Object trust: A specific kind of analytic change.

Abstract

Diversity of analytic change seems today to be taken as a fact. The present article aims at discussing subtle, but important, differences in concepts of analytic change. By starting with a structural viewpoint on analytic change it is argued that there may exist changes with a low degree of differentiation that are important to register. A former patient of psychoanalysis is presented. Material from his outcome is presented from three different sources: self-report, psychoanalytic interview, and Rorschach. The self-report material indicates a successful analytic experience, although the other two point in divergent directions. Through discussion of the three discrepant perspectives on the former patient's outcome, the article aims to shed light on the specific dynamics of this case and to argue that the case illustrates a specific kind of analytic change. The concept of "object trust" is proposed to correspond to changes in the experiential domain. This concept is discussed against other parallel descriptions and concepts within the psychoanalytic literature. Moreover, this kind of analytic change is for some patients seen as a necessary step toward possible further analytic work.

Paradoxical outcomes in psychotherapy: Theoretical perspectives, research agenda and practice implications

“…Evidence of paradoxical outcome has also been reported in multimethod single case studies in which data have been analysed from both self-report scales completed by clients and qualitative interviews (Desmet, 2018;Elliott, 2009). Qualitative studies that involved interviews with clients selected on the basis of good or poor outcomes, as indicated by change in self-report measures, have found themes in client personal accounts of satisfaction with therapy do not necessarily match outcome status (McElvaney & Timulak, 2013;Stänicke & Killingmo, 2013).…”

The Analyst’s Way of Being: Recognizing Separable Subjectivities and The Pendulum’s Swing

“…[1950, p. 82, italics added] Heimann then went a step further by declaring the analyst's countertransference to be "the patient's creation, it is a part of the patient's personality" (p. 83, italics added). Here she moved into theoretical ter-ritory that many consider problematic to the extent such thinking fails to consider the analyst's separable subjectivity-the hook inside the analyst (Gabbard 1995;Stanicke and Killingmo 2013;Westen and Gabbard 2002) upon which the analysand's projection can be hung. Racker's (1957) contribution to our understanding of countertransference chiefly involves his introduction of two contrasting terms-complementary and concordant-to differentiate two types of countertransference reactions.…”

Analytic change: Assessing ways of being in a psychoanalytic follow‐up interview

“…The aim of each step – to identify the structuralized and actualized affect and communicate about them – was the same for every interview. However, participants were to different degrees able to reflect on their own material, especially as concerned relational issues and conflicts that were activated in the follow‐up interviews (see Stänicke,; Stänicke and Killingmo,). Mr A was one of three participants that showed a quite high degree of reflection on his relationship with the interviewer.…”

“…In a recent study of post‐analytic change (Stänicke, , ; Stänicke and Killingmo, ), one aim was to test and refine a method that could assess changes in relational ways of being. The material consisted of psychoanalytic follow‐up interviews with seven participants, all ex‐analysands.…”

“…A psychoanalytic interview of ex‐analysand Mr A is presented in order to illustrate how relational changes can not only be talked about but also observed in action. The interview is part of a conceptual case‐based follow‐up study of psychoanalysis (Stänicke, , ; Stänicke and Killingmo, ). Seven participants were interviewed, who were already part of the Oslo II study (Varvin, ) that consisted of data from their psychoanalysis.…”