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PubMed2003

Cyclones, bi-cycles, and psychoanalysis: the witch-of-us? complex and The Wizard of Oz.

Works of applied psychoanalysis normally use psychoanalytic theory to reveal the secret meanings of works of art. An attempt is made to reverse the directionality of such analyses and see whether a work of art, The Wizard of Oz, has something to teach psychoanalysis about adolescent female psychosexual development. The author argues that the popularity and importance of the film is an effect of its symbolic representation of a girl's entry into menarche, and the meaning of this milestone for herself and for her mother. He addresses ideas about feminine castration fears (or what more recently have been called fears of genital injury), issues about menopause, and fantasies--both surprising and violent--around the meanings of menarche for both mother and daughter.

Adolescent↗

PubMed1980

Psychoanalysis and biography: aspects of a developing affinity.

In examining some aspects of a growing affinity between the materials and problems confronting psychoanalysis and biography, the two disciplines most concerned with man in his historical totality, I have focused on the different methods used in these two fields of knowing about an individual's life and past. The early debt of psychoanalysis to biography, especially to its autobiographical sources, has been reviewed, and the unexplored potential of such documentary sources for our field has been suggested. The particular interest of diaries, especially in early adolescence, has been stressed. I have noted the relation of biography to clinical work, have stressed the historical and social context of a life and the relation between the actual and the psychologically transformed past. A biographical orientation leads inevitably to the question of how we learn about the past, and thus to the matter of documentation and the use of additional documentary materials in the treatment setting. I have concluded with a series of problems or questions for further consideration. These concern the use of "outside" documentation, the place of writing down dreams and experiences, and the use in treatment of information obtained by the patient or the therapist from other people, especially in preoedipal reconstruction and in our effort to understand character patterns not in evidence in the transference, which may be known primarily through their impact on other persons.

Autobiographies as Topic↗

PubMed1983

Psychoanalysis and self psychology: a metapsychological essay with a clinical illustration.

This paper is an attempt to evaluate critically some theoretical and clinical consequences of the psychoanalytic psychology of the self in its broad, supraordinate position. From this either-or position, advocated by Kohut and his followers, self psychology corrodes some of the most central explanatory concepts of psychoanalysis--conflict, transference, and resistance. In an extensive case illustration, I have tried to show the conceptual and technical impoverishment of the self-psychological views with respect to the concepts of organization in conflict, in defense, and in development, and with respect to the role of aggression and to the concepts of transference and resistance. These consequences of the supraordinate self-psychological viewpoint are related to its overt attack on metapsychology, which is linked to an epistemological fallacy as a consequence of the exclusive use of empathy and introspection with grave consequences for our explanatory power, i.e., a fundamental confusion between the realms of content and of function. This also implies an obstacle in the systematic study of self-deception and a threat to psychoanalysis defined as the study of human behavior considered from the viewpoint of conflict. Finally, an attempt is made to integrate the views of Kohut with those of Winnicott and of classical metapsychology.

Adult↗

PubMed1985

Irony in psychoanalysis.

Irony is a more important element of analysis than we generally recognize. First, verbal irony characterizes the discourse of certain patients who employ it as a defense, both adaptively and as a resistance, especially against the expression of intense affect associated with the transference. The frequent employment of irony reflects a significant character trait, an habitual mode of dealing with conflict. It is also a frequent manifestation of a particularly active self-critical faculty. Ironic employment of a "double audience" is also relevant to analytic technique. Second, situational irony is inherent in many aspects of psychoanalysis, as a process and a point of view. It implies the acceptance of the inevitability of conflict, ambiguity and paradox, never quite capable of perfect resolution. It emphasizes critical examination of mixtures of motives of both analysand and analyst, and it requires perpetual questioning of what might otherwise be taken as accepted doctrine, including the principles of psychoanalysis per se. An ironic stance requires some degree of detachment in conjunction with deep commitment, itself an ironic circumstance. Third, the capacity to understand and employ irony can be traced to childhood, relatively early in the course of development of speech and sphincter control; some of its early determinants are to be found in the anal phase of psychosexual development; it reflects as well the capacity to use certain early defenses and mechanisms originally described as characteristic of the dream work. Its later fate as a prominent feature of character is very much a matter of ego and superego development, including such components as intelligence, verbal skills, the capacity for joking and for play, i.e., controlled regression. Sources of identification in the family and the culture are of obvious importance. Finally, an understanding of irony has an important place in the theory of technique, especially with regard to transference and resistance. An ironic stance and understanding on the part of the analyst are valuable, even essential; but irony may become a questionable defense for him as well as for his patient.

Aggression↗

PubMed1986

Psychoanalysis and time.

Psychoanalysis is fundamentally related to time because it is an effort to understand how disturbances in the present are determined by events in the past. Technically, we know that the patient who is reporting immediate perceptions is not aware of the passage of time, but he becomes self-conscious as undesirable elements threaten to appear in his associations. Time is not sensed by direct awareness, nor is it an agent of action or events. Various functions of the ego influence how time is experienced consciously, leading to phenomena such as déjà vu, a sensation of timelessness, misjudgment of time duration, the experience of premonition. Psychoanalysis more than any other discipline sheds light on the coexistence of past, present, and future, as influenced by unconscious fantasy thinking. The analyst's understanding of the patient's associations is guided by temporal factors such as context and contiguity, succession of similar or opposite elements. Basically, the self is a time-bound concept; identity implies that a self is the same entity at different points in time. There is a deep-seated rebellion against the tyranny of time, beginning with need frustration in the infant and culminating in the knowledge that man is destined to lose the struggle against death.

Awareness↗

PubMed1987

Changes in the level and quality of object relations in psychoanalysis: followup of a longitudinal, prospective study.

As part of a prospective, longitudinal study of suitability for and outcome of psychoanalysis, 22 patients were evaluated for changes in the level and quality of their object relations. These patients had been accepted for supervised analysis with candidates in training by senior analysts who had diagnosed them as neurotic. The majority of these patients reported difficulties in relationships as at least one of their reasons for originally seeking psychoanalytic treatment. Prior to beginning analysis, each patient was given a battery of psychological tests. One year after the termination of analysis, the test battery was readministered and a followup interview was conducted separately with each patient and analyst. Ratings of change based on patient and analyst interviews and comparisons of psychological tests before and after treatment all showed statistically significant improvement in the level and quality of object relations for this patient group. The results of this study support what is often observed in clinical practice, that psychoanalysis has a positive effect on the level and quality of a patient's object relations.

Adult↗

PubMed1987

The role of reality testing in psychoanalysis: followup of 22 cases.

As part of a prospective, longitudinal study of psychoanalytic outcome, 22 patients were evaluated for changes in their level of reality testing. These patients had been accepted for supervised psychoanalysis with candidates in training by senior analysts who had diagnosed them as neurotic. Psychological tests given prior to the beginning of analysis indicated, however, that more than one third of our sample demonstrated serious distortions in their perceptions of reality. When psychological tests administered one year after the completion of analysis were compared with these pretreatment tests, no significant improvement was found in the level of reality testing for the group as a whole. However, when excluding two patients who had suffered major traumas in the year following psychoanalysis, significant improvement in reality testing was found for the remaining 20 patients. Post-treatment interviews with the treating analysts revealed that in the course of analysis itself, approximately one third of these patients showed some disturbance in reality testing; only three of these patients showed significant improvement in the level of their reality testing during treatment. These findings suggest that while patients may not present clinically with evidence of impaired reality testing, such evidence may be available in psychological testing, and may become apparent in the course of the treatment.

Ego↗

PubMed1988

The four psychologies of psychoanalysis and their place in clinical work.

Clinical psychoanalysis has led to the development of four conceptually separable perspectives on the functioning of the human mind. These are referred to herein as the psychologies of drive, ego, object relations, and self. Their clinical relevance is explored by applying them to issues regarding evenly hovering attention and the mutative factors in psychoanalysis. Those two areas, in turn, are seen to undergo an expansion when viewed from the perspective of each of the four psychologies.

Attention↗

PubMed1988

The contribution of ego psychology to understanding the process of termination in psychoanalysis and psychotherapy.

Ego psychology is presented as an integrated psychoanalytic developmental theory, including a theory of object relations. The process of termination is employed as one of the many possible illustrations of the usefulness of this theory. Termination is regarded as a process that pervades the treatment from the outset, rather than as the final phase of treatment only, because the treatment process, whether psychoanalysis or psychotherapy, includes continuous promotion of ever-increasing autonomy. Ideally, by the time termination proper takes place, maximum autonomy has been attained. To the definition of autonomy as intersystemic, involving relative independence of the ego from the drives (and from the super-ego), an object-relations dimension is added which extends that definition to include an intrasystemic consideration--namely, relative independence of the self-representation from the object representations. Especially in the treatment of the borderline conditions is the intrasystemic factor cogent because borderline states are characterized by varying degrees of incompletely differentiated self- and object representations. The objective, in the psychoanalysis of neurosis, where self- and object constancy already exist to a large degree, is ego autonomy in the intersystemic sense. In the psychotherapy of the borderline conditions, the objective is greater differentiation of the self-representation from the object representations.

Ego↗

PubMed1990

The rhetorical voice of psychoanalysis.

The rhetorical voice of psychoanalysis has a long history and has only recently come to be seen as a special feature of the theory. Its beginnings can be found in Freud's earliest pleadings for the usefulness of metaphor and analogy, although he felt that they were largely provisional and would eventually be replaced by more durable concepts. We have begun to see problems in replacing the central metaphors; the rhetorical base of psychoanalysis may be more enduring than we thought. While our metaphors may never provide epistemic access to the stuff of the mind, they can and do point to specific clinical encounters. Ways must be found to expand our rhetorical treasure chest and develop language even better suited to our concepts and observations.

Freudian Theory↗

PubMed1990

Followup of psychoanalysis five to ten years after termination: III. The relation between the resolution of the transference and the patient-analyst match.

As part of a long-term followup study of the outcome of psychoanalysis, we examined the relation between the extent of resolution of the transference at termination and the characteristics of the patient-analyst match. For twelve of the seventeen patients interviewed five to ten years after termination of psychoanalysis, the researchers found that the patient-analyst match played a role in the outcome of the analysis. Illustrations of the influence of the match in cases where the transference was resolved and those where it was not are presented.

Adaptation, Psychological↗

PubMed1992

An investigation into some implications of a Vygotskian perspective on the origins of mind: psychoanalysis and Vygotskian psychology, Part I.

The Russian psychologist Lev Vygotsky proposed an analysis of language, thought, and internalization that has direct relevance to the current concerns of psychoanalysts. Striking methodological and conceptual similarities and useful complementarities with psychoanalysis are discovered when one peers beneath the surface of Vygotskian psychology. Our adaptation of Vygostsky's views expands upon Freud's assigned role to language in the topographic model. We suggest that the analysand's speech offers several windows into the history of the individual, through prosody, tropes, word meaning, and word sense. We particularly emphasize Vygotsky's views on the genesis and utilization of word meanings. The acquisition of word meanings will contain key elements of the internal climate present when the word meaning was forged. Bearing this in mind, crucial theoretical questions follow, such as how psychoanalysis is to understand the unconscious fantasies, identifications, anxieties, and defenses associated with the psychodynamics of language acquisition and later language usage. We propose that the clinical situation is an ideal place to test these hypotheses.

Freudian Theory↗

PubMed1992

The differential effect of psychotherapy and psychoanalysis with anaclitic and introjective patients: the Menninger Psychotherapy Research Project revisited.

Analyses of the data from the Menninger Psychotherapy Research Project (MPRP) have consistently indicated little difference in the therapeutic outcome between patients seen in psychoanalysis and those seen in psychotherapy. Reanalysis of the data from the MPRP, utilizing a distinction between two broad configurations of psychopathology (Blatt, 1974, 1990a; Blatt and Shichman, 1983), however, indicates that patients whose pathology focuses primarily on disruptions of interpersonal relatedness and who use primarily avoidant defenses (anaclitic patients), and patients whose pathology focuses primarily on issues of self-definition, autonomy, and selfworth and who use primarily counteractive defenses (introjective patients) differ in their responsiveness to psychotherapy and psycho-analysis. Based on recently developed procedures for systematically evaluating the quality of object representation on the Rorschach, reanalysis of the Menninger data reveals that anaclitic patients have significantly greater positive change in psychotherapy, while introjective patients have significantly greater positive change in psychoanalysis. These statistically significant patient-by-treatment interactions are discussed in terms of their clinical implications as well as the importance of differentiating among types of patients in studies of therapeutic outcome and of therapeutic process.

Adult↗

PubMed1993

Psychoanalysis, psychobiology, and homosexuality.

The potential role of biological influences in human sexual orientation was considered more seriously during the early phases of psychoanalysis than in the years since World War II. Recently studies of homosexuality and heterosexuality in the neurosciences have attracted widespread attention both in the scientific and lay communities. The salience of these new data for psychoanalytic theory and practice is just beginning to be explored. In this article, we review research on sexual orientation in the following areas: genetics, crosscultural studies, studies of development in individuals with abnormal prenatal hormone exposure, childhood play patterns, and brain studies in both nonhumans and humans. Differences between male and female homosexuality are explored. We propose that psychoanalytic theory can grow and profit from a careful consideration of new findings in the psychobiology of sexuality, and that the interaction between mind and body is the appropriate purview of psychoanalysis.

Brain↗

PubMed1995

The continued usefulness of psychoanalysis in the treatment armamentarium for panic disorder.

The case of a late adolescent with panic disorder and obsessive-compulsive disorder is described. The patient experienced resolution of both disorders in brief psychodynamic psychotherapy, but required psychoanalysis in order to make inroads into his restricted life-style. This case illustrates the continued usefulness of psychoanalysis in the treatment of such patients.

Adolescent↗

PubMed1996

The irrelevance of infant observations for psychoanalysis.

The current consensus among psychoanalysts holds that direct infant observations are one means for testing the developmental propositions of psychoanalytic theory; that the observations have already falsified some of the theory's basic propositions; and that they hold the key to a qualitatively different developmental theory of psychoanalysis. The consensus, although not universal, has motivated a wide range of research programs on early infancy, whose findings are commonly interpreted as disclosing psychoanalytic metapsychology and clinical theory in an entirely new light. This essay examines some of the assumptions that have motivated such investigations, as well as the research strategies by which the new versions of theory are promulgated. On the basis of these explorations it is concluded that psychoanalytically informed infant observations may be the source for new theories of social-emotional development, but that they are essentially irrelevant for psychoanalysis as a psychology of meanings, unconscious ideas, and hidden motives.

Humans↗

PubMed2002

Psychoanalysis and infertility. Myths and realities.

Psychoanalysis, long interested in infertility, and a valuable treatment for men and women suffering with this affliction, has also helped to create and support a myth of psychogenic infertility. Multiple causes of infertility exist across the physiological-psychological spectrum. There is no simple psychodynamic causality. Advances in assisted reproductive technologies provide treatments that create emotional stress and outpace psychological preparedness of patients and analysts. This paper is based on the experience of a unique study group in Boston. An analytic case illustrates some of the ways analysis can be a treatment of choice for people using assisted reproduction. In fact, analysis offers a unique opportunity to elaborate fully the complex realities and dilemmas faced by people and their therapists throughout the infertility experience. More generally, this study of the concept of psychogenic infertility explores a valuable role for psychoanalysis in the treatment of medical conditions.

Female↗

PubMed2003

Psychoanalysis as a creative shaping process.

The author first explains the concepts of creativity, play and aesthetic experience. He then outlines the psychoanalytic process as a creative one that shapes reality. Making a link between psychoanalysis and the humanities, he demonstrates that creative play is a fundamental aspect of the human experience of reality. Aesthetic experiences during the psychoanalytic process are comparable to the play by which children structure their world and artists' activity in following their urge to shape. Furthermore it is shown that creative actualisation testifies to a quasi-biological need for coherence and structure. Through modern hermeneutics, the truth claims of aesthetic shaping can be established in epistemological terms. The basic principles of hermeneutics--historicity, linguisticity and communicative experience--find their psychoanalytic counterparts in memory, representational shaping and transference-countertransference. Psychoanalysis is demonstrated to be simultaneously a science and an art. On the basis of a case history, aesthetic experience is shown to constitute a specific and unique form of access to psychic reality. Aesthetic experience and creativity do not only aid recovery from 'bad psychological states', they are also indispensable for the entire understanding of internal and external reality. It is possible to develop this understanding through a creative psychoanalytic attitude.

Attitude↗