The development and organizing function of perversion: the example of transvestism

Perversion had been viewed as oedipally determined and in a reciprocal relationship with neurosis. In our widening scope, however, pre-oedipal and traumatic contributions have been increasingly emphasized. While both perspectives represent aspects of clinical reality, the tendency has been to overlook sexual and aggressive drive derivatives, with their related conflicts, object representations, and symbolic enactments, even though they may make significant contributions to the analytic situation. These latter, 'classical' patients have what I consider 'organized' perversions: complex, evolved, neurotic-level, stable psychopathological formations that may be distinguished from borderline or near psychotic syndromes enlisting perverse mechanisms to ward off disorganization. This paper will review Freud's work, briefly consider some recent trends in conceptualizing perversion and perverse mechanisms, characterize organized perversion, and present clinical material to illustrate its evolution, clinical manifestations, and analysis. Transsexualism, overtly similar to transvestism but not functioning as an organized perversion, will serve as a point of contrast.     

Becoming (and Remaining) an Analyst in Latin America

The following overview of the development of psychoanalysis in Brazil and in Porto Alegre outlines the current situation and the challenges to psychoanalysis in my country. I will explain my own experiences on becoming an analyst, the main reasons for my choice, my main influences, and my evolution as a clinical psychoanalyst and as a member of psychoanalytic and psychiatric institutions. I include my main contributions to psychoanalysis and consider two broad areas of interest: psychoanalytic technique and its teaching, and the relationship of psychoanalysis and culture. As for the former, my main interests are studies on countertransference and analytic neutrality, to which I will propose a comprehensive concept. As for the latter, I discuss a culture that contrasts vividly with the one in which Freud created the discipline, psychoanalytic views on violence and perversity, psychoanalytic institutions, and the application of analytic ideas for the understanding of some artists and their work.

I will also describe some general features of my country and the development of psychoanalysis in it; report my experiences as a candidate and an analyst; and offer some information about my evolution as an analyst through papers I have written over the past 30 years.     

Human psychobiology in Scandinavia: I. Psychophysiology—theory, method and empirical research

The present paper reviews Scandinavian contributions to the field of psychophysiology in a fifteen year perspective (1968–1983). Psychophysiology is defined as that domain within psychobiology where the investigator uses a physiological measure to indirectly assess a psychological construct, e.g. heart-rate to index anxiety. Only research that fit this definition is reviewed. Thus, research belonging to physiological psychology and behavior pharmacology is excluded. The paper is divided into several areas covering studies related to attention and the orienting response (OR); classical autonomic conditioning and biofeed-back learning; clinical psychology and behavior medicine; emotion and motivation, and methodological contributions. The review of studies related to attention and OR is focussed on the work by Näätänen and by Öhman who both have made distinguished contributions to this area of research. The so-called "prepared-learning" project is described as an example of Scandinavian conditioning studies. Other examples include Bohlin's research on attention and habituation, and the work by Schalling and by Fredrikson in clinical psychology and psychopathology. Norwegian research on muscle tension and respiratory activity done by Svebak is also reviewed. A total of 114 papers written by about 95 different researchers are reviewed. Thus, psychophysiology may be regarded as a firmly rooted research tradition in Scandinavia, both qualitatively and quantitatively. It is concluded that Scandinavian psychophysiology research is at the front line internationally concerning problem areas and methodology.     

An Ecological Approach to Therapy With Gender Minorities

This special series includes four articles that review important considerations for clinical work with gender minorities, including youth and young adults, individuals who are nonbinary, transgender individuals in inpatient or residential care, and transgender individuals recovering from trauma. These articles provide important insights and concrete suggestions for how to enact affirming practice, spanning across macro, mezzo, and micro levels. Ultimately, a multilevel approach to working with transgender and gender diverse individuals is essential to addressing health disparities in this population, as the work of an affirming provider goes beyond the therapy hour and the therapy office or treatment unit. In this commentary, I review the major themes from these contributions, provide a perspective on how they fit within the existing literature, and provide an overview of pressing future directions in gender minority research.     

Locating dialogue a reply to flax

The thoughtful discussions of my paper by Alan Schore, Wilma Bucci, and James Fosshage raise important considerations about the relationship between theory, research, and the micromoment interactions constituting the activity of psychoanalysis. For the opportunity afforded by their contributions, and to Psychoanalytic Dialogues for publishing our exchanges, I express deep gratitude. I am initially impacted by the appreciation shown by my colleagues for the approach I am illustrating to clinical attention and its value for an expanded and, in certain ways, revised scope of psychoanalytic activity. In particular, I am appreciative of the ways that each commentator has taken up my emphasis on expanding psychoanalytic attention beyond symbolic pathways of exchange and has further contributed to understanding how this can occur. As part of a consideration of points of convergence and difference between us, I address how such convergences and differences shape both the values and pitfalls of comparisons across research, theory, and practice.     

Anterior prefrontal cortex contributions to attention control

In a series of event-related functional magnetic resonance studies, we consistently found activation in anterior prefrontal cortex related to visual dimension changes in singleton search tasks. I review these data and discuss possible contributions of anterior prefrontal cortex to attention control in visual search. It is proposed that anterior prefrontal cortex may detect task-relevant stimulus changes when the target is ambiguously defined. This process may occur in the absence of awareness and may support visual dimension weighting by inhibition of the old relevant dimension in favor of the new dimension.     

An Independent Theory of Clinical Technique Viewed Through a Relational Lens: Commentary on Paper by Michael Parsons

This discussion of Michael Parsons's exposition of the Independent Tradition's clinical theory of technique compares and contrasts the British Independent and American Relational perspectives in regard to their approach to technique. In this discussion I will consider the question whether, given strong object relational influences on relational psychoanalytic theory, we are able to locate systematic differences in the way that Independent and Relational analysts attempt to work, to be with, and to relate to their patients in the psychoanalytic situation. Overlapping historical roots of the two traditions are considered, along with apparent differences in the ways in which the contributions of common ancestors, such as Ferenzci, are applied. I suggest that the integration of American Interpersonal School ideas with Object Relations theory in American Relational Psychoanalysis led to a different therapeutic sensibility, different ways of thinking about and participating in the analytic process from those that are reflected in the Independent Tradition as Dr. Parsons describes it. The discussion includes an imaginative reconsideration of clinical process along relational lines, in an attempt to clarify different emphases in technique between the two schools.     

Daniel Stern: Microanalysis and the Empirical Infant Research Foundations

ABSTRACT

Daniel Stern changed the face of psychoanalysis, as well as that of infant research. He was a brilliant, innovative, and playful thinker. Psychoanalysis particularly values his contributions on the relevance of infant research to adult clinical practice and theory, for which he is best known. But this work has its foundation in his early empirical infant research, which is less well known. I believe that a better appreciation of the original empirical basis of his work using microanalysis will deepen our appreciation of his later thinking.

In this article I return to the beginning of his work, using frame-by-frame microanalysis of film and, particularly, his first paper published in 1971. I sketch out some of the important findings and ideas emerging from this paper that continued to influence his thinking throughout his career. This research was conducted in the 1970s, the period in which I worked with him directly.     

Shepherd Ivory Franz: His contributions to neuropsychology and rehabilitation

Shepherd I. Franz was an important figure in psychology of the last century, and historians of psychology have given recognition to much of his work. However, his experimental work with animals and his pioneer investigations in experimental and clinical neuropsychology have been largely ignored. This article reviews his conceptual, assessment, and treatment contributions, including (1) his pioneering work on the use of learned behavior as a baseline for the study of cerebral ablations, (2) his interest in brain plasticity, (3) his development of comprehensive psychological assessment methods, and (4) his work on the rehabilitation of neurological patients with techniques derived from his animal experiments. His work predated much of what is now part of the conceptual substance of the experimental and clinical neurosciences.     

Attention between phenomenology and experimental psychology

It is possible to consider attention as the modulating dimension of consciousness. Understood in this sense, attention can be a privileged theme for relating the first person point of view (conceived as a psycho-phenomenology inspired by the work of Husserl) to the experimental sciences (e.g. psychology, neuropsychology, etc.), which have done a great deal of work on attention. This article will take up in succession some different points of view regarding the status of attention and its structure (e.g. static aspects). It will also consider the dynamic of attention from a micro-genetic point of view as well as a functional point of view. The final section will seek to show not only the unique and original contributions of each perspective, but also each perspective's limitations and biases.     

THE PHILOSOPHY OF JOSEPH MARGOLIS

Abstract: In this article I focus on some of Joseph Margolis's contributions to medical ethics. I first discuss some of Margolis's normative and metaphysical views on death and abortion, particularly in his early work Negativities , as well as some of his metaphysical assumptions. Then these views and assumptions are related to his theory of persons and, by implication, his theory of culture, set forth in a number of later works. In the course of the discussion, I call attention to some controversial issues of today, such as embryonic stem cell research and the creation of embryos for the sole purpose of research, and ask for Margolis's views on them, given his earlier contributions and assumptions. Finally, I comment on his relativism and his program for research in aesthetics and ethics.     

The Search for Integration or How to Work as a Pluralist Psychoanalyst

In my professional path, I strove for the integration of my identity as a psychiatrist and as a psychoanalyst, in the frame of pluralism, which exists in modern psychoanalysis. Having been trained in a Kleinian approach, I will explore the painful breach experienced during my parallel trainings as a psychoanalyst and as a dynamic psychiatrist. I worked for five years as a psychoanalyst and a researcher in Germany and was involved to a large extent with the psychoanalytic world, which increased my self-definition as a pluralist. On my return to Chile, I discovered the need for political changes in the psychoanalytic society and curricular modifications in my training institute to recover psychoanalysis from its academic isolation. Finally, I will analyze the extant connections between the ideology of pluralism in psychoanalysis and its application in clinics. I will show that the exploration of the inference processes of the psychoanalyst inside a session—the psychoanalyst's mind at work—demonstrates that the analyst in fact functions as an artisan thinker. This means that pluralism—that is, the use of more than one theoretical frame and of different levels of abstraction and explicitness—is the way the majority of psychoanalysts “naturally” work. What probably differs is the self-consciousness, scope, and rank of pluralism.     

Framing Further Considerations: Reply to Commentaries by Philip Bromberg and Glen Gabbard

This response to discussants Philip Bromberg and Glen Gabbard explores the relevance of a self-state perspective to my reflections (2007) on the benefits of reconsidering traditional recommendations regarding an analytic frame. The clinical and theoretical implications of Bromberg's view that the shifting choreography of a multiplicity of self-states of analyst and patient, in collision and negotiation, are implicated in the structuring and resructuring of an analytic frame, are considered. I also explore Gabbard's perspective that analysts' reliance on traditional, rigid constructions of an analytic frame no longer characterizes most contemporary work. Although I agree that relational contributions to psychoanalysis have become increasingly well established and that our more traditionally trained colleagues are beginning to grapple with and even integrate them to some degree, I nevertheless suggest that many of the traditional ways of defining and structuring a psychoanalytic frame continue to exercise a strong atavistic influence on training, practice, and the very definition of psychoanalysis.     

Transgenerational transmission of indigestible facts: from trauma,deadly ghosts and mental voids to meaning‐making interpretations

Abstract: In this paper¹ I will discuss clinical material and make some hypotheses on how to work with patients for whom trans‐generational transmission of trauma is an issue. Basing my hypothesis on two clinical cases, I will propose a way of dealing with undigested facts, the fabric of trauma, which generate deadly ghosts and mental voids that are transmitted from one generation to the next. I will propose a way of formulating interpretations for the unthinkable to become thinkable and find a representation in the mind of patients who suffer from transgenerationally transmitted trauma. Some thoughts will be given to the maternal and the paternal transmitters of trauma in relation to child development issues.     

Suits,Autotelicity, Temporal Reallocations,Game Resources and Defining ‘play’

Bernard Suits bequeathed a rich legacy of philosophical insights contributing to our developing a deeper understanding of sport-related issues, and his work has attracted much attention and stimulated valuable controversy over many years. However, the interest it has stimulated appears uneven. In this context and with reference to the former claims above, I focus on a part of his work that has received relatively less commentary, in the hope that it too will yield work of value. Given the imaginative quality of Suits's writing, it is pessimistic to assume that attention to a relatively neglected part of his work will fail to bear fruit, if not as a result of my labours here, then perhaps of someone else's in further discussion. My concern is his account of ‘play’, by which he meant to toy, fiddle or trifle with something or other, written over 30 years ago, and it stems from reflection on one recent effort to examine this part of Suits's work, namely Morgan's discussion of ‘play’. My article attempts an analysis of the definition Suits gave and an evaluation of efforts he made to defend his understanding, alongside brief exploration of Morgan's work. Both of these tasks are undertaken against a background of Suits's broader concerns with the place of games in an ideal life. The conclusions I reach are that Suits's account embodies too many issues to be acceptable; that Morgan's attempt to rescue him from one of them is misdirected; but that even if my criticisms are damaging to the account of ‘play’ I examine, they leave Suits's main work on playing games seriously as sports unscathed.     

Horst Wessel: Contributions to the Theory of Logical Consequence,Non-Traditional Theory of Predication and Logical Theory of Terms

The present work takes the decease of Horst Wessel as an opportunity to present and honour his work (and that of his group), which has not received the attention it deserves. The focus will be on works which might not be sufficiently well-known. Wessel was, as we aim to show, familiar with the international debate concerning logical and philosophical issues and strived to solve them by considering theories of logical consequence, a non-traditional theory of predication and the theory of logical terms, all of which he developed in joint work with Alexander Sinowjew. Wessel had to significantly refine these theories in order to formulate his criticism towards alternative logics and to apply the theories to a treatment of intensional contexts. He was vehemently opposed to approaches which revised fundamental laws of classical logic. Questions concerning the history of Philosophy are addressed in Wessel’s criticism of the Kantian antinomies of pure reason, in Wessel’s contributions to the problem of universals and his analyses of fatalism, tychism and antifatalism.     

Major alternatives to the Classic Experimental Design

In summary, giving up any of the three defining features of the Classic Experimental Design has (at least) two important effects. Each concession creates a significant threat to our confidence that any improvements observed were actually attributable to the treatment we are studying. At the same time, each concession opens a door by enhancing, sometimes greatly, the feasibility of conducting work in settings that are the most true to everyday clinical practice. When the work is thoughtfully and responsibly conducted, the alternative designs can contribute to clinical knowledge in a way that is equally important to the contributions made by work that conforms to the stringent requirements of the "Classic" design. In the next article, we will discuss single-time-point designs, along with the important dictum, memorized by most everyone who has taken a course called "Introduction to Research" or "Introduction to Statistics" that correlation is not causation.     

Gurwitsch’s Phenomenal Holism

Aron Gurwitsch made two main contributions to phenomenology. He showed how to import Gestalt theoretical ideas into Husserl’s framework of constitutive phenomenology. And he explored the light this move sheds on both the overall structure of experience and on particular kinds of experience, especially perceptual experiences and conscious shifts in attention. The primary focus of this paper is the overall structure of experience. I show how Gurwitsch’s Gestalt theoretically informed phenomenological investigations provide a basis for defending what I will call Phenomenal Holism, the view that all the parts of a total phenomenal state metaphysically depend on it. To illustrate how the ideas developed along the way can be used in advancing work on the phenomenology of particular kinds of experience, I draw on them in defending Husserl’s view that we can be aware of abstract objects against a phenomenological objection.     

Art and architecture as experience: an alternative approach to bridging art history and the neurosciences

In 1972, Michael Baxandal characterizes the processes responsible for the cultural relativism of art experience as highly complex and unknown in their physiological detail. While art history still shows considerable interest in the brain sciences forty years later, most cross-disciplinary studies today are referring to the neurosciences in an attempt to seek scientific legitimization of variations of a generalized and largely deterministic model of perception, reducing interaction between a work of art and its observers to a set of biological automatisms. I will challenge such an approach and take up art theory's interest in the historico-cultural and situational dimensions of art experience. Looking at two examples of large-scale installation and sculptural post-war American art, I will explore instable perceptions of depth and changing experiences of space that indicate complex interactions between perceptual and higher cognitive processes. The argument will draw on recent theories describing neuronal processes underlying multistable phenomena, eye movement, visual attention and decision-making. As I will show a large number of neuroscientific studies provide theoretical models that help us analyse not the anthropological constants but the influence of cultural, individual and situational variables on aesthetic experience.