Psychoanalytic Interview Research Articles

The Maternal Body, HIV and Race: Dual Raced and Ambivalent Maternal Experiences in a Vertically Infected HIV-Positive Adolescent

The HIV pandemic in South Africa has tragically left a wake of vertically infected children who have suffered parental loss and social marginalization. Vertically infected HIV-positive children are those who have acquired the virus from their mother during pregnancy, childbirth, or breastfeeding. In this paper, the development and alienation of the self is explored in a psychoanalytically informed research case study of a black adolescent girl who was vertically infected with HIV and later fostered by a white mother. This case study explores the sociogenic meanings of raced maternal experiences and disease identified in a series of psychoanalytic interviews, using interpretive phenomenological analysis. Drawing from Melanie Klein, Franz Fanon and other feminist and post-colonial psychoanalytic theorists, the early primal raced and diseased scene is considered through internalizations and fixation on the body. Nosipho is first introduced through a short vignette and a discussion of her early maternal relational experiences. The paper then explores the ambivalence experienced by the participant as part of her HIV and raced lived experiences. HIV and raced subjectivities are both powerful internalized conscious as well as unconscious embodied experiences. For Nosipho, it has been a complicated process found in the shared dual mothering experiences between a biological mother who is black and the subsequent white maternal experiences. The interrogation of this embodied dual experiences of having black mothers who are HIV-positive whilst simultaneously having white mothering roles in children who are vertically infected with HIV is a terrain that is infused by deep contradictory and conflicting emotional and affective states around love and hate, joy and despair, fear, and hope, all at once. Consequently, holding both the HIV and the raced subjectivities is deeply painful for black children who are vertically infected with HIV.

Differential neural response to psychoanalytic intervention techniques during structural interviewing: A single-case analysis using EEG.

Previous studies detected changes in the electroencephalographic (EEG) signal as an effect of psychoanalytic interventions. However, no study has investigated neural correlates of specific psychoanalytic interventions in the EEG power spectrum yet. In the present case study, we contrasted three types of interventions (clarification, confrontation, and interpretation) and a neutral control condition during a structural psychoanalytic interview conducted while EEG was recorded. A 27-year-old male patient diagnosed with major depressive disorder and borderline personality disorder with recurrent suicidal and self-injurious behavior underwent a structural interview while recording EEG. Two independent experts selected by consensus the characteristic episodes of the four conditions (clarification, confrontation, interpretation, and neutral control) within the interview, which were included in the EEG analyses. Fast Fourier transformation (FFT) was applied to subsegments of the intervention type to analyze the EEG power spectra. Alpha and beta power from central, frontal, and parietal sites were considered in linear mixed-effects models with segments as a random factor with maximum-likelihood estimates due to the lack of balance in the length of the interview segments. The interventions "interpretation" and "confrontation" showed a significantly lower alpha power compared with the control condition in the central electrodes. In the frontal and parietal sites of the alpha power and all beta power sites, the omnibus tests (full model/model without intervention) and comparisons relative to control conditions showed no significant overall result or failed significance after alpha error correction. Incisive interventions, such as confrontation with discrepancies and interpretation of unconscious intrapsychic conflicts, may have provoked temporary emotional lability, leading to a change in psychic processing akin to interference from external stimuli. This conclusion is consistent with the finding that interpretations, which are potentially the most concise interventions, had the strongest effects on alpha power. Using EEG during therapeutic psychoanalytic intervention techniques might be a helpful tool to evaluate differential responses to the psychotherapeutic process on a neural level. However, this single-case result has to be replicated in a larger sample and does not allow generalizations.

DEPRESSION’S WAY OF EXPRESSION IN THE CASE OF A PARANOID-SCHIZOTYPAL PERSONALITY STRUCTURE

Motivation: A psychiatric patient should be looked at in the longitudinal dynamics of their life because it is possible that during youth, mental suffering has a certain tone to it, which is later erased, transformed or moved, through a greater or lesser contact with the ideas or the affect. Objective: We want to present the life history and dynamics of a subject whose first episode of mental illness of a depressive nature was around the age of 20, and to emphasize how over the years, this nature has faded. Currently, there is an absence of connection between the symptoms and the possible causalities. Material and methods: psychiatric and psychoanalytic interviews in dynamics, analysis of the life map, interpretations, the symptom’s evolution under medication, social support, identification of positive and negative prognostic factors, differential diagnoses, performing the diagnostic tree. Results: The patient presented a first depressive episode in youth with a trigger related to an important emotional relationship; the episode overlapping with childhood difficulties (a father with a penal past, absence of parental Superego, attempts to build a shield through divinity). There follows a period of well-being, over which, about ten years ago, a hypochondriac pathology occurs, which associates the significant change of in a bizarre psychotic sense, with homelessness, delusional interpretation and completed with suicide attempt, so that the last episode is predominantly psychotic, but with a mystical and guilt theme and sin, with important changes, which also highlights the paranoid personality background of the person in question. Conclusion: The personality structure along with social functioning are important milestones of clinical evolution, beyond the main diagnosis of axis I, which in this case remained of recurrent depressive disorder, major depressive episode with psychotic phenomena, with the first two differential diagnoses: Bipolar disorder or schizophrenia depressive episode

Towards a formulation of the fatherhood constellation: Representing absence

ABSTRACT In contrast with Daniel Stern’s extensive work on the motherhood constellation, very little has been written about the fatherhood constellation. In an effort to explore emergent fatherhood and the idea of the fatherhood constellation, psychoanalytic research interviews were conducted with white, middle-class South African fathers of infants. The findings highlight two central themes which offer a way to begin thinking about the nature of the fatherhood constellation. Firstly, the fatherhood constellation is constituted by the father’s wish to protect and support the mother and baby. Secondly, the fatherhood constellation is characterized by what fatherhood is not, as opposed to what it is to be a father. Unlike the mother, the father does not get pregnant, he does not give birth and he cannot breastfeed, all defining features of motherhood. This paper subsequently suggests that the representation of absence may be a key step to the father’s presence in his own mind.

“I Am You and You Are Me”: A Self Psychology Perspective on Sibling Relationships

Vertical and lateral functions shape one’s sense of self and help one understand their place in the world. Yet, there are significant gaps in self psychology regarding the subjective aspects of self-sustaining functions provided by siblings and how these may differ from parental functions. This article examines these concepts from the perspective of a volunteer group of six adult participants who had high-access parent and sibling relationships in childhood. The analysis of eighteen psychoanalytic interviews showed that siblings can function as more than reparative or replacement vertical figures. As the participants’ parents were subjectively experienced as present and good enough at offering specific vertical functions, this article outlines some of the distinctive lateral functions that can be fulfilled by siblings, including idealizing and twinship. Further theoretical and clinical engagement with vertical and lateral functions is necessary in order to deepen self-psychological understandings of parent and sibling relationships.

Beyond Remembering the Forgotten Parent: The Conception of the Father

While it is true that the father occupies the third position and that he is excluded from the mother-infant dyad, he does not have to be the “forgotten” parent, and, in the last few decades, there has been an increased interest in remembering the father. However, in both theory and practice, the focus seems to be on remembering the importance of the father for the mother and infant, while comparatively little attention has been given to the father himself. In particular, there is a lack of research on the father’s representation of himself as a father. In an effort to explore the representational world of the father, psychoanalytic research interviews were conducted with South African fathers whose infants were in the phase of pre-oedipal development. The findings suggest that, for the fathers in this research study, rudimentary and inchoate representations of the self as a father predominate until the father experiences his infant as actively responsive to him. At this point, the father appears to undergo a highly affective, internal reconstitution which binds him to his infant and which begins to enrich his representation of himself as a father. Through the mirroring gaze of the infant, the father is conceived.

The effectiveness of psychoanalysis in a case study using multi‐perspective methodology: Conflict in choosing a partner due to transgenerational mandate

Translations of summaryA case study is presented to evaluate the effectiveness of psychoanalysis and the persistence of its benefits 20 years later in a young woman with severe depression, professional inhibition, and difficulties in partner selection due to transgenerational mandate (). The investigation was carried out with psychoanalytic interviews with the patient and analyst, which were evaluated by both psychoanalytic and non‐psychoanalytic judges following a methodology based on one tested in Germany by Leuzinger‐Bohleber et al. (2003). The psychoanalytic treatment began in the early 1980s in Monterrey, Mexico. The study concludes that the psychoanalysis was effective in assisting with the patient's character disorder and partner selection, mainly because of the therapeutic alliance, the analysis of transference and character, and the patient's increased capacity for mentalization as a result of the interpretation of the s.

Critical incidents in mental health units may be better understood and managed with a Freudian/Lacanian psychoanalytic framework

This paper explores critical incident management in an Irish adult public mental health services with a population catchment area of approximately 245,000 people. Data were collected by non-participant observation, informal opportunistic interviews and formal psychoanalytic interviews. The amassed data were analysed using a Freudian/Lacanian framework. Findings indicated that due to the unconscious influence of the group, some critical incidents arise from staffs’ lack of consistent engagement with patients and failure to recognise or tolerate overwhelming levels of anxiety. Some critical incidents were managed by the imposition of restrictions or pseudo-treatment reflecting impatience, guilt, hatred and despair which compromises care. Incidents of acting out by service occupants were a consequence of the failure to work with transference. Staff interventions mirror patient and their family’s behaviours resulting in rejection, dismissal and banishment. Critical incidents may be more manageable if staff were provided with appropriate supports enabling them to operate differently: by better accepting negative feeling towards patients and learning transference management skills. The patient–staff relationship needs to be reconsidered in the light of two conclusions: firstly, that all staff are suffering from a constitutional lack to utilise their natural qualities to manage transference or more likely, membership of the group unconsciously prohibits the use of this natural skill.

Theoretical Value of Psychological Testing

Apart from their diagnostic value, psychological tests, especially the Rorschach test, have an important theoretical value for understanding psychopathology. They present a picture of a living person, in contrast to a picture of forces and agencies within the person. This rests on 2 advantages of tests over the usual psychiatric and psychoanalytic interviews: Tests are ahistorical and they present information primarily of a formal kind.

Prädiktoren für die Inanspruchnahme einer Psychotherapie

The aim of this study was to discover prognostic criteria for outpatients' making use of psychotherapy. Data from patients and therapists were collected. After initial psychoanalytic interviews, 92 patients at a university psychotherapy outpatient department were asked to complete narrative forms and standardized questionnaires (FMP) regarding their motivation to seek psychotherapy. In addition, the therapists contributed a Global Assessment of Functioning (GAF) and estimate of the initial therapeutic working alliance (iTAB) for each patient. In the follow-up, we investigated patients' actual use of psychotherapy. Sociodemographic variables, personality variables, and diagnoses had only minor prognostic relevance, whereas therapists' assessments of patient resources for therapeutic relationship and work proved to be of high predictive value. Positive assessment of a patient's ability for therapeutic working alliance in the initial diagnostic interview is shown to be an important prognostic factor of a patient's entering psychotherapy.

A successful trial utilizing the Leuzinger‐Bohleber methodology for evaluation of psychoanalytic treatment: Preliminary report

Utilizing audio‐recorded psychoanalytic interviews of both patients and their analysts, group discussions of these interviews, and the application of questionnaires commonly used in psychotherapy research, the authors investigate the potential use of the Leuzinger‐Bohleber methodology as an objective evaluative instrument to assess the quality of psychoanalytic treatment. Preliminary study results were obtained through interviews conducted with seven analysts and their respective patients, three of whom were treated with psychoanalysis (three or more sessions per week, for a duration of no less than one year) and four with psychotherapy (one or two sessions per week, for a duration of no less than one year). Patients were found to be eager to participate, and no adverse experiences were reported by analysts, patients or the research team. In addition to the interviews, further data were obtained through review of mailed‐in questionnaires completed by 21 patients. The authors present both preliminary observations regarding the methodology as a whole, as well as the detailed results of one specifi c case subject treated with psychotherapy. Review of study fi ndings supports the utilization of this methodology as an evaluative instrument which may ultimately advance current knowledge of the process and outcome of psychoanalytic treatment.

The Psychoanalytic Interview as inspiration for qualitative research

A qualitative research wave has swept through the social sciences in the past decades. Interviews, textual analyses, and natural observations have come into widespread use as modes of inquiry. The qualitative research movement is interdisciplinary, and an opening of the social sciences to the humanities has taken place, drawing on hermeneutics as well as narrative, discursive, conversational, and linguistic forms of analysis.The science of psychology has until recently remained outside the qualitative research movement. This is rather odd, because key modes of qualitative research, such as the interview, work through human inter-relationships, which are the subject matter of psychology. In addition, substantial areas of current psychological knowledge were initially brought forth through qualitative interviews. In particular this pertains to Freud’s psychoanalytical interview, which has also inspired subsequent interview research. Piaget’s interviews of children’s thought and Adorno and colleagues’ interviews about the authoritarian personality illustrate this point. The Hawthorne interviews with industrial workers and the consumer interviews by Dichter were also inspired by the psychoanalytical interview.In an attempt to advance psychological interview research today, I take these historica interview inquiries as a point of departure. Rather than follow the methodological and paradigmatic direction of the qualitative research wave, I pursue a pragmatic approach, taking the significant knowledge produced by psychoanalytical and other psychological interviews as a basis for this endeavour. Pointing to the paradox that knowledge originally produced by qualitative interviews has become generally accepted but the interview method producing this knowledge has generally been rejected, I also address the methodological marginalisation of qualitative research in psychology. In the concluding section I outline two different therapeutic and academic paths of interview research by addressing questions about human interrelations and methodology, about objectivity of knowledge and ethical tensions, which arise when treating therapeutic interviews as research inquiries.

The Psychoanalytic Interview as Qualitative Research

The psychoanalytical interview is one innovative form of knowledge production that has remained outside the discussions of scientific method in psychology. Major parts of the knowledge presented in current textbooks of psychology stem from psychoanalytical interviews, a method that does not exist in textbooks of psychological methods. Some postulates and paradoxes about psychoanalytical knowledge production are posited and aspects of the psychoanalytical interview as a research method are outlined on the basis of Freud’s writings on therapy and technique. Drawing on postmodern conceptions of knowledge, the relational and constructive aspects of therapeutic knowledge production are emphasized. Characteristics of psychoanalytical knowledge production are then discussed, and it is concluded that therapeutic researchers may learn from current developments in social science interview research, and that social scientists may learn from the knowledge production in therapeutic interviews, a knowledge source that remains to be taken seriously by therapeutic researchers themselves.

A Psychoanalytic Study of Evil

A Psychoanalytic Study of Evil C. Fred Alford For all things, from the Void Called forth, deserve to be destroyed . . . . Destruction,—aught with Evil blent,— That is my proper element. —Goethe. Faust, part 1. Quoted by Freud in Civilization and its Discontents Sigmund Freud (1930, 120–122) does not write very much about evil, or at least he does not call it that. In Civilization and its Discontents he does, quoting the above lines by Goethe, and equating evil with the Todestrieb, the drive toward death. Not just because the Todestrieb seeks destruction, but because it seeks the void, nothingness. I too argue that evil is about nothingness—not just the nothingness we seek, but the nothingness we dread. Evil is nothingness because it is no-thing: the dread of boundlessness, and all that goes with it—loss of self, loss of meaning, loss of history, and loss of connection to the world itself. Though I refer to Freud, I draw more heavily upon Thomas Ogden, the analyst who originated the concept of the autistic-contiguous position, an experience of boundlessness at once transcendent and terrifying. One might respond that dread is not the same as evil: the former is a psychological experience, the latter a moral category. There would be some truth to such a response, and I address their complex relationship shortly. For now it must suffice to say that when sixty-eight subjects were asked to talk about evil, most referred to an experience of dread. Each interview lasted about two hours, and was conducted in a conversational, open-ended fashion. Fifty of the respondents were average citizens responding to advertisements placed in a campus newspaper, a local newspaper, and the newspaper of a retirement community (the methodological appendix addresses the problem of self-selection). Eighteen of [End Page 27] the respondents were hardly average, prisoners at a maximum security prison with a small group therapy program. Most had murdered a relative or loved one. I met with the inmates as a group, several hours once a week for over a year. The sheer time spent with the prisoners (over two hundred hours) fostered an intimacy and trust that was rare but not unheard of in a two-hour interview with an individual subject. Free informants are referred to by first name and last initial. Inmates are referred to as Mr. or Ms. This is not to patronize, but reflects the practice of the prison, the way the inmates were known to me. All names are pseudonyms. Presenting the results in numbers (32 hold this, 21 hold that) or percentages does not seem appropriate or useful, granting an aura of precision that is unwarranted and unnecessary. As Aristotle puts it, “it is the mark of a trained mind to expect no more precision than the subject matter allows” (N.Ethics 1094b30). Instead, I have employed the terms “almost all,” “most,” “many,” “some,” “few,” and “very few” in as precise a manner as seems warranted by the terms themselves, using each to reflect a specific number range of responses. The methodological appendix gives the number range to which each of these terms refers, as well as the questions asked, in addition to providing some demographic information about the informants. About most (but not all) questions, the response totals of free citizens and inmates were similar. The differences were in the reasoning and the tone. These differences in tone and logic are important differences (perhaps the most important) that numbers alone cannot capture. The numbers aim to give a feel for how a fairly large group of people responded. What is as interesting, and at least as important, is the tone of the informant’s response, and this is not always adequately represented by numbers. It is often better represented by quotations from the informants. What is a Psychoanalytic Interview? What is a Psychoanalytic Conclusion? Neither the discussions with prisoners, nor interviews withfree subjects, were psychoanalytic in a strict sense. Indeed, [End Page 28] it is hard to know what a psychoanalytic interview would mean. The interviews, and group work, were, however, psychoanalytically informed. Above all, this means most of the time was spent listening: for the image, the...

Emotional adaptation of children undergoing bone marrow transplantation.

To examine stress reactions and psychic adaptation of children aged 8-12 years in single-room treatment under isolation conditions after bone marrow transplantation (BMT). The prospective longitudinal study included free diagnostic interviews and a large test battery. We used a mixture of projective tests questionnaires and an intelligence test (the German version of the revised Wechsler Intelligence Scale for Children) to evaluate different adaptation processes. The questionnaires clearly showed children's strong tendencies to adapt to the situation and to normalize their behaviour under isolation conditions. In contrast, the psychoanalytic interview and the projective tests demonstrated a very differentiated emotional adjustment: Before transplantation, coming to terms with the life-threatening situation was deferred. After transplantation, very intensive emotional examination of the situation and superficial adaptation (protective denial) were observed. It is very important to intensify the child's and the family's psychosocial support before admitting the child for hospital treatment. Family conflicts and neurotic developments should be regarded as risk factors for marked and potentially dangerous stress reactions.

Wittchen, H.-U., Zaudig, M. & Fydrich, T. (1997). SKID Strukturiertes Klinisches Interview für DSM-IV. Achse I und II. Göttingen: Hogrefe, DM 158,-. Hiller, W., Zaudig, M. & Mombour, W. (1997). IDCL Internationale Diagnosen Checklisten für DSM-IV und ICD-10. Göttingen: Hogrefe, DM 198,- bzw. DM 239,-

Most of the gouty patients are men. It is very rare that menstruating women suffer from gout. Within a research program 41 male gouty patients were explored with the psychoanalytic interview and with other methods. It was surprising that most of them had almost no possibility for a normal identification with their fathers. The emotional ties to their mothers were on the other hand close and intimate. Further relations as to the family situation and to the present social status are pointed out. In addition to the uricosuric effect of oestrogen psychodynamic facts in the sense of latent homoerotic characteristics are discussed for the explaination of the fact that most often men are affected from gout.

Einfluss psychischer Faktoren in der Schwangerschaft auf die entstehendeEltern-Kind-Beziehung

In a longitudinal prospective study on 38 couples and their first child, we examined the influence of prenatally assessed psychological factors of the parents on somatic and psychic aspects of birth, the quality of the newly established parent-child relationship and the early development of the baby. Half-standardized psychoanalytic interviews with the couple (pre- and postnatally conducted, video-recorded), the Giessen test for couples, an evaluation of the parents' birth narratives and a parent questionnaire about functional symptoms of the baby were used. We found a high continuity between the pre- and the postnatal measurements of the partnership and the emotional experiences of the parents. Somatic complications of the birth event were not correlated with prenatally assessed psychological factors. But there exists a highly significant correlation between the mental representations and the relationships of the parents and the emotional experiences of birth, the early relationship between the parents and their baby and manifestations of functional disorders of the newborn. Relevant psychological and psychosocial aspects should be included in the medical care of pregnant women. One should listen to the imaginations and expectations of the parents about the future parentship, including ambivalent feelings. The father should also be seen for psychological assessment.

An outcome study of psychotherapy for patients with borderline personality disorder.

This study evaluated the effectiveness of well-defined outpatient psychotherapy for patients with borderline personality disorder. Thirty patients with borderline personality disorder diagnosed according to the DSM-III criteria were given twice weekly outpatient psychotherapy for 12 months by trainee therapists who were closely supervised. The treatment approach was based on a psychology of self (this term being used in its broad sense), and strong efforts were made to ensure that all therapists adhered to the treatment model. Outcome measures included frequency of use of drugs (both prescribed and illegal), number of visits to medical professionals, number of episodes of violence and self-harm, time away from work, number of hospital admissions, time spent as an inpatient, score on a self-report index of symptoms, and number of DSM-III criteria (weighted for frequency, severity, and duration) fulfilled. The subjects showed statistically significant improvement from the initial assessment to the end of the year of follow-up on every measure. Moreover, 30% of the subjects no longer fulfilled the DSM-III criteria for borderline personality disorder. This improvement had persisted 1 year after the cessation of therapy. The results suggest that a specific form of psychotherapy is of benefit for patients with borderline personality disorder.

Alexithymia: anxiety and hostility in psychosomatic and psychoneurotic patients.

Verbal samples obtained from 40 psychoneurotic and 40 psychosomatic patients, matched with respect to age, sex, intelligence and some social indicators, were examined using different methods of content analysis. According to the concept of 'alexithymia' it was postulated that the restricted fantasy life and difficulty in expressing feelings attributed to psychosomatic patients would be reflected at the speech level (psycho-analytic interviews). The measurement of anxiety and hostility using the Gottschalk-Gleser scales gave the following results: with total anxiety in particular, and its subscales guilt, shame, separation and diffuse anxiety, and with hostility, the psychosomatic patients showed lower values than the neurotic patients, which were in part highly significant. The results confirm the existence of the 'psychosomatic phenomenon' but they do not permit statements concerning its etiology.

Cardiac correlates of cognitive processing.

A 17 minute passage taken from a simulated psychoanalytic interview was played to a sample of trained therapists, therapists in training and inexperienced undergraduates who were alerted to the organizing theme (of termination of treatment) and asked to attend to direct and indirect references to this theme. Tonic heart rate, averaged over 30 second periods, was lower when clues were present than during control periods when clues were not present. Phasic heart rate (11 second profiles) in the vicinity of each clue was significantly lower than profiles surrounding control passages. Profiles surrounding recalled clues were significantly lower than profiles surrounding control clues. Profiles surrounding more relevant clues were significantly lower than profiles surrounding control clues whether or not the clue was recalled later. The findings suggest that decrease in mean heart rate can be used to mark the appearance of a significant stimulus even in cases where it does not appear in later recall; thus an on-line heart rate (HR) decrease may be a more sensitive index of stimulus processing than a later verbal report. Correlations were also found between HR change and clinical experience and between awareness of termination clues and clinical orientation.