How do patients internalize new good object experience and how these previously closed systems open up? What happens within between analyst patient that leads to the opening up of affective channels them allows consciousness become transpersonal? The ways in which self-state becomes more fluid cohesive, or less dissociated, is an process. This process occurs intersubjectively, as well self-states each individual. When particular come together patient, especially those associated with pain...

Spontaneous common bile duct perforation is an uncommon clinical entity in both adults and children. Few case reports have been published since the first description 1882. Our work has reported line with SCARE criteria. Herein, we describe of a 28 year-old female who suffered spontaneous while admitted for choledocholithiasis. The occurred in-hospital, extensive imaging laboratory tests characterized disease detail. To our knowledge, this report witnessed from pre-perforation through...

Relational perspectives on the nature of self and unconscious have transformed how we can understand addictions substance use problems. Addictions received little attention in contemporary literature therapeutic approaches outside psychoanalysis been skeptical psychoanalytic approaches. It is my contention that viewing problems through lens a relational/multiple self-state model offers new clinical possibilities resulting greater success treating these patients. In this model, addictive...

How do we help patients who come to us without access feelings and curiosity about themselves others? The author suggests that the analyst’s imagination intuition provide a channel or medium through which apprehend aspects of patient’s internal life, make contact communicate with younger parts patient, containment these person. As analyst engages her in this way, communication channels open shared states consciousness between patient are created, thereby facilitating interpenetration minds...

Psychopathy has long been considered untreatable. The purpose of this paper is to provide a report from the field on therapeutic gains made in case psychopathic personality and outline what appear be most effective aspects treatment, as well help integrate current psychedelic research theory with psychoanalytic theory. These factors include: tactful acknowledgment confrontation patient’s behavior disclosure him diagnosis psychopathy; focus his resentment toward existence itself; cultivation...

In their rich discussions, Jonathan Slavin and Steven Stern have raised several issues that I take up in this reply. agree with Slavin's point about agency, also respond to his perspective on the “real mind of analyst.” response Stern, reassert utility multiple self-state theory discuss further experiences enactment my patient. expand ideas shared consciousness its role opening closed internal object worlds. Stern's questions how what was unconscious became conscious for me are explored....

This paper discusses Janine de Peyer’s “Unspoken Rhapsody: Female Erotic Countertransference and the Dissociation of Desire,” elaborating on professional clinical aspects working with female erotic countertransference male patients, a focus dissociation containment in these contexts. Perspectives from evolutionary psychology affective neuroscience are offered to better understand how analyst/male patient dyads differ that analyst/female patient.

There is much area of agreement between the author and discussants. The addresses areas concern questions raised in commentaries. These topics include use reverie, how I have defined maternal desire, concerns about avoidance negative transference, analyst’s own dissociation, compassion.

This is a reply to the discussions by Arthur Fox, Megan Rundel, and Jeffrey Guss. Clarification made on utility of diagnosis, as well further elaboration what common both psychedelic states altered consciousness encountered in deep psychoanalytic work. Additional thoughts integration relational multiple self-state model with therapy are provided. The importance updating our models new science emerges emphasized. intersection analyst’s belief system its impact countertransference discussed....

Burton's response to discussions by Krystal and Khantzian addresses the manifestation engagement of aspects bad objects in addictions treatment acknowledges broader relationship between compulsive behaviors dissociation. In addition, Burton presents thoughts on cross-disciplinary communication an emergent relational metapsychology its potential impact across schools psychotherapy.