This is a completely revised and enlarged edition of the well-known classic. In the twenty years since the previous edition was published much progress has been made in regard to the clinical concept of psychoanalysis, and this new edition brings the subject completely up to date. New knowledge of the psychoanalytic process has been added, together with advances in understanding the clinical situation, the treatment alliance, transference, countertransference, resistance, the negative therapeutic reaction, acting out, interpretations and other interventions, insight, and working through. The book is both a readable introduction to the subject and an authorities work of reference.
Coen (training and supervising analyst, Columbia U. Center for Psychoanalytic Training and Research) offers advice to psychoanalysts working with extremely difficult patients. His central premise is that both patients and therapists have difficulty tolerating intense affects (such as loving and hating) and that the clinician needs to "feel with and for his patient, over a prolonged time, what she finds so terrifying" (emphasis in original). Also stressed is the need for clinicians to confront their own fears and doubts about treatment. Annotation copyrighted by Book News, Inc., Portland, OR
People's lives can be dramatically transformed by psychoanalysis. Yet the decision to undertake this enterprise can seem so formidable that many deny themselves an extraordinary experience. This book makes that decision--admittedly a complex one--better informed, clearer, and easier. It provides seven detailed case reports, easy to read and free of technical jargon, in which the patients' lives--in their own judgements--were transformed. This is not meant to imply that psychoanalysis always or even usually yields transformative results. These case studies are intriguing in their own right and help the reader think knowledgeably about psychoanalysis and assess its potential as a life-changing enterprise.
The question of how psychoanalysts are affected by their patients is of perennial interest. Edward Glover posed the question in an informal survey in 1940, but little came of his efforts. Now, more than half a century later, Judy Kantrowitz rigorously explores this issue on the basis of a unique research project that obtained data from 399 fully trained analysts. These survey responses included 194 reported clinical examples and 26 extended case commentaries on analyst change. Kantrowitz begins The Patient's Impact on the Analyst by documenting how the process of analysis fosters an interactional process out of which patient and analyst alike experience therapeutic effects. Then, drawing on the clinical examples provided by her survey respondents, she offers a detailed exploration of the ways in which clinically triggered self-reflection represents a continuation of the analyst's own personal understanding and growth. Finally, she incorporates these research findings into theoretical reflections on how analysts obtain and integrate self-knowledge in the course of their ongoing clinical work. This book is a pioneering effort to understand the therapeutic process from the perspective of its impact on the analyst. It provides an enlarged framework of comprehension for recent discussions of self-analysis, countertransference, interaction, and mutuality in the analytic process. Combining a wealth of experiential insight with thoughtful commentary and synthesis, it will sharpen analysts' awareness of how they work and how they are affected by their work.
Psychoanalysts increasingly find themselves working with patients and states that are not amenable to verbal and dialogic engagement. Such patients are challenging for a psychoanalytic approach that assumes that the patient relates in the verbal realm and is capable of reflective function. Both the classical stance of neutrality and abstinence and a contemporary relational approach that works with mutuality and intersubjectivity, can often ask too much of patients. The Unobtrusive Relational Analyst introduces a new psychoanalytic register for working with such patients and states, involving a present and engaged analyst who is unobtrusive to the unfolding of the patient’s inner world and the flow of mutual enactments. For the unobtrusive relational analyst, the world and idiom of the patient becomes the defining signature of the clinical interaction and process. Rather than seeking to bring patients into greater dialogic relatedness, the analyst companions the patient in the flow of enactive engagement and into the damaged and constrained landscapes of their inner worlds. Being known and companioned in these areas of deep pain, shame and fragmentation is the foundation on which psychoanalytic transformation and healing rests. In a series of illuminating chapters that include vivid examples drawn from his work with individuals and with groups, Robert Grossmark illustrates the work of the unobtrusive relational analyst. He reconfigures the role of action and enactment in psychoanalysis and group-analysis, and expands the understanding of the analyst’s subjectivity to embrace receptivity, surrender and companioning. Offering fresh concepts regarding therapeutic action and psychoanalytic engagement, The Unobtrusive Relational Analyst will be of great interest to all psychoanalysts and psychoanalytic psychotherapists.
Forewords by Theodore Jacobs and Donnel Stern The Role of the Patient-Analyst Match in the Process and Outcome of Psychoanalysis is a compilation of Judy Kantrowitz’s previously published papers on the patient-analyst "match" and its effect on the process and outcome of psychoanalysis. The match between patient and analyst places attention on the dynamic effect of interactions of character and conflict of both participants on the process that evolves between them—a spectrum of compatibility and incompatibility that is relevant to the analytic work. Classical psychoanalysis had been viewed as a "one-person" enterprise, with one analyst interchangeable with another. Analysts’ experiences of countertransference reactions were viewed as unresolved conflicts, reasons to return to personal treatment, not inevitable and potentially informative about the current analytic work. This view began to shift in the 1980s, with Judy Kantrowitz’s work contributing to the development of the recognition that psychoanalysis was a "two-person" process. In this collection of her most significant papers, Kantrowitz explores the importance of the match, which refers to observable styles, attitudes and personal characteristics that may be rooted in residual and unanalyzed conflicts, triggered in any patient-analyst pair. Match is neither a predictive nor static concept. Rather it refers to the unfolding transaction that itself that may shift and change during the course of analytic work. Pulling together the history of the shift in theory from the one-person to two-person understanding of the psychoanalytic enterprise, The Role of the Patient-Analyst Match in the Process and Outcome of Psychoanalysis will be of great interest to contemporary psychoanalysts.
Winner of the 2009 Goethe Award for Psychoanalytic Scholarship! Irwin Hirsch, author of Coasting in the Countertransference, asserts that countertransference experience always has the potential to be used productively to benefit patients. However, he also observes that it is not unusual for analysts to 'coast' in their countertransferences, and to not use this experience to help treatment progress toward reaching patients' and analysts' stated analytic goals. He believes that it is quite common that analysts who have some conscious awareness of a problematic aspect of countertransference participation, or of a mutual enactment, nevertheless do nothing to change that participation and to use their awareness to move the therapy forward. Instead, analysts may prefer to maintain what has developed into perhaps a mutually comfortable equilibrium in the treatment, possibly rationalizing that the patient is not yet ready to deal with any potential disruption that a more active use of countertransference might precipitate. This 'coasting' is emblematic of what Hirsch believes to be an ever present (and rarely addressed) conflict between analysts’ self-interest and pursuit of comfortable equilibrium, and what may be ideal for patients’ achievement of analytic aims. The acknowledgment of the power of analysts’ self-interest further highlights the contemporary view of a truly two-person psychology conception of psychoanalytic praxis. Analysts’ embrace of their selfish pursuit of comfortable equilibrium reflects both an acknowledgment of the analyst as a flawed other, and a potential willingness to abandon elements of self-interest for the greater good of the therapeutic project.
"On Learning from the Patient is concerned with the potential for psychoanalytic thinking to become self-perpetuating. Patrick Casement explores the dynamics of the helping relationship - learning to recognize how patients offer cues to the therapeutic experience that they are unconsciously in search of. Using many telling clinical examples, he illustrates how, through trial identification, he has learned to monitor the implications of his own contributions to a session from the viewpoint of the patient. He shows how, with the aid of this internal supervision, many initial failures to respond appropriately can be remedied and even used to the benefit of the therapeutic work. By learning to better distinguish what helps the therapeutic process from what hinders it, ways are discovered to avoid the circularity of pre-conception by analysts who aim to understand the unconscious of others. From this lively examination of key clinical issues, the author comes to see psychoanalytic therapy as a process of re-discovering theory - and developing a technique that is more specifically related to the individual patient. The dynamics illustrated here, particularly the processes of interactive communication and containment, occur in any helping relationship and are applicable throughout the caring professions. Patrick Casement's unusually frank presentation of his own work, aided by his lucid and non-technical language, allows wide scope for readers to form their own ideas about the approach to technique he describes. This Classic Edition includes a new introduction to the work by Andrew Samuels and, together with its sequel Further Learning from the Patient, will be an invaluable training resource for trainee and practising analysts or therapists."--
In The Analyst’s Experience of the Depressive Position: The Melancholic Errand of Psychoanalysis, Steven Cooper explores a subject matter previously applied more exclusively to patients, but rarely to psychoanalysts. Cooper probes the analyst’s experience of the depressive position in the analytic situation. These experiences include the pleasures and warmth of helping patients to bear what appears unbearable, as well as the poignant experiences of limitation, incompleteness, repetition and disappointment as a vital part of clinical work. He describes a seam in clinical work in which the analyst is always trying to find and re-find a position from which he can help patients to work with these experiences. The Analyst’s Experience of the Depressive Position includes an exploration of the analyst’s participation and resistance to helping patients hold some of the most unsettling parts of their experience. Cooper draws some analogies between elements of theory about aesthetic experience in terms of how we bear new and old experience. He provides an examination of the patient as an artist of sorts and the analyst as a form of psychic boundary artist. Just as the creative act of art involves the capacity to transform pain and ruin into the depressive position, so does the co-creation of how we understand the patient’s mind through the mind of the analyst. The Analyst’s Experience of the Depressive Position explores a rich, provocative and long overdue topic relevant to psychoanalysts, psycho-dynamically oriented psychotherapists, as well as students and teachers of both psychoanalysis and psychodynamic psychotherapy.
What Happens When the Analyst Dies explores the stories of patients who have experienced the death of their analyst. The book prioritizes the voices of patients, letting them articulate for themselves the challenges and heartache that occur when grappling with such a devastating loss. It also addresses the challenges faced by analysts who work with grieving patients and/or experience serious illness while treating patients. Claudia Heilbrunn brings together contributors who discuss their personal experiences with bereavement and/or serious illness within the psychoanalytic encounter. Chapters include memoirs written by patients who describe not only the aftermath of an analyst's death, but also how the analyst's ability or inability to deal with his or her own illness and impending death within the treatment setting impacted the patient's own capacity to cope with their loss. Other chapters broach the challenges that arise (1) in 'second analyses', (2) for the ill analyst, and (3) for those who face the death of an analyst or mentor while in training. Aiming to give prominence to the often neglected and unmediated voices of patients, as well as analysts who have dealt with grieving patients and serious illness, What Happens When the Analyst Dies strives to highlight and encourage discussion about the impact of an analyst's death on patients and the ways in which institutes and therapists could do more to protect those in their care. It will be of interest to psychoanalysts, psychotherapists, counselors, gerontologists, trainees, and patients who are currently in treatment or whose therapist has passed away.
