Showing papers in "International Forum of Psychoanalysis in 2009"

Large-group identity, international relations and psychoanalysis

Abstract: This paper examines the psychology of ethnic, national, religious or political ideological groups composed of thousands or millions of people. In such large groups most of the individuals will never meet during their lifetimes. But, they share a persistent sense of sameness, “large-group identity.” This paper examines how this abstract concept, large-group identity, can become the central force that influences international relationships. Psychoanalysts who are willing to become involved in interdisciplinary initiatives can provide information to the diplomats about large-group psychology in its own right and suggest peaceful strategies for international conflicts.

Dramatology in life, disorder, and psychoanalytic therapy: A further contribution to interpersonal psychoanalysis

Abstract: Action and interaction, and emotion and thought as the inner wellsprings of action, play a central role in the lives of individuals, families, and society, spanning the continuum between everyday life and disorder. Until now, the narrative tradition has been the main methodology for portraying and formulating human action and interaction, and little has been written about the dramatic approach to life, disorder, and therapy. Since the essence of drama is action, dialogue, character, and emotion, it is time to give drama its due. The author proposes a methodological concept – dramatology – analogous to narratology, to highlight the dramatic method of investigating action and interaction in life, disorder, and therapy. Breuer and Freud presented both aspects of dramatology: dramatization in dream and fantasy, and dramatization in act, focusing on the person. This approach was elaborated by psychoanalysts with an interpersonal orientation, focusing on the person and speech as action. Dramatology is ...

From psychoanalytic narrative to empirical single case research

Abstract: The psychoanalytic literature is living not only from its theory, but also by its vivid case presentations. From a scientific standpoint, however, it often will be argued that the case material is applied only for the purpose to demonstrate that the specific theoretical presuppositions are correct. Therefore, many scientifically oriented colleagues demand that the frequent convincing literary anecdotes and short novels with their extreme subjective character should more often be substituted by verifiable, empirical single-case research. This is urged by the multiple theoretical diversity in our profession and the defensive position of psychoanalysis within today’s society. It is therefore invaluable to have unedited and uncensored texts from the verbal exchanges between therapists and patients. One example of such a verbal protocol is the presentation of Dewald (1972); another is that of Lichtenberg, Lachmann, and Fosshage (1996). Dewald wants to provide knowledge of the application of ego-psychology, whereas Lichtenberg and his co-workers relate to a broader spectrum of technical principles and a specific set of interventions. Helmut Thomä conducted a psychoanalytic therapy of 531 sessions with Amalia X covering a 5-year span, 517 sessions being audiotape-recorded. At that time, Thomä was a wellrespected psychoanalyst attached to the well-known and acknowledged principles of psychoanalytic technique. The full text is available for study at hand of qualified researchers via the Ulmer Textbank. At the onset of therapy, Amalia X was 35 years old. She lived as a teacher on her own and came to therapy for increasing depressive complaints. She especially suffered from religious scruples with occasional obsessive thoughts and impulses. Furthermore, Amalia X had to endure an idiopathic hirsutism. Her development and social adaptation had been affected by this observable fact, which she experienced as a stigma of a virile syndrome. She felt it as impossible to enter into any close sexual relationship. The presentation of this therapy of Helmut Thomä covers about 100 pages of the book. The following themes are described within the succeeding stages of the process: external situation, symptoms, body hair, sexuality, family, other relationships, self-esteem, relationship toward the analyst, idea of norm, relationship outside the family, topic of guilt, fear, the sexuality/masturbation topic of guilt, body, body hair related to sexuality, school, and anxiety. The case description not only contains many parts of the verbal interactions between therapists and patient; we can also read a longitudinal overview of the entire analysis built around changes in symptoms, manifest behaviors, general object relationships, and the specific transferences. Additionally, detailed cross-sectional accounts along the same dimensions are presented. This book documents the ‘‘longstanding work concerning the subject of psychoanalytic single case research’’ (p. xxiii) of the authors. In addition to the main authors Kächele and Thomä are included Joseph Schachter and several clusters of different authors from the Ulm Psychoanalytic Process Research Study Group. It should be remembered within this connection that Thomä and Kächele are the authors of three books that they edited over decades with international reputation, in which they developed the theory and practice of psychoanalysis based on systematic research on psychoanalytic processes and its results. Within this book, Thomä and Kächele reprint parts of their third volume from 2006 (Psychoanalytic Therapy, Research). In detail, it contains the following chapters:

Conceptualization of hostile psychopathy and sadism: Drive theory and object relations perspectives

Abstract: A distinct formulation of hostile psychopathy is presented, based on analytic clinical experience with psychopathic youth and adults. Two psychodynamic conceptualizations of aggression are presented – one connoting a basic destructive drive, the other portraying aggression as a means of ensuring gratification and countering frustration. Following Meloy's (1988) analysis of psychopathy as a combination of a deficient object relational capacity to bond and high levels of instinctual aggression, hostile psychopathy in general, and sadism specifically, are conceptualized from these two perspectives. Sadism, which features re-enacted events of violence, is posited as a distinct manifestation of hostile psychopathy with ritualized features attributable to object relations disturbances. Other variants of hostile psychopathy are analyzed as derivatives of more direct aggressive instinctual expressions that are not relational in their intent or function, in which destructiveness is an end in itself. Hosti...

Countertransference and changes in the conception of the psychoanalytic relationship

Abstract: The concept of countertransference has a long history in psychoanalysis. This paper sketches the phenomenon referred to by countertransference and the development of the concept, from being signs of disturbance in the analyst to an important road to knowledge about the patient's inner life. The complexity of the questions discussed today – how to understand the concepts of neutrality, abstinence, and empathy; the relative subjective mutuality and symmetry of the analytic situation; the analyst's enactments and self-disclosure of feelings – reflects the complexity of the contemporary view of the patient–analyst relationship. In conclusion, the author presents a model illustrating the disturbing and informative aspects of countertransference together with the conceptual relationship between countertransference on the one hand and empathy and projective identification on the other. Finally, by differentiating between intuitive and irrational levels of functioning, an integrated model for countertran...

Bion and Sullivan: An enlightening comparison

Abstract: The author compares the life and work of two pioneers and major sources of inspiration to the contemporary psychoanalytic debate: W.R. Bion (1897–1979) and H.S. Sullivan (1892–1949). Both their life and their work show similarities that allow the author to illuminate and constructively compare the one with the other. The author proposes his work as a useful exercise in the field of “comparative psychoanalysis,” an important key for the reconstruction of the history of our field and for a more scientifically coherent articulation of its theories.

The psychodynamics of forensic mental health nursing

Abstract: The aim of this paper is to clarify some important interpersonal dynamics that underpin forensic patients’ presentations within the clinical environment, in a way that is accessible to nurses. The world of forensic mental health nursing is often difficult to describe to those who have not experienced first hand prolonged clinical contact with patients at the therapeutic interface of secure services. Even then, the characteristic, intense emotional phenomena that tend to arise out of interpersonal relationships with patients and colleagues is not easy to articulate. Yet, for those of us who consider our professional identity to be one of “forensic mental health nurse,” it seems important to find a way to put words to what appears to occupy a large component of our working lives. More importantly, if we can develop a way to make sense of the way our work makes us feel and the way we can find ourselves relating to others within our professional roles, we will be in a better position to harness our e...

Children of Nazi Germany 60 years on

Abstract: Defence against shock, feelings of guilt, and shame about German atrocities during National Socialism (NS) have dominated the public discourse in Germany for decades. Mitscherlich and Mitscherlich have talked about the inability to mourn due to the involvement of most German families in Nazi terror. The research projects “Childhood in War” at the University of Munich and “War Children and their Flight” at the Hamburg DPG Institute are studying the long-term implications of a childhood during World War II and the Nazi period. In most cases, the personal development of the “war children” was affected – in the case of psychoanalysts, their psychoanalytic socialisation and current professional practice as well. The transgenerational transmission forms an NS introject in the personality. Due to their parents’ lack of empathy, war children are unconsciously looking for a containment of their unbearable feelings in their childhood. Psychoanalysis (including training analysis) becomes a stage where the a...

Mind works. Technique and creativity in psychoanalysis

Abstract: In 1999, Elisabeth Bott Spillius introduced the English edition of the first book by Ferro, The Bipersonal field: Experiences in child analysis (originally published in Italian in 1992), praising his ‘‘gift of clinical imagination.’’ In 2005, Thomas Ogden presented the English edition (2005) of Ferro’s sixth book, Seeds of illness, seeds of recovery (Ferro, 2005a; original edition 2002), emphasising what he called ‘‘the method’’ that Ferro transmits to his patients and to us as readers and colleagues. But now we have an exceptional achievement: the fifth book by Ferro to be translated into English in such a short time as 10 years (1999 2009). In his review of Ferro’s first book in the Italian Rivista di Psicoanalisi, Eugenio Gaburri (1992) congratulated the author on his original and brilliant revisitation of Bion’s work, and today we are (especially as Italians) very happy to congratulate him also on having been assigned (the first Italian ever) one of the three keynote papers at the next Chicago IPA Congress (July 29 August 1, 2009): ‘‘Transformations in dreaming and characters in the psychoanalytic field: Preliminary reflections on the difference between theoretical models in psychoanalysis.’’ In her review of Ferro’s first book, Athol Hughes (2000) had been able to tell the readers how his thought-provoking theoretical concepts were connected to the specific development of Italian psychoanalysis, with particular regard for its reception of the work of Freud, Klein, and Bion. As an aside, such a specificity, in terms of what he calls ‘‘Italian narratology,’’ was also emphasised by Werner Bohleber in his preface to the German edition of Ferro’s 1996 book, produced by the same publisher, Hans-Jürgen Wirth, who in 2003 had published in German Ferro’s first book, and at the beginning of 2009 the author’s fourth book. No wonder that the review of the original Italian edition of Ferro’s sixth book (2002), Fattori di malattia, fattori di guarigione published by the International Journal of Psychoanalysis was written by Anna Ferruta (former scientific secretary of the Italian Psychoanalytic Society, SPI), whose very good knowledge of his work allowed her to anticipate the theme of the book I will be reviewing below with the following words: ‘‘Ferro’s writing [and I would add here, clinical] skills . . . are like those of a great musician who can allow himself virtuosities while never for a moment forgetting, or lessening, the technical clarity of his performance’’ (Ferruta, 2003, p. 460). Ferruta ends her review by citing some words by Ferro (taken from the book she is reviewing) that express very well the synthesis between technique and creativity that he specifically pursued in his latest book: ‘‘The art of a psychoanalyst lies precisely in regulating the ‘breathing’ of the analytic field... the analyst is positioned as a breathing center that must constantly modulate according to necessity the breaths of the field’’ (cf. 2003, p. 462). The following year, Laura Ambrosiano (the present scientific secretary of the SPI) reviewed in the same journal the Italian translation of the second book by Ferro to have been published first in Portuguese: Il lavoro clinico. Nuovi seminari di São Paulo e Riberão Preto [Clinical work. New São Paulo and Riberão Preto seminars]. In this, she also emphasised one of Ferro’s themes (or methods) that informs Mind works: his adoption of Luciana Nissim Momigliano’s (1919 1998) stance of the ‘‘spiral dialogue,’’ that is, the usefulness of always considering what patients say after and/or how they react to our interpretations. ‘‘Ferro,’’ writes Ambrosiano furthermore, ‘‘believes that the analyst makes the quality of his mental functioning available to the patient, rather than his interpretations, with the transformations that this quality allows and with the risk of dysfunctioning that it implies’’ (2004, p. 1037). This is also one of the aspects of Ferro’s work which Irene Cairo (New York) particularly stressed in her 2007 review of two of his books:

Disturbances of “groupishness”? Structural violence, refusal and the therapeutic community response to severe personality disorder

Abstract: We explore the problematic dynamics in the relationship between societal systems of care and the chronically excluded, with particular reference to severe personality disorder and the “difficult-to-reach” patient. The individual who “refuses” is often met with a violent response: yet his violence must be understood as related to an experience of being violently excluded. We reformulate personality disorder as a disturbance of “groupishness” and suggest, as a paradigm for the problem of refusal, the story of Diogenes the Cynic, who “holed himself up” in a barrel; and of his legendary encounter with Alexander the Great, who tried unsuccessfully to persuade him to “come in from the cold.” We suggest it may be as important to focus on Alexander's violence as on that of Diogenes, and we examine modes of violence deployed by society against the excluded outsider, with particular reference to the hostile attribution of intentionality to the personality disordered individual's acts of violence and self-h...

The use of psychoanalytic knowledge during the implementation of penal measures

Abstract: Theoretical and clinical concepts of psychoanalysis are presented here in terms of their relevance for forensic psychotherapy. They can be applied to individual psychotherapy, special nursing care, and the theory and practice of a therapeutic community. Essential concepts of seduction and traumatisation are presented in the language of drive psychology, as well as in the modern terms of self psychology and object relations theory. The criminal act forms the basis of forensic psychotherapy, the aim of which is to prevent a repetition of this or a similar act. This means that a certain type of act, namely a criminal act, lies at the heart of not only forensic psychotherapy, but also the concept of action itself. Psychoanalytic concepts stress the unconscious processes around and after the act. These processes are repeated in the everyday life of the therapeutic community and in the specific psychotherapeutic situations. Empiric evaluations are methodologically very difficult, as they must investiga...

From “disciplined subjectivity” to “taming wild thoughts”: Bion's elaboration of the analysing instrument

Abstract: Freud encouraged the analyst to use his unconscious “as an instrument of the analysis,” but did not elaborate on how this should be done. This recommendation opened the door to a consideration of unconscious communication between the analyst and patient as an intersubjective exchange. Both Wilfred Bion and Erik Erikson emphasised the importance of the analyst's intuition, and the author compares and contrasts these two approaches. Erikson advocated a more cautious attitude regarding the analyst's subjectivity, while Bion promoted a broader application of the analyst's various private reactions to the analysand. A brief vignette from the analysis of a five-year-old boy is offered to illustrate the importance of the analyst's reveries, the mutual process of containment and transformation between analyst and patient, and the co-creation of an analytic narrative.

Transference and the psychoanalytic encounter

Abstract: John Klauber's introduction of the concept of “encounter” signifies a milestone on the way towards an intersubjective understanding of the psychoanalytic method. The concept of encounter is comprehensive and refers to all aspects of the “here-and-now,” including transference from the “then-and-there.” Klauber's contribution points out that the psychoanalytic situation is primarily a therapeutic one. The solution to the transference depends on new experience, and therefore he emphasizes the role of spontaneity. Klauber describes unintended traumatizing aspects, one of the antidotes for which is spontaneity. What is real and actual in the transference should be admitted – at least as “plausible.”

The exclusion of psychoanalysis and psychodynamic psychotherapy from the publicly financed medical health sector in Sweden

Abstract: Two years ago, the Swedish National Agency for Higher Education questioned the right of the Swedish Psychoanalytic Association and the Swedish Psychoanalytic Society to issue diplomas in psychotherapy (Sjödin, 2007). This critique initiated a process that has ended with a radical change in the conditions surrounding psychoanalysis and psychodynamic psychotherapy in Sweden. At the last meeting of the editorial board of the International Forum of Psychoanalysis, we discussed this new situation. Several members of the board expected a similar development in their own countries, especially in those countries within the European Union that have a developed social security system that includes psychotherapy. In Sweden, most medical treatment is publicly financed and controlled by county councils. Even if the Stockholm county council is politically elected, it follows national laws and is supervised by national institutions, such as the National Board of Health and Welfare. These in their turn are guided by the work done by the Swedish Council on Technology Assessment in Health. The Swedish National Agency for Higher Education supervises higher education, including psychotherapy programs. Together, these organisations control the medical health sector and training in the professions, regulated by legislation. The national institutions also have to adjust to the laws and institutions of the European Union. The Bologna Process affects training, and the right of professionals to work in a regulated profession is regulated by Directive 2005/36/EC but is also affected by the fundamental principles of the constitution.

Psychic structure and identity in a globalising world

Abstract: The author presents some psychoanalytic views on the current trends of our globalizing world. He then revises the concepts of psychic structure and psychic identity and discusses how both aspects might be influenced and challenged in a globalizing world.

Fatal violence – from trauma to offence: A case study in forensic psychotherapy and trauma therapy with a migrant patient

Abstract: That persons who are objects of violence and traumatisation become offenders themselves is a typical feature of ill-fated cycles of violence in countries torn by fierce political, ethnic, and religious conflicts. Some refugees and migrants with this background present a challenge to forensic psychotherapy when they continue such patterns of physical force and criminal behaviour in a host country like Germany, and are found to be either not responsible or of diminished responsibility for their criminal acts by reason of mental disorders or addictions. Their offences create a critical legal situation for them, since they are threatened with deportation. At the same time, their clinical condition is critical, for they were possibly subjected to traumatic experiences by authorities in their past; their cooperation in the treatment can seriously affect their legal status. Finding a way out of these complications has to take these special factors into account. Our paper focuses on the case study of a r...

Experiencing the shadow of the future

Abstract: This text was written for a panel with the ambitious title “With Bion to the future.” Can we tell something about the future? Can we apply this to the future of psychoanalysis? And are some of Bion's concepts of any help to such questions? Bion, following Freud, tells us that the caesura between present and future is not so great. The shadow of the future is present. So how can we read this shadow with Bion as a companion? We may see the future as consisting of many probable evolutions – like an infinite number of virtual lines, growth curves or probability lines only one of which is becoming real. Which lines will develop; which seeds will grow? And is our mind equipped to have an idea of this?

Reflections on catastrophic change

Abstract: Bion asserted that the possibility of change inherent in emotional growth and development was inevitably linked to fears of catastrophe. Did he intend this to apply to all patients and parts of the mind, or only to psychotic areas of functioning? Does subsequent clinical experience substantiate the universality of this assertion? These questions will be taken up from a general theoretical perspective in an attempt to understand what Bion had in mind when he proposed this view, and a clinical case will be presented to illustrate and examine the link between catastrophe and change.

Fascination, alienation and fear of contact: Ethnopsychoanalytic considerations on large-group identity

Abstract: The subject of large-group identity has repeatedly been raised and elaborated upon in psychoanalytic discourse by Vamik Volkan (1999, 2002, 2005). Having developed this term, he has above all appli...

Oedipus in China: Can we export psychoanalysis?

Abstract: The author describes experiences gathered during several years of teaching psychodynamic psychotherapy with psychologists and psychiatrists within a 2-year-training programme in Shanghai, China. Questions and problems of the reception of psychoanalysis – shame, sexuality, harmony, abstinence – as well as the possibilities and limitations of exporting psychoanalysis are discussed. The possible future development of psychoanalysis in China is also outlined.

Bion, Rangell, and Haynal: A pioneer and two protagonists of contemporary psychoanalysis – a selection of papers of the Bion 2008 Conference and two interviews

Abstract: Thanks to the initiative of his “Italian ambassador” Francesco Corrao (1922–1994), past President (1969–1974) of the Italian Psychoanalytic Society (SPI), and of Bion's daughter Parthenope (1943–19...

Psychoanalysis and forensics – identifications with the oppressor and with the oppressed

Abstract: I thank the Editors and the Editorial Board of the International Forum of Psychoanalysis for the honour to edit a special issue about forensic psychotherapy. Psychoanalysis in forensic settings like prisons and special psychiatric inpatient and outpatient units has often had the touch of less precious, less pure psychoanalysis. However, starting with Sigmund Freud himself, psychoanalysis has dealt in a significant way with forensic issues. This included amongst others August Aichhorn’s work with antisocial adults and Edward Glover’s introduction of group and individual analysis into high security units in the United Kingdom (Hoffmann, 2005). Psychoanalysis has never been restricted to a technique used in private practice. Analytic parameters (Eissler, 1953) taking into consideration different ego-structures do not only exist in prisons, in forensic units, in mental hospitals, in child-care-units or in halfway houses, they can also be discussed for the private practice situation (Who sends a patient for what purpose? Who pays for the treatment? Which information about the patient does the health insurance company require?). Especially in the tradition of the Institute of Psychoanalysis (IfP) and its founder Norman Elrod, psychoanalysis deals with individual, collective and societal subjectivities (Rostek, 2003). This approach is essential to forensic psychotherapy, in which identification with the oppressed (when and how are or were we victims, when and how are or were we perpetrators?) and gender issues (male and female identifications) are essential. The forensic department of Reichenau Mental Hospital organised a jubilee symposium on 7 December 2007 where many of the contributions of this volume were presented to a multiprofessional audience (psychoanalysts, psychiatrists, clinical psychologists, nurses, social workers, justice people). Klaus Hoffmann presents the psychoanalytic foundations of forensic psychotherapy including psychoanalytic remarks about what delinquency and criminals mean for society. These concepts are relevant for understanding patients’ biographies and for the work and attitude of the staff working with these people. In recent years, studies using attachment and mentalisation concepts have shown how strongly early deprivations are connected with later violent and delinquent behaviour. Working through early experiences of traumatisation and of criminal actions and fantasies is essential in forensic treatments. Contemporary clinical approaches include group analysis and therapeutic communities. The attitudes of all the staff members, of the administration and of political authorities are essential. Revenge and salvation fantasies prevalent in patients and care-givers have to be analysed as well as their common feelings of boredom, depression and despair. Samuel Juni goes deeply into the important contemporary discussion about psychopathy. Psychoanalysis is not free from biologistic conceptions. Aggression and destructiveness can be seen as a result of frustration, but also as innate traits. In the author’s view, the built-in aggression serves mainly self-protection and less libidinal purposes. Juni shows how persons who have been abused in childhood re-enact their past by looking for abusive partners. He demonstrates that sadism as libidinal drive is not the same as psychopathy. John Adlam and Christopher Scanlon develop Bion’s concept of groupishness in terms of the dialectic between the individual and society, interpreting the story of the philosopher Diogenes and the emperor Alexander the Great. The question of power is more central than the issues of diagnoses which are to be seen in the socio-political context:

Alpha-transformation, mental void, and edition

Abstract: There are patients whose outstanding feature is a particular difficulty in “communicating with themselves.” According to Bion, who reconceptualized Freud's theory, all of us have in our inner world the potential for both producing and blocking alpha-transformations. When they are blocked, beta-elements are formed, which are unable to generate thought. Our capacity to think and to think “ourselves” depends exclusively on alpha-elements. Patients suffering from problems derived from a compensated “structural mental void” are unable to think. Following Bion, the “non-edited” would, generally speaking, be one of the facts that condition the formation of beta-elements. The production of beta-elements transforms these personalities into “functional illiterates.” To what extent can we ignore the “novelties” that these patients present us with through the production of beta-elements and “bizarre objects”? I wonder whether the concepts of “repetition” and “re-edition,” as they are currently used in the cl...

Gender constructions from a project on sex offenders

Abstract: The four-year group therapy of 16 sex offenders in prison was videotaped, and 21 sessions were carefully transcribed and analysed by means of conversation analysis and analysis of metaphor and narration. These qualitative methods are apt for verbal data and can be combined with psychoanalytic thinking in a productive way. New forms of process analysis can be developed. The results presented here are selected to relate to the topic of how the imprisoned group therapy participants constructed “gender” by ways of speaking about themselves, women, and their victims, young girls. The results show that it would be a mistake to think of these ways of speaking as if they could be ignored in favour of “deeper” motives, lying “behind” the words. Our results show how unconscious constructions of gender are not beyond language, but in language. “Doing gender” is a conversational practice.

Inner freedom and independence: An interview with André Haynal

Abstract: This interview, performed by e-mail from December 2007 to September 2008, covers the psychoanalytic itinerary of Andre Haynal. His emigration from Hungary to Switzerland gave him occasion to think about alienation and its significance for identity. Gustav Bally, among others, introduced Andre Haynal in the Swiss Psychoanalytic Society after a very special interview. Other encounters with prominent and interesting personalities such as Jean Piaget and Michael Balint are also evoked. Furthermore, Haynal′s involvement in the publishing of the Freud–Ferenczi Correspondence and in the renaissance of Ferenczi's influence in contemporary psychoanalysis is also discussed.

Following old paths to new places – thirdness, mentalization, and the search for a transformational meeting

Abstract: Both parts of the therapeutic dyad are searching for ways of relating between them that are more flexible and that open up new possibilities for thought and feeling. When therapy succeeds, patients transcend old transference expectations and fears in a meeting with another subject, a meeting with qualities of something essentially new. Here, it is hypothesized that the patient in the transference unconsciously searches for a transformational meeting with another person. Through the interaction that is a result of this search, the patient moves between twoness and thirdness, and thereby enhances his or her mentalizing capacity. A transcript (of recorded material) from an intensive psychoanalytic therapy with a female patient in her early twenties is presented, analyzed, and discussed, focusing on how she made progress in her relational search during a session.

Meeting Venus: A film about passion, and the outsider

Abstract: This paper discusses the conflict between lustful desire leading to an extramarital affair and loyalty to one's partner. Drawing a parallel between the hero of Wagner's opera and the conductor-hero of the film Meeting Venus, the consequences of being an “outsider” are being considered. Whereas Tannhauser's conflict is resolved in that he finds salvation from the Virgin Mary, Szanto is abandoned by the woman he loved and by his wife. He remains an outsider and alone.

Sarah and the camps: Case history, metapsychology and countertransference

Abstract: Violence inflicted on men and women has repercussions on succeeding generations. Indeed, suffering that is not narrated and shared can become masochism and destruction. Based on a clinical case, I will propose an illustration of this fact and discuss it. I will also propose a discussion of countertransference linked to this case history. Finally, I will approach some topics on metapsychology and the way I use this concept to understand my experience.

The role of action in a creative theory of personality

Abstract: Psychoanalysis is a technique to let creativity develop, and thought must be a prelude to action, rather than its substitute. Megalomania, redefined according to Bion as the capacity to act responsibly, lies at the extreme positive end of the spectrum of personality.

Hiding and being lost: The experience of female patients and staff on a mixed sex secure ward

Abstract: In this article, I explore the themes of hiding, losing, and being found in relation to the experiences of women in secure mental health settings. Their hidden abuses, acts of violence, creative aspects, and secret desires play a central role in their identity, but are often lost to those who work with them, and even to the women themselves. Psychotherapeutic engagement with these women, including the work of arts therapists, can enable them to give voice to their hidden experiences, to disclose and explore their violent thoughts, feelings, and actions. Sometimes the women have used their bodies to encode those experiences which cannot be put into words, for example through hidden acts of self-harm. For other women, sexual feelings are hidden away, through shame and guilt. I will explore how therapeutic approaches can enable what is hidden to be brought into the open, using illustrative clinical material and inviting discussion throughout.