The journal of the American Academy of Psychoanalysis and Dynamic Psychiatry
January 1, 2011
Myron L Glucksman, Milton Kramer
The initial dream reported in psychotherapy provides clinically useful information. Analyzing 63 patients' first treatment dreams, independent evaluators found that these dreams almost always contain negative emotions. The psychodynamic themes in these dreams reliably predict core issues that emerge later in therapy. Transference—feelings toward the therapist—is evident in many initial dreams and is often negative. The most common dream themes fall into relational or injury categories. These themes, along with positive or negative transference, relate to how well patients progress in therapy. The findings confirm that the first dream reported in treatment offers significant predictive and clinical information.
The journal of the American Academy of Psychoanalysis and Dynamic Psychiatry
January 1, 2009
Moshe Halevi Spero
A psychoanalyst recounts the analysis of a religiously devout Jewish priest (ko'hen) who was emotionally constricted. For over three years, the patient produced many dreams but the sessions remained emotionally flat and repetitive, with a restricted transference. The patient's relationship with God initially seemed absent from the therapeutic dynamic, mirroring a void in his emotional representation of parental figures. This absence distanced the analyst from his own sense of divinity. A spontaneous enactment in the countertransference helped reframe the shared and divergent religious perceptions of both, leading to a significant transformation in the patient's religious experience.
The journal of the American Academy of Psychoanalysis and Dynamic Psychiatry
January 1, 2009
Kevin Fauteux
Some people's religious experiences can repair underlying psychological wounds, while others remain fixated in a blissful escape from those wounds. This work examines what makes an experience reparative versus escapist, and how a clinician's intervention—including countertransference issues—affected the potential for three people's religious experiences to be transformative or escapist.
The journal of the American Academy of Psychoanalysis and Dynamic Psychiatry
January 1, 2009
Moshe Halevi Spero, Mariam Cohen
An introduction to a symposium explores how the image of God, as an ineluctable element of human mental development, influences the analytic dialogue and process through the countertransference experiences of both analyst and analysand. Contributors provided detailed clinical material focusing on their own religious imagery and internal experiences. Of the 14 authors, most identified as currently religious, while 4 were circumspect. The intensity of countertransference involvement related to personal religious experience varied across the group. The symposium did not assume authors or analysts are formally religious.
The journal of the American Academy of Psychoanalysis and Dynamic Psychiatry
January 1, 2009
Gilead Nachmani
A man with an undiagnosed physical illness entered psychoanalytic psychotherapy after two years of unsuccessful medical treatment. The therapy involved religious experiences that attuned patient and analyst, and the patient's fights with doctors, family, and the analyst were seen as a transcendence of his troubled life, mustering courage to live with illness and loss. He used a godlike fantasy figure, considered a vivid good internal object. The therapeutic work included catastrophic change, hope, and disappointment, and the patient learned to live with adversity and return to a normal life as possible. The psychotherapy remains ongoing.
The journal of the American Academy of Psychoanalysis and Dynamic Psychiatry
January 1, 2009
Richard D Chessick
Despite advances in neuroscience, there is no consensus on how the brain generates the mind, a problem that also puzzled Freud. No progress has been made on the 'hard problem' of how brain processes produce conscious experiences, feelings, and intentions (qualia). This review describes major contemporary positions on the mind-brain problem, from Freud's Project to today. The author concludes that 'mysterian' positions or derivatives such as 'anomalous monism' or 'agnostic materialism' are most plausible given current knowledge. These suggest we do not yet know enough about the physical world of matter, though future discoveries may help. Currently, the introspective data of consciousness are ontologically subjective, requiring study in their own domain through introspection, for which psychoanalytic psychiatry is the most meticulous method.
The journal of the American Academy of Psychoanalysis and Dynamic Psychiatry
January 1, 2006
Milton Kramer, Myron L Glucksman
Affect is central to understanding dreams, but it is unclear whether affective or narrative aspects drive dream development. In 24 patients who completed psychoanalytic treatment, affect appeared in 58.3% of manifest dream reports. The valence of affect became more positive over treatment, rising from 19.2% in the first dream report to 53.3% in the last. When affect was absent from a dream report, associations to the dream contained affect 94.1% of the time. Overall, affect was present in either the dream report or its associations 97.9% of the time. The positive shift in affect likely results from psychotherapy, though psychotropic medication (used by 46% of patients at the last dream report) and the passage of time may also contribute.