Dual diagnosis: Clinical issues in the treatment of substance abuse,and affective,personality, and psychotic disorders

Co-morbidity of alcohol and substance with the spectrum of other psychiatric diagnoses is examined with specific emphasis on diagnostic indicators for anxiety and mood disorders. Diagnostic issues for the chemically dependent person are examined with the context of borderline personality disorder, schizophrenia and other psychiatric disorders. Clinical research related to the dually-diagnosed patient is explored     

Making Sense of the APA: A History of the Relationship Between Psychology and the Military

The American Psychological Association (APA) has been steadfast in its position that psychologists must have the right to participate in interrogations in U.S.-run illegal detention centers. One wonders why the APA is so resolute in this view especially in light of the opposition to involvement in these sites by all other relevant professional organizations. This paper offers an answer to this question by means of an exploration of the historical bond between American psychology and the military. It is demonstrated that the dramatic growth of psychology after World War II is attributable to resources supplied by the Department of Defense and the Central Intelligence Agency. It is argued that the historical and current dependency of psychology on the military for research funds as well as clinical training and treatment has resulted in a historical and current debt on the part of psychology to both of these organizations. This debt is repaid by an unquestioned endorsement of military policy, no matter how questionable its ethical or legal basis might be.     

Racial Insult and Repair

This discussion examines the theme of time as it is experienced by someone who has suffered a loss, in an attempt to understand and differentiate certain contrasts in these authors' approaches to theory and technique. The discussant argues that the frame is a vital tool in helping the analyst to gain access to the differential interplay between awareness of mortality and our flight from it. Finally, the discussant asks whether certain prevalent relational themes, such as mutuality, empathy, and the ubiquity of enactments, have contributed to an atmosphere in which attention to the frame can recede.     

The Paradoxical Place of Enactment in Psychoanalysis: Introduction

Ringstrom's “comparison of relational psychoanalysis and intersubjective systems theory” exhibits a category mistake that renders the core of his argument logically incoherent.     

The Last Time: Commentary on Paper by Stuart A. Pizer

Pizer presents poetic details of his patient's complex therapy and analysis. This commentary examines one moment in the treatment that may have violated the potential in potential space. The question is raised as to the impact of such a moment.     

“I'll Have What She's Having”: Commentary on Paper by Karen E. Starr and Lewis Aron

This discussion utilizes a feminist discourse originating in the 1970s to reconsider Freud's famous question, “What do women want?” and from there explores some hidden dimensions in Starr and Aron's paper concerning female agency, sexuality, and the twists and turns of psychoanalytic theory and social conventions. Highlighting Rachel Maines's researches into the use of vibrators in medical treatment in particular, the discussion illuminates how social conventions function as powerful determinants that legislate what is seen and not seen, what is questioned and what is accepted—and ultimately what is considered psychoanalytic “bedrock.”     

Applications,Implications, Complications: Reply to Reviews by Elkind,Gerson, and Levine

The author appreciates the careful reading and thoughtful reviews by Sue Elkind, Sam Gerson, and Howard Levine. Elkind's review particularly captures and articulates many of the key ideas in the book Building Bridges: The Negotiation of Paradox in Psychoanalysis and creatively applies concepts of negotiation, paradox, an inherently multiple “distributed self,” and metaphor in her own work consulting on treatment impasses. Gerson incisively focuses on the core idea of recognizing, accepting, and bridging differences and contradictions in personal, and national, perspectives; he also articulates an understanding of the attempt of relational analytic writers to bridge the intrapsychic and the interpersonal with due recognition of each. The author replies extensively to Levine's comparison of Pizer's work with that of Semrad and other “classical” analysts and challenges Levine's premise that a relational perspective, grounded as it is in a two-person contextual psychology, ignores or devalues interpretation, insight, free association, and autonomous mental functioning. Quoting from clinical material in his book, Pizer presents the outcome of a “relational” analysis in terms of the patient's increased access to internal “potential space,” unconscious experience, curiosity, and reflectiveness about the mental life of self and other, and an increased ability to value personal experience in relationship and in solitude.