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.     

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.     

When culture fails: coping with cultural trauma

The research into the phenomenon of cultural trauma is growing as the effects of historical transformations are recognized and analysed. The concept of cultural trauma and the analytic concept of the cultural complex is a suitable theoretical approach for this research. The Lithuanian experience of cultural trauma after the historical shifts indicates the importance of the interplay between societal and individual factors in coping with trauma. Academic psychotraumatological studies carried out at Vilnius University indicate a stronger traumatic experience by people who are survivors of direct political repression and even intergenerational transmission of trauma, but this group also seems to demonstrate an intergenerational transmission of resilience. Paradoxically, from a long‐term perspective, the victims of direct repression seem to have suffered less than the people who accommodated to the regime, and this applies also to their offspring. Analysis in terms of overcoming cultural trauma indicates that society is gradually integrating historic traumatic experiences, although a healthy cultural identity has not yet been restored.     

The seventh penis: towards effective psychoanalytic work with pre‐surgical transsexuals

The author reflects on his contrasting analytic work with two transsexual patients. He uses three previous psychoanalytic studies (Stoller, Morel and Lemma) to explore whether effective analytic work with the issues driving a person's determined wish for sex reassignment surgery (SRS) is possible. Particular consideration is given to how such work might navigate a path between traumatizing and pathologizing the patient on the one hand and avoiding important analytic material out of fear of so doing on the other. The author proceeds to ask whether it is possible to tell in advance, with any degree of reliability, who is and who is not likely to benefit from surgery. He considers certain diagnostic issues in relation to these questions. Illustrations are given of how, in practice, countertransference anxieties about psychopathologizing transsexual patients can contribute to significant difficulties in working clinically with them. It is argued that the understanding and containment of such anxieties could eventually lead to more effective analytic work, and that such work might be further facilitated by considering the contribution of mind‐body dissociation to transsexualism.     

Uprooted minds: displacement,trauma and dissociation

The author, English born and living in Sydney, Australia, presents an argument for the usefulness of the recognition of the implicit simultaneous links between the following:

• development of psychic skin and the establishment of the body schema
• development of a sense of identity
• relationship with place

such that the formulation psychic skin< > mind < > body < > self < > place < > world can be thought of as an organising gestalt or implicit continuum of ‘skin’ experience and process upon which the explicit always depends. This constitutes a taken‐for‐granted ground‐plan of the self‐in‐place . The author follows this with an exploration of the consequences for psychic health of a traumatic rupture of this gestalt for both individual and group. Material from two cases is presented: first, a young woman whose family fled the Balkan wars which splintered the former Yugoslavia; second, the transmission of displacement trauma into the third generation of a family who arrived in Australia after WW II from the former Yugoslavia. For the purposes of this paper I will not make a distinction between migrants/exiles/refugees and instead refer to either displacement or dislocation.     

Foetal trauma,body memory and early infant communication: a case illustration

This paper presents the complex case of a male patient who started life as an unwanted pregnancy and adoptee in an era of socio‐cultural shame and blame. When able to contact his birth mother later in life, he experienced a number of confronting synchronicities as well as visions which he felt were related to failed abortion attempts and to other pre‐ and post‐natal events. The case material lends weight not only to Freud's, Ehrenwald's and FitzHerbert's assertions that the earliest form of mother‐infant communications is telepathic in nature but that this mode of communication can be retained if emotional trauma inhibits normal developmental processes. Contemporary neuroscience research is presented supporting the hypothesis that emotional memory can become imbedded in the psyche/soma of the foetus. Such memory traces can later emerge into imagery and/or words if the traumatic impingement has been substantial enough and if other defensive strategies are in place. Clinical implications are then suggested regarding analysts’ attention to the emotional conditions underpinning their patients’ conceptions and foetal development; the connection to projective identification components of the countertransference as being aspects of the earliest telepathic mother/infant communication channel and the need for reductive analyses in analyst training programmes.     

Disquiet in the consulting room: everything/nothing that is said here is confidential

Writing from experiences in the consulting room in private practice in Australia, the author refers to the layered complexity of a conflict of ethical duty which has legal and social implications. The paper explores how the ethics that are congruent with creating a safe vas bene claustrum can be diametrically opposed to the social and legal structures and processes on which we all rely. It is suggested that within the vas, analysts and analysands engage in a shared process of emotionally connected, layered, symbolic thinking. Subpoenas directed at analysts are seeking concrete evidence that will stand up in court. The paper argues that this is a category error based on ignorance and misconceptions of what analytic work entails. The intrusion of a subpoena into the vas has the potential to cause havoc in the mental health and the lives of already vulnerable, possibly traumatized and isolated individuals. It can undermine a fundamental human right and undermine the profession of psychotherapy as a whole. The paper proposes that analysts have an ethical obligation to protect the work contained within the vas from these category errors and to educate other professionals as to why we cannot provide the kind of evidence that the courts require.     

Early trauma and affect: the importance of the body for the development of the capacity to symbolize

In this paper I aim to outline the importance of working clinically with affect when treating severely traumatized patients who have a limited capacity to symbolize. These patients, who suffer the loss of maternal care early in life, require the analyst to be closely attuned to the patient's distress through use of the countertransference and with significantly less attention paid to the transference. It is questionable whether we can speak of transference when there is limited capacity to form internal representations. The analyst's relationship with the patient is not necessarily used to make interpretations but, instead, the analyst's reverie functions therapeutically to develop awareness and containment of affect, first in the analyst's mind and, later, in the patient's, so that, in time, a relationship between the patient's mind and the body, as the first object, is made. In contrast to general object‐relations theories, in which the first object is considered to be the breast or the mother, Ferrari (2004) proposes that the body is the first object in the emerging mind. Once a relationship between mind and body is established, symbolization becomes possible following the formation of internal representations of affective states in the mind, where previously there were few. Using Ferrari's body‐mind model, two clinical case vignettes underline the need to use the countertransference with patients who suffered chronic developmental trauma in early childhood.     

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.     

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.     

Mind,brain and body. Healing trauma: the way forward

The paper explores an interdisciplinary whole person approach to healing from trauma that conserves our rich inheritance from Jung but also takes on board insights from research in the areas of attachment, trauma and the neurobiology of emotion. It is now over 20 years since insights from neurobiology began to be used to inform clinical practice. The paper reviews key insights which have emerged, along with the ways they enable therapists to help mind, brain and body to heal and the ways in which they clarify why, in clinical practice, we do what we do. Traditionally the emphasis has been on words, interpretations, and meaning‐making. Currently there is greater appreciation of the affective, relational, embodied aspects of therapeutic work and the way in which these relate to traumatic early interactive experience that is held outside of human awareness. The ways in which knowledge of particular systems of connectivity inform understanding of the whole mind‐brain‐body relationship are examined. The way forward for clinical practice to become more focused in order to help clients to heal in mind and body is reviewed.     

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).     

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.     

On Murray Jackson's 1961 ‘Chair,couch and countertransference’

One of the problems facing psychoanalysts of all schools is that theory has evolved at a much faster pace than practice. Whereas there has been an explosion of theory, practice has remained, at least officially, static and unchanging. It is in this sense that Murray Jackson's 1961 paper is still relevant today. Despite the rise of the new relational and intersubjective paradigms, most psychoanalysts, and not a few Jungian analysts, still seem to feel that the couch is an essential component of the analytical setting and process. If the use of the couch is usually justified by the argument that it favours regression, facilitates analytical reverie and protects the patient from the influence of the analyst, over time many important psychoanalysts have come to challenge this position. Increasingly these analysts suggest that the use of the couch may actually be incompatible with the newer theoretical models. This contention is strengthened by some of the findings coming from the neurosciences and infant research. This underlines the necessity of empirical research to verify the clinical effectiveness of these different positions, couch or face‐to‐face, but it is exactly this type of research that is lacking.     

Synchronistic mind‐matter correlations in therapeutic practice: a commentary on Connolly (2015)

This commentary adds some ideas and refinements to the inspiring discussion in a recent paper by Connolly ( 2015 ) that makes use of a dual‐aspect framework developed by us earlier. One key point is that exceptional experiences (of which synchronicities are a special case) cannot in general be identified with experiences of non‐categorial or acategorial mental states. In fact, most exceptional experiences reported in the literature are experiences of categorial states. Conversely, there are non‐categorial and acategorial states whose experience is not exceptional. Moreover, the psychodynamics of a synchronistic experience contain a subtle mesh of interacting processes pertaining to categorial, non‐categorial and acategorial domains. We outline how this mesh may be addressed in particular cases of synchronicity described by Connolly.     

The latency complex: the dead hand of anti‐development

It is common knowledge that the same phenomena can be viewed in a variety of ways. This paper considers the implications of a constellation observed in some adult patients who have increasingly reminded the author of some of the children of latency age with whom he has also worked. In the literature these patients may also have been thought about in terms of ‘defences of the self’ (Fordham), patients who are ‘difficult to reach’ (Joseph), ‘psychic retreats’ (Steiner), and those who make ‘attacks on linking’ (Bion). They may equally be considered in terms of schizoid, narcissistic or borderline personalities, or as showing features on the autistic spectrum, such as mindlessness and extreme obsessionality. Writers such as Helene Deutsch with her concept of an ‘as‐if personality’, Winnicott with his ‘false self’, and Rosenfeld, discussing the split‐off parts of the personality in narcissistic patients, have also offered much to think about in their consideration of some of these phenomena. This paper proposes yet another vertex – the author's own imaginative conjecture – that is by no means mutually exclusive of any of these others.     

Temporality and the torments of time

Immersion in time gives birth to consciousness, as well as conflict and torment. When human beings developed a sense of future, they also gained the ability to anticipate threats from nature or their fellow beings. They thereby created cultures that are bastions of survival, as well as places of poetry, art and religion where they could band together and reflect upon their common plight. The practice of psychoanalysis is in many ways a temporal process, a process of remembering, for owning and elaborating a past that gives us substance, thereby providing a basis for reflective consciousness. Stimulated by Freud's early writings, Lacan, Laplanche and their successors in particular have focussed extensively on time and psychoanalysis, and their views are a central point of this discussion. A substantial case study is offered that provides concrete examples of these perspectives. A multi‐faceted view of temporality emerges, one that is more syncopated than linear or teleological. In conclusion, I will briefly discuss recent findings in the neuroscience of memory and ‘time travel’ that underpin contemporary psychoanalytic ideas in surprising ways. It is important to remember that acceptance of the contradictory nature of temporal experience can open space for increased freedom and playfulness.     

The making of a tragedy: perversion in the perception of truth

A type of wilful blindness can pervert an individual's perception of truth or reality, not because that reality is too much to hold, but because it is distasteful. Undesired. The case of Adam will be used to explore perversion as it twists an analytic process, affecting the transference and countertransference in ways that are difficult to see. Theorists of Freudian, Kleinian, Lacanian, and Jungian traditions are drawn from to explore potential roots to this perverted turn, and the way it can rigidify an individuation process. The anxiety that haunts this case echoes Jung's anxiety as he wondered if the stone saw him or he saw the stone. Object and observer blend when both analyst and patient hide from themselves and one another, knowing the truth of what is being discussed but blind to it.     

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 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.