Going Beyond Certain Limits Together: How Ferenczi's Notion of Elasticity Informs Group Treatment of Traumatized Patients

This paper explores Ferenczi's elasticity techniques, ideas about mutuality, and analyst self-disclosure. It describes the application of Ferenczi's theory of working with traumatized patients to a group comprised of six patients. By exploring Ferenczi's techniques in working with his patients individually, the author hopes to guide clinicians in applying and recognizing the special value of Ferenczi's theory in a group setting. The author's emphasis on promoting an atmosphere of tenderness in the group led members to reveal their experiences of trauma after they had developed sufficient feelings of safety and freedom in the group.     

The Leader’s Illumination of Group Phenomena Hidden in Plain Sight: Why Is No One Talking About the Elephant in the Room?

This article discusses an important leadership function: calling attention to phenomena in group therapy that are NOT observed or observed but not commented on by group members. The article includes group scenarios that often generate member omission, ways to mitigate shame that can result from uncovering members’ blind spots, and misuses of this leadership function. Numerous clinical examples are provided. Concepts borrowed from attachment theory and interpersonal neurobiology help explain how the group’s internalization of this leader function may help the group become a more potent therapeutic environment. The limited contribution of neurological findings to clinical decision-making is discussed.     

The influence of individual attachment styles on group members' experience of therapist transitions

Attachment theory has recently been applied to clinical practice in an effort to improve understanding and treatment of the maladaptive relational patterns clients bring to therapy. While most of this research has focused on individual therapy, interest in the application of attachment theory to group psychotherapy is growing. This paper will explore the impact of clients' attachment styles on their experiences of co-therapist transition in an ongoing psychodynamic therapy group. This discussion will elucidate how knowledge of attachment theory and an understanding of clients' individual attachment styles can be useful in predicting responses to therapist-initiated terminations and transitions.     

A Jungian contribution to a dynamic systems understanding of disorganized attachment

This panel emerged from shared clinical concerns when working with adult patients whose presentation style was reminiscent of a disorganized (Type D) infant attachment pattern. Psychotherapeutic work with such patients poses complicated transference and countertransference dilemmas which are addressed by all four panellists via theory and clinical vignettes. In common is an interest in contemporary attachment, neuroscience and trauma theories and their relationship to analytical psychology. Intergenerational trauma seems to be a salient factor in the evolution of fragmented and fragmenting interactions that lead to failures in self-coherence and healthy interpersonal relationships. Such early relational trauma is compounded by further episodes of abuse and neglect leading to failure in a core sense of self. These clinicians share how they have integrated theory and practice in order to help dissociated and disorganized patients to transform their dark and extraordinary suffering through implicit and explicit experiences with the analyst into new, life giving patterns of relationship with self and others. The alchemy of transformation, both positive and negative, is evident in the case material presented.     

“You Must Remember This”

The question of a theory of analytic change is approached through a consideration of analytic impasse. Impasse is considered in relation to impasse in the analyst, linked to an impasse in some forms of mourning in the analyst. The analyst's impasse is considered in the light of character formation, the relation of analytic vocations to early attachment, and object ties in the analyst leading to problems with omnipotence. Impasse then is tied to various processes and defenses that shape and contribute to the analyst's countertransference. Analytic change is considered then in the context of theories of nonlinear development, models of speech practice, and mutative action. These ideas are explored through case material.     

The Influence of Individual Attachment Styles on Group Members’ Experience of Therapist Transitions

Abstract

Attachment theory has recently been applied to clinical practice in an effort to improve understanding and treatment of the maladaptive relational patterns clients bring to therapy. While most of this research has focused on individual therapy, interest in the application of attachment theory to group psychotherapy is growing. This paper will explore the impact of clients’ attachment styles on their experiences of co-therapist transition in an ongoing psychodynamic therapy group. This discussion will elucidate how knowledge of attachment theory and an understanding of clients’ individual attachment styles can be useful in predicting responses to therapist-initiated terminations and transitions.     

When Avoidance Is Mutual Regulation: Disorganized Attachment and Analytic Attunement

This paper looks at and counters the notion that the analyst’s reluctance to know, to comprehend and interpret, the fuller meaning of a patient’s behavior is a countertransference avoidance. Drawing on attachment theory and infant research that has not yet been fully integrated into the clinical literature, the author believes that the movement from enactment to the expression of dissociated feeling is a process that leads to the creation of previously unknown meaning within an analytic impasse. The infant research literature and the literature on disorganized attachment is referenced to elucidate aspects of the clinical process. The clinical material presented involves the analyst’s failure to engage a patient’s chronic lateness, a failure that represented a mutual avoidance. The meaning of this enactment was locked in the patient’s traumatic past and could not be transmuted into new relational experience until the analyst had emerged from her own dissociative state. The therapeutic space created by their mutual avoidance, contrary to being a stalemate, became a protective space that held the meaning that was hibernating in dissociation. For the patient, the dissociated memory of traumatic abuse was linked, actually and symbolically, to her pervasive lateness. What was represented in the chronic lateness was discovered by analyst and patient together, along with the feelings engendered by “waiting.”     

Narrating the Unsayable: Enactment,Repair, and Creative Multiplicity in Group Psychotherapy

This article introduces an approach to group analysis that places dissociation of traumatic experience at the center of group interaction. Healing in group is regarded as hinging on the enactment of unformulated and dissociated experience and affect. Enactments are regarded as involving the members of the group, the group as a whole, and the group analyst. Clinical examples are offered to illustrate the enactment of dissociated trauma that was unable to be suffered earlier and the enactment of absence and neglect that is non-represented. In this hermeneutic conception, the group comes to narrate what has happened but never been experienced, and healing accrues through the group’s witnessing and making affectively real what was hitherto unsayable and unthinkable. The group analyst uses and shares his or her own experience to facilitate this process.     

个体依恋特征的二重性：特质性依恋与状态性依恋

传统依恋理论认为个体依恋心理和行为模式具有相对稳定性, 但无论在信息加工还是个体发展过程中, 个体依恋模式均表现出二重性, 即既具有相对稳定性, 又具有情境敏感性。个体在情境中所表现出的依恋模式是个体相对稳定的特质性依恋和情境特征相互作用的结果。依恋启动研究中特质性依恋特征与依恋启动效应之间的交互作用模式为理解依恋二重特征及其关系提供了窗口。依恋系统激活的两阶段模型为整合和解释这些相互作用模式提供了框架。未来研究应优化依恋二重特征关系研究中启动效应的操作检验, 考虑依恋焦虑和回避维度的交互作用, 关注高焦虑群体内的依恋差异, 以理析依恋二重特征之间的相互作用方式, 同时关注依恋策略影响依恋启动效应的时间进程, 探究依恋二重特征相互作用的机制。     

Attachment to God,Images of God,and Psychological Distress in a Nationwide Sample of Presbyterians

Drawing broadly on insights from attachment theory, the present study outlines a series of theoretical arguments linking styles of attachment to God, perceptions of the nature of God (i.e., God imagery), and stressful life events with psychological distress. Main effects and potential stress-moderator effects are then evaluated using data from a nationwide sample of elders and rank-and-file members of the Presbyterian Church (U.S.A.). Key findings indicate that secure attachment to God is inversely associated with distress, whereas both anxious attachment to God and stressful life events are positively related to distress. Once variations in patterns of attachment to God are controlled, there are no net effects of God imagery on levels of distress. There is only modest support for the hypothesis that God images moderate the effects of stressful life events on psychological distress, but no stress-moderator effects were found for attachment to God. Study limitations are identified, and findings are discussed in terms of their implications for religion-health research, as well as recent extensions of attachment theory.     

‘Translation’ and ‘transformation’ in the analytic situation: Freud – Bion – Laplanche

Following a short introduction to the core theses of Jean Laplanche’s theory of a ‘general seduction’ the author presents the resultant clinical position of the analyst. In the same way that an adult sends ‘enigmatic messages’ to the child, it is the analyst’s task to reopen this primal situation so that the patient can find new ‘translations’ for these messages. Laplanche distinguishes between the function of the analytic frame – which represents and supports attachment – and the ‘sexual’– which is the repressed and constitutes the unconscious. Only the focus on this unconscious facilitates the deconstruction of ‘incorrect’ translations. Accordingly, the analyst, says Laplanche, should not take part in construction – this is a self‐construction of the patient – but only in reconstruction. The author compares this clinical model with Freud’s notions and the ‘transformation processes’ through the alpha function as described by Bion. She illustrates Laplanche’s model and the interpretation strategy with case material.     

Making room: Developing reflective capacity through group analytic psychotherapy – in the analyst and in the group. Part one

Abstract

This paper is in two parts. This, the first part, traces the inter-related development of trainee group analyst and training group during the first nine months of the group's life. The influence that personal group analytic psychotherapy, supervision and theoretical learning have on the trainee are also considered in relation to the development of the group and its members, many of whom suffer from narcissistic and borderline disorders. The metaphor of ‘making room’ is used to explore the efforts of analyst and group to contain the chaotic, confused and unbounded projective identifications of its members. In this way, amidst the crowded turbulence of the group, a space begins to open up in which, slowly and painfully, the capacity for reflection may emerge.     

Psychoanalysis is a two‐way street

The paper discusses psychoanalysis as a mutual exchange between the analyst and analysand. A number of questions are raised: What was Ferenczi's and the early psychoanalysts' contribution to the interpersonal relational dynamics of psychoanalytic treatment? Why did countertransference become an indispensable tool in relationship‐based psychoanalysis? Why is the transference‐countertransference dynamic seen as a special dialogue between the analyst and analysand? What was Ferenczi's paradigm shift in the trauma theory? How did he combine the object relation approach with Freud's original trauma theory? The paper illustrates through some case study vignettes the intersubjective and intrapsychic dynamic in the process of traumatization. We can look at countertransference as an indicator of the patient's basic interpersonal experiences and traumas. Finally the paper discusses countertransference in the light of attachment theory, connecting the early initiatives of inter‐relational approaches in psychoanalysis with recent research.     

'Talk to me baby, tell me what's the matter now': Semiotic and developmental perspectives on communication in psychoanalytic infant treatment

Infants suffer to a considerable degree from disturbances in nursing, sleep, mood, and attachment. Psychotherapeutic methods are increasingly used to help them. According to case reports, psychoanalytic work with infants and mothers has shown deep‐reaching and often surprisingly rapid results, both in symptom reduction and in improved relations between mother and child. The clinical urgency of the method makes it important to study its results and theoretical underpinnings. Among the theoretical issues often raised in discussions on this modifi ed form of psychoanalysis, those addressing the nature of communication between analyst, baby, and the mother are the most frequent. For example, how and what does an infant understand when the analyst interprets to her? What does the analyst understand of the infant's communication? These issues are addressed by investigating the infant's tools for understanding linguistic and emotional communication, and by providing a semiotic framework for describing the communication between the three participants in the analytic setting. The paper also investigates problems with the traditional ways of using the concept of symbolization within psychoanalytic theory. The theoretical investigation is illustrated by two brief vignettes from psychoanalytic work with an 8 month‐old girl and her mother. demand for the breast. Like the two lovers in the blues, they seemed to be slaves to     

Attachment anxiety,intra‐group (dis)respect,actual efforts,and group donation

The current study examines attachment‐style differences in responses to inductions of group respect and disrespect. Participants completed a scale assessing attachment anxiety and avoidance, performed group tasks, and received high, average, or low respect feedback from group members. Then we assessed commitment to this group, actual effort expenditure on behalf of the group, and money donation to the group. For participants scoring relatively high on attachment anxiety, high group respect heightened group commitment and effort expenditure on behalf of the group, whereas group disrespect led to lower group commitment but to more money donation to the group and higher effort expenditure. Participants who scored relatively low on attachment anxiety were not significantly affected by group respect or disrespect. The implications of attachment theory for group dynamics were discussed. Copyright © 2008 John Wiley & Sons, Ltd.     

Attachment,caregiving, and volunteering: Placing volunteerism in an attachment‐theoretical framework

Recent studies based on attachment theory demonstrate that dispositional and experimentally manipulated attachment security facilitate cognitive openness and empathy, strengthen self‐transcendent values, and foster tolerance of out‐group members, suggesting an effect of one behavioral system, attachment, on another, caregiving. Here we report 2 studies conducted in 3 different countries (Israel, the Netherlands, and the United States) to determine whether the 2 dimensions of attachment insecurity—anxiety and avoidance—are related to real‐world altruistic volunteering. In both studies and across the 3 locations, avoidant attachment was related to volunteering less and having less altruistic and exploration‐oriented motives for volunteering. Anxious attachment was related to self‐enhancing motives for volunteering. Additional results suggested that volunteering ameliorates the interpersonal problems of individuals high in anxiety and that volunteering has more beneficial effects if it is done for altruistic reasons. Future directions for experimental research on this topic are outlined.     

Coming to our senses: the application of somatic psychology to group psychotherapy

Somatic psychology, the interplay of the body, the mind, the emotions, and the social context, significantly contributes to the theory and practice of group therapy. The processing of sensory experiences in the here-and-now of the therapy group helps group members to develop self-awareness, the ability to understand their relationships with others, and the capacity for empathy. When group members know what they experience, they can understand how others feel and resonate emotionally with those feelings. Neurobiology, sensory processing, and attachment theories help us to understand how the sense of self develops somatically. Principles of somatic therapies are applied to group therapy practice in working with attachment disorders, transference impasse, and trauma. The importance and implications of the group therapist's embodied attunement are explored.     

Die Bindungstheorie als Basis psychotherapeutischer Interventionen in der Terminalphase

Recent attachment research has shown that every person develops, already in early childhood, special attachment strategies activated in cases whenever the person cannot cope on his own with dangers. These strategies are classified into four categories: “secure”, “insecure-avoidant”, “insecure-ambivalent/enmasked” and “disoriented/disorganized” attachment patterns. The death of a next person represents a situation of a unique and final separation causing psychical disturbances for the patient himself and his relatives. It is, therefore, an especially effective trigger for the activation of the attachment system. This article aims on relating attachment theory to an attachment-oriented therapy, that would open, particularly in the field of palliative medicine, possibilities of application which have been neglected. Case studies illustrate how these insights may be applied during the psychotheraputic care for patients and their relatives. As dying patients generally are brought by their family to the clinic, physicians have a particularly favourable situation to observe the attachment patterns in the family and integrate these informations into their treatment strategy: for example in case of “avoidant” attachment patterns, to bring cautiously the denied emotions into the communication and to support hopes for the fulfilment of needs for affection and protection; or in case of so-called “ambivalent/entangled” attachment patterns to help to disentangle too close relationships; or in case of “disorganized” attachment patterns to support emotional regulation and help to clear the relationships. It is obvious that this approach based on attachment theory and offering alleviations during the process of dying, is not only on a palliative board relevant, but may be applied with success in the medical care of dying patients and their relatives.     

The Nonhuman Environment in Normal Development and in Schizophrenia by Harold F. Searles

Abstract

Somatic psychology, the interplay of the body, the mind, the emotions, and the social context, significantly contributes to the theory and practice of group therapy. The processing of sensory experiences in the here-and-now of the therapy group helps group members to develop self-awareness, the ability to understand their relationships with others, and the capacity for empathy. When group members know what they experience, they can understand how others feel and resonate emotionally with those feelings. Neurobiology, sensory processing, and attachment theories help us to understand how the sense of self develops somatically. Principles of somatic therapies are applied to group therapy practice in working with attachment disorders, transference impasse, and trauma. The importance and implications of the group therapist’s embodied attunement are explored.