Psychoanalytic Teaching by Video Link and Telephone

[Psychoanalysts Online: Media regulation and digital boundary crossings]

Objectives: The present explorative study evaluates the question of media regulation in treatment and the question of psychoanalysts' experiences with digital crossings of boundaries. Methods: Using a self-constructed questionnaire, N = 50 completed questionnaires were distributed to psychoanalysts (age: M = 48,64, SD = 12,71; m = 44 %, f = 56 %) at the 51st IPA Congress held in July 2019 that were analyzed using aMann-Whitney U-test and Chi square test. Results: The majority of the psychoanalysts surveyed 68 %, (n = 34) do not regularly discuss the use ofmedia with their patients at the beginning of treatment, 28%(n = 14) of the analysts surveyed contacted their patients using digital media services without discussing this possibility of contact beforehand, 16 % (n = 8) contacted their patients at night, 46 %, n = 23 googled their patients and 24 %, (n = 12) secretly used a mobile phone during analysis. Conclusions: Due to the advancing technology of the health care system, further psychoanalytic research that accompanies the process of using media in treatment is necessary.

Emergency Remote Training in Psychoanalysis and Psychotherapy: An Initial Assessment from Columbia

The Covid-19 pandemic and the social distancing required to combat it have set in motion an experiment in psychoanalytic education of unprecedented scope. Following an abrupt shift from in-person study to remote classes, supervision, clinical work, and training analyses, the Columbia University Center for Psychoanalytic Training and Research polled its psychotherapy and psychoanalysis trainees to assess their initial experience of remote training. Most candidates found the technical aspects of online learning easy and were satisfied with remote training overall. Across all programs, most trainees considered class length and reading load about right and felt their class participation was unaffected, though they found it harder to concentrate. Most found it no harder to start a training case, felt the shift to remote supervision had no negative effect, and were satisfied with seeing their training analyst remotely. Most trainees preferred in-person classes, clinical work, and training analyses to those offered remotely, yet in light of the health risks they said they were less likely to continue training in fall 2020 if in-person work resumed. Trainees suggested several modifications of teaching techniques to improve their participation and concentration in class. These findings' implications for the debate regarding remote training in psychoanalysis are explored.

Assessing Distance Training: How Well Does It Produce Psychoanalytic Psychotherapists?

How effective is psychoanalytic/psychodynamic distance training over the Internet? To assess this, we surveyed graduates of the 2-year and 4-year programs of the China America Psychoanalytic Alliance (CAPA). The main results of the 90 graduates' surveys showed that 77% of their work involves a psychoanalytic formulation of their cases as compared to other theoretical orientations. Graduates highly rated the effectiveness of their own psychoanalytic therapy over videoconferencing (VCON). Graduates' ratings of treatment with their patients over VCON positively correlated with years of psychoanalytic education, number of days a week in own treatment, years doing psychoanalytic treatment, and degree working with a psychoanalytic orientation. Graduates thought that therapist variables (skillfulness, warmth, empathy, and wisdom) were much more important in the effectiveness of their treatment than whether the treatment was in-person or with VCON, or the presence of cultural differences with their therapist. The graduates' ratings of how they are practicing psychoanalytic treatment were highly correlated with how their own therapists practiced psychoanalytic psychotherapy, as measured by the psychodynamic/interpersonal process items on the Comparative Psychotherapy Process Scale (CPPS).

IMPLEMENTATION AND SUSTAINABILITY OF CHILD-PARENT PSYCHOTHERAPY: THE ROLE OF REFLECTIVE CONSULTATION IN THE LEARNING COLLABORATIVE MODEL

Recent implementation science in mental health has focused on identifying the most effective strategies to disseminate and implement evidence-based treatments (EBTs) into real-world practice settings. The learning collaborative training methodology and its use of expert trainers/consultants have become increasingly popular as one of these approaches. Moreover, there is preliminary evidence that ongoing expert consultation may increase the adoption, learning, and sustainability of EBTs by an already practicing workforce and, consequently, help trainers, practitioners, and organizations address implementation barriers. This article describes the authors' experiences in facilitating Child-Parent Psychotherapy (CPP) training and explores the role of reflective clinical consultation as an active process that supports the implementation of a rich, but complex, model that requires sophisticated knowledge and skills from practitioners. It examines the intricate range of the CPP consultant's functions, which ultimately support clinicians' reflective practice as they learn and adopt this EBT. Reflective consultation is proposed as an essential component for the integration of knowledge, experience, and emotions in practitioners and as a catalyst for organizational change. Using their voices as trainers-consultants and those of their trainees, the authors discuss the implications of reflective consultation for the effective implementation and sustainability of CPP. Reflections are offered on lessons learned.

THE ULTIMATE INSIGHT: THE PATIENT'S AWARENESS OF MOTHER'S FILICIDAL WISHES

The author reviews myths and traditional tales in which the protagonist is a filicidal mother. In a displaced form, filicidal mothers appear as the ubiquitous witches of folklore. This imago is universal in fantasies and pavor nocturnus in children, regardless of the quality of care of the real maternal figures. To this phenomenon-the result of defensive externalization of primitive fears-a fundamental dimension is added when this dread seems corroborated by the mother's manifestly murderous wishes and behavior. Clinical examples of this pathogenic circumstance are provided, with comments on the development of dissociation versus repression, depending on the severity of early traumas. The evolution of symptoms and character disorder in adulthood is discussed, as well as interpretive and technical dilemmas posed by these patients.