OM PROJEKTIV IDENTIFIKATION; FEM PSYKOANALYTIKER TILLÄMPAR BEGREPPET UTIFRÅN OLIKA PERSPEKTIV

Understanding another person's mind is based on a shared frame of reference that derives from primary identification. In a psychotic disorder, this metaphorical configuration becomes damaged, leaving the ego in a state of extreme helplessness. To safeguard at least a minimum of psychic survival in this situation, the helpless ego resorts to a delusion that will form a surrogate frame of reference, which is no longer linked to primary identification, but to autoerotic excitations and self-induced affect states. The treatment of a psychotic patient should aim at the recovery of the original frame of reference based on primary identification and represented by the analyst in the analytic setting. The shared understanding of the patient's extreme helplessness paves the way for the unfolding of object directional needs and wishes in the therapeutic relationship and for their gradual internalisation into a more solid psychic structure.     

Christer Sjödin interviews Jan Stensson

Abstract

The author examines different definitions and applications of the terms “psychic energy” and “libido.” With regard to the “psychic energy” terminology, he shows that its application and usage relate in particular to the perspective of Brenner and not to Freud's definition. He argues that Freud uses the term “psychic energy” as a synonym for “libido,” and not “libido” as a synonym for “psychic energy.” It is demonstrated that in Freud's view, up until 1914, “libido” relates to manifestations of bodily sexual tensions, and subsequently this term applies to the manifestations of sexual energy in the psychic field. The author rejects this change in terminology and also challenges Freud's attempt to use dynamic-economic considerations as an explanatory device for epistemological reasons. Freud's concept of energy is inconsistent with the meaning of energy as defined in the physical sciences, and whereas the metapsychological topographical, dynamic, and structural viewpoints have a solid foundation in the representational world to which the psychoanalytic process affords unique access, this is not true of the economic viewpoint. It is claimed that bodily tensions only exist in the representational world in the form of affects, so that, in the author's opinion, the economic viewpoint should be abandoned in favour of an affective one. In the context of the endeavour to obtain pleasure and avoid unpleasure adduced by Freud, this viewpoint focuses on the relationships between affects and the different elements of the representational world, thereby serving as the subject of metapsychological investigation.     

Regulation of Negative Affect During Mother–Child Problem-Solving Interactions: Adolescent Depressive Status and Family Processes

Despite recent suggestions that depression can be conceptualized as a disorder of affect regulation, relatively little research has focused on affect regulation skills in depressed individuals. This paper investigated whether depressed adolescents (N = 25) differ from nondepressed adolescents (N 25) on two indices of affect regulation (i.e., duration of negative affective states and reciprocity of maternal negative affect) as well as whether these indices are related to microsocial family interactional processes. Analyses revealed that depressed teens differed from their nondepressed peers with regard to duration of negative affective states but not in their likelihood of reciprocating negative affect. Additionally, indices of adolescent affect regulation were related to family interactional processes. Duration of depressive affect was positively associated with maternal display of facilitative behavior contingent on adolescent depressive behavior. Duration of aggressive behavior was inversely related to maternal problem-solving responses to aggressive behavior. Finally, adolescent reciprocity of maternal depressive and aggressive behaviors was strongly associated with mothers' reciprocity of adolescents' negative affective behavior.     

Emptiness as defense in severe regressive states

This paper examines the empty states experienced by severely ill borderline patients. At times of stressful regression, these patients use complaints of emptiness to describe profound disturbances of affect, cognition, object relations, and bodily experience. Empty states may be seen as complex defensive configurations which protect a borderline level of psychic structure from the impact of aggressively charged object relations, and ward off further regression to states of fragmentation or fusion. Severely ill borderline patients consolidate an empty screen by means of a characteristic repertoire of primitive defenses consisting of various forms of projective identification, including bitriangulation and projective identification of psychic agencies, somatization, acting out, and specific alterations in cognition. The author describes the highly deviant organizations of the object world seen in empty states, and the complex and disturbing countertransferences which these states evoke.     

Memory: Between traumatic shock and psychic historicization

‘I want to erase him from my memory,’ she said, ‘his eyes, his eyes staring at me … they are there every night, his hand … every night it hits me again and again …’. On the basis of these few words taken from the therapeutic work with Keltoum, the author reflects theoretically and clinically on the place of memory in a traumatism: a fixed memory, a ‘frozen image’, the signs of a traumatic compulsion to repeat, are the expressions of a process of psychic disorganization but also of a ‘symbolized and symbolizing’ memory anticipating a possible historicization of this memory, of a path, therefore, towards a resolution of the trauma resulting from a process of psychic integration and reorganization.     

Levels of Emotional Awareness: a model for conceptualizing and measuring emotion-centered structural change

The need to establish the efficacy of psychoanalytic long-term treatments has promoted efforts to operationalize psychic structure and structural change as key elements of psychoanalytic treatments and their outcomes. Current, promising measures of structural change, however, require extensive interviews and rater training. The purpose of this paper is to present the theory and measurement of Levels of Emotional Awareness (LEA) and to illustrate its use based on clinical case vignettes. The LEA model lays out a developmental trajectory of affective processing, akin to Piaget's theory of sensory-cognitive development, from implicit to explicit processing. Unlike other current assessments of psychic structure (Scales of Psychological Capacities, Reflective Functioning, Operationalized Psychodynamic Diagnostics) requiring intensive rater and interviewer training, it is easily assessed based on a self-report performance test. The LEA model conceptualizes a basic psychological capacity, affect processing. As we will illustrate using two case vignettes, by operationalizing implicit and explicit modes of affect processing, it provides a clinical measure of emotional awareness that is highly pertinent to the ongoing psychoanalytic debate on the nature and mechanisms of structural change.     

Tacit assumptions,countertransference and psychoanalytic technique. Part two: The influence of countertransference on theory and technique

In this article, the author examines bodily symptoms attributed to psychic mediating factors in the light of a psychoanalytic model of affect and sym- bolization. He uses clinical material from a consultation-liaison setting and a psychoanalytic treatment to illustrate how the model might help to understand different bodily symptoms as manifestations of different degrees of failure in the psychic elaboration of affect. On a more personal note, this could be seen as an attempt to understand, using a newly acquired conceptual tool, what went on in his 20 years of experience in the general hospital psychiatry setting.     

The Rubber Hand Illusion: two's a company, but three's a crowd

On the one hand, it is often assumed that the Rubber Hand Illusion (RHI) is constrained by a structural body model so that one cannot implement supernumerary limbs. On the other hand, several recent studies reported illusory duplication of the right hand in subjects exposed to two adjacent rubber hands. The present study tested whether spatial constraints may affect the possibility of inducing the sense of ownership to two rubber hands located side by side to the left of the subject's hand. We found that only the closest rubber hand appeared both objectively (proprioceptive drift) and subjectively (ownership rating) embodied. Crucially, synchronous touch of a second, but farther, rubber hand disrupted the objective measure of the RHI, but not the subjective one. We concluded that, in order to elicit a genuine RHI for multiple rubber hands, the two rubber hands must be at the same distance from the subject's hand/body.     

Temporality and psychopathology

The paper first introduces the concept of implicit and explicit temporality, referring to time as pre-reflectively lived vs. consciously experienced. Implicit time is based on the constitutive synthesis of inner time consciousness on the one hand, and on the conative–affective dynamics of life on the other hand. Explicit time results from an interruption or negation of implicit time and unfolds itself in the dimensions of present, past and future. It is further shown that temporality, embodiment and intersubjectivity are closely connected: While implicit temporality is characterised by tacit bodily functioning and by synchronisation with others, explicit temporality arises with states of desynchronisation, that is, of a retardation or acceleration of inner time in relation to external or social processes. These states often bring the body to awareness as an obstacle as well. On this basis, schizophrenia and melancholic depression are investigated as paradigm cases for a psychopathology of temporality. Major symptoms of schizophrenia such as thought disorder, thought insertion, hallucinations or passivity experiences may be regarded as manifesting a disturbance of the constitutive synthesis of time consciousness, closely connected with a weakening of the underlying pre-reflective self-awareness or ipseity. This results in a fragmentation of the intentional arc, a loss of self-coherence and the appearance of major self-disturbances. Depression, on the other hand, is mostly triggered by a desynchronisation from the social environment and further develops into an inhibition of the conative–affective dynamics of life. As will be shown, both mental illnesses bear witness of the close connection of temporality, embodiment and intersubjectivity.     

Affectivity: Regulation,Identity Formation,and Metaphorical Thought

ABSTRACT

Understanding affects, and their multiple roles in all aspects of the human condition and development, has more and more become a focus of study for contemporary psychoanalysis. Psychodynamic personality theories have always regarded affective life as pivotal to developmental experiences, the evolving structures of the personality, identity formation, and clinical processes. The centrality of emotion in development and affect regulation, as a maturational theme in the adolescent stage, are explored through the views afforded by object relations theory and ego psychology, intersubjectivity, the second separation individuation process, and unconscious metaphorical thought in the dream states of two clients and their therapist.     

Affect regulation and Depressive Personality Disorder

Depressive Personality Disorder (DPD) has been under consideration for inclusion in the Diagnostic and Statistical Manual of Mental Disorders since 1994; yet, few studies have been published that test whether those with DPD have affective experiences that are characterized exclusively by depression and negative affect. One hundred ninety-seven undergraduate students were interviewed for DPD and Borderline Personality Disorder with the Personality Disorder Interview for DSM-IV (Widiger, Mangine, Corbitt, Ellis, & Thomas, 1995), in order to control for frequently co-occurring BPD which is characterized by affective lability. Participants also were administered measures of affective lability, affective intensity, anxious and depressive states, and more trait-like manifestations of depression, anxiety, and anger. Results indicate that those with DPD may be described as having a mood state characterized by transitions from a baseline neutral mood to one of anxiety, with their experiences being more prominently depressed and dysphoric. They also have tendencies toward angry hostility, though they may not report frequent shifts from a baseline neutral mood to anger. Those with DPD also report intense, frequent experiences of depression and dysphoria, with many shifts between depression and anxiety.     

Interventions on causal exclusion

Two strains of interventionist responses to the causal exclusion argument are reviewed and critically assessed. On the one hand, one can argue that manipulating supervenient mental states is an effective strategy for manipulating the subvenient physical states, and hence should count as genuine causes to the subvenient physical states. But unless the supervenient and subvenient states manifest some difference in their manipulability conditions, there is no reason to treat them as distinct, which in turn goes against the basic assumption of nonreductive physicalism. On the other hand, one can preserve the distinction between the two by introducing asymmetric manipulability conditions that the supervenience thesis entails. But this response can be used to argue that mental causes never have physical effects. However, this argumentation can also be used to show that mental causes can have mental effects.     

In the mood for adaptation: how affect regulates conflict-driven control

Cognitive conflict plays an important role in tuning cognitive control to the situation at hand. On the basis of earlier findings demonstrating emotional modulations of conflict processing, we predicted that affective states may adaptively regulate goal-directed behavior that is driven by conflict. We tested this hypothesis by measuring conflict-driven control adaptations following experimental induction of four different mood states that could be differentiated along the dimensions of arousal and pleasure. After mood states were induced, 91 subjects performed a flanker task, which provided a measure of conflict adaptation. As predicted, pleasure level affected conflict adaptation: Less pleasure was associated with more conflict-driven control. Arousal level did not influence conflict adaptation. This study suggests that affect adaptively regulates cognitive control. Implications for future research and psychopathology are discussed.     

Affect regulation and synchrony in mother—infant play as precursors to the development of symbolic competence

This study examines relationships between organizing processes of affective communication in infancy and the development of symbolic competence. Thirty six mother—infant dyads were observed at 3 and 9 months, and 32 dyads were reassessed at 24 months. Mother's and infant affective states during face-to-face play at 3 and 9 months were coded in .25-second frames. The underlying structure of infant affect and the time-lag synchrony between mother and infant affective states were assessed with time-series analyses. In addition, interactions at 3 and 9 months were assessed for the global level of infant positive affect and maternal affect attunement. At 2 years, three dimensions of symbolic competence were evaluated: symbolic play, verbal IQ, and the child's use of internal states words. Infant affect regulation at 3 months, defined by the existence of a non-random, stochastic-cyclic organization of affective states, predicted all three domains of symbolic competence at 2 years. Maternal synchrony and attunement each had an independent contribution to the prediction of symbolic play and internal state talk. The microanalytic and global indices of affect each added meaningfully to the prediction of symbolic functioning. The organization of behavioral sequences into coherent affective configurations is discussed as a possible precursor to the general capacity to develop symbols. © 1997 Michigan Association for Infant Mental Health     

Do We Know How Happy We Are? On Some Limits of Affective Introspection and Recall

This paper aims to show that widespread, serious errors in the self‐assessment of affect are a genuine possibility—one worth taking very seriously. For we are subject to a variety of errors concerning the character of our present and past affective states, or “affective ignorance.” For example, some affects, particularly moods, can greatly affect the quality of our experience even when we are unable to discern them. I note several implications of these arguments. First, we may be less competent pursuers of happiness than is commonly believed, raising difficult questions for political thought. Second, some of the errors discussed ramify for our understanding of consciousness, including Ned Block's controversial distinction between access consciousness and phenomenal consciousness. Third, empirical results based on self‐reports about affect may be systematically misleading in certain ways.     

Some remarks about relativism and pseudo‐relativism in ethics

This article deals with socio‐cultural ethical relativism. An attempt is made to analyze an ethical relativistic statement, i.e. a statement which, prima facie, ascribes different value‐qualities to the same type of conduct, depending on the society in which it occurs. The conclusion arrived at is that, in the main, such statements do not express genuine relativism. On the other hand, views which can be regarded as genuinely relativistic, arc found to lack plausibility.     

HOMOSEXUALITY OR HOMOEROTICISM?: ‘NARCISSISTIC EROTICISM’

It may be dangerous for a psychoanalyst to let him/herself be influenced by the social and media pressure that proposes the use of the term 'homosexual' to describe the affective functioning of a homophile, for this assumes—from the outset—that it is of a truly sexual nature. However, following certain Freudian writings and the works of Férenczi in 1911, we know the different mechanisms of the narcissistic register that come into play in the quite particular relational behaviour that should more relevantly be called 'homoeroticism'. On the other hand, our diagnostic and therapeutic approach will benefit from not considering, at the outset, all the economically and psychogenetically very different varieties of homoeroticism, male or female, latent or manifest, in too global a fashion, with reference also to the Freudian concept of psychic bisexuality. The French psychoanalytical research team working with the author has focused on these important issues for a number of years now. This article aims to give a fairly brief account of its work, with the objective of opening up a discussion amongst psychoanalysts, within the framework of Freudian thought.     

Affect and the therapeutic action of psychoanalysis1

In connection with controversial IJP articles by Stern et al. and Fonagy on the interpretation of the repressed and the recovery of past memories, the author maintains that the affect that is inherent in positive transference is at the heart of therapeutic action. Points of view put forward in the controversy (based on neurobiological knowledge) are related to Freudian metapsychology, as well as to their precursors whose scope was necessarily limited by a lack of access to more recent scientific discoveries. The author demonstrates metapsychological elements of therapeutic action inherent in the intersubjective relationship, especially identification, manifested in introjection and empathy. He describes cognitive development as spontaneously blossoming from the affective nucleus, and he explains the neuroscientic bases of this step forward. The classic (interpretative) psychoanalytic method makes up the cognitive superstructure necessary for the organisation of the mind that has sprung from the affective substructure. As a primary factor in psychic change, interpretation is limited in effectiveness to pathologies arising from the verbal phase, related to explicit memories, with no effect in the pre‐verbal phase where implicit memories are to be found. Interpretation the method used to the exclusion of all others for a century is only partial; when used in isolation it does not meet the demands of modern broad‐spectrum psychoanalysis, as the clinical material presented illustrates.     

Coping as a building mechanism to explain the unique association of affect and goal motivation with changes in affective states

Background and objectives: In this study, we examined the mediating role of university students’ coping strategies in the unique/additive influence of affective states and goal motivation on upward changes in affect during a midterm exam period. Design: Using a short-term prospective design, key assumptions from the self-concordance model and the broaden-and-build theory were drawn upon to determine whether coping strategies are influenced by goal motivation and affective states, while also subsequently influencing short-term changes in affective states during a semester. Method: A sample of 272 students (79% females and 21% males) participated in a study in which they completed questionnaires twice during the semester. Results: Results of structural equation modeling, using a true latent change approach, have generally supported our hypotheses. Positive affective states and autonomous goal motivation prospectively predicted task-oriented coping which, in turn, was associated with increases in positive affect. Negative affective states and controlled goal motivation prospectively predicted disengagement-oriented coping which, in turn, was associated with increases in negative affect. Conclusion: Coping partially mediates the unique association of affect and goal motivation with changes in affective states of university students.