Some observations on the psychoanalytic process

The author's aim is to delineate the psychoanalytic process and to distinguish it from the psychoanalytic situation, the transference neurosis, "insight," and psychoanalytic technique in general. Freud's 1913 views provide the basis for a concept of the psychoanalytic process centered on the recognition and interpretation of resistances and on the patient's reactions to the analyst's interventions. This clinically observable "unit" of the process is described and compared with Bernfeld's "facts of observation." The proposition is advanced that the process does not come to an end with the termination of analysis. It continues postanalytically in the form of the patient's more objective and more effective capacity for self-observation. The paper closes with a warning about the "pitfalls of perfectibilism" and with a plea for the elevation of the not-so-good analytic hour.     

From Freud’s dream-work to Bion’s work of dreaming: The changing conception of dreaming in psychoanalytic theory

Bion moved psychoanalytic theory from Freud's theory of dream-work to a concept of dreaming in which dreaming is the central aspect of all emotional functioning. In this paper, I first review historical, theoretical, and clinical aspects of dreaming as seen by Freud and Bion. I then propose two interconnected ideas that I believe reflect Bion’s split from Freud regarding the understanding of dreaming. Bion believed that all dreams are psychological works in progress and at one point suggested that all dreams contain elements that are akin to visual hallucinations. I explore and elaborate Bion’s ideas that all dreams contain aspects of emotional experience that are too disturbing to be dreamt, and that, in analysis, the patient brings a dream with the hope of receiving the analyst’s help in completing the unconscious work that was entirely or partially too disturbing for the patient to dream on his own. Freud views dreams as mental phenomena with which to understand how the mind functions, but believes that dreams are solely the ‘guardians of sleep,’ and not, in themselves, vehicles for unconscious psychological work and growth until they are interpreted by the analyst. Bion extends Freud's ideas, but also departs from Freud and re-conceives of dreaming as synonymous with unconscious emotional thinking – a process that continues both while we are awake and while we are asleep. From another somewhat puzzling perspective, he views dreams solely as manifestations of what the dreamer is unable to think.     

Freud's baby: Beyond autoerotism and narcissism

The prevailing notion in the psychoanalytic literature is that Freud's thinking on neonatal object relations is completely captured in terms of his concepts of autoerotism and primary narcissism. Indeed, for Freud, autoerotism and primary narcissism conceptualize the earliest libido distributions, but these concepts do not exhaust Freud's model of early mental life. In this paper, the author endeavors to show that Freud's hypothetical infant arrives at autoerotism and narcissism at the expense of, and secondary to, primitive object-relatedness. More specifically, an appreciation of Freud's views on primitive object relations in light of the self-preservative instinct demonstrates his view that the infant is born into a state of mutual adaptation with the mother. The author makes detailed use of Freud's writings to show his conception of an infant who, from the inception of neonatal life, has the mental sophistication to maintain complex relations with instinctual objects, the sources of gratification or frustration, part-objects confusedly perceived because of cognitive immaturity and/or fantasy distortion. Such complexity includes the infant's capacity for primitive forms of perception, boundary formation, reality testing, and defensive, splitting-based projections and introjections.     

Recurring thoughts on unconscious ego resistances.

Analysis of the unconscious ego resistances is one of those clinical concepts more honored in the breach than in the observance. This same point has been made periodically over the past fifty years. It has not been sufficiently realized that a true psychoanalytic understanding of resistance analysis could only begin with Freud's second theory of anxiety. Freud himself never fully embraced this theory, and clinical contributions since then have varied in their ability to use the techniques inherent in the second theory of anxiety. Recent contributions to the literature have not eliminated the espousal of theories of resistance based on earlier views of anxiety. Reasons cited for this include: the ambiguities in Freud's writing, the direction of the early ego theorists, and proclivities toward deeper interpretations.     

Toward a psychoanalytic iconography

In describing the principles of psychoanalytic iconography, I follow a historical approach, pointing out that the rudiments of such an interpretive mode are present in Freud's works on Leonardo and on the Moses of Michelangelo and reach a classical expression in Kris's paper on Messerschmidt. Some recent scholarly studies of works of art rest on the incorporation of psychoanalysis into contemporary views of the nature of man, thus permitting a level of analysis of art not previously attained. The interface between a psychoanalytic understanding of the artist's life and preoccupations and the unconscious content present in the work itself continues to offer an opportunity for refining the analytic tool as an instrument for understanding aesthetic response and creativity.     

Freud's Irma dream and the origins of psychoanalysis

This paper investigates Freud's Irma dream as a response, in part, to the publication of Studies on Hysteria (Breuer & Freud, 1893-1895). As such, Freud's dream and associations reveal a great deal regarding the origins of psychoanalysis. The preamble to the dream reflects Freud's concern with the ground rules and boundaries of the psychotherapeutic technique that he was in the process of developing. This paper cites evidence for Freud's concerns regarding the consequences of alterations in these basic tenets. The Irma dream and Freud's associations also convey a deep and apparently unconscious concern within Freud in respect to the concept of transference, which he may have realized on some level had been used to defensively deny disturbing inputs by the therapist into the treatment situation and patient. The dream may be understood also as reflecting a deep sense of concern regarding unrecognized harmful effects of psychoanalytic psychotherapy and Freud's concern that the treatment process might be more destructive than helpful. The curative aspects of psychotherapy are viewed in terms of action-discharge rather than insight. In all, this reanalysis of the Irma dream focuses on Freud's unconscious conflicts, fantasies, and anxieties at a time when he, along with Breuer, presented a burgeoning psychoanalytic treatment modality to the professional world.     

Mental health – a normal state?

ABSTRACT

How can we conceptualize mental health; what is the relation between mental health and normality; and what has psychoanalysis to say about these questions? After a short resume of the views concerning normality and melancholia in the last centuries, the author turns to Freud and Bion. For Freud, mental health at best seems to be a relatively mild neurotic state, and perfect mental health is an unattainable ideal. Bion underlines the dynamic nature of the concept; mental health comprehended as a process. Problems connected to the individual’s subjective view of his or her mental health are considered, and some consequences that the questions under discussion have for psychoanalytic treatment are discussed. The author concludes with a reflection on the complex relation between mental health and normality.     

Erikson's General and Adult Developmental Revisions of Freudian Thought: “Outward,Forward, Upward”

In this paper I explore Erik Erikson's revisions of Freudian thought and reasons for his conceptual departure. I show Erikson as the second stage psychoanalytic theorist who shifted thought upward in consciousness, outward to the social world, and forward throughout the complete life span. I explore Erikson's dispute of Freud's reductionism and predeterminism, and illustrate Erikson's movement afield of a model of mental illness, fragmentation, and negation. I explore Erikson's view that the social world is both inside and outside the psyche, rather than solely external to the person as Freud had held. Addressed is Erikson's conversion of Freud's notions of adult morality to a developmental view of the adult as a potentially moral–ethical person, and Erikson's revision of Freud's concepts of the potentially rational adult to a view of the adult with rational and emotional attributes. These words are Erikson's (1975, p. 39) terms for his theoretical focus. Erikson said that he had felt compelled to alter Freudian views, for the second stage psychoanalytic thought in which he participated required a focus on healthy development instead of attention to deviations from health. Such thought also required analysis of the importance of consciousness and of engagement in the social world, as well as a theory of adult development that extends throughout the mature years to chart the person's psychosocial growth and the development of principled behavior. To Erikson, Freud's views were reductionistic due, in part, to their placement within Newtonian and Darwinian thought. Further, Freud's thought was based on the assumption of an invariably moral person, and of the human who would eventually rise above the irrational powers that he found to govern the self. In this paper, I take up these points. I look to Erikson's revisions of Freudian thought, emphasizing the ways in which he made us think differently about psychological life and about adults in their ongoing development. This synthesis adheres to the points Erikson himself made about his departure from Freud, thoughts that appear in Erikson's (1987b) Harvard notes and marginalia, in his audiotapes, and in portions of his published writings.     

The psychoanalytic view of phobias. Part I: Freud's theories of phobias and anxiety.

This paper initiates a series of communications on psychoanalytic and current psychiatric approaches to the understanding and treatment of phobic syndromes with a review and discussion of Freud's evolving ideas on phobias and anxiety. A list of issues that any theory of phobic syndromes must address is compiled on the basis of Freud's work.     

Some Characteristics of Dreams in Group - Analytic Psychotherapy

Abstract

Group psychoanalytic theory rests on many of the same psychoanalytic assumptions as individual psychoanalytic theory but has been slow in developing its own language and unique understanding of conflict within the group, as many group phenomena are not the same as individual psychic events. Regressive fantasies and alliances within and to the group are determined by group composition and the interaction of fantasies among members and leader. Bion’s useful but incomplete early abstract formulation of psychic regression in groups was the initial attempt to move beyond Freud’s largely sociological view. This paper explores some of the origins of Bion’s neglect of murderous violence in groups as a result of his own experiences in the first European war. In the following, I present evidence for the existence of a violent basic assumption and offer evidence as to Bion’s avoidance of murderous and violent acts.     

Sacrifice: Psychodynamic,Cultural and Clinical Aspects

Noting that the topic of sacrifice has remained largely unaddressed in psychoanalytic literature, the authors offer a discussion of it. Their elucidation of sacrifice opens with the definition and etymology of the word and moves on to the place of sacrifice in various religious traditions. They then summarize Freud's views on the topic and suggest that the subsequent analytic contributions have gone in three directions: the first extends and modifies Freud's proposal of triadic-hostile origins of sacrifice, the second locates such origins in dyadic and loving relations, and the third seeks to synthesize the foregoing trends. The authors then delineate the triad of altruism, masochism, and narcissism that underlie sacrifice. They propose that a spectrum of phenomena, ranging from healthy to pathological, is subsumed under the rubric of sacrifice. They also discuss the significance of such ideas to the conduct of psychotherapy and psychoanalysis.     

Interpretation as Freud's specific action,and Bion's container‐contained

This is a paper showing how a concept central to the work of Wilfred Bion, and one of Klein's important recommendations concerning the practice of analysis with adults and small children, can both be seen in the light of Freud's earliest formulation of the origin of anxiety and the mother's first responses to her infant in distress. In the paper I suggest that these clinically influential concepts of Klein and Bion show an underlying consistency and affinity with Freud's early ideas about the management of anxiety in the mother‐infant relationship, described in two of his pre‐psychoanalytic writings, How Anxiety Originates (1894b), and The Project for a Scientific Psychology (1950 [1895]). The specific mode of operation of psychoanalytic interpretation is clarified by the comparisons made, with no attempt to suggest that Klein or Bion based their concepts upon these particular early formulations of Freud's.     

Freud's great voyage of discovery

The author discusses some of Freud's most significant contributions: the psychoanalytic method, called free association by Freud; the discovery that symptoms have a meaning and that every symptom is a compromise formation; the interpretation of dreams; psychic determinism; the central role of infantile sexuality; and sublimation. Included is a brief review of the views of some noteworthy analysts, all of whom agree in ignoring the importance of infantile sexuality and/or in minimizing its importance.     

The way of authenticity and the quest for personal integrity1,2

The author reviews the respective conceptions of authenticity proposed by the existentialist philosophers, Fredrich Nietzsche and Martin Heidegger, each of whom situate it in the inherent difficulty of resisting the herd instinct in one's interpersonal relationships, then sets out to show how, despite the absence of authenticity as a technical term in the psychoanalytic lexicon, the technical principles of psychoanalysis enumerated by Freud are compatible with the views of both Nietzsche and Heidegger. The author then gives examples of other psychoanalytic authors who similarly embrace the spirit of authentic relating in their conception of the clinical situation, including the work of D. W. Winnicott, Wilfred Bion, and Jacques Lacan. The author concludes that in the psychoanalytic context the imposition and experience of suffering are invaluable components of authenticity and therapeutic change.     

The mind: psychoanalytic understanding then and now

The author discusses the evolution of psychoanalytic understanding from Freud's time to the present, citing the influence of various sociocultural changes. He addresses Freud's proper place in history and notes ways in which Freud's contributions cast him as belonging to Romanticism. Freud's shift from the topographic model of the mind to the structural one, and the influence of this on psychoanalysis, is discussed, as well as important developments in the field since Freud. The author focuses particularly on difficulties encountered in psychoanalytic practice today, and he describes what he has termed organizing interpretations as uniquely valuable in the treatment setting.     

FREUD'S PRIVATE MINI-MONOGRAPH ON HIS OWN DREAMS: A CONTRIBUTION TO THE CELEBRATION OF THE CENTENARY OF THE INTERPRETATION OF DREAMS

A virtually unknown brief commentary by Freud on the characteristics of his own dreams is described and discussed. Freud's mini-monograph, discovered after some 80 years, has autobiographical, theoretical and organisational significance in the enigmatic context of the early development of psychoanalysis. Found among papers of Alfred Adler, this extraordinary document adds to our knowledge of psychoanalytic history, including the significance of dreams in the evolution of psychoanalytic thought. Freud's commentary permitted the identification of a particular dream as his own. This dream had been presented in anonymity to the fledgling Vienna Psychoanalytic Society for interpretation. The dream was later inserted, again anonymously, into The Interpretation of Dreams with Freud's own remarkable pre-oedipal interpretation. Freud's conflicted relationships with Adler and Jung are considered in historical context.     

Book reviews

Wilfred Bion is regarded as a psychoanalytic purist and his austere portrayal of the analytic aim and attitude is often considered to make impossible demands on patient and analyst alike. Not surprisingly, the applicability of Bion's theory and recommended practice to once-weekly psychotherapeutic work is often questioned. Bion is thus ambivalently regarded by psychotherapists as the embodiment of an analytic ideal, whose developmental theories are important, but whose practical utility is doubted, especially in the context of the typical therapeutic setting. This paper seeks to challenge these assumptions by presenting the once-weekly therapy of a woman with attenuated mentalizing capacity and a tendency to destructive acting out. The therapy was guided by the application of central concepts, models and ‘technical’ principles emerging from my understanding of Bion's work. The aim of the paper is to demonstrate that Bion's utility is not confined to formal psychoanalytic settings and that his work may be usefully applied in more modest psychotherapy contexts.     

From unity to atonement: Some religious correlates of Hans Loewald's developmental theory

Loewald's understanding of ego development offers a way to conceptualise, from a psychoanalytic perspective, those aspects of religious experience that can reflect or contribute to the enrichment of the ego, in contradistinction to the defensive and regressive elements of religious experience that have been well detailed in the psychoanalytic literature in the past. In Loewald's view, a dynamic and metabolic interplay between ego and reality characterises the developmental process. With increasing levels of internalisation, differentiation, individuation and integration, ego and reality are restructured into increasingly resilient and durable forms. An ongoing dialectical tension between separation and reunion provides the driving force for development. Loewald's emphasis on the synthetic rather than defensive aspects of ego functioning forms the basis for his characterisation of sublimation as a 'genuine appropriation' rather than a defence, thus opening up one way to understand non-defensive aspects of religious experience from a psychoanalytic perspective. In the course of this exploration of Loewald's view of ego development and its implications for an understanding of religious experience, the author offers perspectives on Freud's views of religion, on some extreme forms of religious fundamentalism, and on the dynamics of 'mature' faith as illuminated by Loewald's developmental theory.     

The myth of Freud's ostracism by the medical community in 1896-1905: Jeffrey Masson's assault on the truth

The story recounted by Jeffrey M. Masson of the medical community's outraged response to the seduction theory is treated as historical fact in some of the recent literature on Freud's early psychoanalytic experiences. In this article the evidence adduced by Masson in The Assault on Truth (1984) to buttress his account of Freud's supposed ostracism is critically examined. It is concluded that this evidence fails to substantiate Masson's version of events, that there is abundant evidence that refutes it, and that he has ignored the historical research that demonstrates that the notion that Freud's early psychoanalytic writings received an irrationally hostile reception is a myth.     

One Pilgrim's Progress Toward the Psychoanalytic Citadel

My psychoanalytic odyssey started in my childhood. My parents were avid readers of Freud and discussed his views with their friends. Our family doctor had been analyzed by Freud and spoke to my family about it on many occasions. I renewed my interest in psychoanalysis in college while studying English literature and then even more so in medical school, where we had a very inspiring department of psychiatry. My psychoanalytic training was to cross many frontiers: orthodox Freud, classical Freud, Fairbairn, Winnicott, and then Klein and Bion. I entered the field of psychoanalysis at a time when it was highly respected and virtually dominated the field of psychiatry, especially in medical schools. I have sadly watched its decline from popular favor and was even sadder to encounter its bitter divisiveness, especially in this country. Today psychoanalysis is left divisive and more variegated. Many different schools of thought have emerged that are now accorded legitimacy, fortunately. One might say that I have seen it at its best and at its worst but have not lost faith in its capacity to excite one's imagination and to inspire hope for a more evolved consciousness of self.