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

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

This paper describes a technique using photographic portraits in medical education to encourage close observation, cultivate empathic curiosity, explore learners' values and beliefs, and to reveal and reflect on fundamental biases. This new and evolving educational method uses the lens of psychotherapy to explore learners' experience of the portrait in a similar way we would discuss a case in psychodynamic supervision. Through close looking and small group engagement, the facilitator creates a space for deeper reflection and collaborative exploration of the therapeutic relationship, with emphasis on countertransference and the role of prior expectations. The exercise strengthens dialectical thinking through perspective-taking, challenging implicit assumptions and fostering cultural humility. Radiologists are taught to look in every corner of the X-ray and to observe each shadow, all while evaluating the entire image. Portraits can be examined in the same way, looking for subtle clues to the personality and history of the subject. Information from other sources confirms, or sometimes profoundly changes, our evaluation. In this example, we use a historical photographic portrait to demonstrate ways of engaging medical learners as they discover common psychotherapeutic approaches. The method has the potential to enhance therapeutic encounters, improve analytical skills and reduce bias. [ABSTRACT FROM AUTHOR]

The article discusses various new frontiers in psychoanalysis and the expansion of human, scientific, and clinical horizons in the field. It highlights the importance of the intersubjective dimension in clinical work and the recent evolution of scientific knowledge in psychoanalysis. The article also explores the concepts of countertransference, total situation, and the role of the digestive system in mental life. Additionally, it discusses the theoretical and clinical features of control-mastery theory, the effectiveness of psychoanalysis in treating bipolar disorders, and the interdisciplinary dialogue between psychoanalysis and music. [Extracted from the article]

"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 February 2024 issue of the Journal of Analytical Psychology features a range of stimulating papers. Silvia Presciuttini's paper explores the impact of mask usage in the treatment setting during the COVID-19 pandemic. Wes Wallace examines Jung's paper on the psychology of transference and proposes a new translation to clarify Jung's meaning. Ginny Hill discusses the clinical application of Jung's Black Books and The Red Book in therapy for a patient experiencing feelings of being the "living dead." Gunnar Reefschläger investigates synchronicity in psychotherapy and psychoanalysis, focusing on relational and transferential aspects. Benjamin Swogger pays tribute to Anthony Stevens and his contributions to the archetype debate. Joe Cambray interviews Ann Casement, discussing her journey in depth psychology and her various roles in the field. The Clinical Commentaries section presents a vignette on unconscious-to-unconscious linkage and the challenges it poses for the analyst. The issue also includes book reviews on a variety of topics. [Extracted from the article]

This paper describes the flexible application of existential-humanistic (E-H) and relational approaches to supervision when working with adolescents with life-threatening illness. Powerful therapeutic work can occur through the balance of utilizing practical therapeutic interventions─including open-ended questions regarding existential anxieties, use of countertransference and somatic reactions, reflecting on values and priorities, dream interpretation, learning from each emotion, creativity, and what is psychological health─and understanding how an illness is processed through the patient's unique cultural, family, medical, and relational history. The relational approach provides a balance to the E-H therapy emphasis on individuality in its focus on the complexity and adhesiveness of how early relational patterns and expectations are repeated throughout life. The E-H approach, on the other hand, provides a richness and depth to adolescents' anxieties and desire for freedom and choice. The language of agency, uncertainty, groundlessness, and responsibility can be particularly relevant to the turbulence of this developmental stage. The ultimate goal of supervision is that the supervisor becomes part of the supervisee's "internal chorus" along with other teachers, therapists, and mentors when dealing with future clinical challenges. [ABSTRACT FROM AUTHOR]

Individuals with borderline personality disorder (BPD) struggle to identify whom they can safely trust, and this struggle contributes to profound emotional turmoil in their close relationships. Transference-focused psychotherapy (TFP) is an application of object relations theory (ORT) that posits that polarized mental representations of self and other define the personality organization of BPD. TFP aims to utilize a clear treatment frame coupled with an analysis of the therapeutic relationship (i.e., the transference) to help individuals with BPD integrate their polarized mental representations. Improvement in the capacity to trust others is inherent in the mechanisms of change in TFP. In this article, a social cognitive model of trust processing provides a new lens through which we formulate how TFP may enhance trust processing in BPD. Recent evidence from randomized clinical trials supports the argument that TFP may intervene with BPD in a way that is concordant with uniquely improved trust processing. [ABSTRACT FROM AUTHOR]

Trust is central to successful therapeutic work with adolescents, but establishing trust can be challenging, especially with adolescents with personality disorders. We present our understanding of trust in working with adolescents with and without personality disorders. We draw on complementary and overlapping perspectives, namely the attachment model, Kernberg's object relations model, and Fonagy's mentalization model. In Kernberg's object relations conceptualization, difficulties in trust experienced by patients with borderline personality disorders result from paranoia associated with splitting and identity diffusion. In Fonagy's mentalization model, epistemic trust is rooted in early experiences of being responded to and understood. We outline how techniques used in transference-focused psychotherapy for adolescents promote the development of the adolescent's capacity to trust by facilitating identity integration, thus reducing paranoia. Finally, we use two clinical case illustrations to demonstrate how trust unfolds in working with adolescents with and without personality disorders. [ABSTRACT FROM AUTHOR]

Transference-focused psychotherapy (TFP) is an empirically supported treatment for borderline personality disorder (BPD) that improves functioning via targeting representations of self affectively relating to others, particularly as evoked in the therapeutic relationship. If change in TFP operates as theorized, then shifts in patterns of "self affectively relating to others" should be observed in the transference prior to shifts in daily relationships. Using ecological momentary assessment (EMA), a patient with BPD rated daily interpersonal events for 2-week periods during 18 months of TFP; at 9 and 18 months these ratings included interactions with the therapist. Results suggest that positive perceptions of her therapist that ran counter to her negatively biased perception in other relationships preceded changes in her perceptions of others. EMA shifts corresponded to improvements in self-reported symptoms, interview-based personality functioning, and therapist assessments. Implications for assimilation of a trusting experience with the therapist as a mechanism of change in TFP are discussed. [ABSTRACT FROM AUTHOR]

Alyson may already be sensing this intuitively when she writes: "I think it was important to [Kathleen] that I was willing to keep looking at her, seeing, feeling and acknowledging the hurt I had caused" (Kepple, [2], pp. 584-585). As testament to the power of Alyson's overall response, Kathleen wells up with tears which spill down her face as she feels Alyson's full recognition of her experience. I feel honored by Alyson Kepple's use of my 2019 paper, "Airless Worlds", to help her make sense of her patient Kathleen's life-long struggles with the sequelae of her parents' disappointed, frightened, and reflexively aversive responses to her from birth on. Alyson describes how she and Kathleen spent "a good part of our first year together exploring her somatic complaints in great detail" (Kepple, [2], p. 588). [Extracted from the article]

Therapists are expected to work therapeutically with increasing numbers of older adults due to the unprecedented global growth in older population. This work is considered emotionally challenging because it can evoke intense countertransference reactions in therapists. However, the field lacks empirically based practice recommendations on how to better identify and manage therapists' countertransference with older patients. This study explores therapists' experience of their countertransference in psychotherapy with older adults, using Hayes's (2004) structural model of countertransference as a guide. Semistructured interviews were conducted with 14 therapists and analyzed using grounded theory methodology. The findings are clustered around three themes: (a) unresolved conflicts related to therapists' own aging and death as well to their own parents are the sources of therapists' countertransference toward the older patient, (b) therapists' countertransference reactions are triggered inside therapy in response to the patients' health issues and the issue of death, and (c) countertransference is manifested as various affective and behavioral reactions to the older patient. Our findings indicate that therapists' unresolved issues related to the inevitable developmental phase of aging as well as to their own parents might be regarded as countertransference sources unique to psychotherapy with older adults. Our findings also demonstrate the wide range of emotional and behavioral countertransference manifestations in psychotherapy with older adults. Since effective management of countertransference is related to psychotherapy process and outcome, therapists should consider expanding their awareness of how countertransference origins are triggered and manifested in therapy with older adults, in order to engage in effective management strategies. Public Significance Statement: The present study suggests that therapists' unresolved issues related to their own aging and death as well as to their own parents are the sources of therapists' countertransference toward the older patient. These issues are then manifested inside therapy in response to certain triggers in the form of various emotional and behavioral reactions. These findings highlight the importance of being aware of unique countertransference issues when working with older adults. [ABSTRACT FROM AUTHOR]

Regarding the enactment, it is noteworthy that Rachel often submits to unilateral decisions in her interactions with men, as she may have done at the beginning of the analytic treatment when the use of the couch was not taken in consideration by her analyst. So, the analyst "surprises" himself twice, Rachel responds by speaking "in a confusing and disorganized way" and, joining them, I find myself disoriented and - very much as the analyst describes his patient - "oscillating very quickly between different possibilities." Could it be that the analyst could no longer bear the pressure of the patient's gaze, who could be seeking a kind of fusion or confusion with the analyst, as seems to be the case with her partners, and thus pushed her away and towards the couch? The vignette of Rachel, submitted by an analyst who remains anonymous, was read by Dr. Jay Greenberg. [Extracted from the article]

The numbers of people with the time, interest and economic resources to commit to psychoanalysis as a patient and/or as a candidate are dwindling, and psychoanalysis is an ageing profession. Others have sought to maintain that it is not appropriate to ask these kinds of questions of psychoanalysis (e.g. Hoffman [13]; Stern [25]), but it is hard to deny that the relative lack of an evidence base has contributed to the declining status of psychoanalysis. " Psychoanalysis, Psychoanalytic Psychotherapy and Supportive Psychotherapy: Contemporary Controversies." The concept of identity seems only latterly to have become a concern for psychoanalysts. [Extracted from the article]

In this paper, I set out to describe the different viewpoints, conceptualisations and defence mechanisms of the state of passivity; the categorisation by Freud; how the perspective of his thinking was altered by later insights and clinical observations; the close connection between the superego, passivity and masochism; the significance of the internal object world for Melanie Klein; countertransference as a means of access to masochism and destructiveness, with the aid of a short case illustration; and, finally, Betty Joseph's clinical experiences in work with her patients. [ABSTRACT FROM AUTHOR]

This paper discusses why similar institutional rules (Municipal Plan, Fund, and Council) and intergovernmental transferences) may influence municipal decision-making to participate in inter-municipal consortia differently in two Brazilian federal public policies—health and education. The paper argues that the more institutionalized the national policy design, the higher the probability of the municipalities getting into IMC. Based on quantitative analysis, findings show why the financial dimension is relevant for health policy, the most institutionalized in comparison with education, regarding municipal options for IMC. Similar evidence was not found in both policies considering the effect of their institutional rules. [ABSTRACT FROM AUTHOR]

Background: In order to comply with the 2020 health restrictions, many psychotherapeutic approaches have begun to hold online sessions, including psychodynamic psychotherapy, for which this modality marked a new procedure. The authors are psychologists with a psychoanalytic background, who mostly work with bereaved people. They considered it essential to initiate research, not only on online psychodynamic psychotherapy, but also on the scientific results regarding this practice used explicitly in cases of bereavement. For these reasons, two literature reviews were conducted according to the PRISMA protocol concerning: the use of online psychodynamic therapy in general (1), and its use in cases of bereavement (2). Methods: The databases used were PubMed, Cochrane Library, and Google Scholar, Eric and Web of Science. Inclusion criteria contains peer-reviewed scientific articles published in English from 2010 to 2022, with a focus on online psychodynamic psychotherapy and bereavement cases. Exclusion criteria included non-peer-reviewed studies, non-English articles, systematic reviews, quantitative scale validation studies, research protocols, and studies primarily focused on training. Compared with the research on the effectiveness of psychodynamic psychotherapy conducted online with all the different types of patients (1), only 5 research papers were selected from 842,103 articles. Out of 431,372 articles on the use of psychodynamic teletherapy with bereaved patients (2), in the end no articles were selected. Results: The results suggest that online psychotherapy involves a dynamic process very similar to faceto- face therapies. The small number of articles selected for both reviews underscores the need for further research on this topic. Conclusions: Since psychodynamic psychotherapy is based on concepts that are difficult to standardize (such as countertransference or free association), it is possible that clinicians and researchers have not yet found specific ways to validate it online. [ABSTRACT FROM AUTHOR]

Strategic concepts are more than simply academic concepts but must also relate to strategic practice, which affects how we should gauge concept quality. Rather than purely academic measures, strategic concepts must also be judged according to their usefulness for practice. Yet the relationship between general theory and specific practice has hardly been explored, a task this article undertakes. Academic theory generates ad hoc concepts, which are used to build specific theories of victory, which are used to generate orders. The measures by which to judge a concept's quality depends on where in this multi-phase transference process any concept is located. [ABSTRACT FROM AUTHOR]

This article examines the importance of malignant regression in analytic treatment in terms of how such processes can be detected and limited as well as how they should be dealt with over the course of the treatment process. Different meanings of regression in psychoanalysis are briefly discussed, focussing on how and in which cases the treatment technique for fostering regressive processes can be helpful, namely in the perspective on regression under the aspect of an opening up or closing of an analytical space. The concepts of regression and malignant regression are considered in relation to other concepts. In this respect, the relation to an intact psychoanalytic framework proves to be pivotal as well as the perspective that malignant regression hinders a working through of negative countertransference. The article ends in a proposal for an ethical stance in psychoanalysis that consists of taking all psychologic instances into account in a balanced way. [ABSTRACT FROM AUTHOR]

In the view of the author the concept of regression has been explicitly little discussed in recent years, even though it implicitly represents a psychoanalytic concept that is known and used by everyone. She therefore recalls Balint's concept of distinguishing between malignant and benign regression and attempts to show how these two forms of regression can be distinguished clinically and through countertransference. The core of malignant regression is ultimately the lack of separation between subject and object. First of all, knowledge of the concepts, awareness of the danger of malignant regression and its limitation are decisive for dealing with regressive processes. [ABSTRACT FROM AUTHOR]

Over the years, the psychiatric inpatient treatment paradigm has shifted to more brief stays focused on acute stabilization and psychopharmacologic-focused interventions, rather than individual psychotherapeutic engagement. Unfortunately, this has allowed patients with complex interpersonal dynamics, particularly borderline personality disorder, to slip through the cracks of effective treatment. This can contribute to repeated inpatient admissions, where both patients and clinicians feel trapped in a maladaptive, unhelpful cycle. In this article, we examine the evolution of inpatient treatment with de-emphasized psychotherapy practices, review the particular dynamics that patients with borderline personality disorder may evoke within an interdisciplinary treatment team, and provide a framework of clinically based vignettes for scenarios that may arise within inpatient treatment of this patient population. With attention to countertransference patterns and common pitfalls of communication, we offer alternative approaches and conversations with the hopes of improving outcomes and alliances in a new landscape of psychiatric practice. [ABSTRACT FROM AUTHOR]

By its title, Dr. Waska's latest book indicates that it is a primer on Kleinian thinking. If one had a professional education in psychotherapy (as many therapists do nowadays) or even in psychoanalytic psychotherapy, a therapist will welcome its refreshing creativity in doing Kleinian work as well as the easy language and brevity used to describe Kleinian theory. Waska, using a similar framework, suggests that the therapist listens to two types of wishes patients have in using PI. [Extracted from the article]

In fact, the author observes, "just as any other couple immersed in long-term and emotionally intense social interaction, a psychoanalyst and a patient can end up locked in a profound, or total, silence for long periods of time. Slowly the analyst came to interpret how her experience of helplessness and painful frustration had reflected reversed roles the traumatic-dissociated experience of Susan as a child "in relationship to her critical aggressive mother and to her distant but idealized father" (p. 117). Silence and Silencing in Psychoanalysis: Cultural, Clinical, and Research Perspectives, edited by Aleksandar Dimitrijevi'c and Michael B. Buchholz, Routledge, Abingdon and New York, 2021, 386 pp. [Extracted from the article]

S.H. Foulkes's paper concerning the Oedipus situation—published some 40 years ago—is still relevant in current group analytic practice. Main phrases of the Foulkes article, such as 'regression', 'infantile sexuality', 'Oedipus conflict', the 'Sphinx-like mother' and 'transference' are examined. Based on a case report about sexual pairing in group psychotherapy, the author depicts the course of events before analysing the enactment of the protagonists, the role of the group, somatic sufferings during the group process, boundary violations and countertransference factors, and discusses diagnostic and therapeutic implications as well as the need for further research on the special topic in group analytic psychotherapy. [ABSTRACT FROM AUTHOR]

Winnicott's acknowledgement of his debt to Milner is cited, as well as ways in which he "pinched" some ideas - and Milner in her turn "pinched" some of his. This is a beautifully written book, offering a perceptive, well-researched account of the life, work and "Method" of the writer, artist and psychoanalyst Marion Milner (1900-1998). Halton-Hernandez suggests there is good reason to believe Winnicott's patient was Milner. [Extracted from the article]

This paper describes a method for investigating clinical process, Layered Analysis, which combines therapist countertransference reports and multi‐faceted microanalytic research approaches. Findings from the application of Layered Analysis to video‐recorded micro‐events of rupture and repair in four psychoanalytic parent–infant psychotherapy sessions are presented. Layered analysis showed that countertransference and observation are complementary perspectives, which enable concomitant study of interactive events, conscious internal experiences, as well as nonconscious and unconscious elements of therapeutic interaction. Interactional rupture and repair were found to constitute co‐constructed micro‐events that occurred fleetingly and often implicitly, and differed in the structure, coherence and flow of interactions and in the relationship between verbal and nonverbal communication. Furthermore, interactional ruptures were found to sometimes 'get into' the therapist and transiently disrupt their self‐organization, such that the therapist became a locus of disruption for the patient(s), actively contributing to the rupture, which thus became embedded in the therapeutic system. Interactive repair was found to be most often initiated by the therapist and to be underpinned by the therapist re‐establishing self‐regulation, through metabolizing embodied and verbal aspects of the rupture. Studying such processes can enhance our understanding of clinical process, inform therapist training and clinical supervision, and contribute to clinical outcomes. [ABSTRACT FROM AUTHOR]

Chloe entered treatment with me when she was 17 years old. We begin the work to differentiate Chloe from Kate and explore Chloe's desire to create relationships that are less transactionally focused and not based on "controlling people with sex." Although my treatment with Chloe was over 15 years ago, while writing this case, I had a countertransference dream reactivating my distress to help liberate Chloe from the destructive parts of herself. Chloe, now 21 years old, brought a dream to her first appointment to begin the second phase of treatment: I There was a clown's face. [Extracted from the article]

In his work, Francesco Corrao has addressed cutting-edge themes developed in psychoanalysis between the 1960s and the 1980s. A contemporary re-reading of his writings offers a valuable opportunity to highlight central themes in today's psychoanalysis, such as the epistemological approach to the reality of the unconscious, the theory of the drives, countertransference, new and different perspectives on the transference, the centrality of the Oedipus complex, and the way in which digital technology has affected both culture and psychoanalysis. It seems particularly noteworthy that, while on the one hand Corrao's thinking preserves and integrates a part of the more recent contributions, on the other hand it provides a more solid redefinition of the fundamental elements of psychoanalysis, showing both the tensions that emerge from contemporary developments in psychoanalysis and culture, and a number of potential solutions. [ABSTRACT FROM AUTHOR]

Providing culturally affirmative clinical care entails taking care not to engage in therapy microaggressions nor invalidate the client's own experiences of microaggressions. The present study aimed to understand if therapy trainees enact microaggressions of overpathologization and invalidation toward racial and/or sexual orientation minority clients and to understand whether factors such as countertransference, perceived multicultural competence, empathy, heterosexism, andcolorblindnesscontributedtothelikelihoodof enactingthosemicroaggressions. One hundred and ten participants were randomly assigned to read one of four clinical vignettes of a client who reported experiencing discrimination because of her identity. Conditions differed by client race (White or African American) and sexual orientation (heterosexual or lesbian). Participants did not overpathologize racial and sexual minority clients. However, participants who reported greater overwhelmed/disorganized countertransference and greater colorblindnessweremore likely to overpathologize their clients. Participants invalidated themicroaggression experiences of the White heterosexual client the most when compared to the other conditions. Additionally, participants who reported experiencing overwhelmed/disorganized countertransference reactions and more colorblindness were less likely to believe the client's experiences of microaggressions, whereas having greater helpless/inadequate countertransference and positive countertransference was associated with beingmore likely to believe the client. Results suggest that therapy training programs might facilitate therapy trainees' engagement in self-reflection around countertransference reactions and helpstudents minimize colorblindness so that traineeswill better acknowledge and sensitively address clients' experiences with microaggressions. [ABSTRACT FROM AUTHOR]

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]

This paper examines the characteristics and clinical utility of the psychoanalytic field theory proposed by M. and W. Baranger, with particular emphasis on the issues of the transferential-counter transferential relationship and the 'second look'. The role of central key metaphors embodied in the experience of both patient and analyst is illustrated through the author's personal experience and participation in Three Level Model (3LM) work groups. The risk of moments of intense communication between patient and analyst has the possibility for the analyst to lose distance, making it necessary to go beyond moments of emotional resonance and reverie and to take a "second look" to understand the analyst's involvement in the interactional process in order to prevent the constitution of bastions of the field. The 3LM work groups extend the temporal context to include longer periods of time and a "third group look" that triangulates perspectives through group discussions, allowing for the exploration of transformations that have occurred in the analysis. The field perspective contributes to a deeper understanding of the transference-countertransference relationship. The "second" and the "third look" broadens the analyst's insights and enriches the understanding of the psychoanalytic process and its multifaceted dynamics. [ABSTRACT FROM AUTHOR]

This paper is a presentation of the concept "transference" in psycho-analysis. In Freud's thought, transference movements are new editions, copies of tendencies or phantasies that are the repetition of infantile prototypes, relived with a lively feeling of actuality. The text shows Freud's reflection on transference, and the importance of the countertransference which has been much developed by the post-freudians authors. Then, the principal forms of transference are presented, for example passionate transference, or transference by reversal. The psychoanalytic reflection about transference leads to study the analyst's neutrality, and to pay attention to the setting of the sessions. André Green emphasizes that the transference that is addressed to the analyst is at the same time a transference on the setting and on to speech. In the complexity of the "analytic situation" (Donnet), speech is transformed under the effect of the transference address (Rolland). [ABSTRACT FROM AUTHOR]

This brief introduction gives an historical outline of the development of the concept of transference in the different psychoanalytic traditions. It goes back to the various meanings of the German term "Übertragung" – transference, transcription, transmission, transposition and assignment – and how they were accentuated by the different psychoanalytic schools. The paper depicts the transition from a mainly intrapsychic understanding of transference as repetition to a more bipersonal and intersubjective approach exploring the different meanings of "intersubjectivity" and the forces that operate within the analytic field. Major developments arose from a new understanding of the role of the analyst's countertransference and the detection of transference mechanisms in narcissistic, borderline and psychotic states. The exploration of different forms of splitting and projective and introjective identification deepened the understanding of the analytic communication and led to concepts like "acting in", role-responsiveness, "actualization" and "enactment". As the author tries to show, all these approaches can find a legitimization in Freud's original writings, but the main differences concern technical issues, i.e. the interpretation of transference. [ABSTRACT FROM AUTHOR]

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 the context of the socio-political instability that exists in Ukraine, the problem of stress resistance among psychological service professionals has emerged. The aim of the research is to analyse the professional activity of psychologists in Ukraine at the present stage under the influence of stress factors. The following methods were used to study the nature of stress and its impact on the personality of a psychologist: analytical and synthesis methods, statistical, comparative, survey and interpretive methods. The research results theoretically reveal the peculiarities of the concept of stress, the stages of stress development, and identify the main stressors of professional activity. An empirical study of the stress resistance of psychologists was conducted. The influence of stress on the quality of psychological care was determined. Professional qualities in the psychologist's personality structure were identified, the phenomenon of professional exhaustion, the role of countertransference in counselling were studied, the importance of the code of ethics for psychologists and its violation in the course of practice were revealed. The importance of interventions and supervision as a means of psychological support for the professional development of psychologists was investigated, and statistical indicators of the level of stress were analysed. The practical significance of the research is determined by the current coverage of the problem of the impact of stress on the professional activity of a psychologist and in the creation of effective ways of emotional self-preservation and development of stress resistance, which provide the search for their resources for self-healing and effective work. [ABSTRACT FROM AUTHOR]

Therapists report significant countertransference reactions when treating clients with eating disorders (EDs). Countertransference may be pronounced among therapists with eating disorder lived experience (EDLE). Minimal research examines how therapists with EDLE negotiate their experiences while treating ED clients. Informed by the person‐of‐the‐therapist philosophy, this study sought to understand how therapists use and manage their EDLE when working with ED clients. Using constructivist grounded theory methodology, semistructured interviews (Mtime = 89 min) were conducted with 22 therapists with EDLE. Results revealed that therapists engaged in two interconnected systems. The Central System helps therapists transform their lived experiences into clinical guidance. The Checks and Balances System allows therapists to find a balance between connecting with the client and allowing for differences in experiences to emerge. Lastly, three personal processes existing outside of these systems were found to impact therapists' use of self. Findings provide novel ways that therapists can use their EDLE. [ABSTRACT FROM AUTHOR]

The present study aimed to examine the role of daily emotional processes in the relationship between countertransference (CT) management and emotional well‐being in novice school counselors. We collected data for 7 consecutive days from 305 novice school counselors in South Korea. Multilevel mediation analyses revealed that novice school counselors with low CT management ability were less likely to be aware of their emotions, increasing their daily emotional exhaustion. In contrast, novice school counselors with a high level of CT management ability were more likely to engage in daily decentering and, in turn, were less likely to experience daily emotional exhaustion. Although emotional inhibition (lack of emotional awareness) significantly exacerbated emotional exhaustion over time, decentering was not related to emotional exhaustion over time. The practical and theoretical implications of this study are discussed. [ABSTRACT FROM AUTHOR]

One essential albeit often neglected aspect of dreams is that we dream in images. Freud repeatedly emphasized the hallucinatory quality of dream images: the dreamer does not see the images, but experiences them. Without the experiential character of the dream, there would be no wish fulfillment, because it is the appearance of the real that the wish needs. In this way, the hallucinatory dream image is the guardian of the wish. The body image is of extraordinary importance in dreams. Through such dream images, the analyst can gain insight into their patients’ unconscious representations of their body. If the patient manages to accept these rejected ideas as their own, the dream can become a transitional object for them. Crucial to this process are the sensations that have been incorporated into the body images and become incapacitated. What remains of these dormant sensations can be aroused through analytical work. Gradually, the autoerotic cathexis of the previously rejected body images becomes possible. This deepens the patient’s capacity to be alone. These reflections are elaborated in this paper with the help of various patients’ dreams. [ABSTRACT FROM AUTHOR]

In this paper I will try to show how the chimera, as I understand it, is the result of an unsettling encounter between the traumatic traces of the two protagonists, culminating in a process of reverie, a process, indeed, of hallucinatory emergence, in which a creature emerges from the emotional embers of their traumatic clay. Although I take up Michel de M’Uzan’s notion of depersonalization, I would like to show how my understanding of a chimera filled with sensory qualities is different from his. Back in 2016, I spoke of the unconscious and clandestine agreement of the traumatic traces of both protagonists, from which I think it emerges. This conception seemed to me to reposition the question of the subjective and intersubjective effect of the two protagonists in the session, reaching into their deepest interior, since this »mythical creature«, to use de M’Uzan’s words, emerges from in between them during the analyst’s reverie, expanding into depersonalization. Not only does it arise from the dispositif that contains the emotional truth of the patient and of the analyst, but it also completes the attainment of O, that ultimate reality by which the analyst abolishes their ego by becoming one exclusively with the emotions of the patient. In the first section I will discuss in detail the metapsychology from which de M’Uzan recasts his conception of the chimera, followed by that of James Grotstein, who insists on the agency of projective identification, and finally I will address de M’Uzan’s challenge to the Kleinian approach through his conception of the »vital-identital«, which delineates a field of self-preservation infused with unheard-of energies. With the help of an example, I will try to show that when this creature emerges from the very deepest intimacy of each couple, it comes from the greatest distance and mixes the species based on what is most affective in the transitional characters of the infantile. I will follow a path that connects the Freudian memory traces of 1896 with Bion’s rejection of memory in the session in favor of O – that ultimate reality achieved through the experience of oneness or »at-one-ment« when the analyst, confronted with the patient’s emotional experience, draws on his or her own corresponding emotional resources. Evidence for this will be provided by a detailed example of a chimera. [ABSTRACT FROM AUTHOR]

In the commentary by Jutta Gutwinski-Jeggle, the intuitive imagination of psychoanalyst Johannes Picht is discussed, who noticed a striking coincidence between his idea and a patient's narrative about a serious car accident. The author raises the question of how this coincidence fits with Freud's statement about transference and countertransference. She suggests that the story of the accident could be a cover memory that conceals an earlier, unconscious trauma. The joint work on defense mechanisms leads to a deeper relationship between the patient and the analyst. However, the psychoanalytic framework can be experienced as unbearable and attacked. The author concludes by emphasizing the importance of accepting the decisions of the patients. The text discusses various concepts and approaches in psychoanalysis, particularly in relation to truth and the representation of unrepresented states. It is emphasized that truth is constructed in the psychoanalytic process and depends on the relationship between analyst and patient. The text refers to various authors such as Picht, von Uexküll, and Winnicott to explain these concepts. It is also noted that interpretations and hypotheses in psychoanalysis should not be considered as historical truth, but as attempts to create meaning and continue living. [Extracted from the article]

Knowledge arising from the clinician’s bodily sensations and visual imagination are considered through a clinical example where disruption to the setting culminated in the psychotherapist developing temporarily incapacitating physical symptoms in the consulting room. A subsequent imaginative visualisation allowed the clinician to attribute meaning to the moment of rupture, thus allowing her to use this bodily reaction as a way of gaining intuitive insight into the patient’s emotional state. This process is understood with reference to Bleger’s (1967) ideas about the setting as an institution, Lemma’s (2014) work on the embodied setting, and Sapisochin’s (2013, 2019) notion of enactments as representations of psychic gestures. Another example from the literature is used to further the suggestion that the clinician’s visual imagination can sometimes be used to enable a differentiation from a fusional aspect of the transference – countertransference dynamic and thereby increase their understanding of the patient. [ABSTRACT FROM AUTHOR]

From a self-psychology perspective, the profound disruption of the will to exist physically and psychically in patients suffering from anorexia can be seen as a primary impairment of the selfobject's capacity to make space for them within itself. Kohut viewed the primary phase of the baby's existence in the mother's mind as its "virtual conception." On this foundation, the author uses the notion of "virtual selfobject" to understand the impaired will to exist in patients with anorexia and describes how the therapist may embrace a standpoint that creates a space-for-being for the patient, facilitating the reactivation of self needs in the transference. The notion of virtuality thus entails a future perspective, which ostensibly foretells or creates the potential future emergence of the patient's self. This conceptualization and its application are illustrated through a life-restoring therapy with a patient hospitalized with a life-threatening eating disorder. [ABSTRACT FROM AUTHOR]

This paper offers insights into the process of conducting psychoanalytically oriented research in a neonatal high care unit with premature infants and their mothers. The paper emphasises how evocative and emotional the experience of conducting an ethnographic study with traumatised mother-baby dyads can be. The importance of constantly scrutinising the counter-transferential responses, thoughts and feelings induced in the researcher is emphasised. Case illustrations highlight how a reflexive exploration of these reactions resulted in crucial insights about the experience of prematurity. The 'lived experience' of anguish, pain and overwhelm allowed a profound sense of understanding and respect for what premature infants and their mothers need to endure. The challenges inherent in navigating the overlapping roles of researcher, psychotherapist, mother, and human being are also addressed. [ABSTRACT FROM AUTHOR]

Apprehending the full range of one's countertransference presents a challenge for the new therapist and psychiatry resident. Experiencing negative or aggressive feelings while also striving to consolidate one's professional identity and self-experience as a good, helpful, and competent doctor feels dissonant and contradictory. Developing and practicing the skills of countertransference awareness and analysis are crucial aspects of psychiatry and psychotherapy training. These skills can help the trainee navigate difficult clinical interactions through reflection on their own anxieties, as well as the unconscious social and personal biases and motivations that shape their countertransferences. This article examines some of the countertransference reactions that may be colored by social and personal stigma toward patients with substance use disorders. Acknowledging and exploring such countertransference reactions in training not only can provide valuable insights into the psychodynamic experiences of the patient and the treatment dyad, but also can sharpen a lifelong tool, helping the trainees weather powerful and disorienting countertransference currents, untangle their personal motivations and prejudices, and recognize the times when supervision may help to provide containment and clarity throughout their careers. [ABSTRACT FROM AUTHOR]

Taking the liberty of imagining the lawyer in Melville's "Bartleby, the Scrivener" as narrator/therapist and Bartleby as patient, this article, written with the therapist/reader in mind, traces the vicissitudes of countertransference and speculates on what constitutes a "good enough" therapeutic effort. [ABSTRACT FROM AUTHOR]

The author provides a historical overview of the psychodynamics of addiction with particular emphasis on countertransference awareness and its relationship with treatment outcomes and prognosis. Countertransferences that frequently occur in the treatment of substance use disorders include shared helplessness, hopelessness, sadness, anxiety, fear, anger, rage, shame, and guilt. These emotional states in clinicians may lead to fatigue, avoidance, and acting out unless therapists are able to ground themselves and disidentify with the projected affective states. Positive emotions may lead to excessive enthusiasm in clinicians and deflect from the therapeutic process, resulting in deviation from established practice guidelines. Coexisting negative and positive affective states may lead to rescue fantasies and transgressions of boundaries. Contemporary psychodynamic clinicians appreciate the quantitative aspect of emotional reactions, where countertransferences accumulate exponentially over time, causing allostatic overload and compassion fatigue. Unanalyzed negative countertransferences are linked to either clinical avoidance or aggression, resulting in withdrawing care, failure of empathy, and dissolution or fragmentation of the therapeutic alliance. The negativism associated with the treatment of addictions may be rooted in unanalyzed countertransferences and psychosocial factors such as internalized negative societal attitudes and stigma. Degrading and dehumanizing attitudes toward people with substance use disorders could stem from internalized negative societal constructs against disenfranchised, minoritized, and stigmatized persons. This editorial introduces the work of Bernardine Han, an addiction psychiatrist who utilizes psychodynamic concepts to guide interventions with people with substance use disorders. [ABSTRACT FROM AUTHOR]

Did Caldwell's physical reactions reflect aspects of the patient's mother's experience, her response to becoming pregnant with the patient so soon after the birth of her first child? By sensing and gathering bits and pieces of the patient's wordless experience, the analyst supports the patient's inchoate sense of I-ness. I Body as psychoanalytic object: Clinical applications from Winnicott to Bion and beyond i explores the role of the body in analysis from an object relations perspective. [Extracted from the article]