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.     

God of the hinge: treating LGBTQIA patients

This paper looks at systems of gender within the context of analysis. It explores the unique challenges of individuation faced by transsexual, transgender, gender queer, gender non‐conforming, cross‐dressing and intersex patients. To receive patients generously we need to learn how a binary culture produces profound and chronic trauma. These patients wrestle with being who they are whilst simultaneously receiving negative projections and feeling invisible. While often presenting with the struggles of gender conforming individuals, understanding the specifically gendered aspect of their identity is imperative. An analyst's unconscious bias may lead to iatrogenic shaming. The author argues that rigorous, humble inquiry into the analyst's transphobia can be transformative for patient, analyst, and the work itself. Analysis may, then, provide gender‐variant patients with their first remembered and numinous experience of authentic connection to self. Conjuring the image of a hinge, securely placed in the neutral region of a third space, creates a transpositive analytic temenos. Invoking the spirit of the Trickster in the construction of this matrix supports the full inclusion of gender‐variant patients. Nuanced attunement scaffolds mirroring and the possibility of play. Being mindful that gender is sturdy and delicate as well as mercurial and defined enriches the analyst's listening.     

Bureaucracy and creativity: do they make companionable bedfellows?

This essay will look at the benefits and weaknesses of the increasingly bureaucratic nature of training structures and processes in the training of Jungian psychotherapists and analysts. The author will draw on her experiences during two different periods of time as Director of Training at the Society of Analytical Psychology in London with observations on and discussion about some of the changes that have evolved. By way of contrast, she will offer some comparisons with developments in the training of Jungian analysts in countries with little or no legacy of an analytic culture. Here, there is a need to professionalize training in Jungian analysis but the attendant growth of bureaucracy can easily come to echo the politics of non‐democratic regimes.     

Mind,brain and body. Healing trauma: the way forward

The paper explores an interdisciplinary whole person approach to healing from trauma that conserves our rich inheritance from Jung but also takes on board insights from research in the areas of attachment, trauma and the neurobiology of emotion. It is now over 20 years since insights from neurobiology began to be used to inform clinical practice. The paper reviews key insights which have emerged, along with the ways they enable therapists to help mind, brain and body to heal and the ways in which they clarify why, in clinical practice, we do what we do. Traditionally the emphasis has been on words, interpretations, and meaning‐making. Currently there is greater appreciation of the affective, relational, embodied aspects of therapeutic work and the way in which these relate to traumatic early interactive experience that is held outside of human awareness. The ways in which knowledge of particular systems of connectivity inform understanding of the whole mind‐brain‐body relationship are examined. The way forward for clinical practice to become more focused in order to help clients to heal in mind and body is reviewed.     

MATERNAL TRAUMA AFFECTS PRENATAL MENTAL HEALTH AND INFANT STRESS REGULATION AMONG PALESTINIAN DYADS

We examined how diverse and cumulated traumatic experiences predicted maternal prenatal mental health and infant stress regulation in war conditions and whether maternal mental health mediated the association between trauma and infant stress regulation. Participants were 511 Palestinian mothers from the Gaza Strip who reported exposure to current war trauma (WT), past childhood emotional (CEA) and physical abuse, socioeconomic status (SES), prenatal mental health problems (posttraumatic stress disorder and depression symptoms), and perceived stress during their secondtrimester of pregnancy as well as infant stress regulation at 4 months. While all trauma types were associated with high levels of prenatal symptoms, CEA had the most wide‐ranging effects and was uniquely associated with depression symptoms. Concerning infant stress regulation, mothers’ CEA predicted negative affectivity, but only among mothers with low WT. Against hypothesis, the effects of maternal trauma on infant stress regulation were not mediated by mental health symptoms. Mothers’ higher SES was associated with better infant stress regulation whereas infant prematurity and male sex predisposed for difficulties. Our findings suggest that maternal childhood abuse, especially CEA, should be a central treatment target among war‐exposed families. Cumulated psychosocial stressors might increase the risk for transgenerational problems.     

IMPACT OF JOINT ATTENTION ON SOCIAL‐COMMUNICATION SKILLS IN INTERNATIONALLY ADOPTED CHILDREN

Internationally adopted (IA) children have often experienced early adversity and are at risk for long‐term deficiencies in multiple developmental domains. This study examined the association between IA children's joint attention (JA) soon after arrival and later cognitive, communicative, and socioemotional competency 6 months’ postadoption. We expected a child's initial JA would positively predict later cognitive, communication, and social ability. IA children (n = 63) adopted from Eastern Europe were seen soon after their arrival into the United States to assess their JA. Their socioemotional competency, social communication, and cognitive abilities were measured at a follow‐up session 6 months’ postadoption. We found that higher order JA was positively associated with measures of social relatedness. Furthermore, individual hierarchical regressions of each measure of JA (higher order JA, initiating JA, responding to JA, and initiating behavior requests [BR]) considered with age‐at‐adoption showed that each measure was an independent and positive predictor of Mullen outcomes in the receptive and expressive language domains. These results suggest that JA may be a sensitive predictor of subsequent functioning in the social, communicative, and cognitive domains. Thus, assessing JA soon after arrival has the potential to identify at‐risk IA children, and interventions targeting JA may support those children in overcoming the negative impacts of early adversity.     

MOTHER–CHILD AND FATHER–CHILD PLAY INTERACTION: THE IMPORTANCE OF PARENTAL PLAYFULNESS AS A MODERATOR OF THE LINKS BETWEEN PARENTAL BEHAVIOR AND CHILD NEGATIVITY

Based on the premise that father–child play is an important context for children's development and that fathers “specialize” in play, similarities and differences in the role of playfulness in the father–child and mother–child relationship were examined. Participants in this study included 111 families (children's age: 1–3 years). Father–child and mother–child play interactions were videotaped and coded for parental playfulness, sensitivity, structuring, and nonintrusiveness as well as child negativity. Results indicated that mothers and fathers did not differ in playfulness and that mothers and fathers who were higher in playfulness had children with lower levels of negativity. However, playfulness differently moderated the links between parents’ and children's behaviors for mothers and fathers. A double‐risk pattern was found for mothers, such that the links between child negativity and maternal sensitivity, structuring, and nonintrusiveness were significant only for the subgroup of mothers with low levels of playfulness. When mothers had high levels of playfulness, these effects were negligible. For fathers, a double‐buffer pattern was revealed, indicating that the links between child negativity and paternal sensitivity and structuring were significant only for fathers with high levels of playfulness. When fathers had low levels of playfulness, these effects were negligible. These findings demonstrate the important role that parental playfulness has on parent–child interaction as well as the need to examine moderation patterns separately for fathers and mothers.     

THE MAGIC OF PLAY: LOW‐INCOME MOTHERS’ AND FATHERS’ PLAYFULNESS AND CHILDREN'S EMOTION REGULATION AND VOCABULARY SKILLS

Using data from a diverse sample of low‐income families who participated in the Early Head Start Research Evaluation Project (n = 73), we explored the association between mothers’ and fathers’ playfulness with toddlers, toddler's affect during play, and children's language and emotion regulation at prekindergarten. There were two main findings. First, fathers’ playfulness in toddlerhood was associated with children's vocabulary skills in prekindergarten whereas mothers’ playfulness was related to children's emotion regulation. Cross‐parental effects were found only for mothers. The association between mothers’ playfulness and children's vocabulary and emotion regulation was strengthened when fathers engaged in more pretend play and when children were affectively positive during the play. These findings show that playfulness is an important source of variation in the vocabulary and emotion regulation of children growing up in low‐income families. They also point to domain‐specific ways that mothers and fathers promote children's regulatory and vocabulary skills, and highlight the importance of children's positive engagement in play.