Disintegration of the self and the regeneration of ‘psychic skin’ in the treatment of traumatized refugees

This paper presents a tentative understanding of the characteristics of the extreme traumas, elsewhere called ‘complex PTSD’, that some refugees and asylum‐seekers bring into therapy. It suggests that these kinds of traumas suffered during adulthood may involve a disintegration of the self and a loss of ‘psychic skin’. This conceptualization is derived from the treatment of a refugee who survived multiple extreme traumas and with whom efforts were made in therapy to identify a complex methodology making use of supplementary therapeutic tools in addition to individual psychotherapy. The case demonstrates how the disintegration of self implies not only a deep somato‐psychic dissociation, but also a loss of intrapsychic and interpersonal space. In the treatment this was worked through via repetition of the victim‐aggressor dynamics at multiple levels. In the end, the therapeutic context was structured like a set of concentric layers, creating a ‘bandage’ over the patient's wounds whilst his ‘psychic skin’ was able to regenerate. The conditions triggered by extreme traumas in refugees challenge some of the cornerstones of individual psychoanalytic technique, as well as the idea that individual therapy may be thought of as existing in an environmental vacuum.     

A slow unfolding – at double speed: reflections on ways of working with parents and their young children within the Tavistock clinic's under fives service

This paper describes clinical work carried out as part of the Tavistock Clinic Under Fives Service, which offers brief focused psychoanalytically based interventions to families with young children, as well as longer-term work. It elaborates psychoanalyst Annette Watillon's idea that it is the dramatic way in which children enact their (and their family's) predicament in the consulting room which speeds up the process of change. The author clusters clinical cases into three categories, each cluster representing a different kind of ‘dramatic’ enactment and leading to a different kind of intervention relating to the therapist's role, the structure of the interventions and the ‘ports of entry’ for the work. The categories are defined as: ‘child-led drama’ with the therapist in the role of ‘therapeutic observer’; ‘internal parental drama’ with the therapist in the role of ‘therapeutic consultant’; and ‘external parental drama’ with the therapist in the role of ‘therapeutic modulator’. The author defines these categories, illustrating each category with clinical examples.     

Establishing Therapeutic Dialogue with Refugee Families

The article describes an investigation into dialogues between native Swedish psychotherapists and refugee families. Dialogue is needed to establish the therapeutic alliance, which is ultimately important for healing, whether of individual sickness or family crisis. However the development of dialogue is hindered by cross-cultural and language barriers. We concentrate on one aspect of research originally presented in a Doctoral Thesis by the first author, asking how culture and power differences, together with their resettlement in a strange country, affected meetings with refugee families, and how these problems were overcome; language and the presence of an interpreter are not discussed. A multi-perspective methodology was used in the original research, combining text analysis, review of video-recordings by the participating therapists, and interviews with the families. All these forms of investigation are drawn on here, but particularly text analysis. Significant hindrances to dialogue turn out to be differences in cultural values between refugee and therapist, their different power positions, and the refugee’s weariness and distrust of meetings. Strategies to minimise power differences are an essential aspect of the Finnish open dialogue approach, which turns out to be particularly relevant to such refugee meetings.     

Being in‐between: The relevance of ethnography and auto‐ethnography for psychotherapy research

Aims: This paper proposes that ethnography and auto‐ethnography can make important contributions to counselling and psychotherapy research. Auto‐ethnography is a recent methodological approach that focuses on the subjective experiences of the researcher. It is informed by anthropology, which encourages the researcher to journey alongside the persons being observed and to make meaning of complex symbolic systems in their lives. Method: Examples from a study of therapeutic processes in a mental health setting for women are examined. Discussion: If auto‐ethnography situates the researcher with the insider's perspective and ethnography is from the outsider's perspective, the researcher is caught ‘in‐between’ these two approaches. Acknowledging the concept of ‘in‐between‐ness’ can both cause discomfort and transform the experience of all who engage in the process and enhance the quality of the research.     

Purity and danger in the solar temple

Based on research conducted in Québec, this study explores the shape of the social life, apocalyptic ideology and authority structure of the Ordre du Temple Solaire (OTS) or Solar Temple within the framework of Mary Douglas's typology of ‘group and grid’. The pollution fears and purity rituals of this controversial new religious movement are analysed as an important factor in their decision to orchestrate a religiously‐motivated mass suicide/homicide, explained in their suicide documents as a ‘transit’ (a magical feat of soul travel) to the Star Sirius. Douglas's insights into how the human body becomes a ‘natural symbol’ for small, persecuted groups, mirroring the social body and the vulnerability of its exits and entrances vis‐à‐vis the surrounding culture, are applied to the alternative patterns of sexuality and parenting in the OTS. It is suggested that the magical aspect of the mass suicide expressed a concern for purity and for protecting the boundaries of their community. It is also suggested that the ritual homicides in Morin Heights resemble the ‘witch‐hunts’ characteristic of Douglas's ‘small society’ that conceives of itself as the perfect, impermeable vessel.     

White is a colour too: engaging actively with the risks,challenges and rewards of cross‐cultural family therapy training and practice

Due to increased global mobility and displacement there is a growing cultural diversity within therapeutic encounters between therapists and clients. Literature on cross‐cultural therapy traditionally focuses on the culture of clients. However, due to recent theoretical shifts in the family therapy field, the importance of including the culture of therapists in the discourse about cross‐cultural therapy has been highlighted. Drawing on the experience of the author, as therapist, trainee and trainer, as well as recent developments in the literature, this paper reflects on cross‐cultural training and practice within family therapy in Britain. The author argues that white is a colour too, thus challenging ‘white’ therapists not to leave thinking about and addressing cross‐cultural issues in family therapy to their colleagues ‘of colour’, but to actively engage with the risks and uncertainties of cross‐cultural learning and practice. Ways to facilitate this process are suggested. In particular a multi‐dimensional approach that allows for complexity and contradiction is promoted and the potential of using the personal life experiences of therapists as a safe, non‐pathologizing training tool is discussed.     

Secret passages: the theory and technique of interpsychic relations

Semi-structured interviews were carried out with six individuals who unilaterally discontinued long-term psychoanalytic psychotherapy. Their six therapists were separately interviewed. The twelve interviews were analysed using qualitative methodology. The results suggest that individuals who ‘drop-out’ of therapy could be seen as having ‘dropped-in’ – as part of shopping around for a therapy that suits them or in order to explore a particular therapeutic approach and the extent to which they can tolerate or benefit from it. Most of the therapists felt intensely affected by their patient's decision to leave, and the paper examines how they manage these feelings.     

Constructing the stereotype of immigrants' criminality: Accounts of fear and risk in talk about immigration to Greece

This paper explores the discursive construction of immigrants' criminality in interview accounts obtained by a sample of Greek people in Thessaloniki (Northern Greece). Analysis, which adopts a discursive approach to stereotypes and category construction, indicates that fear and insecurity on the part of Greek people are represented as a sine qua non consequence of immigration to Greece. Two different lines of argument are used to account for the arousal of fear. According to the first, fear constitutes a corollary of a widespread stereotypical representation of immigrants as criminals. The stereotype of immigrants' criminality is considered to be ill‐warranted and it is attributed to the media or to other unspecified people. According to another, more regularly used, line of argument, however, fear is predicated upon the sordid living conditions of immigrants in Greece which make the probability of them being involved in illegal acts particularly high. In this case, fear is seen to derive from a ‘rational estimate’ of the probability of immigrant's involvement in criminal acts. Nested within the discourse of ‘risk’ the stereotypical image of immigrants' criminality is sustained and used to account for the need to protect the ‘ingroup’ from ‘immigrant groups’ through immigration control and surveillance. Copyright © 2011 John Wiley & Sons, Ltd.     

Family in transition: parents,children and grandparents in lesbian families give meaning to ‘doing family’

Lesbian parents, their children and grandparents ‘do family’ in rich and diverse ways. This article draws on innovative grounded theory research using qualitative, multi‐generational family interviews with twenty lesbian‐parented families living in Victoria, Australia. The intersection between the public and the private in lesbian family life has been seriously neglected by family researchers, and in particular the perspectives of family members other than the lesbian parents themselves. This article addresses the question of ‘How members of lesbian‐parented families define and describe their family’, and the results reported here focus on children's and grandparents' views, because they are the voices less well represented in the literature. Children and grandparents straddle both mainstream and marginalized spaces as they negotiate contemporary family life. We examine the interface and tensions between the traditional and the transformative, and the implications of these findings for family therapists are briefly discussed.     

‘Just black sometimes’, part 2: reflections on an adolescent's journey

In this second article about work at a refugee centre for unaccompanied minors in Berlin, the author discusses his encounter with Syrian and Afghani adolescents who were enrolled in the program. Issues around adaptation to a new culture are explored with attention to the dynamics of conformity and marginalization. The questions of what happens to adolescent refugees separated from their families, and how their identity formation is shaped by this burden is explored in relation to the author's meeting with a Syrian adolescent living in Berlin. To illustrate the long reach of a missing father who has been left behind, characters from Virgil's Aeneid are discussed to amplify heroic and spiritual aspects within father‐son relationships. The interplay between needing help and allowing for resilience is explored as an important aspect of refugees’ transitions, while also considering variables such as dependence and independence, foreign and familiar, being with or without family, and adjusting to the present and/whilst relating to the past; tensions between these alternatives can create various psychosocial challenges for adolescent refugees.     

Where are you,my beloved?: On absence,loss, and the enigma of telepathic dreams

The subject of dream telepathy (especially patients' telepathic dreams) and related phenomena in the psychoanalytic context has been a controversial, disturbing ‘foreign body’ ever since it was introduced into psychoanalysis by Freud in 1921. Telepathy ‐ suffering (or intense feeling) at a distance (Greek: pathos + tele)‐is the transfer or communication of thoughts, impressions and information over distance between two people without the normal operation of the recognized sense organs. The author offers a comprehensive historical review of the psychoanalytic literature on this controversial issue, beginning with Freud' years‐long struggles over the possibility of thoughttransference and dream telepathy. She then describes her own analytic encounter over the years with five patients' telepathic dreams' dreams involving precise details of the time, place, sensory impressions, and experiential states that the analyst was in at that time, which the patients could not have known through ordinary sensory perception and communication. The author's ensuing explanation combines contributory factors involving patient, archaic communication and analyst. Each of these patients, in early childhood, had a mother who was emotionally absent‐within‐absence, due to the absence of a significant figure in her own life. This primary traumatic loss was imprinted in their nascent selves and inchoate relating to others, with a fixation on a nonverbal, archaic mode of communication. The patient's telepathic dream is formed as a search engine when the analyst is suddenly emotionally absent, in order to find the analyst and thus halt the process of abandonment and prevent collapse into the despair of the early traumatization. Hence, the telepathic dream embodies an enigmatic ‘impossible’ extreme of patient‐analyst deep‐level interconnectedness and unconscious communication in the analytic process. This paper is part of the author's endeavour to grasp the true experiential scope and therapeutic significance of this dimension of fundamental patient‐analyst interconnectedness.     

Indicating a Translation for ‘Bedeutung’

The translation of both ‘bedeuten’ and ‘Bedeutung’ in Frege's works remains sufficiently problematic that some contemporary authors prefer to leave these words untranslated. Here a case is made for returning to Russell's initial choice of ‘to indicate’ and ‘indication’ as better alternatives than the more usual ‘meaning’, ‘reference’, or ‘denotation’. It is argued that this choice has the philosophical payoff that Frege's controversial doctrines concerning the semantic values of sentences and predicative expressions are rendered far more comprehensible by it, and that this translational strategy fulfills the desiderata of offering a translation which is acceptable both before and after Frege introduced the distinction between sense and reference or, as this paper would have it, between the sense of an expression and what it indicates.     

Floating Provisos and Sinking Islands

Rising sea levels may sink entire countries. Individualistic solutions to this climate catastrophe, such as those proposed by Meisels and Risse, are inadequate on both Kantian and Lockean criteria. This article concurs with Cara Nine's recent argument that such ‘ecological refugee states’ are entitled to territorial remedies. But Nine's proposal, founded on Locke's ‘sufficiency’ proviso and Nozick's famous application of it to waterholes in the desert, is instructively incorrect. Careful consideration of the distinction between land and territory, and of the structure of Proviso arguments, supports a new theory of how territorial claims can be positive‐sum — how the amount of territory can increase even as the land base remains constant or decreases. This normative conception of territory as the ratio of justice to land use provides a better foundation for a political solution to the problem of ecological refugee states and also generates deeper insight into the nature of territory itself. The article thus contributes not only to our thinking about redress for ecological refugees, but also to the burgeoning literatures on territory and on the Lockean Provisos.     

Toward a Perspicuous Presentation of “Perspicuous Presentation”1

Gordon Baker in his last decade published a series of papers (now collected in Baker 2004 ), which are revolutionary in their proposals for understanding of later Wittgenstein. Taking our lead from the first of those papers, on “perspicuous presentations,” we offer new criticisms of ‘elucidatory’ readers of later Wittgenstein, such as Peter Hacker: we argue that their readings fail to connect with the radically therapeutic intent of the ‘perspicuous presentation’ concept, as an achievement‐term, rather than a kind of ‘objective’ mapping of a ‘conceptual landscape.’ Baker's Wittgenstein, far from being a ‘language policeman’ of the kind that often fails to influence mainstream philosophy, offers an alternative to the latent scientism of Wittgenstein's influential ‘elucidatory’ readers.     

Polarity and Inseparability: The Foundation of the Apodictic Portion of Aristotle's Modal Logic

Modern logicians have sought to unlock the modal secrets of Aristotle's Syllogistic by assuming a version of essentialism and treating it as a primitive within the semantics. These attempts ultimately distort Aristotle's ontology. None of these approaches make full use of tests found throughout Aristotle's corpus and ancient Greek philosophy. I base a system on Aristotle's tests for things that can never combine (polarity) and things that can never separate (inseparability). The resulting system not only reproduces Aristotle's recorded results for the apodictic syllogistic in the Prior Analytics but it also generates rather than assumes Aristotle's distinctions among ‘necessary’, ‘essential’ and ‘accidental’. By developing a system around tests that are in Aristotle and basic to ancient Greek philosophy, the system is linked to a history of practices, providing a platform for future work on the origins of logic.     

Mirror Self‐Recognition and Self‐Identification

That great apes are the only primates to recognise their reflections is often taken to show that they are self‐aware—however, there has been much recent debate about whether the self‐awareness in question is psychological or bodily self‐awareness. This paper argues that whilst self‐recognition does not require psychological self‐awareness, to claim that it requires only bodily self‐awareness would leave something out. That is that self‐recognition requires ‘objective self‐awareness’—the capacity for first person thoughts like ‘that's me’, which involve self‐identification and so are vulnerable to error through misidentification. This objective self‐awareness is distinct from bodily or psychological self‐awareness, requires cognitive sophistication and provides the beginnings of a more conceptual self‐representation which might play a role in planning, mental time travel and theory of mind.     

Reply to Reynolds

Abstract

How should we read Foucault's claims, in his late work, for the relevance of ‘aesthetic criteria’ to politics? What is Foucault's implicit understanding of the nature of aesthetics and the autonomy of the aesthetic sphere? Would an ethics which gave a place to the aesthetic legitimize a politics of manipulation, brutality and aggression ‐ in short, a ‘fascist’ politics ‐ as some of Foucault's critics argue? In this paper, I examine key accounts of the fascist ‘aestheticization of politics’ ‐ from Walter Benjamin's classic essay, ‘The Work of Art in the Age of Mechanical Reproduction’ (1936), to Philippe Lacoue‐Labarthe's work on the relation between Heidegger's philosophy and the fascist theme of politics as the plastic art of the state. Through a discussion of Foucault's late work, the paper demonstrates the connection between Foucault's turn to ancient Greek ethical practices and his call for a contemporary renewal of the idea of ethics as an art of living. The aim of the paper is to show in what ways the ethico‐political position which is presented in Foucault's late work, far from contributing to a fascist politics, in fact provides ways of thinking about the relationship between the aesthetic and the political which avoid both mindless radicalism and totalitarian narcissism. In doing so, the key question is, ‘What's aesthetic about Foucault's “aesthetics of existence"?’     

The End(s) of Philosophy: Rhetoric, Therapy and Wittgenstein's Pyrrhonism

In Culture and Value Wittgenstein remarks: ‘Thoughts that are at peace. That's what someone who philosophizes yearns for’. The desire for such conceptual tranquillity is a recurrent theme in Wittgenstein's work, and especially in his later ‘grammatical‐therapeutic’ philosophy. Some commentators (notably Rush Rhees and C. G. Luckhardt) have cautioned that emphasising this facet of Wittgenstein's work ‘trivialises’ philosophy – something which is at odds with Wittgenstein's own philosophical ‘seriousness’ (in particular his insistence that philosophy demands that one ‘Go the bloody hard way’). Drawing on a number of correlations between Wittgenstein's conception of philosophy and that of the Pyrrhonian Sceptics, in this paper I defend a strong ‘therapeutic’ reading of Wittgenstein, and show how this can be maintained without ‘trivialising’ philosophy.