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A full recording of the 2012 Annual Freud Memorial Lecture introduced by Professor Roderick Main, from our Centre for Psychoanalytic Studies, and delivered by Professor Jan Abram on 'Winnicott's last word on the death instinct' (clinical examples have been removed for confidentiality reasons).

The Centre for Freudian Analysis and Research recently held the second of their annual conferences dedicated to the theme of the relation between characteristic styles of British and Lacanian clinical practice. The Conference was entitled "Lacan and the British Tradition II", and was held in the University of London Union on 29th November, 1997. The theme that is being developed in this series of conferences is intriguing as well as enlightening: a cross comparison of clinical orientation sheds much light on the nature of psychoanalytical work. This year, the focus of the meeting was on the concept of cure in psychoanalysis, and in particular the notions of the direction and the end of the treatment.

 Introduction

 

This paper is a development of one of the topics of my book Desire and the Female Therapist. I will discuss one very specific dynamic of the transference and countertransference which I have observed with male patients working with female therapists. In considering why it is that certain men, working with female therapists, end their psychotherapy 'prematurely', I have noticed a pattern. This is reflected in the subtitle I give to this paper which is 'men who leave too soon.' However I stress the point that this is addressed to male as well as female colleagues. Whilst there are common factors which transcend gender difference, I consider that giving attention to this pairing may highlight particular countertransference problems encountered by the female therapist and the difficulties some male patients experience in the transference. I hope that the paper will generate thoughts about other clinical experiences with regard to gender which we can discuss in the second part of this morning.

 

 

What is the disease concept of addiction? It says simply that addiction is a disease. Many treatments of addiction are based on this idea. Most experts working in the field of addiction and the general public believe this is the best way of understanding the clinical nature of addiction. The disease concept states that addiction is a specific disease to which some people are vulnerable. It was first proposed in the late 1930's in America when it was only applied to alcoholism. The disease is progressive, because those who are vulnerable to it, start with normal social drinking, they then progress to ever greater amounts, to private and secret drinking, to developing an increased tolerance to alcohol and to experiencing withdrawal distress if drinking is interrupted; they begin to have blackouts and forget the previous day's drinking. Those who have the disease will eventually not be able to control their drinking, because the disease produces the disability of "loss of control" or "powerlessness" over drinking. Addiction progresses stage by stage in a regular and standard fashion. This standard course is the same for everyone who is sick and is therefore transindividual. Once the disease takes hold difference goes out the door. Eventually every addict will hit "rock-bottom" in the form of a physical and/or emotional breakdown and premature death in the final step, unless with luck, or God's puce or indeed the help of AA, NA, GA, SA, etc., or another kind of treatment the addict manages a radical conversion to total abstinence. Abstinence is the only hope as the disease is incurable.

 

Subcategories

The case history has become a standard method of transmitting psychoanalytical knowledge. Freud wrote a number of now famous case histories and his successors modelled themselves upon him, as if to emphasize that their theories were rooted in experience. At one time the International Journal of Psychoanalysis separated out articles lacking clinical material which were published in a separate journal, termed the Review, although the two have now been combined again. But the case history, written by the analyst, is only one side of the story. Where is the voice of the patient?

Accounts of the experience and treatment of madness written by the madmen exist, (one of the most famous perhaps being the Schreber case), but are not common. It is also rare for analysands to publish accounts of their analyses.

Without having to consider which version is more ‘true’ (nothing passed through the human mind is completely free from error), it remains instructive to see the experience of treatment from two different points of view. A kind of binocular vision.

This is the thinking behind THERIP's creation of a section of the website devoted to collecting people's accounts, past and present, of analysis and/or psychotherapy, which we have called FROM THE COUCH. We include also accounts from relatives.

THERIP members wishing to contribute to the project can do so, using the 'add article' function; non-members are most welcome to participate by sending contributions to This email address is being protected from spambots. You need JavaScript enabled to view it. (contributions are rewarded with short-term honorary membership).

We are creating an resource on Jean Laplanche. Please contact the webmaster if you would like to contribute