Abstract The paper discusses the centrality of experience to the creation of meaning and the implications of this for analytic therapies, especially Jungian psychotherapy. Analytical Psychology includes a significant focus on the influence of image—through dreams, symbols and archetypal material such as myth, fairytales, religions and alchemy. In this paper, I focus on the areas of somatic experience, primary affects and metaphor as the underlying foundational contributors to experience. Supported by phenomenology, neuro‐affective research and clinical vignettes, my primary proposal is that meaning emerges from experience. Contemporary critiques of archetypal theory are briefly reviewed which call into question a priori elements of experience embedded in archetypal patterns and images. The paper proposes modifications of analytic training suggested by an emphasis on the creation of meaning as emerging from experience.
Abstract This study is rooted in Pakistan's socio‐political history. I consider Pakistani intergenerational trauma as leading to a state of mass hypervigilance, a psychic arousal that initially protects as a trauma response but, when chronic, can constrain feeling, imagination and free speech. As a group conductor, I explore how inhibition, liberation and imagination meet inside analytic groups and what enables speech to emerge. Two cultural metaphors orient this work: the legend of Anarkali and the Subcontinental Garden. Anarkali represents a female voice of resistance against male authority, showing how defiance can resonate with many and challenge hierarchies. The garden illustrates how, in hypervigilant communal systems, the growth of new species (like group analysis) may be fiercely resisted. This study is an example of how the use of poetry, a well‐rooted local form of knowledge exchange, can facilitate imagination and speech liberation in a hypervigilant social environment where other types of expression may be too inhibited. I argue that poetry and folklore can function as a postcolonial method for understanding the social unconscious (Social unconscious refers to the collective unconscious anxieties, fantasies, history and cultural fragments that operate outside awareness but shape social and group life) and disinhibiting free speech.
Abstract This deep‐hermeneutic single‐case study explores a therapeutic enactment marked by an ambivalent tension between intimacy and distance, encapsulated in the formula “come close – yet stay away.” Drawing on Lorenzer's method of deep‐hermeneutic text interpretation, the analysis reconstructs a therapeutic encounter in which an experienced psychodynamic therapist, in her pursuit of authenticity and emotional resonance, co‐creates a social boundary crossing that blurs the distinction between professional role and personal involvement. The reconstruction traces how the longing for genuine connection paradoxically culminates in a loss of symbolic containment, enacting a latent conflict between the wish for closeness and the fear of fusion. Boundary crossings are conceptualized not only as individual misconduct but also as intersubjective and culturally conditioned phenomena that expose the fragility of the therapeutic position within late‐modern ideals of authenticity and emotional presence. The study highlights the importance of reflective engagement with enactments, boundaries and power relations as integral aspects of professional competence and psychotherapeutic understanding.
God is often encountered in clinical work not as doctrine but as an affect‐laden inner figure that can soothe, accuse, withdraw or demand. Drawing on psychoanalytic accounts of God representations and identity status theory, this qualitative study examines how emerging adults relate to God across ego identity statuses, with attention to symbolic function, affect regulation and moral experience. Twelve Albanian participants (19–30) completed the Extended Objective Measure of Ego Identity Status (EOM‐EIS) and participated in psychodynamically oriented semi‐structured interviews. Reflexive thematic analysis generated six themes: inherited God as relational introject; God as inner conflict; God as emotional container; silence and distance; God as internal symbol; and moral authority versus chosen ethics. Identity Achievement narratives tended to show more internalized and symbolically flexible God representations linked to reflective morality and steadier affect regulation. Narratives associated with Moratorium and Foreclosure statuses more frequently featured ambivalence, surveillance or distance, with God functioning as a contested or inherited authority. Findings suggest that God representations can be read clinically as indicators of identity organization and of how individuals manage guilt, longing, dependence and agency. Implications are discussed for psychoanalytic psychotherapy and spiritually sensitive clinical formulation.
The aim of this study is to investigate the social emotional experiences of participants, such as creativity and spontaneity, during psychodrama sessions. In this framework, psychodrama sessions were conducted for 10 weeks with a group of 10 participants, 9 of whom were women, selected using the criterion sampling method. After the psychodrama sessions, the Marmara University Creative Thinking Tendencies Scale and a semi-structured interview form were applied to the participants to reveal the meanings of their experiences. Wilcoxon signed-rank test was used to analyse quantitative data and content analysis was used to analyse qualitative data. The results of the study showed that there were significant differences between the pre-test and post-test scores of the experimental group in terms of creative thinking tendencies in favour of the post-test scores. In addition, in line with the qualitative findings obtained through content analysis, the themes of positive impact, change and affected scene were achieved. The effects of psychodrama on ensuring group interaction, encouraging the expression of common problems and strengthening creativity are among the notable findings.
Men with antisocial personality disorder (ASPD) are frequently excluded from psychotherapeutic services and are often regarded as resistant to treatment. This paper explores the role of shame and difficulties with intimacy in a long-term therapeutic group in a non-custodial outpatient setting for men with ASPD and histories of serious violence. Drawing on psychoanalytic, attachment-based, and group-analytic perspectives, we examine how shame-experienced as exposure, humiliation and threat to bodily and psychic integrity-organises both violent behaviour and avoidance of emotional closeness in this population. Using clinical material from a group that has met weekly for over a decade, we illustrate how shame is communicated primarily through action, withdrawal and enactment, rather than explicit verbalisation. Particular attention is paid to moments of heightened relational intensity, including the impending ending of the group, which reactivated anxieties about dependency, loss and abandonment. We suggest that the group itself acquires a containing function that exceeds that of individual members or therapists, functioning as a form of collective regulation or 'wisdom of the crowd'. This process enables a tentative shift from the management of danger towards the experience of safeness, in which vulnerability and ambivalence can be partially tolerated. The paper argues that sufficiently long-term group treatment offers a unique opportunity to address the social nature of shame and the profound difficulties with intimacy characteristic of ASPD. Therapeutic change is conceptualised not as symptom reduction, but as the gradual capacity to remain in relationship without resorting to violence or withdrawal.
In the present study, the theoretical framework, basic concepts, application and advantages of the Relational Cyclical Model in psychological counselling are discussed. The Relational Cyclical Model aims to make sense of the relational worlds of individuals with a cyclical and contextual perspective and offers a new perspective on psychological counselling processes. In the theoretical framework, the connections of the model with psychodynamic theories, attachment theory and systemic approach are explained. It is emphasised how individuals' past experiences and contextual factors shape their current relational patterns. Basic concepts include relationality and circularity. How the model helps individuals to recognise and transform their repetitive relational patterns is discussed. In terms of its application in psychotherapy, the model's interventions for clients to develop awareness and insight into relationship dynamics are examined. In addition, the contributions of the model to help clients identify problematic relationship cycles and develop healthier relationship dynamics are evaluated. Among the advantages of the model is that it focuses on the relational dynamics of the clients and includes contextual factors. The present study evaluates the contributions of the Relational Cyclical Model to psychological counselling by presenting its theoretical and practical aspects. The evaluation of the model is important as it provides psychological counsellors with a comprehensive perspective on the process of making sense of and changing clients' complex relationship patterns. Considering the relational context in psychological counselling is also important in terms of helping clients develop deeper insights and consciously transform their relational cycles. In this context, the present study offers both theoretical richness and important practical implications for psychological counsellors.
This study explores the challenges in maintaining the therapeutic frame and attitude when working in a collectivist country like Pakistan, where boundary-keeping can conflict with certain cultural expectations. Drawing on 4 years of experience in a mental health clinic in Pakistan, I interrogate the frame in relation to culturally-specific expectations, focusing on examples where the frame risks being experienced as culturally incongruent and alienating. The analysis is informed by personal clinical observations and by reflective discussions with local psychodynamically oriented therapists. I will present a grounded account of how some of us navigate tensions between what we want to do, what we feel we should do and what we were taught to do, trying to maintain accountability without compromising the therapeutic frame or cultural sensitivity. I will argue that, in collectivistic contexts, flexibility and relationality are conducive to fostering a strong therapeutic alliance without compromising the analytic ethos. In writing this paper, I reflect on my own bias, having viewed the frame as a Eurocentric, rigid construct. I recognise my tendency to 'other' it, questioning whether it stemmed from colonial residues, patriotic ambivalence or a desire to culturally reinterpret and humanise analytic practice. I conclude that psychodynamically informed practitioners in Pakistan are pragmatically using the frame in a way that is congruent with the cultural context, but is also consistent with international critical discussions of the frame and the analytic attitude.
In this paper, I claim that Freud's original conception of the free association method-based on the principles of free association by the patient complemented by evenly hovering attention by the analyst, the mutual exploration of the patient's resistance to free association and the emergence of transference as a key element in the patient's resistance-has largely dropped out of use in the clinical thinking and practice of psychoanalytic psychotherapists. I bolster this claim by analysing a number of Clinical Commentaries from the British Journal of Psychotherapy, which show that the free association method has been largely replaced by a clinical method based on the idea of an interpersonal relationship. I argue that there would be significant clinical benefits to both patient and therapist by reinstating a method based on free association. Patient and therapist would have a clearer idea of how the therapy works. The exploration of the patient's resistance to free association creates a strong sense of cooperative working. And the initial emergence of a transference picture of the therapist as contributing to the patient's resistance establishes a solid foundation for future transference interpretations by the therapist.
In the context of Pakistan's medically dominated clinical training culture, where psychoanalytic thinking has a limited foothold, Balint groups offer a rare and vital space. They serve as reflective forums for exploring the doctor-patient relationship, where clinicians can safely engage with emotional complexity, ambiguity and relational depth. The work unfolds at the intersection of three cultural frameworks: a biomedical psychiatric training culture shaped by Euro-American nosology, the psychoanalytic tradition of Balint work and Pakistani sociocultural norms, including hierarchy, gender and religion. I argue that they cultivate psychoanalytic ways of thinking within a healthcare community largely unfamiliar with formal analytic training. This paper reviews how, since 2017, Balint groups for healthcare professionals in Pakistan have evolved into a society with a local Balint leadership training pathway. Rooted in Pakistan's context, the challenges in establishing Balint groups, conceptual resistance, institutional rigidity and cultural dynamics around emotional expression offer insights for psychoanalytically informed clinicians globally. These challenges provoke reflection on the cultural portability of psychoanalytic frameworks and the creative adaptations required to sustain reflective practice. Notably, these adaptations have emerged not from compromise but from a nuanced sensitivity to local dynamics, allowing the method to remain authentic yet alive and responsive within its cultural setting.
Abstract This paper develops a psychoanalytic field account of moral injury in dementia caregiving, understood as a disturbance of moral self‐recognition arising through the erosion of relational conditions that render moral experience recognisable, thinkable and inhabitable. Using a conceptual‐clinical reanalysis of two published case examples, it examines how reciprocity, recognisability and symbolic containment may weaken as relational and institutional fields change, leaving carers struggling to sustain a morally viable sense of themselves as caring and responsible subjects. Drawing on post‐Bionian field theory, the paper foregrounds the ego ideal as a field‐supported orientation through which carers sustain an image of themselves as loving, responsible and morally viable subjects. When this image loses relational support, ordinary limits and ambivalence may be experienced as signs of moral failure. Moral injury is therefore approached not primarily as the consequence of discrete ethical transgressions, but as a disturbance in the field conditions that sustain moral self‐recognition.
Encouraged by the journal's current Editor‐in‐Chief, as a new member of the Editorial Board with this essay, I use myself as a representative case example of current pluralistic trends in training in the United States and describe multiple threads that characterized my journey to become a psychoanalyst. Amid these pluralistic influences, I identify six vectors of concern for modern psychoanalysis and psychoanalytic psychotherapy as practiced in America: pluralistic training; how technology has changed the analytic frame; economic issues; diversity, equity and inclusion; political polarization; and the existential threat of climate change.
This paper describes a countertransference configuration that I have come to think of as the Analytic Superego, in which the patient's internal persecutor colonises the analyst's professional ideal and converts ordinary analytic striving into a persecutory demand for flawless performance. Drawing on clinical material from the analysis of Jane, a woman in her forties who presented with a profound sense of psychic deadness following the early loss of her mother, the paper explores how sustained transference pressure can weaken the analyst's ego and lead to a defensive collusion organised around intellectual mastery, leaving the work technically competent yet emotionally lifeless. The clinical problem is understood not simply in terms of the superego's severity but in relation to the ego's capacity to bear its demands. As the analyst relinquishes the defensive need for correctness and tolerates the patient's disappointment, the analytic atmosphere changes. Memory begins to acquire symbolic meaning rather than serving defensive recall, enabling mourning, symbolic memory and a renewed capacity for emotional presence.
This article examines how change becomes possible in couple discourse within psychoanalytic couple therapy. It proposes "couple discourse" as a clinical and theoretical concept for listening to the ways partners signify, project and transform experience together. Drawing on object relations theory, semiotics, philosophy of language and discourse studies, the article distinguishes between individual meaning and couple meaning, and between features of couple discourse that are more open to change and those that remain more resistant. Clinical vignettes are used to show how bodily-affective immediacy, conflictual exchange and symbolic mediation may be understood as different states within the couple's shared discursive field. The article argues that therapeutic change depends not only on interpreting unconscious projections, but also on cultivating shared language, first-person speech and agency within the couple relationship. It concludes that couple discourse offers a framework for understanding how partners may move from the repetition of early object relations toward more deliberate forms of dialogue, mutual recognition and shared meaning.
Long-term couples construct a shared world, a third entity neither reducible to either partner nor equal to the sum of their qualities. In this article, the entity is named the Third Body and argue that the existing concepts of relational thirdness, though illuminating, cannot together hold the four properties it requires: material conditions, unconscious saturation, a developmental lifecycle, and ruins. Benjamin's intersubjective third describes what the couple achieves when recognition succeeds and what vanishes when it fails; Ogden's analytic third captures the unconscious field but treats material circumstance as backdrop; Morgan's couple state of mind names a reflective capacity rather than a deposit; Britton's third position names a geometry but not what fills it when the capacity to occupy it has worn through. Drawing on Winnicott, Wittgenstein, Cavell and Ruszczynski, this study proposes that the Third Body is what occupies the place of potential space when the conditions sustaining it have failed: play that, once trust and surplus are exhausted, collapses into automated grammar. Clinical material from 14 months' work with a long-married couple grounds the argument in the consulting room. The concept emends the British couple psychotherapy tradition from within rather than displacing it from outside.
Psychoanalytic work requires that clinical material be understood in relation to the mental state from which it is communicated, rather than treated as meaningful in itself. This paper presents a composite case study drawn from an assessment of Jane, a 23-year-old woman with a history of anxiety, depression and identity disturbance. Focusing on four early consultations, the paper examines how rapidly shifting mental states, paranoid, depressive and manic, were communicated primarily through the pressures they exerted in the transference and countertransference. Particular attention is paid to the use of countertransference as a diagnostic and technical guide in conditions where the patient's need for certainty forecloses the clinician's capacity for independent thought. Gender identity is treated here not as a separate clinical category but as a particularly high-pressure instance of the general technical problem: the demand that the clinician respond to the content of the patient's certainty rather than to the mental state from which it arises. Within this framework, questions of gender identity are understood not as fixed statements about the self, but as expressions of particular mental states, in which defensive certainty and concrete thinking may temporarily displace symbolic communication. The paper highlighted the technical challenge of sustaining a reflective analytic stance when both the patient and the wider cultural and institutional context exert pressure toward premature certainty or action and argues that psychoanalytic work may function as a counterforce to such pressures, preserving the conditions for symbolic thought where cultural and institutional forces might otherwise foreclose them.
This piece considers disablism with particular reference to the physical, clinical spaces often used to practice psychoanalytic psychotherapy, and psychotherapy more broadly. We ask, where exclusionary and disabling clinical, teaching, working and training spaces continue to be used, how might we think about the states of mind that sustain this? We suggest that this in part reflects unconscious anxieties in action around impairment (which we differentiate from the process of disablement) which act to impair thinking and assist us to accept, tolerate or minimise the significance of such practices. In relation to this specific focus, we note that while a psychosocial understanding of disability has been emerging from the work of a small minority in recent years, disability and disablism remain often ignored or pathologised, and a medical model remains implicitly influential. In a limited way, we consider the policy approaches of registering organisations. We argued for further research, understanding, promotion and upholding of disability access standards.
In the philosophy of mind literature, consciousness is commonly defined not in terms of its physical correlates but rather its subjective character - the 'something that it is like to be' an organism. In this conceptual article, this formulation is applied to the study of neonate subjectivity, giving rise to the question: what is it like to be an infant? I begin by outlining prevailing responses to this question from the perspectives of Bionian metapsychology, mentalization, and affective neuroscience. These accounts demonstrate significant consistency in their conceptualization of a first differentiation of raw sensory and affective experience into the binary states of comfort and discomfort which, in health, are co-regulated with the caregiver in the context of the relational dyad. However, such coherence at the level of description does not amount to phenomenological access to what it is like to be an infant; reflection on this question reveals the epistemological gap between developed and infantile states of mind. I consider the utility of Bion's concepts of reverie and O as resources for negative capability in respect of the inevitable condition of not knowing. A brief vignette is presented to illustrate this framework. Implications in relation to infant observation and clinical psychoanalytic practice are described.
