International Journal of Psychoanalysis最新文献

This paper examines dreams that become landmarks in analytic work, opening new pathways for understanding a patient's internal world. Through the analysis of a young patient whose sessions oscillated between despair, omnipotence, and intense claustrophobic anxieties, it shows how dreams provided a shared space for the development of imaginative conjectures. A central dream-structured as a film perceived from multiple points of view-revealed the patient's unstable contact-barrier and her confusion between psychotic and non-psychotic modes of experience. The paper shows how this dream provided a perspective from which to observe the mental functioning of the patient, changing the initial atmosphere of despair into a possibility of exploration and thinking, becoming a landmark in the development of the analytic process. A supervisory vignette further illustrates how approaching dreams as a way of understanding the architecture of the mind could transform a negative therapeutic atmosphere into one of curiosity and collaboration.

Publishing touches on fundamental questions of abstinence, it has an impact on our treatments. It is most likely impossible to prevent patients from recognising themselves (or wanting to recognise themselves) in clinical reports, but steps should be taken to prevent third parties from identifying them. My suggestion is to view anonymisation as a multi-stage process, in which the original clinical event is first documented and recorded in the form of a narrative based on the subjective experience of the analyst. This first step already constitutes an interpretation, as it usually involves a selection and summary of the clinical material. In a second step, a more general insight must be abstracted from this initial observation, one that applies not only to this specific individual case. Only after a structure has been identified does the actual anonymisation take place in the third step, in which the knowledge or hypothesis gained (about this structure) is illustrated in the form of a clinical vignette. This multi-stage process is illustrated with a clinical example. Whether this process provides sufficient protection against recognition by third parties presumably depends on the degree of acquaintance or intimacy between the analysand and the respective third party.

This paper addresses certain aspects of the role of sensoriality in psychic functioning and, in particular, seeks to compare child sensoriality - a natural component of development that precedes the ability to think - and the perceptual-sensorial distortion that occurs in certain pathological conditions. In the course of severe psychic disorders such as psychosis, and in other respects in post-traumatic conditions, the mind is invaded by sensorial perceptions that block its functioning as an organ of knowledge. In the case of trauma, the intrusive mental phenomena are more limited and related to untransformed traumatic anxiety. Instead, the psychotic transformation of the mind is most radical; it develops into psychic retreat that shatters the ability to think and perceive psychic reality. In this instance, the mind's sensorial mode of functioning is so extreme that these patients are immersed in a newly created sensorial reality; they do not think but rather see their own thoughts or perceive sounds or voices that do not exist.

This paper revisits Francis Pasche's 1993 seminal essay From the Ambivalent Superego to the Impersonal Superego. Particular emphasis is given to Pasche's view on the specific verticality in the relation between the ego and superego, and on its evolution. Pasche conceptualises the transformation of this relation from primary admiration and idealization towards an impersonal superego, which he describes as apophatic - defined by what it is not. In doing so, Pasche outlines an ethical horizon that is central to his conception of psychoanalysis, and more specifically of the analyst's inner stance. These ideas are discussed more precisely in reference to some of his other papers. Beyond Pasche's concepts, further reflection is given to the relationship between the ego and the superego and to the way it evolves, notably through processes of de-identification.

We are moved to present this paper, chosen by Dana Birksted-Breen for the Key Papers section, before she passed away. There is an important ethical preoccupation running through this complex paper by Francis Pasche and the discussions by Nathalie Zilkha and Vic Sedlak, who all insist on the importance of the psychoanalyst's countertransference work. Dana would have shared this concern.

Case-writing is always poised between the wish to convey clinical truth and the duty to protect the patient's privacy. In the digital age, where clinical material circulates widely and remains permanently accessible, this tension has become more acute. We argue that anonymisation should not be reduced to the concealment of details regarding our patients but understood as a transformation process akin to mentalisation: a way of reshaping raw experience into a narrative that can be shared without falsifying the therapeutic encounter. Preserving clinical truth requires placing the therapeutic alliance and the patient's trust at the centre of the writing process. Yet we must also remember that anonymisation is never neutral. For patients belonging to minoritised communities, such as LGBTQIA+ individuals, alterations intended to protect privacy may risk reproducing forms of misrecognition, thereby committing epistemic injustice. We propose that case-writing must be guided by a relational ethic: cultivating humility, openness, and disciplined curiosity to sustain trust and safeguard the therapeutic alliance, while distributing responsibility for confidentiality across the psychotherapeutic community as a whole.