Something is different but what or why is unclear: commentary on the Boston Change Process Study Group

Research in child psychoanalysis: twenty-five-year follow-up of a severely disturbed child

In an era of managed care, psychoanalytic treatment of children is under fire as critics question whether the evidence of success in child analysis is sufficiently robust to warrant the large commitment of time and money required for this treatment. This article chronicles the history and current state of research at the Anna Freud Centre, and describes the evolution of a database that has methodically recorded and systematically organized data from over 750 cases of children referred to the Centre over a forty-five-year period. Analysis of this database has determined what kinds of childhood disorders are best treated with intensive psychoanalysis, and what kinds do not respond to this form of treatment. A long-term follow-up of a small sample of these childreen suggests the kinds of long-term benefits that can be gained when an individual is treated with intensive psychoanalysis as a child. As an example, clinical material from the analysis of an eight-year-old is presented along with follow-up interview data twenty-five years later.

Complexity and postmodernism in contemporary theory of psychoanalytic change

The contemporary literature on change in psychoanalysis has struggled to integrate recent developments in theory. Reasons for its limitations are discussed. The present article brings to bear relevant concepts drawn from postmodernism and complexity theory on ideas about how change occurs in psychoanalysis. In elaborating these two skeins, it looks critically at some recent attempts to incorporate them and considers their relationship to each other. A general description of complexity theory is offered because it has not yet been well documented in the analytic literature. Postmodern theory is talked about in relation to change; it has been discussed more generally in the author's earlier work. Ways in which postmodernism and complexity theory can inform psychoanalysis but also constrain some of its assumptions are explored. The nature and occurrence of qualitative events of psychoanalytic change are described. Four kinds of such events are described and illustrated with clinical vignettes. Analytic change viewed from a macro rather than a micro level is also discussed.

From developmental metaphor to developmental model: the shrinking role of language in the talking cure

Psychoanalysts have invoked infant development diversely to understand nonverbal and unspoken aspects of lived experience. Two uses of developmental notions and their implications for understanding language and the therapeutic action of psychoanalysis are juxtaposed here: Hans Loewald's conception of developmental metaphors to illuminate ineffable aspects of the clinical situation and Daniel Stern's currently popular developmental model, which draws on findings from quantitative research to explain therapeutic action in the nonverbal realm. Loewald's metaphorical use of early development identifies and thus potentiates a central role for language in psychoanalytic treatment. By contrast, Stern and his colleagues exaggerate the abstract, orderly, and disembodied qualities of language, and consequently underestimate the degree to which lived interpersonal experience can be meaningfully verbalized, as demonstrated here with illustrations from published clinical material. As contemporary psychoanalysis moves toward embracing developmental models such as Stern's, it is concluded, psychoanalysts accept a shrinking role for language in the talking cure.