'Strong clinging to objects': materiality and relationality in Melanie Klein's Observations after an Operation (1937)

This article presents and analyses a set of notes written by the psychoanalyst Melanie Klein following an operation in 1937. The notes, entitled Observations after an Operation, act as a case study of the intersection of psychical, material and social relations as they play out in the immediate aftermath of surgical intervention. Using a close reading method, the article contextualises an analysis of Observations after an Operation by linking it to Klein’s wider corpus of theoretical work. It deals in turn with the representation of anxiety mechanisms in the patient experience, drawing upon Klein’s notes on the similarity with ‘anxiety-situations’ in early childhood; with Klein’s changed relation with both external objects and their counterparts in the individual’s mental landscape; with the role of sensation in phantasy, and the connection to bodily pain; with the doctor-patient relationship and the way this is perceived as being embodied in material objects, played out across two dreams experienced by Klein during her recovery; with the emphasis on illness as a form of mourning; and with the creative potential that the experience offers for a renewed structure of object relations. The article concludes that a greater attention to the role and representation of material objects, using psychoanalytic object relations theory as a starting point, can enhance how we collectively understand and assess the psychical impact of healthcare settings upon the patient. It also invites other scholars across the critical medical humanities to consult and analyse the newly available text upon which this article is based.

Processing trauma in psychoanalysis in 'real' time and in dreams: the convergence of past, present and future during COVID-19

In the current collective unrest, we and our analysands are living in real time and need vantage points from which to make meaning, as subjective experience of time is collapsing. For many analysands, the past is being relived in the present, with no imaginable future. During the time of COVID‐19, dreams are providing a valuable mechanism in working with atemporal emotional trauma, previously uncontextualized. Dream metaphor can provide a transitional space to move around in within the analytic framework. This paper explores a variety of dreams from individual analysands demonstrating different ways of conceptualizing personal and collective experience, bridging between the past, present, and future. Parallels between feeling states related to the current condition and unprocessed implicit memories from the past will be examined, as a vehicle for processing past trauma. Dreams expressing current states of dread for an unimaginable future, as well compensatory dreams showing a hopeful vision of the future will be considered.

Psychoanalysis and Interdisciplinarity With Non-analytic Psychotherapeutic Approaches Through the Lens of Dialectics

Psychoanalysis, in its purist mainstream sense, tends to be considered as an isolationist discipline that steers clear of interdisciplinary connections with other psychotherapies. Its drive for purity does not open up to influences that cast as alien and a threat to its core principles. We refer to Hegelian dialectics in an attempt to offer an alternative approach to interdisciplinarity in clinical psychoanalysis. Psychoanalysis entertains a complex dialectical relationship with the major theories it opposes. In this dynamic, psychoanalysis begins by negating the non-psychoanalytic theory as a part of self-negation (Hegel calls this phase self-alienation). But in its own process of growth, it negates this negation and reabsorbs the alienated self part. Reabsorbing the negated component, psychoanalysis does not revert to its original identity but becomes sublated into a different, more complex idea. In this epistemological process, psychoanalysis deals with its own practical and theoretical anomalies and lacunas. The paper illustrates this process using three central developments in the history of psychoanalysis: empathy in self psychology (connection with Rogers' humanist psychology), short-term dynamic psychotherapy (connection with short, intensive therapies), and mentalization-based psychotherapy (connection with cognitive-behavioral therapies). In all of these cases, psychoanalysis integrates components it previously opposed and changes these components to their own, specific characteristics. We address the epistemological shifts in the scientific status of psychoanalysis and show their connection to dialectics. Finally, we conclude that dialectical development is what allows psychoanalysis to remain relevant and up to date, to be open to interdisciplinary influences without its identity and tradition coming under threat.

Interoception Disorder and Insular Cortex Abnormalities in Schizophrenia: A New Perspective Between Psychoanalysis and Neuroscience

The existence of disturbances in the perception of somatic states and in the representation of the body with the presence of cœnesthetic hallucinations, of delusional hypochondriac ideas or of dysmorphophobias is a recognized fact in the psychopathology of schizophrenia. Freudian psychoanalytic theory had accorded a privileged place to the alteration of the perception of the body in schizophrenia. Freud had attributed to these phenomena a primary and prodromal role in the psychopathology of psychosis. We propose to look at this theory in a new way, starting from the perspective of recent studies about the role of the insula in the perception and representation of somatic states, since this structure has been identified as underpinning the sense of interoception. The data in the neurobiological literature about abnormalities in the insular cortex in schizophrenia has shown that insula dysfunction could constitute one of the biological substrates of disorders of body perception in schizophrenia, and could be a source of the alteration of the sense of self that is characteristic of this psychiatric pathology. Moreover, this alteration could thus be involved in the positive symptomatology of schizophrenia.

Castration fever: On trans, China, and psychoanalysis

This essay considers the evolution of the author's research over the last 15 years in which the treatment of castration as a historical problem holds promise for bridging disparate scholarly fields and paradigms. In particular, by tracing the shift in the author's intellectual focus from the science of sex change to the history of transcultural psychoanalysis, some insights are offered in regard to the intertwined politics of transness, Chineseness, and the unconscious. Though psychoanalysis may appear as a subject far removed from the eunuchs of ancient China, this essay highlights some of the methodological stakes that have saturated the historical study of both topics. These reflections can serve as a touchstone for thinking beyond disciplinary norms and conventions, especially in Chinese studies and the history of science.

[Reconversions of hysteria]

What has become of the hysterics of yesteryear? Despite the evolution of nosographic categories, their symptoms cannot be reduced to this, and they invite all clinicians to listen to the power of their words to express the effects of the unconscious. Disappointed lovers, worshippers of knowledge, they challenge those who would try to squeeze them into overly restrictive diagnostic boxes, to silence their truth. For they embody in their tribulations the effects of language on the being, a metonymy that they wear on their bodies. Their posture invites us to listen to the singularity of each case by highlighting the dignity of the symptom.

[The hysterical 'truth strike' and the questions it addresses to the contemporary master]

Today's hysteria, contemporary with its clinical disappearance from current nomenclatures relayed by neuroscience, is scattered in the 'catch-all' categories of conversion disorders, histrionic personality, etc. These approaches convey what Jacques Lacan called the foreclosure of the subject, or what amounts to saying, its rejection or oblivion, in particular in the relationship to knowledge and to the jouissance of the symptom. The Freudian discovery of the unconscious, and its studies on hysteria, which made hysterical conversion a message to be deciphered, is reduced in the contemporary clinic to the dimension of a disorder to be and no longer to be interpreted, because interpretation implies the subject, its word. Fortunately for the clinic, hysteria has other strings to its bow in which the subject ultimately finds his word.

Thoughts on Transference Analysis in Transference-Focused Psychotherapy

Transference-focused psychotherapy (TFP) represents a specific extension of psychoanalytic therapy for treatment of individuals with personality disorders, who may be helped without the more significant time investment required of a standard psychoanalysis. The treatment represents a contemporary formulation of psychoanalytic psychotherapy, updated in light of both empirical research and scientific developments in boundary fields close to the psychodynamic endeavor, particularly affective neuroscience and the psychology of couples and small groups. In TFP, the transference signifies the enactment in the here and now of a specific affective relationship between patient and therapist that reflects one aspect, defensive or impulsive, of a pathogenic dynamic unconscious conflict. This conflict needs to be analyzed, interpreted, and resolved. Various elements of transference analysis in TFP are discussed in this article.

Infanticide and the influence of psychoanalysis on Dutch forensic psychiatry in the mid-twentieth century

This article demonstrates how psychoanalytic thought, especially ideas by Adler, Reik, Deutsch, and Alexander and Staub, informed forensic psychiatry in the Netherlands from the late 1920s. An analysis of psychiatric explanations of the crime of infanticide shows how in these cases the focus of (forensic) medicine and psychiatry shifted from somatic medicine to a psychoanalytic emphasis on unconscious motives. A psychoanalytic vocabulary can also be found in the reports written by forensic psychiatrists and psychologists in court cases in the 1950s. The new psychoanalytic emphasis on unconscious motives implied a stronger focus on the personality of the suspect. This article argues that psychoanalysis accelerated this development in the mid-twentieth century, contributing to the role of the psy-sciences in normalization processes.

Empathy: Expanding the Capacity for Humanness and Freedom

This paper elaborates on the implications of Heinz Kohut's radical revision of the concepts of introspection and empathy for psychoanalytic practice and therapeutics. I focus on three of Kohut's papers: "Introspection, Empathy, and Psychoanalysis," published in 1959, and its follow-up, "On Empathy", and "Introspection, Empathy, and the Semi-Circle of Mental Health," both published in 1981. Specifically, I address the importance of the analysand's introspective capacity as an active element in the therapeutic process augmented by the empathy of the analyst in the form of understanding and interpretation. Analysands enter psychoanalysis because they are aware that they cannot solve the problems with which they suffer or access the selfobject milieu that would help them. Through analysis patients' capacity for introspection and action is broadened and deepened, allowing them to understand and deal creatively with their problems, particularly their inability to fulfill the potential of their self.

Psychology qua psychoanalysis in Argentina: Some historical origins of a philosophical problem (1942-1964)

Contemporary Argentinian psychology has a unique characteristic: it is identified with psychoanalysis. Nonpsychoanalytic theories and therapies are difficult to find. In addition, there is an overt antiscientific attitude within many psychology programs. How should this be explained? In this paper, we claim that a philosophical history of psychology can shed new light on the development of Argentinian psychology by showing that early Argentinian psychoanalysts held positions in the newborn psychology programs and a distinctive stance toward scientific research in general and psychology in particular. In the absence of an explicit and articulate philosophical position, psychoanalysts developed an implicit meta-theory that helped shape the context that led to the institutionalization and professionalization of psychology in Argentina. Although we do not establish or even suggest a monocausal link between their ideas and the current state of Argentinian psychology, we do claim that their impact should be explored. Finally, we discuss some limitations of our study and suggest future complementary investigations.

On Difference and the "Beyond Psychotherapy" of Psychoanalytic Method: The Pivotal Issue of Free-associative Discourse as De-repressive Praxis

It is argued that, in the course of the history of psychoanalysis since 1914 or thereabouts, the clinical and theoretical interests of psychotherapy have occluded our comprehension of the radicality of the free-associative method that is special to psychoanalysis. Setting aside the entirety of the range of endeavors that we might call "psychotherapy," this essay defines critically the practices of "psychoanalytically-informed therapies" and distinguishes them from Sigmund Freud's "analysis" that is tied to the unique method by which he discovered the inherent repressiveness of self-consciousness. This thesis implies that the human psyche can neither be properly understood nor healed by theory-driven techniques that prioritize epistemological considerations. Rather the liberatory potential of psychoanalytic praxis must be grasped as an "onto-ethical discipline," by which the ideological commitments of therapy might be subverted.

Is the Influence of Freud Declining in Psychology and Psychiatry? A Bibliometric Analysis

Sigmund Freud is occasionally perceived as outdated and his work no longer relevant to academia. The citing papers (CPs) that cited Freud works were collected from Web of Science and analyzed. The 10 most common research areas of the CPs were noted, and the overall volume of the respective bodies of literature were retrieved. I computed the annual percentage of the respective bodies of literature that cited Freud. On a separate note, I computed the annual percentage of citations coming from psychology and psychiatry. Results based on 42,571 CPs found that psychology accounted for over half of the citations to Freud. The percentage of psychology papers citing Freud declined gradually from around 3% in the late 1950s to around 1% in the 2010s, in an extent of −0.02% per year over the entire survey period spanning across 65 years from 1956 till 2020 (P < 0.001). In psychiatry, a similar decline was observed, from around 4–4.5% in the late 1950s to just below 0.5% in the 2010s, in an extent of −0.1% per year (P < 0.001). However, a reverse trend was observed for psychoanalysis literature, which generally increased from 10–20% before the 1980s to 25–30% since the 2000s, in an extent of +0.2% per year (P < 0.001). Meanwhile, the annual percentage of CPs coming from psychology and psychiatry was decreasing by 0.4% per year (P < 0.001). Bibliometric data supported the notion that Freud's influence was on a decline in psychology and psychiatry fields.

ICD-11 Personality Disorders: A Psychodynamic Perspective on Personality Functioning

The new ICD-11 introduces a fully dimensional classification of personality disorders representing a fundamental change in personality disorder diagnosis with major implications for clinical practice and research. The new system centers on the evaluation of the severity of impairment in the areas of self and interpersonal functioning. This focus on personality functioning converges with long-standing psychoanalytic/psychodynamic conceptualizations of personality pathology. In a detailed conceptual analysis and review of existing empirical data, points of convergence and notable differences between major exponents of the psychodynamic tradition-object relations theory as developed by Kernberg et al. and the Operationalized Psychodynamic Diagnosis-and the ICD-11 system are critically discussed. Personality functioning can be considered to be the current "common ground" for the assessment of personality disorders and constitutes a considerable step forward in making personality disorder diagnosis both clinically meaningful and suitable for research purposes.

Part 2

The paper sets out to present Doctor Ludwik Jekels' activity for the development of psychoanalysis in Poland between 1909 and 1914. The second part of the paper focuses mainly on the period of 1911-1912 when Ludwik Jekels was the most active in promoting psychoanalysis. The article also includes the discussion of Jekels' book publications including two translations of Sigmund Freud's works and the first Polish publication on psychoanalysis entitled Szkic psychoanalizy Freuda (An Outline of Freud's Psychoanalysis). The reactions of the scientific circles, particularly those associated with the Lviv School of Psychology, were also analyzed. The access to previously unpublished sources allowed the authors, for the first time, to report on Jekels' educational activity in Krakow and Lviv. The sources also gave insight to Jekels' completely unknown actions to promote psychoanalysis in Cieszyn Silesia. Jekels' lectures were followed by a wide range of reactions from the public with the medical community increasingly criticizing psychoanalysis. The pinnacle of Jekels' activity was the Second Congress of Polish Neurologists, Psychiatrists and Psychologists was organized in Krakow in 1912. It was the culmination in the discussion on the place of psychoanalysis in the Polish science. The paper presents the participants of the psychoanalytic session with a special focus on Dr Jekels' contribution, the way how psychoanalysis discussion was conducted and the effects of the congress on further development of psychoanalysis. In conclusion an attempt was made to assess the overall significance of Dr Jekels' activities in Poland.

Potential Space in Hospitals: Insight From a Health Psychologist

OBJECTIVE

Humanization is a challenge for the future of healthcare. Architecture may play a major role in designing spaces that enhance communication and help the patient to maintain mental health during physical illness. Health psychologists struggle to find adequate space for taking care of their patients. There is an urgent need to better define how relational space, defined here as potential, can be guaranteed in everyday hospital psychological consultations.

BACKGROUND

The author relates to his work as a health psychologist and psychotherapist in a consultation-liaison psychiatry (CLP) service operating in a general hospital in Lugano (Switzerland).

METHODS

An autoethnographic method is applied through calling on childhood memories on architecture and analyzing insights regarding the healthcare space in everyday work as a psychologist. Photographs and drawings are employed as evocative material.

RESULTS

Autoethnographical data show that building interiors can be a metaphor for an inner dimension. Spaces can be perceived as depersonalized in hospital. Through psychoanalytical theory, it is argued that space becomes ideal for CLP if it can ensure the continuity of the patient's self during hospitalization. Proximity, confidentiality, and privacy are healthcare design requirements to be considered for favoring potential space and psychological intervention.

CONCLUSION

Fostering potential space represents an outstanding challenge for the hospital of tomorrow in order to humanize healthcare spaces and promote a person-centered approach.

Part 1

The paper sets out to present Dr Ludwk Jekels' activity for the development of psychoanalysis in Poland between 1909 and 1914. Ludwik Jekels was the first Polish psychoanalyst and the first translator of Sigmund Freud's works into Polish. Throughout numerous years he gained his psychoanalytic skills in the classical Viennese school of psychoanalysis while attending lectures conducted by Freud himself. The article analyses a number of previously unknown and unpublished historical sources (e.g., Ludwik Jekels' memories and correspondence as well as daily newspapers and scientific journals). The research allowed the current knowledge of Dr Jekels' activity and achievements in his early career as a psychoanalyst to be significantly complemented. The first part of the paper presents briefly Dr Jekels' professional development and the causes why he gained interest in psychoanalysis. A little-known period of psychoanalytic activity prior to his first public presentations in Krakow and Warsaw in 1909 was reconstructed. The article includes a detailed review of Jekels' first lectures on psychoanalysis, including one which has been completely unknown to the historians of medicine. The varied reactions of the Polish neurologists and psychiatrists' to Jekels' promoting activity and psychoanalysis itself were critically assessed.

Psychosocial curating: a theory and practice of exhibition-making at the intersection between health and aesthetics

A recent Manifesto for a Visual Medical Humanities suggested that more in-depth analysis of the contribution of visual art to medical humanities is urgently required. This need perhaps arises because artists and curators experience conflict between the experimental approaches and tacit knowledge that drive their practice and existing audience research methods used in visitor studies or arts marketing. In this paper, I adopt an innovative psychosocial method-uniquely suited to evidencing aesthetic experiences-to examine how an exhibition of my own curation facilitated audiences to undertake psychological processing of complex ideas about mental distress. I consider the curator working in a health context as a creator of care-driven environments where complex affects prompted by aesthetic approaches to illness can be digested and processed. My definition of care is informed by psychosocial studies and object relations psychoanalysis, which allows me to approach my exhibitions as supportive structures that enable a spectrum of affects and emotions to be encountered. The key argument of the paper is that concepts from object relations psychoanalysis can help to rethink the point of entanglement between curating and health as a process of preparing the ground for audiences to do generative psychological work with images and affects. The case study is Group Therapy: Mental Distress in a Digital Age, an exhibition that was iterated at FACT (Foundation for Art and Creative Technology), UK and University of New South Wales Galleries Sydney, with an emphasis on audience response to key artworks such as Madlove-A Designer Asylum (2015) by the vacuum cleaner and Hannah Hull. It is hoped that this paper will help to reaffirm the significance of curating as a cultural platform that supports communities to live with the anxieties prompted by society's most complex medical and social issues.

Positioning Shifts From Told Self to Performative Self in Psychotherapy

According to Positioning Theory, participants in narrative interaction can position themselves on a representational level concerning the autobiographical, told self, and a performative level concerning the interactive and emotional self of the tellers. The performative self is usually much harder to pin down, because it is a non-propositional, enacted self. In contrast to everyday interaction, psychotherapists regularly topicalize the performative self explicitly. In our paper, we study how therapists respond to clients' narratives by interpretations of the client's conduct, shifting from the autobiographical identity of the told self, which is the focus of the client's story, to the present performative self of the client. Drawing on video recordings from three psychodynamic therapies (tiefenpsychologisch fundierte Psychotherapie) with 25 sessions each, we will analyze in detail five extracts of therapists' shifts from the representational to the performative self. We highlight four findings:

• Whereas, clients' narratives often serve to support identity claims in terms of personal psychological and moral characteristics, therapists rather tend to focus on clients' feelings, motives, current behavior, and ways of interacting.

• In response to clients' stories, therapists first show empathy and confirm clients' accounts, before shifting to clients' performative self.

• Therapists ground the shift to clients' performative self by references to clients' observable behavior.

• Therapists do not simply expect affiliation with their views on clients' performative self. Rather, they use such shifts to promote the clients' self-exploration. Yet, if clients resist to explore their selves in more detail, therapists more explicitly ascribe motives and feelings that clients do not seem to be aware of. The shift in positioning levels thus seems to have a preparatory function for engendering therapeutic insights.

We other narcissists: self-love in Freud and culture

I examine the paradoxical place of narcissism in contemporary culture, and within the work of Freud. Paying close attention to the repeated moments of equivocation and contradiction within Freud's descriptions of primary and secondary narcissism, I draw on the work of Jean Laplanche, who suggests that the ambiguities in Freud's texts often mirror ambiguities within the constitution of the ego. I argue that we should read Freud's inability to rigorously distinguish self from other in his explications of self-love not - or not only - as a failure on his part, but also as a trace of an alterity at the heart of identity. It is the very 'failure' of Freud's concept of narcissism that leaves it open to the other and makes it remain a vital concept today, when the word narcissism has been reduced to an impoverished notion of self-obsession. In closing I suggest that, with his knotted and never fully coherent concept of narcissism, Freud provides us with a way of thinking about human relationships outside of the binaries of selfless v selfish love that so commonly constrain our popular and theoretical ideas about love.

[Acting out in the four psychic structures]

To try to understand acting out, it depends of conciliation between the reality of the act and the psychic life. For that, it is necessary to listen the word of the criminal authors. What transgression represents for them? Based on clinical experience in a correctional center, this article takes a closer look about prisoner, incarcerated after having committed criminal acts. This clinical material could help to raise a new perspective around modern psychopathology. What is the act's difference between neurosis, perversion, borderline and psychosis? Our research will try to differentiate the psychic issues.

Creativity and positive psychology in psychotherapy

Creativity is the ability to produce something novel and useful that is a valuable contribution to a specific domain. It is a significant common factor in most forms of psychotherapy. Accordingly, it is essential to investigate its role both in psychotherapy in general and in specific approaches like relational, cognitive-behavioural, psychodynamic, systemic, and existential psychotherapy. Positive psychology in particular has pointed up the usefulness of creativity in psychotherapy. Here we draw upon a case example to show how the creative discovery of novel and useful solutions takes place in different dimensions: relational, behavioural, psychodynamic, systemic and existential. The case description demonstrates how principles of positive psychology are useful in many realms of psychotherapy. We propose an integrated model of psychotherapy that brings together different psychotherapeutic methods and is based on interdisciplinary creativity research. The integration of neuroscientific, psychological and cultural findings produced by creativity research can be expected to lead to a deeper understanding of psychotherapeutic, positive-psychological, and creative processes.

On Kuhn's case, and Piaget's: A critical two-sited hauntology (or, On impact without reference)

Picking up on John Forrester's (1949-2015) disclosure that he felt 'haunted' by the suspicion that Thomas Kuhn's (1922-96) interests had become his own, this essay complexifies our understanding of both of their legacies by presenting two sites for that haunting. The first is located by engaging Forrester's argument that the connection between Kuhn and psychoanalysis was direct. (This was the supposed source of his historiographical method: 'climbing into other people's heads'.) However, recent archival discoveries suggest that that is incorrect. Instead, Kuhn's influence in this regard was Jean Piaget (1896-1980). And it is Piaget's thinking that was influenced directly by psychoanalysis. Psychoanalysis then haunts Kuhn's thinking through Piaget, and thus Piaget haunts Forrester through Kuhn. To better understand this second site of the haunting-which is ultimately the more important one, given the intent of this special issue-Piaget's early psychoanalytic ideas are uncovered through their interaction with his early biology and subsequent turn to philosophy. But several layers of conflicting contemporary misunderstandings are first excavated. The method of hauntology is also developed, taking advantage of its origins as a critical response to the psychoanalytic discourse. As a result of adopting this approach, a larger than usual number of primary sources have been unearthed and presented as evidence (including new translations from French originals). Where those influences have continued to have an impact, but their sources forgotten, they have thus been returned. They can then all be considered together in deriving new perspectives of Forrester's cases/Kuhn's exemplars/Piaget's stages.

'Containment, delay, mitigation': waiting and care in the time of a pandemic

In this paper, we take up three terms - containment, delay, mitigation - that have been used by the UK Government to describe their phased response to the COVID-19 pandemic. Although the terms refer to a political and public health strategy - contain the virus, flatten the peak of the epidemic, mitigate its effects - we offer a psychosocial reading that draws attention to the relation between time and care embedded in each term. We do so to call for the development of a form of care-ful attention under conditions that tend to prompt action rather than reflection, closing down time for thinking. Using Adriana Cavarero's notion of 'horrorism', in which violence is enacted at precisely the point that care is most needed, we discuss the ever-present possibility of failures  within acts of care. We argue that dwelling in the temporality of delay can be understood as an act of care if delaying allows us to pay care-ful attention to violence. We then circle back to a point in twentieth-century history - World War II - that was also concerned with an existential threat requiring a response from a whole population. Our purpose is not to invoke a fantasised narrative of 'Blitz spirit', but to suggest that the British psychoanalytic tradition born of that moment offers resources for understanding how to keep thinking while 'under fire' through containing unbearable anxiety and the capacity for violence in the intersubjective space and time between people. In conditions of lockdown and what will be a long and drawn-out 'after life' of COVID-19, this commitment to thinking in and with delay and containment might help to inhabit this time of waiting - waiting that is the management and mitigation of a future threat, but also a time of care in and for the present.

Freud and Albert Moll: how kindred spirits became bitter foes

This article explores the antagonism between Sigmund Freud and the German neurologist and sexologist Albert Moll. When Moll, in 1908, published a book about the sexuality of children, Freud, without any grounds, accused him of plagiarism. In fact, Moll had reason to suspect Freud of plagiarism since there are many parallels between Freud's Drei Abhandlungen zur Sexualtheorie and Moll's Untersuchungen über die Libido sexualis. Freud had read this book carefully, but hardly paid tribute to Moll's innovative thinking about sexuality. A comparison between the two works casts doubt on Freud's claim that his work was a revolutionary breakthrough. Freud's course of action raises questions about his integrity. The article also critically addresses earlier evaluations of the clash.

The Active Room: Freud's Office and the Egyptian Tomb

The present study examines the striking similarities between the architectural design and spatial composition of the ancient Egyptian tomb and Sigmund Freud’s office at Berggasse 19 in Vienna, Austria. I argue that the Egyptian tomb elements represented within Freud’s office permitted the enclosed space to play an active role in his psychoanalysis sessions. I supplement this argument by analyzing the office’s spatial and architectural arrangements in relation to ancient Egyptian architectural frameworks, psychoanalytic container theory (Freud, Danze, and Quinodoz), and Freud’s archeological metaphor model. This study contributes to the greater body of work on architecture as an active entity, psychoanalysis, and ancient Egyptian history.

The Digital Phenotyping Project: A Psychoanalytical and Network Theory Perspective

A new method of observation is currently emerging in psychiatry, based on data collection and behavioral profiling of smartphone users. Numerical phenotyping is a paradigmatic example. This behavioral investigation method uses computerized measurement tools in order to collect characteristics of different psychiatric disorders. First, it is necessary to contextualize the emergence of these new methods and to question their promises and expectations. The international mental health research framework invites us to reflect on methodological issues and to draw conclusions from certain impasses related to the clinical complexity of this field. From this contextualization, the investigation method relating to digital phenotyping can be questioned in order to identify some of its potentials. These new methods are also an opportunity to test psychoanalysis. It is then necessary to identify the elements of fruitful analysis that clinical experience and research in psychoanalysis have been able to deploy regarding the challenges of digital technology. An analysis of this theme’s literature shows that psychoanalysis facilitates a reflection on the psychological effects related to digital methods. It also shows how it can profit from the research potential offered by new technical tools, considering the progress that has been made over the past 50 years. This cross-fertilization of the potentials and limitations of digital methods in mental health intervention in the context of theoretical issues at the international level invites us to take a resolutely non-reductionist position. In the field of research, psychoanalysis offers a specific perspective that can well be articulated to an epistemology of networks. Rather than aiming at a numerical phenotyping of patients according to the geneticists’ model, the case formulation method appears to be a serious prerequisite to give a limited and specific place to the integration of smartphones in clinical investigation.

Gazing Back, Playing Forward: Contemporary Psychoanalytic Musings on the Relational Essence of Hypnotherapeutic Action

To build bridges between hypnosis and contemporary psychoanalysis, this article addresses how hypnosis, when used in psychotherapy, facilitates curative action through its relational essence. The author's extensive experience with hypnosis, psychotherapy, and psychoanalysis orient the narrative toward the unconscious patient-therapist interaction, with particular attention paid to the ethics of the inherent hypnotic seduction. Whether used primarily in relief-oriented ways or geared toward more transformative therapeutic aims, powerful unconscious factors are in play for both patient and therapist and are explicated to illustrate the interactive and frequently unformulated, intersubjective factors that facilitate effective, psychotherapeutic hypnosis. Consequently, therapists attuned to such intersubjective dynamics can make use of their own internal mental activities to understand a patient's current state of mind and level of developmental functioning, and thereby subsequently formulate mutative interventions. For instance, because hypnotizability reflects the ability to play in imaginative space, the regression promoted in hypnotherapy may activate both an illusion of omnipotence and its optimal disillusionment through the relational context. This requires going beyond more traditional, procedural ways of bifurcating hypnotic interventions as being either direct or indirect and instead further distinguish hypnotic interventions in accordance with their maternal and paternal relational dimensions. Arguably, then, the skillful hypnotherapist needs to maintain a coupling interplay between the maternal, maximally receptive and the paternal, more active modes of functioning within hypnotic play space.

Dancing in the In-Between: Hypnosis, Transitional Space, and Therapeutic Action

This article develops the idea that hypnosis is an interactive phenomenon occurring in a relational matrix. A tripartite model for explicating this relational matrix is presented, which includes a discussion of transference, contemporary relationship factors, and the interaction of these to produce a sense of therapeutic alliance. These relationship factors are central to the therapeutic action of hypnosis as a vehicle to potentiate change and growth. The unique and specific contribution of each of these factors to the process of hypnotherapy and to therapeutic action is examined. Phenomenologically, this relational interaction is conceptualized as occurring in transitional space, shaped by processes of regression and attunement. From this perspective, the hypnotherapist is viewed as a kind of transitional object whose empathic presence contains and facilitates those interactive phenomena which evoke and balance the transferential and contemporary aspects of the relationship and which allow for uniquely evocative developmentally focused interventions in trance work. Several examples are presented from an ongoing case that demonstrate how these relational variables shape the hypnotherapeutic process and how they can be used for uncovering and self-examination, for structural maturation, for affect regulation, and for emerging ego mastery. The therapeutic action demonstrated relies on hypnotic interventions rooted in the various components of the relational matrix made possible by the clinician's awareness of and attunement to these and by hisor her informed and sensitive management of them and of his or her own intersubjectivity. Specific strategies are presented via these examples to effectively utilize this experience in the service of treatment goals.

'Containment, delay, mitigation': waiting and care in the time of a pandemic

In this paper we take up three terms - containment, delay, mitigation - that have been used by the UK Government to describe their phased response to the COVID-19 pandemic. Although the terms refer to a political and public health strategy - contain the virus, flatten the peak of the epidemic, mitigate its effects - we offer a psychosocial reading that draws attention to the relation between time and care embedded in each term. We do so to call for the development of a form of care-ful attention under conditions that tend to prompt action rather than reflection, closing down time for thinking. Using Adriana Cavarero's notion of 'horrorism', in which violence is enacted at precisely the point that care is most needed, we discuss the ever-present possibility of failures  within acts of care. We argue that dwelling in the temporality of delay can be understood as an act of care if delaying allows us to pay care-ful attention to violence. We then circle back to a point in twentieth-century history - World War II - that was also concerned with an existential threat requiring a response from a whole population. Our purpose is not to invoke a fantasised narrative of 'Blitz spirit', but to suggest that the British psychoanalytic tradition born of that moment offers resources for understanding how to keep thinking while 'under fire' through containing unbearable anxiety and the capacity for violence in the intersubjective space and time between people. In conditions of lockdown and what will be a long and drawn-out 'after life' of COVID-19, this commitment to thinking in and with delay and containment might help to inhabit this time of waiting - waiting that is the management and mitigation of a future threat, but also a time of care in and for the present.

Waiting for other people: a psychoanalytic interpretation of the time for action

Typical responses to a confrontation with failures in authority, or what Lacanians term 'the lack in the Other', involve attempts to shore it up. A patient undergoing psychoanalysis eventually faces the impossibility of doing this successfully; the Other will always be lacking. This creates a space through which she can reimagine how she might intervene in her suffering. Similarly, when coronavirus forces us to confront the brute fact of the lack in the Other at the socio-political level, we have the opportunity to discover a space for acting rather than continuing symptomatic behaviour that increasingly fails to work.

Childhood Trauma, Personality, and Substance Use Disorder: The Development of a Neuropsychoanalytic Addiction Model

BACKGROUND

While traditional psychoanalysis has been criticized as insufficient for the treatment of substance use disorder (SUD), recent progress in the field of neuropsychoanalysis has generated new and promising hypotheses regarding its etiology. However, empirical research applying this framework has been sparse.

AIM AND SCOPE

The present overview aims at developing and empirically validating a neuroscientifically informed psychodynamic framework regarding the etiology of SUD. For this purpose, this review provides a concise overview of the most relevant historical and contemporary psychoanalytic theories on SUD etiology. Furthermore, the original research summarized in this paper consists of three studies investigating connections between childhood trauma, primary emotions, personality structure and attachment, as well as their relation to SUD development and treatment.

CONCLUSIONS

The results highlight the empirical validity of the neuropsychoanalytic approach towards SUD etiology. In particular, the findings underscore the conceptualization of SUD as a disorder related to dysfunctional attachment and affect regulation abilities especially linked to increased SADNESS and ANGER dispositions, which mediated the relationship between SUD and traumatic childhood relationships. Based on these findings, a refined model of SUD etiology is proposed, which should be tested in future studies.

Mysteries of the Psychoanalytic Process: Reflections on Chaos, Complexity, and Emergence

Psychoanalysis is inherently messy and mysterious. The mysteries of the psychoanalytic process are viewed through the lens of chaos and complexity theory. The analyst-analysand relationship is an example of a nonlinear dynamic system, meaning that it is continuously changing, adapting and coevolving; deterministic predictability is lost in the process of continuous adaptation. The fractal nature of the psychoanalytic relationship and the emerging qualities that arise from its self-organizing system and from bottom-up therapeutic approaches are explored and examined in relationship to the nature of healing. The analyst must tolerate chaos, uncertainty, and messiness for the healing process to naturally emerge. In addition, the age-old question of free will versus determinism is examined from the perspective of complexity theory.

Bound Together: How Psychoanalysis Diminishes Inter-generational DNA Trauma

The concept of intergenerational transmission of trauma plays a fundamental role in psychoanalysis. While it is known that intergenerational trauma can be transmitted through attachment relationships, a new branch of genetics (epigenetics) has emerged to study the interaction between human behavior and changes in DNA expression. Therefore, psychoanalysis, which has proven to reduce the intergenerational transmission of trauma from a behavioral perspective, can play a positive role in regulating DNA changes caused by environmental stress. The present paper focuses on recent research suggesting a direct correlation between psychological trauma and DNA modifications. In particular, DNA changes caused by psychological trauma can be transmitted from generation to generation, validating the psychoanalytic concept of intergenerational transmission of trauma. This evidence not only supports the essential role psychoanalysis has in influencing human behavior, but also suggests that it affects not only the individuals who undergo it but their offspring, as well, via the epigenetic passage of DNA.

Reconsidering Leonardo Da Vinci and a Memory of His Childhood

Previous considerations of Freud's 1910 pathography of Leonardo da Vinci have grappled mainly with errors of fact (among them a mistranslation in the study's signature childhood memory, widely known since the 1950s). Here a more consequential flaw is examined: Freud's fatefully pathogenic framing of Leonardo's homosexuality. While few present-day analysts share that perspective in its entirety, Freud's complex and plausible reconstruction drew wide support in the literature for more than a century and has to date never been subjected to rigorous critique. A close reading of the study, exploring Freud's perspective and that of later psychoanalysts and historians, seeks to account for the biography's tenacious grip on the psychoanalytic imagination. In the end, it is argued, the pathography is a failed effort to grapple with an unsettling transformation unfolding around and within Freud: the emergence of the category that eventually would be called the "healthy homosexual."

The madness of Princess Alice: Sigmund Freud, Ernst Simmel and Alice of Battenberg at Kurhaus Schloß Tegel

During the winter of 1930, Princess Alice of Battenberg was admitted to Kurhaus Schloß Tegel, where she was diagnosed with schizophrenic paranoia. When Freud was consulted about her case by Ernst Simmel, the Sanatorium's Director, he recommended that the patient's ovaries be exposed to high-intensity X-rays. Freud's suggestion was not based on any psychoanalytic treatment principles, but rooted in a rejuvenation technique to which Freud himself had subscribed. In recommending that psychotic patients should be treated with physical interventions, Freud confirmed his conviction that the clinical applicability of psychoanalysis should not be extrapolated beyond the neuroses, yet he also asserted that a proper consideration of endocrinological factors in the aetiology and treatment of the psychoses should never be excluded.

'Between-time stories': waiting, war and the temporalities of care

This article analyses how World War II shifted and contained embodied experiences of waiting in relation to broader ideas of lived time in modernity. The trench warfare of World War I has often been imagined as a limit experience of anxious waiting, but World War II produced compelling accounts of experiences of suspended time in civilian populations exposed to the threat and anticipation of 'total war'. This article analyses representations of this suspended present drawn from Elizabeth Bowen and Virginia Woolf, alongside materials in the Mass Observation Archive, to develop an account of how exposure to a future shaped by the potential of annihilation from the air reshaped experiences of durational temporality and the timescapes of modernity in the London Blitz. It also explores the relationship between anxiety, waiting, and care by attending to psychoanalytic theories that developed in the wartime work of Wilfred Bion and Melanie Klein. Extending Freud's account of anxiety as producing 'yet time', this article describes how and why both literary and psychoanalytic texts came to understand waiting and thinking with others as creating the conditions for taking care of the future.

Unconscious Emotion and Free-Energy: A Philosophical and Neuroscientific Exploration

Unconscious emotions are of central importance to psychoanalysis. They do, however, raise conceptual problems. The most pertinent concerns the intuition, shared by Freud, that consciousness is essential to emotion, which makes the idea of unconscious emotion seem paradoxical. In this paper, I address this paradox from the perspective of the philosopher R. C. Roberts' account of emotions as concern-based construals. I provide an interpretation of this account in the context of affective neuroscience and explore the form of Freudian repression that emotions may be subject to under such an interpretation. This exploration draws on evidence from research on alexithymia and utilises ideas from free-energy neuroscience. The free-energy framework, moreover, facilitates an account of repression that avoids the homunculus objection and coheres with recent work on hysteria.

Culture counts: the diverse effects of culture and society on mental health amidst COVID-19 outbreak in Australia. Ir J Psychol Med. 2020;37:237-242. [PMID: 32406358 PMCID: PMC7373827 DOI: 10.1017/ipm.2020.37]

Since COVID-19 first emerged internationally, Australia has applied a number of public health measures to counter the disease’ epidemiology. The public heath response has been effective in virus testing, diagnosing and treating patients with COVID-19. The imposed strict border restrictions and social distancing played a vital role in reducing positive cases via community transmission resulting in ‘flattening of the curve’. Now is too soon to assess the impact of COVID-19 on people’s mental health, as it will be determined by both short- and long-term consequences of exposure to stress, uncertainty, loss of control, loneliness and isolation. The authors explored cultural and societal influences on mental health during the current pandemic utilising Geert Hofstede’s multidimensional construct of culture and determined psychological and cultural factors that foster resilience. We also reflected on the psychological impact of the pandemic on the individual and the group at large by utilising Michel Foucault’ and Jacques Lacan’ psychoanalytic theories. Remote Aboriginal Australian communities have been identified as a high-risk subpopulation in view of their unique vulnerabilities owing to their compromised health status, in addition to historical, systemic and cultural factors. Historically, Australia has prided itself in its multiculturalism; however, there has been evidence of an increase in racial microaggressions and xenophobia during this pandemic. Australia’s model of cultural awareness will need to evolve, from reactionary to more reflective, post COVID-19 pandemic to best serve our multicultural, inclusive and integrated society.

Such stuff as dreams are made on: John Bowlby and the interpretation of dreams

In this paper, newly uncovered archival material from the Bowlby archives is presented on Bowlby's own dreams and dream interpretation. Although he was critical of orthodox psychoanalysis, Bowlby appears to have been seriously involved in Freudian dream interpretation in the 1930s and 1940s. Here, we present in annotated form his own interpretations of several of his dreams from that time and a series of lectures on dreams. In Attachment and Loss, classic dream interpretation is absent and Bowlby used the content of dreams as a reflection of the influence of real-life experiences on the representations of attachment relations, with a clear focus on grief, loss, and mourning. Bowlby's shift from psychoanalysis to a more behavioral approach and the introduction of the concept of "defensive exclusion" to supplant Freud's concept of "repression" may have led him to think about how grief and mourning may affect the content of our dreams.

Mary Barkas at the Maudsley: 1923-1927

The Maudsley Hospital, reopened in January 1923, became the centre of British psychiatric research and achieved a world-wide reputation. At a time when women were rare in psychiatry, New Zealand-born Mary Barkas was the only woman (and psychoanalyst) among the first four psychiatrists appointed. This paper looks at her role in the early years at the Maudsley. The letters she wrote to her father, often on a daily basis, provide a unique insight to the earliest years of the hospital that was to have such an influence on British psychiatry. It is the only insider record we have of this crucial time. Barkas demonstrated her versatility in psychiatry and child psychiatry. She used psychoanalysis to treat her patients, receiving recognition from her colleagues. Her work in this field proved to be an exception as analysis was not practiced after she left the Maudsley. Her problem was the institutionalised prejudice against women in psychiatry, which caused her to leave. Her career was terminated at an early stage and her life took a puzzling turn after she returned to New Zealand in 1933. We can remember Mary Barkas as a forgotten psychiatric pioneer whose life and work deserves to be more widely known and recognised.

Armed against Unhappiness: Psychoanalytic Grammars in Buenos Aires

Psychoanalysis has produced an ensemble of institutions, expertise, procedures, and practices for rendering the psychoanalytic subject legible and, through this, psychic life as an actionable site of intervention, dislocation, and struggle. This article examines how diverse psychoanalytic communities in Buenos Aires have produced unique grammars that influence how individuals articulate ideas about health and well-being. Descriptive, culturally specific, historically informed, and always provisional, this grammar is empirically grounded in lived experience. Through presenting several case studies, I flesh out how this grammar, as a deictic expression of/for the unconscious is deployed, reworked, and embodied in everyday interactions. I demonstrate how psychic life is enmeshed within social and political experience. In doing so, I consider how interpersonal, existential, environmental, social, and political contingencies shape divergent notions of well-being and structure desires of what it means to live "a good life."

"An Extraordinarily Pernicious Influence": The Discursive Figure of the Spoiling Grandmother before 1937

Discourses about the dangers of spoiling children and images of grandparents came together in nineteenth-century literature, with the literary figure of the spoiling grandmother emerging as familiar cultural currency. From there, it would become a concern for the generation of psychoanalysts after Freud, for whom the grandmother represented a dangerous supplement to the importance of the mother for a child's psychological development. The literary and the psychological uses of the figure of the spoiling grandmother then intersected in scientific and popular guidance for parents in the battle for authority regarding the right way to engage in childcare.

Entropy, Free Energy, and Symbolization: Free Association at the Intersection of Psychoanalysis and Neuroscience

Both a method of therapy and an exploration of psychic reality, free association is a fundamental element of psychoanalytical practices that refers to the way a patient is asked to describe what comes spontaneously to mind in the therapeutic setting. This paper examines the role of free association from the point of view of psychoanalysis and neuroscience in order to improve our understanding of therapeutic effects induced by psychoanalytic therapies and psychoanalysis. In this regard, we first propose a global overview of the historical origins of the concept of free association in psychoanalysis and examine how Freud established its principles. Then, from Freud's distinction between primary and secondary processes, we proceed to compare the psychoanalytic model with research originating from cognitive psychology and neuroscience. The notions of entropy and free energy appear particularly relevant at the intersection of these different domains. Finally, we propose the notion of symbolizing transmodality to describe certain specificities of symbolization processes within free association and we summarize the main functions of free association in psychoanalytic practices.

Sigmund Freud and Martin Pappenheim

During World War I, Martin Pappenheim, as a young doctor in the field of neurology and psychiatry, studied various possible consequences of war traumas, perhaps as part of a wider project of the Austro-Hungarian monarchy's army. He visited military hospitals, sanatoriums and prisons, and between February and June 1916, while residing in Terezin, he had several opportunities to talk with Gavrilo Princip, who was imprisoned there. Princip was a young Bosnian Serb who had assassinated Archduke Franz Ferdinand of Austria and his wife, Sophie, in Sarajevo on 28 June 1914. There is written evidence of Pappenheim's conversations with Princip; they were first published in Vienna 1926. My article is concerned with the possibility of Pappenheim's influence on the later development of Freud's theory.

REALIZATIONAL PERSPECTIVES: BION'S PSYCHOANALYSIS AND DOGEN'S ZEN

The author discusses similarities, differences and identities between the later work of the psychoanalyst Wilfred Bion and the Soto Zen Buddhist teacher Eihei Dogen. The discussion elaborates points that help to explain the interest in Bion by psychoanalysts who work to integrate Buddhism and psychoanalysis. Four major points of convergence structure this discussion. They include: a radical openness to unknowing; a shared orientation to the relation between intuition and cognition; a shift from attention to static mind states to an emphasis on fluid functions and actional relationships; and a radically experiential orientation rooted in the present moment.

Love, Work, and Striving for the Self in Balance: Anaclitic and Introjective Patients' Experiences of Change in Psychoanalysis

One of the most famous quotations credited to Freud is that, when asked what he thought a psychologically healthy person should be able to do, he said: "to love and to work." A central goal in psychoanalytic treatment is to bring about changes in basic, mostly unconscious, mental structures. The aim of this study was to investigate, applying an inductive thematic analysis, the experiences anaclitic and introjective patients have had of change after psychoanalysis with regard to the domains Love and Relationships and Work and Achievements. Analyzing patient interviews, we identified a third domain of experienced changes, The Self, which refers to increased self-understanding, self-acceptance, and self-care rather than an improved dynamic balance between love and work. All patients experienced several positive changes in their lives during and after psychoanalysis. We also found distinctive patterns that appear to be closely linked to the patients' initial personality orientation with regard to relationships and achievements. Generally, the patients described symmetrical, but opposite, change processes within the two specific domains of Love and Work. For the anaclitic patients, this indicated a movement inward in the domain of Love (from an excessive preoccupation with issues of their relationship with others toward more distinct self-boundaries and increased agency) and outward in the domain of Work (from unenterprising toward becoming more outgoing and daring). For the introjective patients, this pointed to a reverse movement outward in the domain of Love (from an excessive preoccupation with issues of autonomy toward increased responsiveness to others and desire to be establish close, mutual relationships) and inward in the domain of Work (from an excessive orientation on achievements toward increased becoming more grounded in their own feelings, needs, and desires). In conclusion, patients in both groups have experienced a reduced preoccupation with issues related to their initially predominant personality dimension (relatedness or self-definition) and increased receptivity to needs typical for the complementary dimension. These changes seem to be mediated by changes in the domain of The Self. Our study suggests the clinical relevance of focusing the therapeutic work on fostering a better and more dynamic balance between love and work, relatedness, or self-definition.

Considering Life and Death in Psychoanalysis

Psychoanalytic therapy is not supposed to cure man from death, nor to help him forget about it. It is supposed to deal with the soul, and it is up to the soul to deal with death. Death is actually not an issue for psychoanalytic therapy-its only problem can be the soul. On the other hand, only for the soul is death an authentic problem. Only the soul can authentically bring death into question. Psychoanalysis has indebted humanity by finding the strength and critical prudence in a crucial moment for civilization to remove the veil of prohibition and shame from sexuality, which had been repressed for centuries. Today, sexuality is no longer repressed (it may be even too present in the media for some)-but death became repressed. This paper considers death as an essential topic for psychoanalysis.