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PubMed1993

Impasses in psychoanalysis: overcoming resistance in situations of stalemate.

Many impasses occur in treatment when the patient fears that analysis will repeat frightening or disappointing experiences. These stalemates result from the patient's conviction that the analyst has confirmed a preexisting belief that is central to the patient's primary conflict. Frequently, this belief involves an unacceptable or frightening self- or object representation. At these times, intense resistance and strong negative transference/countertransference reactions may develop. Impasses are differentiated from these strong negative reactions only by virtue of the fact that they remain unanalyzed. The factors that create these negative states can best be understood in instances where the potential impasse is resolved. When impasses persist, most often patients leave treatment. Under these circumstances, we can try retrospectively to understand what has gone wrong, but without the patient's confirmation, our conclusions must remain speculative. Four cases illustrate varying degrees of analysis and resolution of resistance and transference/countertransference binds.

Adult↗
PubMed1993

Developmental transformations: the Isakower phenomenon as an example.

A review of the literature, and clinical analytic material suggest that the Isakower phenomenon and its variants consist of representations or sense memory traces of the original infantile feeding experiences integrated with later representations of experiences during the anal and oedipal stages, latency, and even later. With progressive development, memories of earlier experiences are transformed with regard to function, form, content, and meaning.

Adult↗
PubMed1994

Monitoring the analytic surface.

How do we listen during an analytic hour? Systematic analysis of the speech patterns of one patient (Mrs. C.) strongly suggests that the clustering of shared pronouns (e.g., you/me) represents an important aspect of the analytic surface, preconsciously sensed by the analyst and used by him to determine when to intervene. Sensitivity to these patterns increases over the course of treatment, and in a final block of 10 hours shows a striking degree of contingent responsivity: specific utterances by the patient are consistently echoed by the analyst's interventions.

Association↗
PubMed1994

Some ambiguities in the method of free association and their implications for technique.

The method of free association, rooted in the topographic model, has not been clearly defined in structural terms. Little changed since Freud; the method is geared toward overcoming rather than investigating resistances. Furthermore, it is designed to discourage rather than encourage self-analysis. This seems to be another example of a "developmental lag" in adapting the psychology of the ego to clinical technique.

Defense Mechanisms↗
PubMed1994

On love and lust in erotic transference.

Intense erotic transference is one of the most powerful and challenging phenomena in clinical psychoanalysis. Powerful longings for love and for sexual gratification are likely to elicit enactments in the analytic setting that interfere with the analyst's ability to maintain a dual state of awareness in which he or she is both a participant in and an observer of the immediate experience with the patient. These enactments occur on a continuum from frank love affairs between patient and analyst to subtle forms of partial transference gratification. Moreover, the two primary elements in the manifest content of erotic transference--love and lust--may be dissociated from one another and may produce significantly different reactions in the analyst.

Adult↗
PubMed1994

Bedrock and beyond: an examination of the clinical utility of contemporary theories of female psychology.

Libido theory and the idea of an innate matrix of bisexuality are an inadequate basis on which to understand female psychology. Rather, it is the mutual influence of sexuality, aggression, object relations, and a superego that inherits the object-related conflicts of early childhood, intertwined as these are with gender issues, that determine the way a woman experiences herself. A woman can have a basically confident, narcissistically valued sense of femaleness and at the same time be troubled by intense feelings of inadequacy and deprivation. Instead of arbitrarily attributing these feelings to penis envy and a sense of castration, based on the idea of bisexuality as bedrock, this paper suggests that we consider primary femininity as bedrock, but that the superego, as heir to unresolved preoedipal and oedipal object-related conflicts, functions to maintain these painful emotions. Clinical material illustrates the utility of these ideas.

Adult↗
PubMed1994

Oedipal sibling triangles.

Sibling triangles exist independent of parent-child triangles and undergo parallel development into constellations bearing significant formal and dynamic similarities to the standard parent-child oedipal relationships. They may exert definitive effects on the individual's identifications, adult object choices, and patterns of relating. Recognition of such constellations and their outcomes is often crucial to successful therapy. A developmental line is delineated with emphasis on the recapitulation throughout development of oedipal sibling issues. Speculations are offered about the possible factors responsible for pathological outcomes of oedipal sibling triangles, and about why, in many cases, oedipal sibling experience may be more influential in development than oedipal parental experience.

Adolescent↗
PubMed1994

In the eye of the beholder: Helmholtzian perception and the origins of Freud's 1900 theory of transference.

Freud's 1900 theory of transference was indebted to the convergence of philosophy and physiology found in nineteenth-century theories of visual perception. The author maps out the post-Kantian philosophical and German physiological currents that gave rise to Hermann von Helmholtz's influential work on perception, and proposes that Freud's 1900 theory of transference was a creative synthesis of novel notions like unconscious wishing and psychic defense with a Helmholtzian model of visual illusion.

Dreams↗
PubMed1994

Observing the other: reflections on anthropological fieldwork.

Aspects of anthropological fieldwork are examined from a psychoanalytic viewpoint using two sources: (1) Malinowski's A Diary in the Strict Sense of the Term, a fieldwork journal he kept in New Guinea and the Trobriand Islands "as a means of self-analysis"; (2) the analysis of an anthropologist both before and after she returned from the field. Malinowski's Diary, written in a virtually free-associative form, illustrates how fieldwork stimulates derivatives of significant early infantile conflicts. The patient's analysis revealed the unconscious meaning of, and motivation for, fieldwork for this particular individual. Based on these data, it is postulated that during fieldwork a new, emotionally charged object relationship, with its concomitant transference responses, may be unconsciously established by the anthropologist with the alien society being studied.

Anthropology, Cultural↗
PubMed1994

Oedipus and the sphinx: triumph and catastrophe.

The downfall of Oedipus in Sophocles' most famous play, Oedipus Tyrannus, is the reversal of his triumphant entry into the city of Thebes 17 years earlier. The oracle at Delphi has told the Thebans that the plague will end only when the murderer of Laius is identified and punished. The unconscious collusion between Oedipus and the Thebans to ignore the unsolved murder breaks down. Told by Teiresias that he is the culprit, Oedipus begins a desperate effort to find evidence to refute this accusation. When other witnesses come forward, his cause is lost. The effect of Oedipus's collusive interaction with the Thebans is balanced in Sophocles' account by the story of the riddle of the Sphinx. The Sphinx is a goddess of discontinuity. She represents the unconscious forces at work both in Oedipus's personal fantasies and in the collective fantasies of the Thebans. The tragedy results from the interaction of these fantasies in the government of the polis. Sophocles' play thus exemplifies the intricate intertwining of the child's innate wishes and the reaction they evoke from the environment during the oedipal period. The neurotic patient's illusion of sexual triumph over his or her father or mother as a child can be best understood through the interaction of these factors.

Defense Mechanisms↗
PubMed1994

Nonverbal communications: some reflections on their role in the psychoanalytic process and psychoanalytic education.

This paper focuses on the phenomenon of nonverbal behavior and its role in analytic practice and in the teaching of technique. The idea is presented that data arising from the nonverbal realm are underutilized both in the clinical situation and in supervision. Some possible reasons for the development of this situation are presented, illustrated by several clinical examples drawn from the author's experiences as a candidate.

Female↗
PubMed1995

The phallic castration complex and primary femininity: paired developmental lines toward female gender identity.

I suggest that two developmental lines contribute to the achievement of female gender identity. One is rooted in the phallic castration complex, and the other in primary femininity. Far from being mutually exclusive, the two comprise necessary aspects of every girl's progress toward becoming a woman. To that extent, every woman's analysis will include the analysis of compromise formations that emerge from both. In distinguishing clinical manifestations of each developmental line, I suggest that it may be useful to conceptualize primary femininity and the phallic castration complex as affect-defense configurations which incorporate two fundamentally different ideas about danger. In conflicts of primary femininity, danger is anticipated: anxiety is the signal for compromise formation, since what is actually possessed (the female genital) is valued and is therefore imagined as subject to danger. In the phallic castration complex, danger is imagined already to have occurred. Depressive affect becomes the primary motive for defense, based on a fantasy that what is valued (the male genital) has already been lost. This distinction may facilitate our efforts to specify exactly how recent revisions in theories of female development have explicit implications for practice.

Adult↗
PubMed1995

Telling about the analyst's pregnancy.

Pregnancy is one of several events in the life of an analyst which may affect an analysis, calling for special technical considerations. For the analyst, this exception to the tenet of anonymity, along with countertransference guilt, narcissistic preoccupation, heightened infantile conflicts, and intense patient responses, may stimulate anxiety that becomes focused on the timing and manner of informing the patient. For the patient, preoccupation with the timing of the telling may serve as a displacement from other meanings of the pregnancy. Candidate analysts may face particular difficulties managing the impact of their pregnancies on control cases. We address practical and technical considerations in telling, the transference and counter-transference surrounding it, ethical concerns, and the challenges of supervising a pregnant candidate.

Adult↗