International Journal of Psychoanalysis最新文献

Interfaces connect spaces that must both be sufficiently similar and different. The differences are the driving force for an exchange between the spaces. In doing so, interfaces control the quantity and quality of the exchange that takes place through them. In terms of spatial and temporal dimensions, interfaces are highly complex, self-organising, and finitely extended. The interface-function is a highly specialised process that enables difference-based exchange. At the driving end, it requires energy from outside, which reduces entropy and increases information, and in this way creates and maintains difference. The interface-function as a basic principle is being employed here metaphorically to develop the hypothesis that there is an analogous basic function in the psyche since interfaces are ubiquitous in the entire organism, i.e. brain and body, and function simultaneously. Transferring the assumption of the interface-function to mental processes postulates difference as a basic principle. We will illustrate our reflections here with the help of clinical vignettes from psychoanalytic treatments thus illuminating the interface-function's various properties and some aspects of its disruption and restoration.

Founded in 1933, the Portman Clinic, now part of the Tavistock and Portman NHS Foundation Trust, in London UK, is a nationally funded out-patient clinic providing psychoanalytic psychotherapy to children, adolescents and adults who present with delinquency, violence, and problematic sexual behaviours. The Portman Clinic came into being during the interwar years, a fertile time in which psychoanalytic theories became influential within criminology. This article describes the foundation and early history of the Clinic within the wider social and political context of the early and mid-twentieth century, including the impact of the second world war and the dawn of the welfare state. It explores the ideas of the psychoanalysts Grace Pailthorpe, Edward Glover, Kate Friedlander, and Melitta Schmideberg, which were based on their work with patients at the Portman Clinic but were also shaped by the internal war within the British psychoanalytic community, the so-called Controversial Discussions. The review draws on previously unpublished clinical material from archived records of patients seen at the Portman Clinic since 1933, providing a fascinating glimpse into the profile of these patients, and how their psychopathology and offending behaviours were influenced by changing societal norms and significant historical events.

The fundamental rule requiring analysands to say whatever passes through their mind has a crucial counterpart on the side of the analyst in the "evenly suspended attention", where having an ear finely tuned to unconscious processes, as Freud describes it, implies a suspension of any acquired knowledge. Such an attention is orientated to the sequence of the analysand's uttered signifiers, in a listening attuned to what produces effects of sense and non-sense beyond the intention of the discourse. The possibility of sustaining the position of not-knowing is, according to Lacan, what constitutes the very frame of the analytic process. The analyst's rigorous listening brings to the fore its own logic and the temporality associated with it.

This paper attempts to use Winnicott's theory of the transitional object to develop a concept of the psychoanalytic frame as a transitional object commonly shared by analyst and analysand. The process of creating the frame, often neglected in theories, is characterized by different phases. After the interview, a phase is postulated in which the symmetrical aspects of the analytic relationship are considered crucial for the formation of a frame: the commonly shared transitional object. In a following phase, the asymmetry of the relationship is considered significant: the analyst takes over the protection of the frame. Using the example of a patient who called by telephone from a moving car during his session, reflections will be made about teleanalysis/remote analysis and the consequences of the Covid-19 pandemic for psychoanalytic treatment techniques. Finally, the need for considerations about a psychoanalytic media theory with reflections on the medium "telephone" is emphasized.

There has historically been controversy among psychoanalysts about the use and efficacy of teleanalysis. As COVID-19 arrived, most analysts offered teleanalysis despite their opinions and any prior experiences of this format of analytic care. Twelve psychoanalysts and thirteen candidates in training analyses in the US using teleanalysis two years into the pandemic were interviewed. Giorgi's phenomenological research method (Giorgi, A. 2009. The Descriptive Phenomenological Method for Psychology. Pittsburgh, PA: Duquesne Press) was used to develop a generalizable description of teleanalysis including its constituent parts. Results suggest that teleanalysis allows more access to treatments at analytic frequency, but it is not equivalent to in-person analysis as there are aspects that are felt to be missing and important. The impact of the medium, including increased distractions, difficulties with maintaining the frame, and missing aspects, are felt by both analysts and candidates in training analyses, but are even more starkly felt by candidate analysands than analysts. Providing teleanalysis presents unique challenges to the analyst due to less control of the teleanalytic frame and the need to represent and analyze in some way what is missing. Analyzing the unconscious motivations, dynamics, and meanings of the use of teleanalysis (or in-person or hybrid analysis) may deepen the treatment regardless of what format is ultimately used.

Henri Rey's theory of claustro-agoraphobia is helpful for the understanding of the difficulties that can arise when the frame of treatment is modified in remote analysis or psychoanalytic psychotherapy. The felt intense closeness and the actual distance of remote analysis lend themselves to a defensive position in remote analysis when the patient feels at once trapped in the analysis and yet unable to be without the analysis. I suggest here that such claustro-agoraphobic fears arise particularly at times in the analytic process in which change is imminent. The patient is then confronted with giving up old systems of defence. Moving away and changing to remote analysis can provide a relief in the face of the simultaneous fear of closeness and of distance. With such patients, the two steps of moving away and changing to remote analysis can be seen as an unconscious attack on the frame by a part of the patient that is defending itself against such fears in the face of change. Once the setting has changed in remote psychotherapy, the analyst too can be drawn into the claustro-agoraphobic position in the face of the patient's attacks on the analyst's symbolic thinking and his internal frame.

This paper's clinical material derives from psychoanalytic parent-infant psychotherapy (PIP). It applies Freud's concept of infantile sexuality to clinical processes in PIP. Freud's sources were everyday baby observations and adult patients' childhood accounts. He was unclear as to when infantile sexuality emerged in babies, claiming it was observable in the newborn as well as unobservable only until about three years of age. Furthermore, he argued that the sexual drive leant on the survival instinct, thereby adding erotic pleasure to breastfeeding. This process remained unclear until Laplanche suggested a traffic of enigmatic messages in dyadic interactions. Their meanings were unconscious to the adult and incomprehensible to the baby. The paper investigates if the baby might experience certain communicative expressions as especially enigmatic. It applies an observational and interpretative method, layered analysis, to a clip of a video-recorded PIP session. It shows the analyst approaching a gaze-avoidant baby by greeting and smiling. These efforts were conscious to him. In contrast, as his lips made two kiss-like motions they were unconscious to him and retroactively interpreted as signifying his infantile sexuality. The paper discusses if such micro-events correspond to Laplanche's enigmatic messages.

The outbreak of the pandemic forced a temporary change from an in-person setting to a distance setting via a screen, generating a debate about the viability of the psychoanalytic process in the case of distance settings. This discussion leads us to reconsider the fundamental elements of the setting, such as the hitherto unquestioned co-presence of the bodies of the patient and the analyst in the same space. After reviewing key moments in the evolution of the concept, from Freud to Bleger, and analysing the contemporary situation, including recent IPA reports, it is emphasised that the physical presence of the body, in which psychic life is rooted, is essential to enable unconscious communication. To support this idea, clinical examples and a detailed vignette are presented. In addition, the importance of the frequency of sessions is highlighted, underlining the fact that the quantitative factor is crucial to the nature of psychic life and any attempt to modify it.