Mutual Vulnerability: Intimacy,Psychic Collisions,and the Shards of Trauma

In this paper, I explore the profound potential, and the challenges, of mutual vulnerability in psychoanalysis. I describe ways in which analysts are penetrated by shards of our patients’ trauma, and how this interpenetrates with our own vulnerabilities and ungrieved losses (Harris, 2009; Levine, 2016). In my patient Lisa’s fierce determination to come into being, and in our mutual efforts to survive each other’s ruthlessness (Winnicott, 1969) we each struggle to recognize and own malignant “not-me” versions of ourselves (Bromberg, 1998), as we reach toward reparation, mutual recognition, and healing.     

When theory and practice diverge: gender-related patterns of referral to psychoanalysts.

This study tests the hypothesis that female analysts, relative to male analysts, receive a disproportionately small percentage of male referrals. Referral patterns for 170 analysts from four institutes accredited by the American Psychoanalytic Association were examined. One thousand, five hundred and ten patients referrals were studied. The findings were extremely robust and offered dramatic confirmation of our hypothesis. The major implications of the study are as follows: (1) Women analysts receive relatively few adult male referrals, making it difficult for them to gain requisite clinical experience with men. (2) Analysts and nonanalysts alike demonstrate a reluctance to refer male patients to female analysts. (3) Adult referrals, including those made by analysts, are significantly influenced by the issue of gender match between patient and analyst. (4) Analysts' behavior with regard to making referrals does not correspond to explicit clinical theory regarding how analysts make referrals--specifically, the extent to which gender influences the referral process is not adequately described by theory. We believe that these findings are of some concern from the standpoint of analytic education and that they also raise questions regarding unacknowledged aspects of how gender match between patient and analyst enters into clinical decision making.(ABSTRACT TRUNCATED AT 250 WORDS)     

The educational boundary1

In this contribution, the authors defi ne and discuss the educational boundary in analytic training, which they believe is an often neglected and useful concept in psychoanalytic education. The framework on which their discussion rests includes the recent attention of psychoanalysts to issues of boundaries and ethics. Their understanding of how clinical work affects the mind of the analyst educator, as well as the ways the personalities of various analysts affect their dealings with faculty peers and students, are the other cornerstones of their discussion. The authors contend that many of the institutional problems encountered in the training of analysts can be better understood when viewed through the prism of the educational boundary. They present examples which illustrate several of the ways psychoanalytic educators complicate the training experience of candidates, offer specifi c explanations as to why analysts struggle as they try to manage their educational interventions, and indicate in a discussion of potential remedies that those behaviors might be avoided if the educational boundary is in focus. They also provide an example of how the educational boundary can be more effectively managed.     

A note on the history of the Norwegian Psychoanalytic Society from 1933 to 1945

The Norwegian analysts, who were trained in Berlin before 1933, were drawn into a struggle against fascism, informed by politically leftist analysts who worked at the Berlin Institute. The Norwegian group, including the analysts Wilhelm Reich and Otto Fenichel, were committed to Marxist or social democratic ideologies in order to fight down fascism and Nazism. They were a source of inspiration but also of conflict. After the war the leadership of the IPA was sceptical about the Norwegian group because of its former connections with Die Linke, as well as its relations with Wilhelm Reich. This paper in part considers the courageous efforts of Nic Waal, whom Ernest Jones used as a delegate and courier to solve problems for the IPA and who was unjustlytreated after the war.     

CONSUETUDO CARNALIS IN AUGUSTINE'S CONFESSIONS: Confessing Identity/Belonging to Difference

The political theorist William E. Connolly reads Augustine's Confessions as an exhortation to deny the paradox of identity/difference. The paradox for Connolly is this: if one confesses a true identity, one must be false to difference, but if one is true to difference, one must sacrifice the promise of true identity. I revisit Augustine's Confessions here in order to offer a reading of their paradoxical character that contrasts with Connolly's. I will argue that Augustine's confession does not deny the paradox of identity/difference but exemplifies what it means to struggle within it. I turn to James Wetzel's work on Augustine's idea of free will and Catherine Keller's work on the doctrine of creatio ex nihilo to suggest that treating Augustine's confession as confession reveals this struggle.     

The dark side of analytic conviction: impasses of omniscience and complacency

It is common for analysts to struggle with substantial periods of impasse, and with the associated subjective feelings of shame and failure, while analyzing patients who rely heavily on narcissistic defenses. Facing the feelings that accompany periods of impasse, while at the same time pushing oneself to take necessary creative risks, is a huge and painful task for the analyst if it is deeply confronted. These patients engage in false uses of the analytic process in which the pursuit of understanding is systematically undermined. In response, the analyst is susceptible to being drawn in to processes of mutual seduction, false conviction, and impasse. Through the analyst's partial living out of the patient's projective identifications (and eventually observing the patient's living out of the analyst's projective identifications), the analyst is able to gain a depth of understanding of the patient, of him- or herself, and of the interaction that might not otherwise be possible. Because analysts tend to employ theory defensively, it is essential that they attend, through self-analysis and consultation, to the ways in which they use it. Two cases are presented in which prolonged impasses were eventually understood and resolved.     

Seeking an Analytic Identity

Abstract

Rothstein has stimulated all analysts to rethink how we can better commit ourselves to our analytic work. In this paper I focus on factors in analysts' personalities and experiences in their training and practice that contribute to or distract from establishing an analytic identity.

First, I explore analysts' background and motivation. In admissions to psychoanalytic institutes we look for candidates who can see psychoanalysis as an intellectual puzzle to be solved and an emotional involvement to be experienced. We look for earlv conflicts that the candidate can sublimate in the service of analytic functioning. We assume that the capacity to sublimate is only partial and that analysts in their development continue to recognize conflicts in transference—countertransference reactions.

Second, I give some examples of experiences from analysts' training that stimulate the formation of their analytic identities. These include transient identifications and counter-identifications with the training analyst, supervisor, seminar leader, and favorite analytic authors.

Third, I discuss more external factors that influence the development of analytic identity. These include the climate in training and continuing education at the institute. How much does the institute support its members in immersion in psychoanalysis? Economic factors continue to he an important factor in determining individual choice in this immersion.

Finally, I review studies on the effectiveness of psychoanalysis. Dedicated analysts with considerable experience believe that analysis works despite some limitations. Part of high motivation to continue analytic work includes understanding how analytic results differ from the simpler solutions achieved by nonanalytic therapies.     

Free Love: A Hegelian Defense of Same‐Sex Marriage Rights

By revisiting Hegel's Philosophy of Right, I mount a Hegelian defense of same‐sex marriage rights. I first argue that Hegel's account of the Idea of freedom articulates both the necessity of popular shifts in the determinations of the institutions of right, as well as the duty to struggle to progressively actualize freedom through them. I then contend that Hegel, by grounding marriage in free consent, clears the path for expanding this ethical institution to include all monogamous couples. Lastly, I close by sketching the specifically Hegelian reasons we ought to actively struggle to expand the institution of marriage.     

Analytic Confidence and Political Decision‐Making: Theoretical Principles and Experimental Evidence From National Security Professionals

When making decisions under uncertainty, it is important to distinguish between the probability that a judgment is true and the confidence analysts possess in drawing their conclusions. Yet analysts and decision‐makers often struggle to define “confidence” in this context, and many ways that scholars use this term do not necessarily facilitate decision‐making under uncertainty. To help resolve this confusion, we argue for disaggregating analytic confidence along three dimensions: reliability of available evidence, range of reasonable opinion, and responsiveness to new information. After explaining how these attributes hold different implications for decision‐making in principle, we present survey experiments examining how analysts and decision‐makers employ these ideas in practice. Our first experiment found that each conception of confidence distinctively influenced national security professionals' evaluations of high‐stakes decisions. Our second experiment showed that inexperienced assessors of uncertainty could consistently discriminate among our conceptions of confidence when making political forecasts. We focus on national security, where debates about defining “confidence levels” have clear practical implications. But our theoretical framework generalizes to nearly any area of political decision‐making, and our empirical results provide encouraging evidence that analysts and decision‐makers can grasp these abstract elements of uncertainty.     

Traversing Narcissistic Pathways: From Freud to Present Times

This article begins with Freud’s struggles in dealing with the concept of transference. His struggles were particularly acute with certain types of narcissistic patients. The view presented is that Freud, in some ways, was prototypic of the type of struggles that contemporary analysts have in allowing transference manifestations to effloresce. Kohut is seen as advancing the struggle and setting a new boundary for analyzability that allowed analysts to begin to move into the patient’s world. Bach, Winnicott, Bion, and Klein are then pictured as moving the boundary in a manner that allowed for a greater range of patients to survive in the analytic situation. The difficulties in allowing the transference, and particularly narcissistic and fragmentary transferences, to unfold are discussed in the light of several clinical examples.     

Life, death and (inter)subjectivity: realism and recognition in continental feminism

I begin with the assumption that a philosophically significant tension exists today in feminist philosophy of religion between those subjects who seek to become divine and those who seek their identity in mutual recognition. My critical engagement with the ambiguous assertions of Luce Irigaray seeks to demonstrate, on the one hand, that a woman needs to recognize her own identity but, on the other hand, that each subject whether male or female must struggle in relation to the other in order to maintain realism about life and death. No one can avoid the recognition that we are each given life but each of us also dies. In addition, I raise a more general, philosophical problem for analytic philosophers who attempt to read Continental philosophy of religion: how should philosophers interpret deliberately ambiguous assertions? For example, what does Irigaray mean in asserting, ‘Divinity is what we need to become free, autonomous, sovereign’? To find an answer, I turn to the distinctively French readings of the Hegelian struggle for recognition which have preoccupied Continental philosophers especially since the first half of the last century. I explore the struggle for mutual recognition between women and men who must face the reality of life and death in order to avoid the projection of their fear of mortality onto the other sex. This includes a critical look at Irigaray’s account of subjectivity and divinity. I turn to the French philosopher Michèle Le Doeuff in order to shift the focus from divinity to intersubjectivity. I conclude that taking seriously the struggle for mutual recognition between subjects forces contemporary philosophers of religion to be realist in their living and dying. With this in mind, the lesson from the Continent for philosophy of religion is that we must not stop yearning for recognition. Indeed, we must even risk our autonomy/divinity in seeking to recognize intersubjectivity.     

The Divergent Paths of Behavior Analysis and Psychology: Vive la Différence!

Twenty years ago I suggested that behavior analysts could effect a quiet and covert takeover of the American Psychological Association (APA). I gave as precedents the operation of similar initiatives in the nineteenth and twentieth centuries, the Darwinian-inspired X-Club, and the psychoanalytically-oriented Secret Ring. Though a conscientious program of working within established APA bylaws and rules, behavior analysts could ensure that behavior analysts were nominated for every significant elective position within the APA, and move to get their colleagues placed in appointive positions, such as journal editorships, review boards, and major committees. This would be one approach to remake psychology along behavioral lines, which was an early ambition of B. F. Skinner. The community of behavior analysts ignored my suggestion, and instead pursued the path of creating an independent discipline of practitioners, one with its own degree-granting programs, conventions, journals, and legal regulation. This effort has been immensely successful, although much critical work remains to be done. In retrospect, I was wrong to suggest changing psychology from within, and I have been delighted to witness the emergence of our new and independent field.     

Journeys through the valley of death: multimethod psychological assessment and personality transformation in long-term psychotherapy

The Psychodynamic Diagnostic Manual (PDM Task Force, 2006) is based on the assumption that an in-depth understanding of clients' underlying emotional, personality, and interpersonal patterns will facilitate their treatment. In this article I show how such an understanding can be achieved through multimethod psychological assessment, and how useful such information can be in long-term psychotherapy with high-achieving, successful clients who struggle with forming and maintaining intimate relationships. Such treatments are extremely difficult, because when these clients attach to their psychotherapists, many of them temporarily become more symptomatic. I illustrate these points with a detailed account of my long-term therapy with a resilient but highly traumatized young man. Repeated use of the Minnesota Multiphasic Personality Disorder-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) and Rorschach with my client helped guide us in our work, and also helped create an important therapeutic "opening" into the underlying traumatic material. This and other experiences have convinced me that it is extremely useful for psychologists to have training in both assessment and psychotherapy.     

Contribution of Hungarian Psychoanalysts to Psychoanalytic Psychosomatics

How is psyche related to soma? What tricks does the mind play on the body—and vice-versa? In psychoanalysis, few have probed these questions more deeply than analysts from the Budapest school. Their work began in Hungary and was carried forward in other countries, following their forced emigration. In this study, I touch upon common features of Ferenczi's and Groddeck's thinking about psychosomatics. I explore the work of Sándor Ferenczi, Lajos Lévy and Mihály Bálint among others, and the attraction between avant garde Hungarian intellectuals—mainly writers influenced by Ferenczi—and Georg Groddeck.     

The puzzle of Freud's puzzle analogy: Reviving a struggle with doubt and conviction in Freud's Moses and monotheism

In this paper the author points to a puzzle raised by Freud's contradictory use of an analogy of a jigsaw puzzle. She shows how, through the attempt to resolve this puzzle, meanings and implications of Freud's difficult struggle with his search for truth in Moses and monotheism come alive, both in Freud's writing and in the author herself. Central to this struggle is an encounter with the sources of doubt and conviction that ultimately allows one to embrace ideas experienced as true, although they are not demonstrable evidentially. The paper sheds light on the importance of Moses and monotheism as a theoretical text that reflects on developments in Freud's thinking on truth, and the possibility, dangers and inherent difficulties of grasping it.     

The Disappearing (or Ghost) Mother Transference: In Search of the Available Mother Within

As analysts, we speak of maternal transference as if it were a unitary phenomenon. We are trained to expect intense, powerful transference reactions. Yet there is a group of female patients who have a specific type of transference that lacks intensity. These patients often present by not presenting. I term this phenomenon the disappearing (or ghost) mother transference. This transference is quiet and does not create much stress. Using a case example, I will define this particular type of object relationship and discuss an alternative technique in treating these patients. It is my premise that these women must discover for themselves, at their own time and in their own way, the caring, living, available mother in the analyst.     

The Psychoanalytic Other: Commentary on Paper by Helen K. Gediman

Dr. Gediman locates the intersection of modern Freudian and relational theory in the arena of what she calls the “disclosures of everyday analysis” (p. 242). She suggests that because Freudian analysts, like their relational colleagues, work intersubjectively, relational theory does not itself embody a paradigm shift away from the Freudian model. I disagree. Relational theories assume that the analyst's work is inevitably informed by the relational context in a way that precludes clinical certainty. Gediman, however, believes that the analyst is capable of separating her countertransference response from her subjectivity and thus can interpret from a position of clinical certainty. Each set of theoretical assumptions is associated with a somewhat different analytic stance and analytic ideal. Freudian analysts aim for a position of “methodological neutrality” that relies on considerable certainty in the countertransference while giving the analyst plenty of room within which to use her subjectivity. The relational ideal concerns the analyst's capacity to enter into an asymmetrical treatment relationship and to tolerate the uncertainty generated therein.     

Black client,white therapist: Working with race in psychoanalytic psychotherapy in South Africa

In post‐apartheid South Africa we speak about race extensively. It permeates our workplace, weaves a thread through the fabric of our professional and personal lives, as well as our private conversations and public interactions with others. From within psychoanalytic theory, the thread weaves through the unknown content of our racialized unconscious. When there is a focus on race in the South African psychoanalytic context it largely takes the form of the struggle to articulate the complexities of working with difference, as Swartz notes, or the struggle to map out issues of race. Such struggles are not localized in South Africa, but strongly reflect a much broader struggle within the global psychoanalytic community, as mirrored in the expanding focus on race. Although the consulting rooms seem far removed from the ongoing political tensions that have recently emerged in South Africa, psychoanalytic psychotherapy remains a space of meaningful engagement with the other, and where the therapeutic dyad is one of racial difference it permits an encounter with our racialized unconscious. This article seeks to document the experience of my black client and my white response to her racial pain and struggle; in doing so, I describe the racial ‘contact’ between us and within us that triggers a racialized transference and countertransference dynamic, which contains the space for racial healing for both of us.