Entries followed by a lower-case n and a number (i.e., 14n9) indicate material contained in footnotes and the number of the specific footnote.
Abstinence, and therapeutic frame,42–46
Acting out, and paranoid-schizoid position,145–146
Acute care settings, and psychiatric emergency services,117–124
Adulthood, and attachment styles,110
Advice, by therapist,44
Affect-driven relational template,195–196
Age.
See Adulthood; Child abuse; Childhood adversity; Development
Aggression, and manic reparation,148–149
Ainsworth, Mary,108–109
All-good and all-bad objects,7, 141–142, 158
Alpha-elements, and development of self,103
Amygdala,180–181,
184,
186, 187, 190
Anonymity, and self-disclosure by therapist,42
Anterior cingulate cortex (ACC),184,
186Anxiety disorders,198
Attachment styles, and development of sense of self,107–112
Aviram, R.B.,167n7
Balint, Michael,14n9
Bandura, Albert,90–91
Barratt, B.B.,152n13
Behavior.
See Acting out; Aggression; Impulsivity
Behavioral reenactments, of trauma,191–194
Bell, V.,190n11
Belsky, J.,194
Bergstein, A.,229
Berzoff, J.,26n1
Beta-elements, and development of self,103, 104
Bibliography, and supplemental readings,29
Bick, Esther,125n7
Bion, Wilfred, and discussions ofcommunication in therapeutic setting,2, 60
continuity across sessions,73, 74n4
development of sense of self,15, 98, 103–107, 129n8
emotional arousal and cognitive rigidity,185
Oedipal situation,142, 166n5
projective identification,10
psychotic dimensions of personality,195
termination of therapy,226
Bipolar disorder, and manic defenses,147
Body language,68
“Body prediction errors,” and neurobiology,190
Bollas, Christopher,118n2
Borderline personality disorder (BPD)child abuse and,194
paranoid-schizoid position and,146
psychodynamic psychotherapy for,196
splitting and projective identification,11
Bos, K.,185n8
Boundaries, and therapeutic frame,47
Bowlby, John,107, 110, 211n2
Boyer, L.B.,220
Britton, R.,131, 155, 168n8, 169, 172
Case examples.
See Clinical vignettes
Cathexis, definition of,6
Cavelzani, A.,188
Central nervous system (CNS), development of,179–185
Charles, M.,131
Child abuse, and neurobiology,190, 193, 194
Childhood adversity, and neurobiology,189.
See Trauma
Children.
See Development
Clinical vignettes, as illustrations ofdevelopment of sense of self,125–135
Oedipal situation,170–175
preservation of anonymity,16–17
process and content of sessions,80–82
psychiatric emergency services,121–124
silence and use of words in sessions,63–64
termination of therapy,223–225
therapeutic frame of sessions,46–49
Clock, and therapeutic frame,40–42
Cognitive-behavioral therapy (CBT),198
Communication.
See Language
intonation and context of,67–68
nonverbal forms of,68, 71
silence and facilitation of,53,
58Confidentiality, of material shared in supervision,25
Containmentdevelopment of sense of self and,103
neuroscience and,185–187
Continuityacross sessions of therapy,72–75
development of sense of self and,92
Cortisol, and hypothalamic-pituitary-adrenal axis,181
Countertransferenceconcordant vs. complementary,60n3
definitions of,2, 75n5
object relations approach and,6
silence and,52
Death drive, Freud’s concept of,99n7
Defenses, and termination,218–219.
See Manic defenses; Splitting
De Paola, H.,101n9
Depression, and psychodynamic therapy,198
Depressive positionOedipal situation and,140–151, 158, 161–167
shift between paranoid-schizoid position and,88, 137–140
termination of therapy and,221, 227
Developmentattachment schema and,107–112
neurobiology and,4, 141n4, 179–185, 189
of sense of self,88–107
timelines of dyadic and triadic relating,86–88
Dialogue, and use of questions or statements,62
Disinhibited social engagement disorder,108n11
Disorganized/disoriented attachment,110
Displacement, and “finding” of transference,76
Dissociative amnesia,192n13
“Dodo bird verdict,”197
Dorsolateral prefrontal cortex (DLPFC),184, 185,
186, 188
Dreamsprocess of interpretation,81–82
termination and,229
traumatic acceleration and,192
Education.
See Psychoeducation; Trainees
importance of psychodynamic thought in contemporary,3–5
use of term learners in,5
“Ego-destructive superego,” and development of self,107
Emergency department (ED),117, 118n1
Empathyneuroscience and,185–187
projective identification as base of,10
therapeutic frame and,35–36
Envydevelopment of sense of self and,100–102, 106–107
Oedipal situation and,153
Erikson, Erik,86
Erikson, Joan,88n1
External object, definition of,6–7
Facial expressions, and nonverbal communication,68
Facilitative dimensions, and development of sense of self,91–97
Fairbairn, Ronald,14n9
“False self,” and pseudomaturity,96
FantasyOedipal situation and,166
perception of objects and,7n3–4
“perfect object” in clinical encounter and,119–120
Feldman, E.,101n9
Feldman, M.,9, 64
Ferenczi, S.,128, 191, 211n3
Fink, Bruce,56
“51st-minute empathy,”35–36
Fluoxetine,198
Fosshage, James,13
Fragile good object, and Oedipal situation,149–151
Freud, Anna,42n2
Freud, Sigmund, and discussions ofabstinence,42
concept of id,70n2
continuity of sessions,73
countertransference,5
death drive,99n7
development of sense of self,93n4, 94–95
eye contact during sessions,71
intention of psychoanalysis,210n1
mourning process,213n6
Oedipal situation,141n4, 152
resistances,124n6
significance of dreams,81
stages of development,86
superego,157
theory of ego,57
transference,76
traumatic acceleration,191, 192
use of term object,6n2
Fusiform gyrus,187
Gabbard, G.O.,46, 218n8, 225
Gaslighting, and manic reparation,148n10
Genetics, and development of sense of self,89
Gibson, Eleanor,90
Glucocorticoid receptors (GRs),180
“Good-enough” parent, and development of self,93
Good Will Hunting (film 1997),53–54
Gratitude, as antithesis of envy,101
Greenson, R.,42n1
Group dynamics, and Oedipal situation,166
Guntrip, Harry,14n9
Haig, D.,154n15
Harlow, Harry,107
Heimann, Paula,75n5
Hippocampus,182–183
Holding, use of term,91
Hurston, Zora Neale,53
Hypothalamic-pituitary-adrenal (HPA) axis,179–180, 181,
184Id, Freud’s concept of,70n2
Idealization, of therapist,219
Impulsivity, and paranoid-schizoid functioning,163
Identity.
See Self
Infantile amnesia,192
Insecure attachment,109
Insula, and brain structure,181–182, 188, 190
Internal objectsdefinition of,7–9
superego and,157–158
supervision and role of in understanding of patient,30
Internal working model, of attachment,110
Interpersonal therapy, and neurobiology,198
Interventions, use of silence as,51, 55–56
Isaacs, Susan,7n3–4
Jacques, E.,161n1
Jealousy, and Oedipal situation,153
Joseph, B.,45, 124, 169
Kernberg, Otto,14n9, 132n11, 149n11
Khan, Masud,94
Klein, Melanie, and discussions ofchild development and internal objects,8n6
concept of envy,100n8
development of sense of self,15
Oedipal situation,137n1, 140, 141n4, 148n9, 149, 153, 154, 158
paranoid-schizoid position,87
primary death instinct,99n7
projective identification,12
superego,157
termination of therapy,217, 220
“K Link,” and development of sense of self,103–104, 105
Kohut, Heinz,132
Kristeva, J.,101
Lafarge, L.,212
Language.
See Communication; Pronouns
differences in interpretations of words,57–60
questions vs. statements,60–62
use of in current volume,16–17
Lateness, of patients for sessions,37–40, 215.
See Therapeutic frame
Libidinal object constancy,144
Lichenberg, J.D.,221
Life expectancy, and borderline personality disorder,194
Limbic system, and neuroanatomy,180n5
Lorenz, Konrad,107
Mahler, Margaret,15, 144–145, 146
Main, Mary,110
Major depressive disorder (MDD),198
Malcolm, Rita Riesenberg,158n20
Manic defenses, and depressive position,146–149
Media, and “fragile good object,”151n12
Meditation, and neurobiology,197
Mentalization, and triangulated relationships,141n4
Miller, C.W.T.,185n8, 198n16
Mind, relationship of therapist with own,168–169
Mindfulness, and neurobiology,197
Moral disengagement,91n2
Mourningdepressive position and,141
termination and,213, 216, 226
Narcissism, and omniscience,132–133
Neural cascade, in response to stimulus,184Neuroplasticity, definition of,179n4
Neurosciencechild development and,4, 141n4
containment and empathy,185–187
early adversity and intergenerational templates of,187–190
nervous system development and,179–185
psychotherapy and,178, 194–199
traumatic acceleration and behavioral reenactments,191–194
Neutrality, and therapeutic frame,42–46
“Nirvana Principle,”99n7
Notes, and supervision,24–25
Object, use of term,6.
See All-good and all-bad objects; External object; Fragile good object; Internal objects; Whole objects
Object relations theory.
See Depressive position; Neuroscience; Oedipal situation; Paranoid-schizoid position; Psychotherapy; Self
acute care settings and,117–124
attachment schema and,107–112
definition of object relations,5–14
final reflections on,229–230
object relations as basic unit of understanding in clinical encounter,5
principles of object relations lens,14, 52
Oedipal situationdefinition of,137–138
depressive position and,140–151, 161–167
Freud’s description of Oedipus complex and,152
Kleinian and object relations perspective on,153–156
overview of concept,138–140
psychotherapy settings and,167–175
superego and,157–158
Ogden, Thomas H.,10, 11, 122n5, 162n2
Omniscience, and narcissistic patients,132–133
Optimally facilitating environment, and development of self,93–94
Orbitofrontal cortex,184, 187, 189
Orens, M. H.,212
Orgel, S.,212n4, 220
O’Shaughnessy, E.,227
Ostow, M.,178n1
“Other,” perception of transitional objects as,92
Panic disorder,198
Paranoid-schizoid positionKlein’s characterization of,87, 163
Oedipal situation and,156, 158
patient’s experience of termination and,220
regression and,143–146
shift between depressive position and,88, 97–107, 137–140, 141, 163
termination of therapy and,221, 227
Patients.
See Silence
experience of termination,217–225
involvement of in decisions about termination,210–212
lateness for sessions,37–40, 215
selection of cases for supervision and,25–27
Penn Psychotherapy Project,167
“Pen transference,” and notes,25
Perls, Fritz,199
Personal therapy, and supervision,29–30
Petot, J-M.,149
Postnatal day 10 (PND 10),180–181
Posttraumatic stress disorder (PTSD),182, 192, 198, 199
Prefrontal cortex (PFC),183–185, 186, 189
Premature termination,221–222
“Previous provider bias,”22
Process notes, and supervision,23
Projective identificationcommunication and interpretations of words,59, 64
containing object and,125n7
definition and process of,9–14
neurobiology and,190
Pronouns, use of in therapy,62, 79
Protective shield (Betzschutz),94
“Pseudomaturity,” and concept of false self,96
Psychoeducation.
See Education
silence at beginning of session and,54
transference and,77
Psychological mindedness,69n1
Psychopharmacologyinfluence of on subjective experiences,178
therapeutic alliance and,196–197
Psychotherapy.
See Object relations theory; Oedipal situation; Self; Silence; Supervision; Termination; Therapeutic frame
“finding” of transference in,75–79
neuroscience and,178, 194–199
process and content in,35, 68–75, 80–82
repetitive content and,79–80
Questions, vs. statements by therapist,60–62
Racker, Heinrich,60n3
Raihani, N.J.,190n11
Rapprochement, and paranoid-schizoid position,144–146
Reactive attachment disorder,108n11
Readings, supervision and assignment of supplemental,28–29
Reality, and manic forms of reparation,148–149
Regression, and paranoid-schizoid position,143–146
Representational model, of attachment,110
Residents, use of term,16.
See Trainees
Resistances, Freud on meaning of,124n6
Robertson, James and Joyce,107–108
Rosenfeld, H.,132n10
Rustin, M.,102
Secure attachment,109
Selfchildren and development of sense of,88–91
clinical vignettes on development of sense of,125–135
facilitative dimensions of development of sense of,91–97
group dynamics and issue of identity,167
interactive dimensions of development of sense of,97–107
Self-disclosure, by therapist,43–44, 47–49
Separateness, and termination,227
Separation-individuation, and paranoid-schizoid/depressive position dynamics,144
Serotonin, and social functioning,198
Shalev, I.,194
Shostrom, E.L.,199
Silence, in therapy sessionsclinical vignettes of,63–64
comfort of therapist with,51
cultivation of,53–56
indication of in process notes,23
speech by therapist and,56–60
Skogstad, W.,104n10
Sleep terror,193
Smart phones, and triangulation dynamics,165
Social media, and “fragile good object,”151n12
Social referencing,90
Spielman, P.M.,153n14
Spillius, Elizabeth Bott,8, 143, 154
Splittingdefinition of,7
Oedipal situation and,166–167
paranoid-schizoid position and,146
Steiner, J.,163n4, 174–175, 226
Strange Situation paradigm, and attachment schema,108–109, 110
Stress, and neurobiology,191
Stress hyporesponsive period (SHP),180–181
Structural model, of id, ego, and superego,157n19
Suicide and suicidal ideation, in acute care setting,120
Superego, and Oedipal situation,152, 157–158
Supervisionassignment of supplemental readings and,28–29
discovery of patients and,21–23
personal therapy and,29–30
role of in development of therapist,19–21
selection of cases for,25–27
structure of supervisory hour and,23–24
supervisor’s approach to,27–28
taking of notes during sessions and,24–25
“Take-home points,” and end of session,36
Tarr, Béla,1
Technical approach, goals of and structure of current volume,15
Termination, of therapydiscussions with patient about,216–217
finding of way forward from,225–229
impact of on therapist,212
patient involvement in decisions about,210–212
patient’s experience of,217–225
time-limited forms of treatment and,209–210
trainees and,213–216
Therapeutic alliance, and psychopharmacologic agents,196–197
Therapeutic frame.
See Lateness
attachment styles and session endings,111
case vignettes and,46–49, 82
clock and,40–42
definition of,33
establishment of clear time allotment,34–40
importance of,34
termination and,216n7
Thought evasion or modificationBion on development of sense of self,104, 105
neurobiology and,178,
186Time-limited treatment, and termination,209–210
TMI (too much information),73
Topographical model, of id, ego, and superego,157n19
Total situation, and transference,75n5
Trainees.
See Education; Supervision
termination of treatment and,213–216
use of term,16
Transcription, of process notes,23–24
Transferenceattachment styles and,110–111
definition of,2
process of “finding,”75–79
Transitional objects, and development of self,92
Trauma.
See Childhood adversity
neurobiological effects of,190, 191–194
patients in acute care settings and,119n4
Triangulation, and Oedipal situation,137n1,
138, 156, 165–166, 168–170
Tronick, E. Z.,188
Turin Horse, The (film),1
Tinbergen, Nikolaas,107
Ventromedial prefrontal cortex (VMPFC),184–185,
186, 187, 189, 197n15
“Visual cliff” study,90
Volkan, V. D.,167n7
Vygotsky, Lee,94,
95Walk, Richard,90
Whole objects,8
Winnicott, Donald, and discussions ofdevelopment of sense of self,89, 91, 92, 93, 94, 96–97, 130n9, 162
end of sessions,36
interpretation and communication with patient,60
triangulation,138
Wittgenstein, Ludwig,58n2
Working-through, of termination,221, 226
“Zone of proximal development,”94,
95