Psychoanalysis is a two‐way street

The paper discusses psychoanalysis as a mutual exchange between the analyst and analysand. A number of questions are raised: What was Ferenczi's and the early psychoanalysts' contribution to the interpersonal relational dynamics of psychoanalytic treatment? Why did countertransference become an indispensable tool in relationship‐based psychoanalysis? Why is the transference‐countertransference dynamic seen as a special dialogue between the analyst and analysand? What was Ferenczi's paradigm shift in the trauma theory? How did he combine the object relation approach with Freud's original trauma theory? The paper illustrates through some case study vignettes the intersubjective and intrapsychic dynamic in the process of traumatization. We can look at countertransference as an indicator of the patient's basic interpersonal experiences and traumas. Finally the paper discusses countertransference in the light of attachment theory, connecting the early initiatives of inter‐relational approaches in psychoanalysis with recent research.     

Transformations in dreaming and characters in the psychoanalytic field1,2

Having reviewed certain similarities and differences between the various psychoanalytic models (historical reconstruction/development of the container and of the mind's metabolic and transformational function; the significance to be attributed to dream‐type material; reality gradients of narrations; tolerability of truth/lies as polar opposites; and the form in which characters are understood in a psychoanalytic session), the author uses clinical material to demonstrate his conception of a session as a virtual reality in which the central operation is transformation in dreaming (de‐construction, de‐concretization, and re‐dreaming), accompanied in particular by the development of this attitude in both patient and analyst as an antidote to the operations of transformation in hallucinosis that bear witness to the failure of the functions of meaning generation. The theoretical roots of this model are traced in the concept of the field and its developments as a constantly expanding oneiric holographic field; in the developments of Bion's ideas (waking dream thought and its derivatives, and the patient as signaller of the movements of the field); and in the contributions of narratology (narrative transformations and the transformations of characters and screenplays). Stress is also laid on the transition from a psychoanalysis directed predominantly towards contents to a psychoanalysis that emphasizes the development of the instruments for dreaming, feeling, and thinking. An extensive case history and a session reported in its entirety are presented so as to convey a living impression of the ongoing process, in the consulting room, of the unsaturated co‐construction of an emotional reality in the throes of continuous transformation. The author also describes the technical implications of this model in terms of forms of interpretation, the countertransference, reveries, and, in particular, how the analyst listens to the patient's communications. The paper ends with an exploration of the concepts of grasping (in the sense of clinging to the known) and casting (in relation to what is as yet undefined but seeking representation and transformation) as a further oscillation of the minds of the analyst and the patient in addition to those familiar from classical psychoanalysis.     

Characters on the Stage. Ibsen's “Life-Lie” Revisited

The authors inquire as to how far psychoanalysis uses its inherent capabilities to decipher the inner structure of subjectivity in present-day psychoanalytic practice and thinking. They maintain that in psychoanalytic practice, the analyst's unresolved neurotic conflicts cause him to create conscious mystifications of his own unconscious situation, thus distorting his understanding of the patient's unconscious in a systematic manner.     

The analytic setting today: using the couch or the chair?

This paper re‐visits Murray Jackson's 1961 paper in the Journal of Analytical Psychology, ‘Chair, couch and countertransference’, with the aim of exploring the role of the couch for Jungian analysts in clinical practice today. Within the Society of Analytical Psychology (SAP) and some other London‐based societies, there has been an evolution of practice from face‐to‐face sessions with the patient in the chair, as was Jung's preference, to a mode of practice where patients use the couch with the analyst sitting to the side rather than behind, as has been the tradition in psychoanalysis. Fordham was the founding member of the SAP and it was because of his liaison with psychoanalysis and psychoanalysts that this cultural shift came about. Using clinical examples, the author explores the couch/chair question in terms of her own practice and the internal setting as a structure in her mind. With reference to Bleger's (2013) paper ‘Psychoanalysis of the psychoanalytic setting’, the author discusses how the analytic setting, including use of the couch or the chair, can act as a silent container for the most primitive aspects of the patient's psyche which will only emerge in analysis when the setting changes or is breached.     

Selecting a patient or initiating a psychoanalytic process?

The defences provoked in the analyst by the anxieties associated with the difficult tasks of ‘assessment’ and ‘selection’ for psychoanalysis can result in a tendency to think in terms of ‘hurdles to be cleared’ by potential psychoanalytic patients, rather than ‘opening the gates’. This can result in a diminution of the analyst's capacity to enlist and sustain a psychoanalytic stance. Only within a psychoanalytic frame can a meaningful psychoanalytic process unfold, at all stages of a potential patient's movement from their first contact through to, possibly, entering into an analysis. The author illustrates the value of this thinking by describing the work of the London Clinic of Psychoanalysis where there has been a shift of emphasis in psychoanalytic consultation towards working with individuals on their potential to initiate a psychoanalytic process, and away from the sole aim of ‘selection of a suitable patient’. In this paper, the author notes that when institutional culture and practice supports psychoanalytic identity, this makes it more possible to recognize and articulate the anxieties provoked by the ‘emotional storm’ inevitable in psychoanalytic consultation, and the draw towards unhelpful enactment that may otherwise obscure the initiation of a psychoanalytic process that may or may not result in analytic treatment. Illustrative case material from the Clinic is presented.     

Critical refl ections on intersubjectivity in psychoanalysis1

The authors review the philosophical trend known as postmodernism and the way it has infl uenced a part of psychoanalytic thought, concluding with some comments on the qualities and shortcomings of the new developments. The authors consider the origins and the cultural and aesthetic‐philosophical meaning of postmodernism, identifying some key concepts such as deconstructionism, the disappearance of the ‘individual subject’ and individual identity, and the rejection of ‘in‐depth’ models of psychoanalysis. Then they examine various, wide‐ranging developments in psychoanalytic thought and treatment. They review the intersubjective fi eld in psychoanalysis, especially in the USA, and then explore whether the underlying lack of truth to be discovered, stressed by these ‘new view’ statements, or the fact that the ‘truth’ only exists in linguistic‐narrative constructions is consistent with basic analytic concepts such as the unconscious, phantasy, transference and countertransference, which recall the tri‐dimensional nature of inner psychic reality. The psychoanalytic process is a condition activated through a bond that is able to hold and contain the relationship of the analytic couple and the patient's unconscious world and not through hermeneutic or narrative constructions.     

FROM EXTENSION TO REVOLUTIONARY CHANGE IN CLINICAL PSYCHOANALYSIS: THE RADICAL INFLUENCE OF BION AND WINNICOTT

This paper addresses the radical departure of late Bion's and Winnicott's clinical ideas and practices from traditional psychoanalytic work, introducing a revolutionary change in clinical psychoanalysis. The profound significance and implications of their thinking are explored, and in particular Bion's conception of transformation in O and Winnicott's clinical‐technical revision of analytic work, with its emphasis on regression in the treatment of more disturbed patients. The author specifically connects the unknown and unknowable emotional reality‐O with unthinkable breakdown (Winnicott) and catastrophe (Bion). The author suggests that the revolutionary approach introduced by the clinical thinking of late Bion and Winnicott be termed quantum psychoanalysis. She thinks that this approach can coexist with classical psychoanalysis in the same way that classical physics coexists with quantum physics.     

To Be Is to Betray: On the Place of Collective History and Freedom in Psychoanalysis

This paper explores an open frontier between psychoanalysis and critical theory, the relations between subjective experience and collective history. Its drive is a concern with the question of freedom: How might contemporary psychoanalysis help us think about freedom? How could it, as a practice, help us to be free? On the theoretical level, the paper follows the critique of psychoanalysis offered by Foucault and Adorno, particularly the latter's close reading Ferenczi in Negative Dialectics and his notion of “the spell.” I employ their critique in order to articulate the dilemma psychoanalysis faces vis-à-vis the notion of freedom in social context. I argue that, unlike traditional psychoanalytic discourse, relational psychoanalysis can address this dilemma in a generative way. I find this prospect in the readiness of relational psychoanalysis to realize the potential inherent in the psychoanalytic setting: the creation of a mutually constituted intersubjective space. I tell the story of a young woman for whom love seems impossible, and of a psychoanalytic expedition that finds her ability to love being held hostage. I suggest that what appears in one register as gender and sexual trouble appears in another as a dilemma of attachments and loyalties: my patient's ability to love is spellbound, trapped in a subjective-collective no man's land between her desire to be for herself and the unconscious demands of collective heritage. I argue that for psychoanalysis to be a practice of freedom, it must address the ways in which subjective experience answers to social forces and collective history. I question in this context the relations between freedom, guilt, and responsibility. Re-engaging Adorno, I agree that selfhood may always involve a guilty betrayal of others but argue against him that we must allow this guilt to be reconciled with living. I suggest, in conclusion, that theory is the bearer of collective responsibility.     

CHARACTER,PSYCHOANALYTIC IDENTIFICATION,AND NUMERICAL IDENTITY

Identification figures prominently in moral psychological explanations. I argue that in identification the subject has an ‘identity‐thought’, which is a thought about her numerical identity with the figure she identifies with. In Freud's psychoanalytic psychology character is founded on unconscious identification with parental figures. Moral philosophers have drawn on psychoanalysis to explain how undesirable or disadvantageous character dispositions are resistant to insight through being unconscious. According to Richard Wollheim's analysis of Freud's theory, identification is the subject's disposition to imagine, unconsciously, her bodily merging with the figure she identifies with. I argue that this explanation of identification is not adequate. Human character is held to be capable of change when self‐reflection brings unconscious identifications to conscious self‐knowledge. I argue that for self‐knowledge these identifications must be an intelligible part of the subject's self‐conception, and that Wollheim's ‘merging phantasy’ is not intelligible to the subject in this way. By contrast, the subject's thought that she is numerically identical to the figure she identifies with does provide an intelligible starting‐point for reflecting on this identification. This psychoanalytic account provides a clear conception of identification with which to investigate puzzle cases in the moral psychology of character.     

An overview of the treatment of severe narcissistic pathology

This paper provides an overview of narcissistic personality disorders as they present clinically along a spectrum of severity ranging from the best functioning forms of pathological narcissism to the most threatening to the patient's psychosocial and physical survival. It proposes a general interpretive psychoanalytic stance with all these clinical syndromes that range from standard psychoanalysis to a specific psychoanalytical psychotherapy for the most repressive and life threatening conditions that may not respond to standard psychoanalysis proper. This general psychoanalytic approach is placed into the context of related developments in contemporary psychoanalytic understanding of pathological narcissism and its treatment.     

Psychoanalysis and Human Values

Psychoanalysis can contribute quite a lot to the question of values and to a theory of ethics. While the first part of this presentation is focused on the impact psychoanalysis continues to exert on present day ethical theory, the second part discusses Erich Fromm's particular approach to psychoanalysis. Fromm was the first to reformulate in his psychoanalytic approach the idea of an ethic of the virtues. With his theory of character (and of social character) he made values an integral part of psychoanalytic theory. Hence, what matters most morally from a psychoanalytic stance is the quality of character orientation. Despite the fact that - in Fromm's own socio-psychoanalytic approach - man's character is the product of adaptation to the environment, morality for him is dictated by economic and social requirements - whatever common sense may tell us to the contrary. For Fromm there is an intrinsic primary tendency to growth in all human beings. Thus, morally good is whatever furthers the growth of our own powers by which we relate to the outside world and to ourselves in a loving, "sane" and creative way. The last section reflects some implications of Fromm's approach to understanding values as an integral part of psychoanalytic theory, and finally discusses whether the search for truth and human values is as obsolete as postmodern thinking claims.     

‘For Beauty is nothing but the barely endurable onset of Terror’: Outline of a general psychoanalytic aesthetics

Even close to 80 years after Freud's words that psychoanalysis “has scarcely anything to say about beauty” (Freud, Civilization and its Discontents, SE 21, p. 82) the question of a specific psychoanalytic aesthetic is still faced with a deficit in theory. Since aesthetics is related to Aisthesis, the Greek word for ‘perception’, a psychoanalytic aesthetic can solely emerge from a psychoanalysis of perceptive structures. The term ‘kinaesthetic semantic’ is introduced in order to exemplify via music how perceptive experiences must be structured for them to be experienced as beautiful. The basic mechanisms – repetition of form (rhythm, unification) and seduction (deviation, surprise) – are defined. With the help of these mechanisms an intensive contact between perceiving object and kinetic subject, the physical self, is established. The intensive relatedness is a requirement for the creative process in art and also for psychic growth on the subject's level. The described basic mechanisms of the aesthetic process in music can also be encountered in painting and poetry. By the means of a self‐portrait by Bacon it will be examined how, in art, terror and traumatization are represented via targeted disorganization of beauty endowing mechanisms, hence finding an enabling form of confrontation and integration of fended contents.     

Forum der Psychoanalyse: A journal documenting the “normalization” of the psychoanalytic field in Germany

Abstract

Forum der Psychoanalyse, which holds a firm place in the German-speaking world today, was founded in 1984 in a rugged landscape of psychoanalysis in Germany that was the consequence of the malignant group processes that had occurred between psychoanalytic societies after World War II. The Forum's foundation was guided by the idea of creating a constructive climate between the rivalrous groups and moderating the gap between them, given the increasing recognition of the shared history of psychoanalysis in Germany that had started to take root in the 1980s. Emphasizing the common ground in psychoanalytic theory and practice, the Forum is open to all psychoanalysts, to discussions of the various psychoanalytic trends, and to contemporary interdisciplinary dialogue. It promotes exchanges between psychoanalytic societies, and is also meant as a bridge to the development of psychoanalysis abroad.     

“This beastly science…”: On the reception of psychoanalysis by the composers of the Second Viennese School, 1908–1923

This paper explores the links between psychoanalysis and music in Vienna between the years 1908 and 1923, focusing in particular on two members of the highly influential Second Viennese School, the composers Alban Berg and Anton Webern. While there is little evidence of an actual interaction between Freud and his circle and contemporaneous musicians in Vienna, this paper discusses the direct personal and professional contact Webern and Berg had with Freud, and also with Freud's one-time colleague Alfred Adler; Berg's wife Helene also underwent psychoanalytic treatment. Both composers documented their experiences with and feelings about psychoanalysis, offering critical insights into the reception of psychoanalysis in musical circles in Vienna, and into the actual connections between psychoanalysis and Vienna's most important musical figures. This paper examines Berg and Webern in the context of Freud's Vienna, Adler's musical background and his treatment of Webern, and Berg's knowledge of psychoanalysis and strong ambivalence towards his wife's psychoanalytic treatment, and concludes by considering Berg's opera Wozzeck (1925) as an example of a musical work influenced by contemporary Viennese attitudes towards psychoanalysis.     

Should Analytic Patients Be “Created”? Reflections on Arnold Rothstein's Psychoanalytic Technique and the Creation of Analytic Patients

Abstract

The five points of Arnold Rothstein's interesting monograph are each discussed and critiqued in this article. In particular, Rothstein is commended for his commitment to expanding the availability of an intensive, psychoanalytic treatment for a broad spectrum of patients who may often be very difficult to engage. Rothstein also accounts for difficulties in engaging analytic patients from obstacles in the attitudes of analysts such as a latent lack of conviction about the efficacy of psychoanalysis and from overly restricted stereotypes about the spectrum of appropriate patients. He recommends a flexibility of technique and accommodation to the needs of patients with which this author agrees.

Others of Rothstein's observations and recommendations seem more problematic. Specifically, issue is taken with his suggestion that analysts attempt to provide a trial of psychoanalysis for all nonpsychotic patients and to begin on a less intensive basis only within the frame or interpreting prospective patients' objections as a resistance. This author also disagrees with Rothstein's interpretation that patients resist the offer of a psychoanalysis out of a self-defeating masochistic enactment that needs interpretation. Case examples are provided that belie this overly generalized interpretation. Additionally, this author critiques the metapsychological assumptions underlying this particular mode of interpreting a reluctance to begin psychoanalysis.

While commending Rothstein's therapeutic goals and recommended flexibility of technique, this author would also stress a fundamental concern about the patient's conscious and unconscious experience of the analyst's agenda. In other words, rather than working toward the analyst's goal of establishing a psychoanalytic situation, emphasis is placed instead on the basic right of patients to proceed in a manner that respects their sovereignty over how intensively they may choose to work. Therefore, in contradistinction to Rothstein's suggestions, it is recommended that the analyst's primary focus should be to provide an availability to work on the patient's conflicts and developmental needs with a respect for the timing of their emergence and expression within a treatment frame that invites but does not prematurely elicit and confront. By proceeding in this way a patient's salient dynamics will be allowed to emerge “organically” instead of being hastened prematurely in reaction to the analyst's insistence on the Tightness of a particular schedule or manner of proceeding. This author believes that with this approach more, rather than fewer, patients will be able to accept the recommendation of an intensive psychoanalytic treatment.     

Psychoanalysis,science, and art: Aesthetics in the making of a psychoanalyst1

This paper critically examines the relationship of psychoanalysis to science and art. Its point of departure is Michael Rustin's theorizing. Specifically, in considering the possibility of a psychoanalyst's having an aesthetic orientation, the author analyses: 1) the difficulty of there being any connection between psychoanalysis and science because science's necessarily presupposed subject‐object dichotomy is incompatible with transference, which, beginning with Freud, is basic to psychoanalysis; 2) the complex relationship between psychoanalysis and aesthetics using Maurice Merleau‐Ponty's philosophical perspective as well as Luigi Pareyson's theory of aesthetics; 3) the Kantian foundations of the psychoanalytic notion of art as the ‘containing form of subjective experience’ 4) intersubjectivity, without which clinical practice would not be possible, especially considering matters of identity, difference, the body, and of sensory experience such as ‘expressive form’; 5) the relationship of psychoanalysis and art, keeping in mind their possible convergence and divergence as well as some psychoanalysts' conceptual commitment to classicism and the need for contact with art in a psychoanalysts's mind set.     

The plight and promise of contemporary psychoanalysis in the light of its social history

This paper addresses the many changes which have beset psychoanalysis and the psychoanalytic community since the widespread, general acceptance of both by the educated, middle-class public in the 1950s. It attempts to explain these changes, at least in part, by reflecting upon them in the light of the history of the psychoanalytic movement and upon the rise of dynamic psychology as well. Many in the psychoanalytic community think that their work is being ignored, devalued, and even attacked by an increasing number of influential persons and organizations. Critics claim that, epistemologically, psychoanalysis is scientifically invalid; therapeutically, it is ineffective; economically, it is too costly and takes too long; and theoretically, it is pluralized to the point of fragmentation. This is the plight of psychoanalysis. This paper argues that many of the major problems which once beset Freud and his colleagues, and which beset the psychoanalytic community today, are best understood in terms of two sociological processes, legitimation and institutionalization. Legitimation is the socio-cultural process whereby a new idea (e.g., Freud's theories, Jung's theories) contests the established web of ideas which give coherence and meaning to social and personal identity. Institutionalization refers to the way legitimated ideas replace once-contested views of reality. The single most decisive factor generating the plight of contemporary psychoanalysis is the ‘decision’ (1) to socially locate (institutionalize) psychoanalysis in institutes, rather than in clinics or universities, and (2) to represent psychoanalysis to the public (legitimation) as a medical science. In order to illustrate and advance these claims, I first define and distinguish sociologically the institute, the clinic and the university. Second, I describe the origins and development of the ‘decision’, made by Freud and his followers, to locate or institutionalize psychoanalysis in institutes. Third, I compare and contrast this early pattern of legitimation and institutionalization with that of the present-day psychoanalytic movement in England (relatively benign institutionalization) and in the United States (relatively destructive institutionalization). Throughout this discussion I draw upon the new literature on the history of psychoanalysis, past and present. As for the ‘promise’ for psychoanalysis, it can materialize insofar as psychoanalysis establishes contact with the clinic and the university (re-legitimation) and insofar as that contact becomes so self-evident that it is taken for granted (i.e., it is re-institutionalized).     

The neglected object: A history of the concept of dreams in Polish psychiatry and psychology in the interwar period, 1918–1939

The development of the concept of dreams in interwar Polish psychiatry and psychology was influenced by Western European concepts as well as by sociocultural factors of the newly independent state. Few Polish psychiatrists addressed the subject of dreams. They were influenced mainly by Sigmund Freud's psychoanalytic concept of dreams, but also by Alferd Adler's, Carl Gustav Jung's, and Wilhelm Stekel's ideas. Nevertheless, they approached psychoanalysis critically. The most comprehensive concept of dreams in Polish psychiatry was oneiroanalysis by Tadeusz Bilikiewicz. Oneironalysis was a method of dream analysis based on psychoanalysis but it rejected the psychoanalytic method of free associations and challenged psychoanalytic approaches to the interpretation of dream symbols. Polish psychologists were even less interested in dreams than psychiatrists. Problems with dreams, the most elaborate psychological work by Stefan Szuman consisted of an outline of epistemological problems with general theories of dreams and a harsh critique of psychoanalysis. The neglect of the subject of dreams in Polish psychiatric society can be seen as connected with the social and professional reception of psychoanalysis in Poland. Psychoanalysis was met with opposition from conservative scholars and publicists presenting nationalistic and anti-Semitic attitudes. It was also criticized by the biologically oriented majority of psychiatrists of the Polish Psychiatric Association. In the case of psychology, the most influential Polish psychological school, Lvov-Warsaw School, promoted Brentanian intentionalism, introspection, and psychology of consciousness, therefore, leading to psychologists' reluctance to explore unconscious states like dreams.