From the Editors

We did not intend this issue, 51(4), as a special issue, however, as we gathered the articles to be included, we noticed a theme. All articles that follow wrestle with a variety of clinical challenges facing contemporary analysts: thus the theme, “Current Practice Dilemmas.”

In “On the Enforcement of Frequency,” Orsolya Hunyady and Pascal Sauvayre maintain that enforcing frequency as a primary criterion of psychoanalysis is a defense against facing the emotional challenges of grappling with the deeper conflicts, complexities, and challenges at the core of psychoanalysis.

Neil J. Skolnick, in “Rethinking the Use of the Couch: A Relational Perspective,” uses relational theory, research, and clinical examples to argue that psychoanalysis off the couch can sometimes be far more effective than psychoanalysis on the couch in helping patients gain access to important dimensions of their experience and make therapeutic gains.

Taking the idea of what constitutes a psychoanalysis one step further, Sarah Schoen asks how we, as clinicians, make decisions about whether or not a particular patient is analytic “material” or not. Her article, “Afraid to Commit: Proposing Psychoanalysis and the Paradox of the Analyst's Desire,” explores the ways in which we may unconsciously foreclose a patient's deeper involvement in treatment through our own blind spots regarding his or her ability to engage in psychoanalysis.

In a shift away from these discussions, this issue moves to some very contemporary concerns. Todd Essig debates the issue of “The Gains and Losses of Screen Relations: A Clinical Approach to Simulation Entrapment and Simulation Avoidance in a Case of Excessive Internet Pornography Use,” considering a case of a patient's extensive use of Internet-based pornography. He suggests a clinical approach that enables patients to recognize their agency (i.e., choice) in how they practice Internet porn.

Rebecca Harrington presents a clinical study to discuss the stretching of the analytic f