Interpreting sex.

Manifest references to sex issue from varied levels of psychic function, and they serve many functions in the patient's construction of the here-and-now analytic relationship. Once explored psychoanalytically, with special reference to transference and countertransference, that manifest material often leads into the unconscious fantasies characteristic of the paranoid-schizoid position, as described by Kleinian analysts. Resolution of sexual problems then requires working through the primitive narcissistic trends on that level. Clinical examples are included. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The use of dreams in brief therapy.

Suggests a general clinical framework for listening to dreams and interacting with the patient's dreams in brief therapy. Dreams may aid in assessing the quality of object relations and transference, facilitating expression of repressed affect, setting a therapeutic focus, placing dream material in reality, determining resistances, locating meaning, and implementing insight. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Freud's narrow escape and the discovery of transference.

Contends that Freud discovered transference in connection with material derived from his treatment of Emma Eckstein. The last chapter of Studies on Hysteria by J. Breuer and S. Freud (1895) in which Freud's 1st published use of the term transference occurs, can be read as a working through of the crisis that occurred when Eckstein nearly died. This concept, it is argued, explained Freud's patient's disturbed feelings toward him as a "false connection" and thereby helped to free him of feelings of personal involvement in her libidinal demands. The story of the troubled circumstances under which Freud discovered transference provides insight into the defensive nature of the concept. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Other times, other realities: Toward a theory of psychoanalytic treatment.

Reviews the book, Other times, other realities: Toward a theory of psychoanalytic treatment by Arnold H. Modell (see record 1990-97902-000). This book is addressed to the psychoanalytically sophisticated reader. Its introduction and 10 chapters take the reader through a history of ideas that have been postulated to explain why psychoanalysis works. Interspersed are valuable comments by Modell that include his own original contributions to the discussion. Chapter 1 revolves around Freud and Nachtr?glichkeit. Chapter 2 illuminates the paradoxical relation between reality and illusions that is manifested in the analytic setting. The concept of reality and its various levels are examined in chapter 3. Chapter 4 discusses the neurobiological theories of Edelman, who postulates that memory is not isomorphic with past experience but a recategorization. Modell sees different levels of reality as corresponding to different forms of transference. He relabels transference neurosis as iconic/projective transference and the transference derived from the setting as dependent/containing transference. Chapter 5 amplifies his remarks on linear and cyclic time. Chapter 6 discusses interpretation and chapter 7 examines the concept of resistance. Other chapters deal with the patient's use of the therapist, with paradox and therapeutic dilemmas, and with various theories of psychoanalytic treatment. Modell tries to classify contemporary theories of psychoanalytic treatment but recognizes such attempts as little more than convenient fictions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How you play the game: On game as play and play as game in the psychoanalytic process.

This article proposes that all communications of patients in psychoanalytic psychotherapy and psychoanalysis are distributed along two coexisting dimensions which are designated "gaming" and "playing." It is suggested that these reflect two different aspects of the underlying therapeutic process, both of which are always present but to varying degrees at different times. "Playing" refers to the symbolic play with thoughts and fantasies, occurring during moments of free association and fantasy play with toys. At these times, the transference appears relatively positive and sublimated, and the therapeutic work consists predominantly of recall and reconstruction of anamnestic material often related to neurotic issues. "Gaming" characterizes periods of repetition of repressed conflicts within the transference neurosis, with highly intensified responses to the therapist with whom and around whom fantasies and conflicts, often of a characterological nature, are reexperienced. These are frequently expressed through action including structured games with children, acting in, and acting out. Clinical illustrations from the treatment of an adult and a child are discussed in relation to these processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aspects of the therapeutic action in child analytic treatment.

Explores sources of gain in psychoanalytic work with children. Therapeutic gains are shown to be directly related to the patient's development of the capacity to empathize with self-representations as experienced and communicated by the therapist. The focus of this article is the patient's use of projective identification. Clinical material is used to illustrate a sequence that involves the projection of initially disowned self-elements, the evocation of corresponding affects and fantasies in the therapist, the patient's empathic scrutiny of the fate of these elements while contained within the therapist, and the eventual reinternalization by the patient of the now therapeutically transformed self-elements. It is argued that those elements of the therapist's self that are experienced by the patient as related to the projected material will also be reinternalized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief psychotherapy for unresolved grief in an 82-year-old-man

This man experienced in old age the torment that occurs when early fantasies that underly anxieties are enacted in real life. His elderly wife, when she became confused, ordered their son to drive him from the marital home. When the wife died, the son kept the news from the husband until after the burial. These acts created in reality the fantasy of a reversed oedipal situation, with the son succeeding as a competitor for his father's wife. If the father had resolved his own oedipal strivings satisfactorily, presumably he would not have feared such competition. But there seemed to have been some early environmental failure that had prevented him from integrating in the process of maturation his own wishes for his mother and his fears of his father. Yet, despite the patient's advanced years, the early failure situation seemed to fade as he used the therapy not only to work through his grief, but also as an opportunity to experience anew in the transference a more facilitating environmental adaptation to his needs.     

Psychoanalytic therapy of the borderline patient: Treating the fusion-separation contradiction.

The thesis of the article is that borderline psychopathology can be successfully treated by psychoanalytic therapy, and the principles of this treatment are outlined. Borderline psychopathology is defined as fusion in close relationships and reality adaptation in other situations. Thus, the major treatment issue is seen as the resolution of the transference psychosis. The article makes a distinction between overt and covert transference psychosis and demonstrates how both forms may be treated through interpretive means. A case treated in this manner is used to demonstrate the resolution of the transference psychosis with primary reliance on interpretation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the Umbilicus as a bisexual symbol.

A middle-aged male patient is described for whom the navel was a symbol of both passive and aggressive sexual strivings and a site for sadomasochistic fantasies. Historical material is presented to support the likely use of the navel in this way and to suggest its possible universality as a bisexual symbol. The patient's use of his own navel as a bisexual symbol allowed him to play both female and male sexual roles in fantasy. By means of projection upward, his navel became a phallic equivalent, but his navel also served as the focus of fantasies of being penetrated. The entire abdominal region had become eroticized in his own body and was the focus of his interest in the bodies of potential male sexual partners. The significance of the navel in the fantasy life of male patients may be more common than has been noted by clinicians. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The analysis of the transference in the here and now and Essential papers on transference analysis.

Reviews the books, The analysis of the transference in the here and now by Gregory Bauer (see record 1994-97149-000) and Essential papers on transference analysis, also by Gregory Bauer (see record 1994-97131-000). These are companion volumes which present an excellent, systematic understanding of Bauer's contemporary approach to Here and Now Transference Analysis in psychodynamic and psychoanalytic practice. The here-and-now method highlights the use of the affective immediacy of the relationship between the patient and therapist to "clarify, explore and modify interpersonal conflict rather than as a springboard for discussing the genetic determinants of conflict." Bauer focuses on reactions and behavior patterns that are transference based, as opposed to focusing on the transference neurosis seen as the systematic development and interpretation of fantasies and attitudes that are highly organized and displaced onto the therapist. The former is viewed as a less intense variation of the latter; both are felt to be a part of the same transference continuum. Bauer's volumes provide the clinician with an excellent overview and primer on Here and Now transference analysis, as well as its history, conceptual underpinnings and techniques for using it in the therapeutic relationship. The analytic and psychodynamic practitioner alike will find these books an invaluable addition to their professional libraries. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Punishment fantasies and the construction of reality.

The internalizations comprising the conscience are not a mere representation of what to expect of one's self and the environment. Such internalizations serve to relinquish incestuous object choices and derivatives and to undo and redirect dangerous hostile, competitive impulses. These internalizations are comprised of self and object-representations that are actively induced and reconstructed in the world. Further, such internalizations are organized sado-masochistically and function as a sort of normative perverse structure, reinforcing narcissistic fantasies of omnipotent control. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The negative therapeutic reaction.

The negative therapeutic reaction (NTR) is a unique case of negativism in which the patient demonstrates an inability to tolerate success in treatment. This results in the deterioration of the patient's condition shortly after progress is achieved. The NTR is distinguished from either a regression that accompanies a transference neurosis or a form of negative transference in psychotherapy. It is suggested that the patient perceives her/his progress and approval by the therapist as a severe threat to the patient's autonomy. The fear of fusion with the therapist propels the patient into an extreme negativistic position that is expressed by her/his deterioration. The case is presented of a 48-yr-old female who reacted to improvement in treatment with a negative refusal to consolidate these gains and translate them into a more effective adjustment. (42 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An interpersonal perspective: The analyst's unwitting participation in the patient's change.

Comments on the analysis of P. A. Dewald's (1972) patient and suggests that Dewald's technique is an example of 1-person psychology. The analyst believes he/she is observing the pure culture of the patient's projection of intrapsychic, drive-based material. The author attempts to bring a 2-person, participant-observation, perspectivist model to the clinical interaction between Dewald and his patient. A variety of ways in which Dewald unwittingly participated in the patient's transference to him are outlined. It is argued that these unidentified countertransference enactments clearly influenced the patient and were not sufficiently addressed in the analysis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lesbian homoerotic transference in dialectic with developmental mourning: On the way to symbolism from the protosymbolic.

This clinical study illustrates the developmental nature of homoerotic transference, when the psychoanalyst is attuned to the evolving dynamics of the mourning process, in this case with a lesbian analysand. The analysand's psychic fantasies of the female analyst as a muse and a demon lover figure are seen to transform into discrete mother and father transferences, as split off feminine and aggressive parts of the self are reintegrated along with heterosexual desires and oedipal desires. Protosymbolic enactments in terms of romantic gift giving and other seductive overtures transform into symbolic expressions of love, concern, regret, and tenderness. A lesbian marriage is preserved, and the loss of intimacy with men is mourned so that desires for intimacy with men can be sublimated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beyond intersubjectivity: Personalization and community.

In this article, personalization is defined as diverse forms of recognizing the other as a unique, responsive, inviolable, and valued subject, all of which are contingent upon community. The processes of personalization are depicted further in terms of (a) the dialectic of recognition and negation, (b) personal and impersonal epistemologies, (c) intentionality and fact, and (d) asymmetrical and mutual recognition. Good enough parenting may be understood in terms of varied forms of personalization, which contribute to psychosocial achievements--psyche-soma integration, sense of going on being or cohesion, self-continuity, sense of aliveness and being real, the capacity to make use of social reality, self-reflection, and emotional regulation. These forms of personalization are supported by the community's web of symbols--symbols that facilitate and represent recognition and appearance of the other as a unique subject. Given the relation between personalization and community, transference is reconceptualized as the patient's history of personalizing, impersonalizing, and/or depersonalizing interactions, as well as his or her desire for and fear of personalization and fellowship. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology's reality debate: A "levels of reality" approach.

For different reasons, some modern and postmodern psychologists are skeptical about the reality of psychological phenomena as irreducible, influential entities. Nonetheless, much psychological inquiry presumes precisely such a reality. The authors present a "levels of reality" approach to psychological reality that they believe can assuage some of the concerns of psychological skeptics. This approach treats psychological reality as inseparably embedded in sociocultural, biological, and physical levels of reality, without being reducible to any of these other levels. The authors develop their "levels of reality" approach in relation to four different doctrines of realism, and elaborate its implications for understanding psychological phenomena. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intergenerational work as an adjunct to psychoanalysis and psychotherapy

Psychotherapy and psychoanalysis are opportunities for individuals to repair faulty aspects of their development that have resulted in symptoms or other difficulties in living. Although transference is the major therapeutic tool in this work, it is not the only one. The potential resources for healing that exist in family relationships is great, especially as these relationships go on long after therapy has ended. We are all living longer; families of three and four generations are no longer uncommon. There are many adult patients who have one or both parents alive and well. Intergenerational work can be a useful adjunct where there is no severe narcissistic pathology or psychosis in either patient or parent. It is especially helpful in cases where there is severe resistance and insight is not effective in promoting change. "By focusing constantly on the patient's transference distortions and ignoring reality elements we undermine self-esteem and make him feel he is always wrong, sick or crazy" (Greenson, 1978b,p. 434). The addition of intergenerational work in the course of psychoanalysis/psychotherapy can shorten the time of therapy and be another tool for dealing with resistance. This work has theoretical implications for the modification of the place that transference has in psychoanalytic therapy. By placing greater emphasis on the patient's real relationships in influencing intrapsychic change we pave the way to exciting clinical and theoretical possibilities.     

Knowing oneself from the inside out, knowing oneself from the outside in: The “inner” and “outer” worlds and their link through action.

This paper illuminates how the “inner world” of wishes, fantasies, affects, and self- and object-representations and the “outer world” of overt behavior and social reality continuously and reciprocally co-create each other. Basing its presentation both on case material and theoretical analysis, it demonstrates the limitations of a linear, archaeological theoretical vision of surface and depths. In its place, the paper shows how daily life and conscious and unconscious subjective organization mutually shape and maintain each other and in the process maintain the individual's dominant personality patterns. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Father-daughter incest: Unconscious fantasy and social fact.

This article examines the etiological role of incest as unconscious fantasy and incest as social fact in producing psychopathology. It reevaluates the importance of the Freudian theory of fantasy for an understanding of father-daughter incest, with particular attention to the relationship between fantasy and memory and between conscious and unconscious fantasy. Although the importance of acknowledging the social fact of incest is affirmed, I maintain that an analysis of the mental representation of the incest experience in fantasy is as crucial to the treatment of incest victims as is an acknowledgment of the primary etiological role of real victimization in producing pathological states. Case material is presented to illustrate the ways in which the reality of incest may combine with stage-specific fantasies to determine the nature and extent of the incest victim's pathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)