OPINION : DISCUSSION PAPER (1) PRESENTED by ALAN LIDMILA to the CPJA on 28th November 2015

Paradigms of Practice/1                               CPJA                                                                            1

By way of introduction, let me tell you a short tale. Twenty-five years ago today, a few of us were trying to get all the band to play.. So, in this actual venue, a meeting was held, probably long forgotten, with the title: ‘The Making of Analytic Psychotherapy – Varying Perspectives’. H.W (a fellow-conspirator at the time)and I were invited to contribute and my offering was entitled :’ The Emperors Clothes – looking again at analytic paradigms’ At the time, we barbarians spoke for the fringe, unsanctified analytic tribes, those unblessed by metropolitan hegemonic holy waters.

There has always been a debate as to what properly constitutes psychoanalytic practice. In alliance with elements of The Guild, AGIP & other ‘liberal’ organisations, we were trying to widen, indeed diversify the range of organised p-a practice in what were pre-UKCP days, in a field that was very exclusively organised in ritual, incestuous obeisance around The Institute. Hence the sub-title on that day. It is a longer tale, but one not only for the archive: history, like food, repeats.

Now, looking for an apposite phrase in very different times I consider plus ca change , plus c’est la meme chose but, things are not quite the same, even if the comment underscores what is often ironic about apparently progressive change, and signifies the importance of history, taking a ‘ long view’ regarding a current zeitgeist, or any uncritical conformity to the flavour of the day..

At that time, as now, sub-texts,politics, are at play. Then, the ‘radical’ tendency was to widen the net, extend the brief, allow in some of the Barbarians from the outer encampments (not a wholly altruistic move, as this would in turn strengthen a power base, assist economic imperatives, in squabbling London town houses). But, that’s politics, and organised psychotherapy did change.

Yet change is ironic, and dialectic, and often unintended; my comments today suggest other consequences in psychotherapy culture ,and in turn a response that is now, necessarily, more ‘tradical’ than radical !

To briefly explain this shift. Now, we inhabit, in wider culture as it impinges on psychotherapy culture, different, but not necessarily progressively better times. Leaving aside the problematic ‘regulatory mind’, we almost over-subscribe to values of ‘inclusivity and diversity’, which may have undesirable consequences as far as a homogenous, clearly differentiated  psychoanalytic  model  is concerned.  Ironically, the old guard, zealous keepers of the flame, upped sticks to form a higher temple elsewhere, leaving a vacuum, fertile for doubters, to ‘develop’, deconstruct, or maybe dismantle the integrity of  the model – a model already under external threat in Nice Times. (I note tendencies, by the way, not conspiracies !)

The confidence in the model seems to have wavered for some, who as a result, have experimented, with techniques, derived from other models. This is not necessarily ‘adapt and survive’, any more than any crisis is nuclear – it is more like anxiety, or at worst panic. There are two interacting factors:

Adaptive responses to external pressures in form of NICE, IAPT, contractions in NHS and trainings, coincident with a translation of the ideology of diversity into shifts in practice technique, so as to resemble a more mixed portfolio, some more strings to the practitioner bow, because, well, we need to reflect and embrace diversity, rather than anything that whiffs of exclusiveness, elitism, even specialism. I am suggesting there is evidence of muddled, if well-meaning thinking, which has contributed to doing a disservice to a confidently held psychoanalytic paradigm. Thanks.

OPINION : DISCUSSION PAPER (2) PRESENTED to the CPJA on 28th November by ALAN LIDMILA

CPJA Discussion Statement:     Parameters of Practice/2

 We need to address the question ‘what is it we do?’ (and what is it we try not to do). Because it may be unclear, and therefore requires redefinition. This short paper seeks to delineate core principles of psychoanalytic practice, based in a reliable theoretical model that has evolved over time.

Essentially, it is a concrete restatement of our ‘flag statement’ (revised 2012) that in simple but meaningful terms may be listed as a series of principles of practice as follows:

  • Rhythm   (translation:  key arrangements around time, frequency, and regularity, typically longer than shorter, based in an understanding concerning, among other factors, infant development);
  • Regression (trans:  also concerning time and the importance of early or past experience ,including as re-experienced, possibly re-enacted, in the therapy setting);
  • The Unconscious (trans:  mental  operations , perhaps determining behaviour,  not immediately apparent, the meaning of which may be accessed  through  language, dream and symbol);
  • Setting/Frame (trans:  the therapeutic space, involving the above, as well as, crucially, attention to boundary and abstinence, as far as possible intellectually, and certainly physically);
    • Language and Thought   ( trans: the epistemophiliac impulse, aka the desire to know – and fear knowing –  as investigated, facilitated and understood , quintessentially, via language and speech);
    • Interpersonal Relationship ( trans:  the inter-subjective relationship/s between therapist and client, often involving multiple objects of a transferential  and countertransferential  nature, that may come to be identified and recognised by means of insight and interpretation);
    • Supervision  ( trans:  therapist normally has recourse to the ‘3rd position’ of supervision, wherein there is located some authority of the model, in addition to managing this position internally).
    •  Language and Thought   ( trans: the epistemophiliac impulse, aka the desire to know – and fear knowing –  as investigated, facilitated and understood , quintessentially, via language and speech);
    • Interpersonal Relationship ( trans:  the inter-subjective relationship/s between therapist and client, often involving multiple objects of a transferential  and countertransferential  nature, that may come to be identified and recognised by means of insight and interpretation);
    • ]Supervision  ( trans:  therapist normally has recourse to the ‘3rd position’ of supervision, wherein there is located some authority of the model, in addition to managing this position internally).
    • I have become, subject to client or pathology, relatively more flexible, responsive and creative in my personal style. But, I suggest, it is within, not beyond the pale.