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The future of analysis.
The aim of analysis is to enable our patients to differentiate themselves from their past. The question we face as analysts is whether we are in fact neurotically bound to repeat the past. This paper addresses this question by considering some of the reasons that there is a 'crisis in analysis'. Two central problems within the practice of analysis are identified as contributing to this 'crisis': 1) a view of the patient as 'enemy', or as innately destructive; and 2) a trend towards here-and-now interpretations within the transference which disregards history and the role of external reality. The danger of such an approach is that it does not allow patients to separate from their hateful primal scenes and to become free of neurotic guilt. When we are anxious about our own destructiveness and aggression and do not link this to a failure to form a loving relation, we run the risk of fostering compliance and conformity within our patients and within our own professional societies. In contrast, it is the recognition of the past and its influence on the present that makes analysis a tool for revolution.
Is transference the 'total situation'?
This paper examines through the detailed explication of analytic material the author's experience of a psychoanalytic and a Jungian way of understanding the interactions between him and his patient. This comparative approach considers where the differences lie with respect to timing and content of interpretations and where the differences are essentially tactical rather than theoretical.
Too much knife, not enough handle. A reply to von Raffay's critical attack on the anima concept.
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Bodily states of anxiety: the movement from somatic states to thought.
My paper attempts to stimulate thought about the relationship between physical and mental 'states of anxiety' by looking at some experiences in the consulting room, particularly at those moments when shifts from predominantly somatic to predominantly psychic forms of representation appeared to be taking place. These experiences are considered in conjunction with some of the ideas of Jung, Fordham, Bion, Winnicott, Meltzer and others relevant to the body-mind question. I conclude with some imaginative speculations.
Sandplay in Jungian analysis: matter and symbolic integration.
Jung described a way of thinking, tied to sensations and feelings, that is a thought connected to the body. Again in The Archetypes and the Collective Unconscious, Jung (1954) speaks of the symbol as a 'live body', corpus et anima. If the mind cannot credit itself with the discomfort that manifests through the body, this is a sign of a separation between mind and body. A consequence of all this is the literalization of the discomfort which makes it impossible to have a symbolic dimension. Therapy activates a process in which the patient can move from a stage of separation to a possible connection between mind and body, resulting in changes in the level of communication and of awareness. The mind opens itself to symbolization and the body becomes a field for a common language. From our reflections we have come to ascertain that we can speak of analysis only when an imaginary space is achieved, an intermediate space between the patient and the analyst, a space that is created from the intertwining of the symbolic capability of the patient with that of the analyst. Focusing our attention on the use of sandplay in analytic therapy, we know that one puts in the sand box objects that are marks of our psyche, visible traits that contain actions, corporeal movements and feelings. When one focuses on the overall representation built, one can go beyond the literal image and the analyst, keeping alive the image through his symbolic capability, opens the possibility of a dialogue with the symbolic dimension. The imagination as a symbolic thought is the humus that allows the analyst to maintain the intermediate symbolic level open by activating a symbolic process within the dialectic of the analysis.
A Spinozan lens onto the confusions of borderline relations.
In this paper the author describes how, in his analytic work with difficult personality disorders, he uses a neo-Spinozan position or attitude of alpha-thinking and functioning to understand, clarify, and so to manage confused and confusing psychosomatic 'body-mind' and emotional relations, both internally and inter-personally. Two case examples are given, followed by reflections on technique and on the limits of mourning, transformation and irony. The author suggests that a private, ideational double-aspect, mind-body position may be helpful in working with these analysands. This analytic mode may create a radically different understanding by incorporating a relational system of containment, self-containment, observation and memory. In addition, the author gives his own version of the aetiology and dynamics of borderline states and relations, and weaves the two cases he reports on into reflections on his countertransferential responses, reactions, inter-actions and 'reverie' through the lens of a neo-Spinozan conceptual system.
Psychotherapeutic approaches in the treatment of mental illness and behavioural disorders in mentally retarded people: the significance of a psychoanalytic perspective.
As a result of the increasing preoccupation with pre-oedipal disturbances, psychoanalytic theory has had to expand its basis. Through this new interpretation, better possibilities for the explanation and treatment of the various forms of psychopathology associated with mental retardation emerge. In this connection, the notion of a 'persisting developmental deficit' plays an important role based on ego-psychology which includes object-relation theory and psychoanalytic developmental psychology. Four specific issues illustrate the significance of a psychoanalytically orientated approach, namely: (I) the transformation of organic brain deficits into mental disorders; (2) 'secondary psychosocial deficit'; (3) the significance of the therapeutic relationship; and (4) re-enactments as expression of a pathological identity.
Promoting psychiatric student nurse well-being.
Although students are often attracted to the profession of psychiatric nursing, they are rarely prepared for the realities associated with clinical seminars and direct clinical practice. Subsequently, student nurses commonly report the resurgence of painful life events or symptoms of psychological injury when learning about or witnessing patient behaviour. This paper underlines the importance of student-faculty collaboration when promoting and monitoring student nurse well-being. Along with providing descriptions and case vignettes depicting two specific forms of psychological injury, this paper suggests practical steps that are designed to promote student nurse well-being.
Confusion and the search for identity.
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Technique and counter-transference.
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Transference-counter-transference: talion law and gratitude.
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Counter-transference, anxiety and change.
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The interrelation between patient and therapist.
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Comment on 'the therapist-patient relationship'.
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Notes on manipulation, activity and handling.
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