The challenges and experiences of psychotherapists working remotely during the coronavirus* pandemic

The experiences and challenges of psychotherapists working remotely during the coronavirus pandemic were explored using a mixed‐methods approach. An online survey completed by 335 psychotherapists produced both quantitative and qualitative data with the latter being subject to a reflexive thematic analysis. Large numbers of therapists were using video‐link platforms and the telephone to conduct client sessions. A majority of therapists felt challenged by remote working, with reduced interpersonal cues, feelings of isolation and fatigue, and technical issues frequently cited concerns. At the same time, most therapists considered that remote working had been effective and that clients were comfortable with the process. Two‐thirds of therapists indicated that remote working would now become core business for them. The great majority of therapists thought that remote working skills should be part of formal therapy trainings.     

A mixed-model for psychoanalytic education*

Abstract

If psychoanalysis is to avoid total marginalization, something has to be changed in the way future generations are prepared for working with patients and doing research. Reformation of psychoanalytic education may easily be the crucial issue when it comes to the survival of psychoanalysis. Its current organizational scheme has been criticized for various reasons, and various models of its structure have been proposed. I advocate a model that would combine the best features of the university education (training in clinical skills together with philosophy of science and research methodology) with personal analysis as part of psychoanalytic institutes. Although universities can remedy some of the problems of psychoanalytic institutions, they cannot contain the subjective experience of being analyzed.     

Group psychology in the totalitarian system: A psychoanalytic view

The author discusses the ideas of three important psychoanalytic thinkers about group processes in large social groups: Sigmund Freud, Wilfred Bion, and Erich Fromm. Their ideas are developed and applied to analysis of group processes in totalitarian systems, as they were known to the author in Czechoslovakia and the Soviet Union. In conclusion, treatment considerations as they apply to patients who grew up in these regimes are developed and illustrated by clinical cases.This paper is dedicated to Dr. Alexander Wolf, who made his groups growth-promoting, free and holding environments.The author wants to thank Valerie Angel, M.S.W., Eva Papiasvili, Ph.D., Susan Kavaler, Ph.D., Maria Luisa Bastos, Ph.D., and Nancy Smith for their support, critical commentary, and helpful suggestions.     

Confi dentiality with respect to third parties: A psychoanalytic view

It is assumed that confi dentiality is not one singular ethical entity but a conglomerate of quite different issues depending upon clinical context and the sector of information sharing at stake. The focus here is on how to think psychoanalytically about requests for information from third parties (payers, courts, public security). Defi ning confi dentiality as a promise to 'never tell anything' outside of the relationship omits evaluation of the impact of the third's listening on the combined freedom of thought and freedom of speech in analyst and analysand. Circulation of information outside the dyad need not be toxic, need not disrupt the analytic couple's openness to new meaning. Key to contamination and inhibition of analytic work is whether or not disclosure serves an analytic end. Current defense of confi dentiality relies heavily on the models of protection of privacy and professional secrecy, which, though useful and relevant, fail to encompass the transitional, intersubjective space engendered by the analytic process. Suggestions are made for alternate sources of paradigms better suited to represent the latter. Offered for discussion is a draft of a confi dentiality policy with respect to third parties that is informed by psychoanalytic theory and clinical practice rather than by local legal jurisdiction or original disciplines ethics codes.     

A Kleinian view of psychoanalytic couples therapy: Part 1

This paper will investigate the central aspects of the psychoanalytic treatment of couples. The concept of analytic contact is introduced and the importance of each party of the couple being witness to the other party's response to analytic contact is discussed. Emphasis will be placed on issues of thinking, projective identification and the concept of container‐contained. Part 1 of the paper will focus mainly on theoretical issues but will then utilize one clinical case to illustrate some of the theoretical points. Using extensive case reports, Part 2 will continue to provide the reader with an in‐depth view of the important process of a couple's therapy within a psychoanalytic framework.     

A Kleinian view of psychoanalytic couples therapy: Part 2

With extensive case material, Part 2 continues to explore the psychoanalytic treatment of couples. Since most couples enter treatment operating in a more primitive paranoid‐schizoid stance, the author contends that it is best to initially focus on each partner's pathological projections and have the other partner witness their struggle to overcome personal issues that contaminate the couple's unified psychology. With continuous working through, the couple can gradually find a more depressive, integrative footing within themselves and as a couple. Again, the value of ‘witnessing’ and working through individual defensive reactions against thinking, pathological projective identifications and the breakdown of the container‐contained function are all examined in the clinical presentations. All these clinical elements are part of the establishment of analytic contact first with each party as individuals and later as a unified couple.     

A psychoanalytic view of the Rorschach Comprehensive System "special scores"

We analyzed the contemporary empirical and theoretical literature concerning the two predominant approaches for scoring formal thought disorder on the Rorschach, the Comprehensive System special scores, and the methodology of Rapaport, Gill, and Schafer (1946/1968). The psychoanalytic research related to selected special scores is reviewed, and some linkages to psychoanalytic developmental theory and psychopathology are made. Recommendations are presented to bridge the gap between these two important avenues of Rorschach research, with an emphasis on empirical rigor and intrapsychic contextual meaning.     

Sanctioned social violence: A psychoanalytic view. Part II

This paper is the second in a series of two papers. In Part I, the first paper, the author reviewed the influence on the development of socially sanctioned violence of psychodynamics of group psychology and mass psychology, the regressive pull of ideologies, personality features of social and political leadership, and historical trauma and social crises. In this Part II, the author explores, from a psychoanalytic perspective, the dehumanization processes related to fundamentalist ideologies and terrorism.     

Sanctioned social violence: A psychoanalytic view - Part I

This paper is the first of a series of two that present an effort to systematize the application of psychoanalytic theory of group processes to the outbreak of massive violence. It explores the origins and social amplification of primitive aggression by means of group psychology and mass psychology, and the combined influences of the regressive pull of ideologies, the personality features of social and political leadership, and the triggering impact of historical trauma and social crises. The paper describes a spectrum of narcissistic-paranoid mechanisms that provide a common matrix for the analysis of those aspects of social psychology that co-determine socially sanctioned violence.     

The edge of chaos: A nonlinear view of psychoanalytic technique

The field of nonlinear dynamics (or chaos theory) provides ways to expand concepts of psychoanalytic process that have implications for the technique of psychoanalysis. This paper describes how concepts of “the edge of chaos,” emergence, attractors, and coupled oscillators can help shape analytic technique resulting in an approach to doing analysis which is at the same time freer and more firmly based in an enlarged understanding of the ways in which psychoanalysis works than some current recommendation about technique. Illustrations from a lengthy analysis of an analysand with obsessive‐compulsive disorder show this approach in action.