The Journal of the American Academy of Psychoanalysis最新文献

The process of religious conversion has not been the focus of psychoanalytic understanding. This article examines one conversion narrative, a spiritual autobiography, in which, the author asserts, evidence can be found that the conversion described involved a process of maturation of the subject's internal god-representation, with an integration of maternal and paternal aspects of that internal object representation. Such a process as one aspect of a religious conversion, has implications for psychoanalytic work with religious patients, including the necessity of acknowledging the psychological and deeply believed reality of God for religious patients.

The author explicates the principles underlying Bion's "Grid" in a way that makes them useful for the clinician. The grid represents an attempt to provide a tool by which we might better understand the abstract rules and principles that facilitate understanding in the analytic process. Bion believed that content often obscures meaning unless we can move beyond the ostensible meaning in our attempts to understand the complexity of a statement and the uses to which it is being put. For Bion, the grid itself was not so important as the attempt to increase one's powers of observation, intuition, interpretation, and transformation. A clinical illustration is provided in which the grid provides a useful means for facilitating these endeavours.

A Mortal Stage of later life may be considered as a subdivision of Erik Erikson's eighth stage of life which he called Mature Age, characterized by issues of integrity versus disgust, despair. Mortality poses the optimal task of Realization (in many positive coping and existential senses) versus Denial (or other non-recognition or emotional paralysis) or Fear (or apprehension or even terror). Premorbid awareness of illness may contribute to or challenge Realization. Literary examples also suggest a reviewing of one's life and works, possible regressions from genitality to anal preoccupations, little social withdrawal, and a compassionate interest in the next generation. In dying the self is not given up, but rather the alternate universe of further interpersonal relations had one lived on.

The names of individuals play a significant role in the organization of ego defenses and the consolidation of identity. Names have several conscious and unconscious meanings to patients in treatment. This article postulates that names also represent similar meanings to the therapist or analyst. The desire or reluctance to address a patient by a particular name can serve as an effective measure of the therapist's countertransference. This provides invaluable information about the patient's character structure and interpersonal relationships, which, if used appropriately, can favorably promote treatment.

Walter Bonime is best known for his influential book, The Clinical Use of Dreams, published in 1962. Though Bonime embraced a neo-Freudian orientation, The Clinical Use of Dreams is remarkable for an absence of theoretical discussions, emphasizing instead a detailed practical approach, aided by illustrative vignettes. His particular emphases are on collaboration in the discovery of meaning and the importance of recognizing feeling representations in dreams. Further writings focussed on character disorders with depressive and paranoid symptomatology, vividly describing the typical underlying neurotic character structures. An outstanding article, co-authored with his wife Florence Bonime, criticizes the usual obscurity of psychoanalytic writings and suggests that conceptual abstractions be well balanced by clinical illustrations. Bonime's style is an exemplary model for such balanced writings.

This article has two purposes. First, a rebuttal to those writers, including Irwin Hirsch, who criticize the current emphasis by relational analysts on the value of affective openness and affective honesty, particularly with regard to their use of clinical vignettes that vividly portray the analyst's use of self-revelation--as if these illustrations were revealing an endorsement of a naive and mindless invasion of the patient's psyche. The second, and perhaps more important purpose, is to illuminate something I feel is obscured by Hirsch's framing the topic of the analyst's "spontaneity" in the context of analytic politics--that an analyst's self-revelation in language is increasingly understood to be not simply "allowable," but a necessary part of the clinical process. Language does not make it less spontaneous nor part of what Hirsch calls a "standardized technique." Its most powerful therapeutic contribution is in facilitating linguistic symbolization of dissociated, enacted, subsymbolic experience that is immune to self-reflective cognition, immune to internal conflict, and thereby unavailable to interpretation until it becomes relationally accessible to language and thought. Both neuroscience and cognitive research support the need for a revised theory of therapeutic action consistent with the growing recognition of the human mind as a nonlinear, self-organizing dynamic system-a system in which normal maturation as well as therapeutic repair depends, developmentally, on an ineffable coming together of two minds in an unpredictable way. From this vantage point, the analyst's self-revelation contributes to the coconstruction of an alive intersubjective space through an ongoing process of engagement between two subjectivities, making the analyst's subjective openness as potentially negotiable as any other aspect of the patient/analyst relationship, rather than an unrepairable "intrusion" into a self-contained psyche.