PubMed Health⌕ Search

Biomedical subjects

Judy L Kantrowitz

Publications and source records attributed to Judy L Kantrowitz.

9 recordsLinked to original sources

Patients reading about themselves: a stimulus to psychoanalytic work.

Patients' reading of their psychoanalysts' papers about them as a vehicle for psychoanalytic work is a relatively new phenomenon in the field. Over the past five years, reports of analysts' employment of their writing in this fashion have begun to appear in the analytic literature. This paper presents clinical illustrations of this specific use of analysts' writing. These illustrations were drawn from interviews with analysts who published clinical articles in Psychoanalytic Dialogues between 1995 and 2003. The author considers some of the clinical and scientific implications of this use of papers written for publication.

Countertransference↗

Writing about patients: IV. patients' reactions to reading about themselves.

When analysands read about themselves in reports, their reactions range from anger, disappointment, or condemnation to a sense of appreciation or even idealization of the analyst. The eleven interviews reported here reflect only conscious responses; the unconscious layers were not probed for. It should be kept in mind also that the analysts of these patients might report very different stories. Other limitations are the small sample size and the representation only of patients who volunteered. Nonetheless, the information they provide may help analysts consider how and when writing about patients may influence their representation of themselves, the analyst, and analysis itself.

Data Collection↗

Writing about patients: V. analysts reading about themselves as patients.

The narratives of twenty analysts written about when they were patients are presented. Their stories provide suggestions about practices to avoid when writing clinical material, but no generalized prescriptions emerge. Individualization and sensitivity to the situation for each pair remain the best guide. The experiences these analysts recount run the gamut of emotions, from negative through neutral to positive. The neutral responses came mainly from twelve analysts who in the course of an interview about their own writing told of having been written about as patients. The other eight, volunteers who initiated contact for the sole purpose of reporting their experience of having been written about, appear on average to be motivated by stronger affective reactions. The era in which the analyst wrote also seems to have influenced the reactions; in earlier times, not asking permission was accepted professional practice. Today, however, it is increasingly common to ask permission when extended clinical examples are published. One problem specific to analyst-patients was concern about the loss of their role as patient when their analyst engaged them collaboratively in the writing.

Humans↗

Writing about patients: I. Ways of protecting confidentiality and analysts' conflicts over choice of method.

Thirty American psychoanalysts who have published articles using clinical material from their patients were interviewed about their method for ensuring confidentiality. Almost twice as many analysts chose to disguise material as regularly requested permission for the use of patients' material. The other analysts in the sample varied their approach, depending on circumstances, between using disguise alone and using disguise but also requesting consent. Methods of disguise, the timing of request for permission in relation to the phase of analysis, and changes in analysts' ideas about the benefits and detrimental effects of these choices are discussed and illustrated. Each decision is reconsidered in light of its potential effect on patients and their analysis. The dilemma posed by the importance of writing about patients for the health and growth of psychoanalysis as a field and the potential negative consequences for patients and their analyses is considered.

Choice Behavior↗

Writing about patients: II. Patients' reading about themselves and their analysts' perceptions of its effect.

Thirty American analysts who have published articles that include clinical material were interviewed about their methods for ensuring patient confidentiality. Eight of these analysts had patients who had read about themselves or heard their cases presented, though their analyst had not requested permission to use this material. Eighteen patients had been asked and gave their consent to have their material used. Twelve of these patients were shown the material written about them. The analysts' thoughts and reactions to their experiences of obtaining consent and having their patients read material about themselves, and of disguising material without asking consent and then having it inadvertently discovered and read by their patients, are discussed. Their views of the effect on their patients of reading written material about themselves are elaborated with case illustrations.

Attitude to Health↗

Writing about patients III: Comparisons of attitudes and practices of analysts residing outside and within the USA.

When analysts write about patients, they find themselves in a position of conflict. Their first loyalty is to their patients and maintaining confidentiality. However, they are also committed to advancing scientific knowledge in the psychoanalytic field. The attitudes and practices of 36 analysts residing outside the USA, who published articles using clinical material from their patients, are reported. Their attitudes and practices are compared with those of 30 author-analysts residing within the USA, who had been previously interviewed. Among the 66 analysts, geographic region was not a basis for distinguishing differences in attitudes or practices. Slightly more than twice as many analysts use only disguised material as regularly ask permission of their patients to write about them. The decision to use only disguise is somewhat more frequent for analysts who reside outside the USA than for those living within it. Analysts around the world are increasingly concerned about the accessibility of published material. More analysts have come to believe that it is necessary to ask permission before publishing material. Some analysts also believe that the request itself, and the patients reading written material about themselves, focus issues that are central to patients' characters and conflicts that can then be explored analytically.

Confidentiality↗

The triadic match: the interactive effect of supervisor, candidate, and patient.

The triadic match is the author's term for the interaction among analytic candidate, supervisor, and patient. Overlapping or diverging characteristics of candidate and supervisor may influence the candidate's learning for good or ill depending on the way patient's and candidate's character and conflicts interact. Four candidates who had found their supervisors' character and supervisory styles particularly beneficial in relation to a particular patient volunteered to describe their experiences. Candidates and supervisors were interviewed. The aim of the paper is to illuminate factors in the match that enhanced or interfered with the candidates' learning. While the paper is presented from the perspective of the candidates' experiences, the balance between challenge and comfort in learning situations is also considered.

Character↗

The external observer and the lens of the patient-analyst match.

A focus on the match between patient and analyst places attention on the dynamic effect of the interaction of character and conflict of both participants on the process that evolves between them. Match is neither a predictive nor static concept. Rather it refers to an unfolding transaction that itself shifts and changes during the course of analytic work. The treating analyst's perception of the effect of this match is by necessity limited by the analyst's own blind spots and other countertransference phenomena. Reporting the analyst's clinical experience to an analytically trained observer, external to the dyad, may broaden the analyst's perspective. Using the lens of the match, a colleague in the role of supervisor, consultant or peer can provide feedback from which the analyst may acquire insight. As a result of this process, the influence that the participants' similarities and differences have upon each other becomes clear to the analyst. This awareness, in turn, may lead the analyst to appreciate the effect of the analyst's stance of distance or closeness and to evaluate whether at this phase of treatment it is beneficial or detrimental to the analytic process. Clinical illustrations of the effect of the external observer's feedback in relation to the patient-analyst match are provided.

Adult↗