The Social Construction of PTSD: The Case of the 'Old Guard' Policemen After South African Democracy.

Often, we assume the traumatic nature of first response work has inevitable repercussions. This can lead to assumptions about trauma being the reason for distress, resulting in fixed ideas about diagnosis and treatment, without the complex socio-political and psychodynamic implications being fully considered. This paper challenges such assumptions by exploring the presentation of PTSD in 'old guard' police officers at the cusp of the post-apartheid era in South Africa.

Autistic defenses in agoraphobic syndrome: "flat" objects and the retardation of projective identification.

The function of autistic defenses in the generation of agoraphobic symptoms is explored in the case of a patient treated in psychoanalytic psychotherapy. The therapist's growing awareness of autistic modes of relating in the case facilitated various changes in the transference relationship. Although oedipal concerns are seen as important, a formulation is presented whereby autistic modes of generating experience are viewed as fundamental to an understanding of agoraphobic experience.

Anticipatory interpretations: addressing "cautionary tales" and the problem of premature termination.

This article explores the use of anticipatory interpretations early in the therapeutic process as a means of addressing the problem of premature termination with some patients. The author argues that emerging transference references, detected through a close attention to "cautionary tales" or derivative communications, should be used in early interpretive interventions. It is suggested that such transference references form a "template of intention" that help determine future difficulties in the therapeutic alliance.

The psychoanalytic research interview: preliminary suggestions.

Psychoanalytically informed interview techniques and interview analysis can yield useful psychoanalytic insights about a particular research subject within the space of a few interviews. Basic hermeneutic principles, often used to understand the research interview, are not sufficient for understanding unconscious meaning and intrapsychic processes; they pay little attention to the particular theoretical and technical aspects of the interview needed to create the best conditions for understanding unconscious meaning. The portability of psychoanalytic concepts and their applicability outside the therapeutic setting are considered, after which four epistemological principles are outlined, derived mainly from the narrative tradition in psychoanalysis, that can inform interview technique and the analysis of the interview.

Working with HIV/AIDS sufferers: "when good enough is not enough".

The authors begin by examining the intrapsychic implications that HIV/AIDS presents after knowledge of infection. Using examples drawn from two cases, they explore how knowledge of infection precipitates an insidious traumatizing process that comprises a number of key defensive strategies and dynamic processes. Particular kinds of defensive splitting, projective dynamics, and key identifications, as well as the collapse of the symbolic function, are isolated as being central to understanding the traumatizing process.

The narcissistic exoskeleton: the defensive organization of the rage-type murderer.

After outlining the characteristics of rage-type murder, the author reviews possible psychodynamic explanations of the predisposing personality and the act itself. He argues that more recent contributions, using an object relations perspective, best account for the complexity of the internal world of these offenders. Using a single case to illustrate observations drawn from his work with nine offenders, the author sets out to develop an understanding of the defensive organization present in these apparently normal murderers.