bluuebunny/crossref_metadata_2025 huggingface dataset:
Group Psychotherapy with the Elderly
Authors: Kapur Raman , Pearce Margaret
Published: June 2007

The paper reviews the literature on psychotherapy with the elderly and points to the lack of therapeutic interventions with this patient population. Transferences, loss and existential issues are reviewed and the paper analyses group processes which can help reconstruct the life of the elderly patient which has been thrown into chaos as a result of the ageing process. The paper encourages clinicians to be more sensitive to the psychological needs of the elderly and provide appropriate therapeutic interventions to meet these needs.
Jeffrey Masson and the Assault on Freud
Authors: Skues Richard
Published: June 2007

Critical analysis of Jeffrey Masson's book The Assault on Truth has generally been inadequate; neither gleeful welcoming nor cursory dismissal is sufficient to meet Masson's challenge. He reconstructs the events which, he claims, led to Freud's abandonment of the seduction theory of neurosis and argues that this turning away from a‘real event’and towards phantasy represents an error from which psychoanalysis has never recovered. This paper argues on the contrary that Masson's historical reconstruction is unsound on its own internal evidence (although his exact thesis is often unclear), and that the theoretical conclusions he draws are based on a gross misunderstanding not only of psychoanalysis and the role of phantasy but also, ironically, of the seduction theory itself. His general reassertion of the aetiological significance of child sexual abuse is therefore misconceived.
The Sexual Abuse of Children
Authors: Scarlett Jean
Published: June 2007

This paper looks at aspects of child abuse: the psychoanalytical approach, the contribution of psychological research and the problems of residential care. It traces Freud's views from his early statement of the part played by sexual trauma in the aetiology of hysteria to hs later emphasis on the role of fantasy. Masson's criticism of Freud and of his attitude to Ferenczi's paper‘Confusion of Tongues between Adults and the Child’is discussed.

The paper also deals with the research on personality characteristics of paedophiles and the children involved with them, polarities of viewpoint on the long‐term effects of such experiences and, finally, attitudes towards sexuality in residential establishments and the task of staff in fostering the adolescent's emotional development.
Projective Identification and Maternal Misconception in Disturbed Mothers
Authors: Apprey Maurice
Published: June 2007

ABSTRACT: The term projective identification has been used in many ways since Melanie Klein introduced it in 1946. I use it here to study intolerance of separation and motives such as envy, mistrust of dependency and persecutory anxiety. In terms of motives we can differentiate it from other forms of delegation like projection and externalisation; it is a defence set in motion after regression in the third trimester of pregnancy, especially during therapeutic regression, and after the physical separation of delivery. It entails the mother's retrieval of delegations when her child begins to move away, and can be transmuted by intervention into exploratory and empathic modes useful for the child's development.

This paper reports a longitudinal study of women from the third trimester of pregnancy to four years after delivery. Our interviews were designed to tap the subject's preoccupations and projects for her child that she developed preconsciously, unconsciously or consciously.

I suggest that destructive projective identification is used to deal with excessive persecutory anxiety, envy, or intolerance of separation by disturbed or vulnerable mothers militating against the child's progress toward autonomy. Relatively normal mothers use reaction formation and other ways of turning instinctual wishes around to bind anxiety and reverse negative attitudes about their children. Thus maternal misperception can be seen clinically in the context of projective identifications; it may be reversed proactively when the clinician can use projective tests or clinical interviews to gather and classify projective identifications in order to help the mother retrieve them and keep her from impeding her child's development.
On Establishing the Psychotherapeutic Alliance in an Unsophisticated Environment
Authors: Hahn Herbert
Published: June 2007

SUMMARY: When a therapist moves from a ‘sophisticated’to an ‘unsophisticated’base, much more preliminary work in the dyad may be essential before ongoing psychotherapy can be established. In the case of Mr Taylor months of sporadic meetings were a sine qua non. To emphasise that there are no simple generalisations to be drawn, different examples are given However the main thesis explored is that as therapists we may too readily assume that because someone is approaching us professionally, we should quickly proceed to implement‘therapy’. To achieve cooperation for the task is however more subtle, difficult and interesting.
The Lost Ones
Authors: Coltart Ingrid , Covington Coline , Hobdell Roger , Sherman Arthur , Beckett Samuel
Published: June 2007

SUMMARY. This is a clinical paper in that it deals with a series of patients seen for psychotherapy by a group of trainees who were supervised together. Several common characteristics emerged and four of the most typical patients are described in detail. They were all difficult to work with, had seen or were seeing many other therapists and could not use insight interpretations. They had all suffered rejection, real or imagined, from previous therapists but persisted in their search for the ideal therapeutic partner who would omnipotently remove their symptoms. The degree of their perplexity and frustration led us to look upon them as lost. Following the description of each of the patients, the paper comments on four main areas: story making and its absence; the importance to the patient of not knowing; holding; technique. We believe that every analyst has encountered such a lost one in their practice.
Outcome of Dynamic Psychotherapy Clinical examples of long‐term follow up correlating symptomatic and dynamic improvement following individual psychoanalytic psychotherapy
Authors: Clementel‐Jones C. , Malan D. H.
Published: June 2007

SUMMARY. This paper outlines the background, the conflicts and the response m psychotherapy of eight patients. The cases are drawn from a sample of 84 patients treated with psychotherapy or psychoanalysis and followed up three to nine years alter the end of therapy. Two patients presented us with a “fake solution” leading to a symptom‐free picture with the initial conflict still very much unresolved, in one case the assessment of outcome was linked to cultural value judgements. The two be, and the two worst outcome results are outlined which throw light on assessment procedures and on reconstruction of childhood experience in therapy. The teacher shows how a moderately satisfactory result can be attained with a very short intervention. The paper illustrates how careful examination of assessment material reveals cogent dynamic hypotheses which may even haw escaped the original interviewer. Detailed semistructured clinical follow‐up interviews reveal how conflicts have evolved or have been solved over marry years. Hardly any studies have focused on this important area, and some of our striking clinical material shows how useful and instructive curiosity about long‐term outcome can be Psychotherapists’lack of such curiosity is, sadly, equally striking.

The patient's reactions to and criticisms of therapy are also examined. The pattern of insight followed by symptom relief provides evidence or causal connection between self awareness and cure.
The Pregnant Psychotherapist: A Potent Transference Stimulus
Authors: Gottlieb Sue
Published: June 2007

The pregnant therapist is not often encountered in the psychoanalytic literature, and yet my patients were profoundly affected by my pregnancy. The patient described attempted to recreate in the transference the lost, longed‐for symbiotic mother. Identification with the (fantasised) baby was the main form of defence against separation from the idealised mother and awareness of ambivalence. In the countertransference I developed a corresponding form of primary maternal preoccupation. The primary identification with mother is thus potentially available for exploration in a particularly clear form. Also outlined are some of the countertransference difficulties to be encountered.
A Psychodynamic Observer in a Chronic Psychiatric Ward
Authors: Donati Flavia
Published: June 2007

ABSTRACT. The everyday life of a ward for chronic psychotics was sampled in regular weekly sessions and the observations analysed to discover the unconscious interactions and shared defences that explained its social structure.

Outwardly there was boredom, monotony, and an absence of interactions, emotions and events but underneath there were pervasive anxieties defensively subdued especially by the staff. Even tiny moves by patients to alter this atmosphere were instantly nullified. These anxieties had two sources:

(a) a massive impotence in face both of chronicity and of identification with the patients as social rejects.

(b) lurking fear of madness stagnation and cmptiness.

This typical psychiatric facility for chronic patients functions as a defensive system that makes change and development safely impossible and demoralises the staff. Some remedial suggestions are offered.
Winnicott and the Developmental Psychology of Infancy
Authors: Murray Lynne
Published: June 2007

Evidence from research in developmental psychology on mother‐infant communication and cognition in the first 18 months is considered in relation to British psychoanalytic theory, and particularly that of D.W. Winnicott. Large overlaps exist between the two disciplines, but there are areas where empirical work indicates modifications of psychoanalytic formulations and, conversely, clinical observations that draw attention to the need for far closer empirical scrutiny of certain developmental issues.
On Travelling Hopefully (Some aspects of the difficulties of working with patients with obsessional thought disorder)
Authors: Gerrard Jackie , Stevenson Robert Louis
Published: June 2007

This paper examines the difficulties in working with two patients who are heavily defended by obsessional thought patterns and thus do not have the psychic freedom desirable for analytical work. Their capacities for fantasy and symbolisation are impaired, and they have not been able to approach their therapy as a space for‘travelling hopefully’. A better understanding of the literature on early damage, particularly with regard to‘autistic barriers’, has helped to modify my technique and expectations.
Inhibited Mourning in a Latency Age Child
Authors: Nilman Ilan , Lewin Charles
Published: June 2007

ABSTRACT. The psychotherapy of a ten‐year‐old boy whose mourning was inhibited by by massive isolation of affect is described. This impasse was overcome by the therapist employing a dramatic presentation. Discussion includes cognitive developmental factors, family influences and theory of effectiveness of drama.
Brief Psychotherapy with Poorly Controlled Diabetics
Authors: Milton Jane
Published: June 2007

ABSTRACT. Diabetes mellitus is a common condition affecting people of all ages and personalities. Treatment is complex and demands considerable personal resources in the sufferer if control of blood sugar is to be achieved and the risk of serious short and long term complications minimised. Some common patterns of difficulty with compliance amongst insulin‐dependent diabetics are identified and discussed. The literature on the compliance issue and on psychotherapeutic intervention in poorly compliant diabetics is briefly reviewed. The treatment is described of six patients using a form of brief focussed psychotherapy in which analytical and cognitive methods can be combined. The difficulties with compliance are specifically addressed in the wider context of the individual's life problems. This is part of an ongoing research project in which the efficacy of psychotherapeutic and educational interventions is being compared in such patients, in the hope of helping patients avoid later complications and make better use of medical services.
Cognitive Therapy: An Outline of Theory, Practice and Problems
Authors: Power M. J.
Published: June 2007

ABSTRACT. An outline is presented of cognitive therapy beginning with the basic underlying theory followed by a description of the structure of therapy. A number of weak points within cognitive therapy are then identified, in particular, the failure to focus on the development of a working alliance, termination issues in therapy, and the concept of unconscious conflict. It is argued therefore that cognitive therapy has much that could be learned from the dynamic psychotherapies.
Blurred Edges: Some Difficulties and Paradoxes about Forming Boundaries
Authors: Yariv Gail
Published: June 2007

Establishing boundaries is a dynamic process and it involves the way the (m)other is met as different. When she is present for him physically and emotionally the infant can both discover his distinction without trauma and explore the object as exciting in itself and as stimulating new possibilities. This is a complex process that continues to resolve itself through creative engagement with life. I shall briefly survey some of the literature on establishing a body identity and on ‘ mechanisms’of interaction and consider the way in which they contribute to boundary experience.
Bulimia in Brief Dynamic Psychotherapy
Authors: Chiesa Marco
Published: June 2007

In this paper I present some aspects of a brief psychoanalytically‐oriented psychotherapy with a 25‐year‐old single woman presenting with a longstanding history of bulimia and who was subjected to early traumatisation. In particular, the three main psychodynamic features which emerged during treatment are described. The finding that her binge‐eating stopped after the assessment and before formal therapy started remains only partially explicable but some possible underlying factors are discussed. At two years follow‐up the patient remains improved.
Speaking in Tongues in the Consulting Room or the Dialectic of Foreignness
Authors: Antinucci‐Mark Giuseppina , Proust Marcel
Published: June 2007

Becoming a therapist is a complex process, much more so if the therapist is a foreigner who practises abroad and not in his/her mother‐tongue. In this paper I try to analyse some aspects of that process drawing on my personal experience as a trainee‐analysand and as a psychotherapist. Clinical examples are given of the anxieties, defences and the creative uses of being a bilingual clinician. A parallel is drawn between some of the dynamics within the patient/therapist couple and Thomas Mann's analysis of foreignness in The Magic Mountain.
The Couple and the Group: Co‐Therapy with Incest Survivors
Authors: Adams Mary
Published: June 2007

This paper provides an account of a six‐month psychotherapy group for incest survivors in the setting of an all‐women centre. It looks at the high level of anxiety expressed by the group members and their struggles with the two women therapists. The paper stresses the attempts to split the co‐therapist couple and the importance of resisting this splitting in order to offer protection and containment to the group. It suggests that the experience of having this containment provided by two women therapists challenged their denigration of women/mothers, which in turn affected their ability to stand up to their abusers. The wish to find a way to relate to their own mothers is considered a powerful motivation for members having joined the group. This is seen as an important part of the separation‐individuation process which the incest had denied them.
The Creative Difficulties of Working in Isolation
Authors: Corker Enid
Published: June 2007

The two people with whom I work and myself presented a description of our aims and methods to my own training organisation AGIP. The idea of submitting this to the British Journal of Psychotherapy sprang from this, as a means of expressing some of our hopes and fears to a wider audience. There are immense difficulties in working outside London, and this is an attempt to help others understand some of the problems.

Interestingly, involvement with other organisations in London has led to the possibility of starting open workshops, and we see this as a great bonus not only for the area but also supporting us in a very positive way.
Giving and Taking: The Foetal‐Maternal Placental Junction as a Prototype and Precursor of Object Relations
Authors: Whyte Robert
Published: June 2007

SUMMARY. An attempt is made to make a theoretical link between the physiological processes of intrauterine life and the psychological processes which develop after birth. These ideas are further discussed in relation to some clinical material.
Relationships in Music Therapy: Do Music Therapy Techniques Discourage the Emergence of Transference?
Authors: Towse Esme
Published: June 2007

ABSTRACT. It seems to be a criticism of the Creative Therapies that the transference relationship is avoided when projective techniques are used. In this paper, the author draws from her own clinical experience to put forward the view that the techniques used by Music Therapists do not in themselves necessitate the avoidance of working with transference.
Aids, Anger and Revenge
Authors: Maharajh Hari , Sarkar‐Crooks Patricia
Published: June 2007

The disclosure of a positive Human Immunodeficiency Viral (HIV) test to infected patients has prompted a cry for revenge directed towards themselves and society. AIDS revenge is a behavioural manifestation of a grief reaction variably influenced by the individual's perception of his illness and society's response to it. Many perceive an infection with the AIDS virus as a shameful death sentence, exposure of homosexual involvement and humiliation to the victim and his family. We wish to present three short cases. There appears to be a need for structured psychological treatment methods. The consultation‐liaison psychiatrist or psychologist must be involved in treatment since they can identify serious problems before they present as medical emergencies.
Beauty and the Beast: The Father's Unconscious and the Riddle of Femininity
Authors: Wieland Christina
Published: June 2007

This paper is about the importance of the father‐daughter relationship in the development of femininity. It is the author's opinion that recent accounts of femininity have concentrated, in contrast to Freud, almost exclusively on the mother‐daughter relationship thus ignoring the father and, most importantly, the father's unconscious masculinity and its influence on the development of femininity. The nature and development of masculinity and its relation to femininity are explored and the implications of these for the father‐daughter relationship and for the development of the girl's sexual identity are examined. Phantasies, fears and anxieties about both masculinity and femininity, the collusion that develops between father and daughter, and the possible solutions and attempts at compromise that the girl develops are explored.
The Need of the Patient to be Emotionally Known: The Search to Understand a Counter‐Transference Dilemma
Authors: Anderson Maxine
Published: June 2007

SUMMARY. Utilising detailed clinical material from two analytic cases, this paper delineates a search to understand a difficult clinical situation in which the analyst's capacity to think and to analyse during the analytic hour are experienced as being paralysed by virulent, primarily unconscious, sadistic attacks on the part of the patient. The intensity of the counter‐transference experience involving such attacks on the analyst's capacity to think left her feeling that the descriptive explanations of the mental processes involved (i.e. ‘perversion of communication’and‘projective identification’) fell short of helping to provide the understanding needed to overcome the analytic impasse. Investigation of Bion's concept of emotional knowing did provide understanding sufficient to resolve the analyst's experience of paralysis and thus overcome the threat to the analytic process.
The Use of Audio and Videotape Recordings of Therapy Sessions in the Supervision and Practice of Dynamic Psychotherapy
Authors: Aveline Mark
Published: June 2007

SUMMARY. The use of audio and videotape recordings in supervision of dynamic psychotherapy is controversial. Recordings give direct, factually correct access to the therapy session which cannot be matched by the common, indirect method in supervision of recollection. The arguments for and against taping are presented and the conclusion is reached that tapes are an essential aid in supervision. They facilitate the close examination of process and technique. Discrepancies between the recollected account and the record are highlighted, not with the purpose of showing up the deficiencies of the therapist but as phenomena that have meaning and significance. How the therapist deals with transference and emotionally‐charged issues can be seen and discussed. Perhaps their greatest value is in private review by the therapist. The meaning of being taped needs to be carefully considered and monitored by the therapist. Taping should be used selectively and sensitively. Careful attention needs to be given to consent, confidentiality and the security of the tapes. Advice is given on how to make recordings. Tapes may also be used in teaching, research and clinical audit.
Coping with Acting‐Out in a Psychoanalytically‐Oriented Adolescent Unit
Authors: Hazan Yoram , Lerner Yaacov , Subar Rachel
Published: June 2007

ABSTRACT. In a psychoanalytically‐oriented inpatient unit for adolescents with severe emotional disorders, acting‐out can at times be most effectively coped with by way of an act of suspension. In this paper we follow the development of the concept of acting‐out, explore its operative meaning within an adolescent inpatient unit, and finally arrive at the means of coping with it which are necessitated within such a setting. Suspension is extensively discussed with emphasis on the conceptual dilemmas it presents the therapist, as well as its implications for the individual treatment of the severely disturbed adolescent.
When Less Is More Or At Least Enough Two Case Examples of 16‐Session Cognitive Analytic Therapy
Authors: Ryle Anthony , Spencer Jose , Yawetz Christine
Published: June 2007

ABSTRACT. The need for a more general use of time‐limited psychotherapy is argued, and an integrated approach ‐ Cognitive Analytic Therapy ‐ is briefly described. The 16 and 24 session therapies of two patients with extensive previous treatment histories are described, indicating the potential value of time‐limited work in this model.
Psychotherapy in the General Practice Surgery: Considerations of the Frame
Authors: Hoag Linda
Published: June 2007

SUMMARY. This paper is an attempt to explore how maintenance of a secure frame, or provision of secure‐frame moments within the deviant frame of the general practice surgery, may have a positive effect on patients in therapy. This assumption is supported by data from my own practice where attempts to secure the frame in several ways contributed to changes in number of failed appointments, premature termination and number of sessions attended.

While the therapist's maintenance of the basic ground rules in relation to the therapy is shown to create a background of safety, a hold or container, and a defined therapeutic space within which communication between patient and therapist can lead to resolution of conflicts and personal growth, it is also suggested that there can be positive effects on the wider setting of the surgery and its staff.

The psychotherapist or counsellor in general practice is in a pioneering role, and may get caught up in her own ambivalence in terms of needing to be seen as acceptable and useful to the medical hierarchy in which she works and, at the same time, needing to provide for patients the setting necessary for psychotherapeutic work to take place. Flexibility of the therapist in managing this situation must be balanced by a willingness to acknowledge the positive potential contained within the basic ground rules, and an ability to examine carefully the effects of deviations from these ground rules.

It is hoped that the material presented here will stimulate other therapists working in general practice surgeries to examine the frame, work to secure it, and acknowledge the effects on the patient of deviation from it. There is also certainly a need for further research on the effects on the wider setting and its staff of having a therapist working as part of the primary health care team.
Two or Three Sessions? A Discussion of Some Ideas about the Frequency of Sessions in Psychotherapy
Authors: Barnett Ruth
Published: June 2007

SUMMARY. In this paper I explore some issues involved in attempting to assess whether there are definable differences, beneficial or otherwise, between psychotherapy at two times and three times a week. I question the common assumption that more is better and I explore whether there is good reason to formulate such an hypothesis and how far it might be tested and evaluated. Firstly, I consider the number of sessions we have ourselves experienced in our training therapies. Secondly, I look at some assumptions we make about the work we do with our patients with regard to number of sessions per week and I illustrate this with material from some of my own patients. Thirdly, I attempt to draw this discussion together around the question of the optimum number of sessions per week. I conclude that there are some discernable differences between the work in two or three sessions a week. Assessment of their benefits and/or disadvantages is more difficult and open to the influence of ideological assumptions and prejudices. My material shows that the frequency of sessions may have rather different meanings for different patients. Nor will therapists necessarily agree on how the different use made of two or three sessions is to be regarded.
Psychotherapists‐In‐Training Evaluate Their Personal Therapy: Results of a UK Survey
Authors: Macaskill Norman
Published: June 2007

SUMMARY. A national survey of the personal therapy experiences of UK Senior Registrars in Psychotherapy found that 87% reported their personal therapy had a moderate to very positive effect on both their work with patients and in their personal lives. Positive effects included increased self‐awareness (76%), increased self‐esteem (47%) and reduction in symptoms (43%). The most common primary goals for personal therapy were personal growth and the resolutions of personal problems.

No trainees reported purely negative outcomes for their therapy but 38% reported some negative effects from their therapy. The main negative effects were psychological distress (29%) and marital or family stress (13%).

These results are discussed in relation to previous research on personal therapy.
The Way of Imperfection
Authors: Field Nathan
Published: June 2007

ABSTRACT. It is entirely admirable that we should aim to become better psychotherapists. But where this becomes an obsession with the correctness of therapeutic technique it may prove counter‐productive. Too great a striving for perfection on the part of the psychotherapist does not help the patient; it only re‐enacts the compulsion to perfection from which the patient himself very likely suffers. Not only is it human to err: error itself, and the capacity to recover from it, can provide both therapist and patient with unique opportunities for insight and personal growth.
The Truth Is, Sir, My Nerves Are Bad’Reflections on Freud's Case of Katharina
Authors: Badini Andrea Sab
Published: June 2007

SUMMARY. I will revisit Freud's conversation with Katharina on a mountaintop, refer to the recent discovery of her identity, and consider this fascinating short case history in terms of diagnosis, etiology, psychodynamics and interpretation.
Before and Beyond Projection? A Discussion of the Therapist's Experience of Holding the Patient in Mind
Authors: Hepburn Jan McGregor
Published: June 2007

ABSTRACT. This paper is an attempt to think about a process and experience which is essentially before thinking in its origins; that is to say, the maternal experience of holding the baby in mind and the baby's experience of being held. I have looked at the issue subjectively and anecdotally, for which in the end I make no apology as I can see no other way to proceed, at least in the first instance; and I want to think about how this thinking applies to the practice of psychoanalytic psychotherapy.
Breaking the Circle
Authors: Bridge Marie
Published: June 2007

SUMMARY. In this paper I explore some thoughts about the relationship between language, an awareness of separateness and the perception of linear time. I focus on work with a patient whose imagery resembled the myths of Paradise and the Fall. I look at how it is only when the circle of idealised omnipotent illusion is broken that language comes to be used as a communication across a gap rather than as the denial of a gap.
The Rime of the Papyraceous Twin
Authors: Heller Mary Brownescombe
Published: June 2007

SUMMARY. In this paper I explore the case of a woman, Miss M, whose twin died ‘in embryo’, employing as an extended metaphor Coleridge's Rime of the Ancient Mariner. Both the poem and Miss M's story describe ‘internal world’ dramas formed through very early object relationships. In Coleridge's allegorical poem we are told much about the poet's own inner world. The poem contains universal themes of destructiveness, loss and the quest for reparation; these themes illuminate the patient's story which was recounted by Miss M during assessment sessions for psychotherapy. The impact of her story, particularly its maritime images, formed many associative connections in my mind with the poem. The result for me was an enriched understanding of both the patient and the poem.
Uncontained in Mind and Body: Eating Disorders in Final Year Students
Authors: Hirsch Nicola Abel
Published: June 2007

SUMMARY. The paper describes a number of final year students with eating disorders. The students shared a ‘feeling’ that they were unable to live independently. Having difficulty containing and experiencing their psychological life, they were also unable to feel physically contained. The notion of the skin as a container is developed and extended to the lining of the digestive system and the paper explores disturbances in the students' perception of this system. Lacking a sense of a permeable ‘digestive boundary’ between internal and external, they equally lack a sense of self and other as seen in their relationship to the Polytechnic. Defending themselves against experiences of separation their wish is to be inside a refuge and their presenting anxiety is the fear that the impending end of their course will threaten them with expulsion and disintegration. In their symbiotic relationship to the Polytechnic the students are understood to be replicating an early relationship to their mother that predates a differentiation between psyche and soma.
An Experience of an Expressive Group with the Elderly
Authors: Sheikh A. Jawad , Mason Debbie , Taylor Alison
Published: June 2007

SUMMARY. Old age may involve a sense of loss which needs working through if psychological health is to be achieved. Rigid ideas about the capabilities of the elderly may lead to a failure to explore useful therapies. Expressive therapy in a group proved to be a fruitful way forward for elderly patients in a day hospital. Fifteen structured sessions were held, which involved role play, art and music. The therapists hoped the clients would gain some insight into their potential strengths and also an acceptance of their limitations.
The Economics of Introjective Identification and the Embarrassment of Riches
Authors: Sanders Kenneth
Published: June 2007

Melanie Klein described the internal good parental object as one which ‘gives the ego a feeling of riches and abundance’ . But painful feelings of ‘indebtedness’ to the object becomes a focus of conflict. Some clinical material illustrates the ‘embarrassment’ when a passionate desire to protect the couple and their creativity, struggles with a narcissistic part of the self, which wants the riches for itself. The implications of the conflict between the desire for good objects and the emotional expense of maintaining them is then explored in other contexts.
Gazing Into Medusa's Eyes: The Fear of Being Seen and Attacks on Insight
Authors: Ariv Gail Y
Published: June 2007

Using a theme from a once weekly therapy I explore the problem of gaining insight when both seeing and being seen are experienced as attack with fears for survival. I use the Oedipus legend to describe narcissistic attacks on sight and the compulsion to return to a rejecting mother. The figures of Hades realm and the story of the Medusa portray the stuck, blind, somatised states I am describing together with the rage, envy and longing involved. I suggest that a cyclic image of movement is useful in the therapy where excessive splitting into opposites with male/female connotations has occurred. Through the theme of eyes, seeing and being blind I develop the relation between critical super‐ego penetration and feelings of submission, violation, exposure and shame that induce the need to stay hidden and affect sexual feelings as well as inter and intra‐psychic relating.
Creating Order Out of Abuse
Authors: Gardner Fiona
Published: June 2007

A number of different avenues are suggested as potentially useful for approaching psychoanalytic psychotherapy with adult survivors of child sexual abuse. The search for memory and order is explored through reconstruction, the concept of ‘historical sets’ and the transference. Clinical material is used to illustrate certain aspects of the process.
Supervision of the Beginning Therapist: Privileges and Problems
Authors: Ashurst Pamela
Published: June 2007

SYNOPSIS

Most of the trainee psychotherapists providing treatment within the National Health Service setting are psychiatrists in training. The Royal College of Psychiatrists recommends that supervised experience in psychotherapy should be gained by all trainees during their general professional training in preparation for the Membership examination. Short‐term dynamic psychotherapy is commonly offered as an economical treatment approach for psychiatric patients within the public sector provision. The conflict between attitudes rewarded in medical training and the qualities needed for the practice of psychotherapy creates problems for the trainees which emerge in supervision. Experience of supervising beginning therapists, the privileges and the problems, and countertransference issues are discussed. A framework for supervision is outlined.
Psychological Processes of Consuming
Authors: Orbach Susie
Published: June 2007

Consumerism has defined a whole culture's relationship to itself over the last two decades (Williamson 1986, Orbach 1986). The way we enter and partake of the public sphere is not through the exercise of conventional political relationships but through the relations of consumption. To be excluded from the relations of consumption is to be disenfranchised.
The Countryside
Authors: Hinshelwood R D
Published: June 2007

The socially constructed concept of the countryside’ varies in different periods of history. These various pictures of ‘the countryside’ can be plotted quite accurately on various unconscious phantasies active within the minds of individuals, and discerned by psycho‐analysis. This paper explores this correspondence between the individual and the social (the collective) from several aspects.
Self Psychology: Origins and Overview
Authors: Lachmann Frank M.
Published: June 2007

The origins of Kohut's theory of self psychology can be found in Freud's metapsychology. In his first book The Analysis of the Self, Kohut, however, reversed the classical assumption that posits narcissism and object love to be in a see‐saw relationship. He proposed separate lines of development for each, that is, an independent line of development for narcissism. Kohut's shift from a psychoanalytic focus on the narcissistic sector of the personality to a psychology of the self is outlined. The concept of ‘narcissistic transferences’ gave way to ‘selfobject transference’ . The self psychological view of sexuality, aggression, resistance, psychosexual development, the Oedipal phase, transference and countertransference are presented. Treatment implications derived from these contributions are the most extensive and revolutionary aspect of Kohut's proposals. A case vignette illustrates Kohut's distinction between Oedipal conflict pathology and Oedipal phase manifestations.
Imagination and the Psychotherapeutic Process
Authors: Barnes‐Gutteridge William
Published: June 2007

SUMMARY. Imagination is a neglected topic in psychoanalysis and in psychotherapy because we have an inadequate conception of the phenomenon. This inadequate conception renders imaginative activity intractable to investigation. I offer a framework for thinking about imagination that remedies this defect, and I show how we might use this framework to develop a procedure by which to investigate different kinds of imaginative activity. I illustrate this procedure by investigating the kinds of imaginative activity that support two mental abilities. One is our ability to respond to fictional objects (characters in novels). The other is our ability to respond to the mental states of others ‐ an ability I refer to as psychological understanding. Phantasy characteristically operates to block an imaginative understanding of others. And I propose that a fundamental condition for a person to achieve normal object relationships is an ability to imagine the mental life of another person. I conclude by suggesting how this framework allows us to investigate a psychotherapeutic culture. And I outline an approach to investigate the psychotherapeutic culture of a residential therapeutic community.
The Absent Father in Psychotic Phantasy
Authors: Mann David
Published: June 2007

ABSTRACT. This paper explores the idea that in some psychotic clients their psychosis can be understood as an attempt to form a relationship with an absent father. Some of the literature on the effects of father's absence is discussed and two clients are examined in detail. The conclusion reached is that father's absence is felt by the infant as confirmation of parricidal phantasy. This leads to two processes: (1) the need to make reparation and bring the father back to life and (2) the needs of the psyche to re‐establish links with the father in order to achieve psychic homoestasis. Both these processes find expression in psychotic phantasy.
Entrance Requirements for Psychotherapy Training: Rationale and Objectives
Authors: Pedder Jonathan
Published: June 2007

SUMMARY. Some themes of a previous paper (Pedder 1989) on courses in psychotherapy, particularly the idea of different levels of psychotherapy and the place of core professional experience, are updated in the light of recent UKSCP developments and a reply offered to some of the responses to the original paper.
What is a Good Training?
Authors: Samuels Andrew
Published: June 2007

ABSTRACT. The author discusses what constitutes a good training in psychotherapy in terms of authenticity, openness and pluralism.
Suicidal Acts Among Latency‐Age Children as an Expression of Internal Object‐Relations
Authors: Cohen Yecheskiel
Published: June 2007

SUMMARY. In this paper the author tries to explain the dangerous, self‐injurious acts of latency‐age children as acts that may be perceived as suicidal. Using the psychoanalytic objectrelations theory, the author describes three cases in which the suicidal attempts seem to be the result of the following: the first case describes the attempts as a kind of role‐responsiveness to unconscious demands by both parents. The second example demonstrates self injury as a pervasive, permanently ongoing internal‐object relationship. The third case tries to show how the child, through suicidal attempts, tries paradoxically to revive his lost mother.
The Psychotherapist's Erotic Subjectivity
Authors: Mann David
Published: June 2007

The therapist's erotic desires towards the client is a much tabooed and little discussed subject within psychoanalysis and psychotherapy. It is suggested that this topic needs to be opened up for scientific exploration and discussion. This paper is an investigation into the nature of the therapist’ s erotic subjectivity. A review of the literature suggests how difficult it is for many analysts to deal with their erotic desires towards the client completely successfully. Some clinical examples are given to illustrate how the therapist's erotic desires may make a positive contribution to the analysis. It is suggested that erotic desires are inevitable and are part of a healthy Oedipal development. The child needs to internalise and identify with the opposite sex parent's ability to contain incestuous longings. Like the parent, the therapist can expect to have sexual feelings for his or her clients. It is further suggested that objective erotic desires can be as useful as any other feeling the therapist might experience so long as they are analysed and understood in the client's interest.
Time to Go: Therapist‐Induced Endings in Psychotherapy
Authors: Murdin Lesley , Drayton Michael
Published: June 2007

This paper looks at the difficulties for the therapist in imposing an ending on a therapeutic relationship. It suggests that there may be some benefits to the patient and that in any ending the crucial issue is for the patient to find a creative solution within the existing transference.
Castration Desire
Authors: Mann David
Published: June 2007

This paper introduces the idea of castration desire: the desire to lose the penis to strengthen identification with the mother, to deny difference and thereby maintain the phantasy of fusion. Castration desire is therefore linked to the regressive part of the personality that seeks to avoid differentiation. In this context, castration anxiety is seen as a later development that actively promotes separation and individuation from the mother. These issues are explored using clinical and mythological examples.
Hateful Relationships
Authors: Gottlieb Sue
Published: June 2007

This paper explores some of the dynamics of hateful relationships between parts of the self as they are played out between patient and therapist. The patients described are dominated by a ruthless internal object bent upon eliminating the most vulnerable parts of the self and the potentially helpful external object. In its most extreme form this type of hatred becomes psychotic when it destroys the means of perception. Also considered is the hatred experienced by the therapist, and a distinction made between ‘objective’ hatred and that resulting from the projection into the therapist of a hating internal object.
The Promise of Family Therapy
Authors: Kraemer Sebastian
Published: June 2007

INTRODUCTION AND SUMMARY

The process of family therapy unleashes forces which are powerful, primitive and potentially theatrical. Family systems therapy has evolved with little acknowledgement, and even disparagement, of the influence of psychoanalysis. In doing so, it has had a revolutionary impact but also one which has diminished the role of experience, particularly in the therapist. There are signs of convergence between modern psychoanalysis and systems therapy, and both have refined techniques that foster the primary task of therapy, which is observation through participation. In order to achieve this, family therapists require their own special skills to protect them from being stage struck by the family/audience (who also provide the script). The positive connotation is just one of these techniques, and I try to unravel its workings from my own experience. Positive connotation is effective when it provokes a transformation in the therapist, which precedes any change in the family. It is a promising technique but it can lead one astray.
In the Name‐of‐the‐Father: Absent Presence
Authors: Weatherill Rob
Published: June 2007

Psychoanalysis exists! It exists despite splitting attacks made on it by the analysand, and by the analyst's own internal objects, which threaten to destroy it. But it is the silent abundant goodness of the analytic setting, its freedom, its openness, its ‘without memory or desire’, that enable us to experience primary hate in face of terror. But no one possesses this goodness. Unless the analyst has some acknowledged or unacknowledged faith in this goodness, which is never his own, he will not be able to bear envy and will resort to cynicism or manipulation.
Further Thoughts on ‘That Which Patients Bring to Analysis’
Authors: Rey J. H. , Magagna Jeanne
Published: June 2007

The concept of the internal objects and internal and external spaces has been further developed in this paper. These objects are an important part of patients seeking treatment for themselves for they are also looking unconsciously for ‘treatment’ of these objects. The objects are ‘damaged’ and the patient does not know how to repair them. He keeps them alive in the hope that help will come. The methods used to keep them alive, even when dying, have been described. The stages at which these objects have been, or are thought to have been, damaged is vital. For example, they can range from the sensori‐motor level to higher levels of maturation, to produce psychosis, borderline or hypochondria. The concrete level is stressed for it leads to concrete repair as opposed to psychic reparation.
Varieties of Disorders of the Self
Authors: Wolf Ernest S.
Published: June 2007

Fifteen years have passed since ‘The disorders of the self and their treatment: an outline’ (Kohut & Wolf 1978) presented an up‐to‐date survey of the progress that had been achieved in the development of self psychology. It seems now that the time is ripe for another stock‐taking. Especially diagnosis, aetiology and treatment possibilities should be brought in line with accumulating clinical experience. The content and focus of this essay are determined by an attempt to clarify aspects of theory and practice that have remained problematical. Again, as in 1978, a classification of self disorders forms the centre of this survey.
Becoming a Grandmother: The Third Position
Authors: Issroff Rahle
Published: June 2007

The third position refers to a type of relationship where one is an observer of a relationship rather than a participant. It is the attainment of this position that enables a grandmother to accept her child's partner and the birth of their baby. The type of anxiety aroused in grandmother by the birth will depend on the extent to which she has been able to resolve her oedipal anxieties. My own experience of becoming a grandmother and my work with a patient who became a grandmother during therapy contributed to my understanding of the significance of this life event.
Problems of Identity in Multi‐Disciplinary Teams: The Self and Systems in Change
Authors: Nightingale Anne , Scott David
Published: June 2007

Rapid changes in the ethos and functioning of the NHS are examined in the light of their effect on the multidisciplinary team members of a psychotherapy service. A process account is given of the nature of the changes in the service, the early emergence of difficulties in the team and their identification in psychodynamic terms. Some preliminary solutions are discussed. A theoretical discussion examines the need for an alternative meta psychology, involving the concept of the autonomous self and open systems theory, to aid our understanding of the process by which a system change can provoke psychic disturbance in the individual.
Why Purchase Psychotherapy Services?
Authors: Healy Kevin
Published: June 2007

Case examples are used to illustrate the human consequences of the significant levels of psychosocial morbidity in Britain today. A variety of psychotherapeutic interventions may reduce morbidity and also reduce the social costs such morbidity accounts for. The value of a psychotherapy assessment is emphasised as a way of matching resources and patients. In this connection the specialist role of the consultant psychotherapist is discussed.