Roots and vicissitudes of psychic bisexuality

Sigmund Freud considered the difficulty in defining masculinity and femininity from a psychic point of view as a hiatus in psychoanalytic theory. I contend that masculinity pertains to the centrifugal (to that which goes out, and ultimately to that which one loses), and femininity to the centripetal (to the appetency for taking the object into one's own internal space), whether one is considering their archaic roots or their genitalized culmination. The masculine/feminine pair draws support from the body (and, through anaclisis, from the subjective space), identified with a container that is liable already in the first psychic stages of life to empty itself of its own content and to be filled by a foreign content: the content is subjective in the masculine and object‐related in the feminine. The conflicts of ambivalence related to these two movements (desire/anxieties linked to active and passive penetration) lead to the setting up of the rigid and labile poles of the personality, and they are liable to give rise to obsessional and hysterical solutions respectively. My hypotheses will be examined in the light of the two key cases of hysteria and obsessional neurosis in Freud's work: Dora (1905e) and the Rat Man (1909d).     

Some Reflections on the Psychoanalytic Theory of Motivation: Toward a Theory of Entelechy

The psychoanalytic theory of motivation needs to be recast in a vitalistic holistic (holographic) language that liberates it from its constraints to the drives and expresses that it constitutes an indivisible function of being- and continuing to being-alive. In the development of his thesis the author retraces the history of Freud's acquaintance with the idea and points out that Freud required a theory of unconscious motivation or intentionality to account for the creation of unconscious phantasies–and ultimately for psychic determinism. Psychic determinism became the template for the concept of psychic responsibility.

The author attempts to place the concept of motivation into the more all-inclusive and more vitalistic notion of entelechy so as to express its more holographic and numinous nature. A discussion of the relationship between motivation and its associated entities is made. These include volition, will, intentionality, agency, and autochthony. It is pointed out that motivation can be considered to be holographic in so far as one can consider the whole individual to be motivated, but along side this consideration one sees motivation within each portion of the psychic apparatus and also with each internal object. A case history is presented which demonstrates abulia (absence of motivation).     

‘Sleeping beauties’: succession problems of adolescence

The author explores the succession problems of adolescence. She uses the Brothers Grimm’s fairy tale Sleeping Beauty to consider various characters and narratives possible in the analytic field during the succession process. Use of the characters in a fairy tale allows an analyst to play with the different roles the patient unconsciously assigns her. The author conceives of the avoidance of adolescent turbulence as a common reaction to adolescence, but one that can also become entrenched, and result in a restriction of emotional growth. The paper explores the psychic isolation of adolescence and the splitting required to manage the conflicting desires of the phase. The persistent absence of passion, including in the analytic process, constitutes a psychic retreat from developmental turbulence. The analyst of such an adolescent may need to allow them to be ‘somnolent’ for some time, but may eventually need to wake them (metaphorically) or even pierce the somnolent, avoidant state. The author uses clinical vignettes of late adolescents to demonstrate such transitions, exploring her countertransference experience as well as the reaction of adults to the succession process of adolescence.     

The Paranoia of Everyday Life: Some Personal,Psychological, and Pastoral Thoughts

Freud, early in his writings, makes the argument that paranoia results from the repression of distressing memories, paralleling hysteria and obsessional neurosis. The difference, however, is that paranoia makes use of a special psychic mechanism—projection—whereas hysteria makes use of conversion into somatic innervations and obsessional neurosis makes use of substitution or displacement. Drawing on recent research in paranoia, which suggests that feelings of paranoia are quite common among non-clinical populations, perhaps even as common as feelings of anxiety and depression in non-clinical populations, I suggest that paranoia “in everyday life”—that is, paranoia among non-clinical or so-called “normal” populations—results from the suppression (rather than the repression) of distressing thoughts (rather than memories). The mechanism of projection is still at work, but because paranoia in everyday life results from suppression rather than repression, it is much less severe but also much more common. I have followed the logic of Freud’s writings and I have used the method of introspection to come to this conclusion. I argue that pastors and other such persons would do well in knowing something about paranoia so that (1) they can deal more compassionately with those struggling with paranoia and so that (2) they can deal more compassionately with themselves, since it is likely, I believe, that many pastors often struggle with feelings of paranoia. I note several strategies for coping with paranoia as I deal with religious and psychological aspects of paranoia.     

Precipitation anxiety

Therapy with autistic and psychotic children led the author to introduce the concept of precipitation anxiety. Freud's first theory of the instincts was expressed in the dynamics of conflict, but his subsequent development of life and death instincts is better understood in terms of a gradient of energy between two extremities of the same axis. Object relations result from a caesura (Bion) which creates a gradient of psychic energy experienced initially as a precipice which, if left unregulated, generates intolerable anxiety. Satisfactory emotional encounters with the mind of the object bring about the necessary adjustments to the slope of the gradient. Autistic mechanisms may block off precipitation anxiety, but they also prevent mental growth. Both the dynamics of conflict and the dynamics of the gradient are vital for psychic development, but the very existence of the former is contingent on successful negotiation of the energy gradient (working through). After illustrating his thesis with clinical material drawn from a group therapeutic setting, the author discusses points of convergence and divergence with two other fundamental notions: the aesthetic conflict (Meltzer) and premature psychic birth (Tustin). The proposed model furthers our understanding of the therapeutic process and stresses the importance of the containing object in the transference situation.     

Unlawful Entry: Male Fears of Psychic Penetration

In this paper, it is argued that males as well as females have an early experience in relation to the nursing mother of being receptive to bodily and psychic penetration. Males tend to lose access to this experience and may come to fear penetration as a threat such that a masculine sense of self is felt to be dependent on an impermeable psychic boundary that is not to be penetrated. Instead, phallicism as a fortress of emotional self-sufficiency—which the author labels the citadel complex—becomes the matrix of a subjective sense of masculinity. The multiple and combined forces of bodily development, the establishment of gender identity, and the process of separation-individuation are examined for their role in this process.

A critique of the Lacanian concept of paternal law suggests that the “law of the father” can be interpreted as a law regulating penetration. Paternal law can be viewed as a code for the establishment of an impenetrable masculinity whereby entry into an adult male psyche becomes unthinkable, “unlawful.” An impermeable bodily and psychic boundary—the ability to penetrate without the ability to be penetrated—collapses a necessary dialectical tension that may affect men's experience of sex and of love and that may shape and limit their desire.     

Psychotic withdrawal and the overthrow of psychic reality1

The author attempts to distinguish between the world of fantasy and the imagination (which fuels our capacity to ‘dream’) from a withdrawal into fantasy. In this withdrawal, the foundations of which are laid in childhood, a dissociation from psychic reality starts and from it the delusional world arises and constitutes the adult illness. During therapies of adult patients who have experienced a psychotic state, it is often possible to reconstruct the state of infantile withdrawal and understand how their dissociation from reality was ignored or unknowingly encouraged by their parents. Children destined to develop psychosis enter into the dissociated world not just as a defence against anguish or loneliness, but also for the pleasure of experiencing a delusional self‐suffi ciency and a gratifying omnipotence in which anything is possible. Mental workings that take place in the withdrawal do not follow the rules governing normal psychic functioning. Those fantasies cannot be either repressed or ‘dreamed’ in order to be transformed into thoughts. These psychopathological structures, which develop early and autonomously, have to be understood during analytical therapy in their origins and ‘deconstructed’ in order to help the patient to escape from their dominion. By means of clinical examples, the author tries to shed light on the possible ways of reaching patients in their psychotic shelters, thereby helping them to re‐emerge into a psychic reality.     

Provocation of panic: three elements of the panic reaction in four anxiety disorders

Subjects with agoraphobia (N = 25), panic disorder (N = 25), social phobia (N = 19) or generalized anxiety disorder (N = 10) and controls with no psychiatric history (N = 16) underwent two provocation tests, voluntary hyperventilation and inhalation of 5% CO2 in air, and three experimental control conditions. They were measured on three elements of the panic reaction: somatic symptoms, psychic anxiety and fears of impending doom, and on a standard YES/NO measure of panic attack. The provocation conditions produced increased somatic symptoms and psychic anxiety across all groups relative to the control conditions. The agoraphobic and panic disorder groups showed a significantly greater increase in fears of impending doom from control to provocation conditions than the social phobic and GAD patients. This difference was not observed on measures of somatic symptoms or psychic anxiety. The present results provide some support for the theory that panic attacks result from the catastrophic misinterpretation of anxious symptoms, in this case produced by the two provocation tests.     

The development of identification in Freudian theory

Once identification achieved its status as a specific psychoanalytic concept it followed a process of reconceptualization that emerged from the different clinical and theoretical contexts in which Freud approached and explained the phenomenon. In tracing the unfolding of the theory of identification throughout Freud's works, we have accounted for the following steps: First, in his correspondence with Fliess, Freud announced topics that would subsequently be theoretically processed. Second, in the first topography, identification was explored in the contexts of hysteria and dreams, and elaborated through reference to two psychic scenes with their respective modes of psychic functioning. Third, in the period of transition to the second topography identification was defined as a substitute for an object relationship and as a preliminary stage of object choice. Interlocked with the concept of narcissism, it produced a reconceptualization of the ego that led to the second topography. Finally, the tripartite model proposed in the second topography manifests the consolidation of the structuring function of identification, since the psychic structure is therein conceived of as resulting from the vicissitudes of object relationships.     

Life within death: Towards a metapsychology of catastrophic psychic trauma

In this paper the author offers a phenomenology and a metapsychology for the effects on the mind of catastrophic psychic trauma, defined as the reaction of the psyche to an utterly external event, which the person is helpless to resist, and against which there is no possible defense. The author affirms that the experience of 'infinite affliction' produces a radical break in being which disarticulates the psyche and causes a headlong descent to the most primitive levels of psychic functioning. When there is a complete surrender to the process of disarticulation, it continues until it extinguishes even the most basic level of mental activity, contact with sensation, producing psychic and then psychogenic death. The author then offers a phenomenological and metapsychological analysis of how the process of disarticulation is stopped so that the state of survival is assured, affirming that, faced with this situation of utter emergency, the survival urge instantly mobilizes the organism in furious activity to preserve life and regenerates psychic activity by sensing the ongoing existence of the psychesoma. Then anguish precipitates on to the body and is sensed as psychophysical pain, which diverts conscious attention from the infinite destruction of utter affliction which is thus encapsulated so that, as an experience, it is no longer present to the mind. This assures survival, but it leaves the psyche in a state of non-integration and begins the unending battle for mastery over the deadly inner object which ceaselessly threatens to become present. This constitutes the precariousness of the state of survival.     

The relevance of castration and circumcision to the origins of psychoanalysis: 1. The medical context1

In this paper the author outlines and discusses the origins and the decline of castration and circumcision as a cure for the nervous and psychic disturbances in women and little girls between 1875 and 1905. The author argues that the opposition to this medical practice affected the conception of hysteria, promoting a distinction between sexuality and the genital organs, and the emergence of an enlarged notion of sexuality, during the period from Freud’s medical education to the publication of the Three Essays on the Theory of Sexuality. The hypothesis is put forward that Freud came directly in contact with the genital theory of the neurosis at the time of his training on the nervous disturbances in children with the paediatrician, Adolf Baginsky, in Berlin, in March 1886. It is hypothesized that this experience provoked in Freud an abhorrence of circumcision ‘as a cure or punishment for masturbation’, prompting an inner confrontation which resulted in a radical reorganization of the way of thinking about sexuality. It is also suggested that this contributed to Freud developing a capacity to stay with contradictions, something which would become a central quality of the psychoanalytic attitude.     

Studies on hysteria--Katharina.

Freud's account of his meeting with the country maid, Katharina, is re-evaluated from a contemporary psychoanalytic perspective. Freud's original explanation of Katharina's hysteria was based on a set of quantitative-economic assumptions and a psychic model based on conflict and defense. A modern analytic perspective would shift the emphasis from the economics of discharge to the aims and objects of sexual activity. The understanding of sensual pleasure focuses more specifically on the related complex of intentions, purposes, meanings, and motives, as well as on the qualities, characteristics, and patterns of interaction with important objects.     

Diagnosing a male hysteric: Don Juan-type

The aim of this paper is to provide a clinical account of a male hysteric, Don Juan-type, taken from the early stages of treatment. The patient presented with a relationship problem but there soon emerged a form of compulsive sexuality or hypersexuality in his love relations that became a central feature of the clinical picture. This hypersexuality expressed itself in a compulsive need to stage, or to stage-manage, interpersonal scenaria of a sexual or sexualised nature. These scenaria, which were repeated in different variations and with different personnel, are seen by the author as a dramatisation of the primal scene with the patient taking up the position of the oedipal father. Explanations for the disappearance of male hysteria are given, including a new theory which claims that an imbalance in psychoanalytic theory itself led to the feminisation of hysteria. This critique allows certain forms of hypersexuality in men to be promoted as a form of hysteria, the most common example being Don Juanism-a form of compulsive sexuality that encompasses normative, conversion and character features. The paper also examines the male hysteric's developmental agenda. What the patient's compulsive sexual tableaux exposed was that he had never faced a separation that was not a triangular experience. This meant that his separations were experienced as two developmental agonies telescoped into one-separation (pre-oedipal) and exclusion (early oedipal). This combination, the author suggests, is so frightening in a particular group of men as to explain the choice of hysteria as opposed to some other choice of neurosis.     

Displacement trauma: complex states of personal,collective and intergenerational fragmentation and their intergenerational transmission

Originally presented at the Journal’s one day conference entitled ‘Displacement: Contemporary Traumatic Experience’ held in London in November 2019, this paper expands on the author’s theory of the implicit psychological organizing gestalt, an associated pattern of psychic functions which operate in an integrated way to simultaneously structure and organize our experience of self-cohesion and self-continuity. The gestalt, which implicitly links the formation of psychic skin, body image, cultural skin and both personal and cultural identity with place, functions as an emergent non-conscious permanent presence or background ‘constant’. It develops over time and emerges out of embodied emotional experiencing with the total environment – both human and non-human. The author argues that it is the rupture of this gestalt and the disorganizing consequences of its loss which underlies the experience of displacement trauma. If disruptions in the formation of the gestalt and/or its later rupture remain unrecognized and unrepresented then the absence creates a void which can be intergenerationally transmitted. Case material is presented which describes this and which highlights the ways in which the gestalt can contribute to our understanding of collective displacement anxiety, cultural trauma and cultural complexes.     

Reading Susan Isaacs: toward a radically revised theory of thinking

The author views Isaacs's (1952) paper, The nature and function of phantasy, as making an important contribution to the development of a radically revised psychoanalytic theory of thinking. Perhaps Isaacs's most important contribution is the notion that phantasy is the process that creates meaning, and that phantasy is the form in which all meanings - including feelings, defense 'mechanisms,' impulses, bodily experiences, and so on - exist in unconscious mental life. The author discusses both explicit formulations offered by Isaacs as well as his own extensions of her ideas. The latter include (1) the idea that phantasying generates not only unconscious psychic content, but also constitutes the entirety of unconscious thinking; (2) the notion that transference is a form of phantasying that serves as a way of thinking for the first time (in relation to the analyst) emotional events that occurred in the past, but were too disturbing to be experienced at the time they occurred and (3) a principal aim and function of phantasy is that of fulfilling the human need to get to know and understand the truth of one's experience. The author concludes by discussing the relationship between Isaacs's concept of phantasy and Bion's concepts of alpha function and the human need for the truth, as well as the differences between Fairbairn's and Isaacs's conceptions of the nature of unconscious internal object relationships.     

Something torn or burst or unbearable: a psychoanalytically-informed exploration of the experience of somatic symptoms

Experiences of and responses to bodily symptoms have long held interest, from earlier roots in hysteria to the most recent category of somatic symptom disorder (SSD) in DSM 5. SSD’s focus on distress implies that symptoms hold meaning for individuals. This study used a psychoanalytically-informed, multiple interview method and analysis to explore such possible meanings. Six participants were interviewed on three occasions each, with four themes emerging as follows: (1) a foreign body in charge; (2) left alone with the foreign body; (3) the body works for the mind; and (4) the body mirrors the mind. Bion’s idea of an active container-contained function and the construct of psychic pain formed a useful framework for understanding themes. The distress that lies in somatic symptoms was formulated as potentially stemming from an initial difficulty with containment in the primary object relationship. It is argued that distress may indicate a struggle with suffering that is not only somatic but also psychological in nature; and that the symptomatic body may have reached its limits in containing psychic pain. Implications for working clinically include the importance of close and sustained attention, through the clinician’s reverie, to somatic and emotional feeling states to help guide treatment.     

Moral masochism

The author questions the existence of unconscious guild and unconscious need for punishment. His thesis is that the self-destructive acts and sufferings of the moral masochist are not caused by an unconscious need for punishment, but rather by a flight from severe castration anxiety into masochistic acts. The analysis of the latent castration anxiety leads to the maturation of the superego. Clinical material from one case is used to support this thesis. Further material from the same case shows how the moral masochism of adolescence and adulthood grew out of the feminine masochism of latency. In addition, the author discusses another case of moral masochism which reviews the intricate relationship between psychic health and moral codes. The importance of the cultural atmosphere is emphasized, particularly what the moral masochist extracts from it.     

Missing what was true: Problems of seeing and knowing in Henry James's The wings of the dove

The author examines a central theme in this late novel by Henry James in relation to current psychoanalytic ideas that link the Oedipus complex with the child's developing perception of reality (both psychic and external), specifi cally through the experience of seeing and being seen. Britton visualises the oedipal triangle as a psychic structure through which the child may achieve recognition not only of its parents' sexual relationship, from which it is excluded, but also of itself being observed by one parent while the child is with the other. Thus, it both observes and is observed. The differing perspectives achieved‐of subjectivity and objectivity‐ promote the perception of objective reality, as the world of relationships grows and becomes more complex. James captures with great subtlety and penetration the experience of three characters living out a symbolic oedipal relationship in which the truth is evaded or perverted. A young couple in love exploit the situation of a dying heiress whose vulnerability is intensifi ed by her reluctance to acknowledge the truth about their relationship. At the same time, she shrinks from the gaze of others and consigns herself to isolation and ultimate despair. The author presents three signifi cant scenes in which seeing and being seen are central to the development. In each, the dying woman is forced to face, if momentarily, her exclusion from the sexual relationship. Increasingly this connects with her approaching death‐but also with the anguished recognition that the couple have cruelly befriended her only to betray her. It is suggested that James's late style and novelistic technique require the reader to tolerate confusion and uncertainty. As the perspective shifts from one protagonist to another, we ourselves are in danger of ‘missing what is true’ in this characteristic Jamesian scenario, where relationships are gradually perverted by manipulation, evasion and lies. In psychoanalytic theory, this would represent a failure to work through the oedipal situation, where the struggle of the child to face reality is met by a parental relationship that is too weak or too perverse to contain the pain and confl ict.     

Art and emotion in psychoanalysis

Freud's view that art satisfi es psychic needs has been taken to mean that art has its source in the unconscious and that it unifi es pleasure and reality. The author argues that there is a third point that Freud repeatedly emphasizes, which should not be overlooked, that art infl uences our emotions. The author examines what Freud means by this claim, in particular, his reading of Michelangelo's Moses. Freud's focus here on emotions as fundamental to subjective experience, as subject to regulation and as potentially healthy forms of communication serves to supplement and even challenge what he says in his theory of affect. The author concludes by making inferences about a contemporary psychoanalytic theory of affects: that it ought to be inclusive of science (more receptive to neurobiology and less bound to Freud) as well as art (preserving the focus on subjective experience, especially the processing of complex emotions), which is illustrated with the concept of mentalized affectivity.