@article{Director, author = {Director, Lisa}, title = {Symposium on clinical judgment in relational psychoanalysis: The problem of technique. Introduction}, series = {Psychoanalytic Dialogues Vol. 12 (2002), pp. 551-579.}, journal = {Psychoanalytic Dialogues Vol. 12 (2002), pp. 551-579.}, abstract = {A view of chronic drug use that draws on central assumptions in relational theory is proposed. Namely, chronic substance use is seen as being driven by conflicting and unresolved relational dynamics that derive from the early organizing relationships in a person's life. In the case of the substance user, the terms of this conflict find concrete expression in characteristic acts of drug use that serve to perpetuate it through the combined effects of reinforcement and disguise. The goal of treatment is for patient and therapist to find the components of the relational bind that are embedded in the drug use, to reformulate these forces in symbolic terms, and to revisit them in the dynamics of the transference, alongside opportunities for new exchange. Seen this way, the treatment needs of substance users can best be met by a relational model of psychoanalysis, augmented by other approaches needed to address addiction. In particular, the relational emphasis on the role of enactment as a vehicle for the expression of unsymbolized experience, and therefore the source of the phenomena to be analyzed and understood, makes this model especially well suited to substance-using people.}, language = {en} } @article{Director, author = {Director, Lisa}, title = {Symposium on psychoanalysis and linguistics part II}, series = {Psychoanalytic Dialogues Vol. 12 (2002), pp. 593-598.}, journal = {Psychoanalytic Dialogues Vol. 12 (2002), pp. 593-598.}, abstract = {In my. Reply to commentaries by Glen Gabbard and Mark Gerald I offer further views on the implications of an integrative approach to treatment of substance-using patients, and the role of countertransference in that approach. I also address the phenomenon of >leverage,< examined by Gerald for the particular role it plays in the treatment of chronic drug use. I consider the use of leverage within the context of discussing the broader therapeutic effort to help substance-using patients achieve integration.}, language = {en} } @article{Director, author = {Director, Lisa}, title = {When actions speak louder than words: Verbal and nonverbal wrangling in the therapeutic arena commentary on paper by F. Diane Barth}, series = {Psychoanalytic Dialogues, Vol. 15 (2005), pp. 567-586.}, journal = {Psychoanalytic Dialogues, Vol. 15 (2005), pp. 567-586.}, abstract = {An assumption made in this paper and explored for its clinical implications is that an act of chronic drug use often marks or serves to implement an underlying omnipotent self-state. Psychoanalytic work with substance users, as compared with other approaches, trains attention on these omnipotent states and makes use of the transferential exchange as a therapeutic tool. States of omnipotence are particularly examined here in the context of recent attention to dissociation as an organizing force in the personality, and in the configuration of the transference - countertransference of the treatment relationship. A case illustration is used to apply current thinking on dissociative and projective processes, and their role in enactment in the therapeutic exchange, to illuminate the frequent interplay of omnipotence and helplessness in analytic work with substance-using and other patients.}, language = {en} } @article{Director, author = {Director, Lisa}, title = {When Worlds Collide: Psychoanalysis and the Empirically Supported Treatment Movement}, series = {Psychoanalytic Dialogues, Vol. 15 (2005), pp. 627-632.}, journal = {Psychoanalytic Dialogues, Vol. 15 (2005), pp. 627-632.}, abstract = {Commentaries by Edward Khantzian and Henry Krystal allow me to elaborate the role of dissociation in addictive disorder, and its misguided place in the design of many therapeutic strategies to overcome it. Promising direction for the treatment of the characters and symptoms of drug-dependent patients lies in the application of developments in current analytic theory and technique. Such developments include familiarity with enactment, dissociative and projective processes, and work in a two-person frame to enable treatment to encompass and reach more of the patient.}, language = {en} }