Dr John Hunter Padel 1913–1999

SUMMARY

With the help of clinical material from two female patients with whom acting out was a major feature of their treatment I have examined the connection between acting out behaviour and separation anxiety.

To begin with, I have drawn on Freud's conception of acting out and have shown that this kind of behaviour can be closely associated with transference in that both can act as a resistance as well as an aid to the psychoanalytic process.

The link between acting out and preverbal experience is commented on and attention is given to the defensive splitting of the primary object during early development.

It is then suggested that one of the essential roots associated with acting out behaviour is that of object loss and separation.

The clinical examples show that if the child separates in a strongly hostile manner from the mother then acting out associated with separations during analysis is going to be greater.

In view of the deficits in the early mother child relationships of the two patients described I adopted a therapeutic strategy based less on confrontation and limit setting and more on a consistent attempt to understand what was being communicated in the acting out behaviour.     

On the process of the psychoanalytic psychotherapy with the borderline depressive patient

Abstract

A certain subgroup of borderline patients often presents depressive symptomatology (either chronic or periodic) and an underlying borderline personality organization.

In this article, the effort is directed at elucidating the psychoanalytic psychotherapeutic process of these borderline depressives by presenting clinical fragments of several psychotherapeutic cases.

The process goes through periods of activation of the patient's depressive or primitive mental functioning, which also reflects on the therapist's countertransference.

The capacity of the therapist to tolerate and elaborate on his patient's projections, facilitates the development of the therapist-patient communication and plays a significant role in the therapeutic outcome itself.     

The perversion of language in the analyst's activity: Navigating the rhythms of embodiment and symbolization

Abstract

In this short text, the problem of how “the talking cure” itself can become a perverse relation is considered and illustrated with a brief clinical vignette. Contributions coming from the work of Stern in infant research and Lacan in post-Freudian thought illuminate the potential for experience to be split off through the use of language itself. These perspectives are brought to bear on thinking about representation, splitting, and perversion as a basis for considering a clinical instance in which patient and analyst enact a perverse relation constituted by the way in which the patient uses the analyst's language to construct a sado-masochistic perversion of the treatment process. Within the clinical episode, Stein's reformulation of perversion, informed by Ogden's observations and expanding Stoller's earlier contribution, provides a basis for considering how the analyst was able to use attention to the body-based countertransferential experience to repair a sense of “erasure” that was being accomplished for both analyst and analysand through the enactment.     

Concepts,Attention, and Perception

Abstract

According to the conceptualist view in the philosophy of perception, we must possess concepts for all the objects, properties and relations which feature in our perceptual experiences. In this paper, I investigate the possibility of developing an argument against the conceptualist view by appealing to the notion of attention.

In Part One, I begin by setting out an apparently promising version of such an argument, a version which appeals to a link between attention and perceptual demonstrative concept possession. In Part Two, however, I show how the conceptualist can challenge what appears to be the key premise of the argument, and I go on to describe, in Part Three, an important further difficulty which we face if we attempt to overcome this challenge in a particular way. My conclusion will be that the conceptualist's challenge to the argument is convincing and hence that the argument remains inconclusive.     

Sibley on ‘Beautiful’ and ‘Ugly’

Abstract

Frank Sibley's ideas have been particularly influential among contemporary philosophers interested in aesthetics. Most studies, however, have focused only on his earlier works. In this essay, I explore Sibley's account of the adjectives ‘beautiful’ and ‘ugly’, paying particular attention to three papers that have only recently been published and that have not yet received adequate attention. In particular, I discuss his account of the adjective ‘beautiful’, which relies on the controversial notion of an aesthetic ideal. In addition, I discuss an account of how aesthetic judgements may change in relation to our coming to know the kind of object being judged and whether, as Sibley maintains, ‘beautiful’ and ‘ugly’ are asymmetric in the sense specified by the author.     

Strengthening the Strengths Perspective

Abstract

This article revisits the strengths perspective as conceptualized in social work practice. Although we find this perspective has value and utility for practitioners, we identify areas where the strengths perspective could be enhanced and augmented by integrating the contemporary relational approach exemplified by Paul Wachtel's cyclical psychodynamics. Specifically, we explore his concepts of therapeutic communication and use of language, including interventions that affirm client strengths such as reframing, searching for variations and exceptions, and reconceptualizing how transference impacts the therapeutic action. We illustrate our view with a case vignette, advocating that Wachtel's integrative approach provides a new context for psychodynamics in current social work practice.     

Autonomy and the Authority of Personal Commitments: From Internal Coherence to Social Normativity

Abstract

It has been argued – most prominently in Harry Frankfurt's recent work – that the normative authority of personal commitments derives not from their intrinsic worth but from the way in which one's will is invested in what one cares about. In this essay, I argue that even if this approach is construed broadly and supplemented in various ways, its intrasubjective character leaves it ill-prepared to explain the normative grip of commitments in cases of purported self-betrayal. As an alternative, I sketch a view that focuses on intersubjective constraints of intelligibility built into social practices and on the pragmatics of how those norms are contested in an ongoing fashion.     

A process of mourning in the life and in the analysis of an adolescent

Abstract

This paper concerns the subject of “loss”, and the way “loss” is dealt with. A loss occurs which may be related to a real object - such as the death of a loved one - or to anything else which may represent a lost object, such as a stage or a function lost in life. Thus in adolescence, one has to face the loss of an infantile state.

Being alive, growing up, developing oneself presupposes losses and gains. One loses something in order to gain something else. This paper attempts to examine the subject, both in its theoretical and clinical aspects. In its theoretical aspect, I bring forward the points of view of Sigmund Freud, Melanie Klein and Wilfred Bion, concerning loss and how one deals with it.

In its clinical aspect, I present the case of an adolescent who, already in the process of having to face up to the loss of an infantile state - as happens to every adolescent - is obliged also to face the death of a loved one. Besides, the process of analysis itself presupposes that a person, in order to develop psychologically, has to face other losses, such as that of one's omnipotence, that of one's idealised objects, etc. Therefore, I am presenting for examination a situation in which a particular person deals with his losses in the light of the analytical transference.     

Clinical Relevance of Social Character and Social Unconscious

The author discusses his recollection of Erich Fromm's views on psychoanalytic work with patients, including the author's treatment of a patient. The remembrance involves Fromm's clinical thinking on social character and the social unconscious, and its relevance to present-day clinical work. The author presents, in detail, his treatment of a 37-year old successful woman which addresses certain of today's clinical views on gender differences that resonate and differ with Fromm's thinking on the treatment of the marketing personality.     

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.     

Befores and Afters of the Womb: Reply to Commentaries by Jeanne Wolff Bernstein and Dodi Goldman

This reply engages with Wolff Bernstein's and Goldman's rich discussions of Farhi's work. Wolff Bernstein's exploration of the relationship between Winnicott and Susan as a perversion of the phylogenetic shield operative in primal repression furthers our understanding of Milner's treatment of her patient. Following Wolff Bernstein's thoughts of the problems caused by Winnicott's mishandlings of Susan, I suggest that we might consider the referral process itself as an analogue to pre-natal life, the conscious and unconscious significations of which can have an important impact on the qualities of relational bonds to be built with the treating analyst.

Goldman's commentary deepens our insight into Milner as a person and as an analyst. At the same time, it also raises an important question about how early in biological life it is logical to assume the possibility of psychic material's registration, which Goldman sees as equivalent to considerations of psychic organization. Seeing the two as temporally distinct, I draw from critical analyses of Laplanche's theory to discuss how experience can be registered as yet-misaligned bits that await a later developmental time before it can become invested with meaning and become psychically organized.     

Lift Up Your Hearts: Humour and Despair in Later Life

SUMMARY

According to Erikson, the homework of later life is integrity versus despair. The work of integrity is difficult, especially when faced with loss and grief, with the pain, suffering and anxiety that often accompany later life. However, it is also the case that humour accompanies the ageing process, and that elderly people laugh at all things associated with ageing right through to death. This paper explores the relationship between humour and despair in the task of integrity. It does so from the work of Kierkegaard, who argued that despair is a sign that we are spiritual beings. Humour comes from our responses to despair–either as giving in too easily and not attempting integrity at all, or as a willful defiance and denial of this task. Ageing humour is used to illustrate Kierkegaard's argument. Humour is then shown to function in various ways. It raises our sights when we too easily retreat into our perishing bodies. It earths us when we attempt to get too spiritual, and it gives us a glimpse of the larger framework of God's future out of which we are invited to live, and to “lift up our hearts.”     

Ambiguity,the Trinity,and Naturalism: From the Methodology of Pannenberg to the Phenomenology of Merleau-Ponty

Abstract

Through an interpretation of Wolfhart Pannenberg's trinitarian methodology, this article presents the argument that theology and naturalism are ambiguously intertwined and that we once again have to determine how to methodologically address the relationship between theology and science. This study contends that Pannenberg's theology is important for our conception of the dialog between theology and science. However, I wish to offer a fundamentally new interpretation of Pannenberg which locates the ambiguous character of his methodology primarily in the substantive issue with which it deals. This redirects the dialogue between theology and science through Pannenberg's hermeneutic of history towards the contemporary phenomenology of the body and ultimately to the suggestion of a trinitarian-phenomenological approach beyond the methodology of Pannenberg.     

Offering a ‘therapeutic presence’ in schools and education settings

Abstract

In this essay I present the clinical work with a client that I have been working with for 9 months now. The essay is divided into sections, each one indicative of one phase of the counselling relationship. In each of them I present the therapeutic process (my client's and myself) by highlighting some newly-acquired psychodynamic concepts, sharing some difficulties encountered, the learning gained though supervision and the progress of the client.     

Reflections of Authority in Psychotherapy

Abstract

This article examines how therapists' expressions of authority affect the psychotherapeutic relationship. The article is based on the proposition that the clinical practitioner is always in a position of authority, regardless of how the role of authority is conceptualized within treatment approaches. The article includes an investigation of power and authority differentials within and across therapeutic approaches that espouse both hierarchical and egalitarian authority relationships. Process material from these approaches is analyzed to identify therapists' exercise of authority within these two approaches. It is suggested that researchers and therapists might use a heuristic research design to study the conveyance of therapeutic authority to identify whether dimensions of authority are overtly or covertly expressed, and whether or how such expression might affect practice and a client's exercise of personal authority.     

Tools for Change

Abstract

This paper discusses the ways in which one may incorporate political action into a client's therapy process so the client may incorporate it into her/his life. A framework for defining this as ethical, therapeutic and necessary to the client is presented. A number of suggestions for helping clients and therapists to become more politically active, as well as vignettes demonstrating how this might work with clients in the therapy process are provided.     

Constructivist psychology of child abuse and implications for psychotherapy

Abstract

This paper reviews constructivist and related literature on child abuse and psychotherapy. Constructivist psychology, with its emphasis on the personal, socially embedded construction of meaning, is uniquely situated to contribute to humanistic psychotherapy for child victims and adult survivors. Conversely, work with abused clients deepens our understanding of developmental meaning‐making processes and the social ecologies of meaning within which they unfold.

Constructivist approaches to child abuse are inherently humanistic, focusing on the child victim's and adult survivor's attempts to make meaning of their experiences, including the often traumatic experiences of abuse and the relational contexts in which it occurs. This paper first discusses how constructivist psychology may deepen our understanding of the impact of abusive experiences, the reverberation of those experiences through subsequent living, and the role of constructivist therapies in the healing process. Secondly, this paper explores reflexive aspects of work with abuse survivors that may challenge our cultural and professional assumptions and deepen our commitment to constructivist, humanistic, and feminist psychotherapies.     

Seeing and Being Seen: Courage and the Therapist in Cross-Racial Treatment

ABSTRACT

Correction of the patient's distortion is often the focus of therapeutic treatment. However, the therapist's distortions, based upon pre-existing fears, which themselves are often rooted in greater societal issues and energized by the work with the patient (especially as they relate to issues of racial difference between the therapist and patient), can lead to clinical impasse. Just as an effective treatment relies upon the patient's opening up to correcting distortions, so too the therapist must be able to use transference response and become vulnerable to knowing and moving beyond his own fears and distortions.     

On the Psychoanalytic Treatment of the Depressive Personality

In order to discuss the depressive personality we have first to distinguish between this clinical entity and other types of depressive psychopathology that might also be chronic. The character traits and psychodynamics of the depressive personality confirm that there is a special group of patients, who belong to a depressive disorder continuum. The particular technical problems that depressive personality present are: (1) the inability to enjoy anything and the consequences of this on the therapist's experience and interventions, and (2) the negative therapeutic reaction which threatens the analytic process and the therapist's competence. If we combine transference/extratransference interpretations with an "empathetic understanding" approach to systematic confrontation and interpretation, we can therefore justify the need for a slightly modified psychoanalytic technique in the treatment of the depressive personality.