Understanding Hope. Persons in the Process of Dying

Changes both within the profession of psychoanalysis and in society as a whole have affected our psychoanalytic training programs and presented new ethical challenges. Whereas in earlier decades training programs needed to be concerned primarily about the inviolability of the training analysis and the choice of appropriate analytic candidates, today there is little support for psychoanalysis as a treatment modality. Institutes are experiencing greater competition in attracting quality candidates and in providing them with adequate training experiences. This strain encourages institutes to operate in unethical ways to attract candidates. On the other hand, within the profession itself we are experiencing much theoretical ferment and the increasing feminization of the profession. These changes are affecting our training institutes and our ethical values in both positive and negative ways.     

Psychoanalysis and University in Brazil: Possibilities and Limits of This Articulation

The goal of this article is to clarify some of the aspects concerning the academic teaching and research that is carried out in the field of psychoanalysis in the Brazilian Universities, versus the transmission and training in psychoanalytic institutions. The author describes how psychoanalysis is present in the Brazilian university context, from undergraduate to graduate studies, and also points out perspectives regarding the future of psychoanalysis in Brazil.     

Killing Me Softly

Abstract

“Forced termination” of psychoanalysis occurs when the analyst electively terminates the treatment for reasons of his own, independent of the clinical indications for termination. The author describes his own experience with the forced termination of his training analysis. The literature is reviewed, with an emphasis on the attitude of each author regarding the straggle around the decision. The author explores sources of general ethical knowledge, the ethical foundations of the analyst-analysand relation ship, and the application of these ideas to psychoanalysis. From these princi ples, the ethical problems of forced termination are derived and examined. The author proposes reforms to address these problems.     

Seeking an Analytic Identity

Abstract

Rothstein has stimulated all analysts to rethink how we can better commit ourselves to our analytic work. In this paper I focus on factors in analysts' personalities and experiences in their training and practice that contribute to or distract from establishing an analytic identity.

First, I explore analysts' background and motivation. In admissions to psychoanalytic institutes we look for candidates who can see psychoanalysis as an intellectual puzzle to be solved and an emotional involvement to be experienced. We look for earlv conflicts that the candidate can sublimate in the service of analytic functioning. We assume that the capacity to sublimate is only partial and that analysts in their development continue to recognize conflicts in transference—countertransference reactions.

Second, I give some examples of experiences from analysts' training that stimulate the formation of their analytic identities. These include transient identifications and counter-identifications with the training analyst, supervisor, seminar leader, and favorite analytic authors.

Third, I discuss more external factors that influence the development of analytic identity. These include the climate in training and continuing education at the institute. How much does the institute support its members in immersion in psychoanalysis? Economic factors continue to he an important factor in determining individual choice in this immersion.

Finally, I review studies on the effectiveness of psychoanalysis. Dedicated analysts with considerable experience believe that analysis works despite some limitations. Part of high motivation to continue analytic work includes understanding how analytic results differ from the simpler solutions achieved by nonanalytic therapies.     

Training analysis in the dutch society for psychoanalytic psychotherapy: A survey of attitudes and feasibility

SUMMARY

As is the case in many training courses in psychoanalytic psychotherapy, one of the training requirements of the Dutch Society for Psychoanalytical Psychotherapy (NVPP) is a training analysis, currently a minimum duration of 700 hours. During the last few years, this requirement has become somewhat controversial. Because the NVPP does not have information about the current interest in NVPP membership, the Board of the NVPP decided to do a survey. Of 995 psychiatrists, clinical psychologists and psychotherapists, who had recently completed their training, or were still in training, 623 filled in a questionnaire. Of those who are interested in the NVPP training, 39 per cent judged the training analysis as not feasible in terms of time, and 61 per cent in terms of money. Forms of personal treatment thought desirable for anyone who wishes to become a psychoanalytic psychotherapist at a specialist level are, in descending order, psychoanalytic psychotherapy (63%), psychoanalysis (39%), psychoanalytic group psychotherapy (25%), and psychoanalytic marital or family therapy (6%). Respondents who judge personal analysis as not feasible, also tend to judge psychoanalysis to be equivalent to other forms of psychoanalytic psychotherapy, whereas those who judge personal analysis as feasible, tend to think that personal analysis is essential for a psychoanalytic psychotherapist at the specialist level.     

Couple Psychoanalysis in the United Kingdom: Past,Present, and Future

ABSTRACT

The evolution of couple psychoanalysis in the United Kingdom is historically rooted in, and currently supported by, what might be called the Tavistock tradition, which principally derives from the work of Tavistock Relationships, a London-based organization combining clinical practice, training, and research. Practitioners working within this tradition draw on a range of psychoanalytic theories and differ in the ways they are applied in clinical practice and with different client groups, but they are united by their focus on relationship dynamics and how these can be affected by unconscious processes. This article charts how the main ideas and practices associated with the Tavistock tradition of couple psychoanalysis came into being, describes the conceptual building blocks that provide the platform for current training and practice, and identifies nodal points that might indicate directions of growth in the future.     

Controversies and Conflicts in the Institution of "Open" Psychoanalysis: Cases from the History of the Therapeia Foundation

The institution of psychoanalysis has included controversies, dissensions and expulsions at both the theoretical-methodological and personal-organizational levels. There have also been several intra- and intergroup conflicts in the history of psychoanalysis, and in constructing and patterning the future of psychoanalytic knowledge. In the context of Finnish psychoanalysis, the Therapeia Foundation (founded in 1958) met from the start with resistance from official psychiatry and also from the IPA. For example, in the mid-1960s, D. W. Winnicott, as the President of the IPA, supported the orthodox Finnish psychoanalytic study group (later to become the Finnish Psychoanalytical Society), and pronounced that the Therapeia group was too loose and was not strictly able to use the IPA-recognized designation "psychoanalytic." The Therapeia Foundation and its Training Seminar combined classical psychoanalysis and its new versions with existentialphenomenological views, anthropological medicine, research on "social pathology" and even modern theological research. On the basis of their Swiss analytic training, three Finnish psychiatrists, Martti Siirala, Kauko Kaila and Allan Johansson, organized Therapeian training to incorporate sciences and arts, and skills involving the therapeutic "carrying" of burdens. The multifacted nature of open psychoanalysis was seen to find its proper organizational expression when the Training Seminar of the Therapeia Foundation became, in 1974, a Member of the IFPS.     

Psychoanalysis in the Netherlands during World War II

To understand what happened in the psychoanalytic world in Holland during the German occupation (1940-1945) we must have knowledge of the conflicts within the Dutch Society of Psychoanalysis in the nineteen-thirties. Those conflicts mainly deal with the subject of lay analysis, the compulsory training analysis and in general if compliance with foreign, with IPA rules was advisable. These differences of opinion reached their peak when four Jewish psychoanalysts arrived from Germany in 1933. The Dutch Society broke up in two parts, but was reunited in 1938. During the German occupation the training was finally regulated according to the IPA rules. This lead to a new splitting in the world of Dutch psychoanalysis that has not been healed to date.     

Psychoanalysis in Austria after 1933-34

Our essay focuses on major developments of the history of psychoanalysis during the fascist and National Socialist years in Austria and sheds light on the re-establishment of psychoanalysis after World War II. With the consolidation of National Socialism in Germany in 1933 and Austro-fascism in 1934, any psychoanalytical reflection that was critical of political and cultural trends was extinguished. Vienna - once again - became the center of the psychoanalytical movement in Central Europe, taking over the role Berlin had played during the twenties. But, during the Austro-fascist system, psychoanalysis was isolated from an important part of its public. Psychoanalysts reacted by adopting an attitude of political abstinence, accompanied by self-censorship, they concentrated on training and clinical work, or they went into exile. Austria's Anschluß to the National Socialist Third Reich led to the final destruction of psychoanalysis. Nearly all Viennese analysts were affected by the anti-Jewish measures of the National Socialists and almost all of them fled the country. During the war years, a small group of people under the leadership of August Aichhorn tried to continue psychoanalytic training. Its members refounded the Viennese Psychoanalytical Society in early 1946. But, scientific traditions were broken and tendencies of anti-enlightenment, especially clerical and catholic prejudices, had continued from the time of Austrofascism and Nationalsocialism. The last chapter of our essay summarizes the research topics and the main historiographical studies done in the field.     

Psychoanalysis and Social Work

Abstract

This paper traces the close relationship between psychoanalysis and social work after Freudian theory's dramatic impact on social work practice in the 1920s. It shows how revisions and expansion of psychoanalytic theory beyond its traditional base influenced clinical work during later decades until the 1960s, when society turned its attention to macrosystems intervention and other theoretical frameworks and practice models. The paper considers the impact of this change in emphasis on clinicians, direct practice, and schools of social work. Although it describes the resurgence of direct practice that occurred in the 1970s and 1980s, it discusses the reasons for the greatly diminished role of psychoanalytic theories in social work curricula. It concludes that there is little reason for optimism about psychoanalysis regaining a prominent position within the profession at the present time and comments on some implications of this state of affairs for those committed to advanced clinical training.     

EDitorial: Identity in Change

Abstract

As we look at the evolution which has occurred in the field of psychoanalysis over the last fifty years, it is simply not possible to discuss contemporary psychoanalysis without invoking Freud. Our conference, of course, is dedicated to contemporary psychoanalysis; therefore, it is entirely appropriate for us to explore this topic.

Early contemporary psychoanalysis, I would suggest, began with the gradual evolution of the libido theory. Subsequently, contemporary psychoanalysis increasingly concerned itself with the early pre-oedipal dyadic relationship between mother and infant as well as the concomitant development of the ego. Finally, Freud's monumental and long lasting contribution to the clinical understanding of hysterical symptoms is increasingly relegated to the status of a superfluous antique. Analysts who are familiar with the ongoing contemporary significance and utility of Freud's early conceptualizations concerning the dynamics of hysteria and its treatment understand that the symptoms often represent and express an incompatible idea which has been repressed. When the analyst directly interprets the symptoms in a timely and accurate fashion, transference analysis is stimulated and enhanced.     

Psychoanalysis is becoming an impossible profession within the public welfare system in Sweden

Abstract

The preconditions for psychoanalytic practice within the Swedish public welfare system are analyzed in this article. Psychoanalysis remains a one-to-one treatment and relies on the analyst's capacity to use his or her own subjective response. The development of the psychoanalytic process is dependent on unconscious reality, making it impossible to work with a model that has a strict relation between diagnosis, treatment method, and result. Objectivity and the desire to predict treatment outcomes characterize the immanent logic in the complex system of laws and recommendations that affects most practices within the field of medicine. As a consequence of this development, psychoanalysis and psychodynamic therapy are marginalized, since our treatment methods are not adapted to the present industrialization and economization of the medical health sector, with the result that the preconditions for psychoanalytic training have changed dramatically. The exclusion of psychoanalysis from the national health insurance scheme is a demanding challenge at a time when the Swedish welfare model is undergoing fundamental changes.     

Affectivity: Regulation,Identity Formation,and Metaphorical Thought

ABSTRACT

Understanding affects, and their multiple roles in all aspects of the human condition and development, has more and more become a focus of study for contemporary psychoanalysis. Psychodynamic personality theories have always regarded affective life as pivotal to developmental experiences, the evolving structures of the personality, identity formation, and clinical processes. The centrality of emotion in development and affect regulation, as a maturational theme in the adolescent stage, are explored through the views afforded by object relations theory and ego psychology, intersubjectivity, the second separation individuation process, and unconscious metaphorical thought in the dream states of two clients and their therapist.     

Affects and globalization

Abstract

The destiny of the learning processes in the context of the psychoanalytical training systems was investigated. The emotional experiences of those learning and those teaching in this system have a decisive influence on the learning of psychoanalysis. As a first step, the concept of learning through experience, taken from Bion, is presented. Subsequently, the manifold and conflicting experiences are discussed, which those participating in the training system experience. The dialectic of fragmentation on the one hand and inner and outer integration on the other hand are discussed in detail. A number of factors are noted, which make it difficult to find ways of relating the different learning processes in psychoanalytical training to one another in a clear and differentiated manner.     

Evidence-based medicine,psychoanalysis and psychotherapy

SUMMARY

The scientific status of psychoanalysis is a matter of importance to both theorists and clinicians in psychiatry. The empirical evidence for both the theory and the practice of psychodynamic practice is much greater than is generally recognised. There is strong evidence for the effectiveness of psychoanalysis and psychoanalytically oriented therapy. the future of psychoanalysis depends on this evidence. We will discuss both the evidence and reasons why it is overlooked in certain quarters, and review the developing neuro-cognitive understanding of the mechanisms that underlie psychoanalytical processes.     

Starting from scratch: Developing clinical psychology training and services in Bangladesh

Abstract

This paper outlines the author's personal experience of contributing to the development of the first ever training in clinical psychology in Bangladesh. This was part of a link project between University College London and Dhaka University. It examines the challenges posed by such an enterprise through the author's experience of teaching and assessing patients in the local psychiatric wards. It questions the validity of exporting Western models of psychotherapy – psychoanalysis in particular – to a non-Western culture.     

Of “sleep and dream: A psychoanalytic essay' by Joyce McDougall (discussion)

Abstract

The author describes experiences gathered during several years of teaching psychodynamic psychotherapy with psychologists and psychiatrists within a 2-year-training programme in Shanghai, China. Questions and problems of the reception of psychoanalysis – shame, sexuality, harmony, abstinence – as well as the possibilities and limitations of exporting psychoanalysis are discussed. The possible future development of psychoanalysis in China is also outlined.     

Part IV: Capstone Papers for the Psychoanalysis Minor

ABSTRACT

After the Chicago class culminates, a number of our students go on to complete the psychoanalysis minor, which requires a capstone paper that can deal with theoretical issues in psychoanalysis or relate psychoanalysis to the subjects of their majors, such as literature, psychology/neuroscience, or their own independently designed majors. We include three representative papers.     

Conflict in psychoanalysis and in life

Abstract

Unconscious conflicts are at the center of Freudian psychoanalytic inquiry, in the psychoanalytic situation as well as in the theory of personality and pathogenesis. The core dynamic formulation, intrapsychic conflict resulting in new psychic formation, is addressed in the paper in the following steps.

First, the development of the concept of conflict throughout the history of Freudian psychoanalysis is reviewed. Next, the analytic and synthetic aspects of conflict theory are explored and the role of conflict in the development of personality organization and pathogenesis is clarified. Then, the contemporary extensions and elaborations of structural theory are presented.

To illustrate analysis focused on conflict, clinical material covering the phases of psychoanalytic process is highlighted. From the beginning stage of analyzing the patient's initial diffuse state of indifference and “weirdness”, analysis proceeds to address primary and secondary symptoms of impotence and exhibitionism and underlying passive-phallic personality organization with conflict around aggression. This leads to the patient's sense of mastery over previously enslaving and “immobilizing” internal turmoil.     

Transsubjectivity: The Space Where Psychoanalysis and Architecture Meet

The use of space as an image for engagement is the framework of the dialogue between architect, Richard Meier, and psychoanalyst, Valerie Tate Angel. The interrelated nature of architecture and psychoanalysis heightens the awareness of experience in the self's relation to intimate spaces.The homogeneity between architecture and psychoanalysis is the bringing together of a sense of openness and a freedom of possibilities in the place where one lives.