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"Leffert, Mark"
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The Therapeutic Situation in the 21st Century
Extending the themes of Contemporary Psychoanalytic Foundations, The Therapeutic Situation in the 21st Century is a systematic reformulation of fundamental psychoanalytic concepts, such as transference, therapeutic action, and the uses of psychotropic drugs, in the light of recent developments in postmodernism, complexity theory, and neuroscience. Leffert offers formulations of areas not previously considered in any depth by psychoanalysts, such as power relations in the analytic couple, social matrix theory, and narrative theory informed by considerations of archaeology, genealogy, complexity, memory, and recall. He also considers new areas, such as the role of uncertainty and love in the therapeutic situation. This book is part of an ongoing effort to place psychoanalysis in the current century, and looks to outside as well as inside areas of thought to inform how we work and how we think about our work.
eBook
Postmodernism and its impact on psychoanalysis
This article explores the heterogeneity of postmodern thought and its contributions to contemporary psychoanalytic theory and practice; the heterogeneity of psychoanalytic theory and the claims of privilege and standing made by individual theories; and the postmodern terrain and its conflicting points of view. Its origins are also traced back to the work of classical analytic authors, notably Erikson, Gill, Hartmann, Klein, and Rapaport. A solution to the problem of theoretical plurality is suggested, addressing its ontological and epistemological roots.
Journal Article
The Self, the Self-Representation, the Psychical Self, and Their Social Network
When psychoanalysts talk or write about the self, it is always necessary to question what exactly it is they are talking about because the term is used in so many, often idiosyncratic, ways. We need to begin by looking at this unintentional conundrum and then move on to more fertile ground: what allied disciplines-neuroscience, postmodernism, and attachment theory among them-have added to our understanding of the concept of self that makes it so much more useful and interesting. This is not a theoretical exercise. The self, the real one, is becoming clinically relevant in ways that have yet to be considered in the psychoanalytic literature. Perhaps the most important one is that if we conceptualize the psychoanalytic process as acting on the self, then it is for once acting on something that actually exists, not some construct. The topic of the self's relations with the social matrix in which it finds itself, similarly undervalued over the years, has also recently become more interesting as it has taken a new and complex turn.
Book Chapter
Some Particular Issues Concerning Therapeutic Action
Implicitly, and at times explicitly, much of this book has been concerned with therapeutic action and the clinical circumstances that foster or impede it. The chapter following this one will serve to weave these various discussions together into a sheave, at times a sheave of différance. In the meantime, there remain some specific points to be covered before moving on to those discussions. A great deal has been written about therapeutic action in recent years; we will examine that literature here in some novel ways. The very term therapeutic action came to prominence out of a desire to describe in process terms more than change and less than cure. I have written on particular aspects of the subject on several occasions (Leffert, 2003, 2007a, 2008, 2010a) and do not propose to restate this material here. What I am offering is an exclusively experience-near clinical theory, one of the two psychoanalytic theories posited by Gill (1976, 1994). Perhaps more dangerously, I am proposing to go a step beyond Gill and a step beyond the positions I have taken in the past, to posit that the second theory, metapsychology, has no ontological basis at all and that clinical theory, or theory of therapeutic action, is best formulated in its absence.
Book Chapter
Power Relations in the Office
The subject of power as it plays out in the therapeutic situation has come rather late to the psychoanalytic literature (Leffert, 2010a, especially chapters 1 and 7). However, its relevance to the wider areas of the treatment of people termed mentally ill and its presence in social relations generally has been a subject of inquiry and discourse in other disciplines for many decades. Foucault (1961/2006a), in his monumental work History of Madness, offers a history of society's dealings with both madness (folie) and the mad (fou) from the 17th to the beginnings of the 19th century. Trained as a clinical psychologist as well as a philosopher, he portrays the relationship in terms of power and fear of contagion. The fou are to be corrected, linking them to the second of Foucault's (1979/1995) great concerns, the prison and the imprisoned.
Book Chapter
Love (the Analyst's) in the Office
As a first-year psychiatry resident at Bronx Municipal Hospital Center in 1970, many experiences stood out, two of which I did not begin to grapple with, let alone understand, until much later. In those days, in that program, the first year was spent on the wards doing short-term and long-term (six months) inpatient work. Somewhat early on, our chief resident mentioned to the five of us that a patient had recently asked him if he loved him-he had said \"no.\" He regretted this because he realized that he did in fact love his patient, but couldn't say it and the therapy had suffered as a result.
Book Chapter
Reading (or Not Reading) Freud in the 21st Century
The case for reading Freud in the 21st century rests largely on who will be doing the reading and why they will be doing it. Is it to be students, teachers, or graduate therapists reading on their own? Is Freud to be read in the academy? Are the readers to be affiliated with the mostly Freudian psychoanalytic institutes of the APsaA, or those trained and practicing under the aegis of the contemporary institutes grounded in relational or intersubjective theories, or still others grounded in other named metapsychologies? Each of these groups has evolved its own responses to and relative involvement in Freud's work. Since it is hoped that the unfolding intellectual life of a psychoanalyst or psychotherapist is a dynamic rather than a static thing, these responses and involvements may well change over time. As our lives change, our professional world is also changing; it offers ideas and challenges to Freud's work that did not exist a half-century ago.
Book Chapter