The Sleeping Analyst,The Waking Dreams: Commentary on Papers by Richard A. Chefetz and David G. Mark

The discussion applies the basic psychological concepts of emotion schemas and the referential process to the case material presented by Drs. Richard Chefetz and David Mark. Emotion schemas are types of memory schemas that develop in an interpersonal field. They include subsymbolic processes, symbolic imagery, and linguistic codes, integrated to varying degrees. In treatment both participants come in with their emotion schemas, developed in the course of their lives, activated in the events of the day; communication between analyst and patient occurs on all levels in subsymbolic somato-sensory and symbolic verbal forms. The discussion of Dr. Chefetz's presentation emphasizes the relationships among multiple schemas of self and others, within the patient and between patient and analyst. The discussion of Dr. Mark's three cases focuses on connections and disconnections within the schemas as well as between them and emphasizes the pivotal role of imagery in connecting subsymbolic experience and words, and in the reconstruction of dissociated schemas in the context of the therapeutic relationship.     

Emotional Communication in the Case of Antonio

ABSTRACT

In describing her work with her traumatized patient Antonio, Dr. Jane Lewis focuses on Barthes’s (1981) notion of a photograph as having the symbolic linking function of an umbilical cord, and emphasizes the notion of the punctum, the specific personal wounding detail in an image that connects to the viewer’s experience. This article discusses these ideas, which appear mystical to Lewis, in the contexts of the theory of multiple coding and the referential process, as well as recent advances in the fields of social neuroscience and embodied communication. In the early Arousal phase of the referential process, emotion schemas associated with painful events of the past are activated for both participants, in subsymbolic, embodied form. Antonio is largely mute and frozen; Lewis also feels herself freezing and disappearing. In the Symbolizing phase, Antonio begins to connect to dreaded experience of his past, and to tell memories, fantasies and dreams. Memories and images of her past, related emotionally to Antonio’s experience, are awakened for Lewis as well. Through their embodied communication and shared imagery, the therapist’s ability to find emotional meaning for her own painful experience appears to support the patient’s beginning to provide some meaning for his pain and dread. Related observations by Bollas and Arlow, and parallels to a case reported by Ogden are discussed.     

The Interplay of Subsymbolic and Symbolic Processess in Psychoanalytic Treatment: Commentary on Paper by Steven H. Knoblauch

Bucci's model of emotional communication, developed in the context of her theory of multiple coding and the referential process, is applied to Knoblauch's microanalytic report of his experience of the patient and himself and their interactions during a single session of an ongoing treatment. The referential process is a bidirectional function connecting the diverse sensory, somatic, and motoric representations of the subsymbolic system with imagery and words. The process operates partially and to varying degrees within both participants; in the case presented here, the dissociation among systems is severe, and emotional communication within the dyad occurs at first primarily in subsymbolic, bodily forms. Where gaps in the referential process exist for the patient, the analyst's own experience and associations operate to evoke new connections for her; we see this process in moment-by-moment glimpses of the analyst's experience and his interactions with the patient. Gaps in the reader's knowledge, and possibly the analyst's knowledge, of the patient are discussed.     

A Buddhist contribution to the psychoanalytic psychology of self

The author attempts to integrate the concepts of self used in psychoanalytic theory with the understanding of the nature of self as explained within the Buddhist meditative tradition. He divides different concepts of self in psychoanalytic theory into three major levels of consciousness and abstraction: self as experience, representational self and self as system. The representational level is defined as consisting of unconscious organizing structures of interaction: the system level is a hierarchically higher organization of representations, while the experiential level consists of the moment-to-moment flow of consciousness. He argues that for the sake of theoretical clarity these levels should be differentiated in discussions of self. He then describes the Buddhist psychology of self and tries to show how this perspective can enrich psychoanalytic understanding of the experiential self and of narcissism, which in Buddhist language would be described as clinging to (seeking or avoiding) images of self that arise in the mind. Last, he describes a model of therapeutic development using different levels of self and the interrelationship between them, showing how psychoanalytic psychotherapy and Buddhist insight meditation emphasize different levels of self using complementary rather than mutually exclusive methods.     

Link between early maladaptive schemas and defense mechanisms

IntroductionDefense mechanism and early maladaptive schemas are two concepts distorting the perception of reality.ObjectiveThe aim of this study was to explore the link between two reality-distorting concepts from two theoretical models: early maladaptive schemas from the cognitive and behavioral model and defense mechanisms based on the psychoanalytic model.MethodTwo hundred thirty-two non-clinical participants completed the Defense Style Questionnaire and the Young Schema Questionnaire (short version). Then a Bravais Pearson correlation analysis connecting these two concepts, and a multiple regressions analysis using early maladaptive schemas as predictors for defense style mechanisms levels were conducted.ResultsThe results indicate that 2 early maladaptive schema domains (i.e. other-directedness as well as over-vigilance and inhibition) predict the frequency of use of the neurotic defense mechanism, and 3 schema domains (i.e. disconnection and rejection, impaired autonomy and performances as well as impaired limits) predict the frequency of use of the immature defense mechanism.ConclusionTo conclude, two psychological concepts based on two different theoretical models (psychoanalytic and cognitive and behavioral therapy) seem to share an important link justifying the use of integrative therapies such as schema therapy.     

Self‐disclosure,trauma and the pressures on the analyst

This paper argues that self‐disclosure is intimately related to traumatic experience and the pressures on the analyst not to re‐traumatize the patient or repeat traumatic dynamics. The paper gives a number of examples of such pressures and outlines the difficulties the analyst may experience in adopting an analytic attitude – attempting to stay as closely as possible with what the patient brings. It suggests that self‐disclosure may be used to try to disconfirm the patient's negative sense of themselves or the analyst, or to try to induce a positive sense of self or of the analyst which, whilst well‐meaning, may be missing the point and may be prolonging the patient's distress. Examples are given of staying with the co‐construction of the traumatic early relational dynamics and thus working through the traumatic complex; this attitude is compared and contrasted with some relational psychoanalytic attitudes.     

On paradoxes and the experience of duality

Abstract

Opposing attitudes, emotions, or perceptions of self and other that set the stage for experiences of duality influence our interactions and self–other schemas. The experience of duality that has been conceptualised as “conflict,” “self state,” and “paradox" in psychoanalytic theory has been extensively considered, particularly in terms of its manifestation in transference–countertransference relations and in the analytic material from patients' experiences. They have not, however, been compared and contrasted as entities that lead to similar kinds of experience. Scant attention has been paid, moreover, to paradox as a mental organisation that underlies certain experiences of duality. The concept of paradox has thus been emphasised and developed in this paper.     

Symbolic conceptions: the idea of the third

The idea of the third which appears in Jung's concepts of the transcendent function and the coniunctio also occurs in several psychoanalytic theories concerning the emergence of reflective and symbolic thought in childhood development (defined here as the development of 'imaginal capacity'). Noting the way this process is often conceived in terms of the metaphor of sexual intercourse leading to 'conception', this paper suggests that such images need to be understood as symbolic conceptions of the meaning-making functions of the human mind. This leads to a different view of psychoanalytic theories that attempt to account for the development of imaginal capacity in terms of the Oedipus complex. It is suggested that a) these functions must be operative in the mind before the Oedipal situation can become meaningful and b) that psychoanalytic theories are themselves symbolic conceptions which, like mythological narratives, seek to communicate and comprehend psychic reality through imaginal forms.     

The Levels Hypothesis: A Re-Examination and Reorientation

The levels-hypothesis appears to be derived from psychoanalytic theory, and in its most popular interpretation is concerned with levels of consciousness. However, it is argued that a gradient of consciousness has no application to projective techniques, essentially because there are no principles of differentiation. It is for this reason that the studies which have been done have concerned themselves with such concepts as pathology, concepts which have a tenuous relation to the original levels-hypothesis. The paper has proposed that consciousness in the sense of awareness can more meaningfully be applied to projective material, and that when it is used in this sense a levels-hypothesis can be derived which is both testable and has an adequate rationale.     

The symbolic and concrete: Psychotic adolescents in psychoanalytic psychotherapy

Unique disturbances in symbolisation are characteristic of the pathology of schizophrenia. Drawing on the case vignette of a psychotic adolescent, the author discusses theoretical problems in the symbolisation process in general and then in psychosis, in particular the relation between 'concretism' as a thought disorder and other psychotic defences. The ability to symbolise on the one hand and to maintain sufficiently stable ego boundaries on the other hand are examined in their relation. The author's clinical experience supports her hypothesis that there is a close relationship between the impairment of the symbolisation process in the adolescent or adult psychotic patient and his/her inability to engage in symbolic play as a child. Special attention is paid to the role of early trauma and consequent pathology of object relations for disturbances of symbolic play in childhood. Regression to concrete thinking is understood as the chance of the psychotic patient to give some meaning to reality in an unreal, delusional world and as his/her last chance to communicate at all. Conclusions are drawn for psychoanalytic techniques in the treatment of patients who are deeply regressed in this respect. Special attention is given to the particular circumstances and challenges of adolescence and to providing psychoanalytic psychotherapy to adolescent psychotic patients.     

Person, personality, self, and identity: a philosophically informed conceptual analysis

Who is the person, or self, associated with personality disorder and its treatment? How are we to account for a self conceptualized in terms of schemas and representations, that at the same time--as self--scrutinizes these schemas and representations (as in cognitive therapy for personality disorders)? Five approaches to personhood are examined: metaphysical, empirical, transcendental, hermeneutical, and phenomenological. An elementary sense of selfhood is tied to all one's experiences and activities; this sense of self is experientially irreducible and conceptually connected to a primordial form of self-relatedness. After examining these issues, I formulate four provisional conclusions: (a) the separation between person and roles (functions, personality features) is a modern fiction--persons are not neutral bearers of roles and functions; (b) the concept of personality in DSM-IV refers to nonhomogeneous behaviors such as feelings, moods, inclinations, temperaments, and habits, and these behaviors differ with respect to their distance to the core self; (c) there exists an enormous variety of ways of self-relating and this variety may affect the contents of the core self under certain circumstances; and (d) the concept of person may be primitive; that is, irreducible and referring to a background of unity and integrity.     

The explicit and implicit dance in psychoanalytic change

How the implicit/non-declarative and explicit/declarative cognitive domains interact is centrally important in the consideration of effecting change within the psychoanalytic arena. Stern et al. (1998) declare that long-lasting change occurs in the domain of implicit relational knowledge. In the view of this author, the implicit and explicit domains are intricately intertwined in an interactive dance within a psychoanalytic process. The author views that a spirit of inquiry (Lichtenberg, Lachmann & Fosshage 2002) serves as the foundation of the psychoanalytic process. Analyst and patient strive to explore, understand and communicate and, thereby, create a 'spirit' of interaction that contributes, through gradual incremental learning, to new implicit relational knowledge. This spirit, as part of the implicit relational interaction, is a cornerstone of the analytic relationship. The 'inquiry' more directly brings explicit/declarative processing to the foreground in the joint attempt to explore and understand. The spirit of inquiry in the psychoanalytic arena highlights both the autobiographical scenarios of the explicit memory system and the mental models of the implicit memory system as each contributes to a sense of self, other, and self with other. This process facilitates the extrication and suspension of the old models, so that new models based on current relational experience can be gradually integrated into both memory systems for lasting change.     

Das zentrale Selbstkonzept von Gesunden

The paper discusses the “Hamburg- Healthy- Project” in a retrospective point of view. First the results of the psychoanalytical and typological research project are presented about 21 subjective healthy persons, who were congregated by a newspaper announcement. During the qualitative research process a short characteristic sentence (“Motto”) about each subject was formulated, in sense of a fictional principle of psychic functioning. The paper reanalyses the case histories together with these formulations. These formulations may represent central integrative self concepts. These self concepts may exist and have an important role in the further development of the biographic process. Their role in psychoanalytic diagnostic and therapeutic process is discussed.     

Self psychology and its contributions to psychoanalysis

Abstract

A schematic overview of the theory and practice of self psychology is presented with a particular focus on what the author believes to be the most important contributions to psychoanalysis. It is recognized that self psychology, as with all psychoanalytic approaches, is an evolving and non-unitary theory. Fundamental features of self psychology are: 1. the consistent use of the empathic mode of observation, that is, to listen and understand from within the vantage point of the patient; 2. the primary motivation which involves strivings to develop and maintain a positive cohesive sense of self; 3. that each person has unique pre-wired “givens” included in the concept of the nuclear self; 4. that each person has selfobject needs which refer to the use of the object for the development and regulation of a positive sense of self; 5. that selfobject needs include mirroring (acknowledgement and affirmation), idealizing (protection, safety, and admired qualities), and twinship (a feeling of essential likeness, of sharing) needs; 6. that development and maintenance of a positive cohesive sense of self requires a sufficient responsiveness to selfobject needs; 7. that insufficient responsiveness arrests normal development, creates pathological organizing patterns of self, others, and self with others, and causes unresolvable conflict; and 8. that psychoanalytic treatment involves the analysis of the selfobject and repetitive dimensions of the transference in order to facilitate expansion of awareness, symbolic reorganization and self-righting.     

Bakhtin and Winnicott on dialogue,self, and cure

This paper develops a Bakhtinian dialogical perspective on the psychoanalytic discourse in general and on the concepts of true and false selves (Winnicott, 1960b) in particular. Bakhtin's assumptions about the origins of dialogicality in children's development are compared to Winnicott's ideas about the origins of true‐ and false‐self processes. This comparison leads to a characterization of the false and true selves as different genres of the narrated self—the epic and the novel—each with its specific configurations of experience and temporality. Moreover, psychoanalysis is conceived as a unique phenomenon that centers on the internal and most of the time simultaneous dialogues that take place in each of the two participants. This perspective underscores the impact of the analyst's subjectivity on the analytic process as well as the multiplicity of the patient's and the analyst's selves. In this context, therapeutic change can be seen most of the time as a transformation of genre and not necessarily as a modification of contents. Free association allows for the transgression of the basic rules of narrativity, thus facilitating a generic shift. A dialogical relation between the openness of free association and narrativity's coherence is suggested.

Life by its very nature is dialogic. To live means to participate in dialogue [Bakhtin, 1963, p. 293].

A word like “self”; naturally knows more than we do [Winnicott, 1960a, p. 158].     

High-Risk,High-Gain Choices: Commentary on Paper by Philip A. Ringstrom

In this commentary building on Philip Ringstrom's paper, I address how improvisation, an unpremeditated spontaneous activity emerging within an interactive context, can be analytic even when not shaped consciously by the analyst's reflective capacity and therapeutic judgment. A microanalysis of the nonverbal dimensions of the analytic exchanges that Ringstrom offers is used to illustrate how affective experience can be attended and coconstructed on a subsymbolic process register carried on kinesthetic, somatic, and acoustic dimensions that may or may not be transduced to symbolic expression for mutative analytic impact to have occurred. The metaphor of jazz is added to the metaphor of improvisational theater to help elaborate this view.     

On not interpreting: The metaphor of the baby,enactment, and transitional experience

Conclusion Winnicott suggests that transitional experiences after outliving their usefulness tend to fade into the background, leaving behind the capacity to develop further transitional experiences and symbolic thought. My understanding of this transitional experience remained uninterpreted as a form of joined action or play in the analysis. This complex set of actions and unverbalized meanings represented for me an aspect of the use of the metaphor of the baby and the allegory of the caretaking parent both in terms of the narrative structure and in the capacity to engage in a process of enacting the patient’s dissociated experiences and facilitating the development of his symbolic experiences of greed and aggression through the development of a playful transitional experience. I believe that it was the patient’s concrete experience of greed and aggression that was at the core of the patient’s arrested development in his capacity to be a sexual and loving adult and to develop an intimate relationship with another person. I believe that the evolving transitional experience of eating the donut and later the cookie enabled us to enact and play out the multiple meanings of greed, envy, the destruction of the object, and finally the reparation and recreation of the object. In the paradox created through the transitional experience I could be both greedy and trustworthy and he could be both sadistic and generous. In the beginning of this paper I suggested a series of dichotomies that define differences in contemporary approaches to psychoanalysis. In the developmental arrest position that I developed in this paper the treatment parameters emphasize mutuality, symmetry, constructivism, the political and social dimensions of experience, and most importantly the analyst’s countertransference participation is thought of as strategic, critical, and voluntary. Psychoanalysis has traditionally been thought of as involving multiple levels of experience, some conscious and verbal and some unconscious and experiential or acted out. The concepts of play, enactment, and transitional experience presented in this paper bring to the fore a mode of psychoanalytic related ness that is experiential and conscious, although not objectively or verbally interpreted, which I believe is necessary as a means of developing the capacity for symbolic thought. Presented to the Association for the Advancement of Psychoanalysis, October 19, 1995.     

高述情障碍者的情绪图式特征

采用混合实验设计,以情绪词和情绪图片为实验材料,选取不同述情障碍得分的大学生为被试,通过三个实验考察了高述情障碍者的情绪图式特征。研究结果发现：（1）高述情障碍组被试对情绪词的效价判断反应时显著长于低述情障碍组,述情障碍各维度得分均与情绪词的效价判断反应时呈显著正相关;（2）高述情障碍组被试对情绪图片的效价判断反应时与低述情障碍组相比差异不显著;（3）高述情障碍组被试情绪图式联结所需反应时显著长于低述情障碍组,情感描述困难与情绪图式联结所需反应时之间相关显著。研究结论如下：高述情障碍者存在情绪语言图式和参考性链接上的缺陷,而在情绪意象上并不存在积极/消极区分能力方面的缺陷     

ON THE ACTIVITIES OF THE SCANDINAVIAN PSYCHOANALYTIC SOCIETIES

This article discusses some basic problems of the theory of science connected with understanding the psychoanalytic process. The epistemology of psychoanalysis is seen in relation to the specific status of time, space and causality. It is argued that in psychic life, time and space cannot be a priori categories in the Kantian sense because they are constituted in psychic development and in the dynamics of the psyche and can be abolished in psychopathological conditions as well as in the unconscious. Psychic causality is discussed in relation to Freud's concepts of Nachträglichkeit and overdetermination and remarks are made on the necessity to consider the complex nature of psychic causality when doing research.