Psychoanalysis: The Sacred and the Profane

Colleagues from a variety of perspectives have written about the propensity to enshrine psychoanalytic theory. The meaning of the word “enshrine” is to cherish as sacred an idea or philosophy and protect it from change. In other words, the way we view psychoanalysis, our theories of mind and technique, become holy writ and we have divided the world of theory into the sacred and the profane. This is the kiss of death for theory, which must constantly evolve and change, but comforting for the analyst who believes he is on the side of the right, the sacred. In this paper I will discuss how our propensity to enshrine theory has had a debilitating effect on the development of psychoanalysis and, in particular, as a treatment for the most vulnerable people who seek our help. I also address the idea that movement away from enshrined positions allows us to construct different versions of reality. In this context, the notion of “action at a distance” is presented along with the attendant idea of psychoanalytic entanglement.     

Therapeutic technique in psychoanalysis and psychoanalytic psychotherapy.

As the distinctions between what we consider to be psychoanalysis and what we consider to be psychoanalytic psychotherapy have become more uncertain and more blurred, it follows that it is equally difficult to designate the techniques that would be appropriate and specific for each modality. The problem has been compounded by the fact that in recent years psychoanalysis in the United States has become considerably less homogeneous than in the past and the ego-psychological structural model is no longer the only point of view in the psychoanalytic marketplace. Further, with alterations in the criteria for analyzability, cases which, generally, had not been viewed as suitable for analysis, have been appearing with increasing frequency on psychoanalysts' couches. We have also recognized that the degree of congruence between our expectations from and the results of psychoanalytic treatment was often less than anticipated. It appears that analysts have become considerably less arbitrary about what psychoanalysis is and how a psychoanalysis can be carried out. The author is unable to delineate one technique that is intrinsic to and limited to psychoanalysis. There are, however, differences in degree and emphasis in the ways in which various techniques are applied in the therapy of psychoanalysis as compared to the therapy of psychoanalytic psychotherapy. Special attention is given to the role of a psychoanalytic process and the central place the analysis of resistance plays in psychoanalytic therapy.     

Supervising Psychoanalytic Psychotherapy: Present Knowledge,Pressing Needs,Future Possibilities

Existing research from the fields of education, cognitive science, neuroscience, and psychoanalytic psychotherapy points us toward possibilities for the future of psychoanalytic supervision. This research suggests that we need to go beyond communicating abstract knowledge and make our supervisory relationships more experiential, participatory, relationship-focused, and personal in order to teach usable knowledge, develop complex psychotherapeutic skills, and facilitate emotional and relational development in our supervisees. The author concludes that a relational model of supervision fits this pedagogical profile. After grappling with our resistances to change, the author hopes that more psychoanalytic supervisors will make use of a relational model of supervision, as well as drawing upon new technologies and neuroscience-based teaching techniques.     

Neural synchronization as a hypothetical explanation of the psychoanalytic unconscious

Cognitive scientists have tried to explain the neural mechanisms of unconscious mental states such as coma, epileptic seizures, and anesthesia-induced unconsciousness. However these types of unconscious states are different from the psychoanalytic unconscious. In this review, we aim to present our hypothesis about the neural correlates underlying psychoanalytic unconscious. To fulfill this aim, we firstly review the previous explanations about the neural correlates of conscious and unconscious mental states, such as brain oscillations, synchronicity of neural networks, and cognitive binding. By doing so, we hope to lay a neuroscientific ground for our hypothesis about neural correlates of psychoanalytic unconscious; parallel but unsynchronized neural networks between different layers of consciousness and unconsciousness. Next, we propose a neuroscientific mechanism about how the repressed mental events reach the conscious awareness; the lock of neural synchronization between two mental layers of conscious and unconscious. At the last section, we will discuss the data about schizophrenia as a clinical example of our proposed hypothesis.     

Subjective education in analytic training: drawing on values from the art academy

Abstract: Kernberg and others have observed that psychoanalytic education has tended to promote the acquisition of theoretical knowledge and clinical technique within an atmosphere of indoctrination rather than of exploration. As a corrective, he proposed four models that correspond to values in psychoanalytic education: the art academy, the technical trade school, the religious seminary and the university. He commended models of the university and art academy to our collective attention because of their combined effectiveness in providing for the objective and subjective education of candidates: the university model for its capacity to provide a critical sense of a wide range of theories in an atmosphere tolerating debate and difference, and the art academy model for its capacity to facilitate the expression of individual creativity. In this paper, I will explore the art academy model for correspondences between artistic and analytic trainings that can enhance the development of the creative subjectivity of psychoanalytic candidates. I will draw additional correspondences between analytic and artistic learning that can enhance psychoanalytic education.     

The Quest for a Unified Psychoanalytic Theory: A Retreat from Uncertainty

There has been a historical shift in psychoanalysis from an earlier time of certainty to our present state of uncertainty with the coexistence of multiple theories competing for our attention. We realize retrospectively how entrenched groups ruled our institutions by maintaining faith in their authority as the keepers of “pure” psychoanalysis. Despite struggles between competing ideologies, there has been progress in integrating clinical theories. As no psychoanalytic theory or technique has been proved superior, we advocate an inclusive approach with all psychoanalysts keeping an open mind about the value of competing theories. This integration of disparate theories has led to a resurgence of interest in psychoanalytic training. Examples are given of some of the difficulties encountered when competing ideas are introduced in psychoanalytic groups.     

Psychoanalysis is becoming an impossible profession within the public welfare system in Sweden

Abstract

The preconditions for psychoanalytic practice within the Swedish public welfare system are analyzed in this article. Psychoanalysis remains a one-to-one treatment and relies on the analyst's capacity to use his or her own subjective response. The development of the psychoanalytic process is dependent on unconscious reality, making it impossible to work with a model that has a strict relation between diagnosis, treatment method, and result. Objectivity and the desire to predict treatment outcomes characterize the immanent logic in the complex system of laws and recommendations that affects most practices within the field of medicine. As a consequence of this development, psychoanalysis and psychodynamic therapy are marginalized, since our treatment methods are not adapted to the present industrialization and economization of the medical health sector, with the result that the preconditions for psychoanalytic training have changed dramatically. The exclusion of psychoanalysis from the national health insurance scheme is a demanding challenge at a time when the Swedish welfare model is undergoing fundamental changes.     

The Body's Contribution to a Female Sense of Self

The study presents a theory of early female development based on infant observation studies and clinical reconstructions. Suggestions are made for applying this theory in doing psychotherapy with women. Examining earlier psychoanalytic studies on gender development in girls in the light of the infant studies underscores the role played by the body in fonning a female sense of self. It challenges us to reassess both our theory and technique in regard to female development and ueatment.     

Therapeutic strategy and psychoanalytic technique

The role of therapeutic strategy within psychoanalytic technique is described. An antistrategic bias inherent in certain aspects of the "classical" technique is explored in relation to the historical development of psychoanalysis. Clinical expertise, which includes the making of strategic or tactical choices, is relegated to the "unofficial," due in part to this negative bias impeding the study of technical differences in favor of general agreement about a theory of technique that may differ considerably from actual clinical work. A case is presented that illustrates strategic choices in the management of a severe character resistance in a supervised analysis. Some consequences of a negative bias against therapeutic strategy as it relates to psychoanalytic training is described.     

Robustness of expected utility model in predicting individual choices

In this paper we show how utility, lottery dependent utility, and weighted utility models can be calibrated using algebraic and statistical techniques. The models are empirically compared in laboratory (student subjects) and real settings (sales force personnel of the Los Angeles Times). In our empirical comparison we evaluate two aspects: the extent to which observed preferences are consistent with each model, and predictive accuracy of the models on a holdout sample. The results indicate that only about 20% of the observed choice patterns in our experimental design are consistent with the expected utility model, 50% with the weighted utility model, and 90% with the general lottery dependent utility model. On individual level predictions to the holdout sample, however, the expected utility model does as well as the other two models. This latter finding is robust across different measurement and estimation methods and student and non-student subjects.     

A reassessment of psychoanalytic education: Controversies and changes2

To understand the many controversies surrounding psychoanalytic education, it is necessary first to understand the unique role played by education in our field where control of educational structures remains the most important measure of professional success for the majority of psychoanalysts. To keep debate about educational policy focused on the task of strengthening the intellectual basis of psychoanalysis, it is also necessary to understand that forces affecting education arise from at least three different domains which can too easily become confused with one another: 1) the domain of knowledge‐ intellectual, scientific and clinical; 2) the domain of the organized professional community; and 3) the domain of local institutional politics. The authors explore controversy arising within and among each of these domains. They also explore the major alternatives proposed to the Eitingon model of psychoanalytic education, arguing that excessive authoritarianism in education arises not from the existence of hierarchical structures per se (as suggested by the ‘French model’), but from two other factors: the condensation of all important professional functions into the single ‘monolithic’ position of the training analyst, and the lack of agreed upon methodology for determining the validity of theoretical propositions. The solution lies not in obliterating all gaps in expertise and status by doing away with hierarchical structures altogether, but rather in strengthening the intellectual, scholarly and research context within which psychoanalytic education takes place. We must attempt to relocate our experience of a gap where it belongs: not between those who are training analysts and those who are not, but between what we feel we already know about mental life and what we do not yet know.     

Homosexuality: Coming out of the confusion

The author asserts that earlier theoretical assumptions contribute to the conceptual confusion about homosexuality in much contemporary psychoanalytic research. Bergeret's article, recently published in this Journal , is exemplary of this confusion. The author refutes his contention that homosexuality is not 'true' sexuality but merely a defensive, narcissistic fixation away from, or a nearly psychotic denial of, heterosexuality. He then clarifies specific areas of conceptual confusion regarding homosexuality still prevalent in psychoanalytic discourse that derive from earlier theoretical premises. These areas of confusion include manifest versus latent homosexuality, narcissism and bisexuality, oedipal dynamics and development, and transference and technique.     

Psychoanalysis and Child Rearing

In this article we suggest that current controversies around the psychoanalytic concepts of narcissism, omnipotence, specialness, and so forth derive from reliance on a single-track developmental model. A single-track model, used implicitly or explicitly by almost all psychoanalytic theorists, posits that normal infants and children function in ways that would be considered pathological in later life. This way of thinking is contradicted by modern infant and developmental research. Additionally, it contradicts common-sense experience and is, therefore, not a useful model for parenting. On the other hand, Freud and many other writers also posited a dual-track model, which simultaneously allows for both healthy and pathological choices throughout life. In this article, we describe some of the ways in which a dual-track model, which we have elaborated as two systems of self-regulation, can be usefully applied to theory, technique, and applications with all those involved with children.     

The Relational Use of Self and Space in Creation: Commentary on Paper by Frank Summers

In this discussion I address some of the ways in which psychoanalytic theory and technique have advanced, taking as my starting point Dr. Summers' chosen schools of thought. I then go on to elaborate what I see as a difference in our understanding of Philip Bromberg's and Donnel Stern's ideas about therapeutic action, suggesting that they actually contribute in bolstering Summers' argument.     

How does psychoanalytic supervision work? A brief communication

In this brief communication, we offer one perspective – the contextual psychoanalytic supervision model (CPSM) – on how psychoanalytic supervision works. The CPSM, a supervisory extrapolation of Wampold’s contextual psychotherapy relationship model, accentuates four psychoanalytic supervisor–supervisee relationship variables as crucial and change inducing: the learning alliance bond, supervisor–supervisee real relationship, creating supervision expectations/providing an expectation-consistent form of supervision, and the supervisee’s engagement in facilitative educational actions. The CPSM is presented in hopes of stimulating further discussion about what makes psychoanalytic supervision work.     

Group affective learning in training for psychotherapy and psychoanalysis

This paper describes The Group Affective Model, a method for teaching psychoanalytic concepts and their clinical application, using multi‐channel teaching, process and review in group settings, and learning from experience in an open systems learning community for psychoanalysts and psychotherapists. This innovation arose in response to criticism of existing methods in psychoanalytic education that have subordinated the primary educational task to that of the training analysis. Noticing this split between education and training analysis, between cognition and affect, and between concepts of individual and group unconscious processes, we developed the Group Affective Model for teaching and learning psychoanalysis and psychotherapy in an open psychological space in which students and faculty experience individual and group processes of digestion, assimilation, and review, which demonstrate the concepts in action and make them available for internalization selectively. We discuss our philosophy and our educational stance. We describe our institution and our participants. We give examples of teaching situations that we have studied to provide some insight about assimilation and internalization of the concepts and clinical approaches being taught. We discuss the transferability of the Group Affective Model to other teaching settings and psychoanalytic training institutions and propose it as the fourth pillar of psychoanalytic training, next to analytic treatment, clinical supervision, and didactic seminars.     

Amalia X: dialogical sequence analysis as a method in theory-based single case research in psychoanalysis

In this article, Dialogical sequence analysis (DSA) is introduced as a method in theory-based single case research. The structure of article is as follows: first, we will describe briefly the historical background of single case studies and their position as the foundation of psychoanalytic knowledge formation. Secondly, we will describe through Amalia X’s case how one psychoanalytic ‘specimen case’ has been used as a cornerstone for a comprehensive psychoanalytic process research model, the so called ‘Ulm model’. Amalia X is one of the most studied single cases internationally also outside psychoanalytic process study field. Thirdly, we will introduce the central theory and practice of DSA. Fourthly, in the last section of our article, we will show in practice how DSA can be used in the analysis of Amalia’s dream in the session 152.     

Understanding Autism Implications for Psychoanalysis

Several lines of evidence inform current psychoanalytic thinking about infantile autism. Although early psychoanalytic interest in autism centered around the notion that experience might play a role in pathogenesis a large body of data suggest this is not the case; rather the condition appears to be the result of genetic and other neurobiological factors. Studies of children with autism do, however, suggest basic problems in capacities for object relations and other aspects of ego development which must be understood in the context of autistic social dysfunction. The study of normally developing infants raises considerable questions about the validity of notions such as a normal autistic phase; rather than for the normally developing child interest in the social world appears to be an innate capacity and one which has considerable importance for our understanding of the nature of early ego development and capacities for self-object differentiation.     

Psychoanalysis, the Anxiety of Influence, and the Sadomasochism of Everyday Life

After reviewing recent upheavals within psychoanalytic institutions and our diminished status in the worlds of academia, psychiatry, and the media, this essay turns to the historical trends that led to the current state of siege in which psychoanalysis finds itself—trends most clearly manifested on the East Coast institutes of the United States. I hypothesize that a legacy of arrogant entitlement on the part of the founding fathers made for an abiding institutional authoritarianism. This hierarchicalism fostered a loss of self-determination and individuation, negative Oedipal submission, identifications with the aggressor within psychoanalytic organizations, and a pseudospeciation with regard to potential critics in the outside world. Promising in many respects, nonetheless many of the current changes in psychoanalytic education and theory inevitably represent a positive Oedipal rebellion against the generation that had oppressed the one now in ascendancy and, more insidiously, a means of containing the candidates now in our charge. Finally, I argue that our future depends on our ability to embrace unwanted and disavowed truths about the history of our field and thereby to reclaim both our idealism and our credibility.     

SPONTANEOUS REMISSIONS: NORMAN REIDER'S FORGOTTEN PAPER,PART I

Almost sixty years ago, Norman Reider published a paper about spontaneous “remissions” he had observed. He discussed the manner in which psychoanalytic theory provided a way to partially explain these otherwise mysterious remissions or improvements in symptoms, some without benefit of either psychoanalysis or psychotherapy. Especially important were his comments about the negligible role of interpretation or insight in these examples. His conjectures reflected controversies that were current at the time and that remain unsettled. Of special interest is his introduction of some highly original ways to think of applying psychoanalytic ideas to supportive psychotherapy. But few analysts today have heard of this paper. A reconsideration of his paper allows us to be vividly reminded about our enduring and profound confusion about exactly what constitutes a “cure” at all. Spontaneous shifts in the severity of symptoms may be viewed as experiments of nature that we have neglected to investigate as valuable restraints on our immodest therapeutic claims.