The superordinate self in psychoanalytic theory and in the self psychologies

The concept of the self has been used in several attempts to resolve the epistemological problems of what is subjective and what is objective, what is personal and what is organismic. In addition, it has been used to mediate between the hermeneutic and natural-science approaches to psychoanalytic explanation, between the motivational and causal dimensions of our theory and experience. In the case of Kohut, the self was initially invoked to deal with clinical difficulties associated with the analysis of patients with narcissistic personality disorders more recently, it has become the central article in a "self psychology" that addresses presumed deficiencies in the traditional psychoanalytic picture of psychopathology. But the concept of the self is not suited to be a panacea for resolving theoretical or clinical difficulties. The self as person refers to an entity that is both enduring and changing; it describes continuity in the face of change and change in the face of continuity. Abend (1974) comes closest to capturing this attribute of the self in his image of the tidal beach with a configuration that changes but an essence that remains the same. Eisnitz (1980) evokes something similar in his figure-ground conception of the self-representation. The crux of the matter is that the notion of self-experience includes a variety of phenomena that cannot be contained within a single self-construct--be it normal pathologic, grandiose, or otherwise. As a result of these considerations, I have argued against the use of the self as a superordinate concept in psychoanalytic theory and have focused on the shortcomings of three self psychologies that use the self in this way. I believe that Klein, Gedo, and Kohut all offer the self as a kind of conceptual tranquilizer for the philosophical, theoretical, and clinical dualities that are inherent in psychoanalytic work. Grossman addressed himself to these dualities as far back as 1967 and elaborated on the problems with Simon (1969) in a pathbreaking paper on anthropomorphism in psychoanalysis. Grossman and Simon contended that the controversy about anthropomorphism in psychoanalytic theory pertains to the basic confusion in psychology between meaning and causality. They submitted that until this confusion was dispelled and until some superordinate concept was found that could "encompass both kinds of discourse", attempts to transform psychoanalysis into a general psychology would result in failure.(ABSTRACT TRUNCATED AT 400 WORDS)     

The concept of the self in psychoanalytic theory and its philosophical foundations.

Concepts of "the self" in psychoanalytic theory have important philosophic underpinnings which may not be adequately appreciated. Both self psychology and ego psychology, with their contrasting positions on the self as a mental structure, retrace paths taken by Western philosophy beginning at least with Hume and Descartes. They reflect traditional philosophic questions, notably of a homuncular self internal to consciousness and the isolation of the subject from other selves. Psychoanalysis has not utilized Hegel's conception of the intersubjective origins of the self, in which the self emerges only in an encounter with another subject, although this approach is implicit in the work of Winnicott on the mother-infant dyad. This movement from a one- to a two-person psychology also presents conceptual problems, as illustrated by the psychoanalytic theories of Sartre and Lacan, who take up opposing positions on the status of consciousness and on intersubjectivity in the formation of the self. Sartre's phenomenology, with its emphasis on the questing nature of the subject in search of an identity, resonates with contemporary theories of narcissism in which the painful isolation of self from self-affirming and mirroring objects is central to clinical practice. Lacan's insight into the role of acquisition of language helps us to understand the formation of the subject in pursuit of a virtual selfhood, as Sartre described, but embedded within an intersubjective matrix.     

The vanished pregnant body in psychoanalytic female developmental theory

The author contends that the pregnant body-the premier icon of the mature female body-has vanished from our psychoanalytic theory of female development. Until we are able to restore this missing entity on a par with the phallus, the developmental theory for both sexes remains fixated in phallocentricism. The author traces some of the evidence for this claim in a brief overview of the literature, a study of the relevant aspects of the case of Little Hans, and a look at the history of medical teaching, in particular illustrations from the first dissections of female bodies in the sixteenth century, which demonstrate a view of the female body as essentially male. A puzzle remains about the marked tendencies that both males and females had, and still have, to distort the female body image. The author offers a clinical example, and the suggestion that the plasticity of the female form in all its developmental phases may underlie the paradoxical requirement that stable mental representations be established upon an elusive set of shifting images.     

Paranoia and narcissism in psychoanalytic theory. Contributions of self psychology to the theory and therapy of the paranoid disorders

Many factors go into a choice of a therapeutic focus: the patient's psychopathology; the therapist's training, countertransference reactions, and ideological beliefs; and, importantly, a decision about what seems most amenable to treatment and change. As a theory, self psychology describes one aspect of the paranoid process; as such, it is an incomplete theory that complements rather than invalidates more classical theories. As a technique, however, it suggests a style and focus conducive to working with paranoid patients, one that is markedly supportive, nonconfrontational, yet also interpretive. In this context, it must be remembered how difficult it is to treat paranoid patients psychotherapeutically, much less to keep them in treatment. The strategies discussed above do not wholly replace other dynamic approaches (e.g., counterprojective techniques), nor are they universally applicable. Some patients may be more amenable than others. However, the techniques provide a very supportive framework that may help the therapist to be more available to and in contact with the paranoid patient. More broadly, this paper's application of self psychology to the theory and therapy of the paranoid disorders further illustrates the practical utility of this approach. Attention to the narcissistic developmental line, interpersonal selfobject relationships, intrapsychic conflicts and deficits, and empathic immersion in the patients's world are important adjuncts to the psychotherapy of paranoid patients. Rather than an either/or dichotomy, the principle of overdetermination suggests a both/and relationship between self psychology and traditional theory, such that the self psychological approach complements rather than contradicts the classical psychoanalytic theory. The vicissitudes of the self simply add another perspective or vantage point from which to understand and respond to the patient, one which has perhaps more applicability for preoedipally disordered patients.     

A genuinely developmental theory of sexual enjoyment and its implications for psychoanalytic technique

A small computer-assisted word frequency analysis, indicating the extent of explicit concern with sexuality in the psychoanalytic literature, has revealed an apparent decline of psychoanalytic interest in psychosexuality. The apparent decline may be related to the limitations of drive theory and object relations approaches in offering persuasive and comprehensive accounts of the psychosexual. A new model of human sexual experience is proposed, rooted in an integration of French psychoanalytic ideas with recent developmental observational research, that once again places sexuality at the center of psychoanalytic clinical inquiry. Because emotion regulation arises out of the mirroring of affect by a primary caregiver and sexual feelings are unique in that they are systematically ignored and left unmirrored by caregivers, sexual feelings remain fundamentally dysregulated in all of us. Adult sexual experience serves as a way of coming to organize the psychosexual. The model accounts for some aspects of the phenomenology of sexual arousal and suggests ways of understanding pathological distortions of sexual behavior. The nature of the psychosexual is explored in the analytic treatment of an adolescent boy.     

The finite and infinite development. II. Recent psychoanalytic theory and therapeutic considerations]

Freud's characterization of the manifest dream is typified by an implicit appreciation and an explicit devaluation of dream images. According to the author, the theoretical-historical motive behind this divergent evaluation is already evident in Freud's prepsychoanalytic writings, where he assigns primacy to the written word. The author holds that the biographic motive derives from an ambivalent internalization of the Mosaic sanction against graven images, conveyed to Freud by his father through the spirit of the Phillipson Bible.     

The self and action in theory of mind research

Research on children's developing theories of mind has contributed to our understanding of the developmental relation of self and action (1) by exploring the relation of the development of self knowledge to the development of knowledge of others' minds and (2) by investigating the relation between theory of mind development and the development of action control. We argue that evidence on theory of mind reasoning in children with deficient action control (ADHD-diagnosed children) is especially relevant to the second issue and we present some first evidence supporting the bi-directional hypothesis, that is, the view that theory of mind leads to improved action control which in turn supports the ability to represent mental states on-line.     

Well-suited partners: psychoanalytic research and grounded theory

Abstract

Research is a ‘core activity’ of ‘central importance in improving mental health and social care’ (NIME, CAMHS National Conference, 2005 CAMHS National Conference. January 2005. Research in CAMHS Conference Handbook January,  [Google Scholar]). This paper examines the philosophical issues confronted when considering psychoanalytic clinical research. It is argued that a well-suited partnership can be formed between psychoanalytic clinical research and Grounded Theory. The methodological issues encountered when using Grounded Theory to analyse qualitative clinical data are explored. The well-suited partnership formed between Grounded Theory and psychoanalytic clinical research has the capacity to provide explanatory mechanisms, findings that are translatable to routine clinical practice, and to discover new ways of grouping young people so that they are alike in the most significant aspects of their mental health presentations. This makes further clinical trials more reliable. Psychoanalytic clinical findings are used together with a range of material from different sources to develop concepts and theory that are readily accessible to the wider professional community. Illustrations will be provided from the author's doctoral research into Risk-Taking, Dangerous Behaviour.

Selon l'Institut National de la Santé Mentale en Angleterre [NIME], la recherche est une “activité fondamentale” d'une “importance cruciale pour l'amélioration des soins en santé mentale et dans le cadre social” [Colloque National des Services de Santé Mentale pour Enfants et Adolescents, 2005]. Dans cet article, l'auteur étudie les problèmes auxquels sont confrontés les chercheurs en clinique psychanalytique. Il affirme qu'un partenariat tout à fait opportun peut être établi entre la recherche clinique psychanalytique et la théorie inductive ancrée dans le réel (“grounded theory”). Il explore les difficultés méthodologiques que soulève cette théorie inductive appliquée à l'analyse des données cliniques qualitatives. Ce partenariat tout à fait opportun entre la théorie inductive et la recherche clinique psychanalytique est capable de fournir des mécanismes explicatifs et des résultats qui peuvent être mis en application dans la pratique clinique ordinaire; en outre, il permet d'envisager de nouveaux regroupements par catégorie basés sur les aspects les plus significatifs de la pathologie présentée par les jeunes. Les contrôles cliniques complémentaires sont alors plus fiables. Les observations cliniques psychanalytiques sont associées à un éventail de matériel de sources différentes pour développer des concepts et des théories à la portée de tous les intervenants de ce secteur. L'auteur illustre ses propos à partir de sa thèse de doctorat de troisième cycle portant sur la prise de risque et les comportements dangereux.

Mots-clés: Recherche clinique psychanalytique, méthodologie de la théorie inductive ancrée dans le réel (“grounded theory”), philosophie de la science, psychothérapeute d'enfants, spécialiste de Niveau 3 des Services de Santé Mentale pour Enfants et Adolescents, refuges

Riassunto: La ricerca è ‘attività principale’ di ‘importanza centrale per il miglioramento della salute mentale e dell'assistenza sociale’ (NIME, CAMHS National Conference, 2005). Questo articolo esamina le questioni filosofiche che si incontrano quando si considera la ricerca clinica in campo psicoanalitico. Si sostiene che un buon rapporto di partnership possa essere stabilito tra la ricerca clinica psicoanalitica e la Grounded Theory. Vengono esplorate le questioni metodologiche che si incontrano quando si usa la Grouded Theory per analizzare dati clinici qualitativi. Il rapporto di partnership che si stabilisce tra Grouded Theory e la ricerca clinica psicoanalitica ha la capacità di fornire meccanismi di spiegazione, risultati che sono traducibili nella pratica clinica di routine, e di scoprire modi nuovi di raggruppare i giovani in modo che siano simili per gli aspetti pi[ugrave] significativi della loro presentazione in salute mentale. Tutto ciò rende pi[ugrave] affidabili ulteriori prove cliniche. I risultati clinici psicoanalitici vengono usati con una serie di materiali di origini diverse per sviluppare concetti e teorie che siano facilmente accessibili alla pi[ugrave] ampia comunità dei professionisti. Verrà fornito del materiale dal lavoro di dottorato di ricerca dell'autore sul comportamento di rischio e sul comportamento pericoloso.

Parole chiave: ricerca clinica psicoanalitica, metodologia della Grounded Theory, filosofia della scienza, psicoterapia infantile, Tier 3 Specialist CAMHS, rifugi

Forschung ist eine ‘zentrale Aktivität’ von besonderer Wichtigkeit in der Verbesserung von psychischem Wohlergehen und Sozialfürsorge’ (NIME, CAMHS Nationalkonferenz 2005) Dieser Artikel untersucht philosophische Fragestellungen, mit denen man konfrontiert wird, wenn man psychoanalytische klinische Forschung in Betracht zieht. Es wird argumentiert, dass eine gut funktionierende Partnerschaft zwischen psychoanalytischer klinischer Forschung und grounded theory hergestellt werden kann. Es werden die methodologischen Fragen, auf die man stösst, wenn man grounded theory benutzt, um qualitative klinische Daten zu analysieren, exploriert. Die gut funktionierende Partnerschaft zwischen ‘grounded theory’ und psychoanalytischer klinischer Forschung hat die Fähigkeit, Erklärungsmechanismen und Ergebnisse bereitzustellen, die routinemässig in klinische Praxis übersetzt werden können, und neue Arten der Gruppierung von jungen Leuten zu entdecken, sodass sie sich in den signifikantesten Aspekten ihrer Präsentierung ähneln. Weitere klinische Versuchsreihen werden dann mehr verlässlich. Es werden klinische Ergebisse zusammen mit einer Reihe von Materialien von verschiedenen Quellen benutzt, um Konzepte und Theorien zu entwickeln, die für die weitere professionelle Gruppe leicht zugänglich sind. Es werden Illustrationen aus der Doktorarbeit der Autorin über das Eingehen von Risiko und gefährlichen Verhaltensweisen gegeben.

Keywords: Psychoanalytische klinische Forschung, Methodologie der ‘grounded theory’, Wissenschaftsphilosphie, Kindertherapeut, Kinder-und Jugendpsychiatrischer Dienst, Zufluchtsorte     

The psychoanalytic process: the developmental and the integrative

Psychoanalysis is a treatment that focuses on intrapsychic events and activates integrative tendencies to promote-insights. Almost from the time it originated, however, it was also promoted as a therapy informed by the interpersonal, inducing change through experiences generated within the psychoanalytic situation. In recent years the interpersonal or object relations approach has come to be categorized as "developmental," a term that fosters no end of ambiguities. The resulting confusion compromises the study of the actual developmental process on the one hand and the structure-enhancing features of transactions on the other. This encumbers research on the psychoanalytic process. The author distinguishes the intrapsychic from the interpersonal, the integrative from the developmental, and the two very different realms of psychological activities currently advanced as "developmental."     

The teaching and learning of psychoanalytic developmental psychology

I have described three areas in psychoanalytic education where I believe greater attention to existing methods is necessary so as to facilitate the learning of certain principles of development. Explanations might be enhanced by including constructivist with reductionist elements; metapsychology might be clarified in a way that would make the "developmental" more available to analytic scaffolding; and finally, the technical precepts that help focus on the emergence of regressive trends should be broadened to permit enhanced awareness of the progressive trends as well.