Homework assignments in relational psychoanalytic treatment of personality disorders: A case study of a patient with narcissistic personality disorder.

Homework assignments, or specific tasks patients are asked to engage in or complete between sessions, are a controversial topic among psychoanalysts. While many argue these interventions contradict psychoanalytic principles, others believe they can help address problems and promote coping skills. We propose that homework can be a legitimate aspect of relational psychoanalysis when used in a way that is attuned to the patient's experience and that homework may be an important component of treating personality disorders (PD). We present the case of a man diagnosed with narcissistic PD. He often felt superior to and reported that he despised others, though the core self-image was of fragile. He embraced the role of the omnipotent caregiver, which came with boredom and anger and lack of satisfaction in his social life. The patient tried to control therapy, asserting that he could psychoanalyze himself. As a result, therapy was stalled and progress was limited. At this point, the therapist asked him to complete homework assignments that encouraged him to refrain from his compulsive caregiving to better understand what motivated this behavior. Through this process, the patient came to realize he acted out of avoidance, as he did not want to disclose his own vulnerabilities and flaws. At that point he was able to experience relationships while adopting different stances and finding new meanings. We argue that homework can be fully integrated into the relational psychoanalytic repertoire to improve self-reflection and foster change in patients with PD.

Death as rupture, mourning as repair: A relational rendering of grief.

This paper honors Jeremy Safran's legacy of scholarship and pedagogy through the lens of his emphasis on rupture and repair. Challenging a Freudian rendering of mourning as ultimately giving up a lost object, the author draws on Nicholas Abraham and Maria Torok's application of Sandor Ferenczi's concept of introjection to offer a relational rendering of the grieving process.

RELATIONAL DIMENSION VERSUS ARTIFICIAL INTELLIGENCE.

Thirty years ago, we proposed the similarity between the functioning of artificial intelligence and the human psyche, suggesting multiple parallels between the Freudian model proposed in the "Project for Psychology for Neurologists" and the connectionist theories applied in the generation of parallel distributed processing systems (PDP), also known as connectionist models. These models have been and continue to be the foundation of general artificial intelligences like ChatGPT, evolving and gaining prominence in everyday life. From the earliest applications in psychiatry, recreating computationally simulated modes of illnesses, to the use of deep learning models, especially in the field of computer vision for tasks such as image recognition, segmentation, and classification. Recurrent Neural Networks (RNN) and Long Short-Term Memory (LSTM) are employed for tasks involving sequences of data, such as natural language processing, or models based on the Transformer architecture, like BERT and GPT (Generative Pre-trained Transformer), which have revolutionized natural language processing. In this present work, we analyze the significance of the emergence and exponential growth of these types of tools in the field of healthcare, from medical diagnosis and patient care to psychological attention and psychotherapeutic treatment, exploring the changes and transformations in the forms of subjective expression that are arising. We also examine and argue for the importance and validity of the relational dimension proposed by our psychoanalytic approach in contrast to the potential use of these tools as treatment models.

Remembering Jeremy Safran: continuing the conversation.

This introduction provides an overview to this special issue honoring the work and legacy of Jeremy D. Safran. Born of the Jeremy Safran Memorial Conference, held on April 2nd, 2023, this issue features a wide range of contributions from leaders in the field, former students, and early career professionals whose work engages and develops central ideas from Safran's work and reflects on his impact on their own clinical work and scholarship. Themes center around the three domains of Safran's major contributions: pedagogy; psychotherapy integration; and Buddhism, spirituality, and psychoanalysis. We observe among the contributions an experiential reconnecting with the deeply relational commitments of our friend and colleague.

Intricacies of Relational Intimacy: Approaching the Invasive Edge with a Schizoid Patient.

In hopes of contributing to the developing self-critique of relational analysis, I offer a case that illustrates a modified approach, one informed by current dialogue. The patient described had considerable unmet selfobject needs and a schizoid sensitivity to intrusion, engendering the question explored: How do two minds meet if one is largely relationally dissociated and acutely vulnerable when integrated? A premature emphasis on intersubjectivity would have obscured the patient's narcissistic needs and reinforced her tendency to retreat. Suspending the goal of intersubjectivity allowed for a regressive process to occur, and for contact to become safe before analyst and patient paved the way for future mutual relatedness.

WHAT'S NEW IN PARALLEL PROCESS? THE EVOLUTION OF SUPERVISION'S SIGNATURE PHENOMENON.

The concept of parallel process has played a central role in psychoanalytic supervision for the last 60 years, generating continuing interest in the power of the unconscious to create unexpected intersections between the analytic and supervisory relationships. I track the evolution of the concept, starting with its invention by an interpersonalist psychoanalyst, adoption by two ego psychologists, enrichment by object relations theory, and, finally, redefinition as a multi-directional dynamic by relational psychoanalysts. I then further elaborate the relational view of parallel process, illustrating its complex, multidirectional nature with an extended vignette. I discuss the relationship of enactment to parallel process and illustrate the usefulness of supervisory consultation when enactments that parallel into the supervisory relationship lead to impasse. Finally, I point to educational and neuropsychological research that suggests that working with parallel process is good pedagogy.

Psychoanalysis and the Experience of Homelessness.

Psychoanalysis is often viewed as a practice relevant only to educated people of means. This article describes a project that matches psychoanalytically trained clinicians with unhoused and formerly unhoused adults in a large urban community. D. W. Winnicott's ideas about impingement, the holding environment, fear of breakdown, and careful monitoring of the analyst's interiority have proven to be most valuable theoretical and clinical tools. A decade-long case example demonstrates the challenges and healing potentials of the work.

Couples therapy with childhood sexual abuse survivors (CSA) and their partners: establishing a context for witnessing.

This article proposes a clinical practice for therapy with couples in which one partner suffered sexual abuse in childhood. Such couples often encounter unique difficulties with physical contact, intimacy, sexuality, communication, and trust, and their relationship dynamic may be marked by reenactments of past traumatic relational patterns. This clinical practice is founded on the assumption that establishing the witnessing lacking during the traumatic event in childhood can break the traumatic reenactments in adulthood, and spur recovery. The suggested practice may facilitate twofold witnessing: the couple's therapist witnesses the reenactments of the trauma in the couple's relationship; and the survivor's partner witnesses the trauma's effect on the survivor's personal life and relationship. Twofold witnessing can help break the cycle of traumatic reenactment and help the survivor integrate the events of her life into a more coherent, continuous narrative. The partner's presence also facilitates acknowledgement of what happened to the survivor, and helps the survivor elaborate on her stories of resistance, survival, and strength. Finally, each of the partners is able to appear more wholly and fully, and together to tell the preferred stories of their life as a couple, replete with the multiple relational patterns they wish to live, which may contradict the characteristics of the original trauma.

An Epistolary Conversation.

This written exchange is between a senior and a younger Jungian analyst on issues relevant to the development of analytical psychology throughout the world today. The younger analyst, Stefano Carpani, considers himself a neo-Jungian. He explains to John Beebe, known for post-Jungian contributions to the study of typology, integrity, and gender, how important it is to include sociological perspectives alongside those that stem from the Jungian practice of relational psychoanalysis. The degree to which analysis has become an extended meditation on the relation of individual self-exploration to supra-personal Self-realization is emphasized by both authors, who envision this introspection leading to an expanded inner openness that Carpani has called "absolute freedom." The authors conclude that absolute freedom is a space of engaged reflection that can permit an informed but individualized approach to the complexities of the world soul today.

Il s'agit d'un échange par écrit entre deux analystes jungiens - l'un plus agé, l'autre plus jeune - sur des questions concernant le développement actuel de la psychologie analytique à travers le monde. L'analyste plus jeune, Stefano Carpani, se considère comme un néo-jungien. Il explique à John Beebe - qui est connu pour ses contributions post- jungiennes à l'étude de la typologie, de l'intégrité et du genre - à quel point il est important d'inclure des perspectives sociologiques aux côtés de celles qui découlent de la pratique jungienne de la psychanalyse relationnelle. Les deux auteurs insistent sur le degré auquel l'analyse est devenue une méditation prolongée concernant la relation entre l'exploration individuelle de soi et une réalisation supra-personnelle du Soi. Ils envisagent que cette introspection mène à une ouverture intérieure élargie que Carpani a appelée « liberté absolue ¼. Les auteurs concluent que la liberté absolue est un espace de réflexion engagée qui peut permettre une approche éclairée mais individualisée des complexités de l'âme du monde aujourd'hui.

Este intercambio escrito es entre un analista junguiano senior y otro más joven sobre temas relevantes para el desarrollo de la psicología analítica en el mundo actual. El analista más joven, Stefano Carpani, se considera neo-jungiano. Explica a John Beebe, conocido por sus contribuciones postjungianas al estudio de la tipología, la integridad y el género, lo importante que es incluir perspectivas sociológicas junto a las que se derivan de la práctica junguiana del psicoanálisis relacional. Ambos autores enfatizan el grado en que el análisis devino en una prolongada meditación en la relación entre la exploración individual del self y la realización suprapersonal del Self, y visualizan como esta introspección conduce a una expansiva apertura interior que Carpani ha llamado "libertad absoluta". Los autores concluyen que la libertad absoluta es un espacio de reflexión comprometida que puede permitir una aproximación fundamentada y singular a las complejidades del alma del mundo actual.

We Have Never Been White: Afropessimism, Black Rage, and What The Pandemic Helped me Learn About Race (and Psychoanalysis).

Amidst a pandemic and the events following George Floyd's murder in 2020, discussions of race have escalated in the psychoanalytic community. One theoretical formulation, Afropessimism, has served as a lightning rod across both psychoanalytic and academic circles. Another, Black Rage, offers a psychoanalytic theory of the psychic effect of racial oppression on traumatized subjects. Using both as catalysts, this essay explores the historicity of the questions raised by the racial unrest of the pandemic--the deep embedding of questions of race and Blackness in unconscious prehistories of modernity, the human, and our understanding of our social worlds.

The man I am trying to be is not me.

This paper explores the therapeutic process between analyst and Josh, a trans man whose life had fallen apart after transition. Repetitive enactments involving hiding, deceiving and mystification constituted a prolonged therapeutic impasse. The analyst's struggle with these binds and with countertransference confusion and anxiety, ultimately illuminated zones that had remained off-limits for a prolonged period of time. Where the couple had been snared in a bind structured by gender, they were now able to access a history of violation and to ask more profound questions about connection, aloneness, authenticity and loss.

Walking the middle ground between hermeneutics and science: A research proposal on psychoanalytic process.

In 100 years of clinical research and 40 years of empirical research, the concept of psychoanalytic process continues to elude a consensual definition, probably because the problem and methodology must be approached in a different way. This article outlines the empirical implications of the epistemological model exposed in a previous article, by proposing a scientific, innovative, and clinically sensitive research programme for the study of psychoanalytic process. This proposal is an attempt at developing psychotherapy research that is founded on psychoanalytic hypotheses derived from a two-person psychology. The research programme focuses on the interactional nature of the analytical work, and on the relationship between the implicit (unconscious) and the explicit (conscious) levels of the analytic endeavour. The authors propose that this research programme be articulated around three methodological approaches: (1) the use of systematic case studies; (2) the adoption of the events paradigm for accessing the salient phenomena of the psychoanalytic process; and (3) a micro-analytic approach to the specific phenomena occurring within relevant sequences of interaction. These ideas are illustrated with a description of the micro-analysis of a clinical case. This article is intended to contribute to a constructive dialogue between psychoanalytic practice and psychotherapy research.

Longing and Fear: The Ambivalence About Having a Relationship in Psychotherapy.

It is unquestioned that reaching the hypnotic state is helped along by relational factors and that, conversely, relational experiences can be deepened through hypnosis. It is also true that deepening the experience of being in a relationship with another person is neither comfortable nor indicated for every patient or therapist. Most humans feel ambivalent about closeness. People vary in their desire for and their skill in sustaining mature intimacy. When we move along the continuum from rudimentary notions about relational factors in psychotherapy, such as rapport, to complex concepts, such as enactments, we move along a corresponding continuum of increasing need for specialized training, supervised experience, and personal therapy. The field of psychotherapy has been plagued from its inception by not knowing what to do with the tensions that emerge when two people listen to and look at each other. Avoiding relational factors may be a very human response to a very daunting matter.

A forgotten review by Sándor Ferenczi: "Otto Gross: Three essays on internal conflict" (1920).

In early 1920, Otto Gross published his last book, Three Essays on Internal Conflict, almost at the same time as "Beyond the pleasure principle", in which Freud revised his drive theory. Gross was one of the most brilliant analysts of the "first generation", but he had spent more than 10 years outside the psychoanalytic movement, and no one showed any interest in his publications except Ferenczi, who immediately wrote a critical review that has never been translated into English. Here we present the first English translation of Ferenczi's review, "Otto Gross. Three essays on internal conflict" (1920), first published in Internationale Zeitschrift für Psychoanalyse. In this review, Ferenczi shows a great deal of interest in the new approach proposed by Gross based on the recently discovered "hospitalism syndrome", identifying the "instinct (or drive) for contact" as the origin of infantile sexuality. This review reveals a key moment in the trajectory of Ferenczi's work, when he took a definitive turn towards investigating early relationships and towards a renewed focus on the trauma factor. This illuminates the rest of his psychoanalytic work and formed the foundations for the attachment and relational approach in psychoanalysis.

Paths of the countertransference in the analyst-clinical examples of working through.

Today the importance of working through the analyst's countertransference is stressed throughout all different schools of psychoanalysis. This article aims to make the microprocesses more transparent regarding the transformations of transference and countertransference, from the beginning of the anchoring of a projection in the analyst up to the re-internalization of a transformed projection in the patient. This is introduced by a survey of the history of two central terms: Projective Identification (on the side of the patient) and Countertransference (coming from the side of the analyst). How the analyst is also a "do-er" and how this fits in with the projective identifications of the patient is a newer development in psychoanalysis and is the main subject of this paper. Alongside the clinical material shown is described what the patient triggers in the analyst with his projections, and how the analyst manages to work through his countertransference where the patient becomes a temporary object, connecting with objects of the analyst until-if all goes well-the analyst manages to transform the projection of the patient while "triangulating with his inner understanding parents".

The analyst's narrative function: Inventing a possibility.

This article describes a psychic function common to analysts that was gradually revealed through clinical work with children. It is a psychic quality derived from function α, which involves analysts' capacity for reverie - their narrative function. The author presents two clinical situations where this function developed in the analytic field in relation to patients' difficulty in symbolizing. In the first case there was an early traumatic experience unavailable for representation. The analyst lent the patient her ability to represent and produced a narrative that made it possible to create a world of phantasies and transform nightmares into 'dreamable' dreams. In other words, she removed the quality of unbearable, irrepresentable reality that characterized those raw experiences encrypted in the psyche. In the second case the analyst's narrative function sought to connect with the isolation, the shell that housed a child suffering from an autistic disorder whose ability to represent had not been established. The analyst provided meaning for the patient's repetitive, stereotyped play, thus weaving the child's subjectivity and gradually introducing a notion of alterity. The author seeks to show how this function, in the thematic construction of the session, facilitated both the working-through of a traumatic situation (with the ability to share representations) and the constitution of the psychic fabric.

Propuesta psicoterapéutica para Juliet en la serie New Amsterdam. Limitaciones de seductoras esperanzas / Psychotherapeutic Proposal for Juliet in the Series New Amsterdam

Este trabajo, se focaliza en la dilemática propuesta psicoterapéutica de una niña de 11 años, desarrollada a posteriori de arribar a un diagnóstico "insensibilidad afectiva", también referida como severas perturbaciones en los procesos de empatía. El análisis e interrogantes planteados del proceso diagnóstico y psicoterapéutico se realiza con el sustrato de un enfoque psicoanalítico relacional que sostiene que en sentido estricto no existe mente aislada, tanto desarrollo como trauma devienen en la dimensión relacional intersubjetiva contextual e históricamente situada. El devenir humano se configura en las complejas correlaciones entre múltiples combinaciones ­conscientes e inconscientes­ de las propiedades genéticas, congénitas y experiencias vividas, en el marco de los abanicos de influjos identificatorios, emplazados en matrices relacionales, que operan como sustrato de las configuraciones de la empatía. La propuesta psicoterapéutica centrada solo en una parte de la conducta manifiesta de Juliet y en su necesidad manifiesta de halagos que ­cuando son puestas en riesgo sobreviene un derrumbe que propicia los acting out de violencia extrema­, deja por fuera: ­los recorridos de configuración de la problemática y sus significados, intra e intersubjetivo; ­pactos conscientes e inconscientes intra e intergeneracionales; ­función de las defensas y conductas manifiestas en el equilibrio intra e intersubjetivo; ­riesgo a convocar miedos inconscientes ante la invitación a conmoverse ante el sufrimiento del semejante. Asimismo, cabe subrayar, que se deja fuera de escena al niño violentado y se lo pone en riesgo a ser revictimizado, todo un fallido ético

This work focuses on the dilemmatic psychotherapeutic proposal of an 11­year-old girl, developed after arriving at a diagnosis "affective insensitivity", also referred to as severe disturbances in the empathy processes. The analysis and questions raised about the diagnostic and psychotherapeutic process is carried out with the substrate of a relational psychoanalytic approach that maintains that in a strict sense there is no isolated mind, both development and trauma become the contextual and historically situated intersubjective relational dimension. Human becoming is configured in the complex correlations between multiple combinations ­conscious and unconscious­ of genetic and congenital properties and lived experiences, within the framework of the fans of identifying influences, located in relational matrices, which operate as a substrate of the configurations of empathy. The psychotherapeutic proposal focused only on a part of Juliet's manifest behavior and on her manifest need for flattery that ­when they are put at risk, a collapse occurs that favors the acting out of extreme violence­, leaves out: ­the configuration paths of the problem and its meanings, intra and intersubjective; ­conscientious and unconscious intra and intergenerational pacts; ­function of defenses and manifest behaviors in intra and intersubjective balance; ­risk of invoking unconscious fears at the invitation to be moved by the suffering of others. Likewise, it should be noted that the abused child is left out of the picture and is put at risk of being re-victimized, a ethical failure

Bridging worlds: participatory thinking in Jungian context.

Introducing the 'participatory' paradigm associated with the work of transpersonalists Richard Tarnas and Jorge Ferrer, the author outlines an approach to Jung's archetypal thinking that might offer a more adequate basis in which to ground a non-reductive approach to practice. In order to demonstrate the relevance of this outlook at the present time, the author begins by examining recent debates concerning the nature of 'truth' in the clinical setting. Reflecting on the difficulties analysts face in attempting to maintain professional authority without falling into an implicit authoritarianism, it is argued that any approach to therapy seeking to orient itself towards 'the unconscious' must posit the challenges of pluralism as a central concern for practice. With reference to the relationship between analytical psychology and the psychoanalytic mainstream, attention is drawn to the theoretical problems raised by the relational commitment to constructivist epistemologies, and a consequent tendency towards biological reductionism. Turning to the Jungian literature, similar tensions are observed at play in the present state of analytical psychology. Drawing attention to the process-oriented qualities of Jung's work, it is suggested that the speculative nature of Jung's psychology offers a more adequate basis for contemporary practice than might be assumed.

Self-disclosure, trauma and the pressures on the analyst.

This paper argues that self-disclosure is intimately related to traumatic experience and the pressures on the analyst not to re-traumatize the patient or repeat traumatic dynamics. The paper gives a number of examples of such pressures and outlines the difficulties the analyst may experience in adopting an analytic attitude - attempting to stay as closely as possible with what the patient brings. It suggests that self-disclosure may be used to try to disconfirm the patient's negative sense of themselves or the analyst, or to try to induce a positive sense of self or of the analyst which, whilst well-meaning, may be missing the point and may be prolonging the patient's distress. Examples are given of staying with the co-construction of the traumatic early relational dynamics and thus working through the traumatic complex; this attitude is compared and contrasted with some relational psychoanalytic attitudes.

The future of Jungian analysis: strengths, weaknesses, opportunities, threats ('SWOT').

Using a methodology derived from management and organizational studies, the author reviews the future of Jungian analysis. The methodology is termed SWOT - strengths, weaknesses, opportunities, threats. A selected list in each of these categories is presented. The author is transparent in allowing for the fact that the paper not only derives from a public lecture on the topic, but also retains the immediacy and the contrarian and opinionated style of such a lecture.