Writing about clinical theory and psychoanalytic process.

Columbia University College of Physicians and Surgeons, New York, NY, USA.
Journal of the American Psychoanalytic Association (Impact Factor: 0.79). 01/2009; 56(4):1261-77. DOI: 10.1177/0003065108326108
Source: PubMed

ABSTRACT In the Senior Candidate Case Writing Seminar, the final component of the Writing as Pedagogy Program at the Columbia Center for Psychoanalytic Training and Research, candidates write about one of their longer training cases, with attention to the ways they use clinical theory, particularly transference and countertransference, to deepen their understanding of psychoanalytic process and therapeutic action. Building on the previous four years of the writing program, this seminar teaches advanced candidates to recognize and integrate the lived experience of conducting an analysis, the micro- and macroprocesses, and the theories most relevant to an understanding of the analytic work. The seminar emphasizes the challenge of dealing with the power of the transference, unrecognized or unacknowledged countertransference, and the nature of therapeutic action. Pedagogical emphasis is placed on peer group discussions and group learning, and common problems in integrating theory and practice are described and illustrated.

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    ABSTRACT: This paper adopts the standpoint that psychoanalytic theory has been in a state of continuous organic development from the beginning, with states of theoretical strain being generated with each new advance in theory. The meaning of concepts becomes stretched, and psychoanalysts develop implicit theories, concepts and definitions that differ from the 'official' or 'public' formulations. While flexible concepts play an important part in psychoanalytic theory, it should be accepted that each may have a number of dimensions of meaning, and that these dimensions may differ from one psychoanalyst to another. Research should be directed towards making explicit the implicit concepts of practising psychoanalysts, and it is suggested that this process will result in the accelerated development of psychoanalytic theory. The essentials of that theory must be those aspects which relate to the work the psychoanalyst has to do, and therefore its main emphasis needs to be clinical. In the second part of the paper, the expansion of the concept of transference with the introduction of defence analysis is discussed, with particular reference to the class of object-related defences, which involve some combination of identification and projection. It is argued that major changes in technical emphasis brought about the extension of the transference concept, which now has dimensions of meaning which differ from the official definition of the term. Finally, three areas among many in which there is a significant distance between theory and practice are discussed. The public and official theories relating to drives, conflict, and internal object-relationships and transference are discussed, and suggestions made in regard to possible developments which might lessen the gap between the public theories and the implicit private clinical formulations of the practising psychoanalyst.
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