Time for Change

Marina Altmann de Litvan, PhD, is a child and adolescent psychoanalyst, a full member and training analyst of the Uruguayan Psychoanalytic Association, and a member of the Clinical Research Subcommittee of the International Psychoanalytical Association (IPA). She has been a member of the Education Committee and Co-Chair of the Education-Research Subcommittee of FEPAL, as well as Research Fellow and Visiting Professor at University College of London, Research Training Programme. She was also awarded the Biannual Exceptional Contribution Award from the Research Committee of the IPA for her research into verbal and nonverbal interactions in mother-baby psychotherapeutic process. She has published chapters of books and papers both in Spanish and English.

'With its impressive wealth of clinical observations and the accuracy of its methodology, this book offers a magnificent response to many doubts raised by the opponents of psychoanalysis. Clinical observation, enhanced and explored in depth, gives an idea of how much progress psychoanalysis has made in reflecting on its own method and transformational outcomes.'- Stefano Bolognini, President of the International Psychoanalytical Association (IPA)'This book is an impressive achievement as it shows a contemporary, well-grounded, methodological approach to clinical observation, which is at the very core of the development of psychoanalysis. Its authors are among the most skilled analysts of today, both as clinicians and researchers. I am sure the readers will be rewarded with a stimulating journey throughout one of the most fascinating areas of contemporary psychoanalysis.'- Claudio Laks Eizirik, past President of the IPA and Professor of Psychiatry at the Federal University of Rio Grande do Sul, Brazil'This remarkable book addresses in new and original ways the challenges of psychoanalytic research and communication amongst colleagues: how to reflect systematically and collaboratively about, and be accountable for, the private and individualised work in each clinical dyad. Here, Marina Altmann de Litvan and her colleagues bring a creative approach to collaborative, systematic research and discussion about individual treatments. Time for Change gives new meaning to psychoanalytic research and collegiality and solves one of our most challenging professional dilemmas.'- Nancy J. Chodorow, PhD, Training and Supervising Analyst at Boston Psychoanalytic Society and Institute Lecturer at Cambridge Health Alliance, Harvard Medical School'The systematic study of psychoanalytic clinical observations and their epistemological significance is about one hundred years overdue. This groundbreaking volume summarises not just what we can learn from clinical observation but, far more importantly, how. This book is an essential training and scientific tool for our time.'- Peter Fonagy, PhD, FMedSci, FBA, OBE, Professor of Psychoanalysis and Head of the Research Department of Clinical, Educational and Health Psychology, University College London

• ABOUT THE EDITOR AND CONTRIBUTORSSERIES EDITOR'S FOREWORD FOREWORD by Charles Hanly INTRODUCTION by Marina Altmann de Litvan PART I INTRODUCING THE THREE-LEVEL MODEL FOR OBSERVING PATIENT TRANSFORMATIONS CHAPTER ONE The three-level model (3-LM) for observing patient transformations - Ricardo Bernardi CHAPTER TWOLeticia: the emergence of questions about herself - Silvana Hernandez Romillo CHAPTER THREE Irina: an adolescent - Marina Altmann de LitvanPART II OBSERVING AND WORKING WITH THE 3-LM CHAPTER FOUR Tracking patient transformations: the function of observation in psychoanalysis - Virginia Ungar with discussion by Margaret Ann Fitzpatrick-Hanly CHAPTER FIVE Depression and trauma: the psychoanalysis of a patient suffering from chronic depression - Marianne Leuzinger-Bohleber CHAPTER SIX Close to observation: some reflections on the value of the three-level-model for studying change - Siri Erika Gullestad CHAPTER SEVEN Working with the third level of the three-level model: the incidence of our theoretical model on our clinical thinking - Adela Leibovich de DuartePART III A PATIENT, A CONCEPT, AND A CASE CHAPTER EIGHT A traumatised patient in analysis: observing patients' transformations - Margaret Ann Fitzpatrick-HanlyPART IV THE 3-LM: A CASE, REPORT, AND DISCUSSION CHAPTER NINE Transformations in Paula with "no history" - Michael Sebek CHAPTER TEN A report on Paula with "no history" - Robert S. White CHAPTER ELEVEN Discussion of Paula with "no history" - Judy KantrowitzPART V CLINICAL CONCEPTS CHAPTER TWELVE Some reflections on the three-level model: organising psychoanalytic knowledge through clinical observations and generalisations - Marvin Hurvich CHAPTER THIRTEEN The assessment of changes: diagnostic aspects - Ricardo BernardiPART VI AN APPLICATION OF THE 3-LM AT THE END OF ANALYTIC TRAINING CHAPTER FOURTEEN The three-level model in psychoanalytic training - Beatriz de Leon de Bernardi and Marina Altmann de Litvan CHAPTER FIFTEEN The use of the 3-LM to teach candidates to observe transformations in clinical cases - Liliana Fudin de Winograd and Adela Leibovich de DuartePART VII FURTHER DEVELOPMENTS OF THE 3-LM IN CHILD ANALYSIS CHAPTER SIXTEEN Three-level model for observing child patient transformations - Marina Altmann de Litvan, Delfina Miller, and Ricardo BernardiAPPENDIX I. Brief guidelines: IPA clinical observation groups - Marina Altmann de Litvan (On behalf of all the members of the Project Committee on Clinical Observation)APPENDIX II. Clinical observation group, San Francisco (CO-SF1), May-August 2012 - William GloverAPPENDIX III. Suggested questions for group discussionAPPENDIX IV. Forms to be used before and after the group discussionAPPENDIX V. Clinical observation work groups (2011-2013)INDEX