Unconscious fantasy and theories of cure

It has long been known that patients' wishes for cure by analysis give expression to unconscious wishes for instinctual gratification which originate in childhood mental life. Patients sometimes develop theories about how they believe analysis attains its ends; these are likely to affect the way they behave in the analytic situation, and analysis of them may therefore constitute an important contribution to progress in the analysis. Two illustrative cases are presented; in both, the unconscious determinants of the patients' theories turn out to be infantile sexual fantasies connected with their uncon scious wishes for instinctual satisfaction. It is further suggested that analogous unconscious fantasies also influence the theories of analysts and other therapists about how analysis works. In some instances these factors, while not affecting theory formation explicitly, may, without being recognized as doing so, contribute to decisions regarding the modification of analytic technique. Awareness of that possibility may aid analysts in assessing the indications for such proposed modifications.     

Types of sexual transference and countertransference in psychotherapeutic work with children and adolescents

The question of normal sexuality begins to arise in the treatment of severely sexually abused or sexually offending patients. The author suggests that it is an interesting and delicate moment during the process of recovery when less perverse, more normal sexuality appears mixed with, or even disguised by, the more habitual perverse fantasies. Writers in the adult field have drawn distinctions between perverse, eroticized and normal erotic transferences, and between Oedipal and post-Oedipal sexuality. Some have also distinguished between countertransferences in the analyst of an erotised versus a normal erotic nature. The paper discusses whether these distinctions could have any relevance for child patients. Freud and Klein have taught us much about the child's sexuality in relation to his interest in and attraction to his parents as sexual beings. But can we also detect some origins in earlier experiences in infancy of the child's later capacity to feel himself a sexual being capable of being wanted by an other? How might such a feeling of sexual self-worth differ from narcissism and from sexualised exhibitionism? The paper asks how therapists might deal with such problems and such possibly healthy developments.     

Death, resurrection, and rebirth: observations in cardiac surgery

The fantasy of life after death is universal, and every culture attempts to deal with concepts of resurrection and rebirth. In the past, these fantasies have dealt with religious and symbolic meanings, but cardiac resuscitation and cardiac surgery have introduced a new dimension: the patients' concept that they die in reality and are reborn or resurrected. This study, which was based on pre- and postoperative psychiatric interviews with cardiac patients, has focused on the problems such patients face. Their defensive immortality-formations appear to confirm Freud's speculations in Thoughts for the Times on War and Death concerning the human being's difficulty in accepting death as an end to life. Case history vignettes were presented, showing how these fantasies of death and resurrection can influence patients' ability to undergo necessary surgery. It was suggested that the idea of rebirth indicates starting life anew without blemish, whereas resurrection fantasies involve having another chance to live but with the same defective body.     

BETWEEN KNOWING AND BELIEVING: SALVAGING ILLUSION'S RIGHTFUL PLACE IN PSYCHOANALYSIS

Illusion has historically received insufficient psychoanalytic attention, even though it plays an indispensable and adaptive role that helps protect individuals from becoming traumatized by the most psychically noxious aspects of reality. Trauma is mitigated by an individual's knowing about the existence of such realities yet simultaneously believing them non‐existent, with neither position granted exclusivity. Psychoanalytic theory is surprisingly predicated on the employment of illusions that picture an individual capable of controlling the potentially traumatic actions of others, just so long as the individual effectively manages his own intrapsychic processes (wishes, fantasies, impulses, etc.). The role of illusion in everyday life is highlighted.     

Why counselling is not sought in deteriorating relationships: The effect of denial

Only a small proportion of couples with relationship problems seek counselling help to improve the quality of their relationships, and little is known about why this is so. The study, a qualitative one, was devised to learn more about this. A total of 36 women and 16 men, who had either been, or had not been, counselled, took part following invitations to recent ex-clients of Bamet Relate Marriage Guidance, to local organisations of divorced and separated persons, and as a result of local publicity. Structured discussions were held in small groups to explore questions concerning the respondents' attitudes to relationship counselling before seeking it or before deciding not to do so. In addition to identifying powerful fears and fantasies associated with counselling, a central underlying cause of counselling not being sought, both by men and women, was found to be their denial of the problems in the relationship or of the seriousness of these problems, or denial that anything could be done about them.     

The power of prospection: mental contrasting and behavior change

People often immerse themselves in dreams and fantasies about a desired future. Though such future fantasies are pleasant, they do not necessarily lead to the effort required to attain the desired future. Indeed, the more positively people fantasize about their desired futures, the less effort they invest and the less successful they are in realizing these futures. However, when fantasies about a desired future are complemented with a clear sense of reality, people find the direction and energy needed to realize their fantasies. We review Fantasy Realization Theory, which explicates these ideas and led to the discovery of mental contrasting future and reality, a self‐regulation strategy of behavior change. Mental contrasting helps people figure out what they really want and wisely select, commit to, and actively pursue prioritized wishes while constructively dealing with setbacks. It helps them live a rewarding life through work, play, health, and relationships.     

The place of annihilation anxieties in psychoanalytic theory

Survival-related clinical reports are abundantly found in the works of classical, object-relational, and self psychological writers, but are underrepresented in major theoretical formulations on anxiety. Fears of being overwhelmed, merged, penetrated, fragmented, and destroyed, as contents of unconscious and conscious fantasies, are regularly interrelated with the typical dangers. Fifteen preliminary propositions invite closer study of such apprehensions and provide definitional components. Annihilation anxieties are triggered by survival threat; are found early but can be engendered throughout the life cycle; constitute a basic danger; are residuals of psychic trauma; have specifiable subdimensions; may occur in presymbolic form or be associated with fantasies in conflict/compromise formation; may arise with or without anticipation; may be accompanied by controlled or uncontrolled anxiety; are motives for defense; and may be associated with particularly recalcitrant resistances. The study of annihilation anxieties in relation to the basic danger series has both theoretical and clinical advantages, especially for understanding traumatic, anxiety, phobic, psychosomatic, addictive, narcissistic, borderline, and psychotic manifestations, as well as sexual problems (including perversions), nightmares, dissociative and panic states, and especially difficult resistances.     

Little Hans and the thought police: the 'policeman fantasies' as the first reported supervisory transference fantasies

The ‘policeman fantasies’ in Freud ’s case of Little Hans, famous for being Freud ’s most direct evidence for specifically sexual oedipal desire by Hans for his mother, are reconsidered. The Hans case is the first recorded instance of psychoanalytic supervision, and recent studies suggest that it is common for patients in supervised treatment to experience fantasies about the supervisor. It is argued that the policeman fantasies are the first recorded instances of such transference fantasies about psychoanalytic supervision and the patient–therapist–supervisor triangle. The explanatory power of this interpretation is supported by the nuances of the features of the fantasies themselves, as well as by the context in which they occurred that might serve as ‘day residues’. Moreover, this interpretation provides an answer to the central mystery of the two fantasies, which goes unaddressed by Freud ’s oedipal interpretation: Who is the policeman?     

Disturbances of the sense of time with special reference to the experience of timelessness

Disturbances of the experience of time are examined, with emphasis on the effects of the vicissitudes of the sense of self, affect, unconscious fantasies, and ideas concerning death. The manifest experience is interpreted as a derivative of unconscious, conflict-laden fantasies. Disturbances of the experience of time may be regarded as specific types of affective states, pleasurable or unpleasurable, the quality of the experience being determined by the nature of the underlying unconscious ideational content. Two experiences of timelessness are analyzed, in which the sense of timelessness was determined by the wish to extend time indefinitely. Many elements have been condensed into this basic wish which, as in a dream, was momentarily experienced as already realized.     

Aggressive fantasies, thought control strategies, and their connection to aggressive behaviour

The present study examined the relations between aggressive fantasies, thought control strategies and aggressive behaviour in a sample of non-clinical female participants (N = 72). First, the nature and prevalence of aggressive fantasies and thought control strategies were examined. Then, the relation between these constructs and aggressive behaviour was studied by means of correlations and regression analysis. Results indicated that aggressive fantasies were a common experience in these non-clinical participants, and that suppression, distraction and cognitive reappraisal were prevalent strategies to control aggressive intrusive thoughts. Most importantly, it was found that thought suppression and aggressive fantasies were positively correlated with aggressive behaviour. A regression analysis underlined the link between thought suppression and aggressive behaviour, but the relation between aggressive fantasies and aggressive behaviour was no longer significant. Further, some indications were found for distraction being an adaptive strategy for controlling aggressive intrusive thoughts.     

“With you I’m Born Again”: Themes and Fantasies of Birth and the Family Circumstances Surrounding Birth as These are Mutually Evoked in Patient and Analyst

Themes of birth and rebirth, being born and born-again, can be readily observed in clinical psychotherapy and psychoanalysis even as they remain undertheorized. A clinical case is presented that traces the first four years of an analysis as seen through the lens of four consecutive supervisory experiences. This paper explores the central importance of fantasies and narratives of one’s origins and birth and the observations, fantasies, and expectations generated by one’s family circumstances at the time of birth. The paper examines birth narratives, fantasies, and myths of origination by following a clinical case across four supervisions. The patient’s birth-related fantasies are shown to interact with the analyst’s concordant and complementary fantasies as the analyst interacts with a series of supervisors in the process of being born as an analyst. The analyst’s personal birth narrative is linked to his fantasies about being born professionally as an analyst, and these are shown to interact with the patient’s birth fantasies. The paper suggests the ongoing significance of unconscious fantasy within the framework of contemporary relational psychoanalysis.     

The double-edged pen: Omnipotent fantasies in the creativity and addictions of Stephen King

The legendary debate over whether a connection between creativity and addictions exists is one that is shrouded in mystery and intrigue, but also one that continuously returns to the circuitous metaphor of the chicken and the egg. In an effort to better understand nuances in the relationship between creativity and addictions, this paper examines the life of Stephen King, and the omnipotent fantasies from which both his creative processes and addictive behaviours emerged. Since the early twentieth century, psychodynamic thinkers have highlighted omnipotent fantasies as a psychological force driving creative processes as efforts towards personal transformation. Similarly, numerous psychodynamic theories have highlighted omnipotent fantasies as playing a cardinal role in the psychological processes that propel substance abuse. And yet, the construct of omnipotence has yet to be examined as a theoretical bridge to bind such theories of creativity and substance abuse together. While fostering personal meaning and self-transformation when manifested in his creative writing processes, omnipotent fantasies have also lead Stephen King down a precarious path of addictive behaviours. Through a narrative analysis of the life of Stephen King, who has written in great depth about both his creativity and substance abuse, I will illustrate how omnipotent fantasies often shape and foster both healthy, creative processes towards growth and maladaptive, addictive impulses towards self-destruction.     

Fairy-tales in psychotherapy

Fairy-tales, like mythologies, can be found all over the world containing the same motif and chains of motifs. In this paper I have presented some theories on the occurrence of this archetypal phenomenon ranging from the old migration theory to Sheldrake's theory of morphogenetic fields. I have then tried to show how fairy-tale-motifs can appear in various ways in analytical therapy, often in hidden forms. We find them in patients' dreams as well as in their fantasies and associations. If the therapist is open to them they will also appear in his or her amplifications. He or she might then take note of the fairy-tale or point it out to the patient; in the latter case it might provide better access to the patient's problems and complexes as fairy-tales have an emotional completeness because of their pictorial character. Finally I have described the favourite fairy-tale of one of my patients and related it to his symptoms, his central complex and his personal ways of experiencing and behaving. This survey of how fairy-tales can be used in therapy with children and with adults far from exhaustive.     

Sadistic fantasies modified by aversive conditioning and substitution: a case study

A case study involving unpleasant electric shocks as the consequence of sadistic fantasies seems to have successfully helped to suppress or extinguish them while incompatible “normal” sex fantasies were strengthened. The results are seen as analogous to other studies using extinction with aversive stimuli.     

From active imagination to active life: at the roots of Jungian social activism

Our traditional Western worldview is often unconsciously based on a polarized, dichotomous perspective. However, many of Jung's ideas hint at a deep interrelation between opposites, such as inside and outside, which are, as the principle of synchronicity shows, rooted in a conceptualization of psyche and matter conceived as intertwined. Another pair of philosophical concepts, traditionally considered as opposites, needs further investigation: that between imagination and reality. If we are lucky in our daily practice as analysts, we can use imagination as a powerful tool to help people discover themselves as individuals and to get in deeper, more lively and responsible touch with reality. This paper explores the difference that Jung outlined between ‘active imagination’ and ‘passive fantasies’, and the transformative power of taking an active part in what imaginatively happens – he called it ‘active participation’ – rather than being passively overwhelmed by invasive fantasies. It is argued that it makes a great difference whether we become the actors and not just the spectators of our lives, and this is linked with the core of the individuation process in which, if individuals discover their particular place and meaning in the universe, they can live an ‘active life’, playing a heartfelt and responsible role in the collective world to which they belong. These ideas are at the heart of Jung's work, and they represent one of the roots of Jungian social activism.     

The Case Study of Jacob: Childhood Sexual Abuse and the Limitations of the Holding Environment

Childhood sexual abuse and trauma influence relational development in significant ways. Notable among them are the development of a patient's internal object world, fantasies, and sense of self. Dynamic formulations and holding techniques are used to identify, process, and alter fractured relational dynamics. However, the use of such techniques may also influence a patient's narrative process, pulling them away from the realities of their life as lived. Using the case study method, focusing specifically on the patient's narrative development, this article examines the impact of analytic framing on a patient's experience of child sexual abuse and trauma.     

Controlling,Avoiding, or Protecting the Object: Three Reactions to the Breakdown of Psychic Retreats

In working psychoanalytically, it is common to encounter patients who need to carefully manage their immediate objects. This is evident in their stories about external life at home, at work, and with friends as well as in how it emerges within the transference. While a frequent theme in many analytic cases, the motives behind this need are varied.

Case material is used to show how these reactions emerge when psychic retreats fail. When unable to find refuge in pathological organizations or psychic retreats, patients are exposed to the worst of paranoid and depressive anxieties with only a fragile foxhole to withdraw into or defend from. In such a precarious psychological state, fantasies of unbearable self and object danger emerge, leading to various forms of acting out, overreliance on projective identification, and perverted images of giving and receiving. These fantasies result in the desire for idealized objects, the drive to resurrect fallen objects, and the need to avoid cruel and attacking objects that have taken over and replaced the sought out ideal.     

The Narcissistic dynamics of submission: the attraction of the powerless to authoritarian leaders

Ferenczi’s conception of identification with the aggressor, which describes children’s typical response to traumatic assaults by family members, provides a remarkably good framework to understand mass social and economic trauma. In the moment of trauma, children instinctively submit and comply with what abusers want—not just in behavior but in their perceptions, thoughts, and emotions—in order to survive the assault; afterwards they often continue to comply, out of fear that the family will turn its back on them. Notably, a persistent tendency to identify with the aggressor is also typical in children who have been emotionally abandoned by narcissistically self-preoccupied parents, even when there has not been gross trauma. Similarly, large groups of people who are economically or culturally dispossessed by changes in their society typically respond by submitting and complying with the expectations of a powerful figure or group, hoping they can continue to belong—just like children who are emotionally abandoned by their families. Not surprisingly, emotional abandonment, both in individual lives and on a mass scale, is typically felt as humiliating; and it undermines the sense that life is meaningful and valuable.

But the intolerable loss of belonging and of the feeling of being a valuable person often trigger exciting, aggressive, compensatory fantasies of specialness and entitlement. On the large scale, these fantasies are generally authoritarian in nature, with three main dynamics—sadomasochism, paranoid–schizoid organization, and the manic defense—plus a fourth element: the feeling of emotional truth that follows narcissistic injury, that infuses the other dynamics with a sense of emotional power and righteousness. Ironically, the angry attempt to reassert one’s entitlements ends up facilitating compliance with one’s oppressors and undermining the thoughtful, effective pursuit of realistic goals.

     

Mit Imagination an Albträumen arbeiten

According to Jung fantasies appear during sleep as dreams and while awake, they appear as more or less conscious fantasies. He understood fantasy as an activity of the psyche itself. Fantasy is that which simply occurs without any effort on our part and is always present. Imagination is what we call fantasy when we concentrate on it, i.e. perceive it and do something with it. Due to the close relationship of dreams, fantasies and imagination, the more they are consciously observed and perceived, the more it is possible to use imagination with dreams to better understand them. This is especially true for nightmares so that through imagination helplessness can be overcome and self-efficacy can be stimulated. Steven Starker already proposed using imagination for working on nightmares in 1974 and he also showed how the style of the nocturnal dreams changed as a consequence. In a clinical vignette I show how this technique can be used and what an influence it has. The analyst and analysand are in a communal space of visualization, framed in the beginning by the nightmare. This space is considered as a space of interaction and of potential transformation. The analyst is a part of the process, offering ideas in a symbolic form and reinforcing the analysand’s ideas which lead to stress-reducing behaviour and images that provide an opening for the future. There are pauses in the imaginative work to talk together about the experiences, to link the situation in the imagination to biographical material, and to understand the resources opening up in the material, through the analysand herself. The goal of working with imagination is to ban the anxiety in the dream and to let the dreamer experience the fact that dreams and imagination are not only determined by the anxious feelings but it is also possible to transform these kinds of energy into creative fantasies.