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Who's afraid in Virginia Woolf? Clues to early sexual abuse in literature.

Virginia Woolf, by self-admission, was a victim of repeated sexual abuses. At age 5 or 6 she was sexually mishandled by her older half brother, Gerald Duckworth. In her teenage years another older half brother, George Duckworth, misused her repeatedly. As a result of these abuses, Woolf suffered the special signs and symptoms of long-standing childhood psychic trauma--sexual numbing, emotional distancing, self-hypnosis, splitting, and dissociation. She also suffered some of the more ordinary signs and symptoms common to most childhood traumas--fears, perceptual repetitions, and repetitions in behavior (in this case, in writing). Interestingly, Virginia Woolf's fictional characters manifest the very same signs and symptoms Woolf manifested all of her life. The occasional reader may treat Woolf's fiction, because of these "symptoms," in much the same way that an actual childhood sex abuse victim is often treated--with boredom, disbelief, and failure to respond.

Child↗

Winnicott's antitheory and Winnicott's art. His significance for adult analysis.

The significance of Winnicott's work for the theory and practice of adult analysis is examined. Winnicott's most valuable contribution was to discern important new clinical phenomena. This is a crucial aspect of theory development, but not the same as explicating new theory, and partly accounts for the difficulty integrating his ideas with traditional psychoanalytic theory. Winnicott left the theoretical revisions possibly necessitated by his discoveries for others to accomplish, and some of this new work is discussed and synthesized. The nature of Winnicott's discoveries, especially the phenomenological field of transitional or intermediate experience, is elusive to define, and is also related to his clinical stance and his attitudes to theory for the purposes of clinical work. His work demonstrates the limits of theorizing and of our theories, and also an attitude toward theory that facilitates clinical and theoretical progress. He also provides conceptual language to discuss what is often called the art of psychoanalysis. Both the value and limitations of studying Winnicott are considered.

Adolescent↗

Narcissistic disorders in children.

This paper discusses children who initially may seem suitable for psychoanalytically oriented treatment but who do not respond in the anticipated manner. Such difficulties in treatment may suggest the presence of a narcissistic disorder. Clinical material from a latency-aged girl is presented to demonstrate the typical difficulties encountered in maintaining a working relationship with such children, and the special frustrations and countertransference issues that are apt to arise. A set of criteria is proposed to help in the diagnosis of a narcissistic disorder, and a treatment approach is suggested.

Child↗

Hilda Doolittle and creativity. Freud's gift.

The problem of work inhibition in a woman is addressed in terms of a specific case. The paper investigates the patient's view of how such an inhibition was cured in a brief analytic treatment of the American poet Hilda Doolittle conducted by Freud in 1933-34.

Creativity↗

The theoretical contributions of Hans W. Loewald.

An integration and dialectical reading of Hans Loewald's developmental theory is offered, demonstrating his ability to bridge theoretical dualisms. He maintains yet revises Freud's structural model and dual instinct theory in a way which embraces developmental and relational perspectives.

Austria↗

Play in adulthood. A developmental consideration.

This paper is about normal development, addressing the basic characteristics and evolution of play throughout life, with particular emphasis on the nature of play in adulthood. Although the psychoanalytic literature on play in childhood is extensive, undoubtedly because of its relevance to child analysis, very little has been written on the subject of adult play or on the relationship between adult play and its childhood antecedents.

Adult↗

Shame and the superego. Clinical and theoretical considerations.

The conception of the superego as a set of compromise formations characterized by the calamity of parental disapproval and the striving of winning or regaining parental love and approval facilitates the awareness that shame and guilt are affects with similar fantasied contents. This paper explores the clinical value of this emphasis on similar fantasied contents of shame and guilt for analytic work with adults.

Adult↗

The legend of the European vampire. Object loss and corporeal preservation.

This paper reconsiders the manifold European legends of the vampire in a clinical context. The study of clinical psychoanalytic material that is homologous with these legends reveals that in both myth and clinical work, vampire legends and fantasies may signal experiences of object loss. Vampires are, after all, persons who have died but who are nonetheless immortal or "undead." This study suggests that an important function of vampire mythology may have been to allow the grief-stricken to believe in the continued existence of their loved ones. Likewise, in the clinical analytic situation, and especially within the transference, the appearance of fantasy material related to vampire legends may signal bereavement, especially transference bereavement.

Bereavement↗

Resistance analysis and psychic reality.

The purpose of this paper is to elucidate some aspects of our mode of working; how we as analysts listen, observe, and collect information to formulate appropriate resistance interventions. Analytic exploration and technique should to a greater extent than what is usual include a careful analysis of verbal and nonverbal resistance expressions, as these may contain important material related to the analysand's psychic and historical reality. Our theoretical and technical conceptualization of how a systematic and consistent resistance analysis is performed should be improved. Our listening and observing attitude involves the simultaneous use of various forms of auditory, visual, and enactive data. This is exemplified by an excerpt from an analytic hour in which a specific resistance problem--an analysand's suppressed response to crying--is examined and linked to specific preverbal experiences.

Adult↗

The role of free movement in separation-individuation. A study of paralysis.

This paper reevaluates the role of free movement in the separation-individuation process through the special case of its absence. We put forward some ideas, formulated gradually during the psychoanalytically oriented psychotherapy of a paralyzed adult suffering from a narcissistic personality disorder. By analyzing the transference and countertransference in this case, we realized that the patient's inability to regulate his distance from his mother by free movement impelled him to use an alternative mode of regulating his object loss and re-engulfment anxieties. We elaborate on two alternative mechanisms to cope with these anxieties: the motoric mode of approaching-distancing, and the mode of idealization-devaluation, inflating and deflating the inner significance of the object. We discuss the implications of these modes for the stability of self and object experiences, their different use of the Doing and Being experiential modalities, and their relation to pathological narcissism.

Adult↗

Offerings and acceptances. Technique and therapeutic action.

This paper presents several proposal about clinical psychoanalysis. One proposal suggests that an analyst's essential offering is a non-hierarchical partnership in discovering. Another implies that a valuable goal of psychoanalytic work is to acquire the adaptive tool of "insighting," an acquisition that is promoted by the structure of the partnership. The paper contains arguments that support the proposals, as well as an extended clinical anecdote that illustrates them.

Adolescent↗

Psychological complications of short stature in childhood. Some implications of the role of visual comparisons in normal and pathological development.

This study examines the effect of short stature on the emotional development of a subgroup of children who were treated in psychoanalysis and psychotherapy. These children became capable of making accurate comparisons of body size in early latency as a result of advances in cognitive development. Recognizing their comparative smallness left them feeling vulnerable and humiliated. They responded with envy and rage toward normally endowed children and vindictively used their intellect to outwit and defeat others. They acted as if their suffering exempted them from ordinary social rules and expectations. Their preoccupation also resulted in arrests in cognitive and social development. Their distrust and intention to deceive and defeat posed particular problems for treatment. This outcome suggests that visual comparisons of size during early latency are implicated in pathological, and therefore in normal, development. Parallels are suggested between the subjective experiences of children in this group and the experiences of children with other kinds of physical deviations and compromising life circumstances.

Adolescent↗

Lie as narrative truth in abused adopted adolescents.

Two case examples of abused adopted adolescents are discussed to highlight tension within the treatment relationship when the therapist is expected to accept without question a clearly unbelievable story. These examples illustrate how the lies of such youths can function as narrative truth. The unbelievable tales that emerge in the therapeutic work effectively alter the adolescents' perceptions about the perplexing loss of continuity, both internal and external, that occurred when they were removed from their homes. Characters in the stories represent fragmented self- and object-representations as victim, abuser, rescuer, and passive onlooker. Counterparts to the patient as victim, abuser, rescuer, and passive onlooker can be recognized in the therapist's subjective responses. If the therapist can use countertransference to inform an understanding of the treatment process, an appreciation emerges that the truth of the lie is in its impact. Decisions about how to intervene can then be crafted. The second separation-individuation intrinsic to adolescent development is understood to provide a ripe opportunity for this working-through process.

Adolescent↗

Erik Erikson's dream specimen paper. A classic revisited.

This paper offers an overview of Erik Erikson's contribution to psychoanalysis, contrasting the humanistic perspective from which he viewed psychoanalysis with the biological perspective adopted by Heinz Hartmann. The vehicle for this comparison and for the explication of Erikson's extension of the work of Freud and Hartmann is Erikson's analysis of Freud's Irma dream, as presented in his Dream Specimen paper. I hope to show that: (1) Erikson's analysis of Freud's Irma dream provides a masterful illustration of the richness and complexity of past and current life themes and conflicts that inform the dreamer's construction of the manifest surface of the dream. (2) Erikson's examination of the relationship between the manifest content of the dream and the current life context of the dreamer leads him to propose a connection between trauma and the origins of the dream. This view complements Freud's discovery of the instinctual motivation for dreaming and anticipates subsequent discoveries concerning the role of dreams and REM sleep in defensive ego functioning and adaptation. (3) The Dream Specimen paper presents readers with a humanistic ego psychology that rests upon--but is subtly different from--the work of Hartmann and the other biologically oriented analysts of his day. In this sense, Erikson's paper is an elegant "specimen" of ego psychology carried to its most creative heights.

Dreams↗

The use of dream analysis in the treatment of a nine-year-old obsessional boy.

In children, as in adults, dreams offer a direct access to the unconscious. The analysis of dreams in the psychoanalytic treatment of children is, however, a neglected area. The work that a 9-year-old boy did with his dreams during the course of his two-and-a-half-year analysis is presented to demonstrate how helpful dream analysis can be in elucidating conflict and defense in the child patient. With children, the responsibility for inquiring about dreams rests with the analyst. The associations a child has to his or her dreams are as useful as an adult's.

Adult↗

Croup, a disorder of the anal phase of development. A contribution to our understanding of the psychosexual development of the larynx.

A brief history of croup is presented. The forms of croup under examination are defined with emotional factors at one end of a continuum and viral and traumatic factors at the other. The complexity of the disorder and its peculiar clinical characteristics are explained. Some of these characteristics are: (1) the predominant 1-3-year age range, which corresponds to the anal stage of development; (2) the relief afforded by vomiting; (3) the occurrence of attacks at night and during sleep, (4) the relative dryness of the cough and its harsh metallic quality; (5) the frequent presence of a ticklish, irritating sensation in the throat; and (6) the presence of edema and/or laryngospasm. Three case vignettes are presented. These cases support a previously developed theory concerning the impulses and defenses underlying the croup attack. Croup is seen as a fixation at the oral level with a regression to that level in the face of conflicts of the anal or sometimes the oedipal stage. The psychosexual development of the larynx is discussed.

Adolescent↗

Aichhorn revisited.

August Aichhorn first published Wayward Youth in German in 1925. His willingness to approach a problem as difficult as delinquency in terms of psychoanalytic theory and to then test his theories with groups of delinquents in a reformatory setting were truly pioneering. Perhaps his greatest success as an educator was in attracting other psychoanalytic leaders, most notably Sigmund Freud and Kurt Eissler, to extol and extend his early efforts. The turn of the century seems a fitting time to revisit Aichhorn's views, to assess his impact on colleagues, and to place his contribution in the perspective of current research and practices.

Adolescent↗