受伤的治愈者——心理治疗中治疗师个体经历的意义

本文通过理解＂喀戎＂——这一受伤的治愈者原型,论述治疗师的个体经历在心理治疗中对其治疗取向的影响,并分析反移情的作用以及治疗师的创伤作为有效的工具在心理治疗中的应用,阐明了受伤的治愈者在心理治疗中的意义。     

Some images of the analyst's participation in the analytic process

This paper was originally presented at a workshop (with G. Atwood and S. Parks) on The analyst's participation in the analytic process'. The analyst's 'vulnerability' is highlighted, with specific reference to the ideas of Winnicott, Searles and Jung. Some personal metaphors for the nature of the analytic engagement are offered, as is the image of the 'troubled analyst' from a patient's dream. The burden and necessity of the analyst's participation are emphasized.     

Like a phoenix from the ashes – or “sack cloth and ashes”?:1 The reconstitution of psychoanalytic institutions in Germany since 1945 and its consequences

Abstract

Here, I attempt to formulate some thoughts about the past, present, and future of psychoanalysis and its institutions in Germany. To do this, I have employed my varied experience as a supervisor and consultant to many such psychoanalytic institutes over the past several years. Themes discussed include the history of psychoanalysis in postwar Germany, the organizational structure of German psychoanalytic institutes, and their cultures in regard to group and organizational dynamics, and political and economic aspects. Finally, I add brief thoughts about the future, taking into account recent developments relating to planned changes in laws governing psychotherapy in Germany. Further, I attempt to analyze and comment on: coming to terms with the past; how to begin after the “Zero Hour”; the form of organization of psychoanalytic institutes in Germany; missing patients and missing candidates; constructive debate and hurting people’s feelings; the lack of “detoxification” and “recycling” of the poisonous remains of psychoanalytic processes; and the future of psychoanalytic institutions in Germany. I end with an example of a typical primary task used in conducting large groups in the institutes in which I worked, and include an anonymized table listing individual interventions, their duration, and frequency. These should provide an idea of my way of working, and an overview of the dimensions of the task.     

Psychotherapists' dreams about their patients

Abstract This study examines therapists’ dreams about their patients from the Jungian and the relational perspectives. Few clinical and empirical references to this subject are to be found in the literature. In the present study 31 dreams were collected from 22 therapists. Dreams were collected using anonymous self‐report inventory. The research focused on three theoretical research questions: 1. What themes appear in the manifest content of therapists’ dreams about their patients? 2. What contributions are made by Jungian interpretation of therapists’ dreams about their patients? 3. To what extent are masochistic contents present in the manifest content of therapists’ dreams about their patients? The first question was addressed using categorical content analysis of a) themes common to different dreams and b) pre‐determined themes for all dreams. The third research question was addressed using Beck's (1967) ‘Masochistic Dream’ measure. Results: Among the themes common to different dreams were: therapist‐patient role reversal; therapist and/or patient attends and remains in meeting, departs/doesn’t depart; cancellation of therapy session; sexuality between therapist and patient; aggression; presence vs. absence; non‐verbal relationship and communication; time; driving vs. stopping. With regard to pre‐determined themes it was found that in 20 of the 31 dreams, the therapist had a negative experience and was characterized as vulnerable. Likewise it was found that 26 out of 31 dreams took place in either a) a street, a road, a route, a corridor; b) en route to somewhere; c) a therapy room and/or building; d) a house. With regard to the contribution of Jungian interpretations of the dreams it was found that 17 of the dreams had diagnostic and prognostic elements, 4 of which were initial dreams, 9 of them were compensatory dreams and in 14 it was found that the patient represents the shadow of the therapist. With regard to the third question it was found that 18 of the 31 dreams met Beck's (1967) criteria for masochistic dreams. The theoretical discussion examines the findings from a Jungian perspective, with an emphasis on also understanding the dream in terms of its expression of relational aspects of the therapist‐patient relationship. The findings affirm the presence of the ‘wounded healer’ archetypes in therapists’ dreams about their patients. The results of the study indicate that therapists’ dreams about their patients can be a valuable tool for deepening understanding of the therapeutic relationship and process.     

How to study the ‘quality of psychoanalytic treatments’ and their long‐term effects on patients' well‐being: A representative,multi‐perspective follow‐up study3

How can we study the ‘quality of psychoanalytic treatments’? The authors attempt to answer this question by discussing a naturalistic, multi‐perspective and representative follow‐up study of psychoanalyses and long‐term psychoanalytic psychotherapies. We studied a representative sample (n = 401) of all the patients who had terminated their psychoanalytic treatments with members of the German Psychoanalytical Association (DPV) between 1990 and 1993. Between 70 and 80 per cent of the patients achieved (average 6.5 years after the end of treatment) good and stable psychic changes according to the evaluations of the patients themselves, their analysts, independent psychoanalytic and non‐psychoanalytic experts, and questionnaires commonly applied in psychotherapy research. The evaluation of mental health costs showed a cost reduction through fewer days of sick leave during the seven years following the end of long‐term psychoanalytic treatments. The results achieved using non‐psychoanalytical instruments are complemented by the richness of the idiosyncratic findings, gained by the psychoanalytic research instruments.     

What kind of research in psychoanalytic science?1

The kind of science that psychoanalysis is (can be), and the kind of research appropriate to it, qualitative and/or quantitative, have been divisive issues from the very inception of the discipline. I explore in detail the complexity of these issues, definitional and semantic, as well as methodological and substantive. A plea is made for the application of qualitative (idiographic)and quantitative (nomothetic) research methods, each to the extent that is appropriate, separately or in conjunction, across the entire spectrum of research domains in psychoanalysis, empirical, clinical, conceptual, historical, and interdisciplinary.     

‘That psychotherapy and counselling trainings should be based in universities’

Psychoanalytic institutes, operating as they do normally outside universities, have been criticized as being like religious institutions, with the emphasis on a narrow set of beliefs more than on critical examination of ideas, and with considerable power invested in the trainers and supervisors. Such criticism may also apply to other schools of psychotherapy. While universities have their own difficulties as institutions, including bureaucracy and even similar standardization of theories in particular disciplines, they can also represent a challenging milieu for psychotherapy and counselling education, for accountability in selection, teaching and assessment, for student participation, and for a broader critique of ideas. The difference between education and training is noted and a two-part assessment, academic and practical, is briefly considered.