Child versus adult psychoanalysis: Two processes or one?

Child analysis continues to be seen as a different technique from adult analysis because children are still involved in a developmental process and because the primary objects continue to play active roles in their lives. This paper argues that this is a false dichotomy. An extended vignette of the analysis of a latency‐aged girl is used to demonstrate that the psychoanalytic process that develops in child analysis is structurally the same as that in adult analysis. Both revolve around the analysis of resistance and transference and use both to promote knowledge of the patient’s mind at work. And both techniques formulate interventions based on the analyst’s appraisal of the patient’s mental organization. It is hoped that stressing the essential commonality of both techniques will promote the development of an overarching theory of psychoanalytic technique.     

Incest in Jung's work: the origins of the epistomophilic instinct

In this paper the differences between Jung's and Freud's writings on incest are explored. Jung's view is that the purpose of the child's sexual interest, as expressed also in his incestuous longings, is not purely the satisfaction of the biological instinct but is more importantly seen to be the development of thinking. The importance of the incest taboo for analytic work and the dangers of enactment of the erotic transference-countertransference dynamics are highlighted.     

The role and importance of interpretation in the talking cure

Starting with an exploration of how the concept of interpretation in analytical treatment has evolved, the author goes on to discuss the role and importance of interpretation in the changes that psychoanalysis brings about. Although interpretation is looked upon as the key element in psychoanalytic activity, the fact that it is subsumed within the transference raises questions as to its influence in the analytical domain. After discussing the foundations of interpretation with respect to the theory of psychoanalytic treatment and examining Strachey’s views on this, the author defines the conditions and constraints surrounding interpretation and preparatory interventions in order to outline the essential nature of the interpretative process as seen against the wider background of the analyst’s activity as manifested through speech. This leads to a discussion of the relative influence of insight and suggestion in bringing about therapeutic change. The author draws the conclusion that interpretation works as a metaphor in lifting repression.     

Self-Disclosure and Vulnerability

Abstract

Based on the theoretical assumption and clinical observation that projective identification is a natural, constant element in human psychology, clinical material is used to illustrate how projective identification centered transference states create situations where acting out of the patient's phantasies and conflicts by both patient and therapist is both common and unavoidable. Because they are more obvious, some forms of projective identification encountered in clinical practice are easier for the analyst to notice and interpret. Other forms are more subtle and therefore difficult to figure out. Finally, some forms, whether subtle or obvious, seem to create a stronger pull on the analyst to blindly act out.

In some psychoanalytic treatments, one form of projective identification might embody the core transference. In other cases, the patient might shift or evolve from one level of this mechanism to another. Some patients attempt to permanently discharge their projective anxiety, phantasy, or conflict into the analyst. There is a patent resistance to re-own, examine, or recognize this projection. Some of these patients are narcissistic in functioning, others are borderline, and many attempt to find refuge behind a psychic barricade or retreat (Steiner 1993). In other forms of projective identification, the patient enlists the analyst to master their internal struggles for them. This occurs through the combination of interpersonal and intra-psychic object relational dynamics. This “do my dirty work for me” approach within the transference can evoke various degrees of counter-transference enactments and transference/counter-transference acting out.

Another form of projective identification, common in the clinical setting, is when a patient wants to expand the way of relating internally, but is convinced the analyst needs to validate or coach the patient along. This is why such a patient may stimulate transference/counter-transference tests and conduct practice runs of new object relational phantasies within the therapeutic relationship. Over and over, the patient may gently engage the analyst in a test, to see if it is ok to change their core view of reality. Depending on how the analyst reacts or interprets, the patient may feel encouraged to or discouraged from continuing the new method of relating to self and object. The patient's view of the analyst's reactions is, of course, distorted by transference phantasies, so the analyst must be careful to investigate the patient's reasoning and feelings about the so-called encouragement or discouragement. This does not negate the possible counter-transference by the analyst in which he or she may indeed be seduced into becoming a discouraging or encouraging parental figure who actually voices suggestions and judgment.

All these forms of projective identification surface with patients across the diagnostic spectrum, from higher functioning depressive persons to those who are more disturbed paranoid-schizoid cases. Whether immediately obvious or more submerged in the therapeutic relationship, projective identification almost always leads to some degree of acting out on the part of the analyst. Therefore, it is critical to monitor or use the analyst's counter-transference as a map towards understanding the patient's phantasies and conflicts that push them to engage in a particular form of projective identification.     

'Go! Sterilise the fertile with thy rage' envy as embittered desire

This paper is concerned with the operation of envy: it considers its origins and their repercussions, in particular its compulsion to sterilize the evidence of fertility, exemplified by Roger Money-Kyrle's evocation of 'the parental intercourse as the supremely creative act'. The inevitable impact on the analytic relationship is considered in the context of two clinical examples of impasse. It is argued that such fundamentally negative transferences, one full of overt aggression and enactment, the other more covertly sabotaging, derive from envious retaliatory impulses originating in experiences--whether phantasied or factual--of exclusion from the anticipated 'good'. Significant recent Jungian contributions to this area are considered and the absence of references to 'envy'--so characteristic of Kleinian discourse--is noted. The ongoing value of integrating Jungian and Kleinian approaches is affirmed.     

Interpretation as Shaped by Projective Identification

How to make interpretations during the course of psychoanalytic treatment is a recurring clinical question. Certain aspects of the analysis serve as helpful signposts along the way. Patients have particular interpersonal ways of presenting themselves. The unique intrapsychic manner the patient has of relating to us (transference) and our feelings (countertransference) to these matters give us clues to study. Our understanding of these situations may lead to the development of a hypothesis we may or may not choose to share with the patient. Projective identification is a complex mental mechanism that can often shape the content and manner of an interpretation.