13558 Chapters
Medium 9781912567362

Appendix III: Supervision with Esther Bick

Bick, Esther; Harris, Martha Harris Meltzer Trust ePub

Ann Cebon

The author revisits her experience of supervision with Esther Bick, which took place over thirty years ago. The patient discussed was a seven year old boy whose disturbance dated from the very beginning of his life. His difficulties had severe implications for the development of his capacity to feel emotionally contained and for the development of a capacity to think. The supervision and the therapy with this child remain alive in the therapist's mind, in part because of Esther Bick's unique and original understanding of the patient's distress and disturbance and its relation to the concrete experience of primitive anxiety, fear of annihilation and death. Esther Bick's teaching has become the backbone of the therapist's clinical understanding.

The memory of supervision with Esther Bick forms the fabric that I use daily in my clinical work with children and adults. It was intrinsically linked to the experience of infant observation I had had with Mrs Martha Harris as part of my training in child psychotherapy. When I was asked by Michel Haag whether I would recount the year of supervision which I had had with Esther Bick, I immediately felt interested. I then thought, what could I remember of the details of a supervision which, after all, had been in 1973–1974? I recalled that I still had some of my notes and that I had written about this case elsewhere (Cebon, 1982). But that was also over twenty years ago. It is an indication of Mrs Bick's incredible gifts as a clinician and teacher, her enthusiasm and her love of the work that made my memory of her so much clearer than I would ever have imagined after 30 years. Both how she taught me and what she taught me remains accessible because it is intrinsic to my work. It forms the fabric that I use daily in my clinical work with children and adults. Mrs Bick's supervision was intrinsically linked to the experience of Infant Observation I had had with Mrs Martha Harris as part of my training in child psychotherapy. Both observation and the clinical training have their roots in the same careful observation, the work to understand phantasy, conscious and unconscious, understanding of the transference and countertransference, and the importance of good boundaries when under pressure to act.

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Medium 9781780490366

Chapter Three: More Recent Psychoanalytical and Psychological Development Concepts

Gottken, Tanja; von Klitzing, Kai Karnac Books ePub

The concept of mentalization and its significance for psychotherapeutic practice

Psychoanalysis has several aetiological models of depression. Some focus on conflicts in which an unconscious wish towards the object has been disappointed and the self works this conflict out, not interpersonally with the object, but intrapsychically (Freud, 1917e), while other models are based on a fixation on the oral phase (Abraham, 1924; Freud, 1917e) and on an intrapsychic conflict in which one layer of the personality comes into conflict with another, when the ego ideal condemns the neurotic gratification of drives.

Our clinical experience shows us that there are children and adults whose depressive developments are based on clearly defined neurotic conflicts that have inhibited the patient's development, allowing him or her to be neurotically “stuck” while other areas of the personality remain undamaged. On the other hand, there are children (and adults) with depressive disorders where the depressive symptoms must be understood as part of a more wide-ranging structural disorder of the personality. Rudolf described these patients as having a structural disorder in which the formation of stable self- and object-representations, affect differentiation, impulse control, and the regulation of self-esteem are hampered (Rudolf, 2009).

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Medium 9781910444061

CAPÍTULO SIETE - La incidencia de nuestro modelo teórico en nuestro pensamiento clínico—trabajando con el tercer nivel del Modelo de los Tres Niveles

Altmann de Litvan, Marina Ediciones Karnac ePub

Adela Leibovich de Duarte

El filósofo escocés David Hume afirmó en el Treatise of Human Nature (1739) que las personas necesitan comprender y explicar todo lo que observan porque esto hace que el mundo adquiera más sentido.

Esta necesidad intrínseca de entender y explicar el mundo que nos rodea incluye nuestra necesidad de reconocer y tratar de dar sentido a los otros con quienes compartimos o no percepciones y concepciones sobre el mundo. El reconocimiento de la otredad está intrínsecamente imbricado en nuestra comprensión general del mundo. Según Bowlby (1969, 1973) el procesamiento de la información tiene lugar en el contexto de nuestro “modelo de trabajo interno” que nos ayuda a percibir acontecimientos y construir planes para el futuro.

Nuestra subjetividad existe en un espacio intersubjetivo y, como plantea Mitchell (2000), una mente presume otras mentes. El encuentro analítico tiene lugar, precisamente, en un espacio intersubjetivo, en tanto es el encuentro entre dos subjetividades diferentes que usualmente comparten un bagaje cultural común y un mismo lenguaje. El reconocimiento de la otredad está intrínsecamente implicado en nuestro trabajo clínico.

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Medium 9781855757646

6: Research, research politics, and clinical experience with transsexual patients

Karnac Books ePub


Friedemann Pfäfflin

When reflecting on the century since the publication of Freud's (1905d) Three Essays on the Theory of Sexuality (1905d), we are not far off the one-hundredth anniversary of the first sex reassignment surgery (SRS) performed in 1912. The term transsexualism did not exist in those days, and the phenomenon described by it was not mentioned in Freud's Three Essays. Yet none of all the sexual abnormalities mentioned in his book has hitherto attracted as much attention as transsexualism. Although the number of transsexuals is comparatively small, the challenge they pose is tremendous.

I start with my first clinical encounter with a transsexual patient (see also Pfäfflin, 1994, 2003) and then, embedded in a narrative of own experiences, add some general research data before turning to very few psychoanalytic findings.

First encounters

As a medical student I appreciated the opportunity to regularly assist a famous psychiatrist, Eberhard Schorsch, at the Department of Sex Research at Hamburg University Clinic. He saw the most extraordinary people who had committed serious crimes, in order to preparepsychiatric expert evaluations for courts. He enabled his patients to talk by being reserved, treading softly, and listening attentively. Although not a psychoanalyst, he was regarded by the courts, by lawyers, and by the public at large as the psychoanalytic forensic psychiatrist in the country because of his capacity to create insight into the motives for and circumstances of the patients’ horrible deeds.

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Medium 9781780490458

CHAPTER SEVEN. White cliffs, white horses: on playing and auto/biography

Karnac Books ePub

Jacki Cartlidge

“Whatever I say about children playing really applies to adults as well”

(Winnicott, 1971, p. 46)

This chapter extends a discussion that I developed in a recent article (Cartlidge, 2011), using the theories of Donald Winnicott, psychoanalyst and physician. The starting point was research carried out for my PhD, which involves engaging with the educational biographies of a small number of non-traditional learners in and around Dover, in the South East corner of Kent. By “non-traditional learners”, I mean people, some of whom are older returnees to education, who, for a range of reasons, are deemed to have “failed” at school, either in their own perception, or that of the educational authorities. I argue that “playing”, as Winnicott employs the term, is potentially crucial in understanding their experiences of learning and of managing transition. I also discuss the potential for using psychoanalytic insights, alongside an auto/biographical narrative approach, to illuminate complex processes in teaching and learning. By auto/ biography, I mean the sense of how we might draw on our own lives to make sense of others, as well as theirs to make sense of our selves, in both research and teaching (Stanley, 1992)

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