Pichon Rivière's psychoanalytic contributions: Some comparisons with object relations and modern developments in psychoanalysis

Enrique Pichon Rivière's work, fundamental to Latin American and European psychoanalytic development, is largely unknown in English‐language psychoanalysis. Pichon's central contribution, the link (el vinculo), describes relational bonds in all dimensions. People are born into, live in, and relate through links. Psychic structure is built of links that then influence external interaction. Links, expressed in mind, body and external action, continuously join internal and external worlds. Links have two axes: vertical axis links connect generations through unconscious transgenerational transmission; horizontal axis links connect persons to life partners, family, community and society. For Pichon, treatment constitutes a spiral process through which interpretation disrupts existent structures, promoting new emergent organizations at successively deeper levels. Psychic and link structures evolve over time unless repetitive cycles stunt growth. For Pichon, transference is constituted in the here‐and‐now‐with‐me because of the analytic link. Pichon also undertook family and group psychoanalysis where individuals become spokespersons for unconscious links and family secrets. He developed operative groups that apply psychoanalysis to both analytic and non‐analytic tasks. After describing Pichon's major contributions, the paper compares Pichon Rivière's ideas with those of Klein, Fairbairn, Bion, Winnicott and Bowlby, and contemporary writers including Ogden, Kaës, and Ferro whose works echo Pichon Rivière's thought.     

Behaviorally treated irritable bowel syndrome patients: a four-year follow-up

Nineteen of 27 patients suffering from Irritable Bowel Syndrome (IBS) who had completed a multicomponent treatment involving progressive muscle relaxation, thermal biofeedback, cognitive therapy and IBS education were located and evaluated 4 yr posttreatment. Seventeen of 19 (89.5, or 63% of the total original sample) rated themselves as more than 50% improved. Six of the 12 patients (50%) who submitted symptom monitoring diaries met our criteria for clinical improvement, i.e. achieving at least a 50% reduction in primary IBS symptom scores. The means on all measures at long-term follow-up were lower than those obtained prior to treatment. When follow-up symptom means were compared with pretreatment means, significant (P less than 0.05) reductions were obtained on abdominal pain/tenderness, diarrhea, nausea, and flatulence.     

Scharffs' Application of Hopper's Concept: “Incohesion: Aggregation/Massification”

We begin by stating our understanding of the concepts presented in Hopper's paper, then comment on the clinical illustration, and conclude by describing two group situations in which we have applied the concepts we have taken from Hopper's paper. Hopper's fourth basic assumption applies to our work as individual psychoanalysts, family therapists, and group leaders because it integrates psychoanalytic and social understanding. We demonstrate how and why we find Hopper's idea to be a useful advance.     

PSYCHOANALYSIS IN CHINA: AN ESSAY ON THE RECENT LITERATURE IN ENGLISH

Using extensive quotation, the author reviews the introduction and current state of psychoanalysis and psychoanalytic psychotherapy in China from the vantage point of recent publications in English. Psychoanalysis was briefly introduced to China before the Communist era, then forbidden, and has experienced an accelerated reintroduction since the late 1980s. The author briefly summarizes the cultural and historical background of China relevant to the introduction of psychoanalysis, the traumatic history of China, and the deep structure of thought and philosophical differences from Western culture that challenge a simple imposition of psychoanalytic ideas and practice, and some psychological effects of rapid cultural change throughout China. Training programs in China, the general enthusiasm for analysis among the Chinese, and a number of notable contributions by Western and Chinese authors are discussed. Also surveyed are the use of distance technology for training and treatment, the personal experience of Chinese senior and junior colleagues, and ongoing challenges to the continuing growth of psychoanalysis and analytic psychotherapy in China.     

Using Dreams in Treating Couples' Sexual Issues

The authors demonstrate use of couples' dreams in couple therapy for problems with intimacy, sexuality, and fidelity. Condensation, symbolization, and projective identification are mechanisms that result in the conversion of emotional and relational pain into sexual symptomatology. Dreams use similar processes to hide and at the same time convey emotional issues, and so dream analysis with couples is particularly useful in exploring and treating dysfunctional sexual relationships. As in individual psychoanalysis and psychotherapy, dreams in couple therapy express the transference. The authors show how dream analysis renders the couple's shared transference for resolution in the treatment process.     

Psychoanalytic Models of the Mind for Couple and Family Therapy

This paper describes an object relations theory of mind that highlights the interactive origin of psychic function and the beginnings of mental structure in the infant's relationships within the family group. Based on this model, psychoanalytic family and couple therapy employs the interactions between family and therapist to detect and work with developmental failures in holding and containment, skewed family projective identification, and attacks on linking, which characterize pathological and traumatized families. The coming together of transference generated by the family as a group and the therapist's countertransference are the fulcrum on which such therapy turns. An extended vignette of a session is used to illustrate the application of object relations theory to the therapeutic process of family therapy.