Doubts & Certainties in the Practice of Psychotherapy

305 Pages·1995·7.672 MB·English

by  Josephine Klein

JOSEPHINE KLEIN
DOUBTS A ND CERTAINTIES

IN THE

PRACTICE OF PSYCHOTHERAPY

K A R N AC BOOKS
Doubts and Certainties

in the

Practice of Psychotherapy

Doubts and Certainties

in the

Practice of Psychotherapy

Josephine Klein
London
K A R N AC B O O KS
First published in 1995 by
H. Karnac (Books) Ltd,
118 Finchley Road,
London NW3 5HT
Copyright © 1995 by Josephine Klein
The rights of Josephine Klein to be identified as author of this work
have been asserted in accordance with §§ 77 and 78 of the Copyright
Design and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted in any form or by any
means, electronic, mechanical, photocopying, recording, or otherwise,
without the prior permission of the publisher.
British Library Cataloguing in Publication Data
Klein, Josephine
Doubts and Certainties in the Practice
of Psychotherapy
I. Title
616.8914
ISBN 978 1 85575 104 0
Printed in Great Britain by BPC Wheatons Ltd, Exeter
ACKNOWLEDGEMENTS

I am grateful to Peter Baynes for permission to quote from Re:
Verse—A Retiring Collection (unpublished); to Faber and Faber
Ltd. for permission to quote Louis McNeice's poem "Entirely"
(from The Collected Poems of Louis McNeice, 1986); to Hugh
MacDiarmid and the Carcanet Press for permission to quote
from the poem "Stones" (from Selected Poems, 1992); and to
Kenneth Wright and his publishers. Free Association Books,
London, and Jason Aronson, North Vale, NJ, for permission to
quote from Vision and Separation: Between Mother and Baby.
v

CONTENTS

ACKNOWLEDGEMENTS
PREAMBLE
PART ONE
Concerning values
1 Imagination and the institutional mind
2 Depression, disadvantage,

and the creative response

PART TWO
Concerning theories and techniques
3 Psychotherapeutics: what makes people better?
4 Holding: recognizing, accepting, understanding,
containing, organizing, integrating, metabolizing,
and other such
Viii CONTENTS
5 - Patients who are not ready for interpretations 94
6 Times when transference interpretations
are (in)appropriate 118
7 Using general concepts of structure
to understand regression, transference,
and the working alliance 169
8 Early attachments
and sources of later well-being 197
PART THREE
Concerning the development of ideas
9 Fathers: changes in psychoanalytic ideas on
men's relationship with their children 217
1 0 The contrasting histories
of psychoanalytic thought
in the United States and the United Kingdom 233
REFERENCES 267
INDEX 279
PREAMBLE

The tension between free-ranging thought and the
institutions that contain us is the unifying theme of
this book, which started as a collection of occasional
papers, mainly on the practice of psychotherapy, some for
pre-qualiflcation students but most for more experienced
professionals. Many I met on those occasions supported the
values that generate this tension, and many wished there were
more discussion of them. They would acknowledge in a sub­
dued sort of way that their experience often corresponded with
mine as regards what works and what does not work in the
practice of psychotherapy, and as regards what seems right
and what seems wrong. They would lament that they often felt
isolated and silenced by their fear of more authoritative*
sounding voices—or just ones that are more difficult to under­
stand. To bring to our attention and confirm and celebrate
these often unexpressed values, I have included the first two
chapters, which are not directly on the practices of psycho­
therapists but on the values that I think should govern us in
our work:
ix