows impairment of the development of the sense of self. Clinical examples of how the invasive experience manifests itself in the analytic setting and in the transference and countertransference are presented. It is argued that this highly complex form of early subject-object interaction (prior to the differentiation of psyche-soma) is more likely to be found in severely narcissistically disturbed individuals. Some refl ections on the origins of invasive phenomena are given.     

Self-evaluation in the pastorate

Conclusion In the absence of resources, then, for adequately supervised and continuous in-course training for the parish minister, it is suggested that he become his own supervisor for self-evaluation in the pastorate. Certain methods and disciplines have been proposed for such a venture. Nothing herein is intended to offer this kind of self-evaluation as a substitute for other resources, either clinical or devotional, available to aid the minister in appraising his vocational involvements. This proposal is simply set forth as another tried and perhaps more readily accessible way of improving that service to which the parish minister feels himself called.     

When Language Gives Out: Conceptualization,and Aspect‐Seeing as a Form of Judgment

This article characterizes aspect‐perception as a distinct form of judgment in Kant's sense: a distinct way in which the mind contacts world and applies concepts. First, aspect‐perception involves a mode of thinking about things apart from any established routine of conceptualizing them. It is thus a form of concept application that is essentially reflection about language. Second, this mode of reflection has an experiential, sometimes perceptual, element: in aspect‐perception, that is, we experience meanings—bodies of norms. Third, aspect‐perception can be “preparatory”: it may help us to decide what linguistic norms to develop and how to conceptualize—make the world thinkable. Fourth, the article discusses the forms of justification for which aspect‐perception allows—the necessity and normativity involved in employing this form of judgment.