This art of psychoanalysis

It is the art of psychoanalysis in the making, a process inventing itself as it goes, that is the subject of this paper. The author articulates succinctly how he conceives of psychoanalysis, and offers a detailed clinical illustration. He suggests that each analysand unconsciously (and ambivalently) is seeking help in dreaming his 'night terrors' (his undreamt and undreamable dreams) and his 'nightmares' (his dreams that are interrupted when the pain of the emotional experience being dreamt exceeds his capacity for dreaming). Undreamable dreams are understood as manifestations of psychotic and psychically foreclosed aspects of the personality; interrupted dreams are viewed as reflections of neurotic and other non-psychotic parts of the personality. The analyst's task is to generate conditions that may allow the analysand-with the analyst's participation-to dream the patient's previously undreamable and interrupted dreams. A significant part of the analyst's participation in the patient's dreaming takes the form of the analyst's reverie experience. In the course of this conjoint work of dreaming in the analytic setting, the analyst may get to know the analysand sufficiently well for the analyst to be able to say something that is true to what is occurring at an unconscious level in the analytic relationship. The analyst's use of language contributes significantly to the possibility that the patient will be able to make use of what the analyst has said for purposes of dreaming his own experience, thereby dreaming himself more fully into existence.     

DREAMING THE ANALYTIC SESSION: A CLINICAL ESSAY

This is a clinical paper in which the author describes analytic work in which he dreams the analytic session with three of his patients. He begins with a brief discussion of aspects of analytic theory that make up a good deal of the context for his clinical work. Central among these concepts are (1) the idea that the role of the analyst is to help the patient dream his previously “undreamt” and “interrupted” dreams; and (2) dreaming the analytic session involves engaging in the experience of dreaming the session with the patient and, at the same time, unconsciously (and at times consciously) understanding the dream. The author offers no “technique” for dreaming the analytic session. Each analyst must find his or her own way of dreaming each session with each patient. Dreaming the session is not something one works at; rather, one tries not to get in its way.     

On psychoanalytic supervision

The author provides both a theoretical context for, and clinical illustrations of, the way in which he thinks and works as a psychoanalytic supervisor. The analytic supervisory experience is conceived of as a form of 'guided dreaming'. In the supervisory relationship, the supervisor helps the analyst to dream (to do conscious and unconscious psychological work with) aspects of the analytic relationship that the analyst is unable to dream or is only partially able to dream. It is the task of the supervisory pair to 'dream up' the patient, that is, to create a 'fi ction' that is true to the supervisee's emotional experience with the analysand. To carry out this work, the supervisor must provide a frame that ensures the supervisee's freedom to think and dream and be alive to what is occurring in the analytic and the supervisory relationship, as well as in the interplay between the two. In one of the clinical illustrations presented, the author illustrates his conception of the importance of the feeling on the part of supervisor and supervisee that (at least occasionally) they have 'time to waste'. Such a state of mind may provide an opportunity for a type of freely associative thinking that enhances the range and depth of what can be learned from the supervisory experience. In another clinical example, the author describes his own experience in supervision with Harold Searles, which contributed to his conception of the supervisory process.     

The Primary Process: Freud’s Profound Yet Neglected Contribution to the Psychology of Consciousness

ABSTRACT

The primary process model is part of Freud’s struggle to define and distinguish conscious and unconscious mental activity. He created two embryonic models of unconscious mind. One he derived from studying symptoms of dynamic repression or sequestration of content already capable of symbolic mental representation. The other, the primary process, is his landmark effort to define a mental activity different from reflective representational thought, derived from studying dreaming. He could not clearly separate the repression model, as it is also based on the primary process. He vacillated as to whether the primary process is qualitatively different from representational symbolic thought. His efforts to articulate preconscious mentation suggest an ambiguous gray area between conscious thought and the primary process. Although he concluded that the primary process is unconscious because it is not intrinsically reflective, its manifestations are psychologically conscious and directly evident except in the physiologically unconscious state of dreaming. Similar problems color the efforts of others including Klein, Matte-Blanco, and theorists of attachment and implicit learning to separate conscious and unconscious mind and to articulate a model of mental function different from reflective consciousness. A model of conscious mental activity different from reflective representational consciousness, called primordial consciousness, is proposed to account for a wide spectrum of human phenomena both normal and pathological that share characteristics of immediacy and belief. They include, in addition to dreaming, psychosis, creativity, spirituality, and mental process in non-western cultures.     

Another look at dreaming: disentangling Freud's primary and secondary process theories

The Interpretation of Dreams contains Freud's first and most complete articulation of the primary and secondary mental processes that serve as a framework for the workings of mind, conscious and unconscious. While it is generally believed that Freud proposed a single theory of dreaming, based on the primary process, a number of ambiguities, inconsistencies, and contradictions reflect an incomplete differentiation of the parts played by the two mental processes in dreaming. It is proposed that two radically different hypotheses about dreaming are embedded in Freud's work. The one implicit in classical dream interpretation is based on the assumption that dreams, like waking language, are representational, and are made up of symbols connected to latent unconscious thoughts. Whereas the symbols that constitute waking language are largely verbal and only partly unconscious, those that constitute dreams are presumably more thoroughly disguised and represented as arcane hallucinated hieroglyphs. From this perspective, both the language of the dream and that of waking life are secondary process manifestations. Interpretation of the dream using the secondary process model involves the assumption of a linear two-way "road" connecting manifest and latent aspects, which in one direction involves the work of dream construction and in the other permits the associative process of decoding and interpretation. Freud's more revolutionary hypothesis, whose implications he did not fully elaborate, is that dreams are the expression of a primary mental process that differs qualitatively from waking thought and hence are incomprehensible through a secondary process model. This seems more adequately to account for what is now known about dreaming, and is more consistent with the way dream interpretation is ordinarily conducted in clinical practice. Recognition that dreams are qualitatively distinctive expressions of mind may help to restore dreaming to its privileged position as a unique source of mental status information.     

Psychoanalytic transformations1

The author describes how Bion took Freud's conception of dreams as a form of thought and used it as the basis of his theory of transformations. Bion developed an expanded theory of ‘dream thought’, understood as a process of selection and transformation of sensory and emotional experiences. In this theory, the work of analysis is in turn conceived as a process not only of deciphering symbols, of revealing already existing unconscious meanings, but also of symbol production‐of a process for generating thoughts and conferring meaning on experiences that have never been conscious and never been repressed because they have never been ‘thought’. Analysis, in its specific operational sense, becomes a system of transformation whereby unconscious somatopsychic processes acquire the conditions for representability and become capable of translation into thoughts, words and interpretations. The rules of transformation applied by the patient in his representations and those applied by the analyst in his interpretations have the same importance for the analytic process as those described by Freud for the process of dreaming. The author discusses the broad categories of transformation adduced by Bion (rigid motion, projective, and in hallucinosis) and introduces some further distinctions within them.     

On talking-as-dreaming

Many patients are unable to engage in waking-dreaming in the analytic setting in the form of free association or in any other form. The author has found that 'talking-as-dreaming' has served as a form of waking-dreaming in which such patients have been able to begin to dream formerly undreamable experience. Such talking is a loosely structured form of conversation between patient and analyst that is often marked by primary process thinking and apparent non sequiturs. Talking-as-dreaming superficially appears to be 'unanalytic' in that it may seem to consist 'merely' of talking about such topics as books, films, etymology, baseball, the taste of chocolate, the structure of light, and so on. When an analysis is 'a going concern,' talking-as-dreaming moves unobtrusively into and out of talking about dreaming. The author provides two detailed clinical examples of analytic work with patients who had very little capacity to dream in the analytic setting. In the first clinical example, talking-as-dreaming served as a form of thinking and relating in which the patient was able for the first time to dream her own (and, in a sense, her father's) formerly unthinkable, undreamable experience. The second clinical example involves the use of talking-as-dreaming as an emotional experience in which the formerly 'invisible' patient was able to begin to dream himself into existence. The analyst, while engaging with a patient in talking-as-dreaming, must remain keenly aware that it is critical that the difference in roles of patient and analyst be a continuously felt presence; that the therapeutic goals of analysis be firmly held in mind; and that the patient be given the opportunity to dream himself into existence (as opposed to being dreamt up by the analyst).     

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.     

Consciousness during dreams

Two aspects of consciousness are first considered: consciousness as awareness (phenomenological meaning) and consciousness as strategic control (functional meaning). As to awareness, three types can be distinguished: first, awareness as the phenomenal experiences of objects and events; second, awareness as meta-awareness, i.e., the awareness of mental life itself; third, awareness as self-awareness, i.e., the awareness of being oneself. While phenomenal experience and self-awareness are usually present during dreaming (even if many modifications are possible), meta-awareness is usually absent (apart from some particular experiences of self-reflectiveness) with the major exception of lucid dreaming. Consciousness as strategic control may also be present in dreams. The functioning of consciousness is then analyzed, following a cognitive model of dream production. In such a model, the dream is supposed to be the product of the interaction of three components: (a) the bottom-up activation of mnemonic elements coming from LTM systems, (b) interpretative and elaborative top-down processes, and (c) monitoring of phenomenal experience. A feedback circulation is activated among the components, where the top-down interpretative organization and the conscious monitoring of the oneiric scene elicitates other mnemonic contents, according to the requirements of the dream plot. This dream productive activity is submitted to unconscious and conscious processes.     

On teaching psychoanalysis

Teaching psychoanalysis is no less an art than is the practice of psychoanalysis. As is true of the analytic experience, teaching psychoanalysis involves an effort to create clearances in which fresh forms of thinking and dreaming may emerge, with regard to both psychoanalytic theory and clinical practice. Drawing on his experience of leading two ongoing psychoanalytic seminars, each in its 25th year, the author offers observations concerning (1) teaching analytic texts by reading them aloud, line by line, in the seminar setting, with a focus on how the writer is thinking/writing and on how the reader is altered by the experience of reading; (2) treating clinical case presentations as experiences in collective dreaming in which the seminar members make use of their own waking dreaming to assist the presenter in dreaming aspects of his experience with the patient that the analytic pair has not previously been able to dream; (3) reading poetry and fi ction as a way of enhancing the capacity of the seminar members to be aware of and alive to the effects created by the patient's and the analyst's use of language; and (4) learning to overcome what one thought one knew about conducting analytic work, i.e. learning to forget what one has learned.     

Associative dreaming: reverie and active imagination

The idea of countertransference has expanded beyond its original meaning of a neurotic reaction to include all reactions of the therapist: affective, bodily, and imaginal. Additionally, Jung's fundamental insight in 'The psychology of the transference' was that a 'third thing' is created in the analysis, but he failed to demonstrate how this third is experienced and utilized in analysis. This 'analytic third', as Ogden names it, is co-created by analyst and analysand in depth work and becomes the object of analysis. Reverie, as developed by Bion and clinically utilized by Ogden, provides a means of access to the unconscious nature of this third. Reverie will be placed on a continuum of contents of mind, ranging from indirect to direct associative forms described as associative dreaming. Active imagination, as developed by Jung, provides the paradigm for a mode of interaction with these contents within the analytic encounter itself. Whether the analyst speaks from or about these contents depends on the capacity of the patient to dream. Classical amplification can be understood as an instance of speaking about inner contents. As the ego of the analyst, the conscious component, relates to unconscious contents emerging from the analytic third, micro-activations of the transcendent function constellate creating an analytic compass.     

Conscious dream synthesis as a method of learning about dreaming: a pedagogic experiment

Stimulated by Freud's comments on the unique perspectives offered by "building up dreams by synthesis," the authors applied this idea to the St. Louis Psychoanalytic Institute's introductory course on the psychology of dreaming. Each student was assigned the task of purposefully and consciously synthesizing a dream, utilizing certain assigned information and meeting the specified criteria. In the use of this device, it was anticipated that the conscious active effort required to duplicate the usually passively experienced processes of dreaming and the unconscious dream work would lead to a deeper understanding and appreciation of the dream.     

Dream actors in the theatre of memory: Their role in the psychoanalytic process2

The author notes that neuropsychological research has discovered the existence of two long‐term memory systems, namely declarative or explicit memory, which is conscious and autobiographical, and non‐declarative or implicit memory, which is neither conscious nor verbalisable. It is suggested that pre‐verbal and pre‐symbolic experience in the child's primary relations is stored in implicit memory, where it constitutes an unconscious nucleus of the self which is not repressed and which influences the person's affective, emotional, cognitive and sexual life even as an adult. In the analytic relationship this unconscious part can emerge essentially through certain modes of communication (tone of voice, rhythm and prosody of the voice, and structure and tempo of speech), which could be called the ‘musical dimension’ of the transference, and through dream representations. Besides work on the transference, the critical component of the therapeutic action of psychoanalysis is stated to consist in work on dreams as pictographic and symbolic representations of implicit pre‐symbolic and pre‐verbal experiences. A case history is presented in which dream interpretation allowed some of a patient's early unconscious, non‐repressed experiences to be emotionally reconstructed and made thinkable even though they were not actually remembered.     

Transcending the caesura: Reverie,dreaming and counter‐dreaming

The author reflects about our capacity to get in touch with primitive, irrepresentable, seemingly unreachable parts of the Self and with the unrepressed unconscious. It is suggested that when the patient's dreaming comes to a halt, or encounters a caesura, the analyst dreams that which the patient cannot. Getting in touch with such primitive mental states and with the origin of the Self is aspired to, not so much for discovering historical truth or recovering unconscious content, as for generating motion between different parts of the psyche. The movement itself is what expands the mind and facilitates psychic growth. Bion's brave and daring notion of ‘caesura’, suggesting a link between mature emotions and thinking and intra‐uterine life, serves as a model for bridging seemingly unbridgeable states of mind. Bion inspires us to ‘dream’ creatively, to let our minds roam freely, stressing the analyst's speculative imagination and intuition often bordering on hallucination. However, being on the seam between conscious and unconscious, dreaming subverts the psychic equilibrium and poses a threat of catastrophe as a result of the confusion it affords between the psychotic and the non‐psychotic parts of the personality. Hence there is a tendency to try and evade it through a more saturated mode of thinking, often relying on external reality. The analyst's dreaming and intuition, perhaps a remnant of intra‐uterine life, is elaborated as means of penetrating and transcending the caesura, thus facilitating patient and analyst to bear unbearable states of mind and the painful awareness of the unknowability of the emotional experience. This is illustrated clinically.     

On psychoanalytic writing

Analytic writing constitutes a literary genre of its own. It involves the linking of an analytic idea (developed in a scholarly manner) with an analytic experience created in the medium of language. What makes this literary genre so demanding is that experience-including analytic experience-does not come to us in words. This fact generates a paradox that lies at the core of analytic writing: analytic experience (which cannot be said or written) must be transformed into 'fi ction' (an imaginative rendering of experience in words) in order to convey to the reader something of what is true to the emotional experience that the analyst had with the patient. The author discusses a clinical passage from one of his recently published papers in an effort to demonstrate some of the conscious and unconscious thinking that goes into his writing. He then looks closely at the way the language works in a successful piece of theoretical analytic writing. The paper concludes with a discussion of a number of facets of the author's experience with analytic writing including the psychological 'state of writing', which is at once a meditation and a wrestling match with language; experimenting with the form (structure) of an analytic essay; and the question of originality in analytic writing.     

The countertransference dream1

Can the analyst's night‐dream about his patient be considered as a manifestation of countertransference‐and, if so, under what conditions? In what way can such a dream represent more than just the disguised fulfillment of a repressed wish of the analyst? Is there not a risk of the analyst unconsciously taking up and ‘using’ the content of a session or other elements coming from the analytic situation for his own psychic reasons? The author, closely following Freud's dream theory, shows the mechanisms which can allow us to use the dream content in the analytical situation: preserved from the secondary processes of conscious thinking, other fantasies and affects than in the waking state can emerge in dream thought, following an ‘unconscious perception’. After examining the countertransference elements of Freud's dream, ‘Irma's injection’, which leads off The interpretation of dreams, the author presents a dream of her own about a patient and its value for understanding affects and representations which had hitherto remained unrepresented.     

Clinical conversations between psychoanalysis and imaginative literature

A literary form created by an imaginative writer captures something of the way the author shapes emotional experience and psychologically engages with it. The manner in which experience is created and contained in an imaginative literary text has much in common with the way experience is generated and worked with in the psychoanalytic situation. The author describes a clinical experience in which there was a collapse of the analytic (imaginative) space. He then discusses how he made use of a "conversation" he created with a short story and his own analytic experience to restore his imaginative capacities and to resume psychological work with the patient.     

On holding and containing, being and dreaming

Winnicott's concept of holding and Bion's idea of the container-contained are for each of these analysts among his most important contributions to psychoanalytic thought. In this light, it is ironic that the two sets of ideas are so frequently misunderstood and confused with one another. In this paper, the author delineates what he believes to be the critical aspects of each of these concepts and illustrates the way in which he uses these ideas in his clinical work. Winnicott's holding is seen as an ontological concept that is primarily concerned with being and its relationship to time. Initially the mother safeguards the infant's continuity of being, in part by insulating him from the 'not-me' aspect of time. Maturation entails the infant's gradually internalizing the mother's holding of the continuity of his being over time and emotional fl ux. By contrast, Bion's container-contained is centrally concerned with the processing (dreaming) of thoughts derived from lived emotional experience. The idea of the container-contained addresses the dynamic interaction of predominantly unconscious thoughts (the contained) and the capacity for dreaming and thinking those thoughts (the container).