Psychoanalysis in later life

After decades of heeding Freud's admonition against taking patients older than fifty years of age into psychoanalytic treatment, psychoanalysts began to treat them and to report encouraging experiences. This essay is another in a series of case reports that confirms and extends the nature of changes possible in the analytic treatment of elderly patients. In order to demonstrate both specific changes and the possibility of satisfactory terminations with patients of advanced age, the author describes his analytic work with a woman who first consulted him when she was sixty-eight years old.     

Naturalistic Observation in Psychoanalysis

Abstract

The writer advocates a naturalistic approach to psychoanalysis. The Jane Goodall technique is an application of this approach in which the analyst studies the analysand as a naturalist would study and document the behavior of an animal species. The technique is particularly useful during difficult phases of treatment, and is sometimes quite powerful. Case material is presented showing how use of the technique can identify various forms of emotional induction used by analysands, the kinds of inductions which often produce countertransference reactions. Topics discussed include projective identification, supervision, and nature of psychoanalytic facts.     

Subversive Redemption in Psychoanalysis

Subversive redemption—the sense of overturning the conventional order of things in order to recover lost parts of the self—is a virtually neglected topic in psychoanalysis. With free association, Freud empowered patients to harness unconventional thoughts and feelings. Patients who engage in subversive redemption frequently have a strong sense of agency prompting them to open up in new ways in lieu of “playing it safe.” When patients begin to express certain forbidden ideas, the boundaries of analysis are broadened, freeing the analytic pair to become fully authentic. Psychoanalysis provides patients with an arena to renew themselves as they risk “killing off” their status quo positions to achieve the paradox of living more dangerously in the safety of the analytic surrounds. Patients then feel more confident about undertaking the process of subversive redemption in the wider world.     

Dreams in Child Psychoanalysis

More than six decades after Freud's death, psychoanalysts are certainly not more unified in their view of the concept of the unconscious—its structure and its way of working—than in ‘the good old days’. Challenges are facing psychoanalysis from many perspectives, urging psychoanalysts to continuously reconsider their theoretical grounds. This paper pursues three lines of argumentation concerning the Unconscious. The first line concerns the relation to neuroscience and this paper suggests the concept of background feelings (Damasio) as a contribution to another understanding of deficits in the psychoanalytic relationship. The second line concerns the relation to cognitive semiotics, and here, the paper stresses the concept of basic image sehemata as a possible link between the subject's pre-reflective awareness of the other and the internal world of phantasy. The third line pursues a concept of the analytic interpretation which is close to the Freudian idea that psychoanalysis is the communication between two Unconscious, and, consequently, that the psycho-analytic interpretation is not per se a conscious act.     

Accompaniment in Jazz and Psychoanalysis

The author explores a fundamental role of the analyst as improvisational accompanist. This role requires a dedicated attention to the shared rhythmic dimension of the interaction, a mode of psychoanalytic attention of embodied self-awareness and sensitivity–that is, embodied attunement to the pulse of the interaction. Directed action follows by providing various forms of accompaniment that depend on the nature of the patient’s needs and emotional state. By refining our accompaniment to meet clinical situations and challenges, we enlarge the range of analytic engagement. Using examples from jazz, the way the rhythm section finds the right form of accompaniment to support the soloist’s creativity and unique voice, the analyst similarly accompanies his or her patient, providing a temporal framework, a pulse that affirms emotionally shared states, recognition, differentiation, and creative expression. Various forms of analytic accompaniment include steady and present beat, an unobtrusive and loose presence, an interactive and conversational presence, or disruptive rhythms. From experiences of solid support and recognition, accompaniment can fuel the patient’s improvisations, allowing him to move away from the analyst and create a clearer differentiated voice. As the patient separates, he ventures out into new or difficult territory, the analyst’s presence is there following.