The significance of the ego in "The Ego and the Id" and its unfulfilled promise.

It is not well known that The Ego and the Id, where Freud presented his second model of the mind, and introduced a new role for the Ego, was ignored by many of the major theorists that followed. I will attempt to demonstrate the importance of this new view of the ego for clinical psychoanalysis, and what has been lost by its being ignored.

El trayecto que recorrí para convertirme en psicoanalista / The journey I traveled to become a psychoanalyst / Le trajet que je parcourus pour devenir psychanalyste

Convertirme en psicoanalista, para que fuese más que algo nominal, fue para mí un largo trayecto. Creo que dicho trayecto es necesario para la mayoría de los analistas, dado que los Institutos de formación, por más que hagan las cosas bien, solo pueden proveer un mapa de ruta para ser psicoanalista. Creo que convertirse en psicoanalista lleva años de estudio, autorreflexión e inmersión en el psicoanálisis clínico. Incluso entonces, se espera que uno siga desarrollándose como psicoanalista. En este trabajo intento poner en palabras los diversos factores que intervinieron para que me convirtiera en psicoanalista, así como algunos factores que, en mi opinión, resultan esenciales para lograr este propósito. Finalmente, intento mostrar por qué pienso que la formación de los institutos debe mejorarse de forma que los candidatos aprendan lo que significa convertirse en psicoanalistal

Becoming a psychoanalyst, in more than name only was, for me, a long journey. I think such a journey is necessary for most analysts, as Institute training, even if done well, can only provide a road map to becoming a psychoanalyst. It's my belief that it takes years of study, self-reflection, and immersion in clinical psychoanalysis to become a psychoanalyst. Even then, hopefully one continues to evolve as a psychoanalyst. In this paper I try to articulate the many factors that coalesced for me to become a psychoanalyst, and sorne of the factors I consider basic to this endeavor. Finally, I try to show why I think Institute training needs to be improved so that candidates learn what it means to become a psychoanalyst

Devenir psychanalyste, pour que ça soit quelque chose de plus que nominal, a été pour moi un long trajet. Je crois qu'un tel projet est nécessaire pour la majorité des analystes, étant donné que les Instituts de formation, meme s'ils font bien les choses, peuvent seulement fournir une feuille de route pour etre psychanalyste. Je crois que devenir psychanalyste prends des années d'étude, d'auto-réflexion et d'immersion dans la psychanalyse clinique. Meme alors, il est attendu que l' on continue a se développer comme psychanalyste. Dans ce travail, j'essaie de mettre en mots les divers facteurs qui sont intervenus pour que je devienne psychanalyste, ainsi que quelques facteurs qui a mon avis sont essentiels pou accomplir ce propos. Finalement, j' essaie de montrer pourquoi je penseque la formation des Instituts doit s' améliorer de façon a ce que les candidats apprennent ce que signifie devenir psychanalyste

Searching for the analyst's reveries.

Over the last 20 years the post-Bionians have begun nothing less than to spell out the beginning of the metabolizing process (reverie) in the analyst's mind that takes place with under-represented mental states. This bold attempt leading to new discoveries, and its many possibilities for understanding patients, seems to have obscured differences amongst leading post-Bionians with regard to how they see the forms of reverie, and how they might best be worked with. With Bion's perspective as a background, this paper explores three approaches, and how they differ with regard to whether one follows the views of early or late Bion. Technical issues associated with these views are raised. A clinical example is offered as one way to use reverie.

THE SEARCH FOR PSYCHIC TRUTHS.

Emphasizing psychic truths as the major domain of psychoanalysis, the author explores the complexity of defining such psychic truths. It is suggested that thinking of levels of psychic truths is the most useful approach. How to understand trauma and historical truth within this context is examined. The role of the analyst as aiding the search for psychic truths, rather than functioning as psychic "truth teller," is discussed within the context of paradigmatic changes in the psychoanalytic method that form an emerging common ground.

Transformando a contratransferência sem forma em uma forma representável: outra perspectiva / Transforming the formless countertransference into representable form: another perspective

O autor explora várias ideias acerca de nossas reações contratransferenciais. Sugere que a reação do analista geralmente inicia em resposta ao uso da ação de linguagem por parte do paciente, quando ele, inconscientemente, utiliza palavras para fazer algo, o que leva o analista a também responder inconscientemente. O analista deve, primeiramente, conter, metabolizar e refletir acerca de sua contratransferência antes de iniciar o trabalho analítico. A partir daí, precisa representar, através de repetidas clarificações, como ocorre a ação de linguagem. Esse procedimento dá início ao que o autor chama de trabalhar dentro da contratransferência(AU)

The author explores various ideas about our countertransference reactions. He suggests the analyst's countertransference reaction usually begins in response to the patient's use of language action, where the patient unconsciously uses words to do something, which the analyst responds to unconsciously. The analyst must first contain, metabolize, and reflect on his countertransference before analytic work can begin. From this the analyst needs to represent, through repeated clarifications, how the language action takes place. This begins the process the author calls, working within the countertransference(AU)

El autor explora varias ideas acerca de nuestras reacciones contratransferenciales. Sugiere que la reacción del analista comienza generalmente en respuesta al uso de la acción del lenguaje por parte del paciente, cuando éste, inconscientemente, utiliza palabras para hacer algo, a lo que el analista responde también inconscientemente. El analista deberá primeramente contener, metabolizar, y reflexionar acerca de su contratransferencia para luego poder comenzar el trabajo analítico. A partir de ahí, el analista tendrá que representar, a través de repetidas clarificaciones, cómo ocurre la acción del lenguaje. Ese procedimiento da inicio al proceso que el autor denomina trabajar dentro de la contratransferencia(AU)

Transformar la contratransferencía amorfa en una forma representable: otra perspectiva / Transforming the amorpbous eountertransference into a representalale form: another perspective

El autor reflexiona sobre el modo en que la contratransferencia puede resultar de utilidad en el trabajo psicoanalítico. Parte de la descripción de los actos de lenguaje del paciente que inducen en el analista toda una serie de reacciones que han de ser cuidadosamente autoanalizadas. Y defiende la aproximación cautelosa, siempre a la parte más accesible del material para la conciencia del analizando. En este sentido, da mucha importancia a la aclaración. Cuando el analista puede mostrarle a su paciente cómo se ha producido un acto de lenguaje, y el paciente puede verificar cómo efectivamente se ha producido en el aquí y el ahora de la relación con su analista, puede ayudar a representarlo y abrir una vía asociativa en el paciente a conexiones con su historia y niveles más profundos de su psíquismo. Se muestra crítico con quienes consideran la contratransferencia como una validadora de las hipótesis del analista y con quienes interpretan desde ahí directamente los estratos más profundos e inaccesibles para la conciencia del analizando (AU)

The author considers the way in which countertransference may prove useful in the psychoanalytic work. He takes as a starting point the description of the patients ‘acts of language’ inducing a wide range of reactions in the analyst which must then be painstakingly self-analysed. He argues the case for the cautious approach, always directed at the part of the material most accessible to the analysand´s consciousness. In this respect, he attaches high importance to ‘clarification’. When the analyst is able to show his patient how an ‘act of language’ has been produced, and the patient is able to establish how this has in fact taken place in the here and now of the relationship with his analyst, this can aid representation and open up an associative pathway in the patient towards connections with his history and deeper levels of his psyche. He is critical of those who consider countertransference merely as a means of validation of the analyst's hypotheses and those who, from this, interpret outright the strata most profound and inaccessible to the analysand´s consciousness (AU)

Nosso ofício vital / Our vital profession / Nuestra profesión vital

Como parte de nossa busca permanente a fim de ajudar pacientes a encontrar, ou reencontrar, o cerne do que significa ser humano, investigo neste trabalho mudanças múltiplas de paradigma no método psicanalítico que constituem novos pontos comuns entre, ao que parece, diversas vertentes. Isto conduz a novas ideias sobre como ouvimos e interpretamos, os objetivos do tratamento e a maneira como se dá a mudança.

In our continual search to help patients find, or re-find, the core of what it means to be human, this paper explores multiple paradigm changes in the psychoanalytic method that form a new common ground amongst seemingly diverse perspectives. This leads to fresh views of how we listen and interpret, the goals of treatment, and how change takes place.

En nuestra búsqueda permanente con el fin de ayudar a los pacientes a encontrar, o reencontrar, la esencia de lo que significa ser humano, este trabajo investiga múltiples cambios de paradigma en el método psicoanalítico que constituyen nuevos puntos comunes entre, al parecer, diversas vertientes. Esto conduce a nuevas ideas sobre cómo oímos e interpretamos, los objetivos del tratamiento y la forma en la que se produce el cambio.

Nuestra profesión vital / Our vital profession

De vez en cuando es útil que recordemos el papel vital que juega el psicoanálisis en ayudar a nuestros pacientes a volver a obtener lo que es básico para su humanidad. Al mismo tiempo, la vitalidad de nuestros métodos puede verse en los importantes cambios de paradigma en el método psicoanalítico que se dieron en los últimos cuarenta años. En nuestra continua búsqueda de ayudar a los pacientes a encontrar o reencontrar el núcleo de lo que significa ser humano, este trabajo explora los múltiples cambios de paradigma en el método psicoanalítico que forman un nuevo terreno común entre perspectivas notablemente diversas. Esto lleva a visiones nuevas sobre: cómo escuchamos e interpretamos, los objetivos del tratamiento y cómo se produce el cambio. Esto no es para subestimar las diferencias significativas que existen entre diferentes escuelas de pensamiento. Un desafío clave para nuestro crecimiento individual, colectivo es la dificultad en comprometemos con el conocimiento en permanente expansión planteado por diferentes perspectivas (AU)

Occasionally it is useful to remind ourselves of the vital role psychoanalysis plays in helping our patients regain what is basic to their humanity. At the same time the vitality of our methods can be seen in important paradigm changes in the psychoanalytic method in the last forty years. In our continual search to help patients find, or re-find the core of what it means to be human, this paper explores multiple paradigm changes in the psychoanalytic method that form a new common ground amongst seemingly diverse perspectives. This leads to fresh views of: how we listen and interpret; the goals of treatment; and how change takes place. This is not to underestimate that significant differences exist amongst schools of thought. A key challenge to our individual and collective growth is the difficulty in engaging with the ever-expanding knowledge posed by different perspectives (AU)

¿Podemos diferenciar el Psicoanálisis de la Psicoterapia? ¿Debemos? / Can we differentiate psychoanalysis from psychotherapy?

¿Está siendo homogeneizado el psicoanálisis con la psicoterapia? El psicoanálisis sufre la presión para no ser diferenciado de la psicoterapia y nuestros métodos de comprensión y tratar pacientes parece que fueran crecientemente influenciados por métodos psicoterapéuticos. La tesis de este trabajo es de que ha habido una evolución en la técnica, raramente reconocida pero consensuada por analistas de culturas aparentemente divergentes, que ha conducido a cambios en los objetivos del psicoanálisis que lleva a que la diferencia con la psicoterapia sea más clara (AU)

Is Psychoanalysis being homogenized with psychotherapy? Psychoanalysis is under pressure to not distinguish itself from psychotherapy, and our methods of understanding and treating patients seems to be increasingly influenced by psychotherapeutic methods. It is the thesis of this paper that there has been an evolution in technique, rarely recognized but agreed upon by analysis of seemingly widely divergent that have led to changes in the goals of psychoanalysis that makes its distinction from psychotherapy clearer (AU)

The workable here and now and the why of there and then.

At an earlier time our work as analysts was easier. We searched for the repressed in order to make constructions that connected the past to the present symptoms. Making these connections conscious, based upon the continuing influence of the Topographic theory, was thought to be the curative factor in psychoanalysis. Freud (1912, 1914) briefly expressed the importance of working in the present but his main focus remained the importance of reconstructing the past. The importance of working in the present started to be fully articulated approximately 30 years ago, and has become a central part of most views on technique. However, it is the contention of this paper that, while there is general agreement on the necessity of working in the here and now, the understanding of what this means or why it is useful runs along parallel lines rather than leading to a central point. Further, it is my impression there is little agreement on the reasons for interpreting the there and then. The idea of a 'workable here and now' is introduced to capture how the here and now might best include the analysand's readiness to synthesize what is offered, while a theory of the necessity for working in the here and now and the there and then is offered.

'Can you push a camel through the eye of a needle?' Reflections on how the unconscious speaks to us and its clinical implications.

There has been a recent surge of interest in a type of thinking seen in some patients most of the time, and all patients some of the time. In the past it was simply called regressive thinking, but attempts to be more specific have led it to be called by various names, like 'pre-symbolic', 'pre-conceptual' and 'pre-operational'. What these labels attempt to capture is that the patient's thinking, at these times, is without representations and closer to actions. As a clinical phenomena I prefer to use Loewald's term, 'action-language', that is, where words become attempts to bore, seduce, anger, etc. It is different from when words are used to communicate internal states via free association. A case is made for action-language being the primary method by which the unconscious speaks to us in psychoanalytic treatment. This paper explores some of the reasons for this type of thinking, along with the clinical methods to find the thinker where there appears to be none. Distinctions will be made as to the use of the process versus the content, on the goal of interventions as bringing insight versus the capacity for insightfulness, and the model of treatment as leading to transformations in thinking, rather than lifting of repressions. A clinical example is presented to demonstrate these perspectives.

'I noticed': the emergence of self-observation in relationship to pathological attractor sites.

The author highlights self-observation as an important goal of psychoanalysis, separate from other concepts with which it is often confounded. To support this position, he presents clinical and developmental data, as well as observations by psychoanalysts on recent findings by cognitive neuroscientists. He introduces the term 'pathological attractor sites' to capture the challenge in moving from the belief in the reality of one's own thoughts to self-observation. Clinical techniques to deal with this specific challenge are presented.

A shadow concept.

The author focuses on the significance of preconscious thinking, and its relationship to what we think of as unconscious fantasies. He reopens Freud's forgotten struggle with preconscious thinking, while he explores preconscious thinking as the basis for thinking about psychoanalytic treatment. This includes our goals in bringing an idea to the analysand's attention, and the role of transitional space where thoughts and feelings can be played with.