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Isakower-like experience on the couch: a contribution to the psychoanalytic understanding of regressive ego phenomena.

Since Isakower's original contribution of 1938, Isakower phenomena have been viewed as primitive experiences involving maternal breast, womb, and face imagery. This clinical report harks back to the less well-known hypothesis with which Isakower concluded his paper: he suggested that these perceptual experiences are related to childhood oedipal masturbatory fantasies at the time of going to sleep. In this paper four Isakower-like phenomena experienced by a patient on the couch are reported in the dynamic context in which they occurred. It is argued that these phenomena constitute a type of regressive ego experience that defends against oedipal conflict.

Adult↗

The female analyst and the erotized transference.

The concept of erotized transference is discussed from Freud's original writings on the subject to those of recent contributors. It is noted that there exists an almost complete absence of reports in the literature of male patients developing an erotized transference to their female analysts. The question of how significant the gender of the analyst is in the unfolding of the transference and its vicissitudes is raised. It is maintained that the four possible analyst/analysand dyads differ qualitatively in that resistance and identification in the transference may be enhanced or inhibited by the gender of the analyst and/or the homosexual or heterosexual nature of the dyad. The erotized transference to the female analyst is focused upon as a vehicle to the study of such qualitative differences. It is hypothesized that the expression of strong erotic urges to the female analyst by the male patient is somewhat inhibited by the fantasy of the overwhelming pre-oedipal mother. In contrast, such erotic feelings are freely expressed by the female patient. Two cases, a male and a female, are described to support the above hypothesis.

Adult↗

The oedipal experience: effects on development of an absent father.

This paper discusses the effects on both child and adult when there has been a loss of the father through separation or divorce in the first five years of life. It is written with regard to the psychoanalytic treatment of individuals who have experienced such a loss of the father. The first part of the paper deals with the developmental effects on the child from the viewpoints of the pattern of oedipal development, superego structuralization, identification and sexual identification, and the analytic treatment process. The second part gives brief accounts of the analyses of two adults. It is proposed that while analysis of such patients may achieve a certain level of success, there may in some cases remain a relatively intractable degree of narcissistic interference and an impairment in their capacity to make an internal separation from the remaining primary object, the mother.

Adult↗

An appraisal of self psychology.

The strength of self psychology lies in its additions to psychoanalytic technique; its weakness in the reductionism of its theories. It offers a coherent clinical theory for treatment within the 'widening scope' consistent with the core technique of psychoanalysis. There are also significant applications to the treatment of neuroses. Self psychology is focused in technique on needs, met in accordance with Rapaport's concept of 'stimulus nutriment', which are, in their essence, outside the sphere of intrapsychic conflict. Archaic needs include processes related to psychotic phenomena and, I suggest, to deficits in the organization of fantasy. Such deficits lead to excessive dependence on the environment so that an interactional theory is required. Self psychology adds an interactional point of view through the concept selfobject. This point of view is focused on the subjective experience of the patient by the recommendation for 'prolonged empathic immersion'. Self psychology has an implicit concept of limited goals so that an analytic end result may mean a reorganization of the self without necessarily leading to object love. The reductionism in self psychology obscures its valid contributions to the role of aggression, conflicts and parental failures in empathy. Integration of self psychology with psychoanalysis requires clarification of the limits of 'prolonged empathic immersion' and the place for interpretation of resistance, defense and drive conflicts.

Aggression↗

The role of the oedipal fantasy in masturbatory and suicidal phenomena.

The multifaceted syndrome of suicide is viewed as a symptom with a manifest and a latent content. An attempt is made to demonstrate a dynamic reciprocal relationship, in a continuum, among fantasy, masturbation, and suicide. Sadomasochistic phenomena, beating fantasies, and suicidal thoughts and acts are viewed as translations of underlying positive and negative oedipal fantasies. Attention is also paid to how suicidal phenomena are facilitated by immature concepts of death, that is, its perception as a transient and reversible phenomenon, as well as its erotization. Four cases highlighting aspects of these themes are presented and then discussed in terms of how they illustrate the varying vicissitudes and elaborations of the masturbatory and/or oedipal fantasy and act, along separate or simultaneous pathways. In conclusion, there is an exploration of interpretive differences, with special reference to an object relations approach to phenomena, with its emphasis on preoedipal determinants and its attempts to accommodate both the drive/structure and object-relational/structure theoretical orientations.

Adult↗

Child analysis with a severely disturbed adopted child.

Much of this paper focuses on the psychoanalysis of Bert, a severely disturbed 9-year-old adopted boy. Constitutional factors, parents' personalities and parenting styles, and libidinal and aggressive zonal fixations all played a role in determining Bert's problems. Besides the normal developmental challenges, the adoptive child faces the unique developmental task of becoming the true adoptive child of true adoptive parents. Bert's case shows how this process can be facilitated in psychoanalytic treatment. After a brief introduction to the psychological implications of adoption at various stages of development, the paper elaborates on how and why Bert first came for treatment and describes three phases in the treatment, the first session, the period of transference developments, and the termination phase. The final section outlines special treatment issues and the implications for the psychoanalytic treatment of an adopted child.

Adoption↗

Border symbolism.

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Association↗

On the concept and consequences of the primal scene.

The concept of the primal scene is in need of redefinition and clarification. The primal scene is not identical with its regressive transformations or later derivatives. Because of the different implications for normal development and for psychopathology, the primal scene as a universal fantasy should be differentiated from the primal scene as real experience. The effects of exposure to the primal scene are considered in relation to the developmental level of the child, other problems in the parent-child relationship, and cultural attitudes.

Age Factors↗

Depressive affect, anxiety, and psychic conflict in the phallic-oedipal phase.

The author's recent contributions to affect theory and its relation to psychic conflict are applied to the understanding of the nature, genesis, and consequences of psychic conflict in the phallic-oedipal phase. These contributions lead to a better understanding of 1) the importance of depressive affect in phallic-oedipal conflicts, 2) similarities and differences between such conflicts in boys and girls, 3) depression as a symptom in adult life, and 4) some aspects of narcissism.

Anxiety↗