An empirical study of the differential roles of libidinous and aggressive shame components in normality and pathology.

Constructed a 2-factor Brief Shame Rating Scale, based on items from the Adapted Shame Rating Scale (W. Hoblitzelle, 1987) and the Personal Feelings Questionnaire (D. Harder and S. Lewis, 1987). Ss were 701 psychology students (aged 18–66 yrs). The 2 subscales (Disgraced/Humiliated, Bashful/Shy) significantly interacted in predicting concomitant levels of psychopathology, level of shame, and narcissism. Consistent with psychoanalytic theory, dominance of the more aggressive Disgraced/Humiliated subscale was associated with psychopathology, shame, and narcissism. Findings suggest that healthy superego integration and identity formation are associated with a greater balance of libido and aggression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The analyst's vision of the patient and therapeutic action.

As psychoanalytic therapy shifts from a conflict resolution theory to a model of self-realization, the analyst's vision of the patient takes on a more prominent role in the process. This article builds on H. Loewald's (1960/1980) concept of the analyst as "behind" because he or she can only build from the patient's spontaneous productions and yet "ahead" in that the analyst goes beyond the patient's material to construct an image of who the analysand can become. In this way, the future becomes a prominent component of the analytic process. The famous case of Anna O. is used to demonstrate the deleterious effects of failing to include the analyst's vision in the treatment process. This case is contrasted with the contemporary treatment of a young woman, a case that illustrates the use of the analyst's vision in the conduct of psychoanalytic treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is a gay Oedipus a Trojan horse? Commentary on Lewes's "A special Oedipal mechanism in the development of male homosexuality."

K. Lewes's (see record 1998-10061-002) article is seen as an effort to locate the psychopathology and desiring patterns of some gay men in a variant of the Oedipus complex. This commentary questions the value of the Oedipus complex as a theoretical tool in the psychoanalytic formulation of male same-sex eroticism both on clinical and political grounds. It argues that the embedded primary of evaluation and reproduction in the theory of the Oedipal complex inevitably devalues same-sex desire. Equally, it argues that the Oedipus complex's tendency to reinforce gender norms and stereotypes is especially distorting when applied to sample-sex desiring men, in that it may contribute to the analyst's clinical neglect of the role of gender conflict in pathogenesis. The author tries to show this through some examination of K. Lewes's (1998) clinical examples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dynamic Systems and the Therapeutic Action of the Analyst: II. Clinical Application and Illustrations.

The author presents a dynamic systems approach to psychoanalytic practice. It depicts psychoanalysis as an activity-dependent, experientially based treatment in which the analyst's behavior toward a patient effects change in how the patient organizes and interprets self-experience and relates to others. The neurobiological and relational components of this approach are reviewed, and their implications for psychoanalytic process and technique are described. Several clinical vignettes illustrate the technical application, dynamic process, and therapeutic action of a dynamic systems perspective on psychoanalytic treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The analyst's role in healing: Psychoanalysis-plus.

We argue that the original structuring of psychoanalytic treatment is based upon an unsound foundation. The questions we raise about the bases of early treatment make understandable the subsequent evolution of substantial changes, and make plausible our recommendation of still further changes. We propose that the nuanced use of techniques of explicit support, consolation, suggestion, persuasion, and advice, all used in healing across many ages and societies, be added to traditional psychoanalytic treatment. These techniques are inconsistent with the analyst's neutrality, a fundamental characteristic of the analyst's stance in the original model. The demonstration that the analyst's own values, beliefs, expectations, and theories profoundly influence all of the analyst's interventions leads us to reconsider the concept of neutrality. The possible risks associated with using these recommended explicit techniques mandate that their use requires the same discriminating judgment as is used to determine whether and when an interpretation is presented. Whether use of these additional techniques, which we have termed "psychoanalysis-plus," will enhance treatment effectiveness is an empirical, not a theoretical, question. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The nature of the patient's problems and how in psychoanalysis the individual works to solve them.

Describes the therapeutic process as the process by which the patient works consciously and unconsciously with the analyst to disconfirm pathogenic beliefs (PBs). The patient's psychopathology stems from PBs acquired in childhood from traumatic experiences with parents. PBs warn patients that if they attempt to gratify certain impulses or to seek certain developmental goals they will risk disruption of parental ties. Because of PBs patients develop fear, anxiety, guilt, shame, or remorse; institute repressions; and develop symptoms, inhibitions, and faulty object relations. In therapy, patients work to disconfirm PBs by (1) testing them in relation to the analyst in the hope of disconfirming them and (2) assimilating insight into PBs conveyed by the analyst's interpretations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Fathers who fail: Shame and psychopathology in the family system.

Reviews the book, Fathers who fail: Shame and psychopathology in the family system by Melvin R. Lansky (see record 1992-98607-000). Melvin Lansky's riveting book is about fathers who cannot find their way in the world of either love or work, but are driven to self-destructive bonds with others by problems with their "paternal imago." This book addresses the central role of the affect of shame, and the defenses against experiencing it, leading to varieties of "impulsive" symptom formation, disturbing the capacity for sustaining work or love relationships and constantly threatening breakdown of fragile self-esteem. Symptoms are viewed as failed efforts to escape shame through rage and to rigidly regulate optimal distance in family relationships. The attempt throughout is to meld a variety of psychoanalytic perspectives with family systems perspectives. The book is organized into several sections, beginning with an overview entitled Symptom, System and Personality in Fathers Who Fail, followed by The Paternal Imago. Next comes Defenses Against Shame: Narcissistic Equilibrium in the Family System, and then a section on shame and symptom formation. A section entitled Treatment Difficulties completes the book. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychoanalysis beyond Freud

Since Sigmund Freud (1856-1939) formulated his first psychoanalytic theories about 100 years ago, there has been a rapid development in psychoanalytic theory and therapy. In this paper, central concepts in the four psychoanalytic "psychologies"--drive/ego psychology, object relations theory, self psychology and interpersonal psychoanalysis--are presented. Basic concepts in psychoanalysis have been under a continuous critical review, and psychoanalytic theories remain versatile. The unconscious and the exploration of subjective experience are central common themes. The role of the psychoanalyst has changed from expert to explorer, working together with the patient. At the same time, the analyst has become more active in the therapy room. The analyst's contribution to what is happening between the analyst and the patient has been increasingly emphasized. The development in psychoanalysis has parallelled both developments in the theory of knowledge as well as the change in cultural trends. Creating meaning is central to the psychoanalytic process, but there are divergent views as to how this happens: by articulating meaning, by uncovering meaning, by constructing or deconstructing meaning. The narrative tradition in which the central point is to tell stories about oneself, is discussed more thoroughly in the paper. The authors challenge the view that psychoanalysis is the work of Freud only.     

Psychoanalytic boundaries and transitional space.

The blurring of the distinction between language and action in contemporary psychoanalytic theories expands the traditional boundaries of psychoanalytic therapy. The current article delineates a conceptualization of psychoanalytic boundaries based on D. Winnicott's (1971) concept that transitional space defines the psychoanalytic process. It is proposed that D. Winnicott's (1971) concept shifts the psychoanalytic paradigm to adaptation, rather than interpretation, as the overriding analytic task. The analyst's adaptation and its limitations define the psychoanalytic dyad, and psychoanalytic boundaries, from this viewpoint, are expressions of the analyst's subjectivity. The clinical implications of this concept of psychoanalytic boundaries are demonstrated in the treatment of a severely regressed patient. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The Psychoanalytic Process: Theory, Clinical Observation and Empirical Research.

The authors have tied their theory of psychopathology to notions of what fosters therapeutic progress and have then taken the unusual step of testing these ideas systematically and scientifically. Their book will appeal especially to those who are receptive to a cognitively oriented psychoanalytic approach and who advocate more informed, scientifically rigorous psychoanalytic research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mistakes.

Psychoanalysts frequently make mistakes, but these errors often go unacknowledged because of the analyst's sense of shame. This is regrettable because mistakes are widely recognized to contain new and very useful clinical information. In three clinical vignettes the author describes the kinds of clinical errors he has made: errors associated with a defensively false analytic self, mistakes based on his narcissistic investment in the patient, and errors made in transference/countertransference enactments. These clinical vignettes demonstrate a method of repairing mistakes that involves disclosure, the selective communication of countertransference, and apology. A visual metaphor is used to describe the process of mistake and reparation: The analyst's “mis-take” is a failure to “see” an aspect of the patient's subjectivity. After expressing distress at feeling “unseen,” the patient helps refocus the analyst's vision. Through this mutual process of refocusing a therapeutic symbiosis develops that causes the patient to relax his or her defenses and thereby bring into vision previously unconscious aspects of him or herself, creating an expanded sense of self. Paradoxically what began as a mistake becomes therapeutic through its reparation. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Free association and analytic neutrality: the basic structure of the psychoanalytic situation

This paper re-examines within a contemporary context an essential foundation of classical technique, the psychoanalytic situation. Defined in terms of basic elements of psychoanalytic relatedness which make possible the most profound exploration of human motivation, its core structure is viewed as an extraordinary interpersonal arrangement anchored by two clearly differentiated yet complimentary ways of relating: free-association and analytic neutrality. The patient's role, organized by the prerequisites of expressive freedom, is counter posed with the psychoanalyst's, which is structured to empower listening and understanding. Elaborating the parameters of this unique relationship, the authors emphasize the synergic effects of each participants' activity in creating a vehicle for destabilizing neurotic equilibrium. An extensive discussion of analytic neutrality, conceived as guiding ideal that informs all the analyst's attitudes and actions in the exploration of psychic reality, is presented. Specifically, the authors distinguish three essential dimensions which bear upon the interactive process: neutrality with regard to conflict, neutrality with regard to sequence, and neutrality with regard to transference. In contrast to the rigid constraint on human responsiveness often caricatured in the literature, this vision of technical neutrality establishes its vital contribution to the integrity, depth, and tone of any analytic process that unfolds.     

Ethical notes on disrupted frames and violated boundaries.

Despite the fact that the analyst's work unfolds at the crossroad of a prevalent moral code, psychoanalysis has neglected to address ethical or philosophical arguments. Such arguments have significant technical implications for the discipline in regard to "dos" and "don'ts." Different approaches to moral dilemmas are considered in relation to pertinent aspects of the psychoanalytic frame and the psychoanalytic process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

God's Influence on My Psychoanalytic Vision and Values.

Contemporary psychoanalysis has come to view all aspects of the analyst's subjectivity as potentially exerting an influence on the analysis. Nevertheless, the analyst's religious background and beliefs about God have not been investigated for their influence. The author's own theoretical and clinical contributions have centered on the themes of mutuality and asymmetry in the analytic relationship. It is not accidental that his or her religious imagination also rests on these dimensions of the relationship between God and the individual. The Brit, or covenant, between God and the people is the core foundation of the Jewish faith. A covenantal relationship requires mutuality, not symmetry or equality, because it is clearly hierarchical, but nevertheless it must be reciprocal, and its centrality implies Judaism's foundations in this mutual relation. Thus, the author uses his own experience as an example of the subtle ways in which religious ideas may influence psychoanalytic theorizing and practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Obstacles for the psychoanalyst in the practice of couple therapy.

In this article, the author discusses common ways in which couple consultation and therapy are practiced by psychoanalysts and the limitations of each. The author argues for an approach to the assessment and treatment of patients who present with a disturbed relationship that addresses the vicissitudes of unconscious collusion and develops this principle as a fundamental criterion for making the recommendation of couple therapy over psychoanalysis or psychoanalytic psychotherapy. The author then elaborates an understanding of a variety of obstacles, those emotionally determined and those determined by analytic ideals, which limit the analyst's freedom to assess the most appropriate modality and to conduct couple therapy within the psychoanalytic model described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Requiem or reveille: A response to Robert F. Bornstein (2001).

The most common error in debating psychoanalysis is confusion between method and theory. From the perspective of operationalism, the touchstone of science, any science should be defined by its method first and theories second. This is the thrust of the author's response to R. F. Bornstein's (2001) condemnation of psychoanalysis as nonscientific. Empirically, psychoanalysis is a method and a technique of observation--of the analysand and analyst's interactions, both verbal and nonverbal, in the psychoanalytic situation; of reciprocal free association; of the dynamics of dream psychology and unconscious intrapsychic and interpersonal processes; of transference--and this results in the special nature of psychoanalytic interpretation. A further source of confusion is the politics of the psychoanalytic movement and its component organizations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nonverbal communication in the context of dissociative processes.

Nonverbal communication, at both conscious and unconscious levels, can be portrayed as a type of "body language," a communication between the psychic bodies of patient and therapist. In this article, the author provides several examples of this communication process in the context of a psychoanalytic treatment with a patient who has a history of trauma resulting in frequent dissociative states. Motoric actions (drawing), somatosensory symptoms, and intense affect states represent the media through which she "informs" the analyst of her painful experiences. The analyst's surrender to countertransference states, such as deadness, constitutes the beginning of attunement to the patient's body communications. In one particularly unusual symptom of dissociation, the patient exhibits physical abilities that she is incapable of in more integrated states. An attempt is made to understand this event from a phenomenological and neurobiological perspective. Using an information-processing model, the author illustrates one instance of how the patient's subsymbolic information may be converted to the verbal symbolic via the analyst's use of evoked images. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal depression, paternal psychopathology, and adolescent diagnostic outcomes.

The authors examined the relationship between maternal depression, paternal psychopathology, and adolescent diagnostic outcomes in a community sample of 522 Australian families. They also examined whether chronic family stress, father's expressed emotion, and parents' marital satisfaction mediated the relationship between parental psychopathology and adolescent outcomes. Mother's education, child's gender, and family income were covaried in all analyses. Results revealed that maternal depression and paternal depression had an additive effect on youth externalizing disorders. In addition, maternal depression interacted with both paternal depression and paternal substance abuse in predicting youth depression but not youth nondepressive disorders. Chronic family stress and father's expressed emotion appeared to mediate the relationship between parental psychopathology and youth depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)