Sigmund Freud: Four Centenary Addresses by Ernest Jones

Group psychotherapists, primarily members of the American Group Psychotherapy Association, were surveyed to determine their practice and attitude toward inclusion of patients receiving psychotropic medication in their “typical” outpatient psychotherapy groups. One hundred forty-three questionnaire responses were received from 258 contacted practitioners (55.4% return rate). More than two-thirds of the physicians, social workers, and psychologists reported including medicated members, and the professions did not significantly differ. Mood disordered patients were most frequently and schizophrenic and manic patients were least frequently reported to receive medication.

Overall, clinicians' attitudes favored including medicated patients in the group. Indeed, therapists did not view inclusion of drugs as a detriment to the treatment process. Clinicians having only one medicated patient in their group felt more strongly that such individuals did not interfere with the treatment process when compared with those having none or more than one medicated patient. The one difference by discipline was that social workers and psychologists did not endorse the idea that medicated patients needed to be in groups led by psychiatrists.     

The Life and Work of Sigmund Freud. Vol. III: The Last Phase by Ernest Jones

This paper describes the ward group, a modified version of group psychotherapy, designed for use in conjunction with comprehensive long-term treatment for severely disturbed adolescents and young adults. The authors examine the structural features of the ward group and discuss the group in relation to the unit and the hospital regarding such issues as membership, confidentiality, space, time, and ward group identity. The complex issues of task boundaries, the ward group as both an administrative unit and as a therapy group, are given special attention. The ward group transmits unit and hospital values and expectations, maintains behavioral controls over patients, exercises administrative decision-making authority, operates as a reflective–explorational therapy group, and represents an important means through which patients can achieve a sense of significance within the institutional setting.     

Never the Twain Shall Meet: A Critical Appraisal of the Combination of Discourse and Psychoanalytic Theory in Studies of Men and Masculinity

In recent years there have been a number of attempts by different researchers to study men and masculinity using a combination of discourse theory and psychoanalysis. The main reason for this development is the sense that, on its own, discourse theory provides an incomplete account of masculine subjectivity. Psychoanalysis is thought to be able to fill those gaps. In this paper I reviewed these arguments, provided an outline of the alleged deficiencies in discursive approaches to men and masculinity, and examined some of the work that has attempted the above synthesis. I argued that, for a number of reasons, such attempts are bound to fail. Instead, I argued that better progress can be made in studies of masculinity by remaining within the theoretical boundaries of Discursive Psychology.     

Reply by Edward S. Casey

Stigma and discrimination against mental illness represent chronic social stressors that can inflame psychiatric symptoms and limit functional adjustment. The implication is that the prevalence and severity of mental illness is determined, at least to a certain extent, by aversive socio-cultural factors. In a hostile social environment, these factors may seriously limit the effectiveness of professional interventions; whereas, removing social barriers to functioning often results in a favorable clinical outcome. For example, studies show that inclusive settings with supportive employment decrease psychiatric symptoms and the use of mental health services. By extrapolation, these results point to the possibility that a society-wide reduction in the prevalence and severity of mental illness may come from benevolent changes in the social climate, not just from innovative treatments. Public health policies rarely take this possibility into consideration in resource allocation decisions.     

The Psychoanalytic Other: Commentary on Paper by Helen K. Gediman

Dr. Gediman locates the intersection of modern Freudian and relational theory in the arena of what she calls the “disclosures of everyday analysis” (p. 242). She suggests that because Freudian analysts, like their relational colleagues, work intersubjectively, relational theory does not itself embody a paradigm shift away from the Freudian model. I disagree. Relational theories assume that the analyst's work is inevitably informed by the relational context in a way that precludes clinical certainty. Gediman, however, believes that the analyst is capable of separating her countertransference response from her subjectivity and thus can interpret from a position of clinical certainty. Each set of theoretical assumptions is associated with a somewhat different analytic stance and analytic ideal. Freudian analysts aim for a position of “methodological neutrality” that relies on considerable certainty in the countertransference while giving the analyst plenty of room within which to use her subjectivity. The relational ideal concerns the analyst's capacity to enter into an asymmetrical treatment relationship and to tolerate the uncertainty generated therein.     

Schools of Psychoanalytic Thought by Ruth L. Munroe

This paper assesses the impact of large-group processes and dynamics upon the patient-staff community meeting in hospital treatment. It focuses upon the therapeutic values and limitations of the large-group format by examining, from an integrated general systems and object relations perspective, how size, structure, patient population, staff training, and leadership variables reciprocally affect the process and content of the community meeting. The special problems associated with selecting an appropriate format for the meeting and the intense pull of regressive group forces upon the large-group leader are discussed.     

How Psychoanalytic Thinking Lost its Way in the Hands of Men: The Case for Feminist Psychotherapy

A feminist stance is adopted to challenge the androcentric nature of many of the concepts which lie within the tradition of male psychoanalytical thinking. Such thinking steadfastly refused, and largely still refuses, to acknowledge the social reality and consequences of women's experience of living in a patriarchal society. It is argued that psychoanalytical theory has construed women as inferior and is wholly revealing of what men expect and want women to be. Any psychotherapy based solely within that tradition thus plays its part in the oppression of women. Two concepts from analytical psychotherapy, transference and counter-transference, are used as specific examples, and some contrasting researches advanced by feminist psychotherapy are outlined.