Podcast by psychoanalyst and writer Adam Phillips

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Adam Phillips · Against Self-Criticism Self-criticism can be our most unpleasant – our most sadomasochistic – way of loving ourselves.

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.



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.