Finding the depressed object in the obsessional: a clinical study

In this paper the author explores the clinical significance of the presence of a depressed internal object in a patient with marked obsessional features, dominating the patient's internal world and restricting relations in external life. After discussing important aspects of the contribution of Freud and later writers to the study of obsessional neurosis, the author provides clinical material that shows the patient's tormented relationship to a feared depressed object that was manifested in the transference. Developing her argument, the author suggests that if the analyst does not fully grasp the primitive anxieties of the underlying state of mind she can be prone to enter into an aggressive enactment with the patient's sadistic superego. This kind of enactment may arouse excitement and triumph in the patient, but actually confirms his doubts and fears about the capacity of his object to contain him.     

THE ROLE OF AN IMMIGRANT MOTHER IN HER ADOLESCENT’S IDENTITY FORMATION: “WHO AM I?”

Immigration is a complex bio-psycho-social process and the immigrant mother has a truly complex task in lending her ego strength to her adolescent offspring. The normal adolescence’s decathexis of the love object and the consequent search for a new object may not happen smoothly for those adolescents whose mothers are immigrants. The immigration experience may cause the immigrant mother, who lost her motherland, deeper disturbance in self-identity as well as disequilibrium in her psychic structure, which in turn impacts adversely her adolescent’s development. The adolescent’s inadequate early experience with an immigrant mother may result in a deeper disturbance in his separation-individuation process as well as his identification process. An immigrant mother who has not mourned adequately, with a different sociocultural background has to go through a far more complex development of motherhood. The case of an adolescent boy, Jason, demonstrates the impact of immigrant motherhood on his ego development.     

DIFFERENT ARCHITECTURES OF CREATIVITY: LOUIS AND NATHANIEL KAHN

The author analyzes Nathaniel Kahn's documentary film My Architect: A Son's Journey, a tribute to the writer‐director's father Louis, the famous architect, who died suddenly when Nathaniel was eleven years old. The film's poetic, evocative images form a testimony to the silent working through that Nathaniel did in searching for his lost father and to the complex intertwining of mourning and creativity. Creativity is seen as both the cause and the effect of working through, as it gives life to a new meaning and allows replacement of the lost object by an object found again. Bereavement, symbolization, and the birth of representation appear to be connected with one another, both when the most elementary representations are involved and when the more complex and artistic ones are. Where and when it is possible to recover a representation that can survive the absence of the lost object, there is a potentially creative psychic space that can be made fertile again.     

A father to love: eros and identification in boys – an emendation of Freud on the male oedipal drama

The relationship between a son and his father is usually characterized as primarily one of rivalry. In this emendation of classic oedipal theory, what has traditionally been referred to as the ‘negative oedipal relation’ is given prominence as a boy’s first emotionally significant relationship in which he initiates affection with another human being, his father. Such love is in the service of identification but is also as important as the template for a male’s later relationships with women (sexual), other men, and his children. A peculiarity of Freud’s relationship with his own father is suggested as the source of oversight of this element of the oedipal drama. A boy’s emotional reactive response to his mother is primarily one of gratitude in response to her love. Proactive loving is first experienced with his father.     

Father and daughter: Identification with difference—a contribution to gender heterodoxy

This paper reinterprets the historical problem of penis envy, that is, the girl's wish to be masculine, in terms of a developmental need to identify with father. Many of the problems posed by earlier analyses of femininity can be clarified by recognizing that before the girl “turns”; to the oedipal father as love object, she looks to the rapprochement father for identification. Identification is not merely an internal structure, it is a relationship in which the subject recognizes herself or himself in the other. In rapprochement, love of the father, who symbolically represents the outside world, takes the place of the practicing toddler's “love affair with the world.”; This identificatory love of the father, initially noticed in boys by Freud and later authors, is often frustrated by the father's absence or inability to recognize the daughter. This frustrated longing takes the penis as its symbol of likeness. The pre‐oedipal over‐inclusive phase of identification with the other sex parent is not superceded by the oedipal constellation, but is integrated with it. Thus identification becomes an important basis of the love of the other: it is not so much the opposite of object love as an important precursor and ongoing constituent of it. Case material illustrates the multiple possibilities of identificatory love and use of phallic symbolism to represent them.     

Freud, Fliess, and the parenthood of psychoanalysis

This paper focuses upon the roles of procreation, fatherhood, and identification with the fertile mother in Freud's creation of psychoanalysis. Fatherhood and motherhood, pregnancy and birth, children and siblings, figure prominently in Freud's self-analysis and in his relationship with his prototransference object, Wilhelm Fliess. Although Freud attributed his self-analytic interest and revived oedipal conflict to the death of his father, becoming a parent himself was also a significant determinant. Birth as well as death reactivated his childhood and stimulated his creative ferment.     

THE FATHER,THE FATHER FUNCTION,THE FATHER PRINCIPLE: SOME CONTEMPORARY PSYCHOANALYTIC DEVELOPMENTS

The author discusses Freud's thinking on the role of the father, as well as that of later French theoreticians. To illustrate his remarks, he draws on the poetry of Carlos Drummond de Andrade (1912–1987), a Brazilian poet whose work often dealt with themes of the father, the family, and his own paternal relationship. The author also discusses the psychic formation of the father principle and how this may be evident in the clinical analytic setting, even when the analyst's approach privileges field theory, intersubjectivity, or other concepts emphasizing the relationship between analyst and patient.     

Purposive aspects of the erotic transference

This paper illustrates the erotic transference of a male patient towards his female analyst and the pressures and resistances within the transference and counter-transference to act out sexually. The patient's desire to act out sexually is seen both as a form of repetition compulsion within the transference and, in its purposive aspect, as an expression of the patient's need to find a loving breast and an empathic father. The patient's confused sexual identity is seen as a narcissistic defence against the experience of unbearable frustration in the pre-Oedipal stage. Through internalizing a new primal scene, the patient is able to separate from his past and to work through the Oedipus complex within the transference.     

Recapturing the Lost Father

Abstract

Father-transference gives voice to libidinal wishes, superego fears, and unmet developmental needs associated by the patient to his or her father. The actual gender of the therapist has no bearing on this displacement In the following case study both therapist and patient are female. Father-transference is categorized by its developmental function: Father, the object of Oedipal longing, a feeling state of transference-readiness; Father, the Oedipal rescuer, enabler of separation; Father, the focus of phallic identification. Under the sway of transference, memories of dead father emerged from repression, conflict was resolved and grief faded.     

Exploring a patient's shift from relative silence to verbal expressiveness: Observations on an element of the analyst's participation

By tracing a portion of close process of a patient's shifts from a relatively silent and inhibited stance to one in which he is beginning to verbalize more about his experience and fantasy, I will illustrate some tensions between the analyst's role as facilitating expressiveness and as occupying a place in the patient's internalized world. Since the analyst's functions as facilitator and as internal object (often an obstacle to the patient's expressiveness) are sometimes in conflict with one another, it is important for the analyst to be able to work internally with this conflict as he works with his patient. Splitting processes between these two functions may provide the analyst with cues related to the patient's and the analyst's resistance to understanding the patient's communication of unconscious conflict and the patient's recruitment of the analyst into the patient's internalized world.     

The clinical popularity of object relations concepts

Object relations theory has the effect of supporting the psychoanalyst when he feels that the patient's effort is strongly opposed to his own. The current popularity of object relations theory may be related to the gradual disappearance from Freudian theory of a simple, clear image of an obligatory insistence by the patient that is useful even though it is unreflective. Object relations theory offers the practitioner a way of fortifying himself against blind demand, while newer Freudian theorists cope with the problem by orienting themselves more stringently toward the original paradigm of optional choice.     

Clinical ethics case report: questionable capacity and the guidance of living wills

After falling from a roof, an older man lost neurological function below his face. In two days, the patient regained consciousness, but it was unclear whether he could communicate his preferences, whether due to injuries or difficulties with language. His family believed he could communicate with them, and that he was capable of making treatment decisions. The staff did not think to contact the hospital's largely inactive ethics consultation service for assistance, and instead looked to the patient's living will for guidance, even though the patient was not terminally ill, and his lack of capacity had not been determined.     

Diagnosing a male hysteric: Don Juan-type

The aim of this paper is to provide a clinical account of a male hysteric, Don Juan-type, taken from the early stages of treatment. The patient presented with a relationship problem but there soon emerged a form of compulsive sexuality or hypersexuality in his love relations that became a central feature of the clinical picture. This hypersexuality expressed itself in a compulsive need to stage, or to stage-manage, interpersonal scenaria of a sexual or sexualised nature. These scenaria, which were repeated in different variations and with different personnel, are seen by the author as a dramatisation of the primal scene with the patient taking up the position of the oedipal father. Explanations for the disappearance of male hysteria are given, including a new theory which claims that an imbalance in psychoanalytic theory itself led to the feminisation of hysteria. This critique allows certain forms of hypersexuality in men to be promoted as a form of hysteria, the most common example being Don Juanism-a form of compulsive sexuality that encompasses normative, conversion and character features. The paper also examines the male hysteric's developmental agenda. What the patient's compulsive sexual tableaux exposed was that he had never faced a separation that was not a triangular experience. This meant that his separations were experienced as two developmental agonies telescoped into one-separation (pre-oedipal) and exclusion (early oedipal). This combination, the author suggests, is so frightening in a particular group of men as to explain the choice of hysteria as opposed to some other choice of neurosis.     

His mother-tongue: from stuttering to separation, a case history

This paper delineates the transference and countertransference experiences in the analysis of a patient whose presenting symptom and main concern was his stutter. I suggest that oral-sadistic rather than anal-sadistic hostile elements may be identified in this patient's particular stutter. I focus on its significance in terms of object relationship: my patient's struggle to 'get born', to emerge as a separate other. I argue that early symbiotic fusion needs in conflict with the need to separate produce his stutter. Speech and language are seen as the vehicle for separation and the stutter as a flight from separateness back to an illusion of fusion with mother.     

The ironic detachment of Edward Gibbon

Edward Gibbon, the author of The History of the Decline and Fall of the Roman Empire, has been widely recognized as a master of irony. The historian's early life with parents he found self-serving and unreliable, his reaction to the events surrounding the death of his mother at the age of 9 and the decline of his father, left an impact on his personality and played a role in determining his choice of his life work. Irony has been approached from a psychoanalytic perspective as a mode of communication, as a stylistic device, as a modality through which one might view reality and as a way of uncovering the linkage between pretense and aspiration, between the apparent and the real. Gibbon's ironic detachment can be understood as rooted in his life history. He felt detached from his family of origin, in need of a protective device which would enable him to deal with passion. Sexual and aggressive impulses mobilized defensive postures that were later transformed into an attitude of skepticism and an interest in undercutting false beliefs and irrational authority, positions he attributes to religious ideation which served to instigate historical decline.     

The real person of the analyst and his role in the process of psychoanalytic cure

This paper focuses on the real relationship with the analyst in the psychoanalytic situation as an aspect of the therapeutic process that leads to change. The role of free association, clarification, and interpretation of the transference are taken for granted as major activities of the analyst, and the real relationship with him is seen as a complementary but important ingredient for change. In particular, his emotional availability determines the climate of analysis. The concepts of neutrality, anonymity, and abstinence, though of importance as guideposts in the conduct of an analysis, have conceptual limitations that not infrequently bind the analyst in a stance that is not useful for the progress of the analysis. On occasion, confirmation by the analyst of the verity of an experience in the patient's early life facilitates the analytic process. This occurs particularly in situations of early trauma, but at times may include chronically traumatic early life experiences. An important motivating force in analysis is the patient's unconscious wish to find the ideal parent absent in early life experience, a wish that is experienced and ultimately analyzed. This is to be distinguished from a defensive idealized transference. Psychoanalytic developmental psychology contributes to our understanding of how the real person of the analyst, his emotional availability, his responsiveness at particular times, his attitude toward action and progressive change in the patient, affect the therapeutic process that leads to change.     

Architecture and psychoanalysis. Nathaniel Kahn and the search for the father

Abstract

This text is intended as a contribution to the study of the profound mutual relations between architecture and psychoanalysis. Architecture creates representations that conceal unconscious forms of thought; psychoanalysis helps to explain the meanings of these representations – forms of construction and forms of the psyche. The multifaceted work of psychoanalyst Christopher Bollas – his thoughts on the relationships between psychoanalysis and architecture, on the vitality of objects, on the creative implications of the Oedipal relationship – serves as a critical and decisive instrument for the authors’ inquiry. The issue of the “vitality of objects” as described by Bollas also concerns – but only in part – the architectural “object.” One modern form of architecture with an inordinate capacity empathy has to be Louis Kahn’s. Kahn’s youngest son , Nathaniel, lost his father when he was still a child and hardly had a chance to get to know him. After becoming an adult and an established film-maker, he managed to recover his father in two ways: by discovering him in his works, with their powerful affective impact; and by drawing from those very works of his father to enhance his own creative process in his filmic art. As it turns out, it is this very process that has allowed for an emblematically positive resolution of the Oedipal relationship.     

Countertransference and containment in a patient with a psychotic mother

The importance of countertransference reactions in the treatment of a borderline patient with a psychotic suicidal mother is discussed. In such a case containment can be seriously disrupted by the violence of the patient's projections into the therapist. Where a psychotic internal object has been brought for treatment it is particularly important that the therapist be able to identify not only with the sane and mad parts of the patient but with the destructiveness and cruelty of the patient and her primary object. The difficulties of tolerating these relentless projections of madness and despair are increased by the multiple and confusing aims of the patient's excessive use of projective identification. The invasive and hostile aspects of this are often heavily disguised beneath idealization of the self and object as well as of madness itself. For the patient, attempts to interpret the idealization are moreover felt as an assault on the lost loved object, and the therapy then unconsciously becomes a persecutory experience for the patient. The therapist can thus be drawn into feeling the full force of the anger and hatred towards the real disappointing object and the sense of hopelessness about the reparative task. Although such feelings need to be tolerated, eventually some distance from the often-unpleasant fluctuations in the countertransference must develop if a useful degree of containment is to be achieved.     

Auditory agnosia: apperceptive or associative disorder?

Neuropsychological testing of a patient with auditory agnosia showed that certain difficulties in the initial analysis of sounds may be the cause of his inability to understand spoken words and other sounds. Abnormalities included a slow reaction time to brief auditory stimuli (but not to equally brief visual stimuli or to longer auditory stimuli) and the need for approximately 1/4 sec of silence between two tones before the patient was able to hear them as separate. He could identify words and word associations if he was able to view the object whose name or word associate he was hearing. The findings imply that this patient's deficit in comprehending speech was probably apperceptive rather than associative in origin.     

Building Blocks Toward Contemporary Trauma Theory: Ferenczi 's Paradigm Shift

In laying down the building blocks of contemporary trauma theory, Ferenczi asserted that trauma is founded on real events and that it occurs in the interpersonal and intersubjective dynamics of object relations. He stressed the significance of the presence or lack of a trusted person in the post-traumatic situation. After the trauma, the loneliness and later the isolation of the victim represent a serious pathogenic source. In the traumatic situation, the victim and the persecutor/aggressor operate differing ego defense mechanisms. Ferenczi was the first to describe the ego defense mechanism of identification with the aggressor. Ferenczi pointed out the characteristic features of the role of analyst/therapist with which (s)he may assist the patient in working through the trauma, among them being the development of a therapeutic atmosphere based on trust, so that the traumatic experiences can be relived, without which effective therapeutic change cannot be achieved. For the analyst, countertransference, as part of authentic communication, is incorporated into the therapeutic process. These are the key building blocks that are laid down by Ferenczi in his writings and appear in later works on trauma theory.