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PubMed1994

Intimacy and science: the publication of clinical facts in psychoanalysis.

This paper starts by stating that in science there are no facts independent of theory. In psychoanalysis, the theory of the decisive importance of the unconscious makes it possible to grasp clinical facts. This leads to the centrality of transference in analysis. The latter is understood as a social fact. Transference, perceived as a private experience, can be known in the intimacy of the psychoanalytic relationship, through the communication by means of language, which is public. Psychoanalysis is then considered a science of intimacy. The analyst, in publishing clinical facts, faces the problem of the transposition of a fact from the intimacy sphere, considered as private, to the public sphere, and thus serves a scientific purpose. A treatment report is presented to illustrate the problems of the registering, editing and publishing of clinical facts, based on the parallel between making conscious that which is unconscious and making potentially public what is private. Thus the analyst confronts similar difficulties and anxieties, when publishing clinical facts, as the ones that the analysand must overcome to know, through the social experience of psychic intimacy, his or her private inner world.

Adult↗
PubMed1994

The assessment of parental functioning: a critical process in the evaluation of children for psychoanalysis.

Because psychoanalysis of a child depends upon the parents' ability to be supportive, they must understand the need for treatment. The evaluation of a child for psychoanalysis provides an opportunity to assess the parents' understanding, an aspect of parental functioning. Once recognized, difficulties that may be obstacles to the successful initiation, conduct, and termination of a child's analysis may be addressed. In this paper, the approach to evaluation is examined, and guidelines for including work toward the amelioration of difficulties in parental functioning are suggested.

Adult↗
PubMed1998

Religious experience and psychoanalysis: from man-as-god to man-with-god.

The author notes that the Freudian psychoanalytic view of religion has become a saturated concept that causes psychoanalysts to disregard the complexity of the religious experience. Issue is taken with the reductionism inherent in the conception of religion as mere illusion and the image of God as being derived solely from the oedipal father. After a presentation of the ideas of some later authors and discussion of the transition from the state of 'Man-as-God' to the relationship of 'Man-with-God' as portrayed in a film, two clinical vignettes are given to illustrate this process of humanisation. The author suggests that religious manifestations in patients should be seen not only in the light of their infantile determinants but also as the result of processes whereby new meaning is assigned to psychic facts. In his opinion, psychoanalysis should not seek solely to reduce religious beliefs to their roots in unconscious fantasies but should lead to a reorganisation of the analysand's image of God and the assignment of new meaning to it. The resulting changes are shown as contributing to psychic growth on the part of both analysand and analyst. The author contends that if psychoanalysis dismisses religion as illusion, it is running the risk of itself becoming an established religion.

Adult↗
PubMed1975

Psychoanalysis, "focal psychotherapy," and the nature of the therapeutic influence.

It has traditionally been asserted that the nature of the therapeutic influence in psychoanalysis is qualitatively different from that in "psychotherapy." This thesis is considered untendable. Analysis of a case history by Balint, Ornstein, and Balint shows evidence that therapeutic change can be conceptualized more parsimoniously along lines other than those traditionally preferred. The therapist establishes himself as a good parent or authority figure vis-a-vis the patient, and within that context mediates important lessons in nonneurotic constructive living. Given strong motivation to seek change, the patient is won over to a point of view different from the one that has, in essential respects, guided his life in the past, and he has to make these teachings his own. Analytic therapy is an education for optimal personal freedom in the context of social living.

Adult↗
PubMed1998

Bowlby before Bowlby: the sources of an intellectual departure in psychoanalysis and psychology.

John Bowlby's first scientific papers express a viewpoint of the etiology of childhood disorders that gradually developed during his university years and the first years of his professional life. As becomes clear from, among other things, Bowlby's private correspondence, it was the period spent as a student at Cambridge, his work as a teacher at two progressive schools, and his work at a child guidance clinic that allowed him to articulate a view on childhood deviancy that was at variance with the Kleinian variant of psychoanalysis. Bowlby's position as an 'independent' thinker in the British Psycho-Analytical Society can be understood against the background of these intellectual influences.

Child Psychiatry↗
PubMed1991

Psychiatry, psychoanalysis, and politics during the First World War.

This article compares the therapeutic power used by psychiatrists and psychoanalysts serving in the German and Austro-Hungarian armies during World War I, and the ways in which their therapeutic techniques were related to governmental and military authority. When treating "shell shocked" soldiers, army psychiatrists were guided by nationalist commitment rather than concern for their patients. Whatever theoretical approach they took, they defined their therapeutic task as administrative intervention aimed to increase the docility of soldiers to the state and its military purposes. But violent means of coercion, designed to force neurotic soldiers back into duty, remained inefficient. Drawing from an alternative body of knowledge, army physicians influenced by Freud's writings, or trained in psychoanalysis, applied cathartic methods to treat the Central Powers' soldiers. Their approach was not only more humane, but also proved to be therapeutically more efficient.

Combat Disorders↗
PubMed2002

Some hazards to neutrality in the psychoanalysis of candidates.

The author looks at the challenges confronting psychoanalysts as they attempt to approach a desirable goal of neutrality in the treatment of psychoanalytic candidates and others who will become or are professional colleagues. Many such hazards are embedded in the interlocking relationships that inevitably exist between the analytic institute and its personnel, its training analysts, and its candidate-analysands. The author considers difficulties in the crucial analysis of aggression in training analyses. The analysis of aggression plays a determinative role in the personal and professional lives of analysands, and vitally affects the health and creativity of analytic institutions and the future of psychoanalysis.

Adult↗
PubMed2004

Comparison of the psychological evaluation test and classical psychoanalysis in infertile women.

This study aims to compare a psychological evaluation test to classical psychoanalysis in infertile women. Two hundred women were submitted to the Psychological Evaluation Test (PET). The sum of the scores for the responses ranged from 15 to 60 points, with scores >/=30 points being defined as 'psycho-emotional maladjustment' (cut-off point: median + 25%). For comparison, the patients were simultaneously submitted to a psychological examination by a psychologist, who was unaware of the PET results. Of the 200 patients, 66 (33%) presented a test with >/=30 points ('psycho-emotional maladjustment') and 134 (67%) a test with <30 points (normal). Upon psychological examination, 105 (52.5%) presented an abnormal evaluation and 95 (47.5%) a normal evaluation. For the PET, statistical analysis showed 82% efficiency, 62% sensitivity, 98% positive predictive value, 99% specificity, 70% negative predictive value, likelihood ratio for a positive test result 62, and likelihood ratio for negative test result 0.38. The PET proved to be a useful clinical instrument, being of help in the selection of patients with psychological needs induced by infertility.

Adult↗
PubMed2006

Borderline histories: psychoanalysis inside and out.

Sociologists and historians have long favored externalist over internalist accounts of practices in the clinical disciplines. This has been particularly true in the case of the so-called new patient or borderline personality, which a range of commentators have located in culturally resonant narratives of decline. I argue here that these narratives, while pleasing, do not hold up as history; most problematic is their assumption that the appearance of the borderline portends the emergence of altogether novel forms of modal personhood. Internalist accounts of the category's consolidation are equally problematic in asserting a coherence and a stable referent that repeatedly proves elusive. In the end, I suggest that a complex account of disciplinary practice that attends to knowledge production in the clinical encounter supports the conclusion that the new patient was new to psychoanalysis. Whether or not he was altogether new cannot be established, undermining the critics' certitude and prophecies of decline.

Borderline Personality Disorder↗
PubMed2000

A field guide to cinetherapy: on celluloid psychoanalysis and its practitioners.

This paper addresses the strange bedfellowship between psychoanalysis and cinema since the century's turn. Its specific focus is the idiosyncratic psychoanalysis/psychotherapy "practised" in mainstream cinema and television. "Cinetherapists" have consistently fallen into one of three categories: Dr. Dippy, a focus of derision, weirder than his patients; Dr. Evil, Hollywood's psychiatric version of the mad, bad scientist; and the unfailingly benevolent, self-sacrificing Dr. Wonderful. The prevalence of these stereotypes has waxed and waned according to shifting cultural circumstances. The study concludes with reflections on the possible impact, deleterious or otherwise, of distorted filmic images of the "impossible profession."

Humans↗
PubMed2000

Conflicts and missed signals in psychoanalysis, behaviorism, and Gestalt psychology.

At the turn of the 20th century, European psychologists found themselves in conflict situations with respect to the role that private mental states should play in a scientific psychology. Out of this conflict arose 3 of the best-known schools of the 20th century: psychoanalysis, behaviorism, and Gestalt psychology. Each of these schools is discussed with respect to two characteristics. First, the authors discuss the attitude of each school on the meaning of the word unconscious as it was understood around 1900. Second, the authors discuss the influence of each school on the reception accorded to books written around 1900 espousing viewpoints that did not cohere with the school's beliefs. Such books may be considered "missed signals" in the history of psychology. "Hits" associated with each school are also highlighted.

Behaviorism↗
PubMed2001

Absurdity and being-in-itself. The third phase of phenomenology: Jean-Paul Sartre and existential psychoanalysis.

Existentialism and phenomenology are closely linked philosophies. Existentialism preceded phenomenology and is not considered a single philosophy but several schools of thought, both theist and atheist in thinking, which grew out of a reaction to traditional philosophy. The development of phenomenology is divided into three separate phases ultimately merging with existentialism. Following Second World War, the phenomenological movement gained momentum in France and encompassed many of the ideas of Edmund Husserl and Martin Heidegger. Gabriel Marcel, Maurice Merlieu-Ponty and, notably, Jean-Paul Sartre established a 'third phase' of phenomenology. This paper explores some of Sartre's ideas related to being and later applications through Medard Boss and R.D. Laing, and offers a short illustrative case vignette that shows the concepts as they might apply to nursing practice. Consideration is finally given to existential psychoanalysis as an applied research methodology

Existentialism↗
PubMed1988

Psychoanalysis and the acquisition of knowledge.

From the myth of Prometheus to the trial of Galileo, history and literature are replete with examples of the clash between institutionally-bound power structures which exploit ignorance and ignore reality, and those that attempt to develop some movement towards scientific and personal truth. Within society as we know it, the genius or messiah figure and the establishment are bound together in an attempt to establish a relationship which can be of constructive relevance to both. The challenge of incorporating new and disruptive, though not necessarily disintegrative thought on the one hand, is contrasted with an uncompromising attack upon those who would lay claim to the previously exclusive rights of the established organisation and the power which accrued from them. Psychoanalysis today is joined in the battle with internal and external prohibitions against the acquisition of knowledge, which may in time point towards the truth of human personality, behaviour and existence.

Freudian Theory↗
PubMed1996

Anna Freud. A historical look at her theory and technique of child psychoanalysis.

This paper traces historically the development of Anna Freud's thinking about the theory and technique of child psychoanalysis. Representing more than fifty years of work, her ideas were refined and many were altered, influenced by naturalistic and clinical observations and her developmental viewpoint. The paper begins with her 1926 Introductory Lectures, which contain both her early views about the technique used with children as compared to adults and the origins of many of her later ideas. It follows her theories up through her final papers, published in the late 1970s.

Adolescent↗
PubMed2005

Recollections of being in child psychoanalysis: a qualitative study of a long-term follow-up project.

To date there has been very little research looking at how former child analytic patients have made sense of the experience of being in psychoanalytic treatment as children. Based on semi-structured interviews with twenty-seven people who, as children, had been in intensive psychoanalysis at the Anna Freud Centre, London, between 1952 and 1980, this study uses a qualitative methodology to explore two central themes: "attitudes toward being in therapy" and "memories of therapy and the therapist". This report presents the findings of the study in narrative form, and argues that the recollections of former child analytic patients are an important, but under-used, source of knowledge for an understanding of the psychoanalytic process.

Adolescent↗
PubMed1996

Paradigm and ideology in psychiatric history writing: the case of psychoanalysis.

The influence that paradigms may exert on scientific research programs is well established. The effect of organizing cognitive models on the writing of disciplinary histories, however, is less familiar although equally decisive. This essay explores the effects of ideological and paradigmatic factors on the construction of historical accounts of psychological medicine. Particular attention is paid to the scholarly case study of psychoanalysis, which for half a century determined the theories, themes, and figures discussed in psychiatric historiography, as well as the interpretations of these subjects. The author observes similar examples of the paradigmatic structuring of psychiatric history writing before and after the psychoanalytic era and speculates on whether it will ever be possible for psychiatry to achieve a single, stable, and consensual historical narrative about itself.

Austria↗
PubMed1983

Paediatrics and psychoanalysis--Miss Anna Freud.

Miss Anna Freud died during the winter at the age of 86. She had been a pioneer in the understanding of children through psychoanalysis and a great champion of the rights of children. Her life began in Vienna as the youngest child of Sigmund Freud, and her early work with children was in Austria. In 1938, because of the Nazi régime and even though she was nursing her father during his terminal illness, she had to escape with him to London. Her work with homeless children and with those in residential nurseries in London during the second world war is well known, as is her work on child development and psychopathology in the postwar years. But one less well known aspect of her life that was of immense importance to a few fortunate British paediatricians was the 'paediatric group' that she ran for over a quarter of a century and which Dr Christine Cooper recalled at the memorial meeting in London earlier this year.

History, 20th Century↗
PubMed1986

Psychoanalysis and analytic psychotherapy in the NHS--a problem for medical ethics.

I question the place of psychoanalysis and psychoanalytically oriented psychotherapy in the National Health Service (NHS), with reference to published material; and, particularly, in relation to primary care, health economics and medical ethics. I argue that there are pressing clinical, research, economic, and ethical reasons in support of the contention that an urgent review of the extent and impact of psychoanalytic practices in the health service is called for.

Ethics, Professional↗