Finding unconscious phantasy in the session: Recognizing form

The concept of unconscious phantasy has played – and still does play – a central role in psychoanalytic thinking. The author discusses the various forms by which unconscious phantasies manifest themselves in the analytic session as they are lived out and enacted in the transference relationship. This paper also aims at expanding the kleinian theory of symbol formation by exploring the impact that emotional aspects connected to early “raw’, “pre‐symbolic’ phantasies have in the analysis and how their corporeal elements interlock with the signifying process. The author follows the expressive forms of primitive unconscious phantasies as they appear in a psychoanalytic session and proposes that the emotional effect that can be experienced in the communication between patient and analyst depends in great measure on “semiotic’ aspects linked to primitive phantasies that are felt and lived out in embodied ways. Rather than a move from unconscious phantasies that typify symbolic equations to those showing proper symbolization, these can coexist and simultaneously find their way to what is communicated to the analyst. As early phantasies bear an intimate connection to the body and to unprocessed emotions when they are projected into the analyst they can produce a powerful resonance, sometimes also experienced in a physical way and forming an integral part of the analyst's counter‐transference.     

The countertransference dream1

Can the analyst's night‐dream about his patient be considered as a manifestation of countertransference‐and, if so, under what conditions? In what way can such a dream represent more than just the disguised fulfillment of a repressed wish of the analyst? Is there not a risk of the analyst unconsciously taking up and ‘using’ the content of a session or other elements coming from the analytic situation for his own psychic reasons? The author, closely following Freud's dream theory, shows the mechanisms which can allow us to use the dream content in the analytical situation: preserved from the secondary processes of conscious thinking, other fantasies and affects than in the waking state can emerge in dream thought, following an ‘unconscious perception’. After examining the countertransference elements of Freud's dream, ‘Irma's injection’, which leads off The interpretation of dreams, the author presents a dream of her own about a patient and its value for understanding affects and representations which had hitherto remained unrepresented.     

The use of child drawings to explore the dual↔group analytic field in child analysis

Awareness that the child is part of a complex relational system has ensured that all child analysts agree on the necessity of establishing a therapeutic alliance with the parents. Unconscious conflictual dynamics involve the child analyst and include him, from the time of the initial consultation, in an analytic field that is closer to that of a group than to the bi‐personal set‐up of therapy with adults. Through a clinical example, the author hypothesizes that the child’s drawings and play can be viewed as tools capable of mapping the unconscious emotions present in an analytic field that extends beyond the analyst–child couple. Play and drawings can be used in the relationship with the parents not in an explanatory sense, but as a probe with which to explore the universe of unconscious emotions present in the group field. The images or the story of the play used with this particular modality prove to be an attractive pathway that is effective in facilitating the alpha function of each of the members of the group. Furthermore, in this sense, they create the conditions for an occasion through which the parents can become more aware of their own unconscious emotions that have been entrusted to the child and expressed through his symptomatology. The possibility for the little group of subjects involved in a child analysis for oscillation in a dual–group field permits not only a shared experience of knowledge, but also a shared creativity aimed at knowledge of emotional truth (O).     

Identification with the aggressor and the ‘normal traumas’: clinical implications

Ferenczi's (1933) surprisingly unknown concept of identification with the aggressor – an abuse victim's ‘eliminating’ her own subjectivity and ‘becoming’ precisely what an attacker needs her to be – has radical implications for our understanding of analytic technique. Its very frequent occurrence also forces us to broaden our understanding of what constitutes trauma. Ferenczi saw the experience of ‘traumatic aloneness’ or ‘emotional abandonment’ as the key element of trauma, since this is what enforces the traumatic responses of dissociation and identification with the aggressor. Identification with the aggressor operates in the analytic relationship in both patient and analyst. This has various consequences, including the structuring of the relationship through unconscious collusions – mutually coordinated, defensive identifications designed to help both participants feel secure. This view of the analytic relationship has clinical implications in at least four areas: the understanding of the patient's free associations, which may reflect the patient's compliance with the analyst's wishes rather than the contents of the patient's own unconscious; the need for some kind of mutuality of analysis; the traumatizing potential of the analyst's authority; and the tendency of some patients to take blame and responsibility reflexively, as a way of protecting the analyst.     

ANALYTIC MIND USE AND INTERPSYCHIC COMMUNICATION: DRIVING FORCE IN ANALYTIC TECHNIQUE,PATHWAY TO UNCONSCIOUS MENTAL LIFE

Developed from established psychoanalytic knowledge among different psychoanalytic cultures concerning unconscious interpsychic communication, analysts' use of their receptive mental experience—their analytic mind use, including the somatic, unconscious, and less accessible derivatives—represents a significant investigative road to patients' unconscious mental life, particularly with poorly symbolized mental states. The author expands upon this tradition, exploring what happens when patients unconsciously experience and identify with the analyst's psychic functioning. The technical implications of the analyst's “instrument” are described, including the analyst's ego regression, creation of inner space, taking mind as object, bearing uncertainty and intense affect, and self‐analysis. Brief case vignettes illustrate the structure and obstacles to this work.     

Working at the “Intimate Edge”: Intersubjective Considerations—Comments on “A Case Study of Power and the Eroticized Transference–Countertransference”

Working from the premise that as analysts we are always vulnerable to unconscious collusion and enactment, and that this has radical implications for how we conceive of the analytic process, I try to illustrate how the process of working at the “intimate edge” of the analytic relationship, and explicitly engaging what goes on intersubjectively between patient and analyst expands the analytic process and the analytic possibilities. I especially focus on how deconstructing interactive enactment can help to access unconscious aspects of what might be in play in relation to the issues of power and eroticized transference–countertransference under discussion here, and how this process itself can become the medium of the work and the focus of therapeutic action.     

The seventh servant: The implications of a truth drive in Bions theory of 'O'

Drawing upon Bion's published works on the subjects of truth, dreaming, alpha‐function and transformations in ‘O’, the author independently postulates that there exists a ‘truth instinctual drive’ that subserves a truth principle, the latter of which is associated with the reality principle. Further, he suggests, following Bion's postulation, that ‘alpha‐function’ and dreaming/phantasying constitute unconscious thinking processes and that they mediate the activity of this ‘truth drive’ (quest, pulsion), which the author hypothesizes constitutes another aspect of a larger entity that also includes the epistemophilic component drive. It purportedly seeks and transmits as well as includes what Bion (1965, pp. 147‐9) calls ‘O’, the ‘Absolute Truth, Ultimate Reality, O’ (also associated with infi nity, noumena or things‐in‐themselves, and ‘godhead’) (1970, p. 26). It is further hypothesized that the truth drive functions in collaboration with an ‘unconscious consciousness’ that is associated with the faculty of ‘attention’, which is also known as ‘intuition’. It is responsive to internal psychical reality and constitutes Bion's ‘seventh servant’. O, the ultimate landscape of psychoanalysis, has many dimensions, but the one that seems to interest Bion is that of the emotional experience of the analysand's and the analyst's ‘evolving O’ respectively (1970, p. 52) during the analytic session. The author thus hypothesizes that a sense of truth presents itself to the subject as a quest for truth which has the quality and force of an instinctual drive and constitutes the counterpart to the epistemophilic drive. This ‘truth quest’ or ‘drive’ is hypothesized to be the source of the generation of the emotional truth of one's ongoing experiences, both conscious and unconscious. It is proposed that emotions are beacons of truth in regard to the acceptance of reality. The concepts of an emotional truth drive and a truth principle would help us understand why analysands are able to accept analysts’ interpretations that favor the operation of the reality principle over the pleasure principle—because of what is postulated as their overriding adaptive need for truth. Ultimately, it would seem that Bion's legacy of truth aims at integrating fi nite man with infi nite man.     

On receiving what has gone astray, on finding what has got lost

Disturbing emotions that act as bodily cryptograms waiting to be deciphered are currently understood as intra-psychic trauma. The author briefly discusses Fordham's concepts of deintegration and primitive identity, as well as early patterns of mother-infant attunement to describe how the empathic capacity of the analyst is dramatically challenged in helping patients to give birth to unbearable emotions that remain an undifferentiated entity. Referring to Ogden's understanding of the mechanism of projective identification, the author will explore how unconscious mental processes in the analyst and the patient can work at re-activating failures in the deintegrative process. Clinical material is presented to show how unconscious psychic events that affect the patient but cannot be known consciously can be born into mind by the analytic couple.     

Process‐orientated psychoanalytic work in initial interviews and the importance of the opening scene

From the very first moment of the initial interview to the end of a long course of psychoanalysis, the unconscious exchange between analysand and analyst, and the analysis of the relationship between transference and countertransference, are at the heart of psychoanalytic work. Drawing on initial interviews with a psychosomatically and depressively ill student, a psychoanalytic understanding of initial encounters is worked out. The opening scene of the first interview already condenses the central psychopathology – a clinging to the primary object because it was never securely experienced as present by the patient. The author outlines the development of some psychoanalytic theories concerning the initial interview and demonstrates their specific importance as background knowledge for the clinical situation in the following domains: the ‘diagnostic position’, the ‘therapeutic position’, the ‘opening scene’, the ‘countertransference’ and the ‘analyst's free‐floating introspectiveness’. More recent investigations refer to ‘process qualities’ of the analytic relationship, such as ‘synchronization’ and ‘self‐efficacy’. The latter seeks to describe after how much time between the interview sessions constructive or destructive inner processes gain ground in the patient and what significance this may have for the decision about the treatment that follows. All these factors combined can lead to establishing a differential process‐orientated indication that also takes account of the fact that being confronted with the fear of unconscious processes of exchange is specific to the psychoanalytic profession.     

The crisis of psychoanalysis and psychoanalytical training: The suffering of the candidate on the long road towards qualifi cation1

The author assesses the impact of the so‐called ‘crisis of psychoanalysis’ on the training of candidates, and on those who accompany them through the course. Different causes of the most relevant symptom of the crisis, i.e. the diffi culty of fi nding patients for a four‐sessions‐weekly analysis, are considered. According to the author, analysts themselves must bear some of the responsibility for it. She draws attention to a number of interrelated phenomena, such as: trainees' tension in their encounters with potential analysands, due to awareness of their own needs as trainees; the necessity to accept very disturbed patients whose selection might arouse criticism from the training committee; analyses in which trainees seem to become patients' hostages because of ever‐present fears of interruption; the diffi cult construction of a psychoanalytic identity in trainees who also are in full‐time psychiatric practice; trainees' profound uncertainty about the future both of psychoanalysis in general and their own careers in particular. In agreement with Kernberg, the author stresses the importance of considering the ‘crisis of psychoanalysis’ as a phenomenon whose development may be infl uenced by the analysts themselves.     

MAPPING THE LANDSCAPE: LEVELS OF TRANSFERENCE INTERPRETATION3

The author argues that there are distinctly different kinds of transference interpretation, each of which might be valid in particular circumstances in analysis, but which contain and imply different understandings of what is meant by a ‘transference interpretation’. She suggests that transference interpretations may be at any one of four different levels, and she describes these levels as ranging from interpretations that point to links between current events in the analysis and events from the patient's history, through interpretations that link events in the patient's external life to the patient's often unconscious phantasies about the analyst and the analysis, to interpretations that focus on the use of the analyst and the analytic situation to enact unconscious phantasy configurations, sometimes pulling the analyst into the enactment. Material from four consecutive sessions of an analysis is presented to illustrate how all levels of transference interpretation may be part of a lively and meaningful analysis, but how the level of interpretation may change as the level of understanding deepens within a session and from one session to the next.     

Assessing analytic applicants using an adapted version of the Australian schema for candidate competence

The author proposes an approach to the assessment of analytic applicants that is based on a schema relating to candidate competence. The protocol relies on the central notion that knowing what competencies we would be expecting of well‐functioning analysts leaves us well placed to know what capacities, and more importantly what potential capacities, we would be looking for in our aspiring applicants. The author is concerned that the traditional interview methods used have been rather individualistic, lacking in comprehensiveness and therefore not easy to teach. He makes a case for the described protocol having distinct advantages as an assessment tool over the traditional one, in that that it has clear, consistent, and comprehensive criteria, as well as a workable methodology. The author notes, as a particular advantage, the protocol's flexibility in being able to move fluidly from functioning as an instrument for selection, to an instrument for candidate evaluation. This allows, in situations of doubt, for particular competencies in a candidate to be further evaluated and tracked in an ongoing way whilst ‘in the field’.     

The analytic third: implications for psychoanalytic theory and technique

The author views the analytic enterprise as centrally involving an effort on the part of the analyst to track the dialectical movement of individual subjectivity (of analyst and analysand) and intersubjectivity (the jointly created unconscious life of the analytic pair--the analytic third). In Part I of this paper, the author discusses clinical material in which he relies heavily on his reverie experiences to recognize and verbally symbolize what is occurring in the analytic relationship at an unconscious level. In Part II, the author conceives of projective identification as a form of the analytic third in which the individual subjectivities of analyst and analysand are subjugated to a co-created third subject of analysis. Successful analytic work involves a superseding of the subjugating third by means of mutual recognition of analyst and analysand as separate subjects and a reap-propriation of their (transformed) individual subjectivities.     

Unconscious phantasy: Some historical and conceptual dimensions

This paper seeks firstly to grasp both conceptually and historically the different phenomenologies that are captured by the term ‘Unconscious Phantasy’. The term is shown to refer to a number of distinct though overlapping conceptual domains. These include: phantasy as scene, phantasy as representation of drive, phantasy as representation of wish as its fulfilment, phantasy as split off activity of the mind functioning under the aegis of the pleasure principle; phantasy as representation of the minds own activities (which Wollheim calls’ the way “the mind represents its own activities to itself’’). Lastly unconscious phantasy is understood as being the basic foundation of all mental life, including drives, impulses, all anxiety situations and defences. Having mapped out this territory through following the development of the concept in the work of Freud and Klein, the author draws on the work of the philosopher Richard Wollheim who, the author contends, has made a fundamental contribution to our conceptual understanding of unconscious phantasy. In the last section of the paper, the author draws a distinction between what he terms ‘objects’ (namely psychic objects) and what he terms ‘facts’. It is suggested that this distinction, though implicit in much of our work, benefits from being made explicit and that in so doing an important dimension of analytic work is illuminated. We aim to help the patient to discover what he is like, to understand the ways in which he conceives and misconceives himself, to unravel the fact‐ness of himself and his world from its ‘object qualities’, to differentiate between unconscious phantasy and reality.     

Synchronicity as A Basis of Analytic Attitude

My aim is to describe Jung's approach to the experience of the chaotic, which could equally be termed the irrational, the non-ego, the unordered or prima materia , and to extract from this a clinical approach to the analytic patient which, in Jung's own writings, is often more implicit than explicit. My interest in this enquiry arises from the clinical experience of the unconscious in the form of transference/ countertransference, involving relentless pressure on both analyst and analysand to attempt to impute meaning and order. I examine Jung's work 'Synchronicity: an acausal connecting principle' and extrapolate from it what I think to be its unique contribution to hermeneutics - the ontologically-based concept of a psychoid understanding of meaning and pattern. In the second part of the paper, I discuss the application to analytic work of Jung's hermeneutic approach. I look at how analysts relate to meaning in terms of their relationship to theory. I illustrate this by comparing two short psychoanalytic papers on aggression, an instinct which is often seen as engendering splitting and which tends therefore to promote the dissociations which Jung was trying to address in 'Synchronicity'. I then illustrate with clinical material how Jungian analysts might relate to meaning in their approach to the patient. Together, these form the basis of what is commonly called 'analytic attitude', which I see as the basis for a distinctively Jungian identity for analytic practice.     

The courage to stay in the moment

In 1934, James Strachey wrote that the active ingredient of psychoanalysis was the mutative interpretation. Even at this early date, Strachey observed that a relatively small proportion of the analytic literature was concerned with the mechanisms for change implicit in the analytic model.

In this paper, the author proposes two modifications of Strachey's ideas. One is that it is a moment, an event, and not an interpretation as such that creates change. The author terms this the ‘mutative moment’. The other modification is the proposal of an unconscious internal group matrix as an image of the structure of self. This is a self that is at one and the same time, internal and external, individual and social.

Building upon Freud, the object relations theorists, Kohut and the work of group analysts, the author pinpoints where and how change occurs in both individuals and in groups. The active ingredient of change is the focus on the here-and-now, a perspective common to both therapists and counsellors. As an understanding of the meaning of this focus develops, it becomes apparent that it takes courage to stay in the moment.     

What is “Good” Technique? How to Teach it? Personal Reflections on Psychoanalytic Training

There is an intense interest in the interactional process across the varying psychoanalytic schools of thought. The analytic relationship itself, in all of its complexity, is the vehicle for our work. These advances raise the question of what we mean by technique these days, a question that has implications for analytic training and supervision. In this paper, the author reflects back on his analytic training experience, specifically at how two of his supervisors regarded technique, how it was taught, and the various ways in which it was communicated. In looking back at these supervisory experiences, the author examines how these teaching analysts embodied some of what they had to teach. The author shows what was mutative across these training experiences in terms of what was needed in order to grow—what facilitated his own development as an analyst and contributed towards the cultivation of his own style.     

Alienating identifications and the psychoanalytic process1

The transmission of psychic life from one generation to the next can result in unconscious, alienating identifications when the parents have not been able to elaborate a process of mourning for their own childhoods. In this article, the author describes the nature of these identifications, constructed around insufficiently symbolized experiences, as revealed during the psychoanalytic process. These unconscious, alienating identifications raise some arduous technical problems for the psychoanalyst as they lead the patient to carry out complex enactments that erase the normal transference markers. The psychoanalyst may then be tempted to resort to pejorative theoretical concepts, such as the death drive. And yet, unknown to the analysand, the insufficiently symbolized psychic elements contain a potential for transformation that may lead to reconstructions and dis‐alienating interpretations. The author distinguishes between alienating identifications and fantasies of identification when the latter transiently appear during the psychoanalytic process. These identification fantasies symbolically register the emotional experience undergone during the analytic sessions and contribute to the integration of insufficiently symbolized psychic elements. These theoretical considerations are fully illustrated by the clinical report of some analytic sessions.     

SUPERVISION: A CONTAINERÆCONTAINED APPROACH

The authors illustrate an approach to the supervisory process as a learning experience for both supervisee and supervisor built on the containment of unconscious anxieties. It is argued that a core function of psychoanalytic supervision is to help contain the emotional turbulence and the unconscious anxieties arising and evolving in the two interacting domains of the analytic and the supervisory sessions. From this perspective, the analyst-patient interaction and that of the supervisee and supervisor can be understood as twin, tiered transformational arenas, the supervisory one being at the service of holding and grasping the roles the supervisee/analyst goes through as part of the analytic process. On the basis of detailed clinical material from a disturbed 7-year-old girl, the authors explore the interrelated issues and difficulties in containing anxieties and turbulence in both the analytic and the supervisory situation. When emotional containment is adequately handled, the supervision helps the understanding and development of the supervisee's use of his/her own personality as a treatment instrument, as advocated by Fleming and Benedek decades ago. The supervisory session thus furthers the resolution of clinical issues through symbol-formation, clinical sessions and supervision being twin domains for recording and understanding emotional evolution.