Supervision, transference and countertransference

The author discusses supervision, transference and countertransference as seen in the context of the clinical case of a patient who had been first seen as a training analysis case and who later, in a fortuitous way, was treated by the supervisor of the training analysis. The supervisor, who in the first instance did not recognize the patient, discusses the reasons for this unusual experience in terms of the presence and absence of transference during the analysis of this patient as a training case and the problems inherent in the task of supervising. The patient's feelings towards the first and the second analyst and the vicissitudes of transference and countertransference during the supervision of the training analysis and its influence on the presentation of the analytical sessions by the student are also detailed and discussed. The question of recorded supervision presentations and their possible influence on the dynamics of supervision is raised.     

Raiding the inarticulate: The internal analytic setting and listening beyond countertransference

The analytic setting exists not only externally but also internally as a structure in the mind of the analyst. The internal analytic setting constitutes an area of the analyst's mind where reality is defined by unconscious symbolic meaning. Clinical examples illustrate how a secure internal setting allows flexibility in the external setting without sacrifice of its analytic quality. The internal setting can help analysts listen inwardly to themselves in a way that is free-floating with regard to their internal processes. This points beyond usual ideas of countertransference. An analytic encounter may stir up elements that belong to the analyst's psyche which, rather than impeding the analysis, can actively enrich it. Seamus Heaney's writings evoke comparisons between listening to poems and listening to patients, and a week in a patient's analysis is described in relation to these themes.     

Some technical implications of Klein's concept of 'premature ego development'

In this paper, the author revisits the problem of 'premature ego development' first introduced by Melanie Klein in 1930. She also highlights several developments in post-Kleinian thinking since the publication of that paper, which can be seen as offshoots of or complements to Klein's work. The author proposes a link between this category of precocious development and the absence of the experience of what Bion termed the 'containing object.' She puts forward several technical considerations relevant to analytic work with patients who suffer as a result of early developmental failures and presents various clinical vignettes in order to demonstrate the ways in which these considerations take shape in the analytic setting.     

‘Bound in a nutshell’: Thoughts on complexity,reductionism, and ‘infinite space’1

Pluralism is the hallmark of 21st century psychoanalytic discourse. Nevertheless, an unpleasant byproduct of pluralism is a tendency in some quarters to retreat into orthodoxy, stemming from a perceived need to shore up theoretical boundaries in the service of differentiating one theory from another. The delineation of borders places us at a risk of losing sight of the fact that genuine psychoanalytic thinking is fundamentally non‐reductionistic. Moreover, the core psychoanalytic notion of overdetermination, which Freud never abandoned throughout his career, has recently been neglected as authors argue in their communications that one point of view is better than another. Both analysts and their patients secretly are drawn to simple formulations that eschew complexity. The need to remain open to the ‘infinite space’ of meaning, motive, and causation should be a hallmark of clinical psychoanalytic practice. The author considers the implications for technique, and provides case material to illustrate some of the challenges inherent in approaching psychoanalytic work as a complex phenomenon.     

Hertzmann,Leezah & Newbigin,Juliet (Eds.). Sexuality and Gender Now: Moving Beyond Heteronormativity. The Tavistock Clinic Series. London: Routledge. 2019. Pp. 358. Pbk. £29.99.

In this paper the author argues that trans-identification and its associated medical treatment can constitute an attempt to evade experiences of psychological distress. This occurs on three levels. Firstly, the trans person themselves may seek to evade dysregulated affects associated with such experiences as attachment trauma, childhood abuse, and ego-alien sexual feelings. Secondly, therapists may attempt to evade feelings, such as fear and hatred, evoked by engaging with these dysregulated affects. Thirdly, we, as a society, may wish to evade acknowledging the reality of such trauma, abuse and sexual distress by hypothesizing that trans-identification is a biological issue, best treated medically. The author argues that the quality of evidence supporting the biomedical approach is extremely poor. This puts young trans people at risk of receiving potentially damaging medical treatment they may later seek to reverse or come to regret, while their underlying psychological issues remain unaddressed.     

Toward a constructive eschatology: An appraisal of Veli-Matti Kärkkäinen's contributions

Faced with diverse cultural challenges to hope, a constructive eschatology should do justice to the entire reality and develop a robust future-oriented hope that helps to transform the present. In this regard Veli-Matti Kärkkäinen has made a significant contribution, especially in dialogue with natural sciences and other faith traditions, to retrieve the cosmic dimension of Christian hope, as well as to address liberationist and ecofeminist critiques of some distorted hopes. After recommending distinctive features of Kärkkäinen's constructive proposal, I suggest advancing it further by combining the phenomenological insight into the lived body with the concept of temporal holism.     

Regression in the countertransference: working with the archetype of the abandoned child

Abstract :  The author describes briefly some experiences of his sense of non-existence as an analyst in relation to five patients. He considers the possible countertransference significance of these experiences and puts forward a hypothesis that his sense of non-existence as an analyst might be a clue to regression in the patient to the anxieties of a baby without a mother, even though other clinical evidence of regression might be lacking. Referring back to Jung's early formulation of transference and countertransference as aspects of the unconscious identity shared between analyst and patient, he further develops his hypothesis, suggesting that, in the cases he has presented, analyst and patient were relating through shared dynamic roots in the archetype of the abandoned child. He briefly demonstrates how the understanding thus achieved was of clinical use in the analyses of the patients he has presented.     

温尼科特的精神分析客体关系理论的治疗观

温尼科特是英国精神分析客体关系学派的重要代表人物,提出了独特的精神分析治疗观,以提供抱持性的分析情境为核心,强调退行至依赖的治疗过程,重视精神分析师的反移情中的恨的情绪体验,珍视病人的主动不交流等,在很多方面颠覆了经典的精神分析治疗观。     

The psychoanalytic vision of Hans Loewald

Hans Loewald is a comprehensive and original theorist on a par with any major post-Freudian thinker, yet neither his ideas nor his person have become the basis for a Loewaldian school or approach, and he is not as well known as other innovators of comparable quality. In this paper the author attempts to characterize the scope and depth of Loewald's theory-his vision of the psyche and psychic life, or metapsychology, his characterization of the psychoanalytic process, and his vision of the clinical and human goals of psychoanalysis. She suggests that Loewald holds in all of these realms, and without apparent contradiction, a doubled-emphatically ego-psychological and emphatically object-relational-perspective, and an equal commitment to both the first topography and the structural theory. His views throughout are undergirded by a bi-directional developmental view that centers on differentiation and integration. The paper includes brief reflections on how to assess psychoanalytic theories, like Loewald's, developed before empirical research that seems to challenge them.