The Strangeness of Passing: Commentary on Paper by Christopher Bonovitz

Christopher Bonovitz gives us a rich landscape of the theoretical, historical, and relational aspects of his work with his mixed-race patient. In my response I explore what seems missing: a stronger sense of the patient as a person, more of her own history in her family, more of the clinical back and forth with her therapist, a sense of what is being played out in the transference, and particularly what “passing” is for her. I show how his choices about how to think about her story and how to tell it are oversaturated with awareness of identity and race at the expense of the basic human relationship. In the face of such racial anxiety, there is a pull to rely too strongly on countertransference as a way to gain privileged access to knowledge about the other. I attribute many of these problems to the inescapable power of race in our culture. Furthermore, I address the themes of hatred, silence, secrecy and transgression as they relate to the history of transgenerational trauma for this patient and invite our broadening our awareness about how they play out in the therapeutic process. We are faced with the difficult, yet the essential task of holding and living out the patient's anger and outrage at the racial hatred that has been endured.     

Childless

This paper explores the complex interplay that unfolded between analyst and patient around their respective childlessness and aims to draw attention to the larger societal issues of imperative parenthood and the stigma of childlessness. As the analyst confronted her own internal conflicts about motherhood, children, and procreation as a woman living in a pronatalist society (one that encourages increasing birth-rates), she was treating a lesbian patient with a history of childhood relational trauma and sexual abuse who was undergoing fertility treatments. The patient’s experience with assisted reproductive technologies raised complicated questions and concerns within the analyst regarding their emotional impact on her patient and, more broadly, how they might reflect societal dissociation. Themes of trauma, loss, dissociation, and shifting self-states, which emerged during the fertility treatments and wove their way throughout the analysis, are discussed. In addition, the author describes the nature of the therapeutic action in this case.     

The Entropic Body: Primitive Anxieties and Secondary Skin Formation in Anorexia Nervosa

This paper develops a metapsychological view of anorexia nervosa, including not only its symptomatic presentation but also its etiology and characteristic psychic and relational styles. Because patients with anorexia are understood as not having internalized maternal comforting functions in the period of separation-individuation, they are unable to digest trauma experiences of infancy. I argue that the anorexic patient’s disturbed relationship with food reflects distortions in transitional object usage. Lacking the ability to contain intense anxieties about disintegration and falling apart, patients with anorexia must find other ways to hold themselves together. The fear of getting fat expressed by these patients is one way that this fear of disintegration is expressed. Furthermore, the almost addictive experience of emaciation holds the personality together. Elaborating this idea, I develop the notion of the entropic body, a particular version of the false body (Goldberg, 2004) employed by patients with anorexia nervosa in an attempt to compensate for absent maternal comforting functions. This body-state (Petrucelli, 2014), which develops against a background of profound early trauma, eschews hunger and dependence in favor of omnipotently controlled protection.     

Is Skepticism about Self-Knowledge Coherent?

In previous work I argued that skepticism about the compatibility ofanti-individualism with self-knowledge is incoherent. Anthony Brueckner isnot convinced by my argument, for reasons he has recently explained inprint. One premise in Brueckner's reasoning is that a person'sself-knowledge is confined to what she can derive solely from herfirst-person experiences of using her sentences. I argue that Brueckner'sacceptance of this premise undermines another part of his reasoning – hisattempt to justify his claims about what thoughts our sincere utterances ofcertain sentences would express in various possible worlds. I describe aweird possible world in which a person who uses Brueckner's reasoning endsup with false beliefs about what thoughts her sincere utterances of certainsentences would express in various possible worlds. I recommend that wereject Brueckner's problematic conception of self-knowledge, and adopt onethat better fits the way we actually ascribe self-knowledge.     

Seeing double,being double: longing,belonging, recognition,and evasion in psychodynamic work with immigrants

Psychically immigrants live double lives, simultaneously dwelling in the world they have left and the world in which they live, and into which most try to fit to avoid the alienating experience of being “other”. Doubleness is not a conscious act, but it is a preconscious counterpoint to just about every social interaction. I argue that successful psychodynamic treatment allows immigrants to take the doubleness for granted, in effect seeing double and being double. In this way they come to effortlessly privilege one self-state over the other. The recognition and acceptance of competing self-states proves transformative in any treatment, but never more so than in working with immigrants who contend with several culturally competing selves in their daily lives and seek one relationship in which they can all be seen and heard. I describe treating an immigrant who, when I began to work with her, excelled at seeing double, but being double posed a terrifying dilemma. At least two self-states were engaged in a tug of war; she feared that the winner would take all.     

Dissociative Collusion: Reconnecting Clients with Histories of Trauma in Couple Therapy

This paper introduces the concept of “dissociative collusion” as a helpful theoretical and clinical tool for understanding and working with clients with histories of trauma in couple therapy. The paper describes ways to diagnose and treat dissociative collusion based on the integration of an object relations approach, a relational approach, and a narrative approach. Dissociative collusion, a unique version of the well‐documented “couple collusion,” describes relational unconscious dynamics where split‐off aspects of one or both partners are mutually dissociated in a complementary fashion that becomes a part of the shared unconscious and is reenacted in destructive ways. The dissociative collusion concept is especially relevant to couple therapists who work with clients with histories of trauma, who frequently use dissociation as a primary defense mechanism. We suggest that the challenge and goal for couple therapy with this population are to help them reconnect and better oscillate between dissociated self‐other configurations. A case of couple therapy of a wife who had been a victim of childhood sexual abuse and her husband who displayed frequent use of dissociative defenses is presented.     

Playing with unreality: transference and computer

In this paper I describe the impact of cyberspace on the analytical relationship. My reflections will move from two clinical histories. In the first history, I describe the case of Melania, a patient who, at a certain moment of her analysis, started sending me e-mails, almost building a 'parallel setting'. I describe the relational dynamics linked to the irruption of the electronic mail into the boundaries of our psychoanalytic relationship. The second case is Louis, a 25 year-old young man with a schizoid personality who uses cyberspace as a psychic retreat. Over the years Louis told me, initially from a sidereal distance, of his necessity to create dissociative moments. The entrance to these retreats procures for Louis an immobile pacification, which may assume the characteristics of a trance: life comes to a halt in a state of 'suspended animation'. We can see the use that Louis makes of the computer as an attempt to live into a non-human object and to protect himself from relational anguish, but also to warm up a mechanical mother. Melania used technology to communicate with me, albeit in a roundabout way; for Louis, virtual space was a 'dissociative retreat' located on the border between sleeping and waking, which for years went untouched by our analytical discourse. For both patients, the computer was a tool for emotional regulation, and the analytical relationship aimed to give this tool some relational meaning, facilitating the shift from compulsive usage to a transformative use of the object.     

Internalism and the Origin of Rational Motivation

What makes a subject's motivationrational is its originating in her practicalreasoning. I explain the appeal of this thesisabout rational motivation, and explore itsrelation to recent discussions of internalismabout reasons for action. I do so in theservice of clarifying an important meta-ethicaldebate between Humean motivational skeptics andtheir Kantian opponents. This debate is oneover whether, as this skeptic contends andKantians deny, considerations about ourmotivational capacities, together withinternalism, restrict genuine reasons foraction to merely instrumental ones. I arguethat properly adjudicating this debate requiresidentifying one particular way in which thethesis about rational motivation has beendeveloped – namely, as a part of what I term``the traditional conception' of themotivational efficacy of practical reason. Onthis conception, rational motivation consistsin choosing some course of conduct out of one'scognitive appreciation of the way its relationto one's practicable good gives one reason todo so. And I side with Kantians against theHumean motivational skeptic in part on groundsthat Kant himself – though not all Kantians –would find congenial: namely, that we shouldaccept the traditional conception.     

Enthusiastic Improvement: Mary Astell and Damaris Masham on Sociability

Many commentators have contrasted the way that sociability is theorized in the writings of Mary Astell and Damaris Masham, emphasizing the extent to which Masham is more interested in embodied, worldly existence. I argue, by contrast, that Astell's own interest in imagining a constitutively relational individual emerges once we pay attention to her use of religious texts and tropes. To explore the relevance of Astell's Christianity, I emphasize both how Astell's Christianity shapes her view of the individual's relation to society and how Masham's contrasting views can be analyzed through the lens of her charge that Astell is an “enthusiast.” In late seventeenth‐century England, “enthusiasm” was a term of abuse that, commentators have recently argued, could function polemically to dismiss those deemed either excessively social or antisocial. By accusing Astell of enthusiasm, I claim, Masham seeks to marginalize the relational self that Astell imagines and to promote a more instrumental view of social ties. I suggest some aspects of Astell's thought that may have struck contemporaries as “enthusiastic” and contrast her vision of the self with Masham's more hedonistic subject. I conclude that, although each woman differently configures the relation between self and society, they share a desire to imagine autonomy within a relational framework.     

‘If I leave home,who will take care of mum?’ Intergenerational transmission of parental trauma through projective identification

Using the construct of projective identification and integrating it with the body of literature on intergenerational transmission of unsymbolized parental trauma, I describe the case of an adult daughter that illustrates intergenerational transmission of unsymbolized parental trauma. It is suggested that the daughter has unconsciously identified with the disavowed feelings of anxiety projected into her by her mother. The daughter’s projective identification of her mother’s unresolved past traumas prevent her from leaving the parental home for the first time, despite being 35 years old. In turn, it is thought that the mother’s unconscious grasping onto her daughter is an attempt to avoid the confrontation of her own unprocessed fears implanted into her by her own mother, thus linking three generations of disavowal. As a way of extending the exiting theory, it is proposed that when there are long-term and inexplicable experiences of anxiety that coalesces around the intergenerational transmission of parental trauma, the term ‘intergenerational transmission of traumatic anxiety’ can be used to describe it.     

Moral Competence, Moral Blame, and Protest

I argue that wrongdoers may be open to moral blame even if they lacked the capacity to respond to the moral considerations that counted against their behavior. My initial argument turns on the suggestion that even an agent who cannot respond to specific moral considerations may still guide her behavior by her judgments about reasons. I argue that this explanation of a wrongdoer’s behavior can qualify her for blame even if her capacity for moral understanding is impaired. A second argument is based on the observation that even when a blameworthy wrongdoer could have responded to moral considerations, this is often not relevant to her blameworthiness. Finally, I argue against the view that because blame communicates moral demands, only agents who can be reached by such communication are properly blamed. I contend that a person victimized by a wrongdoer with an impaired capacity for moral understanding may protest her victimization in a way that counts as a form of moral blame even though it does not primarily express a moral demand or attempt to initiate moral dialogue.     

Licensing Parents Revisited

Although systems for licensing professionals are far from perfect, and their problems and costs should not be ignored, they are justified as a necessary means of protecting innocent people's vital interests. Licensing defends patients from inept doctors, pharmacists, and physical therapists; it protects clients from unqualified lawyers. We should protect people who are highly vulnerable to those who are supposed to serve them, those with whom they have a special relationship. Requiring professionals to be licensed is the most plausible way of doing that. Given the overwhelming support for the licensing of these professionals, I find it odd that so many people categorically reject proposals to license parents. Although the relationship between a parent and her children is different in some respects, it is also relevantly similar to that between a professional and those she serves. To defend these claims, I show how and why the rationale for licensing parents parallels the rational for licensing professionals. I then ask whether such a program could be justifiably implemented. Finally, I describe and reject what I see as the flawed view of the relationship between parents and their children.     

Intergenerational Transmission of Violence: Shattered Subjectivity and Relational Freedom

This article considers a relational perspective regarding the intergenerational transmission of the trauma of violence. The psychoanalytic literature suggests that parents often transmit the trauma of violence to their children in the form of projected nameless dread and unmentalized states that interfere with the children's emotional needs and support. The offspring absorbs the trauma, which manifests itself in the form of disorganized attachment and in turn leads to the development of a predisposition toward cocoon-like dissociative states. This study considers two clinical cases that examine the interpersonal dynamics of dissociative processes. The therapist's reverie about his ancestors' survival of depersonalizing violence and Winnicott's concept of the survival and the use of the object help the therapist find his or her identity and gain the relational freedom needed to overcome the dissociative state, thereby becoming an alive subject who is able to help the child patient.     

Delayed reaction to sibling-loss: The unmourned sibling as a block to procreation and creativity; A post-traumatic state

In this paper I describe a delayed reaction to sibling-loss in a woman patient who had decided to start a family. She began to have unexplained panic attacks after making the decision to have a baby. In analysis it gradually became apparent that these panic attacks were a delayed reaction to the trauma of the loss of her baby brother when she was 16 years old. Recovery of her feelings about the death of her brother led to a gradual resolution of her symptoms and to her successfully being able to have her own baby. It also led to a marked increase in her creativity and to greater satisfactions in personal relationships. The unmourned nature of the death of her brother had had a deadening effect on her feelings including her own maternal feelings and procreative capacity.     

Daniel levinson and his theory of adult development: A reminiscence and some clarifications

I offer some reminiscences occasioned by the death of Daniel Levinson, a modern pioneer in the study of the human life cycle. I clarify three controversial aspects of Levinson's theory—its universality, the role of critical life events, and the place of relationships—as well as briefly foreshadow findings from his forthcoming book on women. I show that relationships to people, enterprises, and social institutions are the stuff out of which the individual life structure—Levinson's central concept—is formed. Levinson's dream was of a society in which the developmental needs of adults were better understood and met so that they could more generatively fill their roles in the institutions upon which the young depend. He thought this essential to the evolution of a society that would be both more competent and more humane. In this dream, which was a product of his own difficult mid-life transition and a measure of the success he achieved in integrating its polarities, Levinson united a warm, scientific interest in others with an affectionate curiosity about nature.     

“To Sleep,Perchance to Dream” … on the Couch: The Interpersonal Nature of Dreams and Other Dissociative Processes—A Case Illustration

I present my experiences with a patient who, for a period of time, frequently slept and dreamt during our sessions. I depict the process of shared exploration undertaken by this patient and myself in our desire to understand, along with her dreams, her sleep and the hypnogogic imagery at its borders. In so doing, I hope to communicate a sense of the clinical richness and manifold meanings of the sleep and dreams as they became apparent to us over time. To this end, rather than following standard format, I have organized the case material into a series of related clinical moments, each followed by a set of theoretical considerations.

A brief survey of the relevant “sleep-on-the-couch” literature, culled from the writings of a variety of prerelational theorists (few more recent theorists have specifically addressed the topic) is presented. I turn also to those whose writings helped illuminate the treatment as it unfolded: Sullivan, Winnicott, Bromberg, Benjamin, and, most particularly, to the writings of Bromberg, Davies and Frawley, and Harris and Gold on the related themes of clinical enactment and dissociative process.