Working With Fathers in Psychoanalytic Parent-Infant Psychotherapy edited by Tessa Baradon,Routledge, Abingdon and New York, 2019, 191 pp.

The American Journal of Psychoanalysis -     

Attachment,Recognition, and Secondary Trauma: Reply to Commentaries

This response first addresses the interimplication of attachment and recognition in couples work and reargues that disorganized attachment is the central dynamic underlying the emotional torment of failing relationships. In the second section, the author expands upon the secondary trauma that haunts the therapist who is trying to hold and contain the destructiveness that couples “on the brink” can enact.     

Structure with Engagement: Toward an Integration of Trauma and Relational Psychoanalytic Models in the Treatment of Dissociative Disorders

Trauma model approaches to the treatment of dissociative disorders may provide containment and direction and yet, these same approaches may be constricting and limit exploration. However, relational psychoanalytic approaches may allow for engagement and exploration while potentially failing to provide containment and structure. This article provides an overview of key elements of both models and considers the question of whether it is possible to creatively resolve theoretical and clinical tensions between trauma model and relational psychoanalytic responses to dissociation. A review of the history of the study of dissociation in the field of psychoanalysis and concerns about psychoanalytic practice in the context of dissociation is followed by comparing contrasting conceptualizations of the assumptions of normality, definitions of dissociation, theories of etiology, goals of treatment, and theorized mechanisms of action. The review ends with a discussion of potential possibilities for clinical integration.     

Broadening Horizons: Self‐Expansion in Relational and Non‐Relational Contexts

The self‐expansion model posits that individuals are motivated to broaden their sense of self by acquiring new identities, developing new perspectives, enhancing capabilities, and gaining resources. The self‐expansion motivation is driven by individuals' desire to increase their potential self‐efficacy and ability to accomplish goals. In this article, we discuss two main ways individuals self‐expand – by forming relationships and including the other in the self and through engaging in novel activities that are challenging and/or interesting either on one's own or with a relationship partner. We provide an overview of recent research detailing the numerous interpersonal and intrapersonal benefits and implications of self‐expansion. Additionally, we differentiate self‐expansion from a series of potentially associated constructs.     

Introduction to Papers from the Conference Dionysius' Ear: Trauma,Tragedy, and Psychoanalytic Listening

In this paper I describe the origin and spirit of the meeting of about 200 European, Israeli, and American psychoanalysts for a week in Siracusa, Sicily, to consider our work as embedded in our Greco-Roman cultural roots while we reveled, Dionysius-like, in that culture in many forms: drama, archeology, food, wine, and music. Organized by five institutes and hosted by ISIPSé (Rome), in June 2004, this meeting revolved around evening performances of Medea and Oedipus Rex in the ancient Greek theater and was entitled “Dionysius' Ear: Trauma, Tragedy, and Psychoanalytic Listening.”     

Maternal Role Confusion: Relations to Maternal Attachment and Mother–Child Interaction from Infancy to Adolescence

Self‐reports of role confusion with the parent in childhood are associated with a variety of adverse outcomes. However, role‐confusion has been studied primarily from the point of view of the child. The current study evaluated an instrument for assessing role confusion from maternal interviews rather than from child observations or self‐reports in adulthood. Fifty‐one mothers participating in a longitudinal study since their own child's infancy were administered the Experiences of Caregiving Interview (C. George & J. Solomon, 1996) when the child was age 20. Interviews were coded using the newly developed Parental Assessment of Role Confusion (PARC; L. Vulliez‐Coady & K. Lyons‐Ruth, 2009). Maternal PARC scores were related to observational measures of role‐confusion in interaction with the child both in infancy and late adolescence. PARC scores also were related to mothers’ hostile‐helpless states of mind on the Adult Attachment Interview (C. George, N. Kaplan, & M. Main, 1984, 1985, 1986) and to the extent of Unresolved loss, but not Unresolved Trauma. PARC scores also were related to mothers’ self‐reports of helplessness experienced in the parenting role. Discriminant validity of the PARC was demonstrated in that role confusion on the PARC was not related to hostile or disoriented forms of parent–child interaction. Implications for clinical assessment of role confusion are discussed.     

Patient Personality and Relational Patterns in Psychotherapy: Factor Structure,Reliability, and Validity of the Psychotherapy Relationship Questionnaire

The aim of this study was to examine the factor structure and the psychometric properties of the Psychotherapy Relationship Questionnaire (PRQ; Bradley, Heim, &; Westen, 2005 Bradley, R., Heim, A. K., &; Westen, D. (2005). Transference patterns in the psychotherapy of personality disorders: Empirical investigation. The British Journal of Psychiatry, 186, 342–349. doi:10.1192/bjp.186.4.342[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]), a clinician report instrument that measures a wide spectrum of thoughts, feelings, motives, conflicts, and behaviors expressed by patients toward their therapists in psychotherapy. A national sample of psychiatrists and clinical psychologists (N = 314) of different theoretical orientations completed the PRQ, as well as the Shedler–Westen Assessment Procedure–200 (SWAP–200; Westen &; Shedler, 1999a Westen, D., &; Shedler, J. (1999a). Revising and assessing Axis II, Part I: Developing a clinically and empirically valid assessment method. The American Journal of Psychiatry, 156, 258–272.[PubMed], [Web of Science ®] , [Google Scholar], 1999b Westen, D., &; Shedler, J. (1999a). Revising and assessing Axis II, Part I: Developing a clinically and empirically valid assessment method. The American Journal of Psychiatry, 156, 258–272.[PubMed], [Web of Science ®] , [Google Scholar]) to assess the personality of a patient in their care. Factor-analytic procedures identified 6 transference dimensions that showed excellent internal consistencies: (a) hostile, (b) positive/working alliance, (c) special/entitled, (d) anxious/preoccupied, (e) avoidant/dismissing attachment, and (f) sexualized. Factor scores were significantly related to patients’ personality characteristics and psychological functioning, regardless of the clinicians’ orientations. The findings support that the PRQ is a valid and reliable tool for evaluating the patients’ relational patterns emerging in clinical practice in a clinically coherent and psychometrically robust way. Clinicians’ careful understanding of these patterns can be very useful for making accurate diagnostic formulations, as well as for providing a roadmap for effective therapeutic intervention.     

Neuropsychological Deficits in Relation to Symptoms of ADHD: Independent Contributions and Interactions

Twelve children with and without Down syndrome (DS) performed eight subtests of an apraxia battery to determine under what conditions children with DS had difficulty performing representational and nonrepresentational gestures. Participants with DS also completed a dichotic listening test. Participants with DS performed just as well as control participants on all aspects of the apraxia battery except a subtest in which they were required to pantomime tool use from verbal instruction. This suggests that children with DS have difficulty generating an action from memory following verbal instruction. Given the sufficient context or visual demonstration, children with DS performed similar to the other participants. As well, there was a great deal of within-group variability for dichotic listening ear advantage. Participants with a greater left ear advantage on the dichotic listening test committed more errors on an imitation test that also included a verbal component than participants with a greater right ear advantage.