Introduction to the Practice of Psychoanalytic Psychotherapy (eBook)

Alessandra Lemma (Autor)

eBook Download: EPUB

2015 | 2. Auflage
John Wiley & Sons (Verlag)
978-1-118-81852-7 (ISBN)

Infos

The 2nd Edition of Introduction to the Practice of Psychoanalytic Psychotherapy, the highly successful practice-oriented handbook designed to demystify psychoanalytic psychotherapy, is updated and revised to reflect the latest developments in the field.

• Updated edition of an extremely successful textbook in its field, featuring numerous updates to reflect the latest research and evidence base
• Demystifies the processes underpinning psychoanalytic psychotherapy, particularly the development of the analytic attitude guided by principles of clinical technique
• Provides step-by-step guidance in key areas such as how to conduct assessments, how to formulate cases in psychodynamic terms and how to approach endings
• The author is a leader in the field - she is General Editor of the New Library of Psychoanalysis book series and a former editor of Psychoanalytic Psychotherapy

ALESSANDRA LEMMA is Director of the Psychological Therapies Development Unit at the Tavistock and Portman NHS Foundation Trust, and a Consultant Adult Psychotherapist at the Portman Clinic. She is a Fellow of the British Psychological Society, Visiting Professor and Clinical Director of the Psychological Interventions Research Centre at University College London, Visiting Professor at Sapienza University of Rome and Honorary Professor of Psychological Therapies at the University of Essex. She is the Editor of the New Library of Psychoanalysis book series, and one of the regional Editors for the International Journal of Psychoanalysis. She has published extensively on psychoanalysis, the body and trauma.

Inhalt

About the Author vii

Preface ix

Introduction: Is Freud Dead? 1

1 Brave New Worlds: A Psychoanalysis Fit for the Twenty-First Century 12

2 An Overview of the Schools of Psychoanalysis: Theory and Practice 28

3 The Process of Psychic Change 75

4 The Analytic Setting and the Analytic Attitude 94

5 Assessment and Formulation 128

6 Unconscious Communication 169

7 Defences and Resistance 194

8 Transference and Countertransference 219

9 Working with Endings 269

Conclusion: The Psychoanalytic Psychotherapist at Work 292

References 302

Index 327

Rezensionen

"This text is a thorough, thoughtful and academically rigorous approach to Freudian and Kleinian thinking today." (Therapy Today, May 2016)

Textauszug

Preface

For the past 25 years I have been on an analytic journey. During this time I have travelled through Freudian and Kleinian personal analyses with a few supervisory stopovers in the middle ground of the Independents. My analytic journey has been, and continues to be, enriching. Each experience has taught me many things of value and it has raised many questions, some uncomfortable, not only about myself but also about psychoanalysis as a method of therapy, as an institution and as a profession.

I know that my choices of analyst and of supervisors when I was training in theory makes me a Kleinian, except that in practice I never chose any of them because they were Kleinians, but because they were compassionate towards their patients, because I liked them, because they had a good sense of humour and because they were inspiring to me for my own idiosyncratic reasons.

As you read this book you will notice that I draw on a wide range of ideas that reflect different traditions within psychoanalysis, and it will not be entirely obvious which analytic group I align myself with. This is because, in fact, I don't align myself with any one group. Groups can all too readily operate in self-contained ways, perpetuating unhelpful assumptions and myths that militate against critical reflection on the tools of our trade. Our need to take sides, to split, to be the favoured child are revived and relived in our organisational lives. When we align to one group and not another, we are not solely driven by theoretical differences or scientific findings; we are also living out, for example, the phantasy that we have successfully relegated our rival to a less privileged group. Ideally, of course, the point of any kind of social organisation should be to encourage the widest possible human diversity.

If there is an “US” there is a “THEM”, and the world of psychological therapies generally, not just psychoanalysis, is no different from any other social grouping: we all have vested interests in promoting our worldview and the therapeutic approach that matches it. I do too. In fact, just in case you are wondering, I think it is essential for our sanity that we have our own subjective viewpoint from which to relate to others, that is, a confident belief in our point of view. I am not an advocate of a relativistic position as such. As Joseph Schumpeter wisely reminds us:

To realise the relative validity of one's convictions and yet stand by them unflinchingly is what distinguishes a civilised man from a barbarian.

(Quoted in Berlin, 1969)

To long for more absolute truths, for certainty, is, as Isaiah Berlin (1969) suggests, a reflection of “a deep and incurable metaphysical need; but to allow it to determine one's practice is a symptom of an equally deep, more dangerous, moral and political immaturity”.

Ultimately, it does not matter if everybody's final vocabulary is different (Rorty, 1989). Sameness is not what we should be aspiring towards as long as there is enough overlap so that everybody has some words with which to express the desirability of engaging with other people's belief systems as well as with their own.

There are indeed several different versions of psychoanalysis. In this book I have approached some chapters at times from different perspectives, pooling together insights gleaned from divergent theoretical orientations within psychoanalysis. Perhaps this makes me a pluralist or an integrationist, though I am never sure what these terms really mean. If they mean that I think there are different ways of understanding the human mind and the process of therapy, this is true. If they mean that I have difficulty identifying primarily with only one school of psychoanalysis, as I just mentioned, this is true. If they mean that I believe that when I work with a patient what matters is a flexible approach that is guided by what the patient needs at any given moment rather than what a particular theory prescribes, this is also true.

Perhaps as someone who had to learn different languages to adapt to the changing cultural landscapes of my childhood, I have an ingrained sense of contingency within me that prevents me from adopting any therapeutic language as final. Debate is important. Difference is dynamic and keeps us thinking. The danger lies in using difference to justify the superiority of one theory or approach over another.

In The Dialogic Imagination, Bahktin (1981) argues for the importance of dialogism, which according to him is mandated by our position within language. Monologism is the delusion that there is only one language. Dialogism is to recognise the limits of any one language, to embrace the immense plurality of experience, to orientate ourselves and find a place within what Bakhtin calls “the critical interanimation of languages”. I'm not sure we see much of this “interanimation of languages” in our field, but it is the spirit with which I approach psychoanalysis.

About this Book

This book has been largely inspired by teaching psychoanalysis to trainee clinical psychologists and other clinicians from different mental health backgrounds, who were often approaching psychoanalysis with little knowledge or experience of it. Even so, many were primed to be critical of it on the basis of prior learning or exposure to psychoanalytic interventions that had been experienced as unhelpful. I approach the subject matter in this book largely with this audience in mind, remembering some of the questions my students have put to me over the years and the criticisms they have voiced. The book is intended primarily as a practical, clinical text for workers in the mental health field who are relative newcomers to the practice of psychoanalytic therapy. It does nevertheless assume a core background in one of the mental health professions, clinical experience with patients and a degree of familiarity with the practice of psychotherapy and/or counselling more generally.

The book also draws on my applied psychoanalytic work as a clinical psychologist in forensic and psychiatric settings within the public health service as well as my work as a psychoanalyst seeing patients on the couch 3–5 times weekly. In my view psychoanalytic work is defined as such first and foremost by the therapist's internal setting (Parsons, 2007) and not by the external setting in which one practices or the frequency of sessions offered to the patient. The distinctiveness of psychoanalytic work lies in the therapist's systematic use of transference, which involves maintaining an analytic stance rooted in the therapist's experience of the transference (see Chapter 8) in order to inform her understanding of the patient's state of mind and how to intervene most productively. Teaching psychoanalysis has helped remind me that when we are trained psychoanalytically it is all too easy to forget that our practice is based on so much that is taken for granted, and on the idiosyncrasies of our own personal analytic experiences with training therapists and supervisors, that it is unsurprising when the newcomer to it finds the ideas confusing and the theories difficult to translate into practice. Teaching is indeed a salutary experience – unless we teach the converted – since it forces us to revisit cherished assumptions. It has taught me to beware the dangers of overvalued ideas, though I am sure that while reading this book you will come across several ideas with which I am all too reluctant to part company.

A word of caution is called for before embarking on this book – I am a synthesiser. In this book, I have traded specificity for generalities and subtle differences in theoretical concepts for common strands between the many psychoanalytic theories that are available. It will thus probably disappoint if you are in search of sophisticated critiques of particular metapsychologies or of the philosophical underpinnings of psychoanalysis. This is not the aim of this book. Rather, my efforts are directed at developing a guiding, yet always provisional, framework for my own clinical work, based as it is on my understanding of theory and on what “works” in my own clinical practice.1 To this end, I draw on several psychoanalytic theories as I have yet to come across one model or theory that can satisfactorily account for all my analytic work.

In this book I am concerned with articulating my “private” clinical theory (Sandler, 1983) and its implications for technique. In some of the chapters I summarise some of the ideas that guide my work as “practice guidelines”. These are not intended to be in any way prescriptive but merely reflect my own attempt to make explicit how I approach my interventions, and to share the technical teachings that my own clinical supervisors have imparted to me over the years. This book pools together these experiences into a working framework that is inevitably personal and evolving. In light of this, I can make no claims that what I do and what I have written about is empirically sound, but I have endeavoured, wherever possible, to anchor my practice in the empirical research that I am familiar with.

Because this is an introductory text commar after text rather than chapter perhaps at the end of each chapter, I have made some suggestions for further reading that will help extend the study of the concepts and ideas presented. If approaching this book with little prior knowledge of psychoanalytic ideas, it will probably be more helpful to read it sequentially as each chapter relies on an...

Produkt-Details

• Erscheint lt. Verlag: 23.9.2015
• Sprache: englisch
• Themenwelt: Kunst / Musik / Theater
• Themenwelt: Geisteswissenschaften ► Psychologie ► Psychoanalyse / Tiefenpsychologie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Psychiatrie / Psychotherapie
• Schlagworte: Psychoanalyse • Psychoanalysis • Psychoanalytic psychotherapy, psychoanalysis, psychotherapy, dynamic interpersonal therapy, DIT, psychoanalytic theory, Freud, unconscious mind, clinical psychology, transference interpretations, neuroscience, evidence • Psychologie • Psychology • Psychotherapie • Psychotherapie u. Beratung • Psychotherapy & Counseling
• ISBN-10: 1-118-81852-0 / 1118818520
• ISBN-13: 978-1-118-81852-7 / 9781118818527