Introduction to the Practice of Psychoanalytic Psychotherapy

"This is so much more than an introductory text; it holds fast to an open, reflective and critical stance, setting out psychoanalytic ideas and their practical application in a way that is remarkably clear,
authoritative and demystifying. The revision extends and updates the original, making psychoanalytic concepts even more accessible and more importantly applicable. This book deserves a wide audience, and I strongly recommend it."

Tony Roth, Professor of Clinical Psychology, University College London



This is a practice–oriented textbook which aims to demystify psychoanalytic psychotherapy. Teaching and learning psychoanalytic therapy is a less clear–cut process than for other therapies, and it is easy for students to feel overwhelmed. This accessible guide is based on the author s own long experience of teaching trainee practitioners, and is built on the core premise that psychoanalysis is not so much skill–based as dependent upon development of the analytic attitude, guided by principles of technique that are used in the clinical situation.

The book provides step–by–step guidance and useful pointers in key areas such as how to make interpretations, how to carry out assessments, how to formulate cases in psychodynamic terms and how to approach endings. It presents critical information in an accessible way with case studies and practice guidelines, explaining the processes which underpin psychoanalytic psychotherapy as clearly and simply as possible. The Second Edition is updated throughout, with notable new material on findings from neuroscience and the increasing evidence base for psychoanalytic psychotherapy, the US relational school and the development of Dynamic Interpersonal Therapy, and recent studies in transference.

About the Author vii

Preface ix

Introduction: Is Freud Dead? 1

1 Brave New Worlds: A Psychoanalysis Fit for the Twenty–First Century 12

2 An Overview of the Schools of Psychoanalysis: Theory and Practice 28

3 The Process of Psychic Change 75

4 The Analytic Setting and the Analytic Attitude 94

5 Assessment and Formulation 128

6 Unconscious Communication 169

7 Defences and Resistance 194

8 Transference and Countertransference 219

9 Working with Endings 269

Conclusion: The Psychoanalytic Psychotherapist at Work 292

References 302

Index 327

ALESSANDRA LEMMA is Director of the Psychological Therapies Development Unit at the Tavistock and Portman NHS Foundation Trust, and a Consultant Adult Psychotherapist at the Portman Clinic. She is a Fellow of the British Psychological Society, Visiting Professor and Clinical Director of the Psychological Interventions Research Centre at University College London, Visiting Professor at Sapienza University of Rome and Honorary Professor of Psychological Therapies at the University of Essex. She is the Editor of the New Library of Psychoanalysis book series, and one of the regional Editors for the International Journal of Psychoanalysis. She has published extensively on psychoanalysis, the body and trauma.