Contemporary Psychoanalytic Theory Research Articles

Teaching & Learning Guide for: Contemporary Virtue Ethics

Teaching & Learning Guide for: Contemporary Virtue Ethics

What's Possible? What Matters? Reply to Commentaries

The three discussants agree that a definition of psychoanalysis tied to session frequency is problematic and needs to change. Yet none supports my recommendation to redefine the practice of psychoanalysis in terms of the practitioner's training. This prompted me to look more closely at my proposal and push my thinking further. I argue that psychoanalysis, like many other professions, needs to define its practice as the application of its complex and evolving knowledge and skill base, grounded in its unique field of inquiry. Although there are individual exceptions, the inculcation of this knowledge and skill base is generally best accomplished through psychoanalytic training. This assertion, however, rests on the premise that our training curricula keep pace with our rapidly evolving field of inquiry and knowledge. To further clarify my vision I examine the nature of psychoanalytic expertise. I suggest that such expertise amounts to the inculcation and integration of a large number of psychoanalytic frames of reference. I contend further that the nature of contemporary psychoanalytic theories is such that important psychoanalytic frames of reference are proliferating more rapidly than in the past, that the relationships among them are becoming more complex, and that consequently the application of psychoanalytic theory to practice is also becoming more complex. Psychoanalytic training programs need to recognize this expanding complexity and revise curricula and pedagogic methods on an ongoing basis to reflect this evolution within our field.

Mixed Race and the Negotiation of Racialized Selves: Developing the Capacity for Internal Conflict

The author uses contemporary psychoanalytic theory in further understanding the negotiation of conflict and dissociation in biracial patients who are both African-American and White. Drawing on the work of contemporary theorists who have made efforts to navigate the relationship between inner and outer worlds in our understanding of race from a psychoanalytic perspective, the author examines the relationship between race, culture, and internalized self-other relations—how they interact with each other and impact splitting and dissociative processes among self-states. The author argues for a notion of the unconscious as one that contains historical trauma related to race relations that influences the developing capacity to sustain internal conflict between opposing self-states borne out of this trauma. The author shows how society works against the integration of racialized self-states and interferes with the capacity to contain conflict. Through an extended clinical vignette from an analysis of a mixed-race patient, the author looks at the interplay of self-states between a White analyst (author) and a mixed-race patient (African-American and White) as manifested through a series of enactments and the unconscious “mating” between dissociated self-states in both patient and analyst. The author argues that the analyst's engagement of his or her own dissociated self-states and containment of internal conflict is critical to aiding the patient in moving toward greater integration.

The Joke Envelope

The concepts of the primeval skin ego, psychic envelope, and related pre-ego containing and wrapping functions elaborated respectively by Esther Bick, Didier Anzieu, and Francis Tustin occupy an important position in contemporary psychoanalytic theory and clinical practice. The psychic envelope begins as a virtual mental protostructure ("proto" because it is not yet based on fully symbolized representations) that holds the budding mind together pending further developments. With maturity, the enveloping functions adopt symbolized, metaphoric form (for example, the aesthetic use of cloth, the analytic framework), but can regress to more concrete and pathological forms. The aforementioned authors based their ideas on a cluster of specific allusions to the idea of a psychic covering, barrier, or envelope in Freud's work. Yet they neglected one reference, hidden in Freud's analysis of the structure ofjokes and humor: the 'joke envelope"--die witzige Einkleidung. The present essay explores Freud's use of the term Einkleidung, including his intriguing idea that a joke requires three people whereas a dream does not and the fact that Freud nowhere speaks of a "dream envelope. "I take the "joke envelope" beyond its original context and posit a relationship between laughter and the early, normative traumas of breathing, crying, and loss, and the dawn of rhythmic envelopes that enable mentalization. Jokes and joking symbolically repeat the early rupture and rapture of breathing and self-other differentiation and the internalization of maternal containing and envelopment.

The Radical Nature of Combined Psychotherapy

The therapist’s commitment in thought and action to combined practice influences all aspects of professional life. Hence, the “radical” (or foundational): The idea as well as the shared history of combined psychotherapy are rooted within the complexities and intensities of the multiple transference-countertransferences, intrapsychic defenses, interpersonal strategies, and inevitable enactments of all members of one’s practice. Case anecdotes illustrate (a) the psycho-social impact of Establishment psychoanalysis and group analysis on the therapist; (b) the intertwining of dyadic-group experience on manifest and latent content, inference making, and interpretation; (c) how the “group” never leaves the room, that is, the salutary effects on the therapist’s thinking and clinical relationships of the idea as well as the reality of group, even with those patients not exposed to combined treatment; and (d) resistances specific to combined treatment. Combined individual-group psychoanalytic therapy is a natural fit, yet a radical extension of contemporary relational psychoanalytic theory and practice.

Review of Attachment in psychotherapy.

Reviews the book, Attachment in psychotherapy by David J. Wallin (see record 2007-05421-000). This intellectual and clinical tour-de-force is what we have been waiting for: a book that is on the one hand a coherent, creative, thoughtful, and remarkably integrated view of contemporary psychoanalysis, with attachment, and attachment processes, at its core, and on the other a reflection on our daily, complex, work with patients. The book has three broad aims: first, to ground the reader in attachment theory and research, second, to broaden the reach of attachment theory by building bridges to other aspects of contemporary psychoanalytic theory and science, and third to apply this broader, deeply psychoanalytic, clinical attachment theory to understanding the dynamics of an individual patient and the dynamics of clinical work. This book should be essential reading for anyone interested in contemporary psychoanalysis. Few writers have the ability to write so directly and clearly about complex science and theory; his scholarship and reach are extraordinary. This book is also a book for therapists at all levels of experience. Throughout every section of the book, Wallin writes about his work with patients, about the therapeutic process, about the therapeutic situation, and about the therapeutic relationship, in all its complexity. In the end, he creates a truly contemporary vision of human development, affect regulation, and relational processes, grounded in the body and in the brain, and in the fundamental relationships that make us who we are, as therapists, as patients, and as human beings. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Desire, demand and psychotherapy: on large groups and Neighbours

Explanations of the disturbing effects of large groups are sought in the group analytic literature, where there is an emphasis on boundary disturbance, and in contemporary psychoanalytic and social theory, where the peculiar nature of the neighbour has become a topic for investigation. It is argued that the human subject is an interrupted subject, with the other/neighbour being a key figure in creating this interruption. In large groups, the alien nature of the neighbour who is both close and unknowable comes to the fore, disrupting attempts to cover over this interruption and promoting confusion and dislocation. The large group is consequently expressive of specific forms of contemporary sociality, and also suggestive for an ethical practice of psychotherapy that does not reduce to consolation.

“Who Wears the Pants Here?”: Gender as Protest

Psychoanalysis has, from Freud's earliest ideas, been drawn to comprehending and defining gender—decoding what is masculine and what is feminine. Although Freud believed that masculinity and femininity would normatively fall along biological lines, gender, as a category, very quickly became destabilized by theorists who contested Freud's view. This article looks at a case in which the analyst came to view the patient's gender performance as a form of protest as it became transacted within the transference-countertransference relationship. In drawing upon contemporary gender and relational psychoanalytic theories, the author considers the multiple layers of gender meanings held within the patient and within the analyst and concludes that gender is never fully resolved and will continue to carry shifting relational meanings.

Transference focused psychotherapy: Overview and update

This paper describes a specific psychoanalytic psychotherapy for patients with severe personality disorders, its technical approach and specific research projects establishing empirical evidence supporting its efficacy. This treatment derives from the findings of the Menninger Foundation Psychotherapy Research project, and applies a model of contemporary psychoanalytic object relations theory as its theoretical foundation. The paper differentiates this treatment from alternative psychoanalytic approaches, including other types of psychoanalytic psychotherapy as well as standard psychoanalysis, and from three alternative non‐analytical treatments prevalent in the treatment of borderline patients, namely, dialectic behavior therapy, supportive psychotherapy based on psychoanalytic theory, and schema focused therapy. It concludes with indications and contraindications to this particular therapeutic approach derived from the clinical experience that evolved in the course of the sequence of research projects leading to the empirical establishment of its efficacy.

The organizing functions of dreaming: Pivotal issues in understanding and working with dreams*

Although contemporary dream models differ, the view of dreams as centrally organizing information and regulating affect in keeping with shifting needs and motivational priorities is an increasingly convergent perspective evolving out of dream and neuroscientific research, contemporary psychoanalytic theory, cognitive psychology, and clinical work. The author's organization model of dreams is presented as a representative of our contemporary understanding of dreams. Pivotal issues concerning understanding and working with dreams are delineated, followed by a detailed clinical illustration.

Balint's Influence on Contemporary Psychoanalytic Theory and Practice

Invited by the Psychoanalytic Psychotherapy Study Center in New York to lecture on my book Michael Balint: Le renouveau de l'Ecole de Budapest, Toulouse, Erès 2000, I first gave my personal and analytic motivations for writing this book. Then I stressed Balint's original contributions to analytical theory and practice: the object relation combined with the theory of instinct, the development of the infant, adolescent and even of old age, the basic fault, archaic defenses (such as ocnophilia and philobatism), as well as his idea about analytic treatment with its phases of regression and "new beginning". His style and his discretion in treatment and mainly the responsibility he recommended to the analysts seem to me very important not to forget. I have shown him as Ferenczi's heir and how he continued his work. His clinical approach and his style are evoked to alert contemporary analysts--who sometimes just know his method to train general practitioners through the Balint group--that they have been influenced unbeknown to them.

“LIKE BUT UNALIKE”: ERIC SUNDQUIST AND LITERARY HISTORICISM

Eric Sundquist, Strangers in the Land: Blacks, Jews, Post-Holocaust America (Cambridge, MA: Harvard University Press, 2005)As measured by that deadly but inescapable phrase “quantity and quality,” Eric Sundquist is perhaps the most productive American literature scholar of his generation. Since 1979, when he was still in his twenties, he has authored half a dozen books while editing another half-dozen. All have made an impact and many of these have been highly influential—his first book, Home as Found: Authority and Genealogy in Nineteenth-Century American Literature, was among the very first to read canonical American works through the lens of contemporary literary and psychoanalytic theory; his edited collection American Realism: New Essays (1982) proved pivotal in reviving the critical energy in a major but long-dormant literary and historical period. To Wake the Nations: Race in the Making of American Literature (1993) was by implicit design and to powerful effect nothing less than a rewriting of the foundational work of American literary history and criticism—F. O. Matthiessen's monumental American Renaissance: Art and Expression in the Age of Emerson and Whitman (1941). I will spend some time describing To Wake the Nations not only because of the book's exceptional importance but because its eloquent introduction provides the closest thing to a critical credo that Sundquist has written. His description there of his critical ideals—particularly of “justice,” boundary-crossing and “verification”—will help orient our approach to Strangers in the Land, which remains loyal to these ideals as it extends his interest in race and ethnicity, black and white, to the tormented subject of blacks and Jews, united by a “bond of alienation.” (52).

Actual Neurosis as the Underlying Psychic Structure of Panic Disorder, Somatization, and Somatoform Disorder: an Integration of Freudian and Attachment Perspectives

Starting from a contemporary critique of the DSM-IV, this paper argues that the diagnostic categories of panic disorder, somatization, and undifferentiated somatoform disorders can be understood as belonging to a common type of psychopathology—i.e., the Freudian actual neuroses. In addition to their strong clinical similarity, these disorders share an etiological similarity; and the authors propose a combination of Freud’s focus on this type of patient’s inability to represent an endogenous drive arousal with the post-Freudian focus on separation anxiety. An etiological hypothesis is put forward based on contemporary psychoanalytic attachment theory, highlighting mentalization. Concrete implications for a psychoanalytically based treatment are proposed.

A Poetic Encounter with Otherness: The Ethics of Affect in Michael Ondaatje's Anil's Ghost

Anil’s Ghost tells the story of Anil Tissera who, having lived abroad for approximately fifteen years, returns to her home country, Sri Lanka. As a forensic anthropologist who works for the United Nations Human Rights Centre, she intends to investigate political murders. On the island, she is unexpectedly confronted with relatives of murder victims including the miner and artificer Ananda Udugama, whose wife was abducted and presumably killed, and the epigraphist Palipana, whose brother was murdered and whose niece Lakma witnessed the murder of her parents. Anil also becomes acquainted with the local archaeologist Sarath Diyasena and his brother Gamini, who are both haunted by the suicide of Sarath’s wife. As a novel that relates specifically to the civil war in Sri Lanka, Anil’s Ghost raises ethical issues. Yet critics of the novel have thus far treated Ondaatje’s ethical concerns somewhat cursorily or viewed them mainly in terms of globalized ethics. For instance, in an article that deals with Anil’s ‘diasporic identity,’ Heike Harting broaches the novel’s ‘ethical (although rather schematic) critique of the failure of global justice’ (43). Likewise Katherine Stanton focuses on the novel’s ‘concern with justice in a globalized world’ (40) and Teresa Derrickson on ‘the need for human compassion and the need for global justice’ (149). Margaret Scanlan, who addresses the subject of terrorism, refers to Anil’s ‘ethical obligation to name’ the body of a Sri Lankan murder victim (3). Antoinette Burton discusses Ondaatje’s postcolonial interest in reclaiming untold, unofficial stories about the nation’s history, but wonders whether his narrative opens up ‘the kind of “ethical space for historiography” which contemporary politics demands’ (52). I would suggest that another important ethical dimension of Anil’s Ghost can be seen by reading Anil’s and the other characters’ personal and traumatic histories of loss and love in the light of contemporary psychoanalytic theory. In what follows, I offer a psychoanalytic consideration of the characters’ repression of traumatic experiences, as well as their expression of buried affects and bodily drives. As we will see, an analysis of the characters’ unconscious minds goes hand in hand with a more formal literary analysis because the novel’s poetic discourse contains traces of the characters’ moods, such as sadness or fear, and of their life and death drives. In keeping with Julia Kristeva’s psycholinguistic writings, in

The Relationship Between Social Work and Psychoanalysis: The Future Impact of Social Workers

Because social workers are likely to have a more expanded role within organized psychoanalysis than previously, it seems timely to consider the numerous challenges and opportunities ahead with respect to social workers’ impact on the practice of psychoanalysis. For those who become social work psychoanalysts, in particular, a pivotal issue is the degree to which they retain their core identity as clinical social workers. It is important for them to integrate and balance the diverse aspects of their dual identity, to participate in our social work organizations, to contribute to developing psychoanalysis, and to work to keep the teaching of contemporary psychoanalytic theories alive in social work education.

Melancholy Femininity and Obsessive—Compulsive Masculinity: Sex Differences in Melancholy Gender

The author offers a revision of melancholy gender (Butler, 1995) in which sex differences are theorized. Drawing on contemporary psychoanalytic feminist theory that emphasizes the mother's role as primary caretaker and as pre-Oedipal object for both boys and girls, the author suggests that, in heterosexual development and within heterosexual cultures, same-sex object-desire is likely to be unavowedly lost for girls but preemptively foreclosed for boys. While the theory of melancholy gender does not differentiate between loss and foreclosure, the author argues that this is an important distinction such that Freud's two preconditions of melancholy—unavowed loss and ambivalent identification—are more likely to be part of female development than of male development, leading to melancholy femininity in girls and obsessive-compulsive masculinity in boys. This argument allows the theory of melancholy gender to speak to the empirical and clinical finding that femininity and depression tend to be associated whereas masculinity and depression do not.

Postmodernism and its impact on psychoanalysis

This article explores the heterogeneity of postmodern thought and its contributions to contemporary psychoanalytic theory and practice; the heterogeneity of psychoanalytic theory and the claims of privilege and standing made by individual theories; and the postmodern terrain and its conflicting points of view. Its origins are also traced back to the work of classical analytic authors, notably Erikson, Gill, Hartmann, Klein, and Rapaport. A solution to the problem of theoretical plurality is suggested, addressing its ontological and epistemological roots.

Description of elements of psychoanalytic technique in a mental health center

The Mental Health Center of Peristeri was established in 1990 and has gradually developed a range of clinical and therapeutic responses of psychoanalytic orientation. These responses are targeted on the treatment of disorders of DSM-IV Axis I and II and bear an educational, therapeutic and research character. Concerning duration, we follow Gabbard's definition that sets a minimum standard of six months as a condition for regarding psychotherapy as a long-term one. Our work is based primarily on a transference-focused model, as it is defined by Kernberg. The theoretical equipment of our intervention consists mainly of object-relations theory and contemporary Kleinian technique for adult psychotherapy, as well as the theoretical models of post-Kleinian authors, such as Joseph, Ogden and others (Racher, Meltzer and Ferro). Generally, irrespective of the specific psychoanalytic theory adopted (Freud, Klein, Bion, Winnicott), we assume that psychic life is for the most part unconscious. As a result, transference represents the primary source for understanding the patient, while counter-transference provides unique information on patient's intrapsychic life and, generally, on what the patient “places” to others. The main goal of this study is the description of a psychoanalytic intervention model that “absorbs” contemporary psychoanalytic theories, without being technically vague, and responds to a broad spectrum of pathology related to personality dysfunction.

Riddles of Masculinity: Gender, Bisexuality, and Thirdness

Clinical examples are used to illuminate several riddles of masculinity-ambiguities, enigmas, and paradoxes in relation to gender, bisexuality, and thirdness-frequently seen in male patients. Basic psychoanalytic assumptions about male psychology are examined in the light of advances in female psychology, using ideas from feminist and gender studies as well as important and now widely accepted trends in contemporary psychoanalytic theory. By reexamining basic assumptions about heterosexual men, as has been done with ideas concerning women and homosexual men, complexity and nuance come to the fore to aid the clinician in treating the complex characterological pictures seen in men today. In a context of rapid historical and theoretical change, the use of persistent gender stereotypes and unnecessarily limiting theoretical formulations, though often unintended, may mask subtle countertransference and theoretical blind spots, and limit optimal clinical effectiveness.

Art and emotion in psychoanalysis

Freud's view that art satisfi es psychic needs has been taken to mean that art has its source in the unconscious and that it unifi es pleasure and reality. The author argues that there is a third point that Freud repeatedly emphasizes, which should not be overlooked, that art infl uences our emotions. The author examines what Freud means by this claim, in particular, his reading of Michelangelo's Moses. Freud's focus here on emotions as fundamental to subjective experience, as subject to regulation and as potentially healthy forms of communication serves to supplement and even challenge what he says in his theory of affect. The author concludes by making inferences about a contemporary psychoanalytic theory of affects: that it ought to be inclusive of science (more receptive to neurobiology and less bound to Freud) as well as art (preserving the focus on subjective experience, especially the processing of complex emotions), which is illustrated with the concept of mentalized affectivity.