Between the basic fault and second skin

The ideas that are commonly associated with Esther Bick, such as primal skin function, defensive second skin phenomena and adhesive identity, are traditionally seen as affiliated to the larger body of work that constitutes the Kleinian school. I shall argue, however, that Bick's thinking owes a largely communally unrecognised debt to the work of her training analyst, Michael Balint. Beginning with a discussion of Bick's early psychoanalytic formation within the British Psychoanalytic Society, her ideas will be reapproached in the light of her contemporary psychoanalytic milieu, with particular reference to Balint's notions concerning primary object-love, the basic fault and space. A brief history of the Manchester Training Centre, a short-lived but pioneering British attempt to extend psychoanalytic training beyond London, is included incidentally. Bick's early intellectual openness to diverse psychoanalytic streams will then be discussed in relation to the formation of psychoanalytic groups and their relative capacity to tolerate difference.     

Expressions of vernacular psychoanalysis

The present paper examines the clinical integration of theory and experience from the perspective of clinicians’ subjective shaping of inquiry. The author suggests that the historical, conceptual development of clinical psychoanalysis parallels the progressive articulations of consensual understanding within the clinical hour. He suggests that the clinician's utilization of vernacular elements, derivative of direct experience as well as of reference to the wider range of psychoanalytic thinking, addresses gaps and disconnections within the abstract understanding of the clinical psychoanalytic process. Providing examples from psychoanalytic history, he concludes with a contemporary example of psychoanalytic papers, reflecting vernacular elements that are of use to practicing clinicians.     

Meaning without words, word without meaning: forgetting of "aliquis". Remarks on Grünbaum's critique of repression

The author addresses the critique of the psychoanalytic concept of repression developed by Grunbaum in regard to Freud's interpretation of forgetting in the "aliquis episode". Reiff counters by pointing out the indispensability of a hermeneutic approach to the transference-countertransference process and supports his contention with case illustrations and with reference to the psychoanalytic discussion of symbolization.     

Prefiguring and Refiguring Triangular Interpersonal Relationships: Commentary on Paper by Elisabeth Fivaz-Depeursinge,Chloé Lavanchy-Scaiola,and Nicolas Favez

The current paper involves a discussion of “The Young Infant's Triangular Communication in the Family: Access to Threesome Intersubjectivity?” Conceptual considerations and case illustrations. The work of the Lausanne Group is reviewed with special reference to its relevance to psychoanalytic theory and practice. The ingenuity of the design of the play paradigm is cited, with its illumination of the role of the body and interactive events in the construction of inner experience. Challenges to psychoanalytic thinking are discussed with special reference to the Oedipus complex and its precursors. A major difference involves the Lausanne group's position that triangles are not inherently problematic. The author also addresses the question of intersubjectivity as a motivational system, taking issue with the group's position that it is.     

Minding the Gap not Bridging the Gap: Family Therapy From a Psychoanalytic Perspective

Following recent interest in this journal in building bridges between a psychoanalytic and systemic approach to family therapy (Vol. 19, 1997), the authors take up the debate. A clinical vignette from a recent article is used for discussion and, in order to describe further work from a psychoanalytic perspective, two case vignettes are presented. The comparisons are discussed with particular reference to the concepts of projective identification, transference/countertransference and internal object relations.     

What's Possible? What Matters? Reply to Commentaries

The three discussants agree that a definition of psychoanalysis tied to session frequency is problematic and needs to change. Yet none supports my recommendation to redefine the practice of psychoanalysis in terms of the practitioner's training. This prompted me to look more closely at my proposal and push my thinking further. I argue that psychoanalysis, like many other professions, needs to define its practice as the application of its complex and evolving knowledge and skill base, grounded in its unique field of inquiry. Although there are individual exceptions, the inculcation of this knowledge and skill base is generally best accomplished through psychoanalytic training. This assertion, however, rests on the premise that our training curricula keep pace with our rapidly evolving field of inquiry and knowledge. To further clarify my vision I examine the nature of psychoanalytic expertise. I suggest that such expertise amounts to the inculcation and integration of a large number of psychoanalytic frames of reference. I contend further that the nature of contemporary psychoanalytic theories is such that important psychoanalytic frames of reference are proliferating more rapidly than in the past, that the relationships among them are becoming more complex, and that consequently the application of psychoanalytic theory to practice is also becoming more complex. Psychoanalytic training programs need to recognize this expanding complexity and revise curricula and pedagogic methods on an ongoing basis to reflect this evolution within our field.     

On the nature and standing of psychoanalytic psychotherapy

In this paper, I offer some reflections on the standing of psychoanalytic psychotherapy in the National Health Service (NHS), with special reference to contemporary forms of evidence-based thinking. I consider what may follow when a narrow view of science or psychotherapeutic practice becomes conventional wisdom and assumes dominance. I place stress on the potential loss to NHS psychology and psychiatry if psychoanalytic psychotherapy becomes increasingly marginalized on the one hand, or overly standardized on the other.     

Psychoanalytic application and psychoanalytic integrity

In this article, the author offers an analysis of psychoanalytic application, defined as the breaking of new conceptual ground in some field of knowledge whereby the new idea is conceived, and later articulated, with the aid of reference to analogous phenomena in psychoanalysis. It requires apt analogy based on competent understanding of the applied field and of psychoanalysis. Only when the relevant differences between the applied and psychoanalytic fields are grasped can the extent of certain parallels emerge. The thinking by analogy that comprises psychoanalytic application may be intuitive and implicit, but should be susceptible of explicit theoretical elaboration that specifies, precisely, the point(s) of correspondence between psychoanalysis and the applied field in relation to a precise specification of their relevant differences. Applied psychotherapy at the interface of the internal and external worlds (historically rooted in casework) is employed as a model. By analogy with Donnet's concept of the analytic site, the author proposes the concept of the psychodynamic (case)work site, and elaborates it for that applied field in order to elucidate the proposed principles of psychoanalytic application.     

The impact of theory on psychological testing: how psychoanalytic theory makes diagnostic testing more enjoyable and rewarding.

Systematically applying psychoanalytic theory to psychological testing cultivates a practical, useful, and enjoyable experience of test administration, test scoring, and test interpretation. Furthermore, by grounding psychological testing in psychoanalytic theory, testing becomes rewarding because there is a lively clinical interplay between testing and psychotherapy. These potential sources of enjoyment and skill for the psychological examiner are explored, and several clinical examples are given for illustrative purposes. The need to appreciate the impact of a given theoretical frame of reference is highlighted.     

Supervision and Analysis at a Crossroad: The Development of the Analytic Therapist: Discussion of Papers by Joan Sarnat and Emanuel Berman

This discussion of papers by Sarnat and Berman on psychoanalytic supervision explores the complex nature of the contemporary psychoanalytic supervisory relationship. It considers how developments in psychoanalytic theory and practice, reflecting relational, intersubjective, attachment, and field theory influences over the past 30 years, have changed the ways in which many analysts practice and theorize supervision. Contemporary supervisors attend not just to the patient being presented, or to the therapeutic dyad, but to the supervisory relationship itself as part of the clinical/supervisory frame of reference. Similarities and differences between therapy and supervision are considered.     

A DISCOURSE ON SOPHOCLES: FREUD AND DETERMINISM

A study on the subjective experience of neuroleptic treatment is used as an example of research that employs psychoanalytic theory and methodology outside the clinical situation. Psychoanalytic tenets such as psychosexuality and the unconscious are highlighted, and the systematic study of internal reality is discussed with reference to the study on neuroleptics, the results of which are presented in extenso. Metapsychology is considered as a means for systematization, and self-reflexive countertransference analysis is seen as a means for fostering trustworthiness and reliability. The validity criteria discussed are clinical relevance, coherence, and originality (as distinct from merely confirming received theory). Value conflicts between academic and psychoanalytic scientific cultures are described with reference to the data of the specimen study. The concluding discussion includes a brief comparison of the time-limited interview method with long-term, clinical psychoanalytic inquiries.

“Flechsig's Brain science is the theory and Schreber's delusions are the practice of the same traumatic collapse of…subjectivity, of the gap separating bodily cause and symbolic effect. Schreber's point would seem to be that the elimination of the gap—the attempt to fill it with neuroanatomical knowledge—is nothing short of soul murder.” Eric Santner (1996), My own private Germany: Daniel Paul Schreber's secret history of modernity (p. 75)     

Reflexive research and the grounding of analysis: Social psychology and the psy-complex

This paper is concerned with reflexivity in research, and the way research is grounded in the operations of the psy-complex in social psychology. A central argument is that qualitative research in general, and a focus on reflexivity in particular, requires theoretical grounding. Distinctions are drawn between ‘uncomplicated subjectivity’, ‘blank subjectivity’ and ‘complex subjectivity’; and the analytic device of the ‘discursive complex’ is described. It is argued that such theoretical grounding can usefully draw on developments in discourse analytic, deconstructionist, and psychoanalytic social research. The opposition between objectivity and subjectivity is deconstructed, and psychoanalytic conceptual reference points for an understanding of the discursive construction of complex subjectivity in the context of institutions are explored with particular reference to the location of the researcher in the psy-complex. The paper discusses the reflexive engagement of the researcher with data, and the construction of the identity of the researcher with reference to professional bodies. An analysis of a document produced by the British Psychological Society is presented to illustrate conceptual issues addressed in the first sections. This illustrative analysis is designed to show how the material is structured by a series of six discursive complexes, and that the institutional structure facilitates, and inhibits, certain forms of action and reflection.     

Psychic phenomena and early emotional states

This paper examines the relationship between severe early trauma and the development of psychic intuition. A case presentation with extensive dream work helps to illustrate this connection by exploring the psychological meaning of one patient's acute receptivity to unconscious communications. The paper includes a historical overview of Freud's attitudes toward occultism, as distinct from later psychoanalytic views, including those of Wilfred Bion. Many of Bion's views have more in common with Jung's perspective than with Freud's, with particular reference made to spiritual and religious differences. Bion clearly states that Freud and psychoanalysts have focused on phenomena, not on noumena, which Bion considers to be the essence of the psychoanalytic point of view.     

Reconsidering Self and Identity Through a Dialogue Between Neuroscience and Psychoanalytic Theory

The terms self and identity have figured prominently in psychological and psychoanalytic writings despite a lack of consistent definitions. Whereas most attempts to clarify the terms have been in the context of a particular theoretical model such as ego psychology, self-psychology, or object relations theory, these clarifications were limited to that particular frame of reference. This paper presents evidence from the dynamic systems models of neuroscience as a foundation to inform psychoanalytic theory toward a clarification of these terms. The neuroscience data supports a distinction between self and identity relative to right hemisphere, reflexive, nonlinguistic experience and left hemisphere, reflective, linguistically mediated experience. A parallel between the empirical study of consciousness in terms of ownership, agency, unity, and continuity is also made with contemporary psychoanalytic concepts and their relationship to self and identity. Additionally, the article offers suggestions for a mutually informing dialogue between psychoanalysis and neuroscience in the hopes of promoting interdisciplinary research.     

Narcissism: origin and goal of the ego. Reflections of Lou Andreas-Salomé

The author presents Andreas-Salomé's theoretically relevant, though largely neglected writings. She devoted special interest to narcissism. Her contributions to this topic are discussed in relation to Freud's corresponding texts, with whom she maintained an enduring friendship. General reference is made to the more recent psychoanalytic debate about narcissism.     

Psychoanalysis and the Body–Mind Problem

In this paper I have tried to clarify some of the differences between on the one hand ordinary doubts and uncertainties that are part and parcel of the psychoanalytic process, and on the other hand the sort of doubt that Socrates called 'aporia', that is, philosophical and conceptual. I have described one point at which philosophical doubt may creep into psychoanalytic thinking on body/mind issues. I presented a psychoanalytical model of the mind, based largely on Bion and Anzieu, in which mind is seen to be emergent from a body–mind nexus, to which we may, under pressure, regress. I elaborated this by reference to an example of my own somatisation, and to Anzieu's theory of a skin ego. Finally I made some comparisons between philosophical solutions to anxieties arising both in the mind/body area and in general epistemology, and psychoanalytic approaches to similar anxieties in life.     

Symposium on The Ego and the Id after fifty years. The need for a new general theoretical frame of reference for psychoanalysis.

This paper briefly discusses some of the serious problems in current psychoanalytic metapsychology and the need for a new general theoretical frame of reference. It highlights the lack of explanatory power and the primitive nature of current metapsychology. The paper suggests the usefulness of an information processing and systems model which is consistent with neurophysiology.     

Is there a place for individual subjectivity within a social constructionist epistemology?

The epistemological turn towards social constructionism has become well established within the field of family systemic therapy. Social constructionism has provided therapists with a theoretical rationale for the concentration upon the social context within which individuals and families live their lives. This is a philosophical position that pushes to the margins the positivist premise that individuals have fixed and measurable personalities in favour of a discourse which proposes that the person is encountered differently within different social contexts. Prompted by the growing interest in systemic practice with individuals and by the rediscovery of the psychoanalytic canon within family therapy literature, the adequacy of this position is examined and an attempt is made to open up a space within social constructionist discourse for a theory of individual subjectivity. Findings from a research project are the starting point for this venture. These findings are understood through the lens of psychoanalytic theory, with particular reference to the work of Jacques Lacan.     

Rapprochement in Sight? Postmodern Family Therapy and Psychoanalysis

This paper explores aspects of the theory and practice of psychotherapy with the aim of identifying similarities in the approaches of both family therapists and psychoanalytic psychotherapists. The author calls for a dialogue between the disciplines, and makes specific reference to the potential value of this in relation to training and research.