Sources of Opposition to Relatedness in Psychoanalysis

This paper examines sources of resistance to the analyst's entering into and developing a necessary and appropriate relatedness to the patient. The elements of two major theoretical approaches, namely contemporary conflict theory and selfpsychology, that interfere with the analyst's comfort in acknowledging his or her feeling involvement with the patient are examined. A case discussion, drawn from a recent American Psychoanalytic Association meeting is used to demonstrate the absence of a relational perspective in an analysis of 15 months duration.     

Children with Autistic Spectrum Disorders: Individual Differences,Affect, Interaction,and Outcomes

In this article, we have drawn upon the attachment motivational system (Bowlby, 1988; Lichtenberg, 1989; Shane, Shane, and Gales, 1997) as a guide to providing “positive new experience” as the cornerstone of therapeutic progress. We see positive new experience as paramount, over and above insight and/or interpretation because insight and interpretation are so varied among different theories. The common denominator that is effective in therapy, then, must be something beyond insight and interpretation. We call that therapeutic factor the positive new experience and will draw from attachment theory to understand its components. In addition, using the attachment motivation system and trauma research, we elaborate on why certain types of negative experiences in psychotherapy and psychoanalysis should be avoided. We address, in particular, harmful repetitions of traumatic relational patterns or traumatic events in the transference, overemphasis on “the empathic stance,” and the search for motivation in patients' behaviors where such a search may be based on the false assumption that all behavior is motivated. This latter category addresses aspects of behaving that may not be motivated; that is, they just “are,” and as such, the search for and attribution of meaning in such instances may lead to failed understanding and insight and to faulty correctives. We have illustrated with clinical examples both positive new experience and three types of negative experiences to be avoided in treatment.     

Obsessive-Compulsive Disorder: Current Views

Obsessive-compulsive disorder has been of central interest to psychoanalysis since Freud's early papers, most particularly in the “Rat Man” case. This early literature spelled out with great clarity the presumed development, psychodynamics, and meaning of obsessional and compulsive symptoms. Unfortunately, since Anna Freud's 1969 review of the subject, virtually nothing has appeared in the psychoanalytic literature that has added to our understanding of the disorder or enhanced the very limited therapeutic influence of psychoanalysis in such cases. Meanwhile, there has been an avalanche of contributions from biological psychiatry and behavioral psychology that have propounded different theories of pathogenesis and have laid claim to significant therapeutic effectiveness. If psychoanalysis is to have credibility in this field, it will have to enlist itself in multidisciplinary research efforts directed toward enriching our knowledge about the psychodynamics and the biological substrate of this illness (more common than once believed) and the efficacy of our efforts to treat it.     

The Atonement of the Alleged Perpetrator's Daughter: Understanding of Model Scenes and Space Attachment in Analytical Dance Therapy

In this rich paper the analysand Annabelle is sent by her analyst to the dance therapist who reports in great detail how Annabelle manages to throw off and—to a certain extent—integrate not only her own life-long misunderstanding but also those of her parents. The reason for Annabelle's referral was straightforward: the analysis had ground to a halt. Words no longer reached her. The reader is reminded of the emotive-relational-motor clusters described in Chazan's and Shahar-Levy's papers. Body image distortions and space misperceptions curtailed this patient's ability to function. When she began to bring her distress to her analytic dance therapy sessions, she could not associate verbally but made use of props her therapist had in store. As she slowly progressed toward true symbolization and expression, her therapist found herself embroiled countertransferentially. The patient's long-suffering mother was remembered as someone who would, or could, only give partial information about the family's history. The father had been a Nazi and was now blamed for all the suffering the family had lo endure. This fact resonated both with Annabelle's analyst and the dance therapist who managed to take a long look at their own family's records during that troubled time.     

Personal mastery predicts pain,stress, fatigue,and blood pressure in adults with rheumatoid arthritis

Among individuals with rheumatoid arthritis (RA), stress-associated disease flare can severely impact well-being. Psychological factors such as personal mastery may buffer an individual from the negative effects of those flares. We tested the hypothesis that a high sense of personal mastery would prospectively predict stress reactivity. Measures of pain, perceived stress, fatigue, and mean arterial pressure (MAP) were collected before, during, and after two interpersonal stressors conducted on 73 individuals with RA. Factor analysis of the personal mastery scale yielded two independent factors: a 5-item “fatalism” component and a 2-item “control” component. Individuals with high fatalism scores reported overall greater joint pain at baseline and those scoring high on control exhibited lower MAP, and reported less stress and fatigue at baseline. After controlling for baseline differences, those high in control exhibited greater MAP increase during stress, and less drop in pain when compared to those low in control. These results suggest that individuals high in control may be more susceptible to the effects of acute stress; however, the overall beneficial aspects of high control outweigh the acute negative effects. Personal mastery may play a role in the experience of pain, stress, and fatigue for people with RA.     

Postpartale psychische Störungen

Any postpartum mental disorder in a mother can influence the mother-child relationship and communication and lead to the development of psychosomatic disorders or disorders of behavioral regulation with diagnostic status. These can have a long-term impact on the mother-child relationship and the child’s mental development. Based on research findings on mother-child interaction, the authors expound why including the child in treatment is crucial. Accordingly, possible contraindications for mother-infant treatment are described. Clinical parent-infant treatment practice is reviewed as an interdisciplinary and multiprofessional challenge and the necessity of adhering to minimum standards, beside adult psychiatric skills, of child psychiatric and developmental expertise in diagnostics and intervention for quality assurance.