The therapeutic action of psychoanalysis

Psychoanalysis does not seek to get rid of symptoms but to question them as witnesses of psychic functioning and as formations of the unconscious. Whatever their nature may be, it is a question of analysing their causes and their functions as they appear and develop during the course of the analytic process. The latter is activated by the transference relationship induced by the method within a specific setting. The aim is to bring about liberating psychic transformations. The extension of the indications and modifications in the expression of psychic suffering have led to the development of psychotherapies. Their relations with psychoanalysis proper have been evolving constantly since the first advances by Ferenczi. This long historical evolution has resulted in their redefinition. Psychoanalytic practices are currently considered to require, depending on the case, different settings and different modes of psychic involvement from the analyst. Contemporary psychoanalysis places emphasis on the internal setting of the analyst (thus his training), analysis of the countertransference, and the risk of anti-analytic aberrations.     

Notes for a dialogue between psychoanalysis and neuroscience1

The author postulates that the dialogue between psychoanalysis and neuroscience is based on the assumption that both deal with virtual structures. They are two facets of the same noumenal reality, but with different phenomenal realities, and it is possible to use metapsychology as a lingua franca to develop communication between the two fi elds. In the second part of the paper, the author refl ects on the results of recent neurophysiological research which seem to offer to psychoanalysis possibilities for fi nding an anatomical‐physiological correlate of some well‐known psychic phenomena and mechanisms, such as imitation, introjection, identifi cation, empathy, identity, mother‐child communication, learning, social communication and the analyst‐patient relationship. Particular neurons, called mirror neurons, have been located in the F5 area of baboons' brains. They are also present in man's brain within Broca's area. These neurons activate our motor system during both the performance of actions and the observation of actions performed by others giving rise to an automatic response, a sort of simulation or, rather, imitation, as the process is not intentional, but automatic and unaware, that is, unconscious.     

Dream actors in the theatre of memory: Their role in the psychoanalytic process2

The author notes that neuropsychological research has discovered the existence of two long‐term memory systems, namely declarative or explicit memory, which is conscious and autobiographical, and non‐declarative or implicit memory, which is neither conscious nor verbalisable. It is suggested that pre‐verbal and pre‐symbolic experience in the child's primary relations is stored in implicit memory, where it constitutes an unconscious nucleus of the self which is not repressed and which influences the person's affective, emotional, cognitive and sexual life even as an adult. In the analytic relationship this unconscious part can emerge essentially through certain modes of communication (tone of voice, rhythm and prosody of the voice, and structure and tempo of speech), which could be called the ‘musical dimension’ of the transference, and through dream representations. Besides work on the transference, the critical component of the therapeutic action of psychoanalysis is stated to consist in work on dreams as pictographic and symbolic representations of implicit pre‐symbolic and pre‐verbal experiences. A case history is presented in which dream interpretation allowed some of a patient's early unconscious, non‐repressed experiences to be emotionally reconstructed and made thinkable even though they were not actually remembered.     

Reconsidering therapeutic action: Loewald, cognitive neuroscience and the integration of memory's duality

Both Loewald's relational theory of memory and the Self-Memory System (SMS) of cognitive neuroscience describe a dual memory system, one system that is experience-near sensory-perceptual, and the other, symbolic and conceptual. In contrast to perspectives that locate therapeutic action in either altering implicit procedural memories or interpreting explicit historical content, we argue that psychological health emerges from effective integration of both memory systems, achieved through a combination of transference dynamics and analytic insight. We support this position by elaborating four key assumptions of the loewaldian and SMS perspectives, followed by application to a clinical example. We highlight the power of certain integrative autobiographical memories called 'self-defining memories' in assisting an understanding of transference dynamics and providing metaphoric touchstones to guide subsequent treatment.     

The colourless canvas: representation, therapeutic action and the creation of mind

Freud's initial formulations viewed psychoanalysis as working towards the rediscovery of psychic elements - thoughts, feelings, memories, wishes, etc. - that were once known - represented in the mind, articulatable, thinkable - but then disguised and/or barred from consciousness. His subsequent revisions implicated a second, more extensive category of inchoate forces that either lost or never attained psychic representation and, although motivationally active, were not fixed in meaning, symbolically embodied, attached to associational chains, etc. Following Freud's theory of representation, the author conceptualizes these latter forces as "unrepresented" or "weakly represented" mental states that make a demand upon the mind for work and require transformation into something that is represented in the psyche, if they are to be thought about or used to think with. This paper describes, discusses and presents illustrations of this transformational process (figurability),that moves intersubjectively from unrepresented or weakly represented mental states to represented mental states, from force to meaning, from the inchoate to mental order.     

Burial and resurgence of projective identification in French psychoanalysis

Curiously enough, the concept of projective identification was ignored, and even rejected in France for at least two decades after the publication of the founding texts of Melanie Klein and Herbert Rosenfeld. This rejection was due to a critique from child psychoanalysts close to Anna Freud and also from the teaching of Lacan: the first took the real mother–child relation extensively into account, while the latter only saw the internal object as a signifier. The fact that during this period the countertransference was a concept reduced to its negative content no doubt explains this deliberate ignorance. With the dissemination of a broader and more positive conception of the countertransference, a renewal of interest could be observed in the 1980s with references to empathic listening and to the effects of thought‐induction.     

论Empathy的翻译及其内涵

"共情"(Empathy)是十分重要的心理现象,影响着人们的社会认知和实际的人际交往;共情更是临床心理学中的专业术语,直接关系到医患关系的建立以及治疗和治愈的效果。针对目前国内心理学界对于Empathy的不同理解乃至使用上的混乱,文章从该术语的起源和本义,以及其专业内涵和翻译的意义等方面,提出了独到的见解和主张。     

Our changing views of the therapeutic action of psychoanalysis: comparing Strachey and Loewald

A comparison of Strachey and Loewald on the nature of therapeutic action reveals a deep shift in analytic interest away from the structural point of view and toward object relational and interpersonal frames of reference. Loewald's theoretical and technical revisions are far more sweeping than is usually acknowledged, and we can better benefit from his contribution by recognizing the full extent of his originality. Loewald's work also illuminates a major challenge for contemporary psychoanalysis: the need for an integration of the now disparate languages of metapsychology and clinical process.     

The predicting brain: Unconscious repetition, conscious reflection and therapeutic change

Neuroscience indicates that 'repetition' is fundamental to brain function. The brain non-consciously predicts what is most likely to happen and sets in motion perceptions, emotions, behaviors and interpersonal responses best adapted to what is expected-before events occur. Predictions enable individuals to be ready 'ahead of time' so reactions occur rapidly and smoothly when events occur. The brain uses past learning as the guide for what to expect in the future. Because of prediction, present experience and responses are shaped by the past. Predictions from early life can be deeply encoded and enduring. Predictions based on the past allow for more efficient brain function in the present, but can lead to mistakes. When what is predicted does not occur, consciousness can be engaged to monitor and correct the situation. But if a perception or emotion seems reasonable for the situation, a person might not notice an error, and a maladaptive 'repetition' may remain unchanged. The author discusses how predictions contribute to psychological defenses and transference repetition, and how conscious self-reflection facilitates therapeutic change. The neuroscience of prediction indicates why, in certain cases, active engagement by the analyst may be necessary. The author makes the argument for use of a 'neuroscience interpretation'.     

内隐学习抽象性研究的新进展

以知识迁移作为内隐学习抽象性众多涵义的统领点,同时结合国内外多领域内隐学习的新近研究,以一些详实的实征研究从一个新视角对其作了进一步的诠释,旨在更好地体现内隐学习的抽象性及其巨大潜力。     

Architecture and psychoanalysis. Nathaniel Kahn and the search for the father

Abstract

This text is intended as a contribution to the study of the profound mutual relations between architecture and psychoanalysis. Architecture creates representations that conceal unconscious forms of thought; psychoanalysis helps to explain the meanings of these representations – forms of construction and forms of the psyche. The multifaceted work of psychoanalyst Christopher Bollas – his thoughts on the relationships between psychoanalysis and architecture, on the vitality of objects, on the creative implications of the Oedipal relationship – serves as a critical and decisive instrument for the authors’ inquiry. The issue of the “vitality of objects” as described by Bollas also concerns – but only in part – the architectural “object.” One modern form of architecture with an inordinate capacity empathy has to be Louis Kahn’s. Kahn’s youngest son , Nathaniel, lost his father when he was still a child and hardly had a chance to get to know him. After becoming an adult and an established film-maker, he managed to recover his father in two ways: by discovering him in his works, with their powerful affective impact; and by drawing from those very works of his father to enhance his own creative process in his filmic art. As it turns out, it is this very process that has allowed for an emblematically positive resolution of the Oedipal relationship.     

Winnicott’s foundation for the basic concepts of Freud’s metapsychology?1

In a recent paper, Fulgencio shows how Winnicott rejected the basic speculative concepts of Freud’s metapsychology – Trieb, psychical apparatus and libido – and replaced them with non-speculative concepts that promoted a factual theorization. In this paper, the author examines some of Winnicott’s concepts and attempts to demonstrate how, rather than replacing Freud’s concepts, he provides a factual foundation for the metapsychology in the double dependence of the infant in care. Freud never actually disregards the necessity of early mothering but he takes it for granted. By differentiating between ego needs and id needs, ego-relatedness and id-relatedness, object-mother and environment-mother, Winnicott attempts to theorize what Freud takes for granted: the function of the holding environment as a framework for id-experiences and the function of object-presenting as a condition of reality-testing. Furthermore, by differentiating between pure male and pure female elements, he is also able to construct a highly speculative theorization in order to distinguish two basic principles: doing and being. Although the death drive is clearly rejected, this rejection follows from his theorization of double dependence. Consequently, the author suggests that Winnicott did not discard metapsychological concepts but theorized the conditions for using both these and the intrapsychic topography.     

知觉和概念加工范式对内隐与外显记忆发展的影响

控制知觉材料的熟悉性和概念范例的典型性,以考察它们对内隐与外显记忆发展的影响。结果表明：（1）知觉内隐记忆的启动效应不存在年龄和熟悉性效应,而知觉外显记忆成绩则具有明显的年龄和熟悉性效应;（2）在概念内隐记忆任务上,典型范例的启动效应不存在年龄差异,非典型范例的启动效应则存在随年龄而增长的启动效应：无论是典型范例还是非典型范例的外显记忆成绩均随年龄增长而提高。     

Mentalization, insightfulness, and therapeutic action The importance of mental organization

Continuing debates over the relative importance of the role of interpretation leading to insight versus the relationship with the analyst as contributing to structural change are based on traditional defi nitions of insight as gaining knowledge of unconscious content. This defi nition inevitably privileges verbal interpretation as self‐knowledge becomes equated with understanding the contents of the mind. It is suggested that a way out of this debate is to redefi ne insight as a process, one that is called insightfulness. This term builds on concepts such as mentalization, or theory of mind, and suggests that patients present with diffi culties being able to fully mentalize. Awareness of repudiated content will usually accompany the attainment of insightfulness. But the point of insightfulness is to regain access to inhibited or repudiated mentalization, not to specifi c content, per se. Emphasizing the process of insightfulness integrates the importance of the relationship with the analyst with the facilitation of insightfulness. A variety of interventions help patients gain the capacity to refl ect upon and become aware of the intricate workings of their minds, of which verbal interpretation is only one. For example, often it seems less important to focus on a particular confl ict than to show interest in our patients’ minds. Furthermore, analysands develop insightfulness by becoming interested in and observing our minds in action. Because the mind originates in bodily experience, mental functioning will always fl uctuate between action modes of experiencing and expressing and verbal, symbolic modes. The analyst's role becomes making the patient aware of regressions to action modes, understanding the reasons for doing so, and subordinating this tendency to the verbal, symbolic mode. All mental functions work better and facilitate greater self‐regulation when they work in abstract, symbolic ways. Psychopathology can be understood as failing to develop or losing the symbolic level of organization, either in circumscribed areas or more ubiquitously. And mutative action occurs through helping our patients attain or regain the symbolic level in regard to all mental functions. Such work is best accomplished in the transference. The concept of transference of defense is expanded to all mental structure, so that transference is seen as the interpersonalization of mental structure. That is, patients transfer their mental structure, including their various levels of mentalizing, into the analytic interaction. The analyst observes all levels of the patient's mental functioning and intervenes to raise them to a symbolic one. At times, this will require action interpretations, allowing oneself to be pulled into an enactment with the patient that is then reprocessed at a verbal, symbolic level. Such actions are not corrective emotional experiences but are interpretations and confrontations of the patient's transferred mental organization at a level affectively and cognitively consistent with the level of communication. Nonetheless, the goal becomes raising the communication to a symbolic level as being able to refl ect symbolically on all aspects of one's mind with a minimum of restriction is the greatest guarantee of mental health.     

自爱与他爱:自恋、共情与内隐利他的关系

自恋者具有低共情的人格特征,而共情是引发利他行为的重要动力。本文通过两个实验研究试图揭示不同情境下,自恋对共情与内隐利他的影响。结果表明:(1)自恋组与非自恋组被试均存在内隐利他倾向,且自恋组的内隐利他倾向显著低于非自恋组;(2)自恋组的共情能力显著低于非自恋组,其中,自恋组在情绪共情上显著低于非自恋组被试,两组在认知共情上差异不显著;(3)共情诱发对自恋组被试的共情与内隐利他均有显著影响。启动条件下自恋组被试的共情水平与内隐利他倾向显著高于控制条件下自恋组被试,且达到与非自恋组被试相同的水平,而非自恋组被试的共情与内隐利他倾向在两种实验条件下差异不显著;(4)共情诱发显著提高了自恋组被试的情感而非认知共情水平。     

The presence of Spinoza in the exchanges between Sigmund Freud and Romain Rolland1

Although Freud recognized his profound affinity with Spinoza, we seldom find explicit and direct references to the philosopher in his works. The correspondence between Romain Rolland, the ‘Christian without a church’, and Freud, the ‘atheist Jew’, is full of Spinozian reminiscences that nourish their works of this period and are underpinned by their mutual transference. The Future of an Illusion is written according to a Spinozian blueprint and aims at replacing religion, qualified as superstition, by psychoanalysis. A quotation from Heine, ‘brother in unbelief’, is a direct reference to Spinoza. Concurring with Freud’s critiques of dogmas and churches, Rolland proposes an analysis of the ‘oceanic feeling’ as a basis of the religious sentiment. Freud replies with Civilization and Its Discontents. In 1936, on the occasion of Rolland’s 70th birthday, Freud sends him an open letter, A disturbance of memory on the Acropolis, where the strange feeling that he has experienced in front of the Parthenon refers inter alia to his double culture: Jewish and German. In the light of this correspondence, the creation of psychoanalysis turns out to be a quest for the sacred that has disappeared in modernity; Freud, though, was able to find it inside man’s unconscious.