On the edge: The psychoanalyst's transference1

Countertransference is a central topic in analytic work and in the literature. The concept of countertransference includes a basic question which has been understood in different ways. The author attempts to differentiate between the psychoanalyst's transference and his countertransference in the analytic process. It is hard to draw a line between them; analysts are always on the edge. The analyst's transference will be explored and described using three approaches: narcissism, regression profile and the analyst's phase of life. Regression profile is a new concept developed by the author, which may help us to understand the core of the analyst's transference in the analytic situation. She illustrates the topic by clinical vignettes.     

Intersubjectivity and interaction in the analytic relationship: a mainstream view

The authors conceptualize intersubjectivity as a meta-theory that reflects the inherent nature of human relatedness and is conceptually independent of any particular theory of mind or school of psychoanalysis. Their view of intersubjectivity joins the emotional life of the analyst to that of the patient and places the analytic relationship at the center of the analytic process. They contrast intersubjectivity with traditional classical conflict theory so as to clarify the relevance of intersubjectivity for psychoanalytic clinical theory and therapeutic practice. In so doing, they hope to direct analysts more firmly toward the study of the unconscious dyadic contributions to the affective, inactive, and interactive dimensions of the analytic situation and their impact upon the patient's actions within and experience of the analytic relationship. To illustrate their thesis, two hours from an analysis are presented in detail.     

The sound-hand

Through clinical vignettes taken from the analytic treatment of an autistic child, the paper explores Bion' s notion of selected fact in relation to the post-Jungian theoretical speculation on the emergent mind. The issue of the subjectivity of the analyst is considered and explored in this light. A review of some neuroscience research contributions to a possible understanding of dialogue, empathy and rhythm is briefly described, particularly in terms of its potential usefulness for the psychoanalytic mind when working with autistic children. In general, the notions of ‘temporal shapes’ (Alvarez) and ‘sound-object’ (Maiello) provide support for the theoretical and clinical explorations of the issue of rhythmic interactions. Rhythmic sounds are distinguished from stereotypical and meaningless sounds produced by the analysand, whether or not they are accompanied by body movements, and their function of activating representations and amplifications in the analyst's mind is explored in the stage of treatment when the child does not yet speak. The Jungian concept of amplification is considered and revisited in this context.     

Western and East Asian sociocultural learning models: Evidence from cross‐cultural and immigrant research

We review Li's research and theory of cultural learning models in light of Chirkov's (2019) theory of sociocultural models that draw on previous theories and research across social sciences. We recast Li's models as sociocultural learning models (SCLMs) by incorporating Chirkov's three emphases: (a) the inseparability between the social and the cultural, (b) the public versus individuals’ internalization of SCLMs and their mutual enforcement, and (c) collective intentionality and intersubjectivity as embedded in the enactment of SCLMs. As an initial attempt to document how public SCLMs become internalized, we further examine the role of joint intentionality and intersubjectivity at the person‐to‐person level. We use discourse analysis to look at two mother–child conversations about learning from our current European American and Chinese immigrant research data. We show evidence that both joint intentionality and intersubjectivity are prevalently and deeply present in the process of parental socialization (transmitting SCLMs to their young). We conclude that intentionality and intersubjectivity are indispensable to enable SCLMs to exist and to continue by enabling the public to become internalized. The internalization is then enacted and repeated by members across the culture, who in turn function to uphold and renew SCLMs.     

Intersubjectivity,otherness, and thirdness: A necessary relationship

The author proposes an interplay among the notions of otherness, intersubjectivity and thirdness with its coincidences and oppositions. Its polysemic nature is analyzed in this paper. The relation internal world–external world is at stake and concerns both the construction of subjectivity as well as the way the analytic relation is deemed to assume. This review focuses on the psychoanalytic developments from Freud to posfreudian and contemporary authors plus, at the same time, interdisciplinary proposals are also included. It is also revisited the notion of “analytic field”, proposed by Willy and Madeleine Baranger who, early as 1961‐62, underlined the transition from “the unipersonal to the intersubjective”, emphasizing that this was an expression of a change in the understanding of the analytic treatment. In this paper, the author argues that the concept of otherness introduces a symbolic aspect of decentring into the seeming interactive symmetry of intersubjectivity. At the same time, it is stressed that thirdness places a wedge into the between‐subjects, which opens the way from and to recognition of the other and others.     

Neutrality,tenderness and the analyst's subjectivity

Addressing the rôle of the analyst in the psychoanalytic relationship, the author takes issue with the emphasis on acknowledging the analyst's subjectivity and the critique of concepts like neutrality and abstinence as these issues are presented in the relational tradition. He advocates a better articulation and emphasis of these concepts in the service of understanding the impact of the analyst's subjectivity, and demonstrates how the mere loosening up of analytic neutrality and abstinence and an acceptance of the analyst's self-disclosure make transference analysis more difficult to handle. Such an attitude also increases the risk for ethically dubious conduct, since there is a close link between clinical methods and ethical standards in psychoanalysis. In conclusion, the author points to the importance of the analyst's continuous self-reflection and countertransference analysis.     

Psychoanalytic Companioning

In this paper I offer an integration of object relations and relational conceptions of clinical interaction and suggest a register of psychoanalytic companioning. I suggest that when working with patients and states where there is no self-other definition and therefore no mutuality, the path to healing and growth is via companioning the patient into the darker, more regressed and unformed states of illusion and merger rather than via the promotion of separateness and relatedness, which, I propose, will accrue from within the companioning register. The analyst works from within an unobtrusive relational position. I offer a case example of my work in this register and suggest that this offers a different register of the use of the analyst’s subjectivity: one that is receptive, “cooperative” (Trevarthen) and responsive to the patient’s internal world and objects, rather than analytic and knowing. I consider the dimensions of intersubjectivity that cohere with the dimensions and levels of the patient’s mentalization as outlined by Leciurs and Bouchard (1997).     

Pentheus rather than Oedipus: On perversion,survival and analytic ‘presencing’1

Following an introductory review of the main developments in the psychoanalytic thinking on perversion, the author focuses on her own understanding of perversion and its treatment, based on the psychoanalytic treatment of patients with severe sexual perversions. This paper uses the term ‘autotomy’ (borrowed from the fi eld of biology) to describe perversion formation as an ‘autotomous’ defence solution involving massive dissociative splitting in the service of psychic survival within a violent, traumatic early childhood situation; thus, a compulsively enacted ‘desire for ritualised trauma’ ensues. The specifi c nature of the perverse scenario embodies the specifi c experiential core quality of the traumatic situation. It is an actual repetition in the present of the imprint of a past destructive experience which is pre‐arranged and stage‐managed; it thus encounters haunting scenes of dread or psychic annihilation while, at the same time, controlling, sanitising and disavowing them. Hence, the world of severe perversion is no longer oedipal, but rather the world of Pentheus, Euripides's most tragic hero‐a world dominated by a mixture of a mother's madness, devourment, destruction and rituals of desire. According to this view, the (diffi cult) psychoanalytic treatment of perversion focuses on patient‐analyst interconnectedness‐brought about by the analyst's ‘givenness to being present’ or ‘presencing’‐at a deep, primary level of contact and impact (the emphasis being on the ontological dimension of experience). This evolving therapeutic entity creates and actualises a new, alternative experiential‐emotional reality within the pervert's alienated world, eventually generating a change in the perverse essence. The author illustrate this approach with three clinical vignettes.     

THE ANALYST'S WAY OF BEING: RECOGNIZING SEPARABLE SUBJECTIVITIES AND THE PENDULUM'S SWING

Whether the analyst finds the patient's emerging transference affectively tolerable or intolerable plays an important role in the analytic couple's negotiation of the configuration that the transference‐countertransference relationship ultimately assumes. If the analyst is deeply repelled by transference‐related roles to which he is assigned, patient‐ascribed attributions, or projection‐drenched interactions, he may react in violent protest, engaging in enactments that say more about his separable subjectivity than about the intersubjective situation. While there has been a recent trend to view enactments as a crucial aspect of psychoanalytic technique, this trend risks overlooking the way in which the analyst's way of being comes into play in the treatment.     

Affective Honesty and Compassion Come in Many Forms: Discussion of “Love (and Hate) With the Proper Stranger: Affective Honesty and Enactment,” By Holly Levenkron,L.I.C.S.W.

Holly Levenkron's work with her patient, Ali, beautifully illustrates one way that a creative analyst makes superb use of her own experience to communicate and negotiate with great affective honesty. Holly's analytic style emphasizes the effective use of a particular kind of self-disclosure and a way of thinking about intersubjectivity and enactment associated with the contemporary Relational movement. Yet, it may be Holly's personal willingness to allow the analytic relationship to profoundly destabilize and influence her that most engages Ali in their work.

An imaginary analytic scenario is described with an analyst, Dr. X, who like Holly is destabilized by Ali but whose thinking about intersubjectivity and enactment emphasizes an empathic immersion in Ali's experience of the analytic relationship. In contrast to Holly, Dr. X focuses primarily on grasping and interpreting the adaptive strivings that animate Ali's differently organized subjective world.

The underlying capacity to acknowledge and use the analyst's own version of the patient's issues may also characterize analyses such as that of the hypothetical Dr. X—in style that are more explicitly “interpretive” (less confrontative) than Holly's work. These two contrasting approaches highlight the wide range of ways to think about intersubjectivity, enactment, and affective honesty in the analytic process.     

Breakthroughs and Phallacies: Commentary on Paper by Dianne Elise

This is the third in a series of papers comparing the work of three contemporary theorists, each of whom is associated with the intersubjective turn in psychoanalysis: Jessica Benjamin (Gerhardt, Sweetnam, and Borton, 2000), Christopher Bollas (Gerhardt and Sweetnam 2001), and Darlene Ehrenberg. This paper describes aspects of the work of Ehrenberg and attempts to show how her trailblazing ideas of the therapeutic relationship and its nuanced particularities bear on issues in intersubjectivity theory. Ehrenberg's distinctive twist lies in her painstaking exploration of the processes of mutual influence in the ongoing therapeutic interaction and their bearing on the analytic process. The manner in which Ehrenberg attempts to integrate both interpersonal and intrapsychic perspectives and uses the interpersonal as a way of locating the intrapsychic is another focus of this inquiry. Moreover, the sense conveyed through Ehrenberg's voice—a voice both sensuous and strident, tender and provocative—in her attempt to make living, breathing contact in the moment with patients otherwise deadened to their own desire is also examined as bearing on issues associated with the intersubjective turn. While our own authorial positioning is never quite declared, our object relational biases exert their influence throughout our reading of her work, not surprising for a paper on intersubjectivity.     

Situational influences on the desirability of different objects of affiliation

The desire to affilitate was examined as a function of two variables: situational context and the type of potential companion. Data were collected via four questionnaires composed of 48 identical items. Each item described a specific situation related to one of four situational clusters previously extracted by factor analytic method (Fox, 1980) and reconfirmed in this study. Each questionnaire examined the desirability of a particular type of companion in various situations (being alone, or with intimates, acquaintances, or strangers). The subjects consisted of 900 male Israeli high school students, 17-19 years of age, each of whom responded to two out of the four questionnaires. The situational factor had the decisive effect on the affiliative preferences. There was a general desire for companionship in pleasant as well as threatening situations, whereas solitude was preferred when concentration was necessary or in periods of unpleasant moods. Across situational categories, there was a relatively less marked preference for the company of intimates over that of acquaintances and strangers, who appear to be equally desirable objects of affiliation. The interaction between situational and companion factors was minimal, in contrast to hypothesis. The results are illuminated in the context of utility affiliation theory. Ths research was supported in part by a grant from the Research Authority, Bar-Ilan University.     

AN ANALYST'S UNCERTAINTY AND FEAR

The motivations for choosing psychoanalysis as a profession are many and differ depending on the psychology of the analyst. However, common to most psychoanalysts is the desire to forge a helpful relationship with the individuals with whom they work therapeutically. This article presents an example of what happens when an analyst is confronted by a patient for whom being in a relationship and being helped are intolerable.     

Enactive Fields: An Approach to Interaction in the Kleinian-Bionian Model: Commentary on Paper by Lawrence J. Brown

In taking up the matter of intersubjectivity in Kleinian-Bionian theories Brown creatively reimagines the clinical situation, transcending demarcations of analytic schools to arrive (though never fully arrive) at new understandings of interaction. I discuss Brown's engaging paper from my own emerging concept of enactivity, drawing distinctions between this approach and Bion's approach and extending the enactive to a consideration of enactive fields that, like Brown's paper, draws on the seminal reinterpretation of Kleinian theory by the Barangers. In writing of the field as an emergent process of becoming I rely on Merleau-Ponty's notion of “singing the world” to illustrate my developing understanding of the possibilities for interaction in the Kleinian-Bionian tradition. My comments on Brown's clinical case material focus on what appears to me to be the intersubjective aspects of his approach.     

5～8岁儿童二级信念-愿望推理能力的发展

该研究依据信念(正确-错误)和愿望(接近-回避)对儿童的二级信念-愿望推理能力进行了细分,并据此设计了四个二级信念-愿望任务,探讨了480名5～8岁儿童在四个任务上的表现。结果发现,对儿童而言,不同的二级信念-愿望任务的难度不同,由易到难的顺序依次为:二级真实信念接近愿望、二级错误信念接近愿望、二级真实信念回避愿望、二级错误信念回避愿望。     

Which Horse do You Ride? Trauma from a Relational Perspective. Discussion of Prince's “The Self in Pain: The Paradox of Memory. The Paradox of Testimony”

Discussing Dr. Robert Prince's clinical case example, the author presents a relational psychoanalytic perspective on working with the traumatized patient. She considers the presentation of his work with a Holocaust survivor from a relational perspective with particular attention to the dyadic interaction, the intersubjectivity and co-creations of patient and analyst, and finally, addresses the role of the “witness” in psychoanalytic work. The idea of the witness has particular currency in contemporary psychoanalytic thinking. The author briefly examines the dimensions of the “witness” from a relational point of view. Consideration is also given to the necessary distinction between adult onset and childhood onset trauma and the repercussions of each for the analytic couple.     

Weeds on the Ruins: Agency,Compromise Formation,and the Quest for Intersubjective Truth

Using Kundera's metaphor of “weeds on the ruins” to examine the impact of organized destruction of memory on the survival of a people, this paper explores the role of symptoms in negotiating a relational “compromise formation” by tracing their evolution as signifiers of previously dissociated intersubjective knowledge. It suggests that recent theorizing on the mutual constitution of agency and intersubjectivity creates the possibility of resurrecting the dramatic tension that characterized dual drive theory by relocating that tension between the desire to know (oneself, the Other) and the destruction of that desire. To do so, the paper contemplates an internally consistent lens for reconciling the terrain of deficit and dissociation with that of conflict by offering a process-oriented view of agency as “drive” that is rooted between subjective and material contexts. Finally, the paper explores the quest for intersubjective truth as offering a means of living beyond the ubiquity of compromise formation.     

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.     

Perversion: a clinical possibility

Abstract

Clinical work with perverse patients presents numerous difficulties to psychoanalysis, be that due to the characteristics typical of the perverse structure, which is founded on the mechanism of disavowal, or to the inefficiency of neutrality and free association in this kind of practice. A study of existing literature on the subject and a thorough examination of their own clinical findings led the authors to propose a different kind of strategy for dealing with transference that would make clinical work with these patients plausible and indicate options for the paralyzing position that is imposed on the analyst by the perverse patient in order to derange the analytic process. By proposing an alternative for the “semblance subject-supposed-knowledge,” the authors defend the idea that clinical work with perverse patients is possible, resulting in a subject less captive of the phantasmagoric scene.

Drummond S et al. Perversion: eine klinische Möglichkeit

Klinische Arbeit mit perversen Patienten bildet zahlreiche Schwierigkeiten für die Psychoanalyse, sei es wegen der Eigenart der perversen Struktur, welche durch den Mechanismus der Verleugnung begründet wird oder sei es wegen der Ineffektivität der Neutralität und freien Assoziation bei dieser Art von Praxis. Ein Studium der vorhandenen Literatur über das Thema und eine gründliche Überprüfung eigener klinischer Befunde führte die Autoren dazu, eine unterschiedliche Art von Strategie des Umgangs mit Übertragung vorzuschlagen. Das würde klinische Arbeit mit diesen Patienten plausibel machen und auf Optionen für die paralysierende Position hinweisen, die dem Analytiker durch den perversen Patienten aufgebürdet wird, um den analytischen Prozess zu stören. Ein Alternative für das “semblance subject-supposed knowledge” vorschlagend, verteidigen die Autoren die Idee, daß klinische Arbeit mit perversen Patienten möglich ist, mit dem Ergebnis eines Subjekts, welches weniger durch die phantasmagorische Szene gefesselt ist.

Drummond S et al. perversión: una posibilidad clínica.

El trabajo clínico con pacientes perversos presenta numerosas dificultades para el psicoanálisis, puede ser debido a las características típicas de la estructura perversa, fundamentado en le mecanismo de repudio, o debido a la ineficacia de la neutralidad y asociación libre en este tipo de práctica. Un estudio de la literatura existente sobre el tema y un examen completo de los hallazgos clínicos, llevó a los autores a proponer un tipo diferente de estrategia para el manejo de la transferencia, que pudiera hacer posible el trabajo clínico con estos pacientes, también indicar opciones para la situación de paralización que estos pacientes imponen al analista para desorganizar el proceso analítico. Con la proposición de una alternativa para la “semblance-subject-supposed knowledge(apariencia del sujeto-supuesto saber),” el autor defiende la idea de que el trabajo clínico con pacientes perversos es posible, resultando un asunto menos cautivo de la escena fantasmagórica.