ACUTE ENACTMENT AS A 'RESOURCE' IN DISCLOSING A COLLUSION BETWEEN THE ANALYTICAL DYAD

The author discusses various aspects of the function of enactment in analytical practice, reviewing the concept, then describing a borderline patient with whom the analytic process seemed to be developing productively. Following a change in the setting, an intense, acute enactment took place. Understanding this led to observation of an unconscious collusion, in which a symbiotic relationship had been established between the patient, the analyst and his family, as a chronic enactment. This relationship had prevented the analyst from touching on highly destructive unconscious fantasies and archaic traumatic situations. Comprehension of the enactment enabled the collusion to be dissolved. The author suggests that, besides the resistance aspect, the collusion may have been useful in strengthening the patient's mental mechanisms and trust in the analytical work, which required some time. The acute enactment arose, unveiling the collusion, when the patient and the analyst felt able to face the terrible feelings related to the triangular situation. He speculates that both enactments may occur in the analysis of these kinds of patients, as part of the 'natural history' of the analytical process, and their function is to relive archaic experiences in the analysis, also with the aim of working them through. Finally, the author proposes a classification of enactments: normal, pathological, acute and chronic.     

Narrating the Unsayable: Enactment,Repair, and Creative Multiplicity in Group Psychotherapy

This article introduces an approach to group analysis that places dissociation of traumatic experience at the center of group interaction. Healing in group is regarded as hinging on the enactment of unformulated and dissociated experience and affect. Enactments are regarded as involving the members of the group, the group as a whole, and the group analyst. Clinical examples are offered to illustrate the enactment of dissociated trauma that was unable to be suffered earlier and the enactment of absence and neglect that is non-represented. In this hermeneutic conception, the group comes to narrate what has happened but never been experienced, and healing accrues through the group’s witnessing and making affectively real what was hitherto unsayable and unthinkable. The group analyst uses and shares his or her own experience to facilitate this process.     

Whose Who in the Psychoanalytic Situation: Subject,Object, and Enactment in the Relational and Contemporary Kleinian Traditions

The concept of enactment, although it has probably has become an overused term in the Relational literature, is a relatively new one for the Contemporary Kleinians of London. In explicating and synthesizing these different theoretical perspectives (Relational and Contemporary Kleinians), the author's primary focus is to tackle the notion of subject and object, in the context of enactment. The author first delineates the relationship between reality and fantasy, and each theory's notion of enactment. In doing so, the author shows how these differing theories and their related notion of therapeutic action inform the kind of object the analyst sees himself or herself as. The author also addresses the technical implications related to the consequences that arise for the analyst as an object of the patient's transferences and projections, including how the analyst extricates himself or herself from the enactment. Two previously published vignettes are used for the purpose of comparison. The author argues for a complementary technical stance comprising two analytic modes: analyst as subject and analyst as object.     

The wish to regress in patient and analyst

The analyst's wish to regress is used as a paradigm of the "forbidden" topic of what analysts want from their analysands. The aim is to expand the subjective domain of analysts' awareness so that they can analyze better by grasping more of their temptations with patients before enactment can occur. Clinical examples illustrate how the author temporarily joined patients in wish-fulfilling mutual regression. Analytic process is disrupted when the analyst wishes to relinquish the more differentiated role of the containing and interpreting analyst in favor of more childlike relatedness both with the patient and with the analyst's internal objects. The author, expecting a more typical counter-transference, had not anticipated that he might temporarily join these nonpsychotic patients in mutual regression. It is suggested that in the face of analytic impasse analysts should consider whether they might temporarily have joined the patient in mutually regressive wishes that have taken them away from more responsible analytic functioning.     

Boundary and analytic attitude: reflections on a summer holiday break

The effect of a boundary in analytic work at the summer holiday break is discussed in relation to archetypal experiences of exclusion, loss and limitation. Some attempts by patients to mitigate an analyst's act of separation are reviewed as enactments, and in particular the meanings of a gift made by one patient. Analytic attitude towards enactment from within different schools of practice is sketched, with reference to the effect on the analyst of departing from the received practice of their own allegiance. A theory is adumbrated that the discomfort of ‘contravening the rules’ has a useful effect in sparking the analyst into consciousness, with greater attention to salient features in an individual case. Interpretation as an enactment is briefly considered, along with the possible effects of containing the discomfort of a patient's enactment in contrast to confronting it with interpretation.     

Enactments: an intersubjective perspective.

We offer a critique and synthesis of classical and interpersonal views of enactment. From an intersubjective standpoint, the study of enactment leads to a reconsideration of the nature of the psychoanalytic process. And enactment becomes virtually synonymous with the psychoanalytic process. Enactments are interactions of analysand and analyst with communicative and resistive meanings that lead to valuable insight and can constitute corrective emotional experiences. Enactments that are recognized and defined become valuable dramatizing moments that have condensing, clarifying, and intensifying effects upon consciousness. The inevitable participation by the analyst in enactment is compatible with appropriate analytic discipline. A case will demonstrate these points.     

Prozedurale Faktoren in der psychoanalytischen Behandlung

The traditional concept of acting out was redefined in the context of intersubjective approaches as enactment. When a resistance was previously recognized in the analysis of classical neuroses that had to be resolved for a promising analysis, in enactment the creative preverbal expressions of covert procedural experiences can now be recognized, which become revealed in regressive states and in structural disorders. They create scenes of preverbal communication in which the analyst becomes involved in the inner world of experiences. This has a strong reparative potential. It can be utilized for new experiences and development if the analyst becomes entangled in such scenes as a co-actor, accepts the relationship offer of the patient and contributes to solutions for the entanglement; however, this requires something more comprehensive than the traditional defensive concept of transference. It emphasizes in particular the activity of the analyst and its impact on the formation of the analytical process and recognizes the involvement of the analyst as a constitutive factor in the process of his own transference. Thus, a new definition of abstinence in terms of a selective abstinence is achieved, which is nowadays characteristic of the developmental approach in psychoanalytic treatment.     

REPORTING A DREAM ACCOMPANYING AN ENACTMENT IN THE TRANSFERENCE SITUATION

Patients with pathological organisations of the personality present the analyst with considerable technical difficulties. One of these problems arises from the fact that, in such patients, dreams frequently are not being used for communication of unconscious meaning, but instead for purposes of manipulation of the transference situation. They then represent attempts to identify the analyst with a part of the patient's self or with a particular internal object in order to draw him/her into collusive enactments. Following the work of Bion and Segal the paper presents a two-dimensional model in order to clarify the structure and use of dreams in this situation. The model may serve as a background orientation for the analyst in the clinical situation, as is subsequently illustrated in a detailed clinical sequence with a borderline patient. To conclude, the author suggests that whenever tendencies towards acting in are predominant, the interpretation of the enactment should generally be given preference over the interpretation of the dream content. The possible advantages and disadvantages of both strategies of interpretation are discussed. Finally, the author highlights consequences that arise when dealing with countertransference.     

Working with Enactment: The Analyst’s Willingness to Be Both Confrontive and Vulnerable

ABSTRACT

One of the most fascinating and perplexing expressions of unconscious-to-unconscious communication is enactment. Having been accepted as inevitable, the actual clinical management of enactment remains somewhat vague, as analysts continue the tradition of not often specifying exactly what they say and do in the clinical hour. The fact that enactment involves a mutual conflict, where both analyst and patient feel out of control, contributes to the difficulty in articulating a path forward once enactment has occurred. This article presents a case where 2 enactments threatened to end the treatment and required the analyst to assume a position of being both confrontive and vulnerable.     

Vitalizing Enactment: A Relational Exploration

Drawing from her extensive work with deeply disturbed children Alvarez (2012) theorized a form of intervention termed “vitalization” in which the analyst actively reaches out to contact and “reclaim” her most inaccessible patients, engaging them in the world of emotions and relationships. In this paper I consider Alvarez’s ideas through the lens of Relational thought, reconceptualizing vitalization as a unique form of enactment that can draw the analytic dyad from deadened impasse into enlivened contact. In vitalizing enactment embryonic affects, hopes, and longings find expression and are potentiated for patient and analyst alike. This is a view of enactment as a progressive and creative lived experience, rather than an unconscious collision to be survived and symbolized. I contextualize vitalizing enactment in relation to Alvarez’s original formulations as well as relevant contemporary theories and present a clinical vignette to illustrate this paper’s themes.     

The unfolding and healing of analytic boundary violations: personal, clinical and cultural considerations

Jungian analysts are not exempt from an unconscious engagement in a group complex. The author hypothesizes that there is a silent, dark legacy of belief in the superiority of men's judgment and the inferiority of women's, left by Jung, that has had a wounding impact on some Jungian analysands. Conscious and public mourning may be needed to heal our cultural complex. The author, a woman, traces the origins of her own patriarchal complexes and reveals how in her first analysis these mingled with the patriarchal complex shared by Jungian institute, her two male analysts and their former analyst, a pillar of the institute's community. Her first analyst aborted her analysis to begin a personal partnership with her. Her second analyst unconsciously colluded with the first analyst in not exploring this outcome as a violation. This resulted in a second compromised treatment. The senior analyst who had been these two analysts' own analyst was consulted, and he too failed to address the transgression. After experiencing severe symptomatology, the patient entered a third analysis with a woman where transference and regression were the focus. Eventually, meaning was found in the confrontations with the particular Jungian organization and its ethics committee, who acknowledged the first analyst's behaviour to be unethical. The author sees this process as a paradigm for the enactment and healing of a group complex.     

Sadism,Penetration, and the Negotiation of Desire: Commentary on Paper by Csillag

The author takes up Csillag’s idea of sadism as the wish to penetrate in the context of a patient who withholds from his analyst. With such a patient, the analyst has to bear the strain stemming from a lack of both satisfaction and recognition–the feeling of not having an impact. The defenses against sadism are examined along with the absence of intentionality in both clinical cases presented, an absence that places sadism in the realm of something that is unconscious or preconscious. Alternative views are offered on the enactment between Csillag and her patient with a focus on the unspoken negotiation of desire and (drawing on Fairbairn) the analyst’s attempt to breach her patient’s closed system of internal objects.     

The analyst's implicit alpha-function, trauma and enactment in the analysis of borderline patients

The present paper discusses situations in which patient and analyst are involved in obstructive collusions, non-dreams-for-two, shaping enactments. Specifically, it describes explosions in the analytical field, acute enactments, which the analyst assigns, at first sight, to his faulty conduct. The subsequent amplification of the analytical dyad's capacity of symbolization makes the analyst investigate his presumed fault. The present work shows how acute enactments revive traumatic situations that were concealed by previous obstructive collusions, or chronic enactments. During chronic enactments unconscious exchanges occur between the dyad, in which the analyst provides implicit alpha-function to the patient, little by little recovering the traumatized parts. When there is enough recovery, the protective collusion is undone and the trauma is revived as acute enactment. This revival will not be traumatic because there are mental resources ready at hand to symbolize it. These situations are articulated with borderline patients. The patient clings to the analyst, using him as a protective shield against reality traumas. The implicit and explicit alpha-function exerted by the analyst contributes to the processing and symbolization of this reality, recovering the injured mind and elaborating the trauma. So the patient creates a triangular space to dream and think.     

From Dead to Alive: Desire,Dissociation and Passion in the Analytic Dyad

When patients present in a deadened state, the analyst may feel a sense of futility and shame in his efforts to have impact. This may cause him to withdraw and contribute to an enactment in which both participants purge themselves of wanting anything from the other, sapping the treatment of purpose and aliveness. The author presents a model in which the analyst can reawaken his desire for recognition and connection and utilize it to introduce the patient to his or her own dissociated longings. This involves fortitude on the therapist’s part, since he must withstand the rejection that had caused him to withdraw in the first place, and also be sensitive to the patient’s fear of retraumatization. But if the analyst can do this, he can not only break through the impasse, but enliven the patient and infuse the treatment with a sense of purpose and hope.     

Los Degradados: Out,down, dead: Transmitted and inflicted trauma as encountered in the analysis of a 6‐year‐old girl1

The author presents the analysis of a precocious traumatized little girl, which reveals the ways in which historical trauma is transmitted and intrafamilial trauma is both disguised and represented. The play as it evolves is seen to simultaneously communicate what the child struggles with and to resolutely try to hide what has actually happened. Analyst and child together participate in play which utilizes displacement, enactment and interactive enactment, the latter play mode being the very hallmark of profound traumatic experience. Carlotta, the child, helps the analyst to follow her quest for meaning making even as the interaction between them adheres to and departs from the deepening pentimenti of traumatic experience, which needs to be unraveled and reconstructed in order that her own developmental progression can be rejoined. The analysis facilitates Carlotta's capacity to play in a more unfettered fashion and to assist her family's recovery as well.     

Cyberpassion: E-rotic transference on the Internet.

While psychoanalysis has generally been regarded as "the talking cure," written communication from patient to analyst commonly appears within the analytic setting. In our electronic age, e-mail communications from patient to analyst have become commonplace. This paper describes a case of erotic transference conveyed primarily through e-mail messages, and discusses their multiple meanings as an enactment. The unique features of e-mail communication are explored and contrasted with verbal discourse in the analytic dyad.     

The pressure toward enactment and the hatred of reality.

The pressure toward enactment is investigated in terms of the threats that primitive, pre-thinking states of mind exert on attempts to know and understand. Clinical material and a review of the literature suggest that when the analyst confronts (by thinking) rather than complies (by action) with the hidden demands of omnipotence, he or she triggers and is then subject to the pre-thinking mental realm of concrete sensory bombardment, which can penetrate and obliterate his or her separately thinking mind. One important pressure driving the analyst toward enactment derives from a defensive response aimed at avoiding the threat of such concrete projections.