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 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.     

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 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.     

The psychoanalytic paradox: the self as a transitional object

I have focused upon a group of patients whose biological needs for nurture and comfort were adequately met but whose mothers never related to them beyond simple caretaking. They never smiled at their children inasmuch as they derived no pleasure from playing with them or in their emerging sense of aliveness. From both the analyses of mothers and these patients, it appears that the mothers used their children as transitional objects. In turn, the children's emotional development became fixated in the in-between transition space. This fixation led to specific types of character structure and ego defects. Early development levels did not form a smooth continuum with higher later acquired adaptive ego states. There seem to be extensive lacunae in the middle layers of the psychic apparatus which manifested themselves as defective modulating elements. These patients showed extremes of behavior, marked polarities of sane, sensitive rationality to psychoticlike irrational episodes. There were no transitional gray areas between black and white. They exhibited a peculiar kind of fragmentation or splitting in which connecting bridges between higher and lower levels were missing. There are many such patients who seek treatment. However, they present special problems in therapy which can be explained in terms of the psychoanalytic paradox. The psychoanalytic paradox refers to a treatment impasse caused by an imbrication of psychopathology and various attributes of the psychoanalytic method. The mother's attitude toward her infant child has some similarity to the low-keyed objective analytic attitude, what has been sometimes referred to as analytic neutrality. These patients require different modes of relating which indicate that the therapist is, unlike the mother, very much concerned with their patient's developing autonomy and their entering and exploring the external world. These variations of analysis are not modifications or deviations of analysis. They are elements of the analytic process necessary for the treatment of specific types of psychopathology. Just as each patient is unique and the transference manifests itself in a particular fashion which then causes the analyst to make certain interpretations, the variations of technique discussed in this article address themselves to the construction of a holding environment appropriate for this group of patients.     

The analytic third: implications for psychoanalytic theory and technique

The author views the analytic enterprise as centrally involving an effort on the part of the analyst to track the dialectical movement of individual subjectivity (of analyst and analysand) and intersubjectivity (the jointly created unconscious life of the analytic pair--the analytic third). In Part I of this paper, the author discusses clinical material in which he relies heavily on his reverie experiences to recognize and verbally symbolize what is occurring in the analytic relationship at an unconscious level. In Part II, the author conceives of projective identification as a form of the analytic third in which the individual subjectivities of analyst and analysand are subjugated to a co-created third subject of analysis. Successful analytic work involves a superseding of the subjugating third by means of mutual recognition of analyst and analysand as separate subjects and a reap-propriation of their (transformed) individual subjectivities.     

The distinction between needs and wishes: implications for psychoanalytic theory and technique.

After a comprehensive survey of the literature is presented and some caveats entered, this paper delineates the concept of a psychological "need," noting that it bears a complex relation to the concept of a "wish." Need is universal, wish experience-bound. A need, unlike a wish, is not subject to repression. In addition, although a wish can be replaced by another wish, a need cannot be replaced by another need. Whereas the frustration of a wish causes dynamic shifts, the frustration of a need leads to structural disintegration. Needs and wishes can be in harmony or in opposition. The paper also identifies six basic psychological needs, which would seem to be ubiquitous, though the degree to which they are overt and the ways in which they are met vary across cultures. Their gratification seems necessary for healthy psychic development to occur, for relationships to survive, and for psychoanalytic work to take hold and to continue optimally. These needs are (1) the need for one's physical needs to be deemed legitimate; (2) the need for identity, recognition, and affirmation; (3) the need for interpersonal and intrapsychic boundaries; (4) the need for understanding the causes of events; (5) the need for optimal emotional availability of a love object; and (6) the need for a resilient responsiveness by one's love objects under special circumstances. Ordinarily these needs are met during the course of treatment with no deliberate effort by the analyst. In the treatment of some patients, however, they require more direct attention. A number of clinical vignettes are presented to elucidate these ideas.