On trying something new: effort and practice in psychoanalytic change

This paper describes one of the ingredients of successful psychoanalytic change: the necessity for the analysand to actively attempt altered patterns of thinking, behaving, feeling, and relating outside of the analytic relationship. When successful, such self-initiated attempts at change are founded on insight and experience gained in the transference and constitute a crucial step in the consolidation and transfer of therapeutic gains. The analytic literature related to this aspect of therapeutic action is reviewed, including the work of Freud, Bader, Rangell, Renik, Valenstein, and Wheelis. Recent interest in the complex and complementary relationship between action and increased self-understanding as it unfolds in the analytic setting is extended beyond the consulting room to include the analysand's extra-analytic attempts to initiate change. Contemporary views of the relationship between praxis and self-knowledge are discussed and offered as theoretical support for broadening analytic technique to include greater attention to the analysand's efforts at implementing therapeutic gains. Case vignettes are presented.     

Ongoing change in psychoanalytic theory implications for analysis of religious experience

Hans Loewald (1980) once made the distinction between ghosts and ancestors, the former always wanting to return to the land of the living, the latter being able to rest in peace and live forth through their progeny in the present generation. Extending this metaphor, Stephen Mitchell (1991) has noted that the intellectual integrity and vitality of psychoanalysis depends on our shifting our view of Freud from an unburied ghost who haunts us to an honored ancestor. I argue that perhaps nowhere is Freud's enduring presence greater than in psychoanalytic perspectives on religion, and it is often as an unburied ghost. Ongoing change in psychoanalytic theory, however, affords respectful amendment to his work in a way that allows Freud to be a dearly honored ancestor from whom we are all psychoanalytic descendents. Three developments in psychoanalytic theory have special implication for the analysis of religious experience. These areas of change pertain to contemporary understanding of illusion, narrative, and social constructivism. I offer in conclusion seven points for further consideration.     

Changing psychic structure through treatment: criteria for change

The author outlines his clinical observations during the "middle game" of psychoanalysis, leading to recognition that structural change is taking place. "Middle game," "structure," process, and content are defined and critically discussed. Illustrative clinical vignettes are offered. The presentation emphasizes the importance of an active and resolving transference "struggle"; in addition, more traditionally noted criteria are briefly touched on, e.g., development of observing ego and treatment alliance, changes in dream function and communication, and the reviewing of the neurosis and transference during the termination phase as instances of mourning and working through. The concept of optimal psychobiological function in the service of a homeostatic principle is discussed.     

Catalysts for psychic change: Perspectives from contemporary psychoanalysis

This paper was given as the inaugural ‘Ellen Noonan Counselling Lecture’ on 3 July 2007, at Birkbeck College, University of London, and I have retained some of the spoken style of the original lecture. Since the 1960s, psychoanalytic models of change and growth have in themselves undergone radical changes. The aims of psychoanalytic and psychodynamic work are now less tied to a model of ‘health’ or ‘normality’ and more linked into processes that enable people to keep developing throughout life. The lecture examines some of the new theories of psychic change and growth from the contemporary Independent, Lacanian and post-Kleinian schools of psychoanalysis and, using clinical illustrations, explores the implications of these new theories for psychodynamic practice.