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PubMed2006

Attachment theory and psychoanalysis: some remarks from an epistemological and from a Freudian viewpoint.

The author examines Bowlby's attachment theory and more recent versions of it from an epistemological viewpoint and subjects it to questioning on whether they are in line with central concepts of Freudian psychoanalysis. He argues that Bowlby's basic tenets regarding attachment theory, which later attachment theorists never seriously questioned, do not conform to scientific standards, and that psychoanalytic issues such as the dynamic unconscious, internal conflicts, interaction of drive wishes and the role of defence in establishing substitutive formations are either ignored or not treated in sufficient depth. In the light of this, Fonagy's assertion that psychoanalytic criticism of attachment theory arose from mutual misunderstandings and ought nowadays to be seen as outdated is reversed: psychoanalytic criticism can only be regarded as outdated if either basic tenets of Freudian psychoanalysis, or attachment theory or both are misunderstood.

Freudian Theory↗
PubMed1992

Psychoanalysis and psychosomatics: a new synthesis.

The usefulness of psychoanalysis to psychosomatic medicine has been limited by the longstanding assumption that the psychological disorder in psychosomatic patients resembles the conflict-based psychopathology that Freud identified in psychoneurotic patients. Recent investigations of the alexithymia construct, and the discovery that social relationships can influence health over the entire life span, have challenged this assumption and created an opportunity for a new and active involvement of psychoanalysis with psychosomatic medicine. In this contribution, I offer a synthesis of contemporary psychoanalytic observations and theories with concepts and research findings from developmental psychology, developmental biology, and the biomedical sciences. The proposed synthesis is consistent with the view that living organisms are self-regulating cybernetic systems; it also extends an evolving new psychosomatic model that conceptualizes illnesses and diseases as disorders of psychobiological regulation. A modern psychoanalytic approach to physically ill and disease-prone individuals focuses less on the resolution of neurotic conflicts, and more on correcting deficits in these patients' self and object representations and capacity cognitively to process emotions.

Affective Symptoms↗
PubMed1996

Assessing outcome in psychoanalysis and long-term dynamic psychotherapy.

The efficacy of psychoanalysis and long-term psychotherapy remains a fundamentally unresolved issue for lack of methodologically sound studies. This article reviews the shortcomings of prior long-term treatment research, and presents a rationale and justification of the importance of more rigorous outcome studies. An emphasis on process research is premature when efficacy remains uncertain. The modern reconceptualization of psychotherapy in terms of hermeneutic theory is discussed in relation to the empirical model. Although historically the hermeneutic perspective has served to repudiate positivism, the hermeneutic and empirical (but not positivistic) approaches to understanding information actually share common priorities. The clearest of these is that the process is ultimately evaluated and validated by the produced effect. It is argued that the recasting of psychoanalytic technique and theory according to aesthetic and pragmatic principles is not inconsistent with contemporary outcome research paradigms so long as the professed treatment objective is clearly specified in verifiable terms. The specific methodologic problems involved in extending the successful short-term psychotherapy research model to psychoanalysis are discussed. An overview of the major components of the Columbia feasibility study currently underway is presented. Finally, a number of assessment domains-for which reliable and validated instruments exist-that are thought to be relevant to outcome are reviewed.

Combined Modality Therapy↗
PubMed2002

Interpersonal psychoanalysis' radical façade.

The participant-observation model initiated the relational turn, as well as the shift from modernism to postmodernism in psychoanalysis. This two-person, coparticipant conceptualization of the psychoanalytic situation moved psychoanalysis from the realm of alleged objective science toward intersubjectivity and hermeneutics. From this perspective, the analyst as subjective other is constantly engaged affectively with the patient in ways that are very often out of awareness. Analyst and patient both, for better or for worse, are believed to unwittingly influence one another. This description of the analytic dyad has led many to mistakingly conclude that interpersonal psychoanalysts advocate wittinly affective expressiveness, often in the form of deliberate self-disclosure of feelings, as part of a standard analytic stance. Upon closer examination, radical interventions are no more emblematic of interpersonal analysts than they are of analysts from most other traditions, though the interpersonalists have indeed expanded what had theretofore been a rather narrow repertoire of interventions.

Affect↗
PubMed2004

[Motivation and psychoanalysis. A cross-road].

The concept of drive in psychoanalysis corresponds to the question of motivation. This is related to the psychoanalytical methodology that is founded up on a specific process of communication, the listening and the interpretation of subjectivity and its unconscious origins. This specificity explains why psychoanalytic psychology deals with attachment and aversion drive (on one side sexuality, broadly speaking, including infantile sexuality, and on the other side aggressivity and destructivity). In the unconscious part of the mind, these drives are materialized in fantasies, action representations, that impose themselves unconsciously upon the conscious mind and give rise to intrapsychic conflicts and to personality disorders that are treated by psychoanalysis.

Adolescent↗
PubMed1981

[Psychoanalysis with the child.].

The author examines the specific nature of child psychoanalysis, its characteristics in Quebec and elsewhere, and the criteria for this kind of analysis. She analyses what distinguishes child psychoanalysis from other forms of therapy (including family therapy), its impact on the family as a whole, how the parents feel about the consultation, the importance of play and the imaginary world, and the process of treatment.

English Abstract↗
PubMed1991

[Developmental psychopathology and psychoanalysis].

In face of the apparent contradiction between psychoanalysis and observational-experimental methods, the author briefly summarizes the input of direct observation to the knowledge of child development and suggests that the reservations of many psychoanalysts to these methods may be explained by the greater importance given to external events in such research, as if the causal role of fantasy was thus being questioned. The author further reviews most recent experimental works, particularly those around the concepts of "competence of the infant", "self", "attachment and security", and suggests that the main object of these research endeavors more and more concerns the foundations and origins of the child's fantasy life. Other recent experimental works bring out the continuity between the observations made during the first year of the child's life and those made of these children now up to the age of six. The author comes to the conclusion that the whole of these observational and experimental works, far from contradicting psychoanalytic hypotheses based on reconstruction, confirms institutions and hypotheses which have become essential to psychoanalysis, particularly concerning the importance of the child's first year of life and of mother-child interaction.

Child↗
PubMedDate not supplied

[Change in diagnostic and therapeutic viewpoints: the contribution of psychoanalysis].

It is not easy to describe the contribution of psychoanalysis and child psychoanalysis to child psychiatry. Though they both have the goal to help the psychologically disturbed child they differ greatly regarding their areas of responsibility and their scientific basic assumptions. Nevertheless one cannot overlook important influences, which, though, may vary according to different local conditions. In this paper the author tries to do justice to the different levels of this problem.

Adolescent↗
PubMed1990

Dante, psychoanalysis, and the (erotic) meaning of meaning.

The author observes a resemblance between (1) the "polysemous" technique of imputing meaning to reality practiced in medieval biblical studies and in Dante's writing and (2) the technique of interpretation in contemporary psychoanalysis. She explores the roots of this resemblance in the development of intellectual history and provides examples of polysemous meanings in Dante's Divine Comedy, which is in part an autobiographical journey of self-reflection and self-realization (like psychoanalysis). She then suggests some implications of this resemblance for contemporary psychiatry.

Freudian Theory↗
PubMed1990

Free association as a method of self-observation in relation to other methodological principles of psychoanalysis.

The method of free association, especially in its self-observative aspect, may be seen as a useful criterion for differentiating among various clinical approaches to psychoanalysis, not only as they evolved in the course of its history but also as they are being practiced today. It is suggested that it may be of some relevance to view the existing variants of clinical psychoanalysis as being based upon differing emphases on one or another of the basic operational concepts, such as free association, interpretation, and the mental disposition of the analyst.

Free Association↗
PubMed1989

The classic and the romantic vision in psychoanalysis.

Psychoanalysis is characterized by a tension to be found in intellectual history at least since the eighteenth century. The classic vision of man is that of distrust of the idiosyncratic and subjective and the emphasis on the need for objectivity and rationality. In psychoanalysis this is reflected in the attitude of benevolent suspicion which seeks the traces of the pleasure principle in order to allow maturation. It is exemplified here through Freud's work. The romantic vision sees man as essentially striving for full selfhood, and mental suffering is the result of the thwarting influence of the environment. Kohut, who is taken to exemplify this vision, takes an attitude in which he seeks for the healthy striving behind the seemingly ill and perverse. He emphasizes the human need for idealization as a normal phenomenon. The tension between classicism and romanticism expresses itself in clinical problems no less than in theory. It is argued that this tension is not to be resolved, as it reflects the tension between the human ability and need for full experience and the capacity for self reflection which is essential to maturity and wisdom.

Attitude↗
PubMed1979

[Present day Marxist sociology and psychoanalysis].

The main common theme in psychoanalysis and Marxist sociology is the understanding that it is not consciousness that determines being, but being (spiritual, social) that determines consciousness. The different variations of Marxist movements today are in fact distant from Marx's theory of sociology. They have become representatives of utopian socialism, using anarchistic methods to achieve that aim. This development can only be understood as a social neurosis, with the narcistic frustation of the intellectual class as its cause, and grandiose claims, intolerance, dogmatic thinking and destructive behaviour as its symptoms. The only justified criticism of psychoanalysis from the pseudo-Marxist side is based on the imperfection and error in the analytical doctrine of superego. This should be replaced by the idea of conscious, subjective, emotional morality which clearly explains the aggression contained in social structures.

Aggression↗
PubMed1984

Cognitive difficulties in psychoanalysis.

The author rises a number of questions about cognitive difficulties in relation to psychoanalysis. He presents the case of an adult patient in whom previously unrecognized childhood cognitive difficulties were discovered during the course of analysis. Their relationship to the patient's problems in adulthood is discussed. Some suggestions and speculations about the questions raised are presented with the hope of stimulating further exploration of what the author considers to be an interesting and important subject for psychoanalysis.

Anger↗
PubMed1981

[Psychoanalysis and reality].

The consequences of the exclusion demanded by psychoanalysis of the social and political reality from the analytical situation are shown.--Assumption of unconscious infantile conflicts as essential motivating forces of macro- and microscopical processes. --Danger of misinterpretation of concrete patterns of behaviour and experience of the patient. --Development of an unrealistic analytical world in the experiences of the patient, psychoanalytical folie à deux. As a basic condition for the use of important and useful conceptions in psychoanalysis, the consideration of the relation between subjective reflection and objective conditions is demanded.

Germany, East↗
PubMedDate not supplied

[Gestalt therapy, extension of psychoanalysis (author's transl)].

Gestalt therapy extends considerably psychoanalysis. 1. Transfer in psychoanalysis allows to work on the disturbed relations which the patient transfers onto his analyst, relations created by the parents and repeated now. The extended transfer in a therapeutic group of life allows to work on the fact that the patient recreates here and now the difficulties he encounters in life. 2. The game of the analyst and the encounter show that beyond transfer and projection, a real encounter may take place, a precious means to create life here and now. 3. The difference between individual therapy and group-therapy is about this: the former is centered on illness, the latter on life; the former helps to understand, the latter to live; the individual talks about facts from the past and from elsewhere and the group lives "here and now", which allows to test feelings, a powerful source of life. 4. A session of group-therapy, as developed here, allows to see how one can find a response to a need or avoid to find a response to it. 5. A comparison-table between psycho-analysis and gestalt shows the difference of method, diagnosis, therapeutic process, therapeutist's attitude and of the position of the patient. 6. Psycho-analysis is perhaps a relay after religion? Several elements make us believe this: tension in contacts, ritual, authority, protection, neutrality, guilty making. 7. To contest or contest one-self has helped me to compare the contester with the psycho-analyst: both contest society, but they don't change their behavior. The gestalt-therapeutist is in a way like a hippie: though contesting society, he brings a change to his way of life, while being closer to life.

Adult↗
PubMedDate not supplied

[Anna, Irma and Dora--the key to the mothers in the creation of psychoanalysis].

As a science caught up between the mythical and the rational, psychoanalysis is subject to the pulls of two opposing currents, a creative enlightened one concerned with the investigation of the unconscious, and a conservative counter-current observable in the psychoanalytic theory of femininity. In her analysis of these warning elements the author goes back to the genesis of psychoanalysis and its creator and takes a close look at the primal myth (the legend of Breuer and Anna O.), the primal dream (Irma), and finally the primal analysis (the case of Dora). King's analysis demonstrates that Freud unconsciously appropriated female psychic features and--in unconscious identification with the mother of the Urszene, bound up with adolescent regression and attendant bi-sexual grandeur fantasies--imagined himself as ideal woman and "conceiver". By appropriating female potency for himself and thus making the opposite sex superfluous, Freud's theory of femininity leaves the place of women vacant, relegating them to the role of a defective entity, a castrated man, rather than acknowledging their otherness. In King's view, this phallic monism is inextricably interwoven with adolescent bisexual identifications and fantasies of grandeur about Freud's own gender, while denying gender-difference genuine recognition and integration.

Adolescent↗