The analytic process in psychoanalysis and psychotherapy: from the interpersonal to the intrapsychic level

The current debate over the conflicting interpersonal and intrapsychic views of the analytic process may or may not help us to distinguish between psychoanalysis and analytic psychotherapy. A comparison of psychoanalysis in the English-speaking world--especially in the United States--with French psychoanalysis reveals the features that unite and at the same time divide these different psychoanalytical tendencies, both of which are the heirs to Freud's thought, in terms, in particular, of the setting (couch and chair) and of technique (interpretation, transference analysis and technical neutrality). Whereas all psychoanalytic work belongs within the framework of an interpersonal relationship, that relationship becomes meaningful only when linked to the intrapsychic dimension, which alone can open the way to the unconscious and to infantile sexuality.     

Today's adolescent: addressing existential dread.

Adolescents, especially those who are gifted, may be susceptible to existential dread. It is suggested here that a team approach be used to implement the following solutions: (a) nourish students socially, (b) work toward acceptance of giftedness and teach methods of enhancing emotional development, (c) provide philosophical nurturance.     

Pluralistic approaches to the study of process and outcome in psychoanalysis. The LAC depression study: a case in point

Approaching process and outcome in psychoanalysis is a topic that touches on ambitious and complex epistemological and methodological issues. As discussed in the first part of the paper, in keeping with challenging epistemic considerations, it would seem appropriate to describe the specificity of psychoanalysis as a specific scientific discipline of the unconscious (spezifische Wissenschaft des Unbewussten, see LIT). Psychoanalysis, over its more than 100-year history, evolved a range of highly advanced research methods for investigating the specific object of its research, namely unconscious conflicts and fantasies. Hence, like many other scientific disciplines, contemporary psychoanalysis comprises a plurality of theories, methods of clinical treatments as well as a plurality of research topics. This position is discussed with reference to a model illustrating different forms of clinical and extra-clinical research in psychoanalysis. A major, ongoing comparative study of outcomes of psychoanalytical and cognitive behavioural, long-term treatments of chronically depressed patients, the so-called LAC-study, serves to illustrate the richness of contemporary research in psychoanalysis.     

The contribution of ego psychology to understanding the process of termination in psychoanalysis and psychotherapy

Ego psychology is presented as an integrated psychoanalytic developmental theory, including a theory of object relations. The process of termination is employed as one of the many possible illustrations of the usefulness of this theory. Termination is regarded as a process that pervades the treatment from the outset, rather than as the final phase of treatment only, because the treatment process, whether psychoanalysis or psychotherapy, includes continuous promotion of ever-increasing autonomy. Ideally, by the time termination proper takes place, maximum autonomy has been attained. To the definition of autonomy as intersystemic, involving relative independence of the ego from the drives (and from the super-ego), an object-relations dimension is added which extends that definition to include an intrasystemic consideration--namely, relative independence of the self-representation from the object representations. Especially in the treatment of the borderline conditions is the intrasystemic factor cogent because borderline states are characterized by varying degrees of incompletely differentiated self- and object representations. The objective, in the psychoanalysis of neurosis, where self- and object constancy already exist to a large degree, is ego autonomy in the intersystemic sense. In the psychotherapy of the borderline conditions, the objective is greater differentiation of the self-representation from the object representations.     

Developmental psychology and psychoanalysis: I. The context for a revolution in psychoanalysis

After describing the manner in which the integration of psychoanalysis and developmental psychology became a central problem for ego psychology, the author examines the conditions that make it possible for new research and theory in developmental psychology to contribute to a revolution in contemporary psychoanalytic theory. They include: (1) the emergence of a state of "crisis" in American psychoanalysis centering on questions of the nature of early development and how it can be known; (2) the explosive growth of developmental research on early childhood dealing with issues at the heart of that crisis; and (3) the presence of a new generation of psychoanalysts and psychoanalytically oriented researchers capable of bringing that research to bear on those issues.     

Applying a prospective approach to the working-through phase of psychotherapy

During the working-through phase of psychotherapy, the core of the patient's conflict is revealed and subjected to analysis. Although the working-through has been the subject of much scholarship, little has been written about identifying its onset and termination. This paper introduces a developmental strategy—previewing—derived from the interactional patterns between caregiver and infant. Previewing involves the caregiver's ability to represent, predict and rehearse future maturational changes affecting the infant. Previewing techniques may be applied analogously to the treatment of adult patients to better diagnose the presence of conflict and to facilitate the working-through of conflict.     

From avant-garde to specialism: psychoanalysis in America.

Psychoanalysis in America functioned first largely as an avant-garde phenomenon. Later psychoanalysis became a specialty within a bureaucratic society. Both roles help explain the importance and the limitations of freud's impact on American culture.