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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]

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]

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

A comprehensive understanding of eating disorders should include engagement with the role of contemporary cultural trends. Feminists and critical social theorists have made significant contributions in this regard. Using two clinical cases, this paper contemplates the relationship between culture and psyche in eating disorder, proposing a psychoanalytic conceptualization underpinned by John Steiner's (1982, 1987, 1993, 2011) theory of pathological organizations and psychic retreats. Two conceptual terms will be introduced, namely 'the normalized body order' and 'the abject body object' to develop the argument. One of the clinical cases will be used to explore a particular kind of therapeutic impasse that can occur when therapist and patient are both female. In this particular case, the normalized body order emerged temporarily obstructing therapeutic progress; the impasse was understood to be an example of the so-called anti-analytic third (Straker, ). [ABSTRACT FROM AUTHOR]

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

Mysticism has long featured in discussions among psychoanalysts and mental health practitioners, anthropologists and scholars of religion. In this paper I analyse the life and visions of a twentieth century mystic in the Catholic Mediterranean. Through this case study I seek to compare the psychoanalytic and to a lesser extent the psychiatric discussions of 'hallucinations' with the theological explanations of visions. Via a Lacanian discussion of the case of the first Maltese saint I argue that there are interesting points of convergence between the two. An adequate understanding of the cultural context within which visions are articulated as meaningful experiences is essential to our understanding and clinical treatment of people presenting symptoms associated with religious content. A psychoanalytical understanding can serve to enrich and enliven theological discussions on madness as a path to sanctity. [ABSTRACT FROM AUTHOR]

The article presents abstracts on psychoanalysis and psychotherapy topics, which include "On Paradoxes and the Experience of Duality," by Hanoch Yerushalmi, "Clinical Facts, Turning Points and Complexity Theory," by Margaret Lush and "Facing Reality Together Discussion: With Culture in Mind: The Social Third," by Jessica Benjamin.

Three dialectical tensions in psychoanalysis are discussed: between scientific and artistic aspects, between development through theoretical writing and individual therapists' discourses, and between influencing and being influenced by the wider culture. Based on these dialectical tensions, I describe as artwork the supervisee's clinical work that becomes reconstructed in supervision through the supervisee's narrative and parallel processes. From this perspective, the patient and the therapist become the artist and the medium for each other, and the supervisor becomes an art critic who evaluates and maintains a direct dialogue with the artwork. Thus, the supervisor assesses not only the subjective and intersubjective aspects of the supervisee's clinical work, but also its cultural aspect by formulating the cultural influences on this work. More importantly, the supervisor evaluates the potential contribution of the original features of the supervisee's clinical work to the analytic culture and, indirectly, to the wider culture. Notwithstanding internal and external restrictive forces, formulating this potentiality is likely to inspire the supervisee's attempts to influence the analytic discourse from different professional platforms. A supervisee, who feels capable of shaping, albeit slightly, the analytic discourse, is likely to sense agency, autonomy, and creativity, and enliven the therapeutic interactions and the analytic culture. [ABSTRACT FROM AUTHOR]

This article discusses various reports published within the issue, including one by Bob Hinshelwood on how individual and social identities depend on unconscious beliefs and another by Phil Mollon on language and culture as the product of displaced sexuality.

The purpose of the present study is twofold: first, to explore the bilingual therapist's experience of working in a second language; and second, to explore the major functions of language within the therapeutic setting. Interpretative phenomenological analysis is used to explore in depth the experience of 16 bilingual therapists of different professional orientations: psychoanalysts, psychotherapists, counselling psychologists, clinical psychologists and counsellors. Semi‐structured life‐world interviews were employed in accordance with the exploratory nature of the research. Four major themes were identified: ‘Listening and understanding the client’; ‘Interventions and interpretations’; ‘Potential impact of language on the therapeutic encounter: Therapist's point of view’; and ‘Therapist's experience of self’. The data demonstrated differences in the understanding of functions of language within the therapeutic setting among psychotherapists. The importance of the symbolic functions of language in therapeutic discourse is discussed. In addition, the specifics of language within the therapeutic encounter are explored and outlined. [ABSTRACT FROM AUTHOR]

This article addresses Donald Winnicott's consistent attention to the idea of black and blackness as manifested in his work in the consulting room from the late 1940s to the 1960s. It describes several very different pieces, published and unpublished, where the use of black is recorded in patients' material and the different directions they open up: skin colour, psychoanalytic research, representations of trauma and serious disturbance. Both Winnicott and this article argue for caution in ascribing any fixed connotation to black and blackness while recognizing its importance across cultures and historical epochs. In one of the articles under discussion, 'Hallucination and dehallucination' (1957), Winnicott refers to two male patients drawing with black pencil and I have linked his discussion both to the more general area of modern art and artists who have been interested in black and to contemporary psychoanalytic interest in unrepresented states. I emphasize the complexity of the arenas opened up by Winnicott and argue for their historical importance. [ABSTRACT FROM AUTHOR]

A variety of new psychotherapy modalities has arisen in which the contact between patient and therapist takes place via the internet. The main objective of this systematic review is to investigate the types of online psychotherapy (OP) conducted nowadays, and to describe their main characteristics to psychodynamic psychotherapists who may wish to better understand the current scientific literature on the subject. The review used two databases, EMBASE and PsycINFO. Fifty-nine studies were retrieved and the main online psychotherapy modalities identified were self-therapy programmes using contact via email or chat; videoconference; and therapy exclusively via chat or email. The result of these studies suggests that OP is more effective than a waiting list control group. When compared with face-to-face therapies, OP showed similar effects. Most studies involved cognitive behavioural therapy; only two studies involved a form of psychodynamic psychotherapy. Different forms of communication allow patient and therapist to establish different relationships and therapeutic possibilities. OPs may be feasible treatment alternatives; however, it remains unclear, especially in relation to psychodynamic treatments, if therapeutic technique in OP, which involves changes in comparison with face-to-face therapies, would be useful in severe cases. Psychodynamic psychotherapists should adopt a posture of constant reflection on the changes taking place in the world and their impact on the minds of individuals, without, nevertheless, idealizing the 'new'. [ABSTRACT FROM AUTHOR]

abstract Ethnically and culturally diverse groups increasingly undertake psychotherapy, but insufficient attention is often paid to aspects of diversity. This article explores qualitative data from a mixed-method study, conducted at a UK psychoanalytic psychotherapy training institution, in which 24 participants from diverse backgrounds were interviewed individually about their experiences of clinical training. Participants were asked how their ethnicity had impacted on their training, and also how social class, sexual orientation, religion and gender might affect the training experience. The data were analysed thematically, and a principal theme that emerged was the way that psychoanalytical clinical trainings tend, for theoretical reasons, to explore 'internal' psychological issues at the expense of 'external' material issues such as ethnicity. Similar concerns arose in connection with social class, gender and sexual orientation, with a specific theme being that of trainees feeling silenced and finding it difficult to openly discuss various aspects of diversity. [ABSTRACT FROM AUTHOR]

Despite a seemingly sexually liberated culture, sexuality is still disturbing. Freud's original emphasis on the importance of sexuality has largely been lost in much contemporary psychoanalysis, displaced by a focus on attachment. His intuition that sexuality and civilization are in some sense in conflict may have profound implications, throwing light on the nature and function of our linguistic culture and the fetishistic nature of human sexuality. Sexuality is the paradigmatic object of shame and repression, tending to incorporate all else that is repressed. Human beings may tend to long for experience that is unmediated by the linguistic--and this is the promise and the terror of sexuality. [ABSTRACT FROM AUTHOR]

I ask whether current interest in consciousness is simply an artefact of the (low) level of cultural development of the West instead of being a problem of real interest and utility in clinical practice. [ABSTRACT FROM AUTHOR]