BRITISH JOURNAL OF PSYCHOTHERAPY

EDITORIAL

Volume 13, Number 2, Winter 1996, pp.161-162

In our pluralistic times we have so many different models of psychoanalysis and psychotherapy in existence that it can be difficult to see overall trands, changes or even practices that we all share. It is possible, however, to see a movement in psychoanalytic thinking away from a positivistic scientific model in which insight or clinical fact is discerned by an objective analyst and then delivered to the patient, towards a model in which psychic truth is reached mutually, created by the clinical couple in the ongoing therapeutic dialogue. Paving the pathway to this progression has been the validation and development of the countertransference not only as a communicative function but as representing the contribution and inclusion of the mind of the analyst. This intersubjective view in which the analyst's and patient's subjective responses to each other create symbol and meaning might well cause confusion and alarm, threatening to shake the analyst out of his safe, shadowy neutrality and edging him into a less comfortable, intersubjective spotlight. This anti-authoritarian move would appear to be immensely destabilizing, for who is the ultimate arbiter of the truth when there are disagreements? Yet it is difficult to see the analytic situation as other than an intersubjective project, given that there are two minds at work, or how else to construe the interaction other than as the therapist and patient taking in each other's projections, adding something to them, then giving them back for further elaboration until truth is found - a joint creative effort.

In a paper that takes account of the difficulty in capturing the human subject in all its 'lawless profusion', Georgia Lepper offers a research methodology for the therapeutic dialogue that consists of studying the language and discourse of the consulting-room. Discourse analysis, developed in the field of sociology, could be adopted by psychoanalytic research to illuminate the elements of interpretation and therapeutic process, with a potential for examining intersubjective models. Lepper calls for those who are interested in research to come forward.

Empathic attunement versus neutrality is an important intersubjective question. Jackie Gerrard claims in her paper that feelings of love must be experienced by the therapist towards the patient in order for progress to be made in the therapy and for the patient to overcome self-hate. Our next paper, by Marguerite Valentine, sharply contrasts with Gerrard's. It is an account of three analyses that would seem to be suffering from an excess of the classical, objective stance in which the patient is fitted into the theory.

Then we have a paper by Sami Timimi about the inpatient treatment of a borderline adolescent girl of mixed race whose treatment entailed attempts to integrate split black/white identifications.

Memories, too, are intersubjective phenomena. We present two further contri butions to the memory debate by Phil Mollon and Jeremy Holmes. Mollon, who was a
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member of the British Psychological Society working party on recovered memories, writes of the 'mutilated' states of consciousness of patients who had severely traumatizing childhoods and how fragments of memories of abuse present in the consulting-room. He recommends a position of tolerance of uncertainty and presents guidelines for psychotherapists for the avoidance of creating or colluding with false memories. Holmes, from an attachment and object relations point of view, looks at memory in its context of early Freudian theory, contrasting it with concepts of memory in contemporary psychoanalysis. Integrative theories from cognitive psychology are brought in, as Holmes discusses memory as an active system depending on the state of the person and his relationships, outlining the treatment of patients with traumatic pasts in which a present therapeutic context of a secure attachment, recontacting the 'good object', can bring recovery.

In the next paper, Katherine Killick shows how effective analytic art therapy can be in containing patients with an extreme degree of disturbance and disintegration. Will the art room as a sanctuary for outpatient treatment disappear?

Then we have two articles on Holocaust survivors. Alfred Garwood offers a new explanation of survivor guilt: it is induced by self-blame which is an omnipotent defence against helplessness and annihilation anxiety, linking with primitive, pre-oedipal helplessness and object loss. Such an omnipotent defence inhibits mourning. Winship and Knowles, too, write of obstacles to mourning, stating that in survivor syndrome the magnitude of social trauma is directly proportionate to the time it takes to mourn, its delay increasing transgenerational disturbance so that hidden trauma produces severe unconscious disturbance in third generation survivors causing serious depressive anxiety, suicidality and somatization.

Finally, we offer Ivan Ward's thoughts on the Freud Museum conference on 'Adolescent Phantasies and the Horror Film Genre' at the National Film Theatre. Ward discusses the attraction of the young to the horror theme, its allure being that it gives a form and content to unconscious fears and mirrors the play of internal objects, the hero, the monster, the victim, helping to resolve developmental tensions. He uses Freud's foray into literary theory, his essay 'The uncanny' (1919), demonstrating Freud's willingness to take popular culture seriously.