The seventh penis: towards effective psychoanalytic work with pre‐surgical transsexuals

The author reflects on his contrasting analytic work with two transsexual patients. He uses three previous psychoanalytic studies (Stoller, Morel and Lemma) to explore whether effective analytic work with the issues driving a person's determined wish for sex reassignment surgery (SRS) is possible. Particular consideration is given to how such work might navigate a path between traumatizing and pathologizing the patient on the one hand and avoiding important analytic material out of fear of so doing on the other. The author proceeds to ask whether it is possible to tell in advance, with any degree of reliability, who is and who is not likely to benefit from surgery. He considers certain diagnostic issues in relation to these questions. Illustrations are given of how, in practice, countertransference anxieties about psychopathologizing transsexual patients can contribute to significant difficulties in working clinically with them. It is argued that the understanding and containment of such anxieties could eventually lead to more effective analytic work, and that such work might be further facilitated by considering the contribution of mind‐body dissociation to transsexualism.     

Temporality and the torments of time

Immersion in time gives birth to consciousness, as well as conflict and torment. When human beings developed a sense of future, they also gained the ability to anticipate threats from nature or their fellow beings. They thereby created cultures that are bastions of survival, as well as places of poetry, art and religion where they could band together and reflect upon their common plight. The practice of psychoanalysis is in many ways a temporal process, a process of remembering, for owning and elaborating a past that gives us substance, thereby providing a basis for reflective consciousness. Stimulated by Freud's early writings, Lacan, Laplanche and their successors in particular have focussed extensively on time and psychoanalysis, and their views are a central point of this discussion. A substantial case study is offered that provides concrete examples of these perspectives. A multi‐faceted view of temporality emerges, one that is more syncopated than linear or teleological. In conclusion, I will briefly discuss recent findings in the neuroscience of memory and ‘time travel’ that underpin contemporary psychoanalytic ideas in surprising ways. It is important to remember that acceptance of the contradictory nature of temporal experience can open space for increased freedom and playfulness.     

Tele‐analysis: the use of media technology in psychotherapy and its impact on the therapeutic relationship

A growing number of approaches in psychotherapy make use of internet‐ and other media‐based interactions. This paper discusses the impact on the therapist‐client relationship of using media technology and gives an overview of the current state of the debate. It is suggested that the technical conditions of internet‐based interactions produce new forms of social relationships that differ significantly from face‐to‐face‐interactions and that unconscious, nonverbal cues get lost. Research on the therapeutic interaction making use of ‘discourse linguistic’ methods is presented. The loss of nonverbal cues has implications for psychotherapy in general and especially for the treatment of patients who have difficulties relying on a secure therapeutic relationship. Emotional security in interactional relationships is transmitted to a much greater extent by nonverbal cues than by verbal content; psychoanalytic methods are specialized to refer to this level of interaction. Two alternative scenarios are discussed based on the psychoanalytic theories of Winnicott and Lacan: the risk of an illusionary, idealized image of the other and the possibility that cyberspace can be used for psychological development as a transitional space.     

Residues in the analyst of the patient's symbiotic connection at a somatic level: unrepresented states in the patient and analyst

This paper discusses the residues of a somatic countertransference that revealed its meaning several years after apparently successful analytic work had ended. Psychoanalytic and Jungian analytic ideas on primitive communication, dissociation and enactment are explored in the working through of a shared respiratory symptom between patient and analyst. Growth in the analyst was necessary so that the patient's communication at a somatic level could be understood. Bleger's concept that both the patient's and analyst's body are part of the setting was central in the working through.     

Foetal trauma,body memory and early infant communication: a case illustration

This paper presents the complex case of a male patient who started life as an unwanted pregnancy and adoptee in an era of socio‐cultural shame and blame. When able to contact his birth mother later in life, he experienced a number of confronting synchronicities as well as visions which he felt were related to failed abortion attempts and to other pre‐ and post‐natal events. The case material lends weight not only to Freud's, Ehrenwald's and FitzHerbert's assertions that the earliest form of mother‐infant communications is telepathic in nature but that this mode of communication can be retained if emotional trauma inhibits normal developmental processes. Contemporary neuroscience research is presented supporting the hypothesis that emotional memory can become imbedded in the psyche/soma of the foetus. Such memory traces can later emerge into imagery and/or words if the traumatic impingement has been substantial enough and if other defensive strategies are in place. Clinical implications are then suggested regarding analysts’ attention to the emotional conditions underpinning their patients’ conceptions and foetal development; the connection to projective identification components of the countertransference as being aspects of the earliest telepathic mother/infant communication channel and the need for reductive analyses in analyst training programmes.     

Hiding in plain sight: Jung,astrology, and the psychology of the unconscious

Astrology was a lifelong interest for C.G. Jung and an important aid in his formulation of psyche and psychic process. Archetypally configured, astrology provided Jung an objective means to a fuller understanding of the analysand's true nature and unique individuation journey. Jung credits astrology with helping to unlock the mystery of alchemy and in so doing providing the symbol language necessary for deciphering the historically remote cosmology of Gnosticism. Astrology also aided Jung's work on synchronicity. Despite astrology's worth to Jung's development of analytical psychology, its fundamental role in guiding his discoveries is all but absent from historical notice. The astrological natal chart seems rarely used clinically, and many clinicians seem unaware of its value as a dynamic diagram of the personality and the potentialities within which nature and nurture foster and/or discourage for individual growth and development over the lifespan. This paper charts Jung's interest in astrology and suggests why his great regard for it and other paranormal or occult practices remains largely neglected and unknown.     

Reflections on the Jungian nature of psychology as the discipline of interiority: a response to Saban's ‘Misunderstandings’

Psychology as the discipline of interiority is the name of the psychology that has developed from Wolfgang Giegerich's work in the field of analytical psychology. This article offers a counterview to that of Mark Saban's claim that Giegerich's psychology is ‘irrelevant’ to Jungians today and is based on a fundamental misunderstanding of the nature of Jungian psychology. It will be shown that, in fact, it is a fundamental misunderstanding of Giegerich's work that has led Saban to form erroneous conclusions. Links between Jung's and Giegerich's conceptions of the ‘objective psyche’ will be highlighted, along with other examples of how, contrary to Saban's conclusions, psychology as the discipline of interiority has obvious connections to, and grounding in, Jungian psychology.     

The making of a tragedy: perversion in the perception of truth

A type of wilful blindness can pervert an individual's perception of truth or reality, not because that reality is too much to hold, but because it is distasteful. Undesired. The case of Adam will be used to explore perversion as it twists an analytic process, affecting the transference and countertransference in ways that are difficult to see. Theorists of Freudian, Kleinian, Lacanian, and Jungian traditions are drawn from to explore potential roots to this perverted turn, and the way it can rigidify an individuation process. The anxiety that haunts this case echoes Jung's anxiety as he wondered if the stone saw him or he saw the stone. Object and observer blend when both analyst and patient hide from themselves and one another, knowing the truth of what is being discussed but blind to it.     

Sandplay therapy with couples within the framework of analytical psychology

Sandplay therapy with couples is discussed within an analytical framework. Guidelines are proposed as a means of developing this relatively new area within sandplay therapy, and as a platform to open a wider discussion to bring together sandplay therapy and couple therapy. Examples of sand trays created during couple therapy are also presented to illustrate the transformations during the therapeutic process.     

Early trauma and affect: the importance of the body for the development of the capacity to symbolize

In this paper I aim to outline the importance of working clinically with affect when treating severely traumatized patients who have a limited capacity to symbolize. These patients, who suffer the loss of maternal care early in life, require the analyst to be closely attuned to the patient's distress through use of the countertransference and with significantly less attention paid to the transference. It is questionable whether we can speak of transference when there is limited capacity to form internal representations. The analyst's relationship with the patient is not necessarily used to make interpretations but, instead, the analyst's reverie functions therapeutically to develop awareness and containment of affect, first in the analyst's mind and, later, in the patient's, so that, in time, a relationship between the patient's mind and the body, as the first object, is made. In contrast to general object‐relations theories, in which the first object is considered to be the breast or the mother, Ferrari (2004) proposes that the body is the first object in the emerging mind. Once a relationship between mind and body is established, symbolization becomes possible following the formation of internal representations of affective states in the mind, where previously there were few. Using Ferrari's body‐mind model, two clinical case vignettes underline the need to use the countertransference with patients who suffered chronic developmental trauma in early childhood.     

When symptom is symbol: some comments on Rosemary Gordon's, ‘Masochism: the shadow side of the archetypal need to venerate and worship’

This paper is a commentary on Rosemary Gordon's paper, ‘Masochism: the shadow side of the archetypal need to venerate and worship’, with a suggestion for an alternative interpretation of masochism as a part of a sado‐masochistic couple. Gordon postulates an archetypal need to venerate and worship that can be hidden in the shadow and distorted in such practices as sexual masochism. Her paper also offers several avenues of exploration for further studies in connection with the phenomenon of masochism, including sexual perversion (‘paraphilia’), chronic psychological victimhood, PTSD and traumatology, religious extremist behaviour such as self‐flagellation, transformation in the individuation process and numinous experience. An extension of her hypothesis to include religious problems of modernity is suggested.     

Political and clinical developments in analytical psychology, 1972‐2014: subjectivity,equality and diversity—inside and outside the consulting room

Utilizing Jung's idea of theory as a ‘personal confession’, the author charts his own development as a theorist, establishing links between his personal history and his ideas. Such links include his relationship with both parents, his sexuality, his cultural heritage, and his fascination with Tricksters and with Hermes. There follows a substantial critical interrogation of what the author discerns as the two main lines of clinical theorizing in contemporary analytical psychotherapy: interpretation of transference‐countertransference, and the relational approach. His conclusion is that neither is superior to the other and neither is in fact adequate as a basis for clinical work. The focus then shifts to explore a range of political and social aspects of the clinical project of analytical psychology: economic inequality, diversity within the professional field, and Jung's controversial ideas about Jews and Africans. The author calls for an apology from the ‘Jungian community’ for remarks about Africans analogous to the apology already issued for remarks about Jews. The paper is dedicated to the author's friend Fred Plaut (1913‐2009).     

Bounded in a nutshell and a king of infinite space: the embodied self and its intentional world

This paper explores the implications of developments in phenomenological biology for a reconsideration of synchronicity and the self. The enactive approach of Maturana and Varela aims to reformulate the relation between biological organisms and the world in a non‐Cartesian way, breaking down the conceptual division between mind and world so that meaning can be seen as a function of the species‐specific way in which an organism engages with its environment. This leads to a view of the self as inherently embodied and engaged with the particularities of its material, cultural and social worlds, while being infinitely extended through the power of imagination; this enables humans to adapt to many different social and material environments. In order to understand these differences, we need to ‘enter into the world of the other’. Where understanding of other animals requires immersion in their environmental milieux, understanding other humans requires us also to recognize that differences in socio‐cultural milieux create significantly different worlds of meaning and experience.     

Rivers of milk and honey ‐ an exploration of nurturing the self in a Russian context

This paper is an exploration of the relationship between nurturing in all its contexts ‐ among them, the nursing couple and the therapeutic relationship ‐ and the evolution of an individual self. The ideas are illustrated by a case vignette of a Russian patient. An attempt is made to show that when the self as an integral unity of body and soul is addressed in the analytic setting, ‘nutritional dreams’ emerge as expressions of the self‐in‐action. Certain psycholinguistic features of the Russian cultural context are described which suggest a link of meaning between development of the self and secure parenting. This linguistic association may facilitate the process of self‐centering.     

A revolution of the mind: some implications of George Hogenson's ‘The Baldwin Effect: a neglected influence on C.G. Jung's evolutionary thinking’ (2001)

George Hogenson's 2001 paper ‘The Baldwin Effect: a neglected influence on C.G. Jung's evolutionary thinking’ developed the radical argument that, if archetypes are emergent, they ‘do not exist in the sense that there is no place that the archetypes can be said to be’. In this paper, I show how Hogenson's thinking has been seminal to my own: it is not just archetypes but the mind itself that has no ‘place’. The mind is a dynamic system, emergent from the cultural environment of symbolic meanings to which humans are evolutionarily adapted. Drawing on the work of philosopher John Searle, I argue that symbols constitute the realities that they bring forth, including the imaginal realities of the psyche. The implications for clinical work include a rejection of structural models of the psyche in favour of the emergence of symbolic realities in the context of psychoanalysis as a distributed system of cognition.     

Working in the borderland: early relational trauma and Fordham's analysis of ‘K’

This paper outlines a view of early relational trauma as underlying borderline states of mind, and argues that Knox's 1999 paper on internal working models and the complex provides a basis for understanding such states of mind. The author argues that in addition to internal working models, the complex also embodies and contains primitive defences of the core self. He outlines how these apply on the objective, subjective, transference and archetypal levels, and in direct and reversed forms and applies this to the account of Fordham's analysis of his patient ‘K’, which ended in impasse. The paper explores the dynamic that emerged in that analysis and suggests that it could be helpfully accounted for in terms of the co‐construction and re‐construction of early relational trauma in the analytic relationship.