The Ties That Bind

In this paper, I define a psychoanalytic object broadly, as an object that “matters” to an individual. My focus is on how someone becomes a psychoanalytic object and how our ideas about this process lead us to a particular conception of an analyst’s mutative role. Further, I examine the function of a psychoanalytic object in one’s inner world. One view of the object leads to a “dynamic” emphasis, examining the object’s role in a system of unconscious conflict and compromise, whereas a second, overlapping line of thought leads to a “structural” focus, emphasizing the object’s role in developing, stabilizing, and often maintaining compromised internal psychic capacities. These capacities are developmental achievements that form the context of conflict and compromise. Dynamic and structural emphases lead to different clinical stances. In considering the object and evolving conceptions of the object within Freudian psychoanalysis (my focus), we simultaneously review the evolution of Freudian psychoanalysis itself.     

Between the Ability to Imagine and Actually Seeing: The Intersubjective in Reclamation

When working with severely damaged, neglected, and deprived patients, the analyst relies on the faith that the intersubjective analytic space can be the site of a live relationship. In this regard, the unique technique of “reclamation” might be used with patients in a moment of imminent danger or of a sense of psychic death and involves an active response to the sense of emergency in countertransference. Reclamation is based on the analyst/therapist's ability to conduct intersubjective dialogue between the various spaces of internalized object relations, and the author attempts to extend the possibility of its technical application by considering reclamation as intersubjective.     

Contributors

Abstract

This paper studies the interaction of the clinical theories of two major British theorists, Melanie Klein and Donald Winnicott. Through three clinical examples, we see how the “Klein-Winnicott dialectic” operates in a significantly developmental fashion to advance and fulfill clinical work. Winnicott’s “object survival” is looked at in developmental conjunction with Klein’s “mourning” as a primary clinical and developmental process. This interaction also captures the essence of working with the aggression of a self that has been traumatically disrupted within its early development. This paper demonstrates how such work leads to the assimilation and grieving of primal object loss, evolving into a “developmental mourning process.” This developmental mourning includes the working-through of an “abandonment depression” in the character-disordered patient. A clinical example in a 1989 essay on “psychic pain” by Betty Joseph is used to set up the clinical challenge of going beyond the symptomatic clinging behavior of developmental arrest, into full psychic birth as a separate other, an Other who can relate to an Other. Conclusively, the subjective visceral affect noted and monitored in its clinical dimensions here is that of human “heartache,” which can also include regret.     

How a Kleinian Analysis Also Tells a Relational and Intersubjective Story Commentary on Paper by Meira Likierman

Dr. Likierman narrates her case in ways that differ dramatically from the usual discourse of relational analysts, and she frames her work with constructs that derive primarily from contemporary Kleinian theory. Yet I believe that if we listen closely to her clinical material, we can see how she and her patient live out a deeply relational/intersubjective process—intersubjective in both Stolorow, Brandchaft, and Atwood's (1987) broad sense and Benjamin's (1995) more developmental point of view.

I suggest is that there is real mutuality in their relationship, a reciprocal, unconscious, taking in of the mind and role of the other—a mutual change in which, paradoxically, both parties seem more real and, more deeply than ever, to express themselves. Ultimately, I think we can see that analyst and patient have “enacted” a slightly subversive, yet vital, mutual dance into and through precisely the paradoxes that Likierman recognizes as “forbidden” territory in the therapeutic relationship.     

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.     

The Symbolic Object

Abstract

The term “symbolic object” is introduced as a way to understand the moments between analyst and patient where “something” new and dynamic emerges within the dyadic relationship. The symbolic object is the bridge between the idealized, all-good object and symbolization proper. The intrapsychic atmosphere between self and object representations is in a relatively non-conflicted state during this process. By reformulating the Nirvana principle and the principle of constancy as ways in which the organism economically strives for the most organized and homoeostatic state possible, the infant or adult can be seen to be searching for the position of lowest unpleasure possible. This is the optimum balance between the libidinal and aggressive forces in the self and object representational field. These moments of “truce” between often highly conflicted phantasies usher in a more refined use of projective identification as a form of intrapsychic/interpersonal communication. This is a particular atmosphere from which both parties, within the projective/introjective, back-and-forth dyadic world, can begin to co-create and rediscover assorted amalgams of self and object functioning. This newly awakened psychic entity is the symbolic object. This outgrowth of something fresh to the dyadic orbit is a mutative moment that propels the relationship into a different direction. Within the pairing of minds, a novel and mutual understanding is produced. Both parties share this new symbolic object and each is shaped by it.     

Trauma Child on The Couch: Transference,Introjection, Identification

This paper attempts to explore some of the psychic processes at work with patients whom I identify as the “trauma child”. The term is a metaphor rather than a diagnosis of “traumatisation”, to indicate patients particularly resistant to maturational processes. They feel blocked and thereby find it difficult to evolve as creative adults. As opposed to the “traumatised” child no particular distressing event can be identified as a cause for emotional suffering. The malaise is often “low key” or silent but functions as a saboteur, undermining satisfactory existence. The trauma child is constantly seduced by regressive functioning and bound by numerous strategies of resistance of reality and often incapable of relinquishing the boundless pleasure of omnipotence. On the basis of my clinical work with the “trauma child”, I will explore the different processes of introjection in transference and counter transference, paying particular attention to the dynamics of identification between analyst and patient and its implications for object relations. Instead of “healthy” identification with the other, taking account of difference and reality, the mode of object relations can be that of “pathological imitation” based on fantasies of oral incorporation. A kind of regressive defense against “mature” relationships; it is an attempt to acquire a substitute identity through magical imitation. Analytical listening, associative work and interpretation stimulate maturational processes within the patient and help him/her to let go of immature relational modes fixated in childhood.     

Silence and communication: nonverbal dialogue and therapeutic action

The subject of this article is silence as communication, with the starting point in the silences of three patients in treatment—in one of them his silences lasted up to a year. Silence is also seen as a specific dimension linked to speech, as the treatment of a third patient shows. The nonverbal interaction between patient and analyst is illustrated. This interaction led to a developmental process in each of the patients, characterized by fusion and separation processes, which included a development of three-dimensionality. The curative process taking place in each of the three, not through verbalisation but through the relation, is understood in the light of Modell's (1990) concept of “dependent/containing transference”. The treatment results demonstrate that the “dependent transference” is curative in itself when the therapeutic setting is maintained. The analyst's inner work during the dependent transference is described: a form of nonverbal participation and joint creativity in the intersubjective field.     

Technique as a Case-Specific Problem: Reply to Commentaries

Seligman's appreciative response to the discussions of his paper is most concerned with the issues raised in Leon Kleimberg's critique of his “modifications of technique.” The dialogue between Kleimberg's and his point of view, with the latter echoed as it in Case and Dent's and Frosch's, reflects a number of key convergences and divergences between the American relational perspective and the British Independents'. Both approaches rely on a fundamentally dyadic perspective that stresses how the analyst's work is fundamentally shaped in response to the patient's internal objects. At the same time, although he is sympathetic to Kleimberg's concerns, he questions the idea of technique as a fixed set of uncontaminated practices. Instead, he endorses the North American relational idea that whatever the analyst does in the name of “technique” cannot be extricated from the transference-countertransference in which it is implicated. From this point of view, technical decisions are most likely to be experienced by the patient, and very often by the analyst, as inevitably reflecting one aspect of another of the patient's internal object world from within the phanstasmatically organized matrix of each analytic relationship. In addition, he is concerned that analysts' rigidly adhering to “technical” positions will reduce their likelihood of being effective with the widest range of patients, an increasing number of whom may not accept the traditional analytic practices. The mentalization concept, although not guiding his decisions in the case, is useful in describing many such situations.     

THE PATIENT'S OBJECTS IN THE ANALYST'S MIND

In every analysis, the analyst develops an internal relationship with the patient's objects—that is, the people in the patient's life and mind. Sometimes these figures can inhabit the analyst's mind as a source of data, but at other times, the analyst may feel preoccupied with or even invaded by them. The author presents two clinical cases: one in which the seeming absence of a good object in the patient's mind made the analyst hesitate to proceed with an analysis, and another in which the patient's preoccupation with a “bad” object was shared and mirrored by the analyst's own inner preoccupation with the object. The use and experience of these two objects by the analyst are discussed with particular attention to the countertransference.     

Altruistic love in psychoanalysis opportunities and resistance

Many patients manifest a desire to help the analyst. This is usually understood as being derivative of defensive aims or in the service of other primary motivations. This paper argues for the developmental and clinical importance of primary altruistic aims, which are often warded off by the patient because of his or her fears of exploitation or rejection. Several pathogenic beliefs and varieties of psychopathology result from the failure of the patient's caretakers to allow the child to contribute to their welfare, to “take”; the child's “help.”; Similarly, some patients require tangible evidence that they are having a positive impact on their analyst. Ordinary “good‐enough”; technique often reinforces the patient's view that he or she has nothing to offer. A full appreciation by the analyst of the importance to patients of having their altruistic gestures and concerns recognized and accepted can open up possibilities for analytic progress and therapeutic growth. Various sources of resistance to and misunderstanding of these dynamics are explored, ranging from ethical concerns to certain traits that cluster in the personalities of analysts.     

Creating the Freedom to Move: Reply to Goldberg and Grusky

In current times, more and more of us are seeing patients who are afraid and unable to make genuine contact with another human being. Their self is more undeveloped than false—more unrealized than broken—and the psychoanalytic, alchemical process of turning reality, truth, and lived experience into meaning often fails, as they wither in psychic encapsulation or retreat. Peter Goldberg and I address the project of how to develop the capacity to play—to help patients come into being and develop a self. Goldberg (this issue) highlights that the analyst’s animating presence and psycho-sensory engagement has alway been present in psychoanalytic processes but usually resides in the background of a treatment, but this crucial inductive dimension of the analytic method comes more to the foreground with the treatment of unintegrated patients. Zoe Grusky (this issue) discusses the medium of play therapy as a means to create transitional space. In my reply, I underscore that a critical component of the project of reclamation, or “inductive dimension” of the treatment with some melancholic patients, is for the analyst to help the patient separate from self-states of non-being that are also anti-life, by meeting the patient where she lives and survive being destroyed; this sort of object-usage is critical to building subjectivity and restoring faith in Life.     

The Analyst as Catalyst: Cultivating Mind in the Shadow of Neglect

I describe an effort to cultivate mind and deepen relatedness in patients who exhibit rudimentary thought and constricted forms of object contact, due to the effects of certain neglect or serious disturbance. Some of these patients require the analyst to serve as a catalyst, who takes proactive steps to summon a psychic realm to the patient’s experience and to forge components of the dyadic bonds that promote such function. The insights of the object relations tradition into foreclosed development are noted. I argue that such insights can be optimally applied with the benefit of the relational school’s emphasis on forms of dyadic engagement and use of the analyst’s subjectivity. In some cases of neglect, and others in which serious developmental challenge is the result of disturbance, priority is placed on the patient’s growth. Similarly, in my case illustration, my goal in using my subjectivity, as a catalyst, is for my patient to take his own emerging mind and psychic self with interest.     

ACQUISITION AND FUNCTIONAL ANALYSIS OF MANDING WITH AUTISTIC STUDENTS

Three autistic students were trained to request a specific object from an adult “supplier” with the sentence, “Give me —” and to deliver that object to another adult, the “director.” Subsequently, the degree to which the object offered by the supplier controlled the “Give me —” verbal response was assessed by delivering to the student an object other than the one requested. Despite knowing the names of all objects used in the experiment, students accepted and delivered to the director any object offered by the supplier regardless of its match with the requested object. After training to say “That's not it. Give me —” when nonrequested objects were offered, students responded differentially to requested and nonrequested objects, suggesting control of the “Give me —” response by the requested object, a characteristic of a mand. These results generalized across settings and objects. Results are discussed in terms of the training technique to establish manding and the functional analysis of the resulting verbal behavior.     

Strangers in Paradise: Trevor,Marley, and Me: Reggae Music and the Foreigner Other

The “immigrant” position calls forth a sense of “strangeness” as a constructed Other. What happens when the self is experienced as a limited, hybridized version of the self one might otherwise be, with opportunity to shape one’s identity? Intersubjectivity is conceptualized as a generative, developmental space in which the “I-ness of me” locates fertile ground for such a project. How do analyst and patient negotiate mutual experiences of alienation in a shared culture of origin, as they encounter experiences of foreignness in a foreign land? As with relational spaces, the construct, “immigrant” is positioned as a thing in itself—a transitional space—in which Otherness might be interrogated. The work of crossing boundaries at the meeting points of race and class is discussed, as two Jamaicans, embedded in the power of Reggae music, engage in psychoanalytic, and socio-political “talk.” Or, is it that we dance?     

A Girl's Loyalty to her Mother

This paper explores the alliance between the analytic couple and the analytic process. The patient doesn't ally only with the analyst, but also with the unfolding of an experiential world. The developmental origins of this alliance are described in terms of infant and child being inside a forming intelligence; womb, mother and family—transforming the mental state of the subject. The structure of the experience is pictured by the resemblance to a simple—experiencing—self being inside a dream, and a rhetoric “I” speaking in an internal dialogue to an unanswering, but present, “you”. The writer describes the negative therapeutic reaction as an attempt to break into this forming intelligence; as an attempt to see who is the creator of the experiential universe. Staying inside the unfolding process is further investigated through the experiences of aloneness and presential immediateness.     

The “Perseverant” Personality: A Preattachment Perspective on the Etiology and Evolution of Binge/Purge Eating Disorders

The author integrates “psycho-digestive” metaphor with contemporary relational perspectives and developmental research to propose a way of thinking about the etiology and evolution of binge/purge eating disorders—including “purging anorexia,” bulimia, and “yo-yo” binge/dieting—and the personality organization that may underlie them. Focusing on the unifying, cyclical nature of these disorders, the author hypothesizes that an early-developing, fear-based form of somatopsychic perseveration may be set in motion from the beginning of life when a nursing infant is unable to achieve a psychic connection with a physically present and feeding (m)other. Without intervention, such a preattachment failure in (m)other/infant synchrony would inevitably impact all subsequent development. The author proposes that it may also lay the foundation for a uniquely intertwined somatopsychic personality organization—what she calls a “perseverant” personality—that fosters the development of binge/purge eating disorders. A perseverant personality is defined as a solitary and circular mode of being, thinking, and relating that is organized around a sustained physiological and psychological reliance on the feeding as a mode of thought-processing and affect regulation.     

Unlawful Entry: Male Fears of Psychic Penetration

In this paper, it is argued that males as well as females have an early experience in relation to the nursing mother of being receptive to bodily and psychic penetration. Males tend to lose access to this experience and may come to fear penetration as a threat such that a masculine sense of self is felt to be dependent on an impermeable psychic boundary that is not to be penetrated. Instead, phallicism as a fortress of emotional self-sufficiency—which the author labels the citadel complex—becomes the matrix of a subjective sense of masculinity. The multiple and combined forces of bodily development, the establishment of gender identity, and the process of separation-individuation are examined for their role in this process.

A critique of the Lacanian concept of paternal law suggests that the “law of the father” can be interpreted as a law regulating penetration. Paternal law can be viewed as a code for the establishment of an impenetrable masculinity whereby entry into an adult male psyche becomes unthinkable, “unlawful.” An impermeable bodily and psychic boundary—the ability to penetrate without the ability to be penetrated—collapses a necessary dialectical tension that may affect men's experience of sex and of love and that may shape and limit their desire.     

Momentums of Meeting

ABSTRACT

In this article, I attempt to engage questions about the momentums of the moments of meeting formulated by Lou Sander as propitious for early development. I wanted to portray observations that grapple with the intersection between psychic change and complex dynamics, like imagistic confluence with verbalized interaction, embodied recognition from parent to child, and affecto/libidinal communication between patient and analyst. The focus is on four different directions for comments: (1) Some links to my own clinical practice and research; (2) An instance of “confluence of visual image between patient and analyst”, a moment of imagistic meeting, as understood through self-analysis by an open-minded analyst, including the discovery of “the importance of unsuccessful empathy in learning and growing”; (3) A study of “engrossment,” exemplifying the ways in which the earliest moments of “recognizing” ones infant, can engender joyful, expansive affects, with enhancement of self-image in fathers; and (4) The continuing generative momentum of Lou Sander’s participation within the Boston Change Process Study Group.     

Innen, Außen, Zwischen

The so-called “intersubjective turn” (or “relational turn”) in psychoanalysis is closely associated with the work of Winnicott. It was him who added a new dimension to the psychoanalytic theories of a separate inner world, a dimension focussing on the mediating processes between the separate spheres of psychic and external reality: a space between subject and object, drive and civilisation, Ego and reality — the “potential space” that unconsciously connects our self to the Other as well as to a shared physical and social world we live in. Winnicotts paradoxical notions of the self are traced in this paper and unwrapped from their often enigmatic, developmentally and epistemologically confusing veils: the infant who does not exist without a holding mother; who is not aware of his/her being held because of its evidence, and only has an experience when falling; who him-/herself creates that reality which is already there; who must destroy the object in order to use it; who can only be alone when another person is present. The author, starting from apparently narcissistic phenomena of the media society, rehabilitates the term of “in-between” in contemporary psychoanalytic discussion which for a long time was considered as suspect, as being part of a “non-psychoanalytic” superficial social psychology (as the intersubjective, the interpersonal or the interactive). Under the strong influence of Winnicott, and overarching the different schools, contemporary psychoanalysis is focussing on intersubjectivity and relationality. The paper is an appeal for reformulating classical intrapsychic concepts — including the theory of the unconscious—in intersubjective terms, thus unfolding a relational approach inherent in Freud’s metapsychology.