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Brown's historical overview of post-Kleinian psychoanalysis traces key steps in the evolving and diverse practice of working in the psychoanalytic situation while regarding it as a two-person field. The Barangers' 'The Analytic Situation as a Dynamic Field' is central to his narrative. I develop my understanding of the originality of their contribution in theorizing a situational unconscious, and of their continuing relevance for thinking about analytic listening and intersubjective collaboration. Brown presents a countertransference dream of his own along with the dream of a patient as an example of the Barangers' concept of the 'shared unconscious fantasy' of the analytic couple. A detailed alternative reading of Brown's clinical vignette reveals an absence of fit with the Barangers' views on collaboration in the analytic situation. Some uses of Bion's 'dreaming' and 'becoming' are implicitly questioned as they risk encouraging the idealization of special states over process. [ABSTRACT FROM AUTHOR]

The clinical case that centers on a female patient who presented with a generalized sense of despair, hopelessness, and shame is discussed. Infant research, child development, neurobiology, trauma research, and nonlinear dynamic systems theory are employed in recontextualizing concepts of defense, resistance, dissociation, development, and therapeutic action. Specific positive new experiences, emergent from within the analytic dyad, lead to the development of consolidated, integrated self-states and a securely consolidated, intimate attachment to the other, which proved mutative. [ABSTRACT FROM AUTHOR]

In this article the author discusses aspects of a report by Antony Garelick regarding psychosis as a defense mechanism against unbearable terror. The author relates her experiences of encountering individuals with psychosis, including once when she was in training as a clinical psychologist and once when she was working with her first patient as part of an analytic training case, and explains how the experiences helped her to help her patients.

This paper discusses Gilbert Cole's book, "Infecting the Treatment: Being an HIV-Positive Analyst." The author provides some personal reflections on the outbreak of AIDS and the impact it had upon his work as a psychotherapist. The paper addresses the importance of the cognitive schemata Cole provides to psychotherapists working with seropositive patients. This paper then addresses a powerful technique, a therapist's self disclosure to a patient, upon which Cole's work focuses. Using the example of psychoanalytic strictures regarding self-disclosure, the author argues that self-disclosure is more likely to be adhered to in theory than it is in practice. The author agrees with Cole that non-disclosure is often a technique used by analysts to hide, rather than provide a therapeutic field of action. The specific case of therapists hiding their antihomosexuality when working with lesbians and gay men is used to illustrate the author's perspective. A specific case presented by Cole in his book is then used to both compare and contrast Cole and this paper's author's use of self-disclosure. The paper commends Cole's study for opening a debate on how to use countertransference and self-disclosure as tools which widen and enrich the therapeutic relationship. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to examine the impact of systemic racism on an interracial therapeutic dyad between a white therapist and an African American adolescent male. Leary (2000) operationalized the term "racial enactments" and made the important point that its "most common" manifestation "has been our relative silence about racial issues" (p. 647). It is the premise of this paper that the youth of color's subjective experience of racial microaggressions and assaults experienced on a daily basis must be validated and explored prior to a meaningful intersubjective exploration in the clinical encounter. The emphasis in this paper is on the racial enactment that precedes the clinical encounter. A treatment vignette is used to highlight the intersection of social and psychic spheres of human experience and how an awareness of unconscious bias in the therapist can facilitate a more meaningful dialogue in which priority is given to the emergence of a powerful client narrative voice. [ABSTRACT FROM AUTHOR]

The current paper discusses issues of transference and countertransference in a psychodynamic psychotherapy of an emotionally disturbed girl in residential treatment. The paper argues that unrecognized rescue fantasies may underlie the strong negative feelings evoked in the countertransference and that projective identification may then be used as a defense against those feelings. The paper also argues that the current emphasis on providing short-term, empirically validated, and cost-effective treatments for emotionally disturbed children and adolescents may be producing residential child-care workers and institutions that are even less prepared to recognize and work through the difficult feelings evoked in the process of working with emotionally disturbed and disturbing young people. [ABSTRACT FROM AUTHOR]

The author discusses the paper "Transference as a therapeutic instrument," by Clara Thompson which explores transference. Topics discussed include the argument of psychoanalyst Sigmund Freud about transference, the origins of transference explored by Thompson, and the complexity of transference. It also explores the argument of Thompson on how can therapist use aspect of patient's transference to achieve a cure.

This paper discusses Andrew Anson's “Ghosts in the Dressing Room,” providing an opportunity to discuss therapist self-disclosure and responses it may provoke in psychodynamic psychotherapy. Freud discouraged self-disclosure, his “blank screen” model based on a belief that the best way for therapists to understand libidinal transferences was to reveal nothing directly to patients. Freud's close follower Sándor Ferenczi eventually became critical of analytic opacity, arguing therapist self-disclosure was often necessary and healing for traumatized patients. Although Freud's libido theory is no longer considered relevant to psychotherapy training, his blank screen model still persists. However, there is little empirical evidence supporting nondisclosure as a superior therapeutic technique compared to self-disclosure. Nevertheless, since Freud and Ferenczi's time, self-disclosure has been controversial due to unexamined beliefs, ideology, and allegiances to particular analytic schools of thought. The dilemma created for openly gay therapists is that coming out, a form of self-disclosure, is perhaps the most commonly shared cultural experience defining a modern gay identity. Yet a blank-screen model that strongly discourages overt admissions about analysts’ subjectivities, let alone their sexual identities, regards openly gay therapists as engaging in undesirable countertransferential enactments. The paper concludes with a more detailed discussion of Anson's clinical material. [ABSTRACT FROM PUBLISHER]

This paper illustrates features of psychoanalytic psychotherapy with a young adolescent who had experienced adverse childhood events, culminating in cumulative trauma. This led to the atrophying of her 'sense of place' and 'place identity', both integral to the development of a sense of self. The patient's memory of places seemed to have been pulverised and required the contact and containment of the adult mind of the therapist to find recomposition. A therapeutic relationship developed, thanks to the sharing of objects and places which had become fragmented in the patient's mind. There was a need for locations, paths, places, indeed entire nations needed to be emotionally recomposed in the transference, to assume rudimentary but thinkable forms. The psychotherapy made it possible to find part of my young patient's memory through play, and the value of intensive but short-term work became evident. Psychotherapy allowed partial repair of the capacity for place attachment, which facilitated the exploration of the external world, the possibility of attachment to new places, and the construction of new place identities, alongside her developing sense of herself. [ABSTRACT FROM AUTHOR]

The aim of this paper is to show how the life, personality, and scientific work of Gaetano Benedetti and Johannes Cremerius shaped the original form and structure of the Milan Associazione di Studi Psicoanalitici (ASP), which they founded together with their pupils in 1971 and which became a member society of the International Federation of Psychoanalytic Societies (IFPS) in 1989. The training analysis was substituted by a personal analysis to be finished before the beginning of the training proper; group supervision had and still has as much importance as individual supervision; transference and countertransference analysis are fundamental dimensions of both psychoanalysis and psychotherapy; and psychoanalysis can survive only in a context of interdisciplinary dialogue, empirical research, and social commitment. The author thinks that all these ingredients, which Benedetti and Cremerius contributed to the life of the Milan Scuola di Psicoterapia Psicoanalitica and ASP, could represent important resources, as far as the future of the IFPS is concerned. [ABSTRACT FROM PUBLISHER]

This paper is written from a psychodynamic clinician's perspective, juxtaposing a psychoanalytic-attachment model of depression with recent developments in neuroscience. Three main components of the attachment approach are described: the role of loss, of childhood trauma predisposing to depression in later life, and failure of co-regulation of role of primitive emotions, such as fear, despair, and helplessness. Blatt's distinction between anaclitic and introjective depression is delineated and related to hyper- and de-activation of the attachment dynamic. Recent advances in evolutionary, sociological, epigenetic, biochemical, and neuro-imaging studies of depression are reviewed. A dynamic model of depression is proposed, linking interpersonal and intra-psychic perspectives with neuro-anatomical models. The final section of the paper considers the specific role of psychodynamic approaches to the treatment of refractory depression. These include length of treatment, capacity to rework implicit memories, and focus on transference and counter-transference. [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]

This paper is intended as a contribution to the dialogue between body-orientated and psychoanalytic approaches to the psychotherapy of trauma. Therapists' use of their own body awareness and somatic countertransference is central to body and movement psychotherapy but is rarely discussed in the psychoanalytic psychotherapy literature. Both phenomena have crucial roles in facilitating therapy, particularly with patients who have been traumatized. Both can provide critical windows into patients' material and dynamics; similarly, the neglect of attention to either can lead to clinical ignorance and errors, no matter what the diagnosis of the patient in treatment. In work with traumatized or dissociative patients however the risks of not attending to somatic countertransference and body awareness include the vicarious traumatization of the therapist. Examples of body awareness and somatic countertransference are given, and their use is addressed. A model for the transmission of vicarious traumatization is briefly described that relates to dissociated kinesthetic mimesis. [ABSTRACT FROM AUTHOR]

This paper illustrates the clinical application of current theorizing about mentalization and reflective functioning and shows how it can synergize with established analytic concepts. The paper presents a single case, that of a middle-aged woman patient with a moderate but significant history of trauma and presenting with narcissistic/borderline and masochistic dynamics. Unlike some applications of the new concepts, however, this paper does not focus the case presentation around them but instead shows how a number of processes contribute to the development of mentalization. These include corrective engagement in enacted repetitions of the patient's past mistreatment, the development of a central metaphor that allows for proto-reflection and playing with painful affects, and a mourning process precipitated by the death of a family member to whom she is ambivalently attached. In the course of the presentation, then, a variety of psychoanalytic concepts are applied, such that the paper works as a synthesis of mentalization theory with them. Specifically, transference-countertransference dynamics are tracked, projective identifications and containment processes are described, interactions and interpretations lead to progressive change, and fantasies, conflicts, and internal object relations are observed and analyzed. Such direct and detailed clinical application of the concept also makes it more vivid, lucid, and experience near. [ABSTRACT FROM AUTHOR]

Seligman's appreciative response to the discussions of his paper is most concerned with the issues raised in Leon Kleimberg's critique of his “modifications of technique.” The dialogue between Kleimberg's and his point of view, with the latter echoed as it in Case and Dent's and Frosch's, reflects a number of key convergences and divergences between the American relational perspective and the British Independents'. Both approaches rely on a fundamentally dyadic perspective that stresses how the analyst's work is fundamentally shaped in response to the patient's internal objects. At the same time, although he is sympathetic to Kleimberg's concerns, he questions the idea of technique as a fixed set of uncontaminated practices. Instead, he endorses the North American relational idea that whatever the analyst does in the name of “technique” cannot be extricated from the transference-countertransference in which it is implicated. From this point of view, technical decisions are most likely to be experienced by the patient, and very often by the analyst, as inevitably reflecting one aspect of another of the patient's internal object world from within the phanstasmatically organized matrix of each analytic relationship. In addition, he is concerned that analysts' rigidly adhering to “technical” positions will reduce their likelihood of being effective with the widest range of patients, an increasing number of whom may not accept the traditional analytic practices. The mentalization concept, although not guiding his decisions in the case, is useful in describing many such situations. [ABSTRACT FROM AUTHOR]

This paper discusses the development of object relations theory which, in Britain, was developed as an extension of Freudian psychoanalysis by such thinkers as Melanie Klein, Fairbairn, Winnicott and their followers and later supported by research from attachment theorists like Bowlby. Object relations theorists made a shift from the conception of a drive-based psyche to one that was primarily motivated towards relationships. Contemporary object relations theory acknowledges the primacy of relationships, which results in the close attention and utilisation of the constantly active system of transference, countertransference, and protective identification in the space between therapist and client. This paper examines object relations in the context of its unique challenges for gay male therapists working with gay male clients in the gay therapeutic dyad. This paper reviews the legacy of homo-negativity in the therapeutic process. It then explores how knowledge of object relations theory can be useful for therapists working within a gay therapeutic dyad. [ABSTRACT FROM AUTHOR]

This paper attempts to address the similarities and differences between psychoanalytic psychotherapy and psychoanalysis as practice. Starting from the manifest technical points, which he dismisses as peripheral, the author reaches the position that he considers to be the fundamental area of contention, i.e. the tranference-countertransference arena. Focusing on the countertransference stance of the professional in this process, the author distinguishes the defining differences of these two approaches, and hopes to show them to be more complementary than antagonistic. [ABSTRACT FROM AUTHOR]

This paper charts a portion of the psychoanalytic therapy of a gay male patient with a gay male analyst. The therapist discloses his sexual identity at the time of referral but otherwise works within a contemporary neutral framework. The case material shows how a patient uses the disclosure of the analyst's sexuality to fortify stereotypical views of what it means to be a gay man, and to avoid the potentially traumatizing exploration of their differences. Analysis of the patient's defense strategies eventually allows him to accept a more complex view of himself, of his relationships and of what it means to be a gay man. [ABSTRACT FROM AUTHOR]

The concept of countertransference as a robust cornerstone of psychoanalytic work has gained momentum over the last five decades. It is a prime example of elastic concepts covering the range from microprocesses to global clinical phenomena. Empirical research on the treatment process has for a long time – and for good reasons – avoided even trying to measure countertransference. We report here on various efforts for approaching a methodology for measuring it. The paper organizes the various approaches in terms of stages of research. [ABSTRACT FROM PUBLISHER]

This paper explores the concept of countertransference as a clinical tool in parent-infant psychotherapy. We describe various theoretical concepts that link to countertransference and outline six parent-infant psychoanalytic psychotherapy cases from our clinical work. We explore and illustrate countertransferential processes using three common clinical categories, anxiety, depression and personality disorder. We present a model of working with the countertransference that enables the clinician to identify the position they take up in relation to the most prevalent emotion communicated by the mother and infant in the therapeutic encounter. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including therapeutic attitudes during and after psychotherapy training, the process of change in long-term psychoanalytic psychotherapy, therapists' experiences of somatic phenomena in the countertransference.

Working therapeutically with people who experience psychosis can be demanding, confusing and even terrifying for psychotherapists, yet there is very little research that has systematically investigated the experiences of psychotherapists concerning their engagement with psychotic phenomena. Theoretically, it has been proposed that managing countertransferential responses to a patient's psychosis is a crucial component of working psychoanalytically with such conditions. In light of this theoretical premise, the study reported upon in this article investigated some of the negative countertransferential dynamics observed by psychotherapists who engage in clinical work with patients presenting with psychotic states or conditions. Focused semi-structured interviews were conducted with eight psychoanalytically oriented psychotherapists. Two core themes emerging from the study are discussed: firstly, the psychotherapist's experience of madness; and secondly, the role of the body and somatic communication. The themes convey important aspects of countertransferential experiences related to the therapeutic encounter with psychosis. [ABSTRACT FROM AUTHOR]

In this paper the author presents a case in light of some of the most exciting and liberating developments in contemporary psychoanalytic theory. Through the story the author reflects on her participation in a fierce life and death struggle to establish a space for ''goodness'' in an otherwise tortured and haunted life. The author summarizes this experience focusing on three dimensions: (1) the psychodynamics of addiction, (2) transference and countertransference implications from an intersubjective perspective, and (3) clinical implications derived from considerations of practice in a Latino and non-traditional therapeutic context. [ABSTRACT FROM AUTHOR]

This paper examines how attachment processes interface with transference and countertransference dynamics that emerge through parallel process in the supervisor-therapist-client triadic relationship. Attachment establishes the groundwork for regulating distress that surfaces when transferences or countertransferences become activated in treatment and supervision. Attention to attachment styles helps prevent and resolve transference reenactments in the supervisory triad. Secure attachment within the supervisory relationship is linked to the self-reflection and affect regulation of the professionals, which then influences the therapist's attunement to, and regulation of, the client's affect in psychotherapy. A case presentation illustrates the role of attachment in clinical supervision. [ABSTRACT FROM AUTHOR]

This paper originated as my contribution to a panel discussion offering differing theoretical and technical points of view. It was based on Joseph Newirth's detailed process description of two clinical sessions of an ongoing analysis. Utilizing Bion's concept of the ‘psychoanalytic game,’ the material is played with from the Kleinian-Bionian perspective of an experienced adult and child analyst. My model of mind addresses with facility the ‘child in the adult’ of the patient, using concepts of an internal family of mother, father, little-boy, and little-girl parts, noting and clarifying misconceptions, misunderstandings, and misapprehensions, as well as a striving in the patient toward truth, beauty, and goodness under the aegis of the primacy of life forces. The impact of concrete thinking on perceptions of reality is addressed in the clinical material. [ABSTRACT FROM AUTHOR]

The author comments on the article "Transference as a therapeutic instrument," by Clara Thompson. Topics discussed by the author include the role of Thompson in the development of psychoanalysis in the U.S. according to author Erich Fromm, the transference cure, and the association of American psychoanalyst Harry Stack Sullivan.

On May 1, 2004, the Association of Gay and Lesbian Psychiatrists (AGLP), with co-sponsorship from St. Luke's–Roosevelt Medical Center, The Haworth Press, and the William Alanson White Institute, organized an all-day conference in New York City entitled Homosexuality and Psychoanalysis: New Directions. The proceedings of the third panel focused on "Clinical Perspectives." The first contributor is Deborah F. Glazer, PhD, who discusses the impact of homoerotic desire and same-sex object choice on the intrapsychic world and the experience of one's self, including one's sense of adequacy in one's body based, gendered self, and the ability to feel sexual desire. In working with a largely gay and lesbian patient population, Glazer finds that many patients enter treatment organizing their self-experience around themes of gender and sexual orientation. These organizing self-identifications can interact in inhibitory ways that need to be addressed in the analytic work. While these kinds of identifications may not be unique to lesbian patients, the heterosexual bias in society at large, and within psychoanalysis, results in some lesbian patients entering treatment with a more powerful need to address these themes. Jeffrey R. Guss, MD, asks, "What does psychoanalysis have to say about homosexuality?" He acknowledges that gay and lesbian therapists have much to say about gay life and therapy with gay and lesbian patients. They share profound life experiences with their patients, including internalized homophobia, stigmatization, denial of sexuality, denial of relationships, and a fierce expertise in conducting fictive or hidden lives. However such knowledge, even if acquired in an analytic therapy, is not analytic knowledge about homosexuality. Guss, in discussing a clinical example, explores what psychoanalysis has revealed about itself in its long relationship to homosexuality, particularly the field's need to regulate gender and sexual desire. Ann D'Ercole, PhD, shifts the focus to clinical work with same sex couples. She underscores the importance in the clinical work with same sex couples of attending closely to expressions of feeling "different" as such feelings can often obscure shameful feelings that can infiltrate and contaminate a relationship. She further notes that it takes courage to invite a stranger, albeit a good-intentioned one, into the intimate workings of a couple's private life. For lesbian and gay couples seeking treatment, this invitation may invite greater risks than those taken by their heterosexual cohorts. Historically, psychoanalytic practitioners obscured the lives of lesbian and gay individuals in the language of pathology, immaturity and immorality, and psychoanalytic theorizing about same-sex couples rarely went beyond judging them as unworkable. While gay-affirmative clinicians have illustrated how cultural messages can hinder intimacy for couples by creating barriers in an otherwise functioning relationship, mainstream psychoanalysis still lacks normative models for understanding the interpersonal dynamics of gay and lesbian couples. D'Ercole's aim is to begin a process of correcting that omission. Towards that end, she presents a clinical example of a lesbian couple that entered treatment after one of the partners discovered the other in an act of infidelity. Scott Masters, MD, concludes the panel with clinical material from an ongoing treatment. In the process, he puts forth some contrasting ideas about the concept of "hypersexuality" as being either a defense or an addiction. During treatment, gay patients describing their sexual activities can create a host of countertransferences, regardless of the gender or sexual orientation of the therapist. At times therapists may find themselves intrigued, disgusted, envious, or even sexually excited. Therapists are forced to examine the value judgments about certain sexual acts that constitute their own sexual hierarchies. Masters presents a complex case in which because of the patient's potentially self-injurious sexual behavior, it became difficult to stay the course and manage his countertransference. [ABSTRACT FROM AUTHOR]

This article will introduce the theory of Control-Mastery, an empirically supported, cognitively oriented interpersonal theory of psychotherapy. Control-Mastery theory offers a distinctive approach to counter-transference in particular and suggests a unique way to understand unconscious functioning. The theory also provides specific guidelines for conducting psychotherapy as well as a useful framework for understanding the impact of familial as well as cultural context on individual psychological struggles. Control-Mastery theory offers a new way of understanding some old issues of particular relevance for social workers especially, given an of- ten difficult practice environment. It is a view of human dilemmas that preserves the dignity of people and provides empirically supported guidelines for how social workers can be useful to them. It suggests a different explanation for behavior that other theories might label as acting out, resistance, non-compliance, or dependency. It is especially powerful for working with people whose backgrounds differ from the therapist's as well as for understanding and making changes in the impact of oppression on clients.

ADHD is increasingly seen as associated with cerebral dysfunction and caused by it. This development is concomitant with an emphasis on medication, behavioural treatments, and parent training programmes. In contrast, psychoanalytic therapy has receded into the background and is often viewed as inefficient or even noxious. This paper argues that such views are based on a misunderstanding of the scope of psychotherapy. Though much more systematic research is needed to establish its efficacy, it can inform on the ADHD child’s emotional experiences. It can shed light on the connections between his/her inner world and symptoms, such as attention deficits, hyperactivity, and impulsivity. On the other hand, it cannot establish causality in the individual or general case. If we recall that the diagnosis is based on a list of symptoms, not of etiology, we realize that this limitation applies to any scientific perspective on ADHD. Psychoanalytic treatment is one of several approaches to understanding ADHD and helping the child cope with it. This is achieved by the psychoanalytic method, a hermeneutic approach with which the analyst interprets the child’s behaviours and communications as they emerge in the session. The implications of such an approach are discussed.​​​​ [ABSTRACT FROM PUBLISHER]

The emotions experienced by a supervisor—including even his private, 'subjective' fantasy experiences and his personal feelings about the supervisee—often provide valuable clarification of processes currently characterizing the relationship between the supervisee and the patient. In addition, these processes are often the very ones which have been causing difficulty in the therapeutic relationship and, because heretofore unrecognized by the supervisee, have not been consciously, verbally reported by him to the supervisor. This thesis is undoubtedly well known to many persons engaged in supervision, and in everyday use by them in this work; but my own experience indicates that it is far from universally recognized, and it has not been presented in the literature, to the best of my knowledge. It would be at least equally valid to express the principle in the following fashion: the processes at work currently in the relationship between patient and therapist are often reflected in the relationship between therapist and supervisor. But it makes for simplicity of presentation to present this material from the viewpoint of the supervisor. [ABSTRACT FROM AUTHOR]

The concept of vicarious resilience captures the therapist's emotional growth occurring as a direct result of therapeutic engagement with traumatized clients. Three chronological case scenarios are presented for exploration of vicarious resilience in relation to attachment trauma. The purpose is to increase awareness and appreciation of the positive functions it serves for client mentalization, therapist skill and resilience factors for both parties. The reflective methodology considers the intrapsychic worlds of the client and the therapist and details how the therapist comes to experience the client's distressing projections. The potential for vicarious resilience begins from the outset of the therapist's actions of containment upon these projections. Advancing early ideas, it is advocated that vicarious resilience requires the therapist to have both the capacity and willingness to maintain a constant reflective stance. [ABSTRACT FROM AUTHOR]

One of the characteristics of psychotherapeutic work with children and adolescents is parental presence, which introduces additional parameters into the setting and function of the therapist. Parental presence makes the existence of the external world constantly present, increasing the risk of bias in interpreting and understanding the intrapsychic world. Interference is common in the therapeutic setting, and mostly challenges the therapist's tolerance. Meetings with parents may trigger fantasies in the therapist's mind, which interfere with the game of identifications with the child and the fantasized parents. The common bond with the child creates conscious and unconscious reactions, and there is always the risk of the therapist being overwhelmed and losing his or her capacity to understand object relations and transference phenomena. The therapist's function may be influenced either through weakening of the symbolizing capability or through hampering the capability to understand the child's function of fantasy. Parents are always present, while the therapist's countertransference movements evolve. Given that the technique of interpretation is not always available, the main goal is to use countertransference challenges in the service of the child's psychotherapy, by understanding the child's internal reality, resistance, and experience, as well as the intensity and nature of external experiences within the family. [ABSTRACT FROM PUBLISHER]

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]

Defense interpretations are commonly used techniques that clinicians employ more frequently than transference interpretations. How and when clinicians interpret defenses, however, has received little empirical examination. In an effort to facilitate the empirical study of defense interpretation, we reviewed 15 works by noted authors who gave a prominent role to interpreting defenses in discussing clinical work in general patient populations. Our goal was to identify and systematize distinct themes from these authors that might be testable hypotheses. We identified 74 themes related to the interpretation of defenses in psychotherapy-for example, 'interpreting too frequently diminishes the emotional impact of interpretation'-which we organized into 17 distinct categories (e.g., factors associated with positive outcome). We subsequently selected 19 themes that were readily operationalizable as hypotheses and examination of which would advance clinical practice. These hypotheses address issues such as when, in what order, and how to interpret defensive material and what successful outcomes would be. We then describe prototypes of research designs, employing naturalistic observation, randomized controlled trials, or experimental laboratory studies, which could investigate these important hypotheses. Overall, this report codifies current clinical maxims and then provides future research directions for determining how clinicians can most effectively address defenses in psychotherapy. [ABSTRACT FROM AUTHOR]

Several factors contribute to the dearth of psychoanalytic treatments and conceptualizations of attention-deficit hyperactivity disorder (ADHD). The author argues that psychoanalysis can contribute to standard treatments of such children. The prerequisites are the child's interest in change and the analyst's insight as to the legitimate aims of such treatments: to help the child discover his inner world and the connections between emotions, thought processes, and symptoms. The patient's reception of interventions varies. Sometimes, he is open to the verbal content of words. Other times, he reacts mainly to nonverbal aspects of the analyst's communication such as tone of voice, dress, or demeanor. The motor behind these vacillations is the present state of the child's internal object. When it is harsh, unyielding, and ridiculing, interventions are taken as assaults that must be defended at. Only in moments when it is welcoming and benevolent can the child use the intervention for building up his ego. The child's so-called semiotic capacity is related to the shifting state of the internal object. This has repercussions on both transference and countertransference. The discussion is illustrated by a six-and-a-half-year-old boy in child psychoanalysis while being in remedial and pharmacological treatment. [ABSTRACT FROM AUTHOR]

Literature on the analyst's positive countertransference with patients diagnosed with schizophrenia is scarce. The literature review and study summarized in this article aims at shedding light on the clinician's experience in the therapeutic relationship with a psychotic patient, specifically the integrative or transformative properties of such an experience for the clinician. The study proposes that while in therapeutic relationships with these patients, an analyst may find insight into him- or herself. This may be due to several components specific to the psychosis: certain interpersonal mechanisms, an unfiltered access to (collective) unconscious operations, and/or their unique social position. The study draws on phenomenological interview data collected from five psychoanalytic clinicians who were asked detailed questions about a therapeutic relationship with a patient diagnosed with schizophrenia in which they experienced positive countertransference. Analysis of the interviews reveals both transformational and learning experiences of psychoanalytic psychotherapists who have worked with patients diagnosed with schizophrenia on a long-term basis. Further interpretation of the transcripts point to these patients' abilities to illuminate the human condition. [ABSTRACT FROM AUTHOR]

Correction of the patient's distortion is often the focus of therapeutic treatment. However, the therapist's distortions, based upon pre-existing fears, which themselves are often rooted in greater societal issues and energized by the work with the patient (especially as they relate to issues of racial difference between the therapist and patient), can lead to clinical impasse. Just as an effective treatment relies upon the patient's opening up to correcting distortions, so too the therapist must be able to use transference response and become vulnerable to knowing and moving beyond his own fears and distortions. [ABSTRACT FROM AUTHOR]

The authors address the transference-countertransference axis as a central dimension of psychoanalytic work and apply the concept of the "analytic field" to describe this area. Initially understood as a locus wherein crossed resistances of the patient-analyst encounter are reduced by the analyst's capacity for "second-thought" interpretations, the field today connotes a meeting point of the multiple potentialities of analyst and patient and of the worlds that emerge in their encounter. With a Bion-inspired view of the field, enriched with concepts from narratology, a series of countertransference levels can be distinguished. Distinctions are based on the modalities that the field shows and makes use of to modulate its own tensions. Transformations of the characters in the session's narratives are shown to represent the transformations in the analytic field. Explorations of such links elucidate the opening and closing of a 'channel' between (the patient's) projective identifications and (the analyst's) reverie. [ABSTRACT FROM AUTHOR]

The author argues that the word frame is misleading because it conjures up the image of a picture frame constructed of unyielding material like wood or metal. Psychoanalytic work demands a flexible frame in which patient and analyst together jointly construct a comfortable envelope within which to interact. Bass candidly acknowledges countertransference blind spots and illustrates the complexities of frame management in the course of analytic work. The transference-countertransference dimensions of psychoanalytic relationship cannot be seen from a position outside the dyad. Hence, periodic consultation with a senior and trusted colleague can be extremely useful in frame considerations. What we think may be in the best interests of the patient can be a rationalization designed to serve our own interests, consultation may be the best strategy for us to allow our blind spots to come into our visual field. [ABSTRACT FROM AUTHOR]

Countertransference and intersubjectivity are concepts emerging from contemporary psychoanalytic practice and transtheoretical psychotherapy that represent golden opportunities for strengthening clinical supervision. Examination of countertransference within the intersubjective matrix of client, therapist, and supervisor promises to improve clinical supervision and professional practice. Case studies addressing unresolved shame and addictive family dynamics demonstrate the clinical benefits of careful examination of parallel processes in the client-therapist and therapist-supervisor dyads. Historical antecedents and recent literature indicate directions for research and training. [ABSTRACT FROM AUTHOR]

To explore the analyst's loving feelings, this article conceives of a wide territory of affective experience marked by the boundaries of a certain affinity with the swooning crush to a melancholy, resigned constancy, contrasts that conform roughly to the categories of the spontaneous and the disciplined, echoing Hoffman's (1998) axis that has now become virtually canonical in contemporary relational thinking about psychoanalytic work. Here I oscillate between these affective experiences, knowing that their relationship is not polar, that the dialectic they activate is not exhaustive, but in the hope that conversation can continue on a theme that can be usefully amplified. I seek here to flesh out the lived experience of the analyst's love, the struggle to maintain a relational neutrality, defined by Davies and Frawley (1994) as the capacity to avoid becoming entrenched in any single transference/countertransference configuration. I want to explore a relational neutrality that involves the analyst's love for the analysand as part of its ground. In order to do so, I present material from an analysis where the themes of love, sadism, enactments, and disclosure are detailed utilizing the conceptual axes of ordinary-special, and discipline-spontaneity. [ABSTRACT FROM AUTHOR]

Freud views Dora's symptoms as displacements of conflictual fantasies and affects. In this essay the focus is shifted to Dora's body in relation, a vehicle for communication. The schism between her soma and psyche—or act and word—is understood as Dora's response to the mystifying, hypocritical relatedness in her family. Freud's bifurcation of theory and clinical praxis may repeat this pattern at moments when metapsychological interpretations do not jibe with the interactive moment. A detailed inquiry regarding the often-embodied transference-countertransference matrix is therefore explored toward better understanding and integration. [ABSTRACT FROM AUTHOR]

Working from the premise that as analysts we are always vulnerable to unconscious collusion and enactment, and that this has radical implications for how we conceive of the analytic process, I try to illustrate how the process of working at the ‘intimate edge’ of the analytic relationship, and explicitly engaging what goes on intersubjectively between patient and analyst expands the analytic process and the analytic possibilities. I especially focus on how deconstructing interactive enactment can help to access unconscious aspects of what might be in play in relation to the issues of power and eroticized transference-countertransference under discussion here, and how this process itself can become the medium of the work and the focus of therapeutic action. [ABSTRACT FROM AUTHOR]

Joseph Newirth tells us that it is his aim in the analytic work to facilitate a ‘symmetrical dialogue [that] involves an equalization of power, [and] a radical view of mutuality and of self-disclosure in the analytic relationship.’ My thesis here is that the process falls short of that objective. Instead, it is characterized by an enactment in which the analyst is always dominant. Several examples of ‘power plays’ are presented in which the analyst, in a manner partially institutionalized as standard psychoanalytic practice, repeatedly gains the upper hand in the analytic relationship. One important aspect of this enactment entails a systematic bias in favor of interpretations that attribute neurotic, primitive, or regressive motives to the patient at the expense of hearing and taking seriously the patient's more mature perceptions and judgments, including those focused on the analyst himself. [ABSTRACT FROM AUTHOR]

This study of power in the eroticized transference-countertransference presents two sessions in the middle stage of an analysis of a woman struggling with issues of anxiety about her own power and a belief that her love and desires are destructive, toxic, and murderous. The case is presented from a neo-Kleinian/relational perspective in which the analytic strategy focuses on the development of enactments and transitional experiences and the use of evocative, presentational language, in contrast to a more traditional interpretive strategy in which discursive language concentrates on historical explanation and the differentiation of fantasy and reality. The two contiguous sessions begin with the patient's concerns about the bad behavior of the analyst and his male colleagues at an institute group-process conference. These reservations reflect the patient's anxieties about potential destructiveness and aggression, her resentment about the unfairness of men's sense of social and professional privilege, and the use of sexuality to dominate and control others. The analysand initially presents her concerns in an abstract, intellectualized, impersonal manner with little affect or connection between external events and her internal world. As the first session progresses, the patient's concerns become articulated in more personal affective forms reflecting the dynamics of a highly eroticized transference-countertransference relationship that is articulated as the patient's identification with a powerful woman and the fantasy of raping the analyst and the subsequent paranoid anxieties about being attacked by a female boss. The second session works through the issues of power and the eroticized transference- countertransference through the development of the patient's unconscious fantasies and beliefs that her loving and desirous feelings will be destructive, leading to loss, disappearance, and murder. [ABSTRACT FROM AUTHOR]