International Journal of Psychoanalysis最新文献

The author deconstructs how elements of defense analysis operate during the process of play in analytic work. In play, a patient's defense process often involves an experience of aliveness and vividness within the analytic couple and is less oriented toward secondary process metacommentary about defensive function than is typical of more formal defense interpretation. The emergence of the analysis of defense that occurs during play is not meant to challenge other forms of defense analysis but is rather adjacent to these forms of defense analysis. This view of a cluster of approaches to defense analysis is consistent with his view that epistemological and ontological approaches often operate simultaneously in analytic work. The author theorizes defense process during play and clinically examines these processes in two vignettes.

The concepts of immersion and digital presence have been widely used to describe the experience of being intensely engaged and the blurring of the differences between tangible and digital environments (e.g. being "in" the video game or "with" the other person on the screen). Existing theories have tended to explain these from models based on adaptation to the environment, evolutionary automatisms or social construction of the world. Alternatively, a psychoanalytic reading of these concepts will be proposed, including the problem of cathexis, defence, the negative work of the psyche, and the dynamic equilibria involved. This theory will be illustrated by applying it to teleanalysis, video gaming, and to some aspects of social networking. We shall also speculate about states of mind in immersion, psychopathologies of virtuality and some of the risks that digital immersion poses to primitive and early emotional development. Finally, the value of considering immersion and digital presence within the psychoanalytic research agenda on human relations in and with the virtual-digital is raised.

In light of the upcoming conference of the European Psychoanalytical Federation (EPF) in Dresden, this letter deals with the eventful history of psychoanalysis in East Germany, especially in the state of Saxony. After a first heyday between 1923 and 1933, marked above all by the early clinical and scientific work of Therese Benedek, the development came to a sudden end with the seizure of power by the Nazis and could not be revived after the Second World War under the communist regime. This dark period of history clearly demonstrated that psychoanalysis can only flourish under social conditions of freedom. While psychoanalytic thought is slowly recovering from its decline during the two German dictatorships, psychoanalysts are facing the dark clouds of the resurgence of antiliberal and intolerant political movements that threaten liberal democracy in Europe and other parts of the free world.

The weak evidence base and profound consequences of gender-affirming interventions for youth call for a particularly sensitive and complex psychoanalytic exploration. However, prohibitions on knowing at the individual and social levels significantly constrain psychoanalytic work with trans-identified youth. Barriers to exploration and thinking that patients bring to treatment are reinforced and reified by the dominant socio-political trends that saturate the contexts in which young people dwell. These trends increasingly frame any attempt to deeply explore why a young person is seeking medical or surgical gender-affirming interventions as "off-limits" and a form of conversion therapy. Furthermore, politically driven clinicians who promote medical gender-affirming interventions misrepresent and attempt to discredit clinicians who explore the meaning and function of trans identification, or who express concern that transitioning may be a drastic solution to various forms of psychic pain. In doing so, they minimise the significance of the weak evidence base for these interventions and their serious, known risks. At the same time, they obscure or deny the psychic pain that is sometimes humming beneath the experience of gender dysphoria. The author asks: If there are significant uncertainties and risks of harm associated with medical interventions for young people, do we want to know?

The relevance of psychoanalysis to geopolitical matters of war and large group suffering is explored. The presence of polarization within small and large psychoanalytic collectives is seen as an effort to manage clinicians' sense of helplessness in the face of overwhelming human suffering. The impact on the clinician of the inability to alleviate suffering that is occurring on a massive level, the difficulty in remaining empathic when the suffering of the other is unimaginable, and the use of projection to maintain internal coherence are considered. The ethical foundation of psychoanalysis defined by Levinas as responsibility for the other is highlighted as essential to restoring cohesion within the profession. A ceasefire within the profession is posited as an essential step toward a restored ability to think together, engage productively with one another, and determine a constructive role for psychoanalysis in the currently violent sociopolitical surround.

The clinician's emotional and somatic responses to patients are an essential source of information, but how can we disentangle what belongs to whom? A certain blurring of boundaries is inevitable in psychoanalytic work, with oscillations between more and less differentiated states of mind↔body, patient↔clinician and patient-clinician dyad↔wider institutional setting. In one sense, psychoanalytic work can be conceived as a cycle of repeated regressive enactments, followed by elaboration and differentiation après-coup. Referring to two clinical vignettes with pubertal/young adolescent patients, I reflect on the role of the clinician's visual imagination in this process. Accessing an internal, dimensional space can re-establish a boundary, while simultaneously processing a communication, thus forming a bridge between somatic reaction and thought. The particular relevance of this in relation to working with young adolescent patients is considered.