Identifications Annealed,Adhesive and Political: Commentary on Paper by Nina Farhi

Farhi's fascinating paper pays tribute to and extends those segments of Milner's clinical work that Milner hesitated to theorize explicitly herself. Seeking to understand the latter, I trace psychoanalytic politics in general and the history of Milner's relationships with Winnicott, Klein, and Riviere in particular to explore how her dutiful compliance to the rigid taxonomy of psychoanalytic power of her time bore on the trajectory of her becoming an analyst with a mind of her own. It is in accounting for how she struggled to disentangle herself from that web, that we discover how Milner was able to creatively refashion her work with her patient Susan, a process by which Susan was greatly impacted.

Following the trail of Farhi's ideas around this process and considering her thoughts around their psychic meanings for both analyst and patient, I explore their clinical implications. I focus on the transferential iterations of these dynamics to consider Farhi's suggestion that an annealed bond needs to be established in the treatment of patients who have, early in life, failed to develop annealed identifications. This opens up questions around how such bonds can malignantly colonize the analyst's mind and psychic reality, raises questions of self-care in the analyst and contributes to prognostically anticipating certain sets of enactments in the course of long-term psychoanalyses.     

From Survival to Creative Destiny: The Psychoanalytic Journey of Nina Farhi

Initially, this paper briefly introduces the work of my colleague, Nina Farhi, who was a highly respected psychoanalytic psychotherapist in London and who sadly died last year. After her death, I was invited to discuss both her paper, “The Hands of the Living God,” and the three commentaries by North American analysts, all published in this issue. As part of my commentary, I provide an appreciative yet critical discussion of the way Farhi uses the term “intersubjectivity.” I argue that there is a need for paternal function or a third position to be found in the mind of the analyst in the later phases of work with deeply disturbed patients. I also contribute to the hypothetical debate about whether or not experiences in the womb can be subject to analytic work, using the Lacanian concept of the “Real” and Piontelli's work on fetal and child observation. After this, I explore some of the ways Lacan revised drive theory and discuss these in relation to psychic devolution in later life, essential aloneness and creative human destiny. Finally, I look at how Farhi's paper's posthumous publication may have affected the commentary.     

Creating an Intersubjective Reality: Commentary on Paper by Arnold Rothstein

The author discusses Arnold Rothstein's paper “Compromise Formation Theory: An Intersubjective Dimension” and challenges his definition of intersubjectivity. She offers a perspective in which the import of intersubjectivity theory is less to dissolve the notion of objectivity than to grasp processes of mutual engagement, regulation, and recognition. While it is true that the recognition that the analyst is also a subject and therefore does not have exclusive knowledge is an important shift in the psychoanalytic paradigm, the author suggests that the intersubjective is far more encompassing than this. Intersubjective theory emphasizes the active creation of consensus or conflict about reality rather than merely the recognition that the analyst's perspective on reality is subjective. This cocreation produces a different emotional experience of connection, not merely a change in the quality of insight. Finally, Rothstein's case illustrates how he responds to the need for recognition and regulation. He shows us how focusing on the procedural allowed him to make an intersubjective shift, not simply an intrapsychic interpretation of compromise formation.     

Commentary on Paper by Hilary Hoge

In this discussion the author raises the question of the analyst's freedom to sustain paradoxical viewpoints, specifically with regard to dream interpretation and related links to internal objects and the self as they appear in the transference. Paradox allows for the creation of multiple, coexisting meanings that can be played with by patient and analyst. Paradox also makes possible an experience of decentering and destabilization pursuant to Bion's catastrophic change. The risk inherent in the emotional experience of catastrophic change may limit and at times foreclose both patient's and analyst's freedom to tolerate and sustain the effects of paradox.     

Commentary on Paper by Michael Parsons

A range of clinical psychoanalytic approaches in the United States is considered as they may parallel Parsons's presentation of an “independent” orientation in Britain.

Attention is paid in particular to the analyst's sense of outsiderness and concern for otherness, along with their moral implications for clinical work. In addition, the limitations of theory and defensive misuse of theory are also addressed.     

Commentary on Paper by Julie Gerhardt

This review discusses factors producing excessive envy in some personalities innate, environmental and developmental. He agrees with Julie Gerhardt that envy is not atomic but molecular and evoked in triangular situations. However he suggests that factors that may manifest themselves in the earliest infantile stage can contribute to its later development and agrees with Gerhardt that the earliest mother infant interaction is crucial.     

Commentary on Paper by Steven Cooper

In this discussion of Steven Cooper's paper, it is argued that, although Cooper's desire to hold himself “accountable” in his work with patients is laudable, the “pluralistic third” approach that he employs gives rise in his doing so to several difficulties in the way that it is described in the paper. The vivid clinical material that Cooper provides to illustrate his approach is used as a starting point to offer an understanding of what transpired between analyst and patient, which although convergent with Cooper's formulations in some respects nevertheless follows a very different line of thinking in other areas. Broadly speaking, it is suggested that although these divergences arise from many sources—a discussion of which is beyond the scope of this contribution—one particular issue involved is a rather different understanding of the role of early internalized object relations in the patient's psychic life and the way these get lived out at many levels in the treatment situation. It is further argued that Cooper's conceptualization of the approaches of schools different from his own appears somewhat circumscribed and this detracts from his desire to make an authentic comparison between his way of working and those of other schools, something that is called for by his proposed pluralistic third method of keeping himself accountable. This is not considered surprising given the difficulties inherent in our becoming adequately familiar, in more than just an intellectual way, with the approaches of schools different from our own, especially when wide divergences are involved between schools.     

Commentary on Paper by Terry Marks-Tarlow

This discussion of the paper merging and emerging: A nonlinear portrait of intersubjectivity during psychotherapy focuses on how the original paper demonstrates the usefulness of the concepts of nonlinear dynamics systems theory (NLD) to clinical psychoanalysis. Diagnosis conceptualize in NLD terms successfully resists the pressure to reduce complex situations to overly simple few word phrases. The phenomena of transference and repetition are redescribed as resulting from an iterative process that is evident in complex adaptive systems. The model of psychoanalysis in terms of coupled oscillators is demonstrated to be clinically useful as is the concept of emergence which overcomes some of the less useful aspects of the reductionist program. The idea of studying boundaries per se, as opposed to their function of separating individuals, arises naturally from the study of fractals and promises to clarify the oversimplified discussions of these matters in the psychoanalytic literature. The original author has successfully demonstrated how useful NLD conceptualizations can be to the clinical psychoanalyst.     

Commentary on Paper by Danielle Knafo

The author discusses the importance of Knafo's rich paper on the often neglected subject of solitude but argues for a clearer demarcation of the multifarious states of aloneness, solitude, loneliness, and isolation. While solitude constitutes a state of plentitude, demonstrating an ability to be alone in the company of an Other, loneliness, in contrast, conjures up a sense of dread and despair, foreseeing no link to an Other. Hence, an artwork can fulfill radically different aspects of the various states of aloneness, it can be a product emerging out of a full sense of solitude, or it can function as a forceful shield against the unbearable sense of loneliness.     

Commentary on Paper by Ken Corbett

A report on the third analysis of a 41-year-old man who had been a feminine boy is used as a vehicle to describe the idiographic aspects of this way of being as well as to specify the input of the environment—parents, analysts, community. The role of self with mother, self with father, and self with mother and father together representations is explored and Zadie Smith's concept of dual citizenship and multiple internal voices is featured as an integrating and explanatory concept. The ways in which each analysis highlights different aspects of the patient's conflicts and dilemmas and reflects successive intrapsychic organizations is also explored.     

Commentary on Paper by Debra Rothschild

In my response to this paper, I begin by appreciating Debra Rothschild's relational approach and pointing to the links with our work at the Clinic for Dissociative Studies. For example, we all respond differently to child alters/states than to adult ones, consider the attachment relationship to be the crucial tool, do not like to see distancing mechanisms privileged by abusing the original concept of “neutrality,” and consider honesty and authenticity are essential when working with extreme trauma. In this we agree with Bass (2007) Bass, A. 2007. When the frame doesn't fit the picture. Psychoanalytic Dialogues, 17: 1–27. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar] that one size does not fit all. We consider patients need to choose between integration or separateness. Where integration is sought we speak of “merger not murder.” I express concern at the prevailing idea that a person with Dissociative Identity Disorder needs safety, stabilisation, and symptom reduction initially when the most needy clients are those who will never be safe. I also raise issues around secondary traumatisation to the therapist, the meaning of self-injury, and the language used to describe the angry alter.     

Stained Hands: Commentary on Paper by Gillian Straker

I attempt, in this discussion, to deconstruct the jouissance present in the witnessing of a deliberate annihilation of a human being. I propose that the crisis in the analyst's subjectivity is linked to an unconscious identification with that which is most abhorrent and unacceptable. The unknowability of trauma ensures that its presence will be enacted in a complex system of mutual influence between analyst and patient in which the roles of victim, perpetrator and bystander oscillate between and within the participants. Taking the discussion to the broader sociopolitical level, I make an analogy between the destructiveness of the South African regime under apartheid and the current destructiveness of the U.S. engaging in a pre-emptive war. In a similar way to how Straker may feel contaminated by her patient's complicity in annihilation, so too are we contaminated by the atrocities perpetuated in the name of our country, even if they are policies we condemn.     

More Metaphor: Commentary on Paper by Ken Corbett

Beyond the inevitability of countertransference feelings is the question of countertransference enactments. From a two‐person, participant‐observer or observing‐participant perspective, enactments are inevitable. The analyst becomes influenced by the patient (and influences the patient as well) and enmeshed in the patient's internalized interpersonal configurations. Analysis works not by avoiding such action but by analyzing from within the interactional system. Analysts who are different from one another become engaged in different ways, since the person of the analyst is a significant variable. This article, using case examples, explores two analyst‐related variables, age and family configuration, to expand the examination of countertransference enactments and some effects on the analytic process.     

Crossing Boundaries: Commentary on Paper by Sarah Hill

This commentary focuses on two aspects of Hill's presentation. First, it addresses the critical role of repetition compulsion in carrying into analytic enactments the patient's early, unsymbolized traumas. This discussion addresses, furthermore, Hill's reference to her early, preverbal, experience with an African nanny, as this resonated with some of the author's personal experiences. It is suggested that, particularly in American culture, the identities of white children who experience extended care by black nannies must be regarded as multiply determined, race being a critical determinant. How this aspect of white identity is negotiated in a culture bounded by established racial dichotomies is regarded as critical to analytic inquiry, regardless of the racial makeup of the analytic dyad.     

Organizational Structure and the Establishment of Psychoanalytic Identification: Commentary on Paper by Randall Lehmann Sorenson

This commentary addresses two themes: parallels between religious and psychoanalytic education and the question of group survival in a world of competitive groups, whether religious (“strict” vs. “weak”) or psychoanalytic (differing psychoanalytic approaches). “Strict” religious education involves teaching both critical thinking and identification with the particular religion. This blend of critical thinking and identification with psychoanalysis is crucial in psychoanalytic education. We want to graduate students who see themselves as psychoanalysts rather than as being “interested” in psychoanalysis. This goal is accomplished when students have close, positive experience with personal analysts, supervisors, and teachers who are strongly committed to psychoanalysis but in a manner that encourages students to think critically and find their own psychoanalytic perspective. With regard to the second theme, I discuss how our narcissistic commitment to one or another psychoanalytic model interferes with open integration of new insights. Individual analysts privately integrate competing ideas in their own idiosyncratic ways. When these individuals publicly represent competing psychoanalytic groups, however, they tend to emphasize differences among these groups. They then find ways to appropriate new ideas as extensions of their own evolving tradition. In this way, a theoretical school is able to integrate new developments while preserving its own identity.     

Commentary on Paper by Aviva Gottlieb Zornberg

In this discussion, I stress two points. First, I have underlined the powerful understanding Dr. Zornberg brings to her exegesis of the book of Jonah via her competence as Biblical scholar, literary critic, and master of psychoanalytic theory. In her hands, Jonah becomes a fully minded person, not just a moral icon. Second, I have focused on her major thesis, that Jonah's need to escape, his repeated going down into and away from himself, evolves from his putative trauma, which is comprised of not only the horror of near death but also the shock of survival.     

A Warrior's Stance: Commentary on Paper by Terry Marks-Tarlow

This commentary highlights specific aspects of a psychoanalytic complexity perspective in considering and discussing Terry Marks-Tarlow's article, “Merging and Emerging: A Nonlinear Portrait of Intersubjectivity During Psychotherapy.” The advantages of a complexity theory sensibility reside in the areas of (a) providing a robust theoretical framework for understanding the sources and phenomenology of complex emotional life and (b) understanding the clinical implications of thinking through a complexity theory lens. The latter involves examining the attitudes that emanate from such a revolutionary perspective and their impact on the therapeutic relationship and on therapeutic action and change. Special emphasis is placed on the distinction between two vital dimensions of psychoanalytic discourse: the phenomenological and the explanatory. This distinction is used as a lens through which the author considers the essential themes of understanding the complexity of the multiple sources of personal lived experience and their concomitant meanings, personal situtatedness (or “thrownness”), emotional responsibility, and personal freedom.