For all we Know: Clinical Creativity as a Dialectic Between Knowledge and Unknownness

Musical thought is an essential instrument for grasping the most secret stirrings of the human heart. Contemporary psychoanalysis has been exploring implicit communication for some time now; I believe that the way in which music communicates is remarkably connected with these matters issues. I speak of musical thought to indicate the ways in which music thinks. In this article I offer a contribution in which I could dare to use musical thought as an essential element of the clinical relationship between my patient Ernesto and me.     

Where is here? When is now?1

With a Kleinian perspective influenced by Betty Joseph, the author describes the distinctive ‘here and now’ of a psychoanalysis as the place and the time of the patient’s inner subjective world as it emerges in the work of patient and analyst. This psychoanalytic ‘here’ and ‘now’ is examined with clinical material from the analysis of Mr X; first, with an account of the way his analysis begins and then through a detailed session five years later.The author identifies Mr X’s problems with place and time, and how these change over the course of the analysis. He moves from sequestered dyadic relationships towards an Oedipal and family space, and from disconnection and timelessness to acquiring a sense of duration, of being in the present with a past and a future – all of which, the paper aims to show, has implications for technique.     

Music perception and octave generalization in rhesus monkeys

Two rhesus monkeys were tested for octave generalization in 8 experiments by transposing 6- and 7-note musical passages by an octave and requiring same or different judgments. The monkeys showed no octave generalization to random-synthetic melodies, atonal melodies, or individual notes. They did show complete octave generalization to childhood songs (e.g., "Happy Birthday") and tonal melodies (from a tonality algorithm). Octave generalization was equally strong for 2-octave transpositions but not for 0.5- or 1.5-octave transpositions of childhood songs. These results combine to show that tonal melodies form musical gestalts for monkeys, as they do for humans, and retain their identity when transposed with whole octaves so that chroma (key) is preserved. This conclusion implicates similar transduction, storage, processing, and relational memory of musical passages in monkeys and humans and has implications for nature-nurture origins of music perception.     

From acting to communicating: The analysis of a boy with a pathological organization1

The author presents the analysis of an 8 year‐old boy prematurely born after a high‐risk pregnancy, then hospitalized for two weeks. He was never breastfed and presented vomiting, intense activity and inadequate behaviour as symptoms. His highly dysfunctional family is composed of a non‐productive father and a homely, though aggressive, mother. The patient displayed a rigid defensive structure with perverse aspects and a cruel superego. His constant interest in magical characters frequently disguises an avoidance of reality. By means of transference interpretations, a trustworthy link with the analyst now allows him his own mental space, where hidden psychotic states come to light. In the clinical material, this boy's skills for insight mingle with oscillations from severely defensive states to integration and vice versa. The analytic relationship in this often hostile scenario has become strong. The analysis is hampered by constant demands from family and school‐both expect the analyst to prevent his frequent acting out. Whereas some perverse polymorphism is part of childhood and may persist throughout life, it is likely that the patient's pathological organization may yield to reality and facilitate reparation, relinquishing the world of make‐believe as well as the intense projective mental functioning.     

Hörräume – Klanghüllen

In psychoanalytic research little attention has been given to one of the analyst’s chief instruments, namely his/her voice, although, apart from a few exceptions, the patient has to rely mainly on the acoustic channel in the course of the psychoanalytic process. The author presumes this to be a sign of a collective resistance among analysts which protects them against an unsettling idea: Our utmost restraint notwithstanding, it is in our voice that our physical nature materializes, that our presence is felt in a sensory way thus affecting our patients. An attempt is undertaken to show to what extent the analyst’s voice as a part of the atmosphere in the analyst’s practice affects the patient physically, thus making it possible for him/her an aesthetic experience, which may as a sensory perception lead to changes of the habitual ways of perception and thus to new experiences. Using the concept of “The Performance” devised by Fischer-Lichte, a lecturer in the theory of drama, the author explains to what extent meanings are created by both participants of a psychoanalytic process: Fischer-Lichte regards the aesthetics of performance as aesthetics of presence which arouse the sensation of physical presence. If the patient’s focus on the voice is not merely interpreted as a means of defence against comprehending the semantic meanings of the words, but is accepted as a necessary transition stage leading to re-animating the patient’s conception of reality, then a new listening and performing horizon is opened where the presence of other things can be experienced.     

Attention and Narration to Micro-Moment Registrations of Embodied Dialogue in the Clinical Interaction: How Are We Doing?

ABSTRACT

This article offers a comparison between two different strategies for clinical attention. The author compares his lens shaped by a musical metaphor of “polyrhythmic patterning” on embodied registrations which he describes as “fluidity” in contrast to a lens of structures or categories of experience. He then contrasts this lens to that offered by Lewis which she describes with the metaphor of an “imaginary camera” with which she creates “snapshots” as representations of unbearable (and often unformulated) trauma shaped by the patient's narrative and her own trauma history. Acknowledging the exquisite connection between analyst and patient, the author uses 2 clinical moments to further illustrate the benefits of each metaphoric lens for possible analytic work.     

Development of Different Forms of Skill Learning Throughout the Lifespan

The acquisition of complex motor, cognitive, and social skills, like playing a musical instrument or mastering sports or a language, is generally associated with implicit skill learning (SL). Although it is a general view that SL is most effective in childhood, and such skills are best acquired if learning starts early, this idea has rarely been tested by systematic empirical studies on the developmental pathways of SL from childhood to old age. In this paper, we challenge the view that childhood and early school years are the prime time for skill learning by tracking age‐related changes in performance in three different paradigms of SL. We collected data from participants between 7 and 87 years for (1) a Serial Reaction Time Task (SRT) testing the learning of motor sequences, (2) an Artificial Grammar Learning (AGL) task testing the extraction of regularities from auditory sequences, and (3) Probabilistic Category Learning in the Weather Prediction task (WP), a non‐sequential categorization task. Results on all three tasks show that adolescence and adulthood are the most efficient periods for skill learning, since instead of becoming less and less effective with age, SL improves from childhood into adulthood and then later declines with aging.     

The Smell of Paper: On the Usefulness of Musical Thought in Psychoanalytic Practice

In this paper I stress the importance of musical thinking when applied to clinical psychoanalysis. The particular form of musical thinking I take into consideration is based on the beginning of Beethoven’s Third Symphony. I compare some musical patterns that happen in this score to some of the emotional patterns of my patient Teresa. I illustrate how musical thinking in psychoanalysis could, at times, be an essential part of our clinical tools as we strive to understand what is happening and how to resolve some impasses. Referring to the work of Daniel Stern and speculating on it, I try to demonstrate how some specifics of musical thinking can help us to face intense clinical moments in novel and less “conceptual” ways.     

The effects of child abuse as seen in adults: George Orwell

The author presents the case of a patient who showed the massive defensive effects seen in people who were abused in childhood. These effects are similar to those described in George Orwell's 1984 and in his autobiographical writings: denial and "doublethink"; masochistic submission to the tormentor; turning of anger against the self and loving "Big Brother"; identifying with the abuser and tormenting others; a burgeoning of anal mechanisms and obsessive phenomena that results in a massive isolation of affects; excessive emotional control alongside outbursts of rage. The interference with memory and emotions compromises identity and humanity. The unforseeable evolution of innate gifts in a child sometimes permits a partial transcendence of these crippling defenses, as Orwell partially transcended what appears to have been the emotional deprivation of his childhood and what he felt to have been the abuse of his schoolboy years.     

Interpersonal synchrony increases prosocial behavior in infants

Adults who move together to a shared musical beat synchronously as opposed to asynchronously are subsequently more likely to display prosocial behaviors toward each other. The development of musical behaviors during infancy has been described previously, but the social implications of such behaviors in infancy have been little studied. In Experiment 1, each of 48 14‐month‐old infants was held by an assistant and gently bounced to music while facing the experimenter, who bounced either in‐synchrony or out‐of‐synchrony with the way the infant was bounced. The infants were then placed in a situation in which they had the opportunity to help the experimenter by handing objects to her that she had ‘accidently’ dropped. We found that 14‐month‐old infants were more likely to engage in altruistic behavior and help the experimenter after having been bounced to music in synchrony with her, compared to infants who were bounced to music asynchronously with her. The results of Experiment 2, using anti‐phase bouncing, suggest that this is due to the contingency of the synchronous movements as opposed to movement symmetry. These findings support the hypothesis that interpersonal motor synchrony might be one key component of musical engagement that encourages social bonds among group members, and suggest that this motor synchrony to music may promote the very early development of altruistic behavior. A video abstract of this article can be viewed at http://www.youtube.com/watch?v=IaqWehfDm7c&feature=youtu.be     

How Do Artificial Neural Networks Classify Musical Triads? A Case Study in Eluding Bonini's Paradox

How might artificial neural networks (ANNs) inform cognitive science? Often cognitive scientists use ANNs but do not examine their internal structures. In this paper, we use ANNs to explore how cognition might represent musical properties. We train ANNs to classify musical chords, and we interpret network structure to determine what representations ANNs discover and use. We find connection weights between input units and hidden units can be described using Fourier phase spaces, a representation studied in musical set theory. We find the total signal coming through these weighted connection weights is a measure of the similarity between two Fourier structures: the structure of the hidden unit's weights and the structure of the stimulus. This is surprising because neither of these Fourier structures is computed by the hidden unit. We then show how output units use such similarity measures to classify chords. However, we also find different types of units—units that use different activation functions—use this similarity measure very differently. This result, combined with other findings, indicates that while our networks are related to the Fourier analysis of musical sets, they do not perform Fourier analyses of the kind usually described in musical set theory. Our results show Fourier representations of music are not limited to musical set theory. Our results also suggest how cognitive psychologists might explore Fourier representations in musical cognition. Critically, such theoretical and empirical implications require researchers to understand how network structure converts stimuli into responses.     

The Secret of Faces: Commentary on Paper by Rachael Peltz

Dr. Rachael Peltz stresses the aesthetic dimension of analysis. In fact the aesthetic experience can serve as a model for all that is deepest and truest in our lives and in the analytic encounter. We all have an “inner painter” which transforms primitive sensoriality into images or pictograms and then tie them up into oneiric thoughts, dreaming and thinking in order to give a personal meaning to experience. This model gives us the possibility in the clinical work to be more attentive to the musical, rhythmic, or semiotic aspects of the interaction between patient and analyst. Dr. Peltz shows in a beautiful vignette how, equating analysis to the aesthetic experience, it is possible to help the patient to reach a fuller sense of consonance and contact between mind and body.     

Reproduction of musical rhythms by children,adult musicians,and adult nonmusicians

Many sequential events, musical rhythms in particular, can be described by a hierarchical structure, with lower order events recursively combining to form higher levels. This study investigated factors influencing the ease of reproduction of short musical rhythms that reflect various organizational principles. For adults and children, reproduction was better for rhythms with the following characteristics: (1) binary rather than ternary subdivision, (2) two rather than three different durations, (3) the ability to be segmented into two shorter rhythms of identical duration, and (4) intensity accents on important hierarchical positions. These findings suggest that a prototypical temporal structure—that is, a regular beat with binary subdivisions—is functional in childhood. The ability to process complex hierarchical structure appeared to be influenced more by musical training than by passive acculturation.     

Are there pre-existing neural, cognitive, or motoric markers for musical ability?

Adult musician's brains show structural enlargements, but it is not known whether these are inborn or a consequence of long-term training. In addition, music training in childhood has been shown to have positive effects on visual-spatial and verbal outcomes. However, it is not known whether pre-existing advantages in these skills are found in children who choose to study a musical instrument nor is it known whether there are pre-existing associations between music and any of these outcome measures that could help explain the training effects. To answer these questions, we compared 5- to 7-year-olds beginning piano or string lessons (n=39) with 5- to 7-year-olds not beginning instrumental training (n=31). All children received a series of tests (visual-spatial, non-verbal reasoning, verbal, motor, and musical) and underwent magnetic resonance imaging. We found no pre-existing neural, cognitive, motor, or musical differences between groups and no correlations (after correction for multiple analyses) between music perceptual skills and any brain or visual-spatial measures. However, correlations were found between music perceptual skills and both non-verbal reasoning and phonemic awareness. Such pre-existing correlations suggest similarities in auditory and visual pattern recognition as well a sharing of the neural substrates for language and music processing, most likely due to innate abilities or implicit learning during early development. This baseline study lays the groundwork for an ongoing longitudinal study addressing the effects of intensive musical training on brain and cognitive development, and making it possible to look retroactively at the brain and cognitive development of those children who emerge showing exceptional musical talent.     

Tribute to Ellen Noonan

This story was written after the conclusion of a period of therapy with a patient who had experienced severe childhood trauma. It was one of those occasions when it didn't feel right to even enquire about the possibility of publishing a paper on the basis of our work together. The priority was to avoid any intervention that might constitute an intrusion into an individual who had already been too much intruded upon. Having come to that conclusion, I found myself writing this short story. The events described are entirely different from those described by my patient. However, the story captures part of the emotional truth of the patient's situation and state of mind and, in this sense, constitutes a reworking of the material that emerged in therapy.     

Types,Tokens, and Talk about Musical Works

It has recently been suggested that the type/token theorist concerning musical works cannot come up with an adequate semantic theory of those sentences in which we purport to talk about such works. Specifically, it has been claimed that, since types are abstract entities, a type/token theorist can only account for the truth of sentences such as “The 1812 Overture is very loud” and “Bach's Two Part Invention in C has an F‐sharp in its fourth measure” by adopting an untenable semantic claim: namely, that the predicates in such sentences, once applied to musical works, undergo a systematic shift in their meanings. This article is a sustained explanation of why our talk about musical works in fact provides no problem for the type/token theorist. First, we demonstrate that the aforementioned “meaning shift” approach to the sentences’ predicates is well motivated and very credible. Second, we explain how the type/token theorist can adopt the best available version of an alternative, generic quantificational approach to such sentences. Third, we establish that other semantic theories, presented as undermining the type/token theory by giving us a reason for adopting eliminativism about types, are much less theoretically virtuous than the two theories that a type/token theorist can freely adopt.     

The child dream and the child transference

This paper explores the symbolic meaning of dreams in which children appear with special attention to the way children in dreams symbolize the self, particularly the dependent and developing self. It is suggested that patients' growth in analysis can be monitored by observing what happens to the children in their dreams. This paper also explores the vicissitudes of the child transference, in which the patient treats the analyst as a child. An analysis is described in which the child dream and the child transference played an important role in elucidating the patient's neurotic behaviors. The author contends that the child dream and the child transference are common and clinically useful phenomena, especially important in the analysis of dependency conflicts. An additional thesis of this paper is that the child transference is most likely to be found in instances where a patient played a parental role with one of their parents during childhood.     

Thirty years of abdominal pain

In this paper, the author describes a brief psychotherapy with a man who has struggled with abdominal symptoms for most of his adult life. After an unhappy childhood, the patient (Mr A) married and then was witness to the birth of his stillborn child, in a foreign country. Soon after his abdominal symptoms started, and plagued him for the following 30 years. In the therapy, Mr A began to explore areas of guilt, hostility, and shame, together with previously unknown-about unconscious phantasies. By the end of the therapy, he reported a substantial diminution in his symptoms, as well as changes to his relationships, and mode of thinking and feeling. Some aspects of working psychoanalytically with patients with somatic symptoms, especially those pertaining to the gastrointestinal tract, are discussed.     

Musical minds

Music might be described as just a special form of noise, but evidence is accumulating to show that listening to it can lead to pronounced physiological and emotional responses. In a recent article, Trainor et al. have shown that specific aspects of musical structure are processed automatically in the human brain, raising the question of whether our response to music has specifically evolved or merely occurs as a side-effect of neural architecture.     

No Association between Music Ability and Hand Preference in Children

Hand preference was studied in 2 groups of children—children with musical ability and children without musical ability—to examine whether particular markers that may connect with handedness patterns, such as bias away from dextrality or mixed-handedness, stabilize during childhood and are associated with musical ability. Children were administered the Edinburgh Handedness Inventory to determine levels of right, left, and mixed handedness. Results demonstrated no differences in hand preference between both cohorts of children, suggesting the relative independence of musical ability and handedness. However, the inclusion of handedness as a motor marker for musical ability in children in conjunction with other preexisting neurocognitive factors cannot be entirely discounted.