On the vicissitudes of Freud's early mothering. III: Freiberg, screen memories, and loss

Utilizing clinical examples, I attempt to show that the memories Freud recalled on his return to his childhood home in adolescence screened the traumata he had suffered when he lost his Kinderfrau, then his playmates and the Freiberg countryside during his early childhood.     

On the vicissitudes of early primary surrogate mothering

I have noted estrangement from biological mothers and intolerance of intimate relationships in patients with an early history of primary surrogate mothering. This observation facilitated discovery of such early histories in 31 of 102 patients I examined during a five-year period. With a review of the literature, and clinical examples, I attempt to associate the estrangement and intolerance with the mother's exclusion resulting from her infant's close tie to a surrogate and the infant's inevitable traumatic loss of the latter. In the analyses of screen phenomena, mother and surrogate mother transferences, all peculiar to that caretaking, the surrogate is seen to emerge from obscurity. In the clinical examples (limited to losses of surrogates following the infant's eighteenth month) screen memories, dreams, and eclipse are found to possess a common feature: the image of the surrogate is screened by that of the mother. Biological mother and, in the countertransference, the analyst play a significant role in perpetuating the concealment of the surrogate.     

On the vicissitudes of early primary surrogate mothering II: loss of the surrogate mother and arrest of mourning

Among the catastrophic events experienced by infants and young children, one of the most frequent is the loss of an early primary surrogate mother (EPSM). Usually permanent, the loss is often followed by the advent of a new, "replacement" caregiver. One aspect of the emotional environment is unique to this kind of caregiving situation: that parents are often unable to validate the true nature of their child's relationship with the EPSM or, ultimately, the trauma experienced by the child when the EPSM leaves. The marked discrepancy between the parent's and the infant or child's experience of the surrogate mothering leads to an arrest of the child's mourning process, with the potential for serious developmental consequences. Issues related to EPSM loss and its aftermath are examined in the light of two examples. Further exploration of the environment of this kind of caregiving directs attention to the critical need to nurture and protect the attachments of both the infant or child and the parent to the ESPM.     

Mourning beyond melancholia: Freud's psychoanalysis of loss

Freud's mourning theory has been criticized for assuming a model of subjectivity based on a strongly bounded form of individuation. This model informs "Mourning and Melancholia" (1917), in which Freud argued that mourning comes to a decisive end when the subject severs its emotional attachment to the lost one and reinvests the free libido in a new object. Yet Freud revised his mourning theory in writings concerned with the Great War and in The Ego and the Id (1923), where he redefined the identification process previously associated with melancholia as an integral component of mourning. By viewing the character of the ego as an elegiac formation, that is, as "a precipitate of abandoned object-cathexes," Freud's later work registers the endlessness of normal grieving; however, it also imports into mourning the violent characteristics of melancholia, the internal acts of moralized aggression waged in an effort to dissolve the internal trace of the other and establish an autonomous identity. Because it is not immediately clear how Freud's text offers a theory of mourning beyond melancholy violence, his account of the elegiac ego is shown here to ultimately undermine the wish for an identity unencumbered by the claims of the lost other and the past, and to suggest the affirmative and ethical aspects of mourning.     

Introduction: Reflections on mothering and on reexperiencing the early relationship experience

As President of the World Association for Infant Psychiatry and Allied Disciplines the Editor has invited me to introduce this issue, which continues with papers from the Stockholm Congress. Advances in developmental biology and medical genetics make it clear that the future of psychiatric and mental health research will be centered in preventive intervention. This prospect highlights the need for more knowledge about environmental/individual interactions. The caregiving relationship experience is a crucial aspect of these interactions and frames the later development of strength or disorder. Several papers in this issue focus on the caregiving experience and provide me an opportunity to offer some reflections on the nature of experiencing and reexperiencing. Propositions that seem important include the following: The experience of caregiving involves a reexperiencing of earlier represented relationships; reexperiencing in this sense involves other past relationships that had a similar role relationship context; reexperiencing involves a dynamic interplay on both sides of a represented role relationship (that is, self and other interacting); early formative relationships are apt to be represented as affective prototypes such that reexperiencing occurs mainly without conscious awareness. Understanding such affective representations can guide infant psychiatry as it opens new opportunities for brief interventions. These can benefit infants and caregivers through the medium of the infant-caregiver relationship experience. Activating formative aspects of that experience can promote health and the strengths of individuality and provide a buffer against illness and self-defeating attitudes.     

Brentano's Psychology from an Empirical Standpoint and Freud's early metapsychology.

Brentano's Psychology from an Empirical Standpoint and Freud's early metapsychology, particularly the Project for a Scientific Psychology, show some interesting similarities. In psychological theory, both men stressed the motivated nature of thought and a conception of a "psychological reality" that is superior to "material reality." Both saw consciousness of one's own mental activity as arising retrospectively and having a calming effect on emotions. Both emphasized a process of "judgment" or "reality testing," made possible only by the presence of a strong unity of consciousness of ego. Methodologically, both agreed that the retrospective analysis of subjective experience is the principal tool of psychology. Freud eventually agreed with Brentano that psychology proceeds best when separated from physiology. They applied similar criteria to "proofs" of the unconscious, with Brentano concluding negatively, and Freud, positvely, after considering new evidence. This article considers the similarities and concludes that they suggest some sort of influence of Brentano on Freud.     

The psychoanalytic view of phobias. Part I: Freud's theories of phobias and anxiety.

This paper initiates a series of communications on psychoanalytic and current psychiatric approaches to the understanding and treatment of phobic syndromes with a review and discussion of Freud's evolving ideas on phobias and anxiety. A list of issues that any theory of phobic syndromes must address is compiled on the basis of Freud's work.     

From the EEL to the EGO: Psychoanalysis and the Remnants of Freud's Early Scientific Practice

While numerous historiographical works have been written to shed light on Freud's early theoretical education in biology, physiology, and medicine and on the influence of that education on psychoanalysis, this paper approaches Freud's basic comprehension of science and methodology by focusing on his early research practice in physiology and neuranatomy. This practice, taking place in the specific context of Ernst Brücke's physiological laboratory in Vienna, was deeply concerned with problems of visuality and the revelation of hidden organic structures by use of proper preparation techniques and optical instruments. The paper explores the connection between such visualizing practices, shaped by a physiological context as they were, and Freud's later convictions of the scientific status of psychoanalysis and the function of its method as means to unveil the concealed structure of the “psychical apparatus”.     

Freud's Leonardo: psychobiography and autobiography of genius.

In his creation of a psychobiography of one genius and the hidden autobiographic analysis of another, Freud exemplifies what he described in the study: "Kindly nature has given the artist the ability to express his most secret mental impulses, which are hidden even from himself, by means of the works that he creates" (p. 107).     

Out of the body: embodiment and its vicissitudes

Body‐mind dualism and the consequent neglect of the body of the analyst can have important negative effects on the analytical process leading all too often to misinterpretations of the analysand's verbal and non‐verbal communications and to disturbances of analytical temporality. This is intensified when we are dealing with individuals where disembodiment and states of psychic deadness are central features. The paper explores the philosophical roots of the idea of a disembodied mind and the way in which this impacts our relationship with the world. While André Green's concept of the dead mother and disturbances in the sense of self‐agency have been held to play an important role in states of psychic deadness, I suggest that it is rather disturbances in the sense of body ownership and of the body image which are more central. The paper then discusses the particular kinds of countertransference that can be evoked in the analyst when we find ourselves dealing with this type of patient and suggests how we can use our embodied countertransference to become aware of and elaborate our own feelings of deadness in order to overcome the loss of temporality that is characteristic of such states. This is illustrated with reference to my work with a young man with a masochistic perversion and a severe disturbance of the body image with an accompanying profound sense of psychic deadness.     

Case vignette: the vicissitudes of managed care

Lee Wilson, age 26, was referred to Dr. Jackson for psychotherapy 5 weeks ago by a friend. Lee has been feeling increasingly depressed about longstanding family issues and the recent breakup of a 2-year relationship with a live-in companion. Over the course of the once-per-week sessions, Dr. Jackson notes persistent suicidal ideation, with vague plans to act if, as Lee puts it, "things get any worse." Just before the sixth session, Dr. Jackson is contacted by a reviewer for the managed care health insurance program covering Lee's therapy. The reviewer informs Dr. Jackson that the company will not authorize payment for further psychotherapeutic care. Dr. Jackson knows that Lee is in need of continued treatment and fears that terminating therapy at this time could result in increased suicide risk. Lee's income could cover only a small portion of Dr. Jackson's usual fee. Dr. Jackson does not wish to abandon Lee, but he already provides a significant amount of reduced-fee service to other clients. Is the health insurance carrier's stance ethical? Should Dr. Jackson be expected to treat Lee for the foreseeable future at a greatly reduced fee? How should Dr. Jackson handle this situation?     

Early object loss and denial. Developmental considerations.

The psychoanalytic treatment of a young woman whose father had been killed in a concentration camp when she was four years old serves to illuminate certain aspects of libidinal and ego development, particularly as it touched on the effects of losing one's father just before entering the oedipal phase and on the defensive use of denial in lieu of mourning. Further consequences of the patient's loss are seen in the extent to which it influenced the self-image, sexual identity formation, and superego functioning, especially with regard to the role of guilt.     

Freud's early metaphors and network of enterprise: Insight into a journey of scientific self-discovery

This paper examines Freud's evolving network of enterprise from 1876 to 1900 and the ensemble of metaphors which he used in the development of his theory (1888–1900). It will be shown that, in spite of Freud's obligatory change of career at age 26, there is no sharp break between Freud's early scientific work and his psychological research. Many signs of continuity between the two periods can be found. Freud's journey of scientific self-discovery only progressively led him to the frontiers of the unknown and his ultimate challenge: exploring the secrets of sexuality. Freud's avowed commitment to the study of the unconscious may have happened as late as 1899 as his metaphors celebrate an intimate fusion between the creator and his creation.     

Some vicissitudes of aggression in the interpretive process.

Interpretation is a product of compromise formation that requires optimal use of the analyst's aggression to be an effective analytic intervention. Aggressive aims useful for the interpretive act are problematic for analysts and have led both to clinical difficulties and to various theoretical reactions against considering interpretation essential for analytic progress. In analysis, diverging aims of analyst and patient are highlighted in connection with the analyst's function as interpreter. The interactions between patient and analyst pertaining to interpretation provide insights into the patient's intrapsychic conflicts that may be less apparent in other material.