Fordham, feeling, and countertransference: reflections on defences of the self

This is a paper about the difficulties we as analysts get into when we find that a patient has activated something in our unconscious which we cannot resolve in our work with them. Fordham described at the end of his life, in a number of papers, his difficulties and discomfort at not being able to resolve an impasse with one of his patients. From the conversations we had about this situation I knew this caused them both a lot of pain. After Fordham's death his former patient consulted me. Arising from these consultations I describe how I have understood the impasse to have arisen between Fordham and his patient. This paper links character and clinical interests, personality and impasse, developmental failures and defences of the self. It is a personal statement in which I have struggled to represent the meaning in the pain these two men suffered during their analytic engagement, which lasted more than ten years. The theme of fathers and sons was central to the problem.     

An Ethical Exploration of Barriers to Research on Controlled Drugs

We examine the ethical, social, and regulatory barriers that may hinder research on therapeutic potential of certain controversial controlled substances like marijuana, heroin, or ketamine. Hazards for individuals and society and potential adverse effects on communities may be good reasons for limiting access and justify careful monitoring of these substances. Overly strict regulations, fear of legal consequences, stigma associated with abuse and populations using illicit drugs, and lack of funding may, however, limit research on their considerable therapeutic potential. We review the surprisingly sparse literature and address the particular ethical concerns pertinent to research with illicit and addictive substances, such as undue inducement, informed consent, therapeutic misconception, and risk to participants, researchers, and institutions. We consider the perspectives of key research stakeholders and explore whether they may be infected with bias. We conclude by proposing an empirical research agenda to provide an evidentiary basis for ethical reasoning.     

Book Review: Contemporary Perspectives on Psychotherapy and Homosexualities

Abstract

This paper is an attempt to illustrate some of the ethical and clinical difficulties which may arise when student counselling takes place under conditions which pay insufficient attention to the ground rules of therapy. It considers the importance of the frame in psychotherapy and the implications for this of working in an institutional setting. It also looks at the changes that may be made in the way the counsellor functions in the institution in order to secure the best conditions for effective counselling work with students, based on the author's personal experience.     

Psychodynamic counselling in a university setting: A space for thinking together over emotional problems

Abstract

The authors describe their experience as psychoanalytically oriented psychotherapists at the Counselling Service for University Students of the Office for Student Affairs, Naples. In this service they have provided, for the last fourteen years, to any student who applies to it, up to four individual sessions, with the possibility of follow-up sessions, should the client ask for them after a few months. Both the procedure and the aims of the interventions are similar to those described by psychotherapists working at the Tavistock Clinic (Copley 1976; Salzberger-Wittenberg 1977) and the Brent Consultation Centre (Hurry 1986; Novick 1987) of London. The technique is an adjustment of the psychoanalytic one and the therapist undertakes a careful listening to the student's verbal and non-verbal communications. The main objective of the intervention is to enter into an alliance with the adult parts of the client in order to examine together his/her personal difficulties. A case report is presented, in order to exemplify both an emotional conflict which can interfere with academic success and the technique of the intervention.     

Containment in theory and practice

Abstract

This article selects the term ‘containment’ as a vehicle for an exploration of multi-professional work and communication in the general practice setting. The term was selected because of its widespread use by and relevance to the different professionals who work in general practice. It is sufficiently elastic to be applied to one-to-one work between patients and GPs, counsellors, nurses or complementary therapists, and to a multi-professional teamwork process.

The exploration of the concept in use at Marylebone Health Centre is complicated by the multi-professional nature of the team and then-wide range of belief systems and language groups. In the process of exploring the term, members of the team had to cope with their discovery that it was being used in contradictory ways. They decided that a new and more grounded definition in shared and ordinary (nonprofessional) language was needed, if the term were to become a vehicle for inter-professional collaboration and if unhelpful, anti-task social defences were to be minimised.     

Mentoring for Mental Health within a University: A psychodynamic approach

This paper explores the role of mentoring in a British University for students with mental health issues and is written from the perspective of the Mentor who is also a Psychodynamic Psychotherapist. Psychodynamic theory is applied to two case studies in order to understand the conscious and unconscious factors when considering these students’ particular learning difficulties and motivation for entering a learning environment. In the first case study, it is suggested that the student hopes to find his lost father within the containing bricks of the institution. When confronted with frustration and disappointment, he mobilises schizoid defences, precipitating a psychotic episode. The second case study formulates the student’s chronic procrastination, which verges on academic sabotage, as a defence against the unbearable guilt concerning his abilities and achievements in contrast with his unsuccessful and disabled siblings. The challenge of helping these students is explored, including the approaches taken by the Mentor, given her remit and the particular issues presented by the students.     

New Concepts for New Dynamics: Generating Theory for the Study of Religious Innovation and Social Change

The Emerging Church movement (ECM) is sociologically interesting—not due to the size of its membership or the centrality of its congregations. Rather, the ECM is significant because it provides an opportunity to generate new concepts for the study religious innovation and social change. Using theoretical language, the ECM consists of institutional entrepreneurs who drive their religiously concerned movement by continually deconstructing and reframing beliefs, practices, and identities from “mainstream” Christianity while at the same time promoting newly formulated and broadly resonant religious imperatives. As Emerging Christians cultivate new or altered religious practices, these must be continually legitimized. Furthermore, their renegotiated beliefs (heterodoxies) require new forms of organization (alternative congregations). Such action is not the work of isolated individuals, nor is it independent of societal conditions. Ultimately, the ECM consists of Emerging Christians who creatively operate through diffuse network structures across wide geographic spaces and among disparate social groups to enact a collective institutional entrepreneurship that seeks to reimagine the assumptions of conventional Christian congregational life.     

机构伦理视野中的KWG——被纳粹的罪扭曲了的科研机构

通过KWG两个研究所在第二次世界大战期间的境遇,揭示了纳粹统治时期德国科研机构存在的伦理问题,并从机构伦理学的视角重新审视了研究机构从事人体试验等反人类活动的行径,分析了其中的社会历史根源。