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Biomedical subjects

M H Spero

Publications and source records attributed to M H Spero.

At least 19 recordsLinked to original sources
PubMed1998

Divine space: contemplating the object behind a religious patient's spatial metaphor.

If we accept that psychic space is fundamentally all about "having somewhere to put what we find" (Winnicott, 1967, p. 99), then the patient's becoming aware of and pointing out the metaphor--and her ability to utilize it--indicates that such "place" is well on the way of having been experienced as available for creative psychic use. In the course of this exposition, I also think we've managed to confirm Charles Taylor's contention that "the self only exists in a space of moral questions, that moral topography is not an external addition, an optional extra, but that the question of being or failing to be a self could not arise outside of this space" (1988, p. 317, emphasis mine). In Bollas's terms (1992, p. 31), makom may be identified as "the place of the complex self." No longer played upon according to the whim of external objects, nor even lost--albeit creatively--in the world of transitional illusoriness, the complex self has attained a modicum of detachment from which high point it questions, challenges, and redefines its relationship to objects. Moses and my patient, each in their own ways, sought out this place in the presence of what they identified as Other. Each individual found a medium for carving out a better sense of internal dimensionality, even though this achievement required relinquishing the concrete comforts of the ever-present object and welcoming a certain degree of existential loneliness. In some sense, the Other's reciprocal sense of loneliness and alterity also has been discerned and must be internalized as well, adding that characteristically bittersweet element increasingly recognized as proper to the domain of the unknown within the very limnal categories of internal space. Ultimately, the makom of utmost psychological relevance to humankind is that place made sacred by internalization. And "there, in the solitary space, we repeatedly contact that essential aloneness that launches our idiom into its ephemeral being" (Bollas, 1989, p. 22).

Adult↗
PubMed1995

Countertransference-derived elaboration of religious conflicts and representational states.

Polysemous qualities of the religious patient's use of language and metaphor are among the subtle factors involved in the creation of an ambience conducive to projective identification, leading to the evolution of countertransference crises in the psychotherapist. The psychotherapist's activity during countertransference crises consists in converting the patient's unsorted images, memory traces, and affective states that have never before been symbolified into resilient representational material. This requires the psychotherapist's imaginative process, but it also involves the accurate preconscious perception and amalgamation, within the countertransference, of the patient's unmetabolized representational object- and self states. The guidelines for organizing such material are communicated through the projective-introjective exchange. Gradually, silent internal exchanges between the therapist and his WORP facilitate novel conceptualizations that free the external linguistic interchange to convey complex relational communications. This development bears directly upon religious objects and representations since these are particularly laden with traces of early, preverbal transformative processes. Through the resolution of transformational countertransference crises during treatment, and the alignment of the patient's historical memories and objects with their subjective meaning, many of the paradoxical or mysterious characteristics that were attributed to God in a conflict-bound manner regain their somewhat more modest, containable, and knowable human proportions. This results in less dichotomy and splitting in the perception and relation with God, without challenging the root otherness and ontological distance that encompass most representations of divinity.

Adolescent↗
PubMed1994

Religious patients' metaphors in the light of transference and countertransference considerations.

The verbal material of religious individuals in psychotherapy is laden with metaphors, folkloristic themes, and literary allusions whose meanings are generally deemed adequately elucidated by analysis of their symbolic content, generally in terms of the classic psychosexual conflict model. Contemporary psychoanalytic models demand that such material be further examined in terms of the level and quality of object relations and representation that characterize such content, and with an eye toward the influence of early, preverbal intersubjective factors that, by nature, tend to attain a minimal amount of psychic representation. These factors add richness and complexity to our overall understanding of the religious personality. The expanded role of countertransference as a tool for comprehending prerepresentational states, and the modes in which these are communicated, helps to outline new dimensions of religious object experience.

Countertransference↗
PubMed1993

The temporal framework and Lacan's concept of the unfixed psychoanalytic hour.

Lacan's controversial clinical innovation of the unfixed analytic hour is evaluated within the context of Lacan's own theoretical and metaclinical views and against the classic, developmentally oriented concept of the fixed temporal analytic framework. Two clinical illustrations featuring disturbed reactions to the temporal framework of the analytic hour elucidate Lacan's proposed master/slave analogy for the treatment relationship, bringing to the fore, ironically, the basic contradictoriness of Lacan's clinical recommendation.

Adult↗
PubMed1993

Phallic patheticness.

The characteristic of patheticness in the case of a young female victim of child abuse has been presented, underscoring the phallic quality of this trait and its root distinctiveness from the tragic character. Many patients, historical figures, and other individuals are prematurely judged as tragic when, in fact, we are reacting uncritically to the impact of their profound patheticness, at a point when, more often than not, such patheticness has not yet reached its lowest ebb, when it is still not too late to transform mute resignation to the neurosis of tragic fatalism into a more heroic deployment of destiny (Bollas, 1991, pp. 31-4). Phallic patheticness, in fact, represents a higher psychical achievement by virtue of its transient quality and its propensity to enable basic, if conflictual object-relationships and the recovery from psychic trauma. To be sure, many individuals with advanced personality structures have introjected into their personal value system a sense of the tragic, an identification with the tragic, or a special proclivity toward the tragic aspects of life, but this in and of itself does not render such individuals tragic, nor do they typically evoke in others the inner experience of maximum catastrophe or calamity. It is argued that the distinction between pathetic and tragic psychic structure can be clarified through carefully interpreted counter-transference.

Adult↗
PubMed1990

Portal aspects of memory overlay in psychoanalysis. An object relations contribution to screen memory phenomena.

Distortion in screen memories illustrates the unique manner in which part-object representations unite perceptions from different temporal periods. "Portal" aspects of a given source memory designate anachronistic distortions borrowed from perceptions at a subsequent time when the source memory and its full emotional significance attempted access to consciousness. The unconscious perception of recall at the subsequent occasion is represented by the appearance of portal details in the source dream. The portal concept is related to object relations theory and the psychology of memory.

Adult↗
PubMed1990

Psychoanalytic reflections on a particular form of language distortion.

A female obsessive patient communicated with her sister via a distortion of the Hebrew language, in which she masculinized the feminine gender second person pronoun and certain nouns. This treatment of words is analyzed in terms ranging from the concrete to the metaphoric uses of language. Lacan's emphasis on the meaning of the word is explored and is seen as an amplification rather than a replacement of the object relations approach to language and metaphor.

Adult↗
PubMed1988

Countertransference envy toward the religious patient.

Four illustrations have been presented which demonstrate the uses and interpretations of envy in countertransference reactions to religious patients. To be sure, envy reactions to any patient are significant, whether they simply distort the therapist's perception or contribute to a deeper understanding of the patient. In the case of the religious patient, envy reactions in the therapist may serve as an additional instrumentality for under-standing the ways in which the dynamic determinants of religious behavior and metaphor become enmeshed in and also transform the pathology of the patient as well as the therapeutic process itself. Both the constructive and destructive object relational implications of envy must be borne in mind by the therapist in order to adequately explore the range of reciprocating forces between therapist and patient. Primitive mechanisms such as projective identification and psychotic transference are particularly prone to evoke envy reactions of surprising intensities, yet an empathic attitude will usually enable the therapist to differentiate the true source of his envy as he more carefully comprehends the quality of object relational and dynamic needs such envy serves.

Adolescent↗
PubMed1987

Qualities of object relations and field dependence in alcoholic and recovered alcoholic males.

Contemporary research suggests an interaction among disordered cognitive, perceptual, and object relational ego functions in the etiology of alcohol abuse. The present study hypothesizes a correlation between extreme field dependence, representing an impairment in cognitive-synthetic functioning, and poor self-other differentiation and clarity of object representation, characterizing impaired object relations functioning. Groups of normals, alcoholics, remitted alcoholics, and psychiatric inpatients (30 Ss each) were administered the Embedded Figures Test and measures of quality of self-other differentiation. The groups tended to differ in severity of impairments as predicted, and a positive correlation was found across the entire sample between inadequate self-other differentiation and cognitive field dependence, although this correlation did not produce a significant group effect. The evidence of impairment among remitted alcoholics suggests that the impairments demonstrated cannot be attributed to current alcohol abuse.

Adult↗
PubMed1987

Identity and individuality in the nouveau-religious patient: theoretical and clinical aspects.

Revitalized interest in the clinical complexities of psychotherapy with religious patients (for example, Bradford 1984; Lovinger 1984; Spero 1985a; Stern 1985) has drawn attention to the need for perspectives on religious personality development that account for healthy and adaptational aspects as well as psychopathological aspects of particular forms and levels of religious beliefs, enabling more creative, enriching psychotherapy. This search represents movement beyond the significance of infantile wish-fulfillment aspects of religiosity toward the broader domain of ego functioning and quality of object relations. Rizzuto (1976, 1979) and McDargh (1983) emphasize qualitative similarities between interpersonal object representations and God representations. Elkind (1971), using a Piagetian model, views religious beliefs and rituals as forms of constructive adaptation to normal cognitive needs for conservation, representation, symbols of relation, and comprehension. Meissner (1984) highlights the role of God concepts as transitional phenomena. In earlier papers, I have demonstrated the relationship between patients' use of religious themes and legends, quality of psychosexual and object relational achievements, and the consolidation of religious identity (Spero 1982a,b, 1986a,b). Throughout the preceding there is unequivocal recognition that religious development recapitulates many important aspects of healthy psychological development, and that in the case of pathological or dysfunctional religiosity something has gone wrong in an otherwise normal process. There is need to understand and if necessary distinguish between the development of religious belief in individuals whose ideological commitment is relatively constant from earliest childhood and its development in those who adopt or modify religious belief in later life, in conjunction with the many technical implications for psychotherapy. Clinical experience has taught that the process of religious change in later life represents a significant psychosocial crisis, requiring certain important psychological tasks in order to achieve successful resolution. In some instances, generally when there are preexisting difficulties or psychiatric disorders, the process of ideological change, either at the onset or during subsequent stages, takes on psychopathological momentum and quality. Clinicians who intervene at this juncture are confronted with patients whose primary complaints include malfunction in their religious lives or misuse of religious metaphor or behavior enmeshed with mild to serious personality disorder.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1985

The reality and the image of God in psychotherapy.

I have suggested that the plea for increased respect for the religious patient's perspectives demands a willingness on the psychotherapist's part to acknowledge the unique reality of the patient's relationships with religious objects, a reality which extends beyond the assumptions and predicates of standard interpersonal models of human behavior. At the same time, the psychotherapist can legitimately expect of the religious patient a willingness (notwithstanding the customary resistances) to expose his or her religious feelings and relationships to the type of analysis which attempts to clarify the nature and quality of the interpersonal or psychodynamic bases and implications of religious material. The psychotherapist can not arbitrate moral claims and decisions for the patient, nor rightfully present himself as possessing the single, "true" understanding of religious experience. Yet the therapist can invite the patient to examine the moral implications of his psychological experiences and the psychological impact and consequences of his religious experiences. What knowledge we as psychotherapists possess about human nature can be used to influence changes in the lives of our patients which they find useful and relevant for living in the world they have created for themselves. But we must, I think, humbly anticipate qualities of human nature and relationship whose ultimate meanings may defy every convention and paradigm.

Adult↗