Change Through Time in Psychoanalysis

Margaret Ann Fitzpatrick Hanly, PhD, is a training and supervising analyst of the Canadian Institute of Psychoanalysis, Chair of the IPA Committee on Clinical Observation, past Director of the Toronto Institute of Psychoanalysis, and a member of the Executive Editorial Board of the Psychoanalytic Quarterly. Marina Altmann de Litvan, PhD, is a Child and Adolescent Psychoanalyst (IPA) and a training and supervising analyst of the Uruguayan Psychoanalytical Association. She is Chair of the Clinical Research Subcommittee and former Chair of the Clinical Research Subcommittee of the IPA (2010–2017).Ricardo Bernardi, MD, PhD, is an Honorary Member of the Uruguayan Psychoanalytical Association, Emeritus Professor of the School of Medicine, full member of the National Academy of Medicine of Uruguay, and Vice-Chair of the IPA Research Committee.

"This book is a relevant contribution to clinical, technical, and theoretical psychoanalysis. The Three-Level Model was already introduced in the first volume of the Committee on Clinical Observation, and this volume shows how the group has continued to deepen their work with this method in a quite remarkable way. While the aim is still to observe psychic change by studying clinical materials in groups, this time an important achievement has been made through the application of the model to different fields, such as child analysis, and clinical cases presented by candidates. The latter contribute significantly towards fostering Psychoanalytic Education. The authors deal with sensitive and difficult subjects such as the notions of impasse, common ground or pluralism, among others, without eluding controversy, thus promoting a sincere dialogue between different theoretical approaches. The book is a must-read for all those truly interested in contemporary psychoanalysis."Virginia Ungar, M.D., IPA President"The authors have woven clinical thinking together with rich verbatim material and systematically documented how psychoanalysts can illustrate how change takes places in psychoanalysis. Their methods are original, rigorous, and creative. The book is inspirational in that the methodology is uniquely suited to illustrate how psychoanalysts and analysands work together and the subtle, and not so subtle, changes that occur over time through their interactions. The material can be studied by many groups of clinicians allowing for replication of ratings, which permits an establishment of reliability. Clinicians will recognize vivid accounts of how patients grow and change over time. Both clinicians and researchers will be impressed by the development of a method that retains the complexity of clinical work. The book provides psychoanalysts with a way to teach present and future psychoanalysts how to practice in, and study, our field."Judith L. Kantrowitz, PhD, training and supervising analyst, Boston Psychoanalytic Society and Institute; author of The Role of the Patient-Analyst March in the Process and Outcome of Psychoanalysis"Change Through Time in Psychoanalysis, by a high-powered international team of respected psychoanalytic clinicians, researchers, and epistemologists, is a major contribution to the current endeavour to develop new methods for studying psychoanalytic processes, bringing together psychoanalysts working from different theoretical models. They are the first in this new field to look at what kinds of changes actually take place in psychoanalysis and how these come about, using an original and clinically meaningful combination of careful in-depth psychoanalytic exploration of detailed cases, together with more systematic forms of assessment. Their work on metaphors as anchor points for evaluating change is one particularly interesting example of how this kind of research remains rooted in, and contributes to, psychoanalytic thinking. I congratulate these excellent colleagues whose book is important reading for all of us who feel responsible for evaluating and validating what we really do and how and why patients can benefit from psychoanalysis."Bernard Reith, President of the Swiss Psychoanalytical Society, past Chair of the EPF Working Party on Initiating Psychoanalysis, Co-Chair for Europe of the IPA Working Parties Committee

• Part I Clinical Thinking in Psychoanalysis 1 A Common Ground in Clinical Discussion Groups: Intersubjective Resonance and Implicit Operational Theories 2 Underlying Clinical Thinking on Change and Therapeutic Action 3 Bodily Metaphors as Anchor Points in Facilitating Change Part II Change in Metaphors and Dreams 4 Changes and no Changes in the Representation of Self and Others through Images and Metaphors 5 Changes in Dreams in the Psychoanalysis of Traumatized, Chronically Depressed Patients in the Frame of the LAC Depression Study Applying the 3-LM Part III Foci of the Analyst’s Interventions, Mechanisms of Change 6 "I Don’t Want To Be Like My Mother": Exploring Changes in Identity Using the Analyst as Model 7 Sequence of Changes and Interventions in the Analysis of a Violent Patient Part IV Impasse 8 Three Hypotheses on Impasse in the Case of Janine 9 Change and Impasse in a Systematic Case Study: Foci of the Analyst’s Interpretations Part V New Uses of the 3-LM in the Transmission of Psychoanalysis and in Professional Development 10 The 3-LM’s Contribution To Developments in Analytical Treatment 11 A Dialogue between 3-LM Presenters and Moderators Part VI Clinical Observation Groups and the Psychoanalysis of Children 12 Observing Transformations and Interventions in a Child Analysis through the 3-LM: The Case of a 5-Year-Old Girl 13 How does a 5-Year-Old Cope with Mourning? Contributions of the 3-LM For Observing Child Transformations Part VII Improving Clinical Evidence 14 Assessing Strengths and Limitations of Clinical Evidence in a Psychoanalytic Clinical Material Part VIII Three-Level Model 15 Guidelines For Organizing 3-LM Groups