On mirroring in group psychotherapy

“A woman has two images. There is a magical person seen or remembered by those who love her, her finest qualities are flesh and spirit illuminated. She herself knows this ideal self; she projects it, if she is confident; or she daydreams her ideal self; or she recognizes it with gratitude in the admiring eye of others. There is at the same time a second image; the woman as seen by those who dislike or fear her. This cruel picture has an all too powerful mirror in her own negative idea of herself. She sees with fear her own ravaging impulses and most painful of all, a graceless, freakish, and unlovable physical self, this was the mirror her parents held before Edith. Her brothers saw her with love. She herself knew both images. Her life, and her poetry, constituted a flight from the second one.”     

Glover on responsibility

In this note I argue that although Rorty's programme (Inquiry, Vol. 15, No. 4) to bring into focus the role that belief plays in self‐deception is a salutary one, her actual claims obscure that role. It is also contended that Rorty fails to de‐mythologize self‐deception, since her account is either paradox‐ridden or else describes a concept recognizably distinct from the concept of self‐deception.     

Self creation and the limitless void of dissociation: the 'as if' personality

The concept of the 'as if' personality has been used variously in analytic literature without having formed part of a clinically based theoretical development over time. The author discusses the bases of her notion of the 'as if' personality, as observed across a number of patients and supervised patients in intensive, long term analytic treatment. In this composite clinical picture, a grouping of elements that form a particular kind of defence of the self is identified in certain patients with an exceptional capacity for creative engagement in the world, surpassing expectations given their background. The picture includes the presence of physical breakdown and illness, as psychic suffering arising from early narcissistic wounding and from a physical, emotional and/or sexual abusive familial environment, was held for too long in bodily memory but not in mind. A distinction is made between the 'as if' personality, the persona and the false self. The 'as if' personality concerns the action of defensive dissociation deriving from very early experiences of internalizing the presence of an absent object, creating the sense of an internal void at the core of the self. At the same time, the self is capable of acts of self creation through a succession of identifications and internalizations with other sources of environmental nourishment, which substitute for, and are constructed around, the original sense of internal emptiness. Thus are restored, but only up to a point, the resources of the originally diminished self. Until these resources have been used up, the self is often able to excel in activities to an exceptional degree. The countertransference is shown to be the means of both useful but often perilously obtained clinical experience and information, supporting the work along the hazardous analytic journey.     

Reconstructing Indian feminine self: A case study of Devaki

This essay addresses the applicability of life history as a genre and method to explore culture and self. It looks at how various aspects of culture and society contribute actively to emergence of cultural self, social self and psychological self. The psychological biography of child widow, Devaki from Banaras explores these concerns. A Hindu widow is known for the traumatic rites of passage she goes through from marriage to widowhood. In the case of child widow her adolescence gets enmeshed, with that of the rites of widowhood. She experiences embodiment of shame and ritual pollution along with economic hardships and social marginality. Devaki’s efforts are steered in the direction of releasing herself from the shame that, envelopes her being, and then her emergence as an independent self. The essay also explores possibility of multiple selves.     

Can parental responses to adult children with schizophrenia be conceptualized in terms of loss and grief? A case study analysis

It has been suggested that parental responses to adult children with schizophrenia may involve feelings of loss and grief, centred around loss of the pre-morbid version of their child. In this exploratory study, an in-depth case study analysis of four parental accounts of their responses was undertaken in order to obtain insights into whether these responses can be conceptualized in terms of loss and grief, with the aim of informing therapeutic practice with parents in this position. Information was also obtained on how parents coped with the reactions that their child's condition elicited in them. Data were analysed using Interpretative Phenomenological Analysis. In relation to the central research question, it was found that the perception of loss was not uniform amongst participants. Three acknowledged a sense of loss, at least to some extent, but one parent resisted such an interpretation because she perceived a continuity over time in her son's behaviour and she also challenged her son's diagnosis. One parent acknowledged a loss of his daughter's pre-morbid self but qualified this by pointing to her continued physical presence. The usefulness of existing models of grief is examined in light of the findings. The implications for the practice of counselling psychology are discussed.     

Subjectivity as Encounter: Feminine Ethics in the Work of Bracha Lichtenberg‐Ettinger and Anne Enright

The fragility of the subject is a recurring issue in the work of Anne Enright, one of Ireland's most remarkable and innovative writers. It is this specific interest, together with her attempt to make women into subjects, that inevitably links her work to Bracha Lichtenberg‐Ettinger's theory of the matrixial borderspace, a feminine sphere that coexists with the Lacanian symbolic order and that, even before our entrance into this linguistic system, informs our subjectivity. By turning to a point in time before language—the encounter between “self” and “other” during pregnancy—both Enright and Ettinger test the boundaries of and the gaps within the linguistic system. It is the going before language that ultimately enables both to go beyond some of the most persistent dualisms present within the linguistic system and to create room for an alternative—a feminine—understanding of the ethical relationality between self and other.     

“I Desire to Suffer,Lord, because Thou didst Suffer”: Teresa of Avila on Suffering

Teresa of Avila's desire for suffering cannot be interpreted as the mere passive assumption of a feminine sacrificial role. On the contrary, Teresa was able to transform her suffering into the incarnated performance of her relationship with God: By desiring suffering and by understanding it and her ability to confront it as proof of divine love, she was able to reinforce her self‐confidence and strength. This article discusses Teresa of Avila's experience and interpretation of suffering in the context of the female ascetic‐mystic Christian tradition. It criticizes Teresa's positive conceptualization of suffering but examines in depth the potential of her ability to actively manage and control it. Although Teresa was able to affirm her personality through ascetic practices such as self‐humiliation and mortification, the general applicability of such practices to the management of suffering is fraught since they leave the suffering individual in a vulnerable position. Although Teresa of Avila finds fulfillment and, paradoxically, self‐actualization through self‐denial and the surrender of her will, such practices entail the substantial risk of total self‐annihilation.     

An interpretation of Babette's Feast as a parable of trauma

In this paper I use the film Babette's Feast as a parable to portray the impasse that often arises out of the experience of complex trauma. The experience of such trauma invokes a crisis of reality. It overflows the boundaries of rational containment. There are no mechanisms with which to apprehend such an event, and consequently it cannot be comprehended; because it cannot be comprehended it cannot be processed. The film Babette's Feast encapsulates the predicament of the individual ensnared in the web of trauma. Although removed from the location and events of her trauma, Babette remains the resident of an austere and colourless environment, her gifts repressed, her brilliance unseen. Healing comes to Babette through her willingness to revisit her true self, a self that has been crushed under the weight of grief and trauma. This revisiting costs her all she has. Yet, it is in this revisiting that she not only frees herself from the austerity of her environment but also engenders purpose and hope within the community who have taken her in. The dissonance of her life is paralleled by the dissonance of the life of the community in which she lives; it is the harmonizing of these dissonances which cannot be spoken that finally gives articulation to the incoherence of Babette's trauma.     

The Risks of Therapist Passivity and the Potentials of Constructivist Influence

Francesca Colzani’s rich report of her sensitive work with Elisa highlights the therapist’s struggle with the issue of the exercise of power and authority bearing on the patient’s choices. It is suggested that sometimes the analyst poses her dilemma in dichotomous terms, choosing, in effect, between coercion and passivity. Also, it is argued that moral choices can be obscured by a turn to medicalization, diagnosis and treatment, of the patient’s “condition.” An alternative is proposed in which the analyst may offer constructive suggestions imbued with her subjectivity—her experience of conflict and uncertainty—leaving Elisa room for the exercise of her own responsible agency. In finding her own voice, the analyst may awaken selves or aspects of self of the patient that might otherwise remain dormant, potentially to her detriment. An example of an interpretation of projective identification, with self-disclosure on the analyst’s part, is proposed that might encourage collaborative reflection on a seemingly dissociative dimension of Elisa’s way of being and relating.     

Self‐Interests and Beliefs: Predictors of Mothers’ Views of Child Care1

Mothers (N= 270) completed questions related to child care for their children who were between 2 and 6 years of age. They completed a 9‐page questionnaire that included scales used to assess their attachment to their careers, financial need to work, and gender‐role beliefs as predictors of their ratings of the effects of child care on 4 criterion measures. Findings supported the hypothesized model that a mother's needs and her self‐interests and beliefs would influence her ratings of the benefits and costs of child care, her anxiety in leaving her child in child care, and her views of the effects of child care on her child. It is suggested that future research should avoid biases that might arise from participant or observer self‐interest and seek more objective approaches to the examination of the impact of child care on children.     

Red beavers and building bridges between assessment and treatment

In this article, I present a case involving early object loss in which I both assessed the patient and treated her. Assessment revealed a particular object relational defensive structure-a false self. The concept false self was then used as a bridge to treatment. The case is discussed from several perspectives including the clinical inference process, the relationship between assessment and treatment, and the vicissitudes of early object loss.     

The child's experience of Munchhausen syndrome by proxy

This paper examines the emotional impact of Munchhausen syndrome by proxy on a child aged 6 who had been poisoned by her mother. It describes her treatment in child psychotherapy over twenty months at the Cassel Hospital where the family worked towards her successful rehabilitation home. The work with her showed her experience of dangerous relationships in her family that left her distrustful of any new relationship, and doubtful of her capacity to be close without being destructive. Like her parents, she was terrified of facing the murderous feelings in the family, retreating into denial when life was too painful. The paper describes three phases of treatment: fear of separation and preoccupation with the trauma of poisoning, ambivalence about facing the destructiveness in the family and the move into more appropriate latency behaviour as she prepared to go home with her parents. It concludes with an overview of the impact of Munchhausen syndrome by proxy on the developing child, as shown in this treatment: the delay in emotional and cognitive development, the interference with the capacity to relate, the retreat into illness under stress, and the fear of permanent damage caused by the emotional and physical abuse.     

The refugee’s flight: homelessness,hospitality, and care of the self

This paper argues that the contemporary international refugee regime is grounded in a paradigm of ‘homesickness’, which puts the refugee in an inferior position of the supplicant, whose subjectivity is framed by the regime of fixed belonging. In order to address this situation, we need to challenge the ontological primacy of homesickness and embrace ‘homelessness’, which offers the possibility of rethinking the positions of both refugees and non-refugees in ethical terms. While the responsibility of the non-refugees lies in cultivating an ethos of hospitality, the refugee can take hold of her subjectivity through the practice of care of the self. This paper first examines Nietzsche’s thought on homelessness and compares it with Foucault’s reading of the role of anakhōrēsis in the Hellenistic practice of care of the self. It then suggests how, by building on the project of universal hospitality, we can interpret the figure of the refugee through the prism of an ethic of freedom, anchored in a positive break with the city. From this perspective, the refugee regains her ethico-political agency by cultivating the relationship with her own living self, which offers new avenues for resistance against the dominant paradigm of ‘homesickness’ that governs her subjectivity today.     

Coming Out in Voices

This paper articulates the personal experiences of a woman with a physical disability who enters therapy to explore issues involving lesbian identity, health and illness, disability oppression and pride, and relationships. Written in the first person, the article uses anecdotes, poetry, and journal entries to chart the author's process of self-discovery. As a woman, a lesbian, and a person with a disability, the author frequently finds herself at odds with the culture around her. This creates conflicts between the author's real self, and the self she must present to others. She discusses how she had learned to "silence the voices" which were not useful in challenging the stereotypes, making others comfortable, or communicating with assistants. The author describes how therapy offered her the opportunity to unlearn the silence, value all of her voices, listen to herself, resolve her internal dilemmas, and develop a deeper sense of self.     

The Never Land – loss of an idealized pre-birth place and the gain of a thinking mind

This paper describes the main themes in the psychotherapy of a severely epileptic girl, over a period of eleven years, aged 16 at the time of writing. For most of the therapy the girl lacked an ability to differentiate between herself and others, and therefore there was little development of rudimentary Oedipal conflicts. Her severe physical and mental impairments were inextricably linked to this fundamental problem in the process of separating: the physical problems compounding the emotional, and the emotional compounding the physical. Her mother's illnesses were significant factors. Throughout the girl's life she was subject to extreme medical interventions. The paper draws upon psychoanalytic models of mind and body integration, including notions of the 'biopsychosocial dysregulation' model of illness. The clinical material describes the girl's use of the dolls to populate a Peter Pan Never Land, with its many static perspectives, denying growth and the difference between the generations, although therein was the beginning of the use of symbolization. As the child's awareness of her physical impairments grew, so did her despair at her own and her mother's hopeless physical condition. However, she became more able to express her outrage, but with the life-saving awareness of a therapist who was not also ill. This led to the girl's increased ability to acknowledge differentiation between self and other, further painful awareness of her disabilities, losses and possible death, as well as those of her ill mother and, gradually, an ability to acknowledge the passing of time and an appreciation therein of a healthy separate thinking part of her that could use symbolization and allow for some separateness and some emotional growth.     

Looking Philosophical: Stuff,Stereotypes, and Self‐Presentation

Self‐presentation is a complex phenomenon through which individuals present themselves in performance of social roles. The success of such performances rests not just on how well a performer fulfills expectations regarding the role she would play, but on whether observers find her convincing. I focus on how self‐presentation entails making use of material environment and objects: One may “dress for the part” and employ props that suit a desired role. However, regardless of dress or props, one can nonetheless fail to “look the part” owing to expectations informed by biases patterned along commonplace social stereotypes. Using the social role of philosopher as my example, I analyze how the stereotype attached to this role carries implications for how demographically under‐represented philosophers may self‐present, specifically with regard to dress and decoration. I look, in particular, to the alienation from one's material environment that may follow on the frustration of self‐presentation through bias. One pernicious effect of bias, I argue, is the power it has to deform and distort its target's relation to her physical setting and objects. Where comfort and ease in one's material environment can be a significant ethico‐aesthetic good, bias can inhibit access to, and enjoyment of, this good.     

From “It's Not Me” to “It Was Me,After All”: A Case Presentation of a Patient Diagnosed with Dissociative Identity Disorder

In cases of extreme childhood trauma associated with abuse and neglect, one's sense of self is seriously compromised. Attachment patterns, symptoms, defensive operations, and character formation will differ depending upon the level of interference and impingement. When repeated trauma occurs in early childhood, the dissociative response may become the first line of defense for the person to rely upon. In its most severe form, patients are diagnosed with Dissociative Identity Disorder (DID). This paper addresses the case of a woman diagnosed with DID. It describes the restoration of a cohesive sense of self from the eight parts of a dissociated and fragmented self in the course of therapy. The clinical case material presented is that of the child part of her, known as Lucy. Her treatment resulted in the integration of the “it's not me!” self to the patient's knowledge that “it was me, after all.”     

Understanding the “ghosts in the nursery” of pregnant women experiencing domestic violence: Prenatal maternal representations and histories of childhood maltreatment

Selma Fraiberg and colleagues (1975) conceptualized the “ghosts in the nursery” as experiences from a mother's past that influenced her ability to form a warm and attuned relationship with her child. Contemporary infant mental health interventions often ask the mother to reflect on her own history of attachment relationships to gain insight into as well as to strengthen her developing relationship with her child. This study investigated the association between a mother's history of childhood maltreatment (CM) and her subsequent prenatal maternal representation during the third trimester of pregnancy. Controlling for domestic violence (DV), distorted prenatal representations were associated with higher rates of self‐reported childhood physical neglect. In addition, DV moderated the relationship between representations and CM, such that women who were exposed to DV during pregnancy and had distorted prenatal representations were least likely to report childhood physical and sexual abuse. Implications are discussed in relation to infant mental health interventions which rely on a parent's ability to psychologically access and reflect on childhood histories to more sensitively parent her own child.     

The therapist's self in dialogical family therapy: some ideas about not-knowing and the therapist's inner conversation

In this article, the focus is on the therapist's self, which will be in line with Bakhtin's thinking, viewed as a dialogical self. First, the dialogical view of the self is situated in the context of psychology's traditional focus on the individual self. Then, leaning on Bakhtin and Volosinov, the self is described as a dialogue of multiple inner voices. Some of the implications of this concept for family therapy practice are examined, focusing especially on the therapist's participation in the therapeutic process and on the therapist's inner conversation. The author argues that not-knowing does not only refer to the therapist's receptivity and respect but also implies that the therapist is aware of his or her experience and reflects on how his or her inner conversation might inform and enrich the therapeutic conversation. Finally, these ideas are illustrated with a brief clinical vignette.