Death Is Nothing at All: On Contemplating Non-Existence. A Relational Psychoanalytic Engagement of the Fear of Death

This paper engages the secular mind’s struggle with mortality from a relational perspective. It critically reviews the legacy of Freud’s refusal to grant mortality psychic significance and the ways in which the fear of death has consequently been understood theoretically and addressed clinically. Analytic omnipotence is foregrounded as an impediment to the kind of intersubjective engagement that minds need from other minds in grappling with the loss of the self through death. A clinical illustration is used to explore the ways in which the analyst found himself relating with a patient around her extreme fear of death, which over the course of treatment became modified into a more bearable anxiety about her own mortality. A conceptual framework is offered to account for these changes, emphasizing the analyst’s personal relationship with mortality as a crucial variable in how the fear of death is engaged psychoanalytically. The author calls for a revisionist psychoanalysis that allows for death’s centrality in both theory and practice.     

Vulnerability,Resilience, and Surviving Destruction: Discussion of “The Analyst’s Experience of Trust and Mistrust”

In this response to Danielle Novack’s intellectually astute and clinically rich paper on the “analyst’s trust,” I reflect on the valuable ways in which Novack elucidates this undertheorized aspect of the analyst’s experience and reconfigures trust/mistrust as a meaningful intersubjective dimension of the therapeutic relationship. Novack shows how attending to shifts in trust/mistrust can provide valuable clues for deciphering the transference/countertransference. While I strongly agree with her construction of trust as a psychoanalytic achievement, I question the notion that the analyst’s trust is a necessary condition for her participation. Novack’s work on the analyst’s trust joins a broader contemporary conversation about potential overreaches in the relational paradigm, which I discuss. Finally, I consider the implications of Novack’s work for specifying the factors that underly resilience and engaging a conversation about surviving destruction in contemporary relational psychoanalysis.     

Intergenerational transmission of violence: Is violence a pathology of intersubjective contact?

In this article, I look at violence as a pathology of the intersubjective contact. In particular, I claim that one possible explanation of violence is lack of recognition on a societal, intersubjective level. I propose an explanation based on Honneth’s concept of struggle for recognition and Merleau-Ponty’s account of intersubjectivity. The article takes the following course: I first give a short outline of the concept of intergenerational transmission of violence, as understood by psychology at the level of an individual, followed by a brief presentation a summary of sociological research on the concept. Then, I proceed with a discussion of Honneth’s three modes of recognition, viz. love, rights, and solidarity, as modes of intersubjective contact, leading to the development of self-confidence, self-respect, and self-esteem. I claim that the lack of these kinds of recognition leads to the decrease in confidence and trust and consequently to abusive behaviour, that it affects social integrity and brings about the destruction of social functions, and that it results in an individual and a society which have lost their “honour” and dignity. Finding his account of intersubjectivity lacking in its philosophical aspect, I complement Honneth’s account of intersubjectivity with that of Merleau-Ponty, based in his understanding of the intertwining of the subject and the world and the reversible contact between and among subjects within the world. Considering the negative effects of misrecognition as described by Honneth, in the light of Merleau-Ponty’s understanding of intersubjective contacts among subjects, I conclude that a country where all three modes of recognition have been disturbed houses a society lacking self-confidence, self-respect, and self-esteem, and consequently shows all the signs of Honneth’s forms of disrespect, i.e. abuse and rape, denial of rights and exclusion, as well as denigration and insult, all of which are forms of intergenerationally transmitted violence.     

The Mutual Development of Intersubjectivity and Metacognitive Capacity in the Psychotherapy for Persons with Schizophrenia

While cognitive behavioral approaches have been shown to help some individuals with schizophrenia, these approaches may be limited when working with patients with impairments in the metacognitive abilities required to form complex and integrated representations of themselves and others. In response, this paper explores the possibility that a key to working with patients with relatively impaired self-reflectivity lies in explicitly focusing on a patient’s intersubjective experience within psychotherapy. We offer theoretical and empirical support for the assertion that the tolerance and capacity for intersubjectivity is a basis for the development of self-reflectivity in general. We also explore how the fostering of intersubjective processes in psychotherapy might enable some patients to form more complex ideas about themselves and so better ward off delusions in the face of the challenges of daily life. To illustrate these principles we present the case of a patient with tenaciously held delusions and limited capacity for self-reflection. We discuss when and how the therapist’s awareness and verbalization of intersubjective processes within session allowed her and the patient to develop more complex and consensually valid ideas about him as a being in the world, which then assisted the patient to achieve improvements in a number of domains in his life.     

The arms of the chimeras

This article seeks to compare the approach developed in 1974 by Michel de M'Uzan to the concept of the ‘chimera’ with Thomas Ogden's ( 1995 , 2005 ) reflections on ‘the analytic third’. This comparison shows that in spite of the different theoretical approaches, unconscious to unconscious communication – a subject of interest in contemporary psychoanalytic research – makes it possible to grasp the intersubjective data deployed in the field of the session. After reviewing M. de M'Uzan's conception of the ‘chimera’ – a product of the unconsciouses of patient and analyst alike, and which emerges during a process of depersonalization in the analyst – the author proposes her hypothesis of the chimera as a particular intersubjective third whose creation, in a hallucinatory state, makes it possible to gain access to the bodily and emotional basis of the trauma. The author describes the chimera as a mental ‘squiggle’ between the two members of the pair which finds expression in different forms; further, she considers that the chimera that seizes the analyst is underpinned by the unconscious affinities of traumatic zones in both protagonists, which permit the grounding, configuration and sharing of the territories of suffering, as apprehended in this paper.     

Psychoanalytic Interpretation as Pharmakon: Applying Derrida’s “Plato’s Pharmacy” to Psychoanalysis

This paper presents a metaphorical heuristic to expand psychoanalysts’ views on the nature and method of interpretation from an intersubjective perspective. It uses one of Jacques Derrida’s findings in his essay “Plato’s Pharmacy,” a critique of Plato’s Phaedrus, as a model of psychoanalytic interaction. A parallel is drawn between psychoanalytic interpretation and the pharmakon—an ancient Greek term for ‘drug’ that means both remedy and poison. From this comparison, the inescapable dependence of personal meaning on contextual factors, specifically the context of the clinical intersubjective field, is shown. As a result, when an interpretation is offered, the analyst cannot truly know if the patient will receive it as remedy or poison. By keeping the context-dependent nature of personal meaning in awareness through the use of the pharmakon metaphor, analysts increase their abilities of interpretive understanding. In further discussion, the classical psychoanalytic concept of ‘negative therapeutic reaction’ is presented as an example of a decontextualized and reified psychoanalytic construct that becomes superfluous when interpretations are viewed through an intersubjective lens as pharmakon. Without the burden of expectation for being the authoritative imparter of reality and truth, the analyst may now attend to the patient in a way that is more fluid and reciprocal, where the relational field becomes what is primarily interpreted. Further, practical clinical implications of the concept of pharmakon suggest that since the analytic interpretation is subjective in every respect, effective clinical practice cannot be reduced to rigid protocols of technique.     

The Compatibility of Hegelian Recognition and Morality with the Ethics of Care

I draw connections between Hegel’s concepts of recognition and morality and demonstrate how they are compatible with an ethic of care. I explore Hegel’s Sittlichkeit and demonstrate the role that intersubjective recognition plays in the development and sustainment of ethical communities. I demonstrate how his emphasis on the community and interpersonal relationships play an important role in his moral theory. I then contrast Hegelian and Kantian views of morality and argue that Hegel’s account places greater emphasis on attending to the needs of others and showing genuine concern for their well-being. By highlighting the intersubjective nature of recognition between self-consciousnesses, and the interconnectedness of agents in an ethical community, I maintain Hegel’s morality is compatible with an ethic of care because it emerges out of intersubjective mutual recognition and its foundation is built upon responding to the needs of particular others and protecting the bonds of the community.     

Better Identity Politics

Suchet's paper is an inspiring demonstration of the power of openness and vulnerability. It offers a clinically daring and theoretically far-reaching account of the transformation that can sometimes occur in the psychoanalytic relationship. My commentary focuses on two of the paper's major threads: the interplay of subjective experience, intersubjective space, and collective forces, and the ethical dimension of the psychoanalytic project. From the outset, the meeting between Ara and Suchet is not only a meeting of bodies and minds, but also a meeting of collective histories and politics. Suchet finds, and in her account powerfully demonstrates, that addressing her patient's trouble requires an exploration of how collective traumas and political narratives infuse the possibilities of intersubjective exchange and subjective meaning. In my commentary I trace and elaborate on the trajectory of this analytic process, contemplating the ways in which identities and identifications involve both familial and social attachments. I attempt to highlight Suchet's contribution to our understanding of how what happens, and is made meaningful, in the register of collective identification and experience, forms the very substance of subjective and intersubjective life, and should be therefore formulated as an intrinsic aspect of the analytic endeavour. Turning to Suchet's engagement with the philosophy of Emmanuel Levinas, I consider her drive to reach beyond the traditional boundaries of psychoanalytic discourse. Following the same drive, I add some ideas developed by Theodor Adorno, as means of illustrating the trouble and the potential for reconciliation inherent in the experience and politics of identity.     

What Are We Doing There? A Therapeutic Tale

In this paper I try to portray our interpsychic work as reflective of an infinite conversation: an intersubjective dreaming of one’s life, moving between multiple positions/self-states, those of the patient and our own; becoming involved while pondering the movement we are part of, sometimes in our hearts and minds, many times aloud and openly with our patient; recognizing her experience and enabling her to see us, and sometimes not reflecting at all—“the “moving talk.” The dilemma of the therapist’s positioning, internally and interpersonally, is further postulated, especially in regard to the posttraumatic patient who suffered severe childhood abuse.     

Rape and Communicative Agency: Reflections in the Lake at L–

Freud's case study of “Dora” ignores indications that her symptoms might have resulted from a fear of rape. Drawing on feminist adaptations of Lacan, this paper suggests that fear of rape may serve as a horizon for women's ability to perceive themselves as efficacious speakers. Freud's failure to recognize this fear may reflect men's unwillingness to acknowledge their own role in rape as well as anxiety over the possibility of losing his own credibility.     

不只是“谈话疗法”：精神分析治疗中的非言语维度

精神分析治疗在很长一段时间里被视为“谈话疗法”,其治愈机制是将潜意识的内容意识化,语言解释在其中发挥关键作用。自20世纪末开始,越来越多分析师强调非言语交流在治疗中的作用。非言语交流不仅能够为咨访双方提供更丰富的交流形式,还能通过互动中的“相遇时刻”,实现对患者过去经验的重组,改变其有缺陷的内隐关系知晓。非言语交流和语言交流能够在治疗中发挥互补作用,未来的精神分析心理学要继续加强对非言语领域的研究。     

Response to MacIntosh’s Review and Discussion of the Psychoanalytic Couple Therapy Journal Literature: A Self Psychological,Intersubjective Perspective

ABSTRACT

After expressing my appreciation to Heather MacIntosh and highlighting her article’s significant contributions to the field, I comment briefly on some of the implications of her methodology and findings. I then elaborate on her summary of the history of the application of self psychology (Kohut, 1971) and intersubjective systems theory (Stolorow, Brandshaft, and Atwood, 1987) to couple therapy, highlighting the key contributions of both theories and describing the current state of the field.     

不只是“谈话疗法”：精神分析治疗中的非言语维度

精神分析治疗在很长一段时间里被视为“谈话疗法”,其治愈机制是将潜意识的内容意识化,语言解释在其中发挥关键作用。自20世纪末开始,越来越多分析师强调非言语交流在治疗中的作用。非言语交流不仅能够为咨访双方提供更丰富的交流形式,还能通过互动中的“相遇时刻”,实现对患者过去经验的重组,改变其有缺陷的内隐关系知晓。非言语交流和语言交流能够在治疗中发挥互补作用,未来的精神分析心理学要继续加强对非言语领域的研究。     

Language and Intersubjectivity: Multiplicity in a Bilingual Treatment

This paper explores the psychodynamics of analytic work conducted between a French patient and an American analyst who are both bilingual in French and English. The depth of the patient's early traumatic relational history is initially bound and cloistered in French, her mother tongue. The author argues that through the symbolization of a series of initially dissociated enactments a transitional space is created in the treatment, facilitating the integration of the patient's (and analyst's) early French-speaking selves. Language is considered as a container for both dissociative and associative forms of multiplicity, as it serves to mediate an external and internal intersubjective expansion both between and within patient and analyst.     

Random Thoughts on Couple Therapy in a Postmodern Society

The postmodern period in psychoanalysis has had a considerable impact and influence on the psychotherapeutic process in both psychoanalysis and psychotherapy. The paradigm shift, reflected in the work of the intersubjectivists, rationalists, and social constructivists, has shifted emphasis from a one-person psychology to a two-person psychology. Implications for treatment are numerous. The change in emphasis affects not only how individual treatment is conducted but also couple therapy and group therapy. In considering the impact of these recent changes, the author notes the wide range of influences that inform her couple and group therapy. Although the current paradigm shift offers much, it seems to be an extension of earlier influences from self psychology, motivational systems, and attachment theory and of findings from neuropsychology. The author concludes that her couple work has also been intuitively informed by the implicit experience of the intersubjective field of group therapy.     

A Reason‐Based Theory of Rational Choice *

There is a surprising disconnect between formal rational choice theory and philosophical work on reasons. The one is silent on the role of reasons in rational choices, the other rarely engages with the formal models of decision problems used by social scientists. To bridge this gap, we propose a new, reason‐based theory of rational choice. At its core is an account of preference formation, according to which an agent’s preferences are determined by his or her motivating reasons, together with a ‘weighing relation’ between different combinations of reasons. By explaining how someone’s preferences may vary with changes in his or her motivating reasons, our theory illuminates the relationship between deliberation about reasons and rational choices. Although primarily positive, the theory can also help us think about how those preferences and choices ought to respond to normative reasons.     

Simultaneous Group and Insulin Therapy

Abstract

The concept of focus can provide a meaningful bridge between theory and practice. The authors’ aim in this paper is to demonstrate that for theory to be clinically useful, it should provide a sense of focus and organization for clinical work. They illustrate how their particular use of a self–psychological/intersubjective model leads to an emphasis on what they refer to as “sustained empathic focus.” The authors’ choice of concepts leads them consistently to stress the patient’s subjective experience and emerging vulnerability.     

The mirroring function of the child analyst

This paper follows the progress of four years of twice-weekly psychoanalytic psychotherapy with a borderline girl aged 4 at the start of treatment. It describes how her early experience with her mother, who was ill, and her subsequent removal from her mother and placement with a foster-family led to her having severe difficulties in relating to others. Using the work of Ekstein as a framework, it follows the changes in the child’s behaviour in the therapy from acting out to playing with toys to role playing to the apparent development of her capacity to phantasize. It focuses on what the dolls’ house represented for her and how it came to be a transitional space where the inner world of the child could be represented. The play in and around the dolls’ house is described to show how she moved from playing on the outside of the dolls’ house to playing in part of the inside to using the whole house and how this seemed to parallel the development of her relationship with her therapist. Furthermore, it presents the views of a number of commentators on the use of the dolls’ house and what it represents for children in therapy and in our culture in general.