David Tuckett

Does anything go? Towards a framework for the more transparent assessment of psychoanalytic competence.

It has been difficult to know what does and does not constitute competent psychoanalytic work and so equally difficult to assess when it is being practised and when it is not. This makes difficult any form of disciplined evaluation of the outcome of training, which has a series of problematic outcomes for psychoanalytic practice, psychoanalytic institutions and the relationship to allied disciplines and professions. In this paper, the author considers how far it might be possible to devise a framework for assessment of training programmes within a disciplined psychoanalytic pluralism. The aspiration is to develop a transparent framework, based on an empirically supported demonstration of analytic capacity. The framework needs to be sensitive and subtle, and to be able to withstand challenge. It needs to take cognisance of the twin facts that there is more than one way to practise psychoanalysis and that it is necessary to avoid ‘anything goes’. Drawing on an ongoing project undertaken by European IPA institutes, the author describes some of the problems colleagues have been experiencing in European institutes, because they have not had available transparent criteria for assessment. He outlines a preliminary form of a proposed method for making more transparent and supportable assessment. The author intends for this paper to inspire hope, enquiry and debate.

Phantastic Objects and the Financial Market's Sense of Reality: A Psychoanalytic Contribution to the Understanding of Stock Market Instability

This paper sets out to explore if standard psychoanalytic thinking based on clinical experience can illuminate instability in financial markets and its widespread human consequences. Buying, holding or selling financial assets in conditions of inherent uncertainty and ambiguity, it is argued, necessarily implies an ambivalent emotional and phantasy relationship to them. Based on the evidence of historical accounts, supplemented by some interviewing, the authors suggest a psychoanalytic approach focusing on unconscious phantasy relationships, states of mind, and unconscious group functioning can explain some outstanding questions about financial bubbles which cannot be explained with mainstream economic theories. The authors also suggest some institutional features of financial markets which may ordinarily increase or decrease the likelihood that financial decisions result from splitting off those thoughts which give rise to painful emotions. Splitting would increase the future risk of financial instability and in this respect the theory with which economic agents in such markets approach their work is important. An interdisciplinary theory recognizing and making possible the integration of emotional experience may be more useful to economic agents than the present mainstream theories which contrast rational and irrational decision‐making and model them as making consistent decisions on the basis of reasoning alone.

To Be or Not to Be a Psychoanalyst—How Do We Know a Candidate Is Ready to Qualify? Difficulties and Controversies in Evaluating Psychoanalytic Competence

What constitutes competent psychoanalytic work, what criteria are used to evaluate psychoanalytic competence and how can we exchange about these matters among colleagues of different psychoanalytic orientations? These are the core questions investigated in an ongoing project of the European Psychoanalytical Federation (EPF) Working Party on Education (WPE). This article reports on several group discussions at EPF conferences over 4 successive years. Findings reveal a great interest in discussing the question of evaluation on one hand, but bringing up uneasiness and anxiety on the other, followed by a tendency to bypass saying “no” to not enough competent clinical work.

Basic readings in medical sociology

Basic readings in medical sociology , Basic readings in medical sociology , کتابخانه دیجیتالی دانشگاه علوم پزشکی و خدمات درمانی شهید بهشتی

Inside and outside the window: some fundamental elements in the theory of psychoanalytic technique.

The underlying concern of this paper is that psychoanalysis as practised today is in danger of losing its specificity and so losing its way. The author suggests this is possible for three reasons: the problem analysts face in responding to the strong emotional demands the great majority of patients necessarily place on them, the unintended consequences of the apparent success of ‘here and now technique’ and the absence of good clinical theory. The paper mainly discusses the author’s ideas about some core elements of the clinical theory that all psychoanalysts must use when they are working and proposes (at the risk of being facile) some relatively simple heuristics related to them which are meant to be helpful. Recalling Kurt Lewin’s maxim that ‘there is nothing so practical as a good theory’, he will suggest that continuous reflection on how one is using theory in daily practice is highly practical, if the theory is good enough. Theory in fact is a necessary ‘third’ in psychoanalytic practice which, if kept in sufficient working order close enough to clinical experience, provides an ongoing and very necessary check on our sense of reality. But, of course, as a third it can, like reality itself, be the focus of both love and hate with equally problematic consequences. The paper starts with a clinical example of a difficult but apparently successful analysis reaching its end, which will be used throughout the paper to illustrate and elaborate the theoretical ideas set out.

TOWARDS A MORE FACILITATING PEER ENVIRONMENT

As this is the last Part of the International Journal for which I am responsible, I would like to end by indulging in some personal reflections. These remarks are prompted by some thoughts about what I now consider I have been trying to do for the past twelve years and where I think we still need to try to go. For some time now it has been common to speak of psychoanalysis as a discipline in crisis. Those who use this term usually have in mind the difficulty some colleagues have in att racting patients or the reduction (at least in some centres) of applications for training. They may also be thinking of the assault on previously taken-for-granted psychoanalytic leadership and privilege that has emerged through competition from competing psychotherapeutic and psychiatric treatment approaches, governmental or quasi-governmental regulation or from competing intellectu al disciplines. At the back of everyone’s mind may be an uneasy awareness that these difficulties exist despite the fact that more and more people worldwide are seeking talking treatments loosely based on Freud’s work. Something is wrong. One way of looking at the problem is to consider that psychoanalysis has failed to transform its clinical achievements and its capacity to illuminate human subjective experience into a securely held and demonstrable set of propositions. It has struggled to be more than a set of opinions underpinned by dogma or ideology, and nowhere more than in those instances where psychoanalysts have found it impossible to agree on fundamentals themselves. This struggle has implicat ions when we consider questions such as who can call themselves a psychoanalyst, what the difference is between a psychoanalyst and a psychotherapist, when a candidate is competent to practise, how we select training analysts and how we relate to other professions and branches of knowledge. Personal experience and anecdote suggest to me that within our profession and within most schools and approaches there is a wealth of clinica l experience and a wealth of good psychoanalytic practice. Many psychoanalysts and many psychoanalytic patients have direct experience of the sensitive and skilful psychoanalytic understanding that exists among us. And yet, even among psychoanalysts, quite leaving aside our critics, it is also true that there has been a collective intellectu al failure to establish secure consensually agreed and demonstrable propositions concerning key questions of theory and technique. I would say, despite a hundred years of practice, what psychoanalysis is, that what a psychoanalytic treatmen t is and how and on whom it works, are all very much in doubt within the discipline, let alone outside it. Indeed, when spelt out in detail few psychoanalytic propositions are treated consensually as having a ‘real’ value, in the sense that to ignore them is considered consequential. N or are they agreed as useful truths so that they necessarily limit the scope for competing beliefs and so constitute a secure fund of knowledge from which any other proposition must take off. As one example, the central concept of transference is a subject for dispute, being

A Psychoanalytic Interpretation of Dot.com Stock Valuations

Financial economists are unable to provide plausible explanations for Internet stock valuations during the recent asset pricing bubble consistent with market rationality. Adopting a psychoanalytic perspective, this paper argues that investors became caught up emotionally with the drama leading to market prices departing in such an extreme way from fundamental value. Specifically, we propose a psychoanalytic theory of mental objects and show how this helps explain what actually took place during the different phases of dot.com mania. The paper concludes, more generally, that an understanding of how emotions determine psychic reality in stock valuations can usefully complement the contribution of conventional normative asset pricing models.

Betty Joseph 1917–2013†

Betty Joseph, who died aged 96 on 4 April 2013, was a member of the British Society, a Sigourney Prize winner, an internationally acclaimed teacher and supervisor and one of the most outstanding contributors to clinical psychoanalysis, ever. Joseph’s main written contributions were gathered together with the help of Michael Feldman and Elizabeth Spillius in her Psychic Equilibrium and Psychic Change (Joseph, 1989), published in the New Library of Psychoanalysis. Central to her thinking, teaching and practice was her work on transference and countertransference, approached through the lens of attending to the fine details of the psychoanalytic session and the analyst’s and patient’s contributions to it. To set out her contribution as clearly as I can I will use her paper Transference: The total situation as illustrative of my view of her seminal contribution. The paper was presented at a scientific symposium of the British Society in December 1983 and then published in this Journal in 1985 (Joseph, 1985). It starts with characteristic Joseph phrasing – familiar not just to colleagues in clinical and scientific discourse but also to friends and relatives when making social arrangements with her. She states her intention to discuss “how we are using the concept of transference in our clinical work today” (italics added). Her use of “we” in this passage expressing, on the one hand, her genuine modesty and location of herself within a team of contributors, while at the same time definitely containing a hint of the royal prerogative and her ambiguous self-deprecating wit. It was always fun as well as inspiring and a privilege to be with her and to work with her in just such a spirit. The fact is that, while it is quite possible to place Joseph’s way of thinking about transference and countertransference inside a long line of contributions from Freud to Klein, Bion, Heimann and beyond, as she did herself, my experience of the way she used these core concepts and made them her own makes me think they were foundational. At some point increments become a paradigm change and I think her contributions along with those by Bion mark such movement. Anyone who had the chance to discuss their clinical efforts with her over any kind of extended period, as I was lucky enough to do, came to appreciate the central concepts afresh. Her core idea about the clinical situation and the role of transference–countertransference within it appears early in the paper I have chosen to discuss:

Bringing Social-Psychological Variables into Economic Modelling: Uncertainty, Animal Spirits and the Recovery from the Great Recession

Conviction narrative theory (CNT), a social psychological approach to the way economic agents take deisions under Knightian uncertainty, together with the new methodology of directed algorithmic text analysis (DATA), provide the opportunity for a theory of economic sentiment or animal sprits grounded in empirical facts. Applying DATA to the full text of the daily Reuters news feeds from January 1996 through November 2013, we derive an “animal spirits” series for both the US and the UK economy. Both series inform the movements in real GDP over the period. For example, in both countries there is a marked downturn in animal spirits in June 2007, well in advance of other indicators of the coming recession. The series may also explain why the subseqeunt recovery has been exceptionally weak from a historical perspective.

To what extent is personal experience and external validation essential in psychoanalytic therapeutic training

Based on a paper presented at an International Conference to celebrate Freuds 150th anniversary and entitled Therapeutic Training after Freud, organized by the Centre for Therapeutic Education, Roehampton University and the Freud Museum, Saturday 20 May 2006. With thanks to the Centre for transcribing the original talk.