1st Edition

Phenomenology, Uncertainty, and Care in the Therapeutic Encounter

ISBN 9780415812603
Published August 25, 2015 by Routledge
208 Pages

USD $62.95

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Book Description

Phenomenology, Uncertainty and Care in the Therapeutic Encounter is the latest in a series of books where Mark Leffert explores the therapeutic encounter as both process and situation; looking for evidence of therapeutic effectiveness rather than accepting existing psychoanalytic concepts of theory or cure without question.

Mark Leffert focuses on the uncomfortable fact that analysts and therapists can and do make many mistaken assumptions and false moves within their clinical practice, and that there is a tendency to ignore the significant levels of uncertainty in what they do. Beginning with a discussion of the phenomenology of the self and its relations with the world, the book moves on to  explore the notion that interdisciplinary discourse both opens up possibilities in the therapeutic encounter but also imposes healthy constraints on what can be thought or theorized about psychoanalytically.

Phenomenology, Uncertainty and Care in the Therapeutic Encounter contributes a new understanding of familiar material and brings a new focus to the care-giving and healing aspects of psychoanalysis and psychotherapy leading to a shift in the analyst’s identity from that of one who analyses to one who cares for and heals. This book will be of interest to Psychoanalysts and psychotherapists, neuroscientists and academics in the fields of psychiatry, comparative literature and literature and the mind.

Table of Contents



1 The Self and Its Contexts


The Self

Collections of Selves: Network Studies

2 Phenomenology and Existentialism


Heidegger the Man

Phenomenology and Existentialism

Dasein and Being-in-the-World

3 Psychoanalysis and Daseinanalysis


American Phenomenological Psychoanalysis

Phenomenological Analysis: Goals and Substance

Clinical Phenomenology

Roger’s Analysis: Phenomenologically Speaking

4 The Phenomenological Unconscious


The Unconscious and Unconsciousness

The Phenomenological Unconscious

The Relational Unconscious

Unconsciousness and the Uncanny

5 The Role of Decisions Made Under Uncertainty in Clinical Psychoanalysis


Uncertainty in Contemporary Psychoanalysis

Decision-Making Under Uncertainty


The Law of Small Numbers

Heuristics and Biases

Variants of Uncertainty

Why Psychoanalysts Need to Study Uncertainty

6 Care and Suffering in Therapeutic Situations


The Nature of Care

Care of the Medical Patient

Care and Suffering in Psychoanalysis and Psychotherapy

7 So What Is Psychoanalysis, Really, and What are its Therapeutic Goals and Actions?


An Expanded Perspective on Psychoanalysis

Neuroscience: Selected Issues

An Expanded Relational Perspective

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Mark Leffert MD, has been on the faculty of five psychoanalytic institutes and has been a Training and Supervising Analyst at four of them. He has taught and supervised psychoanalysts, psychologists, and psychiatrists for forty years. He is the author of many papers and two previous books, Contemporary Psychoanalytic Foundations and The Therapeutic Situation in the 21st Century. Dr Leffert has been engaged in an interdisciplinary reformulation of clinical psychoanalysis drawing on postmodernism, neuroscience, network studies, and (among others), heuristics and biases. Present and future work focuses on phenomenology, care, healing, and the self. He is in private practice in Santa Barbara, California.



Once again, Leffert provides readers with the eclectic scholarship and gentle iconoclasm for which he is justly renowned. Here he sets himself the paradoxical task of theorizing the ‘inconvenient truth’ of a post-modern psychoanalysis bereft of certainties and grand theories. He deftly does this via a) an accessible account of phenomenology (including all you ever wanted to know about Husserl and Heidegger but never dared ask), in which what patients say at the outset of treatment they want to be different about their lives is taken with utmost seriousness b) showing how transference can be understood in terms of Kahnemanian heuristics and systematic biases c) acknowledging that care and palliation are no less important goals for therapists than elusive, and largely mythical, ‘cure’. Convincing clinical material, buttressed by contemporary neuroscience, keeps the reader’s feet on the ground throughout. A must-read for all broad-minded and self-reflexive therapists. - Professor Jeremy Holmes MD FRCPsych University of Exeter, UK

Phenomenology, for Leffert, represents a retreat from the endless academic debates, the internecine professional rivalries, and the pseudoscientific pretense that all too often itnerfer with quality patient care... One hopes that Leffert continues his subversive campaign. - Geoffrey Cox, president of Alliant International University, PsycCritiques

Psychoanalytic theory and psychotherapeutic practice benefit from not taking anything for granted On the hand psychoanalytic training is more indoctrination than exploration with a limited interdisciplinary reach. Dr Lefferts book offers an elegant and eloquent corrective to the limitations of our business as usual approach – Arnold Richards, Editor Internationalpsychoanalysis.net

This important volume is an part of Leffert’s ongoing interdisciplinary odyssey to understand and enrich the therapeutic situation in today’s uncertain post-modern world. Leffert persuasively argues for the need for a phenomenologically-informed psychoanalysis, stripped of metapsychological paraphernalia. He investigates the relevance of complex systems and their properties from neurology to social networks in his characteristically clear and erudite way. Leffert explores ‘big picture’ issues while attending to theoretical and clinical details in his search for an effective therapy focusing on healing, care and what patients want.—Douglas Kirsner, PhD, Emeritus Professor of Philosophy, Deakin University, Melbourne. Author of Unfree Associations: Inside Psychoanalytic Institutes