This target article focuses on dynamics that arise in three typical ethically complex cases in which psychiatric consultations are requested by physicians: a dying patient refuses life-prolonging treatment, an uncooperative patient demands to be allowed to go outside and smoke, and an angry patient demands to be admitted to the hospital. The discussion canvasses what is at stake morally and clinically in each of these cases and explores clinician–patient interactions, dynamics in relationships between consulting physicians and consultant psychiatrists, patient transference, (...) and physician countertransference. The article defines legalism and countertransference and argues that an ethically and clinically important consequence of these phenomena for patients is distortion of clinicians' perceptions of patients' decisions and vulnerabilities. The discussion also describes how legalism and countertransference adversely affect how clinicians treat their psychiatrist colleagues. Finally, the article suggests how the effects of legalism and countertransference can be mitigated. (shrink)

To stress the subjectivity of the analyst is to accept the centrality of countertransference in the analytic relationship. Psychoanalysts have long recognized the importance of transference in the analytic setting—that is, the analysand's way of relating to the analyst in terms of his strong, ambivalent unconscious feelings for earlier figures , a process whose successful resolution constitutes the psychoanalystic "cure." But, since the patient's transference is only experienced by the analyst through his countertransference responses, recent theorists have come (...) to emphasize the importance of countertransference in psychoanalysis. In what Otto Kernberg calls its "totalistic" definition, countertransference refers to "the total emotional reaction of the psychoanalyst to the patient in the treatment situation."1 It is, therefore, a source of both empathic understanding and defensive misunderstanding, of distortion and insight. Hans Loewald remarks: "Since a psychoanalytic investigation can be carried out only by a human mind, we cannot conceive of one in which the analyst's [counter] transference and resistance are not the warp and woof of his activity."2 · 1. Otto Kernberg, Borderline Conditions and Pathological Narcissism , p. 49. · 2. Hans Loewald, "Psychoanalytic Theory and the Psychoanalytic Process," The Psychoanalytic Study of the Child 25 : 56. Cf. Heinz Kohut, "Introspection, Empathy, and Psychoanalysis," Journal of the American Psychoanalytic Association 7 : 459-83. For a clear discussion of the background of the countertransference concept in Freud, see Humberto Nagera, et. al., Basic Psychoanalytic Concepts on Metapsychology, Conflicts, Anxiety and Other Subjects , pp. 200-206. Two surveys of the literature on the topic are particularly useful: Douglas Orr, "Transference and Countertransference: A Historical Survey," Journal of the American Psychoanalytic Association 2 : 621-70, and Kernberg, pp. 49-66. Arthur F. Marotti, associate professor of English at Wayne State University, has written a number of essays on Ben Jonson, John Donne, Thomas Middleton, and Edmund Spenser. He is completing a book-length social-historical and psychoanalytic study of Donne's poetry and a book on Jonson; some of the theoretical assumptions behind both projects are discussed in this article. See also: "Psychoanalysis and the Marionette Theater: Interpretation is Not Depreciation" in Vol. 5, No. 1. (shrink)

In recent years, memories and reconstructions of incestuous child abuse have become common features of psychoanalytic treatment. Among some clinicians, such abuse is suspected even when there is little evidence. How does the analyst distinguish between incest real and imagined, and how do recovered memories of incest affect the analyst? In this poignant and beautifully written study, Elaine Siegel brings new insights to bear on these timely questions. An inveterate note taker, she discloses the countertransferential ruminations and associations to the (...) occurrence of incest at various stages during the treatment process over the course of 30 years of clinical work. The manner in which her "analytic instrument" evolved and was shaped by her analysands' stories makes for a fascinating subtext in a book that addresses itself to the differences and similarities during treatment of real and imagined incestuous abuse. Among the powrfully disturbing clinical cases at the heart of this study are two reports detailing the lengthy analyses of women who found corroboration for multigenerational incest. Siegel also presents two cases in which patients retracted their claims of incest toward the end of their treatments. Through the medium of these and other reports, Siegel explores how psychoanalysts are struggling both to understand incestuous abuse and to accomodate their treatment techniques to shifting societal perspectives. (shrink)

_Winner of the 2009 Goethe Award for Psychoanalytic Scholarship!_ Irwin Hirsch, author of _Coasting in the Countertransference,_ asserts that countertransference experience always has the potential to be used productively to benefit patients. However, he also observes that it is not unusual for analysts to 'coast' in their countertransferences, and to not use this experience to help treatment progress toward reaching patients' and analysts' stated analytic goals. He believes that it is quite common that analysts who have some conscious (...) awareness of a problematic aspect of countertransference participation, or of a mutual enactment, nevertheless do nothing to change that participation and to use their awareness to move the therapy forward. Instead, analysts may prefer to maintain what has developed into perhaps a mutually comfortable equilibrium in the treatment, possibly rationalizing that the patient is not yet ready to deal with any potential disruption that a more active use of countertransference might precipitate. This 'coasting' is emblematic of what Hirsch believes to be an ever present conflict between analysts’ self-interest and pursuit of comfortable equilibrium, and what may be ideal for patients’ achievement of analytic aims. The acknowledgment of the power of analysts’ self-interest further highlights the contemporary view of a truly two-person psychology conception of psychoanalytic praxis. Analysts’ embrace of their selfish pursuit of comfortable equilibrium reflects both an acknowledgment of the analyst as a flawed other, and a potential willingness to abandon elements of self-interest for the greater good of the therapeutic project. (shrink)

In the years since the publication of _The Wounded Healer_, countertransference has become a central consideration in the analytic process. David Sedgwick’s work was ground-breaking in tackling this difficult topic from a Jungian perspective and demonstrating how countertransference can be used in positive ways. Sedgwick’s extended study of the process candidly presents the analyst’s struggles and shows how the analyst is, as Jung said, "as much in the analysis as the patient". The book extends Jung’s prescient work on (...) countertransference to create a dynamic view of the analyst-patient interaction, stressing the importance of the analyst’s own woundedness and how this may be used in conjunction with the patient’s own. Sedgwick begins with a discussion of the need and justification for a Jungian approach to countertransference, then reviews Jungian theories and presents detailed illustrations of cases showing the complexity of transference-countertransference processes in both the patient and the analyst, and concludes with a model of countertransference processing. This Classic Edition also includes a new introduction by the author. It will be an important work for Jungian analysts, psychotherapists and other clinicians and students interested in the struggles of the therapeutic process. (shrink)

Since its inception in the 1900s, the concept of countertransference has been mired in controversy. Psychoanalytic literature is divided on its utility, significance and its clinical value in psychotherapy. While some psychotherapists have advocated for the importance of therapists’ expertise in the comprehension and processing of countertransference dynamics in the treatment of sexually abused children, others see no value in competency in countertransference in trauma treatment of sexually abused children. The purpose of this article is to explore (...) whether countertransference is a useful therapeutic tool, or a hindrance in the treatment of sexually abused children. A qualitative paradigm, particularly interpretative phenomenology, was employed in this research to make meaning of the therapists’ experiences. The analysis of the results revealed the following five main themes that were supported by 18 superordinate themes. These themes reveal that therapists treating sexually abused children experience a myriad of feelings, including a) feeling emotionally overwhelmed, b) anger toward perpetrators and the need to protect and rescue their patients, c) the importance of social support and self-healing, d) feelings of empathy and identification with the client, and e) erotic countertransference. These findings reveal two contradictory findings. Firstly, they tell of variable utilisation of countertransference among participants and, secondly, they highlight a lack of application of countertransference in the treatment of sexually abused children. The implications of the current study are that there is a need to both highlight the importance of countertransference as a therapeutic tool and to incorporate it in the treatment of sexually abused children. (shrink)

The field, as Steven Cooper describes it, is comprised of the inextricably related worlds of internalized object relations and interpersonal interaction. Furthermore, the analytic dyad is neither static nor smooth sailing. Eventually, the rigorous work of psychoanalysis will offer a fraught opportunity to work through the most disturbing elements of a patient's inner life as expressed and experienced by the analyst - indeed, a disturbance in the field. How best to proceed when such tricky yet altogether common therapeutic situations arise, (...) and what aspects of transference/countertransference should be explored in the service of continued, productive analysis? These are two of the questions that Steven Cooper explores in this far-ranging collection of essays on potentially thorny areas of the craft. His essays try to locate some of the most ineffable types of situations for the analyst to take up with patients, such as the underlying grandiosity of self-criticism; the problems of too much congruence between what patients fantasize about and analysts wish to provide; and the importance of analyzing hostile and aggressive aspects of erotic transference. He also tries to turn inside-out the complexity of hostile transference and countertransference phenomena to find out more about what our patients are looking for and repudiating. Finally, Cooper raises questions about some of our conventional definitions of what constitutes the psychoanalytic process. Provocatively, he takes up the analyst's countertransference to the psychoanalytic method itself, including his responsibility and sources of gratification in the work. It is at once a deeply clinical book and one that takes a post-tribal approach to psychoanalytic theory - relational, contemporary Kleinian, and contemporary Freudian analysts alike will find much to think about and debate here. (shrink)

Clinical supervision provides the foundation for cultivating ethical practice and professionalism for mental health trainees. Exploration and management of a supervisee’s personal reactivity or countertransference is a critical component of supervision and has clear ethical implications for clinical management and the development of clinical competence. This article discusses supervision practice and presents the results of a study that investigated the influence of supervisor–supervisee relationship on clinical and counseling doctoral students’ CT disclosures. Respondents completed the Working Alliance Inventory–Supervisee form and (...) the Personal Reaction Disclosure Questionnaire, which assessed respondents’ comfort and likelihood of reporting CT reactions to hypothetical clinical interactions. Results of this analogue study demonstrated positive associations between supervisory alliance and reported comfort and likelihood of CT disclosures, highlighting the importance of the alliance and drawing attention to supervisors their responsibility to particularly attend to the bond dimension of the relationship. (shrink)

Mental health chatbots (MHCBs) designed to support individuals in coping with mental health issues are rapidly advancing. Currently, these MHCBs are predominantly used in commercial rather than clinical contexts, but this might change soon. The question is whether this use is ethically desirable. This paper addresses a critical yet understudied concern: assuming that MHCBs cannot have genuine emotions, how this assumption may affect psychotherapy, and consequently the quality of treatment outcomes. We argue that if MHCBs lack emotions, they cannot have (...) genuine (affective) empathy or utilise countertransference. Consequently, this gives reason to worry that MHCBs are (a) more liable to harm and (b) less likely to benefit patients than human therapists. We discuss some responses to this worry and conclude that further empirical research is necessary to determine whether these worries are valid. We conclude that, even if these worries are valid, it does not mean that we should never use MHCBs. By discussing the broader ethical debate on the clinical use of chatbots, we point towards how further research can help us establish ethical boundaries for how we should use mental health chatbots. (shrink)

This article reflects on pivotal concepts of psychoanalytic practice and theory, applied to a single case study to create new meanings. Drawing from the concepts of transference, countertransference, and projective identification, the author presents the notion that the researcher's subjective reactions are created and induced by the subject of study precisely because this is one, and sometimes the only way available to the subject to communicate something that is out of its full awareness. In essence, some unconscious material can (...) be expressed nonverbally by the subject by means of provoking visceral and bodily reactions in the researcher, or in some cases, psychic imagery such as dreams or fantasies. The material can be meaningfully interpreted by the researcher by receiving, containing, and sorting through these inchoate emotional reactions within self. (shrink)

A major theme in recent psychoanalytic thinking concerns the use of therapist subjectivity, especially "countertransference," in understanding patients. This thinking converges with and expands developments in qualitative research regarding the use of researcher subjectivity as a tool to understanding, especially but not exclusively in observational and interview-based studies. Psychodynamic or psychoanalytic approaches to research add an emphasis on unconscious motivational processes in both researchers and research participants that impact research experience and data. Building upon Anglo-Saxon and continental traditions, this (...) special issue provides examples of the use of researcher subjectivity, informed by psychoanalytic thinking, in expanding research understanding. (shrink)

In this powerful and wonderfully accessible meditation on psychoanalysis, hermeneutics, and social constructivism, Donnel Stern explores the relationship between two fundamental kinds of experience: explicit verbal reflection and "unformulated experience," or experience we have not yet reflected on and put into words. Stern is especially concerned with the process by which we come to formulate the unformulated. It is not an instrumental task, he holds, but one that requires openness and curiosity; the result of the process is not accuracy alone, (...) but experience that is deeply felt and fully imagined. Stern's sense of explicit verbal experience as continuously constructed and emergent leads to a central dialectic at the heart of his work: that between curiosity and imagination, on one hand, and dissociation and unthinking acceptance of the familiar on the other. The goal of psychoanalytic work, he holds, is the freedom to be curious, whereas defense signifies the denial of this freedom. We defend against our fear of what we would think, that is, if we allowed ourselves the freedom to think it. Stern also shows how the unconscious itself can be reconceptualized hermeneutically, and he goes on to explore the implications of this viewpoint on interpretation and countertransference. He is especially persuasive in showing how the interpersonal field, which is continuously in flux, limits the experience that it is possible for participants to reflect on. Thus it is that analyst and patient are together "caught in the grip of the field," often unable to see the kind of relatedness in which they are mutually involved. A brilliant demonstration of the clinical consequentiality of hermeneutic thinking, _Unformulated Experience_ bears out Stern's belief that psychoanalysis is as much about the revelation of the new in experience as it is about the discovery of the old. (shrink)

Despite Carl Jung’s stated debts to Kant, Nietzsche and Schopenhauer, this paper articulates a more profound yet silent intellectual partnership between Schelling’s philosophy and analytical psychology. Schelling’s metaphysics navigate the aporias Jung often encounters in his psychology; Jung provides Schelling’s metaphysics with a therapeutics and mode of being in the world. This paper reads the actants’ dynamism in Schelling’s First Outline and the potencies' work of yearning in the 1815 Ages of the World forward to Jungian metapsychology, which thinks Schelling (...) within a topography of the non-Freudian productive psyche. I end by developing the Romantic metasubject as the non-Freudian subject emerging from this ideational countertransference. (shrink)

In the context of the socio-political instability that exists in Ukraine, the problem of stress resistance among psychological service professionals has emerged. The aim of the research is to analyse the professional activity of psychologists in Ukraine at the present stage under the influence of stress factors. The following methods were used to study the nature of stress and its impact on the personality of a psychologist: analytical and synthesis methods, statistical, comparative, survey and interpretive methods. The research results theoretically (...) reveal the peculiarities of the concept of stress, the stages of stress development, and identify the main stressors of professional activity. An empirical study of the stress resistance of psychologists was conducted. The influence of stress on the quality of psychological care was determined. Professional qualities in the psychologist's personality structure were identified, the phenomenon of professional exhaustion, the role of countertransference in counselling were studied, the importance of the code of ethics for psychologists and its violation in the course of practice were revealed. The importance of interventions and supervision as a means of psychological support for the professional development of psychologists was investigated, and statistical indicators of the level of stress were analysed. The practical significance of the research is determined by the current coverage of the problem of the impact of stress on the professional activity of a psychologist and in the creation of effective ways of emotional self-preservation and development of stress resistance, which provide the search for their resources for self-healing and effective work. (shrink)

Pluralism can bridge the gaps that have opened up between personal experience, psychotherapy, and cultural criticism. In _The Plural Psyche: Personality, Morality and the Father_, a provocative, much praised and widely discussed book, Andrew Samuels lays bare the political implications of the personal struggle everyone has to hold their many inner divisions together. He also shows how pluralism can inspire new thinking in many areas including moral process, the construction of gender, and the role of the father in the development (...) of sons and daughters. In addition, there are innovative chapters on clinical work, focusing on imagery and on countertransference. These themes come to life in a way that makes a significant contribution to debates about psychotherapy, gender, parenting and difference. This Classic Edition of _The Plural Psyche _includes a new introduction by the author. (shrink)

One of the foundational texts of interpersonal psychoanalysis, _Prelogical Experience_ is a pioneering attempt to elaborate an interpersonal theory of personality that encompasses the nonpropositional, nonverbal dimension of human experience. Prelogical processes, the authors hold, cannot be consigned to infancy; rather they shape experience throughout life and are especially salient in relation to dreams, emotion, perception, and the arts. Of special note is Tauber and Green's elaboration of the clinical situation that grows out of an appreciation of prelogical experience. In (...) a striking anticipation of contemporary thinking, they approach patient-therapist interaction in terms of the continuous exchange of "presentational data" by patient and analyst. These data enable patient and therapist alike to "know" more about the other than can ever be expressed in propositional terms. This perspective assigns an important role to what Piaget would term "the cognitive unconscious" in the clinical process. It likewise sustains a view of the countertransference - which includes the analyst's own dreams - as a vital source of presentational data about the patient. As Donnel Stern notes in his Introduction, these and other insights "amount to a surprisingly contemporary description of psychoanalytic treatment.". (shrink)

Preface : how and why the stories came to be -- Introduction : self-deception and red flags -- Sammy meets the wolf : meet the characters who will decide the cases -- I'm not your monkey : loss of control with a difficult client -- Junk yard therapy : self-delusion and exploitation -- Rats! : warring colleagues -- The John : a predator at work and play -- The raid on Hollywood Boulevard : the professional role vs. the right to (...) a private life -- Kill the boss : when clients threaten physical harm -- Broken : Bartering gone bad -- Baby steps off a cliff : the slippery slope to sexual exploitation -- Car crash : a simple disclosure with unforeseen consequences -- Mad FAX : what not to do when clients don't pay -- The star catcher : the undoing of a troubled psychotherapist -- Vampire : Countertransference exploding -- Epilogue : a transformed Dr. Halsey goes home. (shrink)

The well-being of learning and of being taught is a fundamental question that can arise for school teachers. When is this questioning good for teachers. We will analyze the memories of students from 2016 to 2021 in order to highlight the specificities of appropriation of this question of the good for future school teachers. We will compare the pre-health crisis to the research conducted during this crisis. By the methodology of the textometric analysis of memories and by the analysis of (...) the countertransference elements of the teacher-researchers, we will seek to specify the blocking points and the blind zones linked to the anxieties around this notion of the well-being to be learned and to teach. (shrink)

Building on the success and importance of three previous volumes, _Relational Psychoanalysis_ continues to expand and develop the relational turn. Under the keen editorship of Lewis Aron and Adrienne Harris, and comprised of the contributions of many of the leading voices in the relational world, _Volume 5_ carries on the legacy of this rich and diversified psychoanalytic approach by taking a fresh look at the progress in therapeutic process. Included here are chapters on transference and countertransference, engagement, dissociation and (...) self-states, analytic impasses, privacy and disclosure, enactments, improvisation, development, and more. Thoughtful, capacious, and integrative, this new volume places the leading edge of relational thought close at hand, and pushes the boundaries of the relational turn that much closer to the horizon. Contributors: Lewis Aron, Anthony Bass, Beatrice Beebe, Philip Bromberg, Steven Cooper, Jody Messler Davies, Darlene Ehrenberg, Dianne Elise, Glen Gabbard, Adrienne Harris, Irwin Hoffman, Steven Knoblauch, Thomas Ogden, Spyros Orfanos, Stuart Pizer, Philip Ringstrom, Jill Salberg, Stephen Seligman, Joyce Slochower, Donnel Stern, Paul Wachtel. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Desire of the Analysts: Psychoanalysis and Cultural CriticismVera J. Camden (bio)Desire of the Analysts: Psychoanalysis and Cultural Criticism. Ed. Greg Forter and Paul Allen Miller. New York: SUNY P, 2008. 258 pp.This collection takes up the uses of psychoanalysis for cultural studies in the new millennium. Its editors and contributors ask, “Where is psychoanalysis in contemporary thought?” At a time when the empirically based psychologies have long repudiated (...) the “talking cure” to the extent that the unconscious is not visible or easily measured, and when, on the other hand, psychoanalysis has been associated in the humanities with a radical political and social agenda, disappointed hopes for change have led many to throw the baby of psychoanalysis out with the bathwater of a utopian vision of transformation. The question now remains: “Whither psychoanalysis?” To answer this question (which is also a demand), the editors first acknowledge that the critique and curtailing of psychoanalytic thought in the cultural studies programs across the country in the last decade or so has been influenced by the works of Michel Foucault, his disciples, and the New Historicism. At the same time, they believe that the political, psychological, and moral dangers of embracing a knowing and cynical postmodernism that fosters hollow consumerism premised on modes of subjectivity that “neither ‘express’ interiority nor bear any relation to a lived past” are a real and present danger in contemporary life. “That the triumph of such a view has coincided with intellectuals’ renewed suspicion of psychoanalysis should, we believe, give us pause” (8). The essays that constitute the present volume thus insist on the persistence of the desire of the analyst: for knowledge of self and other, and by those who long for interpretive insight into interior lives and social places. The volume thus poses for its readers twin questions: “Why do we continue to desire psychoanalysis, and what should its role be in the cultural criticism of the new millennium?”This collection grew out of a conference organized around this question and thus reflects the varied but not necessarily interconnected papers offered in that setting. In an effort to provide some interconnections, the collection is divided into four sections grouped around the topics of psychoanalysis and the future of cultural criticism, collectivity, the author, and sexuality. The grouping does not, in my estimation, provide unity or coherence to the volume as a whole; nevertheless, each article emerges on its own terms as a strong contribution to the general field of psychoanalytic cultural criticism and critical theory. Henry Sussman’s “Psychoanalysis, Religion, and Cultural Criticism at the Millennium” provides an anchoring perspective to the volume, addressing with particular urgency the mutually transformative desire of and for analysis modeled on the transference/countertransference clinical encounter. This analogy [End Page 153] suggestively sets the stage for a like transformative intervention by the analyst in a cultural critique, while acknowledging that cultural studies provides the best interpretation and assessment of the ways that psychoanalysis operates historically and clinically in contemporary society. Sussman—and indeed many of the contributors—underscores the editors’ organizing declaration that since psychoanalysis derived from lived human experience it stands to reason that “analysis is both the product of and answer to suffering” (15).Thus it comes as something of a surprise that one of its editors, Greg Forter, in “F. Scott Fitzgerald, Psychobiography, and the Fin-de-Siecle Crisis in Masculinity,” locks the subject of psychoanalysis into a stranglehold with his presuppositions about the limits of history and the origins of psychoanalysis in the modern moment: “Because the theory and techniques of psychoanalysis were developed by analyzing modern men and women, psychoanalysis may be a theory of modern subjectivity rather than of subjectivity as such, and its mode of inquiry may be best suited to analyzing the phenomena of modernity” (148). Contrast this limiting and limited sense of the place of psychoanalysis in history (and the concomitant restriction of its utility expressed ironically in a volume with two major articles on premodern cultural texts!) to recent remarks in a new book by Christopher Bollas: “For thousands of years there has been an unconscious preconception of psychoanalysis. We [...] human beings [...] have been searching for... (shrink)

In this remarkable survey of "the communicative repertory of humans," John Gedo demonstrates the central importance to theory and therapeutics of the communication of information. He begins by surveying those modes of communication encountered in psychoanalysis that go beyond the lexical meaning of verbal dialogue, including "the music of speech," various protolinguistic phenomena, and the language of the body. Then, turning to the analytic dialogue, Gedo explores the implications of these alternative modes of communication for psychoanalytic technique. Individual chapters focus, (...) in turn, on the creation of a "shared language" between analyst and analysand, the consequences of the analytic setting, the form in which the analyst casts particular interventions, the curative limits of empathy, the analyst's affectivity and its communication to the patient, and the semiotic significance of countertransference and projective identification. Gedo does not proffer semiotics as a substitute for metapsychology. He is explicit that communicative skill is always dependdent on somatic events within the central nervous system. Indeed, it is because Gedo's hierarchical approach to communication builds on our current understanding of a hierarchically organized central nervous system that his clincal observations become insights into basic psychobiological functioning. Grounded in Gedo's four decades of clinical experience, _The Languages of Psychoanalysis_ points to a new venue of clinical research and conceptualization, one in which attentiveness to issues of communication will not only foster linkages with contemporary neuroscience, but also clarify and enlarge the therapeutic possibilities of psychoanalytic treatment. (shrink)

The tenth volume in the Progress in Self Psychology series begins with four timely assessments of the selfobject concept, followed by a section of clinical papers that span the topics of homosexuality, alter ego countertransference, hypnosis, trauma, dream theory, and intersubjective approaches to conjoint therapy. Section III, "A Dialogue of Self Psychology," offers Merton Gill's astute appreciation of "Heinz Kohut's Self Psychology," followed by commentaries by Leider and Stolorow and Gill's reply. The concluding section offers Stolorow and Atwood's "The (...) Myth of the Isolated Mind," followed by discussions by Gehrie and the Shanes. A forum for the kind of spirited, productive exchanges that have long found a home within the self-psychological community, _A Decade of Progress_ builds on the past in responding to the theoretical and clinical challenges of the present. (shrink)

Volume 12 of the Progress in Self Psychology series begins with reassessments of frustration and responsiveness, optimal and otherwise, by MacIsaac, Bacal and Thomson, the Shanes, and Doctors. The philosophical dimension of self psychology is addressed by Riker, who looks at Kohut's bipolar theory of the self, and Kriegman, who examines the subjectivism-objectivism dialectic in self psychology from the standpoint of evolutionary biology. Clinical studies focus on self- and mutual regulation in relation to therapeutic action, countertransference and the curative (...) process, and the consequences of the negative selfobject in early character formation. A separate section of child studies includes a case study exemplifying a self-psychological approach to child therapy and an examination of pathological adaptation to childhood parent loss. With a concluding section of richly varied studies in applied self psychology, _Basic Ideas Reconsidered_ promises to be basic reading for all students of contemporary self psychology. (shrink)

_Dreaming the Myth Onwards_ shows how a revised appreciation of myth can enrich our daily lives, our psychological awareness, and our human relationships. Lucy Huskinson and her contributors explore the interplay between myth, and Jungian thought and practice, demonstrating the philosophical and psychological principles that underlie our experience of psyche and world. Contributors from multi-disciplinary backgrounds throughout the world come together to assess the contemporary relevance of myth, in terms of its utility, its effectual position within Jungian theory and practice, (...) and as a general approach for making sense of life. As well as examining the more conscious facets of myth, this volume discusses the unconscious psychodynamic "processes of myth", including active imagination, transference, and countertransference, to illustrate just how these mythic phenomena give meaning to Jungian theory and therapeutic experience. This rigorous and scholarly analysis showcases fresh readings of central Jungian concepts, updated in accordance with shifts in the cultural and epistemological concerns of contemporary Western consciousness. _Dreaming the Myth Onwards_ will be essential reading for practicing analysts and academics in the field of the arts and social sciences. (shrink)

The question of how psychoanalysts are affected by their patients is of perennial interest. Edward Glover posed the question in an informal survey in 1940, but little came of his efforts. Now, more than half a century later, Judy Kantrowitz rigorously explores this issue on the basis of a unique research project that obtained data from 399 fully trained analysts. These survey responses included 194 reported clinical examples and 26 extended case commentaries on analyst change. Kantrowitz begins _The Patient's Impact (...) on the Analyst_ by documenting how the process of analysis fosters an interactional process out of which patient and analyst alike experience therapeutic effects. Then, drawing on the clinical examples provided by her survey respondents, she offers a detailed exploration of the ways in which clinically triggered self-reflection represents a continuation of the analyst's own personal understanding and growth. Finally, she incorporates these research findings into theoretical reflections on how analysts obtain and integrate self-knowledge in the course of their ongoing clinical work. This book is a pioneering effort to understand the therapeutic process from the perspective of its impact on the analyst. It provides an enlarged framework of comprehension for recent discussions of self-analysis, countertransference, interaction, and mutuality in the analytic process. Combining a wealth of experiential insight with thoughtful commentary and synthesis, it will sharpen analysts' awareness of how they work and how they are affected by their work. (shrink)

Using Kohut's seminal paper "Forms and Transformations of Narcissism" as a springboard, Frank Lachmann updates Kohut's proposals for contemporary clinicians. _Transforming Narcissism: Reflections on Empathy, Humor, and Expectations _draws on a wide range of contributions from empirical infant research, psychoanalytic and psychotherapeutic practice, social psychology, and autobiographies of creative artists to expand and modify Kohut's proposition that archaic narcissism is transformed in the course of development or through treatment into empathy, humor, creativity, an acceptance of transience and wisdom. He asserts (...) that empathy, humor, and creativity are not the goals or end products of transformations, but are an intrinsic part of the ongoing therapist-patient dialogue throughout treatment. The transformative process is bidirectional, impacting both patient and therapist, and their affect undergoes transformation - for example from detached to intimate - and narcissism or self-states are transformed secondarily as a consequence of the affective interactions. Meeting or violating expectations of emotional responsivity provides a major pathway for transformation of affect. For beginning therapists, _Transforming Narcissism_ presents an engaging approach to treatment that incorporates the therapeutic action of these transformations, but also leaves room for therapists to develop styles of their own. For more experienced therapists, it fills a conceptual and clinical gap, provides a scaffold for crucial aspects of treatment that are often unacknowledged, or are dismissed and pejoratively labeled "countertransference." Most importantly, Lachmann offers a balance between therapeutic spontaneity and professional constraint. Focused and engaging, _Transforming Narcissism_ provides a bridge from self psychology to a rainbow of relational approaches that beginning and seasoned therapists can profitably traverse in either direction. Dr. Lachmann contributed to an article on empathy in the April, 2008 issue of _O_ magazine, pp. 230. (shrink)

Addresses the issue of transference from a Lacanian perspective and discusses the implications which transference has in working with criminal clients. The article begins by briefly discussing the constitution of Lacanian subjectivity which includes a discussion of J. Lacan's concepts of the imaginary and symbolic orders. The idea of transference is then situated between the play of the imaginary and symbolic orders which constantly asks the question, what does the Other want. This question is especially important in the therapeutic work (...) with criminal Ss, and reveals certain countertransference possibilities which when left unexplored, can greatly threaten the success of the treatment. 2012 APA, all rights reserved). (shrink)

Psychobiography has been a topical area and an applied research specialty in psychology since Freud’s (1910/1989) influential psychoanalytic psychobiography of Leonardo da Vinci. Throughout the last century, psychobiographers have emphasized the importance of anchoring interpretations of life histories in established psychological theories and rigorous historiographic research methods. One topical area receiving less attention in psychobiography is the critical relationship between the psychobiographer and her or his subject as it relates to the process of psychobiographical writing. The present article explores the (...) phenomenology and challenges of this relationship in order to ultimately propose practical strategies for navigating countertransference issues throughout the subject selection, research and publication phases of psychobiography. Freud’s psychobiography of Leonardo da Vinci is used as a model of the stages of psychobiography, the evolution of the psychobiographer-subject relationship, and the challenges of countertransference. (shrink)

Objective: The present work aims to conduct the first naturalistic empirical investigation of the process and outcome assessment of functional psychotherapy treatment. The FP model of psychotherapy is rooted in psychoanalysis and integrates the verbal communication approach founded on transference and countertransference dynamics with the analysis of bodily processes.Method: The study sample included ten patients recruited on a voluntary basis and treated by clinicians in their private practices. Each patient received FP with an average duration of 40 h. Therapies (...) had weekly sessions, were audio-recorded with the patient’s written consent, and lasted for an average of 10 months. Outcome and process tools included the Minnesota Multiphasic Personality Inventory-2 and the Luborsky’s the Core Conflictual Relationship Theme, used to assess therapeutic benefit, and the Metacognition Assessment Scale and the Italian Discourse Attributes Analysis Program system, used to evaluate therapeutic benefit and process. The MMPI-2 was used also in the follow-up assessment.Results: Results show that FP had a positive therapeutic outcome on the patients assessed in this study, and that the therapeutic benefits were maintained over time. Some specific features of the FP approach were found to contribute more than others to the observed therapeutic benefits.Conclusion: The current investigation constitutes a first step toward assessment of the therapeutic effectiveness of FP. Future developments should apply the methodology to a larger sample, possibly introducing different methodologies to enable detection of specific bodily oriented processes and techniques. (shrink)

Although psychoanalysis and Zen Buddhism derive from theoretical and philosophical assumptions worlds apart, both experientially-based traditions share at their heart a desire for the understanding, development, and growth of the human experience. Paul Cooper utilizes detailed clinical vignettes to contextualize the implications of Zen Buddhism in the therapeutic setting to demonstrate how its practices and beliefs inform, relate to, and enhance transformative psychoanalytic practice. The basic concepts of Zen, such as the identity of the relative and the absolute and the (...) foundational principles of emptiness and dependent-arising, are given special attention as they relate to the psychoanalytic concepts of the unconscious and its processes, transference and countertransference, formulations of self, and more. In addition, through an analysis of apophasis, a unique style of discourse that serves as a basic structure for mystical languages, he provides insight into the structure of the seemingly irrational Zen koan in order to demonstrate its function as a pedagogical and psychological tool. Though mindful of their differences, Cooper’s intent throughout is to illustrate how the practices of both Zen and psychoanalysis become internalized by the individual who engages in them and can, in turn, inform one another in mutually beneficial ways in an effort to comprehend the ramifications of an individual or collective expanding vision. (shrink)

This is a new kind of anthology. More conversation than collection, it locates the psychic and the social in clinical moments illuminating the analyst's struggle to grasp a patient's internal life as voiced through individual political, social, and material contexts. Each chapter is a single detailed case vignette in which aspects of race, gender, sexual orientation, heritage, ethnicity, class – elements of the sociopolitical matrix of culture – are brought to the fore in the transference-countertransference dimension, demonstrating how they (...) affect the analytic encounter. Additionally, discussions by three senior analysts further deconstruct patients' and analysts' cultural embeddedness as illustrated in each chapter. For the practicing clinician as well as the seasoned academic, this highly readable and intellectually compelling book clearly demonstrates that culture saturates subjective experience – something that all mental health professionals should keep in mind. (shrink)

_The Social Work Psychoanalyst's Casebook_ begins with an interview with Dr. Sanville, who reflects on her evolution as a social work analyst, theoretician, writer, teacher, and leader. These reminiscences are followed by accounts of nine analytic treatments, each of which offers an unusual window into what actually transpired between analyst and analysand during the treatment hours. These case studies concern particularly troubled, often traumatized patients-the very "hard to reach" or "difficult to treat" clients with whom social workers have long been (...) familiar. They include a reanalysis by the same analyst of a patient whose first therapy ended in a stalemate; an account of transference and countertransference phenomena during termination; a report on the analysis of a young woman who experienced both chronic and stress-related trauma; and an account of the special issues involved in the treatment of an aging woman. Most of the case studies reflect the influence of Dr. Sanville, whose work has long evinced the therapeutic imagination and disciplined creativity to which all the contributors aspire. Tthe contributors to this volume offer the salutary reminder that analytic work is built on a relationship of respect and empathy and that treatment success follows from the therapist's willingness to accommodate the unique needs of individual patients. In honoring Jean Sanville, _The Social Work Psychoanalyst's Casebook_ speaks to the robustness of a multidisciplinary approach to psychopathology that transcends the bounds of any single profession-an approach in which contemporary psychoanalysis is enlarged by the insights and emphases of social work just as social work is enriched by the clinical wisdom of psychoanalysis. (shrink)

In order to properly distinguish between pastoral and psychotherapeutic counseling, one must clarify both the interpretive presuppositions underlying each of these professional practices and their respective societal contexts. As a common ground for both kinds of practice, at least insofar as they maintain a distance from the usual medical-scientific model of therapeutic intervention, an ontology of playing is recommended. More precisely, in order for counseling to truly come “into play,” any latent neo-pastoral power discourses must be critically exposed. Psychoanalytic counseling (...) is characterized by rules of abstinence and neutrality as well as by attention to unconscious dynamics, especially those of transference and countertransference. Pastoral counseling, even when it takes place outside of the Ignatian exercises, can still orient itself toward the Ignatian model of spiritual accompaniment, thus requiring a discernment of spirits and a reference to transcendence. Both pastoral and psychotherapeutic counseling can profit from each other. Both must be evaluated in terms of whether, in the course of an authentic communication, they succeed in proposing what truly profits the person seeking advice. All of this applies with special urgency to bioethical decision making and conflict resolution: Persons seeking pastoral advice desire an authentic exposition of the values of the Gospel and their church community in order to reach a well-founded conclusion in conscience. Other persons (or even the same ones) seeking psychotherapeutic help in a bioethical conflict situation desire an empathetic mirroring back of the biographic background framing their decision and of possible psychic consequences that may ensue from their acting accordingly. (shrink)

Termination of psychoanalysis or psychotherapy is centrally important both to the process of treatment and to the patient's experience of treatment. It is surprising, then, that there has heretofore been no comprehensive study of the subject. This book begins to bridge the gap in this area. It is the first volume devoted entirely to issues surrounding the ending of treatment in analytic and therapeutic work with children and adolescents. Organized into separate clinical and theoretical sections, framed by a preface and (...) sectional introductions, and covering a wide range of psychopathology, this book explores the different ways in which children and adolescents grapple with the experience of separation at the conclusion of treatment. Of special note is the contributors' recognition that the parents of children ending treatment face their own termination experience in relinquishing the support of their child's therapist. The presentations are enriched, as well, by frank discussions of countertransference as it enters into the termination phase of treatment. (shrink)

One of the more draining aspects of being a clinical ethicist is dealing with the emotions of patients, family members, as well as healthcare providers. Generally, by the time a clinical ethicist is called into a case, stress levels are running high, patience is low, and interpersonal communication is strained. Management of this emotional burden of clinical ethics is an underexamined aspect of the profession and academic literature. The emotional nature of doing clinical ethics consultation may be better addressed by (...) utilizing concepts and tools from clinical psychology. Management of countertransference, the natural emotional reaction by the therapist toward the patient, is a widely discussed topic in the psychotherapeutic literature. This concept can be adapted to the clinical ethics encounter by broadening it beyond the patient-therapist relationship to refer to the ethics consultant's emotional response toward the patient, the family, or other members the healthcare team. Further, it may aid the consultant because a recognition of the source and nature of these reactions can help maintain ‘critical distance’ and minimize bias in the same way that a psychologist maintains neutrality in psychotherapy. This paper will offer suggestions on how to manage these emotional responses and their burden in the clinical ethics encounter, drawing upon techniques and strategies recommended in the psychotherapeutic literature. Using these techniques may improve consultation outcomes and reduce the emotional burden on the clinical ethicist. (shrink)

_Avoiding Emotions, Living Emotions_ explores the psychoanalytic encounter and examines how emotions are formed and experienced by both the patient and analyst. The author narrates key theoretical concepts through the presentation of clinical material from adult and child analysis and emphasises the importance of being able to foster these narrations. Offering new insights into how the mind works, topics of discussion include: Bion’s thinking and its fertilization: clinical implications variations on transference and countertransference image and narration. Providing the reader (...) with clinical exercises and case reports, this book will be of great interest to psychoanalysts, psychotherapists and psychiatrists, as well as being a helpful tool in psychoanalytic and psychotherapeutic work on a day-to-day basis. (shrink)

Volume 13 provides valuable examples of the very type of clinically grounded theorizing that represents progress in self psychology. The opening section of clinical papers encompasses compensatory structures, facilitating responsiveness, repressed memories, mature selfobject experience, shame in the analyst, and the resolution of intersubjective impasses. Two self-psychologically informed approaches to supervision are followed by a section of contemporary explorations of sexuality. Contributions to therapy address transference and countertransference issues in drama therapy, an intersubjective approach to conjoint family therapy, and (...) the subjective worlds of profound abuse survivors. A concluding section of studies in applied self psychology round out this broad and illuminating survey of the field. (shrink)

_Ghosts in the Consulting Room: Echoes of Trauma in Psychoanalysis_ is the first of two volumes that delves into the overwhelming, often unmetabolizable feelings related to mourning. The book uses clinical examples of people living in a state of liminality or ongoing melancholia. The authors reflect on the challenges of learning to move forward and embrace life over time, while acknowledging, witnessing and working through the emotional scars of the past. Bringing together a collection of clinical and theoretical papers, _Ghosts (...) in the Consulting Room _features accounts of the unpredictable effects of trauma that emerge within clinical work, often unexpectedly, in ways that surprise both patient and therapist. In the book, distinguished psychoanalysts examine how to work with a variety of ‘ghosts’, as they manifest in transference and countertransference, in work with children and adults, in institutional settings and even in the very founders and foundations of the field of psychoanalysis itself. They explore the dilemma of how to process loss when it is unspeakable and unknowable, often manifesting in silence or gaps in knowledge, and living in strange relations to time and space. This book will be of interest to psychotherapists and psychoanalysts, as well as social workers, family therapists, psychologists, and psychiatrists. It will appeal to those specializing in bereavement and trauma and, on a broader level, to sociologists and historians interested in understanding means of coping with loss and grief on both an individual and larger scale basis. (shrink)

This book offers clinicians a long-awaited comprehensive paradigm for assessing object relations functioning in disturbed younger and older adolescents. It gives a clear sense of how object relations functioning is manifest in different disorders, and illuminates how scores on object relations measures are converted into a therapeutically relevant diagnostic matrix and formulation. Outlining the process of object relations assessment, Kelly presents vividly detailed cases of a range of disorders including anorexia nervosa, borderline states, depressive disorders, and trauma. The cases portray (...) the vicissitudes of object relations functioning and disruption that result in a unique structural developmental composite for a given adolescent. A major concern is demonstrating the utility and validity of two object representation measures--The Mutuality of Autonomy Scale and The Social Cognition Object Relations Scale --that are the main ones employed in the assessment of adolescents. MOA and SCORS scores facilitate a multidimensional understanding of the nuances of an adolescent's object relations functioning, and provide clinicians with organized, theory-based data leading to clear, specific treatment directions and guidelines and appropriate therapeutic programming. The book addresses the following questions: * Is individual psychotherapy indicated--will this adolescent benefit from an insight-oriented approach? * What are the likely directions that transference parameters will take in the treatment? * What types of countertransference reactions are likely to be anticipated in a given patient? * Is medication likely to be helpful in making this adolescent more accessible for treatment? Focusing only on adolescents, covering both the TAT and the Rorschach, and utilizing object relations theory as its major interpretive foundation, the book offers practitioners an alternative to general references based on a more actuarial, nomothetic, and atheoretical interpretive approach. It reflects one school of contemporary thought in projective assessment--one that advocates a more phenomenological, theory-based approach to test application and interpretation. (shrink)

_Bion Today _explores how Bion’s work is used in contemporary settings; how his ideas have been applied at the level of the individual, the group and the organisation; and which phenomena have been made more comprehensible through the lenses of his concepts. The book_ _introduces distinctive psychoanalytic contributions to show the ways in which distinguished analysts have explored and developed the ideas of Wilfred Bion. Drawing on the contributors’ experience of using Bion’s ideas in clinical work, topics include: an introduction (...) to Bion clarification of the inter-related concepts of countertransference and enactment concepts integrating group and individual phenomena clinical implications of Bion’s thought Bion’s approach to psychoanalysis. _Bion Today_ will be a valuable resource for psychoanalysts, psychotherapists and all those who are interested in learning more about Bion’s thinking and his work. (shrink)