Jeremy Safran was a unique voice in our field. He exemplified the integration of diverse kinds of scholarship, clinical practice, and spiritual sensibilities. If psychoanalysis as a field is to survive and evolve, it behooves us to make the kinds of integrations that Prof. Safran did as an individual. This article examines our professional present and future, encompassing 3 meanings of the term psychoanalysis:

Motherhood has been deemed a normal crisis, given the significant psychological, biological, and neural changes surrounding pregnancy and the postpartum period. These challenges can become more complex as they are closely related to the parent’s own selfdevelopment and sense of self-efficacy grounded in their personality prior to parenthood. The normal crisis of motherhood may be further complicated

Issues that had been controversial a decade ago in psychoanalytic psychotherapy are mostly no longer so. There is for example little discussion now about the advantages or disadvantages of a relational approach: the overwhelming evidence favouring an interpersonal frame of reference for both development and adult functioning is generally accepted. Similarly, the large number of studies showing psychodynamic

Kohut’s theory of self psychology, centered on the concept of narcissism, has vastly influenced the way narcissism is perceived in the psychoanalytic community. Yet while significantly contributing to the psychoanalytic discourse, his theory gives rise to some issues and concerns. This article deals with the problematic aspects of Kohut’s theory, specifically with reference to the identification, diagnosis

The aim of this paper is to present a theoretical and empirical overview of the hypothesis that patients’ behavior in psychotherapy can be understood as an expression of their efforts to disprove their pathogenic beliefs by testing them in the therapeutic relationship. According to Control–Mastery Theory (CMT; Gazzillo, 2016; Silberschatz, 2005; Weiss, 1986, 1994), psychopathology stems from unconscious

A naturalistic sample of N = 17 trainee therapists treating N = 30 patients in a psychodynamic doctoral training program was evaluated from a discovery-oriented perspective, inspired by the task analytic work of Jeremy D. Safran. A number of research results support the efficacy of integrative treatments, such as Safran’s metatherapeutic approach to working with patient–therapist intersubjective experience

Decades of work by Jeremy Safran and his colleagues have established that ruptures in the therapeutic alliance are not necessarily obstacles to the treatment, and that the process of repairing these events has the potential to deepen the therapeutic relationship and promote change. The field of alliance rupture research has largely focused on therapists’ role in repairing ruptures or patient characteristics

Several scholars have suggested that with the growing pluralism in psychoanalytic thinking, the classical concept of psychic conflict is on the decline in the analytic literature, displaced by a growing emphasis on alternative conceptions of psychopathology, including deficit models, attachment theory, and relational perspectives. The present study utilized a corpus-based analysis to a sample of the

Ambivalence, resistance, and alliance ruptures are three terms commonly used in psychotherapy, across different theoretical approaches and modalities. However, it is still not clear how those terms are related and how the connection can be used to maintain a therapeutic alliance while addressing clients’ ambivalence. This paper aims to briefly describe ambivalence and resistance, describing their impact

The current study explored trainee therapists’ experiences in alliance-focused training (AFT), a form of group supervision focused on training therapists to recognize and negotiate alliance ruptures. We analyzed interviews with 36 former trainees who received AFT during their predoctoral psychology internships. Findings centered on trainees’ views of the central AFT tasks of videotape analysis, awareness-oriented

Grounded in a view of the therapeutic alliance as a process of intersubjective negotiation between patient and therapist, this study examines therapist reflective functioning (RF) as a predictor of process and outcome of psychotherapy in 43 cases of brief relational therapy. Psychotherapy process was measured with the Working Alliance Inventory, Session Evaluation Questionnaire, and a measure of rupture

The present study aims at mapping and interpreting the factors that stand out as relevant to personal change in Lacanian psychoanalytic therapy from a first-person perspective. Using interview data of participants’ personal accounts of their therapeutic journey, we applied (phenomenologically inspired) thematic analysis to gain insight into what they believed effectuated change. We provide a descriptive

The present study examines relationships between patient attachment and therapist countertransference in a large, naturalistic, longitudinal study of psychodynamic psychotherapy in a safety-net hospital. This study explored patterns in the relationship between therapist countertransference and patient attachment in two ways: (a) by studying cross sectional associations between patient-reported attachment

In Germany, the health insurance system covers different forms of psychotherapeutic treatments, including treatments based on psychoanalytic and psychodynamic thinking. Although there are guidelines for selecting a specific psychodynamic approach for a certain individual, it is currently unclear whether these guidelines inform about the actual allocation of patients to psychodynamic treatments in practice

This study reevaluates the factor structure of the Selfobject Needs Inventory (SONI) using a sample of 738 students at an ethnically diverse urban university. The original SONI comprises 5 factors corresponding to approach and avoidance of Kohut’s selfobject needs for mirroring, idealization, and twinship. The current factor analysis revealed 4 factors related to individuals’ needs for affiliation

In the United States and in France, the figures relating to domestic violence are so alarming that the issue has been the focus of multiple policies related to care and prevention, without seeing any real decline in the phenomenon. Beyond the necessity of denouncing violence linked to gender relations between men and women, these policies must therefore be improved. These findings and other aspects

If one understands the projective hypothesis most simply as “the active structuring of the world according to inner requirements and outer demands” (Schafer, 1954, p. 37), then it is evident that a patient’s response to an ostensibly neuropsychological measure can provide significant insights beyond the typical neurocognitive yield. Indeed, the more ambiguous the instructions or stimuli, the greater

The empirical study of defense mechanisms has taken place in relative isolation, with few connections to other fields deriving from psychodynamic theories, including attachment. This study aimed to explore the associations of remembered childhood caregiving and defense mechanisms with adult attachment styles in a nonclinical sample. Furthermore, we investigated which defenses are associated with specific

While research suggests that the therapeutic alliance is important in predicting outcomes of psychotherapy, relatively little is known about the development of the alliance or the moment-to-moment components of the relationship and how they combine to create an alliance, which may represent a serious limitation in existing methods of measurement. Language style matching (LSM), or the degree to which

Although it is known that mothers with substance-use disorders struggle to provide adequate parenting to their children, little is understood about the mechanisms behind this. This cross-sectional study uses an attachment perspective to examine whether reflective functioning mediates the relationship between mental representations of caregiving and maternal sensitivity, in an ethnically diverse sample

Assessing and treating suicidal patients is a high-risk area of practice requiring psychoanalytic psychotherapists to be knowledgeable about risk and protective factors for suicide, and competent at assessing, formulating and treating this group of patients. The therapist must have a method of using research data and clinical judgment to understand the suicidal process, which often involves life span

This exploratory study demonstrates several key aspects of a psychoanalytic theory of omnipotent defenses, based on the Novick and Novick (1996, 2003, 2004) description of a “closed system” sadomasochistic cycle in which omnipotence plays a central role in the regulation of self-esteem and emotions. A new measure, the Rorschach Omnipotence Scale (ROS), assesses Rorschach response content and test behavior

An individual with schizophrenia, and her therapist of 30 years, came to feel strongly that it is important for professionals to hear a patient’s view of the therapy experience and for them to have the opportunity to question both patient and therapist. This article is based on their panel at the American Psychological Association Division of Psychoanalysis meeting in New York, April 25, 2014, which

This article aims to help psychoanalytically oriented clinicians address and manage the needs of patients in Alcoholics Anonymous and other 12-step programs, who represent an understudied population in our field. Drawing upon clinical experiences, it focuses on four challenges that arise for psychoanalytic clinicians, including conflicts between psychoanalytic considerations and the disease model,

Increasingly psychoanalysis is attempting to integrate the essential “backdrop” of the implicit, nonverbal moment-by-moment process into the narrative domain of language and symbols. We present vignettes from an analytic case of a 3- to 5-year-old child, treated by the first author, to illustrate the integration of the verbal narrative with the implicit moment-by-moment process of vocal rhythms and

Resilient patients from pathological backgrounds can manifest an ability to defy unacceptable relational experience and replace it with a wished-for way of relating: the “fantasy relationship.” Through the negation of each bad interaction, the fantasy of a potential good interaction is necessarily created, contributing to the evolving construction of an idealized parent–child dyad in the imagination

Avoidant personality disorder (APD) and borderline personality disorder (BPD) are the most frequent personality disorders (PDs) in clinical practice. Although BPD research dominates the field, both PDs are clearly associated with severe functional impairments and substantial treatment challenges. Few have investigated the relationship between core personality vulnerabilities across PDs. However, such

The Adult Personality section of the Psychodynamic Diagnostic Manual (2nd ed. [PDM-2]; Lingiardi & McWilliams, 2017) reflects the best effort of theorists, researchers, and clinicians to capture clinically relevant personality constellations, from healthy personality styles to highly troubled disorders. We specify some foundational assumptions impelling this work, especially as they differ from those

The new Psychodynamic Diagnostic Manual (PDM-2; Lingiardi & McWilliams, 2017) aspires to emphasize a holistic view of individuals, rather than focusing solely on the treatment of diagnoses or the amelioration of symptoms that constitute them. In this paper, we discuss the ways in which the PDM-2 differs from the Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM–5; American Psychiatric

Among its several changes and innovations, the second edition of the Psychodynamic Diagnostic Manual (PDM-2) strongly emphasizes the importance of the therapeutic relationship. The manual helps clinicians to understand better their behaviors in therapy with different patient groups, to guide therapeutic interventions, to track in-session processes, to deal with ruptures in the therapeutic alliance

In this paper we address the main innovations included in the Subjective Experience chapter (S Axis) of the PDM-2, that is, its conceptualization of adult symptom patterns. We include some comparison between, and discussion of, ICD-10, DSM-5, and PDM-2. A primary goal of the PDM is to consider both biological and psychological susceptibility factors in shaping specific symptom patterns in adults; we

The Psychodynamic Diagnostic Manual (PDM) and its successor, the PDM-2, were developed to provide a framework for conceptualizing psychological dysfunction that is more comprehensive and clinically useful than extant symptom-focused diagnostic manuals (i.e., the International Classification of Diseases, the Diagnostic and Statistical Manual of Mental Disorders). By evaluating symptom patterns and the

This article deals with the phenomenon of split personality and, specifically, with the split between the grandiose self and the inferior self, which is typical of pathological narcissism. While grandiosity is widely regarded as the dominant trait of the narcissist’s personality and the diagnostic hallmark of narcissistic personality disorder, it is suggested that the 2 dissociated self-states—the

Today, psychotherapy is the treatment of choice for patients with a personality disorder (PD). PD patients are however difficult to engage into treatment and little is known about the factors that lead to dropout. The aim of this study was to increase our understanding of dropout in PD patients. In particular, and based on earlier studies, we aimed to identify baseline patient factors predicting dropout

In an empirical study of psychoanalytic processes, the authors identify therapist, patient, and interaction factors from 2 instruments totaling 31 items based on clinicians’ evaluation of 540 sessions from 27 completely recorded psychoanalyses. The 2 instruments, developed over 30 years studying recorded psychoanalyses, are the Analytic Process Scales (APS; Waldron, Scharf, Hurst, Firestein, & Burton

One psychoanalytic justification for the practice of not recommending posttermination patient-analyst contact to former patients is the assumption that such posttermination contact interferes with the patient’s mourning response to the loss of the analyst. We respond to that assumption by describing the empirical studies that have shown that posttermination patient-analyst contacts did not interfere

Deprivation and neglect during the early care of a child is known to possibly lead to the development of reactive attachment disorder (RAD). However, subtler influences within the relationship between mother and child have been less explored and defined. This article discusses the relevance of understanding the relationship between the mother’s mentalizing capacity and the child’s attachment representations

Despite the extensive debate about the role that internalization of the analyst plays in analyses conducted from a more traditional perspective, and the increasing acknowledgment that both insight and the relationship with the analyst are important and coexisting mutative factors, most analysts who value insight continue to see interventions that influence the patient via the relationship as lamentable

The Psychodynamic Diagnostic Manual (PDM; Alliance of Psychoanalytic Organizations [APO], 2006) was developed to add a contrasting, person-centered perspective to the conceptualization and diagnosis of psychological dysfunction in traditional diagnostic systems (i.e., the International Classification of Diseases, the Diagnostic and Statistical Manual of Mental Disorders). In addition to considering

Cosmetic surgery and minimally invasive techniques have recently become popular. Noting the compulsive way in which many people approach these procedures, psychoanalytic scholars have conducted several studies to evaluate the possible presence of mental disorders. In this regard, Alessandra Lemma (2009, 2010a, 2010b) argued that the craving for beauty may hide narcissistic disturbances akin to those

Despite robust findings identifying impairments in interpersonal functioning associated with rejection sensitivity (RS), the object representations (OR) of self in relation to others from which such rejection expectancies and anxieties arise have not been evaluated. Our study was the first effort to evaluate the structural aspects of object representations in RS, which may provide a crucial link in

Negative therapeutic reaction was first described by Freud, and theories about this phenomenon have focused on various patient factors, for example, unconscious guilt, narcissistic pride, and overwhelming feelings of shame, as well as devaluation of the therapist as a defense against envy. Different strategies to counteract negative therapeutic reactions in patients with severe personality disorder

The Reflective Functioning Scale (Fonagy, Target, Steele, & Steele, 1998) was developed to empirically assess the capacity to mentalize thoughts, intentions, feelings and beliefs of oneself and others in the context of attachment relationships (Jurist & Meehan, 2009). To overcome the complexity of the RF scale scoring, the Computerized Text Analysis measure of Reflective Functioning (CRF) was created

Empirical literature has shown that narcissism is often associated with limited empathy, but the mechanism underlying this association is still unclear. The present study investigated the role of identity instability as a mediator of the relationship between narcissistic traits and empathic capabilities. Narcissistic traits, identity instability, and cognitive and emotional empathic capabilities were

With compulsive hoarding now forming a discrete diagnostic category, there has been a recent increase in its visibility in both the clinical and the cultural milieu. However, understanding of the meaning and possible emotional underpinnings of hoarding lags behind. This qualitative study reports findings from in-depth interviewing of 5 participants using a psychoanalytic interview method and analysis

In this article, we examine how the different attachment patterns enable or hinder the resolution of ruptures in the therapeutic alliance. We try to show that secure and insecure patients alike may experience ruptures in the therapeutic alliance, but that their ability to participate in resolving such ruptures differ markedly. Recent findings with the Patient Attachment Coding System (PACS) show that

In this paper, the author examines young adulthood as a developmental stage in its own right and as distinct from adolescence. The author describes the tasks and various factors that contextualize young adulthood and highlights a common developmental crisis that young adults often experience with regard to achieving self-responsibility and individuation. Drawing on Loewald’s seminal work in understanding

The present study aimed to evaluate the nomological network validity of the Movie for the Assessment of Social Cognition (MASC) in its Italian translation, addressing distinct research questions in 3 independent samples of Italian participants comprising adolescent nonclinical participants (N = 393), adult nonclinical participants (N = 193), and adult outpatients with a personality disorder (PD) diagnosis

Most explanations of child sexual abuse perpetration have been premised on assumptions of the individualist/monologic paradigm. Child-abuse prevention programs, including treatment for people known to pose a risk of sexual harm to children (sexual offenders), are also based on monologic assumptions. Drawing from the case study of a Catholic priest who has sexually abused many children, this paper argues

In this article, we present a summary of research on the Wallerstein Scales of Psychological Capacities (SPC), an interview-based instrument designed to bridge the science-practice gap by meeting both clinical and research needs in assessing change in patients who have undergone long-term psychodynamic psychotherapy or psychoanalysis. We begin by reviewing results of published studies of the reliability

Trauma is contagious; its powerful affect and frequently unformulated memories can be transmitted—sometimes nonverbally and often mysteriously—within families, across generations, and from patient to clinician; in the latter case it is commonly referred to as vicarious trauma. In emphasizing trauma’s contagious quality, the current paper explores the relationship between vicarious trauma and dissociation

Formally known as triangulation processes, love triangles feature prominently in relationships—sometimes providing stability, sometimes vibrancy. Alternatively, they can create instability, even destruction. Integrating the relevant psychoanalytic literature with clinical examples, the author explores the meaning of love triangles interpersonally as well as intrapsychically. Their nature, their role

The results of 3 studies are reported designed to test the hypothesis that priming identification with the oedipal “winner” or “loser” in the Oedipal situation will unconsciously bias conscious sexual morality in predictable ways. These studies extend research by Hunyady, Josephs, and Jost (2008) that demonstrated that priming oedipal defeat led men to endorse significantly more prohibitive attitudes

“Pathological identification” is a learned, psychological phenomenon in which patients unconsciously repeat pathological behaviors, attitudes, and affects their parents displayed in the past causing current problems in relationships with spouses, children, coworkers and friends. This phenomenon explains a wide range of pathologies that occur in everyday life that present frequently in psychotherapy

While there has been increasing attention directed toward sociocultural issues in psychoanalytic scholarship and recent efforts to integrate cultural competence as a core emphasis in psychoanalytic theory and practice, there have been no empirical investigations of how cultural competence is conceptualized by psychoanalytic psychologists. The present study aimed to examine how psychoanalytic psychologists

How do adults experience and manage their sexual desires, when these desires are laden with shame, guilt or religious transgression? This study looked at a group of 15 heterosexual, single adult men in the Orthodox Jewish community whose religious laws explicitly prohibit them from both masturbating and from expressing all forms of premarital physical intimacy. When these religious laws are internalized

The article offers an original and comprehensive review of the history of psychoanalytic attitudes toward faith and a religious worldview. It begins with a systematic examination of Freud’s approach to religion and faith, demonstrating that contrary to the common understanding of his attitude as one of radical atheism, Freud displayed ambivalence on this issue. After Freud’s death, psychoanalysis as

Adolescence is a critical period of rapid biological and social development and early signs of adult mental disorders emerge during this life stage. Previous studies suggest that mentalizing failures, specifically difficulties in reflective functioning (RF) are linked with psychological symptoms. However, relatively little is known about the association between RF and psychological adaptation in typical

Both classical and contemporary psychoanalytic theories stress the importance of interpersonal dynamics in treating neurotic symptoms. Associations between the symptomatic and interpersonal level were formally represented in the symptom specificity hypothesis (Blatt, 1974, 2004), which linked obsessional symptoms to an autonomous interpersonal stance. Findings from cross-sectional group studies on

In this paper, I explore the kinds of difficulties arising during the writing process as seen in students embarking on, engaged in the midst of, and at the stage of completion of a dissertation. I am specifically concerned with the dissertation completed as a part of a humanities-based program in contrast to an empirical piece of work based in a scientifically oriented program. Contained in this process