Duncan Cartwright

The Psychoanalytic Research Interview: Preliminary Suggestions

Psychoanalytically informed interview techniques and interview analysis can yield useful psychoanalytic insights about a particular research subject within the space of a few interviews. Basic hermeneutic principles, often used to understand the research interview, are not sufficient for understanding unconscious meaning and intrapsychic processes; they pay little attention to the particular theoretical and technical aspects of the interview needed to create the best conditions for understanding unconscious meaning. The portability of psychoanalytic concepts and their applicability outside the therapeutic setting are considered, after which four epistemological principles are outlined, derived mainly from the narrative tradition in psychoanalysis, that can inform interview technique and the analysis of the interview. Careful attention to feeling states, the search for core narratives, and the exploration of identifications and object relations are isolated as key analytic tasks in the interview analysis. A brief verbatim interview is used to illustrate this process, and methods are suggested to prevent the “wild analysis” of the interview encounter.

The Role of Psychopathology and Personality in Rage-Type Homicide: A Review

This article reviews the role of psychopathology and personality in offenders who have committed acts of rage-type murder. The possible role of depression, PTSD, psychotic disorders, intellectual functioning and alcohol/drug abuse are critically considered. It is argued that although some forms of psychopathology may be indicated in some cases, these still remain in the minority. This seems to be consistent with findings that describe such offenders as ‘apparently normal’. In an attempt to explain this further, the character profile and psychodynamics of personality are reviewed. A pattern of overcontrol is isolated as a key theme that best explains the ‘apparent normality’ of the rage-type offender. The relevance of the DSM-IV classification system of personality disorders for understanding this kind of criminal is considered. It is argued that a particular type of borderline personality organisation, not isolated by the DSM-IV system, best explains this character pattern.

Borderline Personality Disorder: What do We Know? Diagnosis, Course, Co-Morbidity, and Aetiology

Evidence regarding the diagnostic dilemmas, course, co-morbidity, and aetiology of Borderline Personality Disorder (BPD) is reviewed. After considering problems that the clinician and researcher face in using BPD as a diagnostic category, I argue that current evidence indicates that there is reason to be more optimistic about the course of BPD. Emerging dilemmas in considering co-morbidity in the BPD patient are considered. Aetiological factors are presented in support of a ‘multiple pathways’ model of aetiology where characterological and temperamental characteristics interact in complex idiosyncratic ways.

Autistic Defenses in Agoraphobic Syndrome: “Flat” Objects and the Retardation of Projective Identification

The function of autistic defenses in the generation of agoraphobic symptoms is explored in the case of a patient treated in psychoanalytic psychotherapy. The therapists growing awareness of autistic modes of relating in the case facilitated various changes in the transference relationship. Although oedipal concerns are seen as important, a formulation is presented whereby autistic modes of generating experience are viewed as fundamental to an understanding of agoraphobic experience. Clinical findings in the transference-countertransference relationship led to the additional observation that the retardation of defensive forms of projective identification further contributed to the patients agoraphobic difficulties. This formulation is tied theoretically to the idea that agoraphobic experience occurs when the dialectic between paranoid-schizoid and autistic-contiguous modes of generating experience collapses. The treatment implications of these observations are briefly explored.

The experience of non-offending caregivers following the disclosure of child sexual abuse: understanding the aftermath

Non-offending caregivers play a critical role in mediating the child survivor’s recovery from child sexual abuse. Despite this, little has been documented about their experiences in the South African context. This exploratory qualitative study investigates the experiences of 10 caregivers following the disclosure of sexual abuse of a child under their care. Thematic analysis of the data revealed that caregivers experienced multiple forms of emotional, psychological, and situational difficulties following the disclosure of child sexual abuse. Five core themes were identified: distress, concern for the child, alienation, coping style, and grief. The findings suggest that not only do caregivers experience vicarious traumatisation but also that caregiver distress impacted their parenting abilities.

Trainee difficulties with therapeutic engagement: a qualitative study of in-session critical incidents:

Trainee therapists or psychologists starting to practice psychotherapy are met with a number of inherent difficulties in engaging their clients in the treatment process. Using interpersonal process recall and interpretive phenomenological analysis, 18 counselling/clinical psychology trainees were interviewed about core difficulties they faced in engaging their clients in a therapeutic process. Interviews look place after 10 weeks of training and trainees were asked to self-select a single video-taped session for the interview. The analysis uncovered seven main themes: (1) difficulties with ‘personal material’; (2) difficulties with certainty, control, and idealized intentions; (3) frustrations with the client’s presentation; (4) difficulty in becoming the focus of attention; (5) reactions triggered by perceived exclusion; (6) anxieties about difference; and (7) interpersonal strategies to manage intense emotions. Findings are understood to be organized around the trainee’s struggle for self-definition and agency at the expense of empathic relating.

A Catastrophic Solution: Psychoanalytic Perspectives on a Samurai School Attack in South Africa

The case of a rampage attack using a samurai sword is explored from a psychoanalytic perspective. The offender’s upbringing, his interaction in the school context, associated behaviors, and personality characteristics are used to shed light on unconscious and preconscious dynamics evident in the build-up to the rampage attack. A disorganized attachment system and the presence of “false-self” pathology appear to have important implications for the case. The role of malignant shame, dissociation, compulsive fantasy, and deficiencies in the capacity to mentalize are discussed.

A cross-sectional survey of South African psychology interns’ perceptions of negative supervision events:

Prevalence rates of negative supervision events among Psychology interns in South Africa are non-existent. This article investigates the incidence of negative supervision events and explores the influence of various contextual variables on supervision outcomes. Quantitative data were obtained via a web survey from a sample (N = 92) of Clinical and Counselling psychology interns across nine provinces in South Africa. In all, 42 (or 45.6%) of the 92 participants had a negative supervision event during their internship, 26.19% categorized their experience as ‘Harmful’, and 73.81% (or 31) had an ‘Inadequate’ experience. A total of 14 (or 22.6%) interns experienced a negative supervision event on a weekly basis. Proportionately more White interns reported experiencing negative supervision events and had the highest number of reported harmful experiences. Neither race nor gender significantly impacted the feedback and evaluation process. A significantly larger number of mixed race and mixed culture dyads reported harmful negative supervision compared to same race/culture dyads. There was no significant positive relationship between inadequate or harmful negative supervision event and sexual orientation, theoretical orientation, gender, religion, and language. Implications for training and professional development are discussed.

Reflections on the History of South African Student Counseling Services: Achievements, Challenges, and a Way Forward.

ABSTRACT Student counseling services are a recognizable feature of higher education institutions locally and abroad. This article reviews the sociohistorical development and evolution of student counseling services in South African institutions of higher learning, with an emphasis on systemic influences, achievements, and contemporary challenges. This article considers the progress that has been made thus far with respect to the development of the service within higher education, while also attending to issues that require continued reflection and investigation. These include the current status and position of the service in South African higher education, the evolving roles of student counselors, as well as their relationship with institutional stakeholders and the broader South African community. In so doing, this article hopes to augment existing historical perspectives on student counseling by encouraging a critical reappraisal of student counseling’s past, its present, and its future in a dynamic South African and global context.