Distribution by Scientific Domains
Distribution within Psychology

Terms modified by Transference

  • transference number

  • Selected Abstracts


    Antonio Suman
    ABSTRACT Our contribution focuses on the first encounter with the patient and on the social and cultural context in which it takes place; we believe that psycho-therapy begins with the very first encounter, whether or not it leads to a therapeutic relationship. Before the first encounter, the patient produces conscious and unconcious fantasies, sometimes even dreams, about the therapy, the therapist and the encounter itself; these fantasies constitute a sort of preformed, cultural transference. Besides the preformed transference, an actual transference relationship begins to develop, becoming activated in the patient by contact with the real person of the therapist, and in the therapist by contact with the real person of the patient, blending with the culturally preformed transference. This primitive transference can rapidly determine the outcome of the first encounter as well as of the actual project of entering therapy. [source]


    Jackie Gerrard
    ABSTRACT This paper examines Balint's statements regarding ocnophilia and transference interpretations; namely his proposition that making transference inter pretations the over-riding focus of psychoanalytic technique encourages an ocnophilic way of being and relating in the patient. The author is not convinced that this is so and presents her argument, which is later illustrated with four clinical vignettes. [source]

    Playing with unreality: Transference and computer,

    Vittorio Lingiardi
    In this paper I describe the impact of cyberspace on the analytical relationship. My reflections will move from two clinical histories. In the first history, I describe the case of Melania, a patient who, at a certain moment of her analysis, started sending me e-mails, almost building a ,parallel setting'. I describe the relational dynamics linked to the irruption of the electronic mail into the boundaries of our psychoanalytic relationship. The second case is Louis, a 25 year-old young man with a schizoid personality who uses cyberspace as a psychic retreat. Over the years Louis told me, initially from a sidereal distance, of his necessity to create dissociative moments. The entrance to these retreats procures for Louis an immobile pacification, which may assume the characteristics of a trance: life comes to a halt in a state of ,suspended animation'. We can see the use that Louis makes of the computer as an attempt to live into a non-human object and to protect himself from relational anguish, but also to warm up a mechanical mother. Melania used technology to communicate with me, albeit in a roundabout way; for Louis, virtual space was a ,dissociative retreat' located on the border between sleeping and waking, which for years went untouched by our analytical discourse. For both patients, the computer was a tool for emotional regulation, and the analytical relationship aimed to give this tool some relational meaning, facilitating the shift from compulsive usage to a transformative use of the object. [source]

    Repression, transference and reconstruction

    Harold P. Blum
    Whereas Peter Fonagy almost dismisses the importance of repression and the recovery of repressed and suppressed memory, the author believes that the analysis of repression retains importance in clinical psychoanalysis. Transference is a return of the repressed, with repressed memories embedded within a fundamental unconscious fantasy constellation. Moreover, transference is an essential, but not the only, route to the understanding and analysis of the patient. Nor should transference be confused with the real or new analytic relationship. The author does not regard the dynamic unconscious as definitely registered and retrieved in procedural memory, awaiting further research. A focus on the present ,self with other' model of therapeutic action neglects pathogenesis and the importance of childhood and its psychoanalytic reconstruction. [source]

    Transference and dream in illness: waxing psyche, waning body

    Beverley D. Zabriskie
    In times of change, crisis, and illness, the excited points of an individual's personal history are reactivated within the transference and may also be noted by observing countertransference. When there are anomalies in the emotional and imaginal circle of the therapeutic relationship, there is occasion for repetition and/or a transformative opening. In some cases, there is simultaneous treatment of severe developmental fixations and compulsions, and issues of individuation. Images may emerge both from the personal field and from the collective and archetypal imagination. These may be expressions of interpersonal experience, intrapsychic dynamics, and physical as well as psychic state. [source]

    What Does the Conservation of Energy Have to Do with Physicalism?

    DIALECTICA, Issue 4 2006
    Barbara Montero
    The conservation of energy law, a law of physics that states that the total energy of any closed system is always conserved, is a bedrock principle that has achieved both broad theoretical and experimental support. Yet if interactive dualism is correct, it is thought that the mind can affect physical objects in violation of the conservation of energy. Thus, some claim, the conservation of energy grounds an argument for physicalism. Although critics of the argument focus on the implausibility of causation requiring the transference of energy, I argue that even if causation requires the transference of energy, once we accept the other required premises of the argument that lie behind any supposed argument from the conservation of energy the law of the conservation of energy is revealed as irrelevant to the question of whether the mental is physical. [source]

    Agitation and despair in relation to parents: activating emotional suffering in transference

    Inga Reznik
    Abstract Affect and motivation are known to arise in the social-cognitive process transference, which occurs when a new person minimally resembles a significant other, implicitly activating the mental representation of this significant other (Andersen, Reznik, & Manzella, 1996) and indirectly, the relational self (i.e. Andersen & Chen, 2002). Triggering the significant-other representation should also indirectly activate any self-discrepancy held from this other's perspective, resulting in shifts in discrete affect and self-regulation. Participants (n,=,110; 34 men, 76 women) with an actual-ideal or actual-ought self-discrepancy from their parent's perspective (Higgins, 1987) learned about a new person who did or did not minimally resemble this parent. As predicted, this evoked positive evaluation of the new person, that is, a positive transference, and yet, as a function of self-discrepancy, also increased discrete negative mood with ideal-discrepant individuals becoming more dejected and ought-discrepant individuals more hostile and less calm. Self-regulatory focus shifted as well in terms of motivation to avoid emotional closeness. Copyright © 2007 John Wiley & Sons, Ltd. [source]

    Comparative ecology of seed mass in Psychotria (Rubiaceae): within- and between-species effects of seed mass on early performance

    FUNCTIONAL ECOLOGY, Issue 4 2005
    H. PAZ
    Summary 1Experimental field data and interspecific comparative analyses were used to detect effects of seed mass on seedling performance within and among seven species of Psychotria sown in gaps and shaded rainforest sites. In addition we compared the effects of seed mass within and among species to detect concordance between the two ecological scales. We used two comparative methods: phylogenetically independent contrasts and cross-species correlations. 2Among species, we detected weak evidence of a positive correlation between seed mass and the probability of emergence in the shaded forest, and no effects of seed mass in gaps. 3Among species, no significant correlations between seed mass and either seedling survival or seedling recruitment were found in any habitat. Other variables specific to each subgenus appear to be more important than seed mass in determining survival in the shaded forest. 4There was a negative correlation between seed mass and relative growth rate (RGR) in both habitats. In gaps, small-seeded taxa exhibited particularly high RGR, compensating for the initial advantages of higher seed mass. 5All species studied exhibited recruitment in gaps equal to or higher than that in the shaded forest. However, recruitment success in shaded forest relative to gaps increased with seed mass, indicating a higher affinity for shaded forest among larger-seeded taxa, but this relationship was only detected using PICS analysis. 6.,Correlations between seed mass and seedling mass are similar within and among species, indicating a simple principle of mass transference. In contrast, correlations between seed mass and seedling emergence, seedling survival, seedling recruitment and RGR depend on the scale at which they are observed. [source]

    The transference onto God

    Dan Merkur
    Abstract Magical religious practices, defined as instrumental uses of the divine, are devoted to gods and God, in Winnicott's terms, as "subjectively perceived objects," whereas the comparatively rare phenomenon of non-magical religion is devoted to "objective objects." In a "bargain with fate," the divine is a transferential figure whose response to symptomatic cultic behavior is predictable and makes cultic behavior a magical means to control fate. The bargain with fate may be treated as a sublimation of the mother,infant dyad that is isomorphic with pre-Oedipal and Oedipal fixations. The therapeutic goal, at both interpersonal and religious levels of discourse, is to facilitate advance from "object-relating" to "object-usage." Analysis of the transference, arriving at a conception of the divine as a free agent, replaces the concept of fate with a concept of divine grace, interrupting the religious repetition-compulsion. Copyright © 2009 John Wiley & Sons, Ltd. [source]

    Holding on and letting go: developmental anxieties in couples after the birth of a child

    Jenny Berg
    Abstract The authors propose a theoretical sequence for the psychological development of couples from narcissistic, autistic-contiguous and paranoid-schizoid levels to depressive position functioning. The authors illustrate their observations with vignettes from couple therapy with a husband and wife who are dealing with the impact of a third on their fragile relationship, initially in the form of their baby, subsequently his lover and lastly the couple therapist. They show how dealing with resistance and transference enables the couple to give up a shared manic defence, grieve together and move along the developmental levels to achieve a more satisfying reality. Copyright © 2004 Whurr Publishers Ltd. [source]

    Generalizability and transferability of meta-synthesis research findings

    Deborah Finfgeld-Connett
    finfgeld-connett d. (2010) Generalizability and transferability of meta-synthesis research findings. Journal of Advanced Nursing 66(2), 246,254. Abstract Title.,Generalizability and transferability of meta-synthesis research findings. Aim., This paper is a report of a critical analysis of the generalizability and transferability of meta-synthesis research findings. Background., Findings from a large number of qualitative research investigations have had little impact on clinical practice and policy formation. Single qualitative investigations are not intended to produce findings that are directly applicable to clinical practice, simple literature reviews of qualitative studies are not conducted using sophisticated methods to develop new cumulative knowledge, and methods for systematically compiling and synthesizing qualitative findings have just recently been developed in nursing. Data sources., This analysis of qualitative review methods was based on over 10 years of meta-synthesis research experience and a non-time-limited cross-discipline search of the English-language literature related to qualitative research and generalizability. Discussion., Generalizability of meta-synthesis findings is enhanced by insuring validity through systematic sampling, second-tier triangulation, maintenance of well-documented audit trails and the development of multi-dimensional theory. Generalizability of meta-synthesis findings is tentative until successful transference to new situations takes place. Implications for nursing., Nurse researchers are urged to conduct well-designed and executed meta-synthesis investigations that have the potential to generate findings that are relevant to clinical practice and policy formation. They are also encouraged to disseminate their meta-synthesis findings skilfully and work with practitioners and policy-makers to apply and evaluate them judiciously in clinical settings. Conclusion., Qualitative meta-synthesis is a way of putting together qualitative findings from disparate investigations so that they can more readily be used in clinical practice and policy formation. [source]

    Methodological rigour within a qualitative framework

    Gerard A. Tobin BSc MSc RGN RMN RCNT RNT
    Aim., This paper discusses the literature on establishing rigour in research studies. It describes the methodological trinity of reliability, validity and generalization and explores some of the issues relating to establishing rigour in naturalistic inquiry. Background., Those working within the naturalistic paradigm have questioned the issue of using validity, reliability and generalizability to demonstrate robustness of qualitative research. Triangulation has been used to demonstrate confirmability and completeness and has been one means of ensuring acceptability across paradigms. Emerging criteria such as goodness and trustworthiness can be used to evaluate the robustness of naturalistic inquiry. Discussion., It is argued that the transference of terms across paradigms is inappropriate; however, if we reject the concepts of validity and reliability, we reject the concept of rigour. Rejection of rigour undermines acceptance of qualitative research as a systematic process that can contribute to the advancement of knowledge. Emerging criteria for demonstrating robustness in qualitative inquiry, such as authenticity, trustworthiness and goodness, need to be considered. Goodness, when not seen as a separate construct but as an integral and embedded component of the research process, should be useful in assuring quality of the entire study. Triangulation is a tried and tested means of offering completeness, particularly in mixed-method research. When multiple types of triangulation are used appropriately as the ,triangulation state of mind', they approach the concept of crystallization, which allows for infinite variety of angles of approach. Conclusion., Qualitative researchers need to be explicit about how and why they choose specific legitimizing criteria in ensuring the robustness of their inquiries. A shift from a position of fundamentalism to a more pluralistic approach as a means of legitimizing naturalistic inquiry is advocated. [source]

    Lewis acid,base property of P(VDF- co -HFP) measured by inverse gas chromatography

    Baoli Shi
    Abstract Poly (vinylidene fluoride- co -hexafluoropropylene) P(VDF- co -HFP) is an excellent material for polymer electrolytes of lithium ion battery. To enhance the lithium ion transference number, some metal oxides were often embedded into P(VDF- co -HFP). The promising mechanism for the increase in lithium ionic conductivity was Lewis acid-base theory. In this experiment, the Lewis acid,base properties of P(VDF- co -HFP) were measured by inverse gas chromatography (IGC). The Lewis acid constant Ka of P(VDF- co -HFP) is 0.254, and the base constant Kb is 1.199. Compared with other polymers characterized by IGC, P(VDF- co -HFP) is the strongest Lewis basic polymers. Except aluminum ion, lithium ion is the strongest Lewis acidic ion according to their , value of Lewis acids. Therefore, a strong Lewis acid,base interaction will exist between lithium ion and P(VDF- co -HFP). This will restrict the transference of lithium ion in P(VDF- co -HFP). To enhance the lithium ion transference by blending other metal ions into P(VDF- co -HFP), it is suggested that the preferential ions should be Al3+, Mg2+, Na+, and Ca2+ because these metal ions have relative large , values. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci, 2008 [source]

    Identifying the faces in the mirror: Untangling transference and countertransference in self psychology

    James D. Guy
    Experienced psychotherapists realize that there are many levels of meaning behind much that is said during the therapeutic hour. The challenge for the competent professional is to become wise enough to learn what to ignore and sensitive enough to know what to emphasize. Sorting this out is at the heart of the practice of good psychotherapy. In this article, we will briefly share our thoughts on this rich but complicated interpersonal interaction using Kohutian self psychology theory to understand the role of countertransference in the process of conducting psychotherapy. © 2001 John Wiley & Sons, Inc. J Clin Psychol/In Session 57: 993,997, 2001. [source]

    Compensation of aniseikonia in astigmatic pseudophakic eyes,

    Graeme E. MacKenzie
    Abstract Purpose:, A recently published manuscript addressed the problem of compensating for aniseikonia between pseudophakic astigmatic eyes using a least-squares calculation scheme. The purpose of this paper is to revisit this topic with the specific aim of providing explicit formulae for the determination of the intra-ocular lens required to produce a specified transverse image size at the plane of the retina and the characteristics of the contact or spectacle lens required to realize some desired refractive outcome. Methods:, The 4 × 4 ray transference is central to the development of all formulae presented in this paper. Specifically, the formula for the determination of the power of the intra-ocular lens required to achieve some transverse image size at the retina is derived directly from the disjugacy of the pseudophakic eye. Results:, The formula is applicable to both stigmatic and astigmatic systems without restriction. A detailed numerical example for an unusual eye is provided. Conclusion:, A formula for the determination of the intra-ocular lens required to produce any given transverse image size at the retina is derived. This approach does not require the application of the Moore-Penrose pseudo-inverse and one is able to work rather with the properties of the optical system directly without further modification. [source]

    Reading for The English Patient

    ORBIS LITERARUM, Issue 5 2010
    Sofie De Smyter
    Although The English Patient's preoccupation with reading and narrating (lives) has been widely acknowledged, its structure has been insufficiently linked with the mindscape of the characters. It is Peter Brooks's insights into the correspondences between the plot of our lives and the plots of the tales we tell that opens the way for reading (for) the novel's stories and lives as stories. Successfully interrelating psychoanalysis and literary theory, Brooks mainly relies on Sigmund Freud's ideas concerning the death drive and transference, something that proves particularly fruitful for analysing a novel in which the protagonist, the English patient, appears to be telling his defective life story to an analyst. It is a technique of reading that lays bare the relationship between the characters and the structure of the text, and their shared dynamic nature. Brooks's insights are made to interact with Julia Kristeva's ideas concerning the semiotic and symbolic dimensions of language and Lewis Hyde's reflections on the mythic figure of the trickster, as both critics are also , be it perhaps less blatantly , occupied with the endless stories we tell and live (in).1 [source]

    Thermoelectric properties of rapid hot pressed polycrystalline Ag1,xPb18SbTe20 synthesized from doping PbTe nanocrystals

    Xingliang Xin
    Abstract Polycrystalline thermoelectric (TE) materials of n-type and with compositions of Ag1,xPb18SbTe20 (x,=,0, 0.1, 0.2) were prepared by rapid hot pressing from alloy powders, which were obtained by ball milling crystalline ingots. The ingots were synthesized from PbTe nanoparticles, made by solvothermal reactions, and Ag, Sb and Te powders via vacuum-sealed melting in quartz ampoules. Through rapid hot pressing at 748,K for 15,min under 80,MPa, the polycrystalline samples possessed 95% relative densities with the average grain size of 5,µm. The electrical resistivity, Seebeck coefficient and thermal conductivity of the Ag1,xPb18SbTe20 (x,=,0, 0.1, 0.2) samples were measured in the range from room temperature (RT) to 673,K. The thermal conductivity was dramatically decreased, caused by scattering of phonons from grain boundaries and interfaces. By optimizing the values of carrier concentration and carrier transference, the Ag1,xPb18SbTe20 (x,=,0.2) sample achieved a maximum ZT value of 1.019 at 673,K. [source]

    Pollinators and Reproductive Success of the Wild Cucurbit Cucurbita maxima ssp. andreana (Cucurbitaceae)

    PLANT BIOLOGY, Issue 4 2001
    L. Ashworth
    Abstract: We studied the reproductive success and pollinators of Cucurbita maxima ssp. andreana in different disturbed habitats where it grows naturally. Data were obtained from three populations. One grew within a soybean crop, the other within a corn crop, and the third in an abandoned crop field. Cucurbita maxima ssp. andreana is an annual vine with a flowering period from December to April. Male flowers appear first, thereafter female and male flowers appear together. Flower lifetime (9 h) was similar in male and female flowers. The pollinator guild was comparable for the three populations but some differences in the frequency of the insect species were observed. Native bees were the main pollinators in the population in the abandoned field, while beetles pollinated the populations in crop fields. These differences were not linked with the pre-emergent reproductive success, fruit and seed set, or fruit quality. This is a self-compatible plant. Fruit and seed set and fruit traits (total mass, width and length of fruits, number of seeds per fruit, and seed mass) did not show significant differences between hand-cross and hand-self pollinated flowers. This wild cucurbit is a generalist with respect to pollinator guild, and flower visitors seem to be highly efficient in pollen transference. Cucurbita maxima ssp. andreana is well adapted to disturbed habitats because plants ripened fruits successfully, regardless of the group of insects visiting flowers. [source]

    Inheritance of reduced linolenic acid content in the Ethiopian mustard mutant N2-4961

    PLANT BREEDING, Issue 3 2002
    L. Velasco
    Abstract The zero erucic acid Ethiopian mustard lines developed so far are characterized by an exceptionally high linolenic acid content in the seed oil. The mutant line N2-4961, expressing low linolenic acid content in a high erucic acid background, was developed through chemical mutagenesis. The objective of this research was to study the inheritance of low linolenic acid content in this mutant. Line N2-4961 was reciprocally crossed with its parent line C-101 and the linolenic acid content of the reciprocal F1, F2 and BC1 generations was studied. No maternal, cytoplasmic or dominance effects were detected in the analysis of F1 seeds and F1 plants from reciprocal crosses. Linolenic acid content segregated in 1: 2: 1 ratios in all the F2 populations studied, suggesting monogenic inheritance. This was confirmed with the analysis of the reciprocal backcross generation. The simple inheritance of low linolenic acid content in N2-4961 will facilitate the transference of this trait to zero erucic acid lines of Ethiopian mustard. [source]

    The role of cytoplasmic streaming in symplastic transport

    PLANT CELL & ENVIRONMENT, Issue 1 2003
    ABSTRACT The distributing of materials throughout a symplastic domain must involve at least two classes of transport steps: plasmodesmatal and cytoplasmic. To underpin the latter, the most obvious candidate mechanisms are cytoplasmic streaming and diffusion. The thesis will be here advanced that, although both candidates clearly do transport cytoplasmic entities, the cytoplasmic streaming per se is not of primary importance in symplastic transport but that its underlying molecular motor activity (of which the streaming is a readily visible consequence) is. Following brief tutorials on low Reynolds number flow, diffusion, and targeted intracytoplasmic transport, the hypothesis is broached that macromolecular and vesicular transport along actin trackways is both the cause of visible streaming and the essential metabolically driven cytoplasmic step in symplastic transport. The concluding discussion highlights four underdeveloped aspects of the active cytoplasmic step: (i) visualization of the real-time transport of messages and metabolites; (ii) enumeration of the entities trafficked; (iii) elucidation of the routing of the messages and metabolites within the cytoplasm; and (iv) transference of the trafficked entities from cytoplasm into plasmodesmata. [source]

    Proceedings of the 20th Annual Conference of the Japanese Association for Adolescent Psychotherapy, 16 November 2002, Tokyo, Japan

    Article first published online: 28 AUG 200
    Inpatient treatment of obsessive,compulsive disorder in a child and adolescent psychiatry ward M. USAMI National Center of Neurology and Psychiatry, Kohnodai Hospital, Chiba, Japan This is a case report of a 13-year-old-boy (2nd grade in junior high school). His father had poor communication; his mother was a very fragile woman. The boy had been overprotected by his parents, as long as he responded to their expectations. He did not have any other siblings. He played well with his friends since he was young, and did not have problems until the 1st term (from April to July) of 1st grade in junior high school. However, in September he started to have difficulties going well with his friends, and going to school. He spent most of his time in his room, and began to repeat checking and hand-washing frequently. Even at midnight, he forced his mother to touch the shutter from outside of the house for many times. He also ritually repeated to touch his mother's body, after he licked his hands, for over an hour. He became violent, when his parents tried to stop him. In April, year X, his parents visited our hospital for the first time. From then, his mother could not tolerate her son's coerciveness any longer. His father explained to the boy that ,your mother has been hospitalized', and she started to live in the next room to the boy's without making any noise. After 3 months he noticed that his mother was not hospitalized, and he got very excited. He was admitted to our hospital with his family and relatives, in October, year X. At the initial stage of hospitalization he showed distrust and doubt towards the therapist and hospital. He had little communication with other boys and did not express his feelings. Therefore, there was a period of time where he seemed to wonder whether he could trust the treatment staff or not. During his interviews with his therapist he repeated only ,I'm okay' and did not show much emotional communication. For the boy, exposing himself was equivalent to showing his vulnerability and incompleteness. Therefore, the therapist considered that he was trying to denying his feelings to avoid this. The therapist set goals for considering his own feelings positively and expressing them appropriately. Also, the therapist carried out behavioral restrictions towards him. He hardly had any emotional communication with the staff, and his peer relationship in the ward was superficial. Therefore, he gradually had difficulty spending his time at the end of December On the following day in which he and the therapist decided to return to his house for the first time, he went out of the ward a few days before without permission. From thereon it was possible for him to share feelings such as hostility and aggression, dependence and kindness with the therapist. The therapist changed his role from an invasive one to a more protective one. Then, his unsociability gradually faded. He also developed good peer relationships with other boys in the ward and began to express himself feeling appropriately. He was also able to establish appropriate relations with his parents at home, and friends of his neighborhood began to have normal peer relationships again. During childhood and adolescence, boys with obsessive,compulsive disorder are known to have features such as poor insight and often involving their mothers. We would like to present this case, through our understanding of dynamic psychiatry throughout his hospitalization, and also on the other therapies that were performed. Psychotherapy with a graduate student that discontinued after only three sessions: Was it enough for this client? N. KATSUKI Sophia University, Tokyo, Japan Introduction: Before and after the psychotherapy, SWT was administrated in this case. Comparing these two drawings, the therapist was provided with some ideas of what kind of internal change had taken place inside this client. Referring to the changes observed, we would like to review the purposes and the ways of the psychotherapy, as well as the adequacy of the limited number of the sessions (vis-a-vis result attained.) Also we will discuss later if any other effective ways could be available within the capacities of the consulting system/the clinic in the university. Case: Ms. S Age 24 years. Problems/appeal: (i) awkwardness in the relationship with the laboratory colleagues; (ii) symptoms of sweating, vomiting and quivering; and (iii) anxiety regarding continuing study and job hunting. Diagnosis: > c/o PTSD. Psychotherapeutic setting: At the therapy room in the clinic, placed at the university, 50 min-session; once a week; paralleled with the medical treatment. Process: (1) Since she was expelled from the study team in the previous year, it has become extremely difficult for her to attend the laboratory (lab) due to the aforementioned symptoms. She had a feeling of being neglected by the others. When the therapist suggested that she compose her mental confusions in the past by attending the therapy room, she seemed to be looking forward to it, although she said that she could remember only a few. (2) She reported that she overdosed on sedatives, as she could not stop irritating. She was getting tough with her family, also she slashed the mattress of her bed with a knife for many times. She complained that people neither understood nor appreciated her properly. and she said that she wanted revenge on the leader of the lab by punishing him one way or other. (3) Looking back the previous session, she said ,I had been mentally mixed up at that time, but I feel that now I can handle myself, as I stopped the medication after consulting the psychiatrist. According to what she said, when she disclosed the occurrences in the lab to her mother, she felt to be understood properly by her mother and felt so relieved. and she also reported that she had been sewing up the mattress which she slashed before, without any reason. She added, " although I don't even know what it means, I feel that this work is so meaningful to me, somehow". Finally, she told that she had already made her mind to cope with the situation by herself from now on, although it might result in a flinch from the real solution. Situations being the above, the session was closed. Swt: By the remarkable changes observed between the two drawings, the meanings of this psychotherapy and its closure to the client would be contemplated. Question of how school counselors should deal with separation attendant on students' graduation: On a case in which the separation was not worked through C. ASAHARA Sophia University, Tokyo, Japan Although time limited relationship is one of the important characteristics in school counseling, the question of separation attendant on it has not been much discussed based on specific cases. This study focuses on the question of separation through looking at a particular case, in which the separation was not worked through, and halfway relationship continued even after the student's graduation and the counselor's resignation. I was a part time school counselor at a junior high school in Tokyo. The client was a 14-year-old female student, who could not go to her classroom, and spent a few hours in a sick bay when she came to school. She was in the final grade and there was only half a year left before graduation when we first met, and we started to see each other within a very loose structure. As her personality was hyper-vigilant and defensive, it took almost 2 months before I could feel that she was nearer. Her graduation was the first occasion of separation. On that occasion, I found that there had been a discrepancy between our expectations; while I took it for granted that our relationship would end with the graduation, she expected to see me even after she graduated, and she actually came up to see me once in a while during the next year. A year later, we faced another occasion of separation, that was my resignation. Although I worried about her, all I have done for her was to hand a leaflet of a counseling office, where I work as a part time counselor. Again I could not refer to her feelings or show any concrete directions such as making a fixed arrangement. After an occasional correspondence for the next 10 months (about 2 years after her graduation), she contacted me at the counseling office asking for a constant counseling. Why could I not deal with both occasions? and how did that affect the client thereafter? There were two occasions of separation. At the time of the client's graduation, I seemed to be enmeshed in the way of separation that is peculiar to the school setting. In general in therapeutic relationship, mourning work between counselor and client is regarded as being quite important. At school, however, separation attendant on graduation is usually taken for granted and mourning work for any personal relationship tends to be neglected. Graduation ceremony is a big event but it is not about mourning over one's personal relationships but separation from school. That may be why I did not appreciate how the client counted on our relationship. At the time of my resignation I was too worried about working through a change from very loose structure which is peculiar to the school setting to a usual therapeutic structure (fees are charged, and time, place are fixed). That is why I did nothing but give her a leaflet. In this way, we never talked about her complex feelings such as sadness or loneliness, which she was supposed to experience on separation. Looking at the aforementioned process from the client's viewpoint, it can be easily imagined that she could not accept the fact of separation just because she graduated. and later, she was forced to be in double-bind situation, in which she was accepted superficially (handed a leaflet), while no concrete possibility was proposed concerning our relationship (she could never see me unless she tries to contact me.) As a result, she was left alone and at a loss whether she could count on me or not. The halfway situation or her suspense was reflected in her letter, in which she appeared to be just chatting at first sight, but between the lines there was something more implying her sufferings. Above discussion suggests that in some case, we should not neglect the mourning work even in a school setting. To whom or how it is done is the next theme we should explore and discuss in the future. For now, we should at least be conscious about the question of separation in school setting. Study of the process of psychotherapy with intervals for months M. TERASHIMA Bunkyo Gakuin University, Tokyo, Japan This is a report on the process of psychotherapy of an adolescent girl who showed manic and depressive state. At the time of a depressed state, she could not go to a college and withdrew into home, and the severe regressive situation was shown. Her therapy began at the age of 20 and she wanted to know what her problem was. The process of treatment went on for 4 years but she stopped coming to sessions for several months because of failure of the therapist. She repeated the same thing twice. After going through these intervals the client began to remember and started to talk about her childhood , suffering abusive force from her father, with vivid impressions. They once were hard for her to accept, but she began to establish the consistent figure of herself from past to present. In this case, it could be thought that the intervals of the sessions had a certain role, with which the client controlled the structure of treatment, instead of an attack against the therapist. Her object relation, which is going to control an object offensively, was reflected in these phenomena. That is, it can be said that the ambivalence about dependency , difficult to depend but desirous of the object , was expressed. Discontinuation of the sessions was the product of the compromise formation brought about the ambivalence of the client, and while continuing to receive this ambivalence in the treatment, the client started to realize discontinuance of her memories and then advanced integration of her self-image. For the young client with conflict to dependence such as her, an interval does not destroy the process of treatment but in some cases it could be considered as a therapeutic element. In the intervals the client could assimilate the matter by herself, that acquired by the sessions. Psychotherapy for a schizoid woman who presented eccentric speech and behaviour M. OGASAWARA Osaka University Graduate School of Medicine, Osaka, Japan Case presentation: A case of a 27-year-old woman at the beginning of therapy. Life history: She had been having a wish for death since she was in kindergarten and she had been feeling strong resistance to do the same as others after school attendance. She had a history of ablutomania from the age of 10,15, but the symptom disappeared naturally. and she said that she had been eliminated from groups that she tried to enter. After graduating a junior college, she changed jobs several times without getting a full-time position. Present history: Scolded by her boy friend for her coming home too late one day, she showed confusion such as excitement, self-injury or terror. She consulted a psychiatrist in a certain general hospital, but she presented there eccentric behaviours such as tense facial expression, stiffness of her whole body, or involuntary movement of limbs. and because she felt on bad terms with the psychiatrist and she had come to cause convulsion attacks in the examination room, she was introduced to our hospital. Every session of this psychotherapy was held once a week and for approximately 60 min at a time. Treatment process: She sometimes presented various eccentric attitudes, for example overturning to the floor with screaming (1), going down on her knees when entrance at the door (5), entering with a knife in her mouth and hitting the wall suddenly (7), stiffening herself just outside the door without entering the examination room (9), taking out a knife abruptly and putting it on her neck (40), exclaiming with convulsion responding to every talk from the therapist (41), or stiffening her face and biting herself in the right forearm suddenly (52). She also repeated self-injuries or convulsion attacks outside of the examination room in the early period of the therapy. Throughout the therapy she showed hypersensitivity for interpersonal relations, anxiety about dependence, terror for self-assertion, and avoidance for confrontation to her emotional problems. Two years and 6 months have passed since the beginning of this therapy. She ceased self-injury approximately 1 year and 6 months before and her sense of obscure terror has been gradually reduced to some extent. Discussion: Her non-verbal wariness and aggression to the therapist made the sessions full of tension and the therapist felt a sense of heaviness every time. In contrast, she could not express aggression verbally to the therapist, and when the therapist tried to identify her aggression she denied it. Her anxiety, that she will be thoroughly counterattacked to self-disintegration if she shows aggression to other persons, seems to be so immeasurably strong that she is compelled to deny her own aggression. Interpretations and confrontations by the therapist make her protective, and occasionally she shows stronger resistance in the shape of denial of her problems or conversion symptoms (astasia, aphonia, or involuntary movements) but she never expresses verbal aggression to the therapist. and the therapist feels much difficulty to share sympathy with her, and she expresses distrust against sympathetic approach of the therapist. However, her obvious disturbance that she expresses when she feels the therapist is not sympathetic shows her desire for sympathy. Thus, because she has both strong distrust and desire for sympathy, she is in a porcupine dilemma, which is characteristic of schizoid patients as to whether to lengthen or to shorten the distance between herself and the therapist. This attitude seems to have been derived from experience she might have had during her babyhood and childhood that she felt terror to be counterattacked and deserted when she showed irritation to her mother. In fact, existence of severe problems of the relationship between herself and her mother in her babyhood and childhood can be guessed from her statement. Although she has been repeating experiences to be excluded from other people, she shows no attitude to construct interpersonal relationship actively. On the contrary, by regarding herself to be a victim or devaluating other persons she externalizes responsibility that she herself should assume essentially. The reason must be that her disintegration anxiety is evoked if she recognizes that she herself has problems; that is, that negative things exist inside of her. Therefore, she seems to be inhibited to get depressive position and obliged to remain mainly in a paranoid,schizoid position. As for the pathological level, she seems to have borderline personality organization because of frequent use of mechanisms to externalize fantastically her inner responsibility. For her high ability to avoid confronting her emotional problems making the most of her verbal ability, every intervention of the therapist is invalidated. So, it seems very difficult for her to recognize her own problems through verbal interpretations or confrontation by the therapist, for the present. In general, it is impossible to confront self problems without containing negative emotions inside of the self, but her ability seemed to be insufficient. So, to point out her problems is considered to be very likely to result in her confusion caused by persecution anxiety. Although the therapy may attain the stage on which verbal interpretation and confrontation work better some day, the therapist is compelled to aim at promoting her ability to hold negative emotion inside of herself for the time being. For the purpose, the therapist is required to endure the situation in which she brings emotion that makes the therapist feel negative counter-transference and her process to experience that the therapeutic relation itself would not collapse by holding negative emotion. On supportive psychotherapy with a male adolescent Y. TERASHIMA Kitasato University Health Care Center, Kanagawa, Japan Adolescent cases sometimes show dramatic improvements as a consequence of psychotherapy. The author describes how psychotherapy can support an adolescent and how theraputic achievements can be made. Two and a half years of treatment sessions with a male adolescent patient are presented. The patient was a 19-year-old man, living with his family. He had 5 years of experience living abroad with his family and he was a preparatory school student when he came to a mental clinic for help. He was suffering from not being able to sleep well, from difficulties concerning keeping his attention on one thing, and from fear of going to distant places. He could barely leave his room, and imagined the consequence of overdosing or jumping out of a window. He claimed that his life was doomed because his family moved from a town that was familiar to him. At the first phase of psychotherapy that lasted for approximately 1 year, the patient seldom responded to the therapist. The patient was basically silent. He told the therapist that the town he lives in now feels cold or that he wants to become a writer. However, these comments were made without any kind of explanation and the therapist felt it very difficult to understand what the patient was trying to say. The sessions continued on a regular basis. However, the therapist felt very useless and fatigued. Problems with the patient and his family were also present at this phase of psychotherapy. He felt unpleasant at home and felt it was useless to expect anything from his parents. These feelings were naturally transferred to the therapist and were interpreted. However, interpretation seemed to make no changes in the forms of the patient's transference. The second phase of psychotherapy began suddenly. The patient kept saying that he did not know what to talk about. However, after a brief comment made by the therapist on the author of the book he was reading, the patient told the therapist that it was unexpected that the therapist knew anything of his favorite writer. After this almost first interaction between the patient and the therapist, the patient started to show dramatic changes. The patient started to bring his favorite rock CDs to sessions where they were played and the patient and the therapist both made comments on how they felt about the music. He also started asking questions concerning the therapist. It seemed that the patient finally started to want to know the therapist. He started communicating. The patient was sometimes silent but that did not last long. The therapist no longer felt so useless and emotional interaction, which never took place in the first phase, now became dominant. The third phase happened rapidly and lasted for approximately 10 months. Conversations on music, art, literature and movies were made possible and the therapist seldom felt difficulties on following the patient's line of thought. He started to go to schools and it was difficult at first but he started adjusting to the environment of his new part-time jobs. By the end of the school year, he was qualified for the entrance to a prestigious university. The patient's problems had vanished except for some sleeping difficulties, and he did not wish to continue the psychotherapy sessions. The therapist's departure from the clinic added to this and the therapy was terminated. The patient at first reminded the therapist of severe psychological disturbances but the patient showed remarkable progress. Three points can be considered to have played important roles in the therapy presented. The first and the most important is the interpretation by behavior. The patient showed strong parental transference to the therapist and this led the therapist to feel useless and to feel fatigue. Content analysis and here-and-now analysis seemed to have played only a small part in the therapy. However, the therapist tried to keep in contact with the patient, although not so elegant, but tried to show that the therapist may not be useless. This was done by maintaining the framework of the therapy and by consulting the parents when it was considered necessary. Second point is the role that the therapist intentionally took as a model or target of introjection. With the help of behavioral interpretation that showed the therapist and others that it may not be useless, the patient started to introject what seemed to be useful to his well being. It can be considered that this role took some part in the patient going out and to adjust to the new environment. Last, fortune of mach must be considered. The patient and the therapist had much in common. It was very fortunate that the therapist knew anything about the patient's favorite writer. The therapist had some experience abroad when he was young. Although it is a matter of luck that the two had things in common, it can be said that the congeniality between the patient and the therapist played an important role in the successful termination of the therapy. From the physical complaint to the verbal appeal of A's recovery process to regain her self-confidence C. ITOKAWA and S. KAZUKAWA Toyama Mental Health Center, Toyama, Japan This is one of the cases at Toyama Mental Health Center about a client here, we will henceforth refer to her simply as ,A'. A was a second grade high school student. We worked with her until her high school graduation using our center's full functions; counseling, medical examination and the course for autogenic training (AT). She started her counseling by telling us that the reason for her frequent absences from school began because of stomach pains when she was under a lot of stress for 2 years of junior high school, from 2nd grade to 3rd grade. Due to a lack of self confidence and a constant fear of the people around her, she was unable to use the transportation. She would spend a large amount of time at the school infirmary because she suffered from self-diagnosed hypochondriac symptoms such as nausea, diarrhea and a palpitation. She continued that she might not be able to have the self-confidence to sit still to consult me on her feelings in one of our sessions. A therapist advised her to take the psychiatric examination and the use of AT and she actually saw the medical doctor. In counseling (sessions), she eventually started to talk about the abuse that started just after her entering of junior high school; she approached the school nurse but was unable to tell her own parents because she did not trust them. In doing so, she lost the rest of her confidence, affecting the way she looked at herself and thought of how others did. At school she behaved cheerfully and teachers often accused her of idleness as they regarded this girl's absences along with her brightly dyed hair and heavy make-up as her negligent laziness. I, as her therapist, contacted some of the school's staff and let them know of her situation in detail. As the scolding from the teachers decreased, we recognized the improvement of her situation. In order to recover from the missed academic exposure due to her long absence, she started to study by herself. In a couple of months her physical condition improved gradually, saying ,These days I have been doing well by myself, haven't I?' and one year later, her improved mental condition enabled her to go up to Tokyo for a concert and furthermore even to enjoy a short part-time job. She continued the session and the medical examination dually (in tangent) including the consultation about disbelief to the teachers, grade promotion, relationships between friends and physical conditions. Her story concentrated on the fact that she had not grown up with sufficiently warm and compassionate treatment and she could not gain any mental refuge in neither her family nor her school, or even her friends. Her prospects for the future had changed from the short-ranged one with no difficulty to the ambitious challenge: she aimed to try for her favorite major and hoped to go out of her prefecture. But she almost had to give up her own plan because the school forced her to change her course as they recommended. (because of the school's opposition with her own choice). So without the trust of the teachers combined with her low self-esteem she almost gave up her hopes and with them her forward momentum. In this situation as the therapist, I showed her great compassion and discussed the anger towards the school authorities, while encouraging this girl by persuading her that she should have enough self-confidence by herself. Through such sessions, she was sure that if she continued studying to improve her own academic ability by herself she could recognize the true meaning of striving forward. and eventually, she received her parents' support who had seemed to be indifferent to her. At last she could pass the university's entrance exams for the school that she had yearned to attend. That girl ,A' visited our center 1 month later to show us her vivid face. I saw a bright smile on her face. It was shining so brightly. [source]

    The intersubjective links in perversion,

    Alberto Eiguer
    The author studies the intersubjective links which the pervert maintains with analyst or partner, attempting to indicate the differences between the investments in each case. Rather than accepting that empathy towards these patients is impossible to achieve and disturbs the countertransference profoundly, it attempts to show that these difficulties may be overcome if they are reinterpreted in the light of the theory of the intersubjective link. The author examines the theories and the practice of intersubjectivity and gives a definition of his approach to the link between two subjects. He applies these ideas to the case of a sexually masochistic female patient. The countertransference is marked successively by indifference, rejection and smothering. The analysis of the analyst's dream allows the situation to evolve. Failures in primary identification can result in domination over others and utilitarianism. The author examines the place of the challenge to the ,Law' and the father (in the attempt by the patient to put a theory to the test) in order to identify the figure of the witness in the pervert's intersubjective links. The desire of the transference would be marked by the figure of the witness rather than by that of the analyst as accomplice. [source]

    On the edge: The psychoanalyst's transference,

    Aira Laine
    Countertransference is a central topic in analytic work and in the literature. The concept of countertransference includes a basic question which has been understood in different ways. The author attempts to differentiate between the psychoanalyst's transference and his countertransference in the analytic process. It is hard to draw a line between them; analysts are always on the edge. The analyst's transference will be explored and described using three approaches: narcissism, regression profile and the analyst's phase of life. Regression profile is a new concept developed by the author, which may help us to understand the core of the analyst's transference in the analytic situation. She illustrates the topic by clinical vignettes. [source]

    Between memory and destiny: Repetition,

    This essay focuses mainly on the topic of repetition (agieren),on its metapsychological, clinical, and technical conceptions. It contains a core problem, that is, the question of the represented, the nonrepresented, and the unrepresentable in the psyche. This problem, in turn, brings to light the dialectical relation between drive and object and its specific articulation with the traumatic. The author attributes special significance to its clinical expression as ,destiny'. He points out a shift in the theory of the cure from recollection and the unveiling of unconscious desire, to the possibility of understanding ,pure' repetition, which would constitute the very essence of the drive. The author highlights three types of repetition, namely, ,representative' (oedipal) repetition, the repetition of the ,nonrepresented' (narcissistic), which may gain representation, and that of the ,unrepresentable' (sensory impressions, ,lived experiences from primal times,',prelinguistic signifiers,',ungovernable mnemic traces'). The concept-the metaphor-drive embryo brings the author close to the question of the archaic in psychoanalysis, where the repetition in the act would express itself. ,Another unconscious' would zealously conceal the entombed (verschüttet) that we are not yet able to describe-the ,innermost' rather than the ,buried' (untergegangen) or the ,annihilated' (zugrunde gegangen)-through a mechanism whose way of expression is repetition in the act. With ,Constructions in analysis' as its starting point, this paper suggests a different technical implementation from that of the Freudian construction; its main material is what emerges in the present of the transference as the repetition of ,something' lacking as history. The memory of the analytic process offers a historical diachrony whereby a temporality freed from repetition and utterly unique might unfold in the analysis. This diachrony would no longer be the historical reconstruction of material truth, but the construction of something new. The author briefly introduces some aspects of his conception of the psyche and of therapeutic work in terms of what he has designated as psychic zones. These zones are associated with various modes of becoming unconscious, and they coexist with different degrees of prevalence according to the psychopathology. Yet each of them will emerge with unique features in different moments of every analysis, determining both the analyst's positions and the very conditions of the analytic field. The zone of the death drive and of repetition is at the center of this essay. ,Pure' repetition expresses a time halted by the constant reiteration of an atemporal present. In this case, the ,royal road' for the expression of ,that' unconscious will be the act. The analyst's presence and his own drive wager will be pivotal to provide a last attempt at binding that will allow the creation of the lost ,psychic fabric' and the construction, in a conjectural way, of some sort of ,history' that may unravel the entombed (verschüttet) elements that, in these patients' case, come to the surface in the act. The analysand's ,pure' repetition touches, resonates with something of the new unconscious of the analyst. All of this leads the author to underline once again the value of the analyst's self-analysis and reanalysis in searching for connections and especially in differentiating between what belongs to the analyst and what belongs to the analysand. A certain degree of unbinding ensures the preservation of something ungraspable that protects one from the other's appropriation. [source]

    Incorporation of an invasive object

    The author discusses the experience of ,being invaded' that is sometimes communicated by certain severely disturbed patients. The complaint can sometimes be couched in terms of bodily suffering and such patients may state that they have the experience of a ,foreign body' inside. It is suggested that these patients have suffered severe early failure of containment of their projections, while at the same time they have incorporated primitive characteristics of the object that have been powerfully projected into them. An object that invades in this way, it is suggested, experiences a compulsive need to expel unbearable states of mind using others as a repository. The infant incorporates these violent projections as part of his own mental representational system, and normal identifi cation processes are disrupted. There follows impairment of the development of the sense of self. Clinical examples of how the invasive experience manifests itself in the analytic setting and in the transference and countertransference are presented. It is argued that this highly complex form of early subject-object interaction (prior to the differentiation of psyche-soma) is more likely to be found in severely narcissistically disturbed individuals. Some refl ections on the origins of invasive phenomena are given. [source]

    Narcissistic configurations: Violence and its absence in treatment

    ,On narcissism: An introduction' constitutes a turning point in psychoanalysis. Although narcissism is a concept which has not been explicitly referred to by many important thinkers for decades, it could be said that there is no paper written in psychoanalysis since Freud that does not implicitly take into account the modifi cations in thinking that the work brought about. In this paper, the author contrasts two types of narcissistic confi gurations: in the fi rst, the intolerance of the other is dealt with by expulsion and violence; in the second, by withdrawal. The author contrasts patients who express manifest violent behaviour with patients for whom the violent behaviour is absent but who, nevertheless, present similar background histories, which might have led to a prediction of violence. They are also profoundly different in terms of what they provoke in the countertransference. In addition, this paper argues that the treatment of narcissistic personalities has allowed in recent years the understanding of a modality of depression. Following Green, the author argues that, instead of a fruitless debate that involves evolutionary issues around the concept of narcissism, it is necessary to distinguish the narcissistic aspect in any analytic relationship, to identify the narcissistic transference in different types of psychopathologies. [source]

    Freudian and Lacanian approaches to the clinical case: Listening, interpretation, transference and countertransference,

    First page of article [source]

    Primal seduction, matricial space and asymmetry in the psychoanalytic encounter

    Viviane Chetrit-Vatine
    Wishing to highlight the asymmetric dimension that characterizes ethics as ,responsibility toward the other' in Levinas's philosophy, the author presents as an introduction three related concepts of Levinas's thinking: the caress, the face, the saying. Following some poetic narrative reflections offered as ,interlude' moments, the author seeks to bring together her concept of ,matricial space' inspired by Levinas's conception of ethics and the Laplanchian concept of ,primal seduction', both based on asymmetry. She suggests adding to Laplanche's proposition of two kinds of transference (filled-in transference and hollowed-out transference) a third kind: the matricial-space transference. She argues that together with the hollowed-out transference, which is related to the primal seduction, the matricial-space transference, which relates to the matricial position in the parent/analyst, is provoked by the analyst. If the hollowed-out transference assures the moving-on of the analysis, the matricial-space transference, in combination with the hollowed-out transference, is prerequisite for transformation to occur and may be deciphered specifically in ,impasse' situations, at what she coined ,subjectal moments'. As a conclusion, while insisting on the need for asymmetry in the analytic encounter, she suggests the existence in the human neonate of a need for ethics, and she questions the origin of the human capacity to be responsible toward the other. She illustrates her argument using clinical material from her own work alongside that of other authors. [source]

    Creativity and oedipal fantasy in Austen's Emma: ,An ingenious and animating suspicion'

    Margaret Ann Fitzpatrick Hanly
    Austen's Emma is one of the great novels of the Western tradition. In this paper the author explores the meaning of Emma's ,ingenious and animating suspicion' that Jane Fairfax seduced her best friend's husband, Mr Dixon. The interpretation that a psychoanalytic understanding makes possible shows how this suspicion represents an oedipal fantasy projected on to Miss Fairfax. Further exploration demonstrates how the fantasy is linked both to Emma's systematic unkindness to Jane Fairfax and to Emma's famous insult to Jane's aunt, Miss Bates. Emma's suspicion projects an oedipal fantasy with its incestuous impulses on to her rival and satisfies an envious aggression at the same time. The author's purpose in this paper is to bring to light through psychoanalytic understanding Austen's dramatisation of the complexity and creativity of the oedipal situation. In addition to the regression in oedipal fantasy, the primary process also functions with a progressive quality that expands and enriches the ego, a double movement described in Keats's ,negative capability', which has been elaborated by Bion. The primal-scene fantasies are often brought alive in the analytic transference. These situations and painful emotions are dramatically portrayed through Austen's genius as vehicles for change. A sudden integration follows a phase of disorganization: ,It darted through her with the speed of an arrow. Mr Knightley must marry no-one but herself'. Emma, who is Austen's ,imaginist', moves from the projected fantasy of the sad love triangle through envy aggression and the narcissistic blows of self-doubt and loss of love to moments of illumination and connection. [source]

    Repression, transference and reconstruction

    Harold P. Blum
    Whereas Peter Fonagy almost dismisses the importance of repression and the recovery of repressed and suppressed memory, the author believes that the analysis of repression retains importance in clinical psychoanalysis. Transference is a return of the repressed, with repressed memories embedded within a fundamental unconscious fantasy constellation. Moreover, transference is an essential, but not the only, route to the understanding and analysis of the patient. Nor should transference be confused with the real or new analytic relationship. The author does not regard the dynamic unconscious as definitely registered and retrieved in procedural memory, awaiting further research. A focus on the present ,self with other' model of therapeutic action neglects pathogenesis and the importance of childhood and its psychoanalytic reconstruction. [source]