bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinism, Possibility, and Ethics
Authors: Wallace Edwin R.
Published: June 2009

This essay reexamines the age-old “determinism-free will” problem from a psychoanalytic perspective. The first section recapitulates the author's (1985) earlier argument on the nature of causation in psychoanalysis; the second part examines the compatibility of determinism and freedom; and the final section looks at the ethical ramifications of the issues at hand. The author exposits his adherence to universal determinism and attempts to answer the question, “What sort of possibility and ethics are permitted in a deterministic universe?”
The Place and Value of Bestophilia in Perversions
Authors: Traub-Werner Daniel
Published: June 2009

An attempt is made to place bestophilia in cultural, clinical, and theoretical perspective. Archeological and anthropological documentation and records of the widespread appearance in mythology of this practice are cited. This archaic form of perversion is still practiced in rural environments and isolated communities. The treatment of a man who grew up in such an environment gave the author the opportunity to study this form of perversion. The correlation of clinical findings with culturally sanctioned bestophilia provides a bridge between the understanding of psychopatnology and anthropological variation.
The Development of time Sense: From Object Constancy to Adolescence
Authors: Colarusso Calvin A.
Published: June 2009

A developmental line of time sense during the oedipal phase and latency is described. Subjective lime sense is seen as constantly evolving, shaped by the emergence of cognitive capacities, significant emotional themes, and environmental influences. Temporal development during these phases is unique because the capacity to tell objective time is present for the first time. Significant emotional influences are the Oedipus complex, infantile neurosis, and superego formation. The concepts of Mother Time and Father Time are presented as useful descriptors of the child's intrapsychic representation of the chief environmental effectors of temporal organization. Clinical examples demonstrate that the development of time sense can be unaffected, impeded, or incorporated into psychopathology.
Transference Neurosis as A Waking Dream: Notes on A Clinical Enigma
Authors: Kern James W.
Published: June 2009

This paper demonstrates clinically that the interactional features of a transference neurosis are the waking equivalents of a manifest dream. Through analytic investigation of the emerging repetitive extraverbal elements of apparent transference resistance behavior, it is discovered that the systematic analysis of the details of such behavior yields a picture of synthetic construction fundamentally the same as that seen in dreams. By using Freud's technique of systematic dream interpretation, the tightly organized, coded, and camouflaged presence of many key compromise formations determining a neurosis are found to be represented in compact, highly condensed clinical interactions, providing an overall picture of dreamwork in action. The four components of dreamwork are found to be the principal means by which the unconscious genetic and dynamic material is represented in the analytic field.
The Role of Reality Testing in Psychoanalysis: Followup of 22 Cases
Authors: Kantrowitz Judy L. , Katz Ann L. , Paolitto Frank , Sashin Jerome , Solomon Leonard
Published: June 2009

As part of a prospective, longitudinal study of psychoanalytic outcome, 22 patients were evaluated for changes in their level of reality testing. These patients had been accepted for supervised psychoanalysis with candidates in training by senior analysts who had diagnosed them as neurotic. Psychological tests given prior to the beginning of analysis indicated, however, that more than one third of our sample demonstrated serious distortions in their perceptions of reality. When psychological tests administered one year after the completion of analysis were compared with these pretreatment tests, no significant improvement was found in the level of reality testing for the group as a whole. However, when excluding two patients who had suffered major traumas in the year following psychoanalysis, significant improvement in reality testing was found for the remaining 20 patients. Post-treatment interviews with the treating analysts revealed that in the course of analysis itself, approximately one third of these patients showed some disturbance in reality testing; only three of these patients showed significant improvement in the level of their reality testing during treatment. These findings suggest that while patients may not present clinically with evidence of impaired reality testing, such evidence may be available in psychological testing, and may become apparent in the course of the treatment.
Implications for the Structural Model of Freud's Assumptions about Perception
Authors: Slap Joseph W.
Published: June 2009

Freud made assumptions about perception that strongly influenced his final model of the mind, the structural model. Two of these assumptions, (1) that perception is exclusively a function of the ego and (2) that perception is an accurate, veridical representation of external reality, are questioned on the basis of clinical findings and current conceptualizations. Changes are suggested, namely, that we grant that the repressed has a capacity for perception and recognize that perception is not an inherent ability for exact, photographic registration of the external world, but that it is a function of the mind mediated through external receptors and the central nervous system. Perception is dependent on mental organizations (schemas) which are affected by past experience, psychodynamics, affective states, and cognitive style. These changes produce a version of the structural model which is congruent with a schema model previously advanced as a competing model. It is argued that this version of the structural model has significant clinical and theoretical advantages over previous models.
Illness in the Doctor: Implications for the Psychoanalytic Process
Authors: Schwartz Harvey J.
Published: June 2009

The meaning and impact of serious illness in the therapist is described as it affects the doctor's intrapsychic analytic space, the analyzing field, and the fantasy life of patients. The brief literature on this topic is reviewed with particular reference to what patients should be told about one's illness. The author's experience of serious illness is described as it related to his reaction to his work with patients. Patient material is presented that demonstrates the utility of an abstinent stance even when encountering real and disturbing events. Freud's experience with long-term disability is recalled and the special circumstances posed by major illness for the analytic relationship are discussed. The unparalleled experience provided the patient by one's delicate neutrality at such times reveals to him the true depth of unconscious fantasy and its lasting influence on adult functioning.
Idealization of the Analyst by the Young Adult
Authors: Chused Judith Fingert
Published: June 2009

Idealization is an intrapsychic process that serves many functions. In addition to its use defensively and for gratification of libidinal and aggressive drive derivatives, it can contribute to developmental progression, particularly during late adolescence and young adulthood. During an analysis, it is important to recognize all the determinants of idealization, including those related to the reworking of developmental conflicts. If an analyst understands idealization solely as a manifestation of pathology, he may interfere with his patient's use of it for the development of autonomous functioning.
Psychoanalytic Observations on the Effect of Lithium on Manic Attacks
Authors: Loeb Felix F. , Loeb Loretta R.
Published: June 2009

This paper describes a predictable relation between our manic-depressive patients' blood lithium levels and particular changes in their conscious and unconscious mental processes (i.e., their thoughts, wishes, fantasies, inclinations, and feelings). These changes were, in turn, predictively related to specific changes in these patients' overt manic symptomatology. Because each of our patients' manic episodes was heralded by a marked increase in unconscious or conscious phallic sexual thoughts, feelings, and behaviors, and because this increase preceded any observed deterioration in ego or superego functioning, we hypothesize that a primary increase in our patients' phallic instinctual drives secondarily overwhelmed the capacity of their egos to defend against these drives, and that this, in turn, resulted in the development of our patients' overt manic symptoms. Psychoanalysis (or psychoanalytically oriented psychotherapy) made our patients consciously aware both of their previously unconscious phallic sexual thoughts and impulses, and of their defenses against them. This new awareness enabled our patients to recognize when their, now conscious, phallic sexual impulses and thoughts became inappropriately intensified; and this, in turn, permitted them to avoid overt manic episodes by counteracting these inappropriate inclinations with increased doses of lithium.
Fact and Fantasy in the Seduction Theory: A Historical Review
Authors: Schimek Jean G.
Published: June 2009

This article surveys Freud's various versions of the seduction theory, from 1896 to 1933. It is concluded that the seduction theory had never been based on the patients' direct statements and conscious recall of seduction by the father in early childhood—unlike what Freud was to stale much later (1933). This early seduction was mostly reconstructed by Freud from the patient's verbal material and behavior in treatment (including memories of sexual experiences from later childhood) which he interpreted as disguised and incomplete “reproductions” and reenactments of the original seduction trauma. Further, the external trauma urns never meant to account by itself for the later neurotic symptoms. The “delayed action” of its unconscious memory, producing the repression of an event from the lime of puberty, was a necessary part of the process. Thus internal psychic transformations and conflicts, anticipating Freud's later emphasis on fantasy and psychic reality, were already an intrinsic part of the seduction etiology of 1896. It is also noted that the father played no central role in the original theory as presented in 1896. It is only in the letters to Fliess that the father emerged us the prime seducer. The implications of this clarification of the seduction theory for the understanding of the changes and continuity in the development of Freud's theories are highlighted; their relevance to ongoing issues in psychoanalysis about the role of external trauma, fantasy, and reconstruction are briefly examined.
René Magritte: Coping with Loss—Reality and Illusion
Authors: Viederman Milton
Published: June 2009

René Magritte was profoundly influenced in his painterly style and in the content of many of his paintings by his mother's suicide when he was fourteen. This paper explores the influence of this traumatic event on his work. My thesis is that the nighttime suicide of Magritte's mother by drowning: (1) had a profound impact on the form and style of his paintings; (2) his paintings represented an effort, mostly successful, to contain and master through intellectual control with isolation of affect the trauma of this experience, which must at the time have evoked helplessness and despair; (3) the contents of a series of his paintings directly reconstruct the traumatic experience under control and in the service of mastery; and (4) there are paintings, mostly painted at the time he clearly developed his own style (1926-1930), that reveal a breakthrough of projected primitive aggressive impulses and unconscious representations of the aggressive mother. In these latter paintings, both form and content are dramatically different from the main corpus of Magritte's work.
Use of Audiotape Recording in Impasses With Severely Disturbed Patients
Authors: Robbins Michael
Published: June 2009

The psychoanalytically oriented treatment of patients with severe personality disorders is characterized by impasses and by efforts to resolve them. Patient audiotape recording and review of sessions can be a particularly useful technical parameter in such situations. When judiciously employed, it is unusual, if not unique, in that it selectively amplifies the power of traditional elements of technique as well as some of the constructive elements of the analytic process itself, while reducing the power of some of the destructive elements of the transference. Indications for using this parameter are discussed, case illustrations presented, and hypotheses advanced about its mode of action. No single element of technique is responsible for the success or failure of analysis. The most that can be expected of tape recording is that it help break up the treatment logjam and facilitate further work.
On Working Through: A Model from Artificial Intelligence
Authors: Galatzer-Levy Robert M.
Published: June 2009

Working through is centrally important to clinical psychoanalysis. It is inadequately explained in analytic theory. An artificial intelligence model of the process is proposed. Models of problem solving show that the complexity of necessary computation is an important determinant of how a problem is solved. Not optimal, but only good enough solutions are usually found. The quality of solutions depends on the time and resources available. Generally it is far easier to use existing methods than to develop new approaches. When problems must be solved in an emergency fashion, as in trauma, poor solutions are likely to emerge. In studying the annealing of metals and other complex optimization problems, a process, the Boltzman algorithm, was discovered, which continues the search for better solutions while gradually developing a coherent structure of the overall solution. The algorithm provides a model both for psychoanalytic working through and for the normally ongoing process of psychological development and reworking whose deficiency is characteristic of much psychopathology. Working through in the analytic situation is the reactivation of this normal process, and a good analytic outcome is achieved when the process can continue without the analyst. Properties of the Boltzman algorithm clarify such concepts as “optimal” frustration and anxiety which correspond to working in the area where the stable but not rigid structures emerge in the algorithms operation. These studies are an example of how computer science and artificial intelligence area potentially rich source for psychoanalytic theory.
Transparent Screens
Authors: Rosenthal Richard J.
Published: June 2009

There is a kind of transitional phenomenon found among certain borderline patients which is quite distinct from Winnicottapos;s transitional object. These are patients who are preoccupied with maintaining proper physical distance from their objects, in order to regulate anxieties about isolation on the one hand, and identity-annihilating closeness on the other. Since they believe the activity of looking to be intrusive and devouring, hence dangerous, transparent screens are interposed between self and other, and serve as protective barriers. These screens function intrapsychically as well, to split off or hide those aspects of the self felt to be unacceptable.

The analyst may witness the failure of the screen in several ways: it may create too great a distance, isolating the individual and keeping him from life; it may become contaminated by projections and turn into a persecutor, or trap the individual, a state of intolerable claustrophobia; most dramatically, it may suddenly shatter. The latter is associated with psychosis and death, and its appearance may be a harbinger of suicide.
A Case of Hysteria, With a Note on Biology
Authors: Meyer Jon K.
Published: June 2009

Psychoanalysis recently has shown interest in the data of neurobiology. This interest has been fostered by the realization that a model of Cartesian mind-body dualism is inadequate to current observation and knowledge. Despite the theoretical appeal of integrating knowledge from the two fields, there have been few attempts at correlation in specific clinical situations. This paper presents a case of hysteria in which the physical manifestations of hyperprolactinemia, galactorrhea, amenorrhea, and infertility are considered in relation to both the brain regulation of prolactin and to unconscious fantasy, motivation, and conflict. Some of the intriguing possibilities and limitations of research at the frontier of psychoanalysis and neurophysiology are discussed.
Conceptualizing Adult Development
Authors: Settlage Calvin F. , Curtis John , Lozoff Marjorie , Lozoff Milton , Silberschatz George , Simburg Earl J.
Published: June 2009

On the premise that human development is a lifelong process, and with awareness of certain limitations of the stage model, the authors conceptualize a new model based on developmental process. This model is offered as a basic model for the development of mental functions and structures in both childhood and adulthood.
Writing About Psychoanalysis: II. Analysts Who Write, Patients Who Read
Authors: Stein Martin H.
Published: June 2009

When we make a decision to lecture, or to write for publication, we have begun an activity that will affect every one of our patients. If they attend our lectures, or read our published works, they cannot help being influenced. Even if they do not, they will have some reaction to the focusing of our interest on particular phases of the analysis. This will be true whether or not we intend to present clinical material. These considerations inevitably affect the analyst himself, sometimes inhibiting his writing altogether, sometimes constricting its scope, or worst of all, degrading its quality. The analysts writing is also almost certain to influence whether and with what success his patient may choose to write.

Lest these considerations suggest that we avoid writing altogether, I emphasize that such a sacrifice is by no means desirable or necessary. Problems of discretion will arise, and may in some cases be virtually insoluble; but there are ways of writing that can overcome most such objections. The analysts interest in writing should be recognized and its effects, if any, brought into the analysis; so long as the writing itself is done with due regard to the conduct of the analysis and the welfare of the patient, it need have no adverse effects on either.
Psychoanalysis and the Hermeneutic Turn: A Critique of Narrative Truth and Historical Truth
Authors: Sass Louis A. , Woolfolk Robert L.
Published: June 2009

Through a discussion of Donald Spenceapos;s Narrative Truth and Historical Truth, a critical introduction to the hermeneutic or interpretive perspective is presented. Spenceapos;s book has generally been assumed to offer a hermeneutic reformulation of psychoanalysis. However, its presuppositions are incompatible with fundamental tenets of contemporary hermeneutic thought, as expressed in the philosophies of Heidegger, Gadamer, and the later Wittgenstein.

Spenceapos;s basic assumptions are classically empiricist and positivistic. His vision of human experience is essentially associationistic and Humean; it treats experience as involving two processes, the passive reception of raw sense data and a subsequent projection of meaningful interpretation. Spence advocates the gathering of brute data while denying or downplaying the epistemological value of theorizing and of interpretive understandings. These assumptions are contrasted with those of the hemeneutic philosophers. Unlike these philosophers, Spence lends to dichotomize coherence and correspondence theories of truth. As a result, he wavers between relativism (regarding therapeutic interpretations) and objectivism (regarding scientific knowledge).
Concurrent Individual and Individual-In-A-Group Psychoanalytic Psychotherapy
Authors: Schachter Joseph
Published: June 2009

This paperapos;s thesis is that concurrent individual-in-a-group and individual psychoanalytic psychotherapy can be conducted in conformance with psychoanalytic principles of treatment as well as can individual psychoanalytic psychotherapy alone. American psychoanalysts have shown little interest in group psychotherapy, probably because of earlier criticism that transference is diluted by the greater reality of the therapist in group psychotherapy. This is a misconception extrapolated from the mirror model of dyadic analytic technique. The criticism was formulated during a period when that model was prominent and there was little awareness that the actual personal relationship between patient and analyst played an important facilitating role in the dyadic analytic process, including providing a basis for investiture of transference. Also, the criticism was based on one-session-per-week group psychotherapy, whereas concurrent individual-in-a-group and individual psychoanalytic psychotherapy utilizes two group sessions plus one or two individual sessions per week, enabling a more intensive patient-therapist relationship. Concurrent group and individual psychoanalytic psychotherapy constitutes a contribution to the widening scope of application of psychoanalytic treatment.
The Four Psychologies of Psychoanalysis and Their Place in Clinical Work
Authors: Pine Fred
Published: June 2009

Clinical psychoanalysis has led to the development of four conceptually separable perspectives on the functioning of the human mind. These are referred to herein as the psychologies of drive, ego, object relations, and self. Their clinical relevance is explored by applying them to issues regarding evenly hovering attention and the mutative factors in psychoanalysis. Those two areas, in turn, are seen to undergo an expansion when viewed from the perspective of each of the four psychologies.
The Adaptive Significance of Destructiveness in Primitive Personalities
Authors: Robbins Michael
Published: June 2009

Destructiveness in primitive personalities is not restricted to a segment of the person as it is in the case of neurotics, but is global and pervasive. This destructiveness is meaningfully configured in a manner which cannot fully be accounted for by constitutional factors or be comprehended from the individual, intrapsychic, conflictual viewpoint of classical psychoanalysis. It follows an interpersonally meaningful pattern and therefore has adaptive significance in the contemporary life of the individual. The adaptive model I propose does not violate essential canons of psychoanalytic theory, for it can simultaneously be conceptualized in terms of intrapsychic structure and dynamics. This model holds out the possibility for a therapeutic approach to primitive personality organization which differs in some but by no means all respects from classical analysis.
Freud's Three Theories of Love in the Light of Later Developments
Authors: Bergmann Martin S.
Published: June 2009

Evidence is presented that Freud developed three very different theories on love. These theories were not integrated into a coherent theory. In subsequent developments each theory had its own history. The paper discusses the history of the controversy on the genital character, the relation between love and gender identity, between love and narcissism, the hierarchical structure of the capacity to love, and the relation between love and object loss. The impact of some concepts such as symbiosis and the rapprochement subphase on the understanding of conflicts in loving is raised. While at present differences hi emphasis make it difficult to build a coherent psychoanalytic theory of love, it is productive to bring divergent views in touch with each other. A unified theory of love based on psychoanalytic observations is suggested.
Patient's Sleep on the Analytic Couch
Authors: Inderbitzin Lawrence B.
Published: June 2009

Published reports about sleep on the couch have primarily emphasized its preoedipal (especially oral) determinants and defensive purposes. A detailed case is presented in which sleep became the central symptom of the transference neurosis. The primary determinants of the symptom were from the phallic-oedipal stage of development. Like other symptoms, the sleep symptom was a reliving of earlier experiences and was analyzed primarily through the transference. The analytic data from the case are used to illustrate resistance as an ally in the psychoanalytic process.
Some Sources for a Slip in a Translation by Freud
Authors: Grossman William I.
Published: June 2009

Among Freud's papers, we find instances in which Freud describes the "psychopalhology of everyday life" as he found it in himself and in others. "A Religious Experience" (Freud, 1928) contains examples of both kinds. In addition, this paper contains a slip of which Freud appears to have been unaware. Freud's paper interprets a religious conversion described in a letter written to him in English. In the translation of this letter into German, Freud inserted material that was not present in the original. He mentions another slip he made in speaking about the letter. These slips and some associated details in the paper indicate persisting unconscious conflict. The content of these slips and detail points to an association with Freud's childhood anxiety dream reported in The Interpretation of Dreams (Freud, 1900). Freud's associations and discussion of that dream lead to the Philippson Bible of his childhood, which provides additional connections to the paper of 1928.
The Contribution of Ego Psychology to Understanding the Process of Termination in Psychoanalysis and Psychotherapy
Authors: Blanck Gertrude , Blanck Rubin
Published: June 2009

Ego psychology is presented as an integrated psychoanalytic developmental theory, including a theory of object relations. The process of termination is employed as one of the many possible illustrations of the usefulness of this theory. Termination is regarded as a process that pervades the treatment from the outset, rather than as the final phase of treatment only, because the treatment process, whether psychoanalysis or psychotherapy, includes continuous promotion of ever-increasing autonomy. Ideally, by the time termination proper takes place, maximum autonomy has been attained. To the definition of autonomy as intersystemic, involving relative independence of the ego from the drives (and from the superego), an object-relations dimension is added which extends that definition to include an intrasystemic consideration—namely, relative independence of the self-representation from the object representations. Especially in the treatment of the borderline conditions is the intrasystemic factor cogent because borderline states are characterized by varying degrees of incompletely differentiated self- and object representations. The objective, in the psychoanalysis of neurosis, where self- and object constancy already exist to a large degree, is ego autonomy in the intersystemic sense. In the psychotherapy of the borderline conditions, the objective is greater differentiation of the self-representation from the object representations.
The Current Status of Psychoanalysis in Medical Student Education in the United States: A Preliminary Overview
Authors: Asch Stuart S. , Marcus Eric R.
Published: June 2009

With the aim of evaluating psychoanalytic teaching in premedical curricula, a survey was made of the psychiatric readings used in a sampling of 12 United States medical colleges. Eighteen of the main psychiatric texts recommended by the schools are reviewed as one way of evaluating psychoanalytic course content. In addition, the authors present an overview of the problems that confront the teaching of psychoanalytic concepts in medical education. Specific constructive suggestions are offered.
Negativism and Countertransference
Authors: Levy Steven T. , Inderbitzin Lawrence B.
Published: June 2009

The purpose of this work is to explore the phenomenon of negativism and the analyst's response to it during the course of analytic work with a patient in whom negativism is a central behavioral pattern. Melville's short story, "Bartleby the Scrivener," describing in telling detail the response of a sympathetic lawyer to profound and pervasive negativism in his legal scribe, is discussed as a literary analogy to the analyst-analysand dyad. Aspects of the concept of negativism within psychoanalysis are discussed. The potential usefulness of understanding certain unexpected countertransference responses to pervasive negativism is explored, as this is a relatively neglected area of psychoanalytic technique. A case is presented describing the analysis of a patient whose character, like Bartleby's, is a mixture of profound negativism along with schizoid, obsessional, and masochistic elements.
How Dreams Are Told: Secondary Revision—The Critic, The Editor, and The Plagiarist
Authors: Stein Martin H.
Published: June 2009

Secondary revision is a highly provocative concept arising out of Freud's attempts to explain the construction of dreams, but it remains relatively ill-defined. It includes three related, yet by no means identical aspects of the process by which the dream acquires its more or less final form during the experiencing, the remembering, and the telling. It represents one of the most interesting hypotheses dealing with the fluid world between sleeping and waking, a field which still presents us with a host of unanswered questions.

Secondary revision not only reflects the higher levels of the dreamer's mental functioning superimposed on his biological substructure, but it also operates as a sensitive indicator of the cultural factors which have helped mold his personality. These factors include both the subculture of the analytic situation and the impact of society in the larger sense. I make reference to individual dreamers in analysis and to the world of dreams recorded in the past from our own and other cultures.
Pains and Gains: A Study of Forced Terminations
Authors: Martinez Diane
Published: June 2009

The forced termination of psychoanalysis, such as occurs when the analyst makes a geographic move, uniquely disrupts the analytic setting. This paper recounts the author's experience of terminating a full-time private practice of psychoanalysis and psychoanalytic therapy for such a move. The limited literature on the subject is reviewed with a focus on the use of technical variation in the forced termination situation. The author delineates three areas of interaction with patients where technical variation proved in her experience to be of value: dealing with countertransference and counter-reaction, providing information about the move, and the consideration and process of referral for continued therapy. As opposed to what would be predicted from a classical psychoanalytic perspective, the use of such technical maneuvers seemed to facilitate rather than impede analytic work. These variations in technique served at crucial times to maintain the analytic alliance, to preserve the patient's capacity to recognize and make use of transference, and to provide avenues for resolving past traumas in the transference and the actual loss of the analyst. The concept of the analyst as a new or useable object is proposed as providing a theoretical framework for understanding these observations.
The Traumatic Element in the Typical Dream of Feeling Embarrassed at Being Naked
Authors: Myers Wayne A.
Published: June 2009

Material is presented from three cases, where analysis of repetitive dreams of feeling embarrassment at being partially or totally naked was an important feature of the treatment. The indifference by the other people in the dream to the dreamer's nakedness was initially linked to perceived transference slights at the hands of the analyst, and later to repeated episodes of actually being treated indifferently at the hands of the parents. This indifference was related to latency or adolescent attempts by the patients to gain love or attention from the parents by exhibitionistic means.

The stereotypical presentation of the manifest content of these dreams is seen as evidence for their underlying traumatic roots. Such dreams are likened to the typical examination dreams described by Freud, which have also been noted by others to have traumatic roots. This finding is consistent with my own work with certain repetitive manifest dream configurations and with Freud's (1920) reevaluation of his theory of dreams in Beyond the Pleasure Principle, wherein he noted that dreams of patients suffering from traumatic neurosis often manifestly repeated the traumatic situation in an attempt to master it retrospectively.
Psychoanalysis and General Psychiatry: Obsessive-Compulsive Disorder as Paradigm
Authors: Esman Aaron H.
Published: June 2009

To certain areas once dominated by psychoanalytic conceptualizations of psychopathology and pathogenesis, general psychiatry has in recent years made significant contributions. The obsessive-compulsive disorder is cited as an example, and illustrations of such contributions are described and discussed. Some implications for psychoanalytic theory and research are suggested.
Understanding Negative Hallucination: Toward a Developmental Classification of Disturbances in Reality Awareness
Authors: Brakel Linda A. Wimer
Published: June 2009

Negative hallucinations are explored from a psychodynamic viewpoint in four cases of neurosis. Next, shifting to the level of clinical theory, negative hallucinations are contrasted with five better-studied disturbances in reality awareness. It is noted that all six function as screen phenomena, and all occur in everyday contexts. These and other phenomenological issues lead to an assertion that negative hallucinations are regressive perceptual phenomena, similar inform to both preconscious perceptions and infantile amnesia. Finally, developmental considerations are used to derive a coherent hierarchy of disturbances in reality awareness.
Fetishism in a Woman
Authors: Raphling David L.
Published: June 2009

Fetishism is generally considered to be a perversion occurring only in males. In this paper a clinical illustration of an adult woman with a fetishistic perversion is offered and considered within the context of the classic concept of fetishism originally described by Freud. Similarities and differences between male and female fetishism are discussed, with attention given to the greater complexity of the perversion as it occurs in a woman. The clinical example confirms the existence of fetishism in women and suggests that subtle forms of the perversion may go unnoticed and be more prevalent than previously realized.
The Questions and Curiosity of the Psychoanalyst
Authors: Boesky Dale
Published: June 2009

Questions the analyst asks of the patient are a powerful but neglected aspect of the theory of psychoanalytic technique. Their importance resides in their dynamic impact on the psychic equilibrium of the patient because of their ability to destabilize existing compromise formations. A clinical vignette illustrates the view that the linguistic shift from other modes of discourse to the spoken question heralds a less visible parallel shift in the psychic equilibrium of either the psychoanalyst or patient. There is no more and no less complexity to questions than to any other communication by either analyst or patient. For that reason there can be no systematic classification of questions in the clinical psychoanalytic situation, just as there can be no definitive taxonomy of psychoanalytic discourse. It makes no sense to reduce the enormous diversity and range of all the questions the analyst asks to the simple dichotomy of good or bad for the analysis. Questions are the emblem of the analyst's mode of inquiry; they can further the development of self-observation, which is such an important concomitant, cause, and consequence of structural change.
Changing Psychic Structure Through Treatment: Criteria for Change
Authors: Olinick Stanley L.
Published: June 2009

The author outlines his clinical observations during the “middle game” of psychoanalysis, leading to recognition that structural change is taking place. “Middle game,” “structure,” process, and content are defined and critically discussed. Illustrative clinical vignettes are offered. The presentation emphasizes the importance of an active and resolving transference “struggle”; in addition, more traditionally noted criteria are briefly touched on, e.g., development of observing ego and treatment alliance, changes in dream function and communication, and the reviewing of the neurosis and transference during the termination phase as instances of mourning and working through. The concept of optimal psycho-biological function in the service of a homeostatic principle is discussed.
Negative Oedipal Transference of a Male Patient to His Female Analyst During the Termination Phase
Authors: Chertoff Judith M.
Published: June 2009

There has been some debate in the literature concerning the ability of the male patient to experience his paternal, and particularly negative oedipal, transference feelings directly toward his female analyst. In this context, the author describes paternal transference manifestations evident throughout her male patient' analysis, and presents detailed process material from the termination phase. At this time the patient' obsessional neurosis was revived in the context of setting a termination date, and transference to the negative oedipal father could be clearly demonstrated. The paper illustrates that even the negative oedipal component of the paternal transference can be experienced directly in the male patient/female analyst dyad, and interpretation of this material can bring it into clearer focus. The author discusses some possible influences of her sex on the timing and intensity of the material.
Dream Frequency in Psychoanalysis and Psychoanalytic Psychotherapy
Authors: Myers Wayne A. , Solomon Murray
Published: June 2009

The authors examine data on dream frequency from 50 patients, half of whom were seen in psychoanalysis and half in psychoanalytic psychotherapy. Frequency, defined as the proportion of sessions where at least one dream is related, is analyzed statistically as a function of sex, age, and type of treatment, Also, treatment outcome is examined as a function of sex, type of treatment, diagnosis, and dream frequency. Psychoanalytic patients are found to have higher dream frequency than the patients in the psychotherapy group. Higher average dream frequency is correlated with a better treatment outcome in both patient groups.
Spelunking as a Manifestation of a Counterclaustrophobia
Authors: Myers Wayne A.
Published: June 2009

Material is presented from the case history of a patient whose interest in spelunking (cave exploration) was found to be an unconscious expression of a type of counterclaustrophobia. Both oedipal and preoedipal determinants of the claustrophobic anxieties are delineated. Of particular note in this instance is the testicular element in the genesis of the patient' claustrophobia. His confusion of the movements of his testicles into his inguinal canals during childhood defecation with the movements of the feces themselves lent an especial intensity to his fear of being flushed away from the mother by an expulsive anal birth from the claustrum. Childhood anxiety aroused when his testicles would become trapped in the inguinal canals was an important forerunner of the adult fear of being trapped in confined spaces. A counterphobic element of the spelunking per se was his enjoyment in hanging suspended by a rope in caves. In this manner, he was able to act out (by virtue of his body-testicle equation) his identification with, and control over, the disappearing testicles in the setting of a claustrophilic union with the mother.
Recent Contributions to the Theory of Defense Mechanisms: A Comparative View
Authors: Cooper Steven H.
Published: June 2009

Some of the most recent contributions to the theory of defense mechanisms are critically reviewed including theories of complex motivational properties of the ego (Schafer, 1968; Kris, 1984), a functional theory of defense (Brenner, 1982), an object–representational theory of defense (Kernberg, 1976), a “two–person” theory of defense (Modell, 1984) and a self–psychologically based theory of defense (Kohut, 1984). These recently proposed theories of defense mechanisms utilize differing levels of analytic observation and theoretical discourse. One of the major differences among theorists involves the variety of referents of defense mechanisms (i.e., what is being defended against) including impulse, drive derivative, object loss, or environmental failure. Another fundamental difference involves the variety of ways theorists regard the relation between internal homeostasis and the external world. Questions are raised about the recent tendency in psychoanalytic theory to develop or invoke different theories of defense to explain a broad range of clinical phenomena.
The Patient–Analyst Match and the Outcome of Psychoanalysis: A Pilot Study
Authors: Kantrowitz Judy L. , Katz Ann L. , Greenman Deborah A. , Morris Humphrey , Paolitto Frank , Sashin Jerome , Solomon Leonard
Published: June 2009

This paper presents a pilot study in which we explore the possibility that the match between analyst and analysand is a factor of central importance in the analytic situation. It is an attempt to look at the issue of match across a large number of patients. The data we used were not collected for studying this topic; thus, the study has serious limitations. Nevertheless, certain patterns emerged which support our thesis that patient–analyst match plays a significant role in the outcome of psychoanalysis. We present this work as a first step in developing concepts and methods which will be pursued in a more systematic and rigorous fashion in a later study.
Followup in Psychoanalysis: Clinical and Research Values
Authors: Wallerstein Robert S.
Published: June 2009

Psychoanalysis has never developed a tradition of systematic followup study to evaluate outcome and to improve technique and theory for a variety of reasons, partly theoretical, stemming from the conception of the unfolding transference neurosis and its analytic resolution as the precondition for cure, and partly historical, having to do with the happenstance of its development as a private practice–based discipline and training outside of the academic setting. Freud, however, was never bound by such strictures and published whatever post–treatment data he acquired on all his best–known case histories. But following Freud most analysts, with some notable exceptions, eschewed followup activity as unanalytic. It is this tradition that more recent studies like those of Pfeffer in New York and the Psychotherapy Research Project of The Menninger Foundation in Topeka have squarely challenged. Data are presented from the Menninger project dealing specifically with the impact of routine planned followup on issues of treatment termination and resolution and on the nature of the post–treatment period. The degree and kind of patient cooperation with the followup inquiry, the impact of followup on treatment termination and resolution (both impeding and facilitating), and the role of followup intervention in relation to return to formal post–treatment therapy (or consolidating against it), are all discussed.
Emptiness as Defense in Severe Regressive States
Authors: LaFarge Lucy
Published: June 2009

This paper examines the empty states experienced by severely ill borderline patients. At times of stressful regression, these patients use complaints of emptiness to describe profound disturbances of affect, cognition, object relations, and bodily experience. Empty states may be seen as complex defensive configurations which protect a borderline level of psychic structure from the impact of aggressively charged object relations, and ward off further regression to states of fragmentation or fusion. Severely ill borderline patients consolidate an empty screen by means of a characteristic repertoire of primitive defenses consisting of various forms of projective identification, including bitriangulation and projective identification of psychic agencies, somatization, acting out, and specific alterations in cognition. The author describes the highly deviant organizations of the object world seen in empty states, and the complex and disturbing countertransferences which these states evoke.
The Female Psychoanalyst in the Movies
Authors: Gabbard Glen O. , Gabbard Krin
Published: June 2009

The last five decades of the American cinema have produced a remarkably consistent stereotype of the female analyst. In films such as Spellbound (1945), Knock on Wood (1954), Sex and the Single Girl (1964), They Might Be Giants (1971), and The Man Who Loved Women (1983), women analysts are swept away by countertransference love that leads them to become sexually or romantically involved with their male patients. In stark contrast to the data from studies of patient–therapist sexual involvement, there are more than twice as many films portraying unethical sexual behavior on the part of a female analyst as there are films depicting similar countertransference acting out by a male analyst. Moreover, a stable relationship with a man and a successful analytic practice never coexist for any woman analyst in the cinema. Neither does a female analyst ever successfully treat a male patient in the American cinema unless she falls in love with him. On the contrary, the male patient is more likely to cure his female analyst. Clinical reports from cross–gender analyses are useful in understanding these cinematic myths.
Infantile Sexuality, Gender Identity, and Obstacles to Oedipal Progression
Authors: Tyson Phyllis
Published: June 2009

Contrary to when it was first proposed, infantile sexuality nowadays is accepted as an important part of child development. However, Freud's views on masculine primacy and feminine inferiority are seen to be incomplete and inaccurate not only because they overemphasize sexuality and sexual anatomy, but also because they neglect aggression, object relations, ego and superego functioning, and the sense of self. Infantile sexuality is therefore reconsidered within the broader perspective of gender identity. Within this broader perspective, normal and aberrant sexual development is discussed, and new ideas are offered about familiar concepts such as castration anxiety and penis envy.
Ego Analysis and the Relativity of Defense: Technical Implications of the Structural Theory
Authors: Apfelbaum Bernard , Gill Merton M.
Published: June 2009

We suggest that it is recognition of the relativity of defense, of the fact that the same content can be either defense or wish, rather than recognition of unconscious defense, that distinguishes the structural from the topographic theory. The structural theory did not simply add to the topographic theory the recognition that defense can be unconscious; it represented a radical shift in the concept of defense and of the relation between defense and wish. Accordingly, ego analysis, as the technical approach generated by the structural theory, is not complementary or preliminary to id analysis, the technical approach generated by the topographic theory. We attempt to demonstrate that the two theories represent antagonistic paradigms, both theoretically and technically. We suggest that “defense before drive,” the structural formula for interpretation, made ego syntonicity a crucial determinant in formulating interpretations, and assumed the relativity of defense. Accordingly, the structural revision made possible an equidistant position between defense and wish, reducing reliance on suggestion and establishing interpretive neutrality, which we distinguish from behavioral neutrality.