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PubMed2006

On the psychodynamics of collecting.

The urge to collect is a ubiquitous phenomenon which has anthropological, sociobiological and individual psychodynamic roots, but occurs far more frequently among men than women. The author examines the reasons for this gender difference and defines systematic collecting to distinguish it from addictive, obsessive and messy collecting, and from related phenomena such as perversion. The mode of collecting and choice of object are important indicators as to the unconscious psychodynamics of a collector and offer opportunity to describe his structural level. Collecting ranges across a broad spectrum, from an ego-syntonic integrated mode, i.e. sublimation, to a neurotic defence against pre-oedipal or oedipal traumas and conflicts. Alongside this drive-theoretical approach, object and Kleinian theory are also applied to the understanding of collecting. Collecting represents a specific form of object relating and way of handling primary loss trauma, which is different from addiction, compulsion, or perversion. Under certain circumstances collecting can also result in a successful Gestalt or way of life. The paper concludes with a case study showing how collecting develops from a pre-oedipal to a more integrated oedipal mode during the course of the analysis, which is reflected in changes in the transference.

Adult↗
PubMed2002

A Lacanian look at English elegance: some reflections on Ian McEwan's enduring love.

This paper makes use of certain thought-provoking ideas from Lacan's seminars in the years between 1959 and 1962 in order to engage with the very subtly conveyed inner drama that subtends the plot of Ian McEwan's novel Enduring Love. Freud, in his 1914 paper 'On narcissism', had referred to theories on the earliest moments of subjectivity as 'nebulous, scarcely imagined concepts'. In 1959 Lacan created a concept that he called the o-object to make incursions into theories on the lasting impact of the anxiety-ridden passage of the small pre-subject into subjective existence. In particular, the seminar on Anxiety (1962-3), for all the convolutions of syntax and sense that render it so difficult to read, opens up reflections on this topic that are not dissimilar to those stimulated by McEwan's accomplished prose. Both Lacan and McEwan explore the problematic dissolution of the everyday distinction between subjectivity and objectivity attendant on the upsurge of anxiety driven by unconscious forces.

Anxiety↗
PubMed2006

Self, other and dialogical space in autistic disorders.

The authors propose to re-evaluate Tustin's thesis using both the extensive clinical material of a child with an autistic disorder [PDD], and current research on infant development. Beebe's concept of 'interaction structure' that could be inferred from the fifth month of life using face-to-face research data is used for postulating a dialogic space that would be generated inside such structure, allowing for definition of self and other in a relationship. If such space is collapsed, the other would be a threat of annihilation for the self, thus it should be avoided or merged with, which could explain the systematic avoidance of the not-me in autistic states. The authors stress that these ideas are just one alternate model, among several, that seems to be able to explain the patient's deviant development.

Autistic Disorder↗
PubMed2006

Where are you, my beloved? On absence, loss, and the enigma of telepathic dreams.

The subject of dream telepathy (especially patients' telepathic dreams) and related phenomena in the psychoanalytic context has been a controversial, disturbing 'foreign body' ever since it was introduced into psychoanalysis by Freud in 1921. Telepathy- suffering (or intense feeling) at a distance (Greek: pathos + tele)-is the transfer or communication of thoughts, impressions and information over distance between two people without the normal operation of the recognized sense organs. The author offers a comprehensive historical review of the psychoanalytic literature on this controversial issue, beginning with Freud's years-long struggles over the possibility of thoughttransference and dream telepathy. She then describes her own analytic encounter over the years with five patients' telepathic dreams-dreams involving precise details of the time, place, sensory impressions, and experiential states that the analyst was in at that time, which the patients could not have known through ordinary sensory perception and communication. The author's ensuing explanation combines contributory factors involving patient, archaic communication and analyst. Each of these patients, in early childhood, had a mother who was emotionally absent-within-absence, due to the absence of a significant figure in her own life. This primary traumatic loss was imprinted in their nascent selves and inchoate relating to others, with a fixation on a nonverbal, archaic mode of communication. The patient's telepathic dream is formed as a search engine when the analyst is suddenly emotionally absent, in order to find the analyst and thus halt the process of abandonment and prevent collapse into the despair of the early traumatization. Hence, the telepathic dream embodies an enigmatic 'impossible' extreme of patient-analyst deep-level interconnectedness and unconscious communication in the analytic process. This paper is part of the author's endeavour to grasp the true experiential scope and therapeutic significance of this dimension of fundamental patient-analyst interconnectedness.

Adult↗
PubMed2006

Psychotic withdrawal and the overthrow of psychic reality.

The author attempts to distinguish between the world of fantasy and the imagination (which fuels our capacity to 'dream') from a withdrawal into fantasy. In this withdrawal, the foundations of which are laid in childhood, a dissociation from psychic reality starts and from it the delusional world arises and constitutes the adult illness. During therapies of adult patients who have experienced a psychotic state, it is often possible to reconstruct the state of infantile withdrawal and understand how their dissociation from reality was ignored or unknowingly encouraged by their parents. Children destined to develop psychosis enter into the dissociated world not just as a defence against anguish or loneliness, but also for the pleasure of experiencing a delusional self-sufficiency and a gratifying omnipotence in which anything is possible. Mental workings that take place in the withdrawal do not follow the rules governing normal psychic functioning. Those fantasies cannot be either repressed or 'dreamed' in order to be transformed into thoughts. These psychopathological structures, which develop early and autonomously, have to be understood during analytical therapy in their origins and 'deconstructed' in order to help the patient to escape from their dominion. By means of clinical examples, the author tries to shed light on the possible ways of reaching patients in their psychotic shelters, thereby helping them to re-emerge into a psychic reality.

Adolescent↗
PubMed2005

False memories, negative affects, and psychic reality: the role of extra-clinical data in psychoanalysis.

Psychoanalysis as a treatment originated in the idea that neurosis is related to the ways in which individual psychic reality departs from actuality. Psychic reality includes memories, beliefs and their associated affects and fantasies connected with an individual's experience of the inner and outer world. The psychoanalytic determination of what meaningful memories or beliefs are inaccurate, distorted or false ordinarily relies upon principles of intra-clinical validation. By itself, however, intra-clinical validation is subject to limitations and pitfalls that conviction alone about what is actual cannot circumvent. Despite this fact, there are remarkably few analytic case reports demonstrating false or significantly distorted memories through the use of data obtained from outside the consulting room. This paucity of reports may be related, at least in part, to the belief that the use of extra-clinical data is essentially unanalytic or supports resistance. Based on the views that (a) psychic reality cannot be regarded as exclusively subjective or objective but is inherently both; and that (b) a goal of analysis is to achieve a different, acceptable and more accurate view of reality, the authors report a clinical case involving a confirmably false pivotal memory and its associated negative affects. They discuss theoretical and technical considerations in utilizing extra-clinical data during the treatment process.

Adult↗
PubMed2006

All holes are the same: emerging from the confusion.

The author describes a type of mental development in which the primitive libidinal value of faeces and urine is kept unaltered all through adulthood. In this instance, individuals harbour fantasies of projective identification with the internal parents, denying their real dependence, which leads to a pseudomaturity. These fantasies are usually accompanied by anal and genital masturbation and have intense aggressive content. Furthermore, there is a significant confusion among all body orifices, leading to an inability to distinguish the self from the object, the inner world from outside reality. Individuals with this type of development can only maintain limited object relations and have highly erotized excretory activities. Manipulation of faeces may occur. This structure works as a defence against breakdown, but may also provide pleasure as it gives the illusion of omnipotent control of the object, as typical in pathological organizations. The author presents clinical material and discusses the difficulties of the analysis, in which the patient tries to seduce the analyst into colluding with his mental functioning, primarily as a means of communication as well as a projection of his despair and his disbelief in the analyst's ability to help him.

Adult↗
PubMed2006

Who speaks? Who looks? Who feels? Point of view in autobiographical narratives.

In this paper, the author aims to substantiate Freud's claim that neurotic illness creates gaps in autobiographical narratives in terms of the narrator's stating and inducing perspectives. He sketches out the role of narrative perspective and the joint taking of a shared perspective by analyst and patient in psychoanalytic therapy. He introduces four ways of representing perspectives in narratives. Three degrees of narrative distortion are exemplified by three excerpts from life narratives and explored in terms of narrative perspective representation. The most comprehensive perspective representation is achieved in the first example by explicitly stating the present perspective of the narrator as well as the past perspective of the story's protagonist by use of mental verbs. In the second narrative, exclusive use of linguistic forms for inducing the protagonist's perspective both overwhelms the narrator and gives the listener an incomplete picture of what happened. Inconsistent motives, denial of responsibility and omission of detail render the third narrative even more difficult to follow. The author discusses the clinical significance of this exploratory analysis of perspectives in narratives in terms of claiming responsibility for one's past action and of level of defence mechanisms, and by highlighting the emotional impact on listeners, which the author suggests is the stronger the more perspectives are left out. He discusses analogies to countertransference. The analysis of narrative perspectives offers an approach for systematic research in psychoanalytic practice.

Adult↗
PubMed2006

The myths of free association and the potentials of the analytic relationship.

The author challenges the traditional and still prevalent view of 'free association', arguing that it entails three forms of denial (also formulated in terms of corresponding myths): 1) denial of the patient's free agency; 2) denial of the patient's and the analyst's interpersonal influence; and 3) denial of the patient's share of responsibility for co-constructing the analytic relationship. That responsibility includes some degree of consideration of the analyst's needs. Sometimes, the patient's good judgment to that end may be reflected in what is automatically and mistakenly reduced to a form of 'resistance'. Attention to the patient's responsibility must be balanced against the effort to provide a uniquely safe environment for the patient's revealing of shame and anxiety-ridden feelings and attitudes. But the therapeutic action of psychoanalysis, ideally, includes the cultivation, through lived experience, of the dialectical interplay of self-expression, on the one hand, and caring relational engagement, on the other. Recognition of the patient's free agency does not preclude exploration of constraining structures laid down in the past. On the contrary, it deepens such exploration. At the same time, it opens the door to the possibility of explicit recognition, via challenge, criticism, or affirmation, of the patient's contributions to the analytic work.

Adult↗
PubMed2006

The analyst's countertransference to the psychoanalytic process.

There is countertransference, not just to individual patients, but to the process of psychoanalysis itself. The analytic process is a contentious topic. Disagreements about its nature can arise from taking it as a unitary concept that should have a single definition whereas, in fact, there are several strands to its meaning. The need for the analyst's free associative listening, as a counterpart to the patient's free associations, implies resistance to the analytic process in the analyst as well as the patient. The author gives examples of the self-analysis that this necessitates. The most important happenings in both the analyst's and the patient's internal worlds lie at the boundary between conscious and unconscious, and the nature of an analyst's interventions depends on how fully what happens at that boundary is articulated in the analyst's consciousness. The therapeutic quality of an analyst's engagement with a patient depends on the freeing and enlivening quality, for the analyst, of the analyst's engagement with his or her countertransference to the analytic process.

Awareness↗
PubMed2006

Dreams that mirror the session.

Dreams in which the analyst appears undisguised almost always depict violations of the setting. Often experienced as special, epiphanic moments, they give a glimpse of an intense, emotional reaction to traumatogenic or otherwise significant events that have occurred during the session or in the most recent previous ones. Probably, the essential aspect of these dreams can be found in the 'form of their content'. This may be paralleled by the narrative technique of mise en abyme or mirror-text. The dream appears as a story within the main story and the scene of the analysis is reflected anti-illusionistically. The fictional structure of the setting is emphasized. Its theatrical self-consciousness quality is revealed at its best. The author postulates that the transformative therapeutic value of these dreams derives from denouncing the referential illusion of 'concrete reality' and of 'what really happened'. For the analysand, they are an effective (i.e. emotionally intense) opportunity to discover the spatial articulations and the staggering refractions of the inside/outside, the textual/extra-textual, the psychic reality/material reality. In the continual comings and goings from one term to another, the work of symbolization is reactivated and the subject is constructed. Dreams that mirror the session, from this point of view, provide a model for conceptualizing the analytic work, and their significance goes beyond the specific phenomena referred to. A clinical case is given, in which some of one patient's dreams are considered as they occurred over a short period. In one of them, the dream-within-a-dream phenomenon is present.

Adult↗
PubMed2005

The theory of transformations and autistic states. Autistic transformations: a proposal.

This work integrates two areas of thinking: one in which the author develops considerations regarding observation methods of mental phenomena in psychoanalysis according to Bion's theory of transformations; the other in which she is concerned with the investigation of primitive mental states--protomental states--more specifically, the autistic states of neurotic patients, described by Tustin. Some ideas on the 'philosophical' position underlying transformations theory are elaborated, particularly emphasizing the idea that the same phenomenon in psychoanalysis may be considered from different perspectives, as long as it is situated within the theoretical reference frame to which it belongs. The author considers the idea that this method of phenomenon observation is part of a wider context of general human knowledge, in which uncertainty and relativity of concepts are the main components. By adopting transformations theory as a perspective of phenomena observation that pervades the analytical meeting, the author questions whether it is possible to include other groups of transformation of emotional experiences in this theory, which shows particular phenomena with specific qualities, distinct from those emphasized by Bion. She hypothesizes that autistic phenomena present in neurotic patients, characterizing autistic states, may be considered and detached, making up a particular group of transformation of emotional experience, which analysts often face in their daily practice. She names this group 'autistic transformations'.

Autistic Disorder↗
PubMed2006

Cultural function and psychological transformation in psychoanalysis and psychoanalytic psychotherapy.

Cultural experience of silence and individual vicissitudes between talking and being silent influence the way individuals form an alliance and pursue the analytic process. This is of relevance both for the patient and for the psychoanalyst/therapist. The author describes a patient, whose silent phase occurred in the fifth and sixth year of intensive psychoanalytic psychotherapy. She suggests that a) the silence functioned as a protection of a space for the core self and promoted inner transformation and psychological development; b) the silence involved a transference-countertransference matrix with projective identifications of the patient's internalized mother- and father-related objects that caused a tenuous balance between maintaining and erasing the relationship between the patient and the author; c) the silence phase was highly influenced by the author's own cultural background and what she brought into the relationship of tolerance of being silent in the presence of another, and understanding of the many complex functions of silence. During the silent phase the patient moved from simply describing and naming her affects and inner experiences or expressing them as somatic processes, to being able to internally access and verbally convey her own affects and experiences in the therapeutic alliance. This process involved both affect desomatization, affect differentiation, and affect verbalization.

Adult↗
PubMed2005

Missing what was true: problems of seeing and knowing in Henry James's The wings of the dove.

The author examines a central theme in this late novel by Henry James in relation to current psychoanalytic ideas that link the Oedipus complex with the child's developing perception of reality (both psychic and external), specifically through the experience of seeing and being seen. Britton visualises the oedipal triangle as a psychic structure through which the child may achieve recognition not only of its parents' sexual relationship, from which it is excluded, but also of itself being observed by one parent while the child is with the other. Thus, it both observes and is observed. The differing perspectives achieved--of subjectivity and objectivity--promote the perception of objective reality, as the world of relationships grows and becomes more complex. James captures with great subtlety and penetration the experience of three characters living out a symbolic oedipal relationship in which the truth is evaded or perverted. A young couple in love exploit the situation of a dying heiress whose vulnerability is intensified by her reluctance to acknowledge the truth about their relationship. At the same time, she shrinks from the gaze of others and consigns herself to isolation and ultimate despair. The author presents three significant scenes in which seeing and being seen are central to the development. In each, the dying woman is forced to face, if momentarily, her exclusion from the sexual relationship. Increasingly this connects with her approaching death--but also with the anguished recognition that the couple have cruelly befriended her only to betray her. It is suggested that James's late style and novelistic technique require the reader to tolerate confusion and uncertainty. As the perspective shifts from one protagonist to another, we ourselves are in danger of 'missing what is true' in this characteristic Jamesian scenario, where relationships are gradually perverted by manipulation, evasion and lies. In psychoanalytic theory, this would represent a failure to work through the oedipal situation, where the struggle of the child to face reality is met by a parental relationship that is too weak or too perverse to contain the pain and conflict.

Famous Persons↗
PubMed2006

The controversial discussions and après-coup.

The author suggests a distinction between what is descriptively named après-coup, and what is dynamically identified as après-coup. This parallels Freud's distinction between the descriptive unconscious and the dynamic unconscious in the topographical model of the mind. The descriptive après-coup refers to the way in which the concept has found a use, especially but not only in the French literature, to refer to retrospective signification in the moment-to-moment progress of a session. The author outlines dynamic après-coup and she suggests it is at the core of Freudian metapsychology. Dynamic après-coup establishes a link between trauma, castration, repetition compulsion, sexuality and temporality in the context of the transference.

Adult↗