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Preview: Psychoanalytic Psychology - Vol 23, Iss 3

Psychoanalytic Psychology - Vol 34, Iss 1

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

Last Build Date: Fri, 24 Mar 2017 02:00:19 EST

Copyright: Copyright 2017 American Psychological Association



This editorial introduces the current special issue of Psychoanalytic Psychology. For 2017 Psychoanalytic Psychology has introduced a new cover design and larger format to allow the Journal to publish 25%-30% more content. This special issue focuses specifically on the topic of sexual boundary violations, a disturbing but necessary issue to take up, guest-edited by Judie Alpert and Lu Steinberg. The issue is dedicated to the memory of Muriel Dimen, friend and colleague to many of us. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Dynamic conflicts in recurrent major depression: Does combined short-term psychotherapy and antidepressive medication lead to healthy dynamic functioning?


After Malan, Heath, Bacal, and Balfour’s (1975) pioneering empirical work, there has been a growing interest in studying whether psychotherapy improves dynamic conflicts. We examined whether dynamic conflicts and adaptation to conflicts improve following short-term psychotherapy. Twelve patients with acute recurrent major depression were randomized to receive antidepressive medications plus 20 sessions of either cognitive–behavioral or dynamic psychotherapy. The Psychodynamic Conflict Rating Scales (PCRS) assessed conflicts and adaptation to conflicts at intake and 1-year follow-up. The Hamilton and Beck Depression Scales assessed depression, and defenses were rated at intake and at 1 year. Significant change was found on measures of depression. Dynamic conflicts showed significant improvement in levels of adaptation (median/mean effect size = 1.41/.92, 95% confidence interval [CI] [.03, 1.81]). However, change in Overall Pathological Conflict scores was not significant (median/mean effect size = 1.23/.85, 95% CI [−.28, 1.99]), principally because 1/3 of subjects failed to progress in this time frame. At 1 year, change in Overall Pathological Conflict scores correlated with self-report (rs = −.72, 95% CI [−94, .01]) but not observer-rated depression. At 1 year, PCRS Conflict scores were correlated with defensive functioning (rs = .77, 95% CI [−.95, −.10]). Short-term psychotherapy was associated with improvement in depression and adaptation to conflict, but there was more heterogeneity in improvement in conflict pathology. The PCRS showed convergent validity with defensive functioning. Longer term therapies and follow-up may be required to develop dynamic recovery and resistance to recurrences of major depression. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Investigating how interpersonal defense theory can augment understanding of alliance ruptures and resolutions: A theory-building case study.


Interpersonal defense theory is an interpersonal conceptualization of defense processes. It is especially helpful for addressing issues about the therapeutic relationship. This qualitative, theory-building case study investigated whether the theory offers a framework for augmenting our understanding of rupture-resolution phenomena. The case involved the successful treatment of a 28-year-old female patient with adjustment disorder. Alliance was assessed after each session. Two rupture-resolution sequences were identified and examined. Analyses, which were guided by a case formulation based on interpersonal defense theory, included a discourse-analytic method to identify coordination failures in the patient’s behavior and turn-by-turn examination of therapist interventions. As predicted, coordination improved from rupture to resolution sessions. Also, examination of therapist interventions and the temporal patterning of patient and therapist behaviors suggested that, as hypothesized, certain kinds of interventions contributed to alliance ruptures, whereas others promoted resolutions. In particular, the analyses supported the prediction that therapist responses that realized the patient’s central interpersonal wish in the therapy relationship contributed to resolutions. These results suggest a new approach to ruptures and their resolution that focuses on the interpersonal significance of therapist interventions. The study adds to the support for interpersonal defense theory provided by previous investigations because it suggests that we can extend the theory to a new set of phenomena (ruptures and resolutions). (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

The associations between the maladaptive personality dimensions of neediness and self-criticism, defense styles, selfobject needs, and attachment styles in an Iranian sample.


The present study extends previous findings by examining whether defense styles, selfobject needs, attachment styles relate to Neediness and Self-Criticism, as maladaptive personality dimensions focused, respectively, on relatedness and self-definition in an Iranian sample. Three hundred and 52 participants completed a sociodemographic questionnaire as well as the Persian forms of the Depressive Experiences Questionnaire, Experience of Close Relationships-Revised, Defense Style Questionnaire, Beck Depression Inventory—II and Selfobject Needs Inventory. Two multiple linear regression analyses, entering Self-criticism and Neediness as criterion variables, were computed. According to the results, high attachment anxiety, high immature defenses, high depressive symptoms, and high need for idealization were related to self-criticism, and explained 47% of its variance. In addition, high attachment anxiety, low mature defenses, high neurotic defenses, high avoidance of mirroring, and low avoidance of idealization/twinship were related to neediness, and explained 40% of its variance. A principal components analysis was performed, entering all the studied variables. Three factors emerged; 1 describing a maladaptive form of psychological functioning and 2 describing more mature modes of psychological functioning. The results are discussed in their implications for the understanding of neediness and self-criticism as maladaptive personality dimensions focused, respectively, on relatedness and self-definition. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

An empirical study of verb use as indicator of emotional access in therapeutic discourse.


Verbs are the primary linguistic vehicles connecting one to his or her affective bodily core. Previous studies have shown that an increase in patient’s verb repetitions in psychoanalysis is indicative of sensory affective arousal that cannot be narrated in words. If the treatment is operating effectively, the patient can use the therapeutic medium to transform the raw affect into a coherent emotional narrative. Using this premise, this study empirically investigated the effectiveness of a psychoanalytic treatment, whose success has been controversial in the past. Using a single-case design with primarily quantitative linguistic methods, measures of verb repetitions, affect dictionaries, and a computerized measure of Referential Activity (a measure of imagistic emotional language) were applied to verbatim recordings of 30 psychoanalytic sessions representing different years of treatment. Results showed that the verb repetition measure was able to differentiate significantly the sessions in terms of level of affective arousal, and there was a significant decrease in mean verb repetitions across the year. Further quantitative and clinical analyses supported that an increase in the repetition of action verbs and affective verbs was associated with intense affective sensory arousal that disrupts the patient’s ability to think where as an increase in stative verb repetitions helped the patient organize a meaningful emotional narrative. Results suggest that a systematic study of verbs can reveal crucial information about patient’s affective states and provide pointers for the clinicians in terms the kinds of interventions needed according to the patient’s linguistic choices. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Psychoanalytic reflections on limitation: Aging, dying, generativity, and renewal.


In this written version of a talk given to a Division 39 audience, the author reflects on issues of limitation, including mortality. She addresses the evident reluctance of many analysts to engage at a personal level, both clinically and theoretically, with aging, loss of function, and dying and invites a conversation about how elderly therapists may prepare for the impact on their patients of their eventual decline and death. She attributes part of the widespread avoidance of such issues to implicit Western—especially American—cultural ideologies, which are replete with Lockean-era assumptions that resources are boundless, that problems are all fixable, and that individual entitlements are more concerning than communal needs and obligations. She contrasts such attitudes with dominant psychoanalytic sensibilities and clinical knowledge, drawing some inferences for the profession. She considers the positive aspects of limitation, including some ways it opens up possibilities for creativity and generativity. Finally, she takes up specifically the aging of members of Division 39 and other psychoanalytic groups, the accomplishments of the current generation of analysts, and the challenges to be faced by psychoanalytic professionals in the next generation. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Psychoanalysis and the Moebius strip: Reexamining the relation between the internal world and the world of daily experience.


Much of psychoanalytic thought and practice is implicitly grounded in archaeological images and metaphors. This article uses the alternative image of the Moebius strip—an odd structure in which inside and outside are not separate but continually merge into each other to form a single surface—in order to stimulate new thinking about the phenomena that are of psychoanalytic concern. Drawing on the imagery of the Moebius strip and on an important overlooked passage in Remembering, Repeating, and Working Through (S. Freud 1914/1953), the article reexamines the nature of unconscious processes and the dynamics of their inaccessibility, as well as the relation between the concepts of repression and dissociation. In further pursuing an alternative understanding of the relation between “internal” and “external” and conscious and unconscious, the article articulates an understanding of personality dynamics that highlights the reciprocal, bidirectional causal links between the internal world and the world of everyday experience. Such an understanding—centered on examining the vicious circles that are a crucial element in how early patterns of thought, feeling, and fantasy can be perpetuated throughout a lifetime—offers fresh possibilities for addressing the problems that bring patients into analysis. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

The unbearable lightness of being: Authenticity and the search for the real.


In this article I review some of the ways in which the themes of authenticity, spontaneity and improvisation have become important values in the writing of many contemporary psychoanalysts. I examine the emergence of this trend in the context of historical and cultural changes in the construction of the self, and the fragmentation of traditional beliefs and social structures linking the individual to the collective. I also explore the relationship between the principle of authenticity and various dimensions including autonomy, mutuality, intersubjectivity, and the ethical realm. In addition I explore the perceived tensions between traditional social forms and the experience of authenticity, and examine the implications of the questions raised in this essay for our conception of the nature of psychoanalytic practice. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

A portrait of the self in the digital age: Attachment, splitting, and self-concealment in online and offline self-presentation.


This study explores the role of adult attachment dynamics in people’s self-presentation and self-concealment in online and offline spaces. A total of 145 bloggers took the Experiences of Close Relationships Scale (Brennan, Clark, & Shaver, 1998) and answered questions about their blog persona and their offline persona. A mixed-methods approach combined qualitative content analysis with quantitative analyses to examine and compare adjective lists describing online and offline personas. In comparison to securely attached individuals, individuals with high levels of attachment anxiety and avoidance presented themselves in more discrepant, contradictory ways online versus offline. Specifically, blog personas were more self-revealing and included more negative traits in individuals with high attachment anxiety and avoidance, whereas offline personas were described as more actively self-concealing and included fewer negative traits. Also, the offline self-presentations of securely attached individuals were more focused on caregiving of others, whereas blog personas were limited to traits of the self. Findings underscore the utility of attachment theory and theories of the self that emphasize multiplicity in examining people’s use of virtual spaces to cultivate and share themselves with others. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Developing a reflective self in cyber space.


This article will address how cyber technology may facilitate reflective functioning with patients who present with primitive self states, fragmentation, and dissociation. The utilization of text-based information and communication technology may allow for a reflective space, apart from the therapist’s explicit intrusion and the potential danger of abandonment and rejection, and may help develop the capacity for reflection and symbolization. Through a case illustration and research findings, we will discuss the benefits and challenges of using cyber technology as an adjunct to face to face treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

The developmental roots of dissociation: A multiple mediation analysis.


The current study was aimed to test a developmental model of dissociation. This model is based on clinical observations and research findings concerning the role of childhood emotional neglect in the development and maintenance of dissociative symptoms. Seven hundred ninety-two adult volunteers completed questionnaires on parental bonding, theory of mind, alexithymia, and dissociation. Significant associations were found between the investigated variables, and a multiple mediation analysis showed that the relationship between childhood emotional neglect and dissociation was totally mediated by theory of mind and alexithymia. The findings of this study support the view that childhood experiences of emotional neglect may foster difficulties mentalizing as well as problems with affect regulation, with these two factors interacting to generate excessively activated dissociative processes. This may suggest that individuals who were exposed to emotional neglect during their childhood and who currently suffer from dissociative symptoms may greatly benefit from clinical interventions aimed to foster mentalized affectivity. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

“Thinking about arrows”: Modeling the associations between inadequate parenting, mentalizing, and dissociation. Commentary on “The developmental roots of dissociation: A multiple mediation analysis” (Schimmenti, 2017).


In an article published in Psychoanalytic Psychology, Schimmenti (2016) reported an empirical study whose results were interpreted as supporting the trauma model of dissociation and suggested that alexithymia and deficits in theory of mind might mediate the relation between emotional neglect and dissociation. Although interesting and thought provoking, that study also had methodological and conceptual limits, which leave open the possibility that other conclusions could be drawn from the data. In this commentary, we point out the conceptual and methodological issues that should be taken into consideration when interpreting Schimmenti’s (2016) findings; argue that alternative explanations are equally defensible; and propose an alternative (or complementary) model to understand the connections among inadequate parenting, dissociation, and mentalizing (i.e., theory of mind and alexithymia). Finally, we report the results of a reanalysis from the original correlation matrix to demonstrate some evidence in support of the proposed alternative model using Structural Equation Modeling. Clinical implications are then briefly discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Throwing arrows and missing the target: The developmental legacy of childhood emotional neglect—A reply to Garofalo and Velotti (2017).


Garofalo and Velotti discuss in their commentary what they conceive to be the conceptual and methodological limits of my model on the developmentally traumatic origins of dissociation. Based on the correlation matrix of the original study, they propose and test an alternative model on the relationship among childhood emotional neglect, theory of mind, alexithymia, and dissociation, which they claim to be more consistent with developmental and clinical research. In this response, I (a) maintain that the operationalization of the constructs in the original study properly reflects the theory and research behind them as well as the purpose of the study, (b) contend that the statistical model proposed by Garofalo and Velotti may lead to inconsistent or incongruous development of theory, (c) show the superiority of my model against the model proposed by Garofalo and Velotti through structural equation modeling, and (d) briefly discuss the clinical implications of my model and its consistency with the trauma model of dissociation. Finally, I propose an integration between my model and Garofalo and Velotti’s model, and I suggest future directions for research on excessively activated dissociative processes. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Theoretical diversity and pluralism in psychoanalysis: Change, challenges, and benefits.


Psychoanalysis today is theoretically diverse and this multiplicity of perspectives provides opportunities to enrich our field. However, housing so much variety under one roof presents many challenges. Psychoanalysts are not immune to the age-old problem of reacting to differing others from a place of fear, with unfortunate results. Arrogance, intolerance, and divisiveness have taken a toll on our professional integrity. I will discuss why multiple theories are inevitable and explore the benefits and challenges of dealing with change and theoretical diversity. I argue that pluralism—embraced as an attitude of open-mindedness and respectful engagement with differing others—is essential if we want to create something of value from our differences and be an intellectually alive discipline. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Review of the Cognitive-emotional brain: From interactions to integration and The feeling body: Affective neuroscience meets the enactive mind.


Reviews the books, Cognitive-Emotional Brain: From Interactions to Integration by Luiz Pessoa (see record 2013-21329-000) and The Feeling Body: Affective Neuroscience Meets the Enactive Mind by Giovanna Colombetti (2014). This is not a book review in the normal sense of the word but rather an essay presenting some thoughts of the reviewer's own on the current status of affect theory, prompted by the publication of two new books on the topic. Readers who would like to know more about the reviewer's views on this topic are advised to look at his recent publications. Part 1 of the review discusses the first book in which Pessoa’s standpoint in The Cognitive-Emotional Brain is conveyed by his subtitle: From Interactions to Integration. In the preface already, he asserts: “emotion and cognition cannot be separated in the brain” (p. x). The reasoning behind this assertion is simple: “‘affective’ brain regions participate in cognition, on the one hand, and ‘cognitive’ brain regions participate in emotion” (p. 3). For the remainder of the book, he uses the term purely operationally, without reference to any theoretical hypotheses. He speaks only of experimental paradigms and empirical “task conditions” (p. 3). The reviewer summarizes his conclusions of the book under 8 headings. In Part 2, the reveiwer turns to Colombetti's The Feeling Body. Her aim in this book is to introduce to affective neuroscience the so-called “enactive” approach pioneered by Varela. One of the central ideas of enactivism is embodiment. Particularly significant, Colombetti tells us at the outset, is that (in sharp contrast to Pessoa’s approach) the enactive body “is not just a sensorimotor system, namely, a physical system that links sensory inputs and motor actions” (p. xiv). It also emphasizes “the wetter and bloodier self-regulatory dimension of embodiment, which includes the biochemical activity of metabolism, and more generally homeostatic processes” (pp. xiv–xv). The reviewer then proceeds to discuss Colombetti's book in more detail. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Review of Transference focused psychotherapy for borderline personality disorder: A clinical guide.


Reviews the book, Transference Focused Psychotherapy for Borderline Personality Disorder: A Clinical Guide by Frank E. Yeomans, John F. Clarkin, and Otto F. Kernberg (see record 2015-18407-000). Borne out of over a century of combined clinical experience Yeomans, Clarkin, and Kernberg provide simply a treasure trove of theoretically informed, empirically derived methods, illustrated with clinical vignettes to demonstrate the use of transference focused psychotherapy (TFP) with patients with borderline personality disorder (BPD). The volume is organized into sections covering personality theory, the empirical development of TFP, evaluation, and then moving to technical details of this method of treating patients with BPD. To supplement the text, videos with illustrative segments are provided online. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Review of The last asylum: A memoir of madness in our times.


Reviews the book, The Last Asylum: A Memoir of Madness in Our Times by Barbara Taylor (2015). Taylor, a noted historian and professor of humanities, has written a memoir of her long, and at times harrowing, psychoanalysis and psychiatric hospitalization. In this book she goes beyond a standard autobiographical account and links her personal history to the sociocultural history of the asylum movement of the past 150 years. She focuses on the implications of the closing of psychiatric hospitals and residential treatment programs using her experience as a patient in the public mental health system in Great Britain during its last days of long-term psychiatric hospital care. The failure of institutional psychiatric treatment of the past centuries and the equal failure to replace the hospital system with adequate local community care are examined with complex insight into the human cost of our centuries of inadequate and often inhumane care. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Review of Listening with the fourth ear: Unconscious dynamics in analytic group psychotherapy.


Reviews the book, Listening with the Fourth Ear: Unconscious Dynamics in Analytic Group Psychotherapy by Leonard Horwitz (see record 2014-01114-000). Horwitz has been one of the leading lights in the world of American group psychotherapy since the 1960s. In this volume he offers us a treasure trove of insights about the history of group therapy in this country, the theoretical and technical conflicts and disputes that have divided and challenged the field over the years and above all he spells out his own approach, developed and honed over many years of practice, teaching and writing about analytic group psychotherapy. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Review of Metaphor and fields: Common ground, common language, and the future of psychoanalysis.


Reviews the book, Metaphor and Fields: Common Ground, Common Language, and the Future of Psychoanalysis by S. Montana Katz (see record 2013-04408-000). This book is partly a guide to, and partly an expansion of, ideas about psychoanalytic “field” theory. It expands these ideas by joining them with ideas about the significance of metaphor in our thinking and our clinical practice. It largely reprints two issues of Psychoanalytic Inquiry, originally published in 2011 and 2013, with some additional editorial material. The book’s principal motivation, in a sense, is to unite psychoanalysts under a set of “umbrella” concepts. Katz wants to make psychoanalysis more discernible as an integrated profession, as well as more conversant with other disciplines, and wants to widen some of our psychoanalytic ideas to accomplish these goals. The book takes the concept of the analytic “field” and opens it widely, to serve as a large umbrella. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)