A Kleinian view of psychoanalytic couples therapy: Part 2

With extensive case material, Part 2 continues to explore the psychoanalytic treatment of couples. Since most couples enter treatment operating in a more primitive paranoid‐schizoid stance, the author contends that it is best to initially focus on each partner's pathological projections and have the other partner witness their struggle to overcome personal issues that contaminate the couple's unified psychology. With continuous working through, the couple can gradually find a more depressive, integrative footing within themselves and as a couple. Again, the value of ‘witnessing’ and working through individual defensive reactions against thinking, pathological projective identifications and the breakdown of the container‐contained function are all examined in the clinical presentations. All these clinical elements are part of the establishment of analytic contact first with each party as individuals and later as a unified couple.     

Sanctioned social violence: A psychoanalytic view. Part II

This paper is the second in a series of two papers. In Part I, the first paper, the author reviewed the influence on the development of socially sanctioned violence of psychodynamics of group psychology and mass psychology, the regressive pull of ideologies, personality features of social and political leadership, and historical trauma and social crises. In this Part II, the author explores, from a psychoanalytic perspective, the dehumanization processes related to fundamentalist ideologies and terrorism.     

Sanctioned social violence: A psychoanalytic view - Part I

This paper is the first of a series of two that present an effort to systematize the application of psychoanalytic theory of group processes to the outbreak of massive violence. It explores the origins and social amplification of primitive aggression by means of group psychology and mass psychology, and the combined influences of the regressive pull of ideologies, the personality features of social and political leadership, and the triggering impact of historical trauma and social crises. The paper describes a spectrum of narcissistic-paranoid mechanisms that provide a common matrix for the analysis of those aspects of social psychology that co-determine socially sanctioned violence.     

Group psychology in the totalitarian system: A psychoanalytic view

The author discusses the ideas of three important psychoanalytic thinkers about group processes in large social groups: Sigmund Freud, Wilfred Bion, and Erich Fromm. Their ideas are developed and applied to analysis of group processes in totalitarian systems, as they were known to the author in Czechoslovakia and the Soviet Union. In conclusion, treatment considerations as they apply to patients who grew up in these regimes are developed and illustrated by clinical cases.This paper is dedicated to Dr. Alexander Wolf, who made his groups growth-promoting, free and holding environments.The author wants to thank Valerie Angel, M.S.W., Eva Papiasvili, Ph.D., Susan Kavaler, Ph.D., Maria Luisa Bastos, Ph.D., and Nancy Smith for their support, critical commentary, and helpful suggestions.     

The edge of chaos: A nonlinear view of psychoanalytic technique

The field of nonlinear dynamics (or chaos theory) provides ways to expand concepts of psychoanalytic process that have implications for the technique of psychoanalysis. This paper describes how concepts of “the edge of chaos,” emergence, attractors, and coupled oscillators can help shape analytic technique resulting in an approach to doing analysis which is at the same time freer and more firmly based in an enlarged understanding of the ways in which psychoanalysis works than some current recommendation about technique. Illustrations from a lengthy analysis of an analysand with obsessive‐compulsive disorder show this approach in action.     

The psychoanalytic view of phobias. Part III: Agoraphobia and other phobias of adults.

This is the third part of a review and commentary on the psychoanalytic literature on phobias. This section takes up agoraphobia and other phobias of adults, and suggests further avenues for interpenetration of psychoanalytic and psychiatric approaches.     

The psychoanalytic view of phobias. Part IV: General theory of phobias and anxiety.

This is the final part of the work on the psychoanalytic view of phobias. Here we consider general views of phobias, developments and issues in the psychoanalytic theory of anxiety, as it relates to phobias, and take up aspects of some broader theoretical issues, including nosology.     

The psychoanalytic view of phobias. Part I: Freud's theories of phobias and anxiety.

This paper initiates a series of communications on psychoanalytic and current psychiatric approaches to the understanding and treatment of phobic syndromes with a review and discussion of Freud's evolving ideas on phobias and anxiety. A list of issues that any theory of phobic syndromes must address is compiled on the basis of Freud's work.     

Confi dentiality with respect to third parties: A psychoanalytic view

It is assumed that confi dentiality is not one singular ethical entity but a conglomerate of quite different issues depending upon clinical context and the sector of information sharing at stake. The focus here is on how to think psychoanalytically about requests for information from third parties (payers, courts, public security). Defi ning confi dentiality as a promise to 'never tell anything' outside of the relationship omits evaluation of the impact of the third's listening on the combined freedom of thought and freedom of speech in analyst and analysand. Circulation of information outside the dyad need not be toxic, need not disrupt the analytic couple's openness to new meaning. Key to contamination and inhibition of analytic work is whether or not disclosure serves an analytic end. Current defense of confi dentiality relies heavily on the models of protection of privacy and professional secrecy, which, though useful and relevant, fail to encompass the transitional, intersubjective space engendered by the analytic process. Suggestions are made for alternate sources of paradigms better suited to represent the latter. Offered for discussion is a draft of a confi dentiality policy with respect to third parties that is informed by psychoanalytic theory and clinical practice rather than by local legal jurisdiction or original disciplines ethics codes.     

Elements of the Oedipus complex: A Kleinian account1

The author discusses and illustrates the place in current Kleinian practice of the analysis of the Oedipus complex. He outlines the development of the concept of the Oedipus complex by Freud and by Klein and later writers in the Kleinian tradition. Because the child's exclusion from his parents' sexual relationship represents such a fundamental aspect of reality for the child, analysis of the patient's responses to the oedipal situation constitutes the central task of analysis. Despite the Oedipus complex being in this way central, it is sometimes hard to discern because what is most visible are the patient's defensive responses to the oedipal situation. The emergence of meaning in analysis is often understood unconsciously as the product of the parental intercourse, represented by the work of the patient with the analyst, or of the analyst's or the patient's mind. The analysis of the patient's characteristic reactions to moments of meaningfulness in analysis is therefore an especially fruitful focus for the analysis of the Oedipus complex. The author illustrates these ideas by three clinical examples, from a 3½‐year‐old child, a borderline psychotic patient and a more neurotic patient.