Elasticity of Technique: The Psychoanalytic Project and the Trajectory of Ferenczi's Life

The object of this paper is the Elasticity of Psychoanalytic Technique in the work of Sándor Ferenczi. The author sustains that this can be considered neither as an ultimate arrival point nor as a particular stage of Ferenczi's clinical–theoretical body of work, but rather as an ensemble of affective qualities, attitudes and values, which he gradually developed through experience, signalling a paradigm shift in the history of psychoanalysis. The following areas will be explored: the new sensitivity demonstrated by Ferenczi concerning the relational and communicative factors present in the analytic session, his subtle and acute attention to the participation of the analyst's own subjectivity in the therapeutic process, and how these enduring elements of Ferenczi's technique anticipate several significant future developments in psychoanalysis.     

Seeking Security in the Face of Fear: The Disorganized Dilemma

Attachment theory has been instrumental in identifying insecure disorganized attachment as a developmental pathway that leads to severe psychopathology in adults. Psychotherapy with these patients is challenging, offering a confusing pattern of relatedness, difficulties in mentalizing, problems expressing affect, utilizing dissociative defenses, and trying to gain an understanding of their subjectivity. This article provides a theoretical overview of disorganized attachment focusing on its etiology and how it presents throughout the life span. It reviews important therapeutic guidelines that help navigate the relationship with adults and presents a case study highlighting some clinical challenges.     

Issues of Power, Control, and Status in Group Interaction: From Ferenczi to Foucault

Examination of the issues of power, control, and status in human interaction is made from the works of Kafka, Ferenczi, and Foucault. Ferenczi's confusion of tongues theory as a model is used to describe the dynamics of charismatic group leadership in training group for analyst group candidates.     

弗洛伊德的得意门生——亚伯拉罕和费伦茨对精神分析发展的贡献

亚伯拉罕和费伦茨都是弗洛伊德的早期弟子,他们在精神分析早期理论以及治疗技术的创新和发展中都有着重要的贡献。亚伯拉罕重新划分了弗洛伊德的心理性欲发展阶段并探讨了前俄狄浦斯期的母子关系,这都深深影响了后来的客体关系学派;费伦茨发展了弗洛伊德的性诱惑理论并在治疗技术上做出了许多革新,这为精神分析后来的发展开辟出了更广阔的道路。     

Revisiting Bordin's Theory on the Therapeutic Alliance: Implications for Family Therapy

Because of the belief that relationships are a major contributor to problems as well as the avenue for bringing about change, the alliance between therapists and clients is important in family therapy. Writings and ideas on the therapeutic alliance from psychoanalytic theory were used by Edward Bordin to develop a working theory in 1979, and later adapted to the field of family therapy. However, the adaptation did not account for many variables unique and important to family therapy. This article describes the therapeutic alliance and the necessity of creating a theory of therapeutic alliance that accounts for family therapy concepts. Future ideas for scholarship are presented.     

The clinical language of Sándor Ferenczi: Introductory and methodological considerations

Abstract

Reflecting in the present paper on the legitimacy of a work to collect together the ideas, concepts, and terms of Sándor Ferenczi, the author will explore, through a series of questions and answers, the following points: why it is so clear-cut that Ferenczi should be included in the company of those great psychoanalytic authors who might be deemed entitled to such a study; whether Ferenczi possessed his own language, and if this was the case, when and how he acquired it; what we mean when we refer to Ferenczi’s idiomatic language, and how we can profitably identify this language and bring it into focus; how, in practice, such a text should be organized; what its audience and function would be; and how it would be used by readers and students of Ferenczi.     

The Ferenczi cult: its historical and political roots

I examine how Sándor Ferenczi has survived in the cultural memory of psychoanalysis, and why myths and legends have been created around his life and work. It seems that he could not escape the fate of the founding fathers of psychoanalysis, most notably, that of Freud and Jung: their life and work have become an object of cultic respect for the followers, diabolic figures for the enemies. Quasi-religious cultivation of the “great man” is an often observable phenomenon in literature, politics, history and in science, and it has several political and ideological functions. These functions may help to increase the inner cohesion and the group identity of the cultic community, to defend the group against external threats. Psychoanalysis has always been vulnerable to myth formation; first, for obvious sociological reasons, and, secondly, for reasons originating in the nature of therapy. The cultic functions can be realized in several ways, such as, for example, the ritualization of the transmission of knowledge, and the “biography as passion” that is, attempts to create a biographical narrative in which all life history moments crystallize around the great man's central theme. Most of the biographies on the life of great psychoanalysts are of this kind – and Ferenczi is no exception. A historiography of psychoanalysis must follow the path of modern historiography in general, which attempts at deconstructing both myths and counter-myths about persons, events and processes, in political, as well as in cultural and intellectual history. By examining the structure of myth formation about psychoanalysts we can learn a lot about how ideas are operating in changing social contexts.     

Therapists’ perspective on the therapeutic relationship: Examining a tripartite model

The components of a tripartite model of the therapeutic relationship, namely the working alliance, the transference configuration (transference and countertransference), and real relationship, were examined in terms of how they relate to one another and to the outcome of a psychotherapy session, from the therapists’ perspective. Although previous studies have examined these components separately, no study to date has examined the components together in their relation to session outcome. Licensed psychotherapists (n = 249) were recruited from two Divisions of the American Psychological Association. Therapists completed measures for the last session they had with a client. Results revealed that from the therapist’s perspective the real relationship and working alliance related positively to session outcome, and countertransference behavior related negatively to session outcome. The components related to each other mostly as predicted by the tripartite model, and a principal-axis factor analysis revealed the presence of four distinct factors resembling the components theorized to comprise the tripartite model. The components together accounted for 27% of the variance in session outcome and only the real relationship and the working alliance predicted session outcome when all the components were looked at simultaneously in a regression model.     

A Relational Psychoanalytic Model for Case Management: A Literature Review

Abstract

Relationship building is critical in case management with the seriously mentally ill. A theoretical framework, such as relational psychoanalytic theory, with a strong integrative emphasis provides a structure for the complex interplay of internal and external factors/forces in case management. The purpose of this paper is to provide a literature review in the area of case management: relational psychoanalytic theory, relationship building and psychodynamic theory. The review concludes outlining the appropriateness of this theoretical framework for case management.     

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) .     

‘THERE IS A WAR ON! SOMEONE IS GOING TO GET KILLED’

This paper describes the first three years of work providing consultation at the interface between adult mental health and children's services. It suggests that significant numbers of children, living with parents whose mental illness may be ‘severe and enduring’, remain hidden from services. The author applies psychoanalytic theory in an attempt to understand the unconscious factors, for organizations as well as for individuals, which may contribute to making it so difficult for services to work co‐operatively to recognize these children's existence and their emotional needs. She reviews some of the related fields in which the application of psychoanalytic thinking has occurred and also describes the context in which the work takes place. A series of vignettes demonstrate some of the difficulties encountered and the ways in which the presence of a neutral third or ‘other’ can contribute to their resolution. She suggests working relationships between adult's and children's services are profoundly affected by the psychotic processes operating in the minds of these parents and that the consultant acts as a container enabling staff to manage the fragmentation and splitting which would otherwise be inevitable.     

‘Mr K’ – A successful case of analytic oriented therapy documented empirically: the role of the therapeutic relationship and reflexive self-awareness

A successful case of analytic treatment over the course of 250 sessions is described from different perspectives, including considerations from the two-year follow-up. The therapeutic alliance and the patient’s experiencing were evaluated. Pre-treatment diagnosis was validated via diagnostic interview. Symptoms and interpersonal problems were assessed at intervals. Data were analysed using two different time-series analyses. Aspects of agency with regard to mentalizing capacity were assessed with the Metacognitive Assessment Scale. We obtained the following main results: (1) Symptoms and interpersonal problems improved continuously until the end of treatment. Symptom severity fell to below the clinical cut-off. This successful outcome remained stable at the two-year follow-up. (2) The therapeutic relationship improved during the therapeutic process. (3) The patient’s capability for reflexive self-awareness, operationalized as experiencing, decreased. (4) The metacognitive mastery of the patient increased. The following conclusions were made after combining the empirical data with the clinical observations: (1) Mr K improved clinically in terms of symptoms, self-regulation and interpersonal problems as a result of his gaining affect control. (2) The patient’s experiencing does not capture a positive outcome in all cases. (3) Aspects of agency (i.e. metacognitive mastery) deserve further attention in psychoanalytic treatments.     

A dialogue of unconsciouses. A contribution to the panel 'Jung and Ferenczi--the emergent conversation'

I want to explore the notion of 'mutual introjection, the developmental essence of an autobiographical dialogue', an idea that has recently crystallized in the continuing collaborative work of Gershon J. Molad of Israel and myself concerning the autobiographical contribution to the dialogue between analysis (Molad & Vida 2002). One of the sources of this crystallization is the experience of my consultative relationship with a Jungian colleague, who, after reading some of this collaborative work, paraphrased Jung's implication that if, in the course of treatment, the doctor is not as transformed as the patient, nothing has happened (1946). In this paper, I want to breathe some life into these theoretical-sounding words: 'mutual introjection, the developmental essence of an autobiographical dialogue'.     

‘The essay method’ a qualitative method for studying therapeutic dialogues

ABSTRACT

This paper presents a qualitative research method for analysing therapeutic dialogues called ‘the essay method’. A central part of the method uses the format of the literary essay as a model. The method consists of a close monitoring of clinical material guided by an overall psychoanalytic/psychodynamic theoretical frame. It combines both clinical details and global patterns of clinical material and is especially fitted for studying relational qualities of psychotherapeutic dialogues. In this paper, the background for qualitative analysis in studying psychoanalytic material is discussed, and the procedures for using the method are demonstrated. A study of therapeutic competence in a group of student therapists is used as an example of the method in practice, demonstrating that the essay method may have potential for revising theory and establishing new concepts based on empirical findings. The essay method is compared with other qualitative methods, and it is argued that it is suitable for psychoanalytic research.     

Psychoanalytic Psychotherapy for Severely Disturbed Borderline Patients: Observations on the Supervision Group of Psychotherapists

The authors describe the role of a supervision group of psychotherapists within a wider therapeutic field for severely disturbed borderline patients. The group concentrates on the transference and countertransference, seen according to Racker’s distinction between concordant and complementary identifications. The implications of the prevalence of the complementary identifications over the concordant identifications of the therapists to their patients and the resulting regression to primitive defense mechanisms can be counterbalanced by the group’s integrative functioning as receiver (1) of a variety of information about the patient, (2) of the therapist’s attempt to understand and synthesize, and (3) of the therapist’s countertransference reactions to his patient. The major discrepancies between the various conceptions of the borderline patients’ psychic world and the appropriate therapeutic technique to be applied are also discussed, as well as the way the group filters the information and integrates the therapeutic thought. It might be said, therefore, that, in the “inpatient” phase of the individual psychotherapy, the group of psychotherapists functions, for the patient and the treatment, in a synthesizing context, as it provides the therapist with a space of integration for his split-off part of self and object representations, which the therapist makes use of for his patient.*Members of the Athens University Project for Borderline Patients’ research team consisting of psychoanalysts and psychotherapists, Eginition Hospital, 74 Vas Sophias Avenue, Athens 11528, Greece.Maria Chatziandreou, M.D., is a member of the Hellenic Psychoanalytical Society.Haris Tsani, M.D., is a candidate of the Hellenic Psychoanalytical Society.Nikos Lamnidis, M.D., is a candidate of the Hellenic Psychoanalytical Society.Claire Synodinou, Ph.D., is a member of the Paris Psychoanalytical Society and an associate professor at Panteion University, Athens.Grigoris Vaslamatzis, M.D., is a training analyst of the Hellenic Society of Psychoanalytic Psychotherapy and an associate professor of psychiatry at Athens University.Address correspondence to: Maria Chatziandreou, M.D., 1-3, Skippi Street, 11525 Athens, Greece.