The mind: psychoanalytic understanding then and now

The author discusses the evolution of psychoanalytic understanding from Freud's time to the present, citing the influence of various sociocultural changes. He addresses Freud's proper place in history and notes ways in which Freud's contributions cast him as belonging to Romanticism. Freud's shift from the topographic model of the mind to the structural one, and the influence of this on psychoanalysis, is discussed, as well as important developments in the field since Freud. The author focuses particularly on difficulties encountered in psychoanalytic practice today, and he describes what he has termed organizing interpretations as uniquely valuable in the treatment setting.     

Six things worth understanding about psychoanalytic psychotherapy

This paper is written for family therapists who may be curious but sceptical about psychoanalysis and psychoanalytic psychotherapy. It examines a number of areas of misunderstanding within mainstream family therapy discourse (diversity, authoritarianism, terminology, blame, history and separation) which, the author believes, have acted to help maintain a false coherence for family therapy through a distorted construction of the otherness of psychoanalytic therapy and, in so doing, inhibited a potentially more productive relationship.     

Trauma and psychosis: A review and framework for psychoanalytic understanding

Empirical research substantiates Ferenczi's conception of the etiological importance of early neglect and abuse in the development of psychosis. Abuse can derail the development of language, identity, and social relationships that are intrinsic to schizophrenia, possibly through undermining secure attachment relationships. The Lacanian emphasis on language and early proto-dialogues with the Other can be useful in understanding this process. Some therapeutic implications for psychoanalytic approaches to the treatment of psychosis are proposed.     

Reconstruction and perceptual experience: further thoughts on psychoanalytic listening

Freud's monumental shift to the fantasy theory heralded the view that "it is psychical and not material reality" which is our sole domain of inquiry. Yet despite theoretical agreement and cogent technical admonitions against concerning ourselves with absolute or "external" truths, psychoanalytic listening betrays a stance in which the analyst attunes to a reality other than that of the patient's inner world, assuming the position of arbiter--even if a silent one--of what is or is not "distorted" in the patient's perceptual experience. The central impact of perception as a significant component of the patient's inner experience--past and present--goes unattended. Clinical examples from differing theoretical persuasions are reviewed to demonstrate this occurrence. An alternative mode of listening is considered which assumes an underlying shift in outlook, suspending any notion that we can "know" what is "correct" in the patient's perception, while sharpening attunement to its clinical impact--as may be evidenced by a shift in affect or state, a turn of phrase, or the transient appearance of a symptom or old behavior. It is argued that such a stance will lead to a more singular focus on the patient's psychic reality, permitting the emergence of a deepening realm of psychic phenomena, enhancing the capacity of self-observation, and richly facilitating the reconstructive process.     

Language,life praxis and scenic understanding in psychoanalytic therapy

Freud held that the repressed unconscious arose from the separation of thing‐presentations from word‐presentations. The author divests these terms of the implication that they are objectively existing entities by citing some of Freud's other texts. Thing‐presentations are memory‐traces of (as yet) non‐language‐based interactions – that is, precipitates of actions that have been experienced and models of future actions. Scenic understanding, which, on the basis of participation by the therapist in the patient's play, treats all material presented by the patient by an approach analogous to the interpretation of dreams, is therefore the royal road to the unconscious.     

disowning our shadow: a psychoanalytic approach to understanding punitive public attitudes

Punitive public attitudes cannot be easily explained by pointing to instrumental concerns (e.g., fear of crime, personal victimization, or real or perceived levels of crime). Instead, numerous observers have suggested that public punitiveness is more a symptom of free-floating anxieties and insecurities resulting from social change than a rational response to crime problems. We argue that these public concerns might be better understood by drawing on the insights of psychoanalytic theory, and we review relevant theoretical work to that effect.     

Notes towards a psychoanalytic understanding of the couple relationship

In this paper an attempt is made to demonstrate how a particular orientation to contemporary psychoanalytic concepts may be useful to an understanding of the nature of the marital, or couple, relationship. The unconscious forces which may attract two people to each other, which may influence the patterns of their interaction and which may result in psychic stagnation or development are outlined. The second part of the paper addresses the nature of the therapeutic relationship with the patient couple. A hypothesis is offered regarding possible diagnostic criteria for choosing whether to work with a couple presenting for couple psychotherapy employing one psychotherapist or two psychotherapists working as a co-therapy pair. (The usual practice of myself and my colleagues at the Tavistock Institute of Marital Studies is to see our patient couples with a co-therapist partner).     

Minding the gap between neuroscientific and psychoanalytic understanding of autism

This paper offers an integrative approach to the increasingly complex puzzle of autistic spectrum disorders. The author demonstrates how the work of one group of neuroscientists in Parma, on a special class of brain cells called ‘mirror neurons', and the work of researchers at the University of California in San Diego, applying these findings to the problem of autism, intersect with Frances Tustin's discoveries about the nature, function and meaning of psychogenic autism in children and even autistic states in neurotic adults. Included in the author's considerations are the results of some by now well-known studies conducted by a group of biologists at the University of California at Berkeley in the 1960s on the effects of ‘enriched’ versus ‘deprived’ environments upon the development of the brain, and a study of autistic children diagnosed as brain damaged and treated psychoanalytically at the Paediatric Neuro-Psychiatric Institute of the University of Rome in the 1980s. The author concludes with a coherent picture of various dimensions of autistic phenomenon that may constitute more than just the sum of its parts, and points towards new areas for discussion and study.     

Isakower-like experience on the couch: a contribution to the psychoanalytic understanding of regressive ego phenomena

Since Isakower's original contribution of 1938, Isakower phenomena have been viewed as primitive experiences involving maternal breast, womb, and face imagery. This clinical report harks back to the less well-known hypothesis with which Isakower concluded his paper: he suggested that these perceptual experiences are related to childhood oedipal masturbatory fantasies at the time of going to sleep. In this paper four Isakower-like phenomena experienced by a patient on the couch are reported in the dynamic context in which they occurred. It is argued that these phenomena constitute a type of regressive ego experience that defends against oedipal conflict.