Psychoanalytic Quarterly最新文献

This paper introduces potential time as a psychoanalytic concept that extends and complements Winnicott's potential space. Revisiting Freud's principle of constancy, Winnicott's theory of transitional phenomena, and Peter Goldberg's contemporary insights on framing, transitionality, and duration, it develops potential time as both a theoretical framework and a clinical necessity. In an era increasingly hostile to sustained temporal experience, the paper explores how the rhythmic reliability of analytic framing creates the conditions in which psychic life can unfold. Clinical illustrations reveal how the analyst's handling of time fosters the emergence of a patient's own temporal signature. Reflections on mourning and music illuminate how potential time allows for living with loss, coordinating multiple temporalities, and sustaining creative living.

The author explores Loewald's concept of density in psychoanalytic practice, where emotions and meanings are deeply concentrated but not yet differentiated. The paper discusses how this primordial density shapes the self's relationship with the world and plays a central role in early ego development. The author examines the therapeutic process of engaging with these condensed emotional states and the work with the reality of concrete objects, suggesting that psychoanalysis involves participating in and exploring this richness, rather than simply transforming it into clear symbols. Clinical examples highlight how both patient and analyst may inhabit this dense emotional space together, fostering transformation and deep mutual understanding.

In agreement with Winnicott, the author considers all forms of playing as a place of transit between inner and outer reality and between unsymbolized and symbolized experience. Some forms of playing serve more exclusively to clarify the current state of the patient's separate mind, while other forms of playing additionally introduce and mark forms of separateness between patient and analyst that are more likely to cause temporary disruption. This paper aims to distinguish between these two forms of play. Through clinical vignettes, the author demonstrates how each form of play offers various forms of containment, differing in the mechanisms of how to facilitate the process of metabolization. He also suggests that sometimes we can only know a posteriori of the patient's experience of disruption and containment rendering these distinctions between types of playing as a rough scaffolding. Playing always implies a process that is in flux.

W. R. Bion's (1950) case of the Imaginary Twin is revisited from different vertices. This paper has remained underappreciated because of two sets of factors: one related to how Bion structured his text in a baffling manner; and the other related to some of the uses to which the paper has been put. In subsequent commentaries on the Twin case (e.g., Bion's own epistemological commentary alongside the questionable thesis of playwright Samuel Beckett as the patient in question), these aspects have distracted from the Twin as a genuine contribution to contemporary psychoanalytic technique. It is a close clinical reading of how Bion went about analyzing a patient who was quite deft in unwittingly hiding in plain sight and illuminates his unique contributions to analytic technique. While accounting for the analytic mentors who inspired his psychoanalytic work, a thesis is maintained that in this first psychoanalytic case study Bion began to craft what would become his defining signature, namely an interactional/emotional focus in his technique of the here and now. The author terms it Bion's implicit method of clinical inquiry. While he adroitly articulated some of Melanie Klein's ideas, he simultaneously and quietly distanced his technical approach from hers.

There are many myths about how a psychoanalysis ends. In reality, there is no one way. In this paper, I describe what I learned from interviews with eighty-two analysands who volunteered to tell me about how they ended their analyses. Their experiences illustrate many different ways in which analyses end-some very satisfactory and others in disappointment. I also describe many different ways I have concluded psychoanalyses with my patients. I try to end each treatment to fit the needs of each patient and the nature of our work together. There are no formulas to how we end. I consider and explore the issues of being an older analyst: the risks and responsibilities of continuing to treat analytic-or any-patients. I discuss what we psychoanalysts gain from our work with patients-how it is sustaining and how we learn about ourselves as well as our patients. In doing psychoanalytic work with our patients, we stretch our own capacities and change. We, like our patients, though not to the same degree or intensity, mourn our endings.

The author describes her emotional reactions and counter-transferences in ending analyses in lieu of her personal situation, in which she was anticipating retirement. Through a clinical case of a patient who had difficulties in ending treatment, and her own dream which occurred during this time, the author shows how both she and the patient shared unconscious fantasies about aging and stopping the passage of time. The analyst's resistances about retiring from clinical practice in concert with the patient's resistances about ending analysis created a barrier against analytic progress. The author suggests that the analyst's feelings and needs to keep going may be a part of their holding on to patients and extending their treatments interminably.

Although the comparison between two great Victorian masterminds, Sigmund Freud and Sherlock Holmes, and their respective methods, is in itself not new (see for example Ginzburg 1979, 1980; Brooks 1984; Marcus 1984; Shephard 1985; Spence 1987), it merits further investigation, as it raises important questions regarding the nature and structure of clinical evidence, clinical epistemology, and clinical narration. In this article, the author: refers both to the common cultural background of these two projects (including the disenchantment of the modern world and the complicated dialog between rationality and imagination) and their common epistemological situation; analyses their search for a plot and search for clues, and characterizes both Holmes and Freud as applied historians and applied semioticians. Their modi operandi are described as hermeneutical procedures, methodologically similar to Charles Sanders Peirce's abduction. Moreover, the author argues that both can be viewed as manifestations of Aristotle's phronesis. Finally, the author points out one important difference between Freud and Holmes, namely that in fact the Viennese Holmes is at the same time the Viennese Watson.

Lacan's return to Freud gravitates around his aphorism that the unconscious is structured like a language. This is often cause for criticism from non-Lacanian analysts. However, this aphorism has multiple meanings beyond the unconscious consisting of word-forms. This paper sketches relational, affective, neuropsychological, and Freudian criticisms of this linguistic unconscious. I will then highlight that the key signifier is "like": to be structured "like" a language is to be structured according to differential representatives. I conclude with a Lacanian neuropsychoanalytic functional model of differential representatives that need not be words.

The utility of Sebastian Leikert's technical approach of somatic narration is illustrated in a detailed clinical presentation working with a psychotic patient with gaze aversion. In conjunction with Riccardo Lombardi's emphasis on focusing on the patient's transference to her own body rather than the conventional transference to the analyst, the author shows the value of moving away from gaze aversion and focusing, instead, on the patient's experience of her neck as an encapsulated body engram. The role of bodily movement in the consulting room as a critical ingredient in supporting the narrative process will be illustrated.

I consider the place of termination in contemporary psychoanalytic practice. A more flexible approach to therapeutic endings represents one dimension of a broader paradigm shift away from rule-boundedness and toward clinical flexibility. In any event, final, less-than-final, and absent goodbyes have always been part of psychoanalytic reality despite the power of our termination ideal. I first describe the broader move toward flexibility within the field and then address its complex implications for psychoanalytic endings. In that context, I explore the varied ways in which we don't always end treatment relationships. The implications of not entirely ending a treatment are also addressed.