International Journal of Applied Psychoanalytic Studies最新文献

The naturalistic, longitudinal Melbourne Study of Psychoanalytic Psychotherapy was conducted in a subsidized community clinic established by the Victorian Association of Psychoanalytic Psychotherapists as a demonstration project operating over 8 years. It offered lower SES adults twice-weekly psychoanalytic psychotherapy for 2 years. An independent research program used the RE-AIM planning and evaluation framework to investigate the Reach, Effectiveness, Adoption, Implementation and Maintenance of the service. Complementary quantitative and qualitative methodologies studied mental health and general-life functioning outcomes and underlying processes of treatment. Two papers present the qualitative arm of the research, exploring the lived experience of the psychotherapy, reported contemporaneously and retrospectively by patients and psychotherapists. This first paper details the qualitative design and methods employed. In-depth semi-structured narrative interviews during psychotherapy, upon completion at 2 years, and at an additional 8-month follow-up point for patients, were conducted. Analysis of the narrative transcripts of 143 participant interviews revealed themes regarding patient expectations of treatment and the perceptions of both patients and psychotherapists of the long-term psychoanalytic psychotherapy experience and its benefits. Narratives thus provided evidence of the Reach, Effectiveness, Adoption, Implementation and Maintenance of the service. The findings enrich understanding of the effective processes underlying the outcomes of the quantitative arm of the study reported separately. The second qualitative paper presents the findings concerning participants' experiences of facilitative and challenging aspects of the treatment, as well as the implications of the qualitative findings overall.

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.

Qualitative exploration of the experience of psychoanalytic psychotherapy complemented the quantitative evaluation of mental health and life functioning improvements in the Melbourne Study of Psychoanalytic Psychotherapy. Twice-weekly treatment was offered to adults for 2 years by the private sector Glen Nevis Clinic for Psychoanalytic Psychotherapy, established by the Victorian Association of Psychoanalytic Psychotherapists as a subsidized, low-cost community service over 8 years. This paper is the second of two presenting the qualitative arm of the study, involving in-depth narrative interviews with patients and psychotherapists. Analysis of 143 transcripts further contributes to evidence of the Reach, Effectiveness, Adoption, Implementation and Maintenance of psychoanalytic psychotherapy in a community setting. The first qualitative paper reports themes concerning patient expectations of psychotherapy and perspectives of both patients and psychotherapists on the experience and benefits of the treatment. This paper reports what was perceived by participants as facilitative or challenging for therapeutic progress, illuminating how experiences of the nature of psychoanalytic psychotherapy may have affected the Implementation, Effectiveness and Maintenance of the program. The most notable facilitative factors emerging were the exploratory, insight-oriented nature of the work, elements of the patient-psychotherapist relationship, and the frame of the treatment. Challenges were also often seen as inherent to Effectiveness; however, proposing the frame of 2-year treatment, as both an expectation and a limit, probably inhibited program Reach, Adoption and overall Implementation. The limitations and strengths of the qualitative arm of the research, together with implications for further investigation, are discussed.

This paper aims to demonstrate how a socioanalytic perspective deepens an anthropological one. We focused our attention on the instrumentalization of personal and collective anxieties within a small organization, in order to reveal how and why power works. By using psychoanalytic concepts, we were able to draw the space of possibles that nests the relations of dominance. Our research draws on fieldwork conducted in a rural community in Northern Romania. We used participant observation, semi-structured and unstructured interviews. Relying on the observed vulnerabilities and local idiosyncrasies that create specific necessities and expectations, we tried to show how defense systems, basic assumptions and perverse dynamics shape the organization's culture.

This paper explores the emotional appeal of Nazi propaganda from a psychoanalytic point of view. A shared ideological narrative connecting to unconscious fantasies within a large group psychology are utilized to explain this emotional appeal in the context of an intersubjective leader-audience relationship. A narrative of narcissistic revenge, apocalyptic battle, and utopian unity and purification are explored utilizing speeches of Hitler as examples of ideological transmission. Prophesizing the extermination of the Jews of Europe is understood as integral to the emotional appeal of Nazi propaganda.

In the UK in 2007 a national experiment was initiated with the aim of tackling “Britain's Biggest Social Problem”—Depression. Improving Access to Psychological Therapies (IAPT) was devised as the solution. A universal free-to-access talking therapies program would make available evidence-based treatment to all adults with depression. NICE (National Institute for Health and Care Excellence), the body that decides on what is cost-effective, said CBT, not antidepressants, should be its first line offer. The starting gun was fired. The promise from IAPT was 3-fold: to scale up access to CBT rapidly; to achieve recovery targets that would reduce the prevalence of depression over time; and—most ambitious of all—to ensure the Treasury would see a return on its investment by reducing the economic burden from depression. People who were on invalidity benefits due to depression would be supported back into employment. It was a New Deal for depression. As well as for CBT. But did it work? A decade and a half on with IAPT, are we in any position to give an answer? This paper will seek to draw lessons about “What Worked”, and what didn't, to ask ourselves a question: are we—those of us in the applied psychoanalytic community—willing to garner what can be learned from IAPT to advocate a new deal for evidence-based psychoanalysis? Faced with challenges from unemployment and widening inequalities, against a backdrop where global economic recovery must heed the existential threats from climate change and ongoing warfare, to say nothing of the scale of loss and grief for those already impacted by bereavement due to the pandemic, the need for some such deal could not be more urgent.

In January of 2015 Turkey's president Recep Tayyip Erdoğan hosted the Palestinian President Mahmoud Abbas at the newly built extravagant and highly controversial presidential palace. Sixteen warriors representing all of the former Turkic empires in full costume were present at the welcoming ceremony. This paper uses Volkan's psycho-political framework to understand state-led efforts of historical revisionism which manifest itself in historical glories and nostalgia for the Ottoman Empire. The central argument posits that grandiose or mega projects strategically serve historical revisionism in Turkey, amplifying selected glories of Turkish society to bolster support for authentic and national narrative, known as “yerli ve milli (domestic and national)”