bluuebunny/crossref_metadata_2025 huggingface dataset:
Rethinking Homosexuality: What It Teaches Us About Psychoanalysis
Authors: Roughton Ralph E.
Published: April 2008

This presentation, written ten years after the American Psychoanalytic Association adopted a nondiscrimination policy with regard to sexual orientation, discusses the evolving relationship between psychoanalysis and homosexuality. The paper is in three sections: (1) the process of policy change and the overturning of injustice; (2) the excursion after Freud's death into analytic bias and extreme pathologizing of homosexuality, the struggle to overcome those distortions, and the lessons to be learned from this history; and (3) the search, in the coming decade, for new understanding of homosexuality and all aspects of sexuality.
Tennessee Williams: The Uses of Declarative Memory in the Glass Menagerie
Authors: Jacobs Daniel
Published: April 2008

Tennessee Williams called his first great work, The Glass Menagerie, his “memory play.” The situation in which Williams found himself when he began writing the play is explored, as are the ways in which he used the declarative memory of his protagonist, Tom Wingfield, to express and deal with his own painful conflicts. Williams's use of stage directions, lighting, and music to evoke memory and render it three-dimensional is described. Through a close study of The Glass Menagerie, the many uses of memory for the purposes of wish fulfillment, conflict resolution, and resilience are examined.
James Joyce and Molly Bloom: Reflections on their Relationship
Authors: Jacobs Theodore J.
Published: April 2008

The relationship between James Joyce and his memorable creation, Molly Bloom, is explored in relation to Joyce's remarkable creativity and various factors that may have contributed to it. A character forged primarily out of Joyce's perceptions of his wife Nora and memories of his mother, Molly also contains aspects of Joyce's warded-off and wished-for self-representation. A focus on both biographical and dynamic contributions to the creation of Molly helps to illuminate aspects of Joyce's psychology.
Telling Stories
Authors: Busch Fred
Published: April 2008

Patients need to tell their stories. One of our primary tasks as analysts is to help patients tell their stories and own them. The freedom of mind to think, to feel, and to know are dependent on the ongoing capacity for storytelling. The analyst's stance plays a major role in the development of the analysand's storytelling capacities.
Converted Patients and Clinic Patients as Control Cases: a Comparison With Implications for Psychoanalytic Training
Authors: Caligor Eve , Hamilton Margaret , Schneier Holly , Donovan Justine , Luber Bruce , Roose Steven
Published: April 2008

All twenty-eight respondents to a recent poll of the thirty institutes affiliated with the American Psychoanalytic Association reported that they now accept cases converted from psychotherapy to psychoanalysis as control cases. This study was designed to compare converted cases to clinic cases systematically with respect to patient characteristics, treatment, and the educational experience of the treating candidate. The study followed twenty-four candidates entering analytic training between 1992 and 1995, who treated thirty-four clinic cases and forty-three converted cases between February 1993 and July 2000. Clinic and converted patients were comparable with regard to demographics, prior treatment histories, structural diagnoses, and Axis I diagnoses. In addition, the two groups of cases were indistinguishable with respect to the rate at which candidates received credit toward graduation requirements. Candidates treating converted cases earned approximately $7,600 per patient per year, compared to candidates treating clinic cases, who earned nothing. Eighty-four percent of converted patients diagnosed with a mood disorder by the treating candidate were on medication, in contrast to only 20% of clinic patients with the same diagnosis. Similar differences were seen in the case of anxiety disorders. Given the prevalence of affective and anxiety disorders in control cases and the availability of a variety of medications and psychotherapies with documented efficacy in treating these disorders, candidates should be trained to discuss treatment options with patients who present with Axis I disorders.
Analysis and Psychotherapy by Telephone: Twenty Years of Clinical Experience
Authors: Leffert Mark
Published: April 2008

Psychoanalysis via telephone is becoming increasingly prevalent while remaining an area of comparatively little study. The author's early telephone treatment of a series of patients living some distance away or engaged in business travel, and his subsequent telephone treatment of nine analytic and five psychotherapy patients following his own geographic move, are discussed in detail. The mechanics of beginning and carrying out such treatment are examined. The theoretical implications of the shift to the telephone and the ambivalence with which it is often met by clinicians are also explored. The role of nonverbal communication in both in-person and telephone analysis is considered, as is the concept of the analytic office as a literal space and a psychological container. Suggestions for future research are advanced.
The Analyst's Desire and the Problem of Narcissistic Resistances
Authors: Wilson Mitchell
Published: April 2008

The ways in which the analyst's desire for particular experiences with patients is inevitable and often leads to narcissistically based resistances are considered. Five propositions are examined: (1) that the analyst cannot help but have desires and want them recognized by the analysand; (2) that these desires frequently underwrite the analyst's theoretical beliefs and technical interventions; (3) that narcissistic desires and their influence are ubiquitous among practicing analysts; (4) that the patient is often on the lookout for the analyst's various agendas; and (5) that the patient often hopes the analyst will put his or her desire aside and listen so the patient can further his or her own interests. Lacan's concept of the “dual relation” is central to this discussion. The neo-Kleinian position on narcissistic resistances is explored, as is the idea of the “analytic third” as a potential solution to the problem they pose. An extended case description illustrates the main points.
Analysts Who Commit Sexual Boundary Violations: a Lost Cause?
Authors: Celenza Andrea , Gabbard Glen O.
Published: April 2008

The causes of sexual misconduct by analysts are discussed, as is the viability of rehabilitation for different types of transgressors. Common misunderstandings about the transgressor (such as the assumption of psychopathy and the likelihood of multiple offenses) are countered with a summary of data derived from the evaluation and/or treatment of over two hundred cases, most of them one-time transgressors. The typical characteristics of the analyst or therapist who engages in sexual misconduct are presented and discussed as qualities that are to some extent present in analysts generally. The temptation to deny this universal vulnerability is viewed as effectively replicating the kind of vertical splitting or compartmentalization that makes one vulnerable to sexual misconduct in the first place.
The Management of Affect Storms in the Psychoanalytic Psychotherapy of Borderline Patients
Authors: Kernberg Otto F.
Published: April 2008

Affect storms are a frequent complication in the psychoanalytic approach to borderline patients. The descriptive, psychodynamic, and structural characteristics of these storms are explored, and the verbal, nonverbal, and countertransference manifestations that permit the formulation of interpretations under such conditions are described, as are the interventions required to maintain the treatment frame as a precondition for an analytic approach. The principal theoretical formulations regarding the affect pathology of borderline patients are reviewed and related to a proposed interpretive approach. An apparently opposite development, the utter absence of emotional developments in the sessions, is examined, and its defensive function of avoiding affect storms is explored. Clinical case material illustrates the proposed approach to these storms, and clinical evidence is given to support the approach, which centers on systematic analysis of the primitive internalized object relations of these patients in the transference, the use of countertransference analysis without countertransference communication to the patient, and the repeated restoration of technical neutrality in the service of protecting the treatment frame.
Trauma: the Seductive Hypothesis
Authors: Reisner Steven
Published: April 2008

In much of contemporary culture, “trauma” signifies not so much terrible experience as a particular context for understanding and responding to a terrible experience. In therapy, in the media, and in international interventions, the traumatized are seen not simply as people who suffer and so are deserving of concern and aid; they are seen also as people who suffer for us, who are given special dispensation. They are treated with awe if they tell a certain kind of trauma story, and are ignored or vilified if they tell another. Trauma has become not simply a story of pain and its treatment, but a host of sub-stories involving the commodification of altruism, the justification of violence and revenge, the entry point into “true experience,” and the place where voyeurism and witnessing intersect. Trauma is today the stuff not only of suffering but of fantasy. Historically, trauma theory and treatment have shown a tension, exemplified in the writings of Freud and Janet, between those who view trauma as formative and those who view it as exceptional. The latter view, that trauma confers exceptional status deserving of special privilege, has gained ground in recent years and has helped to shape the way charitable dollars are distributed, how the traumatized are presented in the media, how governments justify and carry out international responses to trauma, and how therapists attend to their traumatized patients. This response to trauma reflects an underlying, unarticulated belief system derived from narcissism; indeed, trauma has increasingly become the venue, in society and in treatment, where narcissism is permitted to prevail.
The Social Character of Thinking
Authors: Cavell Marcia
Published: April 2008

What Freud called “the reality principle,” or judgment, presumes on the part of the child who has arrived at judgment the implicit grasp of a complex of concepts: truth and falsity, belief, subjective and objective, the objectively real, my perspective and yours. Work in both philosophy and infant research points to the essential importance in the development of judgment of a triangulating situation that involves particular sorts of communications between two creatures and an external object that interests them both. In this light Bion's theory of thinking is critically examined and the meaning of primary process and fantasy is discussed.
Psychosomatic Medicine: the Divergent Legacies of Freud and Janet
Authors: Gottlieb Richard M.
Published: April 2008

A series of differing explanations of a puzzling case of psychosomatic illness introduces some reflections on a century's history of psychoanalytic interest in the mind-body problem. Freud and Janet explained the physical symptoms of hysteria using radically different models of the mind. Since then Janet's model, banished early on, has returned to haunt the castle of psychoanalysis. The enduring influence of Janet's model on subsequent thought in this field, especially that of Marty and de M'Uzan, Sifneos, LeDoux, and others, is traced, as is the influence of Freud's model on Groddeck, Alexander, McDougall, Fonagy, and others. It is argued that although these models are vastly different at one level of abstraction, at a higher level they share an important set of assumptions.
Ghosts of Paradigms Past: the Once and Future Evolution of Psychoanalytic Thought
Authors: Wilson Arnold
Published: April 2008

An example of the psychoanalytic mode of thought is put forward concerning how psychoanalytic theories have historically been constituted and transformed. The model of world hypotheses, characterized by multiple irresolvable truth claims, captures the nature of most psychoanalytic theorizing until about 1970. Each of two world hypotheses—one grounded in intrapsychic conflict (seen when the analyst observes from outside the transference) and the other in interpersonal internalization (seen when the analyst observes from inside the bidirectional interactive processes)—is an autonomous and self-sufficient aggregate. The stance taken by the analyst-observer with respect to the analytic interaction is key to seeing how the two world hypotheses are made manifest in clinical work and in theory. By contrast, the model of competing programs captures the essential nature of most psychoanalytic theorizing since about 1970, and is characterized by the necessity of each progressively evolving through a particular kind of commerce with its neighbors. Such commerce is necessary when a program is in danger of degenerating. In this way of thinking, there is a fundamental tension between classical psychoanalysis adapting to the demands and exigencies of its particular and ever evolving historical niche and simultaneously retaining the core commitments that guarantee continuity. Honoring the forces of progression displaces the quest for truth as a paramount goal of psychoanalysis. A developmental lag in recognizing this transformation has hindered progress toward a comparative, process-centered psychoanalysis.
A Fresh Look At Perversion
Authors: Richards Arlene Kramer
Published: April 2008

The history of ideas about perversion is considered, along with an examination of whether the concept is clinically useful. Three cases of varying degrees of severity are presented, illustrating the clinical value of the concept in the analytic situation. All three cases are women, and the particular usefulness of the concept of perversion for women is noted. The place of aggression and the pleasure resulting from its expression are highlighted.
The Vanished Pregnant Body in Psychoanalytic Female Developmental Theory
Authors: Balsam Rosemary H.
Published: April 2008

The author contends that the pregnant body—the premier icon of the mature female body—has vanished from our psychoanalytic theory of female development. Until we are able to restore this missing entity on a par with the phallus, the developmental theory for both sexes remains fixated in phallocentricism. The author traces some of the evidence for this claim in a brief overview of the literature, a study of the relevant aspects of the case of Little Hans, and a look at the history of medical teaching, in particular illustrations from the first dissections of female bodies in the sixteenth century, which demonstrate a view of the female body as essentially male. A puzzle remains about the marked tendencies that both males and females had, and still have, to distort the female body image. The author offers a clinical example, and the suggestion that the plasticity of the female form in all its developmental phases may underlie the paradoxical requirement that stable mental representations be established upon an elusive set of shifting images.
Reading Fiction and the Psychoanalytic Experience: Proust On Reading and On Reading Proust
Authors: Poland Warren S.
Published: April 2008

Reading can at times engage one emotionally and entail inner psychological experiences in ways akin to those in clinical psychoanalysis. In that light, after a general introduction regarding the import of reading, attention is turned to Proust, Freud's literary complement, as an exemplary instance to illustrate those similarities. Ideas of Proust on reading are followed by thoughts on reading Proust, with the ending of Proust's masterpiece used to illustrate a parallel to termination in clinical psychoanalytic experience.
Common and Uncommon Ground: a Panel Exchange
Authors: Smith Henry F.
Published: April 2008

Henry F. Smith was the discussant at the panel “Have We Changed Our View of the Unconscious in Contemporary Clinical Work?” at the Fall Meeting of the American Psychoanalytic Association, New York, December 18—19, 1998. Panelists included Jane V. Kite (chair), Sander Abend, Ronald Britton, Ernest S.Wolf, Polly Young-Eisendrath, Philip Bromberg, and Owen Renik. Smith's discussion is presented here, along with three of the panelists' responses to it.
The Continuity of Conflict and Compromise Formation From Infancy To Adulthood: a Twenty-Five-Year Follow-Up Study
Authors: McDevitt John B.
Published: April 2008

This paper reports on one of fifteen subjects from the Mahler separation-individuation project who have participated in a twenty-five-year follow-up study. The focus is on the beginning transfer of interpersonal conflict to intrapsychic conflict and compromise formation early in the second year of life, and on the course and persistence of these into adulthood. Conflict and compromise, along with constitutional and environmental factors, were major determinants of the subject's personality and a major source of continuity in personality development from one-and-a-half to twenty-five years of age.
Clinical and Developmental Dimensions of Hate
Authors: Blum Harold P.
Published: April 2008

Bridging concepts of aggression, affect, and attitude, hate emerges during the process of separation-individuation concurrent with ego development and persisting intrapsychic conflict and fantasy. Rage precedes hate developmentally, though later the two are amalgamated both developmentally and clinically. Hate is the negative pole of ambivalence and is a component of all self- and object representations and object relationships. When excessive and unmodulated, hate interferes with object relations and personality development. Paradoxically, hate may also subserve adaptation and personality organization. Transference hate is often a greater problem for the psychoanalyst or psychotherapist than is transference love. Transference hate threatens the analyst's narcissism and neutrality and tests the analyst's tolerance and patience. The patient's intense hate is often experienced as a direct assault on the analytic relationship and the analytic process. Countertransference hate and the need to defend against it are of great clinical importance. Because it runs counter to analytic ideals and values, the analyst's hatred of the patient may be denied, minimized, rationalized, enacted, or vicariously gratified and may occasion great resistance to analytic self-scrutiny. Countertransference hate is often an unrecognized determinant in cases of analytic and therapeutic impasse. A classic contribution by D.W. Winnicott to the recognition and elucidation of countertransference hate is reevaluated.
Understanding the Patient's use of the Method of Free Association: an Ego Psychological Approach
Authors: Busch Fred
Published: April 2008

While most of our methods of listening have been geared toward unearthing unconscious fantasies, those directed toward the ego's all-inclusive role in effecting the associative process have lagged far behind. It is the thesis of this paper that listening from the perspective of the ego allows the analyst to work more closely with what the patient is ready to understand. Clinical technique, using an ego psychological view, is elaborated, demonstrated, and compared to technique dependent on the reading of signs and symbols of the unconscious.
The Analyst's Reality
Authors: Rosenblatt Allan D.
Published: April 2008

Attention is called to ways in which the analyst's subjective experience and judgment of reality, aspects of his or her psychic reality, not only are necessary to the effective conduct of any psychoanalysis but play a positive and useful role. The theoretical framework of ego psychology risks overemphasizing the primacy of the analyst's reality, while self psychology risks discarding it in favor of the patient's psychic reality. Each view has its dangers, and an integration of both should be sought without losing the advantages of either. Although the analyst's view of reality may in some instances be relatively privileged, most often it is valuable as a heuristic device focusing the analyst's attention when a discrepancy appears between the patient's version of reality and that of the analyst. When used in such a manner, it enhances rather than detracts from the analytic, empathic investigation of the patient's reality.
Creative Misreading: Why We Talk Past Each Other
Authors: Smith Henry F.
Published: April 2008

A close look at Gedo's recent paper on working through reveals a number of devices used in the development of competing psychoanalytic theories, devices which result in analysts talking past each other. Starting with the notion that all theorists “misread” their predecessors, the author examines how different views of the past create confusion in the dialogue between Gedo and his commentators. He then takes up the issue of how data emerging from the neurosciences can be used to support many different psychoanalytic theories and suggests that there will always be a “metaphorical leap” from one frame of reference to the other. Finally, he examines how the drawing of sharp dichotomies both within a theory and between one theory and another misrepresents analytic work and exaggerates differences between one point of view and another. Thus, various devices that are used to buttress one version of analytic theory make it more difficult to develop a more integrated theory and to correlate psychoanalytic data with those emerging from the neurosciences.
The Real Unconscious: Psychoanalysis as a Theory of Consciousness
Authors: Opatow Barry
Published: April 2008

Inquiries into hallucinatory wish fulfillment and the unconscious converge and, by distinguishing the concept of the unconscious in psychoanalysis from that of cognitive psychology, serve to bring out what is most essential to the psychoanalytic conception. Freud's topographical model is used to stress that the psychoanalytic unconscious can be understood only in relation to theories of consciousness and wishing. Moreover, in contrast to the cognitive conception, psychoanalysis holds that the processing of thought in the human mind is inseparable from the activity of desire. This leads to further psychoanalytic reflections on the interrelation of conscious and unconscious, wishing and thinking, and, in consequence, on transference and the mechanism of unconscious fantasy.
A Century After Freud's Project: Is a Rapprochement Between Psychoanalysis and Neurobiology At Hand?
Authors: Schore Allan N.
Published: April 2008

In his 1895 “Project for a Scientific Psychology” Freud attempted to construct a model of the human mind in terms of its underlying neurobiological mechanisms. In this endeavor “to furnish a psychology which shall be a natural science,” Freud introduced the concepts that to this day serve as the theoretical foundation and scaffolding of psychoanalysis. As a result, however, of his ensuing disavowal of the Project, these speculations about the fundamental mechanisms that regulate affect, motivation, attention, and consciousness were relegated to the shadowy realm of “metapsychology.” Nonetheless, Freud subsequently predicted that at some future date “we shall have to find a contact point with biology.” It is argued that recent advances in the interdisciplinary study of emotion show that the central role played by regulatory structures and functions represents such a contact point, and that the time is right for a rapprochement between psychoanalysis and neuroscience. Current knowledge of the psychobiological mechanisms by which the right hemisphere processes social and emotional information at levels beneath conscious awareness, and by which the orbital prefrontal areas regulate affect, motivation, and bodily state, allows for a deeper understanding of the “psychic structure” described by psychoanalytic metapsychology. The dynamic properties and ontogenetic characteristics of this neurobiological system have important implications for both theoretical and clinical psychoanalysis.
Psychoanalysis as the Patient: High in Feeling, Low in Energy
Authors: Shevrin Howard
Published: April 2008

This paper examines the increasingly important role that affect is assuming in psychoanalytic research and practice. This rise in the centrality of affect has been at the expense of an independent role for motivation and a dismissal of any energy concept. Difficulties with this affect-first approach are identified and an alternative offered that accords motivation an independent role and accommodates a useful energy concept. Research on esophageal atresia, addiction, and infant suckling are cited in support of this position.
In Search of the Mind of the Analyst: a Progress Report
Authors: Jacobs Theodore J.
Published: April 2008

Certain difficulties arise in the positions of both those who embrace the intersubjective approach in psychoanalysis and those who oppose it. Various factors that have led to misunderstandings on both sides of the question are identified, and several recent studies highlighting the importance of unconscious communication both in development and in clinical work are cited to buttress the argument that efforts to understand the mind of the analyst as it registers and resonates with this kind of communication open a still insufficiently explored pathway to the unconscious of the patient, one that may lead to major advances in analytic technique.
Integrating Some Mind and Brain Views of Transference: the Phenomena
Authors: Levin Fred M.
Published: April 2008

Because understanding the underpinnings of transferential learning allows the analyst to more effectively exploit transference in the clinical situation, as well as to advance psychoanalytic theory, the functions and mechanisms of transference phenomena in learning are subjected to an interdisciplinary analysis. Through transference the brain creates hierarchical databases that make emotional sense of the world, especially the world of human relationships. Transference plays a role in defense and resistance clinically; less explored but equally important is the adaptive potential of transference and its effect on an individual's readiness for structural change through the activation of working memory. Most investigators within psychoanalysis have not considered the importance of similarity judgments and memory priming, especially as these help to explain why transference and its proper handling are effective in treatment. Yet there are complex relationships among transference, similarity judgment, and memory priming that tie together psychoanalysis, cognitive psychology, and neurophysiology. Evidence increasingly suggests a relationship between transference and the transfer of knowledge between various content domains (databases) of mind and brain, which is essential to cognitive and emotional learning. There are indications as well that transference decisively facilitates learning readiness (“windows”) in general by means of two of its components: free association and spontaneous (self-initiated) activity. The important question of which mind/brain mechanisms motivate transference is not yet understood comprehensively. However, Vygotsky's work on the zone of proximal development(ZPD), M.Stern's teleonomictheory, schematheory, and neural network theory offer further insights into what motivates transference.
The Analyst's Interpretation as Fetish
Authors: Reed Gail S.
Published: April 2008

This paper explores the transference dynamics and underlying fantasies of analysands whose characters have been shaped by conflict solutions common to perversion. Giving the impression of a serious engagement for therapeutic ends, these individuals live out in the treatment a sexualized enactment in which the analyst's interventions are transformed into a fetish. This enactment is designed to support a defensive effort to avoid external perceptions that trigger certain fantasies of danger, including that of castration. It is designed also to cancel out interventions of the analyst that become equated with these frightening fantasies. Since the analyst's efforts to explore and interpret this enactment are also turned into a fetish, such a transference poses grave difficulties for the analysis. A technical approach is suggested in which the analyst focuses on the contradiction itself, the operation of the disavowal, the fantasy of danger that motivates the persistent use of disavowal, and the underlying, often vengeful and envious wishes that contribute both to the undermining of the analysis and to the content of the fantasies of danger that provoke so much anxiety.
Sexual Overstimulation as a Cause of Unstable Gender Identity in Men: a Case Report
Authors: Beatrice James
Published: April 2008

A phase in the analysis of a young man is presented, demonstrating evidence of maternal sexual overstimulation from infancy through early adulthood. A consequence of this overstimulation was a regression to an unstable gender identity. The developmental line of gender identity proved useful in understanding this man's conflicts.
Superego Defense Analysis in the Termination Phase
Authors: Levenson Lawrence N.
Published: April 2008

This paper is a contribution to recent efforts to identify areas in clinical theory and practice in which the analyst's authority is used, rather than analyzed, to achieve therapeutic results. In the termination phase there may occur an intensification of transferences of authority (superego transferences) in response to the aggression inherent in termination. Analysts may develop counterresistances to analyzing these defense transferences, since their analysis exposes the analyst to the patient's heightened aggression at termination. The literature on termination may have contributed to analysts' falling short in analyzing these transferences, by its having accorded internalizing mechanisms a prominence in the therapeutic action of termination that they otherwise lack in contemporary ego psychological theories of therapeutic action. Gray's formulation of the superego as an analyzable defensive activity is applied to events in the termination period, thereby bringing into focus conflicts over aggressive impulses defended against by superego forces. Clinical vignettes from the termination phase of an analysis are presented.
Unconscious Pregnancy Fantasies as an Underlying Dynamism in Panic Disorder
Authors: Milrod Barbara
Published: April 2008

Unconscious pregnancy fantasies are outlined as an underlying dynamic organizer to the panic experience in some patients with panic disorder. Detailed case material from the treatment of two childless panic patients, one male and one female (nonpregnant) is presented to illustrate this. A literature review found reports of nine nonpregnant patients, none exposed to a pregnant analyst, in whom these fantasies are described as central. Four of these patients had a psychiatric syndrome consistent with panic and agoraphobia. Some mechanisms that may underlie these connections are explored.
An Application of the Concept of the Therapeutic Alliance To Sadomasochistic Pathology
Authors: Novick Kerry Kelly , Novick Jack
Published: April 2008

This paper traces the history of the therapeutic alliance concept, examining how it has been used and misused, at times elevated to a central position and at others rejected altogether. The loss of this concept created a vacuum in classical psychoanalysis that has been filled by rival theories. The continuing usefulness of looking at the treatment process through the lens of the therapeutic alliance, particularly in relation to the manifold difficulties of working with sadomasochistic pathology, is suggested. To this end, revisions of the theory of the therapeutic alliance are suggested to address some of the difficulties that have arisen in conceptualizing this aspect of the therapeutic relationship, and to provide an integrated dynamic model for working with patients at each phase of treatment. This revised model acknowledges the complexity of the domain and encompasses the multiple tasks, functions, partners, and treatment phases involved. The utility of the revised theory is illustrated in application to understanding the sadomasochistic, omnipotent resistances of a female patient through the phases of her analysis.
Perverse Defenses in Neurotic Patients
Authors: Coen Stanley J.
Published: April 2008

Distinguishing perverse defenses from the concept of obligatory perversion allows perverse defenses to be examined in neurotic patients. Perverse defenses against reality, one's conflicts, and relationships with others are connected with affect intolerance, difficulty with analytic collaboration, and analytic impasse. Perverse defenses, including the cultivation of states of distraction, excitement, and pomposity, as well as perverse sadomasochistic relations with others, protect against the unbearable: intense affects, painful ideas, and loving, committed need of a valued, distinct person. Patients' perverse, vindictive refusal to be reasonable provokes perverse countertransference reactions whereby the analyst stands in judgmentally and critically for the seemingly absent demands of reason, morality, and analytic progress.
The Analytic Present in Psychoanalytic Reconstructions of the Historical Past
Authors: Brenneis C. Brooks
Published: April 2008

The psychoanalytic reconstruction of specific influential past events has been a regular feature of psychoanalytic practice from its inception. More recently, as reconstructions of incestuous sexual abuse have become more frequent, the reconstructive process has attracted attention, and doubts have been expressed about the validity of the analytic evidence used to substantiate their inference. Over the years, psychoanalytic discourse about the adequacy of this evidence has moved from Freud's uneasy confidence to a rather sharply divided debate between advocates and skeptics. From beyond psychoanalysis, memory research raises questions about the validity of this evidence, and research on influence raises questions about the procedures by which it has been collected. A reexamination of several cases in which reconstructions emerged from unstable therapeutic circumstances leads to the conjecture that dynamics located in the analytic present may have been displaced to the historical past. Although logically “truth in the past” need not foreclose on “truth in the present,” in practice, once a reconstruction surfaces, the latter seems to disappear behind the former.
The Role of the Preconscious in Psychoanalysis
Authors: Kantrowitz Judy L.
Published: April 2008

The analytic process inevitably involves the interdigitation of the intrapsychic structures of both patient and analyst. This interplay is expressed in transference-countertransference interactions. Drawing a dichotomy between intrapsychic and interpersonal factors as central agents of psychic change is a faulty construction. Affective, behavioral interchanges between patient and analyst reflect their individual intrapsychic organizations and their interplay, which influence the form and nature of psychological change. The safer both patient and analyst feel in relation to each other, the more freely will they relax their customary cognitive controls and permit the emergence of preconscious responses. Preconscious resonance between patient and analyst is likely to facilitate the lifting of repressive barriers and the emergence of unconscious material in both participants. The integration and reworking of old conflicts then becomes possible. The role of the preconscious in facilitating the analytic process is illustrated. Creative use of preconscious processes requires the analyst's self-discipline to preserve the analytic role and keep the treatment safe for both participants.
Anti-Semitism in the Clinical Setting: Transference and Countertransference Dimensions
Authors: Knafo Danielle
Published: April 2008

Despite the salient presence of Jews in the history of psychoanalysis, literature on the subject of anti-Semitism in the clinical setting is surprisingly sparse. This paper attempts to comprehend the reasons for the dearth of literature on this important topic. A clinical section then breaks the silence surrounding expressions of anti-Semitism in the consulting room. The major focus is on transference and countertransference reactions that arise with regard to anti-Semitism in the clinical setting. Since the first section is concerned with silence in the psychoanalytic community, its focus is primarily on countertransference issues that may hinder the analyst's understanding and use of anti-Semitic material. The second, clinical section focuses on the ways both transference and countertransference reactions combine and influence one another and how they may, when properly attended to, serve as catalytic tools for advancing therapeutic goals.
The Construction, Reconstruction, and Deconstruction of Memory in the Light of Social Cognition
Authors: Tuch Richard H.
Published: April 2008

Psychic trauma results when the ego is overwhelmed by intolerable affect. Some childhood experiences are directly traumatic, requiring no intervening interpretive process to render them traumatic. Troublesome affect that falls short of being truly traumatic, in the strict sense of the term, may nevertheless exert a psychopathogenic effect on the child's psychic development. Whether a child is troubled by an experience depends on what that experience meant to the child. Accordingly, the psychopathogenic effects of childhood experience are a function of the child's general level of cognitive sophistication and specific ability to appreciate the subtle nuances of social interactions. If a child's cognitive capabilities are not up to the task of providing the necessary explanations for a given social interaction, the child is left to fall back on fantasy to fill in the gaps. The field of “social cognition” proves particularly helpful in understanding what a child is capable of gleaning from an experience. Research in this area helps psychoanalysts understand how experience becomes constructed and reconstructed in the form of memories. Social cognition also helps psychoanalysts understand when and how a lived experience ends up being psychopathogenic or, alternatively, ceases any longer to exert an ongoing psychopathogenic effect on an individual's psyche. A review of social cognition research leads to a reconsideration of such psychoanalytic concepts as repression, dissociation, reconstruction, and resistance. It also directs attention to the concept of developmental (as opposed to psychoanalytic) reconstruction and deconstruction.
The Pressure Toward Enactment and the Hatred of Reality
Authors: Anderson Maxine K.
Published: April 2008

The pressure toward enactment is investigated in terms of the threats that primitive, pre-thinking states of mind exert on attempts to know and understand. Clinical material and a review of the literature suggest that when the analyst confronts (by thinking) rather than complies (by action) with the hidden demands of omnipotence, he or she triggers and is then subject to the pre-thinking mental realm of concrete sensory bombardment, which can penetrate and obliterate his or her separately thinking mind. One important pressure driving the analyst toward enactment derives from a defensive response aimed at avoiding the threat of such concrete projections.
Why Is Reality a Troubling Concept?
Authors: Friedman Lawrence
Published: April 2008

Many psychoanalysts assume that modern philosophy has revealed that objective reality is an illusion, and they take that as their starting point for discussing psychic reality and the direction of treatment. However, the philosophical argument for the antiobjectivist position, far from being a final truth, can be seen as a late echo of the age-old debate over whether it is possible to match unchanging general descriptions to the changing individuals in the world. It is but one of two competing philosophical positions (postulating either a world of incomparable individuals or a world of abstract properties), neither of which can definitively vanquish its rival without violating common sense. The underlying, specifically psychoanalytic problem that stirs these recent debates is not the philosophical problem of reality, but rather the question of what it can mean to say that someone is realistic in regard to the world of human values, roles, and relationships. Analytic tradition begins the inquiry by suggesting that realisticness about human meaning is a matter of feeling out the potentialities of the human world by multiple affective attachments. Many questions remain to be answered.
Hoffman's Ritual and Spontaneity: Three Reviews and a Response
Authors: Benjamin Jessica
Published: April 2008

In this issue we introduce a new format for the JAPA Review of Books. In our first Book Forum, Irwin Z. Hoffman's Ritual and Spontaneity in the Psychoanalytic Process is evaluated by three reviewers—Jessica Benjamin, Lawrence Friedman, and Louis Sass. Each provides in-depth commentary on this important new contribution to the psychoanalytic literature. Their reviews are followed by an equally thoughtful reply by the author. In this manner the dialectical-constructivist approach to psychoanalytic work that Hoffman outlines is considered and reconsidered, challenged and defended, and defined and redefined through the perspectives of some of our field's leading thinkers. A particularly unique feature of this dialogue is the backdrop of death and mortality that has long been ignored or minimized by psychoanalytic writers but is brought into bold relief in Hoffman's work. We are certain that readers will be enriched by this exchange. In future issues we hope to repeat this format for other worthy and provocative new contributions to psychoanalytic thought.
Three Perspectives On Addiction
Authors: Johnson Brian
Published: April 2008

Three perspectives on addiction promulgated during the 1990s are reviewed, along with many earlier contributions to the understanding of addictive illness. It is suggested that these distinct yet overlapping formulations of the dynamics of addiction form a hierarchy for each patient suffering from an addiction. Assessment of a patient's ego strength, and of the relative importance of addictive behaviors in overall character structure, allows referral to various types of treatment, including psychoanalytic therapy. Case examples are presented, including material from the psychoanalysis of a woman addicted to heroin, methadone, cocaine, amphetamines, nicotine, alcohol, and shopping.
Anxiety, Signal Anxiety, and Unconscious Anticipation: Neuroscientific Evidence for an Unconscious Signal Function in Humans
Authors: Wong Philip S.
Published: April 2008

A central tenet of psychoanalysis, and arguably of any comprehensive theory of mind, is the existence of a psychological unconscious. Years of clinical investigation into the nature of unconscious processes have facilitated the development of psychoanalysis as a clinical method. Empirical investigations of unconscious mental processes, however, have lagged behind clinical inquiry. With few exceptions, attempts to understand unconscious processes using rigorous experimental controls have remained sequestered in scientific domains other than psychoanalysis, where they have proliferated recently. In view of this recent upsurge of research on unconscious processes outside of psychoanalysis, efforts to integrate such knowledge into general theories of psychopathology and clinical investigation are critical. In this paper, an interdisciplinary approach is taken to the study of one aspect of unconscious mental functioning—what Freud originally termed signal anxiety. Signal anxiety is examined using information from cognitive psychology and learning theory, psychophysiology, behavioral neuroscience, and psychoanalytic theory. Though the original concept of signal anxiety is supported by recent research, it is concluded that signal anxiety is probably best thought of not as the affect of anxiety but as a subset of unconscious mental processes that have a signal function of anticipating danger. Such unconscious anticipatory processes are a general feature of the mind that includes responses to both real and imagined (neurotic) appraisals of a situation. The neurophysiological structures and processes associated with unconscious anticipation in humans are just beginning to be understood.
A Commentary on “Leading Change with the 5-P Model: `Complexing' the Swan and Dolphin Hotels at Walt Disney World”
Authors: Brownell Judi
Published: April 2008

The management of the Swan and Dolphin Hotels found value in using the 5-P Model for implementing planned change. While such clearly defined methods can achieve desired outcomes, this commentary suggests that a symbolic lens is also useful in capturing and addressing important features of the change process. The success of a symbolic perspective depends in large measure on the leader's ability to listen and to understand how organizational members make sense of the changes taking place. Each stage in the 5-P process is discussed in light of insights gained from a leader who listens and recognizes.
The 5-P Model Is SPOT On
Authors: Davidoff Donald M.
Published: April 2008

The 5-P Model is a well-constructed method for change management, particularly with its requirement of establishing proof of the change's effects. Comparing it to another framework, SPOT (strategy, process, organization, and technology), the two approaches work similarly. The change method to be used depends in part on the personality of the change leaders and nature of the organization.
Mental Arithmetic in Children With Mathematics Learning Disabilities
Authors: Rousselle Laurence , Noël Marie-Pascale
Published: April 2008

The adaptive use of approximate calculation was examined using a verification task with 18 third graders with mathematics learning disabilities, 22 typically achieving third graders, and 21 typically achieving second graders. Participants were asked to make true-false decisions on simple and complex addition problems while the distance between the proposed and the correct answer was manipulated. Both typically achieving groups were sensitive to answer plausibility on simple problems, were faster at rejecting extremely incorrect results than at accepting correct answers on complex addition problems, and showed a reduction of the complexity effect on implausible problems, attesting to the use of approximate calculation. Conversely, children with mathematics disabilities were unaffected by answer plausibility on simple addition problems, processed implausible and correct sums with equal speed on complex problems, and exhibited a smaller reduction of the complexity effect on implausible problems. They also made more errors on implausible problems. Different hypotheses are discussed to account for these results.