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This paper explores the experience of a short‐term psychiatric placement completed by a first‐year Child and Adolescent Psychotherapist in training. Thought is given as to how three specific attributes of the trainee: being black, being female, and being a participant observer shaped the author's experience and the lessons learned. The theory of Internal Racism (Davids, 2011) is used to highlight how a racist structure in the mind acted to navigate and resolve anxiety before the placement began and during its course. Fanon's (1952/2008) notion of 'the Black Problem' is also used to show how historical colonial patterns of relationship have been internalized into a social unconscious and so shaped the trainee's interactions with all individuals on the ward. Two examples are described to illustrate how exchanges with others can be influenced by race. These include 'the nod', a subtle form of recognition used amongst black people and 'racial codeswitching', adjusting one's self‐presentation with the purpose of assimilation. Further thought is given to the practicalities of therapeutic treatment in contrast to medication. [ABSTRACT FROM AUTHOR]

This paper explores psychoanalytic definitions of creativity and presents a creatively relational approach working with clients presenting with cultural issues and illustrates this with a clinical example. The author explores her personal and historical contribution to the countertransferential elements of this article using the autobiographical and ethnographical to examine the emergence of and dependence on creativity. Linking the arts and psychoanalysis, she elucidates the relationship between what is personal and what is political and asks the audience as they read to keep considering what might be personal for them. She reviews concepts of Winnicott and Klein's creative in psychological terms; that of an active demonstration of the ego being different from the creative as the production of an object, the commonality being the creation of a new stimulus. She considers a case example from a socio‐genetic perspective to demonstrate the creative as a response to trauma. Holding the view that an urgent need and therapeutic responsibility exists for new creative measures she concludes that it is in the articulation of the therapist's unconscious psychic reality where the potential lies to actively acknowledge and avoid the deepening of existing societal fissures. [ABSTRACT FROM AUTHOR]

This paper considers whether the psychotic illness of a mother impacts on the development of the mentalizing capacity of her offspring and the consequences this may have for clinical practice as a child psychotherapist. It focuses on the current theoretical understanding that the secure state of mind of a mother with respect to attachment, as well as her mentalizing ability, influences the development of the child's mentalizing skills. After summarizing and evaluating evidence associated with the attachment behaviour and mentalizing capacity of a psychotic mother, the paper gives evidence that there is a strong association between mothers on the psychotic continuum and insecure‐avoidant or disorganized attachment behaviour and impairment of the reflective function. This puts the infant at elevated risk of not fully developing mentalizing abilities. The issue of acquiring hypermentalization or undermentalization patterns is highlighted. In clinical practice, marked mirroring and transparency about the therapist's mental state allow the client to feel seen and to discover his or her own inner experiences in relation to external reality. [ABSTRACT FROM AUTHOR]

This contribution is written in response to Helen Morgan's paper 'Whiteness: A problem for our times'. A distinctive feature of her writing and thinking in this essay, and her new book, is how she moves easily and freely between psychoanalytic, sociological, political and psychological frameworks of understanding. In doing so her work exemplifies something that the psychoanalytic community has mostly been poor at achieving – a recognition of both its distinctive and unique potential to illuminate social and political processes, and a parallel acknowledgement of its need to enter into equilateral dialogue with other intellectual paradigms. Social and political life is historical, specific, local and complex, and not amenable to reductionist or universalizing modes of analysis and engagement. Through some examples I aim to add to Helen's very thoughtful and well researched paper, to show how psychoanalysis needs to respect other languages and methodologies for engaging with the world, render its own more accessible to non‐specialists, and relinquish its tendency to assume the status of a 'master discourse'. [ABSTRACT FROM AUTHOR]

The paper focuses on psychic states in which living and bearing one's vitality have become hindered or totally obstructed, either as a result of a primary trauma or of a late‐onset trauma. The author relates especially to patients who have been severely traumatized and have withdrawn into encapsulated states with schizoid/autistic‐like features that create complex challenges in therapy. The paper weaves together clinical cases with theoretical understandings and with a discussion of the Kurdish movie Turtles Can Fly, in which many orphan Kurdish refugee children try to survive emotionally the traumatic life they have been going through. The author discusses the complex states of mind of the patients presented and of the orphans in the movie, who are sentenced to life, having lost all their hope and ability to tolerate their own vitality or that of others, due to extreme traumas. Consequently an encounter between themselves and another person, including a therapist/analyst, frequently becomes a flooding experience that is beyond their abilities to assimilate, being experienced as an annihilating threat to one's emotional existence and being in danger of creating states of a therapeutic and undigestible excess for which the term toxemia of therapy is suggested. [ABSTRACT FROM AUTHOR]

Dorothy Hamilton, a founder member of the Association of Group and Individual Psychotherapy (AGIP), recently gave a paper to the College of Psychoanalysts about the foundation of the of the UKCP and AGIP's stake in that process (https://agip.org.uk/22-pages/46-history-of-agip). And there are heated debates concerned with the Scope of Practice and Education (SCoPEd) framework and the implications for the status of members of the profession of psychotherapy. We are aware of organizational upheaval in the United Kingdom Council for Psychotherapy (UKCP) and the British Association of Counselling and Psychotherapy (BACP); both organizations have recently seen the sudden resignation of their Chief Executives and other senior members of their leadership teams. [Extracted from the article]

James Strachey published his seminal paper on the nature of therapeutic action in 1934 in which he introduced his ideas on the mutative interpretation. He saw interpretation as the cornerstone of the psychoanalytic method. Since then, there has been a great deal of work looking at the essential nature of the interpretation and how it can promote change. By the1960s, Loewald and others were discussing how interpretation needed to incorporate new psychoanalytic thinking, particularly in the area of object relations. As the intersubjectivity of the psychoanalytic encounter gained more prominence, the use of the structural interpretation decreased. The author suggests that there is still need for further work on how interpretation can promote change. Using theoretical ideas and clinical examples, the paper concludes that the mutative interpretation continues to offer something potentially transformative, but that the technique has to take account of relational aspects of the treatment and the developmental issues of the patient. However, the clinician's relationship with the ideas about a mutative interpretation can also affect the clinician's ability to use it to a therapeutic effect. [ABSTRACT FROM AUTHOR]

Many therapists have been using the telephone for analytic sessions during the Covid 19 pandemic. This paper considers the ways in which the use of the telephone resembles the use of the couch and revisits the value of the couch in order to assess the value of the telephone. The questions raised are whether analytic therapists still find the use of the couch helpful, and if so why. This is then linked to the experience of using only the telephone. The paper considers the ways in which the two techniques increase or diminish shame and the willingness to disclose difficult material. An anonymized clinical illustration is used of a woman who began in face‐to‐face work with a purely practical problem, but in telephone sessions was able to acknowledge her need to understand her own mental state in order to be able to change at a deeper level. Conclusions are drawn about the positive usefulness of the telephone in contrast with the view that it is just the best that we can do in some circumstances. [ABSTRACT FROM AUTHOR]

The attainment of unit status or I AM is a crucial stage in Winnicott's theory of development and arguably ranks amongst Winnicott's more well known ideas, such as transitional object, true and false self, and primary maternal preoccupation. Using Winnicott's 1968 paper 'Sum, I am', the author traces the dangers inherent in attaining I AM and what might hamper this achievement, the personal significance of numbers and divisibility, and how this links with his subsequent ideas on monotheism and a radical revision of Freud's dual drive theory. Returning to the 'Sum, I am' paper, the author briefly explores the importance Winnicott places on play in pedagogy and the significance of an intermediate space followed by Winnicott's thoughts about death, dissociation, and the importance of a mouse! Four clinical examples are used to illustrate difficulties in achieving I AM. Finally, the author suggests the spatula game in 'Observation of infants in a set situation' published over a quarter of a century earlier is a prime example of an I AM experience, with a beginning, middle and end. [ABSTRACT FROM AUTHOR]

This paper arises from the shift, following the start of the 23 March 2020 lockdown in Britain, from clinic‐based to online psychotherapy within National Health Service (NHS) psychological treatment services. The paper draws on previously published observations about privately funded online psychotherapy. It also provides a snapshot of my own and my clinical psychology colleagues' experience of providing clinic‐based and online NHS‐funded psychotherapy before and soon after the March 2020 lockdown began. I use these impressionistic data to illustrate transference and countertransference issues involved in online psychotherapy. In addition, I note problems relating to its setting or frame, and ways in which this form of treatment can obstruct empathic mirroring and the patient's experience of being contained. I conclude by noting limitations of this study based as it was on the immediate reaction of myself and my colleagues to the transition from providing clinic‐based to online psychotherapy, not on interviews with patients about their experience of this transition nor on any measure of the relative effectiveness of online compared with clinic‐based psychotherapy. [ABSTRACT FROM AUTHOR]

In this interview by email, Ann Scott, Editor‐in‐Chief of the British Journal of Psychotherapy from 2009 to 2022, is in conversation with Brett Kahr, responding to questions put to her by him and the Journal's Editorial Board. The interview focuses on Scott's background and its influence on her work; her early role at Free Association Books and her role as Deputy Editor of the BJP. She identifies papers from the Journal, on her watch as Editor‐in‐Chief, that have resonated particularly powerfully for her, commenting that all convey a sense of urgency and immediacy. She is asked to comment on the relationship between clinical and research approaches; current debates about informed consent; the Journal's title; the impact of online as well as print publication; whether published topics have changed over time; and the Journal's international standing. She describes the editorial principles that have governed her approach to the editorship, drawing on work by Britton, Turquet, Rey and Gabbard. She comments on some challenges she has faced as an editor, and shares the highlights of her tenure. Lastly, she is asked whether the editorship has impacted on her clinical practice, whether she has any regrets, and how she would like to be remembered in relation to her editorial work. [ABSTRACT FROM AUTHOR]

In this paper we present the main features of a 10‐year, twice‐weekly psychoanalytic psychotherapy with a female subject (Clare) who presented with severe depression, self‐harm and suicidality. Serious traumatic events in her upbringing led to the formation of a pathological defensive structure based on a rigid identification with the aggressor, used as a dysfunctional means of protecting her against the threat of severe anxiety and psychic annihilation. Although the prognosis appeared bleak, her motivation for greater self‐understanding, her resilience and her therapist's commitment to analytic work allowed for a strengthening of the therapeutic alliance. Gradually and painfully, Clare succeeded in recognizing the difference between her cruel primary figures and the figure of a caring and containing psychotherapist, which in turn allowed her a more robust internalization of a benign object. The change in the nature of the transference towards greater trust coincided with improvements in her life, in the quality of her interpersonal relationship and external functioning. Psychiatric medication was gradually withdrawn and Clare found a part‐time job. Improvements were maintained by follow‐up consultations. The positive outcome confirms that long‐term psychoanalytically oriented therapy is an effective approach for the treatment of subjects presenting with severe emotional difficulties. [ABSTRACT FROM AUTHOR]

In this paper I initially describe Benjamin's conceptualization of the Third followed by Complementarity, within an evolving psychoanalytical context marked by a 'relational turn'. I then briefly outline the current debate surrounding the use of therapist self‐disclosure in the analytic process. With the clinical vignette, I aim to illustrate the impact of self‐disclosure on relational dynamics in the room, and I do so via two self‐reflective appraisals, separated in time and interpretive quality, of an affectively charged session with a client of mine I refer to as Anne. With this narrative structure I endeavour to highlight the inherent complexity in discerning the intrapsychic and the intersubjective in the therapeutic process. I also suggest a basic guideline for the verbalization of disclosures as a kind of sextant to help the analyst negotiate the affective tempests that can suffuse a therapeutic encounter. However, I emphasize it is the analyst's capacity for embodied self‐reflection, which needs to be developed via personal therapy, supervision and experiential groups, that remains the most important navigational instrument. [ABSTRACT FROM AUTHOR]

This paper elaborates the impact that the traumatic experiences of the Lebanese socio‐economic crisis, the Port of Beirut blast, and the COVID‐19 pandemic have had on my work as a psychoanalyst in Lebanon. These shared traumas affected the psychoanalytic setting, frame, and process, 'blowing up' the constants of time, space and fees, triggering 'topical collapse', blurring boundaries, and reviving the 'infantile'. They affected my internal analytic setting, compromising the fundamental rule of free association, triggering enactments, and violating the rule of abstinence. In such situations, psychoanalysts may try to repair the setting by adhering to strict ground rules and techniques. However, emphasizing the analytic frame's physical characteristics may transform it into a fetish that hinders the analytic process and encumbers the analytic relationship. The frame's holding and containing functions depend not on ground rules, setting and technique, but on the unconscious ability to use another person's mind. Thus, to creatively rethink my practice and co‐construct a malleable frame that safeguards the 'analysing situation', and to restore my internal setting, I had to do my trauma work. [ABSTRACT FROM AUTHOR]

The author has researched the Zilboorg papers, the dialogued conversations, and made an excellent attempt to clear Zilboorg's name and bolster his place in psychoanalytic history. Zilboorg's daughter offers an intimate commentary of life in the Zilboorg households, both in Europe and in the United States, Mexico and South America. America became the refuge for European analysts who had been disinherited and exiled by the Nazis. [Extracted from the article]

When a patient presents for psychotherapy having accessed illegal images of children online, it may be impossible to know at the outset whether this reflects an enduring sexual interest in children, or the transient emergence of paedophilic sexual interest associated with a breakdown in ego functioning. Concerns about risk and the emotive nature of paedophilia may undermine the therapist's or analyst's capacity to tolerate uncertainty and maintain analytic neutrality, leading to premature assumptions about the nature of the underlying pathology. This paper describes the treatment of a patient who had a conviction for viewing indecent images of children online, and the challenge of suspending judgement and maintaining analytic doubt while exploring the meaning of his actions. There was a pressure towards a sadomasochistic transference in which the therapist would be perceived to be cruel if doubting him, but weak and naive if not questioning him. Analytic work over seven years led to a formulation of his acting out as reflecting, not enduring paedophilia, but a 'paedophilic breakdown'. Changes were evident in his psychic functioning and his external life, as well as in the quality of the therapeutic process. The countertransference challenges of this work are discussed. [ABSTRACT FROM AUTHOR]

This paper discusses the psychotherapy of a patient with autistic features and rigid resistance to free association. The patient often presented his experience as merely physical sensations. The paper juxtaposes two theories that illuminate the clinical picture. Tustin's theory of autistic objects identifies a defensive manoeuvre whereby sensation is actively substituted for the primary maternal object. Green's concept of the central phobic position describes a peculiarly rigid phobia of free association that functions to defend against awareness that a murder is felt to have taken place in the psyche. The author proposes that, in this patient, Tustin's substitution of sensation for the mother is Green's psychic murder. A therapeutic impasse that arose during the treatment was resolved following some working through in the countertransference. The patient's inability to free associate was subsequently ameliorated, and his previous inability to acknowledge oedipal reality shifted. He could then acknowledge, appreciate and identify with a paternal authority figure. This illustrates, the author considers, Scariati's observation that in the treatment of patients with impaired capacity for symbolization, countertransferential working through precedes the patient's acquiring a capacity for working through in the transference. Indeed, it facilitates this capacity. [ABSTRACT FROM AUTHOR]

This paper gives an account of the early stages in the analysis of a young woman whose parents were unable to make sense of her feelings as a child because they were unable to do so for themselves and bombarded her with theirs. The result was that she remained a stranger to her feeling, which was largely dissociated having never been 'mentalized' or converted into alpha elements, so that she mostly experienced it as undifferentiated and inexplicable panic, while to some extent, she was also terrified that emotions, when they did emerge, might alienate those she depended on. This paper explores the logic, using Matte Blanco's conceptual apparatus, of why uncontained emotion should be so prohibitively terrifying in that it, like the unconscious, threatens to dissolve identity and to be experienced therefore as literally annihilating. The technical issue then is how to establish a relationship between the afflicted individual and their body with its terrifying emotion. This the authors address via the thinking of the Italian analyst, Armando Ferrari, for whom the body is mind's primary, original and originating object. The clinical implication of this is that it is sometimes necessary to privilege this relationship, that between the body and its mind, over the transference relationship, insistence on which may invite the patient to ignore it. [ABSTRACT FROM AUTHOR]

This paper describes two supervision groups of supervisor‐interns undergoing training as supervisors, based on psychoanalytic supervisory principles, within the academic setting of a school of social work. The author focuses on the challenge of creating reflective and containment space, given the importance of such space for the supervisor‐interns' learning and development in the context of the social construction of practice. Participants' descriptions, at their weekly supervision group meetings, of the supervisory process, are combined with vignettes and narratives of their experiences as supervisor‐interns. Those experiences, under the author's tutelage as supervision group leader, were analysed through mirroring and interpreting the unconscious conflicts of a presented patient, the supervisee−patient relationship, or the process in the supervisory situation itself through the stimulus of the unconscious of group members manifesting in the verbalization of ideas. The supervision groups enabled associative thinking and dreaming as participants processed unconscious experiences, unconscious identifications, and communications derived from clinical materials. The relevance of these processes to teaching and learning supervision is discussed, and their usefulness for conceptualizing professional growth and creativity is demonstrated. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to investigate the relationship between subjectivity and the other during the course of integration among 50 young Muslims of dual national heritage in Germany. The largest group of migrants within Germany are people of Turkish and Kurdish origin. During the summer and autumn of 2018, we interviewed 50 individuals of both genders aged between 18 and 25. The interviews were carried out and evaluated in North Germany. We saw that the 'feeling of being held', 'being‐able‐to‐process‐(negative)‐experiences' and 'to take responsibility for oneself and other' are characteristics of well‐educated young Muslims. Those who feel at home in their Turkish family or in the Islamic religion are able to process positive and negative experiences and present more (mature) super‐ego structures. This allows them to be able to deal with the challenges of migration and integration. Based on the data, we developed the 'Triadic Model of Integration' within the Lacanian L‐Scheme of Subjectivity. [ABSTRACT FROM AUTHOR]

This article discusses the three versions of Winnicott's most well known paper 'Transitional objects and transitional phenomena' published in the Collected Works of Donald Winnicott (2016) and traces the development of his ideas over a 20‐year period. It describes the changes in emphasis, the early inclusion and later exclusion of references from child therapy, and notes other omissions that contribute to a change of emphasis. It discusses the addition of two clinical cases in the text of the final version, which together with the introduction of the notion of 'paradox', demonstrate the shifts in Winnicott's own thinking following on extensive clinical experience and lively debate. The article argues for a different assessment of the meanings of the transitional object and the much more extended interest in transitional phenomena that emerges in line with Winnicott's own claim that Playing and Reality, his last book published posthumously, taken as a whole, constitutes a discussion of the significant theoretical and clinical implications of attention to transitionality and transitional phenomena as proposing a shift in the understanding of the analytic session, the analytic process and what analysis does. [ABSTRACT FROM AUTHOR]

In this paper, I argue that moral function in narcissistic states of mind is founded in a self‐preservative ethic aiming to control, rather than regulate, relations between self, others and realities. I propose a working model of superego functioning comprising ego ideal, social rules, ego capacities devoted to moral duties and repressed aggressive impulses recycled through superego activities. In narcissistic states the ego is fragile due to developmental deficits. Ego weakness is compensated by identification with an omnipotent ideal ego and resort to weaponized moral accusations – directed at self and/or objects – to fend off realities which threaten to disturb precarious narcissistic equilibrium. I will illustrate with case material how my fears of facing my failures to live up to my own analytic ideal ego expectations colluded with my patient's fears of facing the reality of her own limitations and needs. I needed to develop my understanding of my own superego processes before I could enable my patient to modify her omnipotent expectations of herself and relinquish her efforts to 'force' herself to control everything by punishing herself mercilessly when she failed. [ABSTRACT FROM AUTHOR]

This paper proposes meditation as an adjunct to psychoanalytic training by adapting meditation techniques to support the development of specific internal analytic settings to fulfil established training requirements (Hinze, 2015). Previous research has suggested how established meditation techniques engender some similar states of mind to those in various psychoanalytic theories (Cooper, 1999, 2014; Epstein, 1984; Hoffer, 2020; Pelled, 2007; Rubin, 2009). Building on this work, the author develops a novel framework to describe meditation using early Buddhist principles as a foundation (Thanissaro, 2012). This framework defines how different types of concentration and discernment can be developed by using mindfulness, alertness and ardency through meditation. As far as the author is aware, this is the first time these links have been explicitly made. This is followed by the analysis of the mental qualities required for evenly suspended attention, and the development and use of a greater awareness of countertransference, chosen as they point towards the analyst's functions of external listening and internal listening respectively (Parsons, 2007). Two meditation techniques are then described within the framework, to support development of these two internal analytic settings. A clinical example shows how these techniques can be utilized in the consultation room. [ABSTRACT FROM AUTHOR]

'Body image' is a familiar concept in work with patients with eating disorders, but usually refers only to the distorted way in which the patient views her external body. However, patients with eating disorders can also experience distorted ideas about the insides of their bodies, specifically related to their bodies' abilities to metabolize food and fluids; they often conceive of their bodies as stuffed full of undigested and ultimately indigestible food. This aspect of the dysfunctional imagined body (Lemma, 2010) is often not openly discussed but engenders significant anxiety, perpetuates eating disorder symptoms, and can contribute to the eating disorder patient's need for inpatient treatment. Although acknowledging physiologic and cultural contributions to the construction of a dysfunctional imagined digestive system, this paper ultimately utilizes Bion's alimentary metaphor (Bion, 1962a) to discuss the relationship between alpha‐functioning and the development of a functioning imagined digestive system. [ABSTRACT FROM AUTHOR]

This paper uses a psychoanalytic infant observation to highlight the significance of grappling with endings. It describes the termination of a two‐year relationship with a child and his mother, who were observed weekly by the author. The content of the ending process is extrapolated to apply to infant observations in general, with implications for termination of psychoanalytic psychotherapy treatments with patients of any age as well as personal relationships. Transference and countertransference reactions and enactments evoked during the prelude to termination are considered. Vignettes from the infant observations illuminate important crossroads during the termination process. The paper also illustrates the resilient capacity that a child (and by extension the child part of an adult) can have to experience, process and bear the ending of a relationship, as well as to continue to hold that relationship internally. This glimpse into one child's, one mother's and one observer's experience of separating from each other demonstrates the ways primitive aspects of the psyche may be activated during a termination. Finally, Donald Meltzer's concept of three‐dimensional interior space and Bion's idea of open‐ended reality are applied, indicating how relationships that have ended may be contained within one's psyche, enduring beyond their ending. [ABSTRACT FROM AUTHOR]

Authors aiming to conceptualize a 'cognitive countertransference' continue to search for the most effective way to integrate psychoanalytic theory, and a coherent definition for such a concept. This paper first argues that authentic attempts at integration of the concept of transference into cognitive‐behaviourism require a return to seminal work on Übertragung (transference) and Gegenübertragung (countertransference). References to these terms throughout the work of Sigmund Freud and Jacques Lacan are discussed in the context of the overall progression in the work of both theorists. With regard to two fundamental psychoanalytic concepts that underlie a Freudo‐Lacanian understanding of transference – the unconscious and repetition – this paper subsequently explores how a Lacanian logic may inform the emerging 'cognitive countertransference' literature. This paper contextualizes such thinking within the ongoing psychoanalytic debate regarding the utility of the analyst's participation in the transference relation. Ultimately, this paper argues that a cognitive countertransference may be redundant in favour of an understanding of shared cotransference, or transference relation, which begets simple theoretical conclusions, and technical recommendations. Implications for cognitive‐behavioural theory and practice are examined. [ABSTRACT FROM AUTHOR]

The clinical diagnosis of borderline personality disorder carries a uniquely pungent stigma. The literature repeatedly refers to these patients as manipulative, malignant and treatment resistant. In this paper, it is argued that when viewed within a broader matrix, the person with borderline organization exhibits unstable emotions and behaviour not because they are 'difficult' but because they lack the option of more socially sanctioned defences. This personality organization has developed because they have been trapped in some kind of irreconcilable circumstance (a double‐bind) and yet also required to deny the truth of this (double‐think). The author explores how this mechanism may be present in less obviously dysfunctional manifestations for many people, including herself, a 50‐year‐old psychotherapy student. This paper argues the person with borderline organization is grappling with the paradoxical need for both merger and separation, but this may be better understood as not just trying to make meaning for themselves as an individual, but as bearing the psychic burden for generations who have gone before them, such as the indigenous Maori people of New Zealand (Aotearoa), who experienced the trauma of colonization. [ABSTRACT FROM AUTHOR]

The importance of working with the parents in a collaborative way when undertaking a therapy with a young child is demonstrated. This paper illustrates the depth and the different quality of the work when both the child and the parents are helped simultaneously. The paper illustrates the movement in the parents' thinking from just reacting to the child's behaviour as 'being difficult' to being able to think about the behaviour in terms of it 'having meaning' in which the child is conveying a feeling through her behaviour. As well as showing the parents' psychological development, the clinical example describes the child's more age appropriate developmental progress. More specifically, it shows how the child was able to relinquish her omnipotent behaviours of 'always being in charge' in favour of relying on parents who were psychologically more available to her. Observations show how, as they realized their child's behaviour wasn't simply designed to persecute them, the parents were jointly able to create 'the cradle of concern' to care for her. As the therapy progressed there was a diminution of unhelpful transgenerational family patterns. [ABSTRACT FROM AUTHOR]

This paper follows my previous paper in the Journal in 2018, which examined Hanna Segal's theory of symbol‐formation and the various modifications she made to it. In this paper it is argued that the specific functions involved in symbol‐formation need to be examined for which fails. To use one thing (a symbol) to represent another requires a kind of suspension of reality; to take one thing as if it were really another underpins the capacity to represent. And yet it does not invalidate the knowledge that the symbol has a separate existence of its own. There is a double relation to the symbol – which is a mark on a piece of paper, and is also the thing it represents. I have termed this the 'as‐if' function that is needed in order to use symbols and representations. It is also the precise location of failure in symbolic equations, where the as‐if quality breaks down into a simple mistaken identity of the symbol with its referent. This addition to Freud's list of ego‐function involved in the reality principle is crucial to the development of representation, and ultimately of the capacity for civilization. [ABSTRACT FROM AUTHOR]

When Guildenstern is confronted with Hamlet's dubious invitation to 'play upon this pipe' (a recorder) a constrictive attitude is cruelly but artfully exposed. At another time and place Jung imagines an incredulous response to a creature so absurd that it should not exist (but does): the duck‐billed platypus. Would the platypus, like Hamlet, have a complaint to make too? In this paper I use these examples, from very different kinds of literature, as touchstones to explore the ways in which the psychotherapeutic encounter can open up or, alternatively, shut down the way to 'psychological understanding', as Jung terms it. The paper addresses both the therapist's and patient's attitude to knowledge and in particular its relation to wonder which, I argue, can function in a way that can fruitfully open up the field for generative therapeutic change. [ABSTRACT FROM AUTHOR]

In this paper the author explores the ways in which a supervision group can be a source of ruptures in the supervisory alliance. Furthermore, the group's involvement in repair of the supervisory alliance is examined. The author draws upon empirical material from supervision sessions with a supervision group consisting of one supervisor and four novice psychotherapists conducting psychodynamic psychotherapy at a university clinic. Based on the work of W.R. Bion, the paper argues that, in group supervision, the supervisory alliance cannot be separated from the group processes in which it is embedded. The author concludes that a supervision group can affect the supervisory alliance negatively through group dynamics, or the alliance can be ruptured by other alliance formations that constitute themselves in group supervision. However, a supervision group can contribute to the repair of the supervisory alliance by supporting the supervisee, compensating for the supervisor's imperfection and supporting the supervisor. [ABSTRACT FROM AUTHOR]

This paper is about the experiences of migration of middle class Iranians living in London, with focus on the psychosocial experiences of one woman. Her story is representative of the stories of Iranians who 'make it' in exile. There is scant study of the lives of middle class Iranian migrants; I carried out research to contribute to the wider literature on migration and to address this gap. The paper is based on the empirical findings of a PhD study which drew on two strands of psychosocial methodology, BNIM (biographical narrative interview method) and FANI (free association narrative interview) to collect data. Ten Iranian men and women living in London were selected through 'purposive sampling' and a 'snowballing process' and each individual was interviewed twice. Examination of the data draws on psychoanalytic, sociological and psychosocial theories to gain insight into experiences of loss and the relationship between loss and sadness expressed in their stories. Common to all of the interviewees was a core sense of loss. This was mostly linked to losses of work, professional status, family attachments and complexities of cultural belonging and dislocation. The findings suggest that this sadness is of an encapsulated nature that cannot be worked through. [ABSTRACT FROM AUTHOR]

This paper argues for George Michael's significance to contemporary culture, a significance that requires a radical reinterpretation of his life. My discussion suggests that what is at stake in understanding Michael's life is a pattern of internalized homophobia. The method of this paper is to trace the double structure of his consciousness – his awareness of his role as icon and his private state of despair – by isolating moments in both parts of his life. From these, I attempt to extract an understanding of Michael's inner world that found expression in his lyrics. These encounters I explore in light of Kohut's theory of narcissism and Winnicott's ideas of transitional objects. In addition, George Michael's later years were defined by two losses, that of his lover and that of his mother. Michael's relationship to his grief is the focus of this essay. Drawing upon the biographies that have been written about George Michael and the interviews he gave over his career, I attempt to trace the origin of his depression to his early encounters with loss. These losses, I maintain, were reactivated at the peak of Michael's fame and led ultimately to withdrawal and artistic silence in his final years. [ABSTRACT FROM AUTHOR]

Within the couple psychotherapy literature there is very little written about how the illness of one or both partners emerges and is treated in the consulting room. This paper redresses this situation by drawing on clinical experience and research findings to develop a conceptual framework to identify how illness is experienced by those with serious illnesses and to locate these findings within a psycho‐dynamic couple context. Narrative research has explored how individuals talk about illness and Frank's (2009; The Wounded Storyteller: Body, Illness and Ethics) restitution narrative, chaos narrative and quest narrative are described and illustrated. In addition, the phenomenological research of Toombs (1987; Journal of Medicine and Philosophy 12: 219–40) identifies five major existential challenges that seriously ill people have to manage – the loss of wholeness, the loss of certainty, the loss of control, the loss of freedom to act and the loss of the familiar world. The work of Frank and Toombs focuses on the experience of individuals and does not account for a couple dimension. This paper cites research and clinical examples of couple functioning to show that these illness‐related experiences are often part of a shared couple interaction and elements in a couple's mutual defence and projective system. [ABSTRACT FROM AUTHOR]

Colm Tóibín's novella The Testament of Mary (2013) offers a provocative re‐imagining of the Virgin Mary's life 20 years after the crucifixion of her son Jesus. Drawing on Richard Kearney's notion of anatheism or a 'return to God after God', I use the fictive space opened up in Tóibín's version of the Gospel as a spur to understanding the way in which faith may be conceived of as wager within both fiction and psychoanalysis. Discussing how the reception of the artistic message requires the same spirit of hospitality as does the encounter with alterity within the psychoanalytic relationship, I argue that in both cases we are faced with an existential moment of choice that requires a whole‐hearted willingness to engage with otherness. The implications of Tóibín's story for psychoanalytic work are then explored with reference to developmental processes outlined by Winnicott (1971) in his paper 'The use of an object'. The paper concludes with a brief discussion of the significance of testimony within psychoanalytic work. [ABSTRACT FROM AUTHOR]

This paper describes the author's reflections on an infant observation which took place at baby Gemma's home for an hour a week over two years. It describes the phenomenological experience of the weekly observation and the observer's progressive attempt to 'feel into' Gemma's developing mind. The author tracks Gemma's journey from her birth to the age of 2 years and witnesses the gradual emergence of a unique separate self. The paper attempts to untangle which feelings belong to the writer, which to Gemma and which to her mother, and it acknowledges 'black holes' of unknowable aspects. The astronomical headings reflect the family's interest in space exploration and also the writer's appreciation of the numinous quality of a close encounter with an infant. [ABSTRACT FROM AUTHOR]

This paper stresses the importance of psychoanalysis for all people who suffer from psychosis and trauma. It follows the author's journey, beginning in London in the 1970s in order to learn from the teachings of the anti‐psychiatrists, to public psychiatric hospitals in France, where she became a psychoanalyst. Through clinical examples, the paper describes transference in cases of psychosis and trauma as a process of co‐research into catastrophic zones of society, a process that unveils what cannot be said, at the crossroads of the patient's and the analyst's stories and history. [ABSTRACT FROM AUTHOR]

This paper focuses on early emotional development, both during pregnancy and in early infancy, as relevant to understanding primitive mental states encountered in clinical work. The first prism chosen in this search to understand the origins of our mind is based on clinical experience and its psychoanalytic theorization. Two main psychoanalytic theoretical approaches are relevant to understanding the psyche of the infant: the first emphasizes primary narcissism and conceptualizes the baby as immersed in a mental state of merger with the primal object; the second approach relates to the baby's psyche as a separate entity that is able to experience a raw sense of separateness from the object, right from the beginning of life. Clinical implications that stem from each theoretical approach are discussed. The second prism chosen is based on psychoanalytic interpretation of fetus and infant observations and on developmental studies. These observations and studies deepen our understanding of the coming into being of thinking processes, emotions and relational patterns during the whole lifespan, in general, and in the therapeutic situation, in particular. The author also discusses the limitations inherent in building retroactive conclusions, about the origins of emotional development that are drawn from within the clinical situation. [ABSTRACT FROM AUTHOR]

By comparing psychoanalytic transformational processes to political revolutions, the author advances the psychoanalytic project in several ways. The analogy extends British object relations theory by elaborating upon Fairbairn's (1952) observation that psychoanalysts arduously compete with their patients' devotions to their internal worlds. In essence, he argues, and by exploiting the 'mutual but asymmetrical' (Aron, 1991) intimacy of the psychoanalytic dyad, psychoanalysts foment change in individuals like revolutionaries alter governments. The comparison to political revolutions also highlights how changes in the behaviour of other persons in patients' lives are necessary for transformation. Clinical insurgencies, when successful, alter patients' intra‐psychic structures, interpersonal relationships, and overall behavioural patterns. The paper includes two case examples, one a successful revolution and the other not, as illustrations. [ABSTRACT FROM AUTHOR]

Couple psychotherapy, rather than seen as an add on or top up for clinicians with other psychoanalytic trainings, is increasingly understood to be an important treatment of choice for certain populations of patients, some of whom may not be able to use individual treatment or where individual treatment is contraindicated. Keogh and Gregory-Roberts speak to this phenomenon in a moving epilogue to the book. This book is an impressive collection of papers on loss, mourning and melancholia. [Extracted from the article]

This essay emerged from my clinical experience of working psychoanalytically by remote means due to the pandemic of COVID‐19. During analytic listening, in the absence of bodily togetherness and in the presence of heightened anxiety about survival, I turned my attention inwardly towards the interior of my own body and made a spontaneous gesture of doodling. These two moves, mental and bodily, both unintentional and unconventional to my analytic training, restored my psychic aliveness and facilitated the process of analytic holding. I will reflect on this particular experience using Milner's concepts: framed gap and the analyst's concentration of the body, which I further conceptualize as 'visceral attention'. I consider it as a corporal counterpart of 'free‐floating attention'. It is my contention that the concept of visceral attention has a wider implication for analytic technique in the ordinary psychoanalytic setting when uncertainty prevails in psychoanalytic treatment and with patients whose predicament is marked by body–mind split. The essay explores an analogy between visceral attention and doodling to hold the analytic process at a non‐verbal level. The blank paper and blank inside of the body stand for the 'framed gap', the negative space for a new symbol to emerge. [ABSTRACT FROM AUTHOR]

This paper explores the discomfort that resulted from a brief exchange between a white male therapist and a black male patient. The discomfort is understood as pointing towards an absence of racial understanding in the therapist, which contributed to a breakdown in empathic communication. This absence is explored in relation to the concept of internal racism and used to highlight an inequality in the subjective experience of race between the therapist and patient (Davids, 2011; Internal Racism: A Psychoanalytic Approach to Race and Difference). The notion of white privilege is introduced and considered as a useful counterpart to internal racism for thinking about white racial experience. White privilege is viewed as a useful concept for making present what is often missing from discussions of race and difference. It is suggested that until white experience acquires racial meanings, the burden of thinking about race will be placed upon the racial other (Davids, 2011). These themes are considered from within a psychoanalytic framework, but significant use is made of ideas from outside psychoanalytic theory to demonstrate the complex interplay of internal and external forces that give shape to unconscious racism. It is suggested that further exploration of these ideas in relation to the superego could be especially useful for clinical understanding. [ABSTRACT FROM AUTHOR]

This volume, the 11th in the series "The Library of Couple and Family Psychoanalysis" (begun in 2009), is different because it specifically focuses on interpretation in couple and family psychoanalysis from a cross-cultural clinical perspective. Couple and family psychoanalysis, however, enlarges psychoanalysis's perspective by virtue of its focus on the intersubjective social world. Many books and papers have been written on the subject of interpretation, widely regarded among psychoanalytic practitioners as a principal (but not sole) agent of therapeutic change. [Extracted from the article]

This paper explores the issue of assisted suicide in relation to disabled people from a psychosocial perspective. The implications, particularly the unconscious implications, for disabled people and for the psychosocial dynamics around disability if assisted suicide was made lawful in the UK are explored. Assisted suicide is the subject of persistent attempts at legal change and while not, in theory, specific to disabled people, the issue brings some of the psychosocial dynamics around impairment and disability into focus, illuminating the attitudes and emotions with which disabled people must try to live. Psychoanalytic ideas in relation to trauma, loss, mourning and containment are drawn upon with particular reference to the work of Freud, Klein, Bion and more contemporary thinkers such as Garland, Sinason and Rustin. The paper draws on three texts by disabled people in order to explore emotional responses to profound impairment. Attachment theory helps in considering varying narrative styles. Disability studies literature and legal, social and political contextual issues inform the psychosocial perspective applied in the paper. [ABSTRACT FROM AUTHOR]

This paper reports on the work of a peer supervision group engaged in simultaneous research and clinical supervision. During an 18‐month period, the group met to discuss 22 individual treatments of people diagnosed with psychosomatic disorders to identify common patterns of resistance and to assist therapists to effectively manage resistance. The aim of the present study was to identify and better understand psychological challenges the group experienced during this research process and its impact on their capacity to work effectively in their tasks. Supervision meetings were recorded and two types of qualitative analyses, derived from the work of Pichon‐Rivière and Bion, were performed to study the group work and processes. Analysis showed fluctuations and compromise formations between the tendency to work objectively and to regress during critical periods of the research process. Factors that pulled the group in both directions are identified and discussed. We believe many of the processes observed in this study are applicable to other peer supervision groups. An understanding of such group processes is likely to enhance group work. [ABSTRACT FROM AUTHOR]

This paper advances a psychosocial hypothesis in understanding relations between recipients, and providers, of health and social care. In doing so, it draws on psychoanalytically informed work which considers the relation between the internal and external worlds and more generally the wider social context. The particular hypothesis in this paper relates to an understanding of an abusive form of relating underpinned by shame and envy. The paper suggests that exposure to these feeling states is more prevalent in a social world marked by increasing inequalities and environmental failures. This argument is underpinned with reference to qualitative and quantitative research, suggesting that antagonistic relationships are increasing and are part of a significant change in the culture. The argument is illustrated by a single detailed description of an initial consultation in an NHS psychotherapy service. An examination of the social context suggests how unhelpful or abusive relations may be manifest between health care providers and recipients, in care organizations and in the wider social world. This aspect of the argument is constructed with reference to relevant organizational and sociological literature. It is suggested that established relations of this type act to limit development, in this case a social development. [ABSTRACT FROM AUTHOR]

In this paper I reflect on and argue for the importance for our profession of the issues I address in the book I wrote on clinical research, Research on the Couch: Subjectivity, Single Case Studies and Psychoanalytic Knowledge. Psychoanalytic theories, often dismissed when first proposed, have been subjected to more serious critical attack for several decades, and thoughtful responses need to be given. This paper summarizes some of my thinking (and that of others) around two issues which constrain the parameters of psychoanalytic research and on which some believe psychoanalytic research has foundered. The first is the problem of subjectivity in contrast to the bedrock of objectivity in the natural sciences; and the second is the inappropriateness of large sample research (as used by many experimental psychologists) for the task of investigating the nature and effectiveness of psychoanalysis. Psychoanalysts have to rely instead on single cases. Brief accounts are given here of research paradigms appropriate to the investigation and validation of psychoanalytic theory and practice. [ABSTRACT FROM AUTHOR]