Out of the body: embodiment and its vicissitudes

Body‐mind dualism and the consequent neglect of the body of the analyst can have important negative effects on the analytical process leading all too often to misinterpretations of the analysand's verbal and non‐verbal communications and to disturbances of analytical temporality. This is intensified when we are dealing with individuals where disembodiment and states of psychic deadness are central features. The paper explores the philosophical roots of the idea of a disembodied mind and the way in which this impacts our relationship with the world. While André Green's concept of the dead mother and disturbances in the sense of self‐agency have been held to play an important role in states of psychic deadness, I suggest that it is rather disturbances in the sense of body ownership and of the body image which are more central. The paper then discusses the particular kinds of countertransference that can be evoked in the analyst when we find ourselves dealing with this type of patient and suggests how we can use our embodied countertransference to become aware of and elaborate our own feelings of deadness in order to overcome the loss of temporality that is characteristic of such states. This is illustrated with reference to my work with a young man with a masochistic perversion and a severe disturbance of the body image with an accompanying profound sense of psychic deadness.     

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.     

Braving the erotic field in the treatment of adolescents*

Abstract

The psychoanalytic literature on erotic transference and countertransference in adolescence is notably sparse, despite the centrality of the developing sexual body/mind. Erotic feelings in the consulting room with an adolescent can feel taboo, causing the analyst to avoid the immediacy of these feelings. Excessive timidity on the part of the analyst can limit the growth of the capacity for containment of sexual feelings and yield what I term ‘erotic insufficiency’ in our work with adolescents. I offer clinical material from a period of erotic transference and countertransference with a 12-year-old boy to consider these ideas. Further, I suggest that the very terms ‘erotic transference’ and ‘erotic countertransference’ can feel defensively remote and antiseptic. I suggest that ‘erotic field’ better captures the subtle, nuanced interplay of feelings.     

A response to Maggie Turp's paper from a body psychotherapy perspective

Whilst appreciating the quality of containment in Turp's work as a learning point for the Body Psychotherapy tradition, the author argues that Turp does not represent a psychotherapeutic way of ‘working with the body’. This would require a deconstruction of the body/mind dualism inherent in much psychotherapeutic (and psychodynamic) theory, so that the complexity of the spontaneous and reflective body/mind processes, especially in their polar extremes (body/mind dissociation – body/mind integration / ‘psyche/soma unity’), can be contained. An holistic body/mind formulation of countertransference is approached by which – rather than being used as a gratifying or cathartic therapeutic shortcut which avoids the intensity of the transference – the body can be seen to constitute an avenue into the full experience of the transference/countertransference process and its relational sources in early development.     

Embodying analysis: the body and the therapeutic process

This paper considers the transfer of somatic effects from patient to analyst, which gives rise to embodied countertransference, functioning as an organ of primitive communication. By means of processes of projective identification, the analyst experiences somatic disturbances within himself or herself that are connected to the split‐off complexes of the analysand. The analysty’s own attempt at mind‐body integration ushers the patient towards a progressive understanding and acceptance of his or her inner suffering. Such experiences of psychic contagion between patient and analyst are related to Jung’s ‘psychology of the transference’ and the idea of the ‘subtle body’ as an unconscious shared area. The re‐attribution of meaning to pre‐verbal psychic experiences within the ‘embodied reverie’ of the analyst enables the analytic dyad to reach the archetypal energies and structuring power of the collective unconscious. A detailed case example is presented of how the emergence of the vitalizing connection between the psyche and the soma, severed through traumatic early relations with parents or carers, allows the instinctual impulse of the Self to manifest, thereby reactivating the process of individuation.     

Countertransference: Our new royal road to the unconscious?

In this paper I am tracing the history of countertransference and how it has informed the current debate about self‐disclosure as a pivotal instrument of analytic work. Now that the analyst's “subjective factor”; has been understood as a central influence on the analysand and as a vital source of information about the analysand's intrapsychic life, I argue that certain currents in the relational school of psychoanalysis confuse the analyst's subjectivity with his personality. While becoming more “real”; with a patient may enliven a stale analytic dialogue, it ought not be confused with, or take the place of, an analysis of unconscious desires and phantasies. I claim that a two‐person psychology can exist only within a tripartite structure in which the analyst does not lose sight of his complex function of being the carrier, observer, and conveyor of the unconscious currents holding both participants in check.     

The Body and Mind (Including of the Analyst) in the Treatment of a Psychotic State: Some Reflections: Commentary on Paper by Riccardo Lombardi

Riccardo Lombardi's paper is considered from a British (Independent) object relations perspective. Although the paper deals with the experience of shame and its relationship to fantasies about sex and death and how these are experienced (including in the body), shame is also a profoundly object related mental state, perhaps one of the most damaging when suffered in infancy, leading to reflexive functioning. The nature of shame is touched upon and its impact on personality development, and how this is handled in the transference and countertransference by Riccardo Lombardi with his particular patient. Although the patient's struggle to own his own hate is Lombardi's principal focus in the clinical account, this author suggests that Lombardi was attuned primarily to the patient's developmental failings due to the impact of shame and, by working primarily in the countertransference, was able to facilitate growth of certain personality functions for the first time.     

On Musical Cognition and Archaic Meaning Schemata

In clinical psychoanalytic work, one often encounters psychical material that is devoid of form or shape. This kind of material is often manifest as concrete somatic sensations on the border of the body and mind. At the same time, it is a primitive body-related self-experience that functions as a background, an essential requirement for more developed, differentiated self-experiences. Bi-logic is a theoretical method by which one can outline these early, partially formless processes and states of mind. This paper includes an overview of the main hypotheses of Matte Blanco's bi-logical vertex, which focuses on the extreme symmetrization of mental phenomena that emanate from the body. Clinical vignettes illustrate ways in which analysis can gradually bring forth such form from the previously formless, dissociated traumatic material into the range of the conscious mind. In this way, the capacity for thinking and reflection increases and the early elements of self-experience are enlivened.     

Language Reflects “Core” Cognition: A New Theory About the Origin of Cross‐Linguistic Regularities

The underlying structures that are common to the world's languages bear an intriguing connection with early emerging forms of “core knowledge” (Spelke & Kinzler, 2007), which are frequently studied by infant researchers. In particular, grammatical systems often incorporate distinctions (e.g., the mass/count distinction) that reflect those made in core knowledge (e.g., the non‐verbal distinction between an object and a substance). Here, I argue that this connection occurs because non‐verbal core knowledge systematically biases processes of language evolution. This account potentially explains a wide range of cross‐linguistic grammatical phenomena that currently lack an adequate explanation. Second, I suggest that developmental researchers and cognitive scientists interested in (non‐verbal) knowledge representation can exploit this connection to language by using observations about cross‐linguistic grammatical tendencies to inspire hypotheses about core knowledge.     

Reply to Commentaries

Each discussant approached my paper on embedded levels of illusion from a different perspective, representing schools as diverse as those derived from Jung and Bion. It is interesting that, although my paper was not primarily about dreams or how to interpret them, but rather about the way in which multiple levels of illusion may open a potential space in treatment, each discussant centered his comments around a dream that I had reported in one of my cases. In this reply, I compare the discussants' approaches to the dream with mine. I also wonder whether the dream itself represents an embedded level of illusion within my paper. If so, it may function as a transitional space in which we may entertain different viewpoints around not only the nature of dream work, but also around questions including the nature of the mind and the therapeutic process.     

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.     

Extending fields of work

The aim of this paper is to describe some acute responses to the suicide of a parent, through the account of the analytic psychotherapy of a latency child who found the body of his dead father. The acute traumatic responses of the child show that the perceptual apparatus, time and space are subverted, while the functioning of the contact barrier is deeply damaged. The importance of the environment in facilitating the first stages of the mourning process is stressed as well as the pre-traumatic personality structure. Both the Bionian model of preconception and the post-Jungian notion of archetype, revisited in terms of an unsaturated predisposition, are considered from a theoretical point of view. Preconceptions and archetypal dispositions to survive traumatic events are very important to the therapeutic outcome, along with the opportunity to start the treatment as early as possible after the traumatic event. This is particularly relevant in relation to the latency period, in terms of the capacity to contemplate the effects of the drives. The importance of allowing the child to work through all the stages of mourning is also considered, particularly rage, protest and hostile fantasies towards the lost object. The clinical material is structured as a narrative in an attempt to evoke the emotional climate experienced during the sessions as well as the state of mind of the child. The narrative is a secondary elaborated account with condensation and displacement at its core, like in dream work. Events, filtered through the analyst's state of self, are reported by lending the first person to the child in the narrative reconstruction.     

The day the clock stopped. Primitive states of unintegration,multidimensional working through and the birth of the analytical subject

This paper is based on one idea and built around one clinical experience that helped me to broaden my comprehension of it. The idea, underlying the work of several authors, is that when the analytic field is saturated with primitive and unintegrated mental contents, the analyst’s somatic countertransference is a precious indicator of a deep, dissociated form of communication. The clinical experience concerns the difficult elaboration of a complex, multifaceted countertransference that took place during the early stages of the analysis of a sensitive patient who used to communicate in a very dissociated way and that I found hard to contain. This experience, closely described in the article, led me to formulate the clinical idea that the transference field may be made of distinct layers (psychoid, affective, verbal), and that each one of them may potentially convey dissociated, even contrasting bits of information. The corollary of this is that the analyst should be ready to accept contrasting sensations, feelings and thoughts at the same time, as they might be the basic ingredients of a complex reverie. The analyst could find himself/herself in front of his/her own internal unelaborated multiplicity before a symbolic image may emerge to link the scattered pieces of the experience. Nevertheless, the heart of this paper is not about suggesting an idea, but in the sharing of a complex working through, which fostered the birth of a new, more human relational perspective: the capacity of being together in time, in a transitional space where there is neither total separation nor fusion.     

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.     

Dances of Desire: Commentary on Papers by Dianne Elise and Jonathan H. Slavin

The richness and creativity of early classical work with dreams became narrowed through doctrinaire obedience to Freud's brilliant hypotheses. Interpersonal psychoanalysis, though originally little interested in problems of mind and private mentation, may be well suited, in part due to its lack of a comprehensive dream theory, to a clinical approach to dreams that is relatively open‐minded, pluralistic, complexly layered, collaborative, and playful. Multiple possibilities for the meanings of dreams and multiple ways of approaching dreams in analytic therapy are suggested. Although many therapists for complex reasons shy away from working on dreams, an interpersonal approach recognizes that several wishes of both patient and analyst may be significantly fulfilled in the pleasures of working together on dreams. If it is mindful of what is unfortunately a growing tendency to project into all dreams a single‐minded preoccupation with transference and countertransference, and if it respects the world of dream imagery in its own right, interpersonal psychoanalysis can make a genuine contribution to our understanding of dreams and dreams can lend an important dimension to interpersonal concepts. Several clinical examples are presented in an effort to highlight an approach that “stays with the image”; and allows the dream images to make their way into the psychoanalytic dialogue.     

Reading dream literature: frequency, influencing factors, and self-rated benefit

Dream books have a very long history, but systematic research on how many people have read magazine articles or books on dreams and whether reading such literature is beneficial to the dreamer is scarce. In the present sample of 444 people (mostly psychology students), about 75% of the participants stated that they had read at least one magazine article on dreams, and more than 40% had read at least one book about dreams. The main factor associated with the frequency of reading dream literature was a positive attitude toward dreaming, whereas personality factors play a minor role in explaining interindividual differences in this variable. The self-rated benefit of reading dream literature varied greatly, from not helpful at all to very helpful, and was associated with dream recall frequency and positive attitude toward dreaming. Using this approach in a more sophisticated way, eliciting details about the kinds of information participants have read would help researchers learn more about what techniques of dream work are effective and thus complement the research carried out in therapist-guided sessions.     

The body in analysis: authentic movement and witnessing in analytic practice

This paper will describe a form of active imagination called authentic movement, in which attention is given to the somatic unconscious. In authentic movement, patients are encouraged to focus inward and attend to any bodily sensations, images and feelings which may arise. In the process of focusing inward on one's bodily-felt experience, images, somatic memory and the accompanying feelings which arise are then available to be explored as a communication from the patient's unconscious. Authentic movement supports the individual in linking image with affect in that the individual re-experiences the somatic aspect of symbolization. What was previously conserved on the somatic level as unmentalized experience, can now begin to be taken up into the mind, thought about, and made available for analysis. In authentic movement, the analyst acts as a silent witness to the patient's explorations. The quiet focused attention of the witness helps to create a secure containing environment in which the person moving can experience a sense of feeling held and seen. The function of the witness is to hold the patient's experience in his own mind, particularly what is not yet mentalized. The witness utilizes his somatic countertransference, including any images, feelings and bodily responses which are generated by what is being communicated non-verbally, as a means of understanding and responding to the patient's material.     

On not being able to dream

In this paper, the author explores the phenomenon of not being able to dream (as opposed to not being able to remember one's dreams) from three different vantage points. First, from the point of view of psychoanalytic theory, he discusses Bion's idea that the work of dreaming creates the conscious and unconscious mind (and not the other way around). A person who cannot dream is unable to generate differentiable conscious and unconscious experience and, consequently, lives in a psychic state in which he is unable to differentiate waking from sleeping, dreaming from perceiving. The author then approaches the problem of the inability to dream from the perspective achieved by a literary work. He discusses a Borges fiction that creates, in a singularly artful way, the experience of not being able to dream. Finally, the author utilises the vantage point of a detailed account of a clinical experience to explore what it means not to be able to dream. He describes an initial state characterised by the patient's proliferation of unutilisable 'psychic noise' which, over a period of years, led to the analyst's experiencing 'reverie-deprivation' and brief periods of countertransference psychosis. Two analytic sessions are presented and discussed in which psychological work was done that contributed to an enhanced capacity on the part of both patient and analyst for genuine dreaming - both in sleep and in analytic reverie states.     

A Farewell to Countertransference

The "discovery" of countertransference provided a much-needed corrective to the one-sided view of transference and a patient's pathology. Even if its usefulness in the development of psychoanalysis was indisputable, its days are numbered. When I present my clinical work at conferences, I am often asked questions about my countertransference. These questions contain numerous assumptions that are challenged in this paper. Treatment is discussed from a self psychological perspective to highlight the therapeutic value of enabling the patient to engage a selfobject transference. The concept of "projective identification" is also challenged. Systems theory, in which the therapeutic relationship is understood as a co-construction between therapist and patient, is proposed as a more effective model to deal with the issues formerly included under transference-countertransference.     

Sub-Abstract Bodies: The Epistemic and Ethical Role of the Body-Mind Relationship in Adorno’s Philosophy

Abstract

The aim of this paper is threefold. In the first place, I should like to show that Adorno’s philosophy is dependent, to a degree perhaps not always directly recognized in the literature, on a deeply contentious view on the relationship between the mind and the body. In order to show this, I explore and bring out the epistemic and ethical stakes for Adorno’s theory of the relationship between mind and body. Secondly, I move to better articulate precisely what Adorno’s view on the nature of this relationship is. I hold that his position revolves around positing a porous boundary between the domains of the somatic and the cognitive. In closing, I show that Adorno’s account relies on this domain boundary being unidirectionally porous, in that determination of somatic impulses by cognitive content does not seem a live option for Adorno. I go on to note that this smuggles in a dubious position which does a lot of unearned work. The stakes which his implicit account of the body and mind relationship served to secure thereby come once more to look highly vulnerable.