Gone but not forgotten: A new look at difficult cases

Many treatments never seem to get off the ground. They end almost as quickly as they begin. These are often treatments of borderline, narcissistic or psychotic patients. While it is easy to dismiss these cases as failed, or unanalysable, they are valuable to study. One such case is presented.     

Adrian Stokes and the portrait of Melanie Klein

This paper focuses on the offer by the art writer Adrian Stokes to commission and pay for a portrait of the psychoanalyst Melanie Klein by the artist William Coldstream. It details some of the precursors of this offer in Stokes's preceding involvement first with Klein and then with Coldstream; her response to this offer; and its outcome and aftermath in Stokes's subsequent writing about Klein and Coldstream.     

Pastoral Theological Reflections on Pamela Cooper-White's Shared Wisdom: Use of the Self in Pastoral Care and Counseling

This article reviews Pamela Cooper-White's book as an extraordinarily well developed, nuanced, and empirically grounded reflection on the significance of transference and countertransference dynamics in ministry; it also points to several ways in which the book's thesis could be more fully developed theologically and more broadly applied in ministry.     

The working alliance and the transference/countertransference relationship: Their manifestation with racial/ethnic and sexual orientation minority clients and therapists

Theoretical propositions are offered about the interrelations of three key concepts in psychotherapy: specifically, the working alliance, on the one hand, and both transference and countertransference, on the other. The role these concepts play, including the interactions between them, is extended to the areas of race/ethnicity and sexual orientation. We examine working alliance, transference, and countertransference considerations for therapy dyads in which at least one of the participants is a member of a racial/ethnic or sexual orientation minority group. Our hope is that this theoretical examination will generate further research and theory development on working alliance, transference, and countertransference where cultural factors such as race/ethnicity and sexual orientation are implicated in the therapeutic relationship.     

Mediation of the stigma in the influence of negative symptomatology over recovery in psychosis

Background/Objective: The interest in recovery processes in psychotic disorders has boosted the necessity of knowledge about the factors that could influence in such recovery. Negative symptomatology and the stigma have been negatively linked to the recovery process in psychosis. The aim of this investigation is to improve the understanding of how the recovery process is affected by negative symptomatology based on the analysis of the mediating effects of the internalized stigma. Method: The sample was composed of 114 people that had experienced, at some point in their life, at least one clinically relevant psychotic episode. CAPE-42, STORI and ISMI were used for the evaluation. The macro PROCESS for SPSS was used. The indirect effect was calculated using 10.000 samples of bootstrap for the bootstrap confidence intervals (IC) corrected for bias. Results: The results show that the influence of negative symptomatology predicts the stigmatization of the person regarding his disorder. This predicts a negative influence in the recovery process of the psychosis. Conclusions: These results back the importance of adding the reduction of the stigma as a specific strategy to improve the recovery process in psychotic disorders.     

Hineni and Transference: The Remembering and Forgetting of the Other

Emmanuel Levinas proposed a philosophical critique that worked to unsettle and decenter generalizing, totalizing, and thematizing attempts to define the self. However, on the other hand, Levinas provides the space for the formation of a configuration of the self that has been conditioned by ethical relation and even points to some of the ingredients for (or shape of) such a self. Throughout Levinas’ work, the concept of hineni (“Here I am”) is used to illustrate the moral event that best characterizes the “psyche.” In the following paper, we consider how to apply the notion of hineni to modern psychological constructs of the human self. In the first section, we flesh out the characteristics of a self lived as hineni. We argue that such a self is “shaped” or oriented morally toward the outside and is radically exposed to the Other (not merely a bearer of moral consciousness or moral attributes). It is a remembering of the preoriginal and primordial ethical relation. In the second section, we use the psychoanalytic concept of transference to illustrate how the moral shape of the self can be forgotten, and how the self enters a state of “mineness” wherein the Other is reduced to one’s own history (Levinas 1990). In this state of forgetfulness, we argue that a “concreteness of egoism” (Levinas 1969) is maintained and a self lived toward the outside remains untenable. Transference, we argue, is an impoverished relation and a forgetting of and violence to the Other. Its proper use, however, in the therapeutic alliance allows for the possibility of a remembering of the Other and a calling beyond oneself.

Transference and katharsis,Freud to Aristotle

Aristotle's theory of tragic katharsis is the most ancient and debated theory of the effect of the theatrical experience on the audience. It affirms that tragedy effects the katharsis of fear and pity, engaging readers with the controversy whether by katharsis Aristotle meant purification of the emotions (i.e. their perfection within the mind) or purification of the mind from the emotions (i.e. their abreaction from the mind). In this paper I will explore how Freud's theory of transference can suggest a new interpretation of Aristotle's tragic katharsis. Transference allows for the representation and expression of repressed emotions through the re‐enactment of past relational dynamics. Although this process is essential to the psychoanalytic method, it is the subsequent analytic endeavour which allows for the “working through” of repressed emotions, bringing into effect the transference cure. I argue that the dynamic between emotional arousal in re‐enactment and emotional distancing in analysis offers an effective parallel of the dynamic between katharsis of fear and katharsis of pity in Aristotle's theory. Such interpretation of tragic katharsis suggests that the theatrical effect in audiences may be an opportunity for self‐analysis and the ‘working through’ of unconscious psychic dynamics.     

Using the concept of the 'total situation' in the analysis of a borderline adolescent

The author discusses two concepts of transference: the broader use of transference as the 'total situation', as it was called by Melanie Klein and further elaborated by post-Kleinians, and the narrow use of transference in the traditional sense. Using clinical material from the four-times-a-week analysis of a severely disturbed adolescent over a period of 4 years, the author tries to show how the understanding of the transference as the total situation enabled her to work with this boy who hardly spoke or played. The observation of his non-verbal communication and the counter-transference feelings of the analyst made it possible to formulate hypotheses about the quality of his relationship with the analyst and the inner world of the patient. After the presentation of the clinical material the author points out some misunderstandings of the concept of the total situation in European psychoanalytic discussion.

L'auteur explore deux façons de conceptualiser le transfert?:?celle, plus large, de la « situation totale », formulée par Melanie Klein et développée par les post-Kleiniens, ainsi que celle, plus étroite, de l'acception traditionnelle du terme. À partir du matériel clinique d'une analyse À quatre séances hebdomadaires pendant plus de quatre ans d'un adolescent gravement perturbé, l'auteur s'efforce de montrer comment la conception du transfert en tant que situation totale lui a permis de travailler avec ce garçon qui ne parlait ni ne jouait guère. L'observation de ses communications non verbales et les éprouvés contre-transférentiels de l'analyste ont permis l'élaboration d'hypothèses relatives À la qualité de la relation patient-analyste et au monde interne du garçon. Après avoir présenté le matériel clinique, l'auteur relève quelques malentendus qui persistent, parmi les psychanalystes en Europe, au sujet de la situation totale.

L'autrice discute due concetti di transfert: il piu' ampio uso del transfert in quanto 'situazione totale', come fu chiamato da Melanie Klein e successivamente elaborato dai post-Kleiniani, e l'uso piu' ristretto del transfert nel senso tradizionale. Usando il materiale clinico tratto dall'analisi di quattro anni a quattro sedute settimanali di un adolescente molto disturbato, l'autrice cerca di mostrare in che modo la comprensione del transfert come situazione totale le ha permesso di lavorare con questo ragazzo che a mala pena parlava e giocava. L'osservazione delle sue comunicazioni non verbali e i sentimenti di contro-transfert dell'analista hanno permesso di formulare ipotesi sulla qualita' della sua relazione con l'analista ed il mondo interno del paziente. Successivamente alla presentazione del materiale clinico l'autrice espone alcuni dei fraintendimenti del concetto di situazione totale nella discussione psicoanalitica europea.

Die Autorin diskutiert zwei Konzepte der Übertragung: den weitergefassten Gebrauch der Übertragung als der 'totalen Situation', wie sie von Melanie Klein benannt und von Post-Kleinianern weiterentwickelt wurde, und den engeren Gebrauch der Übertragung im traditionellen Sinne. Anhand von klinischem Material aus einer vierstÜndigen Analyse eines schwer gestörten Jugendlichen Über den Zeitraum von 4 Jahren, versucht die Autorin aufzuzeigen, wie das Verständnis der Übertragung als der totalen Situation ihr ermöglichte, mit diesem Jungen zu arbeiten, der kaum sprach oder spielte. Die Beobachtung seiner nicht-sprachlichen Kommunikation und der GegenÜbertragungsgefÜhle der Analytikerin ermöglichte es, Hypothesen Über die Qualität seiner Beziehung mit der Analytikerin und der innerer Welt des Patientens zu formulieren. Nach der Präsentierung des klinischen Materials stellt die Autorin einige der Missverständnisse des Konzepts der totalen Situation in der europäischen psychoanalytischen Diskussion heraus.