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This article is a review of the book "Projective identification: a contemporary introduction" by Waska R. The book aims to introduce the concept of projective identification in the contemporary Kleinian tradition. The author uses clinical examples and rhyming mnemonics to describe the therapist's approach to understanding and interpreting projective identification. The book emphasizes the normal use of projective identification as a form of communication, but also acknowledges its potential for destructiveness. It explores the therapist's role in containing and interpreting projective identification, as well as the challenges and benefits of working with this dynamic unconscious phantasy. [Extracted from the article]

This qualitative study investigated how psychodynamically-oriented supervisors experienced supervisory countertransference towards their supervisees and their understandings of this phenomenon. Seven supervisors located in the United Kingdom (UK) were recruited. Individual audio-recorded, semi-structured interviews were used to gather the participants' subjective accounts of this phenomenon. Data was analysed using Interpretative Phenomenological Analysis (IPA). Most of the participants described experiencing supervisory countertransference towards supervisees who were not of the same gender as them. Although definitions of supervisory countertransference have linked this phenomenon to unresolved supervisor issues and blind spots, only one supervisor specifically referred to past experiences that shaped her supervisory countertransference response. Notably, some of the supervisors continued to be affected by their experiences many years after the supervision ended. The study's findings underscored the importance of attending to and processing perturbing supervisory countertransference. Future research could explore the ways in which supervisory countertransference is shaped by gender dynamics and its contribution to supervisory discord. [ABSTRACT FROM AUTHOR]

"The Kleinian tradition for psychotherapists and counsellors" by David Smart is a well-written book that provides a coherent and accessible account of concepts such as projective identification, perversion, and countertransference in the context of their historical development. The book demonstrates how Kleinian thinking evolves in relation to other strands of psychoanalytic thinking and presents key papers that mark the key points of development in Kleinian thinking. It is intended as a handbook or introductory text for trainees in psychoanalytic/psychodynamic ways of working and is well-suited for this purpose. However, the chapter on 'Sexuality' strays into controversial territory and presents a partisan rehashing of standard criticisms, which may not be helpful in this highly sensitive area. The chapter on 'Difference' is brief but interesting, although it may not adequately consider the psychosocial context. Overall, the book is a helpful presentation of developments in Kleinian thinking and is recommended for those interested in the subject. [Extracted from the article]

The darkness of Tyrone's black painting felt foreboding and Tyrone's smile incongruous, as though he were trying to cope with quite a destructive act. Tyrone had been referred for a variety of assessments prior to therapy; this included initial screening for dyslexia by the school's special educational needs coordinator (SENCO) and a referral to the local borough Child and Adolescent Mental Health Service (CAMHS) Neurodevelopmental service. Tyrone's mother reported that his younger brother was born with "more needs" and Tyrone had felt very "jealous". Tyrone attended a speech and language therapy assessment, with an occupational therapist in school, to learn whether his communication style was the result of a speech delay. [Extracted from the article]

Over the past two decades, there have been significant strides towards an improved understanding of race and culture in clinical supervision. Yet, there continues to be less attention directed towards the influence of the contemporary sociocultural context on the lives of supervisees and supervisors. This manuscript explores how race and culture are experienced in supervision amidst ongoing sociocultural traumas and injustice. In particular, I highlight how the key features of psychoanalytic supervision have recently been expanded to include attention to sociocultural dynamics, and then examine how the contemporary sociopolitical context has specific impacts on the lives of supervisees and supervisors. I also underscore the importance of centring the experiences of racial minority supervisees and supervisors, which have remained less visible within scholarship concerning psychodynamic clinical supervision. In an effort to expand prior theorising on racial and cultural dynamics in supervision , I propose further attention to the following areas in psychodynamic supervision: 1) role of unconscious relational processes (e.g. transference, countertransference, and parallel process); 2) the influence of external realities; and 3) the role of vulnerability and humility. The manuscript is a call for a collective mission to integrate race and culture in psychodynamic supervision. [ABSTRACT FROM AUTHOR]

It is difficult to imagine a better guide to Meltzer's work than Meg Harris Williams, a former analysand and intellectual collaborator of Meltzer. Early chapters address Meltzer's Kleinian roots, the significance of dream life, and the post-Kleinian view of projective identification and containment. Donald Meltzer (1922-2004) was an American-born psychiatrist who came to England to have an analysis with Klein. [Extracted from the article]

This can be particularly helpful with patients who are focused on the world of calendars and deadlines and with traumatised patients who dissociate or minimise the impact of trauma on their lives. Then, Chapter 1 discusses the nature of psychological trauma and provides useful phenomenological perspectives such as "repetition without reminiscence", "radical alterity", "the Thing", and trauma being both a presence and an absence. Containing therapist responses can include the following, among others: calm, empathic connecting with the patient in a moment of meeting, interpreting what the patient is experiencing, increasing structure, increasing therapist activity and offering specific recommendations. When therapists deeply connect with traumatised patients, they will often experience trauma-related phenomena. [Extracted from the article]

Aron was surprised that the focus of discussion has often been about the analyst's self-revelation when that is a secondary issue to Aron. Stephen Mitchell and Jay Greenberg had a huge influence on the work of Lewis ("Lew") Aron. Aron speaks with a voice of authority on a wide range of subjects and I regret not knowing more of his contribution before his death, aged 66, in 2019. The self Aron explores the theme of "the self" further in his chapter based on "Self-reflexivity and the therapeutic action of psychoanalysis" (Aron, [3]) drawing out the linking threads of self-reflexivity and intersubjectivity. [Extracted from the article]

Furthermore, the authors conclude that the characteristics of patients and therapists and their relationships seem to determine how effective the therapists' interpretations can be. To relate to the patient's first-person singular perspective, a dedicated therapist cannot abandon his or her own first-person singular perspective because each therapy requires open subject-to-subject dialogue. Kegerreis explains that when therapists sort out what generates their feeling and spurs their actions and how they can co-create the therapeutic reality with patients, they make the best use of themselves as therapists. [Extracted from the article]

In the context of the treatment of perpetrators of violence, psychodynamic discourse has often focused on individual aggression and other related emotions and mental phenomena, such as anger, rage, cruelty, sadism and brutality. Psychodynamic theory has been less explicit, however, about how to address an individual's actual violent acts within the psychotherapeutic setting. This article aims to address this gap. It illustrates how psychoanalytic theory – most notably through Winnicott, Fonagy and Glasser – can be used to inform thinking about, and interventions with, men who use violence against their children and partners, using a clinical case that describes psychotherapeutic work with a perpetrator of domestic violence. The article concludes that the psychotherapist's countertransference is an important tool in working with men who use violence, and highlights the importance of the therapist's capacity for impulse regulation, emotional understanding, and handling of his or her own aggression. [ABSTRACT FROM AUTHOR]

In this paper I explore questions around the role of the therapist's own history in their clinical work. Based on my own experiences and those of other practitioners, I look at the way in which recent developments in the field have changed how this is theorised and worked with, influenced by relational psychotherapy and by a greater understanding of the importance of the real relationship alongside the transference relationship. I consider how our own history influences what we emphasise or overlook in the work and how this connects with ideas about countertransference. I discuss issues around self-disclosure in the light of these considerations. I give particular attention to the role of our own adolescent experiences and to how work with adolescents brings these issues into especially sharp focus. [ABSTRACT FROM AUTHOR]

The stalker appeared to pursue the victim with an insatiable greed, the defence of "Idealisation of the Breast Greedily", (Klein, [17]) determined to fuse with or take from the victim/breast, and consume them whole, thereby satiating their own emptiness but also taking everything from the victim. The stalker here exhibits traits of the Intimacy Seeker, Rejected and Resentful stalker typologies (Mullen et al., [24]), with the victim falling under the Professional Contact victim category. Keywords: envy; greed; stalking; melanie klein; psychodynamic; attachment pathology EN envy greed stalking melanie klein psychodynamic attachment pathology 170 186 17 04/21/22 20220501 NES 220501 Introduction I "[T]he ego hates, abhors, and pursues with intent to destroy all objects which are a source of unpleasurable feeling for it." By examining and interpreting the unconscious processes being enacted in the stalker-victim dynamic, exploring the impact of envy and greed in this insidious dance of love and hate, and facilitating a processing and metaphorical decontaminating and "handing back" of the disowned and split-off parts of the stalker, the victim can begin a journey of healing. [Extracted from the article]

Terry describes how he works to enable the patient to retrieve parts of the self that have become lost in fantasy through projective identification, often because of persecutory guilt from a destructive superego. Terry starts what he describes as a guide to using psychoanalysis by calling it a portrait of his work and his approach to helping patients in pain and distress. This book offers the reader a lens into Paul Terry's, a consultant clinical psychologist, approach to working with psychoanalysis with a range of client's and presentations. [Extracted from the article]

Countertransference, it is widely agreed can either deepen awareness of personal and relational dynamics to the benefit of the work or it can distort and become an impediment through the adoption of defences. The aim of this study was to explore what supported the development of countertransference awareness in an organisational context through a qualitative study. Semi-structured interviews were conducted with 15 therapists either face to face or online. The findings indicate that participants followed one of two pathways, a reflective pathway, where they developed their countertransference awareness to the benefit of the work, and a defensive pathway, the focus of the present paper. Here, the findings suggest that when the organisational setting, the supervisory relationship, and the adopted theoretical framework, did not support the thinking about the relational dynamics, including countertransferential responses, it resulted in the adoption of defences, to the detriment of the work with the client. The implication of the findings, including the limitations of the study and avenues for further research, are also discussed. [ABSTRACT FROM AUTHOR]

Bion's theories of feeling and thinking My response to Cathy's question that therapy is a "feeling space to think in" is ineluctably influenced by Bion. It is fascinating therefore, that Bion, in his life as a psychoanalyst, developed the art of radical defencelessness in sharing his unconscious with his patients in "a state of receptive observation" (Bion, [2], p. 95). Mitfühlen: A feeling space to think in Bion introduces the concept of the Selected Fact (Bion, [2]) and I sense that this is also particularly helpful in relation to Mitfühlen. [Extracted from the article]

Analytic literature explains that the supervisee's countertransferential responses are shaped by the patient's transference and by the supervisee's unconscious internal conflicts and relational patterns. In this paper, I suggest that, rather than interpreting the supervisee's unconscious processes, the supervisor often struggles to expand the supervisee's capacity to sustain ambiguous and confusing inner experiences, perceptions, and thoughts that emerge in therapeutic interactions. I will elaborate on one approach to expanding the supervisee's containment of ambiguous and confusing therapeutic experiences: enhancing the supervisee's tolerance of ambivalence. Tolerating ambivalence enables supervisees to contain conscious contradictory feelings and intentions and unconscious personal and relational conflicts. Furthermore, the suggested approach may help the supervisor apply rich theoretical and experiential analytic knowledge adapted to the supervisory context to achieve a productive outcome. [ABSTRACT FROM AUTHOR]

The article highlights and illustrates several reflections on countertransference observed in the author's private psychoanalytic practice in Ukraine during the COVID-19 pandemic unfolding. The specific psychoanalyst's difficulties presented, associated with forgetting planned sessions, resistance to change setting agreements, becoming 'deaf' to transference, libidinal disinvestment, 'loss in advance' and 'the dead mother' countertransference, are discussed in the context of the situation with the novel coronavirus in Ukraine. The author has formulated several hypotheses for observed changes in countertransference in relation to disinvestment, regression, work of denial and work of grief due to real losses, as well as the possible previous distortions of psychoanalytic stance. Consideration, analysis and acceptance of the above-mentioned countertransference experience allowed for the observation of various patients' responses towards it and made it possible to continue clinical work, studying the new aspects of the psychoanalytic process from the revised viewpoints. [ABSTRACT FROM AUTHOR]

This paper explores psychodynamic therapy with young women with Aspergers Syndrome through the use of a composite case study. It seeks to make sense of a female patient’s obsession with a figure from celebrity culture - ‘Tom’ from ‘Britain’s Got Talent’. The potential use of ‘Tom’ by the patient as an idealised object, an autistic object, a transitional object and a transformative object is considered. Drawing on Rosenfeld’s concept of pathological narcissism and Meltzer’s concept of ‘aesthetic reciprocity’, the paper seeks to make sense of both the defences that the patient utilises and the impact of the deficits she has experienced. Attention is given to the development of the therapy through the use of play and work in the transference. Gradually, the patient becomes more able to tolerate separateness and in doing so becomes more connected to her own internal world and the feelings of others. In so doing, she becomes more aware of her actual social marginalisation and gains a greater sense of awareness of her diagnosis. [ABSTRACT FROM AUTHOR]

This paper tackles the Lacanian topics of scansion and the variable-length session, drawing both on existing literature and on two short case studies. Scansion – the clinical procedure of punctuating, interrupting or cutting a patient’s analytical productions – is discussed in view of a key historical precedent within psychology, namely the notion of the Zeigarnik effect. It is, furthermore, briefly related to Freud’s work (his treatment of the Wolf Man, the technique of free association) before being clinically contextualised via attention to the Lacanian diagnostic structures of neurosis, psychosis and perversion. Fragments of two cases – one focused on an obsessive and another on a hysterical patient – are offered as a means of introducing a more clinically applied description of scansion. This mode of intervention – akin to an enigmatic interpretative gesture – aims to put the unconscious to work; to disrupt the defensive productions of the ego; and to, potentially, extend and support the transference. The paper concludes by noting that while the conventional 50-min session provides a secure, regular and containing space within which patients may speak, what it forecloses are the prospective therapeutic benefits related to the effects of interruption and suspension, separation and non-resolution. [ABSTRACT FROM AUTHOR]

In this interview, Jonathan Asser recounts how working in prisons with violent male inmates was the inspiration behind ‘Starred Up’, his acclaimed film about a young man who enters adult prison for the first time. The film offers an insight into the innovative Shame/Violence Intervention (SVI) that Asser pioneered whilst working as a group therapist at HMP Wandsworth. Asser’s approach included getting members of his groups to acknowledge the shame they felt before these feelings became unbearable and escalated into violence. Drawing on the ideas of American psychiatrist James Gilligan, Asser found he was able to work with the most violent and institutionalised prisoners by developing a technique that relied on a particular use of his counter-transference. Asser also talks about the personal experiences that led him into working therapeutically with this client group. [ABSTRACT FROM PUBLISHER]

Sibling relationships are ambivalent. They are full of love and hate, and therefore, our most basic wish cannot simply be to get rid of our siblings. Many of the conflicts we find ourselves in, either with friends or within institutions, may need a complex and subtle understanding of sibling dynamics. The famous Controversial Discussions that nearly destroyed the Institute of Psychoanalysis in the early forties could be partly attributed to the unacknowledged and unconscious dynamics of the sibling transferences that swirled around Melanie Klein, Anna Freud and Freud. One of the tasks of therapists is to explore how we all must live within a society, with our contemporaries. This difficulty involves observing that sometimes in therapy we are part of the nursery quarrel itself, rather than superior. And so in adult sibling conflict within an institution, there may be a need for an outside moderator, like a parent, to sort out the quarrel; for when sibling passions are revived at work or in the consulting room, they can knock one sideways with the unmeditated quality of the encounter. [ABSTRACT FROM AUTHOR]

This paper discusses the meaning of psychoanalytic faith as a useful developmental concept, which applies to the therapeutic process in the consulting room as to other intimate educational experiences. Faith is a concept which has been little considered in relation to psychoanalysis, partly owing to semantic confusion with ‘the Faith’ as in religious or psychoanalytic dogma, and partly owing to the difficulty of defining or describing what it is, outside accepted jargon. Yet, faith is traditionally the gateway to experiencing the unknown – a psychoanalytic goal-demanding negative capability. It is suggested that philosophy and poetry, where the concept is more familiar, can provide psychoanalytic parallels for this particular type of learning from experience. The viewpoints of Bion, Meltzer and Kierkegaard are taken as contributing to a picture of how, in the psychoanalytic session, there may be a developmental encounter between the infant (patient) and the infinite (the transference process, rather than the analyst as a person). [ABSTRACT FROM PUBLISHER]

In this article, I explore the possibilities of a phenomenological perspective on trauma in psychoanalytic practice. I highlight the problem of interpretations that universalise experiences of trauma, provide explanations in terms of ‘causes’ and assume particular processes/stages of ‘recovery’ from it. The notion of trauma challenges dichotomies of ‘internal’ and ‘external’ worlds. Traumatic experiences always have a context – that of the immediate relational circumstances of the individual suffering from the trauma, including the wider social/relational context, and the person’s history. I argue for an attunement to the language and specificity of the meanings, verbal and non-verbal, conscious and unconscious, of the client’s suffering within the analytical relationship. This requires the therapist to avoid ‘ready-made’ interpretations from psychoanalytic theory and to be open to thepoiesisof the speech, which emergesbetweentherapist and client. My discussion of my reading of the Chilean documentary film,Nostalgia for the Light,which focuses on the traumatic experiences of those who survived Pinochet’s military regime (1973–1989), highlights how diverse responses to trauma are. The originality of the language of the film calls on us as therapists to discover new ways of listening and speaking to our clients’ suffering. [ABSTRACT FROM AUTHOR]

Drawing principally upon the work of Woodmansey the author describes the development of the punitive or humiliating superego as arising from the internalisation of an external conflict, which the child experiences with adult carers, and from whom the child fears retaliatory punishment or scornful reproach. The superego serves the function of extricating the child from the external conflict. Woodmansey’s view of the natural instincts and the development of a moral sense are compared to those of Winnicott, Fairbairn and Guntrip. The notion of a pristine unitary ego and the development of an internal saboteur arising from the frustration of needs for relatedness are outlined and linked conceptually to the development of the punitive superego. The role and judgement of the ego and its emancipation from the superego in accordance with Britton’s formulation are highlighted and related to clinical practice and the alternating transference. These clinical themes are discussed in relation to eliciting affects and narrative construction and deconstruction in brief dynamic work and illustrated by a case example. [ABSTRACT FROM AUTHOR]

Drawing on non-clinical experience and with reference to relevant literature, this article examines countertransference and its impact on the development of a secure frame, focusing in particular on the countertransference dream and on its significance within the therapeutic relationship. [ABSTRACT FROM PUBLISHER]

The ‘black hole’ was a key metaphor introduced by the American psychoanalyst James Grotstein arising from his work with psychotic and borderline patients. Grotstein likens the intrapsychic ‘black hole’ to an astrophysical one and develops the allied concepts of ‘event horizon’, ‘singularity’ and ‘altered space-time’. While a similar metaphor is found in Tustin and Bion, Grotstein offers a more detailed theoretical explanation. A failure of maternal reverie, insufficient holding, an uncontaining environment or a lack of a background presence of primary identification can lead to the formation of a ‘black hole’ in the psyche of the child. Ross and Loly offer an innovative application of Grotstein’s ideas by identifying different forms of transference at each stage. These are illustrated through a case presentation recognising the complexity of transference and challenges to the therapeutic alliance. [ABSTRACT FROM PUBLISHER]

An introduction is presented in which the author discusses various reports within the issue on topics including psychodynamic clinical practice, importance of the countertransference dream in learning, and the work of Irish poet Paul Muldoon.

The article discusses the emotional impact of a fitness training for a marathon and the transference to the trainer. It explores the way in which emotional impact can stir up old conflicts and dependency needs. It also cites the relationship to one's body and the friendships that can develop as well as transference relationship with someone who made expected athletes to succeed in a physical goal.

Effective use of psychotherapeutic treatment in interpreter-assisted settings is well established; however, there has been little discussion of the use of psychodynamically informed treatments in such settings. The literature suggests that therapy facilitated by interpreters is not conducive to psychodynamic approaches due to the presence of a third person, the perceived lack of intimacy, and the difficulties of working with translated material. However, transference, countertransference and other unconscious communications and responses necessarily occur in every therapeutic setting, including triadic therapy using interpreters. This article describes a short-term (12 session) psychodynamically oriented intervention with a 52-year-old Cantonese-speaking man suffering from depression. A female, Chinese-born interpreter assisted in every session. The integral role of supervision in supporting a containing relationship between the therapist and the patient and the difficult emotional responses experienced by the interpreter is highlighted. The article attempts to trace some of the unconscious communications that occurred during the therapy and demonstrates the feasibility of working psychodynamically in an interpreter-assisted setting. [ABSTRACT FROM PUBLISHER]

Living in a post-Colonial culture, many people have a connection with empire. This might be as descendants of former subjects from far off lands, the pink portions on the old world map, or as the offspring of those who went out to those countries to run them. Those days are collectively looked back on as a golden age by traditional British society, when the UK led the world in industry and commerce. I am interested in how this pride in a time gone by affects us as therapists and people who use therapy. How do stories of empire leave its mark on us all, what do we make of the images in colonial literature, for example, Paul Scott’sRajnovels, Forster’sA Passage to India, and more recently Andrea Levy’sSmall Island? How are we as therapists affected in the consulting room and in what way might the therapy be influenced under the intense pressure of the transference when at least two cultures and backgrounds are in the room? [ABSTRACT FROM PUBLISHER]

This article considers how one might define ‘psychoanalytic autobiography’, using statements from theorists of ‘life-writing’ and extracts from autobiographers (some of them psychoanalysts), together with their own commentaries on the genre. The focus is less on content and more on the nature of the art form, with a view to noting analogies with the psychoanalytic process. These analogies are to be found, in particular, in the qualities of transference dialogue; in the art of transformative or communicative projective identification; and in the contrast between self-indulgent and constructive types of memory. Psychoanalytic autobiography is seen as a mode of remaking the self – not omnipotently but through exploratory self-analysis, frequently following the familiar pattern of loss and rediscovery. It entails a special imagined relationship with the unknown reader, and a sense of being guided by a detached observational eye equivalent to that which Bion terms the ‘third party’ in a psychoanalytic situation. [ABSTRACT FROM PUBLISHER]

The article describes how an early years teacher was able to use her understanding of the history of transference and countertransference, and in particular its usage today in parent-infant psychotherapy, to inform her practice and develop her role in a children's centre 1. Vignettes describe the author's struggle to make sense of her experiences with disturbed children in the classroom and track her attempts to use the concepts of transference and countertransference to support childcare practitioners. It is concluded that, while work in the transference and countertransference is risky and complicated, childcare and education practitioners are working in the mire of infantile projections whether we recognise this fact or not. It is proposed that support should be provided to help all early years practitioners own and scrutinise the difficult feelings the work inevitably stirs up. The use of 'psychoanalytic infant observation' and 'work discussion groups', as a means of providing this support, are discussed. [ABSTRACT FROM AUTHOR]

Working as a hospice chaplain I have experienced myself as the object of patients' transference. This has been uncomfortable and has left me feeling unrepresented by my identity as a clergyman. Training as a counsellor/therapist has increased my awareness about my own countertransference and, although this has been equally uncomfortable, the awareness has enabled me to self-reflexively analyse my identity as a clergyman. The trigger for my self-reflexive analysis was the response of a fellow student to my unguarded use of the word 'piss'. I use the theory of Fairbairn to respond to a question posed by Jung. [ABSTRACT FROM AUTHOR]

This paper explores the relevance of the concept of moral masochism as a response to early trauma and the implications of this for psychotherapy. Consideration is given to early conceptualisations of moral masochism within the psychoanalytic literature, in particular, the move from drive theory to object relations. More recent developments in relation to trauma and defences, such as disassociation, are explored. It is suggested that a more complex and fuller understanding requires thinking about the subtle and shifting interaction of both these levels. This allows the possibility of building a more nuanced understanding which can look at both behaviour, as described in the trauma literature, and meaning which is the core of a more classical psychoanalytic approach. Case histories are used to illustrate the linkages between moral masochism and trauma and the transference and countertransference dynamics and challenges involved. Progress varied in these cases, with both positive and negative outcomes. This theoretical background is used to suggest why this may be so. [ABSTRACT FROM AUTHOR]

The origins of today's humanistic and existential schools of psychotherapy may be seen to lie in the philosophical theories of existentialists such as Soren Kierkegaard and Jean-Paul Sartre. In their focus on being and self, some therapies converge meaningfully with the aims and methods of depth psychotherapy - including the later psychoanalytic theory of W.R. Bion. In rather remarkable ways, Bion's views of mental growth and the active counter/transferential process may be seen as conceptually closer to Kierkegaard's notions of relational being and truth - and to Sartre's interplay of subjectivity and objectivity - than they are to certain of Freud's classical constructs. Bion conceives of psychoanalysis as a mutual activity, one where the transference dynamic is characterized by 'client-and-therapist-as-relationally-present'. More than this, the active investment of the analyst's person in the countertransference parallels existentialism's notion of relational being. As a form of joint-feeling and mutual exploration, the patient's emotions, conflicts, and neuroses are seen as intimately related to similar experiences both felt and expressed by the analyst. While neutrality and objectivity remain priorities in Freud's initial theory of analysis, Bion's thought reflects a transference dynamic characterized by the essential ingredient of comradeship. It is not that Bion's theory is necessarily the only (or the best) example of an existential counterpart to psychoanalytic theory. It is difficult, however, not to be inspired by elements of his framework that resound clearly with the more powerful tenets of existentialism. While it is primarily the schema of transference/countertransference examined in the current paper, Bion's later writings also examine other themes that may too be considered as existential in direction. [ABSTRACT FROM AUTHOR]

The paper sets out to stimulate interest in counsellors and therapists about the unconscious relationships which people form with their work, through describing and analysing what goes on in work-related counselling with a psychodynamic approach. The author draws on twentyfive years of experience to reflect on the changing nature of what was once termed 'vocational guidance', and offers some short case studies, as examples of ways in which a person's world of work can become intertwined with their internal world in a confusing and disabling way. The core concepts and techniques which have evolved are identified and discussed; attention is directed particularly to the importance of the client's expectations, the effect of time limitation, the place of work in the whole life, and dealing with transference. [ABSTRACT FROM AUTHOR]

With in-depth analysis, certain patients reveal a great degree of anger and spite towards the object, feeling disappointed in it and devaluing it as unnecessary or useless. This anger is usually in response to feeling unloved or rejected. One way in which this appears clinically is a harsh superego that leaves the patient constantly and cruelly wanting to achieve a state of self-contained perfection. This is the result of projective identification processes in which the desire and demand for an ideal object is put into the object and experienced as both conscious and unconscious judgement, rigidity and expectation. Naturally, this means the patient is always failing themselves and attacking themselves or others for being less than ideal. One case will be explored to understand certain aspects of this problem. [ABSTRACT FROM AUTHOR]

This paper considers unconscious aspects of ageism, particularly in the underlying, reciprocal projective identifications between the 'young' and 'old' which entrench ageism and contribute to the debilitating consequences of ageing. These projections are examined in the context of care for older people, between the carer and the older person and between the therapist and the older client. Illustrations are given of how opportunities to reflect on the projective process through the counter-transference can ameliorate the effects of ageist attitudes and behaviours. [ABSTRACT FROM AUTHOR]

This paper explores how 'the social unconscious', namely the influence of society and politics, impacts upon clinical thinking and practice. The author argues that insufficient attention is paid to the influence of the psychosocial dimension and there is a methodological awkwardness in knowing how to conceptualize it. Furthermore it is argued that psychodynamic practice, with its emphasis on the exploration of the individual psyche, tends to disregard social engagement as a criterion of mental health. Three clinical examples are cited to demonstrate how the influence of politics and society can enter the psychotherapeutic dialogue. A methodology is then proposed using Bion's formulations about binocular vision, to examine the patient-therapist pair from the perspective of a small work group in society. [ABSTRACT FROM AUTHOR]

This study examines the effect of the therapeutic setting on the therapy from the perspective of the therapist. Six psychodynamically-trained therapists working in the NHS were interviewed. The analysis used a grounded theory based on Strauss and Corbin's (1990) methodology, although adapted to take account of Charmaz's (1990) social constructionist position. This assumes an active and non-neutral researcher shaping both the research process and product. Participants experienced the therapeutic setting as highly unstable and complicated. Internal pressures arose from difficulties around containment, anxiety, defences and management of the transference and countertransference. External pressures arose from institutional and management issues in terms of time, space, resources, power and status. Professional relationships within a multidisciplinary team could also undermine their therapeutic work. The study concludes that a psychodynamically informed reflective practice that organizes and manages aspects of the therapeutic setting over which the therapist has control will affect the therapy. Awareness of this should help the therapist to be more confident of working within less than ideal settings. Conflicts and tensions are dealt with more effectively when a therapist is confident in establishing a professional position within the NHS. [ABSTRACT FROM AUTHOR]