Chaotic attractors in the therapeutic system 1

Because little research had been done on the presence and role of latent communication in the context of team‐conducted family therapy, the writers set out to monitor unconscious responses generated under these conditions. Specifically, they investigated an ongoing family treatment situation conducted according to the “reflecting team model.” One team of therapists handles the actual treatment session, while the other observes from behind a one‐way mirror. During the course of a session, the second team makes suggestions to the treatment team either by telephone or by calling the therapists out of the treatment room.

As the project developed, the writers found that the unconscious responses of both family and treatment teams indicated a process at work beyond the conscious intentions of the participants. That is, the therapeutic enterprise was functioning as a dynamical system, whose increasing complexity suggested a self organizing principle at work. This paper traces the development of the system's movement toward greater complexity, identifies the specific interventions that indicate this process, describes how all participants demonstrated a high degree of resonance and synchronization with this overarching‐self organizing pattern. This paper serves to alert therapists to the role of unconscious communication within the therapeutic system and postulates that the generation of form within psychotherapy follows many of the same self organizing processes found in other human and non human systems.     

Person perception from changing emotional expressions: primacy,recency, or averaging effect?

ABSTRACT

Dynamic changes in emotional expressions are a valuable source of information in social interactions. As the expressive behaviour of a person changes, the inferences drawn from the behaviour may also change. Here, we test the possibility that dynamic changes in emotional expressions affect person perception in terms of stable trait attributions. Across three experiments, we examined perceivers’ inferences about others’ personality traits from changing emotional expressions. Expressions changed from one emotion (“start emotion”) to another emotion (“end emotion”), allowing us to disentangle potential primacy, recency, and averaging effects. Drawing on three influential models of person perception, we examined perceptions of dominance and affiliation (Experiment 1a), competence and warmth (Experiment 1b), and dominance and trustworthiness (Experiment 2). A strong recency effect was consistently found across all trait judgments, that is, the end emotion of dynamic expressions had a strong impact on trait ratings. Evidence for a primacy effect was also observed (i.e. the information of start emotions was integrated), but less pronounced, and only for trait ratings relating to affiliation, warmth, and trustworthiness. Taken together, these findings suggest that, when making trait judgements about others, observers weigh the most recently displayed emotion in dynamic expressions more heavily than the preceding emotion.     

‘Characters’ in psychoanalytic and interpersonal therapy: A comparison

In this paper the author considers how the therapist might listen to the characters talked about by his or her patients. In psychoanalytic therapy the emphasis is on listening to the patient's characters as though they are located in psychic reality and as representatives of the transference relationship, whereas in interpersonal therapy (IPT) the patient's characters are taken as inhabiting the realm of external reality. It is argued that clinical thinking in IPT would be enhanced by taking more account of psychic reality, which will make clearer the quality of external reality in which the patient's characters are located. It is also argued that both therapies share an interest in enabling the patient to find characters which can serve as holograms of previously unexpressed affective experience.     

On the nature and standing of psychoanalytic psychotherapy

In this paper, I offer some reflections on the standing of psychoanalytic psychotherapy in the National Health Service (NHS), with special reference to contemporary forms of evidence-based thinking. I consider what may follow when a narrow view of science or psychotherapeutic practice becomes conventional wisdom and assumes dominance. I place stress on the potential loss to NHS psychology and psychiatry if psychoanalytic psychotherapy becomes increasingly marginalized on the one hand, or overly standardized on the other.     

The empathizing–systemizing (E–S) model of autism and psychoanalytic theories of truth,play and symbolization

Little psychoanalytic material or theory features today in psychological work on autism and autistic traits and vice versa. Baron-Cohen's (2003) empathizing–systemizing (E–S) model of the autism spectrum posits two main clusters of autistic features: those surrounding impaired empathy, and those surrounding heightened systemizing behaviours. (Baron-Cohen, 2009) speculates that the common root of these two clusters is the individual's concept of truth. Psychoanalysis has addressed the related issue of internal and external reality since (Freud, 1897) differentiated ‘psychic’ from ‘historical’ truths. This could be of interest to those espousing the E–S model from a cognitive paradigm, as a ‘truth’-oriented cognitive style in autism may develop interdependently with the individual's experience of internal and external realities. Psychoanalysis has developed further ideas of relevance to the E–S model surrounding play and symbolization, the latter being an often-overlooked aspect of Wing and Gould's (1979) triad of autistic features. Seen from a psychodynamic perspective, the E–S model might provide a means to increase therapists' awareness of milder autistic traits amongst service users and analysands. Equally, it could offer a tool to structure empirical research into psychodynamic therapy with autism spectrum conditions.     

The embodied analyst: from Freud and Reich to relationality

This paper presents the impact of clinical supervision on once-weekly psychoanalytically-informed training psychotherapy. The development of Oedipus complex theory is presented, culminating in Britton's work on the triangular space that opens up by working through the complex. The geometry of psychic space is described to highlight the importance of supervision, especially when training in therapy. The theme of spiders and cobwebs emerging from the clinical material provides a powerful metaphor for the tensions in psychic space. In the course of this training, the trainee therapist was at times less able to benefit fully from supervision, and thus the third position partially collapsed. Vignettes from anonymised clinical work are presented in the three ‘phases’ of this therapeutic process, illustrating the impact of the presence – and relative absence – of supervision.     

Author biographies

This paper describes how an application of psychodynamic principles and techniques in a school setting can open up perspectives and insights into aspects of loss and mourning, which result in the personal and professional growth of individuals. It discusses applied psychoanalytic work in relation to its clinical base in the consulting room, in particular family work, and exemplifies this with a variety of cases.     

Report on ‘A conversation about unintegration,disintegration and integration’ with papers by Anne Alvarez and Edna O'Shaughnessy,chaired by Margot Waddell, 25 february 2005 1

This paper attempts to explore the nature and consequences of trauma in infancy by an exploration of a prototype of trauma when babies are born addicted to heroin. The trauma not only involves a painful withdrawal from the drug and invasive medical procedures carried out in isolation in a special care baby unit, but often also an ongoing cumulative trauma of the lack of availability of a receptive containing parent. The paper raises specific issues about these babies as well as about trauma in general. It examines current psychoanalytic, attachment and other theories about trauma and resilience, and includes an infant observation of a baby in a special care baby unit who was born addicted. A detailed case is presented, illustrated by sequences of drawings by an 11-year-old boy who had been born addicted. These show how the lack of containment of any sort in infancy had profound effects on the child's ability to process his emotional experience in any meaningful way. An attempt is made to evaluate the effectiveness of the psychotherapy using criteria derived from Mary Main's work on disordered/chaotic infants. This involves a shift from disintegration and a lack of resolution of any crisis towards the emergence of the possibility of a hopeful outcome.     

Clinical Commentary

This paper describes a lengthy period of psychotherapy with a child. This treatment began only after a prolonged contact with other child and adolescent mental health services during which the child's difficulties, which had initially seemed to be ordinary behavioural problems, had proved puzzlingly intractable to a variety of interventions. Subsequent psychotherapy revealed a profound disorder of development which lay bath the Surface presentation. In a climate where Asperger's syndrome is often felt to be untreatable, this paper argues that some children, at least, can benefit from psychotherapy and can be helped towards real mental growth. Asperger's syndrome in children bears some striking similarities to narcissistic personality disorder as described in the adult psychoanalytic literature and this paper discusses some of the theoretical and clinical implications of the innate origins of Asperger's syndrome.     

Thoughts about the development of a potential space in the psychotherapeutic treatment of infantile psychosis

This paper describes the usefulness for the child psychotherapist of some Winnicottian concepts in psychoanalytic treatment of very young psychotic children. Particular attention is given to the concept of ‘potential space’ as Winnicott has formulated it in his writings. Three clinical cases are presented, one of these includes a complete mother-child session in order to show how the therapist can work to create a space where psychic events can become possible.