Psychodynamic assessment of changes in children with autism under psychoanalytic treatment

In this article the authors report insights into autism developed through their extensive experience of psychoanalytic therapy with children with autism. The fi rst stages of body psychic development are seriously disrupted by this pathology, resulting in primitive anxieties of falling and of being liquefi ed. These anxieties are connected to the fragile development of body ego and of its related spatiotemporal organisation. The changes in children observed by the authors during the therapeutic process lead them to offer a psychodynamic assessment tool, which revolves principally around the development of body ego. After the initial state of 'severe autism', the authors describe three stages: the stage of 'recovery of the skin' (Bick); the established 'symbiotic phase', subdivided into 'vertical then horizontal splitting of the body ego'; and fi nally the stage of 'individuation'. First, the authors describe the principal psychoanalytic approaches to autism and refl ect on the links possible with nonpsychoanalytic work.     

Verdi's Rigoletto: The dialectic interplay of the psychic positions in seemingly 'mindless' violence

In this paper the author demonstrates the interplay of the psychic positions (paranoid-schizoid and depressive, alongside more primitive mental states) as they may appear in experiences of overwhelming anxieties relating to fragmentation and disintegration. These are examined in relation to the appearance of what has been described in the literature as 'mindless' violence. The vehicle for this demonstration is Verdi's opera Rigoletto , which the author examines using Fonagy and Target's model for the understanding of mindless violence. The opera is 'read' as a case study of the protagonist, using the drama as a reflection of Rigoletto's internal object representations. The author attempts to extend Fonagy and Target's model to include primitive mental states, in order to understand 'mindless' violence as a result of collapse of the dialectical relationship of the psychic positions, leading to the violent act as a desperate attempt at re-establishing a sense of self. From this perspective, the moment of the violent act may be seen as use of an autistic object and as supplying of autistic shape. The violence is ultimately directed against the already fragmenting self, especially cherished parts of it, however it may enable acknowledgement of repudiated, unmentalised emotions previously experienced as a void.     

Subliminal processes,dissociation and the 'I'

The study of unconscious processes leads to the hypothesis of the limit of consciousness, which involves two main kinds of psychic activity. The first represents psychic contents which are subliminal for their low energy, the second subliminal contents which are inaccessible to consciousness because they are dissociated in the subliminal region. Dissociation is a concept introduced by Pierre Janet for splitting consciousness due to traumatic events or during hypnosis. It takes a more general form in Hilgard's neo-dissociation theory of hypnotic phenomena and also in Jung's theory of the collective unconscious. Further generalization links it to the modern findings of explicit and implicit perception, leading to a shift in dissociation from hypothesis to clinical, experimental and theoretical reality. Studies in hypnosis also point to the existence of an integrative psychic entity, that comprises the conscious 'I'. Hilgard called this the hidden observer, and his findings represent empirical confirmation of Jung's term for the Self as mirror 'I', which leads to many important consequences for self-discovery and the meaning of life.     

Proclaiming the Passion: Popular Drama and the Passion Tradition in Luther's Germany

Abstract

This article examines Martin Luther's opinions on popular drama, in particular his views on Carnival plays, Corpus Christi plays, and Passion-tide performances. A consideration of key works by the Lutheran playwright, Joachim Greff (1510-1552), provides an insight into the development of Lutheran biblical drama from its beginnings. It accordingly challenges the consensus that Luther objected to, and actively prevented, the performances of Protestant dramatizations in Reformation Germany of Christ's Passion and the Resurrection.     

On broadening the cognitive, motivational, and sociostructural scope of theorizing about gender development and functioning: comment on Martin, Ruble, and Szkrybalo (2002)

In their article on gender development, C. L. Martin, D. N. Ruble, and J. Szkrybalo (see record 2002-18663-003) contrasted their conception of gender development with that of social cognitive theory. The authors of this commentary correct misrepresentations of social cognitive theory and analyze the conceptual and empirical status of Martin et al.'s (2002) theory that gender stereotype matching is the main motivating force of gender development. Martin et al. (2002) based their claim for the causal primacy of gender self-categorization on construal of gender discrimination as rudimentary self-identity, equivocal empirical evidence, and dismissal of discordant evidence because of methodological deficiencies. The repeated finding that gendered preferences and behavior precede emergence of a sense of self is discordant with their theory. Different lines of evidence confirm that gender development and functioning are socially situated, richly contextualized, and conditionally manifested rather than governed mainly by an intrinsic drive to match stereotypic gender self-conception.     

The internal world of Don Giovanni

The author tries to account for the disturbing impact of Mozart's opera Don Giovanni. Some writers idealize Don Giovanni's power and vitality. The author view is that Mozart's music depicts him as a much emptier character, using phallic narcissism as a way of surviving a psychic catastrophe by projecting his pain into others. The music shows how Giovanni lives in projective identification with many other objects and part-objects, masculine and feminine; and how he seduces them into complicity with his defensive system. This situation is contrasted musically with the world of the other characters, particularly the women, who are depicted as more ordinary, more complex and, in fact, more sensual.     

Clinical Commentary

Abstract

This paper is the narrative of a first-time father with a son born seven weeks early by Caesarean section. Against the anxiety and trauma of his infant's birth and his wife's illness, another inner darker drama is being relived. Michael shows all the wounds of a battered child. He asks two awesome questions - Will I be to my son as my father was to me? Will my son be to me as I was to my father? Fearful and at first unvoiced questions, the developing interviews gave them a voice. We respected Michael's sharing of the early and fearful days and nights when his infant first came home. We sometimes found it hard to empathize with his running away to hide in work, until we understood what he was hiding from. Most poignant was his struggle with his anger and hurt with his father and his desire to understand, ‘Why?’, so that he would not be like this to his son. We saw a sensitive revelation of life being born inside him anew, as he made contact with his real infant and his psychic infant within. Of particular interest was the therapeutic use of the research interview space and the interviewer.     

Trauma and traumatic neurosis: Freud's concepts revisited

The authors examine Freud 's concepts of 'trauma', 'protective shield against stimuli ' and 'traumatic neurosis' in the light of recent findings. 'Protective shield against stimuli' is regarded as a biological concept which appears in mental life as the striving to avoid unpleasant affects. 'Trauma' is a twofold concept in that it relates to mental experience and links an external event with the specific after-effects on an individual 's psychic reality. A distinction needs to be made between mentally destructive trauma and affective trauma. A destructive trauma does not break through the protective shield but does breach the pleasure-unpleasure principle, so that in the course of its subsequent mastery it leads to a traumatic neurosis. An affective trauma can be warded off under the rule of the pleasure-unpleasure principle and leads to a psychoneurosis.     

Does John Henry Newman Have a Theo‐Drama?

The essay surveys Newman's work in literary drama, from an early essay on Aristotle's Poetics to his adaptation of Roman comedies for production at the Oratory School, in order to approach his affinities with Hans Urs von Balthasar's theological dramatic theory. Newman does not find a Balthasarian theo‐drama via literary drama – perhaps because he was not properly exposed to medieval religious drama – but scattered dramatic analogies in his history writing suggest that he undertakes a theo‐drama in that genre. Von Balthasar and Newman employ dramatic analogies to reject chiliastic apocalyptic and foster ‘keromatic’ apocalyptic.     

Theodor Waitz on Psychic Unity

The tolerant stance on ‘race’ by prominent Enlightenment figures was followed in the 19th century by a powerful wave of biological racism. Many of its proponents took the view that human ‘races’ constitute separate species, and that most non-white ones are of inferior mentality. An early opponent of this claim was James Cowles Prichard, who used mainly missionary reports in seeking to refute it. Far more extensive work was undertaken by the Herbartian psychologist Theodor Waitz, who collected ethnographic material from all over the world. It was published in six volumes - the last two after his death by his former student Georg Gerland. Waitz aim was to demonstrate the ‘psychic unity’ of mankind. Initially extracts from the volume on African peoples are presented in order to show how he dealt with his material. The main focus is on his first volume entitled Introduction to Anthropology, in which he elaborates his general thesis. In it Waitz maintains, against the biological racists, that mankind is a single species. Furthermore he discusses the changes from savagery to civilization, attributing them to a combination of geography and history. He was followed by Adolf Bastian who, unlike Waitz, was a great traveller with personal experience of peoples all over the globe. Both firmly believed in the psychic unity of mankind, but Bastian’s approach to psychology was very different.     

Flaubert and Madame Bovary: an intimate courtship

The process by which Gustave Flaubert created the character of Emma Bovary is examined, as are various of the author's sources for the heroine and their transformation in the course of composing the novel. Certain aspects of the authors psychic makeup, including his bisexuality, are discussed in this light, as are Flaubert's early traumatic losses and their influence on his way of working. Finally, it is suggested that writing had multiple functions for the author and that the creation of Emma Bovary served as a partial solution to unmet needs.     

Discussion of “I’mprovisation–Therapists’ Subjective Experience during Improvisational Moments in the Clinical Encounter”

The first part of this article discusses Romanelli, Tishby, and Moran’s qualitative research on the impact of training clinicians’ “skill-sets” derived from improvisational theater. Categories of experience were discerned from the data, along with findings of the impressive positive effects from the training on the clinicians’ ability to better respond to unpredictable “improvisational moments” in psychotherapy. The second part elaborates on how the authors' research represents a welcome addition to a larger conversation about how drama theory “puts” “flesh and blood” on the “bones” of Relational Metapsychology, which entails theories of process and change, rooted in an information theory based epistemology in contrast to Freud’s archaic and deeply flawed Metapsychology ensconced in a psychic energy theory epistemology. Finally, the authors’ lends to advocacy for clinical training in drama and improvisation being added to clinically based curriculums.     

The wish for annihilation in ‘love–death’ as collapse of the need for recognition,in Wagner's Tristan und Isolde

Wagner's Tristan und Isolde holds a central position in Western music and culture. It is shown to demonstrate consequences of interruption of developmental processes involving the need for recognition of subjectivity, resulting in the collapse of this need into the wish for annihilation of self and other through ‘love–death’ [Liebestod]. A close reading of the musical language of the opera reveals how this interruption is demonstrated, and the consequent location of identity outside of language, particularly suitable for expression in music. Isolde's dynamics are presented as distinct from that of Tristan, and in contrast to other interpretations of Tristan and Isolde's love as an attack on the Oedipal order, or as a regressive wish for pre‐Oedipal union. Isolde's Act I narrative locates the origin of her desire in the protagonists' mutual gaze at a traumatic moment. In this moment powerful and contrasting emotions converge, evoking thwarted developmental needs, and arousing the fantasy of redemption in love–death. By removing the magical elements, Wagner enables a deeper understanding of the characters' positions in relation to each other, each with his or her own needs for recognition and traumatic experiences. These positions invite mutual identifications resulting in rising tension between affirmation of identity and annihilation, with actual death as the only possible psychic solution. The dynamics described in the opera demonstrate the function of music and opera in conveying meaning which is not verbally expressible.     

Distinction between mental pain and psychic suffering as separate entities in the patient's experience

Abstract

Mental pain and psychic suffering are herein defined as two separate concepts in psychoanalysis. The concept of mental pain lies at the core of psychoanalysis; it was introduced by Freud and was further elaborated by a number of investigators, mostly by Bion. Mental pain refers to a pain that the patient reports as being impossible to describe in words, and lacking any associations, whereas psychic suffering can be both named and described by the patient. Mental pain is derived from non-tolerance on the part of the psychic apparatus when it is harmed by very painful emotions. In contrast to psychic suffering, mental pain resists elaboration and transformation by dream-work. How to address and transform the patient's mental pain is a major challenge facing the analyst in his clinical work because mental pain may halt or slow the progression of the analytical process. To overcome this hindrance, the work of the analyst is focused on helping patients to modify their mental pain into psychic suffering, that is, to reactivate in the patient the chain of transformations that generates thought. The analyst is also challanged with the mental pain of the patients because he has himself to tolerate the mental patient induced by counter transference. Suggestions for the analyst on how to deal with the mental pain of the patient during psychoanalytic therapy are proposed.     

Comments on the Ikonen & Rechardt paper on the origin of shame

Psychoanalysis is concerned with the unconscious; it weaves fleeting connections with it, and studies its effect on the conscious mind. This is the only method which allows us to reach the unconscious, making use of the technique of dream interpretation and free association. The various effects of unconscious impulses take the form of psychic and somatic symptoms and of impulsive behavior. The psychoanalytic method should enable the analysand to make contact with the veiled meanings of the repressed self, above all with its strivings. Simultaneously, the origins of poorly-functioning psychic structures are also revealed. Psychoanalysis also needs to examine the varying potential of the patient to benefit from analytical work and arrive at a better understanding of his or her unconscious mind. We have seen, as Freud did in his time, that the benefit derived from analytical understanding, i.e., interpretation, is by no means self-evident. In the mental structures of patients, we encounter aspects which reject the integrating effect of the analytical understanding. This finding, the so-called negative therapeutic reaction, and the more detailed psychoanalytical study of its contents and the psychic functions and structures involved, has made psychoanalysis every year more and more challenging and interesting.     

The origins of Bion's work1

This study attempts to identify the scientifi c, philosophical and psychoanalytic origins of Bion's work, and includes an organization of these in a comprehensive and synthetic way with the help of a synoptic table. Investigation has revealed Bion's scientifi c orientation, fed by classical and modern authors‐notably, Locke, Hume, Kant, Sylvester and Cayley, Poincaré, Heisenberg, and the German Romantics. Bion was able to rescue certain transcendent aspects of human, and also of Freudian, knowledge that had largely fallen into neglected obscurity. He made an original use of new verbal expressions related to the immaterial facts of psychic reality, the unconscious and the id. The method involves a search for counterparts in reality with two kinds of evidential source: some works and their authors have appeared ipsis litteris in Bion's work. In those situations where Bion does not cite the sources, the study has been able to establish connections with the lengthy marginal notes which Bion left in the texts of the books from his library.     

The influence of extreme traumatization on body, mind and social relations

Extreme traumatization affects the individual's relation to others in several social and psychological ways. The post-traumatic experiences are characterized by helplessness, insecurity, anxiety, loss of basic trust, and fragmentation of perspectives on one's own life. Special considerations should be given to the destruction of the ability to regulate negative emotions (extreme fear, distress, anguish, anger, rage, shame) in relation to others and activate internal good and empathic object relations. Destruction of the capacity for symbolization of traumatic experience may threaten the mind with chaotic states against which the 'I' tries to defend itself and find a balanced psychic mise-en-scene. The authors emphasize three dimensions that the analyst should observe in his understanding of the traumatized mind and its conflicts. The proposed dimensions are called the body-other dimension, the subject-group dimension, and the subject-discourse dimension. All three dimensions have specific structural characteristics that are expressed in the analytic relation. Extreme trauma causes disturbances in each of these dimensions. The authors present clinical material from a traumatized refugee to illustrate the analytic work.     

How can Ethnomethodology be Heideggerian?

The purpose of this paper is to begin to try to understand the extent to which ethnomethodology (EM) might be informed by some concepts and ideas from the work of the philosopher Martin Heidegger. This is done in two parts. The first looks at Heidegger's later work and compares his conception of the ontological difference with Garfinkel's work on the difference between EM and formal sociological analysis (FA). The second part turns to Heidegger's earlier work (around Being and Time) and works through a number of affinities between the analysis of Dasein and ethnomethodological versions of everydayness.     

Influence of the reason for the other's affect on preschoolers' empathic response

Forty-six preschoolers were individually presented four slide-sequence stories in which the main character performed acts that resulted in the character displaying happiness (in two stories) or sadness (in two stories). Within each happy and sad story pair, one story portrayed the main character as having an "acceptable" reason for his or her affect (e.g., the character was happy after finding a friend to play with) and one story portrayed the character as having an "unacceptable" reason for his or her affect (e.g., the character was happy after transgressing against another child). Affective and evaluative responses to the main characters in the four stories were assessed. The preschoolers generally empathized more with (and evaluated more favorably) a story character whose affect was associated with the performance of an acceptable rather than an unacceptable act.