On countertransference enactments

This communication focuses on the relation of countertransference to psychoanalytic technique, calling attention not to the more obvious forms of countertransference that have been commented on by previous writers on the subject, but to its subtler ones. Often well camouflaged within the framework of traditional, time-tested techniques, this aspect of countertransference may attach itself to our way of listening and thinking about patients, to our efforts at interpretation, to the process of working through, or to the complex issue of termination. Less recognizable than its more boisterous counterpart and in some respects less tangible, this side of the problem of countertransference is no less important. For it is precisely those subtle, often scarcely visible countertransference reactions, so easily rationalized as parts of our standard operating procedures and so easily overlooked, that may in the end have the greatest impact on our analytic work.     

The body of the analyst and the analytic setting: Reflections on the embodied setting and the symbiotic transference

In this paper the author questions whether the body of the analyst may be helpfully conceptualized as an embodied feature of the setting and suggests that this may be especially helpful for understanding patients who develop a symbiotic transference and for whom any variance in the analyst's body is felt to be profoundly destabilizing. In such cases the patient needs to relate to the body of the analyst concretely and exclusively as a setting ‘constant’ and its meaning for the patient may thus remain inaccessible to analysis for a long time. When the separateness of the body of the analyst reaches the patient's awareness because of changes in the analyst's appearance or bodily state, it then mobilizes primitive anxieties in the patient. It is only when the body of the analyst can become a dynamic variable between them (i.e. part of the process) that it can be used by the patient to further the exploration of their own mind.     

Raiding the inarticulate: The internal analytic setting and listening beyond countertransference

The analytic setting exists not only externally but also internally as a structure in the mind of the analyst. The internal analytic setting constitutes an area of the analyst's mind where reality is defined by unconscious symbolic meaning. Clinical examples illustrate how a secure internal setting allows flexibility in the external setting without sacrifice of its analytic quality. The internal setting can help analysts listen inwardly to themselves in a way that is free-floating with regard to their internal processes. This points beyond usual ideas of countertransference. An analytic encounter may stir up elements that belong to the analyst's psyche which, rather than impeding the analysis, can actively enrich it. Seamus Heaney's writings evoke comparisons between listening to poems and listening to patients, and a week in a patient's analysis is described in relation to these themes.     

Countertransference in defense enactments

A clinical term is introduced to capture a defense that develops with the patient's deepening but fleeting awareness of painful transference feelings. The analyst's attention to countertransference in such situations is central to the analysis of these defenses. An attempt is made to distinguish defense enactments from other types of defenses, and to differentiate the analyst's countertransference reaction to this type of defense from countertransference reactions that might appear similar. The reasons for this dynamic in the interpersonal space are explored, and a clinical example that describes this phenomenon in the analytic moment is given.     

Reflections on the role of the analytic setting in the light of COVID-19

There have been many reflections, both individual and collective within our Institutes, on the effects on our work with patients caused by COVID-19 and the requirement to move suddenly from the setting of our own consulting rooms to working with patients online (see also, the previous issue of this Journal). This paper focuses on what we have learned from these experiences that can add to our knowledge about the role of the setting in analytic work. Drawing on Bleger’s (1967) seminal paper highlighting the usual setting as a mute projection carrier for primitive wishes and affects, the paper explores how different patients have reacted to the loss of the analyst as the guardian of the setting and in particular as an embodied presence. Some key questions and challenges for both patients and analysts during the pandemic, when ‘the setting begins to weep’, are explored.     

The evocative power of enactments.

The inevitability of analytic enactments, defined as symbolic interactions between patient and analyst, is discussed. Clinical material from the psychoanalysis of a latency-age child is presented to illustrate the role of enactments and to demonstrate their usefulness in furthering the analytic work.     

Liangzhi and the Interpretative Obfuscation Regarding Knowledge

This article aims to argue that interpreting liangzhi良知 as innate,original,or cognitive knowledge is likely to fall into "interpretative obfuscation regarding knowledge." First,for Wang,what is inherent in mankind is moral agency rather than innate or original knowledge.Therefore,the focus ofzhizhi 知 and gewu格物 is instead on moral practice and actualization of virtue rather than on either "the extension of knowledge" or "the investigation of things."Apart from that,drawing support from cognitive knowledge to explicate liangzhi also leads to three related but distinct misconceptions:liangzhi as perfect knowledge,the identity of knowledge and action,and liangzhi as recognition or acknowledgement.By clarifying the above misinterpretations,the meaning and implication of liangzhi will,in turn,also become clearer.     

Decomposing filial piety into filial attitudes and filial enactments

In an attempt to explore the attitude-behaviour relationship, the present study examined the mixed findings from research on filial piety by differentiating filial attitudes from filial behaviours. The Filial Behaviour Scale was developed to tap the behavioural manifestations of filial piety, and its nomological network was established in two Chinese contexts, Hong Kong and Beijing. In addition to filial attitudes, we used values, social beliefs, and self-construals to explain filial behaviours. The results of hierarchical regression analysis showed that the value factor of conservation and the social axiom of reward for application predicted filial behaviour above and beyond filial attitudes; an interdependent self-construal moderated the effect of cultural group on filial behaviour. Gender and regional differences in filial piety were also examined. Males were found to score higher on filial attitudes, but not significantly higher on filial behaviours. Regional differences existed in filial behaviours, but not in filial attitudes, with Mainland Chinese displaying a higher level of filial behaviours than their Hong Kong counterparts. These identified differences suggest the importance of differentiating filial attitudes from filial behaviours in future attempts to understand Chinese filiality.     

Negative hallucinations,dreams and hallucinations: The framing structure and its representation in the analytic setting

This paper explores the meaning of a patient's hallucinatory experiences in the course of a five times a week analysis. I will locate my understanding within the context of André Green's ideas on the role of the framing structure and the negative hallucination in the structuring of the mind. The understanding of the transference and countertransference was crucial in the creation of meaning and enabling the transformations that took place in the analytic process. Through a detailed analysis of a clinical example the author examines Bion's distinction between hysterical hallucinations and psychotic hallucinations and formulates her own hypothesis about the distinctions between the two. The paper suggests that whilst psychotic hallucinations express a conflict between life and death, in the hysterical hallucination it is between love and hate. The paper also contains some reflections on the dramatic nature of the analytic encounter.     

A patient's transference to the analyst's supervisor: effect of the setting on the analytic process

A case is presented in which the patient's transference to the analyst's supervisor became evident just prior to the switch from clinic to private patient status. The patient experienced the supervisor as a restraining father figure who protected her from acting on her erotic wishes toward the analyst. Analysis of this led to the recall of previously repressed memories of sexual wishes toward her brother, and the sense of protection from these wishes that she had gotten from the presence of her father. The literature on transference involving the supervisory constellation and the training setting is reviewed, and the concepts of split and institutional transference are examined. Factors inhibiting the analysis of patients' fantasies about the analyst's status as trainee, including the presence of the supervisor and the institute, are discussed.     

Interpretative memories of artworks

It is well known that memories of self‐relevant experiences are reconstructed over time. Artworks often require an elongated period of interpretative meaning‐making. Such works were therefore used to study temporal aspects of memory construction. In a longitudinal study, individuals' memories of artworks were examined to explore the idea that only with the passage of time would autobiographical memory and emotion be associated with thematic integration of the artwork memory. We also expected that integrated artwork memories would be more differentiated (in terms of number of details) than memories that were not integrated. Memories of artworks were collected from visitors to an art gallery in person as they left the gallery, and 5 months later in a phone interview. Participants were also asked, at both interviews, whether the memory recollection was associated with an autobiographical memory and with an emotion. Associations among the elements of autobiographical memory, emotion, differentiation, and integrated artwork memories were significant only at the time of the longer‐term recollection. The data suggest that, during an incubation period, these elements moved from a state of disconnection to interconnection.     

Interpretative memories of artworks

It is well known that memories of self-relevant experiences are reconstructed over time. Artworks often require an elongated period of interpretative meaning-making. Such works were therefore used to study temporal aspects of memory construction. In a longitudinal study, individuals' memories of artworks were examined to explore the idea that only with the passage of time would autobiographical memory and emotion be associated with thematic integration of the artwork memory. We also expected that integrated artwork memories would be more differentiated (in terms of number of details) than memories that were not integrated. Memories of artworks were collected from visitors to an art gallery in person as they left the gallery, and 5 months later in a phone interview. Participants were also asked, at both interviews, whether the memory recollection was associated with an autobiographical memory and with an emotion. Associations among the elements of autobiographical memory, emotion, differentiation, and integrated artwork memories were significant only at the time of the longer-term recollection. The data suggest that, during an incubation period, these elements moved from a state of disconnection to interconnection.     

Racial identities, racial enactments, and normative unconscious processes

The author surveys various views of racial and ethnic identity, and proposes a model of thinking about identity aimed at capturing both its oppressive and its facilitating character. To further elaborate the dual nature of identity, she discusses the way that inequities in the social world, and the ideologies that sustain them, produce narcissistic wounds that are then enacted consciously and unconsciously by both patient and therapist. A variety of such enactments are presented in a summary of the author's work with an Asian American patient, during which she began to recognize unconscious racial and cultural underpinnings of some of the ways she has thought about certain "basics" of psychoanalytic practice: dependence, independence, happiness, and love.     

Gestural sense-making: hand gestures as intersubjective linguistic enactments

The ubiquitous human practice of spontaneously gesturing while speaking demonstrates the embodiment, embeddedness, and sociality of cognition. The present essay takes gestural practice to be a paradigmatic example of a more general claim: human cognition is social insofar as our embedded, intelligent, and interacting bodies select and construct meaning in a way that is intersubjectively constrained and defeasible. Spontaneous co-speech gesture is markedly interesting because it at once confirms embodied aspects of linguistic meaning-making that formalist and linguistic turn-type philosophical approaches fail to appreciate, and it also forefronts intersubjectivity as an inherent and inherently normative dimension of communicative action. Co-speech hand gestures, as linguistically meaningful speech acts, demonstrate both sedimentation and spontaneity (in the sense of Maurice Merleau-Ponty??s dialectic of linguistic expression (2002)), or features of convention and nonconvention in a Gricean sense (1989). Yet neither pragmatic nor classic phenomenological approaches to communication can accommodate the practice of co-speech hand gesturing without some rehabilitation and reorientation. Pragmatic criteria of intersubjectivity, normativity, and rationality need to confront the non-propositional and nonverbal meaning-making of embodied encounters. Phenomenological treatments of expression and intersubjectivity must consider the normative nature of high-order social practices like language use. Reciprocally critical exchanges between these traditions and gesture studies yield an improved philosophy that treats language as a multi-modal medium for collaborative meaning achievement. The proper paradigm for these discussions is found in enactive approaches to social cognition. Co-speech hand gestures are first and foremost emergent elements of social interaction, not the external whirring of an isolated internal consciousness. In contrast to current literature that frequently presents gestures as uncontrollable bodily upsurge or infallible imagistic phenomenon that drives and dances with verbal or ??linguistic?? convention (McNeill 1992, 2005), I suggest that we study gestures as dynamic, embodied, and shared tools for collaborative sense-making.     

Countertransference enactments informed by cancer in an analyst's child

The author's son was diagnosed with Hodgkin's lymphoma in the spring of 1997. She traces the impact of this trauma on her practice, with specific emphasis on her experience as both analyst and mother, and on the related countertransference feelings and enactments. The paper discusses in detail the analyst's effort to determine for each patient whether or not to disclose the fact of her son's illness, the internal conflict she experienced over those decisions, and the effects of her decisions on her patients. An extensive case discussion focuses on a patient who appeared to intuit in a dramatic fashion the traumatic events in the analyst's private life.