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PubMed1989

The parents' relationship and the child's illness in anorexia nervosa.

The authors examine the impact on the preanorexic child of the parents' relationship with one another, particularly the models they present of mature male/female relationships. The authors suggest that patterns of maternal perfectionism and self-sacrifice combined with paternal entitlement makes sexual maturity particularly threatening for female children in these families, and may partially explain the greater incidence of anorexia nervosa in women, and its explosive incidence in adolescence.

Anorexia Nervosa↗
PubMed1989

Masters of the universe: children's toys as reflections on contemporary psychoanalytic theory.

The emergence of contemporary object relations theory and self psychology as potent theoretical forces has led to rich discussion with far-reaching implications for clinical, developmental, and metapsychological theory. This article examines these developments using as a medium the Masters of the Universe figures and stories, which have captured the imaginations of a broad spectrum of phallic-oedipal and oedipal-aged children. A series of interrelated theoretical questions will be discussed: (1) the nature and character of aggressive drives and whether these are innate and instinctual or disintegration products secondary to emphatic failure; (2) the extent of internalization of mental representations at this point in development; and (3) the status of Kohut's "grandiose self" and "idealized object" vis-à-vis traditional perspectives on phallic-oedipal and oedipal development.

Aggression↗
PubMed1990

Preoedipal factors in "Little Hans".

In this article, the text of "Little Hans" has been reexamined in reference to the existence of negative oedipal and preoedipal factors in the development, meanings, and resolution of Hans's phobia. The cumulative effect of the frequent administration of enemas, sleeping in the parental bedroom, exposure to the bloody birth of a sibling, a generally absent father and a seductive, threatening mother would be expected to interfere significantly with the process of separation-individuation. Evidence suggesting that Hans had problems in this area is discussed. In addition to reflecting the displaced fear of Hans's oedipal rival, his horse phobia may also represent his dread of a castrating preoedipal mother and his fear of a castrating vagina. The treatment, by clarifying many of Hans's misconceptions and by allowing Hans to develop a closer, more solid relationship with his father, assisted Hans in more completely negotiating the phallic-dyadic phase of development and helped him to move more completely into the oedipal phase proper.

Anxiety, Castration↗
PubMed1991

Patients' reactions to the birth of a male analyst's child.

After the author informed his patients he planned to be absent for one week, approximately one month hence, nearly all his patients correctly assumed that his wife was pregnant. The birth of the analyst's child revived conflicts concerning younger siblings. Male patients seemed to respond to the reactivation of oedipal conflicts by a transference intensification of their paternal identifications. Female patients reacted more negatively and more dramatically. For them, the birth of the analyst's child signified a defeat of both their positive and negative oedipal wishes. The author compares and contrasts his findings with the literature on the pregnant analyst.

Countertransference↗
PubMed1996

The application of postmodern thought to the clinical practice of psychoanalytic psychotherapy.

The purpose of this article has been to acquaint psychoanalysts and psychoanalytically oriented psychotherapists with some of the most current ideas in philosophy and psychology, which have crucial implications for our professional organizations and our clinical work. The basic stance of this postmodern thinking constitutes a challenge to what is called foundationalism, which dominated scientific and philosophical thought until recently. In place of foundationalism, even in the production of scientific or philosophical works, we could hope for an ongoing dialogue between a king or queen who states the basic theoretical orientation, the loyal opposition that looks for inconsistencies and kinks in it, the jester who deconstructs the whole thing and introduces parenthetical digressions, and finally, a secret society of organization that functions to hold the adherents of the theory together and provide them with a unifying ego ideal. Postmodern thought is described and there is some discussion of its "four horsemen," Derrida, Rorty, Foucault, and Lyotard, who in general question the possibility of whether any form of interpretation can be thought of as related to reality or the truth. My own point of view is that an intermediate position is necessary rather than a binary opposition between nihilism and foundationalism or more specifically, postmodernism and traditional psychoanalysis. That is to say, within certain horizons and with an understanding of the cultural and historical referents that always affect and delimit both the patient and the therapist, it is still possible to reach conceptions about what is going on both in the psychoanalytic process and the psyche of the patient that have at least a tentative "truth." Careful attention to the patient's material following an interpretation can provide clues about the validity of our conception at the time. But the horizons and historicity that delimit all "truth" reduce the authority and the stature of the analyst, make the analyst less of an arbiter of what is "reality," and focus greater attention on the therapist-patient dyad, which is consistent with the modern trend in psychoanalytic treatment anyway. The notion of social constructions as constituting the psychoanalytic process was discussed and it was suggested that this notion suffers from the lack of sufficient attention to the historical determinants of how a given individual reacts in a given situation. A patient will react differently to different therapists, depending on the transference or projective identifications that the patient brings to the treatment, regardless of the interpersonal interaction. This is in opposition to the idea that transference is primarily an effect of the therapist-patient dyad, and preserves a major aspect of traditional Freudian theory. The dangers of postmodern thought disintegrating into nihilism are described, and the limitations of so-called postmodern thought are discussed, including the intrinsic paradoxical nature of any postmodern proposition. At the same time, postmodern thought is useful in calling attention to the "space of the Other" in human affairs, to the tendency to form binary oppositions in which the second element in each binary pair is part of the Other and is depreciated, and to remind us that there are always further interpretations of the narrative that emerges from the psychoanalytic situation. The feminization of psychotherapy and its relationship to feminism are important current issues. Postmodern thought is valuable in responding to the common complaint of feminists about Nietzsche's attitude toward women; postmodernist approaches emphasize the ambiguous and the allegorical aspects of Nietzsche's thought, to the extreme orf Derrida's contention that Nietzsche is not really interpretable at all. At the same time feminists legitimately object to postmodernist erosion of the grounds for political action. (ABSTRACT TRUNCATED)

Female↗
PubMed1996

Communicating with the schizophrenic superego.

The procedure reported here, which I have called "conversations with superegos," raises a number of important questions, both about ordinary versus psychopathological psychic structure, and about technique. There is no space to enter into a lengthy discussion, but a few brief points may be in order. First, let us consider the issue of psychic structure. I have argued that the superego is a hostile agency within the mind whose operations are essentially inimical to the patient's growth and well-being. (As an element of psychic structure, the superego can be distinguished from the ego ideal on the basis of the associated affect, that is, guilt rather than shame. Similarly, it is possible that the superego may be constructed on the basis of identifications that are different than those that may form the basis of the ego ideal). Further, I have argued that the superego is neither a force for true moral development nor a platform for the voice of the patient's "better" nature, (although it purports to be until challenged). A structure that lies, manipulates, threatens, and appears to be motivated in the end solely by its own continued existence, must certainly be considered suspect as an authority on morality. On the contrary, I see true morality originating in the patient's ego, because in that structure lies the ability to identify with others. One could object, however, that this way of viewing the matter is an artifact of working with a particular patient population. That is to say, it might be the case that in psychotic and borderline psychotic conditions, the superego does function this way, whereas in healthy or neurotic conditions it does not. In a similar vein, it could be argued that a pattern of development that was sufficiently skewed so as to result in psychosis would be more than likely to have been peopled by hostile, punitive, and essentially destructive identification figures, such as could form the basis for a pathological superego, whereas in normal or neurotic development this might not be the case. I would disagree on the following basis: I believe that the course of development is laid out by nature; that is, events like the separation-individuation phase, the oral, anal, phallic, and oedipal phases occur in all of us. It is what happens in the course of that development that will lead either to normalcy or various degrees of pathology. For example, we all project. But it is whether we project an expectation that the next person we meet is a decent, civilized human being or a monster out to destroy us that causes us happiness or pain. That said, my own view of the matter is that the general principal holds for conditions other than the patients reported here, with the difference being one of degree. Where identification figures are essentially benign and foster the development of the self, then their strictures, whether moral or merely practical, would be likely to become assimilated into the ego, without the telltale restriction of reflection and autonomy together with the accompanying guilt that characterize the superego's activity, in which case, we are not talking about superegos at all. What distinguishes psychotic and neurotic development, in my view, is not the issue of whether superego operations are benign or not, but the degree to which the ego is compromised with the resulting formation of fantasy-introjects. I have found, as if it were a principal of physics, that the stronger the ego, the weaker the superego and vice versa. And when some energy of the superego is released, it appears to go directly into the ego without my intervention, though I sometimes ask the "brain's" opinion. The second issue concerns technique. In psychosis, the voice of the superego is very loud, so much so that there are times when I have had to shout to be heard. On the other hand, my patients report that the voice of the ego may be so quiet that the patient hasn't heard it at all, or hears it as a whisper. (ABSTRACT TRUN

Adult↗
PubMed1983

Personality change in sex therapy.

Lasting symptomatic change in sex therapy is not possible without relevant character change. Character change is most likely to take place in the areas of pleasure, assertion-aggression, and object-relatedness, if the therapy is successful. Such positive changes, however, may be accompanied by negative characterological shifts in the areas of dependency and autonomy. In addition, in failed therapy, existing negative character traits may be reinforced or exacerbated. Character change in sex therapy is brought about by a combination of factors, some familiar from psychoanalysis and some unique to sex therapy. These are, principally, identification, transference resolution, and new learning, both behavioral and cognitive, in a couple format. It is the synergistic effect of the cognitive and behavioral elements of this therapy that catalyzes the treatment process in favorable cases, resulting in accelerated character change.

Adult↗
PubMed2002

Convergence: maturation and integration in the course of a religious conversion.

The process of religious conversion has not been the focus of psychoanalytic understanding. This article examines one conversion narrative, a spiritual autobiography, in which, the author asserts, evidence can be found that the conversion described involved a process of maturation of the subject's internal god-representation, with an integration of maternal and paternal aspects of that internal object representation. Such a process as one aspect of a religious conversion, has implications for psychoanalytic work with religious patients, including the necessity of acknowledging the psychological and deeply believed reality of God for religious patients.

Female↗
PubMed2002

Commonalities between the Isaac and Oedipus myths: a speculation.

From a detailed view of the myth of the binding of Isaac, a speculation emerges that Isaac may have had incest with his mother, Sarah. This would explain the death of Sarah shortly thereafter, his absent virility for twenty years, and his blindness. The commonalities with the Oedipus myth are outlined, along with the themes of filicide, patricide, guilt, punishment, and expiation. This suggests that they are the same myth, with some slight variations. The continued interest in both myths may be due to their utility as cautionary tales to teach control of hostile impulses in parents and children. While the outcome in the Oedipus myth is tragic, it is hopeful in the Isaac myth.

Father-Child Relations↗