A Kleinian view of psychoanalytic couples therapy: Part 1

This paper will investigate the central aspects of the psychoanalytic treatment of couples. The concept of analytic contact is introduced and the importance of each party of the couple being witness to the other party's response to analytic contact is discussed. Emphasis will be placed on issues of thinking, projective identification and the concept of container‐contained. Part 1 of the paper will focus mainly on theoretical issues but will then utilize one clinical case to illustrate some of the theoretical points. Using extensive case reports, Part 2 will continue to provide the reader with an in‐depth view of the important process of a couple's therapy within a psychoanalytic framework.     

The edge of chaos: A nonlinear view of psychoanalytic technique

The field of nonlinear dynamics (or chaos theory) provides ways to expand concepts of psychoanalytic process that have implications for the technique of psychoanalysis. This paper describes how concepts of “the edge of chaos,” emergence, attractors, and coupled oscillators can help shape analytic technique resulting in an approach to doing analysis which is at the same time freer and more firmly based in an enlarged understanding of the ways in which psychoanalysis works than some current recommendation about technique. Illustrations from a lengthy analysis of an analysand with obsessive‐compulsive disorder show this approach in action.     

A Kleinian view of psychoanalytic couples therapy: Part 2

With extensive case material, Part 2 continues to explore the psychoanalytic treatment of couples. Since most couples enter treatment operating in a more primitive paranoid‐schizoid stance, the author contends that it is best to initially focus on each partner's pathological projections and have the other partner witness their struggle to overcome personal issues that contaminate the couple's unified psychology. With continuous working through, the couple can gradually find a more depressive, integrative footing within themselves and as a couple. Again, the value of ‘witnessing’ and working through individual defensive reactions against thinking, pathological projective identifications and the breakdown of the container‐contained function are all examined in the clinical presentations. All these clinical elements are part of the establishment of analytic contact first with each party as individuals and later as a unified couple.     

Sanctioned social violence: A psychoanalytic view. Part II

This paper is the second in a series of two papers. In Part I, the first paper, the author reviewed the influence on the development of socially sanctioned violence of psychodynamics of group psychology and mass psychology, the regressive pull of ideologies, personality features of social and political leadership, and historical trauma and social crises. In this Part II, the author explores, from a psychoanalytic perspective, the dehumanization processes related to fundamentalist ideologies and terrorism.     

Sanctioned social violence: A psychoanalytic view - Part I

This paper is the first of a series of two that present an effort to systematize the application of psychoanalytic theory of group processes to the outbreak of massive violence. It explores the origins and social amplification of primitive aggression by means of group psychology and mass psychology, and the combined influences of the regressive pull of ideologies, the personality features of social and political leadership, and the triggering impact of historical trauma and social crises. The paper describes a spectrum of narcissistic-paranoid mechanisms that provide a common matrix for the analysis of those aspects of social psychology that co-determine socially sanctioned violence.     

Group psychology in the totalitarian system: A psychoanalytic view

The author discusses the ideas of three important psychoanalytic thinkers about group processes in large social groups: Sigmund Freud, Wilfred Bion, and Erich Fromm. Their ideas are developed and applied to analysis of group processes in totalitarian systems, as they were known to the author in Czechoslovakia and the Soviet Union. In conclusion, treatment considerations as they apply to patients who grew up in these regimes are developed and illustrated by clinical cases.This paper is dedicated to Dr. Alexander Wolf, who made his groups growth-promoting, free and holding environments.The author wants to thank Valerie Angel, M.S.W., Eva Papiasvili, Ph.D., Susan Kavaler, Ph.D., Maria Luisa Bastos, Ph.D., and Nancy Smith for their support, critical commentary, and helpful suggestions.     

Confi dentiality with respect to third parties: A psychoanalytic view

It is assumed that confi dentiality is not one singular ethical entity but a conglomerate of quite different issues depending upon clinical context and the sector of information sharing at stake. The focus here is on how to think psychoanalytically about requests for information from third parties (payers, courts, public security). Defi ning confi dentiality as a promise to 'never tell anything' outside of the relationship omits evaluation of the impact of the third's listening on the combined freedom of thought and freedom of speech in analyst and analysand. Circulation of information outside the dyad need not be toxic, need not disrupt the analytic couple's openness to new meaning. Key to contamination and inhibition of analytic work is whether or not disclosure serves an analytic end. Current defense of confi dentiality relies heavily on the models of protection of privacy and professional secrecy, which, though useful and relevant, fail to encompass the transitional, intersubjective space engendered by the analytic process. Suggestions are made for alternate sources of paradigms better suited to represent the latter. Offered for discussion is a draft of a confi dentiality policy with respect to third parties that is informed by psychoanalytic theory and clinical practice rather than by local legal jurisdiction or original disciplines ethics codes.     

A psychoanalytic view of the Rorschach Comprehensive System "special scores"

We analyzed the contemporary empirical and theoretical literature concerning the two predominant approaches for scoring formal thought disorder on the Rorschach, the Comprehensive System special scores, and the methodology of Rapaport, Gill, and Schafer (1946/1968). The psychoanalytic research related to selected special scores is reviewed, and some linkages to psychoanalytic developmental theory and psychopathology are made. Recommendations are presented to bridge the gap between these two important avenues of Rorschach research, with an emphasis on empirical rigor and intrapsychic contextual meaning.     

A psychoanalytic view of reactions to the coronavirus pandemic in China*

The American Journal of Psychoanalysis - The coronavirus pandemic, which apparently began in Wuhan in December 2019, and has persisted to the present day, has had several psychological effects in...     

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.     

The goals of psychoanalytic treatment: Conceptual considerations and follow‐up interview evaluation with a former analysand1

There has been a long, ongoing discussion of goals in psychoanalytic treatment. Some analysts are even of the opinion that psychoanalysis ought to be goalless (‘just analysing’). The growing number of outcome studies, however, is in need of a generally accepted set of criteria by which treatment results can be judged. The author proposes a definition of the goals of psychoanalysis that covers four areas: the alleviation of symptoms and complaints, changes in life adjustment, changes in personality structure, and procedural goals such as the resolution of the transference neurosis. She illustrates the relevance of this conceptualization by an empirical study that considers the assessments of 19 psychoanalysts discussing statements made by a former patient about her analytic treatment. On the basis of this case, which comes from the follow‐up study of the DPV (German Psychoanalytical Society), reported by Leuzinger‐Bohleber et al. in 2002, the author demonstrates that psychoanalysts use the criteria defined above implicitly in forming their opinions. Moreover, they arrived at similar judgements regarding the treatment's outcome.