Musing on the topic of initiating analyses, I began asking myself, what do we experience and what do we mean when we commonly say "an analysis unfolds"? Hans Loewald understood the rhythms of psychic development as , and that an analysis (when it works) also seems to follow that pattern. This paper will focus on appreciating in the analytic process as a way to illustrate narrative and behavioral themes in the analytic dialogue. It will explore how these themes relate to the creativity of analytic unfolding from an initial matrix of psychically overdetermined uncertainties. Analyst, supervisor, and patient can all notice and experience shifts of new forms intermingling with the old. This trope will be clinically expanded and examined (1) with materials from a candidate's first analytic case, (2) with a vignette from a seasoned analyst's beginning case; and (3) a Covid-era beginning treatment. A clinical footnote (dubbed by the author's supervisees "The Balsam Sign") describes a nonverbal mime in the office of a new development occurring within the familiar verbal communication, which may signal a patient's readiness to accept a recommendation to begin an analysis.

When we are confronted with the challenge of trying to fully convey or describe something about human life and emotional experience, we find ourselves up against the very limitations of language. This problem becomes especially relevant as we attempt to expand psychoanalytic theory so as to enable us to "approach a mental life unmapped by the theories elaborated for the understanding of neurosis" (Bion1962, p. 37). This paper seeks to aid in that expansion by revisiting Bion's early writings about the beta screen, extending his conclusions about communication from the psychotic part of the mind to the broad area of the unrepresented (the unstructured unconscious), suggesting that there is often a potentially communicative meaning, a mute plea for intersubjective regulatory assistance (alpha function), embedded in the unconscious evocation of emotions in the object and that this cry for help may be encrypted in even the most seemingly destructive, resistant and oppositional patients.

The author describes and then clinically illustrates what he terms the ontological dimension of psychoanalysis (having to do with coming into being) and the epistemological dimension of psychoanalysis (having to do with coming to know and understand). Neither of these dimensions of psychoanalysis exists in pure form; they are inextricably intertwined. Epistemological psychoanalysis, for which Freud and Klein are the principal architects, involves the work of arriving at understandings of play, dreams, and associations; while ontological psychoanalysis, for which Winnicott and Bion are the principal architects, involves creating conditions in which the patient might become more fully alive and real to him- or herself. The author provides clinical illustrations of the ontological dimension of psychoanalysis in which the process of the patient's coming more fully into being is facilitated by the experiences in which the patient feels recognized for the individual he is and is becoming. This occurs in an analysis in which the analyst and patient invent a form of psychoanalysis that is uniquely their own.

This paper plays with the possibilities of writing about psychoanalytic work in different ways with different levels of disclosure about both patient and analyst. Various issues around anonymity, confidentiality, consent and identity are explored, highlighting the many questions that come up. These issues of how to write psychoanalytically are also addressed from the point of view of culture and the sociopolitical gestalt of our time.

This paper explores the intricate nexus of writing and psychoanalysis by addressing a key question: In what and how many directions should analytic writing be ethical? The author structures the argument across three axes. First, in an introduction, writing's role as a psychoanalytic invariant is emphasized. Then, an exploration ensues, delving into writing as praxis, navigating complex technical choices, from micro- to macro-perspectives in clinical vignettes, their autobiographical essence, their relevance as models for theory, self-revelation, etc. Lastly, a succinct epilogue considers the relationship between aesthetics and ethics in psychoanalytic writing.

The author explores some ways that we help patients to hold paradoxical realities intrinsic to transference and play in analytic work. He suggests that Winnicott's guardianship of the setting for the emergence of playing raises questions about the role of neutrality in an ontological analysis. The author tries to demonstrate some ways that the work of helping patients to hold paradox in play overlaps with a concept that he has earlier referred to as an activity of neutrality. He explores how in the analytic process, understanding and being are two dimensions of the analytic process that work in concert with each other. Often the analyst works quietly in spaces between epistemological and ontological approaches in the holding of paradox.

The authors describe their experiences as members of an international online study group, initiated before the COVID-19 pandemic to read aloud and discuss Bion's (1965) . The three separately authored essays and commentary included here reflect the multifaceted phenomena in which images and voices in Zoom rectangles are transformed into shared emotional experience, the O of the group in Bion's language. These observations show how group members translate online experience into a felt sense of being with others, and suggest that oscillations in the sense of being inside or outside the group demonstrate the dialectical and constantly changing nature of the analytic field in an online group.

While we speak casually about beginning of an analysis, we are also aware that there are different senses of in the context of an analysis. Certain differences surrounding the nature of beginning reflect technical-theoretical debates within the field. But in addition and more broadly, the various senses of represent different of our understanding and experience of analysis. In this essay, I explore some of these dimensions and consider the significance and challenges of throughout the course of analytic work.

Wilfred Bion's contributions to psychoanalysis are numerous: his early work on the psychology of groups that grew out of his experiences in the first World War; theories and work on the treatment of psychosis with Melanie Klein and later psychoanalysis with her; and the beginning of his own theoretical and clinical ideas, which nurtured analytic thinking and treatment approaches beginning in the mid-1960's followed by his relocation to the United States (1967). Bion's thinking can be deceptively simple, such as his statement that his third book, (1965), considered by many as exceptionally dense, is about "the communication of both patient and analyst about an emotional experience" (p. 29).

Psychoanalysis reflects the minds of its creators and is an ethical practice in the sense that the theories with which we psychoanalysts identify are those that reflect what is most important in life to each of us. I present autobiographical material that points to the personal sources, even earlier than my psychoanalytic training, of my conviction that the creation of emotional connection between two actual persons lies at the heart of psychoanalysis and is the key element in the beginning of psychoanalytic treatment. I argue that the beginning of an interpersonal/relational treatment has more continuity with the beginning of non-psychoanalytic relationships than does the beginning of treatment carried out by analysts from other schools. I present what I believe are the reasons for this difference and offer comparisons and contrasts of these ways of establishing a psychoanalytic situation. The article ends with a brief clinical illustration.

The author distinguishes between two kinds of beginning, conceptually tied to two ways of approaching the psychoanalytic situation described as and . Through a clinical case, the author shows how her work with a troubled adolescent had two beginnings that corresponded to these types. In this way, she tries to expand on the literature about the focusing on what means in this context. For treatment to succeed, a must emerge, a transformative moment with the potential for significant change. The combined ability to transform the most primitive, somatopsychic pain can be more effective if shared by analysts and patients in a predominantly aesthetic form.

Questions concerning analysts' publication of material from the analyses of their patients have troubled the field of psychoanalysis since its inception. Disguise inevitably distorts the clinical material and is often insufficient to protect the patient from recognition. Asking the patient's consent for publication intrudes upon and alters the analytic process. While analysts have largely reached a consensus about the need for in published material, there is still considerable debate about the necessity for obtaining patients' when using their material for publication. In this paper, I will trace the evolving meanings of disguise, and particularly of consent, in the analytic literature. I will place a particular emphasis upon the that underlie the analyst's decision to ask consent from her patient or not to do so, and I will argue that, although decisions on asking consent remain a complex matter, such coherent belief systems should play an important part in analysts' decisions regarding consent. I will illustrate my thought processes and some clinical situations with brief examples, and I will conclude with some practical recommendations, with the hope that these will stimulate further discussion in the analytic community.

The author offers a creative reading of Winnicott's (1967) "Mirror-role of mother and family in child development." Winnicott presents the idea that a pivotal experience in the process of the infant's coming into being as himself is the mother's communicating to the infant, by the look in her eyes, what she sees there when she looks at him. In the absence of the experience of being seen, the infant's capacity to feel real and alive atrophies. The author fleshes out Winnicott's thinking by suggesting that just as the infant comes more fully into being as he sees himself in his mother's eyes, so too, the mother comes more fully into being as a mother as she sees herself in the infant's eyes. The paradigm shift that Winnicott has contributed to psychoanalysis is reflected in the clinical work he presents: (1) the goal of psychoanalysis is no longer the enrichment of the patient's self-understanding; rather, the analytic goal is the patient's coming more fully alive to himself; and (2) the analyst helps the patient achieve this end not by making astute interpretations but by allowing the patient to experience the pleasure of making discoveries of his or her own.

We propose to critically evaluate and strengthen the level of clinical evidence in psychoanalysis, using a strategy of triangulating clinical phenomena from different perspectives and increasing contextual knowledge. Insufficient discussion of alternative hypotheses and limited contextual information are two Achilles heels of psychoanalytic case presentations. We examine the concept and quality standards of clinical evidence in psychoanalysis and related disciplines, with particular attention to the contribution of the three-level model (3-LM). We analyze the case of a patient treated with transference-focused psychotherapy (TFP), making explicit the theoretical-clinical agreements and disagreements of the authors. We discuss the strengths and limitations of triangulation and contextualization, concluding that they make clinical work and psychoanalytic writing more reliable, transparent, auditable, and replicable.

Rene Kaës (2007), an influential French psychoanalyst relatively unknown to English-speaking readers, extends the field of psychoanalytic investigation and practice to groups. Building on Klein, Anzeiu, Bion, and Lacan, Kaës presents a dual-axes theory in which early oedipal and complexes structure unconscious dynamics of . According to Kaës, analytic group psychotherapy provides access to the phantasies, affects, and action tendencies contained within internal groups that would be otherwise inaccessible. While a few reference articles have appeared in the English literature, Kaës' bold assertions, core concepts, and praxis have not been subject to critical evaluation. I introduce Kaës' main ideas, demonstrate their influence on my group work, and by comparing two case examples, from his practice and mine, articulate our differences, some of which arise from different conceptions of and approaches to . The discussion continues in the final section which briefly considers the nature of psychoanalytic learning and how we may employ the therapeutic group to reach this goal.

The aim of this article is twofold: firstly, to describe the seven-year analytic treatment of a TG adolescent (F "April" to M "Tran") and, secondly, based on the clinical observations, to propose a reflection on the intrapsychic events linked to gender transition. We could witness during this analysis that the dissonant anatomical sex, which is at the heart of the gender dysphoria, resists mentalization and consequently its psychological integration. The psychic events of transition, understood here on the model of a mourning process, could denote the various strategies necessary to the TG individual to negotiate the obstacle of mentalization.

The belatedness of analytic writing and its effects on analytic processes are explored through the concepts of and . The temporal gap between writing about functions as a meaningful pause filled with opportunities for investigating unconscious pathways to the analyst's countertransference. The significance of analytic narration in affecting specific psychoanalytic developments is explored. The theoretical framework utilizes the concept of , which brings to light new meanings in an afterwardness of time. Aspects of analytical writing dynamics are discussed as equivalent to those of nachträglichkeit. Analysts also deploy thirdness in constructing presentations of clinical material. This could be an intrapsychic third or an external figure representing an internal introjected third. A clinical vignette demonstrates the enhanced understanding achieved by writing. It specifically assisted in exploring the analyst's enactment relating to change in the setting, the background for which was a move to online analysis. This evoked infantile anxieties and painful confusions about loss. Historically, the patient had to navigate a path through miasmic ambiguities between reality and phantasy, truths and lies. A conclusion is reached, arguing that analytic processes extend beyond the duration of sessions, and that the processes of clinical writing can provide a significant contribution.

The concept of in psychoanalysis includes the way clinical practice embodies the values on which psychoanalysis is founded. As psychoanalysis evolved from a medical treatment to a process of open-ended psychic development, its underlying values evolved as well. Free-floating attention has many facets, shown in the variety of names given to it. From being a means to an end clinically, it became an implicit statement about the human value of the person being attended to. Clinical vignettes, contributions from philosophers, and examples from literature converge around the idea that the unreserved openness of free-floating attention amounts to an act of love. It is underpinned by the values, which are also virtues, of hope, and faith in the possibility of good; it can also be seen, in non-religious terms, as a form of prayer.

An attempt is made to encircle time and the times psychoanalytically. They are understood as the result of the interplay of different psychic systems: Timelessness of the Ucs system (psychic reality), actual time in the Pcpt-Cs (perceptual reality), and vectorial-linear time in the Cs/Pcs systems (reality principle). Time shows itself in the moment of presence, but it can only show itself if there is a temporal antecedent. At the same time, time and space are intertwined, so that the past is initially the place where something happened. However, the interplay of the mental systems with time and space can only develop in the object relationship. A short clinical example of an autistoid perversion illustrates this dynamic.

Weaving subjective musings with theoretical speculation, this paper explores various themes on the question of identity. I consider identity as identification with a social location, where that social location is a function of groups. As such, identity is inherently contingent, a relational affair, a soft assembly. Though not a particularly psychoanalytic concept, identity is currently being tasked with considerable work in psychoanalysis: functioning as a hinge between the dual registers of the personal and social unconscious. Like any symptom, the term identity both obscures and indexes, signaling the urgent need for a radical revision of theory. The more we use the contingency of identity-how we find ourselves identified (by others as much as by ourselves) in this place and time, whatever this might be-rather than its fixity, thought to transcend place and time, the more that the concept of identity can be used in a specifically psychoanalytic way to help us explore the terrain of the political, which I distinguish from the terrain of politics proper. These ideas are employed to consider the current moment in psychoanalytic organizational life, which takes place under the sign of a fundamental paradigm shift (that is to say: catastrophic change).

This paper explores how the film illuminates psychoanalytic understandings of melancholia and mourning. The author attempts to unwind the complicated character of melancholia, using Freud as an initial point of orientation, then relying on a few ideas from Klein and later writers. The paper attempts to refine our understanding of the difference between absence and emptiness, especially the difference between being captured in the nothing or deadness of melancholic emptiness, on the one hand, and being alive enough to suffer the absence of a lost object, which bears a potential for mourning, on the other. The possibility of psychic tension between these states is explored. Some implications of the relationship between absence and emptiness for the mourning process are considered. The author uses the film as a resource throughout.

This paper aims to describe the processes of construction and maintenance of analytic intimacy, understood as a shared state of relative internal freedom that is most permeable to preconscious and unconscious communications, which facilitate the processes of subjectivation, dreaming, and digestion of unprocessed trauma. The author illustrates the theoretical and technical features related to the concept of intimacy, highlighting the transformations of a clinical case followed in supervision. This article is presented in the form of a conversation with the supervisee, so as to evoke in the reader the dialogic and co-constructive experience of thought construction.

is a timeless exposition of humankind's attempt to find meaning amidst the ceaseless turbulence of existence. This entails navigating the disintegrating pulls of nature and harmful human action that exist alongside affiliative, life-promoting gestures shown toward one another. As the predictability and safety afforded by social and two-dimensional psychic constructs collapse, several characters in this play are forced to reckon with the untamed, less organized realms of the mind and natural world. This leads to movements toward psychic paralysis and disintegration, as well as toward growth and interpersonal healing, dynamics that hinge on the characters' internal structuring.

I use the clinical example of a traumatized adolescent to talk about how a transference experience creates the frame where the analytic work occurs. Out of the external boundaries of the relationships with an object, the internal frame, the womb of transformation processes, is created. The analyst's capacity to wait is essential for the transformation that creates and shapes the transference experience, which, like playing, becomes the matrix of the frame where it happens as it happens. As the traumatic experiences find their place in the transference and begin to be integrated, the adolescent becomes more present and real in the session.

Psychoanalysis is defined in this paper as a process that initiates in the analyst's mind with the framing of the patient's material in terms of and . Once the analyst is able to do this, a first level of transformation of experience is effectuated that then must be through interpretation to the patient of what is occurring in their mind as it is lived out in the experience with the analyst. For this author, Bion's model of container-contained complements Freud's transference and resistance model; it also offers an example to his thesis that only within a clear model of mind and a corresponding theory of therapeutic action can the psychoanalyst define for themselves and for their patients a way of knowing that they are doing analysis. The patient's unconscious storm is present from the moment of the first interviews, and the analytic process begins whenever the analyst is ready to experience, think, and talk about it with his or her patient.