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Psychoanalytic Psychology - Vol 33, Iss 3

Psychoanalytic Psychology serves as a resource for original contributions that reflect and broaden the interaction between psychoanalysis and psychology.

Last Build Date: Sat, 01 Oct 2016 01:00:20 EST

Copyright: Copyright 2016 American Psychological Association

The mirror paradigm: Assessing the embodied self in the context of abuse.


Childhood sexual abuse is a known risk factor for the development of mental health problems in adolescence and adulthood. However, the developmental mechanisms are not well understood. We hypothesized that sexual abuse has an early impact on the development of the self, which plays a key role in adaptation following the trauma. We posit that many of the negative impacts of abuse on the developing self affect sensory-motor states, as well as one’s own body experience, and remain mostly out of cognitive awareness. This study presents a new method to assess the impact of sexual abuse on children’s embodied self-experience in a sample of 68 children aged 5–13 (43 children with histories of sexual abuse and 25 nonabused children). A coding procedure was developed for use with the mirror paradigm (MP) to assess 4 dimensions of children’s embodied self-experience (MP-CESE). The MP consists of a semistructured interview during which the child is requested to answer questions while looking at his image in a vertical mirror. Findings indicate that the embodied self-experiences of children with histories of sexual abuse were significantly more negative than those of nonabused controls. Embodied self-experience scores as measured with the MP-CESE correlated significantly with parent reports of internalized behaviors, externalized behaviors, dissociation and sexualized behaviors, as well as teacher’s reports of children’s externalizing behaviors. This suggests that the MP-CESE is a reliable measure that provides access to disturbances of the embodied self in school-age children, which cut across numerous behavioral problems. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Changing encounters with the other: A focus group study on the process of change in a therapeutic community.


Democratic therapeutic communities (TCs) are long-term group programs that address severely ingrained clinical populations. These psychodynamically informed social environments can facilitate improvement in people suffering from personality pathology. However, the TCs’ working principle is not well documented, which threatens its continued existence. To gain further insight into how TCs work, this study explores former TC residents’ perspectives on their treatment, its outcome, and the process of change they underwent. Four steps that might explain this process were identified through focus group interviews (using qualitative analyses) with 24 former residents of a Belgian democratic TC: (a) I encounter a safe, caring, and challenging Other, (b) I unfold my particular way of interacting with the Other, (c) I am confronted with the Otherness in me, and (d) I live an Other life. This fourth step refers to the reported treatment outcome that consists of 3 main changes: (a) residents became more resilient and capable of coping with their problems, (b) residents became more involved in pleasant social relations, and (c) residents developed the capacity to make choices in their own lives. We recommend a reappraisal of social psychiatry, emphasizing the social aspect of human life, psychopathology and its treatment. Limitations of the study and suggestions for further research are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Do splitting and identity diffusion have respective contributions to borderline impulsive behaviors? Input from Kernberg’s model of personality.


Kernberg’s object relations model postulates that excessive splitting compromises the integration of the positive and negative poles of the representations of self and other, as well as their arrangement into more complex and hierarchically ordered structures such as the individual’s identity, resulting in identity diffusion. In adult functioning, splitting and diffuse identity are conceived as 2 close functional related constructs and associated to borderline impulsivity. The present paper proposes an empirical investigation of Kernberg’s model, with the aim of examining the relations between splitting, identity diffusion, and impulsivity as measured with 2 instruments: one measuring the frequency of occurrence of self-damaging behaviors (BSL-B; Borderline Symptom List-23, Behavior Supplement Scale) and the other assessing the borderline impulsivity trait [Personality Assessment Inventory-Borderline features, Self-Harm subscale (PAI-BOR Self-Harm subscale)]. Data from the Splitting Index (SI) and the Identity Consolidation Inventory (ICI) was collected from a nonclinical sample (N = 204). Multiple regression results showed that only identity diffusion made a significant contribution to the variance of borderline impulsivity trait (PAI-BOR Self-Harm) whereas only splitting made a significant contribution regarding the frequency of occurrence of self-damaging behaviors (BSL-B). Results suggest that both splitting and identity diffusion measures reveal respective associations with impulsivity in a nonclinical sample but these associations seem to vary depending on the instrument assessing impulsivity. Differences between the 2 impulsivity measures are discussed in relation to both psychoanalytic constructs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Listening, learning, and development in psychoanalytic supervision: A self psychology perspective.


In this article, I would like to consider the matter of development in psychoanalytic supervision and how supervisees learn and grow across supervisory space. Although long considered fundamentally developmental in nature, the process of psychoanalytic supervision has not been specifically examined and explicated from a developmental learning perspective. I propose here some ways in which a developmental learning view could complement a psychoanalytic view of supervision. Blending therapist/supervisee developmental conceptualization (e.g., Ronnestad & Skovholt, 2013; Skovholt, 2012; Stoltenberg & McNeill, 2010) with a self psychology focus on the therapist self, I take up 3 issues: (a) a vision of learning in supervision; (b) the evolving sense of practice self during the supervisory process; and (c) how subject-centered and other-centered listening perspectives contribute developmentally to the supervision experience. My perspective is informed by and grounded in the foundational assumption that: Psychoanalytic supervision is a developmentally anchored educational experience in which the supervisory relationship serves as the crucible of supervisee change. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

The supervisor as witness.


Adopting the role of witness can help supervisors to cope with emotional flooding and fluctuations in the supervisees’ self-experience. Assuming the role of witness aids modification of the supervisors’ tendency to hold the supervisees’ in mind and to respond to their selfobject needs and provides the supervisees with a participatory yet external presence, which enhances the supervisees’ creativity. The meaning and the uses of the role of witness in the supervisory context are explained and illustrated in the present article. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

On a culturally humble psychoanalytic supervision perspective: Creating the cultural third.


What is the role of cultural humility in psychoanalytic supervision? In this article, we address that question. While culture has been recognized as central to supervision practice (e.g., Tummala-Narra, 2004), the psychoanalytic supervision literature remains highly limited in addressing issues related to culture and diversity. In what follows, we present a psychoanalytic supervision perspective that is anchored by the construct of cultural humility. Cultural humility is defined, 10 conceptual/practice guideposts of a culturally humble supervision view are proposed, 2 supervision case examples are described, and some supervision/cultural humility research hypotheses are proposed for possible empirical study. Teaching supervisees about and modeling cultural humility is considered to be preparatory education for the creation of a cultural third. Realizing cultural humility via supervisory interaction involves the opening of a supervisor–supervisee third space whereby cultural meanings and experiences are welcomed and can be explored, examined, and experienced anew. This supervision cultural third ideally becomes a prototype for the supervisee/patient’s own creation of a treatment cultural third. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Review of The Psychoanalytic Model of the Mind.


Reviews the book, The Psychoanalytic Model of the Mind by Elizabeth L. Auchincloss (see record 2015-18400-000). This book demonstrates how psychoanalytic theories and approaches can be clear and comprehensible rather than overly complex and mystifying. She repeatedly demonstrates the various theories do not have to be at odds: the models can be interdigitated or used in sequence according to the needs of patients and our best understanding of them. The book is part of a series of efforts at simplification and clarification that are helping us to better study and teach psychoanalytic treatments. By simplification I am not referring to either an easy task or something not useful for psychoanalytic clinicians. It takes tremendous effort and thought to communicate these concepts in a comprehensible form. The book speaks to all levels of health care workers, from students to highly seasoned clinicians. Any nonanalytic therapist or even experienced analyst reading this text will grasp an aspect of an analytic model that was hazy and identify the value of a concept buried due to its perceived unhelpfulness. This refreshing and enlightening work inspires and broadens our clinical efforts. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Review of Cyclical Psychodynamics and the Contextual Self.


Reviews the book, Cyclical Psychodynamics and the Contextual Self by Paul L. Wachtel (see record 2014-16201-000). The first half of this book orients the reader to Wachtel’s particular psychoanalytic vision. At the heart of his “cyclical” theory is the conviction that our inner (private, subjective), intimate (primary relationships), and sociocultural worlds constantly interpenetrate and shape each other. The second half is dedicated to drawing out the implications of Wachtel's vision of psychoanalysis for the broader social world. It is here that the book comes most fully to life. Wachtel argues that psychoanalysis has much to contribute to our understanding of sociopolitical life, turning his attention most squarely to the issues of race, class, greed, and the “social construction of desire.” Extending psychoanalytic thinking into these realms is, for Wachtel, not simply a matter of personal passion; rather, he views it as a responsibility, a necessity. Regardless of how one views the relationship between psychoanalysis and science, one must admire the scope of Wachtel’s thinking and his remarkable penchant for synthesis. Even dissenting readers will be taken with his erudition, diligence, humility, and graciousness. Indeed, with its blend of psychoanalytic progressivism, integrative thinking, persistent skepticism, rigorous presentation of data, and explicit attention to ethical mooring, Cyclical Psychodynamics promises something for everyone. The thinker and the clinician, the seasoned psychoanalyst and the graduate student, are all likely to find meaningful questions and answers in this volume. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Review of Psychological Testing That Matters: Creating a Road Map for Effective Treatment.


Reviews the book, Psychological Testing That Matters: Creating a Road Map for Effective Treatment by Anthony D. Bram and Mary Jo Peebles (see record 2013-35211-000). This is an outstanding text for many reasons. The approach to psychological testing that Bram and Peebles take provides an excellent model for integrating test findings with a focus on treatment planning. The authors are experts in psychological assessment and are seasoned clinicians. They tackle the hard question of how to weigh the evidence and decide which conclusions can be said with confidence and which are speculative. Principles of inference-making are presented. This is a clinically sophisticated presentation that uses language that is understandable for beginning students. The focus of the book is to “explicate methods of inference-making and synthesis that answer referral questions, create an experience of the person of the patient, and affect treatment meaningfully” (p. 8). The framework of the book is that of a psychodynamic perspective that is focused on internal processes and personality characteristics that underlie symptoms. One of the joys in reading this book is that it is also a model of integrating one’s clinical experience and the theoretical literature with the teachings of one’s supervisors and mentors. The framework of test interpretation followed by the psychologists at the Menninger-Topeka Clinic pervades the book as do teachings and writings of classic figures in psychology such as Mayman, Appelbaum, Lerner, and Weiner. It shows how one grows as a clinician over time and continually integrates and synthesizes new information into one’s solid foundation in assessment. Bram and Peebles provide an outstanding synthesis of the process of test interpretation and treatment planning. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)