What Is Effective In Psychoanalytic Therapy

This book begins with Strachey's statement of the therapeutic action of psychoanalysis representing the classical psychoanalytical technique that prevailed in the 1930s. Then Meissner takes up the shifts in thinking that have subsequently evolved. Today we hold a more relational concept of the therapeutic action based on a developmentally rooted, parent-child model. This places greater emphasis on the vicissitudes of relational involvements than on specific interpretive techniques. Emphasis is given to collaborative efforts between patient and analyist as central to the working of the analytic process. Factors such as empathy, interpretation and positive and negative transference to the therapeutic alliance are explored.

In Psychoanalytic Therapy as Health Care, a timely and trenchant consideration of the clash of values between managed care and psychoanalysis, contributors elaborate a thoughtful defense of the therapeutic necessity and social importance of contemporary psychoanalytic and psychodynamic approaches in the provision of mental health care. Part I begins with the question of where psychoanalytic treatments now stand in relation to health care; contributors offer explanations of the current state of affairs and consider possible directions of future developments. Part II looks directly at the conundrums that have resulted from the attempt to integrate psychotherapy and managed care, with contributors examining the ethical and legal dimensions of confidentiality, privacy, and reporting to third parties. Part III opens to wider consideration of the experiences of psychoanalysts under health care systems throughout the world. Finally, Part IV demonstrates the relevance of contemporary psychoanalytic approaches to a variety of contemporary patient populations, with contributors focusing on the applicability of analytically oriented treatment to AIDS patients, seriously disturbed young adults, and inner-city clinic patients. Collectively, the contributors to Psychoanalytic Therapy as Health Care convincingly refute the claim that psychoanalytically informed therapy is an esoteric treatment suited only to the "worried well." Drawing on a wide range of clinical and empirical evidence, they forcefully argue that contemporary psychoanalytic approaches are applicable to seriously distressed persons in a variety of treatment contexts. Failure to include such long-term therapies within health care delivery systems, they conclude, will deprive many patients of help they need - and help from which they can benefit in enduring ways that far transcend the limited treatment goals of managed care.

TABLE OF CONTENTS: 1. Modes of therapeutic action 2. Intervention as assessment 3. Creating opportunities for self reflection 4. Bringing defenses and unconscious mental content into awareness 5. Interaction structures in the transference countertransference 6. Supportive approaches: The uses and limitations of being helpful 7. Studying psychoanalytic therapy 8. Case studies.

Defining the aims of psychoanalysis was not initially a serious complex problem. However, when Freud began to think of the aim as being one of scientific research, and added the different formulations of aim (for example, that the aim was to make the patient's unconscious conscious) it became an area of tension which affected the subsequent development of psychoanalysis and the resolution of which has profound implications for the future of psychoanalysis. In What Do Psychoanalysts Want? the authors look at the way psychoanalysts have defined analysis both here and in America, from Freud down to the present day. From this basis they set out a theory about aims which is extremely relevant to clinical practice today, discussing the issues from the point of view of the conscious and unconscious processes in the psychoanalyst's mind. Besides presenting a concise history of psychoanalysis, its conflicts and developments, which will be of interest to a wide audience of those interested in analysis, this book makes important points for the clinician interested in researching his or her practice.

Addressing the art and science of psychodynamic treatment, Nancy McWilliams distills the essential principles of clinical practice, including effective listening and talking; transference and countertransference; emotional safety; and an empathic, attuned attitude toward the patient. The book describes the values, assumptions, and clinical and research findings that guide the psychoanalytic enterprise, and shows how to integrate elements of other theoretical perspectives. It discusses the phases of treatment and covers such neglected topics as educating the client about the therapeutic process, handling complex challenges to boundaries, and attending to self-care. Presenting complex information in personal, nontechnical language enriched by in-depth clinical vignettes, this is an essential psychoanalytic work and training text for therapists.

Building on the foundations of the "independent tradition" of British object relations theory and modern infancy research, Sanville proffers a new understanding of the role of play in the clinical situation. She attends especially to the therapeutic situation as a safe playground, the therapist's playful engagement of the patient, and the patient's emergent ability to embrace playfully the liberating possibilities of psychoanalytic therapy.