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Therapists’ quest for constructing meaning systems of their patients’ experiences progresses in cycles. These cycles consist of: (1) efforts to achieve closures, propelled by the depressive position with its concomitant judgments, resolutions, and decisiveness, and (2) efforts to dissolve closures, propelled by the schizo-paranoid position, searching anxiously and excitedly for new ways to construct meaning. By struggling to facilitate their supervisees’ cycles of achieving and dissolving closures, supervisors help them to grow as clinicians. Supervisees usually welcome the supervisors’ help in constructing meaning systems and achieving closures. They become wary, however, when their supervisors suggest that they dismantle these systems and dissolve their closures because these suggestions undermine their self-assurance as well as their sense of morality, both nourished by the depressive position. Several approaches are suggested for supervisors to facilitate their supervisees’ efforts to dissolve closures.
Supervisors who wish to meet their supervisees’ needs to grow as clinicians will encounter two paradoxical knowledge-related needs of supervisees. On one pole of this paradox is their need to assimilate new knowledge into their existing clinical knowledge; on the other pole is their need for acknowledgement, validation, and formulation of their unique experiential and unarticulated knowledge. Meeting this need helps the supervisees to balance regressive states and painful gaps between their own and their supervisors’ knowledge, which might put the supervisory relationship at risk.
Psychotherapists currently find themselves considering the extent to which sociopolitical and economic issues in a globalized world can affect the evolutionary nature of the psychic organizations sustaining the individual. It seems we are mostly witnessing a weakening of the psychic structures that contain and maintain a sufficient and constant level of integration and unity of sense within the individual–world relationship. Patients frequently come into analysis with invalidating states of anxiety, panic attacks, and the explosion of sudden psychotic crises, accompanied by experiences of depersonalization and derealization. What I would like to examine in depth relates to the influence of the trans-subjective in us as psychotherapists, committed to dealing with psychic disorders that involve us as persons emotionally and intellectually present in our times, with a sense of awareness and responsibility. The quality of the treatment depends, among other things, on the effective elaboration of fullness and emptiness that one generates in the resonance emerging from the process of transference and countertransference. The word, the presence, and the absence, physically and mentally, of the psychoanalyst and the patient are recognized as those activators of potential transformation which are an appropriate form of medicine at an analyst’s disposal during the process of changing a pathogenic state.
In this study we collocate adolescence within a broader and more present-day scenario than has been the case in psychological and psychoanalytic literature in recent years. Our analysis of this evolutionary passage and its malaise includes contextual and other aspects that condition its real development. We consider the features of contemporary Western society and naturally place them within an increasingly planetary vision of the subject, given that the culture pervading the Western world, although complex, appears to be sufficiently uniform with some specific aspects. We propose a contemporary interpretation of the developmental process of the second decade of life and the forms of malaise it can produce. In this respect, two adolescent conditions are emblematic: self-closure and anorexiform eating disorders. These conditions express paradigmatically some characteristics of subjective adolescent malaise.
The knowledge culture of psychoanalysis relies heavily on the practical wisdom of competent psychoanalytic clinicians. In order to become competent analysts, analysts in training should not content themselves with trusting in their supervisors’ intuition and expertise. There is a need for supervisors and supervisees to explicate implicit theories of interpretive and supervisory techniques in psychoanalytic supervision by raising the question >Where does it come from?< with regard to three too often neglected issues. First, both the supervisor and the analyst in training should actively and constantly try to make transparent the process of contextualization, that is, the methodology of inferring latent meaning from manifest content through privileging certain pieces of information over others. Second, it should become an ongoing task in supervision that concrete (recommendations about) technical interventions are embedded in and reflect the application of a particular theory of technique. This facilitates an understanding that goes beyond the interpretation in a concrete situation and helps to generalize learning into a gradually expanding, integrated technical framework. Third, we should reflect and explicate the (predominant) supervisory approaches we are using in order to remain flexible with regard to both supervisory material and ways of reacting to it. Discussing these issues will enable analysts in training to develop their own psychoanalytic identity and integrated frame of reference for their practice that they critically and deliberately reflect upon and actively acquire rather than passively and seemingly intuitively absorb and adopt. Examples for illustrating the explication of theories of interpretive and supervisory techniques are provided.