Kriegskinder als Psychoanalytiker

A part of the research project made at the Ludwig-Maximilians-Universität München about Childhood during World War II is reported here about the comments of psychoanalysts who were children at the time of World War II, about their life story, their individual development, their psychoanalytic socialization and their present professional practice. Special attention is paid to the question whether and how the war and National Socialism have influenced training analysis as it is represented in the memory of the former analysands, in which war and National Socialism represent a common experiential background both of analysands and training analysts.     

Vicissitudes of ideas of cure in analysands and their analysts: a longitudinal interview study

This longitudinal prospective study focuses on analysands' and analysts' implicit ideas of how psychoanalysis might help analysands' psychological problems. Seven analysands and their analysts were periodically interviewed. Single ideas of cure from 75 interviews were inductively categorized. Nine distinct types of cures emerged, representing the wished-for goals of psychoanalysis, as well as the actions to achieve the wished-for changes. Each category might comprise more or less utopian ideas of wished-for cure as well as ideas of an attainable, more limited cure, or combinations of these. The utopian ideas of wished-for cures persisted throughout the psychoanalytic process for more than half the analysands and analysts. The abandonment of these ideas was related to the experienced outcome of psychoanalysis. The relation between the theories of one analysand and her analyst is explored in depth in a case study with special emphasis on the analytic process. The study suggests that the psychoanalytic process might profit from the analyst's observance of such incongruities and an openness to work through them.     

Countertransference and the myth of the perfectly analyzed analyst

Countertransference is an inevitable feature of every psychoanalysis. Psychoanalysts are (and need to be) only human; psychoanalytic work is arduous and replete with stresses, strains, and deprivations; analysands tend to probe for vulnerabilities in their analysts that can be exploited in the interest of acting out neurotic wishes instead of analyzing them; and a training analysis cannot completely immunize a psychoanalyst against countertransferential reactions that impede analytic progress. Psychoanalysts must be vigilant to the emergence of countertransference reactions so that they can analyze and overcome them. Two illustrative clinical examples are provided.     

“Expanding the Frame”: Reply to Commentary

In responding to a discussion by Susi Federici-Nebbiosi of “When the Frame Doesn't Fit the Picture,” I further consider the ways in which analysts and analysands together create the best conditions for their work. I emphasize that analytic work best fulfills its potential when it grows out of a collaborative search for ways of constructing the psychoanalytic situation that are most fully and subtly responsive to the unique qualities and circumstances of each patient and analyst. Implications for psychoanalytic training of an intersubjective model of frame construction are briefly considered.     

The crisis of psychoanalysis and psychoanalytical training: The suffering of the candidate on the long road towards qualifi cation1

The author assesses the impact of the so‐called ‘crisis of psychoanalysis’ on the training of candidates, and on those who accompany them through the course. Different causes of the most relevant symptom of the crisis, i.e. the diffi culty of fi nding patients for a four‐sessions‐weekly analysis, are considered. According to the author, analysts themselves must bear some of the responsibility for it. She draws attention to a number of interrelated phenomena, such as: trainees' tension in their encounters with potential analysands, due to awareness of their own needs as trainees; the necessity to accept very disturbed patients whose selection might arouse criticism from the training committee; analyses in which trainees seem to become patients' hostages because of ever‐present fears of interruption; the diffi cult construction of a psychoanalytic identity in trainees who also are in full‐time psychiatric practice; trainees' profound uncertainty about the future both of psychoanalysis in general and their own careers in particular. In agreement with Kernberg, the author stresses the importance of considering the ‘crisis of psychoanalysis’ as a phenomenon whose development may be infl uenced by the analysts themselves.     

The psychoanalytic process

Analysts differ in how they conceptualize the psychoanalytic process, according to their understanding of the psychoanalytic theory of mental functioning in general and the nature of pathogenesis in particular. Emphasizing that psychoanalysis is a psychology of mental conflict, the authors see the psychoanalytic process in terms of the dynamic interplay between the manifestations of the patient's unconscious and the analyst's interventions. What analysts communicate to analysands serves to destabilize the equilibrium of forces within the mind, leading to the analysands' growing understanding of the nature of their conflicts and how they deal with them. Psychoanalytic process, accordingly, cannot be distinguished or separated from psychoanalytic technique.     

Some hazards to neutrality in the psychoanalysis of candidates

The author looks at the challenges confronting psychoanalysts as they attempt to approach a desirable goal of neutrality in the treatment of psychoanalytic candidates and others who will become or are professional colleagues. Many such hazards are embedded in the interlocking relationships that inevitably exist between the analytic institute and its personnel, its training analysts, and its candidate-analysands. The author considers difficulties in the crucial analysis of aggression in training analyses. The analysis of aggression plays a determinative role in the personal and professional lives of analysands, and vitally affects the health and creativity of analytic institutions and the future of psychoanalysis.     

Disquiet in the consulting room: everything/nothing that is said here is confidential

Writing from experiences in the consulting room in private practice in Australia, the author refers to the layered complexity of a conflict of ethical duty which has legal and social implications. The paper explores how the ethics that are congruent with creating a safe vas bene claustrum can be diametrically opposed to the social and legal structures and processes on which we all rely. It is suggested that within the vas, analysts and analysands engage in a shared process of emotionally connected, layered, symbolic thinking. Subpoenas directed at analysts are seeking concrete evidence that will stand up in court. The paper argues that this is a category error based on ignorance and misconceptions of what analytic work entails. The intrusion of a subpoena into the vas has the potential to cause havoc in the mental health and the lives of already vulnerable, possibly traumatized and isolated individuals. It can undermine a fundamental human right and undermine the profession of psychotherapy as a whole. The paper proposes that analysts have an ethical obligation to protect the work contained within the vas from these category errors and to educate other professionals as to why we cannot provide the kind of evidence that the courts require.     

Conducting analysis after September 11: implications for psychoanalytic technique

The September 11, 2001, terrorist attack on the World Trade Center profoundly affected the population of New York City, including analysts and analysands. To study the effect of this event on the technique of psychoanalysts conducting ongoing analysis during the weeks after 9/11, confidential questionnaires were sent to all candidates and faculty at the Columbia University Center for Psychoanalytic Training and Research. Respondents indicated that in the days and weeks following 9/11 they initiated phone calls to their analysands, asked about their analysands' families, gave advice when it was requested, offered reassurance, and answered personal questions. They did not initiate physical contact, discontinue use of the couch, or give unsolicited advice. These responses suggest that these analysts made decisions to alter their technique in certain ways in the wake of a catastrophic event shared by the community.     

THE EFFECT OF THE ANALYST'S GENDER AND OTHER FACTORS ONPOST-TERMNATION PATIENT-ANALYST CONTACT: CONFIRMATIONBY A QUESTIONNAIRE STUDY

This questionnaire study was designed to confirm and further explore an earlier finding of a gender difference in post-termination patient-analyst contact, as well as to assess whether practices regarding post-termination contact have changed in the five-year interval since the first study. The hypothesis that women analysts are more likely to have post-termination contact with their analysands than men analysts was confirmed by the present study. Analysts who report thinking frequently about their most significant analyst are contacted by a much larger proportion of prior patients than those who rarely think about their analyst. Further, women analysts are more likely to feel they benefited from the analysis they consider their most significant analysis, and to feel positively about that analyst. In 1994, analysts were much more accepting of and more likely to propose post-termination contact than in 1989. What the analyst reports he/she says to the patient is associated with the likelihood of such contact.     

Freud's writing: his (w)rite of passage and its reverberations

The study of Freud's personal conception of writing and his use of it illuminates a significant aspect of his relationship with others, and also his sense of his own heroic greatness. In two related periods of his life, acts of writing--which were notably overdetermined in Freud and which informed as well as facilitated a distinctive kind of self-expression--gave rise to veritable (w)rites of passage. In those periods, the transferential dynamics in Freud's relationships with Fliess, his daughter Anna, and certain important analysands were expressed in ways connected with the content and process of various types of writing, including editing and translating. In sum, there is something still to be discovered in Freud's attitudes to his writing and to related intergenerational transactions between analysts and analysands who engage together in compositional activities.     

Writing about patients: IV. patients' reactions to reading about themselves

When analysands read about themselves in reports, their reactions range from anger, disappointment, or condemnation to a sense of appreciation or even idealization of the analyst. The eleven interviews reported here reflect only conscious responses; the unconscious layers were not probed for. It should be kept in mind also that the analysts of these patients might report very different stories. Other limitations are the small sample size and the representation only of patients who volunteered. Nonetheless, the information they provide may help analysts consider how and when writing about patients may influence their representation of themselves, the analyst, and analysis itself.     

Technical challenges faced by the immigrant psychoanalyst

This paper delineates the technical challenges faced by immigrant analysts. These include (i) maintaining cultural neutrality toward "native" patients, (ii) wondering about the patient's motivations for choosing an ethnoculturally different analyst, (iii) scanning the patient's associations for interethnic clues to deeper transferences, (iv) negotiating the dilemmas posed by conducting analysis in a language other than one's mother tongue, and (v) avoiding shared projections, acculturation gaps, and nostalgic collusion in working with homoethnic immigrant analysands. While by no means irrelevant to the clinical work of non-immigrant analysts, these tasks seem to have a greater importance for the immigrant analyst. Brief clinical vignettes are offered to illustrate these propositions and to highlight the tension between the universality of fundamental intrapsychic and relational configurations, on the one hand, and the nuances of cultural and linguistic context, on the other.     

The wish to regress in patient and analyst

The analyst's wish to regress is used as a paradigm of the "forbidden" topic of what analysts want from their analysands. The aim is to expand the subjective domain of analysts' awareness so that they can analyze better by grasping more of their temptations with patients before enactment can occur. Clinical examples illustrate how the author temporarily joined patients in wish-fulfilling mutual regression. Analytic process is disrupted when the analyst wishes to relinquish the more differentiated role of the containing and interpreting analyst in favor of more childlike relatedness both with the patient and with the analyst's internal objects. The author, expecting a more typical counter-transference, had not anticipated that he might temporarily join these nonpsychotic patients in mutual regression. It is suggested that in the face of analytic impasse analysts should consider whether they might temporarily have joined the patient in mutually regressive wishes that have taken them away from more responsible analytic functioning.     

Beyond the word in psychoanalysis the unspoken dialogue

The practice of psychoanalysis, traditionally, has privileged verbal communication. In relational theory the therapeutic significance of unconscious, semantically unformulated, but nonverbally encoded communications has been recognized. While patients are understood to generate significant nonverbal material for use in the treatment process, similar nonverbal productions from analysts rarely have been acknowledged as useful for treatment. In this paper, I demonstrate a way to recognize and use the nonverbal productions of analysts as well as of analysands within the analytic process. A brief review is offered of contemporary authors who have conceptualized the importance of the nonverbal realm for psychoanalytic treatment. An approach is then described that builds on process conceptualizations derived from the infant research literature. The model, illustrated with two clinical examples, provides a way of conceptualizing “process contours”; on a nonverbal level of exchange between analyst and analysand that becomes the medium for catalyzing the transition from presymbolic interactions to symbolic language. Working on this level, analyst and analysand coconstruct scenes from both the dreaded past and the hoped‐for present/future, which, when reflected on in a joint process of narrative construction, provide a new context for accessing previously dissociated affective experience.     

The Emperor's clothes: Some serious problems in psychoanalytic training

The author discusses some of the key problems in psychoanalytic training, in particular those problems that stem from the power differential between training analysts and students in training. One effect of this differential can be that some students feel a pressure to comply with their teachers and supervisors, even their training analyst, in ways that can be seriously detrimental to their development. Further, when something goes wrong in a student's training, how is this to be viewed by those in charge of the training? Also, how are complaints dealt with? Is suffi cient weight given to external reality? Too often training analysts, and training committees, get into pathologising a student in a process that should be recognised as ‘wild analysis in committee’, rather than considering more carefully the external realities that may be affecting a student's progress in the training. This ‘analysis’ in committee should never be allowed. There is an urgency for immediate changes to be made in psychoanalytic training so that the problems discussed, with more care being taken, should be prevented from happening. Too often, however, an institutional resistance to change dominates discussions in committee, and in society meetings, with the result that little or no change takes place even after years of debate.     

Was bringt ?GRAS��?

Autonomous groups in the sense of GRAS (group analysis seminars) are groups without leaders. The small groups come together for self-experience within the framework of GRAS (Gruppenanalyse-Seminare, founded by Michael Lukas Moeller in 1977). Their members are group analysts who continue to participate in long-standing small groups on self-experience after completing their educational training as group analysts in GRAS. Participants of these groups (14 women and 11 men, average age 57.7 years) were interviewed about their experiences within GRAS and the subjective effects on their life. The interviews were evaluated in a qualitative research design. The findings show that the effects of GRAS are estimated to be extensive and very positive for private and professional life. The main modus to be in the group is experienced as retentive, acceptive and inspiring. Autonomous groups in the sense of GRAS form an important background of experience for trained group analysts themselves and continuously stimulate personal advancement and mental health.     

Choice

Understanding how and why analysands make the choices they do is central to both the clinical and the theoretical projects of psychoanalysis. And yet we know very little about the process of choice or about the relationship between choices and motives. A striking parallel is to be found between the ways choice is narrated in ancient Greek texts and the experience of analysts as they observe patients making choices in everyday clinical work. Pursuing this convergence of classical and contemporary sensibilities will illuminate crucial elements of the various meanings of choice, and of the way that these meanings change over the course of psychoanalytic treatment.     

The fundamental rule: a study of current usage

Members of the editorial boards of the Journal of the American Psychoanalytic Association, Psychoanalytic Quarterly, and Psychoanalytic Inquiry, plus selected analysts from Canada, France, and England, were asked how they presented the fundamental rule to their analysands and what considerations led to their choice of initial guidelines. Forty-nine of eight-three analysts responded to the survey. The respondents described diversity in phrasing of the fundamental rule, the time in analysis when the guidelines are given, and the reasons for the practice they follow. The method each chose appears to reflect the differing conceptions analysts have of the analytic process. Two major trends emerged: either our respondents emphasized delineating a work or functional framework or contract, or they emphasized establishing an attitude or spirit of cooperation, mutuality and work sharing. In each group respondents differed as to whether they favored minimal or more lengthy instructions. They also differed as to whether they followed a consistent approach or one tailored to the needs of the individual analysand. A source of tension lay in an inclination either to remain in the tradition set by Freud or to experiment with different phrasings and timings. The authors give their reasons for choosing to give explicit instructions, requesting associational material beyond thoughts and feelings, and describing resistance as inevitable and a potential source of insight.