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E-grāmata: Time for Change: Tracking Transformations in Psychoanalysis - The Three-Level Model

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How can we, analysts, evaluate whether analysis is generating transformations in our patients?Time for Change: Tracking Transformations in Psychoanalyses. The Three-Level Model focuses on the question of how to observe changes in psychoanalysis. The IPA Project Committee on Clinical Observation and Testing offers a tool, a heuristic, or a guide for refining, conceptualizing, and systematizing clinical observations about patient transformations: The Three-Level Model for Observing Patient Transformations (3-LM). It enhances clinical observations, making them more accurate and more useful for theory testing and theory building through a systematic analysis of clinical material.

The 3-LM goes from clinic to theory, from implicit to explicit theory, from unquestioned hypotheses to reviewed hypotheses enriched by the work on the clinical material after its discussion by several participants with different perspectives.

Firstly, the 3-LM seeks to make a careful characterization of the patient and his/her problems and capacities when (s)he enters analysis. Then, it observes later moments of his/her treatment and the positive or negative changes that have occurred during treatment, what has not changed, the relevance of changes, and how changes are explained. Reports are elaborated in each group which state the convergences and divergences that emerged during the group discussion.

This book presents the model and the outcome of having worked with it. Approximately 700 analysts from different parts of the world have participated in these clinical observation groups. It has been applied to adult patients, adolescents and children, as well as in analytic training. This tool has proved useful and friendly for analysts, for it rescues and re-values the richness of the clinical experience between analyst and patient. It also allows exercising our abilities and clinical sharpness as well as acquiring precision when communicating our work. It provides the analyst with one way to monitor his/her work in a more subtle and meticulous way, offering a second look at the material for the benefit of both analyst and patient.

Recenzijas

'With its impressive wealth of clinical observations and the accuracy of its methodology, this book offers a magnificent response to many doubts raised by the opponents of psychoanalysis. Clinical observation, enhanced and explored in depth, gives an idea of how much progress psychoanalysis has made in reflecting on its own method and transformational outcomes.'- Stefano Bolognini, President of the International Psychoanalytical Association (IPA)'This book is an impressive achievement as it shows a contemporary, well-grounded, methodological approach to clinical observation, which is at the very core of the development of psychoanalysis. Its authors are among the most skilled analysts of today, both as clinicians and researchers. I am sure the readers will be rewarded with a stimulating journey throughout one of the most fascinating areas of contemporary psychoanalysis.'- Claudio Laks Eizirik, past President of the IPA and Professor of Psychiatry at the Federal University of Rio Grande do Sul, Brazil'This remarkable book addresses in new and original ways the challenges of psychoanalytic research and communication amongst colleagues: how to reflect systematically and collaboratively about, and be accountable for, the private and individualised work in each clinical dyad. Here, Marina Altmann de Litvan and her colleagues bring a creative approach to collaborative, systematic research and discussion about individual treatments. Time for Change gives new meaning to psychoanalytic research and collegiality and solves one of our most challenging professional dilemmas.'- Nancy J. Chodorow, PhD, Training and Supervising Analyst at Boston Psychoanalytic Society and Institute Lecturer at Cambridge Health Alliance, Harvard Medical School'The systematic study of psychoanalytic clinical observations and their epistemological significance is about one hundred years overdue. This groundbreaking volume summarises not just what we can learn from clinical observation but, far more importantly, how. This book is an essential training and scientific tool for our time.'- Peter Fonagy, PhD, FMedSci, FBA, OBE, Professor of Psychoanalysis and Head of the Research Department of Clinical, Educational and Health Psychology, University College London

About The Editor And Contributors ix
Series Editor's Foreword xvii
Foreword xix
Charles Hanly
Introduction xxv
Marina Altmann de Litvan
PART I INTRODUCING THE THREE-LEVEL MODEL FOR OBSERVING PATIENT TRANSFORMATIONS
Chapter One The three-level model (3-LM) for observing patient transformations
3(32)
Ricardo Bernardi
Chapter Two Leticia: the emergence of questions about herself
35(17)
Silvana Hernandez Romillo
Chapter Three Irina: an adolescent
52(45)
Marina Altmann de Litvan
PART II OBSERVING AND WORKING WITH THE 3-LM
Chapter Four Tracking patient transformations: the function of observation in psychoanalysis
97(25)
Virginia Ungar
Margaret Ann Fitzpatrick-Hanly
Chapter Five Depression and trauma: the psychoanalysis of a patient suffering from chronic depression
122(41)
Marianne Leuzinger-Bohleber
Chapter Six Close to observation: some reflections on the value of the three-level-model for studying change
163(8)
Siri Erika Gullestad
Chapter Seven Working with the third level of the three-level model: the incidence of our theoretical model on our clinical thinking
171(16)
Adela Leibovich de Duarte
PART III A PATIENT, A CONCEPT, AND A CASE
Chapter Eight A traumatised patient in analysis: observing patients' transformations
187(22)
Margaret Ann Fitzpatrick-Hanly
PART IV THE 3-LM: A CASE, REPORT, AND DISCUSSION
Chapter Nine Transformations in Paula with "no history"
209(18)
Michael Sebek
Chapter Ten A report on Paula with "no history"
227(10)
Robert S. White
Chapter Eleven Discussion of Paula with "no history"
237(10)
Judy Kantrowitz
PART V CLINICAL CONCEPTS
Chapter Twelve Some reflections on the three-level model: organising psychoanalytic knowledge through clinical observations and generalisations
247(16)
Marvin Hurvich
Chapter Thirteen The assessment of changes: diagnostic aspects
263(18)
Ricardo Bernardi
PART VI AN APPLICATION OF THE 3-LM AT THE END OF ANALYTIC TRAINING
Chapter Fourteen The three-level model in psychoanalytic training
281(14)
Beatriz de Leon de Bernardi
Marina Altmann de Litvan
Chapter Fifteen The use of the 3-LM to teach candidates to observe transformations in clinical cases
295(8)
Liliana Fudin de Winograd
Adela Leibovich de Duarte
PART VII FURTHER DEVELOPMENTS OF THE 3-LM IN CHILD ANALYSIS
Chapter Sixteen Three-level model for observing child patient transformations
303(54)
Marina Altmann de Litvan
Delfina Miller
Ricardo Bernardi
Appendix I Brief guidelines: IPA clinical observation groups On behalf of all the members of the Project Committee on Clinical Observation)
320(9)
Marina Altmann de Litvan
Appendix II Clinical observation group, San Francisco (CO-SF1), May--August 2012
329(14)
William Glover
Appendix III Suggested questions for group discussion
343(4)
Appendix IV Forms to be used before and after the group discussion
347(4)
Appendix V Clinical observation work groups (2011--2013)
351(6)
Index 357
Marina Altmann de Litvan, PhD, is a child and adolescent psychoanalyst, a full member and training analyst of the Uruguayan Psychoanalytic Association, and a member of the Clinical Research Subcommittee of the International Psychoanalytical Association (IPA). She has been a member of the Education Committee and Co-Chair of the Education-Research Subcommittee of FEPAL, as well as Research Fellow and Visiting Professor at University College of London, Research Training Programme. She was also awarded the Biannual Exceptional Contribution Award from the Research Committee of the IPA for her research into verbal and nonverbal interactions in mother-baby psychotherapeutic process. She has published chapters of books and papers both in Spanish and English.