Steering through storms to safe havens: Playing and reality in Brief Dynamic Therapy

The author outlines the contribution and relevance of Winnicott's thinking to the practice of Brief Dynamic Therapy. Specifically he notes three transitions that can be employed to deepen the therapeutic engagement with the patient and enhance effectiveness. The transitions involve acknowledging the let-down, facing the patient's destructiveness and reaching back to what had been good enough in their early experience. The importance of play and spontaneity in the transitional space of brief therapy are also noted as well as their relationship to particular therapeutic techniques. The augmentation that Gustafson has provided to Winnicott's ideas which map the notion of changing a reiterating pattern onto the terrain of the patient's current external world as well as in dreams is described. These themes are then illustrated by two case studies.     

The basic tools of psychoanalysis

The objective of psychoanalysis is to help the analysand make the contents of his or her psyche conscious to him- or herself In this paper, the author identifies four tools central in the attempts to reach this goal: (1) the analysand's self- observation; (2) the analyst's assistance in identifying the obstacles to self-observation (i.e., resistance analysis); (3) the analysand's bringing unconscious contents into the sphere of self-observation with the help of the analyst's interpretations; (4) turning the analysand's tendency to account for the listener into an object of self-observation (i.e., the analysis of transference). Of these tools, the first is regarded as the most fundamental; all methodological instruments used in psychoanalysis aim at enhancing the scope of the analysand's self-observation. Some difficulties in keeping this aim are identified, and the analysand's autonomy in this work is pointed out, leading to the conclusion that the analysand never becomes changed in an analysis; the analysand might, however, change him- or herself as a consequence of a newly-won self-observation.     

WINNICOTT AND HELPLESSNESS: DEVELOPMENTAL THEORY,RELIGION, AND PERSONAL LIFE

The author examines Winnicott's theory of development from the perspective of existential helplessness, arguing that (a) his views illuminate healthy (and unhealthy) aspects of religion, and (b) express his stance toward the helplessness of dying and death. The author contends that Winnicott understood the infant's psychic growth in relation to the reality of existential helplessness and absolute dependency. Four interrelated, dynamic paradoxes embedded in Winnicott's developmental perspective are discussed, and these paradoxes are seen as frameworks to depict his notions of ego, transitional objects, and true/false selves. The author posits that religion, which Winnicott included under the rubric of transitional phenomena, can be understood in relation to existential helplessness and can be assessed in terms of the degree to which these paradoxes are dynamic.     

A process model of the understanding of uncertain conditionals

To build a process model of the understanding of conditionals we extract a common core of three semantics of if-then sentences: (a) the conditional event interpretation in the coherencebased probability logic, (b) the discourse processingtheory of Hans Kamp, and (c) the game-theoretical approach of Jaakko Hintikka. The empirical part reports three experiments in which each participant assessed the probability of 52 if-then sentencesin a truth table task. Each experiment included a second task: An n-back task relating the interpretation of conditionals to working memory, a Bayesian bookbag and poker chip task relating the interpretation of conditionals to probability updating, and a probabilistic modus ponens task relating the interpretation of conditionals to a classical inference task. Data analysis shows that the way in which the conditionals are interpreted correlates with each of the supplementary tasks. The results are discussed within the process model proposed in the introduction.     

“Transitional subjects”: Therapeutic persons being curative

Abstract

The concept of therapeutic persons as “transitional subjects” has been denoted and described primarily by Benedetti. When the intersubjective dimension of providing patients with self-object experiences is supplemented by a very specific personal commitment on the part of the therapist, the constitution of a transitional subject can take place. Transitional subjects can be envisioned as “eu-constructions” or eu-constructive personal transactions, which facilitate patients to enter new territories of experience. Clinical examples are cited where these piloting phenomena emerge. Transitional subjects are based on therapeutic self-object experiences, go a step further, and try to enable novel movements, for example in the area of the capacity to mourn. New psychic possibilities assist efforts to integrate disparate psychic parts and to develop new choices. Various options to comprehend the phenomena of transitional subjects are presented.     

The Chaplain as Translator

The Chaplain finds herself continually in the position of the translator, having to move in the space between subject and object. This space Winnicott calls Transitional, and Ulanov sees as particularly the domain of the clergy. The nature of these gaps is analysed, especially with respect to Chaplaincy and the work of the individual Chaplain. Various kinds of transitional space are examined, and the challenges facing the Chaplain in these situations are highlighted.     

Daimonic elements in early trauma

This paper explores some of the 'daimonic' elements of unconscious mentation that emerge both in dreams and in the transference/countertransference field with early-trauma patients and illustrates these with an extended clinical example. An archaic and typical (archetypal) 'trauma complex' is articulated (with diagram) as a bi-polar structure consisting of divine child protected and/or persecuted by an inner 'guardian angel'. Sources of this structure and its mythological inner objects are traced to trauma at the stage of what Winnicott calls 'unintegration' and to flooding by disintegration anxiety at a time before nascent ego-structure has formed. In an extended case example, the author shows how the patient's traumatized innocence and desire for a new start, thwarted by self-attacking defences, pulls him into playing the inflated role of her guardian angel, leading to re-traumatization in the transference. Working through is seen as the necessary disillusionment and humanization of these daimonic structures as they are projected, suffered, and transmuted by the analytic partners in the stormy process of psychotherapy.     

Favourite objects of autistic children

Favourite objects (FOs) of autistic children were compared with the FOs of healthy preschool and school children as well as mentally handicapped children. Three clusters of objects were obtained for normal children (comprising primary transitional objects and their forerunners, secondary transitional objects, and non-cuddly toys). When autistic children and mentally handicapped children were included, a fourth cluster of deviant objects was found. Frequency distributions of the two handicapped groups in the clusters were similar. Similarities between the two handicapped groups were also found within each cluster. The occurrence of secondary transitional objects was rare in the handicapped groups. The characteristics of "autistic" FOs reported in earlier case studies (e.g. being hard, often having an exciting effect, not being used in their adequate functions) were typical only of objects in the fourth cluster.