Authors:Benjamin L. Robinson Pages: 282 - 296 Abstract: Writing up session notes is essential to therapists’ practice, yet the literature on psychotherapeutic writing focuses almost exclusively on more complex tasks, such as preparing case studies or pieces for publication. Nonetheless, problems with writing up seem widespread: this article finds that 85% of trainees report difficulty. Such ‘session block’ has not before been defined. Given the absence of well-accepted psychotherapeutic tools to overcome such block, and given that writing sessions is a challenge of representation – a phenomenon well described in the world of art – this article appropriates methods from aesthetic theory to address the problem. Applying first the Classical aesthetic metaphor of art-as-mirror, the pressure on therapists to produce a clear likeness of the session is explored, and the mirror metaphor is found to be as oppressive as it is widely accepted. By contrast, a revolutionary metaphor from the Romantic era, namely art-as-lamp, wherein the poet casts an inner creative light over the world, holds promise in overcoming countertransferential blocks and permitting an imaginative write-up. This too, though, has drawbacks, and the article concludes by proposing a method which, by integrating metaphors, permits a free-flowing write-up of the session, both creatively rich and clinically accurate. PubDate: 2017-07-18T18:02:34.513405-05: DOI: 10.1111/bjp.12314
Authors:Sian Ellis Pages: 297 - 311 Abstract: The supervisory relationship is complex and multi-layered, given the multiple sources of unconscious dynamics between patient, supervisee and supervisor. The concept of the parallel process has brought greater depth and understanding to the supervisor's countertransference as reflective of the dynamics within the analytic relationship. The tendency, however, is to consider the parallel process as occurring in one direction only: from the analytic relationship into the supervisory one. In this paper, I consider the multidirectional movement of transference and countertransference between both relationships, including where the supervisor might be the point of origin, rather than the recipient. Clinical material from two patients brought to supervision is analysed from four different vertices: the parallel process; the developmental aspects of the supervisory relationship and of the supervisee; my own potential transferences onto the supervisee and/or the patient; and the potential effect of my transference onto the supervisee, the patient and their interaction. I also refer to some paintings by Richard Diebenkorn, as these offer a powerful metaphor for understanding the challenges in supervision of creating a secure frame, while also allowing for a more ‘translucent’ space, within which the multi-layered dimensions can be imagined and become capable of continual transformation. PubDate: 2017-07-18T18:02:31.44431-05:0 DOI: 10.1111/bjp.12305
Authors:Clare Harvey Pages: 312 - 327 Abstract: Qualitative research in general and the psychoanalytically informed research interview method specifically, can be emotionally demanding on researchers as they form relationships with participants. This is especially the case when researchers and participants share particular identities and experiences. In this paper I reflect on my experience of interviewing mothers raising children with a visible physical disability about their maternal subjectivity. At times this was an emotionally demanding and ethically challenging process as participants closely identified with certain aspects of my identity, particularly with my visible physical disability and motherhood peculiarities. Often participants unexpectedly reversed our roles, asking me intimate questions. I will deliberate these dilemmas using interview material. I argue for a mindful blurring with participants when this occurs. Using certain psychoanalytic-researcher concepts of intersubjectivity, transference–countertransference and psychoanalytic-researcher thirdness helped me successfully navigate these encounters. I will also explore the rich participant psychic functioning that was generated from this intersubjective relationship between myself and the participants. PubDate: 2017-07-18T18:02:32.099301-05: DOI: 10.1111/bjp.12285
Authors:Alina Schellekes Pages: 328 - 345 Abstract: Deciphering the way patients experience time provides an additional key to primitive mental areas which do not express themselves in the usual verbal or symbolic ways and can help us and our patients better understand these deep layers of the psyche. It is when the issue of time moves to the centre of experience as a separate and predominant aspect of existence, that there and then occurs a disturbance in our continuous and natural transition between various temporalities, one that often exposes an inner rupture, many times of a very early origin. The paper first focuses on a number of art works which portray attempts to deal with death anxiety by capturing the moment, or watching, controlling, organizing, cataloguing the movement of time as though such attempts could freeze time and make it endlessly prolongued. Second, theoretical aspects and clinical vignettes focus on understanding the experience of time as fractured and fragmented; on experiences of timelessness, and, on stereotypical, ritualistic, autistic-like relations to time, perceived as frozen still. In addition, conceptualizing the analyst/writer's experience of time in the presence of her patients provided a unique tool for expanding the understanding of the patients' internal world. PubDate: 2017-07-18T18:02:32.983746-05: DOI: 10.1111/bjp.12284
Authors:Hanoch Yerushalmi Pages: 346 - 364 Abstract: This article examines the basic dynamics underlying some of the spontaneous developmental changes created out of the unique structure of analytic therapy. These dynamics include two types of basic forces working in the therapeutic setting: regressive and progressive urges and thrusts, which set opposite processes in motion. The progressive forces, highlighted in the article, are derived from developmental pressures. These forces create the conditions for people to seek new ways of experiencing the self and of connecting to significant others in what they sense to be a more mature and authentic manner. The literature describes how, through the healing power of therapeutic transference and regressive states, therapy can help to release obstructions to these developmental thrusts, which are created by childhood traumas caused by care takers. In this article, however, the release of obstructions is examined through meta-communication, an analytic clinical intervention that can enhance expression and realization of patients’ progressive wishes. PubDate: 2017-07-18T18:02:32.640387-05: DOI: 10.1111/bjp.12280
Authors:Kate Brown Pages: 365 - 387 Abstract: This paper examines how attachment theory has informed understanding of psychosis and has the potential to improve practice working with those who have accrued a diagnosis of psychosis. The treatment of psychosis is placed in its historical context, and commentary is made about the current treatments of those with psychosis and possible future developments. A psychoanalytic perspective is explored, and concern about the apparent colonization of the social and psychological by the biological expressed. Differing understanding and explanations of psychotic symptoms are explored and the predominance of biological explanations of the aetiology of psychosis is questioned. A brief description of attachment theory is given, before concluding how attachment theory informs understanding of psychosis and the implications for treatment. PubDate: 2017-07-18T18:02:33.813091-05: DOI: 10.1111/bjp.12306
Authors:Stijn Vanheule Pages: 388 - 398 Abstract: Starting from the hypothesis that psychosis makes up a structure with a precise status for the unconscious, the author explores how, from a Lacanian point of view, the treatment of psychosis is organized. Special attention is paid to the specificity of the psychotic symptom and the way transference characteristically takes shape. It is indicated that the occurrence of psychotic symptoms bears witness to a subjective crisis, in which no signifiers provide support when, at the level of the unconscious, the subject is dealing with fundamental self-directed epistemic questions (‘who am I'’) and questions concerning the intentionality of the other (‘what do you want'’). Characteristically, such questions are organized around intimate topics like dealing with parenthood and authority; life in the light of death; sexuality in relation to love and procreation; and sexual identity. Psychotic crises are triggered upon confrontations with such issues in daily life, while no support by means of a master signifier or Name-of-the-Father can be found. Crucial to the Lacanian approach to treatment is that the psychoanalyst aims at restoring a place for the subject in relation to the Other, which is threatened in episodes of acute psychosis. Clinical material from Lacanian work with a female patient suffering from manic-depressive psychosis is discussed. PubDate: 2017-07-18T18:02:32.405785-05: DOI: 10.1111/bjp.12301
Authors:Dorothée Bonnigal-Katz; Tomasz Fortuna, Christos Tombras Pages: 399 - 415 Abstract: This clinical roundtable features a presentation by Dorothée Bonnigal-Katz who posits the impairment of the mechanisms of repression as characteristic of psychosis and discusses its consequences for the analyst, especially as regards the place of interpretation. She shows how the analyst's encounter with the psychotic experience radically challenges and paradoxically validates psychoanalytic technique. In response to Bonnigal-Katz's discussion, Tomasz Fortuna offers an overview of the psychoanalytic tradition's response to psychosis, raising the issue of the relation between psychosis and neurosis. Christos Tombras, on the other hand, invokes Freud's discussion of Schreber's Memoirs from a Lacanian perspective and addresses the question of language and experience. PubDate: 2017-07-18T18:02:31.774732-05: DOI: 10.1111/bjp.12315
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