Understanding Hope. Persons in the Process of Dying

Changes both within the profession of psychoanalysis and in society as a whole have affected our psychoanalytic training programs and presented new ethical challenges. Whereas in earlier decades training programs needed to be concerned primarily about the inviolability of the training analysis and the choice of appropriate analytic candidates, today there is little support for psychoanalysis as a treatment modality. Institutes are experiencing greater competition in attracting quality candidates and in providing them with adequate training experiences. This strain encourages institutes to operate in unethical ways to attract candidates. On the other hand, within the profession itself we are experiencing much theoretical ferment and the increasing feminization of the profession. These changes are affecting our training institutes and our ethical values in both positive and negative ways.     

Wilhelm Reich and Anna Freud: His expulsion from psychoanalysis

This article describes the growth of hostility towards Wilhelm Reich in the psychoanalytic community over his Marxist ideology and activism as well as disagreements over the death instinct. It brings to the fore the behind the scenes political manipulations between Ernest Jones and Anna Freud to effect the expulsion of Reich both from the Vienna and Berlin local psychoanalytic societies and from the International Psychoanalytic Association (IPA). It describes Reich's reactions to these events and the pressure placed on other psychoanalysts to stop supporting him and also the revision of history about the expulsion. It discusses the use of the term "crazy" as it was used in the psychoanalytic movement. Further the article discusses personality attributes of Anna Freud leading to counter-transference possessiveness to children and women, especially patients. It briefly touches on the attitudes of both Sigmund and Anna Freud toward sex and how this furthered the clash with Reich. It discusses the similarity between Anna's actions toward the Burlingham children and what happened to the children of Reich.     

Some thoughts about thought disturbance in adolescence

One of the principal aims of adolescence is the development of the capacity to think for oneself. The authors explore the difficulties caused by disturbances of thinking in borderline adolescents, pointing out the role that the analyst can take in promoting better functioning of their patients' mental processes. Two cases are explored, one through a supervision and the other through direct clinical experience. Both illustrate the efforts of the analyst to carry out 'management in the area of thinking' with those borderline patients who have not received help from their parents to think, and still need to be shown how mentation takes place. The authors propose some changes in technique in order to implement this improvement, including sharing with the patient the way in which the analyst thinks about him. Thinking itself can be an important integrating factor for these patients.

Une des tâches principales de l'adolescence est de développer la capacité à penser par soi-même. Les auteurs explorent les difficultés occasionnées par des troubles de la pensée chez des adolescents borderline et soulignent le rôle que peut jouer l'analyste pour favoriser un meilleur fonctionnement des processus psychiques chez ces patients. Deux cas sont étudiés dans cet article ; dans l'un, le matériel est extrait de séances de supervision, dans l'autre, il est tiré directement de la situation thérapeutique. Ces cas mettent en évidence les efforts de l'analyste pour aider le patient à mieux fonder ses processus de pensée ; dans les états limites, le patient bien souvent n'a jamais pu bénéficier de l'aide de ses parents dans ce domaine et devra encore apprendre comment mettre en ?uvre l'idéation. Les auteurs proposent quelques modifications techniques afin de faciliter l'activité mentale chez ce type de patient, visant notamment à lui faire part de la manière dont son analyste pense à lui. La pensée en elle-même peut être un facteur important qui favorise l'intégration psychique chez ces patients.

Uno degli scopi principali dell'adolescenza e' lo sviluppo della capacita' di pensare per se stessi. Le autrici esplorano le difficolta' causate dai disturbi del pensiero in adolescenti borderline, sottolineando il ruolo che l'analista puo' avere nel promuovere un miglior funzionamento dei processi mentali dei loro pazienti. Vengono riportati due casi, uno attraverso l'esperienza di supervisione e l'altro attraverso l'esperienza diretta del lavoro clinico. In entrambi i casi viene illustrato lo sforzo dell'analista di portare avanti il 'management nell'area del pensare' con quei pazienti bordeline che non sono stati aiutati dai loro genitori a pensare, e che ancora hanno bisogno di capire come prende luogo il processo del pensare. Le autrici propongono dei cambiamenti nella tecnica per poter implementare tale miglioramento, compreso il condividere con il paziente il modo in cui l'analista pensa a lui. Il pensare puo' essere di per se' un importante fattore di integrazione per questi pazienti.

Eines der Hauptziele der Adoleszenz ist die Entwicklung der Fähigkeit, für sich selber zu denken. Die Autorinnen betrachten die Schwierigkeiten, die durch Denkstörungen bei Borderline- Jugendlichen verursacht werden, und stellen die Rolle heraus, die Analytiker einnehmen können, um ein besseres Funktionieren der mentalen Prozesse ihrer Patienten zu fördern. Es werden zwei Fälle betrachtet, einer durch Supervision und der andere durch direkte klinische Erfahrung. Beide illustrieren die Bemühungen der Analytikerin, 'Management im Bereich des Denkens' auszuführen mit diesen Borderline-Patienten, die von ihren Eltern keine Unterstützung zu denken erlangt hatten, und denen noch gezeigt werden muss, wie Denkprozesse stattfinden. Die Autorinnen schlagen einige Veränderungen in der Technik vor, um diese Verbesserung zu implementieren, einschliesslich dem, dass man dem Patienten mitteilt, wie die Analytikerin über ihn denkt. Denken selbst kann ein wichtiger integrierender Faktor für diese Patienten sein.     

The Action of God in the World—A Synthesis of Process Thought in Science and Theology

A foundational belief of monotheistic religions is that God acts in the world. In this paper, the case is made that divine action has its origins in the molecular world. Within a metaphysical framework of process thought, a hypothesis is constructed in which God's action in the world, God's ‘initial aim’ for all actualities, is divine motivation of chemical becoming.     

A non-linear model of dynamics: A case of panic

This is a case report of a patient with panic who is on the edge of relapse into alcoholism. It is a case of general theoretical interest, because of the separate phases of containment of his desperation, involving psychopharmacology, sociotherapy, and psychotherapy. It extends the dynamic model into non-linear dynamics, an extension that allows the patient to come to face his amazement at the sudden eruption of unconscious forces, and that allows the psychotherapist to see the therapeutic path of backing up from walking forward, unwittingly, into catastrophe.     

Brief encounters and available places to land

In this paper the author addresses the process of ending in brief therapy. While recognizing the importance of attending to the symbolic meaning of the ending itself and the need to interpret this as it manifests in the transference, he points out the limitations of such an approach. He highlights the significance of the environment of interpersonal relationships and family systems and the wider communities in which the client lives. He suggests that the therapist needs to assess the extent to which these can provide an environment that facilitates the client's development and working through as the therapy ends. The therapist needs to establish whether the patient will have an available place to land, and one that provides sufficient security and safety for the client's onward journeying and exploration without the therapist. The author's conceptualization of 'landing at the end of brief therapy' links together Malan's triangles of insight with Sullivan's concept of the ordinary solution and selective inattention and Gustafson's concept of dilemmas to add depth to the therapeutic effectiveness with which the practitioner can approach brief therapy in general, and the ending in particular. The article concludes with a case example that illustrates these themes.     

Applying Motivational Interviewing in a Domestic Violence Shelter: A Pilot Study Evaluating the Training of Shelter Staff

ABSTRACT

This pilot study examined the use of motivational interviewing (MI) with 20 women receiving services at a domestic violence shelter. The experimental group (n = 10) received regular treatment services (RTS) from shelter counselors who were trained in MI; the control group (n = 10) received RTS only. Fisher's exact test showed that participants who received MI-enhanced RTS were significantly more motivated for change (p = .029), as measured through a dichotomous readiness for change motivational variable on the University of Rhode Island Change Assessment (URICA; Center on Alcoholism, Substance Abuse, &; Addiction Research Division, 1996 Center on Alcoholism, Substance Abuse, &; Addiction Research Division. 1996. University of Rhode Island Change Instrument (URICA) Scale, Albuquerque, NM: Author.  [Google Scholar]). Findings suggest that MI can be helpful in increasing the readiness for change in domestic violence survivors who contemplate leaving abusive relationships.