This art of psychoanalysis

It is the art of psychoanalysis in the making, a process inventing itself as it goes, that is the subject of this paper. The author articulates succinctly how he conceives of psychoanalysis, and offers a detailed clinical illustration. He suggests that each analysand unconsciously (and ambivalently) is seeking help in dreaming his 'night terrors' (his undreamt and undreamable dreams) and his 'nightmares' (his dreams that are interrupted when the pain of the emotional experience being dreamt exceeds his capacity for dreaming). Undreamable dreams are understood as manifestations of psychotic and psychically foreclosed aspects of the personality; interrupted dreams are viewed as reflections of neurotic and other non-psychotic parts of the personality. The analyst's task is to generate conditions that may allow the analysand-with the analyst's participation-to dream the patient's previously undreamable and interrupted dreams. A significant part of the analyst's participation in the patient's dreaming takes the form of the analyst's reverie experience. In the course of this conjoint work of dreaming in the analytic setting, the analyst may get to know the analysand sufficiently well for the analyst to be able to say something that is true to what is occurring at an unconscious level in the analytic relationship. The analyst's use of language contributes significantly to the possibility that the patient will be able to make use of what the analyst has said for purposes of dreaming his own experience, thereby dreaming himself more fully into existence.     

On not being able to dream

In this paper, the author explores the phenomenon of not being able to dream (as opposed to not being able to remember one's dreams) from three different vantage points. First, from the point of view of psychoanalytic theory, he discusses Bion's idea that the work of dreaming creates the conscious and unconscious mind (and not the other way around). A person who cannot dream is unable to generate differentiable conscious and unconscious experience and, consequently, lives in a psychic state in which he is unable to differentiate waking from sleeping, dreaming from perceiving. The author then approaches the problem of the inability to dream from the perspective achieved by a literary work. He discusses a Borges fiction that creates, in a singularly artful way, the experience of not being able to dream. Finally, the author utilises the vantage point of a detailed account of a clinical experience to explore what it means not to be able to dream. He describes an initial state characterised by the patient's proliferation of unutilisable 'psychic noise' which, over a period of years, led to the analyst's experiencing 'reverie-deprivation' and brief periods of countertransference psychosis. Two analytic sessions are presented and discussed in which psychological work was done that contributed to an enhanced capacity on the part of both patient and analyst for genuine dreaming - both in sleep and in analytic reverie states.     

The countertransference dream1

Can the analyst's night‐dream about his patient be considered as a manifestation of countertransference‐and, if so, under what conditions? In what way can such a dream represent more than just the disguised fulfillment of a repressed wish of the analyst? Is there not a risk of the analyst unconsciously taking up and ‘using’ the content of a session or other elements coming from the analytic situation for his own psychic reasons? The author, closely following Freud's dream theory, shows the mechanisms which can allow us to use the dream content in the analytical situation: preserved from the secondary processes of conscious thinking, other fantasies and affects than in the waking state can emerge in dream thought, following an ‘unconscious perception’. After examining the countertransference elements of Freud's dream, ‘Irma's injection’, which leads off The interpretation of dreams, the author presents a dream of her own about a patient and its value for understanding affects and representations which had hitherto remained unrepresented.     

The unwelcome child and his dreams: reconceptualization of dreaming in trauma

Based on the concepts of Sándor Ferenczi on trauma and vincularity, the author examines the operation of the mechanisms of dreaming in the processing of early traumatic situations and their clinical utilization. The difference is established between dreams of “repetition”, which lack dream imagery and contain a great amount of anguish, consisting of bodily sensations which may last on awakening, and the “secondary dream” with imagery, into which the first type can be transformed when the capacity of the psychic apparatus to process the traumatic situation is increased through therapeutic work. This “secondarization” of the repetitive dream has a traumatolytic effect, allowing the patient to reach psychoanalytically the mechanisms and mental states prevailing in the traumatic situation, through the mechanism of dream autorepresentation described by Silberer. In some cases, as illustrated in the clinical material, it is possible to anticipate the event of episodes of somatic disease before they become clinically evident.?The detailed analysis of dreams in patients with these characteristics is presented and discussed.     

From Freud’s dream-work to Bion’s work of dreaming: The changing conception of dreaming in psychoanalytic theory

Bion moved psychoanalytic theory from Freud's theory of dream-work to a concept of dreaming in which dreaming is the central aspect of all emotional functioning. In this paper, I first review historical, theoretical, and clinical aspects of dreaming as seen by Freud and Bion. I then propose two interconnected ideas that I believe reflect Bion’s split from Freud regarding the understanding of dreaming. Bion believed that all dreams are psychological works in progress and at one point suggested that all dreams contain elements that are akin to visual hallucinations. I explore and elaborate Bion’s ideas that all dreams contain aspects of emotional experience that are too disturbing to be dreamt, and that, in analysis, the patient brings a dream with the hope of receiving the analyst’s help in completing the unconscious work that was entirely or partially too disturbing for the patient to dream on his own. Freud views dreams as mental phenomena with which to understand how the mind functions, but believes that dreams are solely the ‘guardians of sleep,’ and not, in themselves, vehicles for unconscious psychological work and growth until they are interpreted by the analyst. Bion extends Freud's ideas, but also departs from Freud and re-conceives of dreaming as synonymous with unconscious emotional thinking – a process that continues both while we are awake and while we are asleep. From another somewhat puzzling perspective, he views dreams solely as manifestations of what the dreamer is unable to think.     

On dreaming one's patient: reflections on an aspect of countertransference dreams

This paper explores the phenomenon of the countertransference dream. Until very recently, such dreams have tended to be seen as reflecting either unanalyzed difficulties in the analyst or unexamined conflicts in the analytic relationship. While the analyst's dream of his/her patient may represent such problems, the author argues that such dreams may also indicate the ways in which the analyst comes to know the patient on a deep, unconscious level by processing the patient's communicative projective identifications. Two extended clinical examples of the author's countertransference dreams are offered. The author also discusses the use of countertransference dreams in psychoanalytic supervision.     

The dream between “here‐and‐now” and “there‐and‐then”

The analysand recounts his/her dream now, and here, in the setting. Though a dream may be recounted repeatedly, the human situation in which the recounting takes place is unrepeatable. Each moment of the analytic relationship is unique, and the recounting is essentially relational. Even if the dreamer were to read from a written text, his/her voice and non‐verbal aspects would render the communication unique. Not only the recounting but also the content recounted may present relational aspects, manifest or latent, but of a relational nature different from that of the session “here‐ and‐now”. The dream dreamt belongs to the “there‐and‐then”, and its analysis, like every analysis, implies an objectification. The analyst reacts to the recounted dream, trying to objectify it in its “there‐and‐then” and also inviting the dreamer to a common task. Working on the manifest content, free associations and interpretations of symbols, they voyage through the time and space of the analysand's life. The recounted dream involves the “here‐and‐now” of the session and asks to be meaningful as a cue in the analytic dialogue (what is the meaning of recounting this dream at this moment). At the same time it refers back to the dream dreamt, to a “there‐and‐then” which, if it is not to remain “an unopened letter”, must be received as an enigmatic challenge and a window on the unconscious, open and ready to close. Thinking of an opening of the dreamer's unconscious the analyst may find himself/herself faced with an opening of his/her own unconscious.     

Dreams that mirror the session1

Dreams in which the analyst appears undisguised almost always depict violations of the setting. Often experienced as special, epiphanic moments, they give a glimpse of an intense, emotional reaction to traumatogenic or otherwise signifi cant events that have occurred during the session or in the most recent previous ones. Probably, the essential aspect of these dreams can be found in the ‘form of their content’. This may be paralleled by the narrative technique of mise en abyme or mirror‐text. The dream appears as a story within the main story and the scene of the analysis is refl ected anti‐illusionistically. The fi ctional structure of the setting is emphasized. Its theatrical self‐consciousness quality is revealed at its best. The author postulates that the transformative therapeutic value of these dreams derives from denouncing the referential illusion of ‘concrete reality’ and of ‘what really happened’. For the analysand, they are an effective (i.e. emotionally intense) opportunity to discover the spatial articulations and the staggering refractions of the inside/outside, the textual/extra‐textual, the psychic reality/material reality. In the continual comings and goings from one term to another, the work of symbolization is reactivated and the subject is constructed. Dreams that mirror the session, from this point of view, provide a model for conceptualizing the analytic work, and their signifi cance goes beyond the specifi c phenomena referred to. A clinical case is given, in which some of one patient's dreams are considered as they occurred over a short period. In one of them, the dream‐within‐a‐dream phenomenon is present.     

Das Traumgenerierungsmodell von Ulrich Moser und die Codierung von Traumprozessen

Under the conditions of sleeping, mental activity creates a psychic microworld “dream” experienced as the present, running predominantly in a pictorial and sensual way in a sequence of situations and sometimes containing verbal relations and cognitive processes. Together with Ilka von Zeppelin, Ulrich Moser has developed a model of the emergence of sleep dreams with the aim to reconstruct the dreaming process, which is normally concealed under the verbal structure of the dream report and to explain this sequence as the result of a cognitive affective regulatory process. In accordance with the theory of French, dreaming is seen as an attempt to cope in a simulative mode with unresolved neurotic conflicts and traumatic experiences. To make this process visible, the authors developed a very differentiated model-guided coding system, a form of operationalization of the “dream work” that records and describes all cognitive elements and all interactive behavior in the dream. This analysis provides the formal and structural characteristics of the dream that precede every interpretation of content or biographical meaning. In this way, dream series in a single person, as well as dreams in different groups, can be objectively studied and compared. A presentation of the dream model is followed by an introduction into the basic principles of the coding system. This dream process coding and the interpretation based on it are demonstrated on a specimen dream. This dream is Freud’s “Dream of Irma’s injection”, which he selected himself to demonstrate his method of dream interpretation in Die Traumdeutung and which was also used by Erikson to illustrate his “configurational analysis”.     

On psychoanalytic supervision

The author provides both a theoretical context for, and clinical illustrations of, the way in which he thinks and works as a psychoanalytic supervisor. The analytic supervisory experience is conceived of as a form of 'guided dreaming'. In the supervisory relationship, the supervisor helps the analyst to dream (to do conscious and unconscious psychological work with) aspects of the analytic relationship that the analyst is unable to dream or is only partially able to dream. It is the task of the supervisory pair to 'dream up' the patient, that is, to create a 'fi ction' that is true to the supervisee's emotional experience with the analysand. To carry out this work, the supervisor must provide a frame that ensures the supervisee's freedom to think and dream and be alive to what is occurring in the analytic and the supervisory relationship, as well as in the interplay between the two. In one of the clinical illustrations presented, the author illustrates his conception of the importance of the feeling on the part of supervisor and supervisee that (at least occasionally) they have 'time to waste'. Such a state of mind may provide an opportunity for a type of freely associative thinking that enhances the range and depth of what can be learned from the supervisory experience. In another clinical example, the author describes his own experience in supervision with Harold Searles, which contributed to his conception of the supervisory process.     

On teaching psychoanalysis

Teaching psychoanalysis is no less an art than is the practice of psychoanalysis. As is true of the analytic experience, teaching psychoanalysis involves an effort to create clearances in which fresh forms of thinking and dreaming may emerge, with regard to both psychoanalytic theory and clinical practice. Drawing on his experience of leading two ongoing psychoanalytic seminars, each in its 25th year, the author offers observations concerning (1) teaching analytic texts by reading them aloud, line by line, in the seminar setting, with a focus on how the writer is thinking/writing and on how the reader is altered by the experience of reading; (2) treating clinical case presentations as experiences in collective dreaming in which the seminar members make use of their own waking dreaming to assist the presenter in dreaming aspects of his experience with the patient that the analytic pair has not previously been able to dream; (3) reading poetry and fi ction as a way of enhancing the capacity of the seminar members to be aware of and alive to the effects created by the patient's and the analyst's use of language; and (4) learning to overcome what one thought one knew about conducting analytic work, i.e. learning to forget what one has learned.     

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.     

Dances of Desire: Commentary on Papers by Dianne Elise and Jonathan H. Slavin

The richness and creativity of early classical work with dreams became narrowed through doctrinaire obedience to Freud's brilliant hypotheses. Interpersonal psychoanalysis, though originally little interested in problems of mind and private mentation, may be well suited, in part due to its lack of a comprehensive dream theory, to a clinical approach to dreams that is relatively open‐minded, pluralistic, complexly layered, collaborative, and playful. Multiple possibilities for the meanings of dreams and multiple ways of approaching dreams in analytic therapy are suggested. Although many therapists for complex reasons shy away from working on dreams, an interpersonal approach recognizes that several wishes of both patient and analyst may be significantly fulfilled in the pleasures of working together on dreams. If it is mindful of what is unfortunately a growing tendency to project into all dreams a single‐minded preoccupation with transference and countertransference, and if it respects the world of dream imagery in its own right, interpersonal psychoanalysis can make a genuine contribution to our understanding of dreams and dreams can lend an important dimension to interpersonal concepts. Several clinical examples are presented in an effort to highlight an approach that “stays with the image”; and allows the dream images to make their way into the psychoanalytic dialogue.     

On talking-as-dreaming

Many patients are unable to engage in waking-dreaming in the analytic setting in the form of free association or in any other form. The author has found that 'talking-as-dreaming' has served as a form of waking-dreaming in which such patients have been able to begin to dream formerly undreamable experience. Such talking is a loosely structured form of conversation between patient and analyst that is often marked by primary process thinking and apparent non sequiturs. Talking-as-dreaming superficially appears to be 'unanalytic' in that it may seem to consist 'merely' of talking about such topics as books, films, etymology, baseball, the taste of chocolate, the structure of light, and so on. When an analysis is 'a going concern,' talking-as-dreaming moves unobtrusively into and out of talking about dreaming. The author provides two detailed clinical examples of analytic work with patients who had very little capacity to dream in the analytic setting. In the first clinical example, talking-as-dreaming served as a form of thinking and relating in which the patient was able for the first time to dream her own (and, in a sense, her father's) formerly unthinkable, undreamable experience. The second clinical example involves the use of talking-as-dreaming as an emotional experience in which the formerly 'invisible' patient was able to begin to dream himself into existence. The analyst, while engaging with a patient in talking-as-dreaming, must remain keenly aware that it is critical that the difference in roles of patient and analyst be a continuously felt presence; that the therapeutic goals of analysis be firmly held in mind; and that the patient be given the opportunity to dream himself into existence (as opposed to being dreamt up by the analyst).     

On the Royal Road Together: The Analytic Function of Dreams in Activating Dissociative Unconscious Communication

I propose a new analytic function of dreams: the use of dreams to activate powerful forms of unconscious affective communication between patient and analyst, which crucially facilitate the transformation of dissociative mental structure. Moments of what I call dissociative unconscious communication serve to “seek-and-find” the unconscious mind of the analyst and open up channels of unconscious empathy. Such analytic dream communications are particularly likely to occur when certain overwhelming experiences are dominating the treatment: (a) the accessing of dissociated early trauma, and (b) the loosening or crumbling of dissociative structure as the patient begins to come alive.     

Of Innocence and Experience: Commentary on Paper by Stuart A. Pizer

In providing the background to a pivotal session, Stuart Pizer reveals his clinical work as an unsupervised neophyte, prior to his own analysis and analytic training. These early therapeutic efforts were flawed, leaving Pizer at times “grimacing with mortification 26 years after the fact.” But they were also extraordinarily helpful to the patient. Schaffer discusses the challenge of supervising similarly talented beginners: how does one teach psychoanalysis without desiccating a treatment? How does one teach a relational approach, with no “basic model” and few rules, to a beginning analyst infused with an unformulated, yet often passionate, sense of what is “curative”? Pizer recognizes that were he to meet the same patient today, he would not conduct the same treatment. Now trained and analyzed, not to mention more cautious and “worldweary,” Pizer would not do what he did then. But what if he were the supervisor then? Schaffer concludes her discussion by asking Pizer how he, now a seasoned analyst, would supervise his early therapist self.     

Commentary on Paper by Lawrence J. Brown

Brown's historical overview of post-Kleinian psychoanalysis traces key steps in the evolving and diverse practice of working in the psychoanalytic situation while regarding it as a two-person field. The Barangers' “The Analytic Situation as a Dynamic Field” is central to his narrative. I develop my understanding of the originality of their contribution in theorizing a situational unconscious, and of their continuing relevance for thinking about analytic listening and intersubjective collaboration. Brown presents a countertransference dream of his own along with the dream of a patient as an example of the Barangers' concept of the “shared unconscious fantasy” of the analytic couple. A detailed alternative reading of Brown's clinical vignette reveals an absence of fit with the Barangers' views on collaboration in the analytic situation. Some uses of Bion's “dreaming” and “becoming” are implicitly questioned as they risk encouraging the idealization of special states over process.     

Psychoanalytic transformations1

The author describes how Bion took Freud's conception of dreams as a form of thought and used it as the basis of his theory of transformations. Bion developed an expanded theory of ‘dream thought’, understood as a process of selection and transformation of sensory and emotional experiences. In this theory, the work of analysis is in turn conceived as a process not only of deciphering symbols, of revealing already existing unconscious meanings, but also of symbol production‐of a process for generating thoughts and conferring meaning on experiences that have never been conscious and never been repressed because they have never been ‘thought’. Analysis, in its specific operational sense, becomes a system of transformation whereby unconscious somatopsychic processes acquire the conditions for representability and become capable of translation into thoughts, words and interpretations. The rules of transformation applied by the patient in his representations and those applied by the analyst in his interpretations have the same importance for the analytic process as those described by Freud for the process of dreaming. The author discusses the broad categories of transformation adduced by Bion (rigid motion, projective, and in hallucinosis) and introduces some further distinctions within them.     

The Deaf and Their Problems by Kenneth W. Hodgson

Abstract

This article is an attempt to develop a coherent, unified, and consistent conceptualization of dreaming and dreamtelling in the clinical setting. Dreams told in a therapeutic setting are challenging events: fantastically rich in content, but often overwhelming in their implications for peoples’ relationships. When told in therapy groups, dreams provide additional challenges for all participants. Learning to work with dreams not only enhances understanding of unconscious intrapsychic and group processes, but may also have a strong impact on the therapeutic culture and working relationships in the group. After differentiating dreaming from dreamtelling, I briefly describe three uses of dreams in groups—the classical “informative” and more familiar “formative” uses, and a new perspective that focuses on the “transformative” aspects of a dream told. According to this perspective, a dream told has an interesting past, an important present, and a worthwhile future because of its interpersonal, intersubjective influence on the dreamer–audience relationship.