A psychoanalytic perspective on attention-deficit/hyperactivity disorder

Psychoanalysts have tended to view the diagnosis of AD/HD either with skepticism or as a contraindication to analytic treatment. The author reviews the history of this puzzling diagnostic entity, which is estimated to account for up to fifty percent of child referrals, and suggests that a psychoanalytic perspective on the underlying disturbance in ego functioning helps to clarify the nature of the symptom picture. Whatever the etiology, which may be compound, she suggests that psychoanalytic treatment, most often in conjunction with psychopharmacological therapy, can address the core disturbance in ego integration that creates the familiar triad of inattention, impulsivity, and hyperactivity.     

A comparison of psychoanalytic and psychodramatic theory from a psychodramatist's perspective

A comparison of Freud's and Moreno's theories with regard to their implications for psychodrama therapy. Basic differences in the theories are discussed with special regard to therapist role, transference and tele, insight and catharsis, the time concept, the body, and developmental psychology. Other topics treated are concepts of drive or energy, psychic structure and role theory, psychic determinism contra the doctrine of spontaneity-creativity and differences between an intrapsychic and an interpersonal approach. An outline of the relationship of psychodrama and its philosophy and practice to other schools of psychotherapy is given.     

Mourning and psychosis: a psychoanalytic perspective

The author attempts to develop some of the basic models and concepts relating to mourning processes in psychotic patients on the assumption that situations of loss and mourning are key moments for psychoanalysis, psychotherapy, and therapeutic approaches in general. Secondly, he reminds us that 'mourning processes in psychotics' are not always 'psychotic mourning processes', that is to say, that they do not necessarily occur within, or give rise to, a psychotic clinical picture. These ideas are illustrated by a number of sessions and vignettes concerning two psychotic patients in psychotherapeutic and psychoanalytic treatment. In theoretical terms, it seems vitally important in this context to combine a relationship-based approach within a framework of special psychoanalytic psychopathology with an updated view of processes of mourning and affective loss. A fundamental requirement at clinical level is to determine the role to be played by psychoanalytically based treatments in combined, integrated or global therapies when working with psychotic patients. For this purpose, the paper ends by outlining a set of principles and objectives for such treatments.     

Interpreting psychoanalytic interpretation: a fourfold perspective

Following an overview of psychoanalytic interpretation in theory, practice, and historical context, as well as the question of whether interpretations have scientific validity, the author holds that hermeneutics, the philosophical and psychological study of interpretation, provides a rich understanding of recent developments in self psychology, inter-subjective and relational perspectives, attachment theory, and psycho-spiritual views on psychoanalytic process. He then offers four distinct hermeneutical vantage points regarding interpretation in the psychoanalytic context, including (1) Freud's adaptation of the Aristotelian view of interpretation as the uncovering of a set of predetermined meanings and structures; (2) the phenomenological view of interpretation as the laying bare of "the things themselves," that is, removing the coverings of objectification and concretization imposed by social norms and the conscious ego; (3) the dialogical existential view of interpretation as an ongoing relational process; and (4) the transformational understanding in which interpretation evokes a "presence" that transforms both patient and analyst. He concludes by contending that these perspectives are not mutually exclusive ways of conducting an analysis, but rather that all occur within the analyst's suspended attention, the caregiving and holding essential to good therapeutic outcomes, and the mutuality of the psychoanalytic dialogue.     

The poet as prophet: a psychoanalytic perspective

The poet spins a public fantasy, created from his own private daydreams and speaking to the unconscious fantasies of his audience. He presents a socially acceptable form of expression of forbidden wishes and conflicts. A process of mutual exculpation is set up between the poet and his audience. For a special group the work of the poet may also make possible the alleviation of pathogenic anxieties. An examination of the play, The Beard, indicates how an artist may intuit and articulate changes in sexual morality. The poet rebels against the constraints of society, thereby helping his audience to rebel without guilt. He may be the herald of a changing morality, and even more, his art may become an instrument for such change.     

Thinking about psychoanalytic curricula: an epistemological perspective

The author discusses the role that curriculum development can play in preparing psychoanalytic candidates to understand the challenges created by theoretical pluralism in our field and by the growth of knowledge in neighboring disciplines. Curriculum design can be used to encourage the development of epistemological perspectives that can serve as organizing frameworks to help candidates think critically about psychoanalytic knowledge. It is possible to teach these complex matters in a way that students find accessible and useful. The author presents exemplars taken from the curriculum at the Columbia University Center for Psychoanalytic Training and Research in New York.     

Becoming a father: a psychoanalytic perspective on the forgotten parent

This article has presented a psychoanalytic perspective on the process of becoming a father. It began with a discussion of the neglect of the father during pregnancy and briefly considered evidence as to the unique contributions made by fathers of the newborn. Nine psychodynamically based wishes emerging throughout the developmental process were next proposed to embody the male's motivation to become a father. The final section examined seven specific phases of expectant fatherhood, from getting ready through parturition.     

The psychoanalytic perspective of adolescent homosexuality: a review

Psychoanalytic theory asserts that adolescent homosexuality is the result of unresolved infantile conflict experienced during the Oedipal and pre-Oedipal periods, in which inadequate object relations and identifications with parents predispose the individual to homosexuality in adolescence. Classical psychoanalytic thought emphasizes the importance of drives and defenses in the formation of homosexuality, while more contemporary approaches understand adolescent homosexuality from a psychosocial and early developmental perspective. In addition to childhood predispositions, the various developmental tasks of adolescence influence the degree and course of homosexuality. This article notes the different types of homosexuality that emerge in adolescence which are influenced by different psychodynamic conditions in each stage of adolescence. Changing developmental roles in relation to individuation, object relations, identification, and identity formation are a few of the factors that contribute to adolescent homosexuality.     

The functioning of religions from a modern psychoanalytic perspective

This paper considers the personal psychological development which can take place in the adherents of certain religions, and compares it with the personal development which can take place in a psychoanalysis. The author argues that the preoccupations of different religions are very various, and to understand their functioning it is important to recognise the variety of their goals. Using the Kleinian notion of psychic ‘positions', and with the help of a neuro-scientific model, it becomes possible to conceptualise the psychological effectiveness of both psychoanalysis and the religions, and to relate them intelligibly. There continues, however, to be a radical difference between the ways in which psychoanalysis and the religions cause their psychological effects, which is best seen by considering the nature of their objects.