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Mental health chatbots (MHCBs) designed to support individuals in coping with mental health issues are rapidly advancing. Currently, these MHCBs are predominantly used in commercial rather than clinical contexts, but this might change soon. The question is whether this use is ethically desirable. This paper addresses a critical yet understudied concern: assuming that MHCBs cannot have genuine emotions, how this assumption may affect psychotherapy, and consequently the quality of treatment outcomes. We argue that if MHCBs lack emotions, they cannot have genuine (affective) empathy or utilise countertransference. Consequently, this gives reason to worry that MHCBs are (a) more liable to harm and (b) less likely to benefit patients than human therapists. We discuss some responses to this worry and conclude that further empirical research is necessary to determine whether these worries are valid. We conclude that, even if these worries are valid, it does not mean that we should never use MHCBs. By discussing the broader ethical debate on the clinical use of chatbots, we point towards how further research can help us establish ethical boundaries for how we should use mental health chatbots. [ABSTRACT FROM AUTHOR]

The emotional responses of psychotherapists to their patients, known as countertransference, can yield valuable insights into the patient's psychological functioning. Albeit from a different perspective, the Rorschach test also provides information about the patient's psychological processes. In particular, the Rorschach human movement response (M) has been shown to be a useful measure of higher-level psychological functioning. In an attempt to bridge these two largely different perspectives, the aim of this study was to explore the association between M responses in the Rorschach protocols of psychotherapy patients and emotional responses exhibited by their therapists. To this end, a convenience sample of 149 outpatients were administered the Rorschach according to the Comprehensive System, and their therapists completed the Therapist Response Questionnaire. Through a series of regression models, controlling for response style, response complexity, and degree of psychopathology, M demonstrated a significant association with the therapists' emotional responses. A lower number of M responses was associated with the therapists' feelings of disengagement, and a higher number of M responses was associated with the therapists' feelings of being more involved with the patient. Taken together, these results suggest a potential relationship between the number of M responses the respondent gives in the Rorschach and the subsequent development of the therapeutic alliance between the respondent and their therapist. [ABSTRACT FROM AUTHOR]

Countertransference (CT) is now recognized as the most important tool in psychodynamic procedures. Despite extensive practical and theoretical research on the patient's interpersonal patterns reflected in the countertransference, little is known about the therapist's contribution to this phenomenon. A difficulty in studying this aspect is the recording of a phenomenon that many researchers unconsciously understand as ego-syntonic. So far, the topic has primarily been approached through case reports by clinically active authors. This article provides a comprehensive review of the empirical research on this subject, drawing on a systematic search of scientific databases. The systematic search was performed using the electronic databases PsycINFO, PsycArticles, PubMed and PSYNDEX and finally included 10 publications in the analysis after title and abstract screening of 1037 studies. It became clear that the studies included vary significantly in their definitions of therapist contribution and countertransference as well as their attempts to measure them. To address the therapistʼs contribution in the context of countertransference events an extension of the concept of Hayes is proposed, which integrates therapist personality traits and attitudes, sociodemographic characteristics, and biographical experiences (subjective assessments versus objective information) to better capture the therapist's role in countertransference. [ABSTRACT FROM AUTHOR]

In the fall of 2019, a much-publicized court case brought to national attention the issues of patient-doctor confidentiality when it comes to reporting the deaths of newborns in the United States. It is unclear whether the recent overturning of Roe v. Wade will lead to more cases like this. This article discusses issues of countertransference, as well as the ethical and legal implications were it to be a psychiatrist, in active treatment of such a patient, who would be required to make such a report. More specifically, as in the publicized court case, the patient could be a minor at the time, receiving treatment from a child psychiatrist. The implications of such a case include how countertransference affects the perception of fatal child neglect compared to intentional neonaticide; the ethical dilemma of generating a mandated report with the goal of child safety when such a report could lead to real legal consequences for a minor child; and considerations regarding continued treatment of a patient after such a report is made. It is likely that countertransference, shaped by attitudes toward mothers and idealized views on mothering, may play a large role in all these circumstances. [ABSTRACT FROM AUTHOR]

This article explores the problems of the frequent loss, in the course of treatment, of the initial goals and motivation for treatment by both patient and therapist, and the connected lack of clarity of the real initial motivation for treatment on the part of both participants. It is strongly proposed that a true coincidence of at least one important initial motivational goal of patient and therapist is essential to assure the success of psychotherapy and that particular care is required to establish such agreement. On this basis, the goals of therapy may be expanded in the course of the therapist's experience, countertransference, and the patient's changing reality during treatment, and the existential and philosophical value systems of the therapist may play an important role in such widening of the therapist's expectations for the patient. [ABSTRACT FROM AUTHOR]

"The Sullivanians: Sex, Psychotherapy, and the Wild Life of an American Commune" is a book that explores the history of a psychoanalytic cult in New York City. The Sullivan Institute for Research in Psychoanalysis, founded in 1957 and dissolved in 1991, attracted individuals interested in psychoanalysis and a hedonistic lifestyle. The group engaged in authoritarianism, sexual and financial exploitation, and aggressive attacks on familial and romantic relationships. The book highlights the abuses within the group and the impact it had on its members. [Extracted from the article]

Collusion designates a specific type of transference-countertransference interaction between two or more persons, linked by an unconscious and shared unresolved issue, which they avoid on an intrapsychic level by externalizing it in the interpersonal space. To find a way to identify collusion and to delineate it from other transference-countertransference interactions. We conducted this study based on a case series approach. The study material consisted of audiotaped clinicians-centered supervisions with oncologists. The case series methodology involved the systematic examination of a purposive sample of supervisions, with the aim to understand how and why they differ from one another with respect to the relational dynamic between the physician and his/her patient. Four cases/supervisions were selected as they allowed to situate collusion on the spectrum of transference-countertransference interactions. We report on it by describing a countertransference reaction, two transference-countertransference interactions, and a collusion. The study reveals the challenges and pitfalls of research on collusion. The results allow to confirm the criteria of our working definition of collusion and to delineate collusion from other transference-countertransference interactions, which represents a first step for the empirical investigation of collusion. [ABSTRACT FROM AUTHOR]

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

The book "Psychoanalysis and Homosexuality: A Contemporary Introduction" by Hertzmann and Newbigin provides an accessible yet complex exploration of psychoanalysis beyond heteronormativity and homophobia. The authors review past and contemporary psychoanalytic approaches, discussing topics such as internalized homophobia and present-day clinical challenges. They also highlight the historical influence of social attitudes on psychoanalytic concepts of sexuality and gender, emphasizing the need to critically question and address the implicit and explicit homophobia within the field. The book offers valuable insights and references for further reading, making it a useful resource for both beginners and experienced researchers in the field of psychoanalysis. [Extracted from the article]

In this article, the authors aim to exemplify how psychoanalysis can apply to the community partially modifying its external setting, such as opening to group settings and including arts and music, while remaining firm in some structural tools, such as psychoanalytical observation and listening, play and attention to the intrapsychic dynamics of participants, including the psychoanalysts and their countertransference. They illustrate the experience of some projects, in particular one carried out for 3 years and ongoing, where young migrants, hosted in Refugee Shelters, meet Italian students in Secondary Schools. This article also describes the value of Music as an element of 'psychoanalytic play', establishing intrapsychic and interpersonal links. [ABSTRACT FROM AUTHOR]

The assumption that primal phantasmatic activity stems from bodily functions is widely accepted in developmental and psychoanalytic thinking. This article attempts to give more specific meaning to this abstract assumption. It examines the influence of sensory, perceptual, and motor capacities on the consolidation of typically differentiated erotogenic experiences relevant to pre-Oedipal and Oedipal organisations. It then proceeds to examine the impact of innate deficiencies in these capacities on the development of phantasmatic organisation in children on the autistic spectrum who often manifest atypical erotogenic organisation. Additionally, it pays attention to non-symbolic therapeutic communication and the unconscious transference-countertransference relationship stemming from such a problematic matrix. The paper is clinically derived from a description of the early-Oedipal organisation of a child with low cognitive and functional capacities and proceeds to the manifestations of the Oedipal constellation of a high-functioning autistic child. [ABSTRACT FROM AUTHOR]

This paper explores clinical work concerning a group of gender-questioning natal males who experienced physical difficulties in childhood. The author argues that these individuals develop a transgender (trans) identity as a defence mechanism against the psychological challenges associated with development, particularly the struggles of forming a distinct mind and identity. Anxieties related to physical health may have contributed to the formation of an anxious attachment to their primary caregiver, perceived as intrusive and demanding. Moreover, these individuals struggle to identify with their fathers, often experiencing them as distant, absent, or unsupportive of their relationship with the mother or other primary caregiver, thereby hindering separation from the primary attachment figure. These early experiences may lead to difficulties in acknowledging and owning their evolving sexuality and aggression, as well as in bearing the necessary guilt associated with separating from the primary caregiver. Consequently, the individual may fantasise about relinquishing identification with an idealised version of themselves and replacing it with a liberated version capable of living autonomously. Through a composite case, the paper illustrates how these conflicts manifest in the therapeutic setting through transference dynamics. Themes explored include gender dysphoria, confusion, adolescence, and transition. [ABSTRACT FROM AUTHOR]

The Oedipus complex is a phenomenon observed in both Eastern and Western cultures. It involves a transition from a child’s early connection with their mother to a more complex relationship that includes the father. The interpretation of this period has evolved from Freud’s idea of the father acquiring a “super-ego” to a modern understanding of acquiring masculinity, autonomy from parental authority, and developing the capacity for other loving relationships. Successfully navigating the Oedipus period requires not just a father figure as a source of fear, but a father who is supportive and willing to make sacrifices for their child’s growth. It is important to resolve any negative countertransference experienced by the father in this role, as it greatly influences the smooth completion of this period. To address the countertransference that inevitably arises during the Oedipus period, religious and philosophical ideas can serve a role similar to that of a supervisor in the analysis process. However, applying Eastern religious and philosophical ideas, such as Confucianism (Yu-gyo), may be challenging due to their emphasis on vertical relationships. Fortunately, the concept of “hyo” holds promise for the future, as it embodies a principle of mutualism that can be applied in a modern context, despite its seemingly vertical foundation. [ABSTRACT FROM AUTHOR]

This article delves into the concept of the psychoanalytic situation and its different elements, such as frame, setting, site, and situation. It highlights the significance of the agreement between the patient and analyst regarding the conditions of the analytic work. The article also explores the physical and psychological boundaries of the psychoanalytic situation. It presents various perspectives on the analytic situation, including the role of the internal frame in the analyst's mind and the functions of the frame and setting in the psychoanalytic process. The article underscores the importance of understanding and interpreting the powerful impulses that arise within the analytic situation. Additionally, it argues that the frame and setting are crucial aspects of the analytic process, supporting the goals of psychoanalysis. The article discusses different theories and techniques related to the frame and setting, including the influence of the analyst's psyche, cultural myths, and implicit theories. It presents diverse viewpoints on the analytic setting, such as Lacan's concept of "scansion" and Viderman's idea of the analytic field. Ultimately, the article emphasizes the significance of the analytic setting and its impact on the therapeutic process. [Extracted from the article]

This paper hopes to enhance understanding about entrenched grievance in a couple of ways: (a) Initially, the paper reviews how entrenched grievance reflects melancholic states of mind in terms of its avoidance of the pain of loss and change. But the main contribution of the paper is likely to be found in (b), that is, via detailed clinical material, the paper illustrates how earnest efforts on the part of the analyst to bring understanding may lead to cognitive entrapments such as the convictions incumbent in the “knowing” analyst. Further, that this knowing analyst may need to become aggrieved, that is, narrow, impatient and concrete towards her patient’s entrenchment, and then to recogize this plight in herself before she can genuinely hear her patient’s grievance about her from a wider view, that is as a complaint from the “lively self”, deserving recognition. The clinical detail demonstrates that such recognition softened the patient’s grievance, allowing both members of the dyad to become more collaborative and open to the pains and growth available from mourning states of mind. [ABSTRACT FROM AUTHOR]

This paper takes as its premise the idea that transferential phenomena emerge out of the endless interactions between the wider social context, including myriad social injustices, and the inter and intra psychic events psychoanalytic therapists are more familiar with thinking about. Freud's was a neuro-psycho-social model of development, with the interrelationship between internal life and social practices carefully mapped in 'Totem and Taboo' (1913) and 'Civilisation and Its Discontents' (S. Freud, 1930). However, what Freud left undone, and is still only nascent in its development, is the work of mapping how this interaction between internal and external, between psycho and social, manifests in the consulting room. Focusing on race, as one aspect of identity that powerfully impacts transferential phenomena, the paper presents accounts of clinical events, one disguised, one fictionalised, to explore the meaning of the author's own Whiteness in this context. Using a Kleinian and post-Kleinian understanding of very early Oedipal struggles, 'Whiteness' is formulated as an anti-developmental merger with the ideal breast. [ABSTRACT FROM AUTHOR]

Measurement of countertransference (CT) has proven challenging throughout the history of studying this construct. We sought to determine the potential value of using a common measure of transference, the Core Conflictual Relationship Theme (CCRT) method, as a means of studying CT. The Relationship Anecdote Paradigm and the CCRT method were used to examine CT in two studies. In Study 1, we examined the correspondence between a therapist's wishes with significant people in her life (i.e., her parents and husband) and three long-term patients. In Study 2, we identified the interpersonal wishes of a different therapist and examined 14 of her sessions with 3 patients for evidence of how these wishes and needs were displayed in her clinical work. Analyses revealed that specific wishes in therapists' personal lives could be detected from projective interviews and these wishes were similar, but not necessarily identical, to wishes in therapists' descriptions of, and actual work with, their patients. Evidence of both chronic wishes and patient-specific wishes was revealed. These findings support the idea that the origins of CT reside in therapists' interpersonal wishes and that the CCRT may be a promising means of identifying CT in research, practice, and supervision. [ABSTRACT FROM AUTHOR]

Inpatient psychiatric units are heavily regulated physical environments designed around the twin aims of treatment and containment. Less formally regulated but no less important are emotional norms and tones that also contribute significantly to psychiatric care environments. Inpatient psychiatric units are co-created by patients and clinicians, but clinicians have authority that patients do not. This means that clinicians' management of their own transference and reactions is clinically and ethically important. This article defines transference reactions and draws on case examples to canvass how positive and negative transference reactions can influence inpatient care of patients who are suicidal. [ABSTRACT FROM AUTHOR]

In the article "Ronald Baker (1993) The Patient's Discovery of the Psychoanalyst as a New Object," Ronald Baker examines the role of transference in psychoanalysis. He emphasizes the importance of the analytic setting and refers to the works of James Strachey and Hans G. Loewald. Baker describes a case study in which he himself became the object of rejection and emphasizes the significance of surviving such attacks for potential change. He explains that the discovery of the analyst as a new object is a prerequisite for changes in the ego and its object relations. Baker compares this discovery to Christopher Bollas' concept of the "transformational object." Another work by Baker, "Finding the Neutral Position," deals with the inner work of the analyst. The article discusses the therapeutic effect of psychoanalysis and the role of transference and countertransference in analysis. It is emphasized that perceiving a new object in analysis requires careful analysis of transference. The analyst should be receptive to transferences but not act as a transference object. It is also noted that distinguishing between countertransference reaction and actual countertransference is important. The discovery of the analyst as a new object allows the patient a new perspective on their internal objects. It is emphasized that this discovery is a prerequisite for reorganizing the ego and its object relations. [Extracted from the article]

"The Analyst's Vulnerability: Impact on Theory and Practice" by Karen J. Maroda is a book that presents the author's vision of psychoanalysis, specifically relational psychoanalysis, which emphasizes the importance of the analyst's vulnerability and personal experiences in the therapeutic process. The book explores the limitations of traditional psychoanalytic approaches, such as neutrality and anonymity, and argues for a more humanistic and interactive approach to therapy. While the author's perspective may not resonate with everyone, the book offers valuable insights and prompts readers to reflect on the role of the analyst in the therapeutic relationship. [Extracted from the article]

Clinical social work practice in organisational settings is complex and challenging. Effective practice is contingent on knowledge and skills that are particular for systems-based work involving multiple interprofessional mental health practitioners and clients interacting in a relational matrix. Yet, not all social work theories and constructs that were developed for application in individual, group, and family modalities are directly transferable to the practice environment of a treatment system. This paper offers a conceptual framework that synthesises contemporary psychodynamic theory with systems theory – referred to as a psychodynamic systems approach – to inform and advance knowledge of systems-based social work practice. This approach considers the interplay of dynamic processes among the four levels of the socially co-constructed system which constitute the system as a whole. It examines how five key clinical phenomena – transference, countertransference, splitting, projective identification and enactment – are actualised in systems. Definitions of these phenomena formulated from a dyadic perspective and a contemporary psychodynamic systems approach are offered, and their similarities and differences are discussed. A composite case example is provided to illustrate how several of these phenomena manifest in clinical practice. [ABSTRACT FROM AUTHOR]

Psychoanalytic theory and practice consider both transference and countertransference as cornerstones for understanding those complicated psychological phenomena which psychoanalysis and psychoanalytic psychotherapy bring to light. The relationship between a patient and a psychoanalyst has been the crucial point on which our attention and interest is focused. In the intersubjective space of psychoanalytic psychotherapy, all interactions between the patient and the analyst are considered to mutually influence each participant of the analytic dyad. Together with patients, clinicians get involved in ambiguous, uncanny and unavoidable enactments. The understanding of the latter requires from a psychoanalyst not only to contain the patient's anxiety and reflect on the patient's inner feelings but also to stay open to the gamut of feelings, anxieties and conflicts that arise from the professional's experience. I suggest that accomplishing the complicated task of understanding both the patient's and his own feelings and experience leads the analyst to the necessity of restoring links with himself. By means of clinical material, I make an attempt to show how the process of understanding an uncanny enactment becomes for the therapist a process of restoring the links in countertransference which, in turn, enables the therapist to interpret the patient's specific difficulties. [ABSTRACT FROM AUTHOR]

Although shared decision making (SDM) has become the most preferable way in doctor–patient communication, it is not fully implemented in mental health care likely due to the complex nature of psychiatric syndromes and treatments. In this review we provide a systematic overview of all perceived and reported barriers to SDM in the literature, acknowledging field-specific challenges, and offering perspectives to promote its wider use. We conducted a systematic search of the wider literature in different databases and included all publications mentioning specified barriers to SDM in psychiatric care. Relevant data and opinions were categorised into micro-, meso- and macro-level themes and put into clinical perspective. We derived 20 barriers to SDM from 100 studies and reports. Eight were on micro-level care delivery, seven involved meso-level issues, five concerned macro-level themes. The multitude of perceived and actual barriers to SDM underline the challenges its implementation poses in mental health care, some of which can be resolved while others are inherent to the nature of the care, with its long-term relationships, complex dynamics, and social consequences, all requiring a flexible approach. We present four perspectives to help change views on the potential of SDM in mental health care. [ABSTRACT FROM AUTHOR]

Palliative care clinicians enhance the illness experiences of patients and their families through building therapeutic relationships. Many psychological concepts underlie a clinician's approach to a specific patient. Through high-yield tips, this article highlights ten selected psychological elements that palliative care clinicians often use to support patients. As we all (both clinicians and patients) bring our own histories and unique biographies to the work of palliative care, a more explicit focus on the psychological aspects of this work can enhance our own experience and efficacy as providers. With a thoughtful focus on the psychological aspects of how we engage with patients, palliative care clinicians can offer a more meaningful therapeutic encounter. [ABSTRACT FROM AUTHOR]

The article discusses a case study of a psychoanalytic treatment with a patient named Ms. N. The author reflects on the challenges and complexities of the initial consultation and the analyst's role in navigating the patient's mixed messages and countertransference. The article also highlights the difficulties faced by psychoanalytic candidates in finding patients and the importance of patient suitability for intensive treatment. The author emphasizes the need for a deep understanding of the patient's motivations and capacities for sustaining psychoanalytic treatment. The article concludes by discussing the development of an erotic transference and the analyst's role in managing it. [Extracted from the article]

This article discusses a case study of a patient named Ms. N. The author reflects on the lifelong task of expanding emotional repertoire as psychoanalysts encounter different patients. The patient in question somatizes pain and avoids emotional suffering by minimizing it. The author explores the patient's phallic identification and her resistance to feeling vulnerable. The article also highlights the emotional demands placed on the analyst and the importance of the analyst's ability to tolerate feelings that the patient cannot. Overall, the article provides insights into the challenges faced by psychoanalysts in difficult cases. [Extracted from the article]

This article explores the notion of inhibition at a theoretical and clinical level in psychoanalysis. The first part follows the development of the notion in Freud's work, from the "Project" (1950a [1895]) to Inhibitions, Symptoms and Anxiety (1926d). It identifies the two approaches to inhibition, the first from an energetic point of view, the second from the angle of its relations to anxiety. The second part of the article is devoted to the links between inhibition and Freud's thoughts about death, in particular in Inhibitions, Symptoms and Anxiety and the links to the death drive. It draws on some of Jones' notes and presents a brief clinical illustration. The third part focuses more particularly on general inhibition, especially in depression and melancholia. Based on the treatment of one patient, the author shows how the slow process of overcoming general inhibition is achieved through the gradual use of negation. From an economic point of view, it is suggested that psychoanalytic treatment, through the transference and associative speech, has an effect on the depletion of energy by diverting the "suction" of stimuli, paving the way for the formation of drive representatives, or inhibitions as symptoms, which will need to be dissected. [ABSTRACT FROM AUTHOR]

The "health emergency" forced analysts to seek new ways of continuing with analysis. The article focuses, in particular, on the changes brought about in the setting by the presence of the sanitary mask, following a line that begins with the theme of the "mask" in the collective uses of human cultures, and develops through the Jungian concept of persona, as opposed to the "face" that may convey an authentic image of oneself. A clinical vignette illustrates the issues that the mask raises in the setting by obstructing the communication of emotions. When there is no transformative processing of concrete data, "unmasking" can also lead to an uncanny encounter and to moments of darkness and confusion in analysis, when the analyst experiences the kind of "unconscious identity" between therapist and patient that Jung defined as nigredo. The article is intended as a contribution to the analytic community's current reflections on the new and unforeseen challenges encountered in analysis at the time of the Coronavirus. It is possible to learn from these experiences with a view to integrating new elements and thus modify one's own internal setting, the compass with which each analyst orientates himself. [ABSTRACT FROM AUTHOR]

Synchronicity describes a meaningful coincidence of events, which is familiar to us from treatments of our patients, but unfortunately has not yet been empirically substantiated. Adding to previous findings that point out beneficial aspects of synchronicity (Marlo, 2022; Lagutina, 2021; Connolly, 2015), in this paper I will show through a series of five synchronistic moments which happened in the context of therapy and analysis and which have been documented empirically, how synchronicities occur and can be used therapeutically. In my research I found several situational factors that can be considered structural aspects of synchronistic moments. Furthermore, I will show that synchronistic phenomena can have a positive influence if certain relational and transference‐countertransference referential aspects are considered by the therapist and analyst. The concept of synchronicity brings the possibility of a further therapeutical instrument for the patient‐analyst‐dyad. [ABSTRACT FROM AUTHOR]

In the introduction to The Psychology of the Transference (1946), Carl Jung sketched out a theory of "erotic phenomenology" which condenses his teaching about sexuality and romantic love into a very concise summary. But the meaning of this passage is obscured in the English translation given in the Collected Works of C. G. Jung. I propose here a new translation which makes Jung's meaning clearer, along with a commentary which explains it in the context of Freudian drive theory and German 19th century philosophy. Invoking the concepts of instinct, mind, and Eros (both the passion and the divine figure), Jung's theory says that male sexual desire can be cultivated or repressed in four distinct ways, each associated with a female symbolic figure or anima image: Eve, Helen, Mary and Sophia. [ABSTRACT FROM AUTHOR]

This article discusses a case vignette involving a patient named Patricia who developed breast cancer during therapy. The author explores the potential dangers of the unconscious-to-unconscious link in the transference and countertransference relationship. They suggest that Patricia's experiences of feeling abandoned and unrecognized in her early life may have contributed to her symptoms. The author also reflects on their own identification with Patricia and the challenges of working with patients who disavow their pain. The article emphasizes the importance of recognition and love in the therapeutic relationship. [Extracted from the article]

This article discusses a case study involving a patient named Patricia and her therapist. The therapist reflects on the limitations of ego-supportive psychotherapy and the concept of empathy. The therapist's clinical approach involves exploring the "alchemical third," which refers to the unconscious connection between the therapist and patient influenced by archetypal patterns. Patricia's history reveals a lack of early nurturing and traumatic experiences, leading to difficulties in forming positive relationships. The article also explores the concept of a "fusional field" and the therapist's use of alchemical imagery in understanding Patricia's inner dynamics. The therapist acknowledges the challenges of working with such deeply wounded individuals and the importance of peer consultation. The article concludes by emphasizing the ongoing search for healing and the therapist's role in providing a safe symbolic space for the patient. [Extracted from the article]

The Journal of Analytical Psychology has published a list of recently received books. One notable book is "On Dreams and the East: Notes of the 1933 Berlin Seminar" by C.G. Jung, H. Zimmer, and G.V.R. Sorge. This book contains notes from a seminar held by Jung in Berlin in 1933, exploring the symbolism of yoga and its application to dream analysis. Another book, "Time and Trauma in Analytical Psychology and Psychotherapy: The Wisdom of Andean Shamanism" by D. Bryon, examines the experience of time in psychoanalysis and Andean shamanism. Other books cover topics such as the therapist-patient relationship in film, feminism and technology, maternal infanticide, and the concept of absolute freedom. Additionally, there are books that analyze the cultural impacts of Brexit and the war in Ukraine, as well as the significance of Wolfram von Eschenbach's "Parzival" on Jung's thinking. Finally, there are reissued classics and collections of essays on psychology and spirituality. One book, "Indian Mirror—The Making of the Brazilian Soul" by R. Gambini, explores the projection of the Christian "shadow" onto early Brazilian natives and its impact on their culture. [Extracted from the article]

This brief essay focuses on Adrienne Harris's consideration of the analyst's vocation, both as work and as a calling. Harris identifies a psychoanalytic vocation as one that is "unsettled," leaving analysts to examine countertransference by attending not only to their own affect states, but through the exhumation of generational transfers that are informed by social histories and constructions. Harris's generative pedagogy, rooted in her capacious comparative scholarship, stands as exemplary of the analytic vocation. [ABSTRACT FROM AUTHOR]

The article discusses the author's dream about a different approach to psychoanalysis and explores the idea of conducting collective analysis and treatment. It references Ankhi Mukherjee's book, "Unseen City," which offers a new account of psychoanalysis by extending its method beyond the private consulting room. The article argues for the expansion of psychoanalysis and the need to challenge its traditional limits in order to assess how it is practiced and how it might be. It also highlights the importance of considering the temporal, socioeconomic, and political conditions in psychoanalytic care. [Extracted from the article]

Institutional transference is a phenomenon describing patients' attitudes toward the institutions where they receive mental health or medical care. While transference toward individual clinicians in palliative care has been described, attitudes of patients with serious illness toward the institutions where they receive specialized care have not been described. Here, we present three cases which demonstrate the phenomenon of institutional transference in patients with serious illness and the resulting clinical implications, which include countertransferential responses of clinicians caring for them. We consider three conditions: (1) the idealized reputation of the academic cancer center, often a tertiary referral center; (2) loss of an institutional connection during care transitions; and (3) countertransferential reactions to institutional transference. We highlight characteristics and personality styles of individuals with cancer that may complicate and intensify institutional transference and identify potential interventions to address common challenges associated with institutional transference. [ABSTRACT FROM AUTHOR]

Many counselors have their own history of trauma which can impact the counselor's ability to provide competent counseling and increases risk for vicarious traumatization if not properly managed. Consequently, counselor educators and clinical supervisors must address this aspect of professional development by preparing counselors-in-training for secondary trauma exposure and potential triggers that can occur while providing mental health services. The Trauma Egg is an intervention created by Marilyn Murray which serves as both a clinical and educational tool with the intended goal of promoting personal reflection and providing a symbolic visualization of one's own trauma history and early attachment relationships. This article proposes an updated version, the Revised Trauma Egg and Resiliency Intervention, which adds an additional integration of resiliency resources. When applied with counseling students and supervisees, the Revised Trauma Egg and Resiliency Intervention aims to increase trauma-work preparedness, improve the management of potential trauma triggers, and address countertransference issues. [ABSTRACT FROM AUTHOR]

"Courting Aliveness: A Review of Vitalization in Psychoanalysis, Perspectives on Being and Becoming" is a collection of essays edited by Amy Schwartz Cooney and Rachel Sopher that explores the concept of vitalization in relational psychoanalysis. The book emphasizes the importance of creating emotionally alive connections between patient and analyst, drawing on various theories and perspectives. The contributors share clinical stories that highlight the role of vitalizing enactments and the therapist's countertransference urgency in fostering therapeutic growth. The book also explores the therapist's role as an enlivening object and the potential for transformative experiences in the therapeutic relationship. [Extracted from the article]

This paper was developed as part of a panel for the International Psychoanalytic Association's (IPA) 53rd Congress in July 2023. In this paper I discuss treatment with students from the American University of Afghanistan as part of a team at New York University's Postdoctoral Program in Psychoanalysis and Psychotherapy. The paper reviews the themes that I identified while working with three students from the university. The themes include issues of identity and power, role confusion, and finally the question "am I doing a good thing?" Simultaneously, I discuss my own countertransferential process and disavowed material based on my own cultural background. [ABSTRACT FROM AUTHOR]

This paper argues that the distinction between the dynamic and the descriptive unconscious is in danger of being lost and indicates some of the practical, clinical consequences of this loss. It does so against the background of Freud’s own struggles with his radical conception of the dynamic unconscious as ultimately unknown, as they appear in the revisions of The Interpretation of Dreams, invoking Laplanche’s recognition of Freud’s Copernican Revolution and the temptation he felt to make a Ptolemaic Return. It also comments on confusion about whether feelings can be said to be unconscious and the implications of this confusion for clinical practice, especially for our understanding of the concepts of transference and countertransference. An extended analysis of a dream is presented to show the dynamic unconscious in action. [ABSTRACT FROM AUTHOR]

Novice supervisees inevitably experience intense emotional challenges during their practicum experience. Their supervisors often must help them manage their emotional reactions, suggesting the relevance of emotion regulation (ER) theory to supervision practice. Five doctoral supervisors described examples of their counseling practicum supervisees' client-based (e.g. countertransference, trauma-related responses) and supervision-based (e.g. constructive feedback) ER challenges and how they responded. Consensual Qualitative Research (CQR) analysis revealed supervisors responded in line with process model of ER, including individualized other-focused and interpersonal emotion regulation (IER) strategies. Findings suggest further investigations could advance supervision research and practice as well as inform ER theory. [ABSTRACT FROM AUTHOR]

What if the author were to position herself as a liar? Not of conscious lying, but an ignorance of what is so close to our collective noses that as psychoanalysts we miss it. Drawing on Harari's (2011) description of liberal ideology, the author suggests that our contemporary psychoanalytic focus on feelings, countertransference, and intuition is more determined by our cultural era than generally recognized. It is suggested that prevailing ideology may at times serve a defensive function. The author discusses a 1970s clinical seminar in which Bion observes that the presenting analyst's attention to feelings is "excusing" the patient (and himself). A second example, from Bion's Cogitations (1991), underscores the complexity of being sensitive to a patient's feelings without gratifying narcissistic demands. A final example is taken from the author's work in which there was a pressure to allow the patient's infantile feelings to determine the analysis. It was subsequently recognized that neither the patient's feelings nor the analyst's understanding were the site of authority in the analysis. Rather, authority lies in the analytic process itself. [ABSTRACT FROM AUTHOR]

Unprecedented changes in traditional psychotherapeutic practice arose from the lockdown restrictions associated with the COVID‐19 pandemic. These changes to practice included the imposed change to the therapeutic frame when transitioning clients from face‐to‐face meetings to delivery of psychotherapy sessions via videoconferencing (defined here as telepsychotherapy). The current study conducted qualitative interviews with 16 Australian psychologists who transitioned their existing adult psychotherapy clients from face‐to‐face therapy to telepsychotherapy and explored their novel experiences associated with countertransference reactions during this period. Thematic analysis of the interviews revealed several unique findings. The type of countertransference reactions towards existing clients was consistent across both face‐to‐face and online meetings; however, the felt intensity of countertransference reactions was reduced. Psychologists reported an increased hesitance to work with intense emotions during telepsychotherapy sessions and felt increased pressure to work harder during online sessions when compared to face‐to‐face meetings. Exposure to their clients' personal and home environments during telepsychotherapy sessions elicited several novel reactions towards their clients. These findings on countertransference and telepsychotherapy are informative for future practice and training. Awareness of these unique countertransference experiences is recommended prior to engaging in telepsychotherapy or when transitioning clients to this modality. [ABSTRACT FROM AUTHOR]

I explore some similarities between experiences of music and of analytic sessions. I focus on qualities of evanescence, the way that music – in contrast to many other arts – in one perspective only lasts as long as it is actually being played. Then it's over. The analyst-patient discussion in a session is similar. Yet the psychic reverberations of some transient, fugitive moments may last a lifetime. And even when no verbally profound understanding is occurring, nevertheless the patient-analyst encounter is emotionally significant. I illustrate this with a clinical example. I explore transference as illusion, and the relationship between truth and illusion in terms of Bion's O. I end with thoughts about the paradoxical value of the illusoriness of aesthetics and nature as considered by Freud in his short paper "On Transience" (1916), and the grin of Lewis Carol's Cheshire Cat, left hanging in the air. [ABSTRACT FROM AUTHOR]

Dissociative identity disorder (DID) is life-long, childhood-onset, posttraumatic developmental disorder where chronic early-life maltreatment and attachment disturbances prevents the child's development of a continuous sense of self across emotional states, relationships, and social contexts. As development proceeds, these self-states acquire a sense of themselves, a capacity for information processing, memory, emotion, and behavior. Conceptualizing DID involves paradoxes and apparent contradictions. DID has been categorized as a severe mental illness with major psychiatric comorbidities. Studies show that DID individuals have a unique personality organization with repeated, often covert posttraumatic reactivity, especially in relationships (e.g., therapy). Paradoxically, research shows that, during development, DID individuals preserve psychological resiliencies consistent with responsivity to long-term, psychodynamically informed treatment. These include, when not stressed, capacities for therapeutic alliance, reality testing, and observing ego. [ABSTRACT FROM AUTHOR]

The present paper seeks to propose, using a combination of psychoanalytic and linguistic thinking, a distinction between three degrees of symbolicity across the somatoform dissociative continuum: the metaphorical, in which there is a symbolic connection between the somatoform phenomenon and the traumatic content, the metonymic, which constitutes a revival of the traumatic experience without the ability to reflect on it, and the psychotic, in which the somatoform phenomenon is experienced as ego-syntonic, thus neither causes distress nor evokes thinking. Three clinical vignettes demonstrate how the higher the degree of symbolization, the more effective the therapeutic process. Finally, a fourth vignette demonstrates how acoustic association in the therapist's countertransference can constitute an antidote to the patient's acoustic dissociation, allowing the reclaiming of the capacity for linking. [ABSTRACT FROM AUTHOR]

This article explores the need for innovative approaches to psychotherapy in India, specifically in terms of adapting existing models and introducing new ones that are culturally and socially responsive. It introduces Cognitive Analytic Therapy (CAT) as a potential model that can be used in the Indian context, emphasizing its transdiagnostic and whole-person approach. The article provides case examples to illustrate how CAT can be applied in therapy sessions, highlighting the importance of a collaborative and authentic therapeutic relationship. It also acknowledges the challenges of implementing psychotherapy in a system with limited access to trained professionals and calls for further research on the effectiveness of CAT in the Indian population. [Extracted from the article]

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