The first interview: Anxieties and research on initiating psychoanalysis

A qualitative clinical study of preliminary interviews by the Working Party on Initiating Psychoanalysis (WPIP) of the European Psychoanalytic Federation suggests that the unconscious dynamics in first interviews are extraordinarily powerful and that they give rise to deep unconscious anxieties in both patient and analyst, with the corresponding defences against them. Furthermore, the group dynamics observed in the clinical workshops and in the research team doing the study suggest that both the anxieties and the defences are conveyed to these groups in the form of unelaborated ‘session residues’ provoking renewed anxieties and defences in them. These findings contribute to our understanding of what goes on in first interviews, but also raise interesting questions about the psychoanalytic research process in psychoanalysis and how confrontation with the unknown is dealt with in that context. Rather than as a means to avoid anxiety, method in clinical research can be seen as a way to help the research group to contain its reactions and to tolerate them until the group finds its way to further elaboration. These points are illustrated with a clinical case drawn from the study.     

Actions and accidents

In acting intentionally, it is no accident that one is doing what one intends to do. In this paper, I ask how to account for this non-accidentality requirement on intentional action. I argue that, for systematic reasons, the currently prevailing view of intentional action – the Causal Theory of Action – is ill-equipped to account for it. I end by proposing an alternative account, according to which an intention is a special kind of cause, one to which it is essential that it represents its effect.     

Memories, fantasies, archetypes: an exploration of some connections between cognitive science and analytical psychology

The value of cognitive science as a means of investigating psychodynamic theory and practice is discussed and the limitations of this approach are described. Research findings from cognitive science are drawn on to clarify the nature of memory, which is seen to be a mixture of reproduction and reconstruction and the concepts of true and false memory are explored in this light. The part played by implicit memory and internal working models in producing transference is also examined. New ways of conceptualizing fantasy, which describes it as another facet of internal working models, and the role of transgenerational transmission of attachment patterns in creating internal working models are explored. The nature of archetypes is considered in the light of cognitive science research and a minimalist model is proposed, in which they can be likened to image schemas, that is, primitive conceptual structures that exist in a form which can never be experienced directly or indirectly.     

测验信度估计：从α系数到内部一致性信度

沿用经典的测验信度定义, 简介了信度与a 系数的关系以及a系数的局限。为了推荐替代a系数的信度估计方法, 深入讨论了与a 系数关系密切的同质性信度和内部一致性信度。在很一般的条件下, 证明了a 系数和同质性信度都不超过内部一致性信度, 后者不超过测验信度, 说明内部一致性信度比较接近测验信度。总结出一个测验信度分析流程, 说明什么情况下a 系数还有参考价值; 什么情况下a 系数不再适用, 应当使用内部一致性信度(文献上也常称为合成信度)。提供了计算同质性信度和内部一致性信度的计算程序, 一般的应用工作者可以直接套用。     

Clinging,gripping, holding,containment: Reflections on a survival reflex and the development of a capacity to separate

This paper attempts to describe how, in the very first months of extra‐uterine life, personality structures are formed around notions of personal space, separateness, attachment and individuation. The contribution of a forgotten Hungarian analyst, Imre Hermann, who wrote about the ‘clinging reflex’, will be explored in relation to the origin of Bowlby's concept of attachment and Rey's theoretical understanding of personal space. Particular attention will be given to transitions, transitional experiences and the development of a sense of internal space. Vignettes from infant observations will be used to illustrate the theoretical frame of reference. Clinical material from the analysis of a child and an adult patient will be provided to postulate how a distorted perception of personal space and separateness in the first few months of life may affect the capacity to attach and to individuate.     

THE FATE OF AGGRESSION IN MASO‐MASOCHISTIC RELATIONSHIPS

This paper examines an underexplored dimension of interpersonal relating: the relationship formed between two individuals who relate to each other in masochistic ways. The common assumption is that a sadist forms an alliance with a masochist, and that a balance is struck between an individual who is “one up” and another who is “one down.” However, relationships are frequently established between two people who both experience themselves as chronically “one down,” each playing victim to the other's aggression. This paper explores disavowed aggression in this type of couple, the implications of this disavowal for treatment, and the sadomasochistic reverberations within the therapist.     

Preparatory Set,Response Complexity,and Reaction Latency

The interaction between preparatory set and response complexity was demonstrated in an experiment investigating the reaction latency of discrete arm movements. Following simple finger-lift reaction-time (RT) trials, subjects performed simple and complex versions of a discrete horizontal arm movement under one of two enforced preparatory set conditions. For the simple task, requiring subjects to attend to the components of the response prior to stimulus presentation (enforced motor set) produced significantly shorter RTs than when concentration was on the stimulus (enforced sensory set). However, RT differences for the complex version of the task failed significance. Theoretical implications of the results for Henry’s (1960) memory drum theory of neuromotor reaction were discussed.     

What Is Love?

SUMMARY

A theory to explain the phenomena of love is suggested. The construct of love is dissected into physiological and psychodynamic components. Love is explained first via its adaptive function, then by its physiological arousal which is interpreted as either anxiety or excitement, which is activated via goodness-of-fit of each individual's internal love model. The leap to love is contingent on the complex constellation of the above-mentioned idiosyncratic components finding synthesis within individuals and between mates. Intimacy can be nurtured, but love, similar to humans and life itself, appears to be greater than the sum of its parts.     

Negotiating time: the significance of timing in ending inpatient work

This paper discusses work with young people during their stay on an NHS psychiatric inpatient unit, especially focusing on the end of treatment and the appropriate timing of discharge into the community. When approaching the end of an admission, various factors are considered that seem particularly relevant to the decision of when a young person may be ready to leave and cope with the transition back to life outside the unit. Indications of medical stability, in patients where this has been an issue, is a factor of prime importance. Other important factors include family functioning; the availability of adequate ongoing local CAMHS support for the child and family; suitable school provision; and the identity of the child within a peer group. The reality of NHS resources and the demand for inpatient beds is another pressing consideration. The young person's own motivation emerges as crucial at this stage – towards the end of treatment – not only in terms of what is said, and therefore evident verbally, but also through signs of internal shifts in the child that indicate a capacity to re-engage with life outside in a lasting way. Decisions about when to stop are taken with all this in mind and when the decision does not seem straightforward, it can provoke considerable anxiety in the multi-disciplinary team. Clinical material from psychotherapy with a young adolescent boy with anorexia nervosa is used to illustrate some of the dilemmas.