Commentary on Jansen's Paper

Karl Jansen raises a fundamental and exciting question: Is humankind's consciousness the result of neuronal function, or are there extra-cerebral aspects as well? While his neurotransmitter model of near-death experiences (NDEs) is well described, I find his supporting evidence weak. Methodological differences between studies of ketamine hallucinations and near-death experiences (NDEs) raise doubts about how similar those experiences are phenomenologically. While Jansen's model has electrifying implications, the data required to support his conclusions do not yet exist.     

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 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 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 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.     

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.     

Commentary on Paper by Ellen F. Fries

In Perchance to Sleep: Minding the Unworded Body in Psychoanalysis, Ellen F. Fries masterfully articulates the complexities of right-brain to right-brain, body-to-body interactions between herself and her patient. Her work highlights the dominance of the nonverbal implicit self over the verbal, explicit self and provides an excellent example of clinical work in which she thoughtfully attends to the unspoken, bodily based communication that takes place within the therapeutic dyad. In this discussion, I offer perspectives from Sensorimotor Psychotherapy on the impact of early attachment on the procedural organization of action sequences that reflect and sustain the implicit self, and embody unconscious relational expectations. The following topics are addressed: (a) Physical actions that provide avenues of exploration into the implicit self, especially actions such as reaching out, making eye contact, or maintaining an upright posture that are abandoned or distorted when they are ineffective in eliciting the desired response from attachment figures; (b) Body-oriented interventions that target the involuntary physical spasms that Fries' patient experiences, which are associated with unresolved physiological arousal originally stimulated in the face of trauma; and (c) The nonverbal manifestation and negotiation of enactments that emerge from the body-to-body dialogue between the implicit selves of patient and therapist.     

Commentary on Paper by Philip A. Ringstrom

When we feel overwhelmed by an inescapable threat, we “identify with the aggressor” (Ferenczi, 1933). Hoping to survive, we sense and “become” precisely what the attacker expects of us—in our behavior, perceptions, emotions, and thoughts. Identification with the aggressor is closely coordinated with other responses to trauma, including dissociation. Over the long run, it can become habitual and can lead to masochism, chronic hypervigilance, and other personality distortions.

But habitual identification with the aggressor also frequently occurs in people who have not suffered severe trauma, which raises the possibility that certain events not generally considered to constitute trauma are often experienced as traumatic. Following Ferenczi, I suggest that emotional abandonment or isolation, and being subject to a greater power, are such events. In addition, identification with the aggressor is a tactic typical of people in a weak position; as such, it plays an important role in social interaction in general.     

Reexamining Change Commentary on Paper by Jeremy Safran

Change—what prevents it, what nurtures it, and what maintains it—is a current that runs throughout the history of psychoanalytic theorizing. While knowledge, in the form of insight, remains an important antidote to repetition, awareness of the here-and-now process of the clinical experience has taken a new place in more recent theoretical understanding. In looking at these questions of change, this commentary offers some additional theories to those already expressed by Safran.     

Commentary on Paper by Lawrence J. Brown

Brown's historical overview of post-Kleinian psychoanalysis traces key steps in the evolving and diverse practice of working in the psychoanalytic situation while regarding it as a two-person field. The Barangers' “The Analytic Situation as a Dynamic Field” is central to his narrative. I develop my understanding of the originality of their contribution in theorizing a situational unconscious, and of their continuing relevance for thinking about analytic listening and intersubjective collaboration. Brown presents a countertransference dream of his own along with the dream of a patient as an example of the Barangers' concept of the “shared unconscious fantasy” of the analytic couple. A detailed alternative reading of Brown's clinical vignette reveals an absence of fit with the Barangers' views on collaboration in the analytic situation. Some uses of Bion's “dreaming” and “becoming” are implicitly questioned as they risk encouraging the idealization of special states over process.     

Speech and Sensuality; Speech and Separation: Commentary on Paper by Sarah Hill

In this response to Bromberg, I note the ways in which his commentary has further stimulated and enriched my thinking.     

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.