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The present article introduces a case study and describes a mutually integrative approach to treating a complex presenting problem. This article examines the specific issues surrounding integration when a supervisor and supervisee hold different theoretical perspectives. On occasion, such a relationship demands that the supervisee adhere to the model being taught by the supervisor. Examining integration in this format presents many advantages for both treatment and training. The key to the mutual integration is that two schools of psychotherapy can be combined in a way that creates a synergy; in that, together they are more powerful than either may be in isolation. A genogram with symbols from each model is incorporated to focus the treatment and create a format for the mutual integration., (© 2019 Family Process Institute.)

Objective: To identify how therapists invite patients with advanced cancer to engage with alternative perspectives about their illness trajectory and their end of life., Methods: Sequences of talk in which a therapist introduced a patient to alternative perspectives, were transcribed and analysed using the method of conversation analysis., Results: The analysis identifies one subtle way a patient is invited to consider an alternative perspective relating to their disease progression. Meaning expansion enquiries invite the patient to expand on the meaning of an utterance and in doing so, implicitly problematize the singularity of the patient's assumptions, without directly challenging them. The questions work as preliminary moves, providing the patient with the opportunity to expand on their assumptions. This enables the therapist to subsequently present an alternative perspective in a way that incorporates the patient's expanded perspective., Conclusion: The analysis reveals a skilful way in which therapists can cautiously and collaboratively introduce a patient to alternative perspectives concerning end-of-life, without invalidating the patient's perspective in this particularly delicate context., Practice Implications: Whilst mentalization is considered an important therapeutic process, the present study reveals precisely how this phenomenon can be enacted in therapy and within the particularly challenging context of end-of-life., (Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.)

The Melbourne Study of Psychoanalytic Psychotherapy examined the implementation, lived experience, and perceived therapeutic gains of psychoanalytic psychotherapy in a low‐cost, private‐sector community clinic. A first in Australia, this 8‐year demonstration project allowed naturalistic study of the impact and process of intensive, long‐term, time‐limited psychoanalytic psychotherapy delivered to self‐referred adults by clinicians with a common theoretical frame of practice. Presented in three papers, the research employed the RE‐AIM planning and evaluation framework, using complementary quantitative and qualitative methods, to study the psychotherapy service in terms of Reach, Effectiveness, Adoption, Implementation and Maintenance. This first paper reports the Reach of the program to be 67% for those presenting for assessment for psychoanalytic psychotherapy, with Adoption of the full 2‐year treatment program being 60%. Improvements in mental health and life functioning provided quantitative evidence of Effectiveness for those completing the 2‐year treatment program, with Maintenance at 8‐month follow‐up. Patient age, gender and personality characteristics did not modify these improvements. In‐depth qualitative exploration of patient and psychotherapist perspectives regarding the psychotherapy is reported in the second paper highlighting expectations, experience and benefits of the psychotherapy. The third companion paper presents the qualitative findings concerning factors experienced as facilitating or challenging therapeutic progress. Each of the three related papers amplifies understandings of how low‐cost, long‐term but time‐limited psychoanalytic psychotherapy can be implemented in the community with adults otherwise unable to afford such treatment, and discusses lessons learned. [ABSTRACT FROM AUTHOR]

This special issue on community mental health focuses on the ways in which several innovative mental health programs across the United States have risen to the challenge of incorporating psychodynamic principles into their clinical practice. Contrasted with these domestic programs are reports from a number of countries in Europe, Latin America, and the Middle East in which local clinicians describe how community mental health programs in their countries are tackling these issues. In this introduction, we emphasize factors common to the populations these authors serve, the organizational challenges they face, and the successes they achieve by way of their skill, creativity, and perseverance. We underscore the ways in which they articulate how psychoanalytic thinking, training, and practices have evolved in response to lessons learned and changing political, economic and cultural climates. We conclude that applied psychoanalysis, and particularly psychoanalysis applied to community mental health has, in some ways, been at the forefront of change in psychoanalytic practice in general. The modifications made by those in community mental health are viewed as necessary accommodations for both the communities served and for the psychoanalytic enterprise itself. [ABSTRACT FROM AUTHOR]

This paper explores the impact of kinship care upon the child, as observed through the clinical lens of child psychoanalytic psychotherapy. It acknowledges the social care and policy landscape, which retains a widely held belief that kinship care is a preferable option to foster care. In the light of this belief, the paper also draws attention to the internal and external dynamics inherent in the complexities of this arrangement as presented in the child's psychotherapy and the parallel parent work. Clinical vignettes are used to illuminate the often unconscious, painful and confusing thoughts, feelings and fantasies experienced by both the child and the kinship parent. Psychoanalytic ideas relating to Freud's 'The Uncanny' and Winnicott's paper 'Mirror-role of the mother and family in child development' are used to underpin the clinical material and reflections. The paper culminates in emphasising the need for practitioners to be attentive to these dynamics, and to provide robust support for the kinship parents, in processing their kinship experience and the intergenerational traumas it may stir up. [ABSTRACT FROM AUTHOR]

In this article I explore conscious and unconscious dynamics in relation to questions of power and vulnerability which frequently permeate relationships between psychoanalytic colleagues. Such dynamics have frequently led to splits in psychoanalytic training institutions. I focus particularly on the anxieties, rivalries, and alliances emergent in relationships between psychoanalytic colleagues in the UK between 1934 and 1945. I highlight how the transgenerational transmission of these dynamics has continued to affect the development of psychoanalytic organisations in the UK contemporaneously. I argue that attention to our own and to our colleagues' vulnerabilities is generative of productive, creative and mutually enhancing professional relationships which allow for critical questioning and differences. Such attention is crucial for psychoanalytic practices if we are to enable our patients to discover the power of their own independent voices. It is also vital for the development and survival of psychoanalytic psychotherapy in the current political climate. [ABSTRACT FROM AUTHOR]

In this paper, I analyse aspects of the experience of some female University students who have been raped drawing on a Kleinian psychoanalytic perspective and Layton's concept of 'normative unconscious processes'. I suggest that Klein's writing provides a theoretical basis for thinking about the projective and introjective processes that may be at play between perpetrator and 'victim'. Here, I focus upon Kleinian conceptualisations of castration anxiety, fragmentation, envy, greed and guilt. In terms of 'normative unconscious processes', I explore how castration anxiety (in a more symbolic sense of powerlessness), fragmentation, envy, greed and guilt may also operate within social discourses around sexual violence. Specifically, I draw upon Freyd's concept of DARVO and Payne's Rape Myth Acceptance Scale which both explain 'victim blaming' in terms of the social reversal of the positions of perpetrator and 'victim'. I illustrate this social process with reference to representations of rape within the mainstream media. My hypothesis is that, although the 'psychic' and the 'social' are two contrasting positions theoretically, it is possible to draw on both of them to make sense of the experience of working with rape clinically. The clinical context of this paper is my work as a psychodynamic counsellor at a modern London-based University. I draw on composite case studies of women who have been raped, drawing on both 'psychic' and 'social' perspectives. I seek to explore how the 'psychic' and the 'social' can be integrated in different ways depending upon the clinical situation. I suggest that they can be mutually enriching ways of working. Through approaching how the 'psychic' and the 'social' might interrelate from a clinical viewpoint, I conclude that the idea of 'working psychosocially' is of most use when approached as a flexible concept that different clinicians may draw on in different ways with different patients. [ABSTRACT FROM AUTHOR]

What are the binding commonalities that demark and define any and all psychoanalytic supervision perspectives? What do we all do as psychoanalytic supervisors that practically matters? Furthermore, might there be a unifying model that anchors those binding commonalities together into a supervision meaning-making, explanatory framework? In this two-part paper, I take up those questions. In Part I, based on a century-spanning literature review, I identify 50 (non-exhaustive) common Support and Learning factors that appear present across the panoply of psychoanalytic supervision perspectives. Relational, educational, and interventional, these 50 factors reflect the very stuff of which psychoanalytic supervision is made. In Part II, I present and elaborate upon the Contextual Psychoanalytic Supervision Relationship Model (CPSRM) – a theoretically-grounded model that anchors and contextualizes those common Support and Learning factors. Because common factors can be seen as nothing more than atheoretical amalgamation (i.e., lists of desirable characteristics endlessly strung together), the CPSRM is proposed as a theoretically-based antidote. A supervisory extrapolation of Wampold's contextual psychotherapy relationship model, the CPSRM accentuates relational connection, expectations/goals, and educational action as preeminently supervisee change inducing and learner affecting. [ABSTRACT FROM AUTHOR]

Psychoanalytic social work scholars lament the marginalization of psychodynamic theory in contemporary social work academia. Modern conflict theory applied to social work theories of pathogenesis and cure can serve as a means to explore this marginalization. Unconscious fantasy is important for understanding the resistance to psychodynamic theory in social work education. I offer some psychoanalytically informed strategies that might begin to restore psychodynamic theory in mainstream social work academia. [ABSTRACT FROM AUTHOR]

Working therapeutically with people who experience psychosis can be demanding, confusing and even terrifying for psychotherapists, yet there is very little research that has systematically investigated the experiences of psychotherapists concerning their engagement with psychotic phenomena. Theoretically, it has been proposed that managing countertransferential responses to a patient's psychosis is a crucial component of working psychoanalytically with such conditions. In light of this theoretical premise, the study reported upon in this article investigated some of the negative countertransferential dynamics observed by psychotherapists who engage in clinical work with patients presenting with psychotic states or conditions. Focused semi-structured interviews were conducted with eight psychoanalytically oriented psychotherapists. Two core themes emerging from the study are discussed: firstly, the psychotherapist's experience of madness; and secondly, the role of the body and somatic communication. The themes convey important aspects of countertransferential experiences related to the therapeutic encounter with psychosis. [ABSTRACT FROM AUTHOR]

This paper discusses the relations between tonal and atonal regions of the psychic space as being responsible for the relations between movement and stasis. Drawing on a musical terminology, I describe the constant tension between a harmonious pole of thinking and an idiosyncratic one, both in psychoanalytic meta-reflection as well as in the clinical realm, presenting thereby bibliotherapy, poetry therapy, and the poetic zones of psychoanalysis and psychotherapy as the therapeutic forces which “pull” toward the link to atonal psychic areas, enabling in that way the ongoing integration of the homely and un-homely, the syntax and the anti-syntax of the psychic space. [ABSTRACT FROM PUBLISHER]

The introduction of the concept of mentalizing into psychoanalytic discourse has provided researchers with an important tool for beginning to understand the mechanisms mediating the relationships between childhood experiences and later psychological functioning. Researchers have made strong statements regarding the strength of this mediational relationship in their movement toward the building of novel and efficacious intervention approaches. The goal of this systematic review was to critically examine the empirical evidence for these statements. Five unique studies were identified that assessed the relationships between the variables of attachment and/or childhood adversity, mentalizing and adult functioning. Some preliminary evidence for the role of mentalizing as an important mediator variable was identified. However, researchers were cautioned to continue to engage in further empirical study to ensure that theoretical explorations do not overstate or move too far beyond the empirical research findings.

In Appreciation of Dennis Brown This article is about the group analytic concept of the Social Unconscious, and is an attempt to grasp some of the challenges that this idea (or collection of ideas) presents, especially to students of group analysis: and perhaps one or two of the possibilities. The mill in my title means firstly the psychoanalytic ‘mill’ located wherever there are two or more people gathered in the service of analysis and secondly my own mental mill working through the learning process, with a passing reference to the class struggles centred on the textile mills in the north of England in the early part of the 19th-century1. What I wish to investigate in particular is the choice made in therapeutic situations, between analysing the unconscious from an individual standpoint, and analysing from a social standpoint, something which has been brought to the fore by the coining of the term ‘social unconscious’. [ABSTRACT FROM AUTHOR]

This paper aims to perform a systematic review of the literature from 2009 to 2015, searching through databases for Psychotherapy Process Q-Set (PQS) contribution to process studies in psychoanalytic psychotherapy. Indexed articles were consulted in the following databases: Web of Science, PsycARTICLES and PsycINFO (American Psychological Association), PubMed. As search strategy, the following key words were used: "PQS", "Psychotherapy Process Q-Set ". Sixty six articles were found and 14 were selected that formed two categories of analysis: one descriptive and the other category based on the studies' focus. This review points out the investigative potential and richness of the findings for the improvement of psychoanalytic psychotherapy practices. [ABSTRACT FROM AUTHOR]

In this brief communication, we offer one perspective - the contextual psychoanalytic supervision model (CPSM) - on how psychoanalytic supervision works. The CPSM, a supervisory extrapolation of Wampold's contextual psychotherapy relationship model, accentuates four psychoanalytic supervisor-supervisee relationship variables as crucial and change inducing: the learning alliance bond, supervisor-supervisee real relationship, creating supervision expectations/providing an expectation-consistent form of supervision, and the supervisee's engagement in facilitative educational actions. The CPSM is presented in hopes of stimulating further discussion about what makes psychoanalytic supervision work. [ABSTRACT FROM AUTHOR]

As I conceive it, existential psychotherapy has deep spiritual roots. Following in the tradition of existential-spiritual philosophy, I describe the nature of these roots, the implications of them for existential-integrative therapy, and a case vignette to illustrate their application. I conclude with a reflection on the importance of contextualizing and integrating existential themes into general therapeutic practice. [ABSTRACT FROM AUTHOR]

The difficulties in conducting psychodynamic psychotherapy research are well documented. More recent meta-analyses have demonstrated clear benefits; however, it has been argued that naturalistic studies are of more direct relevance to clinical services. UK National Health Services ( NHS) provide psychodynamic psychotherapy within psychiatric settings for heterogeneous and generally complex patient populations. Much of the psychodynamic psychotherapy is provided by trainee psychiatrists who rarely have prior experience of delivering such therapy, but who are supervised by senior staff. Our naturalistic outcome study uses both quantitative and qualitative methodology, and describes a symptomatically and functionally impaired patient group (n = 384) deriving significant and clinically meaningful benefit from their therapy. Patient satisfaction and perceived change were positively correlated with each other and with symptomatic improvement. Patients' descriptive comments provided additional rich information, most commonly describing a positive outcome for therapy and the belief that therapy was too short. This study complements more formal research showing that psychodynamic psychotherapy is efficacious in outpatient settings. [ABSTRACT FROM AUTHOR]

In post-apartheid South Africa we speak about race extensively. It permeates our workplace, weaves a thread through the fabric of our professional and personal lives, as well as our private conversations and public interactions with others. From within psychoanalytic theory, the thread weaves through the unknown content of our racialized unconscious. When there is a focus on race in the South African psychoanalytic context it largely takes the form of the struggle to articulate the complexities of working with difference, as Swartz notes, or the struggle to map out issues of race. Such struggles are not localized in South Africa, but strongly reflect a much broader struggle within the global psychoanalytic community, as mirrored in the expanding focus on race. Although the consulting rooms seem far removed from the ongoing political tensions that have recently emerged in South Africa, psychoanalytic psychotherapy remains a space of meaningful engagement with the other, and where the therapeutic dyad is one of racial difference it permits an encounter with our racialized unconscious. This article seeks to document the experience of my black client and my white response to her racial pain and struggle; in doing so, I describe the racial 'contact' between us and within us that triggers a racialized transference and countertransference dynamic, which contains the space for racial healing for both of us. [ABSTRACT FROM AUTHOR]

This papers aims at clarify the confusion between psychotherapies and psychoanalysis. Psychoanalysis is distinct from psychotherapies because when he is a psychoanalyst, psychiatrist does not present himself as knowing what is good for the patient, and does not try to influence him. Few patients are able to use psychoanalysis proper. When it is so, psychiatrist has to modify the therapeutic setting in order to make a psychoanalytic process to occur. In doing so, he practices a psychoanalytic psychotherapy. It is a psychotherapy because the psychiatrist has to act, but it remains a psychoanalysis, because he does not try to influence the patient. Every time psychoanalysis is feasible, it remains the best psychotherapy. [ABSTRACT FROM AUTHOR]

This article explores the concomitant change in one client's object relations and his image of God that occurred in the context of psychoanalytically oriented psychotherapy. The case demonstrates the benefit of long-term psychoanalytically oriented treatment to help an individual with major mental illness to heal emotionally, mentally, and spiritually. The client, who suffers from bipolar I disorder, experienced significant developmental mastery as he moved from the paranoid/schizoid position to the depressive position (developmental stages conceptualized by theorists Melanie Klein and Douglas Fairbairn). In addition, the psychotherapy mitigated the effects of homonegativity on M's self-image and his experience of his homosexuality. Through our work, the client began to see and interact with this clinical social worker, others, and the God of his understanding, in a more realistic and healthy manner. M's participation in a 12-Step group and his adherence to its beliefs augmented changes he made through psychotherapy. Through a long-term psychoanalytically oriented psychotherapy and involvement in Al-Anon meetings, the client's belief in a punishing God shifted toward a more benevolent one-a God who had a plan for his life that was revealed through the transformation of his suffering. In summary, M's object relations changed toward a greater balance of emotions and development of more textured relationships, including his relationship toward himself and God. [ABSTRACT FROM AUTHOR]

This article introduces integrally informed clinicians and their patients to an Integral Psychograph Assessment (IPA). The IPA I employ is a clinical assessment process developed for psychotherapists to be used with their patients in the therapeutic context to evaluate levels of an individual across 10 lines of development. In this article, the integral psychograph is first situated within the Integral model and then within a larger historical discussion of multiple lines of development. The components of the IPA-the map, matrix, and mirror-which utilize third-, second-, and first-person clinical assessment methodologies are then introduced and described. Clinical considerations, with an emphasis on the impact of the assessment process on therapy, are woven into the discussion of the six procedural steps of the IPA. To illustrate the assessment process, I present clinical vignettes in which the IPA was administered in the context of long-term (five year) psychoanalytically oriented integral psychotherapy with an adult patient. I conclude with a discussion of clinical implications to be considered when using an IPA in the context of psychotherapy. [ABSTRACT FROM AUTHOR]

Abstract: Authors propose to consider theoretical knowledge about role and functioning of playing in infant and childhood. Psychoanalytical specialized literature review gives more knowledge and reflections about playing. The main purpose is centred on the role of body experiences in playing in front of adult''s look (psychotherapist or parents). Finally, a research line is given, the most interesting question seems to be the study of child''s playing development during child''s thinking abilities development. [Copyright &y& Elsevier]

Parallel process in psychotherapy and supervision is a phenomenon manifest in relationships and interactions, that originates in one setting and is reflected in another. This article presents an explorative single case study of parallel processes based on qualitative analyses of two successive randomly chosen psychotherapy sessions with a schizophrenic patient and the supervision session given in between. The author's analysis is verified by an independent examiner's analysis. Parallel processes are identified and described. Reflections on the dynamics of parallel processes and supervisory interventions are reported and discussed. [ABSTRACT FROM AUTHOR]

The author describes a reformulation for research purposes of a supportive psychoanalytic therapy for patients with borderline personality disorder. The major influences on the thinking that led to the modification of prior formulations and the historical background of treatment manuals are described. Supportive treatment is contrasted with transference-focused psychotherapy and dialectic behavior therapy in the interest of creating a clear comparison that lends itself to empirical study. [ABSTRACT FROM AUTHOR]

Objective: Both the National institute of Mental Health and the American Psychological Association have called upon psychodynamic practitioners to start demonstrating their outcomes. This effectiveness study attempted to begin to answer these calls. Method: The study was a secondary analysis of data from a multidisciplinary psychodynamic mental health clinic. It used a single-group, within-subjects longitudinal design. The psychometrically validated Outcome Questionnaire was used as a measure of change. A linear mixed and random effects model was used to analyze the data. The aims of this study were (a) to look at whether patients improve and (b) if so, at what variables moderate outcome. Results: Findings suggest that psychodynamic treatment, provided within this practice configuration, is effective over time, producing moderate effect sizes, and points to the particular importance of the first 3 months. Conclusions: Findings suggest a common course of recovery with some between-group variability. [ABSTRACT FROM AUTHOR]

This article briefly introduces the psychological continuum in therapeutic intervention, ranging from purely psychoanalytic to humanistic and eventually to a transpersonal model. The Projective Prism of Consciousness is introduced as a transpersonal tool for Poetry Therapists, who prefer to use their intuitive thinking in assessing the poetic projections of their clients. The prism consist of the Projective Sides of the Prism, the Domains and the Roots, the Content, and the Outcome of Projections focusing on the Personal, Transpersonal, or Universal consciousness of the creator of poetry. The author's own poetry is used as an initial application of the Projective Prism of Consciousness Checklist. [ABSTRACT FROM AUTHOR]

Psychoanalytic perspectives on violence between partners is described and forms a foundation for an approach to group and individual psychotherapy of men and women in relationships in which there is physical violence between partners. The empirical results of a study of the outcome of psychoanalytically oriented psychotherapy are described. Nineteen men and 16 women completed research measures before beginning psychotherapy and after completing 16 sessions of group psychotherapy. Twelve people who completed group psychotherapy continued in individual psychotherapy and completed measures again after 16 sessions of individual psychotherapy, and nine people completed measures again after the 16 sessions of group and 32 sessions of individual psychotherapy. Statistical analyses addressed outcomes in terms of verbal and physical aggression and dysphoric affects and anger. Both research and clinical outcomes are discussed. [ABSTRACT FROM AUTHOR]

My aim is to describe the therapeutic effect of psychoanalytic psychotherapy by estimating the psychotherapeutic relationship from the viewpoint of symbolization– reflectiveness, which forms the framework for my consideration. The psychic development takes place as an evolution of symbolic and reflective functions, which proceed as an epigenetic process in successful psychotherapy. I formulate symbolic function by using Charles Peirce's sign terminology. These signs are index, icon, and conventional symbol, which form the corresponding three modes of symbolic function. The human mind binds physical observations, which come from him:herself and:or from the outer world, by means of symbolic function and the reflective capacity; thus psychic structures and meanings are formed. A model of symbolization–reflectiveness in the psyche is presented. A longitudinal psychotherapy process is described to illustrate the patient's capacity to process the undifferentiated anxiety into psychic differentiation by means of the epigenetic development of indexical, iconic, and verbal symbolization. The emergence of the reflective self is a crucial phase to consolidate the stable core identity. The nature of symbolization –reflectiveness in the human mind is twofold: on the one hand, symbolic function creates psychic structures from physical observations, and on the other hand, the human being can then, using the reflective capacity, give to these psychic structures meanings that are individual and permanent. I use the symbolization– reflectiveness model for the consideration of the psychic development in the process of psychoanalytic psychotherapy. A detailed psychotherapy process of a borderline patient illustrates these dynamic phenomena of therapy. [ABSTRACT FROM AUTHOR]