Life within death: Towards a metapsychology of catastrophic psychic trauma

In this paper the author offers a phenomenology and a metapsychology for the effects on the mind of catastrophic psychic trauma, defined as the reaction of the psyche to an utterly external event, which the person is helpless to resist, and against which there is no possible defense. The author affirms that the experience of 'infinite affliction' produces a radical break in being which disarticulates the psyche and causes a headlong descent to the most primitive levels of psychic functioning. When there is a complete surrender to the process of disarticulation, it continues until it extinguishes even the most basic level of mental activity, contact with sensation, producing psychic and then psychogenic death. The author then offers a phenomenological and metapsychological analysis of how the process of disarticulation is stopped so that the state of survival is assured, affirming that, faced with this situation of utter emergency, the survival urge instantly mobilizes the organism in furious activity to preserve life and regenerates psychic activity by sensing the ongoing existence of the psychesoma. Then anguish precipitates on to the body and is sensed as psychophysical pain, which diverts conscious attention from the infinite destruction of utter affliction which is thus encapsulated so that, as an experience, it is no longer present to the mind. This assures survival, but it leaves the psyche in a state of non-integration and begins the unending battle for mastery over the deadly inner object which ceaselessly threatens to become present. This constitutes the precariousness of the state of survival.     

Verdi's Rigoletto: The dialectic interplay of the psychic positions in seemingly 'mindless' violence

In this paper the author demonstrates the interplay of the psychic positions (paranoid-schizoid and depressive, alongside more primitive mental states) as they may appear in experiences of overwhelming anxieties relating to fragmentation and disintegration. These are examined in relation to the appearance of what has been described in the literature as 'mindless' violence. The vehicle for this demonstration is Verdi's opera Rigoletto , which the author examines using Fonagy and Target's model for the understanding of mindless violence. The opera is 'read' as a case study of the protagonist, using the drama as a reflection of Rigoletto's internal object representations. The author attempts to extend Fonagy and Target's model to include primitive mental states, in order to understand 'mindless' violence as a result of collapse of the dialectical relationship of the psychic positions, leading to the violent act as a desperate attempt at re-establishing a sense of self. From this perspective, the moment of the violent act may be seen as use of an autistic object and as supplying of autistic shape. The violence is ultimately directed against the already fragmenting self, especially cherished parts of it, however it may enable acknowledgement of repudiated, unmentalised emotions previously experienced as a void.     

The impossible reparation

This article discusses the phantasy of returning to the past and symbiotically merging with the mother, which, in an autistic patient, constituted an attempt of impossible reparation. This mode of reparation resulted in a cycle in which any attempt to repair the inner experience by contact with an external object was destined to be disappointing because of the desire for an infantile connection without separateness. The author reviews the literature on reparation and emphasises recent developments resulting from work with Autism Spectrum Disorder children who are far from the depressive position and who have difficulty bearing separateness. The author recognises an essential positive aspect of reparation independent of the ability to perceive the object as separate and suggests that when working with very primitive emotional states, it seems suitable to use a wider definition for what can be considered essentially a primitive reparative act or a precursor for reparation. Next, the author discusses the significance of a phantasy of impossible reparation in an autistic girl with emphasis on the importance of considering the reparative aspects of this defensive phantasy to enable development. Finally, the author relates to the despair that occurs in both analyst and patient when the phantasy is not transformed.     

Early trauma and narcissism—autism bipolarity1

The analyst makes a series of considerations taken a posteriori from the analysis of a small number of patients. These patients have saved themselves from an early narcissistic catastrophe by developing precocious mental processes, while affective relationships rudimentarily repeat the impact with the original trauma. Primitive defences, essentially denial and vertical splitting, dissociate the tear in the psyche and structure a narcissism–autism bipolarity, revealed in aspects of the character which oblige the patient to automatically repeat a single matrix of experience. In therapy, it is necessary to construct a rst time of the trauma, by pending and linking threads of the primary relationship and strengthening them in the analytic relationship. This reconstruction of the background, a screen to project what had originally been rejected, is the prerequisite for coming out, in deferred action, from the hold of the pathological identifications. The author dedicates particular attention to the undifferentiated background, the nature‐environment torn by the trauma, and to the need to reconstruct this fabric of experience in the analytical relationship, as a fundamental element to the recomposition of the dissociated nuclei. In the clinical case, the analyst describes in particular how the analyst's words encounter an unbridgeable gap, a failure in the capacity for representation when opening the autistic nucleus. Through a regression lasting for about a year, a patient was able to live the experience of primitive agonies and that of an unbearable helplessness and, at the same time, was able to feel how the analyst supported her sense of existence. Subsequently, the patient was able to give shape, through visual images, to deep states of being and start the process of metabolising and symbolising the trauma.     

Trauma and daimonic reality in Ferenczi's later work

Jung and Ferenczi made independent discoveries of an 'archaic' (Jung) or 'primordial' (Ferenczi) layer of the psyche that shone through the 'basic fault' in the psyche opened by childhood trauma. This paper explores those parallels through an extended vignette of Ferenczi's work with Elizabeth Severn, known as 'R. N.' in the Clinical Diary. A remarkable inner object known as 'Orpha' appeared in the patient's trauma experience and saved a seed of personality from total annihilation. Ferenczi's speculation about this 'daimonic' object is cited along with his discussion of a transpersonal immaterial reality that Orpha makes visible, and that links the patient's ego-experience with a spiritual/material unity not ordinarily available to consciousness.     

Emptiness as defense in severe regressive states

This paper examines the empty states experienced by severely ill borderline patients. At times of stressful regression, these patients use complaints of emptiness to describe profound disturbances of affect, cognition, object relations, and bodily experience. Empty states may be seen as complex defensive configurations which protect a borderline level of psychic structure from the impact of aggressively charged object relations, and ward off further regression to states of fragmentation or fusion. Severely ill borderline patients consolidate an empty screen by means of a characteristic repertoire of primitive defenses consisting of various forms of projective identification, including bitriangulation and projective identification of psychic agencies, somatization, acting out, and specific alterations in cognition. The author describes the highly deviant organizations of the object world seen in empty states, and the complex and disturbing countertransferences which these states evoke.     

The Theory of Transformations and Autistic States Autistic Transformations: A Proposal1

This work integrates two areas of thinking: one in which the author develops considerationsregardingobservationmethodsofmentalphenomenainpsychoanalysis according to Bion's theory of transformations; the other in which she is concerned with the investigation of primitive mental states‐protomental states‐more specifi cally, the autistic states of neurotic patients, described by Tustin. Some ideas on the ‘philosophical’ position underlying transformations theory are elaborated, particularly emphasizing the idea that the same phenomenon in psychoanalysis may be considered from different perspectives, as long as it is situated within the theoretical reference frame to which it belongs. The author considers the idea that this method of phenomenon observation is part of a wider context of general human knowledge, in which uncertainty and relativity of concepts are the main components. By adopting transformations theory as a perspective of phenomena observation that pervades the analytical meeting, the author questions whether it is possible to include other groups of transformation of emotional experiences in this theory, which shows particular phenomena with specifi c qualities, distinct from those emphasized by Bion. She hypothesizes that autistic phenomena present in neurotic patients, characterizing autistic states, may be considered and detached, making up a particular group of transformation of emotional experience, which analysts often face in their daily practice. She names this group ‘autistic transformations’.     

A meditation on boredom: re-appraising its value through introspective phenomenology

Boredom is almost universally regarded as a dysphoric mental state, characterised by features such as disengagement and low arousal. However, in certain quarters (e.g., Zen Buddhism), boredom is seen as potentially having great value and even importance. The current study sought to explore boredom through a case study involving introspective phenomenology. The author created conditions in which he would experience boredom for an hour and recorded his experience in real-time using a variant of the Experiencing Sampling Method. The data were analysed using an adaptation of Interpretative Phenomenological Analysis. The results indicated that the state of boredom contained three main sources of value: altered perception of time, awakened curiosity about the environment, and exploration of self. Consequently, the article offers a re-appraisal of boredom, suggesting that rather than necessarily being a negative state, if engaged with, boredom has the potential to be a positive and rewarding experience.     

Inner and outer face perception in children with autism.

Possible peculiarities in face perception in the autistic population were explored through two experiments. Fourteen autistic children (mean age=10 years 1 month) were individually matched to verbal mental age (VMA) and chronological age (CA) subjects. In a first experiment, subjects were to match faces on the basis of either their outer (hair, chin, ears) or their inner (eyes, nose, mouth) aspects. Autistic children performed equally well in both conditions, while VMA-matched children performed better in the outer than the inner part condition. In a second experiment, chimeric faces consisting of the outer part of an individual's face and the inner part of another individual's face were presented to the subjects. None of the groups showed a preference for neither the outer nor the inner part of the face in this condition. Results were discussed in terms of the existence of a local visual processing strategy in this population.     

THE THOUGHT AND TALK OF INDIVIDUALS WITH AUTISM: REFLECTIONS ON IAN HACKING

Abstract: Ian Hacking proposes that ways of talking about autistic experience can shape, or even transform, what it is like to be autistic. I explore the grounds for two nonexclusive interpretations of this thesis. The informative interpretation holds that, because nonautistics cannot read mental states into autistic behaviour as they normally do with one another, autistic self-narratives give nonautistics unique insights into what it is like to be autistic. This in turn affects how nonautistics interact with autistic individuals, enriching their social environment in various ways. The more radical, transformative interpretation holds that autistic experience is itself moulded under the influence of developing a language-game for talking about autistic experience. I endorse both theses, albeit with some cautionary remarks.     

Thinking about and working with depressed mothers in the early months of their infant's life

This paper illustrates how my work has developed over the years and informed my thinking about, and work with, depressed mothers. It also describes the work of the Parent Infant Foundation in Sydney where pregnant women and mothers with infants and toddlers are seen in groups and individually through home visits. The relevance of the support of a peer group when doing such difficult work is described. The paper draws on a central theme: the depressed mother, returning to her own infant beginnings through pregnancy and birth, confronts a dead mother-dead infant dyad. Trauma from the mother's own infancy is seen to have created an internal, autistic, deadened, psychic space. It is argued that behind this deadness lies the primeval pain of abandonment and loss. The associated rage, previously repressed but now awakened by her alive infant and his powerful primitive demands, invade the mother's psyche. The internal deadness freezes her alive processes as mother to her baby. Unbearable pain is awakened - and she may be in terror and unable to move, or she may experience herself as drowning in something catastrophic. SUMMARY This paper illustrates how my work has developed over the     

War: Mentalization and Totalitarian State of Mind

For most residents of Europe, war is a new experience in which they find themselves both as witnesses and participants. In this paper the war in Ukraine serves as an illustration and case example. Like any unfamiliar experience, war elicits profound emotional responses which can be so overwhelming that an individual may be unable to fully process them and to create mental representations of the reality of war. When the psyche becomes entrapped in an unprocessed state, without the capacity to derive meaning from it, this results in the “fossilization” of the psyche akin to what McGinley and Segal describes as a totalitarian state of mind. Subjectivity and individual differences come under collective or personal attack, or both. This state of being prioritizes the needs of the collective psyche over the individual psyche. The image of Gorgon Medusa, who transformed living people into “fossilized” ones, is presented as a metaphor of total identification with the collective dimension. In contrast, the psyche can reveal a creative approach to resolving war-induced trauma. This is depicted in the concept of the Alchemical Stone and its creation, which symbolizes a harmonious connection between the external and internal realms, the subjective and objective experiences, and the real and the imaginal dimension.     

The Secret of Faces: Commentary on Paper by Rachael Peltz

Dr. Rachael Peltz stresses the aesthetic dimension of analysis. In fact the aesthetic experience can serve as a model for all that is deepest and truest in our lives and in the analytic encounter. We all have an “inner painter” which transforms primitive sensoriality into images or pictograms and then tie them up into oneiric thoughts, dreaming and thinking in order to give a personal meaning to experience. This model gives us the possibility in the clinical work to be more attentive to the musical, rhythmic, or semiotic aspects of the interaction between patient and analyst. Dr. Peltz shows in a beautiful vignette how, equating analysis to the aesthetic experience, it is possible to help the patient to reach a fuller sense of consonance and contact between mind and body.     

The Enigma of Extreme Traumatism: Trauma,Exclusion and their Impact on Subjectivity<Superscript>*</Superscript>

My aim is to discuss the immediate effects of extreme trauma and to speculate on its long term effects. The formulations associated with the Post Traumatic Stress Syndrome generate an overly medicalized view of trauma, grossly underestimating its devastating impact. Catastrophic traumatic experience rips a hole in the representational continuity of psychic life; neither representations nor narrations are generated. Instead, a representational emptiness occurs, such that what has taken place cannot be shared or transmitted. The cathartic word becomes a robotic mocking of the interchange between human beings. There is no internalization, no ability to make the experience subjective. The resulting deep splitting in the psyche is characteristic of extreme traumatism, and its balance or perpetual working through is elaborated in this paper.     

Displacement as trauma and trauma as displacement in the experience of refugees

This paper investigates the relations between displacement, home, trauma and the self in the experience of refugees, which has become an issue of unexpected and far-reaching proportions in recent times. It questions to what extent and under what conditions displacement in the world may be traumatic and how trauma may be considered the effect of an inner displacement. Refugees’ lives are marked by forced migration that is related to a certain suffering due to the changes in their family, relational, social and cultural lives. The paper explores the extent to which these changes can represent a break so significant as to be traumatic. It outlines the way in which traumatic experiences can produce an inner displacement and reorganization of one’s mental life that leads to a focus on traumatic complexes. Under the most severe traumatic conditions, this can be understood as a displacement of the central axis of Self, in which the ego complex yields its position to other complexes, with a deep change in the organization and functioning of self. The experience of refugees highlights the way in which we live in a matrix of conscious and unconscious links between inner and outer worlds that need deeper and simultaneous consideration to understand their implications and mutual resonances for the psyche. Clinical cases of refugees will illustrate some aspects of these interconnections.     

The social unconscious in persons,groups and societies,Vol 1: mainly theory; and Trauma and organizations

This paper considers the emotional life of the infant in the incubator and develops a new psychological theory which is called the ‘incubator psyche’. Theory building is advanced from three main discourses: (1) psychoanalysis, (2) neo-natal nursing and (3) psychology. A case study of Corey, a 7-year-old boy, who had been delivered prematurely, with a hole in his heart, and spent the first 6 weeks of post-natal life in an incubator, is presented to illustrate how aspects of an incubator psyche might be clinically manifest. The concept of an incubator psyche is advanced with reference to a particular kind of second-skin formation (Bick, 1968, The experience of the skin in early object relations, The International Journal of Psychoanalysis, 49, 484–486). It is proposed that the incubator psyche characterises a client's mental functioning exercised as an environmental sensibility that could be understood in terms of the total transference situation (Klein, 1952, The origins of transference, International Journal of Psychoanalysis, 33, 433–438; Joseph, 1985, Transference: The total situation, International Journal of Psychoanalysis, 66, 447–454). Implications for practice are considered advocating particular attention to the setting.     

Are the interpersonal and identity disturbances in the borderline personality disorder criteria linked to the traits of affective instability and impulsivity?

This study examines the degree to which two putative biologically influenced personality traits, affective instability and impulsive aggression, are associated with some of the interpersonal and intrapsychic disturbances of borderline personality disorder (BPD) and with choice of defense mechanism. In a sample of 152 personality disorder patients, affective instability and impulsive aggression were measured. Defense mechanisms were assessed in 140 of these patients using the Defensive Style Questionnaire (DSQ). The correlations between the traits of affective instability and impulsive aggression and the eight DSM-III-R criteria for borderline personality disorder and 20 DSQ defenses were examined. Affective instability was significantly correlated with the DSM-III-R criteria of identity disturbance, chronic emptiness or boredom, inappropriate anger, suicidality, and the affective instability criteria. It also was associated with the defenses of splitting, projection, acting out, passive aggression, undoing, and autistic fantasy. Impulsive aggression was related to unstable interpersonal relationships, inappropriate anger and impulsiveness and with the defense of acting out. It was negatively correlated with the defenses of suppression and reaction formation. A number of the interpersonal and experiential disturbances and defense mechanisms that are features of BPD are associated with the traits of affective instability and impulsive aggression among patients with personality disorders.     

Prayer as Therapeutic Process Toward Transforming Destructiveness Within a Spiritual Direction Relationship

This article will expand previous conceptualizations (Kuchan, Presence Int J Spiritual Dir 12(4):22–34, 2006; J Religion Health 47(2):263–275, 2008; J Pastoral Care Counsel, forthcoming) of what might be occurring during a prayer practice that creates space within a spiritual direction relationship for the creation of inner images that reveal a person’s unconscious relational longings and co-created representations of God that seem to facilitate therapeutic process toward aliveness. In previous articles, I suggest one way to understand the prayer experience is through a lens of Winnicottian notions of transitional space, illusion, and co-creation of God images. This article expands on these ideas to include an understanding of God as Objective Other (Lewis, The four loves, 1960) interacting with a part of a person’s self (Jung, in: The structure and dynamics of the psyche, collected works 8, 1934; Symington, Narcissism, a new theory, 1993) that has capacity for subjectivity (Benjamin, Like subjects, love objects: Essays on recognition and sexual difference, 1995) and co-creation (Winnicott, Home is where we start from: Essays by a psychoanalyst, 1990), of inner representations of God (Ulanov, Winnicott, god and psychic reality, 2001). I also expand on a notion of God as “Source of aliveness” by integrating an aspect of how Symington (Narcissism, a new theory, 1993) thinks about “the lifegiver,” which he understands to be a mental object. After offering this theoretical expansion of the prayer practice/experience, one woman’s inner representations of self and God are reflected upon in terms of a therapeutic process toward transforming destructiveness, utilizing ideas from Winnicott, Kohut, and Benjamin.     

无聊：一个久远而又新兴的研究主题

无聊是个体由于知觉到生活无意义而产生的负性情绪体验, 它会直接或间接地影响各种社会心理功能。目前, 有关心理健康、社会适应、学业成绩等一系列心理问题的研究已经揭示了无聊的负性作用。但是, 无聊领域的研究还停留在理论探讨和相关研究层面, 概念定义尚没有完全统一, 缺乏系统的理论和完整的模型结构。未来研究可进一步深入探究无聊的作用机制, 并制定有效的干预方案来改善人们的无聊状态。