Panel Reports
1203
damental valuation of an investment. What dominates market behavior is a regression to less conscious thinking. Von Weissenberg discussed very early developmental hallucinatory processes, which he believes occur in the regression that governs market behavior. Preoedipal fantasies put pressure on realistic market expectations, and superego problems also can influence market behavior. He believes one can think in terms of a market mood which is created by regression. Von Weissenberg spoke of how realism, expectations, and sentiment can interact synchronously or unsynchronously within a market and how bubbles occur because of projection phenomena. Juan Carlos Weissmann spoke about the global nature of finance. He believes the financial crisis continues to affect us all, and that in relation to it we all feel loss of love, loss of home and membership in a group, loss of self-respect and self-esteem, and damage to family structure. Other consequences of this crisis are generalized pain, increase in divorce and spousal violence, depression and suicide, sleep disorders, social withdrawal and loss of friends, and addiction. Weissmann asserted that the body and the psyche are one, and spoke of the skin as a membrane, which perceives, reacts, includes and excludes. Using the concepts of the membrane and the unity of body and psyche in the individual as a model for understanding large systems, his perspective extrapolates from the body and the influence of the inside as distinguished from the outside. Social relations, then, parallel individual relationships, and institutions created by people operate in parallel to individual relationships as well. Thus, he concludes, companies and businesses operate in parallel to the individual, and so does the economic system. He asserts that such a perspective allows for an understanding of the current financial crisis. At this point there was an opportunity for discussion with the audience. Evelina List from Austria responded that she felt uncomfortable with what she heard, because psychoanalytic theories concern individuals and their relationships, but do not explain social phenomena. In that spirit she questioned the entire panel discussion of markets because she believes it is unclear what psychoanalysis has to offer as regards a real understanding of society. Von Weissenberg expressed disagreement, stating that systems theory does allow psychoanalysis to understand large group phenomena, like the behavior of markets. Elvira Selow from Germany spoke of Tuckett’s views of the way customers pressure advisors, stating that this is consistent with an object relations view of what goes on in large groups: psychotic parts of group members (customers) influence social behavior. There is a psychotic resonance, she said, and this fits well with Tuckett’s description of the concept of the fantastic object. Anna Christopoulos from Greece spoke of the anxiety and disillusionment which is felt worldwide, because of the erosion of the middle class, the loss of control people now feel over their financial reality. In this sense, she asserted, we are now in a crisis without precedent, because we are seeing psychopathic behavior by the powerful taking away the agency of ordinary people. This, she said, is happening to people all over the world, and she believes psychoanalytic understanding may contribute to putting an end to such an abuse. Tuckett responded that he could not answer all the questions he heard at once. He spoke of changing power relations in economic systems; he agreed that psychoanalysis does not have an adequate societal theory because we focus on the individual (states of mind, unconscious fantasy, for example), but he does feel that psychoanalysis joining with anthropology and sociology can make a contribution to understanding many large group problems. He used the world’s energy crisis to illustrate his point: he suggested that with psychoanalytic thinking we can examine why we cannot grieve and mourn what we now know we do not have, and then better understand our reluctance to change our use of energy. This is an introspective process, and an essential beginning to dealing with larger group phenomena, with larger societal issues. He ended the panel on that optimistic note. Reference Tuckett D (2011). Minding the markets: An emotional finance view of financial instability. Basingstoke, Hants: Palgrave Macmillan.
Watch this space! Research studies in depression: Three studies combining clinical psychoanalytical research with studies of outcome20
David Taylor, Reporter
The strength of psychoanalysis as a form of research and as a therapy derives from its detailed, long-term work with individuals; small numbers of self-selected individuals are seen over the course of any analytic 20 Moderator: Heinz B€ oker (Germany). Panellists: Ulrich Barhke (Germany), Laura Bohleber (Switzerland & Germany), Holger Himmighofen v(Switzerland), David Taylor (UK), Heinz Weiss (Germany).
Copyright © 2013 Institute of Psychoanalysis
Int J Psychoanal (2013) 94
1204
Panel Reports
lifetime. In spite of its strengths, these features make psychoanalysis ill suited to test therapeutic propositions across samples or populations. But increasingly those who make the decisions about what to provide in publicly-funded or insurance-funded health services require evidence about a treatment’s effectiveness, and as well that evidence should take a specific form: it must come from controlled trials in which samples or populations of subjects representative of the whole have been randomly allocated to different treatment conditions. This requirement has been a serious challenge for those who wish to maintain levels of public investment in the provision of psychoanalytic forms of therapy and its presence and status in academic stages of training and research. In response, and without too much fanfare, several European centres have been engaged in the costly, time-consuming and challenging task of research into the outcome of medium or longer-term psychoanalytic treatments of patients suffering from depression. Why depression? Well, as Ulrich Bahrke and Johannes Kaufhold of Frankfurt, the first presenters to this Panel said, depression is up there amongst the most significant causes of human illness and disability. None of the studies presented at the Panel are yet in a position to publish their outcome findings. But over the next two or three years each will do so. A substantial body of findings about patients with depression and the value of psychoanalytic treatments will then enter the public sphere. Whatever the direction of these findings, positive or negative, in terms of their scientific quality they will be equal, or in important respects superior, to any derived from studies of the outcome of other treatment approaches, such as antidepressant medications or cognitive–behavioural approaches. Moreover, those responsible for the three major studies presented at this Panel have been determined to stick by the values, principles and practice of psychoanalysis. They have been supported in this by the willingness of psychoanalysts and empirical researchers to join together in an effort both to remain commensurate with the true complexities of their subject matter, and to be adequate in terms of generally accepted standards for studies of the effectiveness of therapeutic interventions in groups or populations of patients. The three studies are the multicentre German Langzeittherapie bei chronischen Depressionen Studie (LAC) led by Marianne Leuzinger-Bohleber of Frankfurt’s Sigmund Freud Institute, The Zurich Depression Studies headed by Heinz B€ oker, and, finally, the Tavistock Adult Depression Study (TADS) led by Peter Fonagy and me. In addition to Bahrke and Johannes Kaufhold from Frankfurt, the Panel consisted of presentations given by Laura Bohleber and Holger Himmighofen of Zurich, and from me for the Tavistock Depression Study. Following these, Heinz Weiss of Stuttgart and Frankfurt offered the perspective of a clinician researcher. However, he began his discussion by considering what is an absolute fundamental – a sine qua non in these projects: a good mutually respectful relationship between those with clinical knowledge and expertise and those with empirical research knowhow. Aptly, Heinz Weiss turned to Bion’s understanding of the different kinds of relationship that may operate between ideas as well as between people, namely that between container and contained. These can be commensal, symbiotic or parasitic. Weiss suggested that all three studies were distinguished by relationships in which empirical research had been employed to help psychoanalysis to become more “scientific” and clinical knowledge had extended what otherwise are the limitations of empirical research methods. His impression was confirmed by the audience’s very positive response to the presentations. In the first, Ulrich Bahrke and Johannes Kaufhold described the sophisticated design of the LAC Study (part of the allocation to either psychoanalytic or cognitive therapy following the patient’s preference and part randomly), and its five-year endeavour to gather its sample of 250 participating patients (originally 409, but more than 150 of these dropped out before beginning their treatment). As well as detailing the patients’ social and demographic characteristics (fewer married, more divorced or living alone, more childless, and so on), the Study has looked at these depressed people’s early developments and upbringing. Using the Childhood Trauma Questionnaire, which attempts to ‘standardize’ and ‘measure’ the experiences which go to make up trauma and environmental adversity generally, they found high levels of emotional and physical forms of abuse and neglect – multiple so-called traumata. But as psychoanalysts, these researchers fully realize that this level of description does not really do. Trauma is simply not countable like an external event. It is a relational matter in which an outer occurrence has specific kinds of consequences and meanings in a given person’s inner psychic reality. In-depth clinical enquiries between individuals are required to apprehend what is being played out in the lives of depressed patients. Is it trauma, loss, adverse developments? Most likely all of these. The LAC Study’s enquiries have revealed how its clinicians have frequently found indications of emotional neglect, humiliations and limitations of empathy in the parents of these depressed patients; how in more than half of the cases at least one parent was psychiatrically ill. There is work to do in connecting these different levels of descriptions. Currently, each gives only part of the story. As well as examining treatment outcomes, the Z€ urich Depression Study looks into the possibility of lawful correlations existing between depression and its treatment and phenomena at the brain level. In their study, Laura Bohleber and Holger Himmighofen used clinical findings about types of interpersonal relations associated with depression to help construct psychologically meaningful neuroimaging experiments. In particular, Laura Bohleber’s use of visual test cards in the form of cartoon-like figure drawings, in effect a stylized thematic apperception test (TAT) was innovative. The exact ways in which the
Int J Psychoanal (2013) 94
Copyright © 2013 Institute of Psychoanalysis
Panel Reports
1205
level of the brain and neuroscience may combine profitably with that of the person and psychoanalysis are still unclear, but we should not lose sight of how it is only in recent times that detailed correlations across these levels have been possible at all. Before, such correlations were based even more on faith alone. Coincidentally, this presentation demonstrated one of the other values of research enterprises to psychoanalysis: an entry route for talented younger people with a feel for analysis to find places in which they can further their development. The Tavistock Adult Depression Study and its Treatment Manual was the topic of the third presentation. It began its project of assessing the value of 18 months of weekly psychoanalytic psychotherapy for patients with long-term, so-called treatment ‘resistant’ or ‘refractory’ depression in 2000 and it is now in its final stages. It has 129 participants. The final participant in the two-year follow-up period will be rated by December; by then a total of almost 600 years of trial patient data will have been collected. The primary outcome findings will be reported in the course of the next year. The Tavistock Study, like the LACS, has aimed to develop an in-depth understanding of these difficult-to-treat forms of depression. It has combined three methodologies: randomized control trial, qualitative research and clinical investigation, in order that each complements the findings of the others. This author describes how key to the co-operation between researchers and clinicians is the constant attention to maintaining a culture of mutual respect. The approach taken in the Treatment Manual is key to this; it does not set out to teach qualified, well-trained analysts how to do their job. It is permissive and not prescriptive. It does not impose a focus but authorizes the analyst to follow the patient. For Taylor, on the basis of clinical impression, at least some of the seriously ill patients receiving the treatment under test in this trial show themselves able to use and benefit from psychoanalytic therapy. However, the ending of the treatment is often a severe crisis. A brief but moving clinical case illustrated this. In conclusion, this rich, well-stocked Panel, ably time managed by its Chair, Heinz B€ oker, presented three very serious research enterprises. As is proper, the outcome findings are as yet unknown, including to those doing the study. Their attitude is best captured by Samuel Johnson in his letter to Bennet Langton: Let us endeavour to see things as they are, and then enquire whether we ought to complain. Whether to see life as it is, will give us much consolation, I know not; but the consolation which is drawn from truth if any there be, is solid and durable: that which may be derived from errour, must be, like its original, fallacious and fugitive. [Note: The IJP is planning a special issue on psychoanalytic research. We welcome submissions of quantitative and/or qualitative research that explore the grounds for psychoanalytic ideas and conclusions. Guidelines for Research Papers can be found online at: wileyonlinelibrary.com/journal/ijpa. All submissions should be sent in the usual way and will be peer reviewed. Deadline for submission: 1 July 2014.]
The world is looking east: Growth and development of psychoanalysis in the Asian region21
Frances Thomson-Salo, Reporter
This panel gave a glimpse of what the West might see on looking eastward, conveying an extraordinary vibrancy of developments in Asia, and it was perhaps somewhat surprising to learn how long there has been an acceptance of Freud in different cultures as well as interest in self-reflection, and in some cases long histories of trying to gain recognition by the IPA. The co-moderator, Peter Loewenberg, in introducing the panel, shared his hope that Asia might one day become a fourth region of the IPA, particularly now that the other co-moderator, Maria Teresa Hooke, is Chair of the IPA New Groups Committee. The five panellists, in reviewing the process of becoming recognized by the IPA and considering the interplay of specific socio-cultural factors relevant for each place and time, gave an indication of how different cultural systems are modulated when they meet. In outlining developments in their countries, the speakers often conveyed, subtly, the pain involved in this growth, thus illustrating the congress theme of facing the pain. Liu Chia-Chang described Taiwan, named beautiful island by Portuguese explorers 400 years ago, as having a high level of diversity of people, languages, cultures and politics, and making recent attempts to nurture diversity in local initiatives in order to develop psychoanalysis while working towards more formal IPA recognition. Liu Chia-Chang made a number of points about cultural aspects interacting with the development of psychoanalysis; for example, in Taiwan psychoanalysis and psychotherapy are 21 Moderators: Peter Loewenberg and Maria Teresa Hooke. Panellists: Liu Chia-Chang (Taiwan), Do-Un Jeong (Korea), Arup Ghosal (India), Kunihiro Matsuki (Japan), Yunping Yang (China).
Copyright © 2013 Institute of Psychoanalysis
Int J Psychoanal (2013) 94
1203
damental valuation of an investment. What dominates market behavior is a regression to less conscious thinking. Von Weissenberg discussed very early developmental hallucinatory processes, which he believes occur in the regression that governs market behavior. Preoedipal fantasies put pressure on realistic market expectations, and superego problems also can influence market behavior. He believes one can think in terms of a market mood which is created by regression. Von Weissenberg spoke of how realism, expectations, and sentiment can interact synchronously or unsynchronously within a market and how bubbles occur because of projection phenomena. Juan Carlos Weissmann spoke about the global nature of finance. He believes the financial crisis continues to affect us all, and that in relation to it we all feel loss of love, loss of home and membership in a group, loss of self-respect and self-esteem, and damage to family structure. Other consequences of this crisis are generalized pain, increase in divorce and spousal violence, depression and suicide, sleep disorders, social withdrawal and loss of friends, and addiction. Weissmann asserted that the body and the psyche are one, and spoke of the skin as a membrane, which perceives, reacts, includes and excludes. Using the concepts of the membrane and the unity of body and psyche in the individual as a model for understanding large systems, his perspective extrapolates from the body and the influence of the inside as distinguished from the outside. Social relations, then, parallel individual relationships, and institutions created by people operate in parallel to individual relationships as well. Thus, he concludes, companies and businesses operate in parallel to the individual, and so does the economic system. He asserts that such a perspective allows for an understanding of the current financial crisis. At this point there was an opportunity for discussion with the audience. Evelina List from Austria responded that she felt uncomfortable with what she heard, because psychoanalytic theories concern individuals and their relationships, but do not explain social phenomena. In that spirit she questioned the entire panel discussion of markets because she believes it is unclear what psychoanalysis has to offer as regards a real understanding of society. Von Weissenberg expressed disagreement, stating that systems theory does allow psychoanalysis to understand large group phenomena, like the behavior of markets. Elvira Selow from Germany spoke of Tuckett’s views of the way customers pressure advisors, stating that this is consistent with an object relations view of what goes on in large groups: psychotic parts of group members (customers) influence social behavior. There is a psychotic resonance, she said, and this fits well with Tuckett’s description of the concept of the fantastic object. Anna Christopoulos from Greece spoke of the anxiety and disillusionment which is felt worldwide, because of the erosion of the middle class, the loss of control people now feel over their financial reality. In this sense, she asserted, we are now in a crisis without precedent, because we are seeing psychopathic behavior by the powerful taking away the agency of ordinary people. This, she said, is happening to people all over the world, and she believes psychoanalytic understanding may contribute to putting an end to such an abuse. Tuckett responded that he could not answer all the questions he heard at once. He spoke of changing power relations in economic systems; he agreed that psychoanalysis does not have an adequate societal theory because we focus on the individual (states of mind, unconscious fantasy, for example), but he does feel that psychoanalysis joining with anthropology and sociology can make a contribution to understanding many large group problems. He used the world’s energy crisis to illustrate his point: he suggested that with psychoanalytic thinking we can examine why we cannot grieve and mourn what we now know we do not have, and then better understand our reluctance to change our use of energy. This is an introspective process, and an essential beginning to dealing with larger group phenomena, with larger societal issues. He ended the panel on that optimistic note. Reference Tuckett D (2011). Minding the markets: An emotional finance view of financial instability. Basingstoke, Hants: Palgrave Macmillan.
Watch this space! Research studies in depression: Three studies combining clinical psychoanalytical research with studies of outcome20
David Taylor, Reporter
The strength of psychoanalysis as a form of research and as a therapy derives from its detailed, long-term work with individuals; small numbers of self-selected individuals are seen over the course of any analytic 20 Moderator: Heinz B€ oker (Germany). Panellists: Ulrich Barhke (Germany), Laura Bohleber (Switzerland & Germany), Holger Himmighofen v(Switzerland), David Taylor (UK), Heinz Weiss (Germany).
Copyright © 2013 Institute of Psychoanalysis
Int J Psychoanal (2013) 94
1204
Panel Reports
lifetime. In spite of its strengths, these features make psychoanalysis ill suited to test therapeutic propositions across samples or populations. But increasingly those who make the decisions about what to provide in publicly-funded or insurance-funded health services require evidence about a treatment’s effectiveness, and as well that evidence should take a specific form: it must come from controlled trials in which samples or populations of subjects representative of the whole have been randomly allocated to different treatment conditions. This requirement has been a serious challenge for those who wish to maintain levels of public investment in the provision of psychoanalytic forms of therapy and its presence and status in academic stages of training and research. In response, and without too much fanfare, several European centres have been engaged in the costly, time-consuming and challenging task of research into the outcome of medium or longer-term psychoanalytic treatments of patients suffering from depression. Why depression? Well, as Ulrich Bahrke and Johannes Kaufhold of Frankfurt, the first presenters to this Panel said, depression is up there amongst the most significant causes of human illness and disability. None of the studies presented at the Panel are yet in a position to publish their outcome findings. But over the next two or three years each will do so. A substantial body of findings about patients with depression and the value of psychoanalytic treatments will then enter the public sphere. Whatever the direction of these findings, positive or negative, in terms of their scientific quality they will be equal, or in important respects superior, to any derived from studies of the outcome of other treatment approaches, such as antidepressant medications or cognitive–behavioural approaches. Moreover, those responsible for the three major studies presented at this Panel have been determined to stick by the values, principles and practice of psychoanalysis. They have been supported in this by the willingness of psychoanalysts and empirical researchers to join together in an effort both to remain commensurate with the true complexities of their subject matter, and to be adequate in terms of generally accepted standards for studies of the effectiveness of therapeutic interventions in groups or populations of patients. The three studies are the multicentre German Langzeittherapie bei chronischen Depressionen Studie (LAC) led by Marianne Leuzinger-Bohleber of Frankfurt’s Sigmund Freud Institute, The Zurich Depression Studies headed by Heinz B€ oker, and, finally, the Tavistock Adult Depression Study (TADS) led by Peter Fonagy and me. In addition to Bahrke and Johannes Kaufhold from Frankfurt, the Panel consisted of presentations given by Laura Bohleber and Holger Himmighofen of Zurich, and from me for the Tavistock Depression Study. Following these, Heinz Weiss of Stuttgart and Frankfurt offered the perspective of a clinician researcher. However, he began his discussion by considering what is an absolute fundamental – a sine qua non in these projects: a good mutually respectful relationship between those with clinical knowledge and expertise and those with empirical research knowhow. Aptly, Heinz Weiss turned to Bion’s understanding of the different kinds of relationship that may operate between ideas as well as between people, namely that between container and contained. These can be commensal, symbiotic or parasitic. Weiss suggested that all three studies were distinguished by relationships in which empirical research had been employed to help psychoanalysis to become more “scientific” and clinical knowledge had extended what otherwise are the limitations of empirical research methods. His impression was confirmed by the audience’s very positive response to the presentations. In the first, Ulrich Bahrke and Johannes Kaufhold described the sophisticated design of the LAC Study (part of the allocation to either psychoanalytic or cognitive therapy following the patient’s preference and part randomly), and its five-year endeavour to gather its sample of 250 participating patients (originally 409, but more than 150 of these dropped out before beginning their treatment). As well as detailing the patients’ social and demographic characteristics (fewer married, more divorced or living alone, more childless, and so on), the Study has looked at these depressed people’s early developments and upbringing. Using the Childhood Trauma Questionnaire, which attempts to ‘standardize’ and ‘measure’ the experiences which go to make up trauma and environmental adversity generally, they found high levels of emotional and physical forms of abuse and neglect – multiple so-called traumata. But as psychoanalysts, these researchers fully realize that this level of description does not really do. Trauma is simply not countable like an external event. It is a relational matter in which an outer occurrence has specific kinds of consequences and meanings in a given person’s inner psychic reality. In-depth clinical enquiries between individuals are required to apprehend what is being played out in the lives of depressed patients. Is it trauma, loss, adverse developments? Most likely all of these. The LAC Study’s enquiries have revealed how its clinicians have frequently found indications of emotional neglect, humiliations and limitations of empathy in the parents of these depressed patients; how in more than half of the cases at least one parent was psychiatrically ill. There is work to do in connecting these different levels of descriptions. Currently, each gives only part of the story. As well as examining treatment outcomes, the Z€ urich Depression Study looks into the possibility of lawful correlations existing between depression and its treatment and phenomena at the brain level. In their study, Laura Bohleber and Holger Himmighofen used clinical findings about types of interpersonal relations associated with depression to help construct psychologically meaningful neuroimaging experiments. In particular, Laura Bohleber’s use of visual test cards in the form of cartoon-like figure drawings, in effect a stylized thematic apperception test (TAT) was innovative. The exact ways in which the
Int J Psychoanal (2013) 94
Copyright © 2013 Institute of Psychoanalysis
Panel Reports
1205
level of the brain and neuroscience may combine profitably with that of the person and psychoanalysis are still unclear, but we should not lose sight of how it is only in recent times that detailed correlations across these levels have been possible at all. Before, such correlations were based even more on faith alone. Coincidentally, this presentation demonstrated one of the other values of research enterprises to psychoanalysis: an entry route for talented younger people with a feel for analysis to find places in which they can further their development. The Tavistock Adult Depression Study and its Treatment Manual was the topic of the third presentation. It began its project of assessing the value of 18 months of weekly psychoanalytic psychotherapy for patients with long-term, so-called treatment ‘resistant’ or ‘refractory’ depression in 2000 and it is now in its final stages. It has 129 participants. The final participant in the two-year follow-up period will be rated by December; by then a total of almost 600 years of trial patient data will have been collected. The primary outcome findings will be reported in the course of the next year. The Tavistock Study, like the LACS, has aimed to develop an in-depth understanding of these difficult-to-treat forms of depression. It has combined three methodologies: randomized control trial, qualitative research and clinical investigation, in order that each complements the findings of the others. This author describes how key to the co-operation between researchers and clinicians is the constant attention to maintaining a culture of mutual respect. The approach taken in the Treatment Manual is key to this; it does not set out to teach qualified, well-trained analysts how to do their job. It is permissive and not prescriptive. It does not impose a focus but authorizes the analyst to follow the patient. For Taylor, on the basis of clinical impression, at least some of the seriously ill patients receiving the treatment under test in this trial show themselves able to use and benefit from psychoanalytic therapy. However, the ending of the treatment is often a severe crisis. A brief but moving clinical case illustrated this. In conclusion, this rich, well-stocked Panel, ably time managed by its Chair, Heinz B€ oker, presented three very serious research enterprises. As is proper, the outcome findings are as yet unknown, including to those doing the study. Their attitude is best captured by Samuel Johnson in his letter to Bennet Langton: Let us endeavour to see things as they are, and then enquire whether we ought to complain. Whether to see life as it is, will give us much consolation, I know not; but the consolation which is drawn from truth if any there be, is solid and durable: that which may be derived from errour, must be, like its original, fallacious and fugitive. [Note: The IJP is planning a special issue on psychoanalytic research. We welcome submissions of quantitative and/or qualitative research that explore the grounds for psychoanalytic ideas and conclusions. Guidelines for Research Papers can be found online at: wileyonlinelibrary.com/journal/ijpa. All submissions should be sent in the usual way and will be peer reviewed. Deadline for submission: 1 July 2014.]
The world is looking east: Growth and development of psychoanalysis in the Asian region21
Frances Thomson-Salo, Reporter
This panel gave a glimpse of what the West might see on looking eastward, conveying an extraordinary vibrancy of developments in Asia, and it was perhaps somewhat surprising to learn how long there has been an acceptance of Freud in different cultures as well as interest in self-reflection, and in some cases long histories of trying to gain recognition by the IPA. The co-moderator, Peter Loewenberg, in introducing the panel, shared his hope that Asia might one day become a fourth region of the IPA, particularly now that the other co-moderator, Maria Teresa Hooke, is Chair of the IPA New Groups Committee. The five panellists, in reviewing the process of becoming recognized by the IPA and considering the interplay of specific socio-cultural factors relevant for each place and time, gave an indication of how different cultural systems are modulated when they meet. In outlining developments in their countries, the speakers often conveyed, subtly, the pain involved in this growth, thus illustrating the congress theme of facing the pain. Liu Chia-Chang described Taiwan, named beautiful island by Portuguese explorers 400 years ago, as having a high level of diversity of people, languages, cultures and politics, and making recent attempts to nurture diversity in local initiatives in order to develop psychoanalysis while working towards more formal IPA recognition. Liu Chia-Chang made a number of points about cultural aspects interacting with the development of psychoanalysis; for example, in Taiwan psychoanalysis and psychotherapy are 21 Moderators: Peter Loewenberg and Maria Teresa Hooke. Panellists: Liu Chia-Chang (Taiwan), Do-Un Jeong (Korea), Arup Ghosal (India), Kunihiro Matsuki (Japan), Yunping Yang (China).
Copyright © 2013 Institute of Psychoanalysis
Int J Psychoanal (2013) 94
