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.     

Case vignette: the vicissitudes of managed care

Lee Wilson, age 26, was referred to Dr. Jackson for psychotherapy 5 weeks ago by a friend. Lee has been feeling increasingly depressed about longstanding family issues and the recent breakup of a 2-year relationship with a live-in companion. Over the course of the once-per-week sessions, Dr. Jackson notes persistent suicidal ideation, with vague plans to act if, as Lee puts it, "things get any worse." Just before the sixth session, Dr. Jackson is contacted by a reviewer for the managed care health insurance program covering Lee's therapy. The reviewer informs Dr. Jackson that the company will not authorize payment for further psychotherapeutic care. Dr. Jackson knows that Lee is in need of continued treatment and fears that terminating therapy at this time could result in increased suicide risk. Lee's income could cover only a small portion of Dr. Jackson's usual fee. Dr. Jackson does not wish to abandon Lee, but he already provides a significant amount of reduced-fee service to other clients. Is the health insurance carrier's stance ethical? Should Dr. Jackson be expected to treat Lee for the foreseeable future at a greatly reduced fee? How should Dr. Jackson handle this situation?     

Seduction without cause: uncovering explanatory neurophilia

Credibility is a cherished currency in science, but its cues can be counterfeit. A novel series of experiments by Weisberg and her colleagues show that non-expert consumers of behavioral explanations assign greater standing to explanations that contain neuroscientific details, even if these details provide no additional explanatory value. Here, we discuss the part that this 'placebic' information might play in producing a potentially misleading sense of intellectual fluency and, consequently, an unreliable sense of understanding.     

Religion,Reductionism, and the Seduction of Epistemology

This paper examines phenomenology and its psychological relationship to religious education. It comments on this relationship in the light of the critique of phenomenology which Piaget himself made towards the end of his life (Piaget, 1965), though it also draws attention to other aspects of phenomenology theory which are dissonant with Piagetian psychology. This paper, therefore, is not a broad philosophical critique of phenomenology, though an element of this is included. but concentrates on the philosophical and developmental factors which impede the capacity of young people to perform either of the ‘reductions’ demanded by the phenomenological method.     

Adolescent vicissitudes and medical judgement: a case study

Professional concern about the widespread occurrence of adolescent pregnancy is based upon its negative impact on the social, developmental, and economic prospects of the mother and her infant. The usual presumption is that the pregnant adolescent is in good health but suffers from socioeconomic and cultural disadvantages, which the pregnancy will exacerbate. The problems of the pregnant adolescent are more complex when she also has a severe medical handicap. We draw upon such a case to illuminate the issues which arise when medical problems interact with the vicissitudes of adolescence. Although it is clear that the patient's own behavior contributed substantially to the tragic outcome of this case, we believe that greater professional anticipation of the contingencies of adolescent development might have produced a more favorable result.     

Positivism and its vicissitudes: The role of faith in the social sciences

Positivism is a subject about which much is said, yet little understood. Of central importance for the history of the social and behavioral sciences, Postivism appears in widely various guises: as logical positivism of the Vienna School, as a sort of anti-theoretical empiricism against which many theoreticians have railed, and as a doctrine of faith for the regeneration of a broken society. Concentrating on the latter, the author inquires into the development of Positivism in nineteenth-century France in the writings of Saint-Simon, Comte, and Durkheim, all of whom emphasized the role of faith in determining certainty, or, at the very least, in keeping doubt at bay. The thinking of these French Positivists is then linked with the pragmatism of William James.     

The enduring presence of Heinz Kohut: empathy and its vicissitudes

This paper expands upon and further develops the centrality of empathy in psychoanalysis as offered by Heinz Kohut. Using clinical examples, it differentiates sustained empathy as the distinctive component of psychoanalysis, and it demonstrates some of the difficulties in determining the boundaries of empathy in the practice of psychoanalysis. A further distinction is from mind reading, a purely cognitive exercise, as is intuition (Carruthers 2009). To pursue a psychoanalytic perception of empathy one must confront its limitations and go beyond the somewhat simplistic claim of its unquestioned therapeutic effect. Empathy is more than a cognitive act, and as sustained over time it can be difficult to achieve, can be misunderstood, and can at times have no therapeutic effect.     

Analysis of the Vocal Profiles of Male Seduction: From Exhibition to Self-Disclosure

The authors analyzed the suprasegmental (temporary) vocal profiles of 19 young men (not married) during their seductive interaction with 19 young women (not married) whom they had not known previously. The aim of the research was to verify the specificity, the sequential temporal stream, and the efficacy of the acoustical features of the seducer's voice during seductive interaction. In an ecological laboratory situation, the male participants were asked to meet their female partners. Participant-by-participant analysis showed that the male seductive voice is characterized by strong variations during the course of the seductive sequence. At the beginning of the sequence it had a higher pitch and an elevated intensity, as well as a faster rate of articulation than it did during normal speech (the exhibition voice). In the following phases it became gradually lower, weaker, and warmer (the self-disclosure voice). The modulation and variability of the vocal profiles during the seductive interaction were significantly stressed in the 9 successful seducers (those who succeeded in arranging a subsequent meeting with the partner), compared with the 10 unsuccessful seducers. The results have been interpreted as an ability to perform an effective local management of seductive communication.     

On the vicissitudes of early primary surrogate mothering

I have noted estrangement from biological mothers and intolerance of intimate relationships in patients with an early history of primary surrogate mothering. This observation facilitated discovery of such early histories in 31 of 102 patients I examined during a five-year period. With a review of the literature, and clinical examples, I attempt to associate the estrangement and intolerance with the mother's exclusion resulting from her infant's close tie to a surrogate and the infant's inevitable traumatic loss of the latter. In the analyses of screen phenomena, mother and surrogate mother transferences, all peculiar to that caretaking, the surrogate is seen to emerge from obscurity. In the clinical examples (limited to losses of surrogates following the infant's eighteenth month) screen memories, dreams, and eclipse are found to possess a common feature: the image of the surrogate is screened by that of the mother. Biological mother and, in the countertransference, the analyst play a significant role in perpetuating the concealment of the surrogate.     

On the vicissitudes of Freud's early mothering. I: Early environment and loss

Utilizing case examples and published accounts of Freud's infancy, I attempt to demonstrate that an upheaval in Freud's life, with a desperate turning to his mother and to oedipal issues, was the result of the loss of his nurse.     

Some vicissitudes of aggression in the interpretive process.

Interpretation is a product of compromise formation that requires optimal use of the analyst's aggression to be an effective analytic intervention. Aggressive aims useful for the interpretive act are problematic for analysts and have led both to clinical difficulties and to various theoretical reactions against considering interpretation essential for analytic progress. In analysis, diverging aims of analyst and patient are highlighted in connection with the analyst's function as interpreter. The interactions between patient and analyst pertaining to interpretation provide insights into the patient's intrapsychic conflicts that may be less apparent in other material.