Relational Psychoanalytic Perspective on Couples Psychotherapy

ABSTRACT

This places Relational Psychoanalysis within the pantheon of models of couples psychotherapy in psychoanalysis including those from Freudian, Object Relational, Self Psychology, and Intersubjective Systems Theory. Following a brief overview of key ideas pertinent to Relational Psychoanalysis, the article discusses the author’s Six-Step version of a relational psychoanalytic approach to couples psychotherapy.     

An Attachment Perspective on Reunions in Couple Psychoanalytic Psychotherapy

Psychoanalysis has been slow to acknowledge attachment theory as one of its own. Yet traditions of observational and representational research associated with it have much to offer in shedding light on intrapsychic as well as interpersonal phenomena. This paper explores these traditions and their potential clinical utility for couple psychoanalytic psychotherapy. In particular, attention is drawn to behaviour and representations associated with the experience of reunion in therapy sessions.     

Technical Considerations When Handling Questions in the Initial Phase of Psychotherapy

Responding to patients' questions throughout the therapeutic process can be challenging. Questions posed at the beginning of treatment have unique features which make them especially difficult to negotiate. When handled skillfully and tactfully, questions asked during this phase can provide the therapist with important opportunities to foster engagement in treatment. Questions can provide valuable information about the patient's internal world, afford the opportunity to socialize the patient to the therapeutic process, and aid in rapport-building. This article will focus on ways to understand and handle questions patients ask during the initial phase of treatment. Vignettes will be presented and specific responses therapists can offer to patients will be discussed.     

Foregrounding Masculinities in Psychoanalytic Psychotherapy

Against the backdrop of contemporary debates around constructions of masculinities, and explorations concerning how gender figures in psychotherapeutic process, personal reflections are presented by a male psychoanalytic therapist practicing in South Africa. A reflexive, contextual, and historicized conversation is offered, highlighting the precariousness of masculine identities, and their melancholic response to contextual dislocation within a society in transition and in relation to the decline of patriarchal authority. The observations offered emphasize the importance of maintaining a self-reflective stance in order to grapple with normative gender biases and stereotypic assumptions and to reduce the probability of gendered enactments in clinical practice.     

Thinking Developmentally: A Contemporary Psychoanalytic Perspective

This article considers how using a multifaceted developmental framework can help inform the analyst’s clinical choices throughout the course of treatment. The developmental pathway toward achieving a balance between a stable sense of autonomy and individuality and a capacity for relatedness and mutuality is discussed. The building blocks of development—basic trust, the self-other boundary, object constancy, and self-esteem—are outlined, along with ways to clinically assess developmental levels. Clinical material is presented to help illustrate how a sensitivity to the array of developmental data can help the analyst flexibly adapt to the patient’s changing needs and capacities.     

Bullying at Work: A Psychoanalytic Perspective

The paper traces aspects of the history and development of work in this area. It places workplace bullying on a continuum which straddles workplace homicide, violence at work, sexual harassment and the harnessing of the aggressive instincts into effective work. Thought is given to the question of which behaviours should be considered to constitute workplace bullying. A recent example of bullying in restaurant kitchens is examined in more detail. The paper concludes by looking at issues around the responsibility of individuals and organizations to understand and manage bullying at work. © 1997 John Wiley & Sons, Ltd.     

Intersubjective-Systems Theory: A Phenomenological-Contextualist Psychoanalytic Perspective

In this article I outline the essentials of my phenomenological-contextualist psychoanalytic perspective as it has been applied to a wide range of clinical phenomena, including development and pathogenesis, transference and resistance, forms of unconsciousness, emotional trauma, and therapeutic change. I characterize the therapeutic comportment entailed by these formulations as a kind of emotional dwelling.     

Psychoanalytic Psychotherapy with People in Abusive Relationships

Summary

Psychoanalytic perspectives on violence between partners is describedand forms a foundation for an approach to group and individual psychotherapy of men and women in relationships in which there is physical violence between partners. The empirical results of a study of the outcome of psychoanalytically oriented psychotherapy are described. Nineteen men and 16 women completed research measures before beginning psychotherapy and after completing 16 sessions of group psychotherapy. Twelve people who completed group psychotherapy continued in individual psychotherapy and completed measures again after 16 sessions of individual psychotherapy, and nine people completed measures again after the 16 sessions of group and 32 sessions of individual psychotherapy. Statistical analyses addressed outcomes in terms of verbal and physical aggression and dysphoric affects and anger. Both research and clinical outcomes are discussed.     

Encounters with the Universal and Cultural in Psychoanalytic Psychotherapy

The role played by socio-cultural factors in psychoanalytic psychotherapy from the vantage point of both the client and the therapist is elucidated. The position conferred upon culture throughout the history of psychoanalysis from classical to contemporary perspectives is briefly reviewed with special reference to the practice of psychoanalysis in India. A case study having relevance to the present theme is discussed where ignorance of factors salient to Indian culture adversely affected the outcome. Attention is given to internal and external pressures that prompted the therapist to take the stand. It is argued that the therapist may tread the difficult path between cultural universalism and cultural relativism rather than committing to either of them in order to do justice to psychoanalytical clinical work.     

Synthetiki Psychotherapy: An Integrative Psychotherapy for Individuals with Schizophrenic Symptoms

During the past 22 years, the author has developed an integrative psychotherapeutic model, called Synthetiki Psychotherapy (from the Greek word synthesis), for the treatment of individuals with schizophrenic symptoms. It has been influenced by certain philosophical and ethical principles, by ancient and modern Greek civilization and culture, and by the psychotherapy integration movement, and has been tested through research at the Laboratory of Clinical and Social Psychology of the University of Crete, Greece. The principles of Synthetiki Psychotherapy are presented and discussed.     

The Value of Integration: Psychoanalytic Psychotherapy Meets Ego Psychology in a Psychotherapy Group for Children

ABSTRACT

Psychotherapy integration requires us to look beyond the confines of a particular theoretical or technical approach towards other perspectives. Integrative work with children, in particular, meets the socio-emotional needs of the child while simultaneously modeling behaviors and skills. This paper presents an explicitly integrative approach to child group psychotherapy: Relationships. Individuals. Skills. Engagement (RISE) Group. We begin with an in-depth discussion of the RISE group structure illustrated by clinical examples (the “what”) followed by a review of the theory and treatment modalities that inform the approach (the “why” and “how”). The RISE group is grounded in two theoretical perspectives (psychoanalytic principles and ego psychology) and draws upon clinical techniques from multiple treatment modalities (including cognitive behavior therapy, psychodynamic play therapy and dialectical behavior therapy). Combined, the merger of these perspectives results in a multilevel intervention that forges pathways to mastery and competence within the child. Finally, we discuss the value and limitations of integration as applied to group psychotherapy for children.     

Overtones of the Voice: Some Clinical and Developmental Issues in Psychoanalytic Psychotherapy

The rise of language occurs simultaneously in the life of a very young child with the capacity to form self-identity. For this reason, specific characteristics of a person's subsequent use of language may facilitate recognition of factors that were significant to ego formation. Affective memories are laid down in this process and fixed for ego-management. Bower (1981) elegantly demonstrated how a whole nexus of affective memories can be elicited when a specific key association is activated. In two case illustrations, psychoanalytic treatment was facilitated by use of key verbal associations. In both cases, these associations proved to be inwardly permissible because they were based on forms linked to developmental levels rather than the content of what was being expressed.