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The relationship between one's home and its internal representation is a complex one. Imbued with memories of desire, loss, fear and anxiety, these often emerge in the analytic space and wait for interpretation and understanding. The analysts' ability to use their countertransference and explore the patient's underlying feelings often reveals the impact of culture and surround on the patient's contemporary experience of space. [ABSTRACT FROM AUTHOR]

In this article, I write of an 11-year odyssey with a patient who despite our best efforts, remained mired in emotional deadness, anomie, and depersonalization. The journey led me to question my core assumptions about co-creating an effective therapeutic alliance as well as my competence as an experienced psychotherapist-psychologist, well-trained in empirically validated treatments. What I realized was a failed treatment, that led me to pursue psychoanalytic training. In the process, I grew to understand that our parallel traumatic life histories, and my inadvertent and unconscious reluctance to acknowledge my own countertransference, kept me from joining with him in the intersubjective experience of profound grief – that which, in retrospect, I believe would have made all the difference in his treatment. [ABSTRACT FROM AUTHOR]

Ted has been teacher, colleague, and friend to me throughout my professional life. There was something about Ted's person that resonated with me. I felt his presence when I began training at Albert Einstein College of Medicine, where I did my internship and clinical fellowship, and again as I was going through training at NYPSI. Once I graduated, I had the good fortune of being invited to a study group with Ted, Charlie Brenner, and many other senior analysts. I was most impressed with his ways of thinking, his humanity, which came across vividly in his work and in his responses to others. He had an openness and dedication to finding ways to reach each individual patient. I especially admired his emphasis on turning to the evidence from the patient, and his focus on really helping his patients with what was central to them, not having to stick to analytic rules. He was courageous in his willingness to present his careful analytic work when his focus on countertransference was not considered appropriate at the time, with much backlash from others. In terms of Ted's importance to psychoanalysis, starting in the 70ʹs, he focused in on an area of psychoanalysis that was quite undeveloped at the time – the analyst's use of his self, except for a few strong voices from the Kleinians (Heiman, 1950, Racker, 1953), though of course many others later. Ted could see the limitation of focusing only on the transference, omitting countertransference. He focused on "what's happening between us" before any concept of the "analytic third" or "co construction" had been born. So much focus was on the intrapsychic – the only focus of a "true" analyst, at a time when the interpersonal was viewed as "nonanalytic." He brought his analytic lens, studying the analytic data in the countertransference, to the benefit of the psychoanalytic community, a focus quite different from relational analysis and interpersonal analysis. His influence on my own work was powerful. The shared background of training in a place with many gifted and talented people, who all were seriously involved in trying to learn analysis and apply the work to patients, but with an openness to new ideas, to valuing the data from the patient above loyalty to a particular theory, the lens on one's own feelings, thoughts, fantasies, attitudes to facilitate the most full understanding of the patient, all have enriched my understanding and appreciation of the analytic process. [ABSTRACT FROM AUTHOR]

A review of a clinical report by Harold Searles, attending to Searles' ways of working with psychotic patients, his influences and those he influenced, as well as contemporary thinkers (Laplanche), who speak as Searles did, of the power of the other in the construction of psychic life. [ABSTRACT FROM AUTHOR]

Embodiment represents a new theoretical development and innovative research perspective within cognitive science and the philosophy of mind, emphasizing the role that the body has in shaping the mind. However, the idea of mind and body being interconnected is an old one and has long roots within psychoanalysis, e.g., in character analytic tradition emphasizing the "how" of relating and talking as expressed in nonverbal behavior and body language. The article explores how the patient's embodied, structuralized bearing and bodily appearance reveal relational messages. Through a case presentation, I illustrate how embodied affects and ways-of-being are actualized in the transference and can be captured through the embodied emotional response of the analyst. I argue that the concept of relational scenario emerges as fruitful for observing transference-countertransference dynamics. [ABSTRACT FROM AUTHOR]

The author views every symptom, conflict, defense, or unconscious fantasy as a result, in part, of an adaptation. For example, cumulative traumas from childhood aren't just traumatic, but become part of an individual unconscious fantasy while potentially contributing to a way of living that can lead to certain satisfactions along with crippling inhibitions. Analyzing adaptations, along with the other components that bring patients to our offices, is necessary because of a paradigm change in the goals of psychoanalysis from reconstruction to building more complex representations from simple representations. Further, the analyst's appreciation for forces that lead to adaptations helps reduce intense super-ego pressures. Clinical examples are presented to demonstrate the author's perspective. [ABSTRACT FROM AUTHOR]

The creation of safety in a relationship is a prerequisite for the risk-taking required for developmental progress and therapeutic change. Psychoanalysts typically speak of safety in the analytic relationship in terms of verbal exploration of sources of the patient's anxiety, and the analyst's role in maintaining the frame. Yet it is clear that safety is not the same as the absence of threat, but is instead based on psychological safety as well as physical safety. Psychological safety – or safety with another person – requires the developmental capacity making social connections. The fields of infant research and neurodevelopment – particularly the work of Beatrice Beebe and Stephen Porges – have contributed significantly to this critical aspect of analytic work through their explications of stress regulation. Disorders of self-regulation – i.e. impairments in the capacity to manage stress and experience safety – are central to the neurodevelopmental disorder of autism. In addition, language and symbolization are typically compromised in individuals on the autism spectrum. Therefore, therapists working with individuals on the autistic spectrum must explore alternatives to language and symbols for creating a safe environment. These alternative methods of communication are what I call the "music and dance" of therapeutic action. In this article I will first discuss some relevant contributions from research in infancy and neurodevelopment. I will then use a clinical illustration of analytic work with a child on the autistic spectrum to demonstrate nonverbal and largely implicit bodily means of mutual regulation with a patient. This example not only applies to the treatment of autism, but also provides more general insights into methods of creating safety in the analytic dyad. [ABSTRACT FROM AUTHOR]

A psychotherapeutic relationship that can legitimately be referred to as psychoanalysis has expanded considerably since the tempering of the Freudian and ego-psychological hegemonic definitions originally imported to America by European analysts fleeing the Nazis and lasting until the middle 1980s. To some extent, pragmatic considerations have gradually supplanted older metapsychological, though the latter still carry all too much weight in the way analytic practice is conceptualized. [ABSTRACT FROM AUTHOR]

The author approaches his commentary on these original and interesting articles from the perspective of Bion's psychoanalytic theory. Two of the pillars of Bion's thought were surely the concepts of transformations and waking dream thought which enable the alphabetizing of sensorial stimuli in real time and narrative deconstruction and de-concretization, toward an expansion of the oneiric dimension of the psychoanalytic work. The author's observations are made from within the structure called the analytic field in which the session appears as a dream of minds where the figures that come to life during the session are not treated as historically real characters or internal objects but as characters which express the emotions shared by analyst and patient. [ABSTRACT FROM AUTHOR]

Discussion of the work of Alison Howard whose diagnosis of coronavirus, made public, became a complex part of the transference and countertransference. Clinical work under these difficult conditions was discussed in terms of contemporary clinical theory stressing the potency and necessity of change in the analyst, the work of Ogden and Levenson, in particular. [ABSTRACT FROM AUTHOR]

Through the theoretical lens of self psychology and complexity theory, the author illuminates how it happened that writing, and the professional opportunities that emerged because she was an analytic writer, became the royal road to the creation of her sense of being, mostly, a competent analyst after analytic training that left her feeling insecure and inadequate. Then, she describes recent work with a patient, Tom, to open a window into her consulting room and illuminate herself as an analyst at work. [ABSTRACT FROM AUTHOR]

A case vignette involving contemporary communications technology—an iPhone, a computer, digital photos, and Skype—suggests that unconscious communications are not only repetitions of the patient's ongoing experience and dynamics, but may also be prospective, expressing emerging emotional and psychological potentials that were previously unavailable to the patient. These communications may also provide direction for the treatment via the analyst's countertransference fantasies and responses. It is also suggested that these bidirectional communications are shared between patient and analyst through an unconscious field akin to what Jung posited as a collective unconscious. [ABSTRACT FROM AUTHOR]

Unconscious communication, like transference-countertransference, is ubiquitous in life and in the psychoanalytic process. Regardless of a clinician's theoretical perspective, and despite differences in clinical technique, Freud's advice to turn our unconscious to the patient's unconscious "like a receptive organ" has guided generations of analysts toward deeper exploration of the countertransference in the intersubjective analytic field (Freud, 1912a, p. 115). In this clinical article, the recognition and use of unconscious communication, from the ordinary to the more extraordinary or uncanny, is described at moments of separation as harbinger of loss and, ultimately, termination. Such moments hold potential for a depth of emotional resonance with and accessibility to our patient's psychic realities that may otherwise be unavailable due to our systemic defense against a shared existential anxiety that all things come to an end. The emergence of unconscious communication via the analyst's reverie and dreams are considered an opening of potential space where ending can be conceived as a bearable thought—a transitional organizing experience for the dyad. [ABSTRACT FROM AUTHOR]

Growing attention is appropriately afforded to the importance of practicing group psychotherapy in an evidence-based fashion. Pressures with regard to accountability, efficiency, and effectiveness make this an imperative in contemporary psychotherapy. This article illustrates and operationalizes factors that contribute to enhanced group psychotherapist effectiveness; identifies approaches that maximize therapeutic opportunities within the client-therapist relationship in the here and now of the group therapy setting; and illustrates the principles of therapeutic metacommunication within the therapeutic relationship and explores therapist use of self and judicious therapist transparency. An evidence-informed approach guides these articulations and the article illustrates these principles with a clinical vignette and discussion [ABSTRACT FROM AUTHOR]

The desire to help others is a common motivation for becoming a therapist, and boundary crossings are an expectable part of psychotherapeutic work. However, progression to boundary violation is rare. The concept of analtruistic boundary violationis presented and illustrated with detailed clinical material drawn from the analysis of Mrs. A,1a generally ethical therapist, whose violation of the therapist/patient boundary with her patient, M, began as an altruistically motivated enactment and boundary crossing. In Mrs. A’s case, and arguably in all similar altruistic boundary violations, a specific fit existed between patient and therapist. The intense need to rescue this particular patient was fueled by Mrs. A’s history of early physical and abandonment trauma, which increased her vulnerability to overidentification with her traumatized patient. The stress of relocation to another city and closing her practice further magnified her susceptibility. The complex clinical, professional, ethical, and legal issues inherent in consulting on such a case are discussed. I describe my countertransference and my parallel enactment, an initial crossing of the boundary between the roles of supervisor and therapist. [ABSTRACT FROM PUBLISHER]

Freud developed many of his theories and technique while attempting to help hysterical patients. This article approaches hysteria not just as a syndrome consisting of a group of signs and symptoms, but primarily as an inner world configuration that fuels object relations patterns. The internal world hysterical profile informs the transference/countertransference experience and the therapeutic process. I attempt to describe some of the technical problems psychoanalysts have to deal with while working with these patients. Hysterical object relations do not necessarily manifest themselves as somatic symptoms—epileptic-like, paralysis, blindness, etc.—even in patients that show the relational hysterical patterns. These object relations modes can appear in any analysis irrespective of the primary diagnostic conceptualization. [ABSTRACT FROM PUBLISHER]

Dreams create unique opportunities and challenges for the child and adolescent psychoanalyst. The psychoanalytic axiom that dreams are the “royal road to the unconscious” (Freud, 1900, p. 608) can exert an unhelpful pressure to understand and interpret dreams prematurely, especially in work with children and adolescents. It may be useful for the analyst who works with children and adolescents to think about dream imagery kaleidoscopically, allowing his own images of the dreamer’s images to float in mind and to move in and out of consciousness in response to other verbalizations, play, behaviors, and shifting countertransferences. I encourage an open-ended process to dream work that tolerates uncertainty and ongoing questions. [ABSTRACT FROM PUBLISHER]

In basic psychoanalytic theory of technique, interpretation and insight reveal the latent content beneath the manifest appearance of symptoms, character pathology, and disturbed irrational behavior. The understanding of the neutrality and objectivity of the analyst, however, has been modified with new formulations of interpersonal, intersubjective influence and dyadic unconscious communication. Transference is often regarded as coconstructed in the present in a transference-countertransference field, emphasizing the analytic relationship and experience as a two-person analytic process. Nevertheless, the analyst is capable of good enough objectivity and neutrality for analytic work. Countertransference interpretation expands insight into the patient, as well as the analyst. Interpretation is not only resisted, but is reinterpreted by the analytic dyad with gradual partial insight and integration. The infantile unconscious, genetic interpretation, and reconstruction are often devalued in some object relations frameworks. A clinical vignette illustrates the continued importance of the past in the present without neglect of current determinants and perspectives. While integrating newer considerations of the two-person analytic field, interpretation and insight into the dynamic unconscious are here regarded as thesine qua nonof psychoanalysis. [ABSTRACT FROM AUTHOR]

In this work, we briefly describe present-day, postmodern evolution of the family and the attention centers that both the government and the private sector have established when this fails. The birth of child psychoanalysis and its application in one of those centers, forging roots for further psychoanalytic development, is briefly described. The importance of countertransference and analyst supervision for those treating traumatized patients left without a family is discussed, as is an institution that altruistically rescues these children; the function of a psychoanalyst and his/her avatars is shown by way of three clinical cases when a strong countertransference obviously occurred in him/her. Finally, reflections are made about the importance of handling countertransference with the analyst’s supervisor. [ABSTRACT FROM PUBLISHER]

Starting from concepts that Winnicott developed and that are unexpectedly near to postmodern concepts, I attempt to map some features of the complex territory that lies between analyst and patient from the viewpoint of the relationship that exists between subjectivity and objectivity. In the first section, I give a personal reading of Winnicottian model, emphasizing the idea that the subject’s unconscious acts upon and transforms the object’s (thereby putting in motion further unconscious processes within the object). Then I highlight the presence, in the transference, of various levels of communication and of a paradoxical multidimensionality that upsets the traditional space-time categories and also upsets the analyst’s mental stance. In the third section, I present a new form of countertransference (pervasive), through which the patient’s unconscious creates a sensory environment of proto-emotions and atmospheres, of states and rhythms, that have permeated it and that, due to their intensity and nature, arrived there without symbolization. Finally, I attempt to demonstrate how the patient can undergo psychic change only if the analyst has, himself, inhabited an analogous process of transformation in response to the disturbances arising within the analytical relationship. Theclinical-theoretical stanceemerging from these reflections sees the relation to the other, to oneself, and to the world as made possible by subjective creation always taking place in the unconscious. [ABSTRACT FROM PUBLISHER]

The article describes the author's views regarding the impact of Psychoanalyst Antonino Ferro's writing and clinical teaching on analysts at many centers. He states that Ferro's work has moved away from traditional notions of transference toward conceptualization of interpersonal psychoanalysis in which terms such as transference and countertransference are inadequate to convey his meaning. It also include two clinical reports to explain Ferro's approach and author's response to it.

This issue began in an interchange with Anna Ornstein. Heather's patients become equal partners in exploring the meaning of dreams, both the patient's and Heather's own. Henry tracks the details of the patient-analyst/therapist relationship that tend to pass under the radar of buzzwords citing the relational aspect of therapeutic action. [Extracted from the article]