The analyst's implicit alpha-function, trauma and enactment in the analysis of borderline patients

The present paper discusses situations in which patient and analyst are involved in obstructive collusions, non-dreams-for-two, shaping enactments. Specifically, it describes explosions in the analytical field, acute enactments, which the analyst assigns, at first sight, to his faulty conduct. The subsequent amplification of the analytical dyad's capacity of symbolization makes the analyst investigate his presumed fault. The present work shows how acute enactments revive traumatic situations that were concealed by previous obstructive collusions, or chronic enactments. During chronic enactments unconscious exchanges occur between the dyad, in which the analyst provides implicit alpha-function to the patient, little by little recovering the traumatized parts. When there is enough recovery, the protective collusion is undone and the trauma is revived as acute enactment. This revival will not be traumatic because there are mental resources ready at hand to symbolize it. These situations are articulated with borderline patients. The patient clings to the analyst, using him as a protective shield against reality traumas. The implicit and explicit alpha-function exerted by the analyst contributes to the processing and symbolization of this reality, recovering the injured mind and elaborating the trauma. So the patient creates a triangular space to dream and think.     

More Metaphor: Commentary on Paper by Ken Corbett

Beyond the inevitability of countertransference feelings is the question of countertransference enactments. From a two‐person, participant‐observer or observing‐participant perspective, enactments are inevitable. The analyst becomes influenced by the patient (and influences the patient as well) and enmeshed in the patient's internalized interpersonal configurations. Analysis works not by avoiding such action but by analyzing from within the interactional system. Analysts who are different from one another become engaged in different ways, since the person of the analyst is a significant variable. This article, using case examples, explores two analyst‐related variables, age and family configuration, to expand the examination of countertransference enactments and some effects on the analytic process.     

Is Verbal Symbolization A Necessary Requirement of Analytic Change?

This paper considers the potential of bidirectional, nonverbal (procedural) enactments for effecting therapeutic change. Whether such nonverbal enactments need to be symbolized for clinical change to occur is discussed. Clinical and conceptual material is presented which indicates that changes in self-representations can and do occur without the need for verbal symbolization.     

What happens before and after acute enactments? An exercise in clinical validation and the broadening of hypotheses

This paper seeks to validate clinical facts and theoretical hypotheses that have been discussed before and that address configurations involving chronic and acute enactments. Its validation process compares clinical material from psychoanalytic work in different psychoanalytic cultures - work from South America-Uruguay (Yardino), Europe-Spain (Sapisochin), South Africa (Ivey), Europe-UK (Bateman). It documents clinical facts described in four articles and confirms that during chronic enactments the analytic dyad gets caught up in a dual relationship that veils and congeals the triangular situation because acknowledging it would be traumatic. The lack of triangular space impedes the formation of symbols as well as dreaming and creates non-dreams-for-two. During chronic enactments analysts use their implicit alpha-function to assemble traumatic areas. These areas emerge as a mix of discharges and non-dreams that are dreamed through acute enactments. Acute enactments occur when chronic enactments dissolve and patients experience an abrupt contact with reality. The attenuated trauma is then dreamed alive. The linking of new symbols develops a network of symbolic thought and creates dreams-for-two and broadens the patient's mental universe. The validation process has deepened our vision concerning clinical facts, especially in relation to: (1) the wavering between acute and chronic enactments, (2) analysts' inhibitions and feelings of guilt, and (3) the influence of analysts' personalities on the configurations they describe. These theoretical hypotheses have been confirmed and broadened not only in relation to the vicissitudes of dream work in traumatic areas, but also in relation to defenses such as thin or thick skin, and in relation to listening in countertransferential detours.     

Enactment as Unconscious Communication

ABSTRACT

I explore the way in which unconscious primitive and nonsymbolic experience is communicated to the analyst’s unconscious through enactment. As the analyst receives the projections unconsciously, she is encouraged to enact aspects of the patient’s internal world. The analytic work then is through the understanding of these subtle and ubiquitous enactments. I value the work of understanding enactments as a rich and subtle pathway into the deepest levels of the patient’s unconscious. I explore the nature of this work and illustrate my point with clinical examples.     

SEXUAL ATTACHMENTS: A THEORETICAL PSYCHOANALYTIC PERSPECTIVE ON INCEST

A psychoanalytic framework for understanding the incest‐spectrum group of disorders is outlined. Incest disorders are viewed as a group of perverse activities representing a dynamic solution to developmental conflict or, alternately, as compensatory enactments that serve the function of re‐regulating a defective or fragmenting self‐structure. While incest is typically thought of as behavioural in nature, it also involves particular psychodynamics that underpin the sexualized behavioural enactment. Incestuous activity employs sexualized, bodily engagements to restore self‐regulation or to regulate intense adverse affective states. This perspective emphasizes the need to understand the developmental and psychostructural features of the incest patient. Case material is provided to illuminate aspects of this understanding.     

Emotional clich��s and authentic passions: A phenomenological revision of a cognitive theory of emotion

This paper argues for an understanding of emotion based upon Merleau-Ponty's conceptions of embodiment and passivity. Through a critical assessment of cognitive theories of emotion, and in particular Solomon's theory, it argues (1) that there is a sense in which emotions may be judgments, so long as we understand such judgments as bodily enactments of meaning, but (2) that even understood in this way, the notion of judgment (or construal) can only account for a subset of emotions which I call "emotional clichés," and not for authentic passions. In contrast with Solomon's account which conceives the subject as constituting, this account of emotion requires us to understand subjectivity as moved by meanings in the world, and as sometimes, in an authentic passion, dispossessed by those meanings.     

Multiplicity as a Form of Enactment Commentary on Paper by Graham Bass

In this commentary I address the functions of gender and of bodily state as a way of managing memory, affect, and interactions. I consider the status of alters as narrative or as historical truths. Graham Bass's case illuminates problems and potentials of touch and the inevitability of intersubjectively constructed enactments.     

The Analyst as Comic and the Comic in Analysis: Reply to Commentary

This discussion elaborates aspects of the use of humor and jokes in clinical psychoanalysis. The use of humor, like dreams or other symmetrical processes, facilitates the patient's development of the capacity to symbolize unconscious experience and mitigates the need to evacuate unconscious experiences and fantasies into the external world. In focusing on specific clinical interventions I highlight three dimensions of the process: the concept of coconstruction in the emergence of humor in the psychoanalytic relationship, the authority of the patient's psychopathology and affective and cognitive development, and the analyst's willingness to take the risks of self-exposure and possibly hurting the patient implicit in the use of humor and jokes in the analytic relationship. Different forms of humor are described in relation to the different clinical situations, including mutually created jokes, caricatured enactments, cartoonlike images, and self-depreciating commentary on the analytic process. In using jokes and humor in psychoanalysis we introduce the possibility of pleasure within an intense, intimate moment which allows for the transformation of unacceptable aspects of both patient and analyst as they become joined within a broader human experience.     

Introduction to Panel: Dissociation,Enactment and Collective Trauma: The Role of Psychoanalysis

This introduction to a panel presented in Santiago, Chile, highlights the consequences of social violence focusing on the need for institutionalized action to counteract institutional violence, on the interaction of vulnerabilities of patient and therapist expressed as enactments in the treatment, and on the complex interplay of risk and resilience mediating repetition of trauma.     

IRREDUCIBLE SUBJECTIVITY AND INTERACTIONISM: A CRITIQUE1

The authors offer a critique of the privileging of subjectivity in psychoanalysis characteristic of what Hanly has called interactionism, with specific reference to the work of Renik. First, Renik's argument for the irreducible subjectivity of the analyst is explored and critiqued from a philosophical perspective. The need for and plausibility of a subtler notion of objectivity that takes into account the limitations of human subjectivity and that analysts can meaningfully pursue is defended. Second, Renik's ‘re‐visioning’ of psychoanalysis, which follows from his notion of irreducible subjectivity, is explored and critiqued. Renik's view of enactments is contrasted with a ‘totalistic’ perspective of countertransference that allows for important, finer conceptual distinctions. Renik's conceptualisation of countertransference enactments is characterised as a ‘special case’ of countertransference as a vice. Next, Renik's view of transference is critiqued for privileging the adaptive dimensions of transference, and for potentially sidelining archaic dimensions. Finally, Renik's conclusions and ‘revisioning’ of psychoanalysis are shown to follow from his modifying or jettisoning certain features of the analytic situation and process. These features and their implications are elaborated on. The conclusion outlines the extent to which the arguments presented can be extended to other advocates of interactionism.     

Parallel process and projective identification in psychoanalytic supervision

In the present paper I explore the notion of the parallel process, a controversial concept in psychoanalytic supervision. I suggest that the parallel process is essentially the operation of the defensive process of projective identification, which in some quarters is similarly viewed with skepticism and/or is mistakenly seen as primarily a malignant defense operating exclusively in severe character pathology (Kernberg, 1975; Mendelsohn, 2009). Further, I present several vignettes of psychoanalytic supervision where a series of parallel processes occurred, and I suggest that these parallel enactments are the result of the projective identifications which stimulated them. I agree with critical writers who say that simply suggesting the presence of a parallel process in the supervision adds no new information to the supervision, but I show how an exploration of the parallel enactments, which includes (1) exploring the patient-therapist dyadic dynamics, (2) a narrowly focused exploration of the dynamics of the therapist/presenter, and (3) and an exploration of the dynamics of the therapist-supervisor dyad, can enrich the treatment, as well as the supervision. Finally I suggest that while the projective identification that occurs in the supervisory dyad does not always lead to a parallel process, every parallel process is the result of projective identification(s). I further suggest that while every parallel process does not lead to an enactment via projective identification, enactments can only occur via the parallel process instigated by projective identification.     

Positive Enactment as a Clinical Resource

Patients regularly make demands for responses that go beyond listening and nonjudgmental exploration. Some contemporary therapists frame these demands as a mobilized developmental longing that can lead to a positive enactment. This article proposes a conceptual framework that allows inquiry into spontaneously emerging positive enactments as a clinical resource.     

The Analyst's Secret Delinquencies

Despite a burgeoning literature on major analytic boundary violations, there has been little investigation of what might be called analytic delinquencies or misdemeanors—the small and virtually ubiquitous ways in which analysts deliberately withdraw from the therapeutic endeavor. I consider the impact of professional misdemeanors on patient and analyst and compare both with more serious analytic “crimes” and enactments. Professional delinquencies may reflect a therapeutic reenactment, an expression of the analyst's split-off or disavowed need, or an unconscious attempt to self-regulate or to negotiate space within the constraints of the treatment setting. Because the professional ideal leaves so little room for the analyst's humanity, it is often difficult for us to address and work with evidence of our own need when it clashes with what we regard as the analytic contract.     

Stumbling along in the Countertransference: Following Up Enactments with Balanced Therapeutic Interpretations

In the course of a psychoanalytic treatment, many clinical situations create countertransference pulls or invitations to participate in enactments of various degrees. In these projective identification-based transferences, the patient is often successful in drawing the analyst into archaic object relational patterns of acting out. During these moments, the analyst must struggle to find a way to stay therapeutically balanced. The urge to rush to judgment with punitive, seductive, rejecting, controlling, or manipulative comments rationalized as interpretations must be managed. If these unavoidable countertransference enactments are managed and studied, they can provide useful information about the patient's internal struggles and can show the way to making more helpful and more therapeutic interpretations. Case material is used for illustration.     

Who Needs Sensory Education?

Studies in Philosophy and Education - Customarily, reflections on the need to educate sensory and bodily enactments with the world, take for granted that it is the child who must be educated....     

Racial Enactments in Dynamic Treatment

The aim of this paper is to discuss racial enactments for what they might contribute to our understanding of the intersubjectivity of race and racial experience. “Racial enactments” designate interactive sequences embodying the actualization in the clinical situation of cultural attitudes toward race and racial difference. I present examples of racial enactments in several social contexts, as well as in an extended clinical vignette. I consider racial enactments in the light of contemporary psychoanalytic theory and suggest that collaborative methods facilitate the effective analysis of racial material.     

Christian Lobbyist Groups and the Negotiation of Sexual Rights in the UK

Although sexual minority rights have not necessarily generated polarised views within Christian churches and organisations, the subject has tended to forge an arena of contestation between liberal and conservative constituencies. Theological differences have frequently been manifested through the mobilisation of ‘cause’ groups lobbying the political realm and public opinion in order to advance their contrasting standpoints. Based on a survey of documentation and supplementary materials produced for public consumption, this article considers responses of the conflicting rights petitions of Christian cadres either endorsing or opposing minority sexual rights and the relevant legislative enactments in the UK. The article seeks to illuminate how these competing constituencies further their causes while at the same time devaluing the rights claims of their adversaries.     

Collusive induction in perverse relating: Perverse enactments and bastions as a camouflage for death anxiety

The author argues that one of the main functions of perverse relatedness is to induce the analyst into becoming the patient's unconscious accomplice in a “perverse pact” against the analytic work aimed at disavowing intolerable aspects of reality. The intense power of collusive induction in perverse relating leads the analyst to participate in transference‐countertransference enactments and to the crystallization of a silent and chronic unconscious collusion between the patient and analyst in the analytic field, stagnating the process (bastion; Baranger and Baranger). The author claims that analysis of perverse pathology should not be limited to interpretation of the patient's intrapsychic functioning but should also focus on the information obtained by the analyst through his participation in collusive enactments; the analyst should also take a “second look” at the analytic “field” to detect underlying bastions. The author reviews the main psychoanalytic contributions that have clarified the phenomenon of collusive induction in perverse relating and as an illustration, describes the analysis of a man with a perverse character; in this patient, one of the main functions of his perverse relatedness was to induce the analyst to become an accomplice in his disavowal of his terror of death. The author highlights the influence of death anxiety in the bastions that develop in the treatment of perverse patients.