A metapsychological framework for sadomasochism.

The authors present a summary of sadomasochism, its centrality in all pathology and the difficulties encountered by all analysts in working with sadomasochism. An integrative model is presented with determinants and manifestations from all phases of development, including the transmission of pathology between generations. Addiction to pain and the formation of hostile omnipotent beliefs are described as components of sadomasochism that explain how resistant sadomasochism is to change and growth.

Working with "Out-of-Control" Children--A Two-Systems Approach.

The authors apply a two-systems approach to demonstrate improved treatment possibilities and outcomes in this group of children and suggest that psychoanalysis can be defined as a multimodal strengths-based learning experience. Using clinical material from the analysis of an aggressive, "out-of-control" child, they discuss how these behaviors and symptoms are better understood as an actively constructed effort at self-regulation than as a deficiency in capacity or primitive, lagging development. They illustrate how a two-systems framework can allow for an expanded repertoire of techniques and reclaim psychoanalytic concepts that have fallen into disuse.

A new model of techniques for concurrent psychodynamic work with parents of child and adolescent psychotherapy patients.

To address the neglect of the importance of parent work in the psychodynamic psychotherapy of children and adolescents, the authors present a model of concurrent dynamic parent work that has demonstrated success with patients of all ages. The model includes dual goals for all therapies, addresses the challenge of confidentiality by differentiating privacy and secrecy, and emphasizes the importance of parent work throughout treatment.

Two systems and defenses.

The authors suggest that Freud's concept of defense differentiated psychoanalysis from other medical and psychological theories of personality development and functioning then and now. Reclaiming the concept's centrality and linking it with interdisciplinary research findings, they illustrate their extension of defense into a two-system model of self-protection and self-regulation with a clinical example. The authors suggest that the two-system model allows for the reintegration of defense into a multidimensional psychoanalytic theory and multimodal therapeutic technique.

Dialogue with the Novicks.

Two of the editors of The Psychoanalytic Study of the Child converse with authors Kerry Kelly Novick and Jack Novick, Ph.D., about their paper "Concurrent Work with Parents of Adolescent Patients.

Concurrent work with parents of adolescent patients.

Over the last ten years we have seen an increasing acceptance of the general idea of working with parents of child patients. What remains, however, as an area of controversy, conflict, and resistance, is the question of whether and how much therapists should or can work with the parents of adolescent patients. Questions cluster around how to maintain confidentiality and lead to the even larger issue of conceptualizing the developmental goals of the phase of adolescence.

Discussion of Victoria Todd's paper. "Saving the treatment: affect intolerance in a boy, his parents, the mental health community, and his analyst".

D.W. Winnicott wrote, "One analyst cannot have enough cases to cover all contingencies.

Building emotional muscle in children and parents.

The concept of "emotional muscle" arose from clinical work in relation to therapeutic impasse and as a criterion for moving toward a "good goodbye. "It was applied to work at Allen Creek Preschool, a non-profit psychoanalytic school in Ann Arbor, Michigan, dedicated to the emotional and cognitive growth of families and their children from 0-6 years of age. The idea of building emotional muscle makes immediate intuitive sense to parents, children, teachers, therapists, and patients.

Two systems of self-regulation and the differential application of psychoanalytic technique.

Out of our work over the years on child development, clinical technique, and sadomasochism, we have begun to formulate a model of development that describes two possible ways of responding to feelings of helplessness in the face of the challenges of internal and external experience. Any psychoanalytic model has implications for how we think about technique and can be tested on the basis of its utility in generating technical ideas and enhancing our therapeutic repertoire. At this juncture in the history of our field, it is crucial for us to demonstrate that psychoanalytic techniques are effective in helping people enter treatment, change, and finish in a way that consolidates their gains.