Psychoanalytic Treatment Research Articles

Psychoanalytic proof: Revisiting Freud’s Tally Argument

ABSTRACT This paper explores the notion of proof in clinical psychoanalysis by reconsidering an argument Freud made concerning the relation between successful psychoanalytic treatment and truth, dubbed the “Tally Argument” by the philosopher Adolf Grünbaum. I first reiterate criticisms of Grünbaum’s reconstruction of this argument, which bring out the degree to which he has misunderstood Freud. I then offer my own interpretation of the argument and the reasoning that underlies its key premise. Drawing from this discussion, I explore three forms of proof, each inspired also by analogies with other disciplines. Laurence Perrine’s “The Nature of Proof in the Interpretation of Poetry” stimulates my discussion of inferential proof, the relevant form of which involves proving an interpretation through a strong enough Inference to the Best Explanation. Mathematical proof stimulates my discussion of apodictic proof, of which psychoanalytic insight is a fitting example. Finally, holism in legal reasoning stimulates my discussion of holistic proof, which provides a reliable means by which therapeutic success can verify epistemic conclusions. These three forms of proof can play a crucial role in ascertaining psychoanalytic truth.

Banter in psychotherapy: Relationship to treatment type, therapeutic alliance, and therapy outcome.

The use of humor in psychotherapy is widely considered to improve therapy outcomes and typically depends on context, patient sensitivity, and the therapist's humor style. Different types of humor may impact treatment type, therapeutic alliance, and therapy outcome; however, evidence from psychotherapy sessions on the role of banter has been sparse to date. Therefore, the study aims to examine banter in a secondary analysis of psychotherapy sessions. The sample consisted of 68 depressed outpatients treated with one of three treatment types: psychoanalytic therapy (PA), psychodynamic therapy (PD), and cognitive-behavioral therapy (CBT). Banter and therapeutic alliance were rated for therapy sessions taken from the middle phase of treatment, outcome was assessed at the end of treatment. The main findings were (1) clinical examples of banter in psychotherapy were found in 62 from 68 sessions, (2) significantly more bantering in the main bantering category of facilitation for CBT sessions as compared to other treatment types, (3) facilitative banter as a significant predictor for the positive introject, (4) a significant correlation between bantering and bond between therapist and client. Furthermore, based on these results, psychometric properties of the Klagenfurt Bantering Instrument (KBI) are reported. From a bantering perspective, this study emphasizes the need to consider session context, client response, and sarcastic markers when categorizing negative banter using the KBI.

A Brief Analysis of the Application of Psychoanalytic Theory

As the original proponent of psychoanalytic theory, Freud summarized the method of self-analysis through long-term analysis and research, and explored the causes of psychological barriers. On this basis, Freud gradually developed psychoanalytic theory and made great contributions to the field of psychoanalytic therapy. Today, psychoanalysis has a history of more than 100 years. Its theory is not rigid but has been developing and changing. Psychoanalysis, as a kind of deep psychology, is not only to describe psychological phenomena but also to explore people's psychological motivation. To reveal the surface psychological laws and explore people's deep unconscious psychological mechanism, so that the psychological state that is difficult to measure can be understood and investigated by people through a certain method.

A child is being murdered: A contemporary psychoanalytic treatment of a compulsion to child pornography.

A child is being murdered: A contemporary psychoanalytic treatment of a compulsion to child pornography.

A Case Study of Psychoanalytic Play Therapy for a Child Expressing Unconscious Conflict as Aggression in Play

A Case Study of Psychoanalytic Play Therapy for a Child Expressing Unconscious Conflict as Aggression in Play

Elevated cognitive rumination and adverse life events are associated with lower cortical surface area and suicidal ideation in adolescents with major depressive disorder

IntroductionSuicide is the second most common cause of death among young people. Structural brain alterations, rumination, and recent stressful experiences contribute to suicidal thoughts and behaviors (STBs). MethodsHere, we employed structural equation modeling (SEM) to examine the unique and combined relationships of these risk factors with STBs in a sample of young people with major depressive disorder (MDD) from the Magnetic Resonance-Improving Mood with Psychoanalytic and Cognitive Therapies (MR-IMPACT) study (N = 67, mean age = 15.90; standard deviation ± 1.32). ResultsWhereas increased rumination and lower surface area of brain regions, that have been previously reported to be involved in both STBs and rumination, were associated with each other (Beta = −0.268, standard error (SE) = 0.114, Z = −2.346, p = 0.019), only increased rumination was related to greater severity of suicidal ideation (Beta = 0.281, SE = 0.132, Z = 2.134, p = 0.033). In addition, we observed that recent stress was associated with lower surface area in the suicidal ideation model without covariate only (Beta = −0.312, SE = 0.149, Z = −2.089, p = 0.037). For the attempt models, no associations were found between any of the risk factors and suicide attempts. LimitationsWe emphasize that these findings from this secondary analysis are hypothesis-forming and preliminary in nature given the small sample size for SEM analyses. ConclusionOur findings suggest that neither lower surface area nor recent stress are directly associated with youth suicidal ideation or attempt. However, lower surface area is related to recent stress and increased rumination, which predicted greater severity of suicidal ideation in young people with MDD.

LANGUAGE DEVELOPMENT OF AUTISM CHILDREN IN ISLAMIC PSYCHOANALYTIC TREATMENT (Case Study at Southeast Sulawesi Autism Service Center)

Symptoms of autism, in general, are usually detected at the age of children who have not reached three years old, with varying levels in each child, ranging from mild to severe symptoms. These symptoms include constant difficulty in socializing, communicating and interacting with others verbally, difficulty in using and understanding language, and inability in using body language to convey meaning. Therefore, even though they have reached the age when speech development should occur, the children are unable to establish conversations or interactions with other people. Children with autism tend to repeat words or phrases spoken by others without forming their speech style and not developing their language skills. The objectives to be achieved in this study were to describe the language development problems of autistic children who were currently under psychoanalytic treatment at Kendari Autism Service Center and the factors that influenced them. The research findings showed that the language development abilities of autistic children in the phonological form in obtaining vowel sounds and diphthongs were good. However, they were still lacking in obtaining consonants. More practice was needed so that they could pronounce perfect phonemes. Meanwhile, autistic children in Kendari's autistic service could master nouns with more numbers than verbal and adjectives in lexicon skills. However, the phonological process that occurred in autistic children was very slow. This happened because they were sometimes like deaf people who could not hear what people were talking about. If called, they did not want to turn around. They also did not focus on interacting with other people. For example, he would answer if he was being spoken to, but his gaze was not on the person spoken to. Almost more than half of autistic children were unable to speak well. Their speech proned to be echolalia, literal, lack rhythm, lack vowels in the word produced, replacing or removing consonants contained in a word.

Psychoanalytic ego psychology: A European perspective

The best way to reconstruct the history of psychoanalytic ideas is to begin from the study not of theories, but of the various authors and their contexts. Important contributions to the study of the ego in Europe had already come from Ferenczi and Fenichel, well before Hartmann founded Ego Psychology (EP), which became mainstream in North America. In Europe, before World War II, significant contributions to what here is called “psychoanalytic ego psychology” (Pep) (contrasted with Hartmann’s EP) came from Anna Freud, Paul Federn, and Gustav Bally. After World War II, contributions came from Alexander Mitscherlich, Paul Parin, and Johannes Cremerius in the German-speaking community, and from Joseph Sandler in the UK. If this is the case, we should then talk of “ego psychologies” in the same way as we talk of the various object relations theories. Pep – as it was described in the guiding principles formulated by Fenichel in the 1930s – keeps informing the clinical work of many psychoanalysts, even if they are not fully aware of it. For example, it represents the basic ingredient of the empirically verifiable “psychoanalytic therapy” formulated in detail by Helmut Thomä and Horst Kächele.

The father, the Wager, and the question of psychosis in Lacan’s work

ABSTRACT This paper discusses how, starting from Blaise Pascal’s Wager about God, in his later teaching Lacan rearticulates his Name-of-the-Father concept. Building on a discussion of Lacan’s (1963) single seminar session on the Names-of-the-Father and his 1968–1969 discussion of Pascal’s Wager in Seminar XVI, the author examines what this changing conception implies for the Lacanian approach of psychosis. It is argued that – contrary to what Lacan suggests in the nineteen fifties – within these works from the sixties the Name-of-the-Father no longer refers to a privileged signifier, but to an act of faith concerning the virtuousness of the Other. This act of faith functions as a guarantee for the articulation of the subject, separates the subject from what Lacan calls “object a”, and establishes a positive expectant relation with the Other. The strength of Lacan’s revised conception is that it opens new perspectives on the psychoanalytic treatment of psychosis.

Methods used for evaluation of psychotherapy treatment

One of the goals of research in the field of psychotherapy is to improve knowledge about processes and outcomes of psychotherapeutic treatments. Researchers and professionals have been discussing the best methods for evaluating the effectiveness and efficiency of psychotherapeutic treatments for many years. This paper aims to give an overview of the specifics of quantitative and qualitative research methods, by noting the advantages and disadvantages of these methods in the evaluation of psychotherapeutic treatments. Within the quantitative scientific research, three approaches are described: randomized controlled research, mood enhancement by psychoanalytic and cognitive therapies, and meta-analysis. The most common collection methods (observation, interview, other verbal techniques and visual approaches to data collection) and data analysis (comprehensive process analysis, consensual qualitative research and grounded theory) are described within a qualitative scientific methodology. Finally, an approach related to integration of qualitative and quantitative methodology, as well as this related with application of case studies in the evaluation of psychotherapeutic treatments are described. Scientists and professionals in the field of social sciences should use both quantitative and qualitative research methods, separately or in combination, depending on the goal and problems of the research.

Examining Psychotherapeutic Processes with Depressed Adolescents: A Comparative Study of Two Psychodynamic Therapies

To understand processes associated with better or poorer psychotherapy outcomes is vital. This study examined and contrasted interaction patterns between one therapist and two depressed 17-year-old girls, Johanna (good outcome) and Sonja (poor outcome), in short-term psychoanalytic therapies selected from an RCT. Outcome data were collected regarding level of inter- and intra-personal functioning and symptoms of depression. Process data were obtained using the Adolescent Psychotherapy Q-Set on all available sessions. Analyses yielded five relational patterns or "interaction structures" in the two therapy processes; Three explained most of the variance in sessions with Johanna (i.e., 'positive working alliance', 'therapist's active use of psychodynamic techniques', and 'a receptive patient') and two explained more of the variance in sessions with Sonja (i.e., 'therapist using a more problem-solving and symptom-oriented approach' and 'patient displaying limited capacity for mentalization'). The processes in the two cases presented differences related to mentalization, psychological mindedness, and attachment style of the patients. The therapist used different therapeutic approaches, favouring more psychodynamic interventions in the good outcome case and a more problem-solving and symptom-oriented approach with the poor outcome case. In the latter case, the relationship seemed to be more of a struggle.

The efficacy of horney psychoanalytic therapy on personality organization of divorce applicant women: a single subject study on three personality types

The efficacy of horney psychoanalytic therapy on personality organization of divorce applicant women: a single subject study on three personality types

The London Clinic of Psychoanalysis, from the Origins in 1926 to Today

The London Clinic of Psychoanalysis is part of the British Psychoanalytical Society and its training body, the Institute of Psychoanalysis. The paper discusses the functioning of the Clinic and its beginnings. It then looks at what can be learnt from the Clinic's history and phases of development. The author reflects on the various financial, institutional, political and cultural challenges associated with the provision of low-fee psychoanalytic treatment and concludes that money is not the only barrier to ‘psychoanalysis for the people’.

A national study of the psychological theories and therapies covered within clinical psychology training programs in Australia

ABSTRACT Objective Recent advancements in the field of psychotherapy have included a diversification in Cognitive Behaviour Therapies (CBTs), often referred to as the “third wave”, yet relatively little is known about their coverage in Australian postgraduate clinical psychology training. Data were gathered to study the relationships between training program theoretical orientation, therapies covered, and factors determining the coverage of therapies. Method Responses to a semi-structured interview of 28 Directors of Clinical Training (DCT) or equivalent of Australian Psychology Accreditation Council (APAC) approved clinical psychology training programs (representing 72% of all accredited programs) were examined. Results Behaviour and cognitive theories were identified as dominant in programs. Coverage of Beck’s CBT was not correlated with other CBTs, and the number of therapies covered did not distinguish integrative (64.3%) from non-integrative programs. In an examination of the factors guiding the adoption of insight orientated therapies (i.e., Cognitive Analytic Therapy, Interpersonal Psychotherapy, Humanistic Therapy, Psychoanalytic Therapy, Process Experiential/Emotion-Focused Therapy, Gestalt Therapy, and Existential Therapy), the focus of clinical research, and student interest emerged as significant predictors (β = −.16, SE =.06, p < .05, 95% Boot CI [−.27, −.03]). Conclusions Beck’s CBT, and its undergirding theories emerged as dominant and was not associated with coverage of more recent CBTs, suggesting that there is opportunity to diversify therapies covered considering their evidence base.

Exploring Silence in Psychoanalytic Theory and Clinical Work

Silence, as an element of the therapeutic encounter has been of interest in psychoanalytic theory from the early stages of its development. Theoretical views on the functions of silence have broadened considerably since the phenomenon was first examined, in line with developments of theory and technique. This literature review aims to explore silence in psychoanalytic theoretical literature and proposes three broad categories of silence in psychoanalytic psychotherapy, namely: silence as defence; silence as connection; and silence as withdrawal. From this review it appears that silences in psychoanalytic therapy may often be multidetermined in nature; it is suggested that there are limits to the extent to which these can, and possibly should, be understood. The implications of the theoretical understanding of silence for clinical practice are then explored, and the importance of each therapist finding their own way to incorporate silence into their work with each patient is acknowledged. Debate within the literature as well as research in this area are important to further understanding of this phenomenon.

Passing patients' tests-But how? An analysis of therapists' helping skills in response to patient testing.

According to control mastery theory, patients in psychotherapy try to master their problems by disconfirming their pathogenic beliefs. This can be done by testing the therapist. So far, there is hardly any evidence on what concrete interventions or statements of therapists are specifically helpful in passing those tests. In our study, we analyzed the verbal utterances of therapists in test situations to determine whether there is a difference in statements used for passing or failing tests. A total of 168 session transcripts of 21 patients were selected from a total of six therapists, two each in psychoanalytic therapy, psychodynamic therapy, and cognitive behavioral therapy. Test situations were identified, and therapist responses were coded using the helping skills system. There were significant differences in the therapists' reactions to test situations. In particular, closed questions, approval, interpretation, and reflection of the patients' feelings by therapists were associated with a high probability of passing tests. These findings can especially support therapists-in-training to obtain an orientation on how to deal with their patients' test situations that may be perceived as challenging and are important for therapy success while respecting the individuality of their patients. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

From Tomboy to Amazon: The Psychoanalytic Treatment of Two Girls, Unhappy with Their Gender Identity, and the Impact of Title IX

ABSTRACT Two six-year-old girls, inhibited socially and constrained in their physical life, were successfully analyzed before and after the effects of the 1970’s Woman’s Movement and Title IX took hold. Surprisingly, despite the significant changes in society from one era to another, both children were unhappy with their identified genders in comparison to boys and they both identified gender as the root cause of their unhappiness. Both children began their treatment with scenarios designed to communicate their concerns, discover what analysis was about, and in particular, assess who I was and who I could be. In the transference-countertransference enactments, they reexperienced the anguish that had traced their downward spiral toward despair. Fathers who were perceived as critical, menacing, and uncaring were held responsible for the misgivings about gender and desire that confounded their children and damaged their self-esteem. Transformations for both children were reflected in the new paradigms they discovered and created within the real relationship with a safe and caring man.

Hate in the service of love: the negative therapeutic reaction revisited in couple therapy

For many years, the negative therapeutic reaction (NTR) was regarded as a form of resistance arising solely in individual psychoanalytic treatment. The possibility, however, that the NTR may also appear in couples has recently emerged as worthy of exploration. After presenting a case in which NTR dynamics predominate, and reviewing analytic literature about the NTR, the authors propose a conceptualisation of a couple-based form of the NTR that relies upon both paradoxical motivations and paradoxical uses of projective and introjective identification. The countertransference reactions these couples tend to induce in therapists will also be explored, and methods for their management will be suggested.

Psychoanalytic Interventions with Abusive Parents: An Opportunity for Children's Mental Health.

Research has extensively shown that most people who experience maltreatment in their childhood develop mental disorders, psychosocial adjustment problems, and, in many cases, become maltreating adults themselves. Preventing child maltreatment and treating abused children and abusive parents are, therefore, pressing public health issues. As established by the UK Children Act in 1989, child development is enhanced by remaining in the family whenever the child’s safety is assured. Thus, developing prevention and intervention programs for the purpose of repairing, whenever possible, the child–parent relationship should be a social priority. This narrative review focuses on the psychoanalytic studies related to intrapsychic dynamics and therapeutic intervention for physically abusive parents. The role of the transgenerational transmission of abuse and parents’ narcissistic fragility is crucial. Psychoanalytic interventions focus on helping the parent work through their past painful experiences and narcissistic vulnerability. Parent–child psychotherapy and mentalization-based treatment have been found to be prevalent, while there is scarce literature regarding intensive individual psychoanalytic treatment. Within the framework of attachment theory, brief interventions were developed; however, they did not prove effective for those parents who suffered experiences of maltreatment or severe neglect in childhood and for whom long-term parent–child psychotherapy resulted, which proved to be the most effective.

Желание как критерий поступка в теории Ж. Лакана

This article presents the research results of Jaque Lacan’s ethics of psychoanalysis. Lacan suggested both the new theory of desire and the new ethics which is motivated by a desire as a criterion of an action. In this article the author reconstructs the Lacan’s system of arguments, which proves the fact, that desire can be considered as a criterion of an action, not its motive. This paper shows that the ethics of desire, that was originally developed in relation to the problem of the criterion of an analytical act, is also important for the ethical position of the patient, and therefore can be presented as a universal ethic. The article also provides evidence that psychoanalytic work can be considered as an ethical practice, since there is a transformation of the ethical position of the patient in it. Initially, the patient takes an ethical position that can be defined as the desire to achieve the good, it would lead the subject to satisfaction, comfort and tranquility. On the other hand, psychoanalysis reveals a different ethical perspective to the patient, where the desire defines how the patient chooses the path. First of all, this is about the analyst’s desire. This term means a special formation that was resulted by the analyst’s own analysis. Lacan believed that a psychoanalyst is the result of his/her own analysis, one of the main effects of which is the analyst’s desire. The analyst’s desire serves as a criterion for the analyst to perform analytical acts in his/her psychoanalytic practice. But the ethics of desire is important not only for the psychoanalyst. The author’s task is to show that a patient who came to the analysis for the sake of therapy also performs the transformation of an ethical position in the process of analysis. This is the basic condition of psychoanalytic therapy. The main purpose of psychoanalysis is the study of unconscious desire, as a result of which the patient becomes an analysand and gets the opportunity to face his/her desire and follow it. To follow the desire means to decide to abandon the perspective of satisfaction and to bet on what is opposed to peace and completeness, and what can be defined as life.