Conceptualizations of the psychoanalytic process

A demonstrable psychoanalytic process involves elaborate and sustained intrapsychic experiences and phenomena for both analysand and analyst. It also includes a complex and at times subtle interpersonal relationship in which each participant is actively sensitive and responsive to verbal and nonverbal input from the other. These interpersonal experiences stimulate further intrapsychic responses which in turn may have further interpersonal effects. Within the framework of the psychoanalytic situation, these combined intrapsychic and interpersonal responses lead first to facilitative and ultimately to definitive changes in the patient's psychological organization and function. A method for demonstrating a psychoanalytic process is described.     

Experience, Development, and Resilience: The Legacy of Stuart Hauser's Explorations of the Transition from Adolescence into Early Adulthood

The legacy of Stuart Hauser's research into the developmental transformation that takes place from the adolescent living within his or her family to the young adult functioning independently is assessed. Four major themes are identified in this work: the interplay between the intrapsychic and the interpersonal; the need to understand the family in developmental context; the links between development and psychopathology; and the role of resilience in human psychological functioning. Hauser's broad, integrative, and fundamentally optimistic perspective on human nature is discussed as providing a roadmap to guide future research in this area.     

Group psychotherapy of the characterologically difficult patient

A broad range of characterologically difficult patients present for treatment in psychotherapy groups. Despite different clinical presentations, including features of the schizoid, borderline, and narcissistic personality disorders, these patients share a common developmental failing. Specifically, these individuals have failed to attain object constancy and the associated stable internalization of tolerably ambivalent representations of the self, and of the other, in relationship with one another. Splitting mechanisms predominate over integrative ones, as primitive defenses are utilized to deal with the individual's powerful needs and fears related to engagement and intimacy. These maladaptive interpersonal styles are clearly illuminated in group therapy, but often to the exclusion of the latent, intrapsychic derivatives of this behavior, with detrimental effects. This paper examines the group therapy of such patients from the perspective of object relations and self psychology theories, models that provide the essential link between the interpersonal and the intrapsychic worlds.     

A core process in psychoanalytic treatment

A core mechanism of the psychoanalytic process is described. This involves the effects of treatment on an ongoing "unconscious intrapsychic process," which has specific points of vulnerability to pathology. The concept of an intrapsychic process described by the author in previous publications is an expanded formulation of the idea of thought as trial action and of the signal theory of anxiety. The psychoanalytic method alters the functioning of the ego astride this unconscious process, strengthening its control over anxiety, defense, trauma, and symptom formation. This is mutative in the psychoanalytic method.     

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.     

Discussion: The Narcissism of Small Differences — and Some Big Ones

A broad range of characterologically difficult patients present for treatment in psychotherapy groups. Despite different clinical presentations, including features of the schizoid, borderline, and narcissistic personality disorders, these patients share a common developmental failing. Specifically, these individuals have failed to attain object constancy and the associated stable internalization of tolerably ambivalent representations of the self, and of the other, in relationship with one another. Splitting mechanisms predominate over integrative ones, as primitive defenses are utilized to deal with the individual's powerful needs and fears related to engagement and intimacy. These maladaptive interpersonal styles are clearly illuminated in group therapy, but often to the exclusion of the latent, intrapsychic derivatives of this behavior, with detrimental effects. This paper examines the group therapy of such patients from the perspective of object relations and self psychology theories, models that provide the essential link between the interpersonal and the intrapsychic worlds.     

Werkzeugkasten des psychodynamischen Psychosetherapeuten

The authors describe the modification of the classical psychoanalytic treatment technique, which was developed in the past decades to treat people with schizophrenic psychosis. The technique which can be used in modified psychoanalytic as well as other psychodynamic settings, was adjusted to the specific problems which occur in the psychotherapy of patients with schizophrenia. This specific modified psychotherapy deals with a paradigmatic experience in the therapeutic relationship to reduce traumatic fear and to overcome interpersonal and intrapsychic dilemmas. This modification increases the possibility to reconstruct the personal history of the psychosis in a dialogical process together with the patient.     

Counteridentification, comprehensive countertransference, and therapeutic action: toward resolving the intrapsychic-interactional dichotomy.

Two dichotomous trends in thinking about countertransference and therapeutic action can be delineated historically as well as in clinical practice: the intrapsychic and the interactional. The author proposes a new usage of the concepts of counteridentification and comprehensive countertransference to help transform these dichotomizing tendencies into more useful, integrative therapeutic action across the broad spectrum of psychoanalytic treatment for patients from the neurotic to the most severely disturbed.     

Group therapy as psychic containing

This article will examine how the psychoanalytic idea of containing can be used in group therapy to form a conceptual bridge such that the group dynamics are not simplistically reduced to individual dynamics, nor that the individual is lost in the "group-as-a-whole" concept. I take the concept of "containing" as versatile in the sense that Bion (1970) meant it to be-that is, the psychological phenomenon of containment is manifest at various system levels: intrapsychic, interpersonal, group, and societal. This article will explore how far this "bridging concept" can be pursued to understand groups theoretically. The article will review various forms of containing, following Bion's ideas, and in particular a therapeutic, or flexible, form in contrast to rigid and fragile forms.     

Day,Night, or Dawn: Commentary on Paper by Steven Stern

It was in the years immediately following World War II and through the 1950s that the psychoanalytic establishment officially defined psychoanalysis as a subspecialty of psychiatry, and it was in that context of the professionalization of American medicine that they codified the distinction between psychoanalysis and (psychoanalytic) psychotherapy. In this commentary on Steven Stern's “Session Frequency and the Definition of Psychoanalysis,” I deconstruct a series of binaries that was built into the analysis/therapy distinction and that has plagued our discipline. It is argued that psychoanalysis identified itself with the culturally “masculine” and heterosexual values of autonomous individuality (the intrapsychic), while it split off all that was relational and social (interpersonal), marked as “feminine,” homosexual, and “primitive,” onto psychotherapy, which it then devalued. The paper then examines the implications for practice and psychoanalytic education.     

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.     

Ghosts of paradigms past: the once and future evolution of psychoanalytic thought

An example of the psychoanalytic mode of thought is put forward concerning how psychoanalytic theories have historically been constituted and transformed. The model of world hypotheses, characterized by multiple irresolvable truth claims, captures the nature of most psychoanalytic theorizing until about 1970. Each of two world hypotheses--one grounded in intrapsychic conflict (seen when the analyst observes from outside the transference) and the other in interpersonal internalization (seen when the analyst observes from inside the bidirectional interactive processes)--is an autonomous and self-sufficient aggregate. The stance taken by the analyst-observer with respect to the analytic interaction is key to seeing how the two world hypotheses are made manifest in clinical work and in theory. By contrast, the model of competing programs captures the essential nature of most psychoanalytic theorizing since about 1970, and is characterized by the necessity of each progressively evolving through a particular kind of commerce with its neighbors. Such commerce is necessary when a program is in danger of degenerating. In this way of thinking, there is a fundamental tension between classical psychoanalysis adapting to the demands and exigencies of its particular and ever evolving historical niche and simultaneously retaining the core commitments that guarantee continuity. Honoring the forces of progression displaces the quest for truth as a paramount goal of psychoanalysis. A developmental lag in recognizing this transformation has hindered progress toward a comparative, process-centered psychoanalysis.     

Marital conflict and marital intimacy: an integrative psychodynamic-behavioral-systemic model.

A conceptual model of some of the intrapsychic and interpersonal forces that stimulate and maintain repetitive, nonproductive marital conflict behavior is presented. In this model, concepts derived from psychoanalytic and social-learning theory and integrated within a family systems framework. Implications for conjoint therapy with conflictual couples are discussed.     

Toward a definition of psychoanalytic neutrality

The word and concept of neutrality play an important but confusing role in the history of psychoanalysis. Does neutrality imply indifference? The origin of this ambiguity is traced to the fact that Freud himself never used the word "neutrality" (Neutralitaet) in his own writings. (His term Indifferenz was translated as "neutrality" by Strachey.) The essence of the controversy that has simmered in the psychoanalytic literature ever since is contained in the question: "Is remaining true to the concept of neutrality somehow antithetical to the analyst's genuine involvement with the patient?" In this paper, I examine the feeling and power aspects of the word and suggest that the concept of neutrality becomes clinically useful when the analyst asks himself the question, "Neutral to what?" The analyst's awareness of his motives for recognizing and addressing certain conflicts and for overlooking others is heightened. With three clinical vignettes as illustrations, I explore the role of the concept of neutrality in deepening our understanding of (1) the analytic relationship; (2) The influence, on the conduct of the treatment, of the analyst's goals and theoretical persuasion regarding how the goals are to be achieved. As examples, I use the current debates over the relative value of the analyst's focusing his attention on: (a) the patient's mind in the hour rather than his life outside the hour and, (b) transference over nontransference interpretation. Finally, I emphasize the far-reaching implications of adding an explicit concept of "external reality" to A. Freud's exclusively intrapsychic definition of the "objective" analyst's position of neutrality as equidistant from id, ego, and superego. The addition of this fourth point to the analyst's "compass" widens the analytic field toward which the analyst is neutral. The concept of neutrality with respect to specifiable conflicts is thereby also broadened to include (a) interpersonal conflict within the psychoanalytic relationship and (b) conflict within the analyst. With these explicit additions, the concept of neutrality with respect to conflict becomes congruent with the current emphasis on the nonauthoritarian two-persons aspects of the psychoanalytic relationship, without detracting from the primary analytic goal of deeper understanding of intrapsychic conflict.     

Motivation, personality organization, and the four psychologies of psychoanalysis

Four psychologies currently significant in psychoanalytic thinking are described. An attempt is made to (a) advance developmental proposals describing how the phenomena of each of the four achieve motivational status in the intrapsychic life of the individual and (b) develop a model for the understanding of personality organization across the four psychologies, based on the development of personal hierarchies that establish which issues are superordinate and which subordinate. Taken together, these two points are used to suggest that the four psychologies may not simply represent differing perspectives on intrapsychic phenomena (though they do that, in part) but that they also, simultaneously, represent relatively independent ways in which intrapsychic life is organized.     

Sullivan und die intersubjektive Sichtweise

The author sees H.S. Sullivan??s (1892?C1949) interpersonal theory as the best theoretical framework for the contemporary intersubjective perspective in psychoanalysis and presents it in its pluridimensional articulation. After having extended Freud??s therapeutic approach to psychotic patients, Sullivan developed both a developmental psychology and a psychoanalytic and psychotherapeutic technique based on the ??interpersonal field?? as the basic unit of study. To the pluridimensional character of his theory also belongs its application to the cultural and social aspects of our personal identity. Because the contemporary psychoanalytic authors who shaped the intersubjective perspective limited themselves to the clinical dimension, Sullivan??s interpersonal theory can still provide the theoretical framework which any psychoanalytic perspective needs.     

Contributions of object relations theory and self psychology to relational psychology and group psychotherapy

Object relations theory and self psychology are psychoanalytic perspectives that are especially concerned with interpersonal relations and their mental representations. Object relations theory began as an intrapsychic "singleton" psychology with the work of Freud and Melanie Klein. It subsequently evolved into a multi-person psychology with the work of Bion on groups, as well as the clinical and theoretical contributions of Winnicott and Fairbairn. Kohutian self psychology, which emerged later, has been interested in the relations between the self and significant others as mirroring and idealizing "self-objects." Stolorow's "inter-subjective perspective" emerged from self psychology as a full-fledged multi-person point of view. This article considers the significance of contemporary object relations theory and self psychology as relational, multi-person perspectives in terms of their application to group psychotherapy, focusing upon the group-as-a-whole, projective identification, transitional space and object, and self/self-object relations as particularly useful constructs. A clinical vignette is provided.     

Analyzing Multiplicity: A Postmodern Perspective on Some Current Psychoanalytic Theories of Subjectivity

Tensions between modernism and postmodernism in psychoanalytic theory and practice are evident in the allegedly “postmodern” view of subjectivity as not unified but plural. Suggesting that a thoroughgoing postmodern clinical practice does not exist at present, I distinguish between U. S. and European models of the postmodern multiple subject and between modern and postmodern varieties of pluralism in the current psychoanalytic theorization of subjectivity in this country, proposing that all such pluralist theories are in fact mixed models. I argue that these theories do not reflect objective, essential traits of selfhood but are complexly shaped by the cultural presuppositions and intrapsychic needs of the analyst; hence attempts to theorize subjectivity with reference to science (including developmental schemas) are problematic. Because a thoroughgoing postmodern pluralism cannot accommodate such concepts as agency and authenticity or a coherent narrative of the treatment process, clinical psychoanalysis, at least at present, inevitably includes major elements of the modernist approach, in which subjectivity is seen as unified. At this time of paradigm shift between modernism and postmodernism, therefore, it is important that pluralists decenter from their theories and respect the continuing influence of modernism on psychoanalytic theory and practice.     

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.     

History Repeats Itself in Transference—Countertransference

The dynamics of the larger society inevitably are manifest in intrapsychic dynamics, as well as interpersonal interactions, in and out of the psychoanalytic consulting room. Traditional psychoanalytic inattention to the social world predisposes analysts to enact unreflectively some of the racist and classist patterns in the social world around us in our clinical work. This author argues first that U.S. psychoanalysis, as a field, has sought to define itself as white, thereby demonstrating the influence of racism in this country. Second, in a clinical example, the author demonstrates the subtle imprint of racism and classism in a dyad in which both participants are conventionally classified as white. He concludes that open discussion of U.S. history and of the past and current social location of psychoanalysis as a field goes hand in hand with increased awareness of the ways in which social forces organize psychoanalytic interactions.