In the last decade Bowlby's ideas on attachment have been taken up with tremendous flourish within psychoanalysis in general and by feminists, journalists, and politicians. This paper explores this new turn and suggests some historic reasons for the convergence between feminist ideas, politics, and attachment theory. While welcoming the wider dissemination of an attachment paradigm, it cautions against the too easy uptake of ideas that may be less than congruent with the fundamental challenge that attachment theory poses for conventional psychoanalytic models of the mind.
I take this occasion to reflect on the relation between the flourishing attachment tradition established by Bowlby's work and the psychoanalytic tradition. I want to show how Bowlby's virtual expulsion from mainstream psychoanalysis in the early 1960s makes some sense in terms of the history of psychoanalytic ideas, as he was several steps ahead of his own time. I then consider the ways in which other major psychoanalytic authors, W.R.D. Fairbairn and Hans Loewald, as well as the American psychiatrist Harry Stack Sullivan, struggled with the same problems Bowlby did. There is now a marked receptivity among psychoanalysts to the same ideas that earned Bowlby his place, along with Fairbairn and Sullivan, in the psychoanalytic Gulag. Finally, I consider the way in which an integration of these different angles on the same phenomena can be helpful both conceptually and clinically.
Free association allows the emergence of novel formulations about self and, along with them, new insights, but it needs to modulate the risks of chaos and the compromising of mental integrity on the one hand and the arrest of growth on the other. Interpretation acts to contain and hold associative pressures and so helps maintain the patient's mental integrity, but it limits associative freedom by being necessarily inferential. In addition, in current interpretative strategies, analytic progress depends on the patient's ability to associate. This ability may be poor for longer or shorter periods during analysis. To help resolve these difficulties, a strategy of associative dialogue is proposed and clinically illustrated. The proposed strategy draws on the associative abilities of the analyst. This paper elaborates the way in which two basic forms of associative dialogue – bold and focused analysis – may facilitate the negotiation between freedom and continuity in analytic discourse.
This paper discusses one family's struggle with domestic violence involving three generations. In this case, coercive negative maternal attributions interacted with parent-to-child projective identification, which resulted in the child's internalization of parental perceptions involving confusion around danger and protection from danger. Projective identification occurs as readily from a parent to a child as from a child to a parent. As is illustrated, when the parent's use of projective identification is excessive, it has severe implications for the whole of the child's psychic development (Lieberman, 1992, 1994, 1997, in press Seligman 1993, 1995, this issue Silverman, Lieberman, and Pekarsky, 1997).
Using a naturalistic design, 44 patients in psychoanalysis were examined with regard to qualitative and quantitative outcome of therapy. The results were compared with those from 56 dynamic and 164 inpatient therapies. Comparison of symptoms, diagnoses, and motivation prior to therapy led to the conclusion that the patient groups treated within these settings differed greatly. For this reason randomisation appeared to be an inadequate strategy for comparing groups in different therapeutic settings. Using different outcome criteria, it could be demonstrated that psychoanalysis patients on the whole attained good therapeutic results. The outcomes were the best in comparison with the other two therapy categories investigated. The use of different outcome criteria and observer perspectives (patient and therapist) led to therapy results with clear-cut differences. In the patient view, the main effect was cessation of psychosomatic, anxiety- and depression-related symptoms. The therapists furthermore reported clear-cut changes in the scales depicting relationship variables. The study presents success rates obtained on the basis of different outcome criteria and discusses them with special emphasis on the methodology of recording outcomes. The paper concludes by making recommendations for psychoanalysis studies yet to be planned.
Paradox and process
(1999)
In this paper I am tracing the history of countertransference and how it has informed the current debate about self-disclosure as a pivotal instrument of analytic work. Now that the analyst's >subjective factor< has been understood as a central influence on the analysand and as a vital source of information about the analysand's intrapsychic life, I argue that certain currents in the relational school of psychoanalysis confuse the analyst's subjectivity with his personality. While becoming more >real< with a patient may enliven a stale analytic dialogue, it ought not be confused with, or take the place of, an analysis of unconscious desires and phantasies. I claim that a two-person psychology can exist only within a tripartite structure in which the analyst does not lose sight of his complex function of being the carrier, observer, and conveyor of the unconscious currents holding both participants in check.