ANALYTIC MIND USE AND INTERPSYCHIC COMMUNICATION: DRIVING FORCE IN ANALYTIC TECHNIQUE,PATHWAY TO UNCONSCIOUS MENTAL LIFE

Developed from established psychoanalytic knowledge among different psychoanalytic cultures concerning unconscious interpsychic communication, analysts' use of their receptive mental experience—their analytic mind use, including the somatic, unconscious, and less accessible derivatives—represents a significant investigative road to patients' unconscious mental life, particularly with poorly symbolized mental states. The author expands upon this tradition, exploring what happens when patients unconsciously experience and identify with the analyst's psychic functioning. The technical implications of the analyst's “instrument” are described, including the analyst's ego regression, creation of inner space, taking mind as object, bearing uncertainty and intense affect, and self‐analysis. Brief case vignettes illustrate the structure and obstacles to this work.     

A mismatch of meaning and intentionality between analyst and analysand

In this paper, I will consider a type of misunderstanding in the analytical dialogue and the possible unconscious motivations underlying this. I will also make reference to the patient's use of the analyst's words for the purpose of narcissistic enactment and will explore the extent of the analyst's involvement in this. The subjects of misunderstanding and narcissistic enactment will be dealt with in relation to a patient's way of processing certain interpretations at the beginning of analysis and the concealment of her way of processing the analyst's words. By contributing dreams and other significant material in the sessions, the patient gradually revealed her phantasies which enabled the analyst to uncover the possible factors which determined her particular attribution of meaning to the analyst's words and her retention of information about how she had initially construed his interpretations.     

Vulnerability,Affect, and Depth in Group Psychotherapy

This paper describes the importance of a clinical focus on affect and narcissistic vulnerability in the deepening of therapeutic process. An experience of the analyst's emotional availability and understanding is also essential to mutative change. The case material illustrates how such a focus, within a relational context that includes the analyst's own vulnerability, can lead to change.     

Private Terrors Sexualized Aggression and a Psychoanalyst's Fear of Her Patient

This clinical paper explores the meanings and evolution of an analyst's reaction of fear in relation to her patient's sexualized aggression. From both an intrapsychic and an intersubjective perspective, the author analyzes the coconstruction of this transference—countertransference phenomenon. Case vignettes illustrate the author's attempts to address her patient's sexualized aggression while struggling to free herself from the feelings of intimidation and fearfulness stirred by his sadomasochistic fantasies and patterns of interaction. The analyst's unconscious identification with the patient's disowned femininity and narcissistic vulnerability is seen as central to this countertransference “stranglehold.” Release from the analyst's masochistic position comes through a shift in her own affective participation. The importance of the analyst's recognizing her own unconscious contributions to this sadomasochistic dynamic is emphasized and elaborated. Discussion also focuses on the relevance of gender to the issue of countertransference fear, as illustrated in this particular male patient—female analyst dyad.     

Marco Conci interviews Stefano Bolognini

Abstract

This paper suggests that the understanding of intersubjectivity, which refers to “the dynamic interplay between the analyst's and the patient's subjective experiences in the clinical situation”, is crucial for psychoanalytic work. The analyst's inner experiences, from the first moment that he or she thinks about or meets the patient, belong to an intersubjective situation. Not only are these experiences a valuable channel through which the inner experiences of the patient can be understood, but—as Theodore Jacobs puts it—they are often complementary to that which comes from the patient. The author tries to illustrate the above through the study of the analytic process in the psychoanalytic therapy of a severely disturbed patient. This therapy from its very early phase led to the reawakening of some of the analyst's old conflicts. The patient's difficulties in tolerating the limits of the analytic setting and using free association are discussed, as are his enactments. The analyst's close observation of the interaction between her and the patient, the permanent engagement with her countertransference, and the use of her inner experiences with the patient helped her to contain the enactments, defined the nature of her interventions, and contributed to the analytic process.     

Alphabetizing in old age

Abstract: A long term, intensive analysis with a woman in old old age is reported. An attempt is made to answer the question, ‘What, in analytic work, is healing?’. The patient's previous classical Jungian work is contrasted with the author's developmental perspective. It is suggested that an enactment, representing what Neville Symington has called an analyst's act of freedom, was crucial in effecting a profound transformation in the patient's psyche.     

Danger and safety: The analyst as analytic subject

Abstract

This paper considers questions of danger and safety in the analytic relationship in light of the contemporary recognition of analysis as a co-participatory process. In the interest of safety, the psychoanalyst has the responsibility to be persistently curious, particularly about the problems derived from his contact with the analysand. Information about the analyst's impact must be taken to heart; it must be experientially considered. As the process unfolds, the analyst presumes that a portion of its effect will be negative. The analyst aspires not to preempt all negative impact but to create an analytic environment in which the analysand's conscious and unconscious communications about impact may be attended to. The analyst's ability to receive such information is crucial in the establishment of a reliable process capable of addressing and surviving the unanticipated dangers that inevitably emerge and securing the analysand for further self articulation. The analyst can simultaneously attend to being the analyst and being a subject of analysis by regarding all communications from the analysand as representing, at least in part, interpretations of the analyst and the analyst's participation. Illustrative material is presented.     

Journal reviews

Articles reviewed: Astor, James: ‘Some Jungian and Freudian perspectives on the Oedipus myth and beyond’. Colman Warren: ‘That within which passes show: Hamlet and the unknowable Self’. Halberstadt-Freud H. C: ‘Electra versus Oedipus à Femininity reconsidered’. Kulish, Nancy & Holtzman, Deanna: ‘Persephone, the loss of virginity and the female Oedipus complex’ Hopkins, Linda B: ‘D. W. Winnicott's analysis of Masud Khan: a preliminary study of failures of object usage’. Miletic, Michael (ed.): ‘Perspectives on the analyst's self-disclosure during psychoanalysis’. Miletic, Michael J. (ed.): ‘Perspectives on the analyst's self-disclosure during psychoanalysis’. Ornstein, Anna: ‘The fate of narcissistic rage in psychotherapy’. Solomon, Hester McFarland: ‘Love, Paradox of Self and Other’. Stack, Carolyn: ‘The analyst's new clothes: the impact of the therapist's unconscious conflicts on the treatment process’. Von Der Tann, Matthias: ‘Was lesen Jungianer in Berlin für das Examen?’–‘What do Jungians in Berlin read for their final paper?’     

THE USE OF THE ANALYST AND THE SENSE OF BEING REAL: THE CLINICAL MEANING OF WINNICOTT'S “THE USE OF AN OBJECT”

“The Use of an Object and Relating through Identifications” (1968) represents Donald Winnicott's theoretical and clinical legacy. The author develops this concept from a clinical point of view, through the analysis of a woman with psychotic functioning. He reflects upon the dramatic quality of risks inherent in the processes linked to the use of the object with seriously disturbed patients. He explores different meanings of the analyst's survival, linking it to the analyst's response. The processes of the use of the object—that is, the encounter between the patient's potential destructiveness and the analyst's capacity to respond through his own judicious subjectivity—let the patient experience the analyst's capacity to keep his own subjectivity, authenticity, and creativity alive. It is starting from the traces of this live object that patients gradually form their own personal sense of being real.     

THE MISSING FATHER FUNCTION IN PSYCHOANALYTIC THEORY AND TECHNIQUE: THE ANALYST'S INTERNAL COUPLE AND MATURING INTIMACY

This paper argues that recovering the “missing” paternal function in analytic space is essential for the patient's achievement of mature object relations. Emerging from the helpless infant's contact with primary caregivers, mature intimacy rests on establishing healthy triadic functioning based on an infant‐with‐mother‐and‐father. Despite a maternocentric bias in contemporary clinical theory, the emergence of triangularity and the inclusion of the paternal third as a separating element is vital in the analytic dyad. Effective technique requires the analyst's balanced interplay between the paternal, investigative and the maternal, maximally receptive modes of functioning—the good enough analytic couple within the analyst—to serve as the separating element that procreatively fertilizes the capacity for intimacy with a differentiated other. A clinical example illustrates how treatment is limited when the paternal function is minimized within more collusive, unconsciously symbiotic dyads.     

Neutrality,tenderness and the analyst's subjectivity

Addressing the rôle of the analyst in the psychoanalytic relationship, the author takes issue with the emphasis on acknowledging the analyst's subjectivity and the critique of concepts like neutrality and abstinence as these issues are presented in the relational tradition. He advocates a better articulation and emphasis of these concepts in the service of understanding the impact of the analyst's subjectivity, and demonstrates how the mere loosening up of analytic neutrality and abstinence and an acceptance of the analyst's self-disclosure make transference analysis more difficult to handle. Such an attitude also increases the risk for ethically dubious conduct, since there is a close link between clinical methods and ethical standards in psychoanalysis. In conclusion, the author points to the importance of the analyst's continuous self-reflection and countertransference analysis.     

THE PATIENT'S OBJECTS IN THE ANALYST'S MIND

In every analysis, the analyst develops an internal relationship with the patient's objects—that is, the people in the patient's life and mind. Sometimes these figures can inhabit the analyst's mind as a source of data, but at other times, the analyst may feel preoccupied with or even invaded by them. The author presents two clinical cases: one in which the seeming absence of a good object in the patient's mind made the analyst hesitate to proceed with an analysis, and another in which the patient's preoccupation with a “bad” object was shared and mirrored by the analyst's own inner preoccupation with the object. The use and experience of these two objects by the analyst are discussed with particular attention to the countertransference.     

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.     

Trauma,narcissism and the two attractors in trauma1

In this paper, the author sets out to distinguish anew between two concepts that have become sorely entangled‐‘trauma’ and ‘narcissism’. Defi ning ‘narcissism’ in terms of an interaction between the selfobject and the self that maintains a protective shield, and ‘trauma’ as attacks on this protective shield, perpetrated by bad objects, he introduces two attractors present in trauma‐‘the hole attractor’ and the structure enveloping it, ‘the narcissistic envelope’. The hole attractor pulls the trauma patient, like a ‘black hole’, into a realm of emotional void, of hole object transference, devoid of memories and where often in an analyst's countertransference there are no reverberations of the trauma patient's experience. In the narcissistic envelope, on the other hand, motion, the life and death drive and fragments of memory do survive. Based on the author's own clinical experience with Holocaust survivors, and on secondary sources, the paper concludes with some clinical implications that take the two attractors into account.     

Group Psychotherapy by Florence B. Powdermaker and Jerome D. Frank

Subjective countertransference can sharply limit any group leader's effectiveness. However, a therapist can use the group itself to identify such a bias and to remove it as an influence. A five-step method for doing this is presented. These steps begin with introspection but hinge upon the analyst's turning to the group for the vital information that, in the end, clarifies the analyst's own perceptions and helps him or her free the group from the harmful effects of any bias.     

Talking With Chameleons: The Role of Language-Games and Setting: Commentary on Paper by Dana Amir

In this paper I take up Dana Amir's concept of the “chameleon language” of perversion considering Wittgenstein's idea of the language-game and the necessity of taking up the context of communication. The setting of psychoanalysis represents a new context for the language of perversion, one that at first implicitly and later explicitly recognizes the bid for tenderness beneath the stealth. I suggest it is the analyst's willingness to risk vulnerability in this game, as much as the interpretation of perverse pacts, that fosters clinical change.     

Final Thoughts on the Case of Pamela and Commentaries

Much gratitude is offered to Drs. Bach and Bromberg for their rich discussions of the case. Some reflections and final thoughts are gathered. The value of the single case study is underlined. The emphases by Bach and Bromberg on the centrality of trauma, failures in recognition, and the healing fostered by acceptance, consistency, and care in the treatment are highlighted. Bach points to the patient's need to regress and to “float in her own subjectivity” in the treatment, to not be impinged on by another “I” in the room. Bromberg's focus is on the need to accept all of the patient's different self states, including the guardian of the weak vulnerable self. Bach highlights the unbalancing of the analyst's narcissistic equilibrium in enactment and Bromberg emphasizes the importance of real and spontaneous engagement. Both point to how such enactments involve a crucial unthought living through of the central trauma itself in the treatment of such patients. The analyst is both in the enactment and a witness to it, allowing for the transformation of traumatic affect and bodily memory. The issue of regression and the concept of the false self are highlighted as topics for further discussion.     

Comparing Field Theories

While in broad agreement with many of the observations made by Donnel B. Stern, this essay emphasizes certain differences in how BFT in general and the work of Nino Ferro in particular are seen. These begin with the very meaning of the term, field, and include a less authoritarian view of the analyst's “knowing” the degree to which the analyst's unconscious and subjectivity are implicated in the creation of the field, and the nature and degree of the analyst's unconscious contribution to the creation of the field.     

Projective identification,containment and sojourn in the psyche: Clinical notes on a specific type of transference-countertransference interaction

Abstract

This paper suggests that the interplay between transference and countertransference is considered to be a valuable channel of communication. The author puts an emphasis on the containing function of the analyst. The patient strives for an experience of an object (analyst) that tolerates and copes with the patient's projections. There are some moments when analysts feel themselves to be invaded, controlled or abused by their patient's products. As Bion has postulated, this situation takes the form of a sojourn in the analyst's psyche. Clinical vignettes are given to provide support for the ways in which the analyst contains and elaborates the projections of the patients in his or her own mind and the therapeutic role that these processes have.     

Between memory and destiny: Repetition1

This essay focuses mainly on the topic of repetition (agieren)—on its metapsychological, clinical, and technical conceptions. It contains a core problem, that is, the question of the represented, the nonrepresented, and the unrepresentable in the psyche. This problem, in turn, brings to light the dialectical relation between drive and object and its specific articulation with the traumatic. The author attributes special significance to its clinical expression as ‘destiny’. He points out a shift in the theory of the cure from recollection and the unveiling of unconscious desire, to the possibility of understanding ‘pure’ repetition, which would constitute the very essence of the drive. The author highlights three types of repetition, namely, ‘representative’ (oedipal) repetition, the repetition of the ‘nonrepresented’ (narcissistic), which may gain representation, and that of the ‘unrepresentable’ (sensory impressions, ‘lived experiences from primal times,’‘prelinguistic signifiers,’‘ungovernable mnemic traces’). The concept‐the metaphor‐drive embryo brings the author close to the question of the archaic in psychoanalysis, where the repetition in the act would express itself. ‘Another unconscious’ would zealously conceal the entombed (verschüttet) that we are not yet able to describe‐the ‘innermost’ rather than the ‘buried’ (untergegangen) or the ‘annihilated’ (zugrunde gegangen)‐through a mechanism whose way of expression is repetition in the act. With ‘Constructions in analysis’ as its starting point, this paper suggests a different technical implementation from that of the Freudian construction; its main material is what emerges in the present of the transference as the repetition of ‘something’ lacking as history. The memory of the analytic process offers a historical diachrony whereby a temporality freed from repetition and utterly unique might unfold in the analysis. This diachrony would no longer be the historical reconstruction of material truth, but the construction of something new. The author briefly introduces some aspects of his conception of the psyche and of therapeutic work in terms of what he has designated as psychic zones. These zones are associated with various modes of becoming unconscious, and they coexist with different degrees of prevalence according to the psychopathology. Yet each of them will emerge with unique features in different moments of every analysis, determining both the analyst's positions and the very conditions of the analytic field. The zone of the death drive and of repetition is at the center of this essay. ‘Pure’ repetition expresses a time halted by the constant reiteration of an atemporal present. In this case, the ‘royal road’ for the expression of ‘that’ unconscious will be the act. The analyst's presence and his own drive wager will be pivotal to provide a last attempt at binding that will allow the creation of the lost ‘psychic fabric’ and the construction, in a conjectural way, of some sort of ‘history’ that may unravel the entombed (verschüttet) elements that, in these patients' case, come to the surface in the act. The analysand's ‘pure’ repetition touches, resonates with something of the new unconscious of the analyst. All of this leads the author to underline once again the value of the analyst's self‐analysis and reanalysis in searching for connections and especially in differentiating between what belongs to the analyst and what belongs to the analysand. A certain degree of unbinding ensures the preservation of something ungraspable that protects one from the other's appropriation.