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This paper offers a brief résumé of Winnicott's approach to psychoanalysis through a reading that emphasizes his interest in the capacity to be as a fundamental acquisition of human subjectivity. This interest continued throughout his life. The paper argues that it is closely related to his interest in analytic communication and the emphasis in his paper ‘Communicating and not‐communicating leading to a study of certain opposites’ of the importance clinically of the patient's right not to communicate and the analyst's acceptance of it. It refers briefly to the richness of the arena opened up by his idea of the incommunicado self and its implications for both theory and practice. Three clinical vignettes are included to demonstrate Winnicott's way of working. [ABSTRACT FROM AUTHOR]

What emotional experience settles a disturbed state of mind? In this paper I use the work of three psychoanalytic clinicians (John Steiner, Eric Brenman and Henri Rey) to describe the negative state of mind of a patient and draw on clinical material to illustrate my efforts to settle deep emotional disturbance. Recognizing the size of the emotional task by conceptualizing the depth and breadth of the pathological organization, along with thinking carefully about the ingredients of a ‘strengthening introject’ and locating an ‘introjective site’, taking into account the developmental disparity between therapist and patient are all seen as essential counter‐transference processes required to facilitate movement from a bad to a good state of mind. [ABSTRACT FROM AUTHOR]

Clinical practice with children using drawing always provokes surprise, and one of the surprises concerns the diversity in the speech of the child as they draw. If we pay attention to children's speech, we can comprehend children's internal world better, and explore their symptom as a question. In this article, I explore the interpretation of children's speech, through considering a clinical case of a boy using drawing, making use of a drawing method in which there is a transition from one sheet of paper to another. I also look for a point of contact between clinical practice with drawing, and elements of Lacanian psychoanalysis. This approach builds upon, and also then differs from Kleinian perspectives. The paper begins with an account of my work in a nursery with a child drawing, and then moves on to consider both a Kleinian perspective, and some ideas from Lacanian psychoanalysis which particularly concern my interventions as forms of interpretation. Particular emphasis is given to the Lacanian principle of scansion. [ABSTRACT FROM AUTHOR]

The author addresses some issues regarding patients who relocate and who struggle with adaptation to a new reality. She argues that emigration is a complex psychological phenomenon that requires a therapist to pay special attention to the issue of language, difference and identity, and suggests that the issues of different culture and language in analytic psychotherapy need to be considered as part of a wider cultural context to which we all belong, rather than a specialized area of interest. The paper illustrates, through the clinical example of an East European male patient, that the psychic work of emigration can be understood as a process of integrating splits between pre- and post-migration selves. The author concludes that the analyst needs to let herself be involved as a 'real person' to reach the non-interpretative aspects of the patient's psyche through a mutuality of shared experience to promote a change. [ABSTRACT FROM AUTHOR]

This study investigated the detoxification process of shame in integrative psychotherapy from the client's perspective, focusing on the experience of shame and the interventions used in working with toxic shame. Through identifying the detoxification process, successful therapeutic outcomes that reduced shame over time were determined with further exploration into the experience of the shame phenomenon. Interpretative phenomenological analysis was used to analyse data from transcripts of semi-structured recorded interviews from a sample of trainee/qualified therapists who had experienced shame as clients. The findings from the study evidence the separating and isolating qualities of the shame experience, an experience that was crippling and correlated with development and early infantile relationships. The findings of this study highlight how shame is experienced and the fundamental role therapists have in detoxifying shame through recognizing, understanding and working to normalize it. Sensitivity to the shame experience is crucial so as not to compound the shame experience further. The need to be sensitive to regression in treatment, the need for a secure attachment within a relational oriented psychotherapy such as integrative psychotherapy and the centrality of the relationship in the reparative process are seen as fundamental to the effective management of toxic shame. In view of integrative psychotherapy being influenced by a variety of psychoanalytical theories, this paper draws upon psychoanalytic and humanistic perspectives in the analysis and interpretation of the findings. [ABSTRACT FROM AUTHOR]

abstract In this paper I explore programmes of work undertaken to address institutional racism within two institutions providing psychoanalytic psychotherapy training and services. The paper suggests that training institutions of this kind may be paradoxically positioned. The same features that we might expect to facilitate reflection and change in favour of increased tolerance and diversity may act as points of organizational resistance to change. The paper draws on a range of theoretical resources that may be helpful in understanding the acute anxieties that are often mobilized when institutional racism is named and identified as something the organization has decided to tackle. The account is interwoven with various personal reflections on the experience of this work, and some autobiographical observations that may illuminate the stories presented. [ABSTRACT FROM AUTHOR]

This paper describes how the radical concept of maternal perversion first presented by Estela Welldon (1988 ) informs the psychotherapeutic assessment and treatment of female inpatients within forensic services and of women in the community who commit acts of violence. It presents a model of the psychology of female violence that the author describes as ‘crimes against the body’. The paper offers clinical evidence for Welldon's model of female perversion in forensic settings and provides an extended clinical illustration of psychotherapeutic work, when the therapist was pregnant, with a woman who killed her child. [ABSTRACT FROM AUTHOR]

As this paper was originally delivered as the British Journal of Psychotherapy Annual Lecture, I have retained the spoken tone of the original. In contemporary physics, cosmology and philosophy, there is now a recognition that no single paradigm or theory can represent reality and growing credence in the idea that learning is advanced more rapidly through a pluralistic model. This paper argues that the same applies to psychoanalysis and the psychoanalytic psychotherapies. It explores the value given to the recognition of difference in contemporary Independent, Lacanian and post-Kleinian thought and the psychopathology attributed to single vision, and argues for the urgent need to engage in constructive cross-paradigmatic discussion. [ABSTRACT FROM AUTHOR]

Mindful of the importance of word usage for accurate verbal or written description the paper aims to develop Esther Bick's caution about the use of words in infant observation and clinical work. It is suggested that this caution was part of Bick's process of creating a state of mind akin to negative capability, allowing for the accurate perception of experience and its subsequent translation into words. From this point the paper suggests that the task of translation for clinicians and observers benefits from a detailed consideration of the technical writings of certain poets who have explored the problem of translating experience and ideas into words. Overall the paper attempts to draw clinicians' attention to the sensual quality of observation, and thus similarly to the words used to translate what is seen and experienced. [ABSTRACT FROM AUTHOR]

In recent times much has been made of integrative tendencies and common ground between therapeutic orientations, previously locked into highly oppositional frames. This is evident in the rapprochement between psychoanalysis and cognitive-behavioural therapy in adult mental health. It is a trend that is also evident in the shifting relationship between systemic and psychoanalytic orientations. This paper begins with an overview of factors influencing the wider integrative ethos before considering the specific circumstance of the relationship between systemic family therapy and psychoanalysis. The paper considers both the past history of oppositionality between the two orientations as well as some current developments that might facilitate a more creative dialogue. Particular attention is paid to issues of similarity and difference between the therapeutic relationship in systemic family therapy and the psychoanalytic framework of the transference/countertransference. Implications for therapeutic technique are explored. The aim is not to minimize difference but to encourage cross-fertilization between these therapeutic orientations in the interest of patients/families who may benefit from an integrated response. [ABSTRACT FROM AUTHOR]

The first half of this paper attempts to track and to elaborate Freud's thesis on the mechanism proper to psychosis with particular attention paid to the case of Schreber. It is written emphasizing that Freud was only at the initial stages of his work on the function of the father and that this led to the stumbling blocks he encountered and left him dissatisfied with his work. The second half of the paper looks at the way in which Jacques Lacan took up Freud's work. It looks at how he used it to understand the structure of psychosis in a new way, giving the specific problems that arise in psychosis a central place in the practice of psychoanalysis. [ABSTRACT FROM AUTHOR]

This paper considers consciousness from the point of view of extreme materialism, which asserts that everything is physical and extreme idealism, which asserts that 'the world is my idea'. Attempting to avoid dualism, I argue that there is no fundamental ground of being and that consciousness is a no-thing. Science can explain its mechanisms in terms of 'propositional knowledge' but this is distinct from the 'experiential knowledge' that refers to the domain of meaning (psychic reality). Although consciousness is omnipresent and infinite, it is surrounded by the further infinity of the Unknown. Together these comprise the totality that Jung called 'the Self'. The paper concludes with some reflections on the experience of Being in 'the Isness Business'. [ABSTRACT FROM AUTHOR]

In this paper, I argue that construction is not merely a tool amongst the many that are at the clinician's disposal; construction is the very means and end of the psychoanalytic experience. I reinterpret Freud's classic notion in light of the Winnicottian found object and the Deleuzo- Guattarian understanding of desire as production. I then go on to deploy two detailed clinical vignettes in order to show how, thus reinterpreted, construction is at its most valuable when it is generative rather than historical. Instead of merely eliciting an accurate representation of a lost experience, construction brings about further associations, interpretations and, indeed, constructions that reshape the subject. [ABSTRACT FROM AUTHOR]

This paper sets out a framework for a comprehensive theory of Body Dysmorphic Disorder ( BDD), based on interview data and theoretical reading. It combines psychoanalytic, cultural and political insights. It develops the author's earlier work on body hatred ( Parker, 2003). The role of the other - actual, imagined or fantasized - is central, and ambivalence about the body, inflated by shame, is key to this dynamic. Any part of the body may be involved, and checking is compulsive, betraying an omnipotent struggle for acceptability and normality. The author suggests that BDD sufferers are especially sensitive to the power, pleasure and pain of looking and being looked at, with the objective sense of self dominating any subjective sense. Object relations provides explanations of individual differences in susceptibility to BDD, through failures of maternal mirroring. Lacan's theory of the mirror stage explains the origin of the ambivalent relation of the subject to his/her own image, rivalry with self and other, shame and desire, as well as the enduring power of cultural norms of appearance. Freud's ideas on taboo and ambivalence, and their dynamics in changing cultural forms, are illustrated and linked to Douglas's ideas of pollution and taboo. [ABSTRACT FROM AUTHOR]

In Part 1 of this paper the authors summarize those key concepts in Jungian analytic theory which differentiate it from a psychoanalytic approach. To illustrate these perspectives and their application in clinical work, a patient is introduced. The authors elaborate on a particular dream with the proposition that it holds within it both an image of the internal world of the patient's personal psyche and something which might be viewed as archetypal and emerging from the collective unconscious. Part 2 focuses on more recent developments in Jungian analytic thinking. Michael Fordham's important work in extending Jungian theory into an understanding of infant development is summarized and illustrated by a clinical example. This is followed by a brief summary of how contemporary debate within the Jungian analytic community has been much affected by recent developments in areas outside the analytic discourse which have offered both a challenge to and an affirmation of certain Jungian concepts. Examples given are from emergence theory and neuroscience. The Jungian interest in such phenomena stems from a view of the human psyche as rooted in a wider world of matter, culture, history and an unconscious that is not only personal but also collective. [ABSTRACT FROM AUTHOR]

The authors of this paper recognize the paradox of identifying with the body of work of D. W. Winnicott as it was essential to his view that each analyst has to become the analyst s/he is or can be. This is to avoid the dead hand of conformity and falsity. Nevertheless his work continues to inspire creative use with its concern with health and those conditions for its development. Both authors find themselves committed to history taking, to needing and taking time, to a willingness to wait before interpreting, to a recognition that the self derives originally from a bodily state of unintegration, that the body remains significant for the expression of self-states, to an understanding of aggression as not primarily associated with destructiveness, to attending to the state of mind in the analyst that encourages the establishment and maintenance of the analytic setting. Clinically their intention is to maintain a continuity within which psychic change can be facilitated, through an attention to the ongoing exchanges between both parties of the analytic relation. Several clinical examples are given from different settings to illustrate the presence of these tenets in their work. [ABSTRACT FROM AUTHOR]

abstract Taking the correspondence between James and Alix Strachey 1924-1925 between London and Berlin as a starting-point, the paper investigates the relationship between psychoanalysis and culture in the mid-1920s in both capitals. [ABSTRACT FROM AUTHOR]

abstract We worked with Bob Hinshelwood for many years and begin our paper with an account of what we experienced as the essence of his approach in applying psychoanalytic understanding, especially an awareness of the ubiquitous effects of projective identification, to individual, group and organizational dynamics in mental health settings. This takes the form of a juxtaposition of some ideas and responses triggered by contact with patients expressed by Bion, Samuel Beckett and Bob himself. They all conveyed what it feels like when 'bits of identity' are passed around through unconscious interpersonal interactions. We then introduce the forensic psychotherapy context in which we work and try to apply what Bob helped us to see. Contact with severely mentally ill patients, who have committed catastrophic assaults, is work on the countertransference edge where patients' deficit in the capacity for symbolic communication and subsequent resort to action - sustained streams of projective identifications - evoke the maximum emotional impact in staff. We conclude with an example of a reflective practice group for beleaguered, often frightened, staff who desperately need but also attack - much as their patients do - what Bob called the attempt to build a reflective space which is so vital to survival and effective work. [ABSTRACT FROM AUTHOR]

abstract This paper argues, with examples which include the nuclear arms race and climate change, that the most valuable psychoanalytic insights into political questions are likely to be counter-intuitive, since they will draw attention to unconscious states of mind which resist recognition. [ABSTRACT FROM AUTHOR]

abstract Following ), the paper points to an overlooked point of cultural access to psychoanalysis in early 20th century England - the enthusiastic reception of Freudianism amongst scientists in Cambridge. The manuscripts of the Marxist X-ray crystallographer, J.D. Bernal, are employed to reveal his quasi-religious enthusiasm during the 1920s for psychoanalysis as the foundation for a revolution in all the sciences; this enthusiasm disappeared with Bernal's growing commitment to the cause of socialist science. [ABSTRACT FROM AUTHOR]

abstract The paper addresses aspects of the difficult relationship scientific research has had with psychoanalytically-informed institutions. These difficulties stem from a position of rejectionism long held by institutional psychoanalysis with regard to the role scientific research may play in the development of psychoanalysis. It is argued that the development of a solid integration between scientific research and clinical psychoanalysis can help psychoanalysis grow and contribute to resolving the theoretical fragmentation present in today's psychoanalysis. Institutional reactions to results coming from scientific studies that do not confirm assumptions, expectations, beliefs or current practices are described and discussed. Two examples of research studies carried out at the Psychotherapy Department of St Bernard's Hospital and at the Cassel Hospital, during Bob Hinshelwood's time there, that did not meet the institutional blueprint are presented. [ABSTRACT FROM AUTHOR]

abstract The paper recalls experiences as a member of groups taken by Isabel Menzies Lyth during the 1960s and the significance of matters of 'presence' and stance. It sketches out ways in which she was to extend Bion's frame of reference to take account of the institutional contexts in which groups were located and her insistence on the two-way inter-relation between individual and group work, psychoanalysis and group relations. [ABSTRACT FROM AUTHOR]

Drawing on the ideas of Birksted-Breen (1996 ) and Houzel (2005 ), this paper discusses the concept of bisexuality, which has been viewed in various ways in the psychoanalytic literature. An argument is made for a clearer definition and conceptual distinction using the terms ‘psychic’ and ‘mental’ bisexuality. Houzel's ‘psychic bisexuality’ and Birksted-Breen's ‘mental bisexuality’ are distinguished as two separate developmental phases which promote the establishment of psychic space and thought. Psychic bisexuality pertains to the structuring of the self and the development of internal space. Mental bisexuality pertains to the functioning of the mind, with the development of space between internal objects and between self and others. Central to these developments are the containing functions of being both close enough to, and distant enough from, the patient. Clinical material illustrates how interwoven problems at the stage of psychic and mental bisexuality can be and demonstrates that the development of internal space, and space between self and others, requires internalization of both the psychic and mental bisexuality of the therapist. [ABSTRACT FROM AUTHOR]

This paper highlights some key features of a Jungian approach to transference and countertransference and suggests that a Jungian model has crucial aspects in common with contemporary views in attachment theory on the nature of the analytic relationship. The analytic relationship is examined in terms of the fundamental processes of psychic development described in attachment theory and affective neuroscience, namely affect regulation and development of reflective function and of self-agency. The relative value of three analytic techniques, those of interpretation, new relational experience and regression, are discussed in relation to these processes. I suggest that each of the traditional psychoanalytic and Jungian analytic models concentrates on differing aspects of these psychic processes and analytic techniques. I construct a grid to illustrate this and to demonstrate how attachment theory and developmental neuroscience offer a theoretical basis on which we can develop an integrated model of the nature of the analytic relationship and tasks. [ABSTRACT FROM AUTHOR]

This paper examines ways in which Matte Blanco’s ideas can be used to link psychodynamic and cognitive behavioural theories. The two approaches have developed independently but integrative thinking is becoming increasingly important. Psychodynamic concepts are used in some cognitive approaches and unconscious processes are a focus for academic psychology and neuroscience. Matte Blanco provides us with an alternative logic for the unconscious which can be used to develop the cognitive behavioural approach and provide links with understanding from the analytic tradition. [ABSTRACT FROM AUTHOR]

Psychoanalytic thinking is suspicious of the notion of perfection, whereas Christian (and other religious) thinking allows an important place to it. Is psychoanalytic hostility justified, or is it part of the depressive mind-set which even some insiders have attributed to the analytic perspective? With help from George Bernard Shaw and Robert Browning, this paper explores the reasons for therapeutic suspicion, but also considers Jesus' teaching about perfection. Following leads offered by Matte Blanco, Jung and others, it argues for the spiritual and therapeutic value of making space for a dream of perfection -- but it also highlights the murderous consequences of allowing the dream to become concretized. [ABSTRACT FROM AUTHOR]

Psychoanalysis cannot explain social phenomena directly, but the human responses to social, economic and historical forces can be described. In this paper I want to look at the interaction between the underlying psychology of the unconscious of individuals in groups, and to theorize how that provides a basis upon which social forces may act. Certain aspects of racism and national identity serve as useful illustrations of how the social phenomena interact with the psychology of individuals. [ABSTRACT FROM AUTHOR]

This paper investigates some aspects of consciousness by drawing on the psychology of meditation. Three states of mind are described: semiconsciousness, consciousness and, following the mystics, the possibility of a consciousness which transcends ordinary ego awareness. Some experiences of three authorities on Christian spirituality - Augustine of Hippo, Evagrius of Pontus and Teresa of Avila - are explored in the light of psychoanalytic reflections provided by Erikson, Jung, and Winnicott. [ABSTRACT FROM AUTHOR]

In this paper the history of consciousness will be discussed in relation to the place of psychoanalysis in the history of ideas. A holistic way of thinking is described, which brings together various ideas about how the nature of reality is perceived, when science has for the last 200 years seemed to win out over religion. The influence of Goethe on Freud suggests an unrecognized holistic element in Freud's work. A holistic approach reconciles some of the divisions between scientific and religious thinking and leads to a discussion of the sacred. [ABSTRACT FROM AUTHOR]

Consciousness was described by Freud as 'a fact without parallel'. This paper suggests that the attempts by modern psychology and neuroscience to understand consciousness have failed to appreciate that it lies for clear and necessary reasons beyond the reach of 'science' as we have understood it since the seventeenth century. The author goes on to argue that the fact of consciousness implies a world of subjectivity and uniqueness which will only be integrated with the world of empirical science if there can be profound changes in our understanding of science itself; or, alternatively, if clear bounds are recognized to science's domain. [ABSTRACT FROM AUTHOR]

This paper explores some distinctive features of brief analytic psychotherapy as I practise it in a busy inner London GP surgery. The application of brief therapy to a borderline patient is discussed and there is an emphasis on a collaborative way of working. Psychodynamic ideas are applied to the use of the setting and, in particular, the clinical meeting of GPs and psychotherapist where important decisions are made about the continuation and nature of the treatment. Particular features of the discipline of brief therapy are examined such as the use of companionable interaction and exploration of the reasons why ordinary solutions cannot not be spontaneously employed by the patient. Assessment of underlying disorder which had previously remained undiagnosed is discussed in the context of the patient's concealment of her selfharm. [ABSTRACT FROM AUTHOR]

The aim of this paper is to enable the psychoanalytic reader to make an enriched emotional contact with Homer's ancient epic which, in recounting the story of Odysseus' journey homeward after the confusions of the Trojan war, demonstrates the evolution of a new ethics based on communication between the internal objects of the protagonists. Athena plays a facilitating role in adjusting the relationship of father and son, husband and wife. The reading is guided by the internal poetic structure, under the aegis of a post-Kleinian perspective on the reading process which has a clinical analogy. [ABSTRACT FROM AUTHOR]

This paper explores crying in the clinical setting and offers a perspective on the nature of the emotional link which is formed with the crying narcissistic patient. Crying is an ordinary and familiar experience in the clinical setting which is generally characterized by the therapist feeling emotionally moved with a deepening of empathy. In contrast narcissistic crying can be associated with an absence or lack of emotional fit between the therapist and patient. The nature of this lack of fit throws an important light on the underlying difficulties of the patient which must be lived out in the therapeutic relationship and, more importantly, tolerated in the countertransference, before interpretation can be realized. [ABSTRACT FROM AUTHOR]