Psychoanalytic Therapy

Existing research demonstrates that culture has a profound impact on the expression and manifestation of mental illness, especially on depressive disorders among ethnically diverse populations. Currently, little research has focused on the Haitian population, despite the growing number of Haitians living in the United States. This paper discusses clinical observations of the expression of depression among Haitian immigrant women living in the United States. Specifically, this paper examines three distinctive types of depression (pain in the body, relief through God, and fighting a winless battle), explains their symptoms, and provides case examples to illustrate the expression of each type of depression. Additionally, the paper describes treatment processes for each type of depression and makes recommendations to mental health providers with respect to each type of depression. The information provided in this paper highlights the importance of a more systematic and scientific invest...

This paper explores the psychology of physical symptoms; how they present in the psychotherapy room and their underlying dynamics. From the beginning of psychoanalysis there has been an interest in those physical symptoms that do not seem to have a biological origin and, in particular, those physical illnesses that appear to be related to the patient’s psychopathology. In order to explore such symptoms and illnesses further, this paper reviews the concepts of conversion and somatisation. The two concepts are compared and contrasted with specific attention paid to their genesis, to the meaning in the particular form that the symptoms take and to the therapeutic task associated with treating patients who present with these two types of pathology. Illustrative case material is introduced and the paper concludes that the distinction between the two pathologies can be understood in terms of relative mentalizing capacity. This understanding, it is argued, is clinically useful as it helps ...

This paper focuses on comments made by patients about the body of the analyst in therapeutic exchanges. The paper begins by exploring the nature of the asymmetry between analyst and patient and its theoretical foundations in psychoanalysis. The question is then posed as to whether considering some of the specific features of the form and timing of the references to the analyst's body in light of this asymmetry may help therapists understand the dynamics of particular therapeutic dyads. Making use of the existing literature and clinical material to support the argument, the paper suggests that using the nature of the therapeutic frame as a preliminary aid to interpretation may cast light on the extent to which references to the analyst's body can be understood as resistances to the defining features of the therapeutic frame, and in so doing illuminate aspects of the transference-countertransference dynamics.

In the past few years there has been a dramatic increase in the number of psychoanalytic publications on the topic of psychosomatic illness, including edited collections and special editions of psychoanalytic journals. This paper is a critical conceptual review of the topic of psychosomatic illness using the material contained in a number of these recent publications as a basis, but also drawing on other works by the key authors of the publications discussed herein. This paper proposes that currently there appear to be two schools of thought around the origin, development, and treatment of psychosomatic symptoms. The first of these is the well-established "Paris School of Psychosomatics." The second approach does not formally exist, but is referred to in this paper as the "Attachment approach" since there are a number of authors who theorize about the treatment of psychosomatic symptoms in a similar and important way. The paper will compare and contrast the two a...

Conscious Creative Compartmentalization (CCC) is a self-devised, non-clinical psychological method designed to facilitate emotional processing, self-reflection, and problem-solving through the intentional adoption of creative roles or archetypes. Unlike dissociation or pathological fragmentation, CCC operates under continuous conscious awareness of the core self. The practitioner uses creative embodiment as a controlled lens to engage with specific emotional or cognitive domains, promoting insight while avoiding overwhelm. This paper outlines CCC’s theoretical foundation, operational framework, and potential neurological mechanisms, drawing from existing psychological theories and empirical research.

Among the theoretical contributions made by Hans Loewald, some of the most meaningful address the developmental process of differentiation from a primary or original unity into “id-ego and objects.” This differentiation requires “separation, loss, and restitution,” and results in a shift
from oneness/unity to at-onement, a connection that bears within it the trace of the separation it emends. A parallel dynamic plays out in the shift from identification to internalization in Loewald’s work. The author identifies this dynamic as cohering difference, a structural interaction in both intra- and inter-psychic processes graphically illustrated by the hyphen in Loewald’s concept of “atonement.” The author examines these processes and the significance of cohering difference, illustrated by Loewald’s idea of “linking,” and presents a clinical example in which loss, grief, identification,
and internalization play key roles.

It was the goal of this exploratory study to assess the feasibility and potential use of the Computerized Text Analysis for Reflective Functioning (CTA RF) in the measurement of mentalizing capacities in clinical practice and research. For this exploration, we utilized archival data from a research study examining the process of couple therapy with childhood sexual abuse survivors and their partners. The CTA RF is a computerized method of scoring reflective functioning by analyzing narratives to assess mentalizing capacities. It is cost effective, requires little training to administer and score and can be applied to any form of transcript including psychoanalytic sessions and research participant interviews. In this first clinical research application of the CTA for RF in couple therapy sessions with trauma survivors we identified that the CTA RF is a time and cost efficient method of measuring mentalizing that does not require extensive training to administer and score and a method of measuring mentalizing that shows promise in broadening the scope of future research in mentalizing and the role of mentalizing in psychotherapy.

Carl Jung’s theory of synchronicity posits that, alongside causality, there exists an acausal principle that governs the meaningful coincidences connecting psyche and cosmos. Understanding the psyche, therefore, requires not only attention to linear cause-and-effect relationships but also to this additional, non-causal principle. Central to this perspective is the idea that time in the psyche is relative: the unconscious holds the future within the present, and consciousness, as it emerges, lags behind this temporal unfolding. This paper explores prospective, or “future-telling,” dreams as a vivid illustration of synchronicity in action, demonstrating how the psyche anticipates events before they manifest in conscious experience.
Through a clinical vignette, I present an example of synchronicity expressed in a prospective dream, where a patient’s past, present, and potential future intersect to provide both insight and healing, and a synchronistic event illustrates how unconscious foresight and meaningful coincidence can converge. The dream facilitates the patient’s reconnection with his inner child and also allows for the integration of past trauma, present awareness, and the prospective guidance of the psyche. This article highlights how prospective dreams exemplify an unorthodox temporality and the principle of synchronicity, revealing the psyche’s capacity to unify disparate temporal dimensions. By acknowledging this acausal principle, analysts and patients alike can access profound opportunities for insight, healing, and the restoration of wholeness across past, present, and future.

Objectives: Screening for personality dysfunction is relevant to treatment planning in psychotherapy, psychosomatic medicine and psychiatry. This makes short versions of field-tested approaches such as the OPD Structure Questionnaire (OPD-SQ) necessary. Methods: With the aim of developing a screening version, the original sample of the OPD-SQ was divided into two subsamples. After developing a preliminary 12-item version in one subsample, we used confirmatory factor-analysis in the second subsample as well as an independent sample to test the factor structure. The analyses confirmed a structure of three correlating factors with adequate fit indices. Other findings relating to the validity of the long version were replicated as well. In addition, data from an independent sample of psychotherapy inpatients confirmed the factor structure and provided further evidence for its validity. The OPD-SQS is a viable screening instrument for supporting clinical decision making in stepped-care approaches in psychotherapy, psychosomatic medicine and psychiatry.

The authors describe the role of a supervision group of psychotherapists within a wider therapeutic field for severely disturbed borderline patients. The group concentrates on the transference and countertransference, seen according to Racker's distinction between concordant and complementary identifications. The implications of the prevalence of the complementary identifications over the concordant identifications of the therapists to their patients and the resulting regression to primitive defense mechanisms can be counterbalanced by the group's integrative functioning as receiver (1) of a variety of information about the patient, (2) of the therapist's attempt to understand and synthesize, and (3) of the therapist's countertransference reactions to his patient. The major discrepancies between the various conceptions of the borderline patients' psychic world and the appropriate therapeutic technique to be applied are also discussed, as well as the way the group filters the information and integrates the therapeutic thought. It might be said, therefore, that, in the ''inpatient'' phase of the individual psychotherapy, the group of psychotherapists functions, for the patient and the treatment, in a synthesizing context, as it provides the therapist with a space of integration for his split-off part of self and object representations, which the therapist makes use of for his patient.

This is the text of a presentation on 25th July at the IPA Congress in a panel on 'Ethics of confidentiality in the digital age', in which my co-presenters were Glen Gabbard and Cláudio Eizirik. The panel was organised jointly by the IPA Confidentiality and Ethics Committees and chaired by Altamirando Andrade, Chair of the Ethics Committee.

We conducted a MEDLINE search to locate all published randomized controlled trials of psychotherapies identifi ed by their authors as being "psychodynamic" or "psychoanalytic." We also used meta-analyses and review articles to identify trials , examined the reference lists of recovered articles, and consulted experts in the fi eld to ensure that we obtained a comprehensive list. All studies that randomized participants to two or more treatments, one of which was identifi ed as "psychodynamic" or "psychoanalytic" treatment, were included. Studies that identifi ed themselves as precursors to larger and more complete studies were excluded even if randomization was performed. To capture the full range of study quality, we did not use a sample size cutoff in selecting trials. Only studies with published articles in English were included. A total of 94 trials were identifi ed that met inclusion and exclusion criteria.

This article tells the story of the development of an outcome study of psychoanalysis and describes the debate that took place over critical methodological issues. The protocol committee included career psychotherapy researchers who have conducted rigorous outcome studies, clinical psychoanalysts, study methodologists, and a statistician with clinical trial expertise. The committee worked for two years to develop the study design. This project is based on the premise that clinical psychoanalysis is a treatment. Areas specifically addressed are the goals and hypothesis of the study, inclusion and exclusion criteria, choice of psychotherapies as comparison treatments, definition of treatments and selection of therapists, use of medication, development of a treatment adherence measure, randomization of patient assignment vs. patient self-selection, and primary outcome measures. The execution of this outcome study will require significant effort and resources. A positive result would bo...

Systematic research on psychoanalytic treatments has been limited by several factors, including a belief that clinical experience can demonstrate the effectiveness of psychoanalysis, rendering systematic research unnecessary, the view that psychoanalytic research would be difficult or impossible to accomplish, and a concern that research would distort the treatment being delivered. In recent years, however, many psychoanalysts have recognized the necessity of research in order to obtain a more balanced assessment of the role of psychodynamic psychotherapy and psychoanalysis in a contemporary treatment armamentarium, as well as to allow appropriate evaluation and potentially greater acceptance by the broader mental health and medical communities. In this context, studies were conducted of a psychodynamic treatment, Panic-Focused Psychodynamic Psychotherapy (PFPP), initially in an open trial and then in a randomized controlled trial (RCT) in comparison with a less active treatment, Ap...

Information is presented here on CAPP -child and adolescent psychodynamic psychotherapy. Following a definition of anxiety, the authors present study outcomes of non-psychodynamic treatment approaches, alone and in combination with psychopharmacologic treatment, then explore psychodynamic approaches. A detailed overview of psychodynamic psychotherapy is presented, along with two cases illustrating the use of CAPP with young patients with anxiety. The authors also present tables and boxes summarizing CAPP therapeutic processes and strategies as intervention for anxious youth.

Background-Little research has addressed moderators of treatment outcome for anxiety disorders, and none has considered interpersonal loss as a predictor of outcome. Purpose-To examine the effect of interpersonal loss events within the six weeks preceding panic disorder (PD) onset as a moderator of outcome in a randomized controlled trial of Panic-Focused Psychodynamic Therapy (PFPP) and Applied Relaxation Therapy (ART). Researchers hypothesized that such loss events would predict better outcome in PFPP but would not affect ART outcome. Method-Forty-nine subjects with PD were randomly assigned to a 12-week course of PFPP or ART. Independent raters blinded to treatment condition and study hypotheses rated subjects on the Panic Disorder Severity Scale (PDSS) and Sheehan Disability Scale. Exploratory analyses assessed between-group effect size for PFPP and ART following standard moderator analytic procedures. Results-Three-quarters of subjects reported a narrowly defined interpersonal loss (LOSS) in the 6 weeks preceding PD onset. Subjects had a mean duration of PD of 8.2 (9.5) years. PFPP was more efficacious than ART, but LOSS did not moderate PFPP outcome. An unexpected finding was that LOSS moderated ART outcome: subjects without LOSS showed no response to ART (PDSS change= 0.00 [2.90]), whereas LOSS had a pre/post effect size of 4. 29 (5.60). Neither examination of various potential confounding variables nor sensitivity analyses of assumptions regarding attrition altered these findings. Conclusions-Interpersonal loss events preceding onset of panic disorder were common. These losses moderated outcome in ART, a therapy that does not focus on such losses. Implications and need for future research are discussed.

In 1991, André Green gave a lecture on thirdness at the Squiggle Foundation in London.  Green’s reflections on thirdness are grounded in the critique, widespread outside the United States, of Heinz Hartmann’s formulation of Ego Psychology from the late 1930s onwards. Green finds in Winnicott’s thinking an antidote to the drift of Ego Psychology. “Winnicott intuitively understood,” Green says, that “no psychology could be applied to the unconscious.”

We outline a practical approach to psychodynamic formulation to show how useful it can be within the demands of ordinary clinical practice. To do so, we break down the components of a dynamic formulation using a variety of examples. We draw on the Triangle of Insight (Jacobs, 2006) and the Triangle of Persons (Malan, 1979) as our main model of formulation and compare it to other approaches. By doing so, we aim to illustrate how formulation is a flexible, effective tool for therapeutic assessment. The article also outlines a way of thinking through written case formulation, discussed primarily through an extended case example. Waitara Ka huaina e māua he tirohanga aropā ki te tauirahanga hinengaro kia mōhiotia ai tōna painga i roto i ngā nonoi o te mahi haumanu. Kia taea ai ka whāia ētahi tauira hei arohaenga i ngā waehanga tātainga hikareia. Ka huri ki te Mātauranga ā-Tapatoru (Jacobs, 2006) me te Tapatorunga ā-Tangata (Malan, 1979) hei whainga tauira matua tātai ka whakataurite ki ...

Advances in artificial intelligence have led to the emergence of AI chatbots and “digital therapists” capable of simulating therapeutic conversations. This raises a critical question: Can AI ever truly replace a human psychotherapist? From a relational and integrative psychotherapy standpoint, the answer is a resounding no. Psychotherapy is not merely about dispensing advice or techniques – it is fundamentally a co-created relational experience between two human beings. As existential therapist Irvin Yalom noted, in therapy the client is not just getting expertise but “being witnessed” by a fellow human . The healing that occurs in psychotherapy depends on the therapist’s presence, attunement, and genuine subjectivity elements an AI cannot genuinely provide. While AI-based chatbots may offer convenient support or coping tips, what is lost is the human connection that makes therapy therapeutic . The following sections explore why an AI system, lacking human emotion and embodiment, cannot meet the complex relational needs involved in healing. We draw on Richard Erskine’s integrative psychotherapy theory of relational needs, broader relational and intersubjective perspectives (e.g. Jessica Benjamin, Daniel Stern, Thomas Ogden), and recent ethical discussions to illustrate the irreplaceable value of a human therapist in the psychotherapeutic process.

This paper was developed with the assistance of OpenAI’s ChatGPT using its DeepSearch function to generate draft text and explore relevant sources. The author critically reviewed and revised all AI-generated content.

An illustration of the fruitful employment of K. R. Eissler's technique in the setting of consultation/liaison psychiatry, with observations on countertransference and certain universal aspects of the human response to death and dying as they pertain to clinical practice.

This paper reviews the object relations model of W.R.D. Fairbairn and applies it to the understanding of the obsessional personality. Fairbairn ' s model sees attachment to good objects as the immutable component of normal development. Parental failures are seen as intolerable to the child and trigger the splitting defense that isolates (via repression) the frustrating aspects of the object along with the part of the child ' s ego that relates only to that part-object. This fundamental defense protects the child from the knowledge that he is dependent on indifferent objects and preserves his attachment. The split-off part-self and part-object structures are too disruptive to remain conscious, yet despite being repressed make themselves known through repetition compulsions and transference. The specifi c characteristics of families that produce obsessional children impact the child ' s developing ego structures in similar ways. This style of developmental history creates predictable self and object confi gurations in the inner world, which then translate via repetition compulsion into obsessional behavior in adulthood.

This paper reviews the object relations model of W.R.D. Fairbairn and applies it to the understanding of the obsessional personality. Fairbairn ' s model sees attachment to good objects as the immutable component of normal development. Parental failures are seen as intolerable to the child and trigger the splitting defense that isolates (via repression) the frustrating aspects of the object along with the part of the child ' s ego that relates only to that part-object. This fundamental defense protects the child from the knowledge that he is dependent on indifferent objects and preserves his attachment. The split-off part-self and part-object structures are too disruptive to remain conscious, yet despite being repressed make themselves known through repetition compulsions and transference. The specifi c characteristics of families that produce obsessional children impact the child ' s developing ego structures in similar ways. This style of developmental history creates predictable self and object confi gurations in the inner world, which then translate via repetition compulsion into obsessional behavior in adulthood.

Through studying the report of a public enquiry -the Report of the committee of the inquiry into the Personality Disorder Unit, Ashworth Special Hospital (DoH 1999a)and a detailed analysis of interpersonal processes in professional consultations with forensic practitioners through the 'lens' of a psycho-analytically-informed paradigm, a critical link is demonstrated between clinical interpersonal processes with patients in perverse, antisocial states of mind and professional performance. The study shows unconscious processes attacking reality and thinking, 'nudging' professionals into acting out of role in ways known to contribute to the emergence of critical incidents. It is grounded in an enquiry that effected changes in legislation, policy, clinical practice and the delivery of social care in secure psychiatric settings. Social work is conducted within a social arena of contemporary concerns about risk and its prediction and management. When things go tragically wrong, events are scrutinised in the form of internal and public formal enquiries with emotive media commentary. Recent examples -Victoria Climbie, Baby Peter -demonstrate the way the public imagination can focus on perceptions of professional failings. The explosion of private events such as these into the public domain results in changes to structures, processes and political understandings in relation to risk, danger and fear. Such enquiries illuminate professional conduct with hindsight, foregrounding decisions that may appear misguided and are popularly held as evidence of incompetence. However, rarely do they ask why apparently 'ordinary decent' professionals appear to have acted in extraordinary ways and usually sensible people sometimes do foolish things. This forensic study suggests that a psychoanalytic paradigm is a useful means of achieving a depth of insight in this context. It proposes widely applicable understandings of the types of personal qualities and management structures necessary to delivering high risk, high profile, anxiety-driven services in a social climate of fear. The paedophile is the bogeyman of our age. The very word itself has become a conduit for fear and public loathing, often beyond all moderation. Indeed, despite the fact that the overwhelming majority of paedophiles are male, commentators reach easily for parallels with a reviled figure from a bygone age -the witch. While we haven't yet reinvented the ducking stool or trial by water, we have found a pretty effective 21 st -century equivalent in trial by newspaper. And, after being named and shamed, the "guilty" are hounded from the community by a mob baying for blood. (Silverman & Wilson 2002: 1) Chapter 1: Introduction: "Favouring fright over facts" (Gostin 2002) These crimes are sickening. It is against this backdrop that one must ask why this child was allowed to visit these men, frequently unsupervised, at all, let alone on any ward, but particularly on this ward housing patients with serious personality disorders, all of whom had serious criminal histories, including murder, rape and sexual assaults against children. (DoH 1999a: 3.11.3) …the professional isolation of the Social Work Department vividly demonstrated in the Hospital's approach to child protection, which appeared to reflect almost complete ignorance of the Children Act 1989 and its guiding principles. We shall see an example of the lack of clarity over the social work role when it came to vetting visitors. We shall also see the problems caused by a particular autonomous professional who neglected core social work duties for therapy; whose record-keeping was poor; and whose general approach to his social work duties demonstrated poor standards and reflected poor supervision. (DoH 1999a: 1.32.13) ...Before 1989 no sensible lawyer, doctor, social worker, psychologist, hospital administrator, or responsible member of the public would have thought it appropriate to expose young children to paedophiles, particularly paedophiles with known criminal histories. Before 1989 responsible members of the public would have been horrified by the knowledge that such exposure was allowed on the basis of it being therapeutically advantageous for such criminal paedophiles, who were not even close family members. That this occurred is something for which no one involved in Ashworth Hospital can escape a degree of criticism…. (DoH 1999a: 3.31.16

The paedophile is the bogeyman of our age. The very word itself has become a conduit for fear and public loathing, often beyond all moderation. Indeed, despite the fact that the overwhelming majority of paedophiles are male, commentators reach easily for parallels with a reviled figure from a bygone age - the witch. While we haven't yet reinvented the ducking stool or trial by water, we have found a pretty effective 21 st-century equivalent in trial by newspaper. And, after being named and shamed, the "guilty" are hounded from the community by a mob baying for blood. (Silverman & Wilson 2002: 1)

This paper describes a specific psychoanalytic psychotherapy for patients with severe personality disorders, its technical approach and specific research projects establishing empirical evidence supporting its efficacy. This treatment derives from the findings of the Menninger Foundation Psychotherapy Research project, and applies a model of contemporary psychoanalytic object relations theory as its theoretical foundation. The paper differentiates this treatment from alternative psychoanalytic approaches, including other types of psychoanalytic psychotherapy as well as standard psychoanalysis, and from three alternative non-analytical treatments prevalent in the treatment of borderline patients, namely, dialectic behavior therapy, supportive psychotherapy based on psychoanalytic theory, and schema focused therapy. It concludes with indications and contraindications to this particular therapeutic approach derived from the clinical experience that evolved in the course of the sequence of research projects leading to the empirical establishment of its efficacy.

The authors address psychodynamic therapies, particularly transference‐focused psychotherapy (TFP), in the treatment of patients who present with non‐suicidal self‐injury. In doing so, they briefly discuss various psychodynamic approaches with empirical evidence for their effectiveness. They describe TFP, including its treatment rationale, putative change mechanisms, and outcome research. They then present a case illustration of a patient with borderline personality disorder who engages in non‐suicidal self‐injury to demonstrate how TFP can be applied to such cases. © 2007 Wiley Periodicals, Inc. J Clin Psychol: In Session 63: 1105–1120, 2007.

This volume is the latest addition to a series on relational psychoanalysis. It comprises 19 papers and a foreword by Spyros Orfanos. The subtitle of this volume is Evolution of Process and the contributions as a whole cover various aspects of analytic process from the point of view of relational analysis. There are several papers in this volume which are exquisitely, at times poetically, expressed, deeply moving clinical vignettes. It is also clear that the analysts have a deep emotional involvement with their patients and with their patients' treatments. Various aspects of the relational view of the clinical process are discussed in this volume and, as might be expected, there are differences in focus. There is a creative paper by Slochower on the clinical "misdemeanors" of the analyst, and a discussion of a relational model of development by Seligman. Salberg discusses the somewhat infrequently addressed subject of termination in analysis and Beebe and Stern separately set out a developmental model of mother-infant interaction to account for the therapeutic action of psychoanalysis from an intersubjective, relational perspective. Gabbard and Ogden discuss the connection between the personal and professional development of the analyst and suggest that all analysts are affected by their own analysts and supervisors from the past and that a form of "parricide" is needed to free the analyst from this influence to find his or her own voice. However, the topic addressed most frequently in this collection is relational techniques and interventions to resolve transferencecountertransference impasse and enactments. The challenge that these papers present is whether the consistent use of self-disclosure as a generally applicable intervention facilitates therapeutic action for the benefit of the patient in an analysis stuck in an impasse. Several authors-for example, Bromberg, Harris, Ehrenberg, Davies, Cooper, and Knoblauch-address this issue. Harris ("You Must Remember This") persuasively deconstructs the analyst's unconscious co-creation of impasse, and cites an autobiographical example to focus on the role of shame and sadness. She emphasizes that speech is action and that "the embodiment and intersubjectivity of speaking and listening, is at the heart of relational ideas" (p. 371). Knoblauch ("Body Rhythms and the Unconscious: Expanding Clinical Attention with the Polyrhythmic Weave") says that Freud's idea that

Recent contributions to the psychoanalytic literature propose new ways of understanding analytic neutrality, anonymity, abstinence, and self-disclosure. They advocate elective self-disclosure by the analyst as an antidote to the allegedly game-playing quality of transference and resistance analysis. The analytic relationship, they assert, becomes unreal when attempts are made to observe the principles of neutrality and abstinence. Both are seen as ill-conceived because of the irreducible subjectivity and unwarranted authority of the analyst. These relational and interactional views are criticized because (1) they ignore the fact that transference and resistance analysis have from Freud onward been accepted as minimal criteria qualifying a clinical process as psychoanalytic; (2) elective self-disclosure carries metapsychological implications dismissing not only Freud's theory of motivation but motivation as a basic feature of human personality; (3) they do not recognize interpers...

This study examines the role of natural resources in regional conflicts and assesses respondents' perceptions regarding their management. The results show that the majority of participants perceive natural resources as a key factor in tensions, while current management is considered insufficient, particularly in terms of transparency and income redistribution. The involvement of local communities is identified as a priority to improve the situation and prevent conflicts. The proposed mechanisms include fair and transparent management, as well as benefit sharing. The study highlights the importance of participatory approaches to ensure that natural resources truly benefit local populations and promote sustainable development.

The present systematic review of the literature aims to provide a comprehensive overview of the state of the art of research in psychoanalysis. The arguments draw a difference between psychoanalytic research and research in psychoanalysis, meaning that in the past decades, there has been an attempt to bridge the gaps between psychoanalysis and broader research in psychology. Major scientific databases for contemporary psychological research (Ebsco PsycINFO, Ebsco CINAHL, Scopus, Web of Science, PubMed, and PEP-Web) were searched to gather psychoanalytic-oriented research, both theoretical and empirical. The PRIMA method provided a total of 36 results, on which a conceptual/reflexive thematic analysis was conducted. The identified themes or dimensions are: i) the epistemological status of psychoanalysis; ii) the research domains in psychoanalysis; iii) the research methodology in psychoanalysis; iv) the research methods in psychoanalysis; and v) the instruments of research in psychoanalysis. We conclude that, despite long-lasting difficulties in the epistemological cohabitation between psychoanalysis and mainstream psychological research, new hybrid ways for future psychoanalysis can be identified.

L'étude examine les causes, les impacts et les solutions au phénomène des enfants de la rue à Bukavu, mettant en lumière les facteurs socio-économiques et politiques qui contribuent à cette problématique. Les principales causes identifiées incluent la pauvreté extrême, les conflits armés, et l'instabilité politique, qui provoquent des situations de précarité et d'abandon familial. Le manque d'accès à l'éducation et aux soins de santé, ainsi que l'urbanisation rapide, aggravent les difficultés rencontrées par ces enfants. Les impacts de cette situation incluent des problèmes de santé, de marginalisation sociale, et des défis importants pour l'intégration dans la société. Pour remédier à cette situation, plusieurs stratégies sont proposées. La mise en oeuvre de politiques d'éducation inclusive, la réduction des coûts des soins de santé, et le développement de centres communautaires polyvalents sont des mesures cruciales pour améliorer l'accès aux services et offrir un soutien approprié. L'engagement des leaders religieux et l'organisation de campagnes de sensibilisation sont également essentiels pour mobiliser le soutien communautaire et réduire la stigmatisation. Une approche intégrée et coordonnée est nécessaire pour offrir une réponse complète aux besoins des enfants de la rue et favoriser leur réintégration sociale et leur bien-être. Mots clés : Enfants de la rue, Bukavu, Pauvreté extrême, Conflits armés, Sud -Kivu

The authors examine the concepts of repression and splitting and their interplay during the psychoanalytic process. Initially, repression was introduced by the clinical phenomenon of resistance, leading to the formulation of the association between intrapsychic conflicts and neurotic symptoms. Later, repression was linked to normal development and to personality organization. Splitting, on the other hand, has been defined in quite diverse ways. The two main definitions are of splitting within the ego, and splitting of representations of the self, and of internal and external objects. Repression and splitting are compared developmentally, dynamically, and with respect to their relationship to psychic functioning and energic conditions. Clinical material is presented from the analysis of a patient who presented with borderline personality organization and narcissistic features. During the initial phase of analysis, splitting associated with projection, projective identification and idealization were the main defence mechanisms. As the analysis progressed and the themes of omnipotence and mourning were explored with the simultaneous working through of drive derivatives expressed in the transference, repression gained ground over the more primitive defence mechanisms. The evolution of the case showed a gradual shift from splitting to repression and the association of repression with a more advanced psychic organization. This development reflected the dynamic movement from borderline to hysterical organization in psychoanalytic nosology.

The authors examine the concepts of repression and splitting and their interplay during the psychoanalytic process. Initially, repression was introduced by the clinical phenomenon of resistance, leading to the formulation of the association between intrapsychic conflicts and neurotic symptoms. Later, repression was linked to normal development and to personality organization. Splitting, on the other hand, has been defined in quite diverse ways. The two main definitions are of splitting within the ego, and splitting of representations of the self, and of internal and external objects. Repression and splitting are compared developmentally, dynamically, and with respect to their relationship to psychic functioning and energic conditions. Clinical material is presented from the analysis of a patient who presented with borderline personality organization and narcissistic features. During the initial phase of analysis, splitting associated with projection, projective identification and idealization were the main defence mechanisms. As the analysis progressed and the themes of omnipotence and mourning were explored with the simultaneous working through of drive derivatives expressed in the transference, repression gained ground over the more primitive defence mechanisms. The evolution of the case showed a gradual shift from splitting to repression and the association of repression with a more advanced psychic organization. This development reflected the dynamic movement from borderline to hysterical organization in psychoanalytic nosology.

The current classification of personality disorder in ICD-11 includes a description of personality functioning, derived from a number of theoretical paradigms, but most notably consistent with the psychodynamic approach. Concurrently, an object-relations model of personality functioning in a dimensional assessment of severity is provided in the Structured Interview of Personality Organization-Revised (STIPO-R). To date, there are no published measures of International Classification of Diseases-11 (ICD-11) personality severity, though the construct is very comparable to the concepts assessed in the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) levels of personality functioning concept, which is measured by the Level of Personality Functioning Scale-Self-Report (LPFS-SR). This study examined the validity of ICD-11 personality functioning, as measured by the LPFS-SR, by evaluating its associations with the STIPO-R in Kurdistan region. The samples included 231 Univers...

total submission and using him as a patch to her ego. For a long period of the treatment the patient resorted to angry silences or attacked the analyst verbally. The point we would like to make is that a decisive moment in the substitution of the acting out behaviour by the mentalisation process was when the patient's body came to represent the analytic setting, allowing productive interpretative work in this way around the issue of the body boundaries.

Work with survivors of childhood trauma sheds light on the enigmatic subject of just how psychotherapy produces change. The focus of this paper is the observation that there are two fundamental change mechanisms in psychotherapy, catharsis and internalization. Each one has a different time course and different clinical characteristics including the role played by the therapeutic relationship. Catharsis is triggered by the presence of the empathically attuned therapist, while internalization is driven by the therapist's slightly aloof stance of expectancy and the patient's need for connection. Each mechanism has a different childhood origin. Taken together, these two mechanisms are sufficient to explain therapeutic gains in other forms of psychotherapy and with other pathologies.

Resumo: O conceito da contratransferência (CT) talvez seja um dos mais controversos da técnica psicanalítica. De obstáculo ao tratamento à ferramenta importante para a compreensão dos pacientes, a CT é atualmente considerada por muitos autores imprescindível à técnica psicanalítica. O presente trabalho tem como objetivo revisar a origem, evolução conceitual, manejo e aplicabilidade clínica da CT na psicoterapia psicanalítica de adulto. Para isso, foi realizada uma revisão narrativa da literatura a respeito dessa temática, com consulta a autores clássicos e estudos empíricos sobre o tema. Conclui-se que, apesar da evidente evolução e metamorfose da CT, ainda há questões abertas e divergências, entre os teóricos, em relação ao seu manejo e sua aplicabilidade clínica, o que reforça a necessidade de mais estudo sobre o tema a fim de preencher tais lacunas.

The Emotional World of the Child

Title
DW Winnicott, British psychoanalyst and paediatrician, intriguingly stated that 'There is no such thing as a baby'. Using Kleinian and Winnicottian theory, consider the emotional development of the infant from infancy up to the end of the first year of life

In this paper the city of Copenhagen is used as a starting point to highlight some critical historical events, both concerning the exchange of ideas between the physicist Wolfgang Pauli and C.G. Jung and the history of psychotherapy in Scandinavia. Pauli's years in Copenhagen under the influence of Niels Bohr and his philosophy prepared him mentally to receiveC.G. Jung's ideas. The paper also recounts the one occasion that Jung was in Scandinavia, attending the 9th conference of the General Medical Society for Psychotherapy in Copenhagen, just before going to New York in 1937 to give his final seminars on Pauli's dreams. The reason for focusing on these particular events is that they also constitute part of the history of the reception of psychodynamic psychology in Sweden and Scandinavia.

In this paper the city of Copenhagen is used as a starting point to highlight some critical historical events, both concerning the exchange of ideas between the physicist Wolfgang Pauli and C.G. Jung and the history of psychotherapy in Scandinavia. Pauli's years in Copenhagen under the influence of Niels Bohr and his philosophy prepared him mentally to receiveC.G. Jung's ideas. The paper also recounts the one occasion that Jung was in Scandinavia, attending the 9th conference of the General Medical Society for Psychotherapy in Copenhagen, just before going to New York in 1937 to give his final seminars on Pauli's dreams. The reason for focusing on these particular events is that they also constitute part of the history of the reception of psychodynamic psychology in Sweden and Scandinavia.