Body talk: somatic countertransference

This article focuses on a clinically observed event: the impact of the analytic session on the corporeality of the psychotherapist. The author sees this as an example of countertransference, in this instance ‘somatic countertransference’. Short and long clinical extracts are used to detail these events. The author touches on some early ideas on somatizing. The Kleinian concept of projective identification is itself explored and then used to explore further the idea of somatic countertransference.     

Editorial

Abstract

This paper is an attempt to address the issue of trust in the therapeutic relationship from the counsellor's perspective, with a particular reference to working with drug addicts. It is a personal reflection on previous work with drug addicts in which a cognitive-behavioural approach was used. The comparison will be made, in a post hoc, reflective manner, on the issue of trust from a very different perspective; namely psychodynamic. It is suggested that the counsellor's trust in their own ability to contain the patient's often projected anxiety, is a central element or variable that can be seriously disrupted by the process of projective identification. And, moreover, it may have some explanatory power for the choice of method of working with this particular client population, that the issue of trust and its containment says as much, if not more, about us as counsellors, as it does about the client. It is argued that our anxieties may lead us to adopt a certain course of action in the therapy, rather than to address the possible meaning of these anxieties in terms of the relationship regarding the clients' needs.     

Self-Disclosure and Vulnerability

Abstract

Based on the theoretical assumption and clinical observation that projective identification is a natural, constant element in human psychology, clinical material is used to illustrate how projective identification centered transference states create situations where acting out of the patient's phantasies and conflicts by both patient and therapist is both common and unavoidable. Because they are more obvious, some forms of projective identification encountered in clinical practice are easier for the analyst to notice and interpret. Other forms are more subtle and therefore difficult to figure out. Finally, some forms, whether subtle or obvious, seem to create a stronger pull on the analyst to blindly act out.

In some psychoanalytic treatments, one form of projective identification might embody the core transference. In other cases, the patient might shift or evolve from one level of this mechanism to another. Some patients attempt to permanently discharge their projective anxiety, phantasy, or conflict into the analyst. There is a patent resistance to re-own, examine, or recognize this projection. Some of these patients are narcissistic in functioning, others are borderline, and many attempt to find refuge behind a psychic barricade or retreat (Steiner 1993). In other forms of projective identification, the patient enlists the analyst to master their internal struggles for them. This occurs through the combination of interpersonal and intra-psychic object relational dynamics. This “do my dirty work for me” approach within the transference can evoke various degrees of counter-transference enactments and transference/counter-transference acting out.

Another form of projective identification, common in the clinical setting, is when a patient wants to expand the way of relating internally, but is convinced the analyst needs to validate or coach the patient along. This is why such a patient may stimulate transference/counter-transference tests and conduct practice runs of new object relational phantasies within the therapeutic relationship. Over and over, the patient may gently engage the analyst in a test, to see if it is ok to change their core view of reality. Depending on how the analyst reacts or interprets, the patient may feel encouraged to or discouraged from continuing the new method of relating to self and object. The patient's view of the analyst's reactions is, of course, distorted by transference phantasies, so the analyst must be careful to investigate the patient's reasoning and feelings about the so-called encouragement or discouragement. This does not negate the possible counter-transference by the analyst in which he or she may indeed be seduced into becoming a discouraging or encouraging parental figure who actually voices suggestions and judgment.

All these forms of projective identification surface with patients across the diagnostic spectrum, from higher functioning depressive persons to those who are more disturbed paranoid-schizoid cases. Whether immediately obvious or more submerged in the therapeutic relationship, projective identification almost always leads to some degree of acting out on the part of the analyst. Therefore, it is critical to monitor or use the analyst's counter-transference as a map towards understanding the patient's phantasies and conflicts that push them to engage in a particular form of projective identification.     

Book reviews

Wilfred Bion is regarded as a psychoanalytic purist and his austere portrayal of the analytic aim and attitude is often considered to make impossible demands on patient and analyst alike. Not surprisingly, the applicability of Bion's theory and recommended practice to once-weekly psychotherapeutic work is often questioned. Bion is thus ambivalently regarded by psychotherapists as the embodiment of an analytic ideal, whose developmental theories are important, but whose practical utility is doubted, especially in the context of the typical therapeutic setting. This paper seeks to challenge these assumptions by presenting the once-weekly therapy of a woman with attenuated mentalizing capacity and a tendency to destructive acting out. The therapy was guided by the application of central concepts, models and ‘technical’ principles emerging from my understanding of Bion's work. The aim of the paper is to demonstrate that Bion's utility is not confined to formal psychoanalytic settings and that his work may be usefully applied in more modest psychotherapy contexts.     

投射测验体系中的树木意象

树木是绘画测验中常用的意象之一, 其主要的分析体系为房树人测试与树木测试, 二者对树木的操作过程和分析方法存在差异。树木意象的测试具有一定的信效度, 可以有效地反应个体的心理状态, 敏锐地体现出个体与当前环境的交互作用, 检测病理性创伤反应, 鉴别特殊群体。未来研究可考虑测试的文化特异性, 进一步检验树木–伤疤–创伤理论并完善其在灾难心理领域的应用, 也期待研究者改进测试程序并继续对其进行标准化。     

From Projective Identification to Empathic Connection

SUMMARY

This article examines the challenging journey of successful coupling by understanding the marital relationship within a developmental framework. The process of Projective Identification is viewed as a useful concept found at the confluence of family systems and psycho-dynamic streams of thought, bridging the interpersonal and intrapsychic experience of couples whose individuative strivings are stalled. A map is offered for the transformation of a marriage from the stages of Idealization and Disillusionment toward the stage of Acceptance and empathic connection.     

A Farewell to Countertransference

The "discovery" of countertransference provided a much-needed corrective to the one-sided view of transference and a patient's pathology. Even if its usefulness in the development of psychoanalysis was indisputable, its days are numbered. When I present my clinical work at conferences, I am often asked questions about my countertransference. These questions contain numerous assumptions that are challenged in this paper. Treatment is discussed from a self psychological perspective to highlight the therapeutic value of enabling the patient to engage a selfobject transference. The concept of "projective identification" is also challenged. Systems theory, in which the therapeutic relationship is understood as a co-construction between therapist and patient, is proposed as a more effective model to deal with the issues formerly included under transference-countertransference.     

Projective identification fifty years on: A personal view

Since its introduction by Melanie Klein in 1946 the concept of projective identification has inspired, baffled, rankled, but always mesmerized its adherents and opponents alike. I offer in this paper a brief outline of the concept's development over the past fifty years by way of some thoughts on a personal journey of discovery surrounding its meaning and clinical usefulness to my work as a child therapist. I would like to suggest that definitions in current use seem to be derived more from adult work than from work with children, which has sometimes skewed the debate surrounding the concept in a particular direction. In both its conceptual guises, namely, as an unconscious 'phantasy' and as an interpersonal feature of the transference, projective identification is a logical extension of certain aspects of Klein's work with small children. In child work too the developmental status of the concept comes more into focus.     

A projective assessment of autonomous motivation in children: Correlational and experimental evidence

This article presents two studies aimed at validating a new TAT-like projective measure of autonomous motivation in children. Study 1 assesses the validity of the new measure by correlating it with self-report questionnaires of autonomous motivation, positive and negative affect, task value and mastery goal orientation. Study 2 is an experiment in which autonomous motivation is manipulated and then assessed with the new projective measure and with a self-report scale. Results of both studies support the validity of the new projective measure. In study 2, regression analysis suggests that the new projective measure is sensitive to aspects of experimentally induced autonomous motivation that are not captured by a self-report measure.

Working with countertransference

The transference-countertransference relationship is only one of five modalities of relationship that research has identified as potentially present in the therapeutic encounter. This paper gives the background and definition to one aspect of this - the countertransference - and traces the development of the concept from Freud's first use of the term in 1910 to the contemporary view that it is a useful tool of psychotherapy. The first part explains its connection with the Kleinian concept of projective identification and discusses its elaboration by the object relations school. There is general acceptance nowadays that the countertransference contains a great deal of information about the client's psychological world. It is therefore important to understand this process and the authors have identified three main dimensions to countertransference. These are its vector (or direction and force), its variance (the quality it represents), and its valence (its effect on the client). The second part of the article illustrates, through the use of example and metaphor, how these three dimensions are defined and can be recognized. Common themes and paradigms of countertransference are identified and discussed along with some ways in which experience has shown how these might be contained and worked with constructively. Finally, a clinical vignette is presented in which some of the dimensions of countertransference are identified and used to understand the client's psychic world and foster therapeutic change.     

‘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.     

Towards the logic of projective identification

This paper is devoted to the ‘logic of the unconscious’ and its application to the analysis of projective intentionality in psychoanalysis.Subjective assumptions concerning the existence and identity of intentional objects are often unconscious. They result from personal experience through its assimilation and transformation in further psychological (e.g. defensive) processes. Formal aspects of these subjective assumptions and their influence on our judgment and action have been studied by a number of psychoanalytic authors, in particular by Silvano Arieti, Ignacio Matte-Blanco and their followers who tried to develop ‘logic of the unconscious’. My project consists in the reformulation, clarification and elaboration of the logic of the unconscious using contemporary modal and relevant logics, in particular Graham Priest's logic of intentionality. An important advantage of this logic is that it allows for truth indeterminacy and paraconsistency of the propositional content of intentional states. In this article I explore the logic of projective identification, which I assume plays the central role in the logic of the unconscious.Special attention is given to the logical analysis of the notion of an internal object, and to a logical reconstruction of the fantasy of projective identification.     

Effects of Quantity and Quality Instructions on Brainstorming

One of the basic presumptions of brainstorming is that a focus on generating a large number of ideas enhances both the number of ideas generated and the number of good ideas (original and useful). Prior research has not clearly demonstrated the utility of such a quantity focus in comparison to a condition in which quantity is not emphasized. There have been some comparisons of the impact of quantity and quality focus on the number and quality of ideas, but the results of these comparisons have been mixed. The present study examined brainstorming with four different types of instructions: no specific focus, a quantity goal, a quality goal, or a joint quantity and quality goal. The quantity goal condition was superior to the other three conditions in leading to the generation of more ideas and more good ideas. These findings support Osborn's (1953) assumption that a quantity focus is most beneficial for brainstorming.     

Abandoning our parents and grandparents: does social construction mean the end of systemic family therapy?

This paper explores how ideas from first- and second-order cybernetics may be incorporated into the contemporary interest in social constructionist perspectives. We argue that it is possible to contemplate a third-order cybernetics which incorporates ideas from systems theory and social constructionism and that this may capture the reality of the 'hands-on' integration of ideas that many practitioners are currently exploring. A framework consisting of eight connecting threads is proposed as a way of helping us to clarify the continuities and discontinuities between the original and contemporary ideas. It is argued that this is an important and potentially useful endeavour, since many practitioners use a mixture of ideas and techniques in an eclectic way but are wary of potential criticisms of being 'linear', 'expert', 'manipulative' and 'non-collaborative'. A case study is offered to illustrate a 'hands-on' integration of contemporary and pioneering ideas and to invite discussion of how concepts and techniques from first- , second- and the new 'third-order' cybernetics influenced by social constructionism might be further integrated.     

Projective expected utility

Motivated by several classic decision-theoretic paradoxes, and by analogies with the paradoxes which in physics motivated the development of quantum mechanics, we introduce a projective generalization of expected utility along the lines of the quantum-mechanical generalization of probability theory. The resulting decision theory accommodates the dominant paradoxes, while retaining significant simplicity and tractability. In particular, every finite game within this larger class of preferences still has an equilibrium.     

Sumner On Desires and Well-Being

Berkeley holds that objects in the world are constituted of ideas. Some commentators argue that for Berkeley, ideas are identical to acts of perception; this is taken to proceed from his view that ideas are like pains. In this paper, I evaluate the identity claim. I argue that although it does not follow from the pain analogy, nonetheless the texts suggest that Berkeley does think ideas and acts are identical. I show how Berkeley can account for objects persisting over time and being perceivable by multiple observers, even if the ideas that constitute them are intermittent and dependent on particular actors.     

The complement of a point subset in a projective space and a Grassmann space

In a projective space we fix some set of points, a horizon, and investigate the complement of that horizon. We prove, under some assumptions on the size of lines, that the ambient projective space, together with its horizon, both can be recovered in that complement. Then we apply this result to show something similar for Grassmann spaces.     

Recent Scholarship on Hume's Theory of Mental Representation

In a recent paper, Karl Schafer argues that Hume's theory of mental representation has two distinct components, unified by their shared feature of having accuracy conditions. As Schafer sees it, simple and complex ideas represent the intrinsic imagistic features of their objects whereas abstract ideas represent the relations or structures in which multiple objects stand. This distinction, however, is untenable for at least two related reasons. Firstly, complex ideas represent the relations or structures in which the impressions that are the objects of their simple components stand. Secondly, abstract ideas are themselves instances of complex ideas. I draw two important conclusions from these facts. Firstly, contra Schafer and Garrett (to whom Schafer responds), the Copy Principle, properly emended, constitutes the entirety of Hume's theory of mental representation. Secondly, whereas paradigm examples of complex ideas, e.g. ideas of spatial and temporal complexes, are structured by relations of contiguity, abstract ideas are those complex ideas instead structured by relations of resemblance. As such, they represent their objects not as spatially or temporally contiguous but rather as resembling.     

Collaborative fixation: Effects of others' ideas on brainstorming

Three experiments examined whether or not fixation effects occur in brainstorming as a function of receiving ideas from others. Exchanging ideas in a group reduced the number of domains of ideas that were explored by participants. Additionally, ideas given by brainstormers conformed to ideas suggested by other participants. Temporal analyses showed how the quantity, variety and novelty of ideas fluctuate over the course of a brainstorming session. Taking a break modulated the natural decline over time in the quantity and variety of ideas. Although fixation was observed in brainstorming in terms of conformity and restriction of the breadth of ideas, it did not influence the number of ideas generated in these experiments. Copyright © 2010 John Wiley & Sons, Ltd.