Journal of the American Psychoanalytic Association recent issues

Doublethinking Our Way to "Scientific" Legitimacy: the Desiccation of Human Experience

Hoffman, I. Z. — Fri, 16 Oct 2009 09:37:06 PDT

A multifaceted contemporary movement aims to correct alleged weaknesses in the scientific foundation of psychoanalysis. For both pragmatic-political and scientific reasons we are encouraged to do and/or study systematic empirical research on psychoanalytic process and outcome, as well as apparently relevant neuroscience. The thesis advanced here is that the privileged status this movement accords such research as against in-depth case studies is unwarranted epistemologically and is potentially damaging both to the development of our understanding of the analytic process itself and to the quality of our clinical work. In a nonobjectivist hermeneutic paradigm best suited to psychoanalysis, the analyst embraces the existential uncertainty that accompanies the realization that there are multiple good ways to be, in the moment and more generally in life, and that the choices he or she makes are always influenced by culture, by sociopolitical mind-set, by personal values, by countertransference, and by other factors in ways that are never fully known. Nevertheless, a critical, nonconformist psychoanalysis always strives to expose and challenge such foundations for the participants’ choices. The "consequential uniqueness" of each interaction and the indeterminacy associated with the free will of the participants make the individual case study especially suited for the advancement of "knowledge"—that is, the progressive enrichment of sensibility—in our field.

Meditation on Lovesickness, Loss, and Temporality

Furlong, A. — Fri, 16 Oct 2009 09:37:07 PDT

The film 2046 is used as a screen and a springboard from which to reflect on the compulsive plight of some lovesick individuals. A particular oedipal constellation that generates lovesickness is hypothesized, wherein an unmourned third object preoccupies yet frustrates the primary object. This thwarted longing for another on the part of the original parent figure inflicts a defect in the self-esteem of the subject, who is then compelled to seek out an object that will re-create, while promising to repair, the wound. A trait common to the new object of adoration and the old, retriggering the peculiar paradoxical draw of the parent, sets this process in motion. The chaotic temporality so often associated with both the raptures of new love and with the chronic condition of lovesickness may be related to a traumatic hobbling of the ego’s stimulus barrier in the presence of such a paradoxically exciting object.

Writing About Patients: What Clinical and Literary Writers Share

Miller, E. — Fri, 16 Oct 2009 09:37:07 PDT

Anyone who seeks publication wants readers, but self-expression, self-assertion, and self-promotion have consequences, especially for those who draw on clinical material and who must honor publication standards of integrity and reliability, as well as ethical codes governing confidentiality, consent, disguise, and collaboration. This paper employs tools of literary analysis, principles of moral philosophy, and psychoanalytic theories about writing to show that writers of fiction and autobiography also struggle with these dilemmas. They worry about their responsibilities to the sources of their stories, and wonder if changing names and dates will prevent friends and family, whose lives get used as material, from feeling embarrassed, betrayed, or exploited. Because they understand that the composing process blurs boundaries between fiction and nonfiction, fantasy and memory, self and other, they recognize that an author’s relationship with his or her subject (matter) can disable the capacity to recognize when self-interest has taken over a concern for the welfare of others. More important, literary authors are free to write about writing, and what they render transparent about primitive, unconscious processes suggests that what clinical writing has in common with fiction and autobiography should be included in efforts to update ethical standards and procedures regarding psychoanalytic publication.

Introduction

Litowitz, B. E. — Fri, 16 Oct 2009 09:37:07 PDT

Volition and Will in Psychoanalysis

Meissner, W.W. — Fri, 16 Oct 2009 09:37:07 PDT

To clarify the role and function of the will in psychoanalytic theory and praxis, the use and meaning of the concept of will are traced in the philosophical tradition influencing Freud, in Freud’s own view of will, and in the subsequent history of psychoanalysis. Functions of the will relevant to psychoanalysis are described in terms of intellective preference and executive functioning. Operations of will as an executive function of the ego-self are analyzed, emphasizing will as efficient cause of motivated actions. The will functions to decide, choose, and initiate action directed to motivationally determined goals. The conclusion is drawn that will action is determined and directed by motivational influences, and that will decision and choice, while predominantly secondary process in organization, can operate consciously or unconsciously. Expressions of will action in psychopathology and in the analytic process are briefly discussed.

The Role of Unconscious Volition in Psychoanalysis: Commentary On Meissner

Rangell, L. — Fri, 16 Oct 2009 09:37:07 PDT

Response To Rangell

Meissner, W.W. — Fri, 16 Oct 2009 09:37:07 PDT

Selected Posters From the 2008 Poster Session of the American Psychoanalytic Association

Kaplan, M., Vrouva, I., Fertuck, E. A. — Fri, 16 Oct 2009 09:37:07 PDT

Termination

Feller, A. — Fri, 16 Oct 2009 09:37:07 PDT

Sex and Shame: Clinical Dilemmas

Jaffe, S. — Fri, 16 Oct 2009 09:37:07 PDT

Bending the Frame and Judgment Calls in Everyday Practice

Levine, A. R. — Fri, 16 Oct 2009 09:37:07 PDT

The Role of Dream Work in Contemporary Psychoanalytic Practice

Spiwak, A. — Fri, 16 Oct 2009 09:37:07 PDT

Finding Your Way Through Chaos, Fractals, and Other Exotic Mathematical Objects: a Guide for the Perplexed

Galatzer-Levy, R. M. — Fri, 16 Oct 2009 09:37:07 PDT

Book Review: RANGES OF PSYCHOANALYTIC INTEREST CONSULTING PSYCHOLOGY: SELECTED ARTICLES BY HARRY LEVINSON. Edited by Arthur M. Freedman and Kenneth H. Bradt. Washington, DC: American Psychological Association, 2008, 334 pp., $59.95

Eisold, K. — Fri, 16 Oct 2009 09:37:07 PDT

Book Review: PSYCHOTHERAPY WITHOUT THE SELF: A BUDDHIST PERSPECTIVE. By Mark Epstein. New Haven: Yale University Press, 2007, 261 pp., $14.00

Kovel, C. — Fri, 16 Oct 2009 09:37:07 PDT

Book Review: THE ART INSTINCT: BEAUTY, PLEASURE AND HUMAN EVOLUTION. By Denis Dutton. New York: Bloomsbury Press, 2009, 278 pp., $25.00

Esman, A. H. — Fri, 16 Oct 2009 09:37:07 PDT

Book Review: PROJECTEDSHADOWS: PSYCHOANALYTICREFLECTIONSONTHEREPRESENTATION OF LOSS IN EUROPEAN CINEMA. Edited by Andrea Sabbadini. New York: Routledge, 2007, 190 pp., hardcover $99.00, paperback $36.95

Sklarew, B. H. — Fri, 16 Oct 2009 09:37:07 PDT

Book Reviews: RADICAL EVIL: A PHILOSOPHICAL INTERROGATION. By Richard J. Bernstein. Cambridge, UK: Polity Press, 2002, xi + 289 pp., $29.95

Stolorow, R. D. — Fri, 16 Oct 2009 09:37:07 PDT

Book Review: BEFORE FREUD: HYSTERIA AND HYPNOSIS IN LATER NINETEENTH-CENTURY PSYCHIATRIC CASES. By Lilian R. Furst. Lewisburg, PA: Bucknell University Press, 2008, 207 pp., $43.50

Drinka, G. — Fri, 16 Oct 2009 09:37:07 PDT

Book Review: PSYCHOTHERAPY AND MEDICATION: THE CHALLENGE OF INTEGRATION. By Fredric N. Busch and Larry S. Sandberg. New York: The Analytic Press, 2007, 177 pp., $39.95

Tobin, B. — Fri, 16 Oct 2009 09:37:07 PDT

Book Reviewers

Fri, 16 Oct 2009 09:37:07 PDT

Privacy and Disclosure in Psychoanalysis

Kantrowitz, J. L. — Tue, 01 Sep 2009 14:19:03 PDT

The tension between privacy and disclosure in psychoanalysis operates in various ways in analyst, supervisee, and supervisor. Analysts need to maintain the privacy of their patients by keeping their material confidential; they also need to know and share their own internal conscious conflicts to be able to discover unconscious conflicts and their characterological ramifications. Clinical writing is one vehicle for the exploration, discovery, and communication of transference-countertransference issues and other conflicts stimulated by clinical work, but it does not provide the perspective that comes from sharing with another person. Telling a trusted colleague what we think and feel in relation to our patients and ourselves enables us to see our blind spots, as well as providing perspective and affect containment in our work. Mutuality in peer supervision tends to reduce the transference. The special problems of privacy and disclosure in psychoanalytic training are addressed, as are the ways the analyst’s belief in maintaining privacy may affect the analytic process and therapeutic relationship.

The Question of Drive VS. Motive in Psychoanalysis: a Modest Proposal

Meissner, W.W. — Tue, 01 Sep 2009 14:19:03 PDT

This essay explores the possibility of an alternative hypothesis to the prevailing psychoanalytic instinctual drive theory whose theoretical and clinical validity has been variously critiqued and challenged. Arguments are suggested in support of the concept of motive as a viable alternative theory to the drive theory and as a replacement for the traditional instinctual drive model. Issues discussed include the understanding of the mind—body relation, the meaning of psychic determinism and overdetermination, the opposition of drive vs. motive (and the related distinction of cause vs. motive), the meaning of psychic energy, and the difference between the concept of drives as the source of all mental energy and the concept of personal agency. The discussion concludes with some observations on the clinical implications of these concepts.

Studying The Interpretation of Dreams in the Company of Analytic Candidates

Levy, J. — Tue, 01 Sep 2009 14:19:03 PDT

Seminars serve as an important, though undervalued, component of psychoanalytic education. The focus of this paper is on the teaching of Freud’s The Interpretation of Dreams through a series of seminars presented to analytic candidates at the Toronto Psychoanalytic Institutes. This has been an essential book for introducing generations of candidates to the psychoanalytic concept of the mind and for shaping candidates’ understanding and attitudes toward working with their patients’ dreams. Four of Freud’s basic dream concepts—(1) the method and its application to the exploration of the relationship between manifest and latent dream content, (2) the sources of dreams (day residues), (3) the dream-work, and (4) wish fulfillment—are critically studied in the seminars. Detailed discussion of these basic dream concepts among the candidates and with the teacher, as well as the candidates’ feedback at the conclusion of the seminars, are summarized and discussed. Through the teaching and study within the seminar framework of the fundamentals of Freud’s dream theory, a shared growth experience results for both teacher and candidates.

Child Development and Child Psychoanalysis: Research and Education

Tyson, P. — Tue, 01 Sep 2009 14:19:03 PDT

Innovation in Child Psychoanalytic Training: an Implementation Study

Miller, J. M., Emde, R. N. — Tue, 01 Sep 2009 14:19:03 PDT

A five-year evaluative research project regarding an innovation in psychoanalytic training within institutes of the American Psychoanalytic Association (APsaA) was conducted through the Committee on Child and Adolescent Analysis (COCAA) of its Board on Professional Standards, which led to significant policy changes within APsaA’s Principles and Standards of Education. Eleven candidates at four different institutes (Columbia, Denver, Houston-Galveston, and St. Louis) entered a pilot training program for child and adolescent analysis without the requirement of adult training. Satisfaction with training and supervision in these programs was rated high by candidates, faculty, and program directors, with additional flexibility for child analytic training seen as an advantage. The limitations and implications of this implementation study are discussed, including its encouragement of educational evaluation and further research.

Child Analytic Training: the Establishment of a Separate Training Track At Institutes of the American Psychoanalytic Association

Morales, J., Farley, A. J. — Tue, 01 Sep 2009 14:19:03 PDT

In 2002 a pilot program was established under the auspices of the American Psychoanalytic Association, with the participation of four of its institutes, to study the feasibility of creating a separate training track in child analysis without the requirement of previous adult analytic training. The program, which ran from 2003 through 2006, was evaluated by a research project completed in 2007. These efforts resulted in the formal creation of a separate training track in child analysis to train child analysts only. The experience of two of the pilot programs, which required the analysis of three children and one adult, is described.

A Cross-Sectional Survey of Child and Adolescent Analysts in New York City

Hoffman, L., Karush, R. K., Garfinkle, M. S., Roose, S. P., Cherry, S. — Tue, 01 Sep 2009 14:19:03 PDT

The field of child and adolescent psychoanalysis has been considered an endangered specialty for many decades. This study surveyed the nature of the practice of child and adolescent analysts (graduates and candidates) affiliated with three institutes accredited by the American Psychoanalytic Association in the New York City area. Sixty-one percent of those surveyed (63 of 103) responded. The child and adolescent analysts in this cohort treat a total of 201 adult, child, and adolescent analytic cases (M = 3.2, SD = 2.6). Of these cases, 17% are at a three-times-weekly frequency. Child and adolescent analytic practice is small, with a total of 56 analytic cases (M = .9, SD = 1.2). While 64% of these analysts have no child or adolescent analytic cases currently in treatment, 24% have very active child and adolescent analytic practices, conducting 73% of all the child and adolescent analyses reported. Implications of these findings and recommendations for future work are discussed.

Research in Child Psychoanalysis: Twenty-Five-Year Follow-Up of a Severely Disturbed Child

Tyson, P. — Tue, 01 Sep 2009 14:19:03 PDT

In an era of managed care, psychoanalytic treatment of children is under fire as critics question whether the evidence of success in child analysis is sufficiently robust to warrant the large commitment of time and money required for this treatment. This article chronicles the history and current state of research at the Anna Freud Centre, and describes the evolution of a database that has methodically recorded and systematically organized data from over 750 cases of children referred to the Centre over a forty-five-year period. Analysis of this database has determined what kinds of childhood disorders are best treated with intensive psychoanalysis, and what kinds do not respond to this form of treatment. A long-term follow-up of a small sample of these childreen suggests the kinds of long-term benefits that can be gained when an individual is treated with intensive psychoanalysis as a child. As an example, clinical material from the analysis of an eight-year-old is presented along with follow-up interview data twenty-five years later.

Psychoanalytic Perspectives On Early Trauma: Interviews With Thirty Analysts Who Treated an Adult Victim of a Circumscribed Trauma in Early Childhood

Gaensbauer, T. J., Jordan, L. — Tue, 01 Sep 2009 14:19:03 PDT

Information on the long-term effects of early trauma and how such effects are manifested in treatment was obtained through interviews with thirty analysts who had treated an adult patient with a circumscribed trauma in the first four years of life. Childhood traumas fell into four categories: medical/accidental; separation/loss; witnessing a traumatic event; and physical/sexual abuse. Traumatic carryover was recorded in terms of explicit memories, implicit memories (somatic reliving, traumatic dreams, affective memories, behavioral reenactments, and transference phenomena), and global carryover effects (generalized traumatic affective states, defensive styles, patterns of object relating, and developmental disruptions). Linkages between the early trauma and adult symptomatology could be posited in almost every case, yet the clinical data supporting such linkages was often fragmented and ambiguous. Elements of patients’ traumas appeared to be dispersed along variable avenues of expression and did not appear amenable to holistic, regressive reworking in treatment. The data did not support linear models of traumatic carryover or the idea that early traumatic experiences will be directly accessible in the course of an analysis. Factors that we believe help explain why traumatic aftereffects in our sample were so heterogeneous and difficult to track over the long term are discussed.

Internet Interaction: the Effects on Patients' Lives and Analytic Process

Dini, K. — Tue, 01 Sep 2009 14:19:03 PDT

Book Review: Recent and Contemporary Kleinians: ROSENFELD IN RETROSPECT: ESSAYS ON HIS CLINICAL INFLUENCE. Edited by John Steiner. London: Routledge, 2008, 176 pp., $21.99

Schafer, R. — Tue, 01 Sep 2009 14:19:03 PDT

Book Review: LISTENING TO HANNA SEGAL: HER CONTRIBUTIONS TO PSYCHOANALYSIS. By Jean-Michel Quinodoz. New York: Routledge, 2008, 171 pp., $31.95: 10.1177/0003065109338859

Levine, H. B. — Tue, 01 Sep 2009 14:19:03 PDT

Book Review: ENVY AND GRATITUDE REVISITED. Edited by Priscilla Roth and Alessandra Lemma. London: International Psychoanalytical Association, 2008, 252 pp., {pound}25.99

Long, K. M. — Tue, 01 Sep 2009 14:19:03 PDT

Book Review: Theory of Mind: MIND TO MIND: INFANT RESEARCH, NEUROSCIENCE, AND PSYCHOANALYSIS. Edited by Elliot L. Jurist, Arietta Slade, and Sharone Bergner. New York: Other Press, 2008, 454 pp., $28.00 paperback

Vivona, J. M. — Tue, 01 Sep 2009 14:19:03 PDT

Book Review: FORMS OF KNOWLEDGE: A PSYCHOANALYTIC STUDY OF HUMAN COMMUNICATION. By Anna Aragno. Baltimore: Publish America, 2008, 428 pp., $29.95

White, R. S. — Tue, 01 Sep 2009 14:19:03 PDT

Book Review: MARKING THE MIND: A HISTORY OF MEMORY. By Kurt Danziger. New York: Cambridge University Press, 2008, 305 pp., $120.00 hardbound, $45.00 paperback

Litowitz, B. E. — Tue, 01 Sep 2009 14:19:03 PDT

Book Reviewers

Tue, 01 Sep 2009 14:19:03 PDT

Leaping From Brain To Mind: a Critique of Mirror Neuron Explanations of Countertransference

Vivona, J. M. — Mon, 20 Jul 2009 11:43:03 PDT

In the current vigorous debate over the value of neuroscience to psychoanalysis, the epistemological status of the links between the data of brain research and the constructs of interest to psychoanalysts has rarely been examined. An inspection of recent discussions of mirror neuron research, particularly regarding countertransference, reveals gaps between psychoanalytic processes and the available brain activation data, and allows the evaluation of evidence for three implicit assumptions frequently made to bridge these gaps: (1) there is a straightforward correspondence between observed brain activity and mental activity; (2) similarity of localized brain activity across individuals signifies a shared interpersonal experience; (3) an automatic brain mechanism enables direct interpersonal sharing of experiences in the absence of inference and language. Examination of mirror neuron research findings reveals that these assumptions are either untested or questionable. Moreover, within neuroscience there are competing interpretations of mirror neuron findings, with diverse implications for psychoanalysis. The present state of mirror neuron research may offer us new hypotheses or metaphors, but does not provide empirical validation of the proposed models. More generally, as we attempt to learn from research findings generated outside psychoanalysis, we must strive to think scientifically, by minding the difference between data and interpretation.

Leap Carefully From Brain to Mind--But It Can be Done: Commentary on Vivona

Olds, D. D. — Mon, 20 Jul 2009 11:43:03 PDT

Mirror Neurons and Mind: Commentary on Vivona

Eagle, M. N., Gallese, V., Migone, P. — Mon, 20 Jul 2009 11:43:03 PDT

Response to Commentaries

Vivona, J. M. — Mon, 20 Jul 2009 11:43:03 PDT

What is A "Good Enough" Termination?

Gabbard, G. O. — Mon, 20 Jul 2009 11:43:03 PDT

In Freud's technique papers, he failed to develop a systematic approach to termination. Much of the existing literature is based on psychoanalytic mythologies about the way patients are expected to end analysis. The models described in the literature are often starkly at odds with what one sees in clinical practice. A wish for idealized versions of termination underlies much of what has been written, and we need to shift to a conceptual model involving "good enough" termination. A number of different endings to psychoanalysis may, in the long run, lead to productive outcomes; these models are examined, as are various approaches to the dilemmas presented at the time of termination.

"After A Long Pause": How to Read Dora as History

Ahbel-Rappe, K. — Mon, 20 Jul 2009 11:43:03 PDT

Freud's "Fragment of an Analysis of a Case of Hysteria" (1905a,b) is well recognized for making psychoanalytic history. In the Dora paper Freud first publicized a new theory of the etiology of neurosis that made fantasy and repression central. And yet the paper also refers to trauma and seduction. What role do they play in the text? Part 1 shows that this is not a case of Freud broadening his etiological framework by adding a new focus to older ones. Rather, the references to trauma and seduction in Dora need to be understood in two ways. First, there is in the 1905 paper an implicit theoretical autobiography, of which Freud's references to the trauma and seduction theories early in the paper are part. Second, Freud's reference to seduction later in the paper constitutes Freud's first public critique of the seduction theory. The Dora paper is the actual site of the abandonment of the seduction theory. In Part 2 the focus shifts to the text's "theoretical unconscious." Despite its rejection of the seduction theory in its avowed theorizing, the text is haunted by displaced signifiers of the theory. This suggests that Freud was unconsciously conflicted about not applying the insights of the seduction theory to Dora.

Romantic Fantasies of Madness and Objections to Psychotropic Medication

Tutter, A. — Mon, 20 Jul 2009 11:43:04 PDT

Many patients object to, and often refuse, psychotropic medications. The exploration—a "defense analysis"—of their objections brings attention to ubiquitous fantasies of madness, which may be feared and concealed as a source of shame, destruction, and loss, and also cherished and revered as a source of power, inspiration, and mystery. They are commonly illuminated when the prospect of taking medication threatens to expose, confirm, and defuse the fantasized hidden or latent madness. Conscious or unconscious, fantasies of madness can be deeply, appealingly romantic in nature, providing valuable narcissistic supplies while defending against their more humiliating and terrifying aspects. Drawing on personal dynamics, experiences, and identifications, they are thus ultimately and intimately linked to representations of the self. Significant romantic texts illustrate how split-off conceptualizations of madness function as an organizing repository for unacceptable and intolerable emotions, wishes, and impulses. Psychoanalysts may also object to the introduction of medication into an analytic treatment. The analyst's own fantasies around madness and medication may in some cases motivate enactments in which the talking cure is privileged and medication excluded from analytic treatment or from analytic process.

Empirical Research, Psychoanalytic Training, and Psychoanalytic Attitudes

Glick, R. A., Roose, S. P. — Mon, 20 Jul 2009 11:43:04 PDT

The Training Analyst: Analyst, Teacher, Mentor

Bosworth, H., Aizaga, K., Cabaniss, D. L. — Mon, 20 Jul 2009 11:43:04 PDT

Although the literature has stressed that the training analysis should be identical to a nontraining "therapeutic analysis," it was hypothesized that differences do exist between the two, particularly with respect to educational aims. Candidates at the Columbia University Center for Psychoanalytic Training and Research were sent anonymous questionnaires and asked to identify aims they felt were being achieved in the training analysis and to identify certain types of interventions that their training analyst made. Most candidates reported that widely accepted goals of the training analysis, such as promoting understanding of countertransference reactions, were being met in their analysis. Many also endorsed didactic and educational goals. Almost all reported using their analyst's technique to some degree as a model for their own. Most notably, a significant minority of candidates reported that their analyst made interventions that appeared to have a primarily didactic, supervisory, or mentoring purpose. The implications of these findings for an understanding of the role of the personal analysis in psychoanalytic education are discussed.

Why We Recommend Analytic Treatment for Some Patients and Not for Others

Mon, 20 Jul 2009 11:43:04 PDT

One hundred consecutive patients applying for analysis completed a comprehensive battery of structured interviews and self-report questionnaires assessing dimensions of psychopathology and psychological functions that analysts consider important when evaluating patients for analysis. Patients were evaluated for analysis by a candidate supervised by a training analyst. Fifty patients were accepted for analysis and fifty rejected. In both groups, psychiatric morbidity and psychosocial impairment were high, with a 50% current and 74% lifetime diagnosis of mood disorder, 56% current and 61% lifetime history of anxiety disorder. The mean Beck Depression Inventory score fell in the moderate range, 19.1 (SD = 11.0), mean Hamilton Depression score in the mild range, 14.1 (SD = 7.8), and the mean Hamilton Anxiety score in the moderate range, 14.6 ( SD = 8.1), with 57% meeting criteria for an Axis II diagnosis, and mean social adjustment in the moderate to high pathology range. Patients accepted and rejected for analysis did not differ with regard to any of these dimensions. Accepted patients scored lower on measures of impulsivity, aggression, and sociopathy, and on scores of personality rigidity, primitive defenses, and outward aggression. The major finding was the striking similarity between patients accepted and rejected for psychoanalytic treatment.

Dropout Rate of Training Cases: Who and When

Hamilton, M., Wininger, L., Roose, S. P. — Mon, 20 Jul 2009 11:43:04 PDT

Training cases define clinical immersion for candidates and are essential to their education, progression, and graduation. While dropouts from treatment are expected, repeated dropouts can be detrimental to a candidate's education and progression. In a study of the rate and timing of dropout in 145 cases at the Columbia University Center for Psychoanalytic Training and Research, 40 percent of patients were found to have dropped out within the first twelve months of treatment, though converted cases were less likely to drop out than were new patients evaluated at intake. This high dropout rate raises many questions about the reasons for it and suggests that there are critical educational issues regarding supervision and/or regarding candidates' technique during the induction phase.

A Prospective Study of Career Development and Analytic Practice: the First Five Years

Cherry, S., Wininger, L., Roose, S. P. — Mon, 20 Jul 2009 11:43:04 PDT

To better understand the professional development of early career analysts, the Columbia University Center for Psychoanalytic Training and Research initiated a prospective longitudinal study of its graduates beginning in June 2003. Twenty-six of 29 graduates (90%) have completed confidential baseline questionnaires focusing on four domains: experience in analytic training, current private practice, postgraduate activities, and career goals. Participants are followed longitudinally with annual follow-up questionnaires and interviews. Of the cohort of graduates from 2003—2007, 58% were female, compared to 20% female in the cohort of graduates from 1973—1977. A bimodal distribution emerges wherein half of all graduates continue to sustain immersion of at least three ongoing cases in analysis at a four-times-weekly frequency. The other half do not maintain this immersion in four-times-a-week treatment; they primarily apply their training to psychotherapy practice. The more immersed group indicate significantly stronger interest in pursuing training analyst appointment as a primary career goal. The nonimmersed group conduct psychotherapy, feel positive about their training experience, teach at the institute, and have high morale, yet do not consider being a psychoanalyst their primary career identity. Thus, by five years, two viable and satisfying career paths emerge among our graduates. These data are important for training programs, both in preparing their graduates for future practice and in supporting their postgraduate experience.

Sexuality and Shame: SENSUALITY AND SEXUALITY ACROSS THE DIVIDE OF SHAME. By Joseph Lichtenberg. Psychoanalytic Inquiry Book Series, Volume 25. New York: The Analytic Press, 2008, 160 pp., $34.95. SHAME AND SEXUALITY: PSYCHOANALYSIS AND VISUAL CULTURE. Edited by Claire Pajaczkowska and Ivan Ward. London: Routledge, 2008, 242 pp., {pound}19.99

Balsam, R. H. — Mon, 20 Jul 2009 11:43:04 PDT

Book Review: Perspectives: RADICAL HOPE: ETHICS IN THE FACE OF CULTURAL DEVASTATION. By Jonathan Lear. Cambridge: Harvard University Press, 2006, 208 pp., $22.95

Graham, G. D. — Mon, 20 Jul 2009 11:43:04 PDT

Book Review: FUNDAMENTALS OF PSYCHOANALYTIC TECHNIQUE: A LACANIAN APPROACH FOR PRACTITIONERS. By Bruce Fink. New York: W. W. Norton, 2007, 301 pp., $35.00

Kirshner, L. A. — Mon, 20 Jul 2009 11:43:04 PDT

Book Review: POLARITIES OF EXPERIENCE: RELATEDNESS AND SELF-DEFINITION IN PERSONALITY DEVELOPMENT, PSYCHOPATHOLOGY, AND THE THERAPEUTIC PROCESS. By Sidney J. Blatt. Washington, DC: American Psychological Association, 2008, 404 pp., $69.95

Greenspan, S. I. — Mon, 20 Jul 2009 11:43:04 PDT

Book Review: SELF-ORGANIZING COMPLEXITY IN PSYCHOLOGICAL SYSTEMS. Edited by Craig Piers, John P. Muller, and Joseph Brent. Psychological Issues Monograph 67. Lanham, MD: Jason Aronson, 2007, 186 pp., $28.60

Solomon, B. C., Solomon, D. S. — Mon, 20 Jul 2009 11:43:04 PDT

Book Review: Winnicott: ATTACHMENT, PLAY, AND AUTHENTICITY: A WINNICOTT PRIMER. By Steven Tuber. Lanham, MD: Jason Aronson, 2008, xiii + 237 pp., $35.95 paperback

Knight, R. — Mon, 20 Jul 2009 11:43:04 PDT

Book Review: THE GADDINI-WINNICOTT CORRESPONDENCE, 1964--1970. Edited by Andrea Sabbadini. Psychoanalysis and History 5:1--69, 2003

Ilahi, M. N. — Mon, 20 Jul 2009 11:43:04 PDT

Book Review: The Vienna Psychoanalytic Society: VIENNA PSYCHOANALYTIC SOCIETY: THE FIRST HUNDRED YEARS. Edited by Andrea Bronner. Vienna: Christian Brandstatter Verlag, 2008, 96 pp., 19.90

Thompson, N. L. — Mon, 20 Jul 2009 11:43:04 PDT

Book Reviewers

Mon, 20 Jul 2009 11:43:04 PDT

The Interpretive Process in the Psychoanalytic Psychotherapy of Borderline Personality Pathology

Caligor, E., Diamond, D., Yeomans, F. E., Kernberg, O. F. — Wed, 10 Jun 2009 16:39:10 PDT

While all patients become more concrete in their psychological functioning in areas of conflict, especially in the setting of transference regression, in the treatment of patients with severe personality pathology this process poses a particular clinical challenge. In the psychoanalytic psychotherapy of patients with severe personality pathology in general, and borderline personality disorder in particular, the interpretive process serves multiple functions. This process comprises a series of steps or phases that can be viewed as moving the patient further away from a single, poorly elaborated, and concrete experience in the transference, which dominates and floods subjectivity, and toward more fully elaborated, complex, stable, and integrated representations of the analyst and of what he or she evokes in the patient's internal world.

The Ordinary and the Extraordinary Countertransference

Freedman, N., Lasky, R., Webster, J. — Wed, 10 Jun 2009 16:39:10 PDT

This is both a clinical and an epistemological inquiry into the concept of countertransference. A distinction is made between the ordinary countertransference, a transitory disruption residing within the analyst's consciousness, and the extraordinary countertransference, an impasse intolerable to the analyst to such an extent that it remains outside awareness. This distinction, rooted in the history of psychoanalytic thought, is here traced in a recorded psychoanalysis. The clinical material is examined from three perspectives, including empirical evaluation by computer-assisted monitoring of spoken language and two modes of psychoanalytic interpretive listening. Analytic sessions designated as ordinary were readily identified by quantitative measures. However, the threshold between the ordinary and the extraordinary countertransference was reached at the point where empirical observations broke down. Detailed psychoanalytic observation of the four sessions that lie beyond empirical validation led to a formulation of the analyst's state of consciousness during these pivotal hours.

Time and Timelessness: Inscription and Representation

Levine, H. B. — Wed, 10 Jun 2009 16:39:10 PDT

Time is a real dimension of the physical universe and a subjective matter of mind. Depending on their relationship to Eros and the Death Instinct, our feelings about time and timelessness may serve disparate ends— positive or negative, constructive or destructive. The conflicts that emerge between time and timelessness will be affected by and drawn into our conflicts between the reality principle and the pleasure principle and by our capacity to acknowledge and bear the losses, hurts, and disappointments with which life presents us and the hopes and possibilities that life may hold. The "making" and inscribing of time—i.e., articulating and ordering mental elements in the act of representation, symbolization, and verbal linkage of previously unrepresented and inchoate proto-mental elements and states—are central to psychic functioning and the psychoanalytic process. Clinical material will illustrate these processes and their relation to the binding and mastery of trauma: internal and external, massive and cumulative.

Japa Review Articles: an Introduction

Roose, S. P., Gerber, A. J. — Wed, 10 Jun 2009 16:39:10 PDT

The Neurobiology of Personality Disorders: Implications for Psychoanalysis

Siever, L. J., Weinstein, L. N. — Wed, 10 Jun 2009 16:39:10 PDT

As advances in neuroscience have furthered our understanding of the role of brain circuitry, genetics, stress, and neuromodulators in the regulation of normal behavior and in the pathogenesis of psychopathology, an increasing appreciation of the role of neurobiology in individual differences in personality and their pathology in personality disorders has emerged. Individual differences in the regulation and organization of cognitive processes, affective reactivity, impulse/action patterns, and anxiety may in the extreme provide susceptibilities to personality disorders such as borderline and schizotypal personality disorder. A low threshold for impulsive aggression, as observed in borderline and antisocial personality disorders, may be related to excessive amygdala reactivity, reduced prefrontal inhibition, and diminished serotonergic facilitation of prefrontal controls. Affective instability may be mediated by excessive limbic reactivity in gabaminergic/glutamatergic/cholinergic circuits, resulting in an increased sensitivity or reactivity to environmental emotional stimuli as in borderline personality disorder and other cluster B personality disorders. Disturbances in cognitive organization and information processing may contribute to the detachment, desynchrony with the environment, and cognitive/perceptional distortions of cluster A or schizophrenia spectrum personality disorders. A low threshold for anxiety may contribute to the avoidant, dependent, and compulsive behaviors observed in cluster C personality disorders. These alterations in critical regulatory domains will influence how representations of self and others are internalized. Aspects of neurobiological functioning themselves become cognized through the medium of figurative language into an ongoing narrative of the self, one that can be transformed through the analytic process, allowing for the modulation of genetic/biological thresholds.

Changes in Defensive Functioning in Completed Psychoanalyses: the Penn Psychoanalytic Treatment Collection

Roy, C. A., Perry, C. J., Luborsky, L., Banon, E. — Wed, 10 Jun 2009 16:39:10 PDT

Theory predicts that patients completing psychoanalysis should improve in their dynamic functioning. The aim of this naturalistic study is to examine whether a sample of 17 subjects from the Penn Psychoanalytic Treatment Collection with completed, tape-recorded psychoanalyses demonstrated improvement in one dynamic aspect: their defense mechanisms. The pre-post effect size for the change in overall defensive functioning (ODF) of the sample was large (.76) and statistically significant (p = .01). The percentage of subjects who improved in their ODF (71%) was similar to that found by others who studied the same sample using general functioning measures. These findings provide the first empirical evidence to support a trait-like change in dynamic personality functioning in patients who have undergone psychoanalysis. Randomized controlled studies with homogeneous samples are needed to further confirm these findings.

Summaries of the Sixth Annual Poster Session of the American Psychoanalytic Association: Part 3: Longitudinal Study of Psychoanalysis: the Mid-Phase Begins

Cogan, R., Porcerelli, J. H. — Wed, 10 Jun 2009 16:39:10 PDT

Dependency as a Resilience Factor for Relationship Satisfaction When Confronted With Interpersonal Stress: a One-Year Prospective Study in the Community

Lowyck, B., Luyten, P., Demyttenaere, K., Corveleyn, J. — Wed, 10 Jun 2009 16:39:10 PDT

Patients' Adult Attachments and Attitudes About Group Therapy

Wed, 10 Jun 2009 16:39:10 PDT

Therapist and Patient Mental Representations: the Early Therapy Relationship in Long-Term Psychodynamic Psychotherapy

Marmarosh, C., Whipple, R., Schettler, M., Pinhas, S., Wolf, J., Sayit, S. — Wed, 10 Jun 2009 16:39:10 PDT

Evaluation of Psychoanalytic Treatment Notes Using Language and Theme Measures

Pavlinovic, L., Bucci, W., Hoffman, L., Maskit, B. — Wed, 10 Jun 2009 16:39:10 PDT

Psychoanalysis of Avoidant Personality Disorder: a Systematic Case Study of Process and Outcome

Porcerelli, J., Dauphin, B., Ablon, J. S., Leitman, S., Bambery, M. — Wed, 10 Jun 2009 16:39:10 PDT

Analytic Practice Patterns Among Psychoanalytic Institute Graduates: a Bicoastal Comparison

Pretsky, J. E., Aizaga, K., Cherry, S. — Wed, 10 Jun 2009 16:39:10 PDT

Treatment Monitoring: Changes in Affective Distress and Dependency Following Symptom Alleviation of Eating Disorders

Rothschild, L., Stein, D. — Wed, 10 Jun 2009 16:39:10 PDT

Mind Over Medicine: the Influence of Expectations on Antidepressant Response

Rutherford, B. R., Roose, S. P., Sneed, J. — Wed, 10 Jun 2009 16:39:10 PDT

Using the Rorschach Reality-Fantasy Scale (Rfs) for Assessing Mental Functioning in Adults Exposed To Constant Threat of Terror

Tibon, S. — Wed, 10 Jun 2009 16:39:10 PDT

Parent-Infant Psychotherapy

Masur, C. — Wed, 10 Jun 2009 16:39:10 PDT

Psychoanalysis and Religious Mysticism: CRUCIFIED WITH CHRIST: MEDITATION ON THE PASSION, MYSTICAL DEATH, AND THE MEDIEVAL INVENTION OF PSYCHOTHERAPY. By Dan Merkur. New York: State University of New York Press, 2007, 156 pp., $55.00. CENTERS OF POWER: THE CONVERGENCE OF PSYCHOANALYSIS AND KABBALAH. By Joseph H. Berke and Stanley Schneider. New York: Jason Aronson, 2008, 254 pp., $29.95. INTO THE MOUNTAIN STREAM: PSYCHOTHERAPY AND BUDDHIST EXPERIENCE. Edited by Paul C. Cooper. New York: Jason Aronson, 2007, 192 pp., $41.95

Leavy, S. A. — Wed, 10 Jun 2009 16:39:10 PDT

Book Review: A STORY OF HER OWN: THE FEMALE OEDIPUS COMPLEX REEXAMINED AND RENAMED. By Nancy Kulish and Deanna Holtzman. New York: Jason Aronson, 2008, 219 pp., $39.95

Kieffer, C. C. — Wed, 10 Jun 2009 16:39:10 PDT

Book Review: AWAKENING THE DREAMER: CLINICAL JOURNEYS. By Philip M. Bromberg. Mahwah, NJ: The Analytic Press, 2006. 223 pp., $55.00

Oppenheim, L. — Wed, 10 Jun 2009 16:39:10 PDT

Book Review: LANGUAGE, SYMBOLIZATION, AND PSYCHOSIS: ESSAYS IN HONOUR OF JACQUELINE AMATI MEHLER. Edited by Giovanna Ambrosio, Simona Argentieri, and Jorge Canestri. London: Karnac Books, 2007, 299 pp., $43.95

O'Connor, S. — Wed, 10 Jun 2009 16:39:10 PDT

Book Review: COASTING IN THE COUNTERTRANSFERENCE: CONFLICTS OF SELF INTEREST BETWEEN ANALYST AND PATIENT. By Irwin Hirsch. New York: The Analytic Press, 2008, 240 pp., $34.95

Waugaman, R. M. — Wed, 10 Jun 2009 16:39:10 PDT

Book Review: HURRY DOWN SUNSHINE. By Michael Greenberg. New York: Other Press, 2008, 234 pp., $22.00

Esman, A. H. — Wed, 10 Jun 2009 16:39:10 PDT

Book Reviewers

Wed, 10 Jun 2009 16:39:10 PDT