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Biomedical subjects

L Rangell

Publications and source records attributed to L Rangell.

14 recordsLinked to original sources
PubMed1992

The psychoanalytic theory of change.

The concept of change by psychoanalysis has undergone an historical process related to the course and development of psychoanalytic theory. Change has changed from an effect on symptoms, to underlying etiologic conflicts, to background character, to the functioning of psychic structural systems. The psychoanalytic process does not overlap with the process of change. The former may be present without the latter. The will to recover is accompanied by the unconscious need to cover. The methodology of change is examined with regard to process, agent(s), and intrapsychic results. Every analysis is a training and supervised analysis. With increasing autonomy of the ego, the patient, identifying with the analysing functioning of the analyst, becomes his own analyst. The theory of change is related to the psychoanalytic theory of neurosis of which it is part, and differs in alternative theories extant today. The dynamic occurrences I have described as bringing about change rest upon my view of 'total composite psychoanalytic theory' as evolved to the present.

Adaptation, Psychological↗
PubMed1991

Castration.

Castration is not a metaphor within the array of psychoanalytic theories, but a pathological belief operative in the unconscious, which originated during the period of childhood sexuality. Of the two major anxieties, separation and castration, castration anxiety is the most overlooked in clinical discourse and theoretical awareness. Castration conflicts have a developmental history and are composed of phases as much as separation-individuation is. These extend from the preoedipal to the oedipal years and beyond and, as separation conflicts, persist throughout life. Clinical material is demonstrated from across the diagnostic spectrum and all developmental levels. Phylogenetic studies are corroborative. As loss of love is a wider derivative of separation anxiety, castration anxiety radiates out to wider fears of invasion and injury to the body. The transference neurosis is more attuned to encompass separation than castration conflicts. This stratum of psychopathology makes reconstruction and the recovery of historical data indispensable.

Adult↗
PubMed1989

Rapprochement and other crises. The specific and nonspecific in analytic reconstruction.

The historical development of preoedipality in evolving psychoanalytic theory is traced. Particular reference is paid to the elaboration by Mahler of the separation-individuation phase and the specific rapprochement conflict and crisis within it. In addition to the valuable contributions these discoveries have brought about, the tendency is noted for every new locus of interest to be obscured by excessive claims, and distorted by overuse and reductionism to explain complex and multidetermined behavior. This leads to the question of the specific and nonspecific in analytic reconstruction. Psychoanalysis invites a search for the specific superimposed upon the general. What I believe is nonspecific is the experience of the traumatic state, variable in degree, and the anxiety always adherent to it. The cognitive and historical data which initiated and maintain these affective states need to be arrived at with clinical accuracy and sustaining data, transference and historical. With discipline and restraint, and effective clinical bridges for interpretation, reapprochement and other distant preoedipal determinants can be pointed to in analytic reconstruction with confidence and profit to the analysis. Clinical examples are cited of valid and therapeutically effective reconstruction of early infantile traumas, including reapprochement, as well as instances in which significant etiologic determinants from contiguous phases are fused and continuous. Reapprochement plays an important role, but the temptation to isolate it is to be tempered with an openness to all levels and an awareness of the continuing developmental line. Such a wide etiologic spectrum is in keeping with the total range of observations and formulations made by Mahler, from the psychological birth of the infant, through separation-individuation, to phenomena and stages long after the attainment of object constancy.

Adolescent↗
PubMed1989

Action theory within the structural view.

This paper presents a summary of a cohesive theme coursing through a group of selected papers written by the author over four decades. Purpose, intention, choice and decision are seen as firmly anchored within structural metapsychological theory. These constitute a cohesive and operative psychoanalytic theory of action, which Hartmann stated did not exist within psychoanalytic theory. The exposure and inclusion of this unconscious series of intrapsychic events obviates the need for many alternative theories which have been erected to give a place to these very functions. Unconscious decision, ego will and volition, the unconscious initiation and execution of action, operate during waking life, with as complete and complex secondary process mentation as secondary revision organizes the final shape and contents of a dream during sleep. These conceptual changes and advances have important psychosociolegal implications. Man not only does not know why he acts; he also does not always know that he acts. The mainstream itself is not monolithic and has also resisted the development of many of these advances. Factors responsible for this lag or block are adduced, which include anti-scientism or intellectuality, as well as, most importantly, a resistance to an increase of responsibility and accountability.

Anxiety↗
PubMed1987

A core process in psychoanalytic treatment.

A core mechanism of the psychoanalytic process is described. This involves the effects of treatment on an ongoing "unconscious intrapsychic process," which has specific points of vulnerability to pathology. The concept of an intrapsychic process described by the author in previous publications is an expanded formulation of the idea of thought as trial action and of the signal theory of anxiety. The psychoanalytic method alters the functioning of the ego astride this unconscious process, strengthening its control over anxiety, defense, trauma, and symptom formation. This is mutative in the psychoanalytic method.

Anxiety↗
PubMed1979

Contemporary issues in the theory of therapy.

I have drawn comparisons of psychoanalysis as a process and as a treatment between 1954 and 1979. I have selected for discussion controversies centering on the subjects of transference versus reconstruction, oedipal versus preoedipal, and the cognitive-affective duality. Also considered were the quantitative factors in the negative therapeutic reaction, the fate of signal anxiety, and the role of the patient in the process of cure.

Adaptation, Psychological↗
PubMed1976

Disaster at Buffalo Creek. Discussion of the Buffalo Creek disaster: the course of psychic trauma.

The specific contribution of the psychiatrist to the team study of the human disaster at Buffalo Creek focuses on the course of psychic trauma. The initial violent intrusion by the flood waters was followed by a second phase of the traumatic cycle, the physical dislocation of the survivors, with disruption of their "ground" and "surround." During this long subsequent period the level of trauma did not recede but kept rising, although at a slower pace. Distant effects of the trauma may succeed the more immediate ones. The finite psychic space of the survivors is encroached upon by traumatic memories for an indefinite period of time, leaving fewer resources available for normal effective living. The absorption and merging of traumatic stimuli into a traumatophilia poses still another potential problem. The unprecedented legal decision as to the linear effects of psychic trauma on a succession of connected individuals will need further interdisciplinary clarification.

Disasters↗
PubMed1976

Lessons from Watergate. A derivative for psychoanalysis.

Periods of social upheaval, by revealing aspects of behavior ordinarily repressed, provide an opportunity for deepening out insights into the nature of man. The searing experience of Watergate is viewed not as the psychopathology of a man, or the group psychology of forty men under the ex-President, but as reflecting psychic processes at the base of the population pyramid. The people supported Nixon for a quarter century during which his character traits were known, and were in collusion with the cover-up to the end during the two and half years of Watergate. The theory is advanced that this was due to an identification with Nixon based on the universal wish to triumph over the superego. Ego-superego conflicts are as ubiquitous and ongoing in mental life as the struggle between ego and id. The latter results in neuroses, the former in compromises of integrity. The 'syndrome of the compromise of integrity' is on a par with neurosis in human affairs.

Ego↗