WORKING THROUGH ENVY: SOME TECHNICAL ISSUES

The author argues that envy appears in an analysis as a hostile, life-destroying force and is directed at the good qualities of the object, often manifesting in the patient's need to devalue analytic work that has been helpful. An intractable negative therapeutic reaction can thus become a persistent feature of an analysis. Sometimes powerful envy is silently operating beneath the surface, with the patient feeling continually wronged and mistreated by the object. The author argues that bringing the projected envy into the patient's personality structure is an important aspect of successful analysis, but that various technical problems have to be considered before painful insight can be achieved into the division in the patient's self. Presenting material from a relatively long analysis, she discusses some technical issues in dealing with these processes. Interpretation of envy can be a delicate matter, requiring consideration not only of how to interpret, but also of the nature of the countertransference and the form of the interpretation. A transference interpretation directed solely at the patient's self-destructive behaviour and destructiveness towards the object carries the risk of further stimulating the destructiveness, even if it is correct; it is also important to bring the patient's libidinal aspect into the interpretation.     

An Island Entire of Itself: Narcissism in Anorexia Nervosa

ABSTRACT

This article explores the idea of anorexia nervosa as a narcissistic disorder, in which the denial of the need for food symbolically represents a denial of the need for relatedness and dependence. Narcissism is a state in which self and object are undifferentiated and all objects are felt to be within the individual’s omnipotent control. Primary narcissism occurs when the capacity for object relations has never developed and secondary narcissism develops as a defense against dependence which is associated with overwhelming anxiety, envy, or fear of disappointment. Both processes can occur in anorexia nervosa, which provides a cognitive and behavioral framework for the expression and maintenance of the narcissistic position. Narcissistic anorexia is a state of omnipotent isolation in which the patient denies one of her most basic needs and rejects a powerful source of connection with the outside world. An important aim of therapy is to help the patient to develop a capacity for object relations and to be able to acknowledge dependence. This is achieved through coming to experience the therapist as separate and real and requires the therapist to resist being taken over by the patient’s projections.     

Countertransference envy toward the religious patient

Four illustrations have been presented which demonstrate the uses and interpretations of envy in countertransference reactions to religious patients. To be sure, envy reactions to any patient are significant, whether they simply distort the therapist's perception or contribute to a deeper understanding of the patient. In the case of the religious patient, envy reactions in the therapist may serve as an additional instrumentality for under-standing the ways in which the dynamic determinants of religious behavior and metaphor become enmeshed in and also transform the pathology of the patient as well as the therapeutic process itself. Both the constructive and destructive object relational implications of envy must be borne in mind by the therapist in order to adequately explore the range of reciprocating forces between therapist and patient. Primitive mechanisms such as projective identification and psychotic transference are particularly prone to evoke envy reactions of surprising intensities, yet an empathic attitude will usually enable the therapist to differentiate the true source of his envy as he more carefully comprehends the quality of object relational and dynamic needs such envy serves.     

Envy and us

Within emotion theory, envy is generally portrayed as an antisocial emotion because the relation between the envier and the rival is thought to be purely antagonistic. This paper resists this view by arguing that envy presupposes a sense of us. First, we claim that hostile envy is triggered by the envier's sense of impotence combined with her perception that an equality principle has been violated. Second, we introduce the notion of “hetero‐induced self‐conscious emotions” by focusing on the paradigmatic cases of being ashamed or proud of somebody else. We describe envy as a hetero‐induced self‐conscious emotion by arguing (a) that the impotence felt by the subject grounds the emotion's self‐reflexivity and (b) that the rival impacts the subject's self‐assessment because the rival is framed by the subject as an in‐group member. Finally, we elaborate on the asset at stake in envy. We contend that this is esteem recognition: The envier covets the esteem that her reference group accords to the rival. Because, in envy, the subject conceives of herself as member of a group to which the other is also understood to belong, we conclude that envy is a social emotion insofar as it presupposes a sense of us.     

Silence as the Voice of Trauma

Silence is a key to the unspoken world of the patient. Rather than interpreting silence as a defensive maneuver, the analyst may understand this disruption as a royal road to the patient’s traumatic experiences. The author proposes to recognize traumatic silences in the analytic process and the transference as a re-experiencing of past, unpredictable traumatic affective states and memories. Silences in this context are both a repeat of a disconnecting experience as well as a manifestation of a silencing identification with the original silencer. The clinical material illustrates effects of a German mother’s World War II (WWII) personal traumata and collective shame-based silence on her daughter’s self and good object development. In the daughter’s analysis, the patient and the analyst, who herself experienced similar WWII traumata, face the pain of trauma recovery and un-silencing. The author suggests that the deadening effect of past traumata may be reversed by an analytic process of re-membering and re-speaking for both the patient and analyst. This allows for a more transparent, subjective experience in the transference and a verbal integration of ego functions.     

The preoedipal patient and the pregnancy of the therapist

This article is a contribution to the sparse literature on the pregnancy of the therapist. The therapist's pregnancy is viewed as an event that can facilitate progress for some female patients with preoedipal problems. In these cases, it provides a dramatic opportunity to address developmental difficulties, including separation problems and inadequate ego ideal formation, through the analysis of the self-object transference. Clinical material illustrates the working through of these issues for a patient in whom the therapist's pregnancy was stressful but not traumatic. Therapeutic interventions were aimed at fostering greater differentiation between self and object. A contrasting case is also examined in which the pregnancy was felt to be traumatic and feelings about it largely denied. However, underlying transference issues were eventually addressed.     

Identity maintenance in the affectively distant patient

Patients who are affectively distant, in that they appear to have little conscious emotional investment in the analyst, have been described increasingly in the psychoanalytic literature of the last twenty years. Typically, they have been understood either from a developmental point of view as defensively struggling against wishes for symbiotic union or, on the Kleinian model, as having unconscious fantasies of bodily fusion with the mother that, upon separation from her, result in annihilation anxiety that generates autistic defenses. Of special importance is the work of Heinz Lichtenstein, who stresses early identity maintenance and the role of mirroring experiences with the mother in the development of an "identity theme." This concept is used here as a symbiotic precursor of ego identity that ties the self to a particular mother. It is this primitive form of identity that can occasion regressive self-definition in the transference of the affectively distant patient. Two cases are presented that illustrate dynamics and transference dispositions occurring in the psychoanalysis of these patients. The discussion focuses on the role of the patient's catastrophic fear of acceptance, as well as on the consequent need for self-protective measures. It is argued that careful and consistent analysis of these conflicted areas of these patients' transference leads toward greater integration of their identity and personality.     

The countertransference impact of autistic defence in an otherwise neurotic patient

This paper investigates the question of why, in the psychoanalytic psychotherapy of a patient with encapsulated autistic pathology, the steady maintenance of a therapeutically neutral stance can be especially difficult. Transference and countertransference vicissitudes are examined. The author notices that the patient's intolerance of ‘opposites’ (cf. Tustin, 1986), combined with extreme antipathy to having that intolerance noticed, can elicit corresponding, and potentially destabilizing, countertransference reactions. These reactions comprise an unstable tension between co‐existing pressures towards fusion with, or expulsion of, the patient, their co‐existence under further pressure to remain unnoticed. Until perceived, this state of affairs risks collusion with the pressure either to merge with or to expel the patient, and compromises the capacity to notice the detail of the transference process and even to notice co‐existent positive and negative transference images. Detailed clinical illustration is given, including a session where it was difficult to notice the patient's experience of a couple as a combined object. The author finds these observations of bipolar countertransference tensions illuminated by Green's concepts of positive and negative narcissism and of the disobjectalizing function, and specifically accounted for by Ribas's theory of autism as radical drive defusion.     

Flirting With Death: The Role of Father in Containment of Sexually Perverse Behavior

The author demonstrates, through clinical case illustration, how sexual perversion is linked to traumatic early separation-individuation processes. The illusion of fusion with a seductive and gratifying mother-introject led a young man into the risky business of unprotected gay sex with strangers. The pleasure-seeking child and enabling mother narrative was played out in the transference/counter-transference relationship threatening to pervert the analysis. Authoritative limit setting re-introduced a potent, previously castrated, father figure into the patient’s inner world and gave the patient impetus to separate from the undifferentiated mix-up between mother and child, resulting in containment of dangerous sexual behaviors.     

Striving Toward Useful Interpretation While Managing Countertransference Enactments: Encounters With a Thick-Skinned Narcissistic Person

Narcissistic patients tend to push the analyst to work harder than usual to contain, understand, translate, and utilize their countertransference states. This is because of the unusually extreme reliance on denial, devaluation, projective identification, and control that these individuals exhibit. Defenses against loss, envy, greed, and dependence create difficult transference states in which symbolic or creative material is flattened, stripped, and neutralized. Feelings are out of the question. This clinical paper explores the narcissistic lack of connection to self and other that endures in the transference as well as in all aspects of these patients' lives. With thick-skinned narcissistic patients, there is a subtle lack of engagement, an underbelly of control, and a complete uncoupling of feeling or link between self and object. Envy is often a cornerstone of such difficult clinical problems and is part of an internal desolation that fuels an emotional firebombing of any awareness of interest in self or other. Detailed case material is used to show how confusing, alarming, and demanding such narcissistic patients can be, trying the very essence of the analytic process. They enter treatment looking for help, wanting a quick fix to their suffering, but resist the deeper understanding, learning, and change that psychoanalytic treatment offers.     

His mother-tongue: from stuttering to separation, a case history

This paper delineates the transference and countertransference experiences in the analysis of a patient whose presenting symptom and main concern was his stutter. I suggest that oral-sadistic rather than anal-sadistic hostile elements may be identified in this patient's particular stutter. I focus on its significance in terms of object relationship: my patient's struggle to 'get born', to emerge as a separate other. I argue that early symbiotic fusion needs in conflict with the need to separate produce his stutter. Speech and language are seen as the vehicle for separation and the stutter as a flight from separateness back to an illusion of fusion with mother.     

Father regression Clinical narratives and theoretical reflections1

The author deals with love‐hate enthrallment and submission to a primitive paternal object. This is a father‐son relationship that extends through increasing degrees of ‘primitiveness’ or extremeness, and is illustrated through three different constellations that constitute a continuum. One pole of the continuum encompasses certain male patients who show a loving, de‐individuated connection to a father experienced as trustworthy, soft, and in need of protection. Further along the continuum is the case of a transsexual patient whose analysis revealed an intense ‘God‐transference’, a bondage to an idealized, feared, and ostensibly protective father‐God introject. A great part of this patient's analysis consisted in a fi erce struggle to liberate himself from this fi gure. The other end of the continuum is occupied by religious terrorists, who exemplify the most radical thralldom to a persecutory, godly object, a regressive submission that banishes woman and enthrones a cruel superego, and that ends in destruction and self‐destruction. Psychoanalytic thinking has traditionally dealt with the oedipal father and recently with the nurturing father, but there is a gap in thinking about the phallic, archaic father, and his relations with his son(s). The author aims at fi lling this gap, at the same time as she also raises the very question of ‘What is a father?’ linking it with literary and religious themes.     

The breadth and boundaries of a self‐psychological immersion in shame a one‐and‐a‐half‐person perspective

Shame colors other feelings and perceptions about the self. From reflections about his own personal experiences and observations regarding a particular manic‐depressive patient, the author discusses the evolution of his current clinical and theoretical understanding of shame. The framework of analytic self psychology is offered as a particularly useful perspective from which to consider shame, with its emphasis on the concept of selfobject to account both for shame's development (through selfobject misattunement and unresponsive‐ness) and for its amelioration (through empathic mirroring, idealization, and twinning). A developmental sequence for shame is advanced reflecting limitations in selfobject responsiveness, and problems are noted in the ability of current self psychology theory to fully account for the alleviation of shame. The self plays its part in the construction of those selfobjects needed to ease shame, representing the “one‐and‐a‐half‐person psychology”; of the paper's subtitle. Finally, the important role of countertransference shame is considered through a clinical example of therapist disclosure of his own shame to his patient, utilized in order to repair an interrupted kinship selfobject transference.     

Envy: One or many?

This paper reports conceptual and clinical research about envy. It consists of an examination and comparison of Klein's points of view of 1952, where the feeling of exclusion from the envious object is stressed, and of 1957, based on the split death instinct that is projected onto the envied object. These two approaches are contrasted with the point of view of the author, where envy is understood as the result of a particular kind of object relation, in which the subject registers an asymmetry with its peer, that he considers unfair, due to the biased action of an idealized omnipotent object, on whom the subject depends and that gives to the envied one, and deceives the envious one, leading to experiencing a compound of emotions: hatred, love, sense of unfairness, wish of revenge, helplessness and incapacity of the subject to provide for himself. The mental state just described emerges from clinical observations, and is illustrated with the passage from the Bible where Abel, the envied one, is killed by Cain, the envious one, showing their relationship with Jehovah, biased in his preferences, a situation designated by the author as 'Cain's complex'. In this paper some considerations are also made concerning the modalities of envy: penis envy in women, the relationship between envy and narcissism, the difference between envy and jealousy, and the interpretative handling of envy. To answer the question posed in the title, the conclusion is that envy presents a central nucleus with different elaborative branches.     

Envy divides the two faces of narcissism

In this article, we test psychodynamic assumptions about envy and narcissism by examining malicious envy in the context of narcissistic grandiosity and vulnerability. In Study 1, students (N = 192) and community adults (N = 161) completed trait measures of narcissism, envy, and schadenfreude. In Study 2 (N = 121), participants relived an episode of envy, and cognitive‐affective components of envy were examined in the context of both self‐ and informant reports of their envy and narcissism. In Study 3 (N = 69), narcissism was linked to reports of envy covertly induced in the laboratory. Vulnerable narcissism was strongly and consistently related to dispositional envy and schadenfreude (Studies 1–2), as well as to all cognitive‐affective components of envy (Study 2). Furthermore, it facilitated envy and schadenfreude toward a high‐status peer (Study 3). Grandiose narcissism was slightly negatively related to dispositional envy (Studies 1–2), and it did not predict informant reports of envy or cognitive‐affective components of the emotion (Study 2). Finally, it did not exacerbate envy, hostility, or resentment toward a high‐status peer (Study 3). The results suggest envy is a central emotion in the lives of those with narcissistic vulnerability and imply that envy should be reconsidered as a symptom accompanying grandiose features in the diagnosis of narcissistic personality disorder.     

Discontinuities in the male psyche: waiting, deadness and disembodiment. Archetypal and clinical approaches

The discontinuities of development in the male psyche that are manifested in some analyses in unconscious experiences of inner disintegration are described. Narcissism and a de-somatized relationship to their own presence are the dominant clinical presentation in these patients. The analyst sometimes experiences these analyses as 'dead', as a result of the projection of a 'dead mother' object. The question of how psychic deadness and impotence can be worked with is examined. Clinical experience with these men shows how notions associated with the puer-senex archetype can illuminate the stark realities of a patient's early experiences, particularly in how mother's presence is felt. A theoretical and clinical bridge is proposed between puer and narcissus to frame how a man may unconsciously strive against psychic fragmentation by clinging to an identification with both--in order to remain intact in the face of being caught in a pre-pubescent state which reflects the insecure attachment to mother. The author describes how patients may find a more grounded embrace of reality via the use of the analyst's empathy and a greater potency through work in the transference/countertransference. These strengthening achievements help men to begin to leave the 'dead mother' behind.     

Countertransference and containment in a patient with a psychotic mother

The importance of countertransference reactions in the treatment of a borderline patient with a psychotic suicidal mother is discussed. In such a case containment can be seriously disrupted by the violence of the patient's projections into the therapist. Where a psychotic internal object has been brought for treatment it is particularly important that the therapist be able to identify not only with the sane and mad parts of the patient but with the destructiveness and cruelty of the patient and her primary object. The difficulties of tolerating these relentless projections of madness and despair are increased by the multiple and confusing aims of the patient's excessive use of projective identification. The invasive and hostile aspects of this are often heavily disguised beneath idealization of the self and object as well as of madness itself. For the patient, attempts to interpret the idealization are moreover felt as an assault on the lost loved object, and the therapy then unconsciously becomes a persecutory experience for the patient. The therapist can thus be drawn into feeling the full force of the anger and hatred towards the real disappointing object and the sense of hopelessness about the reparative task. Although such feelings need to be tolerated, eventually some distance from the often-unpleasant fluctuations in the countertransference must develop if a useful degree of containment is to be achieved.     

The therapeutic object relationship

This paper introduces the concept of the therapeutic object relationship in order to clarify our understanding of the nature of fully analytic work with the more regressive patient, which has unsystematically developed over the last 30 or 40 years. The need for such a clarifying concept seems to arise from several sources. Our analytic work with the more regressed patient appears to entail a relationship demand factor which cannot be usefully treated only as resistance to the development of the transference. These are patients with what may be described as object hunger emanating from faulted ego development and a disordered internal object world. This object hunger cannot be adequately met within the framework of the tacit, ordinary, good-enough environment of the concerned and nonjudgmental analyst. In addition, the literature on this subject still dichotomizes the relationship factor of treatment from the transference. The concept of the therapeutic object relationship appears to offer the possibility of a clinical and theoretical unification between transference and relationship. The major point of the paper may be described in terms of the manner in which we have progressed from Eissler's parameter paper of 1953 to the widened scope of analytic work made possible by object relations theory, developmental theory and observation of infant and child development. The face of analysis seems to have undergone profound modification from the early classical model to one in which developmental maturation, in addition to making unconscious conflict conscious, has become a matter for our concern. This change seems to require seeing the analyst as a special form of real object with whom the patient passes through a revised version of certain developmental pathways. The therapeutic object relationship is viewed as a potentially unifying concept which may make possible higher degrees of generalization about the variously unsystematized approaches to analyzing the more regressive, but nonpsychotic patient. Some history of definition of the analytic relationship in terms of transference or relationship is presented. In the course of the paper the therapeutic object relationship is gradually defined as one of: primal intimacy; increased permeability of boundaries between self and other; intensive empathic interaction; the evolution of self and object definition in a context of intimate relation with an object that is instrumental in this process; and the activation of transcendant forms of symbolic-creative intercommunication.(ABSTRACT TRUNCATED AT 400 WORDS)