The Intergenerational Transmission of Unresolved Mourning: Personal, Familial, and Cultural Factors
Author: Marilyn Charles, Ph.D.
"The experience of loss is a powerful one that can affect us at many levels, from the most personal to our larger cultural underpinnings and world views. The inability to adequately mourn and integrate previous losses becomes an obstacle which interferes with attempts to work through later experiences of loss. This failure to mourn is passed along the generations via the types of constricted affective and cognitive functions that impede the establishment of good object relationships, thereby compounding the sense of aloneness and insufficiency in the face of a harsh and unforgiving world. When there is a cultural heritage of losses that have not been successfully mourned and integrated, cultural membership itself becomes a risk factor for pathological grief."
Allelopathy and the Depressive Object
Author: Edward Gibeau, Ed.D.
"We have all felt hopeless, helpless, and ineffectual in our day to day work with depressed persons struggling to survive the ravages inflicted on them by their own depressive objects. This may be especially true in our attempts to relate with those individuals who give the impression that they are surrounded by a fault, schism, dead space or some other type of barrier to being connected with, or touched by the analyst or the analytic process. These are, I believe, some of the most difficult times for both patient and therapist in the treatment of depression."
The Implicit in Psychoanalysis
Author: Robert E. Hooberman, Ph.D.
"I would like to concentrate on describing my take on the process of making the inaccessible within patients’ psyches more available for articulation and analysis. This reflects my practice of often listening more to what is not being said than to what is being verbalized.
What exactly do I mean by the ‘implicit’? The ‘implicit’ refers to the general manner in which a patient presents. It represents both public and private selves. It refers to aspects that create the sense of identity of the person, the essence, the sense of being in the world...."
Analyzability or the Ability to Analyze
Author: Bertram P. Karon, Ph.D.
"It is traditional for psychoanalytic institutes to have a course in analyzability. The notion is that there are certain patients who are analyzable and certain patients who are not analyzable. In essence, the question is whether the patient is good enough to be analyzed; that is, whether the patient has a high level of ego functioning and object relations, which will make a therapeutic alliance easy to achieve, and a full transference neurosis easy to develop, easily tolerated, and easily resolved. A great deal of thought has gone into what aspects of ego functioning are most relevant and how best to measure them. On the other hand, history shows how vain this search is.
It is the wrong question. The right question is what needs to be done to make this person an analyzable patient."
Appeared in Contemporary Psychoanalysis, 2002, 38:121-140
The Tragedy of Schizophrenia without Psychotherapy
Author: Bertram Karon, Ph.D.
"No one who read Frieda Fromm-Reichmann's "Transference problems in schizophrenia," could reasonably think about persons with schizophrenia in the same way as before. Her writings made clear that schizophrenia is a human experience with meaning, meaning that is hard to uncover, but it only takes patience, kindness, a tolerance for not understanding as well as for the patient's desperate defenses, and a willingness to understand the human condition at its most painful and to take psychoanalytic ideas seriously when patients talk about them. Understanding persons with schizophrenia means facing facts about ourselves, our families, and our society that we do not want to know, or to know again (in the case of repressed feelings and experiences)."
Families and professionals are settling for treatments that aim at making the patient a lifelong cripple who is not too disturbing. Psychoeducational programs, which potentially could be helpful, usually give false information which makes worse the burdens of both patients and their families. The ultimate genetic experiment, the Nazi sterilization and annihilation of patients, led to no decrease in schizophrenia in the next generation. Long-term follow-up studies show one third of schizophrenics fully recover within 25 years and another third have social recoveries with or without treatment---and psychological treatments before the neuroleptic era, from “moral treatment” to psychoanalytic therapies, produced superior results, but we are not using them. The central role of terror in producing symptoms and the genesis and psychotherapeutic handling of symptoms, including delusions and hallucinations, will be described.
Appeared in The Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry, 2003, 31:89-118
Four Modes of Listening in Psychotherapy
Author: David B. Klein, Ph.D.
As our patients speak, how do we listen? For what are we listening? These are important questions, for our primary activity in psychotherapy and psychoanalysis is listening to the patient. We probably spend more time listening than performing any other therapeutic function. More important than the amount of time spent, however, is the fact that our spoken interventions, which are of undisputed import, in many ways flow from our listening. And our formulations, which often are created outside the sessions and constitute our overarching understanding of the patient, are also based on what we have heard as list..."
The Application of Therapist's Maternal Capacity in Prerepresentational Body-Based Transference and Countertransference
Author: Ellen L. K. Toronto, Ph.D.
"Theoretical development and clinical experience over the past 20 years have come increasingly to recognize a group of pathologies whose onset occurs in the early developmental period of the child, before language and before significant structural differentiation has taken place. These pathologies, involving developmental arrests and deficits in the core structure of the self, have necessitated a revision or certainly an extension of classical theory and technique. We have come to recognize that crucial reparative work must frequently be done and that this work must take place within the contest of a relationship which provides the kind of empathic attunement that was missing in the original mother/infant experience."
Appeared in Psychoanalytic Social Work, 1999, Volume 6, Number 2