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
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: A national survey of candidates was conducted to identify motivations for pursuing psychoanalytic training, obstacles that prevent progression or completion, and candidates' ideas on how best to increase interest among potential trainees. In 2009-2010, 40 percent of candidates on the affiliate member e-mail list completed an anonymous web-based survey. Candidates strongly endorsed contact with a personal psychotherapist, psychoanalyst, or supervisor as the most important influence in discovering psychoanalysis and deciding to pursue training. They identified the total cost of analytic training as the greatest obstacle. This was followed by the cost of personal analysis, loss of income for low-fee cases, time away from family, and difficulty finding cases. To enhance training, local institutes should work to improve institute atmosphere and provide assistance with finding cases; national organizations should increase outreach activities and publicize psychoanalysis. Psychoanalytic institutes could recruit future candidates by working to increase personal contact with psychoanalysts, reducing the cost of training, improving institute atmosphere, assisting with case-finding, enhancing outreach activities, and widely publicizing psychoanalysis. Narrative comments from candidates and the implications of these findings regarding engagement of future trainees are discussed.
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ABSTRACT: Application of a computerized text analysis procedure is proposed that has the potential for use by psychoanalytic and psychodynamic clinicians: the systematic examination of linguistic style as reflected by clinicians in their ongoing process and case notes, which are ubiquitous in the mental health field. The studies reported here are, as far as is known, the first attempts to study treatment notes systematically using such procedures. Linguistic measures are used to track the trajectory of the clinical process throughout the treatment in two contrasting cases, one rated successful, the other not. The computerized linguistic analysis used here focuses on two analytically relevant linguistic variables: Mean High Referential Activity (MHW), a measure of the degree to which language is connected to emotional processing, and Reflection (REF), the use of words referring to logical functions. Changes in the relative position of these measures indicate nodal points in the treatment that might be analytically or therapeutically problematic, and that might be overlooked in a solely clinical reading. The analyst's activity as reported in notes during such nodal periods is clinically examined to see how it may have affected the course of the analysis. This method has the potential for use in ongoing treatments, and may help clinicians refine their interventions.
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