Editorial

Abstract

This paper will examine the current crisis in psychoanalysis in terms of the profession's decline, the apparent lack of patients, the ongoing debate over what constitutes psychoanalysis versus other therapies, and the lack of clinical focus in those debates. The concept of analytic contact will be introduced, and clinical material is used to showcase this concept as a bridge from the circular political debates to a more meaningful examination of what is psychoanalytic. In addition, case material will explore how patients tend to fight off the establishment of analytic contact in favor of safer, less threatening modes of relating. The author suggests that most patients fight off analytic contact and try to shift the treatment into something less analytic. It is up to the analyst to detect this, interpret it, and notice any countertransference collusion that may occur. Although the state of psychoanalysis as a profession is less than stellar in the eyes of the public, and the profession is apt to sabotage itself with endless debates about what constitutes true analytic work, the end is not necessary near. This paper proposes analytic contact to be the more useful focus of research and productive area of clinical exploration. If the decline of our field is to turn around, it will be on the clinical battlefront, not in terms of the theorizing among disagreeing groups of territorial analysts afraid of losing their political high-ground. The concept of analytic contact assumes that a deep exploration of intrapsychic phenomena, conflicts, and defenses, all within the realm of the transference, is the best clinical method of helping the mentally troubled individual. This genuine chance of change is best administered by a trained psychoanalyst. This simple idea is something the profession has contaminated with its often pointless arguments over frequency, analyzability, couch, and so forth. The clinical material will show that what happens in the room between analyst and patient is what best defines the true psychoanalytic treatment.     

THE SECOND SPHERE AND THE STORY OF NO STORY

The author discusses Roy Schafer's ideas of the second self and second reality, as well as his consistent theme of storyteller and story. The latter theme is also explored in the context of more recent psychoanalytic influences, such as Bionian thought, trauma theory, the French approach, and the interpersonal perspective. To illustrate the idea of the nonstory in today's clinical encounters, the author presents two clinical vignettes.     

PSYKOANALYTISKT ORIENTERAD PSYKOTERAPI

The increasing discourse of the concept of intersubjectivity in modern psychoanalysis has pushed the interest in the intrapsychic and its emphasis on drive and object into the background. Authors who wish to avoid a one-sided focus on intersubjectivity usually subscribe to a dual dimensional approach, taking both perspectives into account. In this article, the analytic situation is described not in two, but in three dimensions, the analytic function constituting a third dimension necessary for the interplay between the other two dimensions. Focusing on the analyst's position, the author presents a model that consists of (1) the-analyst-as-subject, (2) the-analyst-as-function, and (3) the-analyst-as-object. The analytic function is understood to be invested with a particular form of desire and it is argued that the asymmetry between this desire of the analyst and the desire of the analysand is a central characteristic of the analytic situation.     

Causes,Counterfactuals, and Non-Locality

In order to motivate the thesis that there is no single concept of causation that can do justice to all of our core intuitions concerning that concept, Ned Hall has argued that there is a conflict between a counterfactual criterion of causation and the condition of causal locality. In this paper I critically examine Hall's argument within the context of a more general discussion of the role of locality constraints in a causal conception of the world. I present two strategies that defenders of counterfactual accounts of causation can pursue to respond to Hall's challenge—including the adoption of a counterfactual condition that is sufficient for causal action-at-a-distance in place of Hall's ‘process’ condition—and conclude that Hall's argument against counterfactual accounts of causation is unsuccessful.     

Uses and abuses of theory: a group analytic perspective

Group therapy occupies a curious and ambiguous status in the overall mental health field: groups are recognized and marginalized, sought after and avoided, respected and dismissed as second best to individual therapy. Groups are now practised widely in many services, probably because of the pressure of referrals and increased concern about funding, but even then have a secondary status. The under-recognition of both the value and complexity of groups seems to parallel the problems of theory which are part of the group psychotherapeutic culture. Rather than attempt a comprehensive theory of groups in this article, I intend to present some of the problems about theory and its link to practice, focusing particularly on the ambivalence about groups that I see as a continuing concern. I do so from a position which values theory, seeing in theory the container of understanding which guides psychotherapeutic practice. I do not identify with a critical position which rejects theory. This position recognizes fully the risks and dangers of over-theorizing, the potential to distort human contact through a rigid adherence to theory; however, I write in the spirit of appreciating theory thoughtfully applied as without theory, our work might be impoverished and even impeded.     

SOME IMPLICATIONS OF BION'S THOUGHT

Following up Bion's idea that dreaming is a continuous process that takes place in waking life as well as in sleep, the author develops its theoretical and technical implications. He describes the narrative derivatives of waking dream thought as the means, or interface, whereby access may be had, albeit indirectly, to the constantly forming sequences of alpha-elements. Examples of the formation of these sequences out of childhood memories, present-day experiences and sexual feelings are given. Reference is also made to the notion of the analytic field. The author goes on to demonstrate the clinical value of these concepts both for studying the session's microtransformations and as a means of in-depth examination of the analyst's own mental functioning, including its lapses, in a session. Abundant clinical material is presented to help analysts who normally apply different models of the mind share these ideas. Finally, it is suggested that night dreams result from a further elaboration of the elements formed during waking life.     

Analytic Group Psychotherapy: A Uniquely Effective Crisis Intervention

This paper describes the author's experience doing crisis intervention with survivors of the 9/11 attack on the World Trade Center in New York City. It focuses on enhancing the understanding of and potentially expanding the theory and technique of analytic group therapy as applied to this unique situation.Private practice in     

Journal Reviews

Covington, Coline. 'Learning how to forget – repeating the past as a defence against the present'.
Grotstein, James. 'Bion, the Pariah of O'.
Hinshelwood, R. D. 'The elusive concept of "internal objects" (1934–1943): its role in the formation of the Klein Group'.
Lippmann, Paul. 'On dreams and interpersonal psychoanalysis'.
Renik, Owen. 'Conscious and unconscious use of the self'.
Schaverien, Joy. 'Men who leave too soon: reflections on the erotic transference and countertransference'.
Williams, Gianna, 'Reflections on some dynamics of eating disorders: "no entry" defences and foreign bodies'.
Slavin, Malcolm & Kriegman, D. 'Why the analyst needs to change: towards a theory of conflict, negotiation, and mutual influence in the therapeutic process'.