Conundrums and Predicaments in Psychotherapy and Psychoanalysis : The Clinical Moments Project book cover
1st Edition

Conundrums and Predicaments in Psychotherapy and Psychoanalysis
The Clinical Moments Project

ISBN 9781138079854
Published March 7, 2018 by Routledge
316 Pages

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Book Description

From time to time therapists find themselves in a bind—faced with a challenging situation, unsure how to proceed. Such a conundrum leaves the therapist on edge, concerned that the success of treatment might rest on how he or she responds to the circumstance. The situation seems to call for more than pat clinical protocol, leaving the therapist uncertain as he or she ventures into novel territory wondering "what do I do now?"

Conundrums and Predicaments in Psychotherapy and Psychoanalysis: The Clinical Moments Project comprises twelve distinct clinical moments during which the treating/presenting analyst feels him- or herself in just such a quandary. The presented moment comes to a head at a point where the therapist feels uncertain what his or her next and best "move" might be—one that balances the protection of the therapeutic alliance with the need to address a clinical development head on. Space is then left for 25 well-known analysts ("commentators") of varying theoretical persuasions to weigh in, sharing what they think about the situation and how they imagine they might have proceeded.

In the final analysis, the point of this project is not to determine how the moment "should" have been handled given the input of experts; rather, it aims to illuminate the clinical theories that therapists carry with them into sessions where they operate implicitly, directing their attention to select sorts of data that are then used to fashion an intervention. This, then, is the ultimate lesson of the Clinical Moments Project—to learn how to listen to how therapists listen to the unfolding material. This book will be of great interest to psychoanalysts and psychoanalytic psychotherapists of all persuasions.

Table of Contents

INTRODUCTION: MOMENTS OF WAKING AND RECKONING: "Now what do I do?" SECTION 1: TAKING A STAND CHAPTER 1: WHETHER TO SPEAK UP OR LET THINGS BE (Richard Tuch) with commentary by Fred Busch and James L. Fosshage CHAPTER 2: VENTURING ON TO THIN ICE: TIPTOEING IN THE WAKE OF EMPATHIC FAILURES (Lynn S. Kuttnauer) with commentary by Rosemary H. Balsam and Rachel Blass CHAPTER 3: "IF YOU KEEP TALKING TO ME THIS WAY, I AM GOING TO QUIT!" (YOU TALK . . . I WALK) (Robert James Perkins) with commentary by Robert Michels and Irma Brenman Pick SECTION 2: COUNTERTRANSFERENCE ENACTMENTS CHAPTER 4: COUNTERTRANSFERENCE ENACTMENTS—THREE TIMES OVER (Jill Model Barth) with commentary by Salman Akhtar and Anne Alvarez CHAPTER 5: FEELING MISUNDERSTOOD BILATERALLY (Susan L. Orbach) with commentary by Andrea Celenza and Donnel Stern SECTION 3: WHAT PATIENTS WANT; WHAT THERAPISTS CAN PROVIDE CHAPTER 6: PATIENT AS BEAN COUNTER (Rina Freedman) with commentary by Robert Glick and Judy Kantrowitz CHAPTER 7: WITHSTANDING THE PATIENT’S DEMAND FOR ANSWERS (Janet K. Smith) with commentary by Jay Greenberg, Albert Mason and Dominque Scarfone CHAPTER 8: TO ATTEND OR NOT TO ATTEND THE EXHIBIT? (Nancy Kulish) with commentary by Morris Eagle and Joseph Lichtenberg SECTION 4: HAVING IMPACT—THE BALANCING OF POWER CHAPTER 9: HOW FAR DO WE ENTER INTO A CHILD’S FANTASY WHEN WE PLAY? (Bernadette Kovach) with commentary by Susan Donner and Alan Sugarman CHAPTER 10: A SHOCKING REVELATION (Deborah Harms) with commentary by Stefano Bolognini and Mitchell Wilson CHAPTER 11: CONSIDERING THIRD PARTIES: THE QUESTION OF ALLEGIANCE (Michele Gomes) with commentary by Edgar Levenson and Nancy McWilliams CHAPTER 12: WORRIED SICK ABOUT A PATIENT (Richard Tuch) with commentary by Darlene Ehrenberg and Ted Jacobs

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Richard Tuch is Training and Supervising Analyst at the New Center for Psychoanalysis and the Psychoanalytic Center of California. He is Clinical Professor of Psychiatry at the David Geffen School of Medicine, UCLA.

Lynn S. Kuttnauer is a Training and Supervising Analyst at the New Center for Psychoanalysis. She is the founder of the Clinical Moments program at the New Center for Psychoanalysis and was one of the founding members of the Clinical Moments program at the Michigan Psychoanalytic Institute.


"Psychoanalytic therapies are often assumed to be governed by rigid rules (e.g., one explores the patient's childhood, one tries to be "neutral"). In reality, all analysts create unique integrations of theory, identifications, clinical experience, and their own authentic temperaments. For anyone who wants to know how psychoanalytic therapists really think and behave, this book is indispensable. As we witness seasoned therapists address challenges that have no clear resolution, their individuality comes through vividly, just as it does in actual practice. I recommend this engaging book to anyone who wants to understand what psychoanalysis looks like in real-world clinical situations."-Nancy McWilliams

"This is such a great idea, and the editors have brought together such an all-star cast and keen educational format that it hardly needs my words to support it. I can't think of another book that will so directly grab the curiosity of everyone in the profession. It's irresistible."-Larry Friedman, M.D.

"Beyond classroom training, supervision, and an analyst’s conducted analyses, lies an innovative method of learning involving the presentation of a clinical dilemma in an informal setting to an audience of equals who exchange their reactions from the vantage point of different psychoanalytic schools and cultures. Such a forum, which breaches the confines of formal education and institutionally sanctioned learning, provides a stimulating way for analysts to become increasingly thoughtful about their work. In place of audience participation, this book replicates just such a learning exercise by substituting the voices of master clinicians."-Stefano Bolognini