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Martin Heidegger's thought deeply influenced both Hans Loewald and Jacques Lacan, the catalyst they seemed to have been waiting for. For Loewald, Heidegger's ontological centrality of time to Being-in-the-World would bridge to Freud's centrality of transference to the analytic process, thereby operationalizing transference as a prism of time. In revealing the interwoven correlatives of present-past-future, how they bootstrap one another phenomenologically, Loewald also revealed a spiral of recursive meaning (in essence, après-coup) that draws us into the future, "the something more" of existence. In parallel, through his recognition of the power of après-coup, Lacan rescued from obscurity Freud's profound conception of Nachträglichkeit, or the spiral and causal force of unfolding meaning. Lacan was now situated to bring après-coupin conjunction with Heidegger's Being-in-the-World, with time interwoven into all aspects of existence, thereby underpinning, too, language and the Symbolic Order. By reading Freud through Heidegger and then creating their brilliant syntheses, Loewald and Lacan, through their striking sameness and differences, illuminate the nature of the unconscious, of memory and meaning, of the spiral of time, and of existence itself.

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Palliative care has been shown to help patients live well with serious illness, but the specific psychological factors that contribute to this benefit remain investigational. Although support of patient coping has emerged as a likely factor, it is unclear how palliative care helps patients to cope with serious illness. The therapeutic relationship has been proposed as a key element in beneficial patient outcomes, possibly undergirding effective patient and family coping. Understanding the distress of our patients with psychological depth requires the input of varied clinicians and thinkers. The complex conceptual model we developed draws upon the contributions of medicine, nursing, psychology, spiritual care, and social work disciplines. To elucidate these issues, we convened an interdisciplinary seminar of content experts to explore the psychological components of palliative care practice. "Healing Beyond the Cure: Exploring the Psychodynamic Aspects of Palliative Care" was held in May 2019 at Harvard University's Radcliffe Institute for Advanced Study. Over two days, the working group explored these essential elements of successful palliative care encounters through lecture and open discussion. This special report describes the key psychological aspects of palliative care that we believe underlie optimal adaptive coping in palliative care patients. We also outline key areas for further development in palliative care research, education, and clinical practice. The discussion held at this meeting became the basis for a planned series of articles on the psychological elements of palliative care that will be published in the Journal of Palliative Medicine on a monthly basis during the fall and winter of 2021-2022.

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One can only be disillusioned if once one lived within illusions-and so disillusionment is always after the fact ( après coup or nachträglich), as illusions come into view even as they are crumbling within. With a crisis of disillusionment-or existential disillusionment-one falls away from a coherence of meaning, revealing a system of intertwined fundamental illusions that had always been lived within and implicit, part of one's being-in-the-world, and that now seem broken, strange, and uncanny. This way of being that one recognizes only retrospectively may be called "illusionment," a state of being apprehended in the very process of its falling apart. That is, prior to disillusionment, there may not have been an illusion as such; rather, there was some overall effective-enough, taken-for-granted coherence, an experience of world and being that now comes into view and seems broken precisely because it no longer holds together. For example, a sense of a common "we" might be revealed to be so flawed as to have been a fiction, a fantasy, a set of pervasive, interwoven illusions that one had once naively lived within as unquestioned beliefs. Severe disillusionment, then, carries with it a sense of falling out of the once taken-for-granted world, undermining a sense of solid existential grounding. Saturating all aspects of the psyche, traumatizing disillusionments may lead to a lifelong cascade of après coup attempts to find new grounding in how to live, as one attempts to repair this world-broken-ness.

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Lost and falling, the feeling that life is disorienting: none of us escapes the experience. For those clinicians who venture on to inpatient wards, lost-ness takes on a special urgency. But what does it mean to "find" another? Surely feeling lost is at the heart of our existential search for grounding. And so how does one find oneself? And why is another so important in this self-search? This paper explores two brief encounters on an inpatient ward where the lost-ness of psychosis and despair cover the shock of unbearable feelings. Yet the intolerable story is displayed as both a symptom and a sign, inscribed in the body, an uncanny symbol hidden in plain sight. And here may be a way in, and a way out-here a person might be found.

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There are no clinical techniques not always already embedded within a psychoanalyst's way-of-being-in-the-world. This claim, grounded in the author's reading of Steven Ablon's "What Child Analysis Can Teach Us about Psychoanalytic Technique" (in this volume), takes us to Ablon's exemplary psychoanalytic comportment, with a particular focus on poetics, playfulness, practicality, and pluralism. These complex, intertwined features of child psychoanalysis have had a broad and deep impact on contemporary adult psychoanalysis, influencing praxis, conceptions of therapeutic action, ethics, and workaday worldview.

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