Contemporary Psychoanalytic Theory Research Articles

Amidst the Transforming Letters: The Biographical Subjectand The Biographical Hero in Józef Hen’s Ja, Michał z Montaigne...

The article analyzes the relationship between the biographical subject and the biographical hero in JózefHen’s novel Ja, Michał z Montaigne... (I, Michel de Montaigne...), demonstrating how the author incorporateshimself into the narrative of the French essayist’s life. The work highlights the duality of identity,where the thoughts of Montaigne and Hen intertwine, creating a shared narrative. Historical and literarycontexts help shape the character of Montaigne, and so do contemporary psychoanalytic theories. Henfi ctionalizes the biography, creating a space for the refl ection on subjectivity and authenticity in biographicalliterature, and his creative process opens up a dialogue between the author and his subject.

The poetics of the symptom

In contemporary psychoanalytic theory and practice, the patient’s and the analyst’s body are growing in importance. Over time psychoanalysis has become enriched by neurosciences, sociology, neonatal studies, philosophy, literature, and art. It is especially focused on what has not been represented and integrated within the mind, and on how to recover, represent, transform, and integrate these types of experiences, with the corporeal experience now acquiring more prominence. I will assemble those so-called “poetic” aspects in the formation and manifestation of the symptom, which come from embodied and non-symbolized experiences. I will start from the observation that poetry offers an embodied meaning, learned through the body before being understood in the mind. Similarly, the suffering world of our patients can resonate within the therapist like a poem or a piece of music. Through careful attention to the resonances in the body and in reverie, therapists can deduce the personifications inhabiting that internal world. It is as if the poetic experience is situated “on the border” between the sensorial dimension and the verbal dimension. After a brief review of the psychoanalytic literature on corporeal experience in psychoanalysis, a clinical vignette will clarify these statements.

Gay Men and Suicidality: The Development and Nature of the Critical Superego

National research studies report elevated suicide rates amongst gay men, particularly those under the age of 26. Much of the current health and psychiatric literature on suicide tends to focus on the external world impacting on the suicidal individual. Although valuable, it is not enough to understand the specific circumstances that could contribute to gay men's suicidality. This paper focuses on the relationship between the external and internal dynamics at play in the suicidality of gay men, with particular emphasis on the development, influences, and nature of a cruel and punishing superego. The author provides some contemporary psychoanalytic theories on same‐sex desire as a useful framework to understand minority sexuality. Some influential classic and contemporary psychoanalytic theories regarding suicidality and the development and character of a cruel and punishing superego are presented. The concept of internalized homophobia and the impact of heteronormative masculinity on the gay man's psyche are explored as drivers for suicidality. A composite case study from clinical experience with suicidal gay men in an NHS setting is presented to illuminate the discussion. This paper could add new perspectives and important dialogue for psychoanalytic psychotherapists working with this patient population.

Approaches to a contemporary psychoanalytic Field Theory: from Kurt Lewin, Georges Politzer and José Bleger, to Antonino Ferro and Giuseppe Civitarese

ABSTRACT Today in Italy, a group of psychoanalysts works according to Field Theory. In this paper I would like to show that a line of thought from the beginnings of Field Theory in physics, philosophy and psychology leads to the conception of the field of Antonino Ferro and Giuseppe Civitarese. The assumption of a continuous dynamic and a direct relationship between all parts of the field is fundamental for the conception of the analytic field. These parts have a field-dependent identity and are different in sum than when the parts are taken on their own. To trace the evolution of field-theoretical psychoanalysis, I describe the epistemological context in which Kurt Lewin developed Field Theory. I will add selected theoretical elements from works by Georges Politzer and José Bleger.

Not so hysterical now? Psychotherapy, menopause, and hysterectomy

In the context of the body, the essentially female; wombs, menstrual cycles, and concurrent hormones, have seen women ascribed madness, insatiability, untrustworthiness, and danger. Female bodies have been identified in selective parts, considered in abstract, or envisaged as having overwhelming power over the mind. “Hysteria”, the problematic neurosis of uterine origin was at the heart of early psychoanalysis. This diagnosis enshrines a slippage from the physical to the fantastical, and ultimately to the denial of the lived reality of women’s and girl’s bodies. In apparent collusion with patriarchy the neglect of some female bodily experience is perpetuated in contemporary psychoanalytic theory. Nowhere is this more evident than around menopause and hysterectomy (as experienced by either client or therapist). There has been little or no exploration of how practitioners might best support clients for whom menopause is significant, or how we might facilitate women before or after gynaecological surgery. It is as if removal and psychological loss of the same female body parts that our forebears used to so neatly differentiate, diagnose, and pathologise women are now not of note. I am interested as to how we as psychotherapists reclaim female body narratives from this outdated theoretical paradigm to best serve clients experiencing menopause, gynaecological surgery, and mid life in the twenty-first century.

Psychoanalysis and Telepathic Processes.

Freud's writing on the topic of thought-transference stimulated controversy among analysts and original reflection on psychoanalytic understandings of the psyche. The notion of telepathy has also contributed significantly to the development of fundamental psychoanalytic concepts, including transference, projective identification, and primary forms of symbolization processes. The notion of telepathy, especially in light of current trends in post-Bionian and field theories, is used to outline an epistemological framework in which the clinical relevance of this notion becomes clear. Epistemological questions raised by telepathy and how this notion relates to the most originary and primary forms of the intersubjective relationship are addressed before questioning the conditions for the emergence of telepathy, its integration within contemporary psychoanalytic theory, and its ontological nature.

Transference-Focused Psychotherapy for Adolescents With Personality Disorders.

This article presents a conceptualization of personality disorders in adolescence and the adaptation of transference-focused psychotherapy (TFP) for personality disordered adolescents (TFP-A). The model of assessment and treatment presented is based on contemporary psychoanalytic object relations theory developed by Otto F. Kernberg and supported by findings from current evidence-based outcome research. We present a method of assessing personality disorders in adolescents that addresses the variability of personality disorder symptoms and traits among adolescents and their instability over time. We then present the goal of TFP-A and its major phases of implementation. A major focus is therapist interventions.

Drive theory, redux: a history and reconsideration of the drives

ABSTRACT A large and significant portion of contemporary psychoanalytic theory has given up on the drives. The shift toward object relations in the 1940s and 50s, the scepticism about metapsychology in the latter half of the twentieth century, and a general confusion about the coherence of Freud’s drive theory have all contributed to their slow decline in prominence. There are legitimate criticisms of the drives that deserve attention but the drives themselves require a careful examination before any successful defence of their place in the metapsychology may be mounted. The current paper provides an account of the drives informed by the intellectual history of German and English thought related to the drives and instincts as they came to Freud. This history allows us to clearly distinguish between “drive” (or Trieb) and its conceptual neighbour “instinct” (or Instinkt).

From an intrapsychic to an interpersonal symptom: Relations Training in Action

This article proposes a conceptualization of symptoms from an interpersonal perspective and advocates group analysis as an appropriate medium for treatment. Psychoanalytic theory has traditionally conceptualized symptoms using the language of intrapsychic conflicts in the individual’s mind. In this article, drawing on ideas from group analysis and contemporary psychoanalytic theories, I propose an interpersonal conceptualization of symptomatic phenomenology. In addition, I introduce a concept that describes a treatment process based on this perspective: Relations Training in Action1. I will argue that a symptom occurring in one person symbolizes an inadequate interpersonal relations pattern, and that recognition of the pathological relations pattern in therapy enables a process which paddles the creation of healthier communication. Furthermore, I suggest group therapy as a space which offers a rich set of opportunities for the repetition and reparation of relations disorder (Friedman, 2007), and that the transition from the language of intrapsychic symptoms to the language of relationships plays a significant role in broadening the areas of interpersonal communication (Foulkes, 1964). Therapy based on an interpersonal perspective regarding symptoms will facilitate participation in a meaningful and significant relationship with the other, improve the mental health of patients and decrease their need to cling to the symptom.

Repression: A Critical Assessment and Update of Freud's 1915 Paper.

The concept of repression has been relegated to the periphery in current psychoanalytic theorizing. This is in part due to a reflexive and ill-informed avoidance of Freudian metapsychology, and in part due to preoccupation with 'primitive' and 'deeper' states of mind, a perspective that presumes that repression operates exclusively in 'higher level' or 'neurotic' forms of psychopathology. A careful scrutiny of psychoanalytic theory and clinical practice does not uphold such compartmentalization. Repression is ubiquitous in mental life. It contributes to normality (e.g., onset of latency), undergirds the 'psychopathology of everyday life' (e.g., parapraxes), exists alongside splitting in severe character disorders (e.g., borderline patients "forgetting" their appointments) and, by permitting a modified return of exiled mental contents, gives birth to neurotic symptoms as well as creative imagination. Taking Freud's seminal discourse on repression (in: Repression. Standard Edition, vol 14. Hogarth, London, pp 141-158 1915a) as its starting point, this paper elucidates the complex, nuanced, and pervasive nature of this defense. It deconstructs Freud's unitary concept of repression into four implicit binaries and updates his proposals in the light of contemporary psychoanalytic theory. The paper offers clear guidelines for clinical applications of these ideas.

Childhood Trauma, Personality, and Substance Use Disorder: The Development of a Neuropsychoanalytic Addiction Model.

BackgroundWhile traditional psychoanalysis has been criticized as insufficient for the treatment of substance use disorder (SUD), recent progress in the field of neuropsychoanalysis has generated new and promising hypotheses regarding its etiology. However, empirical research applying this framework has been sparse.Aim and ScopeThe present overview aims at developing and empirically validating a neuroscientifically informed psychodynamic framework regarding the etiology of SUD. For this purpose, this review provides a concise overview of the most relevant historical and contemporary psychoanalytic theories on SUD etiology. Furthermore, the original research summarized in this paper consists of three studies investigating connections between childhood trauma, primary emotions, personality structure and attachment, as well as their relation to SUD development and treatment.ConclusionsThe results highlight the empirical validity of the neuropsychoanalytic approach towards SUD etiology. In particular, the findings underscore the conceptualization of SUD as a disorder related to dysfunctional attachment and affect regulation abilities especially linked to increased SADNESS and ANGER dispositions, which mediated the relationship between SUD and traumatic childhood relationships. Based on these findings, a refined model of SUD etiology is proposed, which should be tested in future studies.

Lived Depth: A Phenomenology of Psychoanalytic Process and Identity

ABSTRACTIn this article, I lay out the implications of a phenomenological perspective in which subject, world, and others are given in one stroke, part of the same emergent process. Trends in contemporary psychoanalytic theory lean toward this radical nondualistic view but never quite relinquish a perspective in which subject and object, subject and subject are separate. Through my early studies in phenomenology, I have come to see that psychoanalytic process is better understood as a perceptual engagement in which meaning is formed in the relationship between what is experienced and its context/background/field, a process of lived depth. Strikingly, psychoanalytic identity is a similar process. Inchoate shifts in meaning and investment that we cannot know in formation come clear in relation to a coalescing sense of our place in a professional context. We come to know ourselves retrospectively, an act of après-coup that momentarily stills a continual shape-shifting process, one part of the lived experience of depth.

Psychodynamic approaches to violence

SUMMARYThe assessment and management of violent behaviour in mentally disordered patients are no longer the sole domain of forensic psychiatrists, but are increasingly part of the day-to-day work of all psychiatrists and mental health professionals. Violence risk assessment has become a huge industry, and although the importance of dynamic, as well as actuarial, risk factors is now recognised, a more systematic approach exploring the psychodynamics in the aetiology, assessment and treatment of violent behaviour is often lacking. In this article I revisit some of the key psychodynamic principles and concepts relevant to an understanding of violence, summarising the historical contributions of key psychoanalytic writers on violence and aggression, and exploring the ideas of more contemporary writers working in the field of forensic psychotherapy. A psychodynamic framework for working with violent patients is introduced, focusing on the setting and containment, specific therapeutic interventions and monitoring countertransference reactions.LEARNING OBJECTIVES•Understand historical and contemporary psychoanalytic theories of the aetiology of aggression and violence•Utilise a psychodynamic framework for working with violent patients and offenders•Understand the use of countertransference in the risk assessment and treatment of violenceDECLARATION OF INTERESTNone.

Psychodynamic approaches to suicide and self-harm

SUMMARYRates of suicide and self-harm are rising in many countries, and it is therapeutically important to explore the personal stories and relationships that underlie this behaviour. In this article psychoanalytic and psychodynamic principles and concepts in relation to violence towards the self are introduced and the various unconscious meanings of suicide and self-harm are explored within a relational context and attachment framework. We describe how a psychodynamic approach may enhance the risk assessment and treatment of patients presenting with self-harm and suicidality, particularly examining the role of transference and countertransference within the therapeutic relationship.LEARNING OBJECTIVES•Understand historical and contemporary psychoanalytic theories and concepts regarding the aetiology of suicide and self-harm•Understand the different meanings and expressions of acts of suicide and self-harm•Understand the use of countertransference in the risk assessment and management of self-harm and suicide attemptsDECLARATION OF INTERESTNone.

Varela and Contemporary Psychoanalysis, an Epistemological Gesture: From Representations to Co-emergence

ABSTRACTThis paper intends to articulate common epistemological elements between Francisco Varela’s and Contemporary psychoanalytic relational-intersubjective theories. These shared elements could be described as a common epistemological gesture, the overcome of a reductionist and dualist paradigm, instead giving away to a paradigm of complexity. In both perspectives, a phenomenological and close to experience philosophical reflection is incorporated, which can account the human experience as an irreducible and valid source of knowledge. In Varela’s theory, the notion of embodiment permit to conceive the mind as natural endowment of the body. In Contemporary psychoanalytic theories, nature of human experience is conceive as intrisically social, proposing a “two person” psychology and the intersubjective model. Finally, in line with both currents and in a preliminary way, I propose the notion of co-emergency, seeking to overcome different forms of dualisms like internal/external, subject/world, I/Other, etc. From a clinical perspective, co-emergency can be conceived a s the coupling of two subjectivities, as a particular experiential mode of being with others, intending to overcome dualism regarding transference and represented mental states.

The Theory and Art of Child Psychotherapy: A Corrective Developmental Approach.

The history of child psychotherapy is sketched from the psychoanalytic pioneers Anna Freud and Melanie Klein to the popular "nondirective" approach of Virginia Axline. The author's approach to child psychotherapy, based on contemporary psychoanalytic theories, allows the therapist to play any parental role that helps to repair developmental deficiencies and conflicts. These include nurturing, supporting, mirroring, role modeling, challenging, and limit setting. Following Winnicott, psychotherapy is conceived as a play space in which therapist and child are both spontaneous. The value of interpretation and insight in child therapy is discussed. There follows a more detailed discussion of three major problem areas in child psychotherapy: handling anger and hostile aggression; handling issues related to sexuality; and handling narcissistic issues of inferiority and shame.

Interactions between obsessional symptoms and interpersonal dynamics: An empirical single case study.

Both classical and contemporary psychoanalytic theories stress the importance of interpersonal dynamics in treating neurotic symptoms. Associations between the symptomatic and interpersonal level were formally represented in the symptom specificity hypothesis (Blatt, 1974, 2004), which linked obsessional symptoms to an autonomous interpersonal stance. Findings from cross-sectional group studies on symptom specificity, however, do not converge, possibly indicating that the complexity of associations is underestimated. This article presents a theory-building case study specifically aiming at refinement of the classical symptom specificity hypothesis by quantitatively and qualitatively describing the longitudinal clinical interplay between obsessional symptoms and interpersonal dynamics throughout a psychodynamic psychotherapy. Interpersonal functioning was assessed by means of the core conflictual relationship theme method (Luborsky & Crits-Cristoph, 1998). Findings affirm a close association between symptoms and interpersonal dynamics. However, obsessional symptoms proved to be determined by profound ambivalences-manifesting both within and between relationships- between dependent and autonomous interpersonal behavior. Psychodynamic interventions focusing on interpersonal conflicts were associated with symptomatic alterations. Conceptual and methodological considerations, limitations and future research indications are discussed.

(Inter)Subjectivity in the Research Pair

We draw on our experiences in one organizational study to explore the reflexive process of writing fieldnotes. Bridging the literatures on reflexivity, intersubjectivity, and psychoanalysis, we develop a unique four-dimension method of writing and analyzing fieldnotes–observing, capturing the story, articulating countertransference, and developing interpretations. Fieldnotes developed individually, and shared between researchers, can become the basis of reflexive dialogue to enhance researchers’ intersubjective understanding of the field and, in so doing, give voice to research participants. Shared fieldnotes provide an opportunity to explore different noticings as a means to develop more nuanced interpretations. Articulating countertransference, a technique borrowed from contemporary psychoanalytic theory, informs our efforts to raise awareness of the unconscious dimensions of field experiences and develop a reflexive double-loop within the research pair. We illustrate our reflexive fieldnote-writing method with excerpts from our fieldnotes while describing our research process. Our approach is unique in that it focuses on the researcher-researcher relationship and the hidden emotions that influence research accounts.

Dream Images and Creation.

This article links contemporary psychoanalytic theories of the dream, especially Bion's, with the work of the American video artist Bill Viola, who is deeply influenced by altered states of consciousness and produces images of dreamlike quality. We discuss the oneiric and infantile roots of creativity and artistic inspiration, finally taking Viola's monumental artwork The Passing (1991) as paradigmatic of the artist's aesthetic and philosophical elaboration of the relationship between life and death.

Emotional Detachment of Partners and the Sanctity of the Relationship with the Analyst as the Most Powerful Curative Factor.

The relationship between partners and the analyst is considered the most basic means for healing in contemporary psychoanalytic theories and analyses. It also holds as one of the most fundamental phenomenon's of psychoanalysis, so it comes as no surprise that it has always been deliberated over as an object of great interest as well as immense controversy. This same relationship, mutually co-created by the analyst and each individual and partner in analysis, represents also the core of sanctity and sacred space in contemporary psychoanalysis.