This article will address the issue of using understandings of psychodynamic interrelations as a means to grasp how social and cultural dynamics are processed individually and collectively in narratives. I apply the two theoretically distinct concepts of inter- and intrasubjectivity to gain insight into how social and cultural dynamics are processed as subjective experiences and reflected in the interrelational space created in narrative interviews with trainee social educators. By using a combination of interactionist theory and psychosocial theory in the (...) analysis of an interview with a student of social education, I demonstrate how the often conflicting demands and expectations are being played out in the interrelational tension between the researcher (myself) and the interviewee or narrator. In a confrontation with "inner" expectations and concerns regarding a future profession and one's ability to cope, and the "outer" socially and culturally embedded discourses as they are played out in the objectives of self-development and education, the narrative about a forthcoming internship is filled with tension and contradiction. In this article I will demonstrate how such tensions and contradictions are valuable sources of information in understanding the process of becoming a social educator. (shrink)

Children who live on the margins of society are disadvantaged in achieving their developmental potential because of the lack of a necessary stable environment and nurturing care. Many early prevention programs aim at mitigating such effects, but often the evaluation of their long-term effect is missing. The aim of the study presented here was to evaluate such long-term effects in two prevention programs for children-at-risk growing up in deprived social environments focusing on child attachment representation as the primary outcome as (...) well as on self-reflective capacities of teachers taking care of these children. The latter was a key component for promoting resilient behavior in children. Five hundred and twenty-six children aged 36 to 60 months at risk due to immigration status, low family socio-economic status and child behavior were examined in a cluster-randomized study comparing two preventions, the psychodynamic, attachment-based holistic approach EARLY STEPS (ES) with the classroom based FAUSTLOS (FA) for their efficacy. Primary outcome was the child attachment representation measured by the Manchester Child Attachment Story Task (MCAST). Secondary outcomes were derived from (a) the Caregiver-Teacher Report Form (C-TRF: problem behaviors, including anxiety/depressive symptoms, emotional-reactive and somatic problems, social withdrawal, aggressive behavior, and attention deficit), from (b) the Strength and Difficulties Questionnaire (SDQ, parent version: resilience and wellbeing) and (c) Self-Reflective Scales for teachers (SRS: self-reflective capacities of teachers). Compared to baseline, attachment and behavioral problems improved in both programs. ES led to more secure and more organized attachment representations (medium effect sizes). Aggressive behavior and externalizing problems were reduced in the FA group compared with ES, particularly in boys (medium effect sizes). Self-reflective capacities of the teachers increased only in the ES group. High correlation between children’s attachment type with the number of social risk factors and the increase of problematic social behavior strongly indicate that an increase in teachers’ self-reflective capacities helps to change children’s attachment patterns which thus strengthens the resilience of these children-at-risk [An ethical vote from LPPKJP 2009-02-25 was obtained and the trial registered; Clinical trial registration information: The trial was registered 14.02.2012 (DRKS00003500;https://www.drks.de)]. (shrink)

Contemporary ethicists largely ignore the recent, revolutionary findings of psychodynamic psychology. The author argues that ethicists have been dissuaded from taking psychodynamic psychology seriously by hostile attacks on the credibility of the psychodynamic paradigm, and confusion about the contribution that clinical findings can make to ethics. With respect to these obstacles, the credibility of the psychodynamic paradigm is vouchsafed by a growing body of empirical studies that support the main psychodynamic hypotheses, particularly those of interest (...) to ethicists. This new research points toward the need to expand the range of issues covered by contemporary ethics by retrieving and updating the ancient tradition of askesis, involving thought-exercises oriented towards cultivation of habits of mind conducive to acting morally in one's daily activities. The paper concludes by sketching several ways in which self-reflection may improve moral decision-making. (shrink)

This article is a discourse analysis of two historical inquiries into what clinici-ans today call attention deficit hyperactivity disorder . Of primary con-cern in this regard are psychodynamic perspectives towards ADHD symptoms, championed by psychoanalysts and psychologists, and neurological perspectives towards ADHD, which continue to favor a purely physiological approach to understanding the disorder. Those within the psychodynamic camp are inclined to view ADHD as an interactional difficulty between self and social environment - a condition best remedied by (...) psychotherapy. Those within the neurological camp see ADHD as a specific brain process, whose effective treatment depends upon adequate psychopharmacology. This essay argues that both psychodynamic and neurological perspectives towards ADHD have strategized to legitimate one perspective through the expulsion of the other. Within the current era of ADHD nomenclature and treatment it is clear that neurological perspectives dominate the debate. However, neurological perspectives continue to be haunted by a considerable amount of skepticism, both nationally and internationally. Because of this it would be difficult to assert that neurological perspectives, though winning the “legitimation race” in contemporary understandings of ADHD, are entirely monolithic sources of ADHD knowledge. (shrink)

_The Psychodynamic Image_ is the first selection of John D. Sutherland’s major papers. It provides an overview of the development of his thought on self and society and reveals the extent of his contribution to the field of mental health. Jill Savege Scharff introduces Sutherland’s most important and influential essays. These reflect his range as a theoretician, moving easily from the intrapsychic to the interpersonal level, building bridges between points of view and integrating psychoanalytic and social theories. Sutherland’s work (...) calls for changes at the individual level through understanding conflicts and unconscious processes as aspects of parts of the self in interaction. He inspires respect and understanding of the self and its drive toward autonomy. These papers push the boundaries of psychoanalytic thinking and succeed in demonstrating the relevance of psychoanalysis to the wider society. They will be of great interest to psychoanalysts, psychotherapists, counsellors and social workers. (shrink)

The discovery of psychoanalysis and of psychotropic medications represent two radical events in understanding and treatment of mental suffering. The growth of both disciplines together with the awareness of the impracticality of curing mental suffering only through pharmacological molecules – the collapse of the “Great Illusion” - and the experience of psychoanalysts using psychotropic medications along with depth psychotherapeutic treatment, have led to integrated therapies which are arguably more effective than either modality alone. The authors review studies on the role (...) of pharmacotherapy with psychoanalysis, and the role of the analyst as the prescriber. The psychotic disorders have specifically been considered from this perspective. (shrink)

Psychodynamic theory and practice are often misunderstood as appropriate only for the worried well or for those whose problems are minimal or routine. Nothing could be further from the truth. This book shows how psychodynamically informed, clinically based social care is essential to working with individuals whose problems are both psychological and social. Each chapter addresses populations struggling with structural inequities, such as racism, classism, and discrimination based on immigrant status, language differences, disability, and sexual orientation. The authors explain (...) how to provide psychodynamically informed assessment and practice when working with those suffering from mental illness, addiction, homelessness, and cognitive, visual, or auditory impairments, as well as people in prisons, in orphanages, and on child welfare. The volume supports the idea that becoming aware of ourselves helps us understand ourselves: a key approach for helping clients contain and name their feelings, deal with desire and conflict, achieve self-regulation and self-esteem, and alter attachment styles toward greater agency and empowerment. Yet autonomy and empowerment are not birthrights; they are capacities that must be fostered under optimal clinical conditions. This collection uses concepts derived from drive theory, ego psychology, object relations, trauma theory, attachment theory, self psychology, relational theories, and intersubjectivity in clinical work with vulnerable and oppressed populations. Contributors are experienced practitioners whose work with vulnerable populations has enabled them to elicit and find common humanity with their clients. The authors consistently convey respect for the considerable strength and resilience of the populations with whom they work. Emphasizing both the inner and social structural lives of client and clinician and their interacting social identities, this anthology uniquely realizes the complexity of clinical practice with diverse populations. (shrink)

For many years, psychological–clinical research has been aiming at studying the Mafia from different viewpoints: the man of honor's inner world, relational and psychopathological structures of his family matrices, connections between inner and social worlds, interiorized and social rules. Today, however, a complex phenomenon has come to light, which concerns the great connection between the Mafia and financial crime, and for us as researchers it is very interesting and complicated to analyze, because it involves the study of psychological peculiarities that (...) can be specifically found in the numerous illegalities. The crossbreeding of the various criminalities, which are always more interacting and merging and less isolated, makes this picture even more complex. (shrink)

The COVID-19-pandemic brought massive changes in the provision of psychotherapy. To contain the pandemic, many therapists switched from face-to-face sessions in personal contact to remote settings. This study focused on psychodynamic therapists practicing Guided Affective Imagery, Hypnosis and Autogenous Relaxation and their subjective experiences with psychotherapy via telephone and videoconferencing during the first COVID-19 related lockdown period in March 2020 in Austria. An online survey completed by 161 therapists produced both quantitative and qualitative data with the latter being subject (...) to a qualitative content analysis. Our research suggests that telephone and videoconferencing are considered valuable treatment formats to deliver psychodynamic psychotherapy. However, therapists’ experiences with remote psychotherapy are multifaceted and ambiguous. In particular, the findings raise questions concerning the maintenance of the therapeutic alliance, the development of the analytic process, the sensitivity to unconscious communication, and the indication for certain types of patients that still need further investigation. Our research indicates that the long-standing reticence toward remote treatments offers among psychodynamic therapists is becoming more differentiated and partially dissolves as therapists gain experiences in their use. Attitudes are becoming more open. At the same time, the way is being prepared to take a closer look at the specific processes and dynamics of remote psychotherapy and to examine them critically in future studies. (shrink)

Thomas Kretschmar and Andreas Hamburger provide an important overview of psychodynamic work in companies, presenting different viewpoints and explaining key psychoanalytic terms and techniques for coaching and supervision. Written in the form of a dialog between Kretschmar, an entrepreneur, and Hamburger, a psychoanalyst, the book provides unique insight into psychodynamic coaching and supervision. Psychodynamic Coaching and Supervision for Executives begins with an overview of coaching, psychodynamic approaches, the unconscious and relevant psychoanalytic theory. Kretschmar and Hamburger then (...) consider Operationalized Psychodynamic Diagnosis (OPD) in business, assess current research into coaching and supervision and present a selection of key case studies. At the end of each chapter, the authors compare their positions, giving important contextual information, exploring objections, complications and improvements, and providing a precise summary of the topic. This book will be an illuminating guide for therapists and professionals who wish to learn how psychoanalytic theory and practice can be used for coaching, counseling, and supervision in an organizational context. (shrink)

Useful Servants: Psychodynamic Approaches to Clinical Practice provides a simple but not simplistic overview of nine major approaches to psychodynamic theory and psychotherapeutic practice. Each chapter includes clinical vignettes as well as an extensive case illustration of how theories may be used in the consulting room. For beginners in the field, Useful Servants makes accessible the central ideas that have shaped the discourse of psychotherapy. The advanced clinician will find this book an invaluable review and reference tool; in (...) particular, the chapter on Lacan offers a fresh and digestible summary of the clinical application of this immensely complex thinker. (shrink)

Does work psychodynamics--a sub-discipline of clinical psychology in the field of work sciences--offer a relevant methodological reference to analyze the psychological processes that come into play when a CEO is working? The objective of this article is to propose an answer to this question by going back to a doctoral research, which focused on the clinical analysis of the CEOs' "presentation of self," noted as one aspect of their work. The author's arguments for a clinical approach are presented as well (...) as the later decision to resort to "astute" tactics that, beyond the traditional frameworks of work psychodynamics, were required to have access to the CEOs' presentation of self. Following the presentation of the research's achievements, the article shows that, while methodologically unconventional, the astute tactics proved useful in ushering in new elements of knowledge that otherwise would have remained inaccessible. Notably, the specifics of the intersubjective relationship that was established between the author and each CEO had a major positive impact on the interpretations. To legitimize this clinical approach further, the conclusion draws a few indications on criteria that could be investigated to scientifically validate the qualitative methods and their interpretive results. (shrink)

Based on a 1984 conference sponsored by the Health Program of the John D. and Catherine T. MacArthur Foundation, this book presents a series of papers by ...

This article focuses on systems psychodynamics and particularly on the CIBART-model which explores conflict, identity, boundary, authority, role and task and how these phenomena work out on an unconscious level. Therefore, this article presents empirical findings on CIBART in a German multinational engineering organization operating in South Africa. For this study, 16 managers where interviewed on their transformation toward Industry 4.0 with special interest in the interconnection how CIBART aspects play out in the South African context. Findings show that all (...) of the CIBART-phenomena are important during the transformation to more advanced technological levels and restructuring processes. Conclusions are drawn and recommendations are given how to deal with systems-psychodynamic influences within the organization. (shrink)

Despite a rich theoretical and clinical history, psychodynamic child and adolescent psychotherapy has been slow to engage in the empirical assessment of its effectiveness. This systematic review aims to provide a narrative synthesis of the evidence base for psychodynamic therapy with children and adolescents. Building on two earlier systematic reviews, which covered the period up to 2017, the current study involved two stages: an updated literature search, covering the period between January 2017 and May 2020, and a narrative (...) synthesis of these new studies with those identified in the earlier reviews. The updated search identified 37 papers. When combined with papers identified in the earlier systematic reviews, this resulted in a combined total of 123 papers. The narrative synthesis of findings indicates that there is evidence of effectiveness for psychodynamic therapy in treating a wide range of mental health difficulties in children and adolescents. The evidence suggests this approach may be especially effective for internalizing disorders such as depression and anxiety, as well as in the treatment of emerging personality disorders and in the treatment of children who have experience of adversity. Both the quality and quantity of empirical papers in this field has increased over time. However, much of the research demonstrates a range of methodological limitations, and only 22 studies were Randomized Controlled Trials. Further high-quality research is needed in order to better understand the effectiveness of psychodynamic psychotherapy for children and young people. (shrink)

In _Short-Term Psychodynamic Therapy with Children in Crisis, _Elisabeth Cleve presents the therapeutic stories of four children who have experienced trauma or are displaying dramatic clinical symptoms such as low self-esteem and anxiety. Exploring the situation between the individual child and the therapist, the therapeutic space and their experiences, each chapter follows the sessions and the progress made, concluding with a follow-up after the end of therapy. Cleve explores each case as it progresses, emphasising the inner strength of the (...) children and including the interactions between the therapist and the children’s parents. The focus of the psychotherapeutic encounter is in each case to help the child face the trauma, mourn what had been suffered and then move on in life with renewed strength. The final chapters explore the ethics of sharing case material and present Cleve’s reflections on working with traumatised children, and the book also includes forewords by Lars H. Gustafsson, paediatrician and associate professor of social medicine, and Björn Salomonsson, child psychoanalyst and researcher at Karolinska Institutet in Sweden. This warm and readable work will be insightful reading for child psychologists and psychotherapists and other clinicians working with children who have experienced trauma. It will also be of interest to readers wishing to learn more about the processes of psychotherapy with children. (shrink)

The case of Xiang as described by Jane Carroll is indeed disconcerting well beyond the immediately apparent factors contained within the article. While Xiang’s direct medical expenses are excessive and his inability to pay for those expenses and further support his noncustodial family seem to be the main issues up for debate, Xiang, however, is likely going to need much more psychosocial support if he is to regain his previous independent functionality or retain any aspect of a quality of life (...) whilst continuing his indefinitely isolated treatment. In this response, I briefly outline the probable effects of Xiang’s current situation on his social identity and mental health as well as a potential way that we can minimize these adverse effects. (shrink)

This manual presents a carefully researched, detailed psychodynamic treatment program for the alleviation of a transdiagnostic range of primary Axis I anxiety disorders, including panic disorder, generalized anxiety disorder, social anxiety disorder, post-traumatic stress disorder, and related psychological problems. First exploring the principles of psychodynamic theory and formulation, the authors then present a three-phased process of Panic Focused Psychodynamic Psychotherapy-Extended Range : initial evaluation, interpretation of central conflicts and defense mechanisms, and termination. Each phase is discussed in (...) depth and relies on central case illustrations to demonstrate techniques and results. A subsequent chapter explores how to address complex issues that may arise during the course of treatment. Altogether, this manual not only provides a demonstrated, adaptable approach for anxiety disorders, but also clearly embodies a spirit of research and empiricism heretofore rare in psychodynamic psychotherapies, with an eye toward future development. (shrink)

This commentary serves as a reply to Hoffart and Johnson’s article contending that psychodynamic psychotherapy (PDT) models cannot be examined with regard to mechanism of change or represent within-person causal relationships. Hoffart and Johnson cite purportedly paradigmatic examples of PDT and cognitive therapy and examine them with respect to Kazdin’s requirements for investigation of mechanisms of change. We highlight inaccuracies in Hoffart and Johnson’s representation of PDT and, in doing so, provide reasoning in support of the empirical examinability of (...) PDT. We conclude by recommending a metatheoretical system (i.e., functionalism) and empirical methodologies that clinical scientists may consider when investigating mechanisms of PDT in the future. (shrink)

A recurrent theme that is addressed in psychotherapies is the client’s conflicting emotions. This article discusses discursive practices of working on conflicting emotions during psychodynamic psychotherapy. We focus on a phenomenon that we refer to as a ‘delayed response’ and analyze the client’s uses of interactional means, such as a display of negative experience, to invite affiliation or empathy from the therapist. The therapist, however, does not take a turn in the first possible place after the client’s turn. Recurrently, (...) the therapist’s silence is followed by the client’s new turn that backs down from the emotional experience under discussion. After these retractions, the therapists respond with a turn that is responsive both to the retraction and to the initial display of negative experience that occurred prior to it. We argue that the timing of the therapist’s response in these sequences is in the service of psychotherapeutic work on conflicting emotions. (shrink)

This paper aims to elucidate some dysfunctional aspects of health care utilisation by combining concepts from modern systems theory and from psychoanalysis. Contemporary health care in industrialised countries can be conceived as a social system in terms of modern systems theory. According to this theory, social systems are operating on the basis of a ‘guiding difference,’ which in the case of health care is the distinction between ‘healthy’ and ‘ill.’ Its rigidity in adhering to the healthy-ill dichotomy exposes health care (...) to being collusively entangled in the interpersonal defence arrangements of patients. In the psychoanalytic view, individual conflicts can be warded off from consciousness not only by intrapsychic defence, but also by interpersonal defence mechanisms. These mechanisms involve the patients’ close social environment, often including doctors and hospitals. The functioning and the motivational structure of health care itself shows features of neurotic defence: Not only its representatives, but health care as a whole act in a rigid, obsessive manner in order to separate the healthy from the ill and to battle against (presumed) diseases. This obsession sometimes results in excessive diagnostic activism and in inconsiderate application of aggressive medical treatments. Both are inappropriate with regard to the salient problem of modern medicine: the increase of chronic nonfatal diseases like depression and chronic pain. The described defence mechanisms are unconscious not only to patients but also to health care professionals (let alone health politicians), and are contributing to dysfunctional health care overuse. (shrink)

Moving from the paradigms of “mentalization” and “reflective function”, this article develops the concept of “mentalizing” in organizations, understood as a process of construction of shared meaning in the work contexts, and whose absence or deterioration produces suffering in organizational experience, exposing individuals to significant psychosocial risks. This model converges in outlining a framework in which the absence of a reflective competence and the lack of symbolization of the experience of work fall on the perception of one's own job, and (...) on the relationship with colleagues and management, producing unsustainability of the work experience. The availability of reflective spaces that are inscribed in the ordinary dimension of work thus appears as a solution capable of promoting organizational well-being. (shrink)

This article takes the stance that the subjectivity of the researcher is an integral part of the research process. It should be studied as a key to understanding the interrelational processes of meaning in an interview situation. The article demonstrates how the subjectivity of the researcher can be made accessible methodologically and methodically by combining a psychodynamic approach with an autoethnographic approach. The methodical question is therefore how the researcher can conduct introspection and at the same time reflect upon (...) and analyse the central object of investigation. The approach is psychoanalytically informed, but autoethnography became the actual vehicle for moving beyond reflections on the psychodynamics represented in the texts. The researcher ventured into an introspection of not only the texts, but also her own feelings, fantasies, and bodily experiences at the time of the interview and also when bringing the data into new situations. The abstract reflections after the interview situation were left for a while, and instead a more experiential and sensual/bodily understanding appeared, based on narratives, feelings, and reflections from the research field. In doing so, the affective and experiential personal process became an important step in the interpretation. (shrink)

Background: The classical symptom specificity hypothesis (Blatt, 1974) links obsessional symptoms to autonomous interpersonal behavior. Inconsistent findings from cross-sectional group studies on symptom specificity have previously been associated with several conceptual and methodological limitations intrinsic to nomothetic research. Previous empirical case research reported ambivalences between autonomous and dependent interpersonal behavior in obsessional pathology. Aim and Method: The present ‘theory-building’ case study specifically aims at further refinement of the classical symptom specificity hypothesis by testing specific operationalizations within an empirical single case (...) design. Consensual Qualitative Research for Case studies is used to quantitatively and qualitatively describe the longitudinal, clinical interplay between obsessional symptoms and interpersonal dynamics throughout the process of a psychodynamic therapy. Interpersonal functioning is assessed by means of the Core Conflictual Relationship Theme method. The classical symptom specificity hypothesis is contrasted to an alternative hypothesis of interpersonal ambivalences as determinants of obsessional symptoms. Results: Close associations between obsessions and interpersonal dynamics are observed. Findings predominantly affirm the ambivalence hypothesis rather than the classical symptom specificity hypothesis. Psychodynamic interventions focusing on interpersonal conflicts are related to symptomatic changes. Conceptual and methodological considerations, limitations and future research indications are discussed. (shrink)