Social anxiety and fear of bodily sensations in panic disorder and agoraphobia: A matched comparison

This study tests the hypothesis that social anxiety and fear of bodily sensations are associated with the development of agoraphobic avoidance behavior in panic disorder patients. Twenty patients with panic disorder were compared to 20 patients with panic disorder with agoraphobia, matched by sex and duration of disorder. The two groups did not differ on measures of fear and frequency of assertive social responses. However, the agoraphobics scored higher on measures of interpersonal sensitivity, depression, feelings of inadequacy, and hostility. They also reported higher fear of bodily sensations. Although definitive conclusions need to be postponed until prospective studies have been conducted, there is evidence suggesting that the development of agoraphobia in panic patients is associated with hypersensitivity to bodily sensations and interpersonal situations.This research was supported by Grant 560-268-009 of the Dutch Organization for Scientific Research.     

Art, dreams and active imagination: a post-Jungian approach to transference and the image

The term active imagination is sometimes applied rather uncritically to describe all forms of creative activity that take place in depth psychology. Whilst there are many forms of expression that evoke or are evoked by active imagination, they cannot automatically be classed as active imagination. In this article investigation of visualized mental imagery, dreams and art reveals three distinct forms of image-based psychological activity. Integrated and mediated within the transference and countertransference dynamic, it is proposed that the engagement in active imagination reflects and is influenced by the transference. Distinctions between sign and symbol, simple and big dreams as well as diagrammatic and embodied imagery clarify the differences. Examples from clinical practice demonstrate each mode in action within the analytic frame.     

Is transference the ‘total situation’?

This paper examines through the detailed explication of analytic material the author's experience of a psychoanalytic and a Jungian way of understanding the interactions between him and his patient. This comparative approach considers where the differences lie with respect to timing and content of interpretations and where the differences are essentially tactical rather than theoretical.     

Confidentiality and paradox: the location of ethical space

Implicit in Jung's alchemical metaphor of the vas bene clausum is the idea of an analytic frame with a space inside it for something vital, a relationship between two selves, to develop. For this to happen, analysts must respect their patients' rights to confidentiality. The paper explores the analyst's state of mind and the intrapsychic processes that are constellated when struggling with ethical dilemmas about issues of confidentiality in analytic work. The author suggests that at times when analysts consider breaking confidentiality, there is often a disturbing inner conflict between their moral principles (codes of ethics) and their internal personal ethical attitude. At these difficult moments, the mutuality of the work and the vas bene clausum can be significantly disrupted. The analyst tries to find a third position, a mental and emotional ethical space where the subjective and the objective, the ethical and the unethical can become more companionable bedfellows.     

Dreaming the other's past: Why remembering may still be relevant to psychoanalytic therapy,at least in some traditions

Against the background of a reconstruction of the reasons for the vanishing role of remembering in the history of psychoanalysis, Botella's (2014, Int J Psychoanal, 95 ) arguments regarding the therapeutic significance of reconstruction and remembering and of the therapist's role are discussed. The difference between intellectual reconstruction and actual emotional remembering are underlined, the term regredience is compared to competing concepts such as equally suspended attention, countertransference and reverie. It is argued that to conceptualize the use of countertransferential associations for reconstructing past traumatic events is difficult with a monadic conception of the unconscious and problematic both in terms of truth claims and in terms of achieving a shared creative atmosphere in which therapist and patient participate alike. It is concluded that historical truth may be important for traumatic experiences, and that biographical reconstruction and change in the subjective life story help to make sense of neurotic patterns and integrate diachronic identity.     

The body of the analyst and the analytic setting: Reflections on the embodied setting and the symbiotic transference

In this paper the author questions whether the body of the analyst may be helpfully conceptualized as an embodied feature of the setting and suggests that this may be especially helpful for understanding patients who develop a symbiotic transference and for whom any variance in the analyst's body is felt to be profoundly destabilizing. In such cases the patient needs to relate to the body of the analyst concretely and exclusively as a setting ‘constant’ and its meaning for the patient may thus remain inaccessible to analysis for a long time. When the separateness of the body of the analyst reaches the patient's awareness because of changes in the analyst's appearance or bodily state, it then mobilizes primitive anxieties in the patient. It is only when the body of the analyst can become a dynamic variable between them (i.e. part of the process) that it can be used by the patient to further the exploration of their own mind.     

An overview of the treatment of severe narcissistic pathology

This paper provides an overview of narcissistic personality disorders as they present clinically along a spectrum of severity ranging from the best functioning forms of pathological narcissism to the most threatening to the patient's psychosocial and physical survival. It proposes a general interpretive psychoanalytic stance with all these clinical syndromes that range from standard psychoanalysis to a specific psychoanalytical psychotherapy for the most repressive and life threatening conditions that may not respond to standard psychoanalysis proper. This general psychoanalytic approach is placed into the context of related developments in contemporary psychoanalytic understanding of pathological narcissism and its treatment.     

Burial and resurgence of projective identification in French psychoanalysis

Curiously enough, the concept of projective identification was ignored, and even rejected in France for at least two decades after the publication of the founding texts of Melanie Klein and Herbert Rosenfeld. This rejection was due to a critique from child psychoanalysts close to Anna Freud and also from the teaching of Lacan: the first took the real mother–child relation extensively into account, while the latter only saw the internal object as a signifier. The fact that during this period the countertransference was a concept reduced to its negative content no doubt explains this deliberate ignorance. With the dissemination of a broader and more positive conception of the countertransference, a renewal of interest could be observed in the 1980s with references to empathic listening and to the effects of thought‐induction.     

Learning from the patient: The East,synchronicity and transference in the history of an unknown case of C.G. Jung

This article presents the history of one until now unknown case of C.G. Jung: Maggy Reichstein. Born in Indonesia in 1894 in a very aristocratic family, she brought her sister to Zurich to be treated by Jung in 1919, and later she herself was in analysis with him. Jung used her case as example in his lecture in 1937 on the realities of practical psychotherapy, relating it to the process of transference and countertransference. Jung deepened his studies in Eastern psychology after a series of dreams she had, which culminated in the Yoga Kundalini Seminars. She was also the case presented in his article of 1951 on the concept of synchronicity. Jung wrote that her case, concerning synchronicity, remained unique in his experience. Jung also published some of her mandalas. He considered her able to understand his ideas in depth. Reichstein was for Jung an important case, which challenged and triggered his interests in different subjects.     

The Countertransference Experiences of Pregnant Counselors Working With Sex Offenders

Using a phenomenological approach, the authors explored the lived experiences of female counselors who were pregnant during the course of providing clinical services to sex offenders. Themes included awareness of countertransference, emotional distress, safety concerns, and clinical objectivity.