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As some of the psychoanalytic world still struggles to give due weight to psychosocial factors in our patients' difficulties, Rustin presents us with both a straightforwardly sensible and a subtle awareness of the complexity of the interactions between a child's internal world and their external world. As I embarked on reading this selection of past papers by Margaret Rustin, I set about it in the way I have often used in book reviews - copying particularly inspiring or insightful phrases into a document so I could refer to them or quote them in the review to come. Finding a Way to the Child: Selected Clinical Papers 1983-2021 Margaret Rustin. [Extracted from the article]

Winnicott's unique contributions to a psychoanalytic theory of depression are not as familiar as Freud and Klein's writings. I concentrate on six areas: depression as a developmental achievement which denotes unit status; the role of destruction which arises from love (as opposed to hate which for Winnicott is a more mature affect); the importance of contributing‐in and the response of the (m)other in recovery from depression; the startling idea that the patient seeks out the analyst's depression; some thoughts on the differences between Winnicott and Freud and Klein; and lastly, the effect of depression on the development of self, creativity and the capacity to play. Winnicott does not shirk the darker side of being human, but at the same time he offers us a hopeful picture. [ABSTRACT FROM AUTHOR]

This paper proposes a Lacanian theory of shame linked to the era of Lacan's work starting with Seminar X and the invention of the object a. From a Lacanian perspective, shame is not evoked by the exposure of a deficit, but rather by the exposure and witnessing of the divided subject's constitutive lack. This paper proposes that the affect of shame is an index pointing to the divided subject's structural lack when it is exposed and witnessed by object a instantiated as the gaze of the scopic drive and the voice of the invocatory drive. Since shame can freeze speech as well as provoke flight from the analytic work, we suggest that it is helpful for the clinician to understand how the structure of shame manifests in the patient's speech and in the transference. Clinical examples are given throughout. The paper concludes with a case discussion of Lacanian analytic work with a female patient confronted with multiple existential dilemmas that evoked shame in relationship to her body, sexuality and death. [ABSTRACT FROM AUTHOR]

In clinical practice, there is a well‐established developmental path from beginner to post‐qualification and on to some form of expertise or mastery. In this paper, I explore whether the outline of a similar pathway could be mapped out for analytic supervision. For the clinician, a key element in becoming more competent and skilled is the capacity to reflect on one's work and learn from experience. To do that the clinician learns to develop a form of internal conversation which orients them to the work. I argue that an important developmental step for the supervisor is to acquire a similar capacity, which I call the supervisor's internal monologue. In this paper, I illustrate what I mean by the supervisor's internal monologue and discuss some of its functions and characteristics. [ABSTRACT FROM AUTHOR]

This paper addresses the conditions for the development of creativity and the possible obstacles along the way. It explores conscious and unconscious mechanisms which either impede or support this process. Creativity is seen as a special case of relationships between internal and external objects, with some aspects being more consistent and others being more fluid throughout an individual's life. This paper is based on the clinical experience of psychodynamic work with clients whose psychological predicaments related to creativity impoverished different areas of their lives. The non‐exhaustive list of factors to be considered when working with those clients includes a blocked epistemophilic instinct, excessively repressed aggression, and strong negative projections. A harsh superego opposing a weak 'internal supporter' combined with an internalised negative parental attitude to their own creativity constitutes a powerful unconscious force which prevents it from blossoming. A high level of basic anxiety, a low degree of omnipotence, and the release of endorphins in response to suffering contribute to these difficulties. Insufficient capacity to sublimate emotions and an inability to free associate prevent clients from finding the links between ideas born in the mind and their expression that could be accessed by others. [ABSTRACT FROM AUTHOR]

This study provides an account of the way shame, intrusion or other adverse experiences in early childhood can prevent genuine identification with an ego‐ideal, which is felt to be a burden. I argue that the ego‐ideal is necessary to impel the individual towards continual growth and that its absence vitiates the formation of a durable ego. The paper points out the consequences for the subject, which include incapacitation of the ego and the desire to circumvent life. [ABSTRACT FROM AUTHOR]

This paper aims to advance a theoretical and clinical perspective on the developmental origin and role of omnipotence in early object relations, and a differentiation of the adult sequelae of these maturational dynamics. The focus is on negative omnipotence as inherent in the constitution and impact of the psychotic part of the personality. The case history of the psychoanalytic psychotherapy of a man with a psychiatric diagnosis of obsessive–compulsive disorder illustrates the self and treatment defeating impact of negative omnipotence. Diplomatic therapeutic engagement, based on the understanding that these negative therapeutic dynamics represent unfinished maturational processes, is presented as enabling treatment to progress and facilitate gradual beneficial modification in the use of omnipotence intra‐psychically and inter‐personally. [ABSTRACT FROM AUTHOR]

This book review discusses "Transforming Infantile Trauma in Analytic Work with Children and Adults: The Clinical Writings of Alessandra Cavalli," a collection of papers by Alessandra Cavalli, a Jungian-trained analyst. The book explores Cavalli's work with severely traumatized children and adults, focusing on the impact of early infantile trauma on the developing self. The review highlights Cavalli's dedication to establishing meaningful emotional connections with her patients and her persistence in trying to communicate with highly defended children. It also mentions Cavalli's exploration of intergenerational trauma and her consultancy work with a staff team at a home for street children in Mexico. The reviewer recommends the book to child and adult psychotherapists. [Extracted from the article]

This paper starts from the thought that we cannot take for granted that a society's highest values will survive in the long term as effective motivators within that society. By 'highest values' I mean values such as justice, concern for members of weak and minority groups, and respect for promises and for the attempt to speak truthfully - values that apply at the highest level of generality. If they are to survive and to be effective, two things may be necessary: firstly, unpredictable 'epiphanic' moments in which the power of these values is emotionally experienced by individuals, and secondly, institutions and a vocabulary in which these values can be remembered, discussed and affirmed in emotionally and imaginatively impactful ways. I shall suggest, with reference in particular to the thought of Emmanuel Levinas and Ronald Dworkin, that the second of these factors, the remembering and affirmation of values, marks out the crucial, perhaps even the irreplaceable, contribution of a 'religion' to a society. The failure, within psychoanalysis and also more widely, to appreciate the working of this function in a society over generations may mean that the consequences of 'growing out of religion' (Winnicott) have not yet been adequately recognized. [ABSTRACT FROM AUTHOR]

This paper looks at the creation of narrative in the treatment of a 10‐year‐old girl. It will explore how psychodynamic, psychoanalytically informed work can help a child whose internalized narrative structure seemed built to harbour violent, unpredictable and psychopathic objects. It will examine how close and vigilant observation of a child's internalized storyline and choice of figurines/symbols can lead to more compassion and thoughtful personification in play, and how this in turn can lead not only to the facilitation of creativity around a more coherent storyline, but also the opportunity for the therapist to 'co‐author' a different trajectory for the figurines, and outcome. Whilst the analysis will concentrate on the patient's internal world, it will extend to a discussion about the blurred lines between truth and play. The paper will present the examination and participation of symbolic play as a highly useful device for a therapist in shifting a child's interiority, in this case enough for the patient to be self‐determining in their external world. [ABSTRACT FROM AUTHOR]

This paper investigates whether conspiracy theories arising during the COVID‐19 pandemic are linked to early trauma or a specific organization of the mind. Using the Reptilian conspiracy theory as an example, the paper proposes that belief in conspiracy theories can activate unresolved memories of trauma and serve as a mediator between the psyche and intrusive content. Classic psychoanalytic concepts, as well as more modern ideas from Britton and Steiner, are explored to understand the role of early trauma and inner object relations dynamics in the development of Belief in Reptilian Conspiracy Theories (BiCT). The concept of après‐coup is introduced to explain how newer responses to familiar psychic experiences may shape beliefs in conspiracies. Additionally, the paper proposes that belief in conspiracy theories can function as a psychic retreat. Two clinical cases are presented to illustrate these ideas while maintaining anonymity. [ABSTRACT FROM AUTHOR]

This paper explores how the process of learning to harness one's creativity in analytic listening can be analogous to the process of learning to do so in painting. It draws on clinical work with one client divided into two vignettes. The first describes the author's attempts to listen analytically by paying attention to form and content; narrative structure and use of language; and by paying attention to transference and countertransference communications. The second vignette explores what happened between therapist and client as the author had grown sufficiently confident to respond more intuitively to her client's communications. It describes how the process of becoming sufficiently familiar with theory was, paradoxically, what enabled her to respond to unconscious communications more loosely and creatively in the analytic encounter. It then explores what happened when she communicated this back to the client. The paper also describes how, as a result of the training and personal therapy, a parallel process of learning to let go and play was unfolding in the author's experience of painting. It concludes that learning to harness creativity in the therapeutic encounter can have an unexpected and welcome impact on the therapist's own artistic endeavours. [ABSTRACT FROM AUTHOR]

My intervention briefly addresses the long, complex debate on technical and educational issues within British psychoanalysis during the late 1930s and 1940s. I hope to show that some of the problems discussed and the resolutions proposed by the Training Committee of the British Society during the years of the Controversies which we are commemorating are still a source of food for thought today, in spite of the fact that they belong to a specific past. I stress the importance of Strachey's ideas about an open psychoanalytic forum. This would not be the solution to all our problems, as crises and dissent are an inevitable part of the development of our discipline. However, the more transparent and the more informed we are about our past, and about the whole internal history of our discipline, including the wider cultural, scientific and socio-political context within which psychoanalysis developed and is developing, the better chance we have of understanding our present. [ABSTRACT FROM AUTHOR]

The attempt to identify and classify distinct experiences falling under the common designation of countertransference has been labelled the specifist tradition. In this paper, a model describing two dimensions differentiating four components of countertransference experience is proposed. For each experiential component (subjective countertransference, objective countertransference, therapeutic attitude and emerging experience), a brief description based on previous literature from diverse theoretical fields is offered, along with clinical implications and illustrations and an account of empirical literature explicitly or implicitly addressing the specific component. In conclusion, the model is presented as a heuristic guide that can serve different purposes across different therapeutic orientations, with valuable implications for practice, training and supervision. [ABSTRACT FROM AUTHOR]

In this paper, the author looks at some central psychoanalytic themes through the lens of literature. In literary criticism, it is clear that we construct a meaning with the help of certain formal principles. In literature, we also know that fiction differs from documentary or scientific prose. The literary critic thinks that, specifically in fiction, one may find new formal principles and, through that, new perspectives on reality. With the help of these literary constructs, the author looks at character, transference, therapeutic change and truth/reality in psychoanalysis. The argument is elaborated in relation to a clinical example. [ABSTRACT FROM AUTHOR]

Domestic violence is a prevalent public health concern, affecting millions worldwide. The presence of domestic violence affecting women and couples experiencing homelessness both continue to be underreported areas of clinical work and commissioning within the sector. This paper explores the difficulties of trying to house and contain unhoused couples with reference to the psychoanalytic ideas of attachment and the claustro‐agoraphobic dilemma. The paper argues that more wrap‐around support, such as temporary alternative housing options, are required to manage instances of domestic abuse and instances of attachment anxiety. Flexible options are also required to account for the likelihood that a couple may return to the streets when perpetrators are evicted based upon the implementation of blanket policies. The paper also attempts to offer some nuance into the complexities of relational dynamics, which are amplified by two unhoused minds coming into intimate contact with one another in front of a professional audience. The paper concludes with drawing attention to the lack of therapeutic support and lack of appetite to commission this to enable couples to explore the roles each partner can play when enmeshed in destructive forms of relating. [ABSTRACT FROM AUTHOR]

abstract Isabel Menzies Lyth's seminal paper on social systems as a defence against anxiety is so well known and frequently cited that it risks acquiring mythic or legendary status. But what explains its phenomenal influence? In this contribution I suggest that it is a model example of the psychoanalytic case study, deriving its power from a deep engagement with organizational particularities as a basis for general theorizing. Its continued influence depends upon the way in which it is used to conceptualize new organizational experiences. An example from an institutional observation undertaken as part of an advanced social work training at the Tavistock illustrates this. Institutional observation is one of a range of non-clinical psychoanalytically informed methods of training at the Tavistock, and in the final part of the paper I discuss new applications of Menzies Lyth's work that aim to illuminate the irrational forces shaping modern social policy. Death and anxieties about death emerge as a subtext of the present paper, perhaps reflecting the fact that it was prepared as part of a memorial conference to Menzies Lyth herself, and also that the paper taught us to think better about death as an aspect of organizational experience. [ABSTRACT FROM AUTHOR]

Reading the preface and foreword to Linda Hopkins and Steven Kuchuck's skilfully edited book, there is an instant feeling that it was nigh on miraculous that this book ever made it to publication. The diaries, which have been painstakingly edited, document Khan's years working as a psychoanalyst, editing and writing for various publications and working on papers with Winnicott. Diary of a Fallen Psychoanalyst: The Work Books of Masud Khan 1967-1972. [Extracted from the article]

The technical aspect of managing the analyst's emotional responses to a patient has changed over the years, from Freud's position (1910, 1912, 1915), stating that emotions are a sign of an incomplete analysis from the analyst, to the recognition of this emotion as a communication between patient and analyst by Bion (1954). This recognition led to the acknowledgment of their importance as a diagnostic tool, while avoiding disclosure by Heiman (1950) and King (1978). More recently, consideration in the ways we can interpret these feelings during the analysis has been study (Winnicott, 1947; Little 1951; Casement 1986; Ogden 2018). This paper, advocates for the disclosure of such feelings (self‐disclosure) mainly when they are of a positive nature and the patient has a history of neglect. Also, there is a reflection on the advantages and disadvantages of doing so. Finally, there is consideration of the difference between a patient's need and a patient's desire before such disclosures. [ABSTRACT FROM AUTHOR]

What can psychoanalysis learn from literary fiction? In this paper, I suggest that Kazuo Ishiguro's novel The Remains of the Day sheds light on what Freud (1900), in The Interpretation of Dreams, calls the 'day‐residues'; those unnoticed memories and fragments of experience that in the dream come to be imbued with psychic significance. Ishiguro's unreliable narrator is the butler Stevens, whose desire for 'dignity' and 'greatness' ensures he has carefully erased any trace of feeling from the account he offers of his life and relationship with Miss Kenton, the housekeeper with whom he once worked. But what readers eventually come to know of Stevens, and what Stevens comes to know about himself, is gleaned less from what he says than from what he does not say. Drawing on Freud, Laplanche, Bollas and Barthes as well as a brief clinical example, I explore parallels between the inarticulate nature of the knowledge embodied in Ishiguro's novel and the tacit kind of knowing exemplified within the psychoanalytic transference. I conclude that literary fiction has the capacity to illuminate how psychoanalysis can accommodate and expand the borders of knowledge that is unspoken or inaccessible. [ABSTRACT FROM AUTHOR]

This paper attempts to explore the stranglehold on the life of a patient who is be‐devilled by his inner world. It suggests that the opposite of Evil is the word itself backwards, that is, 'Live'. In other words, reverse Evil and we have Live. Living is about loving (whole object relating) and working (being creative). Freud said that a normal person should be able to love and to work—'Lieben und Arbeiten' (Erikson, Childhood and Society, 1965, p. 256), which meant that the individual would not be so preoccupied with work productiveness 'to the extent that he loses his right or capacity to be a genital and loving being' (Erikson, p. 256). In this paper, the author considers the word 'Live'—living in its fullest form of loving and working to be the counterpart to a non‐life dominated by the grip of destructiveness and evil thoughts. This theme is fleshed out through the clinical material on Mr A. [ABSTRACT FROM AUTHOR]

National research studies report elevated suicide rates amongst gay men, particularly those under the age of 26. Much of the current health and psychiatric literature on suicide tends to focus on the external world impacting on the suicidal individual. Although valuable, it is not enough to understand the specific circumstances that could contribute to gay men's suicidality. This paper focuses on the relationship between the external and internal dynamics at play in the suicidality of gay men, with particular emphasis on the development, influences, and nature of a cruel and punishing superego. The author provides some contemporary psychoanalytic theories on same‐sex desire as a useful framework to understand minority sexuality. Some influential classic and contemporary psychoanalytic theories regarding suicidality and the development and character of a cruel and punishing superego are presented. The concept of internalized homophobia and the impact of heteronormative masculinity on the gay man's psyche are explored as drivers for suicidality. A composite case study from clinical experience with suicidal gay men in an NHS setting is presented to illuminate the discussion. This paper could add new perspectives and important dialogue for psychoanalytic psychotherapists working with this patient population. [ABSTRACT FROM AUTHOR]

In his paper 'Communicating and not communicating leading to a study of certain opposites' (1963), Donald Winnicott suggests that there is a silent, non‐communicating area of experience at the core of the self. Poetic expression takes a prominent role in the text. In this article, I concentrate on the aesthetic dimension of Winnicott's text and use it to explore the role of aesthetic experience in the development of self‐experience. I suggest that the paper's aesthetic dimension—form, quality and structure—expresses essential characteristics of the core of the self and the mature self's communication with it. I furthermore suggest that Winnicott, by use of poetic expression, offers the idea that the core, defined here as pre‐reflective experience, can be approached through aesthetic means. Building on George Hagman and Giuseppe Civitarese, I argue that aesthetic experience creates a bridge between pre‐reflective and reflective aspects of self‐experience and thus contributes to the integration of self. I suggest that forming a connection with the core can be seen as an aesthetic act where the intention is not to transform pre‐reflective experience into reflective. Since aesthetic experience includes reflection, the effort to represent the core of the self remains paradoxical. [ABSTRACT FROM AUTHOR]

This paper presents the findings of a research project that explored the experiences of psychoanalytic psychotherapists based in the UK during the first period of lockdown in the COVID 19 pandemic. Groups of therapists met regularly to share and reflect on the impact of the sudden changes to their practice, and this paper pulls together the key themes which emerged from these discussions. The overarching preoccupations of the psychotherapists were those of loss and survival, with sub‐themes of difficulty holding the frame; reduced security and safety; challenged analytic technique; and altered relationship dynamics. The groups were highly valued by participants as offering support during times of unprecedented stress, while also providing a forum to learn from and make creative use of the challenges presented by working remotely. [ABSTRACT FROM AUTHOR]

Matricide is suggested as an important counterpart to the traditional oedipal manifestations of patricide. This paper turns to The Oresteia to examine its murderous protagonists and the meaning of the drive to eliminate mothers. A daughter may enact unconscious matricidal wishes in order to separate from an ambivalent tie to her mother, by excising femininity and femaleness in herself. The author explores early bisexual pulls that can emanate from primal scene identifications. The capacity to relinquish the option to have all options is brought in as a ubiquitous and painful developmental move away from having and being all sexes. Father's role as crucial in the sexual development of daughters, including Freud's role in relation to his daughter Anna, is considered and mourning is linked to Klein's Depressive Position. The author includes clinical material of two children from the literature and draws on interviews conducted with trans men to reflect on these struggles. The paper explores early awareness of the difference between the sexes and argues that this can fuel a protest for daughters, sometimes manifesting as a 'no‐mother' or matricidal state of mind. If these wishes or phantasies remain unmourned, they can at times lead to a concrete flight from femininity. [ABSTRACT FROM AUTHOR]

The psychedelic state can be thought about as an interdependent intrapsychic, somatic, interpersonal and spiritual happening which encourages, perhaps both to the relief and dismay of those participating in the experience, the shocking and impressive emergence of one's unconscious desires and traumata's; a state which may be experienced as cathartic or healing, and as anxiety‐provoking and confusing. Often, in clinical trials investigating psychedelics in mental health conditions, these go hand in hand. Amid a renewed, at times hyperbolic, interest in psychedelics as a potential treatment for mental ill health, significant gaps of knowledge remain. Additional studies exploring the impact of the extra‐pharmacological factors and adjunct therapeutic models on treatment outcomes are needed. Drawing from psychoanalytic perspectives, this paper explores points of intersectionality between psychedelic therapy under investigation and psychoanalysis in the context of traumatic stress. To that end, the psychedelic state will be considered an attempt to make the unconscious conscious by immersing self in a bewildering waking‐dream to better tolerate reality; immersing self in a wilful state of vulnerability, to develop trust in one's agency and capacity to trust others; immersing self in an indescribable experience to learn how to redescribe, to self and to others the traumatic past. [ABSTRACT FROM AUTHOR]

This paper aims to consolidate existing literature on the psychological impact of sending children away to boarding schools in Britain. A scarcity of literature pertaining specifically to independent boarding schools leads the author to examine child developmental theory, peer victimization in the British Army, trauma within captivity and adaptive behaviours. In conclusion, it is clear from this research that more time and effort is needed to understand the psychological impact of sending children away from home to be schooled, socialized and parented institutionally. In particular, the ethos and traditions associated with British and colonial schools, and the way in which these things are preserved warrants further study as it appears to be a significant source of the attitude toward children in boarding schools. The psychoanalytic community may be best placed to understand, and make understood, the positive or negative impact on children attending boarding schools in Britain. [ABSTRACT FROM AUTHOR]

The intention of this paper is to explore how societal food choices may be affecting our clients' mentation and to discuss alternative drivers behind their feelings of anger, sadness and fear that potentially lead to fixed moods of anxiety and depression. The current perception of nutrition within psychotherapy is framed within lifestyle, self‐care enquiry and a rich, metaphorical use of digestive systems within the therapeutic process. Yet over the last two decades the synthesis of nutritional therapy with psychiatry has theorized a network of ideas under the umbrella title of 'nutritional psychiatry', which links positivist research to suggest poor diet and gut microbiome health are also factors behind the development of mental illnesses. The differing epistemological positions in these two fields create a challenge to the case study used which explores working psychotherapeutically with a client's food choices, whilst interrogating whether nutritional psychiatric‐derived theories relate to the client work and how to incorporate these ideas within psychotherapeutic practice. [ABSTRACT FROM AUTHOR]

An organ transplant involves complex psychodynamic processing that has been explored particularly in terms of object relationship theory. In the present study, we develop a model of transplantation based primarily on Lacan's explanations of the torus. In a prospective study, we examined 40 patients, 2 weeks, 3 months and 6 months post‐transplant. Based on the analysis of a dream, we identified the so‐called 'transplantation complex' in the form of earlier, for example, oral‐sadistic fantasies. In a further step, we examined the extent to which direct and indirect indications of this complex were found in the interviews of the total sample. In the present paper, these results are related to Lacan's graph of the torus. Our results display the dialectic of a repetitive demand, especially on the lungs, and the desire for an object that is basically lost or Oedipally forbidden. This dialectic may explain both the different quality of life and the frequent occurrence of feelings of guilt reported by the patients. We also show the function of identification, for example, with a single trait of the donor. Overall, the model of the torus may be a way of understanding the processing of the transplant in a deeper and more coherent psychodynamic manner. [ABSTRACT FROM AUTHOR]

The paper describes an analysis with a very difficult, emotionally inaccessible patient who, after more than a year, unexpectedly terminated the analysis, leaving the analyst with a sense of frustration due to incomplete and interrupted analysis. In the theoretical section of the paper, the author presents his understanding of the creation of such a pathological organization, starting with Freud's concept of death drive, then going on to Melanie Klein's and her successor's discoveries. John Steiner's concept of 'psychic retreat' helps us to understand the process of development of a pathological organization of personality. In the last part, the author describes how he works through mourning and prompts reflection on the reasons for the premature termination of the treatment by the patient. He indicates the causes in both the patient and the analyst. [ABSTRACT FROM AUTHOR]

In this paper I consider the experiences around the time boundary of therapeutic sessions of both therapists and patients working remotely during the pandemic. I discuss the precision of electronic time and the different dynamics around the beginning of sessions. The business of arriving, whether early, on time or late, has different drivers and meanings in the online world. I consider how difficult it is to take up these dynamics adequately when faced with the real uncertainties of internet connections. Communications between therapist and patient around time boundaries have also presented new challenges, and the way sessions end is very different. The experience of time within sessions is altered, and sessions are no longer bracketed with the journey to and from the consulting room. The dynamics around power and vulnerability are different and the management of time boundaries bring these dynamics vividly to life. The paper closes with some practical considerations around remote working as this is likely to be a part of our practice even after the pandemic is finally over. [ABSTRACT FROM AUTHOR]

This paper was born out of a very specific emotional experience I had with a patient that alerted me to a phenomenon of casual violence which, owing to its everydayness, may remain incipient. The experience described with Mr X is specific, but he is also a placeholder for patients who seemed to come together in my mind. The nature of this seemed both elusive and pervasive in many patients. What they seemed to have in common was a certain violence by which they were expelled from spaces – official and/or intimate. Post #MeToo, some of them were accused of being predatory. For a long time, I could not identify it in the transference. The paper traces this violence to a quotidian misogyny and furthermore to the introjection of a 'mis‐understanding link'. There appears to be a correspondence between 'banal' absence of thinking (Arendt, 2000) and a relationship of 'mis‐understanding' (Bion, 1962). Such mis‐understanding finds expression in forms of violent masculinity (Rose, 2021). Finally, it is suggested that contemporary masculinity is not of the older macho sort, but seems to have an affinity towards 'adolescent states of mind' (Meltzer, 1973). It is speculated that cultural practices seem to encourage a perpetual adolescence. [ABSTRACT FROM AUTHOR]

This paper explores insight and the development of the thinking voice in the psychoanalytic process. It begins with music and images, narrating an important Australian historical event. The composers have created a dreaming space, and for this paper, a metaphor for the analytic space and the creative process. At once physical, aural and visual, it also exists within and reflects the patient's and analyst's shared historical and cultural frame. It is a liminal space, for exploration, crossing, and a product of the alchemy created between patient and analyst. Pickering's (2016) and Grier's (2019) consideration of musicality as an essential part of the analytic experience assists recognition of the multidimensional nature of the space created between patient and analyst. Ferro and Civitarese's (2015) conceptualization of the space where patient and analyst dream one another, and Baranger and Baranger's (2008) discussion of the bi personal field are pertinent here. Symington's idea of insight as an essential 'thing in itself', within the individual patient helps articulation of insight as a product of an internalized linking, or parental intercourse, enabling movement to a separate third position. [ABSTRACT FROM AUTHOR]

Adult sulking is an emotional state and behaviour, characterized by misery and sometimes hostility, that occurs within intimate relationships. A remnant of unmet needs in infancy, it is enacted when omnipotence, grandiosity and feelings of entitlement are threatened. Sulking signals the sulker's feelings of dependency and powerlessness in relation to a significant other while defending against feared consequences of self‐assertion. As protest, appeal or coercion, sulking may be the recourse of any individual when words fail or are refused. This paper examines sulking in couple relationships because sulking is intrinsically interpersonal: a sulker requires someone to sulk at or to. While the sulker overtly cold‐shoulders the other, emotionally he is far from indifferent to the other's response. Sulking sits on a narcissistic continuum, with relatively benign moodiness at one end and coercive control at the other. Section 1 of this paper explores sulking firstly in childhood and then in adult relationships, together with the way spatial metaphors – the cave and tent – may assist the clinician's understanding of the sulker's self‐positioning in relation to his object. Sulking's purposive aspects are also considered. In Section 2, psychic agony is discussed to demonstrate how some people may become prisoners of their own or the other's sulking. [ABSTRACT FROM AUTHOR]

Freud in [1] in his paper "Group psychology and the Analysis of the ego" described the split between the individual psychology and the group psychology, as "fictitious". This is a book about the I application i of psychoanalytic and systemic ideas to the understanding of group and organization dynamics, including our own contribution, whether as members or "consultants", to the dynamics that unfold. In the chapter "On change and the resistance to change", Obholzer makes a simple but very prescient observation concerning the willingness to consider and explore how ideas and solutions necessarily change over time regardless of whether one is a clinician, a consultant or a leader; with reference to our own training, Obholzer writes: in training for our professional roles we learn about the "correct" way of going about things. [Extracted from the article]

Deborah was referred to me for psychoanalytic psychotherapy following a suicide attempt and depression. We began a fascinating journey spanning more than 10 years. During therapy, many questions arose concerning the suicidal episode, which she could not register consciously. I tried to understand the reasons for her depression and the attempted suicide through the unconscious process in the therapeutic relationship and through the music and poetry that she brought to sessions. In this paper I describe the process of listening for the signifiers of semiotic and symbolic language, both metaphoric and metonymic, as revealed in poetry and music according to the theories of Kristeva and Lacan. The poetry enabled the patient to retrieve childhood memories, experience the movement from unconscious to conscious, and mourn through the experience of transference and countertransference in the therapeutic relationship. Also illustrated is the transition from singing the music to more symbolic language, turning the patient's sensory experience into language, and connecting her personal experience with the culture of her past. The patient's mourning and the lost love objects are discussed through the prism of classical and object relations theories. [ABSTRACT FROM AUTHOR]

Those undertaking therapy with couples will undoubtedly at some point during their work encounter the technically challenging question of deciding how best to proceed when the couple therapist's designated patient, that is the couple, fails to attend and instead the therapist is confronted with the presence of only one of the partners. Equally, couple therapists must also consider under what circumstances, if any, it is advisable to see and work with only one of the partners. This paper is therefore concerned with exploring the complexity involved in undertaking couple therapy in the presence of only one of the partners and the implications of this for the therapy as a whole. Given the importance of this topic for couple therapists, it seems surprising that there is such a paucity of literature on the matter, and so this paper is attempting to address a gap in thinking and practice for those undertaking couple therapy. [ABSTRACT FROM AUTHOR]

This paper is based on the author's experience of working with a particular group of female/male trans children and young people who present a similar clinical profile: a fragile ego prone to fragmentation and concrete thinking. Often, there is evidence of a grievance over the failed ideal object, which is internalized, projected into the body, and then attacked. Faced with the developmental challenge of sexuality at puberty, young adults withdraw to a psychic retreat designed to halt development. This paper focuses on the development of a trans identity in defence against an underlying fear of depressive anxieties and psychic collapse. It describes the ongoing assessment of Joanne, a 19‐year‐old biological female who wanted to be known as Luke in therapy and wished to transition in the belief that this was the only way she could have a life. The concrete nature of Joanne's thinking created problems in the therapy, as thoughts were often experienced as physical actions. This paper describes the function of the phantasy that transitioning performs in creating a psychic retreat from the demands of psychological development. [ABSTRACT FROM AUTHOR]

This paper is developed from a report to the British Psychoanalytic Council (BPC) in 2016, 'Recommendations for best practice for responsible retirement'. In expanding the thinking, some of the problems we can have in addressing the painful and difficult decisions we have to make about retirement whilst maintaining both an ethical and compassionate attitude to the topic are discussed. The paper explores potential conflicts that can arise between the needs of both the analyst and the patient in contemplating retirement and managing serious illness. It considers the role of clinical trustees in dealing with fitness to practice issues and with the aftermath of the death of the analyst. The role of our institutions in helping us when problems arise is discussed. Recommendations are made to assist moving forward to make the subject more open to thought and to overcome the resistances we have, both personal and institutional, conscious and unconscious, in accepting that this topic poses a challenge to most analysts and psychotherapists. [ABSTRACT FROM AUTHOR]

Chapter 7, on the patients apparent deadness and obsessionality, takes further Bergstein's conviction that nameless experiences, those that should have been registered and represented by the primary object, can still be registered (adequately for the first time) through the countertransference - thereby becoming tangible to the patient. One of the strengths of the book is how it combines a good balance of theoretical discussion with detailed work from Bergstein's encounters with his patients, which he uses to illustrate his argument. Bergstein also draws our attention to an important paper by Jim Rose ([8], p. 113), which is still under-recognized, and under-appreciated, but very relevant to the case Bergstein is making. [Extracted from the article]

This paper explores potential reasons why a high proportion of children of alcoholics develop significant substance misuse problems. The author suggests it is potentially indicative of transgenerational trauma, which results in developmental deficits that may be managed by substance misuse. The paper describes how Jung's concept of the transcendent function provides a powerful therapeutic tool to link divided and split off parts of the self in a containing matrix. This is contrasted with Kleinian approaches to addictive states of mind. The alcoholic defence or 'solution' is examined through a Jungian lens. The transformative potential lies in holding the tension between wanting to 'give up' the family cycle of alcoholism versus 'giving in' to the alcoholic solution. Moving away from an identification with the alcoholic solution involves mourning and loss which is often vehemently resisted. The value in Jung's idea of the transcendent function is in the creative potential leading to growth arising from the dynamic tension of these opposites. The paper describes how they come together in fantasy, symbols and transference using a clinical case. [ABSTRACT FROM AUTHOR]

The psychodynamic therapist is both aware of and open to phenomena arising in their relationship with the patient. This paper compares two different phenomena and expands on how processing these phenomena aids the therapeutic pair: Bion's container–contained relationship and Jung's concept of the collective unconscious, which could be thought of as containing the therapeutic relationship. The two concepts will be described and elucidated using a clinical example of a therapist's dream from the collective unconscious following sudden termination in therapy. This supports a synthesis of the two concepts in a developmental context and within the wider scholarship of both thinkers. Finally, their relationships to embodied processes will be explored. [ABSTRACT FROM AUTHOR]

Using a composite clinical case, this paper describes working with complex trauma, non‐recent child sexual abuse and dissociative identity disorder within an NHS setting. The clinical work of an NHS trauma service is described in both historical and current terms. The case history elucidates the use of specialist group work for non‐recent child sexual abuse and then individual work within a trauma team setting as the diagnosis of dissociative identity disorder comes to light. The recognition of the role of shame in both non‐recent sexual abuse and dissociative identity disorder presentations serves to highlight the countertransference experiences of disbelief or inauthenticity. This is linked to the history in psychoanalysis of the shift away from external realities of abuse and to its exploration of the concept of dissociation. The question of acknowledging and attending to the reality of abuse continues to be an issue within many aspects of British psychotherapy and psychoanalysis and has perhaps added to the disbelief that the diagnosis of dissociative identity disorder often seems to engender. The consideration of setting in relation to the NHS and limitations on lengths of treatment is also addressed for these complex patients. [ABSTRACT FROM AUTHOR]

Since the publication of Freud's Interpretation of Dreams over a century ago, there has been a surprising dearth of systematic treatment in the psychoanalytic literature on ways to address dream interpretation in practice and in training. It is argued here that dreams remain a royal road to the unconscious and that understanding can be enriched through the application of a methodical approach which incorporates a range of different theories (despite their having generated major rifts in the history of psychoanalysis). In earlier research, I developed a four‐part sequential 'model in theory' for organizing, comparing and integrating contributions from different theorists to dream interpretation. The present article reports on the model's usefulness for examining case material. Analysis of three case vignettes from experienced clinicians revealed that the model's constructs hold good for examining real‐life dream material, which also suggests its applicability as a basis for training. Further work with the vignettes gave rise to a related 'model in practice' for understanding dream work in therapy as a triangular situation in which the dream, the patient, and the practitioner have distinct roles. Applying these models to case material, as illustrated in this paper, indicates their potential for further exploration, and to use in the structure, design and practical implementation of learning and training that specifically addresses work with dreams. [ABSTRACT FROM AUTHOR]

This paper considers education in the context of life‐threatening illness from a psychoanalytic perspective and is an edited and shortened version of a dissertation written for a Master's Degree in Psychoanalytic Observational Studies. Informed by the Work Discussion module, this paper uses observational material of a single case study during the author's time working as a learning mentor in a hospital school. The case study, with its participant observation method, considers the complexity of engaging a 4‐year‐old girl in learning while she undergoes treatment for cancer. The defences this child used against anxiety, such as a muscular rigidity as a form of protection against the trauma she was experiencing, will be explored. The author also suggests that with the consistent daily presence and available mind of the observer/mentor, who was able to think about Poppy's experience, the child began to let go of her 'second‐skin' defences and showed the beginnings of an interest in learning. The way in which the staff group struggle to manage the intense anxieties stirred up by their everyday work will also be discussed. [ABSTRACT FROM AUTHOR]

Those offenders who are diagnosed with antisocial personality disorder (ASPD) pose a higher risk of re‐offending and are a challenge to rehabilitate. In this paper, the author discusses a community service use of group therapy with men diagnosed with ASPD, using interpersonal techniques based on group analysis and mentalization‐based therapy. With clinical material taken from a year‐long psychodynamically informed group to highlight intra‐ and inter‐personal development, the author examines how the group progressed from a hostile place where cooperation could not be imagined to a space in which trust became a possibility. This paper explores how antisocial men might become more prosocial using both the group process itself as a medium for intervention and the exploration of symbol and metaphor to develop an emotional language to enable change. Psychological change is perceived in the way words are used to develop insight and capacity to think about the minds of others. I conclude that more research is needed but that a mixed technique group has promise in the treatment of offenders with ASPD in the community. [ABSTRACT FROM AUTHOR]