Facing the unthinkable: Life-threatening illness in the analyst and its impact on the analytic couple.

This article explores the impact of the analyst's life-threatening illness on the analytic couple; it is informed through two theoretical lenses - Freud's ideas about the vicissitudes of mourning, which have been elaborated on by Melanie Klein and John Steiner, and Christopher Bollas's ideas about destiny and idiom. Clinical material will focus on my on-going work with a middle-aged man who has a history of early abandonment and loss and who struggles with being able to remain separate from his objects while being in relationship with them.

On the question of the internal frame.

This paper attempts to expand José Bleger's classic, metapsychological descriptions of the psychoanalytic frame to formulate and emphasize the role of the analyst's internal frame in establishing a psychoanalytic observational perspective in the analytic situation. The rationale for doing so follows from clinical necessity, especially when working with patients and psychic organizations that are 'beyond neurosis' and in non-traditional settings such as distance and telemetric analyses. Clinically speaking, in its most effective state, the analyst's internal frame can inform the possibility of an observational vertex aimed at the intuitive grasp of psychic reality rather than a sense-based, empirical observation of parameters denoted by the elements of a consensually validatable social reality.

Entrenched grievance as a harbour for the unmourned.

This paper hopes to enhance understanding about entrenched grievance in a couple of ways: (a) Initially, the paper reviews how entrenched grievance reflects melancholic states of mind in terms of its avoidance of the pain of loss and change. But the main contribution of the paper is likely to be found in (b), that is, via detailed clinical material, the paper illustrates how earnest efforts on the part of the analyst to bring understanding may lead to cognitive entrapments such as the convictions incumbent in the "knowing" analyst. Further, that this knowing analyst may need to become aggrieved, that is, narrow, impatient and concrete towards her patient's entrenchment, and then to recogize this plight in herself before she can genuinely hear her patient's grievance about her from a wider view, that is as a complaint from the "lively self", deserving recognition. The clinical detail demonstrates that such recognition softened the patient's grievance, allowing both members of the dyad to become more collaborative and open to the pains and growth available from mourning states of mind.

Frame, setting, process, and movement.

The author addresses the theme of frame and setting in psychoanalysis, suggesting that they are "functions" of the psychoanalytic process. Frame is defined as the external components of the context that enable the development of a process, and setting as the primarily psychoanalytic elements within the analyst's mind, necessary for establishing an analysing situation where a process should take place. The author emphasizes that the characteristics of both also define the outline of the process, while discussing attributes that would aid in its development. The author proposes the creation of an imaginary model regarding possible invariants in psychoanalytic theories and theories of technique with the intention of deepening the understanding of the relationship between frame, setting and process. The author concludes with a reflection on the effect of implicit theories on the construction of frame and setting.

A Psychoanalyst's Confrontation With Illness, Aging, and Death.

Offering a personal example, the author argues for the protocols of respectful, confidential, and responsible institutional support as a corrective to an individual clinician's lack of optimal judgment when facing difficult clinical challenges or personal crises.

Ferenczi e a clínica psicanalítica contemporânea: uma revisão sobre suas contribuições ao papel do analista / Ferenczi and the contemporary psychoanalytic clinic: a review of his contributions to the role of the analyst / Ferenczi et la clinique psychanalytique contemporaine: une revue de ses contributions au rôle de l'analyste / Ferenczi y la clínica psicoanalítica contemporánea: Una revisión de sus contribuciones al papel del analista

Objetivou-se fazer uma revisão sistemática da produção científica nacional e internacional, no período de 2015 a 2020, sobre a obra de Sándor Ferenczi e suas contribuições à clínica psicanalítica na contemporaneidade, no que concerne ao papel do analista. Os seguintes descritores foram utilizados: "Ferenczi" "clínica psicanalítica" e "analista". As bases de dados pesquisadas foram: P@rthenon, SciELO e Pepsic. Foi utilizada a metodologia da Análise de Conteúdo. O processo de análise levou a leitura dos títulos, resumos e textos completos, e 52 artigos preencheram os critérios. A pesquisa compreendeu que a retomada dos trabalhos de Ferenczi quanto ao papel do analista evidenciam uma nova configuração de relação analítica baseada em uma ética do cuidado. O papel do analista apresenta-se como uma possibilidade de contorno e sustentação às experiências traumáticas, colaborando com o paciente, na produção de sentidos e elaborações dessas experiências

This is a systematic review of national and international scientific papers published between 2015 and 2020 on Sándor Ferenczi's work and his contributions to the contemporary psychoanalytic clinic, mainly regarding the role of the analyst. Search was conducted on the P@rthenon, Scielo and Pepsic databases using "Ferenczi," "psychoanalytic clinic" and "analyst" as search descriptors. After reading the titles, abstracts and full texts a total of 52 articles met the inclusion criteria. Resumption of Ferenczi's work on the role of the analyst reveals a new configuration of analytical relations based on an ethics of care. The analyst presents a possibility of shaping and underpinning traumatic experiences, collaborating with the patient to produce meanings and elaborations of these experiences

Il s'agit d'une revue systématique des articles scientifiques nationaux et internationaux publiés entre 2015 et 2020 sur l'œuvre de Sándor Ferenczi et ses contributions à la clinique psychanalytique contemporaine, notamment en ce qui concerne le rôle de l'analyste. La recherche a été effectuée sur les bases de données P@rthenon, Scielo et Pepsic en utilisant « Ferenczi ¼, « clinique psychanalytique ¼ et « analyste ¼ comme descripteurs. Après la lecture des titres, des résumés et des textes intégraux, 52 articles répondaient aux critères d'inclusion. La reprise des travaux de Ferenczi sur le rôle de l'analyste révèle une nouvelle configuration des relations analytiques fondées sur une éthique du soin. L'analyste offre la possibilité de concevoir et d'étayer les expériences traumatiques, en collaborant avec le patient pour produire de significations et d'élaborations de ces expériences

El objetivo fue realizar una revisión sistemática de la producción científica nacional e internacional, en forma de artículo científico, de 2015 a 2020, sobre la obra de Sándor Ferenczi y sus aportes a la clínica psicoanalítica en la contemporaneidad, en torno al papel del analista. Se utilizaron los siguientes descriptores: "Ferenczi", "clínica psicoanalítica" y "analista". Las bases de datos buscadas fueron: P@rthenon, Scielo y Pepsic. Se utilizó la metodología de Análisis de Contenido. El proceso de análisis condujo a la lectura de títulos, resúmenes y textos completos y 52 artículos cumplieron los criterios. La investigación entendió que la reanudación del trabajo de Ferenczi sobre el rol del analista revela una nueva configuración de relación analítica basada en una ética del cuidado. El rol del analista se presenta como una posibilidad de modelar y sostener experiencias traumáticas, colaborando con el paciente, en la producción de significados y elaboraciones de estas experiencias

A Compreensão da Intersubjetividade Entre um Adolescente Suicida e seus Pais Através da Combinação de Métodos na Análise do Discurso / La Comprensión dela intersubjetividadentre un adolescente suicida y sus padres mediante la combinación de métodos en el análisis del discurso / Understanding Intersubjectivity Between a Suicidal Adolescent and His Parents Through the Combination of Methods in Discourse Analysis

Trata-se de um recorte de pesquisa de doutorado em que se intencionou estudar o vínculo intersubjetivo familiar em um adolescente com histórico de tentativa de suicídio, pautando-se nos desejos e defesas. Utilizou-se a combinação de três instrumentos (ADL-AH, ADL-R e o Genograma) para a análise do discurso. Após exame individual dos dados apontados por cada instrumento, realizou-se asanálises comparativas. Inicialmente, confrontou-se os resultados do ADL-AH com o ADL-R conforme a descrição do caso. Em seguida, o Genograma propiciou o entendimento intergeracional da família estudada, confirmou aspectos já levantados e elucidou pontos dos quais o ADL não poderia ter alcançado, embora esse último tenha encontrado discrepâncias no discurso, isto é, aquilo que se pretendia disfarçar ou esconder de forma consciente ou inconsciente. A combinaçãodos três instrumentos trouxe consistência para a investigação no sentido de uma melhor compreensão da intersubjetividade do adolescente, sua família e do comportamento suicida AU

Este es un extracto de una investigación doctoral que tuvo como objetivo estudiar el vínculo familiar intersubjetivo en un adolescente con antecedentes de intento de suicidio, basado en deseos y defensas. Para el análisis del discurso se utilizó una combinación de tres instrumentos (ADL-AH, ADL-R y Genograma). Luego de examinar individualmente los datos indicados por cada instrumento, se realizaron comparaciones. Inicialmente se confrontaran los resultados del ADL-AH con el ADL-R según la descripción del caso. Luego, el Genograma proporcionó una comprensión intergeneracional de la familia estudiada, confirmó aspectos ya planteados y aclaró puntos que la ADL no podría haber logrado, aunque este último tenga encontrado discrepancias en el discurso, es decir, lo que se pretendía disfrazar u ocultar consciente o inconscientemente. Esta combinación aportó consistencia a la investigación y con ella fue posible tener una mejor comprensión de la intersubjetividad, del adolescente, su familia y la conducta suicida AU

Aportes del psicoanálisis a los estudios de abuso sexual infantil: Análisis del discurso de la madre de una niña abusada sexualmente / Contributions of psychoanalysis to studies of child sexual abuse: Mother's speech analysis about her sexually abused daughter

Se presentan los resultados dela tesis doctoral sobre los deseos y defensas (y sus estados) de la madre de una niña abusada sexualmente, con el objetivo de conocer su estructuración subjetiva en este difícil acontecimiento. Se trata de un estudio de caso en el que se usa como método el Algoritmo David Liberman (ADL), en el análisis del discurso de la madre, seleccionadas tres sesiones y una carta manuscrita. El estudio de deseos y defensas puede contribuir a describir y conocer el posicionamiento subjetivo de una madre frente a la situación abusiva de su hija, y como ésta es vivida por ella AU

The results of the doctoral thesis on the wishes and defenses (and their states) of the mother of a sexually abused girl are presented, with the aim of knowing her subjective structuring in this difficult event. This is a case study in which the David Liberman Algorithm (ADL) is used as a method in the analysis of the mother's speech, three sessions and a handwritten letter selected. The study of desires and defenses can contribute to describing and knowing the subjective position of a mother in the face of her daughter's abusive situation, and how it is experienced by her AU

A Letter from Winnicott to Bion: An Imaginative Conjecture to Illustrate a Paradigm Transformation.

On the evening of October 5, 1955, Bion presented the paper Differentiation between the psychotic and non-psychotic personalities to the British Society of Psychoanalysis. Two days later, on October seventh, Winnicott commented on Bion's paper in a letter and in particular, discussed its clinical material. The author makes use of this exchange to examine how the transformations that took place in Bion's thought and Winnicott's contributions helped bring about a quantum revolution of the psychoanalytic paradigm. These may have facilitated the transition from an epistemological psychoanalysis (where what matters is what the analyst knows and what the patient comes to know about himself) to an ontological psychoanalysis (where the presence of the analyst becomes crucial-everything that the analyst is and the way in which he manages to become the patient's emotional experience). And what we witness in ontological psychoanalysis is a significant clinical transformation in which a theory of technique that focuses on interpretation can coexist with a theory of technique enriched, in the author's perspective, with new tools that make it possible to treat the most severely ill patients.

Kairos and chronos: clinical-psychoanalytic reflections on time.

The present paper attempts to define "time" in clinical-psychoanalytic terms. After brief remarks on time, on timelessness, on times, and on Nachträglichkeit, the treatment of a breakdown state is described. The breakdown from the earliest period of the patient's life first manifested itself in an autistoid perversion. It finally occurred in the transference in a presence moment and could become conceivable as a thought for the patient in a turbulent process. Here two time dimensions became apparent: The timeless state of breakdown unfolds in the treatment in such a way that preforms of temporal experiences precede the event of time in presence moment, from which then the times past, future and present can become. In the presence moment and its sublation in the presentational symbol, not only did the breakdown become psychically real, but time, times, and space emerged, albeit dynamically very differently in the analyst and the analysand: for the analyst, past and place emerged with the presentational symbol, while for the patient, temporal location did not occur in the time "past," but in the place where the perversion was practiced. Past is the place where it happened. For the discovery and use of times, it is necessary for the patient to distinguish the absent object from the retraumatizing one. Then the present absent object becomes the object that was there in the past understanding and will be there in the future. The assurance of this figure of thought is obtained in the use of the object.

Observing and interpreting clinical process: Methods and findings from 'Layered analysis' of parent-infant psychotherapy.

This paper describes a method for investigating clinical process, Layered Analysis, which combines therapist countertransference reports and multi-faceted microanalytic research approaches. Findings from the application of Layered Analysis to video-recorded micro-events of rupture and repair in four psychoanalytic parent-infant psychotherapy sessions are presented. Layered analysis showed that countertransference and observation are complementary perspectives, which enable concomitant study of interactive events, conscious internal experiences, as well as nonconscious and unconscious elements of therapeutic interaction. Interactional rupture and repair were found to constitute co-constructed micro-events that occurred fleetingly and often implicitly, and differed in the structure, coherence and flow of interactions and in the relationship between verbal and nonverbal communication. Furthermore, interactional ruptures were found to sometimes 'get into' the therapist and transiently disrupt their self-organization, such that the therapist became a locus of disruption for the patient(s), actively contributing to the rupture, which thus became embedded in the therapeutic system. Interactive repair was found to be most often initiated by the therapist and to be underpinned by the therapist re-establishing self-regulation, through metabolizing embodied and verbal aspects of the rupture. Studying such processes can enhance our understanding of clinical process, inform therapist training and clinical supervision, and contribute to clinical outcomes.

Este ensayo describe un método para investigar un proceso clínico, Análisis en Capas, el cual combina los reportes de contratransferencia del terapeuta y los acercamientos investigativos micro analíticos multifacéticos. Se presentan los resultados de aplicar Análisis en Capas a micro eventos, grabados en video, de ruptura y reparación en cuatro sesiones de sicoterapia sicoanalítica de progenitor e infante. Los Análisis en capas mostraron que la contratransferencia y la observación son perspectivas complementarias que, en combinación, permiten el estudio concomitante de eventos interactivos, experiencias internas conscientes, así como elementos no conscientes de la interacción terapéutica. Adicionalmente, los resultados mostraron que la ruptura y la reparación constituyen micro eventos co-construidos que ocurren muy fugazmente y a menudo implícitamente, y que difieren en la estructura, coherencia, flujo de interacciones y en la relación entre la comunicación verbal y no verbal. Es más, rupturas interaccionales pueden 'meterse en' el terapeuta y transitoriamente interrumpir su autoorganización, de manera que el terapeuta se convierte en un punto de interrupción para el paciente y la ruptura pasa a ser parte del sistema terapéutico. La reparación interactiva está sostenida por, y depende de, la metabolización del terapeuta de los aspectos incorporados y verbales de la ruptura. Estudiar tales procesos puede mejorar nuestra comprensión del proceso clínico y ser usado en entrenamiento y supervisión de terapeutas.

Cet article décrit une méthode d'investigation du processus clinique d'Analyse Multidimensionnelle en Couches, qui combine des rapports de contre-transfert du thérapeute et des approches de recherche micro-analytique à facettes multiples. Les résultats de l'application de l'analyse multidimensionnelle en couches à des micro-événements enregistrés à la vidéo de rupture et de réparation dans quatre séances de psychothérapie psychanalytiques parent bébé sont présentés. L'analyse multidimensionnelle en couches a montré que le contre-transfert et l'observation sont des perspectives complémentaires qui, combinés l'un avec l'autre, permettent une étude concomitante d'événements interactifs, d'expériences internes conscientes et d'éléments non-conscients de l'interaction thérapeutique. De plus, les résultats ont montré que la rupture et la réparation constituent des micro-événements co-construits, qui se passent très fugacement et souvent implicitement et diffèrent en structure, cohérence et flux des interactions et dans la relation entre la communication verbale et non verbale. Enfin les ruptures interactionnelles peuvent 'entrer' dans le thérapeute et perturber de façon transitoire leur auto-organisation, de telle manière que le thérapeute devient le locus de la perturbation pour le/la/les patient(e/s) et la rupture s'encastre dans le système thérapeutique. La réparation interactive est étayée par, et elle en dépend également, la métabolisation d'aspects verbaux et incarnés de la rupture du thérapeute. L'étude de tels processus peut améliorer notre compréhension du processus clinique et être utilisée dans la formation et la supervision des thérapeutes.

Unrepresented States and the Bodily Encoded Unconscious.

Unrepresented states are considered important obstacles to the psychoanalytic process. They describe elements that are beyond the reach of the symbolic network with which psychoanalysis is used to working. The emergence of unrepresented states has often been described as the failure of the caregiver to symbolize the child's emotions and thereby enable the child to connect his or her bodily states to the psychic representation. Psychoanalysis, however, has been reluctant to name the locus of these inscriptions beyond the symbolic network as the body-self. The author proposes to do so and discusses two concepts for describing the dynamics of the bodily unconscious and the therapeutic method for calibrating our technique to unrepresented states. The concept of the encapsulated body engram is used to describe the dynamic structure of the bodily unconscious. Processes of disorganization, petrification, perceptual defense, and secondary self-stimulation form the dynamics of the bodily unconscious. The method of somatic narration systematically examines body sensations of the analysand, reverses the defense processes of the engram, and leads to a reorganization of the body self, which can now find connection to symbolic structures again. This requires a more active analytic stance that responds to the defensive processes with which the subject fends off the threat of annihilation he or she was exposed to in the traumatic engram. A clinical vignette illustrates the mode of operation.

A multicentre study: Comparison of 3-LM group output and therapeutic outcome measures. Adding to the trustworthiness of the 3-LM? Part 2.

This is the second report (part 2) of an investigation whose general objective was to provide evidence regarding the trustworthiness of the Three-Level Model (3-LM). Three groups of analysts from different IPA regions worked with this model on the same clinical case. SPECIFIC OBJECTIVES: 1) To analyze group output with the same structured qualitative methodology (part 1); 2) To compare the results of the 3-LM group output reported in the 3-LM forms with the process-outcome measures used in the clinical case (part 2); 3) To describe the presence-absence of anchor points in the groups, their similarities and differences (part 2); 4) To exemplify the interrelationship of the three levels of the 3-LM in relation to patient change and the analyst's interventions (part 2). SAMPLE: verbatim transcript of three 3-LM groups. MATERIALS: 3-LM forms, process and outcome measures (APS, DIS and PHI-RADIO) and Operationalized Psychodynamic Diagnosis. RESULTS: Objective 2 found global convergence in the PHI, DIS and APS scores across sessions. Objective 3 showed convergences and divergences in the themes relating to the anchor points. Objective 4 showed how an anchor point corresponds to the focus of treatment and how this is present in the analyst's attitudes and interventions. DISCUSSION: The results offer preliminary support for the trustworthiness of the 3-LM.

Psychoanalysis of young children with autism spectrum disorders. An adaptation of technique in the approach to three cases.

At present, the therapeutic approach for young children with autism spectrum disorder is a major challenge for child psychoanalysis. These patients place us in a special clinical and metapsychological terrain with its own characteristics and call our technique into question. What tools do we have for working in situations where speech has not yet acquired a communicative value? How can we intervene when an experiential subject has still not been constituted? How can psychoanalysis benefit these patients? The purpose of this paper is to show an adaptation of technique in the treatment of three children who came to my practice between the ages of two and three with a diagnosis of autism spectrum disorder. In this context, there were certain elements that in the affective proximity of the transference bond which encouraged the child's openness to representational world and a progressive psychic structuring and subjectivation. These elements were the analyst's active search for an encounter with the child, the non-verbal exchanges between analyst and patient, and the characteristics of the interpretations.

The Analyst's Courage and Vulnerability in the Countertransference.

Courage requires us to persist and persevere despite fear. We make choices everyday-some are courageous, and some are not courageous at all. This dimension of psychoanalytic work is significant, yet relatively neglected in the psychoanalytic literature. Maintaining a courageous stance as an analyst can be challenging and threatening. Often, the therapist faces deeply rooted fears about abandonment, envy, competition, anger, or other forms of intense emotional arousal. This requires us to confront ourselves but also, at times, confront our patient's behaviors. It is crucial to think and act independently, and deal with their disapproval and opposition, despite the risks challenging patients present. Ultimately, we need to manage our vulnerable feelings while remaining authentic, rather than hiding behind an overly clinical stance. The author presents two patients who required and inspired the courage to face her own anxieties, ultimately contributing to the treatments' progress.

[A Comparative Study on the Effect of Different Settings on Psychoanalytically Based Long- Term Treatments of Children and Adolescents]. / Vergleichsstudie zurWirksamkeit verschiedener Settings bei psychoanalytisch begründeten Langzeitbehandlungen von Kindern und Jugendlichen.

The present study compares different settings - individual treatment, group treatment and combined setting - of psychoanalytic long-term treatments of children and adolescents with regard to their effectiveness. In addition to the parameters of therapy success (symptom reduction), the focus lies on the structural changes and conflict management on which a therapy success is based from a psychodynamic point of view, as well as the acquisition of psychosocial skills such as sporting and/or extracurricular activity, social competence and intelligence.The sample comprises N = 114 subjects (65.8 % male, 34.2 % female) aged five to 18 (MW = 10.76, SD = 3.22), who were randomized to the three settings.The pre-post results clarify that psychoanalytic long-term treatments are effective both in terms of reducing symptoms and in terms of increasing psychosocial skills. The study was also able to demonstrate changes in the structural level - as a central goal of psychoanalytical therapies. On the other hand, there are no significant changes of intrapsychic, developmentally impaired conflicts.There was no setting effect for any of the parameters examined either.The combined therapy enables legitimate flexibility tailored to the individual needs of the patients and their caregivers and/or the therapeutic goals.

Working with patients with disruptions in symbolic capacity.

This article focuses on understanding and working with patients who have poorly developed symbolic capacity, or for whom symbolic capacity has been disrupted due to trauma, particularly as it pertains to the use of reverie and interpretation in the analytic process. Many patients who present for Jungian analysis will initially present with deficits in symbolic functioning. This situation results in necessary limitations or modifications in utilizing traditional Jungian techniques such as dream analysis, active imagination, sand tray and other expressive art techniques. The initial phase of analytic work with these patients requires a focus on developing their symbolic capacity before traditional Jungian techniques can be utilized effectively. During the paper Jung's concept of 'the symbolic attitude' will be examined as well as the conceptual models of Wilfred Bion and other post-Bionians who outline theories and method for cultivating symbolic capacity and reflective functioning in patients for whom these capacities are impaired or poorly developed.

Cet article se concentre sur la compréhension et le travail avec des patients dont la capacité symbolique est mal développée, ou pour qui la capacité symbolique a été perturbée par le traumatisme. Ceci concerne tout particulièrement l'utilisation de la rêverie et de l'interprétation dans le processus analytique. Beaucoup de patients qui viennent pour une analyse Jungienne montrent initialement des déficits dans le fonctionnement symbolique. Ceci a pour conséquence des limitations nécessaires ou des modifications dans l'utilisation de techniques traditionnelles Jungiennes telles l'analyse des rêves, l'imagination active, la thérapie par le jeu de sable et autres techniques d'expression par l'art. La phase initiale du travail analytique avec ces patients requiert de mettre l'accent sur le développement de leur capacité symbolique avant que les techniques Jungiennes traditionnelles puissent être utilisée de manière efficace. Dans l'article, le concept Jungien 'd'attitude symbolique' sera étudié ainsi que les modèles conceptuels de Wilfred Bion et d'autres post-Bioniens qui présentent des théories et une méthode pour cultiver la capacité symbolique et le fonctionnement réfléchi chez des patients pour qui ces capacités sont déficientes ou mal développées.

El presente artículo se focaliza en la comprensión y trabajo con pacientes que han tenido un desarrollo limitado de su capacidad simbólica, o para quienes, la capacidad simbólica se ha visto perturbada debido a un trauma, particularmente en lo que se refiere al uso del reverie y de la interpretación en el proceso analítico. Muchos pacientes que se presentan para un análisis Junguiano, presentan inicialmente deficitis en su funcionamiento simbólico. Esta situación tiene como resultado limitaciones necesarias o modificaciones en la utilización de técnicas Junguianas tradicionales como el análisis de sueños, la imaginación activa, la caja de arena y otras técnicas artísticas y expresivas. La fase inicial del trabajo analítico con estos pacientes requiere hacer foco en el desarrollo de su capacidad simbólica antes de que técnicas Junguianas tradicionales puedan utilizarse efectivamente. Durante el escrito se examina el concepto de Jung de `actitud simbólica`, así como los modelos conceptuales de Wilfred Bion y otros post-Bionianos quienes describen teorías y métodos para cultivar la capacidad simbólica y el funcionamiento reflexivo en pacientes para quienes estas capacidades se encuentran perturbadas o poco desarrolladas.

Can we differentiate between psychoanalytic and psychodynamic psychotherapy? - An empirical investigation of therapists' self-reports.

Therapy differentiation is a crucial component of psychotherapy research. It refers to whether inspected treatments differ from one another. In the history of psychoanalysis, the differentiation between psychodynamic and analytic psychotherapy was often discussed but seldom inspected empirically. In this study, we propose a set of items which should in theory offer the possibility to differentiate between psychodynamic and analytic psychotherapy on session level. We inspect these items using therapists' self-reports concerning N = 295 cases of different psychodynamic and analytic therapies. Results of an exploratory factor analysis and subsequent inspections of the psychodynamic and analytic items in different forms of therapies strengthen the usability of these items for differentiating between psychodynamic and analytic therapy. However, further studies using different perspectives (e. g., observer ratings) are essential. The presented items are a promising step towards the development of an instrument for treatment differentiation which could later be used in treatment comparison studies.

Self-constitution and "Infrastructural" Change: An Interdisciplinary Account of Psychoanalytic Action.

Beyond revealing unconscious pathological identifications and traits-including their past usefulness but current toxicity-what techniques in our psychoanalytic practice can lead to change? Radically different from mainstream philosophical views advocating that such undesirable self-aspects should not be endorsed as Self, psychoanalysts hold that these negative traits must instead be understood as part of one's Self. But then what? Investigating concepts from classical conditioning, neuroscience, the philosophy of mind and action, and psychoanalytic practice itself, this article will suggest a preliminary account of the mechanism of action of psychoanalytic work after insight.