Sandplay therapy with couples within the framework of analytical psychology

Sandplay therapy with couples is discussed within an analytical framework. Guidelines are proposed as a means of developing this relatively new area within sandplay therapy, and as a platform to open a wider discussion to bring together sandplay therapy and couple therapy. Examples of sand trays created during couple therapy are also presented to illustrate the transformations during the therapeutic process.     

Some reflections on empathy and reciprocity in the use of countertransference between supervisor and supervisee

Reciprocity refers in its general meaning to a mutual give and take. It is a background feature of all productive supervisory relationships. In this essay I want to bring it into the foreground. I will describe it by contrasting supervision and analysis. For, in my view, that is exactly what reciprocity is in the supervisory relationship: it is an attitude of mind in which the supervisor performs the task of differentiating internally the supervisory from the analytic vertex, in the context of the asymmetry of the supervisory relationship.     

The Unreal Child1

Unrepresented mental states lead to an impaired ability to feel emotions and trust in oneself, one’s history and in the world. The article explores the question of how representations of oneself and the relevant other, the mother, become possible in the course of therapy when dissociative processes previously made this impossible, and what role unconscious communication plays in the analytic realm. This question will be explored by examining the theories of André Green, Philip Bromberg, and Howard Levine.     

I am I:A/M—The Therapist as Personification of Hopper's Fourth Basic Assumption

The group therapist often and perhaps necessarily personifies Incohesion and displays its predominant defenses of contact-shunning Aggregation, and merger-hungry Massification. Hence, I am I:A/M. In Hopper's group example, and in each of three of this author's groups, the therapist displayed aggregative and massified defenses, countertansferential duals of basic assumptive transferences. In any therapeutic interaction, it is possible to find elements of incohesion, dependency, pairing, and fight/flight. The incohesion concept has significant clinical utility. A theoretical question remains, whether Hopper's proposed axis of experience and defense merits the special status, basic assumption, or whether incohesion may be collapsed into the existing triad of basic assumptions.     

Providing a Transcultural Genetic Counseling Service in the UK

This paper uses a broad definition of culture to explore the practice of transcultural genetic counseling through three case studies. The first case involves a White genetic counselor seeing an Asian family, the second, an Asian genetic counselor seeing an Asian family and the third, a hearing genetic counselor seeing a culturally Deaf client. Boundaries, transference and countertransference reactions are considered within each transcultural encounter and the author of each case reflects in detail on their role in the client interaction and their impact on the transcultural dynamic. The cases are used to illustrate some cultural beliefs or characteristics that may challenge the genetic counselor’s expectations. The value of identifying and interpreting these differences to facilitate useful clinical work is considered. The paper debates, where possible, whether it is helpful to culturally match genetic counselor and client.     

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.     

The analyst's countertransference when supervising: friend or foe?

This paper explores transference and countertransference dynamics in the supervisory relationship and their impact on the task of supervision. The development of analytic theory in relation to supervision is described and the value-and ambiguity-of the concepts of 'mirroring', 'parallel process' and 'reflective process' are discussed. The impact of organizational dynamics on the supervisory relationship is investigated in relation to four main unconscious forces: a) organizational defences, b) power and authority, c) accountability and responsibility, d) ethical concerns. Clinical situations which illustrate these issues are described and explored and used as a basis for examining the role of the supervisor's countertransference in supervision. The different framework of practice in supervision, as opposed to analysis, is described in terms of its focus, the supervisor's ways of responding and the dynamic process, and the concept of refracted countertransference is introduced and explained.     

Collusive induction in perverse relating: Perverse enactments and bastions as a camouflage for death anxiety

The author argues that one of the main functions of perverse relatedness is to induce the analyst into becoming the patient's unconscious accomplice in a “perverse pact” against the analytic work aimed at disavowing intolerable aspects of reality. The intense power of collusive induction in perverse relating leads the analyst to participate in transference‐countertransference enactments and to the crystallization of a silent and chronic unconscious collusion between the patient and analyst in the analytic field, stagnating the process (bastion; Baranger and Baranger). The author claims that analysis of perverse pathology should not be limited to interpretation of the patient's intrapsychic functioning but should also focus on the information obtained by the analyst through his participation in collusive enactments; the analyst should also take a “second look” at the analytic “field” to detect underlying bastions. The author reviews the main psychoanalytic contributions that have clarified the phenomenon of collusive induction in perverse relating and as an illustration, describes the analysis of a man with a perverse character; in this patient, one of the main functions of his perverse relatedness was to induce the analyst to become an accomplice in his disavowal of his terror of death. The author highlights the influence of death anxiety in the bastions that develop in the treatment of perverse patients.     

Examining Differential Effects of Internal and External Resources on Counselor Burnout Symptoms in South Korea

This study aims to bring to light the relationship between internal/external resources and counselors’ burnout depending on the type of clients (traumatized/bereaved vs. personal growth issues). Moderated mediation analysis was conducted with 165 counselors in South Korea. The results indicated that counselors of traumatized or bereaved clients were more likely to be affected by internal resources (countertransference management ability), whereas counselors of clients with personal growth issues were more likely to be affected by external resources (environmental resources). Implications and limitations of this study are discussed.     

NARCISSISTIC DEFENSES IN THE DISTORTION OF FREE ASSOCIATION AND THEIR UNDERLYING ANXIETIES

This paper examines particular distortions in the process of free association characteristics of patients with narcissistic personality disorders. The author proposes that the dominant narcissistic transference developments typical of the early and middle phases of the analytic treatment of these patients are reflected in these distortions of free association. This paper gathers the various patterns that these defensive distortions present, along with technical interventions geared to deal with them.