Introductions Setting The Boundaries For The Assessment

In our assessment role, we aim to create the best possible conditions for the patient to show himself as he is so that we can assess his problems and steer him towards appropriate help. Accordingly, our assessment style is worthy of consideration. Assessments are not approached in a uniform way by psychoanalytic therapists. Some clinicians advocate a more aloof stance in the context of an unstructured approach that gives the patient few cues about what is expected of him. This style of...

Psychoanalytic Perspectives On Anxiety

Freud placed the experience of anxiety at the core of our psychic functioning - the defining psychic burden of a human being. Because of the existence of the life and death instincts and their unavoidable conflict, Freud emphasised the inevitability of anxiety. Freud put forward two theories of anxiety. In his first theory he understood anxiety as a reaction to the build up of instinctual tensions. Anxiety was not connected to specific ideas or thoughts that were felt to be dangerous, but was...

The Challenges Of Working In The Transference

Not untypically, those new to the practice of psychoanalytic therapy are hesitant about making transference interpretations. When patients are encouraged to work directly with transference reactions, conflictual issues are identified and the patient's anxiety is heightened. The patient may perceive our behaviour as critical, attacking or intrusive. In these situations, we may find it difficult to be experienced as the bad, persecuting object. The interpersonal strain that is generated when...

The Holding Environment

The frame that supports the analytic relationship is also referred to as the holding environment, an expression that highlights its containing function. Bion 1967 drew a parallel between the mother's capacity to receive the raw intensity of her baby's projections, to empathise and to bear them, thereby rendering them eventually manageable for the baby, and the therapist's function of receiving, containing and transforming the patient's communications. This helps the patient eventually to...

The Erotic and Sexualised Transference

More has been written about resistances arising from aggressive impulses than those arising out of loving or sexual feelings towards the therapist. It is not the aim of this general chapter to enter into a detailed discussion of specific types of transference, but a few words on the erotic transference are perhaps indicated since it usually elicits considerable anxiety in the therapist. Freud helped us to understand that love is not only problematic in life but also in therapy. Freud 1915b...