Journal of the American Psychoanalytic Association recent issues

Getting Our Ideas Across: Three Very Different Views

Glick, R. A. — 2008-05-30

Analyst as Teacher / Teacher as Analyst: A Confusion of Tongues?

Skorczewski, D. — 2008-05-30

An ad hoc volunteer force, psychoanalytic educators must make do with little formal preparation in teaching methods before they enter the classroom. When they inevitably encounter common pedagogical problems, they often attribute their difficulty to a personal failure or the recalcitrance of candidates, but rarely to a lack of instruction in the craft of teaching. Given this situation, how can analysts who spend most of their time with patients learn to lead productive classroom discussions? How can they enhance participation when discussions become stale and strained? Most important, how can they determine whether candidates actually learn something in their classes? It is only slight exaggeration to say that the answers to these questions cannot be found in the thousands of pages that the profession has devoted to the subject of psychoanalytic education. A supplementary literature of psychoanalytic education is proposed that would directly address pedagogical issues through close attention to the goals and outcomes of courses and through case studies of moment-to-moment interactions in the classroom.

Access To Psychoanalytic Ideas in American Undergraduate Institutions

Redmond, J., Shulman, M. — 2008-05-30

To determine the prevalence of teaching about psychoanalytic ideas in the undergraduate curricula of 150 highly ranked colleges and universities, a software-based search was conducted to find references to psychoanalytic content in published course catalogues. Results showed that psychoanalytic ideas were represented somewhere in the curricula of most (though not all) of these schools, and that overall there were many times more courses featuring psychoanalytic ideas outside psychology departments than within them. The data also suggest that there are regional differences in the likelihood an undergraduate will encounter psychoanalytic ideas at these schools. Though psychoanalytic ideas are available in some form in most of these schools' psychology departments, the average number of courses per school is small. At the same time, psychoanalytic ideas have found applications in many areas of the humanities and social sciences. The nature of the presentation of psychoanalytic ideas in these areas, however, may often be unfamiliar to clinically oriented analysts, as seen in examples of the courses that were found. Challenges and opportunities of the current academic climate vis-à-vis organized psychoanalysis are described and various suggestions made regarding how analysts can engage the academic world to its benefit.

"Why Is It That I See Everything Differently?" Reading a 1933 Letter From Paula Heimann To Theodor Reik

Rolnik, E. J. — 2008-05-30

A letter from Paula Heimann to her training analyst, Theodor Reik, written shortly before her emigration from Berlin to London, sheds light on some of the technical controversies and personal animosities that shaped psychoanalytic clinical discourse in the early 1930s, as well as on Heimann's subsequent development as a clinician. A close reading of this letter highlights several distinctive aspects of psychoanalytic training and demonstrates the transgenerational transmission of psychoanalytic ideas.

Is There Life After Enactment? The Idea of a Patient's Proper Work

Friedman, L. — 2008-05-30

All talking therapies profit from a patient's deliberate work in treatment, for a number of reasons, each of which deserves separate study and reflection. This is as true for psychoanalysis as for other psychotherapies. But in psychoanalysis the idea of a patient's deliberate work is paradoxical and problematic, bringing special overt and covert benefits, but also risking countertransference hazards like those associated with the notion of therapeutic alliance. Many analysts today use the implicit idea of a patient's proper, deliberate work as a contrast in defining an enactment, and the idea of this proper work serves both parties as an image of aspiration when they are trying to climb out of an enactment. As always in these matters, that sort of usefulness carries the hazard of unrealistic and unpsychoanalytic expectations.

Screen Memory: Its Importance to Object Relations and Transference

Reichbart, R. — 2008-05-30

A screen memory of an obsessive and narcissistic man, reported early in psychoanalysis, both represented and disguised the patient's oedipal conflict, incestuous wishes, and sibling rivalry. It symbolized for him his relationship with his mother and was treated by him, in a repetitive and fetishistic manner throughout treatment, as the reason for his bitterness toward life, his sense of entitlement, his narcissism, and his distrust of women. In the transference, the memory—far from being inert— constantly played an active role in his wishes and disappointments regarding the analyst, and in his fantasied oedipal triumph over him. As the analysis progressed, and after years of treatment, the encapsulated nature of this memory began to give way to the patient's growing awareness of his oedipal wishes, the full range of his feelings toward his mother, and his sense of abandonment by her. The nature of screen memory is explored, including how it relates to a patient's personality and use of the past in general, how it may figure in the development of a person's object relations, and the decisive role it may play throughout a treatment.

The Fall of Fantasies: A Lacanian Reading of Lack

Ruti, M. — 2008-05-30

The purpose of this article is to explain to a non-Lacanian audience the broad philosophical foundations of Lacanian theory, particularly the relationship that Lacan draws between the human subject's ontological lack and his or her creative capacities. In an effort to explain Lacan's distaste for psychoanalytic approaches aimed at strengthening the ego, the article outlines the manner in which Lacan connects ego-driven fantasies to the constriction of the subject's psychic world. Lacan suggests that narcissistic fantasies are misleadingly seductive because they—in occluding the internal rifts and antagonisms of the subject's being—alleviate his or her anxieties about the contingent basis of existence. However, the illusory sense of plenitude and self-presence that such fantasies provide prevents the subject from effectively discerning the "truth" of his or her desire, thereby holding him or her captive in socially conventional psychic paradigms. In consequence, it is only the fall of the subject's most cherished fantasies that empowers him or her to pursue a degree of subjective singularity. The article also considers the clinical implications of Lacan's theory of lack, including the ways in which the analyst's lack enhances the patient's capacity to claim an increasingly autonomous and multidimensional mode of encountering the world.

The Interplay of Genes, Environments, and Psychoanalysis

Hauser, S. T. — 2008-05-30

Depression and Internally Directed Aggression: Genetic and Environmental Contributions

2008-05-30

This study uses behavior genetic (BG) methodology to investigate Freud's theory of depression as aggression directed toward the self (1930) and the extent to which genetically and environmentally influenced aggressive tendencies contribute to depressive symptoms. Data from the Twin and Offspring Study in Sweden (TOSS) is used to demonstrate how, in estimating shared and unique environmental influences, BG methods can inform psychoanalytic theory and practice, particularly because of their shared emphasis on the importance of individual experience in development. The TOSS sample consists of 909 pairs of adult twins, their partners, and one adolescent child per couple. The Center for Epidemiologic Studies Depression Scale (Radloff 1977) was used to measure depressive symptoms and the Karolinska Scales of Personality (Schalling and Edman 1993) to measure internally directed aggression. Genetic analyses indicated that for both men and women, their unique experiences as well as genetic factors contributed equally to the association between internally directed aggression and depressive symptoms. These findings support Freud's theory that constitutionally based differences in aggression, along with individual experiences, contribute to a person's depressive symptoms. Establishing that an individual's unique, not shared, experiences and perceptions contribute to depressive symptoms and internally directed aggression reinforces the use of patient-specific treatment approaches implemented in psychoanalytic psychotherapy or psychoanalysis.

Psychoanalytic and Musical Perspectives on Shame in Donizetti's Lucia Di Lammermoor

Nagel, J. J. — 2008-05-30

Two disciplines, psychoanalysis and music, are synthesized here with an eye to the origins and vicissitudes of shame and guilt as seen in the emotional disintegration of the eponymous heroine of Donizetti's opera Lucia di Lammermoor. Lucia's affects and her intrapsychic and interpersonal dynamics are heard in the music itself. A psychoanalytic and musical analysis of the opera, taking Lucia's dynamics as a quasi-substitute for clinical material, illuminates the intersections between certain theoretical aspects of the two disciplines. Both manifest and latent themes are expressed through the music of Donizetti's score.

Panel Report: The Action in Therapeutic Action: Nonverbal Interventions

Evans, H. M. — 2008-05-30

Panel Report: Unattainable Goals in Psychoanalysis

Nagel, J. J. — 2008-05-30

Panel Report: When Analysis Makes Patients Worse: The Negative Therapeutic Reaction Revisited

Grabel, S. — 2008-05-30

Panel Report: Multiple Models in Clinical Practice: Bane or Blessing?

Panzer, D. E. — 2008-05-30

Panel Report: How Much Can Analysis Be Discovery, Not Suggestion?

Colombo, D. — 2008-05-30

Book Review: PSYCHOANALYSIS AND MIND REVOLUTION IN MIND: THE CREATION OF PSYCHOANALYSIS. By George Makari. New York: Harper Collins, 2008, 613 pp., $32.50

Wurmser, L. — 2008-05-30

Book Review: PSYCHODYNAMIC DIAGNOSTIC MANUAL. By The PDM Task Force. Silver Spring, MD: Alliance of Psychoanalytic Organizations, 2006, 857 pp., $45.00 hardcover, $35.00 paperback

Dunn, P. B. — 2008-05-30

Book Review: FRATRICIDE IN THE HOLY LAND: A PSYCHOANALYTIC VIEW OF THE ARAB-ISRAELI CONFLICT. By Avner Falk. Madison: University of Wisconsin Press, 2004, 300 pp., $35.00

Alderdice, T. L. — 2008-05-30

Book Review: THE FUTURE OF PREJUDICE: PSYCHOANALYSIS AND THE PREVENTION OF PREJUDICE. Edited by Henri Parens, Afaf Mahfouz, Stuart Twemlow, and David Scharff. New York: Guilford Press, 2005, 256 pp., $70.00

Szajnberg, N. — 2008-05-30

Book Review: PRACTICAL PSYCHOANALYSIS FOR THERAPISTS AND PATIENTS. By Owen Renik. New York: Other Press, 2006, 179 pp, $24.00

Benson, R. M. — 2008-05-30

Book Review: ENDINGS AND BEGINNINGS: ON TERMINATING PSYCHOTHERAPY AND PSYCHOANALYSIS. By Herbert J. Schlesinger. Hillsdale, NJ: The Analytic Press, 2005, 256 pp., $59.95

Munich, R. L. — 2008-05-30

Book Review: CRAFT AND SPIRIT: A GUIDE TO THE EXPLORATORY PSYCHOTHERAPIES. By Joseph D. Lichtenberg. Hillsdale, NJ: The Analytic Press, 2005, 216 pp., $47.50

Friedman, H. J. — 2008-05-30

Book Review: MOTHERLAND OF PSYCHOANALYSIS. By Thomas Freeman. Edited by John Finlay and Richard Ingram. London: Whurr Publishers, 2005, 100 pp., $50.00

Downey, T. W. — 2008-05-30

Book Review: JOHN SLOAN'S WOMEN: A PSYCHOANALYSIS OF VISION. By Janice M. Coco. Newark: University of Delaware Press, 2004, 135 pp., $45.00

Kuspit, D. — 2008-05-30

Book Review: EXPLORING THE INVISIBLE: ART, SCIENCE, AND THE SPIRITUAL. By Lynn Gamwell. Princeton: Princeton University Press, 2002, 344 pp., $49.95 hardcover, $35.00 paperback

Harrison, A. M. — 2008-05-30

Modern Times

Levy, S. T. — 2008-04-07

A Genuinely Developmental Theory of Sexual Enjoyment and Its Implications for Psychoanalytic Technique

Fonagy, P. — 2008-04-07

A small computer-assisted word frequency analysis, indicating the extent of explicit concern with sexuality in the psychoanalytic literature, has revealed an apparent decline of psychoanalytic interest in psychosexuality. The apparent decline may be related to the limitations of drive theory and object relations approaches in offering persuasive and comprehensive accounts of the psychosexual. A new model of human sexual experience is proposed, rooted in an integration of French psychoanalytic ideas with recent developmental observational research, that once again places sexuality at the center of psychoanalytic clinical inquiry. Because emotion regulation arises out of the mirroring of affect by a primary caregiver and sexual feelings are unique in that they are systematically ignored and left unmirrored by caregivers, sexual feelings remain fundamentally dysregulated in all of us. Adult sexual experience serves as a way of coming to organize the psychosexual. The model accounts for some aspects of the phenomenology of sexual arousal and suggests ways of understanding pathological distortions of sexual behavior. The nature of the psychosexual is explored in the analytic treatment of an adolescent boy.

Six Essays on Sexuality: An Introduction

Gottlieb, R. M. — 2008-04-07

The Otherness of Sexuality: Excess

Stein, R. — 2008-04-07

The present essay, the second of a series of three, aims at developing an experience-near account of sexuality by rehabilitating the idea of excess and its place in sexual experience. It is suggested that various types of excess, such as excess of excitation (Freud), the excess of the other (Laplanche), excess beyond symbolization and the excess of the forbidden object of desire (Leviticus; Lacan) work synergistically to constitute the compelling power of sexuality. In addition to these notions, further notions of excess touch on its transformative potential. Such notions address excess that shatters psychic structures and that is actively sought so as to enable new ones to evolve (Bersani). Work is quoted that regards excess as a way of dealing with our lonely, discontinuous being by using the "excessive" cosmic energy circulating through us to achieve continuity against death (Bataille). Two contemporary analytic thinkers are engaged who deal with the object-relational and intersubjective vicissitudes of excess.

Sex and Shame: The Inhibition of Female Desires

Elise, D. — 2008-04-07

A developmental narrative is presented that centers on bodily based narcissistic injury and sense of shame in response to unrequited oedipal longings. Through an experience of oedipal defeat in relation to both mother and father, a female sense of inadequacy and shame may be internalized and accepted as one's identity, in contrast to the male phallic-omnipotent trajectory. The demise of genital narcissism in females can underlie various expressions of pervasive inhibition and failure to actualize desire. The thesis offered goes beyond separation-individuation theory in suggesting that girls may inhibit sexuality and aggression, and themselves more generally, due to a representation of self as "not having what it takes" genitally, and then bodily and psychically. Mental representations of the self, based on positive imagery of the female body, are needed to give voice to a woman's bodily experience and sexual desire and agency in various realms. Two clinical vignettes illustrate female inhibitions in sexuality and in professional ambition as understood within the framework presented.

Women Showing Off: Notes on Female Exhibitionism

Balsam, R. H. — 2008-04-07

The limitations of the phallocentric cast of earlier psychoanalytic formulations of "female exhibitionism" linger into the present. In part this connects to certain historical expectations for women's social behavior, and to the vicissitudes of Freud's insufficient knowledge of women in his libidinal psychosexual phasing used as a basis for analytic understanding. The contemporary fade of libido theory contributes to the neglect of such topics as they relate to the biological body. Yet ease and conflict regarding conscious and unconscious female body image representations related to that stepchild of theory—pregnancy and childbirth in particular—play a major role in female body display. Recognition of such body fantasies and female body meanings from early childhood into maturity tends to be marginalized within all of the psychoanalytic theories current today. The focus here on female exhibitionism suggests a normative spectrum for pleasurably active sex seeking and pleasurable procreative desire and fantasy that is present in a female's use of her body and which (of course, but secondarily) can become caught up in conflict. Two cases accenting analyses of female "showing off" behavior are included.

Masturbation, Sexuality, and Adaptation: Normalization in Adolescence

Shapiro, T. — 2008-04-07

During adolescence the central masturbation fantasy that is formulated during childhood takes its final form and paradoxically must now be directed outward for appropriate object finding and pair matching in the service of procreative aims. This is a step in adaptation that requires a further developmental landmark that I have called normalization. The path toward airing these private fantasies is facilitated by chumship relationships as a step toward further exposure to the social surround. Hartmann's structuring application of adaptation within psychoanalysis is used as a framework for understanding the process that simultaneously serves intrapsychic and social demands and permits goals that follow evolutionary principles. Variations in the normalization process from masturbatory isolation to a variety of forms of sexual socialization are examined in sociological data concerning current adolescent sexual behavior and in case examples that indicate some routes to normalized experience and practice.

Sexual Differentiation of Behavior: The Foundation of a Developmental Model of Psychosexuality

Friedman, R. C., Downey, J. I. — 2008-04-07

The sexual differentiation of the brain and behavior occurs as the result of prenatal hormonal influences. Knowledge of this area is helpful for the construction of an appropriately modern psychoanalytically informed developmental paradigm of psychosexuality.

Primary Mental Expression: Freud, Klein, and Beyond

Robbins, M. — 2008-04-07

Freud formulated the primary process model, describing mental activity that creates the illusion of an actual experience in lieu of reflective thought, at the very start of his career. In this, his initial formulation of unconscious mental activity, he was attempting to account for the nature of dreaming, by inference for the mind of infancy and, more speculatively, for adult psychosis. He never revised the model in light of his later formulations of the structural model and the death instinct, nor did he elaborate on his speculation that it could serve as a model for psychosis, and there has been little subsequent effort to employ the model outside the context of dreaming. A small number of analysts, including Klein, Bion, and Matte-Blanco, have constructed theories of psychosis in idiosyncratic conceptual languages that seem to be describing phenomena similar to those from which Freud constructed his model. Although Klein's model of positions, which has become the most widely accepted theory of psychosis, is generally considered a fundamental departure from Freud, both accounts have remarkable similarity and both tend to confuse primary mental expression with mature thought and normal infancy with psychosis. Contributions by cognitive-developmental psychologists including Werner and Piaget suggest ways to clarify some of the confusion and to supplement and amplify Freud's and Klein's description of some of the salient features of primary mental expression. Findings from neuroimaging studies of dreaming and of schizophrenia support the proposition that primary mental activity is a qualitatively distinctive form of mental expression.

Toward a General Theory of Unconscious Processes in Psychoanalysis and Anesthesiology

Mashour, G. A. — 2008-04-07

Psychoanalysis and anesthesiology appear radically different in their clinical practice, yet they share a focus of inquiry: unconscious processes. Despite this common domain, there has been no exploration of the relationship between "the unconscious" as conceived by psychoanalysts and "surgical unconsciousness" as conceived by anesthesiologists. This is likely due to the fact that general anesthesia has been assumed to be a state in which the brain is simply "turned off." More recent neuroscientific data invalidate this assumption by demonstrating that the anesthetized brain is both cognitively dynamic and capable of implicit learning. Current perspectives on anesthetic mechanisms suggest that general anesthesia is characterized not simply by the absence of cognitive activity, but by the disintegration of cognitive activity. The cognitive unbinding paradigm of general anesthesia is discussed and its application to Wilfred Bion's theory of thinking, as well as his concept of attacks on linking, is elucidated. Based on the common structure and function of unconscious processes in psychoanalysis and anesthesiology, the foundation of a general theory is established.

Affect Integration in Dreams and Dreaming

Grenell, G. — 2008-04-07

The processes by which dreaming aids in the ongoing integration of affects into the mind are approached here from complementary psychoanalytic and nonpsychoanalytic perspectives. One relevant notion is that the dream provides a psychological space wherein overwhelming, contradictory, or highly complex affects that under waking conditions are subject to dissociation, splitting, or disavowal may be brought together for observation by the dreaming ego. This process serves the need for psychological balance and equilibrium. A brief discussion of how the mind processes information during dreaming is followed by a consideration of four component aspects of the integrative process: the nature and use of the dream-space, the oscillating "me / not me" quality of the dream, the apparent reality of the dream, and the use of nonpathological projective identification in dreaming. Three clinical illustrations are offered and discussed.

Pluralism in Action

Brendel, D. H. — 2008-04-07

Current Views of the Oedipal Complex

Tucker, S. S. — 2008-04-07

What Use Is Consciousness? A Clinical Neuroscience Roundtable

Colombo, D. — 2008-04-07

Mortal Combat: The Tragic Vision of Philip Roth

Levine, H. B. — 2008-04-07

Recent Work by Hugo Bleichmar

Abelin-Sas, G. — 2008-04-07

Book Review: EDITH JACOBSON: SIE SELBST UND DIE WELT IHRER OBJEKTE, LEBEN, WERK, ERINNERUNGEN. Edited by Ulrike May and Elke Muehlleitner. Bibliothek der Psychoanalyse. Giessen: Psychosozial Verlag, 2005, 447 pp.

Baker, R. M. — 2008-04-07

Book Review: FALSE SELF: THE LIFE of MASUD KHAN. By Linda Hopkins. New York: Other Press, 2006, 551 pp., $35.00

Waugaman, R. M. — 2008-04-07

Book Review: EDWARD BIBRING PHOTOGRAPHS THE PSYCHOANALYSTS OF HIS TIME, 1932-1938. Edited by Sanford Gifford, Daniel Jacobs, Vivien Goldman, and the Boston Psychoanalytic Society and Institute. Hillsdale, NJ: The Analytic Press, 2005, 206 pp., $49.95

Shopper, M. — 2008-04-07

Book Review: THE ROAD TO UNITY IN PSYCHOANALYTIC THEORY. By Leo Rangell. Plymouth, UK: Jason Aronson, 2007, 132 pp., $34.95

Honig, R. G. — 2008-04-07

Book Review: OUT OF THE WOODS: TALES OF RESILIENT TEENS. By Stuart T. Hauser, Joseph P. Allen, and Eve Golden. Cambridge: Harvard University Press, 2006, 321 pp., $27.95

Parens, H. — 2008-04-07

Book Review: GOOD GOODBYES: KNOWING HOW TO END IN PSYCHOTHERAPY AND PSYCHOANALYSIS. By Jack Novick and Kerry Kelly Novick. Lanham, MD: Jason Aronson, 2006, 149 pp., $34.95

Phillips, J. — 2008-04-07

Book Review: HAUNTED BY PARENTS. By Leonard Shengold. New Haven: Yale University Press, 2006, 257 pp., $35.00

Wexler, J. — 2008-04-07

Book Review: A CURIOUS INTIMACY: ART AND NEURO-PSYCHOANALYSIS. By Lois Oppenheim. New York: Routledge, 2005, 208 pp., $52.95

Brauer, L. D., Brauer, R. L. — 2008-04-07

Book Reviewers

2008-04-07

Training Analysis and Reanalysis in the Development of the Psychoanalyst

Meyer, J. K. — 2007-01-01

The Second Person

Litowitz, B. E. — 2007-01-01

Unlike third-person sciences, psychoanalysis is the science of the second person. Briefly tracing the history of our focus on a second person, this paper contrasts two different approaches-the dyadic and the dialogic, proposing the latter as the better model for our field and the one that marks our unique contribution to other disciplines.

The Reality Principle, Tragic Knots, and the Analytic Process

Schafer, R. — 2007-01-01

Civilization and Its Discontents is shown to occupy a special place in Freud's development of psychoanalytic theory and technique. Especially emphasized is its implications for an inclusive understanding of the reality principle. The concept tragic knots is then defined and used to emphasize Freud's readiness to include tragic elements in that principle. An extended section then illustrates the spread of tragic knots into several diverse aspects of human existence: victimization, intimacy, and maintaining privacy. Finally, implications are drawn for the clinical assessment of working through unconscious conflicts.

Narcissistic Temptations to Cross Boundaries and How to Manage Them

Coen, S. J. — 2007-01-01

The narcissism of analysts is considered here from the perspective of the narcissistic temptations of boundary crossing. The literature on boundary crossing in psychoanalysis has focused minimally on the more ordinary, nonsexual temptations analysts face with their patients. Narcissistic temptations with particularly impressive patients are explored. What analysts find impressive in their patients depends both on what patients bring and on what analysts need. This paper aims to heighten analysts' awareness of their narcissistic needs in treating patients who tempt them too much. The goal is for analysts to be able to catch and then examine their narcissistic excitement with such patients in order to avoid compromising the treatment. Danger signs and ways of managing the problems they point toward are presented.

Sibling Differentiation, Identity Development, and the Lateral Dimension of Psychic Life

Vivona, J. M. — 2007-01-01

The lateral dimension of psychic life, lived through relationships with siblings and their substitutes, is structured around a distinct psychic challenge: to find one's unique place in a world of similar others. Like the challenge that structures the vertical parent-child dimension, the lateral challenge is fraught with conflict and ambivalence; its resolution imbues psychic structure. That resolution may be accomplished through a process of differentiation, an active and unconscious process of identity development by which a child amplifies differences with siblings and minimizes similarities. Differentiation from siblings serves to mitigate interpersonal rivalry with them and to ease internal conflict associated with the lateral dimension. Three clinical examples are offered to illustrate the operation of sibling differentiation and its costs, particularly in terms of constricted identity and attenuated relationships with siblings and peers. Differentiation as a process of becoming what the other is not has been eclipsed by identification in psychoanalytic theories of identity development. Yet differentiation is a common strategy for resolving the primary rivalries and conflicts of the lateral dimension, and has unique developmental and clinical implications.

The Reassembly of the Body from Parts: Psychoanalytic Reflections on Death, Resurrection, and Cannibalism

Gottlieb, R. M. — 2007-01-01

Terror of the dismemberment, disintegration, and decay of the body after death has been represented in ritual, myth, legend, art, and religious belief throughout the ages. So too has the wished-for triumph over these inevitable processes. Commonly, bodily experience after death is represented mentally in cannibalistic ideas of eating and being eaten, which are then countered by the wishful undoing of cannibalistic destruction through its reversal: swallowing as regurgitation, dismemberment as re-memberment, disintegration as reassembly. Luca Signorelli's fresco The Resurrection of the Flesh is part of his celebrated group of decorations (1499-1504) of the Cappella Nuova in the cathedral at Orvieto. The doctrinal, iconographic, social, and political contexts of this admired and influential work are explored in order to illustrate how and why this painting represents our greatest fears, along with our triumph over them, as well as our most destructive urges and their reparative counterparts. The photographer Sally Mann has explored these same themes. In What Remains (2003), a series of pictures with accompanying text, Mann documents her exhumation and reassembly of the body of her beloved pet greyhound. Two clinical examples illustrate some ways these concerns (cannibalism and reassembly) may make their appearance in psychoanalytic work.

Cannibalism and the Work of Culture in Bereavement: Commentary On Gottlieb

Conklin, B. A. — 2007-01-01

Response to Commentary

Gottlieb, R. M. — 2007-01-01

Innovative Frontiers in Psychoanalytic Research: Pursuing Underlying Processes and Their Trajectories of Change

Hauser, S. T. — 2007-01-01

Individual Differences in Melancholy Gender Among Women: Does Ambivalence Matter?

Jay, M. — 2007-01-01

This research offers an empirical investigation inspired by Butler's theory of melancholy gender (1995) and a revision of this theory (Jay 2007a). Psychoanalytic feminist theory is drawn on to suggest that melancholy and gender are more likely to be associated in female development than in male development, and Freud's theory of melancholy (1917) is taken to suggest that ambivalence predicts individual differences in melancholy gender among women. In a longitudinal study of women's adult development, an examination of femininity, depressive symptoms, and ambivalence in attachment was conducted in order to evaluate these claims. Findings show that depressive symptoms and femininity are significantly correlated within the sample, but that individual differences in melancholy gender exist. To understand these differences, an analysis was conducted to determine whether ambivalence in attachment accounts for the relation between depressive symptoms and femininity; complementary analyses examined whether low ambivalence in attachment attenuates, or lessens, the relation between femininity and depressive symptoms. Results from these analyses support the notion that it is not the loss and internalization of the same-sex object choice per se that results in melancholy gender in women, as Butler argues; rather, it is the internalization of a lost, ambivalent same-sex attachment that forges the link between melancholy and gender. Narrative material is presented to personify melancholy and unmelancholy gender.

The Dynamics of Empirically Derived Factors in the Therapeutic Relationship

Nuetzel, E. J., Larsen, R. J., Prizmic, Z. — 2007-01-01

The therapeutic relationship is the source of major concepts in psychoanalytic clinical theory. Such concepts as resistance, transference, countertransference, and the alliance are fundamental, even though there may be shifts in meaning between theoretical schools and clinical contexts. In the clinical psychoanalytic literature, disagreement exists over the nature of the alliance and its essential components. Empirical studies using reliable patient, therapist, and observer scales to assess the alliance demonstrate a correlation with psychotherapeutic gains. In the study reported here, thirteen patients were followed for 6 to 33 months of psychodynamic psychotherapy, during which time their views of the therapeutic relationship were assessed, and several experiential measures taken, all on a weekly basis. Statistical analyses reveal that the therapeutic relationship, as reflected in the patients' weekly responses to the St. Louis Therapeutic Relationship Rating Scale, has four distinct components: therapeutic alliance, resistance, transference love, and negative transference. On a week-by-week basis, the therapeutic alliance was the strongest predictor of improvement in patient-reported general adjustment, as reflected in such areas as self-esteem, positive affect, social relations, work productivity, satisfaction, and optimism. Time plots of the variables show the typical time course for the components of the therapeutic relationship, as well as for improvement on the experiential variables. Results indicate that the therapeutic alliance, transference, and resistance are central components of the psychotherapeutic relationship, which in turn predict the ongoing life experience of the patient.

Beneath the Surface of the Therapeutic Interaction: the Psychoanalytic Method in Modern Dress

Bucci, W., Maskit, B. — 2007-01-01

This study represents a new generation of psychotherapy process research, using multiple perspectives on the data of the analytic situation, including impressions of the treating analyst, ratings of complete sessions by clinical judges, and objective linguistic measures. Computerized measures of language style developed in the framework of multiple code theory were applied to verbatim session recordings from a psychoanalytic case; the measures are illustrated in microanalyses of the process in two sessions. The results show agreement between the linguistic measures and clinical ratings based on a psychoanalytic perspective. The linguistic measures look beneath the surface of the therapeutic interaction by relying largely on lexical items of which clinicians are not likely to be explicitly aware, and enable a new perspective on the therapeutic discourse as seen in the graphic images of the microprocess. While the results of this study were limited to a single case, the automatized measures can be readily applied to large samples and in repeated single case designs. Two goals of process research, using measures such as those developed in this study, are discussed: to develop measures of mediating variables that can be used to identify specific treatment effects in comparative outcome studies; and, beyond this pragmatic aim, to assess development of capacities for self-exploration and self-regulation as psychoanalytic treatment goals.

Book Reviews: Critical Dialogue: WRITING ABOUT PATIENTS: RESPONSIBILITIES, RISKS, AND RAMIFICATIONS. By Judy Leopold Kantrowitz. New York: Other Press, 2006, 335 pp., $26.00

Bernstein, S. B. — 2007-01-01

Book Reviews: WRITING ABOUT PATIENTS: RESPONSIBILITIES, RISKS, AND RAMIFICATIONS. By Judy Leopold Kantrowitz. New York: Other Press, 2006, 335 pp., $26.00

Rudnytsky, P. L. — 2007-01-01

Book Reviews: Bernstein: Response to Rudnytsky

Bernstein, S. B. — 2007-01-01

Book Reviews: Rudnytsky: Response to Bernstein

Rudnytsky, P. L. — 2007-01-01

Book Reviews: Psychoanalytic History: PUTNAM CAMP: SIGMUND FREUD, JAMES JACKSON PUTNAM, AND THE PURPOSE OF AMERICAN PSYCHOLOGY. By George Prochnik. New York: Other Press, 2006, 455 pp., $29.95

Gifford, S. — 2007-01-01

Book Reviews: FREUD'S WIZARD: ERNEST JONES AND THE TRANSFORMATION OF PSYCHOANALYSIS. By Brenda Maddox. DaCapo Press, 2007, 368 pp., $26.00

Moraitis, G. — 2007-01-01

Book Reviews: Psychoanalysis, Aesthetics, Spirituality: AESTHETIC EXPERIENCE: BEAUTY, CREATIVITY AND THE SEARCH FOR THE IDEAL. By George Hagman. Amsterdam: Rodopi Press, 2005, $52.00

Baudry, F. — 2007-01-01

Book Reviews: DEATH AND THE FEAR OF FINITENESS IN HAMLET. By Jerome Oremland. San Francisco: Lake Street Editions, 2005, 147 pp., $30.00

Stern, J. — 2007-01-01

Book Reviews: PSYCHE, SELF AND SOUL: RETHINKING PSYCHOANALYSIS, THE SELF AND SPIRITUALITY. By Gerald J. Gargiulo. London: Whurr Publishers, 2004, 168 pp., $45.00

Leavy, S. A. — 2007-01-01

Looking Back and Moving Forward in Child Analysis: An Introduction

Tyson, P. — 2007-09-01

Little Hans: A Centennial Review and Reconsideration

Blum, H. P. — 2007-09-01

Freud's "Analysis of a Phobia in a Five-year-old Boy" (1909) has stimulated interminable "reanalysis." The case of Little Hans, an unprecedented experimental child analytic treatment, is reexamined in the light of newer theory and newly derestricted documents. The understanding of the complex overdetermination of Hans's phobia was not possible in the heroic age of psychoanalysis. Current analytic thought, as well as distance de-idealization vis-à-vis the pioneering past, has potentiated a reformation of the case. The severe disturbance of his mother had an adverse impact on Little Hans and his family. Her abuse of Hans's infant sister has been overlooked by generations of analysts. Trauma, child abuse, parental strife, and the preoedipal mother-child relationship emerge as important issues that intensified Hans's pathogenic oedipal conflicts and trauma. With limited, yet remarkable help from his father and Freud, Little Hans nevertheless had the ego strength and resilience to resolve his phobia, resume progressive development, and forge a successful creative career.

Little Hans "Analyzed" in the Twenty-First Century

Fingert Chused, J. — 2007-09-01

Freud's monograph on the analysis of Little Hans is examined from a perspective aimed at highlighting elements of current thinking that would be considered mutative from those originally emphasized at the time it was written, and with a specific focus on the relative importance of verbal versus nonverbal interventions.

Trauma and Abuse in the Case of Little Hans: A Contemporary Perspective

Munder Ross, J. — 2007-09-01

Newly available interviews with Max and Herbert Graf describe the severe pathology of Little Hans's mother and her mistreatment of her husband and her daughter, who committed suicide as an adult. Reread in this context, the text of "A Phobia in a Five-year-old Boy" provides ample evidence of Frau Graf's sexual seduction and emotional manipulation of her son, which exacerbated his age-expectable castration and separation anxiety, and her beating of her infant daughter. The boy's phobic symptoms can therefore be deconstructed not only as the expression of oedipal fantasy, but as a communication of the traumatic abuse occurring in the home. Through subliminal, indeed unconscious, injunctions conveyed in abusive behavior, parents can confirm the child's worst imaginings and immature views of the world and thereby render the child's oedipal conflicts and fantasies pathogenic.

Little Hans and Freud's Self-Analysis: A Biographical View of Clinical Theory in the Making

Stuart, J. — 2007-09-01

For nearly a century, Freud's "Analysis of a Phobia in a Five-year-old Boy" (1909) has been read mainly—if often critically—with Freud's conscious aim in mind: providing evidence for the central importance of oedipal conflict. Material recently released by the Freud Archives casts new light on Freud's treatment of Hans's mother, Olga Graf (nee Hönig)—which began at the height of his self-analysis in 1897—and of Hans himself. Read in the enriched context of new information from Eissler's interviews with Max Graf and Herbert Graf, two texts—Freud's 1897 letters to Fliess and the 1909 case history—illuminate possible personal motives for Freud's insistence on the primacy of oedipal conflict.

Attachment and Sibling Rivalry in Little Hans: The Fantasy of the Two Giraffes Revisited

Wakefield, J. C. — 2007-09-01

Freud's interpretation of Little Hans's "phantasy of the two giraffes" (1909) is pivotal to his oedipal analysis that Hans has inchoate desires for sexual intercourse with his mother. Bowlby (1973) argued that Freud's focus on his oedipal theory led him to ignore preoedipal attachment-related factors that have equal plausibility in explaining the clinical data. However, Bowlby did not attempt to apply the attachment perspective to the interpretation of Hans's fantasies that form the core of the case material. A microanalysis of Hans's giraffe fantasy and the evidence used to support Freud's claims about it yields an attachment-based sibling rivalry account arguably of greater explanatory power than the oedipal account. Consistent with Bowlby's hypothesis, the evidence suggests that Hans's giraffe fantasy is about the sibling rivalry triangle involved in caregiver attachment access, rather than (or in addition to) the oedipal triangle. The issue of multiple levels of meaning and the methodological challenges raised by multiple determination is also considered. The giraffe fantasy's attachment-theoretic explanation encourages a rethinking of this classic case and strengthens Bowlby's claim that the case is fruitfully viewed from an attachment perspective.

Postscript: Reconstructing Our Collective Past

Stuart, J. — 2007-09-01

Nonverbal Communication in Psychoanalysis: Commentary On Harrison and Tronick

Fingert Chused, J. — 2007-09-01

The Importance of Being Fuzzy and the Importance of Being Precise: Commentary On Harrison and Tronick

Galatzer-Levy, R. M. — 2007-09-01

The Anatomy of a Symptom: Concept Development and Symptom Formation in a Four-Year-Old Boy

Erreich, A. — 2007-09-01

The case of a four-year-old boy with a postural symptom that resolved rapidly in the course of play therapy is presented. Various unconscious fantasies appeared to underlie the symptom. In particular, this case illustrates a young child's sophisticated capacity to abstract a complex relational feature from a set of unconscious fantasies that then became the basis of his symptom. The structure of the boy's symptom is relevant to (1) the question of what constitutes a symptom, (2) the relationship between concept development and symptom formation, and (3) the status of certain primary process mechanisms as they relate to concept development. Proposals are presented to help situate the contributions of psychoanalytic theory with respect to the domain of cognitive psychology, and to illustrate the unique contributions of each domain toward their mutual enrichment.

Psychoanalytic Approaches To Work With Children With Severe Developmental and Biological Disorders

Parks, C. E. — 2007-09-01

Play in the Psychoanalytic Situation

Lang, F. — 2007-09-01

Psychoanalytic Education Needs To Change: What's Feasible? Introduction To Wallerstein

Glick, R. A. — 2007-09-01

The Optimal Structure for Psychoanalytic Education Today: A Feasible Proposal?

Wallerstein, R. S. — 2007-09-01

Our psychoanalytic training system, close to a century old, has been subjected to increasing criticism, starting shortly after its creation, for failing to properly fulfill its avowed purposes. The most intense critiques have centered around the authoritarian power lodged in a self-selected training analyst elite, the inadequate development of a psychoanalytic research tradition, and the isolation of our educational structure from cognate disciplines concerned with human mental life, owing to its private and part-time nature, apart from the university with its spectrum of biological and human sciences. Efforts to reform this system, including the establishment of psychoanalytic institutes within medical school departments of psychiatry, and the further call for their autonomous placement within the university at large, with full-time students and faculty, have been only partially successful and have not become widespread. The values of the newly emerging multifaceted psychoanalytic center as the best currently achievable fundamental reform are presented.

Optimal Education Requires an Academic Context: Commentary On Wallerstein

Michels, R. — 2007-09-01

On "The Optimal Structure for Psychoanalytic Education": Commentary On Wallerstein

Paul, R. A. — 2007-09-01

A Shared Vision: Response To Commentaries

Wallerstein, R. S. — 2007-09-01

Emptiness in Agoraphobia Patients

Milrod, B. — 2007-09-01

In light of new research findings about the efficacy of psychodynamic treatment for panic disorder and agoraphobia, it seems a prudent time to carefully address psychoanalytic thinking about the treatment of agoraphobia. The literature has highlighted oedipal contributions to its genesis and clinical unraveling in psychoanalysis. While those contributions are indeed central to the disorder, structural deficits in the self-representation often become a central focus of treatment once symptomatic remission has been achieved in psychoanalytic treatment. This aspect of the clinical presentation of agoraphobia has not yet been specifically addressed in the psychiatric literature. Some aspects of the phenomenon have been described by psychoanalysts. It is more difficult to treat this "emptiness" than the overt symptoms of agoraphobia, as described in DSM-IV. Nonetheless, this phenomenon may be one of the contributors to the chronicity of the disorder. Two clinical cases illustrate these points.

Emptiness in Agoraphobic Patients: Commentary On Milrod

Dunn, P. B. — 2007-09-01

Telephone Analysis

Bassen, C. R. — 2007-09-01

The Plastic Brain Creates

Young-Bruehl, E. — 2007-09-01

Book Review: International: TRUTH, REALITY, AND THE PSYCHOANALYST: LATIN AMERICAN CONTRIBUTIONS TO PSYCHOANALYSIS. Edited by Sergio Lewkowicz and Silvia Flechner. London: The International Psychoanalysis Library, 2005, 308 pp., $66.58

Rizzuto, A.-M. — 2007-09-01

Book Review: SER HUMANO: LA INCONSISTENCIA, LOS VINCULOS, LA CRIANZA (HUMAN BEING: INCONSISTENCY, LINKS, RAISING CHILDREN). By Julio Moreno. Buenos Aires: Libros del Zorzal, 2002, 285 pp., $14.30

Leonor Cairo, I. — 2007-09-01

Book Review: FREUD ALONG THE GANGES. Edited by Salman Akhtar. New York: Other Press, 440 pp., 2005, $27.00

Hanly, C. — 2007-09-01

Book Review: PSYCHOANALYSIS: A PARADIGM FOR CLINICAL THINKING. By Andre Green; translated by Andrew Weller. London: Free Association Books, 2005, 324 pp., $35.00 paperback

Brett, E. — 2007-09-01