Gratitude, freedom and refusal.

This paper is an exploration of gratitude as a fundamental concept in psychoanalysis. Melanie Klein's classic article "Envy and Gratitude" (1957) named gratitude at one pole on an axis of human suffering and flourishing, but with a few notable exceptions, the article stimulated research into envy. This paper explores the historical and philosophical traditions that have, to some extent unconsciously, influenced our contemporary understandings of gratitude. The paper also works to explore the social and ethical meanings of gratitude as well as gratitude's psychoanalytic significance. The aim is to uncover the overall psychic significance of gratitude and its place in human flourishing.

Transience and hope: A return to Freud in a time of pandemic.

This essay is about what it is like to read Freud again in the time of the coronavirus pandemic. It offers a close reading of Freud's essay "On Transience" and it brings to light how it might be read differently with the thoughts of world-catastrophe on our minds.

Encountering and speaking to the unconscious.

This paper tries to answer the question: what is it about the fundamental rule of psychoanalysis that makes it fundamental? The paper argues that the fundamental rule is fundamental to psychoanalysis because it is fundamental to human being that we are animals who think and speak and understand ourselves in logos - that is, in a special form of responsibility-bearing language. We learn how we bear these responsibilities by learning how to take a Sabbath-like rest from them. The fundamental rule is fundamental because in its very structure it probes deeply into and thus reveals and thus gives practical access to the beings we are.

Wisdom won from illness: the psychoanalytic grasp of human being.

From its inception psychoanalysis claimed not merely to be an effective therapy for psychological suffering, but to shed light on the human condition. But what kind of insight does psychoanalysis offer? This paper locates psychoanalysis in the western philosophical tradition, arguing that psychoanalysis provides not only theoretical wisdom about the human, but practical wisdom of a peculiar kind. The human mind, through its self-conscious understanding can be immediately and directly efficacious in shaping its own structure.

Technique and final cause in psychoanalysis: four ways of looking at one moment.

This paper argues that if one considers just a single clinical moment there may be no principled way to choose among different approaches to psychoanalytic technique. One must in addition take into account what Aristotle called the final cause of psychoanalysis, which this paper argues is freedom. However, freedom is itself an open-ended concept with many aspects that need to be explored and developed from a psychoanalytic perspective. This paper considers one analytic moment from the perspectives of the techniques of Paul Gray, Hans Loewald, the contemporary Kleinians and Jacques Lacan. It argues that, if we are to evaluate these techniques, we must take into account the different conceptions of freedom they are trying to facilitate.

Elaborar el fin de una civilización / Working through the end of civilization

Este texto trata de cómo una civilización elabora los problemas a los que se enfrenta cuando es amenazada con su destrucción. Los conceptos psicoanalíticos juegan un papel crucial a la hora de explicar hasta qué punto es posible una respuesta creativa. Y, a la inversa, centrándose en estas amenazas, el psicoanálisis puede descubrir nuevos desafíos que contribuirán a su propio desarrollo conceptual (AU)

This is an account of how a civilization works trough the problems it faces when it is threatened with destruction. Psychoanalytic ideas play a crucial role in explaining how a creative response is possible. Conversely, by focusing on this threat psychoanalysis can discover new challenges for it own conceptual development (AU)

Working through the end of civilization.

This is an account of how a civilization works through the problems it faces when it is threatened with destruction. It focuses on the example of the Crow Nation, an Indian tribe of the northwest plains of North America, and their last great chief Plenty Coups. Psychoanalytic ideas play a crucial role in explaining how a creative response was possible. In particular, their collective use of dream-visions and dream-interpretation made possible the creation of a new ego ideal for the tribe. This allowed for the transformation of traditional allocations of shame and humiliation. It also allowed for the possibility of transformation of psychological structure. And it opened up new possibilities for what might count as flourishing as a Crow. Conversely, the threat of civilizational collapse allows us to see new possibilities for the conceptual development of psychoanalysis. In particular, psychoanalysis needs to recognize that destruction can occur at the level of the culture while the individuals are not physically harmed. The psychological states of these individuals can be various and complex and cannot be neatly summed up under the category of trauma. A culture can be devastated, while there is no one-to-one relation to the psychological states of the individuals who participate in that culture. It is also true that a collapse of a way of life makes a variety of psychological states impossible. Coming to understand these phenomena is essential to understanding how a culture works through threats to its very existence.

Elaborar o fim de uma civilização / Elaborar el fin de una civilización / Working through the end of civilization

Este é um relato de como a civilização elabora os problemas que enfrenta ao ser ameaçada de destruição. As idéias psicanalíticas têm o papel fundamental de explicar o modo pelo qual se possibilita uma resposta criativa. Dessa forma, ao focalizar nessa ameaça, a psicanálise pode encontrar novos desafios para o seu próprio desenvolvimento conceitual.

Este es un relato de cómo la civilización elabora los problemas encontrados al ser amenazada de destrucción. Las ideas psicoanalíticas tienen un papel fundamental al explicar el modo por el cual se posibilita una respuesta creativa. De esta forma, enfocándose en esta amenaza, el psicoanálisis puede encontrar nuevos desafíos para su propio desenvolvimiento conceptual.

This is an account of how a civilization works through the problems it faces when it is threatened with destruction. Psychoanalytic ideas play a crucial role in explaining how a creative response is possible. Conversely, by focusing on this threat psychoanalysis can discover new challenges for its own conceptual development.

Reelaborando el fin de la civilización / Working through the end of civilization

Este trabajo trata sobre cómo una civilización elabora los problemas con los que se enfrenta cuando siente la amenaza de ser destruida. Analiza el ejemplo de los Crow, una tribu india de las llanuras nordoccidentales de Norteamérica, y de su último gran jefe Plenty Coups. El abordaje psicoanalítico permite comprender cómo fue posible desarrollar una respuesta creativa a este tipo de amenaza. En particular el uso colectivo de los sueños y de su interpretación hicieron posible la creación de un nuevo yo ideal para la tribu. Esto permitió la transformación de las tradicionales atribuciones de vergüenza y humillación, como también la transformación de la estructura psicológica. Y abrió nuevas posibilidades para lo que podría considerarse la modalidad de desarrollo genuino de los Crow. Por el contrario, la amenaza de un colapso de la civilización nos permite ver nuevas posibilidades de desarrollo conceptual del psicoanálisis. De manera especial, el psicoanálisis tiene que admitir que la destrucción puede acaecer a nivel cultural aunque las personas, singularmente, se mantengan físicamente indemnes. La situación psíquica de estos individuos puede ser muy diferente y compleja, y no cabe ser incluida en la categoría de traumática. Una cultura puede ser devastada, sin que se produzca un impacto directo en la situación psíquica de los individuos que forman parte de ella. Es cierto también por otra parte que la destrucción de un modo de vida imposibilita una variedad de estados psicológicos. La comprensión de estos fenómenos permite entender como una cultura consigue elaborar psicológicamente la amenaza a su propia existencia.

Reelaborando el fin de la civilización / Working through the end of civilization

Este trabajo trata sobre cómo una civilización elabora los problemas con los que se enfrenta cuando siente la amenaza de ser destruida. Analiza el ejemplo de los Crow, una tribu india de las llanuras nordoccidentales de Norteamérica, y de su último gran jefe Plenty Coups. El abordaje psicoanalítico permite comprender cómo fue posible desarrollar una respuesta creativa a este tipo de amenaza. En particular el uso colectivo de los sueños y de su interpretación hicieron posible la creación de un nuevo yo ideal para la tribu. Esto permitió la transformación de las tradicionales atribuciones de verg³enza y humillación, como también la transformación de la estructura psicológica. Y abrió nuevas posibilidades para lo que podría considerarse la modalidad de desarrollo genuino de los Crow. Por el contrario, la amenaza de un colapso de la civilización nos permite ver nuevas posibilidades de desarrollo conceptual del psicoanálisis. De manera especial, el psicoanálisis tiene que admitir que la destrucción puede acaecer a nivel cultural aunque las personas, singularmente, se mantengan físicamente indemnes. La situación psíquica de estos individuos puede ser muy diferente y compleja, y no cabe ser incluida en la categoría de traumática. Una cultura puede ser devastada, sin que se produzca un impacto directo en la situación psíquica de los individuos que forman parte de ella. Es cierto también por otra parte que la destrucción de un modo de vida imposibilita una variedad de estados psicológicos. La comprensión de estos fenómenos permite entender como una cultura consigue elaborar psicológicamente la amenaza a su propia existencia. (AU)

Just regionalisation: rehabilitating care for people with disabilities and chronic illnesses.

BACKGROUND: Regionalised models of health care delivery have important implications for people with disabilities and chronic illnesses yet the ethical issues surrounding disability and regionalisation have not yet been explored. Although there is ethics-related research into disability and chronic illness, studies of regionalisation experiences, and research directed at improving health systems for these patient populations, to our knowledge these streams of research have not been brought together. Using the Canadian province of Ontario as a case study, we address this gap by examining the ethics of regionalisation and the implications for people with disabilities and chronic illnesses. The critical success factors we provide have broad applicability for guiding and/or evaluating new and existing regionalised health care strategies. DISCUSSION: Ontario is in the process of implementing fourteen Local Health Integration Networks (LHINs). The implementation of the LHINs provides a rare opportunity to address systematically the unmet diverse care needs of people with disabilities and chronic illnesses. The core of this paper provides a series of composite case vignettes illustrating integration opportunities relevant to these populations, namely: (i) rehabilitation and services for people with disabilities; (ii) chronic illness and cancer care; (iii) senior's health; (iv) community support services; (v) children's health; (vi) health promotion; and (vii) mental health and addiction services. For each vignette, we interpret the governing principles developed by the LHINs - equitable access based on patient need, preserving patient choice, responsiveness to local population health needs, shared accountability and patient-centred care - and describe how they apply. We then offer critical success factors to guide the LHINs in upholding these principles in response to the needs of people with disabilities and chronic illnesses. SUMMARY: This paper aims to bridge an important gap in the literature by examining the ethics of a new regionalisation strategy with a focus on the implications for people with disabilities and chronic illnesses across multiple sites of care. While Ontario is used as a case study to contextualize our discussion, the issues we identify, the ethical principles we apply, and the critical success factors we provide have broader applicability for guiding and evaluating the development of - or revisions to - a regionalised health care strategy.

The idea of a moral psychology: the impact of psychoanalysis on philosophy in Britain.

In this paper the author addresses the question of the significance of psychoanalysis for moral psychology via a more specific question: the impact of psychoanalysis on British philosophy in the twentieth century. He argues that there has been no influence of any real significance, and offers intellectual reasons why not. However, he also argues that there has recently emerged the possibility for a future engagement between psychoanalysis and philosophy, and he offers a history of the emergence of this possibility. In particular, the author discusses how the emerging interest within philosophy to work out a satisfying approach to naturalist moral psychology leads it to a concern with internal mental structure and, most importantly, to transformations of intrapsychic structures. He believes that this will lead philosophy to take a greater interest in psychoanalysis.

Jumping from the couch: an essay on phantasy and emotional structure.

This paper addresses two questions: first, how do phantasies work? Second, how do these mental activities affect a person's overall emotional life? The first question tends to be overlooked since those who accept, for example, projective identification as a basic mental activity tend also to treat it as an explanatory primitive. On this view, there is no further question to ask about how projective identification itself works; rather, other psychological and emotional phenomena are explained in terms of it. By contrast, this paper asks, how does projective identification itself work? The aim is not to provide a reductive explanation but to ask how it is that phantasies have the efficacy they have. To that end, one moment in the analysis of the Rat Man is re-examined. There is then an attempt to show the difficulties involved in weaving an account of phantasy into the broader-scale interpretation of emotional life.