God of the hinge: treating LGBTQIA patients

This paper looks at systems of gender within the context of analysis. It explores the unique challenges of individuation faced by transsexual, transgender, gender queer, gender non‐conforming, cross‐dressing and intersex patients. To receive patients generously we need to learn how a binary culture produces profound and chronic trauma. These patients wrestle with being who they are whilst simultaneously receiving negative projections and feeling invisible. While often presenting with the struggles of gender conforming individuals, understanding the specifically gendered aspect of their identity is imperative. An analyst's unconscious bias may lead to iatrogenic shaming. The author argues that rigorous, humble inquiry into the analyst's transphobia can be transformative for patient, analyst, and the work itself. Analysis may, then, provide gender‐variant patients with their first remembered and numinous experience of authentic connection to self. Conjuring the image of a hinge, securely placed in the neutral region of a third space, creates a transpositive analytic temenos. Invoking the spirit of the Trickster in the construction of this matrix supports the full inclusion of gender‐variant patients. Nuanced attunement scaffolds mirroring and the possibility of play. Being mindful that gender is sturdy and delicate as well as mercurial and defined enriches the analyst's listening.     

Chilled to the bone: embodied countertransference and unspoken traumatic memories

Starting from a deeply challenging experience of early embodied countertransference in a first encounter with a new patient, the author explores the issues it raised. Such moments highlight projective identification as well as what Stone (2006) has described as ‘embodied resonance in the countertransference’. In these powerful experiences linear time and subject boundaries are altered, and this leads to central questions about analytic work. As well as discussing the uncanny experience at the very beginning of an analytic encounter and its challenges for the analytic field, the author considers ‘the time horizon of analytic process’ (Hogenson 2007 ), the relationship between ‘moments of complexity and analytic boundaries’ (Cambray 2011 ) and the role of mirror neurons in intersubjective experience.     

Working in the borderland: early relational trauma and Fordham's analysis of ‘K’

This paper outlines a view of early relational trauma as underlying borderline states of mind, and argues that Knox's 1999 paper on internal working models and the complex provides a basis for understanding such states of mind. The author argues that in addition to internal working models, the complex also embodies and contains primitive defences of the core self. He outlines how these apply on the objective, subjective, transference and archetypal levels, and in direct and reversed forms and applies this to the account of Fordham's analysis of his patient ‘K’, which ended in impasse. The paper explores the dynamic that emerged in that analysis and suggests that it could be helpfully accounted for in terms of the co‐construction and re‐construction of early relational trauma in the analytic relationship.     

Imaginal action: towards a Jungian conception of enactment,and an extraverted counterpart to active imagination

This theoretical paper considers the fashion in which Jung's psychology radically challenges modern assumptions concerning the nature of subjectivity. With an eye for the clinical implications of Jung's late work, the author introduces the idea of imaginal action. In order to explain what is meant by this, the paper begins by exploring how Jung's thinking demonstrates an underlying bias towards introversion. It is argued that while Jung's interest in synchronicity ultimately resulted in his developing a worldview that might address the introverted biases of his psychology, the clinical implications of this shift have not been sufficiently clarified. With reference to some short examples from experience, the author outlines a conception of relational synchronicity wherein the intrapsychic emerges non‐projectively within the interpersonal field itself. Comparing and contrasting these occurrences to the more introverted practice of active imagination, it is claimed that such a notion is implicit in Jung's work and is needed as a corrective to his emphasis on interiority. The author suggests that imaginal action might be conceived as a distinctly Jungian approach to the psychoanalytic notion of enactment. It is also shown how the idea outlined might find further support from recent developments in the field of transpersonal psychology.     

Psychological implications of a vision disorder

The paper discusses how the condition of crossed‐eyes affects a baby's eye contact with mother and potentially results in the loss of a vital emotional connection with her during the earliest days of life. This loss may contribute to a rupture that arrests emotional development at a deep psychic level. It is suggested that, in the same way as premature separation, the rupture can precipitate a ‘fusional complex’, a defence that develops to protect the infant against psychotic anxieties. The paper proposes that psychological development atrophies in this place and creates a blind spot. These ideas are explored through analytic theory and developmental literature. The dreams of a patient and his art are used to illustrate a 10‐year ‘alchemical’ process of bringing repressed material into consciousness and transformation. Healing the psychological wounds of deficits in early eye contact may be found to bring sight to a blind spot that was created by the nature of the condition itself.     

Confronting Bluebeard: totalitarian regimes in childhood and in the collective psyche

Beginning with the story of Bluebeard, the author considers how traumatic overwhelm can occur in everyday childhood situations of a psychically murderous quality; for example, a nanny’s totalitarian regime may be invisible to parents ruled by collective social and cultural norms. A child who is remote from mother and idealises a father embodying a powerful patriarchal system may remain naïvely dependent in marriage and unable to cope with the realities of human aggression. The paper describes analytic work with a woman who had suffered repeated breakdowns and needed to relinquish a fragile, socially constructed identity in order to establish her own true orientation.     

Intersubjectivity and the creation of meaning in the analytic process

By means of a clinical illustration, the author describes how the intersubjective exchanges involved in an analytic process facilitate the representation of affects and memories which have been buried in the unconscious or indeed have never been available to consciousness. As a result of projective identificatory processes in the analytic relationship, in this example the analyst falls into a situation of helplessness which connects with his own traumatic experiences. Then he gets into a formal regression of the ego and responds with a so‐to‐speak hallucinatory reaction—an internal image which enables him to keep the analytic process on track and, later on, to construct an early traumatic experience of the analysand.     

The analyst's Rorschach: gateway to opening the dialectical field

The author offers an account of his evolving relationship with the Rorschach test which for over 20 years as a private practice psychologist, he used in his clinical practice with the intent of mining patients’ psyches for useful information about personality organization and functioning . Coinciding with having found himself on the homestretch of analytic training and during a time when he desired clarity on how Rorschach assessment and Jungian analysis could fruitfully merge, there was an unexpected shift in emphasis wherein the Rorschach suddenly became a method for looking at himself as well. This challenge to identify and integrate aspects of self hitherto neglected was found to enrich his clinical practice. An historical perspective on this experience is offered which highlights the enigmatic relationship that existed between Carl Jung and Hermann Rorschach. The proverbial question of ‘What might this be?’ has been asked when administering the Rorschach for nearly a century. From an analytic perspective, the question is more fully and meaningfully asked when the person doing the asking has also been willing to step in, look around, and take notice of what happens.     

The mirror and the hammer: the politics of resacralization

The paper consists of the opening chapter of Andrew Samuels’ book The Political Psyche, published in 1993, together with a retrospective introduction. In the chapter, the author discussed the possibilities and limitations of applying depth psychological thinking to social and political problematics. He situates the attempt to make such applications within a wider movement to refresh and reform Western political endeavours. He terms this wider project ‘resacralization’. The author cautions against psychological reductionism and a simplistic approach to market‐based capitalism, calling for a transformation of the latter to the degree possible. He links sociopolitical criticism and psychological writings on numinous experience, thereby connecting the worlds of politics and depth psychology without losing their separate and unique qualities.     

The analytic setting today: using the couch or the chair?

This paper re‐visits Murray Jackson's 1961 paper in the Journal of Analytical Psychology, ‘Chair, couch and countertransference’, with the aim of exploring the role of the couch for Jungian analysts in clinical practice today. Within the Society of Analytical Psychology (SAP) and some other London‐based societies, there has been an evolution of practice from face‐to‐face sessions with the patient in the chair, as was Jung's preference, to a mode of practice where patients use the couch with the analyst sitting to the side rather than behind, as has been the tradition in psychoanalysis. Fordham was the founding member of the SAP and it was because of his liaison with psychoanalysis and psychoanalysts that this cultural shift came about. Using clinical examples, the author explores the couch/chair question in terms of her own practice and the internal setting as a structure in her mind. With reference to Bleger's (2013) paper ‘Psychoanalysis of the psychoanalytic setting’, the author discusses how the analytic setting, including use of the couch or the chair, can act as a silent container for the most primitive aspects of the patient's psyche which will only emerge in analysis when the setting changes or is breached.     

Acoustic resonance at the dawn of life: musical fundamentals of the psychoanalytic relationship

This paper uses a case vignette to show how musical elements of speech are a crucial source of information regarding the patient's emotional states and associated memory systems that are activated at a given moment in the analytic field. There are specific psychoacoustic markers associated with different memory systems which indicate whether a patient is immersed in a state of creative intersubjective relatedness related to autobiographical memory, or has been triggered into a traumatic memory system. When a patient feels immersed in an atmosphere of intersubjective mutuality, dialogue features a rhythmical and tuneful form of speech featuring improvized reciprocal imitation, theme and variation. When the patient is catapulted into a traumatic memory system, speech becomes monotone and disjointed. Awareness of such acoustic features of the traumatic memory system helps to alert the analyst that such a shift has taken place informing appropriate responses and interventions. Communicative musicality (Malloch & Trevarthen 2009) originates in the earliest non‐verbal vocal communication between infant and care‐giver, states of primary intersubjectivity. Such musicality continues to be the primary vehicle for transmitting emotional meaning and for integrating right and left hemispheres. This enables communication that expresses emotional significance, personal value as well as conceptual reasoning.     

The image schema and innate archetypes: theoretical and clinical implications

Based in contemporary neuroscience, Jean Knox's 2004 JAP paper ‘From archetypes to reflective function’ honed her position on image schemas, thereby introducing a model for archetypes which sees them as ‘reliably repeated early developmental achievements’ and not as genetically inherited, innate psychic structures. The image schema model is used to illustrate how the analyst worked with a patient who began life as an unwanted pregnancy, was adopted at birth and as an adult experienced profound synchronicities, paranormal/telepathic phenomena and visions. The classical approach to such phenomena would see the intense affectivity arising out of a ruptured symbiotic mother‐infant relationship constellating certain archetypes which set up the patient's visions. This view is contrasted with Knox's model which sees the archetype an sich as a developmentally produced image schema underpinning the emergence of later imagery. The patient's visions can then be understood to arise from his psychoid body memory related to his traumatic conception and birth. The contemporary neuroscience which supports this view is outlined and a subsequent image schema explanation is presented. Clinically, the case material suggests that a pre‐birth perspective needs to be explored in all analytic work. Other implications of Knox's image schema model are summarized.     

The analyst and analysand as citizens in the world

Beginning with Jung's reflections on individuation as a starting point, this article examines the analytic relationship in the context of our current reality. The latter exerts pressures of all sorts that do not favour individuation. Indeed, geopolitical commentators see present‐day society as marked globally by excessive self‐love that seeks to dominate, at the expense of the other. Given that such forms of dominance are now also very prevalent in the workplace, this article examines how to help the increasing number of individuals with highly successful professional careers who suffer from this pressure and who then seek analysis. ‘Progressive movement’, an indicator of and incentive to change, is examined by studying the narrative processes emerging from dream activity ‐ including dreaming with the hands in the sand tray ‐ in the co‐transference. The article highlights how ‘progressive movement’, founded on narrative Competence and on the reflective function, may generate experiences of ‘realistic hope’. The latter signals the start of an individuation process in the analytic couple and, simultaneously, the transformation of both the analyst and the analysand into good enough ‘citizens in the world’.     

Bridging worlds: participatory thinking in Jungian context

Introducing the ‘participatory’ paradigm associated with the work of transpersonalists Richard Tarnas and Jorge Ferrer, the author outlines an approach to Jung's archetypal thinking that might offer a more adequate basis in which to ground a non‐reductive approach to practice. In order to demonstrate the relevance of this outlook at the present time, the author begins by examining recent debates concerning the nature of ‘truth’ in the clinical setting. Reflecting on the difficulties analysts face in attempting to maintain professional authority without falling into an implicit authoritarianism, it is argued that any approach to therapy seeking to orient itself towards ‘the unconscious’ must posit the challenges of pluralism as a central concern for practice. With reference to the relationship between analytical psychology and the psychoanalytic mainstream, attention is drawn to the theoretical problems raised by the relational commitment to constructivist epistemologies, and a consequent tendency towards biological reductionism. Turning to the Jungian literature, similar tensions are observed at play in the present state of analytical psychology. Drawing attention to the process‐oriented qualities of Jung's work, it is suggested that the speculative nature of Jung's psychology offers a more adequate basis for contemporary practice than might be assumed.     

Revisioning Fordham's ‘Defences of the self’ in light of modern relational theory and contemporary neuroscience

This paper explores the evolution of Michael Fordham's ideas concerning ‘defences of the self’, including his application of this concept to a group of ‘difficult’ adult patients in his famous 1974 paper by the same name. After tracing the relevance of Fordham's ideas to my own discovery of a ‘self‐care system’ in the psychological material of early trauma patients (Kalsched 1996 ), I describe how Fordham's seminal notions might be revisioned in light of contemporary relational theory as well as early attachment theory and affective neuroscience. These revisionings involve an awareness that the severe woundings of early unremembered trauma are not transformable through interpretation but will inevitably be repeated in the transference, leading to mutual ‘enactments’ between the analytic partners and, hopefully, to a new outcome. A clinical example of one such mutual enactment between the author and his patient is provided. The paper concludes with reflections on the clinical implications of this difficult case and what it means to become a ‘real person’ to our patients. Finally, Jung's alchemical views on transference are shown to be useful analogies in our understanding of the necessary mutuality in the healing process with these patients.     

The use of Skype in analysis and training: a research and literature review

Of recent years there has not only been an increasing use of Skype in analytic treatment, supervision and teaching, but also a number of writers have been endeavouring to assess its effectiveness. Whilst it is generally agreed that Skype can facilitate an analytic encounter where distance prohibits a face‐to‐face process, where continuity needs to be maintained and where analysands are in areas far from specialized centres, there is divergence in the literature as to whether analysis, as opposed to psychotherapy, can be successful using Skype. This paper reviews the literature and concludes that the essentials of a genuine analytic process are not necessarily precluded by Skype. One central reason is because there exists a cross‐modal communication channel between the human senses (underpinned by audiovisual mirror neurons) in addition to the recently discovered instinct for communication and interpersonal understanding, and these can override the need for physical proximity of the participants. The essentials of an analytic frame can thus be maintained, and the continuity that Skype enables means that containment is also facilitated and this counters the negative aspects of shuttle analysis. The critical issues for the profession then become the professional development for practitioners in the use of Skype and suggestions are listed.     

Working with chronic and relentless self‐hatred,self‐harm and existential shame: a clinical study and reflections

This paper is the first of a two‐part series which explores some of the theoretical and experiential reference points that have emerged in my work with people whose relationship to their body and/or sense of self is dominated by self‐hatred and (what Hultberg describes as) existential shame. The first paper focuses on self‐hatred and the second paper focuses on shame. This first paper is structured around vignettes taken from a 14‐year analysis with a woman who was bulimic, self‐harmed and repeatedly described herself as ‘feeling like a piece of shit’. It draws together elements of Jung's concepts of the complex and symbol, and Laplanche's enigmatic signifier to focus on experiences of ‘inner otherness’ around which we are unconsciously organized. It also brings Jung's understanding that emotion is the chief source of consciousness into conversation with Laplanche's approach to the transference which is that by being aware that they do not ‘know’, the analyst provides a ‘hollow’ in which the patient's analytic process can evolve. These combinations of ideas are linked speculatively to emerging understandings of the neuroscience of perception and throughout the paper clinical material is used to illustrate these discussions.     

Self‐disclosure,trauma and the pressures on the analyst

This paper argues that self‐disclosure is intimately related to traumatic experience and the pressures on the analyst not to re‐traumatize the patient or repeat traumatic dynamics. The paper gives a number of examples of such pressures and outlines the difficulties the analyst may experience in adopting an analytic attitude – attempting to stay as closely as possible with what the patient brings. It suggests that self‐disclosure may be used to try to disconfirm the patient's negative sense of themselves or the analyst, or to try to induce a positive sense of self or of the analyst which, whilst well‐meaning, may be missing the point and may be prolonging the patient's distress. Examples are given of staying with the co‐construction of the traumatic early relational dynamics and thus working through the traumatic complex; this attitude is compared and contrasted with some relational psychoanalytic attitudes.     

Political and clinical developments in analytical psychology, 1972‐2014: subjectivity,equality and diversity—inside and outside the consulting room

Utilizing Jung's idea of theory as a ‘personal confession’, the author charts his own development as a theorist, establishing links between his personal history and his ideas. Such links include his relationship with both parents, his sexuality, his cultural heritage, and his fascination with Tricksters and with Hermes. There follows a substantial critical interrogation of what the author discerns as the two main lines of clinical theorizing in contemporary analytical psychotherapy: interpretation of transference‐countertransference, and the relational approach. His conclusion is that neither is superior to the other and neither is in fact adequate as a basis for clinical work. The focus then shifts to explore a range of political and social aspects of the clinical project of analytical psychology: economic inequality, diversity within the professional field, and Jung's controversial ideas about Jews and Africans. The author calls for an apology from the ‘Jungian community’ for remarks about Africans analogous to the apology already issued for remarks about Jews. The paper is dedicated to the author's friend Fred Plaut (1913‐2009).