Family Dynamics and AIDS Phobia: A Case Study

The author introduces and defines AIDS phobia. He illustrates the hypochondria type of AIDS phobia from a combined individual, couple, and family treatment perspective. He describes the treatment process and outcome after an effective countertransference-based intervention, connects the individual manifestations of the index patient's illness to the family dynamics, and concludes with an analysis of the multigenerational contributions to the individual's psychopathology.     

Neurotic and psychosomatic disorders interdependence in terms of the search activity concept

There are no correlations between MMPI Hysteria (Hs) and Depression (D) scales in psychosomatic patients in contrast to other patients with somatic disturbances, neurotic disturbances, and in healthy subjects. The roles of depression and hypochondria in the dynamics of psychosomatic disturbances are discussed according to the search activity concept. It is suggested that hypochondriacal complaints are prognostically favorable in comparison with anxiety-depression complaints.     

A PSYCHOANALYTIC READING OF PETER HØEG'S NOVEL MISS SMILLA'S FEELING FOR SNOW3

The author presents a psychoanalytic reading of the Danish author Peter Høeg's masterpiece ‘Miss Smilla's Feeling for Snow’, focusing on the special linguistic style of the novel. Further, the author puts forward an interpretation of the heroine, seeing her as a literary example of female bisexuality. Investigating the heroine's fate, the author discusses Miss Smilla's phallic defence and identity. The narrative technique in Høeg's novel is analysed through Lacan's concepts of the Real, the Imaginary and the Symbolic. The main figure is interpreted as an imaginary example of female bisexuality. Miss Smilla has neither an unambiguous gender identity nor ethnicity. The heroine is pictured in a conflict between two cultures: the Greenlandish and the western European, and her bisexuality both reflects this and is part of it. The author proposes to interpret a significant memory from Smilla's early childhood as an example of a castration phantasy, which retroactively gives new significance to the little girl's pre‐oedipal frustration.     

WITHSTANDING TRAUMA: THE SIGNIFICANCE OF EMMA ECKSTEIN'S CIRCUMCISION TO FREUD'S IRMA DREAM

The author considers the medical rationale for Wilhelm Fliess's operation on Emma Eckstein's nose in February 1895 and interprets the possible role that this played in Freud's dream of Irma's injection five months later. The author's main argument is that Emma likely endured female castration as a child and that she therefore experienced the surgery to her nose in 1895 as a retraumatization of her childhood trauma. The author further argues that Freud's unconscious identification with Emma, which broke through in his dream of Irma's injection with resistances and apotropaic defenses, served to accentuate his own “masculine protest”. The understanding brought to light by the present interpretation of Freud's Irma dream, when coupled with our previous knowledge of Freud, allows us to better grasp the unconscious logic and origins of psychoanalysis itself. 1     

Clinical Relevance of Social Character and Social Unconscious

The author discusses his recollection of Erich Fromm's views on psychoanalytic work with patients, including the author's treatment of a patient. The remembrance involves Fromm's clinical thinking on social character and the social unconscious, and its relevance to present-day clinical work. The author presents, in detail, his treatment of a 37-year old successful woman which addresses certain of today's clinical views on gender differences that resonate and differ with Fromm's thinking on the treatment of the marketing personality.     

On Hare's attempt to bridge the Kantian-consequentialist gap: A response to Forschler's rejoinder

In a paper in this journal (Wall 2016), the author of the present paper critiqued Scott Forschler's attempt (2013) to establish that Jens Timmermann's argument (2005) against R. M. Hare's attempt (1981) to bridge the Kantian-consequentialist gap is unsuccessful. Forschler's thesis is that Hare's utilitarianism is strictly normative, not metaethical. In Hare's ethical rationalism, which is metaethical but contains no intrinsic ends (Forschler 2013), reason determines the proper ends, and preference satisfaction has no value prior to reason's determinations (Forschler 2013). The present author responded that Hare's moral approach presupposes that preference satisfaction is the ultimate end (Wall 2016) and that an analysis of preference satisfaction in Hare's moral approach cannot be confined to normative ethics. Forschler's rejoinder (2017) suggests that Hare's moral theory was misinterpreted by the author, who now shows that such a judgment results from significant oversights concerning the foundation of Hare's moral theory and utilitarian foundations.     

Shades of Mark Twain: Commentary on Paper by Steven H. Cooper

The author considers Cooper's notion of the pluralistic third from several angles as Cooper's use of the term covers a range of applications from that of an internal supervisor to the use of ideas from psychoanalytic traditions other than one's own in evaluating one's clinical work. The impression created of the American situation is contrasted with the institutionalized pluralism of the British Psychoanalytical Society since the Second World War. The author believes that the theoretical question of the analyst's accountability to a professional authority is overdetermined in the paper because the clinical material is dominated by the patient's problems in facing up to parental authority. A crucial enactment is seen as starting at the analyst's first contact with the patient, which seems to subvert the analyst's capacity to be an authority figure. The analyst finds a working relationship with his own psychoanalytic authority in the second session of the analysis but seems to lose it through an overextension of the ideas of “play,” self-questioning, and the seeking of agreement between patient and analyst. The author considers the clinical material from the point of view that his peer supervision group would take.     

Enactment as Therapeutic Hand Grenade: How Bursts of Emotional Honesty Can Get a Stuck Treatment Moving Again: Discussion of Holly Levenkron's Paper

In my discussion of Levenkron's article, I consider ways of understanding the patient's therapeutic progress that were not highlighted by the author. Adding my own criteria to Levenkron's definition of enactment, I suggest that what the author labels as enactment might be seen as a last-ditch but successful effort to get patient and analyst out of a stuck and painful place. I explore the interplay of confrontational and nonconfrontational interventions in contributing to cure, and I suggest placing a greater emphasis than did the author, on the intersubjective contexts out of which the patient's troublesome behaviors emerged.     

Bion and C.G. Jung. How did the container‐contained model find its thinker? The fate of a cryptomnesia

This paper investigates the possible impact of C.G. Jung's Tavistock Lectures on Bion's concept of the living container. In the first part of the paper, the author offers clues pointing to such an essential impact, which can be found in text passages as well as in the facts of the Bion‐Beckett case, up to and including Bion's first publication of ‘The imaginary twin'. The author suggests that cryptomnesia is the result of repression targeting a highly cathected author's communication which functions like a deep interpretation for the recipient, whose new theory then is a return of the repressed content as well as a transformation of it. The second part of the paper investigates the fate of the assumed cryptomnesia. From this point of view Bion's concept of the container in itself appears to be the result of growth in the container‐contained mode. Finally the author deals with the question whether cryptomnesia in psychoanalytical literature can frequently be seen as the result of psychic growth.     

Didn't You Run the Spell Checker? Effects of Type of Spelling Error and Use of a Spell Checker on Perceptions of the Author

We investigated expectations regarding a writer's responsibility to proofread text for spelling errors when using a word processor. Undergraduate students read an essay and completed a questionnaire regarding their perceptions of the author and the quality of the essay. We manipulated type of spelling error (no error, homophone error, non-homophone error) and information provided about the author's use of a spell checker (no information, author did not use a spell checker, author did use a spell checker). Participants' perceptions of the author's abilities and the quality of the essay suffered when the essay contained non-homophone spelling errors—errors that are typically flagged by a spell checker. Further, participants reported that they would be most likely to blame the writer rather than the spell checker for spelling errors contained in the text. These findings suggest that perceptions of both an author's abilities and the written products are affected by spelling errors. Even when supportive tools are available, the responsibility for producing error-free text remains with the author.     

Should Analytic Patients Be “Created”? Reflections on Arnold Rothstein's Psychoanalytic Technique and the Creation of Analytic Patients

Abstract

The five points of Arnold Rothstein's interesting monograph are each discussed and critiqued in this article. In particular, Rothstein is commended for his commitment to expanding the availability of an intensive, psychoanalytic treatment for a broad spectrum of patients who may often be very difficult to engage. Rothstein also accounts for difficulties in engaging analytic patients from obstacles in the attitudes of analysts such as a latent lack of conviction about the efficacy of psychoanalysis and from overly restricted stereotypes about the spectrum of appropriate patients. He recommends a flexibility of technique and accommodation to the needs of patients with which this author agrees.

Others of Rothstein's observations and recommendations seem more problematic. Specifically, issue is taken with his suggestion that analysts attempt to provide a trial of psychoanalysis for all nonpsychotic patients and to begin on a less intensive basis only within the frame or interpreting prospective patients' objections as a resistance. This author also disagrees with Rothstein's interpretation that patients resist the offer of a psychoanalysis out of a self-defeating masochistic enactment that needs interpretation. Case examples are provided that belie this overly generalized interpretation. Additionally, this author critiques the metapsychological assumptions underlying this particular mode of interpreting a reluctance to begin psychoanalysis.

While commending Rothstein's therapeutic goals and recommended flexibility of technique, this author would also stress a fundamental concern about the patient's conscious and unconscious experience of the analyst's agenda. In other words, rather than working toward the analyst's goal of establishing a psychoanalytic situation, emphasis is placed instead on the basic right of patients to proceed in a manner that respects their sovereignty over how intensively they may choose to work. Therefore, in contradistinction to Rothstein's suggestions, it is recommended that the analyst's primary focus should be to provide an availability to work on the patient's conflicts and developmental needs with a respect for the timing of their emergence and expression within a treatment frame that invites but does not prematurely elicit and confront. By proceeding in this way a patient's salient dynamics will be allowed to emerge “organically” instead of being hastened prematurely in reaction to the analyst's insistence on the Tightness of a particular schedule or manner of proceeding. This author believes that with this approach more, rather than fewer, patients will be able to accept the recommendation of an intensive psychoanalytic treatment.     

Response to “Poison Cookies” Discussions

This is a response to the discussions of the case presented by this author. Responding to the discussions has allowed the author to pull together her own ideas about the case as well as about the work we do. The author sees Sheldon (Shelly) Bach's view of sadomasochism as a particular type of object relationship as informing her own point of view. Next comes a discussion centering on Steven (Steve) H. Knoblauch's emphasizing the importance of the internal symbolic world of the patient. The author makes the point that understanding the level of differentiation of the internal objects in the patient's representational world is important in thinking about the types and timing of interventions the analyst makes; for example, those which Mary-Joan Gerson describes in her comments. Finally, the author addresses Sue Grand's response, especially her emphasis on the importance of siblings in our patients’ histories and the resulting sibling transferences to the analyst.     

Hidden in Plain Sight: Freud's Jewish Identity Revisited

Using a contextualizing, integrative approach, the author looks at aspects of Freud's life and the multiple levels of influence in terms of his theories. While keeping a broad overview of the historical and cultural life for Jews in 19th-century Europe, including the effects of anti-Semitism, emancipation, and the enlightenment movement, the author intertwines Freud's parents' lives and personalities as they played out in Freud's own development and in his theories. The author believes that Freud formed a particular repression linking Jewishness, passivity, femininity, and religion while elevating in his theories masculinity, activity, science, and atheism. The author specifically focuses on Freud's theories of the Unconscious and the oedipal complex as particularly representative of a split between his own Jewish home and the German high culture he was educated within. Drawing on literature within psychoanalysis and the disciplines of Jewish studies and broad cultural history, the author concludes that Freud's rejection of certain parts of his own life are embedded within his theory when considered from a multiply-layered point of view.     

THE RESPONSE OF A THEOLOGIAN TO CHARLES TAYLOR'S A SECULAR AGE

The author of this article confirms Charles Taylor's thesis that despite the growing spread of unbelief in modern society, i) religion remains an independent variable, ii) a creative “back and forth” continues to occur between secular wisdom and religious faith, and iii) the difference between these two does not necessarily produce opposition between them. The author also agrees with the importance Taylor attaches to the emergence of immanent humanism. Yet the author disagrees with Taylor's account of contemporary culture and religion as expressions of people's quest of identity; the article demonstrates instead that religion participates in all contemporary social movements.     

ROY SCHAFER'S CONTRIBUTIONS TO PSYCHOLOGICAL TESTING: FROM CLINICAL SENSIBILITY TO THE ANALYTIC ATTITUDE

The author reviews Schafer's contributions to psychological testing, emphasizing his development of the test battery, his significant contributions to psychoanalytically oriented Rorschach interpretation, and his understanding of the complex interpersonal dynamics involved in psychological test interpretation. The author also discusses his use of Schafer's writing in his own teaching and academic work, noting that Schafer's contributions have not only provided innovative methods for examining test data, but have also promoted a respectful, humanistic, and individualized approach to the patient in testing and treatment. The author asserts that Schafer's later seminal contributions to psychoanalysis had their origins in his early career as a psychologist applying psychoanalytic ideas to testing.     

The unconscious

A discussion of the unconscious leads naturally to Freud and to a theory on subjectivity we may designate as de-centred. The unconscious reminds us that not only do we not know ourselves. In the core of our subjectivity, we have to acknowledge the notion of otherness. Re-reading Freud's text, The Unconscious, from 1915, the current author emphasises the character and function of the unconscious as radically different from what we know about conscious processes. This allows for the concept of the preconscious, which the author links to Winnicott's intermediary area and Green's tertiary processes. Taking as point of departure Freud's differentiation of word presentation and thing presentation, the author points to Freud's introduction of the term thing-cathexies of the object as designating the primal psychic representation. The Freudian perspective is broadened, encompassing the notion of otherness as discussed by Laplanche and Aulagnier. Concluding the paper, the author draws some implications for psychoanalytic technique, focusing especially on transference.     

THE VALUE OF UNCERTAINTY

The author discusses some of the characteristics of Roy Schafer's contributions to psychoanalysis that he finds most valuable, such as his openness to uncertainty, his anti‐reductive view of analytic constructions, his unique formulation of the analyst's role, and his close attention to how the patient engenders particular emotional reactions in the analyst. The author also presents a clinical vignette illustrating the value of the analyst's tolerance of uncertainty in the face of the patient's push for interpretations, explanations, and reassurance.