Psycho-analytic Psychotherapy in South Africa

Conceptualisations of the developmental functions of siblings in psychoanalysis continue to be fraught with theoretical gaps and tensions. Psychoanalytic literature on siblings outlines the ways in which lateral figures can be traumatic in pre-oedipal development, as well as complicate Oedipus complex resolution. The case material that informs this literature is generally concerned with unresolved sibling dynamics as evidenced by the developmental history and transference manifestations in the psychoanalytic clinical treatment setting. These case studies provide a futile outlook on the resolution of pathological sibling dynamics due to the greater intensity of the affect and weaker motivations for relinquishing the oedipal struggle with siblings. As such, research and theory on healthy developmental pathways of the functions of siblings in development are lacking, representing a significant gap in the literature. This paper outlines the prevailing conceptualisations of the developmental functions of siblings in psychoanalysis and highlights the absence of case material on diverse sibling experiences and reflexivity by the theorists themselves that may contribute to biases and tensions in existing psychoanalytic perspectives on siblings. Further psychoanalytic inquiries could look beyond the clinical setting to determine under what conditions optimal developmental outcomes may be possible. The diverse and nuanced possibilities for the functions of sibling relationships in development require greater theoretical development and exploration.

As technology is constantly advancing, new developments have filtered into the therapeutic enterprise, affecting the way that many clinicians conduct treatment. New modes of communication introduce a host of clinical concerns, which need careful consideration. To this end, South African psychologists are guided by the HPCSA ethics guidelines on ‘telemedicine’, and additionally, psychoanalytically informed clinicians consult current psychoanalytic recommendations on this topic. This paper deliberates the ethical implications of online treatments, informed by both of these professional sources. It addresses dilemmas pertaining to: contractual issues, the question of the best interests of the patient, confidentiality, impact on the frame, transference-countertransference dilemmas, and some of the practical problems that may arise. Vignettes are used to illustrate these dilemmas.

The Editorial Board is happy to announce the winners of the 2017 PPSA author prizes. The winner of the 2017 PPSA Student Prize, for best publication by a student contributor, is Nardus Saayman for his paper Flying blind in the psychotic storm. The 2017 Rika Van den Berg Prize, for the best publication written by a first time contributor to PPSA, has been awarded to Wahbie Long for his paper Alienation: A new orienting principle for psychotherapists in South Africa. The Editorial Board offers congratulations to both authors and encourages submissions for 2018.