Collaboration and Guided Discovery

Collaboration and guided discovery, collectively described as collaborative empiricism, are two primary features of Aaron T. Beck’s Cognitive Therapy (CT) that remained central to his work throughout his long and productive career. This commentary highlights how collaboration and guided discovery were described during the early development of CT. In addition, conversations with Beck are cited that reveal how his own life may have influenced their inclusion and importance in his therapy.     

Adaptations for Youth

Aaron T. Beck exemplified the clinical scientist, willing to test his hypotheses, and willing to share his experiences and treatment features with others. Assessment and treatment of emotional disorders have been forever improved through the efforts of Aaron T. Beck. Using the psychological treatment of an emotional disorder in youth (i.e., anxiety), this commemorative reflects on how Aaron T. Beck’s clinical strategies have been impactful well beyond his initial focus. As a world-renowned clinical scientist, Beck’s work has influenced multiple fields addressing mental health. As a friend and colleague, Beck was a gentleman and a scholar.     

A Discussion of “Accompaniment in Jazz and Psychoanalysis”

The author discusses the contributions of Markman’s text (this issue) focusing on similarities and differences in how he and this author use rhythm as a musical metaphor for the interactional processes constituting a psychoanalytic encounter. This review emphasizes 1) Markman’s unique sense of reverie, 2) his thinking about rhythm in terms of embodied registrations, and, 3) the difference between Markman’s unit of analysis and that frequently used by this discussant for describing embodied registrations.     

A Child Therapist at Work: Playing,Talking, and the Therapist’s Inner Dialogue

The author reflects on his work with a child patient struggling with affect regulation, loss, and his adoption through a detailed process account of the treatment with a focus on the therapist’s inner dialogue in relation to the child’s play and words—how each affects the other. Drawing from his personal use of clinical theory stemming from multiple theoretical influences, the author shows how his associations, identifications, and tentative formulations inform his work and how the various transference/countertransference matrices influence his inner dialogue. Attention is paid to the movement from the therapist as an object within the patient’s closed system to a system that gradually becomes more open, in which the patient is able to take in the therapist’s own person as they come upon various ways to communicate and build a narrative together.     

Accessing the multitude within: A psychoanalytic perspective on the transformation of masculinity at mid‐life1

This paper reflects upon the essential components of male identity that commonly are reworked in middle age. The author argues that healthy masculine gender identity involves an ongoing, plastic process of destabilization and reconstruction at various pivotal developmental stages, particularly during middle adulthood. In essence, a man's mature transformation of his sense of masculinity results when finite concepts of gender identity are superseded by an awareness of the complexity of one's multiple, early and diverse gender identifications. A clinical case provides insight into how psychoanalytic treatment can contribute to a new experience of masculinity. The case illustrates how a maturing man, meeting an altered sense of identity in mid‐life, relies less on gender splitting and more on reuniting previously antithetical intrapsychic elements. Why this more pluralistic, polythreaded masculinity frequently must wait until mid‐life is further clarified. Specific importance is attached to the early development of male gender identity as it is founded on the boy's unique struggles in separating from his mother. The foundation for male gender identity formation is reconsidered as the author questions the ‘dis‐identification’ model while explicating how the boy's striving for narcissistic completion shapes the gendered masculine ego ideal. Classically termed ‘phallicism’ is understood both to facilitate and obstruct a man's adult development, while the concept of ‘genitality’ is augmented by the postclassical notion of ‘interiority’. At mid‐life, ‘phallic’ ego ideals (resting on omnipotence, desires for narcissistic completion and gender splitting) are transformed into more realistic, ‘genital’ ego ideals (synthesizing autonomy and connection). The achievement of a mature, less sharply gendered ‘masculine’ ego ideal (revitalizing the foreclosed dimensions of both the early maternal and paternal imagos) occurs as the balance of forces shifts in the direction of true genitality rather than defensive phallicism.     

Mental Files,Blown Up by Indexed Files

Abstract

Our paper discusses Recanati’s application of the mental files apparatus to reports of beliefs and other attitudes. While mental files appear early on in Recanati’s work on belief-reports, his latest book introduces the concept of indexed files (a.k.a. vicarious files) and puts it to work to explain how we can report other people’s attitudes and to account for opacity phenomena. Our goal is twofold: we show that the approach in Recanati’s Mental Files (Oxford: Oxford University Press, 2012) departs significantly from his earlier proposals as well as from the very spirit of truth-conditional pragmatics; and we argue that the indexed files approach, qua an attempt to provide a semantics for belief-reports, is untenable.     

Revisioning Fordham's ‘Defences of the self’ in light of modern relational theory and contemporary neuroscience

This paper explores the evolution of Michael Fordham's ideas concerning ‘defences of the self’, including his application of this concept to a group of ‘difficult’ adult patients in his famous 1974 paper by the same name. After tracing the relevance of Fordham's ideas to my own discovery of a ‘self‐care system’ in the psychological material of early trauma patients (Kalsched 1996 ), I describe how Fordham's seminal notions might be revisioned in light of contemporary relational theory as well as early attachment theory and affective neuroscience. These revisionings involve an awareness that the severe woundings of early unremembered trauma are not transformable through interpretation but will inevitably be repeated in the transference, leading to mutual ‘enactments’ between the analytic partners and, hopefully, to a new outcome. A clinical example of one such mutual enactment between the author and his patient is provided. The paper concludes with reflections on the clinical implications of this difficult case and what it means to become a ‘real person’ to our patients. Finally, Jung's alchemical views on transference are shown to be useful analogies in our understanding of the necessary mutuality in the healing process with these patients.     

Who is my Jung? Memories,Reflections, Prospects

The author describes his personal and professional journey in relation to the subject of the AJA 40^th anniversary conference, ‘Who is my Jung?’ The first part of the paper covers his early life and his attempt to bring together two opposing parts within him: valuation of a scientific approach, and an interest in the inner world, dreams and the paranormal. Discussion of his professional life follows, including his relationship with Gerhard Adler, past problems and splits within the Jungian community and the author's attempts to heal these. The value of both remembering and forgetting is questioned. This leads onto ideas that bring value and meaning to his work and life, and which bridge the inner divisions he felt in his early life: notably Jung's focus on applying scientific theory to the mystery of the psyche, his relational attitude (exemplified by the dialectical process and his interest in countertransference) and his theory of synchronicity. Recent discussion in Jungian writing has questioned the nature of synchronistic experiences and explored how they may emerge naturally from complex systems. The paper ends the author's continuing journey with two personal vignettes describing how meaning may emerge from the unconscious.     

Looking back,looking forward: A reexamination of Benjamin Wolstein’s interlock and the emergence of intersubjectivity

In this paper the author takes a close look at Benjamin Wolstein’s chapter, ‘Therapy’, from his book, Countertransference, published in 1959. This chapter contains a discussion of what he refers to as the interlock between analyst and patient, or today what we might describe as transference/countertransference enactment. The author shows how Wolstein’s concept of the interlock and its relation to the analyst’s countertransference was radical and innovative for its time. Wolstein’s notion of a transference/countertransference interlock, along with the seminal contributions of Ferenczi and some of the early interpersonal theorists, anticipates the complexities of a two‐person psychology and the entanglement which can occur from the intermingling of unconscious processes of analyst and patient in the experiential field. The author highlights three main ideas. First, the author provides a brief review of enactment with an emphasis on the role of the analyst’s participation as conceptualized by the various theoretical perspectives. An historical context is given for Wolstein’s clinical theorizing. Second, the author explicates Wolstein’s concept of the interlock, with particular attention to the processes involved which account for the complexities it presents. Third, the author examines the ‘working through’ process, including the emergence of intersubjectivity in the resolution of the interlock. The author shows throughout Wolstein’s emphasis on the influence of the analyst’s personal psychology, mutuality, and intersubjectivity, all of which anticipated the gradual interpersonalization of psychoanalysis across the various schools of thought.     

A personal commentary on J.W. Perry,M.D., and introduction to ‘Reconstitutive process in the psychopathology of the Self’

John Weir Perry’s influence on the understanding of the psychotic process through his research in San Francisco between 1950 and 1981 was groundbreaking, because it both verified and expanded upon C.G. Jung’s research at the Burghölzli Hospital in Switzerland in the early 1900’s. The author explores both the brilliance of Perry’s contribution as a psychiatrist and Jungian analyst and also shows the flawed human, who, with his rare sensitivity to the psychotic process, devoted his life work to the schizophrenic population and their often ill-fated search for meaning. She tells how his creative engagement with the analytic processes of Self discovery eventually led to analytic boundary violations, which ultimately resulted in his indefinite suspension from membership in his local Jungian community. Further, this paper describes her reflections on the innovative work that influenced both the treatment of this population, as well as educating candidates in analytical training to be receptive to and cognizant of psychotic affects and imagery. The archetypal field of the psychotic process, its influence on the development of analytical psychology relative to the psychotic process, and one man’s impact on the analytic community are considered.     

THE VALUE OF UNCERTAINTY

The author discusses some of the characteristics of Roy Schafer's contributions to psychoanalysis that he finds most valuable, such as his openness to uncertainty, his anti‐reductive view of analytic constructions, his unique formulation of the analyst's role, and his close attention to how the patient engenders particular emotional reactions in the analyst. The author also presents a clinical vignette illustrating the value of the analyst's tolerance of uncertainty in the face of the patient's push for interpretations, explanations, and reassurance.     

ROY SCHAFER'S CONTRIBUTIONS TO PSYCHOLOGICAL TESTING: FROM CLINICAL SENSIBILITY TO THE ANALYTIC ATTITUDE

The author reviews Schafer's contributions to psychological testing, emphasizing his development of the test battery, his significant contributions to psychoanalytically oriented Rorschach interpretation, and his understanding of the complex interpersonal dynamics involved in psychological test interpretation. The author also discusses his use of Schafer's writing in his own teaching and academic work, noting that Schafer's contributions have not only provided innovative methods for examining test data, but have also promoted a respectful, humanistic, and individualized approach to the patient in testing and treatment. The author asserts that Schafer's later seminal contributions to psychoanalysis had their origins in his early career as a psychologist applying psychoanalytic ideas to testing.     

Book Reviews

Abstract

Derrida argued at great length early on in his career that texts live on in the absence of their author. The question remains, however, of precisely how this survival takes place. In this paper I argue that the life of Derrida’s own ?uvre is sustained through his particular practice of self‐inheritance. I justify this claim by focusing on one moment in the text Rogues: Two Essays on Reason, in which Derrida inherits from himself through self‐citation. In citing himself while at the same time modifying his citation, Derrida sets into motion a deconstruction of his own text that he does not seem to anticipate. It is this movement of deconstruction that enables Derrida’s text to live on.     

<Emphasis Type="Italic">Doctor Anonymous</Emphasis>: Creating Contexts for Homosexuality as Mental Illness

In this essay, the author describes how he faced institutionalized homophobia during his psychiatric training, and how he later wrote a play inspired by the life of a gay psychiatrist. Despite Freud’s supportive stance, homosexuality aroused the antipathy of American organized psychiatry and psychoanalysis and came to be listed as an illness in the Diagnostic and Statistical Manual (DSM). Dr. John E. Fryer outed himself as “Dr. H Anonymous” at a 1972 meeting of the American Psychiatric Association, and the next year homosexuality was removed from the DSM. The 2014 play Doctor Anonymous offers a fictionalized account of this watershed moment in the history of the gay rights movement. The author discusses his own psychotherapeutic work with gay male patients, including those who had previously been treated with conversion therapy, and explores how the play mirrors his own life experience and the experience of his patients.     

Psychoanalytic transformations1

The author describes how Bion took Freud's conception of dreams as a form of thought and used it as the basis of his theory of transformations. Bion developed an expanded theory of ‘dream thought’, understood as a process of selection and transformation of sensory and emotional experiences. In this theory, the work of analysis is in turn conceived as a process not only of deciphering symbols, of revealing already existing unconscious meanings, but also of symbol production‐of a process for generating thoughts and conferring meaning on experiences that have never been conscious and never been repressed because they have never been ‘thought’. Analysis, in its specific operational sense, becomes a system of transformation whereby unconscious somatopsychic processes acquire the conditions for representability and become capable of translation into thoughts, words and interpretations. The rules of transformation applied by the patient in his representations and those applied by the analyst in his interpretations have the same importance for the analytic process as those described by Freud for the process of dreaming. The author discusses the broad categories of transformation adduced by Bion (rigid motion, projective, and in hallucinosis) and introduces some further distinctions within them.     

Reflections of a black woman practitioner-researcher

Poetry as a tool for research reflectivity is used in this article to explore the individual and personal experience of a black woman researcher-practitioner, working and studying in two white male-dominated organisations—the British Prison Service and a university institution. The discussion will trace how she reconciled her multiple identities and how these identities shaped her perception of her gender-racial group, prison culture, and university culture. An interpretive creative poem that reflects the author’s attempt at capturing the essence of her experience as a prison service employee is presented. The author then examines an excerpt from her journal alongside an in-depth qualitative interview extract and discusses her interpretive comments. The article discusses the issues related to the author’s outsider-within position, a result of her gender and racial minority status, and highlights how poetry allowed her to articulate the anxiety and tension caused by her multiple identities.     

THE FATHER,THE FATHER FUNCTION,THE FATHER PRINCIPLE: SOME CONTEMPORARY PSYCHOANALYTIC DEVELOPMENTS

The author discusses Freud's thinking on the role of the father, as well as that of later French theoreticians. To illustrate his remarks, he draws on the poetry of Carlos Drummond de Andrade (1912–1987), a Brazilian poet whose work often dealt with themes of the father, the family, and his own paternal relationship. The author also discusses the psychic formation of the father principle and how this may be evident in the clinical analytic setting, even when the analyst's approach privileges field theory, intersubjectivity, or other concepts emphasizing the relationship between analyst and patient.     

Art in support of life: Caravaggio and the plague

In the struggle with COVID-19, art offered a way to face the solitude of the lockdown. The focus of this paper is primarily on Caravaggio’s painting The Seven Works of Mercy, with references to other paintings to amplify some aspects of the artist’s approach to life and his uniqueness in the artistic landscape of his time. Darkness was part of Caravaggio’s research for spiritual truth and by entering the stories of his life and exploring the tales told through imaginative expression in his paintings, it is possible to understand his process of exploration of ancestral darkness. The author uses her imagination to reflect on how art can help to contact the profound fears buried in the unconscious which are now being awakened by the pandemic. The contemplation of this painting facilitated the emergence of emotions related to the darkness of our time, with the discovery that empathy and mercy offer a way to come to terms with the pandemic. This approach demands a different understanding of reality with Caravaggio’s dark creative world becoming a companion that permits the exploration of what is not yet thinkable in daily life. Images accompany the author’s research that relies on her imagination and amplifications.