In this article the authors, using psychoanalytic concepts, will discuss the treatment process in a drug-free Therapeutic Community (TC). A TC is a long-term group programme for people suffering from addiction that aims at an identity transformation and a drug-free lifestyle. Although the TC model exists for over 50 years and is applied worldwide, it has always been controversial because of its “totalitarian” approach. Subjects that are under the spell of a drug addiction do not tend to seek treatment for psychological problems. If help is sought, it is usually related to the debts, family problems, prison sentences and so on that are the consequences of addiction. Once the addict has decided to embark on a TC programme, they go through a process of detoxification and enter the drug-free TC peer group. By living together in an environment that is both holding and frustrating, the subject manages to reconnect with his own emotions and thoughts and the process of the becoming of the subject can continue. Affects such as anxiety and anger can be experienced and carried and the mirroring effects of peers provides the material for symbolization. Maintaining the TC values that guarantee a safe environment is essential to this process.
Psychopathy as a concept has always been subjected to reductionist thinking, causing it to be heavily contested within psychiatry and psychoanalysis. On the basis of research involving prisoners and the insights of the Belgian psychiatrist-psychoanalyst Léon Cassiers, the author describes recurring patterns in the relation of the psychopath towards the Other and towards language. Fundamental to psychopathy is the defence mechanism of the Retraction of the Law in which an initial Bejahung is followed by a retraction. The aim of this retraction is to escape the lack and the division by the signifier. A case study of an impostor is used to illustrate the theory.
This article outlines the possibility of a psychoanalytic clinic within a forensic setting. It is difficult to provide treatment within a judicial discourse, which leaves no room for the subject of the patient but only for their status as defined by the law and its enforcement. However, psychoanalysis can still provide an opening for the patient to speak despite this prevailing discourse. The singular position of the analyst will be especially crucial. Firstly, transference as working tool is actively used via a treatment of the Other (l’Autre), to establish changes in the relationship of the patient to the other (l’autre). Secondly, the setting and the specificity of volatile patients within a clinic of the Real with accompanying acts, aggression and crises, require a creative form of intervention. A recognition of the suffering of the patient is thereby necessary. The casuistry throws light on the clinical as well as the forensic aspects of the patient.
The publication of the diary of Anna G. has provided a new resource for the examination of the course of a psychoanalytic cure with Freud. The way in which Freud handled the (counter)transference and its effect on the femininity of his analysand is examined by analysing the diary as a form of free association. This method will allow us avoid the pitfalls of most other commentators. A slip of the tongue of the analysand (concerning Schnitzler’s Die Hirtenflöte) seems to hold the key to the transference in this cure.
This article reports on a unique document which remained unpublished until 2009: the diary of a patient who was in analysis with Freud in 1921. Six fragments are presented and conclusions are drawn on how Freud worked with patients during that period, with particular reference to transference.