The married manic.

In group psychotherapy and follow-up studies, the interpersonal relationships and psychodynamics of the married manic depressive patient and spouse were studied. Prominent among these subjects were massive denial of grief, rage, and dependency in the context of symbiotic relationships; and the absence of a father during early development. Clinical expressions of these factors are presented, and therapeutic implications are discussed.

The usefulness of dreams during pregnancy.

This paper explores the idea that dreams in analysis during pregnancy offer an especially valuable perspective for understanding and facilitating mastery of the developmental challenges of pregnancy as well as related central unresolved conflicts and earlier developmental problems. In this way, dreams during pregnancy facilitate the long-range work of the analysis. The regressive and self-oriented focus of pregnancy, and the heightened awareness of what is happening within, lend extra meaning, impact and richness to dreams in the analytic process, with its inward-seeking and regressive elements. In addition, during pregnancy, patients often feel highly motivated to resolve problems prior to the birth of the baby. A shift in our understanding of the narcissistic and early developmental aspects of transference has helped analysts understand how analysis during pregnancy can be useful. During pregnancy there is often an increased access to experiences from early childhood, involving a feeling of being taken care of and of feeling abandoned. In addition, during pregnancy, identifications with the analysand's mother and separation from her mother are perhaps especially deeply felt. These ideas are explored in discussing the dreams and associations of a 36-year-old analysand during different phases of the pregnancy.

Developmental forces and termination in child analysis.

Re-examining Sigmund Freud's 'Analysis terminable and interminable' (1937) from the perspective of child analysis highlights the importance of developmental assessment and developmental forces in psychoanalysis. This paper explores the questions of the goals of child analysis and the criteria for successful treatment. Also discussed is how unrealistic expectations on the part of the analyst and the parents, as well as the parents' and analyst's conflicts may result in an analysis being interminable. An additional problem at termination is the mourning involved for both the child and the analyst. These issues are explored in the context of the final year of analysis of a 5-year-old boy who stuttered. Reflecting on this boy's analysis, questions about the relationship of termination to developmental forces, the resolution of the transference neurosis, reconstruction, counter-transference and identification with the analysing function of the analyst are explored. The importance and meaning of the child's, the analyst's, and the parents' simultaneously intuitive sense of the time for termination are discussed.

"How can we know the dancer from the dance?" The analysis of a five-year-old girl.

How the analyst and the patient shape the analysis is a complex matter varying with the stage of the analysis and the individual characteristics of each patient and analyst. Examining analytic hours from the beginning, middle, and end of a five-through-seven-year-old girl's treatment suggests an intricate pattern evolving from observing and learning toward elaborating a free-ranging, creative, multilevel interplay of internal dialogues and affects.

"Where work is play for mortal stakes": the good hour in child analysis.

To explore the concept of the "good hour" in child analysis I discuss an hour in the analysis of a six-and-a-half-year-old girl. Elements of this hour include a palpable therapeutic alliance, affective immediacy, surprise, and discovery, oscillating therapeutic action of action, play, and verbalization, creative accessibility to the unconscious, the transference, the countertransference, and a capacity to work with conflict, defense, and fantasy. These qualities are similar to those described by Kris for adult analysis over forty years ago. The present hour, however, illustrates greater emphasis on affect rather than drive, the therapeutic action of play in the analytic setting, and the transformative importance of the relationship. In addition, the hour highlights a greater focus on communication by action and enactment, the highly informative uses of the countertransference, and the co-creation of the analytic process.

The work of transformation. Changes in technique since Anna Freud's Normality and pathology in childhood.

Psychoanalysis aims to restore the artist in the patient, the part of the person that makes interest despite, or whatever, the early environment. At its most extreme, for the artist her own life, it is not so much a question of what she has been given (no one chooses their parents, but everyone invents them, makes what they can of them). The psychoanalytic model here is the dream, or the child's infantile sexual theory, in which so-called reality functions more like a hint than an instruction, setting the dreamer and child off on the work of transformation (Phillips, 1998, pp. 4-4).

Developmental aspects of self-esteem in the analysis of an 11-year-old boy.

This paper explores the vicissitudes of self-esteem in the analysis of an 11-year-old boy. The paper highlights the complex interplay from different developmental periods that underlies the growth and sustaining of self-esteem. This interplay, catalyzed in the crucible of the transference, includes issues of evolution of affect states, self-structure, object relations, psychosexual development, conflict, and defenses.