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PubMed2001

The twin poles of order and chaos. Development as a dynamic, self-ordering system.

The diversity of theories regarding children's development is commensurate with the enormity of the task of seeking ordering designs for explaining behavioral and psychic ontogeny in infants, children, and adults. The purpose of this paper is to look at these developmental theories as epigenetic stages themselves. I shall suggest that the next stage in the epigenesis of theories of development is to see variability and disorder on a continuum with order and stability, as a constant dialectic that moves development along, whether at the level of the cell or at the level of fantasy. I shall explore four questions that are implicitly about development as an ordering process and about theories of development as methods for bringing order to what is an inherently messy, even chaotic. The first two questions--what does it mean to take a developmental perspective, and what does any theory of development need to explain--set the stage for the consideration of some different perspectives for thinking about development. These other perspectives, borrowed from general systems theory, focus on the interplay of order-stability and variability-instability in psychological development. The third question, asks what does a more detailed consideration of the variability or noise in development add to our current developmental perspectives? Exploring dynamic systems and self-ordering processes will lead to several fields not explicitly clinical, psychological, or even psychoanalytic, but I shall circle back to apply these ideas to psychoanalytic perspectives on development, change, and adaptation in the fourth and concluding question. What can these cross-disciplinary attitudes offer to the psychoanalytic developmental perspective, whether in the form of our theories or our work with patients?

Adolescent↗
PubMed2003

Symptom, screen memory, and dream. The complexity of mental representation and disguise.

The relationship between screen memory, symptom and dream is not immediately obvious. All three are mental products to be sure and therefore they must have complex connections with each other, however far apart their genetic origin may be, however discreet they may seem from each other in the mind's archival filing system. A case is presented in which "the content" of a screen memory and a symptom and a subsequent dream shared certain similarities. The "content" became the subject matter of elaborate free associative explication in the context of analytic process and transference neurosis. As all three products began to "converse" with each other in the psychological fugue known as analytic process, the seamlessness of the human mind and its complemental series of complexities unscreened itself, as illusion became its own mirror rather than an exercise in perpetual self deception. A screen memory, a symptom, and a dream were show to be only façades of an architectural complexity they hinted at to be sure, but without analysis were unable to reveal.

Adult↗
PubMed2004

Thoughts on hate and aggression.

The phenomenon of hate is explored from two perspectives: in terms of intensive bodily arousal and mobilization, and as a form of active but paralyzed aggression. Aggression, in this context, is viewed not in terms of discharges of drive energies but rather as reinforced effort aimed at the removal or destruction of barriers that impede the organism's movement, in real or symbolic space. Winnicott (1950) already had emphasized how the basic fact of the child's motility, its activity, lies at the source of what becomes aggression. Encounter with 'reality' brings interference with free, unrestricted movement at first in actual, physical space, then gradually within the representational world. Inasmuch as such additional mobilization finds intrapsychic representation which, in turn, comes to be coupled with an 'injured' response from a loved or valued object, an intrapsychic representation of what the person experiences as his own aggressiveness emerges. Aggression thus derives from accumulating 'inevitable' collisions between adaptive motility and objects (real and symbolic barriers, obstacles) in the way. Aggression plays its part in the development of object relations. If aggressive mobilizations are sufficiently interfered with to block any further movement but continue to be stimulated in pursuing valued actual or symbolic goals, hate emerges as a form of active but paralyzed aggression. Selections from two patients' material illustrate these issues clinically.

Adult↗
PubMed2004

A reconsideration of the concept of regression.

Regression has been a useful psychoanalytic concept, linking present mental functioning with past experiences and levels of functioning. The concept originated as an extension of the evolutionary zeitgeist of the day as enunciated by H. Spencer and H. Jackson and applied by Freud to psychological phenomena. The value system implicit in the contrast of evolution/progression vs dissolution/regression has given rise to unfortunate and powerful assumptions of social, cultural, developmental and individual value as embodied in notions of "higher," "lower;" "primitive," "mature," "archaic," and "advanced." The unhelpful results of these assumptions are evident, for example, in attitudes concerning cultural, sexual, and social "correctness, " same-sex object choice, and goals of treatment. An alternative, a continuously constructed, continuously emerging mental life, in analogy to the ever changing, continuous physical body, is suggested. This view retains the fundamentals of psychoanalysis, for example, unconscious mental life, drive, defense, and psychic structure, but stresses a functional, ever changing, present oriented understanding of mental life as contrasted with a static, onion-layered view.

Adult↗
PubMed2004

Latency and the capacity to reflect on mental states.

The development of the capacity to reflect on mental states has its origins in the mother's function of accepting the infant's projections of unbearable states of mind and re-presenting them in a more tolerable form. During the oedipal period, the continued availability of a parent who can take in the child's mental states and represent them from a different perspective results in the emergence within the child of a reflective mode of mental functioning. This mental capacity allows the child entering latency to begin to be able to recognize that her experience is but one perspective among many. Reflection on mental states takes place within an intermediate area of experience that belongs neither to the inner world nor to external reality, but partakes of both. In latency, the capacity to reflect on mental states remains a vulnerable capacity that is dependent on the reflective function of a parent at times of crisis. When a parent who can contain and transform the child's experience is not available, the child's potential space for reflection can collapse, leaving the child unable to differentiate inner from outer reality. The mother's relationship to a loved object other than the child is necessary for her continuing ability to support the child's reflective function. The child's awareness of a parental relationship from which she is excluded is also essential to the child's internalization of the capacity to reflect on mental states because it creates a vantage point from which the child can imagine herself being observed from the outside. These points are illustrated with material from a first psychotherapy session with a latency age boy.

Ego↗
PubMed2005

On foresight.

Examples of our interest in the future are drawn from poetry, religion, general medicine, and from the aims of psychoanalysis. The concept of foresight is taken as a focus for questions regarding the relative inattention to a psychology of the future in psychoanalytic thought. This inquiry leads to consideration of the varying constraints and potentials that are determined by the formal properties of verbal language and mental images, which are briefly compared and contrasted in regard to their usefulness in understanding complex dynamic systems such as psychoanalysis. The paper concludes with questions regarding the qualities of conscious and unconscious, and secondary and primary process thought, and with comments on technique.

Adult↗
PubMed2001

Vesaas's The Birds and a patient's history elucidated by means of the theory of object relations and the death instinct.

The psychoanalytical theories of object relations may elucidate both patient histories and fictional characters in literature. In this article I apply the notions of paranoid-schizoid and depressive positions, projective identification, symbolization, communication, and death and life instincts in my understanding of the main character Mattis in Vesaas's The Birds and, furthermore, in referring to one of my patients. Some literary theory is compared with the theoretical issues mentioned above. Comparing Mattis and my patient, I find both differences and similarities. The two men are both disabled, albeit to different extents, and they are quite aware of this. To be observant of suicidality in these patients seems important to me as a clinician, and I find the theory of the death instinct valuable in evaluations concerning these matters. I also find The Birds to be of importance in the understanding of patients and humanity in general.

Adult↗
PubMed2003

Using attachment theory to understand patients' responses to a therapist's medical break.

The impact of a therapist's planned medical break is described and discussed, using attachment theory. The break is compared to Ainsworth's strange situation test and the responses of patients with avoidant, ambivalent and disorganised patterns of attachment are explored. The paper examines patients' responses at the point where news of the break is given and on reunion and looks at communication through breaks in the frame. An overview is given of the understanding of separation and loss in broader analytic theory and the ways in which these complement Bowlby's theory. The clinical cases are reviewed in the light of several authors.

Adult↗
PubMedDate not supplied

A developmental perspective on psychological principles of burn care.

The treatment of pediatric burn patients requires careful attention to psychological principles underlying good pain management. These principles, and a variety of specific psychological treatments, have been described thoroughly. In this article the cognitive capabilities, emotional understanding, and behavioral competencies that characterize children at various stages of development are outlined. Important age-related developmental issues are noted, and the child's experience of a burn injury at different ages is outlined. Guidelines for interventions tailored to the developmental capacities and frailties of children in different age groups are offered. Various psychological coping techniques are understood in light of their likely value for pain management with a developmental framework in mind.

Adolescent↗
PubMed1998

Psychoanalysis: a dysfunctional family?

The discussion opens with an account of the author's mother's bizarre family in which a strong, charismatic grandmother maintained absolute control over her large family by encouraging a neurotic dependence in them through daily reports of their complaints. Getting interested in psychoanalysis in an effort to understand the dynamics of this dysfunctional family, the author, a biographer, turned to the study of Melanie Klein, becoming entranced by her ideas. Her research also revealed how Klein had discouraged her followers from developing ideas that diverged in any way from her own. Her portrait of the pioneer analyst provoked intense indignation. A similar pattern of absolute loyalty to his person and theories was to be found in Freud's Secret Committee, formed primarily as a means of getting rid of Jung who had been showing disturbing signs of independence. When Ferenczi and Rank began to pursue independent lines of enquiry in their work, they too were though to be undermining the foundations of classical psychoanalysis. Finally, the author concludes that though there have been sorry incidents in psychoanalysis, we should be mature enough to accept both the contributions of the early pioneers and the realizations that new ideas must be permitted to evolve.

Codependency, Psychological↗
PubMed2000

Subjectivity and unconsciousness.

Concepts of the unconscious were crucial to both Jung's and Freud's thinking. Psychoanalytic and analytical psychological views of the unconscious are compared and contrasted, and both are critically reviewed. It is suggested that we need to revise our conceptualization so as to take better account of the role of the analyst's expectations and inferences, and therefore of his or her subjectivity, whenever he or she makes a clinical judgement that unconscious mental processes are in operation. Some technical implications of a revised definition of unconsciousness are considered, especially indications for self-disclosure by an analyst of his or her own experience of events within the treatment.

Adult↗
PubMed2001

Enactments and amplification.

Advances in the understanding and articulation of enactments allow a reassessment of analytical psychology's method of amplification. Subjective and objective aspects of the amplificatory process, evolving notions of its role in analysis together with the use of countertransference phenomena provide the frame for reexamination of this method. Using a single analytic day, this paper explores the inevitable play of enactments with a focus on countertransferential components contained in the act of amplification. An internal examination of such an act is used to attempt to identify and differentiate the operative personal, interpersonal and collective aspects. The impact and traces of this act are followed through the workings of the day and demonstrate that the impulse to amplify is a suitable object for analytic scrutiny. This leads to a more general question of the mythic nature of enactments.

Adult↗
PubMed2001

Memories, fantasies, archetypes: an exploration of some connections between cognitive science and analytical psychology.

The value of cognitive science as a means of investigating psychodynamic theory and practice is discussed and the limitations of this approach are described. Research findings from cognitive science are drawn on to clarify the nature of memory, which is seen to be a mixture of reproduction and reconstruction and the concepts of true and false memory are explored in this light. The part played by implicit memory and internal working models in producing transference is also examined. New ways of conceptualizing fantasy, which describes it as another facet of internal working models, and the role of transgenerational transmission of attachment patterns in creating internal working models are explored. The nature of archetypes is considered in the light of cognitive science research and a minimalist model is proposed, in which they can be likened to image schemas, that is, primitive conceptual structures that exist in a form which can never be experienced directly or indirectly.

Fantasy↗
PubMed2003

A dialogue of unconsciouses. A contribution to the panel 'Jung and Ferenczi--the emergent conversation'.

I want to explore the notion of 'mutual introjection, the developmental essence of an autobiographical dialogue', an idea that has recently crystallized in the continuing collaborative work of Gershon J. Molad of Israel and myself concerning the autobiographical contribution to the dialogue between analysis (Molad & Vida 2002). One of the sources of this crystallization is the experience of my consultative relationship with a Jungian colleague, who, after reading some of this collaborative work, paraphrased Jung's implication that if, in the course of treatment, the doctor is not as transformed as the patient, nothing has happened (1946). In this paper, I want to breathe some life into these theoretical-sounding words: 'mutual introjection, the developmental essence of an autobiographical dialogue'.

Austria↗
PubMed2004

Narcissistic disorders in clinical practice.

In this paper, the concept of narcissism in the psychoanalytic literature is reviewed and three uses of the term are defined, firstly, clinical narcissism, secondly, an innate force or tendency opposed to relationships and thirdly, narcissistic personality disorders. The latter can be further differentiated on the basis of the transference/countertransference into borderline (thin-skinned), aloof (thick-skinned) and as-if (false-self) narcissistic disorders. The characteristics of each of these patterns are described. The author suggests that narcissistic disorders arise when there is a failure of containment in infancy and childhood that gives rise to an ego-destructive super-ego leading to the evolving of a narcissistic organization. The libidinal defensive organization arises when parental failure of containment is the primary factor and destructive organization when the infant has an excess of object-hostility. Two case descriptions are given to illustrate the distinction between a predominantly destructive and a predominantly libidinal narcissistic disorder and the author suggests that both arise from the production, by projective identification, of a narcissistic relationship with an ego ideal in order to evade a relationship with a destructive parental super-ego.

Adult↗