Can Psychoanalysis Become Empirically Supported?

The article discusses the application of the ideas of evidence-based medicine or empirically supported treatment to the field of psychoanalysis. The author argues that empirical support is gradual rather than categorical, and that the randomized clinical trial (RCT), which is commonly heralded as the appropriate method of support, confounds patient suitability factors with treatment 'as such'. As a consequence of the exclusive reliance on the RCT, empirical validation of psychological treatments has generally favoured cognitive-behavioural treatments, although there is ample evidence - albeit non-RCT - for the beneficial effects of short-term and long-term psychoanalytic treatment. The author argues for a suitability matching approach to empirical validation, where each treatment is tested, as powerfully as feasible, on samples based on selfselection (patient's choice, clinical assignment, suitability judgments etc.). The paper concludes by referring to two recent studies, indicating that there is reason to evaluate alleged empirical support with caution.     

Psychoanalysis in Austria after 1933-34

Our essay focuses on major developments of the history of psychoanalysis during the fascist and National Socialist years in Austria and sheds light on the re-establishment of psychoanalysis after World War II. With the consolidation of National Socialism in Germany in 1933 and Austro-fascism in 1934, any psychoanalytical reflection that was critical of political and cultural trends was extinguished. Vienna - once again - became the center of the psychoanalytical movement in Central Europe, taking over the role Berlin had played during the twenties. But, during the Austro-fascist system, psychoanalysis was isolated from an important part of its public. Psychoanalysts reacted by adopting an attitude of political abstinence, accompanied by self-censorship, they concentrated on training and clinical work, or they went into exile. Austria's Anschluß to the National Socialist Third Reich led to the final destruction of psychoanalysis. Nearly all Viennese analysts were affected by the anti-Jewish measures of the National Socialists and almost all of them fled the country. During the war years, a small group of people under the leadership of August Aichhorn tried to continue psychoanalytic training. Its members refounded the Viennese Psychoanalytical Society in early 1946. But, scientific traditions were broken and tendencies of anti-enlightenment, especially clerical and catholic prejudices, had continued from the time of Austrofascism and Nationalsocialism. The last chapter of our essay summarizes the research topics and the main historiographical studies done in the field.     

Psychoanalytic psychotherapy in paediatric liaison: a diagnostic and therapeutic tool

Paediatric liaison work requires an appreciation of the interweaving of the different factors involved when a child has physical symptoms. Psychoanalytic psychotherapy is usually viewed simply as a potential treatment option. This paper argues that its use is both therapeutic and diagnostic and that it should be valued for this breadth of contribution. The therapeutic process is conducted in a way that can promote an understanding of the child and their context and thus enhance the ability 9 to meet the child's needs by all involved in their care. This can be achieved without sacrificing the degree of privacy that the psychotherapist/patient relationship requires. Material is presented from the psychotherapy of a child who had an hereditary condition which moved unexpectedly into a terminal 2 phase after psychotherapy was started. Examples are given to illustrate the importance of the understanding gained from therapy and how, through an integrative process, it was used to assist the overall 4 care. The material also describes the potential diagnostic use of information from psychotherapy when this is formulated by consideration of conscious and unconscious mechanisms alongside mental state phenomenology. This has implications for the relationships between disciplines and for their training requirements.     

Treating Multidimensional Presenting Problems with a Mutually Integrative Approach Using the Genogram

The present article introduces a case study and describes a mutually integrative approach to treating a complex presenting problem. This article examines the specific issues surrounding integration when a supervisor and supervisee hold different theoretical perspectives. On occasion, such a relationship demands that the supervisee adhere to the model being taught by the supervisor. Examining integration in this format presents many advantages for both treatment and training. The key to the mutual integration is that two schools of psychotherapy can be combined in a way that creates a synergy; in that, together they are more powerful than either may be in isolation. A genogram with symbols from each model is incorporated to focus the treatment and create a format for the mutual integration.     

A few dissents from a magnificent piece of work

Despite enthusiastic agreement with most of Meehl’s paper, I dissent on “the idiographic problem” (as based on false premises), and on the goal of refuting theoretical propositions in soft psychology with any useful certainty (its generalizations are inescapably statistical, and Popper’s paradigm does not apply). Some implications for research, especially on psychoanalytic theory, are briefly outlined.     

Prayer as Therapeutic Process Toward Aliveness Within a Spiritual Direction Relationship

This article underscores the potential benefit of a specific form of Christian prayer that creates space within a spiritual direction relationship for the creation of inner images that reveal a person’s unconscious relational longings and co-created representations of God. In this specific type of prayer that can be facilitated by mental health professionals and pastoral counselors, imagery of God’s presence is created in the space between a Christian spiritual director and a Christian directee while they are open to inner experiences that reveal God’s presence interacting with infantile processes toward aliveness. Aliveness is understood using Winnicottian notions in dialog with theories proposed by Allan N. Schore, affective neuropsychologist and Clinical Faculty at UCLA David Geffen School of Medicine, Ann Belford Ulanov, Jungian Analyst and Professor of Psychiatry and Religion at Union Theological Seminary and W.R.D., British psychoanalyst in the Objects Relations School. Ideas of transitional space, good enough mother, holding environment, aggression, creativity, and play are set alongside theories of affect regulation, the developing brain, co-created objective God images, the relational nature of God and being received as good while illuminating three prayer experiences during one 30-year-old Asian American woman’s 16-month therapeutic process toward aliveness.

The uses of humor in life,neurosis and in psychotherapy: Part 2

Abstract

The first part of the paper focused on the dynamics of wit in life, literature, and psychoanalysis; the second part of this paper is devoted to the use of humor in therapy. The central concept is Freud's psychoanalytic method, as distinguished from Freud's various theories of disorder, or neurosis, with a further elaboration of Freud's inherently interpersonal conception of the analytic process, already present in the cathartic phase of the therapeutic technique. The cathartic, or discharge, function of humor is connected to reciprocal free association (a term coined by the author) to define the mutual and reciprocal free association in analysand and analyst, playing an essential role in the genesis of insight and interpretation. Humor has its role in loosening repression, facilitating the emergence of unconscious emotions and ideas, bringing to light character defenses, and thus driving the process of analysis.     

Brief communications from the edge: psychotherapy with challenging adolescents

Issues of technique in work with adolescents who, if adult, would attract a forensic label, are discussed with especial focus on interpretation and countertransference in the light of primitive anxieties and body-based mechanisms of defence. The therapist as 'new object' and 'developmental object' is explored. The case study of Matthew - a mid-adolescent who has abused a younger child, is delinquent, seeks violent and dangerous situations and experiences outbursts of aggression - is used as illustration throughout.