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.     

THE USE OF THE ANALYST AND THE SENSE OF BEING REAL: THE CLINICAL MEANING OF WINNICOTT'S “THE USE OF AN OBJECT”

“The Use of an Object and Relating through Identifications” (1968) represents Donald Winnicott's theoretical and clinical legacy. The author develops this concept from a clinical point of view, through the analysis of a woman with psychotic functioning. He reflects upon the dramatic quality of risks inherent in the processes linked to the use of the object with seriously disturbed patients. He explores different meanings of the analyst's survival, linking it to the analyst's response. The processes of the use of the object—that is, the encounter between the patient's potential destructiveness and the analyst's capacity to respond through his own judicious subjectivity—let the patient experience the analyst's capacity to keep his own subjectivity, authenticity, and creativity alive. It is starting from the traces of this live object that patients gradually form their own personal sense of being real.     

“THESE ANXIETIES ARE NOT MINE”: ADOLESCENCE,THE OEDIPAL CONFIGURATION,AND TRANSGENERATIONAL FACTORS

Part 1 of this paper draws on the film Back to the Future (1985) to highlight various aspects of adolescence, the oedipal situation, and transgenerational factors. The authors then discuss the Oedipus myth and its themes of adolescence, narcissism, identity, acting out, repetition, aggression, and the parent–child relationship, among others. Comments drawn from Winnicott's writing on oedipal issues are discussed as well. As an illustration of some of these issues, in Part 2, the authors present the clinical case of Osvaldo, age sixteen. Transference‐countertransference issues in this treatment are explored in depth.     

“More Life,Not Less”: Using Narrative Therapy With Older Adults With Bipolar Disorder

Counselors who work with older adults with bipolar disorder are in a unique position to help them navigate their challenges. Older adults with bipolar disorder have lived decades with mental illness and also face the regular aging process. Narrative therapy provides counselors with a framework to deal with these issues.     

“She was on my side,and grounded me when I needed it:” Research supervision in the field of therapy,based on counsellors’ and psychotherapists’ views on their engagement with research

Research‐supported practice is increasingly emphasised within counselling and psychotherapy at all stages of training. Guided by an interest in how to support therapists in their efforts to develop research knowledge during doctoral training, this paper focuses on research supervision. Research supervision is a surprisingly under‐researched area. Little is known to date about how supervisors “go about their supervision” (Bruce & Stoodley, 2013, p. 5), despite the fact that “high failure rates for research dissertations in the social sciences have been partly attributed to student dissatisfaction with supervision and poor student–supervisor relationships” (Armstrong, 2004, p. 134). Between 2016 and 2019, we explored accredited counsellors' and 'psychotherapists engagement with research during or after their doctoral training. This paper explores research supervision with these two previous studies serving as the backdrop (Bager‐Charleson et al., 2018; Bager‐Charleson et al., 2018b), together with a literature review into research supervision within social sciences and psychotherapy. Supervision is discussed as a crucial coping/support strategy to (a) link research with practice in therapy work, practically and epistemologically; (b) contain and make sense of the use of transformative learning; (c) balance “enculturation” with critical thinking and emancipation; and (d) support reflective and reflexive development. This paper discusses an adaptive research supervision model, akin to a “holding bond” (Stevens, 2016) which supports the student to reflexively position her/himself personally, intersubjectively, theoretically and socio‐culturally, whilst “negotiating the tension” (Lee, 2008) during a process of enculturation into the discipline, and also fostering critical thinking and emancipation to contribute to new knowledge.     

“A definite feel‐it moment”: Embodiment,externalisation and emotion during chair‐work in compassion‐focused therapy

Chair‐work is an experiential method used within compassion‐focused therapy (CFT) to apply compassion to various aspects of the self. This is the first study of CFT chair‐work and is focused on clients' lived experiences of a chair‐work intervention for self‐criticism. Twelve participants with depression were interviewed following the chair‐work intervention and the resulting data were examined using interpretative phenomenological analysis. Three superordinate themes were identified: “embodiment and enactment,” “externalising the self in physical form” and “emotional intensity.” The findings suggest the importance of accessing and expressing various emotions connected with self‐criticism, whilst highlighting the potential for client distress and avoidance during the intervention. The role of embodying, enacting and physically situating aspects of the self in different chairs is also suggested to be an important mechanism of change in CFT chair‐work. The findings are discussed in terms of clinical implications, emphasising how core CFT concepts and practices are facilitated by the chair‐work process.