ANALYTIC MIND USE AND INTERPSYCHIC COMMUNICATION: DRIVING FORCE IN ANALYTIC TECHNIQUE,PATHWAY TO UNCONSCIOUS MENTAL LIFE

Developed from established psychoanalytic knowledge among different psychoanalytic cultures concerning unconscious interpsychic communication, analysts' use of their receptive mental experience—their analytic mind use, including the somatic, unconscious, and less accessible derivatives—represents a significant investigative road to patients' unconscious mental life, particularly with poorly symbolized mental states. The author expands upon this tradition, exploring what happens when patients unconsciously experience and identify with the analyst's psychic functioning. The technical implications of the analyst's “instrument” are described, including the analyst's ego regression, creation of inner space, taking mind as object, bearing uncertainty and intense affect, and self‐analysis. Brief case vignettes illustrate the structure and obstacles to this work.     

THE VIBRANT CHALLENGES OF CLINICALLY EFFECTIVE PSYCHOANALYTIC MINDEDNESS

In addressing the central challenges of developing and maintaining the analyst's psychoanalytic mindedness, this paper focuses on two particularly challenging core components of clinical effectiveness not so easily developed despite the rigors of the tripartite training model. The first is the analyst's receptivity to unconscious communication, which entails the analyst's curiosity, acceptance of human nature, doubt, restraint, narcissistic balance, and integrity. A brief clinical vignette illustrates this. The second factor is recognizing and managing the inherent disappointments and narcissistic challenges in working psychoanalytically. The author maintains that the ability to lose and subsequently recover one's analytic mind entails discipline, courage, and faith that only experience can provide.     

Private Terrors Sexualized Aggression and a Psychoanalyst's Fear of Her Patient

This clinical paper explores the meanings and evolution of an analyst's reaction of fear in relation to her patient's sexualized aggression. From both an intrapsychic and an intersubjective perspective, the author analyzes the coconstruction of this transference—countertransference phenomenon. Case vignettes illustrate the author's attempts to address her patient's sexualized aggression while struggling to free herself from the feelings of intimidation and fearfulness stirred by his sadomasochistic fantasies and patterns of interaction. The analyst's unconscious identification with the patient's disowned femininity and narcissistic vulnerability is seen as central to this countertransference “stranglehold.” Release from the analyst's masochistic position comes through a shift in her own affective participation. The importance of the analyst's recognizing her own unconscious contributions to this sadomasochistic dynamic is emphasized and elaborated. Discussion also focuses on the relevance of gender to the issue of countertransference fear, as illustrated in this particular male patient—female analyst dyad.     

From “disciplined subjectivity” to “taming wild thoughts”: Bion's elaboration of the analysing instrument

Abstract

Freud encouraged the analyst to use his unconscious “as an instrument of the analysis,” but did not elaborate on how this should be done. This recommendation opened the door to a consideration of unconscious communication between the analyst and patient as an intersubjective exchange. Both Wilfred Bion and Erik Erikson emphasised the importance of the analyst's intuition, and the author compares and contrasts these two approaches. Erikson advocated a more cautious attitude regarding the analyst's subjectivity, while Bion promoted a broader application of the analyst's various private reactions to the analysand. A brief vignette from the analysis of a five-year-old boy is offered to illustrate the importance of the analyst's reveries, the mutual process of containment and transformation between analyst and patient, and the co-creation of an analytic narrative.     

Between memory and destiny: Repetition1

This essay focuses mainly on the topic of repetition (agieren)—on its metapsychological, clinical, and technical conceptions. It contains a core problem, that is, the question of the represented, the nonrepresented, and the unrepresentable in the psyche. This problem, in turn, brings to light the dialectical relation between drive and object and its specific articulation with the traumatic. The author attributes special significance to its clinical expression as ‘destiny’. He points out a shift in the theory of the cure from recollection and the unveiling of unconscious desire, to the possibility of understanding ‘pure’ repetition, which would constitute the very essence of the drive. The author highlights three types of repetition, namely, ‘representative’ (oedipal) repetition, the repetition of the ‘nonrepresented’ (narcissistic), which may gain representation, and that of the ‘unrepresentable’ (sensory impressions, ‘lived experiences from primal times,’‘prelinguistic signifiers,’‘ungovernable mnemic traces’). The concept‐the metaphor‐drive embryo brings the author close to the question of the archaic in psychoanalysis, where the repetition in the act would express itself. ‘Another unconscious’ would zealously conceal the entombed (verschüttet) that we are not yet able to describe‐the ‘innermost’ rather than the ‘buried’ (untergegangen) or the ‘annihilated’ (zugrunde gegangen)‐through a mechanism whose way of expression is repetition in the act. With ‘Constructions in analysis’ as its starting point, this paper suggests a different technical implementation from that of the Freudian construction; its main material is what emerges in the present of the transference as the repetition of ‘something’ lacking as history. The memory of the analytic process offers a historical diachrony whereby a temporality freed from repetition and utterly unique might unfold in the analysis. This diachrony would no longer be the historical reconstruction of material truth, but the construction of something new. The author briefly introduces some aspects of his conception of the psyche and of therapeutic work in terms of what he has designated as psychic zones. These zones are associated with various modes of becoming unconscious, and they coexist with different degrees of prevalence according to the psychopathology. Yet each of them will emerge with unique features in different moments of every analysis, determining both the analyst's positions and the very conditions of the analytic field. The zone of the death drive and of repetition is at the center of this essay. ‘Pure’ repetition expresses a time halted by the constant reiteration of an atemporal present. In this case, the ‘royal road’ for the expression of ‘that’ unconscious will be the act. The analyst's presence and his own drive wager will be pivotal to provide a last attempt at binding that will allow the creation of the lost ‘psychic fabric’ and the construction, in a conjectural way, of some sort of ‘history’ that may unravel the entombed (verschüttet) elements that, in these patients' case, come to the surface in the act. The analysand's ‘pure’ repetition touches, resonates with something of the new unconscious of the analyst. All of this leads the author to underline once again the value of the analyst's self‐analysis and reanalysis in searching for connections and especially in differentiating between what belongs to the analyst and what belongs to the analysand. A certain degree of unbinding ensures the preservation of something ungraspable that protects one from the other's appropriation.     

The analyst's countertransference to the psychoanalytic process1

There is countertransference, not just to individual patients, but to the process of psychoanalysis itself. The analytic process is a contentious topic. Disagreements about its nature can arise from taking it as a unitary concept that should have a single defi nition whereas, in fact, there are several strands to its meaning. The need for the analyst's free associative listening, as a counterpart to the patient's free associations, implies resistance to the analytic process in the analyst as well as the patient. The author gives examples of the self‐analysis that this necessitates. The most important happenings in both the analyst's and the patient's internal worlds lie at the boundary between conscious and unconscious, and the nature of an analyst's interventions depends on how fully what happens at that boundary is articulated in the analyst's consciousness. The therapeutic quality of an analyst's engagement with a patient depends on the freeing and enlivening quality, for the analyst, of the analyst's engagement with his or her countertransference to the analytic process.     

A mismatch of meaning and intentionality between analyst and analysand

In this paper, I will consider a type of misunderstanding in the analytical dialogue and the possible unconscious motivations underlying this. I will also make reference to the patient's use of the analyst's words for the purpose of narcissistic enactment and will explore the extent of the analyst's involvement in this. The subjects of misunderstanding and narcissistic enactment will be dealt with in relation to a patient's way of processing certain interpretations at the beginning of analysis and the concealment of her way of processing the analyst's words. By contributing dreams and other significant material in the sessions, the patient gradually revealed her phantasies which enabled the analyst to uncover the possible factors which determined her particular attribution of meaning to the analyst's words and her retention of information about how she had initially construed his interpretations.     

Field of Vision: Radical Uncertainty and the Analyst's Conduct: Commentary on Paper by Donnel B. Stern

There is a relationship between biography and theory. The analyst's ideas or formulations about his patients—theories really—must be determined, to some degree, by the certain and uncertain impact of his own history. Harry Stack Sullivan brought psychoanalysis squarely into the ambit of the relational/historical world by insisting that the mind is thoroughly and inherently social. In doing so, he staked a claim for the link between history, that is, social experience, and personhood. Our personalities and our theories are social-historical constructions. In relation to this, some differences between the interpersonal/relational and Bionian concepts of field theory are provided. One important difference pertains to the role of the analyst's conduct. Two meanings of conduct—to behave or to organize behavior—are at the center of what distinguishes the interpersonal/relational view of the analyst's position in the field from the Bionian view. For the relational analyst, action in the analytic field, including enactment, is conduct, and conduct is always bidirectional. The analyst, then, is a medium to alter, to reconstruct the self. He does not provide experience, he is experience. The form of an analytic exchange gives shape to the field and its content.     

Dissociation,the Analyst's Vulnerability,and the Body: Review of Awakening the Dreamer: Clinical Journeys by Philip M. Bromberg

This review praises Bromberg's rich and evocative new book for its clinical and theoretical usefulness and elaborates on three broad themes: the analyst's personal role in traumatic enactments, dissociative/addictive uses of the body, and the distinction between life-threatening and developmental trauma. Extending Bromberg's formulations, the author argues that in successful work with trauma survivors, the analyst must be actually (temporarily) traumatized as actual, personal vulnerabilities of the analyst are necessarily engaged. The analyst's vulnerability serves as an internal contact point, opening up a process of unconscious empathy with the patient and providing crucial validation of the patient's experience. The review also explores how bodily processes are used to further dissociation with eating disordered patients and how they become the source of treatment difficulties. When the patient's states of desire have been “detoured” into the body (where they are ruthlessly controlled or attacked) as well as into the relationship with food (where they are temporarily gratified), they are not as available to be mobilized in the analytic relationship. The review also questions Bromberg's assumption that the underlying dissociative mechanisms are the same for life-threatening trauma (or Posttraumatic Stress Disorder) and developmental (or relational) trauma.     

Cross-Continental Divides Regarding Survival,Play, and Enactment: Reply to Commentaries by Keene,Ilahi, and Coen

The author distinguishes between the ways that the Independent Group and Relational Theorists conceptualize object survival, play, enactment, and mutuality. American relational theory is simultaneously focused on both the patient's and analyst's experience and the patient's inner representational world. Interaction is informed by and informs our understanding of the patient's conflicts including forms of enactment. In contrast, analysts from the Independent Group tend to view the American interest in interpersonal phenomena and perceptual dimensions of the patient's experience as a distraction from unconscious representations. For relational analysts in the United States, maternal functions of reverie emphasized by the Independent Group are seen as one dimension of the analyst's complex subjectivity, which may be used in containment and interpretation. For relationally oriented analysts containment itself is postulated as to some degree porous unlike the notion of analytic functions of reverie emphasized by the Independent Group. The author tries to focus on these points of divergence and overlap between the two theoretical orientations and their application to case material.     

Unconscious fantasy (or phantasy) as clinical concept

A clinical phenomenology of the concept ‘unconscious fantasy’ attempts to describe it from a ‘bottom‐up’ perspective, that is, from the immediate experience of the analyst working in session. Articles of psychoanalytic authors from different persuasions are reviewed, which taken as a whole would shed some light on how the concept of unconscious fantasy takes shape in the analyst's mind during the session with the patient. A clinical phenomenology in three steps is described. Each step is illustrated by clinical material. Current controversies around the concept of unconscious fantasy (or phantasy) are still trapped in the discussion about if and how they are really unconscious. The strategy to describe from a ‘bottom‐up’ perspective the process of how the analyst's mind embraces the idea that an emerging phenomenon in the relationship with the patient can be defined as ‘unconscious fantasy’, allows us to elude the question as to whether or not we believe that unconscious fantasies exist at all, since we are neither required to assert or deny such a prior existence in order to describe the process of elaboration which, in the end, does formulate a fantasy as fantasy.     

Between listening and expression

This paper sets out to conceptualize what goes on in the analyst's mind as he listens—and expresses something—to the patient. Bion's ideas of approaching the patient's O, without memory and desire, are discussed. An alternate, more permissive, attitude to desire is suggested. This is based on the idea that containment, instead of denoting a dyadic interaction between mother and child, is a process which links the child to a begetting couple, thus a triad. Containing the patient corresponds, in the unconscious, to thinking about a sexual couple in a mutually beneficent interaction. Since the patient's anxiety, in his unconscious, parallels a frightening primal scene, containment is viewed as a continuous translation of a primitive primal scene into a mature act of love. A specific kind of genital desire is thus necessary for containment. This finds expression in the analyst's resonance with the patient. Clinical material from an analysis with a 7-year old boy is provided.     

The basic tools of psychoanalysis

The objective of psychoanalysis is to help the analysand make the contents of his or her psyche conscious to him- or herself In this paper, the author identifies four tools central in the attempts to reach this goal: (1) the analysand's self- observation; (2) the analyst's assistance in identifying the obstacles to self-observation (i.e., resistance analysis); (3) the analysand's bringing unconscious contents into the sphere of self-observation with the help of the analyst's interpretations; (4) turning the analysand's tendency to account for the listener into an object of self-observation (i.e., the analysis of transference). Of these tools, the first is regarded as the most fundamental; all methodological instruments used in psychoanalysis aim at enhancing the scope of the analysand's self-observation. Some difficulties in keeping this aim are identified, and the analysand's autonomy in this work is pointed out, leading to the conclusion that the analysand never becomes changed in an analysis; the analysand might, however, change him- or herself as a consequence of a newly-won self-observation.     

Characters on the Stage. Ibsen's “Life-Lie” Revisited

The authors inquire as to how far psychoanalysis uses its inherent capabilities to decipher the inner structure of subjectivity in present-day psychoanalytic practice and thinking. They maintain that in psychoanalytic practice, the analyst's unresolved neurotic conflicts cause him to create conscious mystifications of his own unconscious situation, thus distorting his understanding of the patient's unconscious in a systematic manner.     

The Analyst's Anticipatory Fantasies: Aid and Obstacle to the Patient's Self-Integration

In this paper I explore instances of enactment related to the analyst's feelings and fantasies about how analysis will proceed. As I discuss a patient who was developing a new capacity to experience conflict, I explore how the analyst's fantasies about the impact of his interpretations may be utilized in helping him to elaborate and understand the patient's unconscious fantasies and identifications and unintegrated feeling states. In so doing, we sometimes discover how we are unwittingly influencing or avoiding understanding our patient's own version of their psychic catastrophe. As we develop language where there was previously no integrative language for the patient's internalized and interactive version of catastrophe, we always project particular kinds of expectations into the therapeutic situation.     

Psychotherapy in the aesthetic attitude

Abstract: Drawing upon the writings of Jungian analyst Joseph Henderson on unconscious attitudes toward culture that patients and analysts may bring to therapy, the author defines the aesthetic attitude as one of the basic ways that cultural experience is instinctively accessed and processed so that it can become part of an individual's self experience. In analytic treatment, the aesthetic attitude emerges as part of what Jung called the transcendent function to create new symbolic possibilities for the growth of consciousness. It can provide creative opportunities for new adaptation where individuation has become stuck in unconscious complexes, both personal and cultural. In contrast to formulations that have compared depth psychotherapy to religious ritual, philosophic discourse, and renewal of socialization, this paper focuses upon the considerations of beauty that make psychotherapy also an art. In psychotherapeutic work, the aesthetic attitude confronts both analyst and patient with the problem of taste, affects how the treatment is shaped and ‘framed’, and can grant a dimension of grace to the analyst's mirroring of the struggles that attend the patient's effort to be a more smoothly functioning human being. The patient may learn to extend the same grace to the analyst's fumbling attempts to be helpful. The author suggests that the aesthetic attitude is thus a help in the resolution of both countertransference and transference en route to psychological healing.     

Activating and Enlivening Ourselves and Our Patients: Commentary on Paper by Susan H. Sands

In my response to Sands's paper I offer comments on four aspects of clinical work with dissociation: the sensory power of language, the evocation of the analyst's own dissociated experience and internal growth, the question of the relationship between dissociation and unconscious experience, and the different responses evoked by patients who are at different points on the path toward association.     

Journal reviews

Articles reviewed: Astor, James: ‘Some Jungian and Freudian perspectives on the Oedipus myth and beyond’. Colman Warren: ‘That within which passes show: Hamlet and the unknowable Self’. Halberstadt-Freud H. C: ‘Electra versus Oedipus à Femininity reconsidered’. Kulish, Nancy & Holtzman, Deanna: ‘Persephone, the loss of virginity and the female Oedipus complex’ Hopkins, Linda B: ‘D. W. Winnicott's analysis of Masud Khan: a preliminary study of failures of object usage’. Miletic, Michael (ed.): ‘Perspectives on the analyst's self-disclosure during psychoanalysis’. Miletic, Michael J. (ed.): ‘Perspectives on the analyst's self-disclosure during psychoanalysis’. Ornstein, Anna: ‘The fate of narcissistic rage in psychotherapy’. Solomon, Hester McFarland: ‘Love, Paradox of Self and Other’. Stack, Carolyn: ‘The analyst's new clothes: the impact of the therapist's unconscious conflicts on the treatment process’. Von Der Tann, Matthias: ‘Was lesen Jungianer in Berlin für das Examen?’–‘What do Jungians in Berlin read for their final paper?’     

THE ANALYST'S APPROACH AND THE PATIENT'S PSYCHIC GROWTH

Psychoanalysis, which shares many functions with other therapies, is built upon its unique concern for the unconscious forces active behind a patient's symptoms and difficulties. What defines psychoanalysis is the analyst's approach as a disciplined engagement in the service of exploring those forces and their roots, an approach that is the product of curiosity working in the service of the other. As a result of the analyst's actualizing this approach, the patient comes to benefit not only from whatever specific declarative interpretations and insights have been explicitly opened, but also, importantly, from observing and taking in the unspoken underlying psychoanalytic mental processes. In this light, the patient's significant capacities for empathy, a subject often neglected, are also discussed. ¹