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CHAPTER SIX: The Propositional Method for the study of psychoanalytic concepts

Freedman, Norbert; Geller, Jesse D.; Hoffenberg, Joan; Hurvich, Marvin; Ward, Rhonda Karnac Books ePub

Marvin Hurvich and Norbert Freedman

The Propositional Method to be described in this chapter is being presented as a way of generating another kind of evidence for the study of psychoanalytic concepts. Propositions become vehicles for framing this other kind of evidence, for facilitating new clinical observations, and for offering a structure for comparative psychoanalysis. It is both propositional and generative.

The Method to be described is a procedure to highlight the key features of psychoanalytic concepts, through a reliance on clinical observations and clinical generalizations, and an effort to decrease metapsychological language and formulations. It is intended to facilitate a systematic study of psychoanalytic concepts, and their application to the psychoanalytic process.

Concepts are not only elastic, changing over time, but they are also sources of controversy and conflict. They are statements evoking concordance, spelling out what we are thinking, doing, and inferring clinically, and they are sources of discordance. What we look for is a method that offers a genome that can encapsulate both the commonality and the diversity of thought, and then distil it so that it becomes available for analysis within a single frame. With the method in hand, we hope to find a coherent path towards confirmation or disconfirmation, thus enhancing coherence without succumbing to the search for universals.

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CHAPTER EIGHTEEN: Nodal moments and the essence of Progressive Symbolization

Freedman, Norbert; Geller, Jesse D.; Hoffenberg, Joan; Hurvich, Marvin; Ward, Rhonda Karnac Books ePub

Norbert Freedman and Rhonda Ward

The question is: “What have we learned about working through?” For some authors, this concept, given to us by Freud in 1914, is too vague, too all-encompassing, refers simply to a higher level of compromise formation, and hence should be discarded. Notwithstanding this pessimistic assessment, we undertook a specimen study, using the Propositional Method to illuminate the specific components of working through. We examined a transformation cycle, delineated its four phases, and distilled the specifics of each.

To review, within every phase we noted a paradoxical move: the initial symbolizing phase was marked by the appearance of induced transference regression and with it the onset of the downward slope (Chapter Fourteen); the desymbolizing phase, one of unambiguous regression, contained at critical junctures nodal moments, signs of reversal and signifiers of the upward slope (Chapter Fifteen); the enactive phase, marked by both patient and analyst centered enactments, culminated in higher symbolic forms (Chapter Sixteen); and the re-symbolizing phase, with the appearance of a frankly erotic transference, contained a mini-cycle, a recapitulation of the previous phases, leading to both higher as well as lower levels of symbolic functioning (Chapter Seventeen).

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CHAPTER SEVEN: Meet Mohamed and the method implemented

Freedman, Norbert; Geller, Jesse D.; Hoffenberg, Joan; Hurvich, Marvin; Ward, Rhonda Karnac Books ePub

Marvin Hurvich and Norbert Freedman

The recorded psychoanalytic therapy of Mohamed, a refugee from torture in Somalia, treated in Oslo, Norway is the subject matter of this chapter. We begin with a brief portrait of Mohamed, sketch out our method of analysis of the transcripts of sessions,2 present an account of the major variables of concern, Annihilation Anxiety (AA), and the symbolizing process (Symbolization and Desymbolization), and then return to the theme of our Propo-sitional Method with the question: how to infer clinical change or a process of transformation?

Mohamed was a political refugee from an African country. He was in his early forties and was an active Muslim. He had a wife and six children at the time of his arrest in the mid-Eighties for his association with groups opposing the dictator of his country. He was in prison for nine years, where he experienced severe torture, maltreatment, and under-nourishment, and was also sentenced to death. He was forced to watch the torture of his wife and one of his daughters, as well as to witness torture and other inhumane acts being inflicted on fellow prisoners, including children. A recurrent theme in therapy was his agony about what he had seen the soldiers and prison guards doing to others. This tormented him as did the physical suffering he himself had experienced. He managed, in spite of this, to find some comfort in his religious beliefs all through his time in prison. However, it was a hard blow for him when the authorities circulated a rumour that he had betrayed his comrades during torture.

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CHAPTER TWO: Patients' representations of the therapeutic dialogue: a pathway towards the evaluation of psychotherapy process and outcome

Freedman, Norbert; Geller, Jesse D.; Hoffenberg, Joan; Hurvich, Marvin; Ward, Rhonda Karnac Books ePub

Jesse D. Geller, Donna S. Bender, Norbert Freedman, Joan Hoffenberg, Denise Kagan, Carrie Schaffer, and Neal Vorus

The next three chapters explore the hypothesis that the operationalizing and measurement of the construct “representations of the therapeutic dialogue” can serve as a valid source of evidence about the outcomes of psychoanalytic therapy and the internalization processes whereby psychoanalytic therapy becomes and remains an adaptive resource in patients’ lives after termination.

The research strategy we have adopted to explore this central idea is based on our shared commitment to three basic operating premises:

1. We conceive of representations of the therapeutic dialogue as the intrapsychic equivalents or analogues of the types of verbal and nonverbal exchanges patients have with their therapists. As early as 1926, Freud came to the view that the very essence of psychoanalysis is that it is a conversation in which “… nothing takes place between [the patient and the analyst] except that they talk to each other” (1926b, p. 187).

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CHAPTER THREE: The RTD Coding System and its clinical application: a new approach to studying patients' representations of the Therapeutic Dialogue

Freedman, Norbert; Geller, Jesse D.; Hoffenberg, Joan; Hurvich, Marvin; Ward, Rhonda Karnac Books ePub

Jesse D. Geller, Donna S. Bender, Norbert Freedman, Joan Hoffenberg, Denise Kagan, Carrie Schaffer, and Neal Vorus

The Schedule of Therapy Remembered (STR) produced a rich narrative of people's recollections of their therapy experiences. How to use this information to get a measure of patients’ judgments about what was and what was not accomplished during a course of therapy now became the question to be answered.

The primary aim of Chapters Three and Four is to demonstrate the potential of the Representation of the Therapeutic Dialogue Coding System (RTDCS), as well as its operational definitions, scoring principles, and instructions. This will be followed by a presentation of the ways in which RTD scores can be analysed to be specifically responsive to the need for normative information about patients’ retrospective reconstructions of the verbal and nonverbal aspects of the therapeutic dialogue. Included are the first steps in analyses of RTDCS data sets used on a case by case basis to arrive at highly particularized outcome criteria and to try to test the hypothesis that the likelihood of benefiting from a course of treatment is increased if a patient avails himself/herself of the opportunity to construct, remember, use, and identify with benignly influential representations of the therapeutic dialogue in the physical absence of the therapist.

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