The body one has and the body one is: Understanding the transsexual’s need to be seen

The transsexual individual confronts the analyst with a disturbing otherness. How this otherness is understood, that is, how the analyst ‘looks’ at the patient through her distinctive theoretical lens impacts, in turn, on the patient’s experience and what transpires between them. In this paper the author outlines a developmental model rooted in attachment and object relations theory to provide one alternative way of ‘looking’ at some of these patients’ experiences in the clinical setting. It is suggested that in some cases of transsexuality the primary object(s) did not mirror and contain an early experience of incongruity between the given body and the subjective experience of gender: it remains unmentalized and disrupts self‐coherence leading to the pursuit of surgery that is anticipated to ‘guarantee’ relief from the incongruity. Through an account of work with a male to female (MtF) transsexual who underwent surgery during her five years of psychotherapy, the author explores how a focus on the transsexual’s experience of ‘being seen’, that is, of being taken in (or not) visually and mentally by the object in their state of incongruity, affords another window through which to approach the transsexual’s experience in the transference–countertransference dynamics.     

How Many Times and How Many Ways: The Impact of Number of Nonsuicidal Self‐Injury Methods on the Relationship Between Nonsuicidal Self‐Injury Frequency and Suicidal Behavior

Several variables have been proposed as heavily influencing or explaining the association between nonsuicidal self‐injury (NSSI) and suicidal behavior. We propose that increased comfort with bodily harm may serve as an incrementally valuable variable to consider. We sought to indirectly test this possibility by examining the moderating role of number of NSSI methods utilized on the relationship between NSSI frequency and lifetime number of suicide attempts, positing that increased variability in methods would be indicative with a greater general comfort with inflicting harm upon one's own body. In both a large sample of emerging adults (n = 1,317) and a subsample with at least one prior suicide attempt (n = 143), results were consistent with our hypothesis. In both samples, the interaction term was significant, with the relationship between NSSI frequency and suicidal behavior increasing in magnitude from low to mean to high levels of NSSI methods. Although frequency of NSSI is robustly associated with suicidal behavior, the magnitude of that relationship increases as an individual engages in a wider variety of NSSI methods. We propose that this may be due to an increased comfort with the general concept of damaging one's own body resulting from a broader selection of methods for self‐harm.     

Recognition of Difference in the Author–Discussant Relation: Reply to Commentary

This author describes how poetry infuses her way of thinking, feeling, and writing and her way of working analytically. She introduces the concept of a nonanalytic third—the analyst's personal, intimate, and substantially abiding relationship to some body of experience unrelated to materia psychoanalytica. She posits that this nonanalytic third, the nature of which is unique to each analyst, constitutes a source of enrichment, texture, and dimensionality as well as personally compelling metaphors that the analyst may offer to the patient as other-than-me substance and a placeholder for cultivating the potential in the discourse of analytic potential space, in addition to serving as a facilitator and comfort for transition when the analyst must recognize and promote the necessary ending of an intimate analytic relationship.

Using Stephen Mitchell's notions of intersubjectivity and also using the analyst's and patient's separate role responsibilities in the creation of a context for the absence of conscious intentions, the author develops her concept of the nonanalytic third and the particular contribution of poetry to clinical process. These ideas are illustrated with a detailed case example of an unfolding analytic process that includes an e-mail exchange at the time when a shocking form of nonanalytic third appeared—September 11, 2001.     

RUPTURES IN THE ANALYTIC SETTING AND DISTURBANCES IN THE TRANSFORMATIONAL FIELD OF DREAMS

This paper explores some implications of Bleger's (1967, 2013) concept of the analytic situation, which he views as comprising the analytic setting and the analytic process. The author discusses Bleger's idea of the analytic setting as the depositary for projected painful aspects in either the analyst or patient or both—affects that are then rendered as nonprocess. In contrast, the contents of the analytic process are subject to an incessant process of transformation (Green 2005). The author goes on to enumerate various components of the analytic setting: the nonhuman, object relational, and the analyst's “person” (including mental functioning). An extended clinical vignette is offered as an illustration.     

The importance of feeling sexually attractive: Can it predict an individual's experience of their sexuality and sexual relationships across gender and sexual orientation?

Limited research exists on the implications of feeling sexually attractive for various aspects of sexuality and sexual relationships. This article examined associations between self‐perceived sexual attractiveness and sexual esteem, sexual satisfaction and amount of sexual experience, among both men and women who identified as heterosexual (n = 1017), gay or lesbian (n = 1225) or bisexual (n = 651). Results of the study demonstrated that positive self‐perceptions of sexual attractiveness predicted greater sexual esteem, greater sexual satisfaction, a higher frequency of sexual activity with others and a larger number of sexual partners among both men and women who identified as heterosexual, gay, lesbian or bisexual. The findings suggest that feeling sexually attractive may have implications for how an individual experiences their sexuality and sexual relationships regardless of their gender or sexual orientation. The importance of considering an individual's self‐perceptions of sexual attractiveness when they present with concerns related to their sexual experiences or relationships, and the potential benefits of educational and therapeutic interventions designed to enhance self‐perceptions of sexual attractiveness are discussed.     

THE ANTEROOM: A CAMERA OBSCURA FOR GRASPING ASPECTS INVISIBLE IN THE CLASSICAL SETTING

The anteroom ¹ , ² is not only an architectural space, but also a location in the field where analyst and patient meet in a different frame of mind from the therapeutic attitude that characterizes their relationship in the consulting room. Drawing a parallel with the variations in perception generated by the camera obscura in the experience of a painter, the author investigates how new aspects of the conscious and unconscious relationship between analyst and patient can emerge within a different setting. Observation of these variations suggests the possibility of regarding the setting no longer as an invariant of the field, but instead as one of the factors that can actively mold the analytic relationship.     

‘The bereaved therapist speaks’. An interpretative phenomenological analysis of humanistic therapists' experiences of a significant personal bereavement and its impact upon their therapeutic practice: An exploratory study

Aim: The aim of the research was to explore the under‐researched area of therapists' personal bereavement and its impact upon their therapeutic practice. Method: Data were collected via semi‐structured interviews with four humanistic therapists and were analysed using Interpretative Phenomenological Analysis (IPA). Findings: Four master and eight subordinate themes emerged from the rich data collected that exemplified both convergence with and divergence from the small body of extant literature on therapist bereavement and current thinking in thanatology. The findings suggest that bereavement is a unique experience that can affect the individual's personal and social identity and worldview. It can also be a transformative experience resulting in personal growth and a renewed sense of self and agency. In terms of professional practice, the findings suggest that the lived experience of the grieving process, mediated by supportive supervision, enabled participants to experience deeper levels of empathy and connectedness within their therapeutic relationships. Conclusion and implications: Bereavement is an experience that can profoundly impact upon therapists' personal identity and assumptive world. Such an experience can have an equally profound impact upon their therapeutic practice. There are therefore implications for students, trainers, therapists and supervisors particularly in terms of self‐care and the use of the ‘self’ in therapy. Further research needs to be undertaken in order to explore in greater depth the intersection between personal bereavement and therapists' evolving personal and professional identity development.     

Being in‐between: The relevance of ethnography and auto‐ethnography for psychotherapy research

Aims: This paper proposes that ethnography and auto‐ethnography can make important contributions to counselling and psychotherapy research. Auto‐ethnography is a recent methodological approach that focuses on the subjective experiences of the researcher. It is informed by anthropology, which encourages the researcher to journey alongside the persons being observed and to make meaning of complex symbolic systems in their lives. Method: Examples from a study of therapeutic processes in a mental health setting for women are examined. Discussion: If auto‐ethnography situates the researcher with the insider's perspective and ethnography is from the outsider's perspective, the researcher is caught ‘in‐between’ these two approaches. Acknowledging the concept of ‘in‐between‐ness’ can both cause discomfort and transform the experience of all who engage in the process and enhance the quality of the research.     

Thinking Out Loud about Teaching Bioethics: A Contribution from the Edge

Abstract. Teaching bioethics might be likened to a rollercoaster ride of twists, turns, and dips that invite teachers and students to experience something of their own edges of fear and comfort. Here the author provides readers with a glimpse into her distinctive approach to teaching bioethics that encourages students to move beyond boundaries of personal comfort zones by willfully transgressing traditional or comfortable boundaries. The essay describes how this is accomplished through a variety of methods – provocative readings, classroom discussion, student response papers, and student ethics committees. The author contends that teaching bioethics ought to include critical pedagogical methods and an alertness for real‐life intersections of science and ethics. Teaching bioethics can be a subversive activity that encourages students and teachers to engage in making life morally livable.     

The manifestation of transference during early psychotherapy sessions: Exploring an alternate data source for therapist narratives in transference research

Introduction: Previous transference studies have compared in‐session client narratives about significant others to in‐session client narratives about the therapist, limiting data to the information that clients are willing to share with the therapist. Method: The first three sessions of 30 therapies with high‐functioning individuals were examined using the Core Conflictual Relationship Theme (CCRT) method. Client narratives about others were drawn from the psychotherapy sessions and client narratives about the therapist were drawn from a Participant Critical Event (PCE) interview conducted after the third session of therapy. Results: Factor analyses of the CCRT components indicated several relational patterns: a complementary pattern of relating characterised by a devaluation of the therapist and idealisation of others; a concordant relational transfer where clients feel bad with both the therapist and others; and as clients experience control issues with significant others, they wish to adopt a submissive stance toward the therapist. The results suggest that the source of therapist narratives may influence the results of transference research.     

THE “AS‐YET SITUATION” IN WINNICOTT'S “FRAGMENT OF AN ANALYSIS”: YOUR FATHER “NEVER DID YOU THE HONOR OF”… YET

The author proposes a new hypothesis in relation to Winnicott's “Fragment of an Analysis”: that as early as 1955, in the case described in this text, Winnicott is creating the paternal function in his patient's psychic functioning by implicitly linking his interpretations regarding the father to the Freudian concept of Nachträglichkeit. The author introduces an original clinical concept, the as‐yet situation, which she has observed in her own clinical work, as well as in Winnicott's analysis of the patient described in “Fragment of an Analysis” (1955).     

SOME REFLECTIONS ON IAN MCEWAN'S ATONEMENT: ENACTMENT,GUILT, AND REPARATION

Recognizing that enactments have been discussed in psychoanalysis primarily as occurrences in the treatment setting, the author proposes a new application of the term enactments: that it may pertain to the actions of some individuals in their efforts to cope with bad things that they have done to others. That is, enactment can be a substitute‐for‐atonement mechanism. The author illustrates this view of enactment through a discussion of Ian McEwan's novel Atonement (2001), and in particular by examining the behavior and motivations of one of its central characters, Briony Tallis. Included are explorations of the relationships between enactment and guilt and between enactment and reparation.     

The analytic setting today: using the couch or the chair?

This paper re‐visits Murray Jackson's 1961 paper in the Journal of Analytical Psychology, ‘Chair, couch and countertransference’, with the aim of exploring the role of the couch for Jungian analysts in clinical practice today. Within the Society of Analytical Psychology (SAP) and some other London‐based societies, there has been an evolution of practice from face‐to‐face sessions with the patient in the chair, as was Jung's preference, to a mode of practice where patients use the couch with the analyst sitting to the side rather than behind, as has been the tradition in psychoanalysis. Fordham was the founding member of the SAP and it was because of his liaison with psychoanalysis and psychoanalysts that this cultural shift came about. Using clinical examples, the author explores the couch/chair question in terms of her own practice and the internal setting as a structure in her mind. With reference to Bleger's (2013) paper ‘Psychoanalysis of the psychoanalytic setting’, the author discusses how the analytic setting, including use of the couch or the chair, can act as a silent container for the most primitive aspects of the patient's psyche which will only emerge in analysis when the setting changes or is breached.     

Cognitive meaning and cognitive use

In the first part of this paper the author restates arguments made earlier against well‐known criticisms of a logical nature leveled (by C. Hempel and others) against the so‐called verifiability principle, which purport to show that it is at once both too restrictive and too permissive: including as cognitively meaningful, statements intuitively lacking this property, and excluding others that are generally admitted to possess it. The author claims to show that the charge that the verifiability principle is unduly permissive will not stand, because of certain logico‐semantical blunders made by the critics; and that the charge of being too restrictive can be removed by introducing the notion of guasi‐truth‐conditions. He then moves on to an examination and elaboration of the concept of cognitive use, in terms of which he attempts to turn the flank of the argument purporting to show that the verifiability principle is too restrictive, explaining that even if one does not invoke the concept of quasi‐truth‐conditions, that of cognitive use enables one to save for science and cognition in general sentences that lack truth‐values (cognitive meaning). A version of the verifiability principle that denies cognitive meaning to non‐finitistic, non‐analytic mixed‐quantifications does not therefore do any injury to science, frequent claims to the contrary notwithstanding.     

Parenthood and parental functions as a result of the experience of parallel psychotherapy with children and parents

The concept of parenthood as defined in classical theory and later theorizations is discussed. Parenthood is defined as a transformative process, activated by the idea of having a child and by interaction with the child, through which a constellation of affective and psychic capacities is developed, promoting growth and psychic change and evolving over time. Parental functions, rather than being learnable skills, are considered as mind functions linked to character traits that cannot be split from the personality as a whole and are, as such, susceptible to improvement through psychotherapeutic work. The author illustrates this with a model of psychotherapies and parallel analyses of parents and children tested and elaborated in public and private practice, showing its therapeutic and cognitive advantages. The central thesis of the paper is that whatever the approach and working method with the parents, the therapeutic space offered encourages certain processes that are vital for the structuring of the self and the psychic growth of the child: creation of a space for the representation and emotional investment of the child; improvement in the parental functions; and identification with the therapist as a new or reactivated developmental object. Two clinical cases illustrate the parallel evolution of therapeutic relationships and of the parent‐child relationship.     

BECOMING RELATED: THE EDUCATION OF A PSYCHOANALYST

The author uses a “professional memoir,” a story about his first experiences in clinical work, to illustrate what he believes to be certain fundamental aspects of an analytic attitude. Taking place in a psychiatric hospital, it is meant to highlight the central place of intuition, emotional receptivity, empathy, relatedness—and their inherent dangers—in engaging therapeutically with patients' emotional disturbances. The author postulates that these and related aspects of clinical psychoanalysis are not sufficiently emphasized in psychoanalytic training and are often eclipsed by idealizations of psychoanalytic theories and their derivative techniques, third‐party demands for evidence‐based data, preoccupations with neurobiological correlates of experience, etc. Despite the clinical fact that psychoanalysis can be extraordinarily helpful to patients, he questions whether clinical psychoanalysis is rightly regarded as a “treatment.”     

My Art by the Numbers

The author explains his affinity for numbers as it relates to his work as an artist spanning his long career. This affinity helped him invent one of the first systems for making four-color digital prints. Having been only recently introduced to the book Number and Time, by Marie-Louise von Franz, the author finds that he is in full agreement with her depth psychology theories on number. Recounting a synchronicity that he experienced while writing this paper helped the author to understand Jung’s concept of the unus mundus, as explained by von Franz in Number and Time. He speculates that number archetypes must have evolved in human consciousness over very long periods of time and writes about the number zero as a “recent” example. The author also describes his experience of a spontaneous mathematical vision that led him to create an algorithm, which in turn led him to realize that crystals having fivefold symmetry could exist in nature, which was considered impossible at the time. The author discusses his new inventions of quasi-periodic and random tile patterns, which were inspired by 15th-century Islamic tile patterns, as they related to the aperiodic patterns invented by Roger Penrose in the 20th century. He speculates about the ability of artificially intelligent computer software to be able to generate random quasi-periodic patterns. Lastly, the author recounts a synchronistic experience that occurred during the month of his 72nd birthday, in which his work with numbers is seemingly reciprocated by nature.     

Psychoanalysis in the university: A full‐time vision1

Psychoanalysis may be unique among scholarly disciplines and professions in having grown as an educational enterprise in a private part‐time setting, outside the university. Freud would have liked it to be otherwise, but in Central Europe, when it was created, university placement was not possible. In America, after World War II, the concept of the medical school department of psychiatry psychoanalytic institute was established in some psychoanalytic training centers but it could only partly overcome the educational and research inadequacies of traditional psychoanalytic training. The possibilities for a true university‐based full‐time training structure are explored.     

Getting down and dirty: An exploration of participation in the field of obstacle challenges

This paper examines the contemporary phenomenon of obstacle challenges and why people participate in events that result in them getting soaking wet, freezing cold, and dirtier than they have ever been while also getting shot with pellets and receiving “electric shocks.” Many participants in these challenges have taken part numerous times and keep coming back for more. Using multiple research methods including questionnaires, participant observation where the author completed one of Ireland's more well‐known and “toughest physical and mental endurance challenges,” and also depth interviews with challenge participants has resulted in a rich and detailed account of the obstacle challenge experience. These events are so much more than a few hours of strenuous and muddy physical exercise. The sense of community and camaraderie that people experience during these challenges could be described as “transformative” with participants in many cases more rewarded and moved by this collaborative aspect than the gruelling physical endeavour that they undertake. The escapism provided by the experience is also one its main rewards, relief from the quotidian and the chance to just “be.” The servicescape proves to be critically important to the experience but in ways that are largely incompatible with research in this area to date in that the comfort and cleanliness expected of more traditional servicescapes are spurned and physical hardship is welcomed. As this is an exploratory and novel research topic, suggestions for further research are plentiful.