Discussion of “The Therapeutics of the Fee in Psychoanalysis”

This discussion of Dr. Pauley’s paper (this issue) on the therapeutics of the fee first highlights the various valuable contributions Pauley makes. It applauds his unusual openness in sharing his internal vulnerability with patients around fees, his raising the question about why fee setting is so complicated for analysts and patients alike, his focusing on omnipotent fantasies in the transference and countertransference, and his uncovering of the multiple meanings money has for therapists beyond just their income. Berger picks up on Pauley’s invitation to therapists to be more curious about their own discomforts with money. Drawing on her own teaching, writing and clinical experience, she adds to Pauley’s more global ideas, stressing instead the more specific meaning of money in each treatment dyad. Among these specifics, Berger highlights the chronic avoidance of teaching about money in analytic institutes. She clarifies some Freudian ideas about how money can become tied up with anal witholding, and offers examples of how she got stuck with three patients around setting and raising their fees. Berger describes how these patients’ believed that their fees could mean safety, value or exploitation and how these attribuitions generated countertransference blind spots for her. The discussion urges clinicians to keep digging hard into themselves for the many meanings of money, to pay attention to the devil in their own details, and thereby maximize the richness of their work with patients around a topic so loaded for all of us.     

The Frame,Within and Without: Discussion of “The Therapeutics of the Fee in Psychoanalysis”

The author picks up and expands on themes of fusion and separation brought up in Pauley’s discussion of the therapeutic uses of the fee in the psychoanalytic encounter. She asserts that the elemental nature of the exchange of goods speaks to us in the language of corporeal experience, making it a powerful disruptive force that can reshuffle defenses at the level of our most primary experiencing selves. This affords the fee the potential to reach us in the registers of sensation and enactment that bypass conscious, verbal communication making our authentic and ongoing attempts to grapple with it vital to the analytic project.     

Transference and “The Rebbe” Idiographic and Nomothetic Factors in the Psychoanalysis of Lubavitch Chassidim

The Lubavitch Chassidim are one of several ultra-orthodox groups within Judaism. Their central focus is on their leader or Rebbe, who is seen as not only the possessor of all wisdom but also having supernatural powers. In working therapeutically with Lubavitch, one needs to distinguish if the beliefs of the individual are unique to them or reflect the belief system of the community. If the former, then it obviously needs to be analyzed. If the latter, then it is seen as an identification with the group and reflective of the need for group cohesion and often a regulator of self-esteem. The following article demonstrates these factors.     

What is IPT? The Basic Principles and the Inevitability of Change

Interpersonal Psychotherapy (IPT) is an empirically validated treatment for a number of psychiatric disorders. Like all psychotherapies, IPT can be described by its theoretical foundations and its primary targets, tactics, and techniques. The need for continued creativity in IPT and other treatments is reviewed, and several specific proposals for change in IPT based on clinical observations and theoretical considerations are discussed. A paradigm for collaboration between academic research and clinical observation required for continued creativity is offered. Change is inevitable, and the empirically validated therapies such as IPT will be even more effective as they incorporate and test new and creative elements.

Rapprochement in Sight? Postmodern Family Therapy and Psychoanalysis

This paper explores aspects of the theory and practice of psychotherapy with the aim of identifying similarities in the approaches of both family therapists and psychoanalytic psychotherapists. The author calls for a dialogue between the disciplines, and makes specific reference to the potential value of this in relation to training and research.     

“Psytizens”: The Co-construction of the Professional Identity of Psychology Students in the Postmodern World

This work aims to analyze the relations between psychology as social engineering and self-reflective citizenship from a historiogenetic point of view. Such a connection was founded during modernity; hence our proposal is to study its operative continuity in the postmodern world, taking into account the mismatches due to the new global, multicultural, and technological conditions. Based both on the theory of activity and the concept of semiosphere, the interaction and discussions of a group of Spanish students of psychology in a virtual forum were analyzed. They were asked to negotiate and co-construct their double condition of citizens and future psychologists in connection with the controversial exhibition of religious symbols in Spanish schools. Results show that students segregate both conditions. On one hand, they agree and consolidate the neutral image of a professional psychologist being respectful with the multicultural world. On the other hand, they argue about the citizen and religious topics from a personal or ideological point of view, establishing limits to multiculturalism. Neither the interchange of ideas nor the writing-reading features of the virtual artefacts improved the reflexivity on the close dependencies and contradictions of the two identity domains. This great resilience is due to a sociocultural context –the Western World- where psychology has been constituted as a neutral, objective Science World, one of whose socio-historical products - reflective citizenship- has evolved until proclaiming his/her autonomous agency, forgetting any root in the social engineering.     

The “Once and Future” Focus of a Relational Psychoanalysis: Discussion of “Vitalizing Enactment”

In this discussion of Amy Schwartz Cooney’s paper (this issue) I focus on the current interest in relational theorizing on the analyst’s proactive role vis-à-vis her patient, that is, what she actually does for or gives to her patient. I consider the role of the analyst’s own internal “bad” objects in facilitating or inhibiting the therapeutic process. I end with a set of theoretical propositions about the ways in which an intense and deadening shame can lead to dissociation and/or repression of hopeful fantasies about the future.     

The Power of the Spoken Word in Life,Psychiatry, and Psychoanalysis—A Contribution to Interpersonal Psychoanalysis

Starting with a 1890 essay by Freud, the author goes in search of an interpersonal psychology native to Freud's psychoanalytic method and to in psychoanalysis and the interpersonal method in psychiatry. This derives from the basic interpersonal nature of the human situation in the lives of individuals and social groups. Psychiatry, the healing of the soul, and psychotherapy, therapy of the soul, are examined from the perspective of the communication model, based on the essential interpersonal function of language and the spoken word: persons addressing speeches to themselves and to others in relations, between family members, others in society, and the professionals who serve them. The communicational model is also applied in examining psychiatric disorders and psychiatric diagnoses, as well as psychodynamic formulas, which leads to a reformulation of the psychoanalytic therapy as a process. A plea is entered to define psychoanalysis as an interpersonal discipline, in analogy to Sullivan's interpersonal psychiatry.     

“The indestructible,the barbaric principle”: The Role of Schelling in Merleau-Ponty’s Psychoanalysis

The aim of this paper is to examine Merleau-Ponty’s idea of a “psychoanalysis of Nature” (Merleau-Ponty in The visible and the invisible. Northwestern University Press, Evanston, 1968). My thesis is that in order to understand the creation of a Merleau-Pontean psychoanalysis (together with the role the unconscious plays in this psychoanalysis), we need to ultimately understand the place of Schelling in Merleau-Ponty’s late thought. Through his dialogue with Schelling, Merleau-Ponty will be able to formulate not only a psychoanalysis of Nature, but also fulfil the ultimate task of phenomenology itself; namely, of identifying “what resists phenomenology—natural being, the ‘barbarous’ source Schelling spoke of” and situating it precisely at the heart of phenomenology (Merleau-Ponty in Signs. Northwestern University Press, Evanston, p 178, 1964b). The plan for studying this natural psychoanalysis is threefold. First, I provide an overview of the role psychoanalysis plays in the 1951 lecture, “Man and Adversity,” focusing especially on this lecture as a turning point in his thinking. Second, I chart how Merleau-Ponty’s psychoanalysis is informed by the various ways in which the unconscious is formulated in his thought, leading eventually to a dialogue with Schelling. Accordingly, in the final part of the paper, I trace the role of Schelling’s thought in the creation of a Merleau-Pontean psychoanalysis. As I argue, what distinguishes this psychoanalysis is the centrality of Schelling’s idea of the “barbaric principle,” which manifests itself as the notion of an unconscious indexing an “excess of Being” resistant to classical phenomenology (Merleau-Ponty in Nature: course notes from the college de France. Northwestern University Press, Evanston, p 38, 2003).     

The Validity of the “Mother” and “Father” Cards of the Rorschach

This article presents analyses on psychometric properties of a recent revision of the Substance Abuse Subtle Screening Inventory (SASSI-3). Participants were 772 individuals from a range of clinical settings who were independently diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association [APA], 1987) or DSM-IV (APA, 1994) criteria regarding the presence or absence of a substance-dependence disorder. A development sample (n = 391) was used to formulate SASSI-3 decision rules that yielded 95% agreement with clinical diagnoses of substance dependence. Correspondence with the criterion variable was shown to be 97% in a cross-validation sample (n = 381) from the same clinical settings. Convergent relations were demonstrated with a variety of other indexes of substance misuse, including clinical assessments of substance abuse history, alcohol and drug-related arrests, self-reported use of illicit drugs, and other instruments designed to screen for substance misuse. Further, logistic regression analyses indicated no significant differences in the overall accuracy of the SASSI-3 as a function of respondents' demographic characteristics or clinical ratings of respondents' level of adjustment and functioning (Global Assessment of Functioning ratings; APA, 1987, 1994).     

Meta—Realization in Horney and the Teaching of Psychoanalysis

Horney was the first psychoanalyst to develop a comprehensive framework for understanding character structure and character pathology, and the first to do so in experience-near terms. She uncovered the often hidden metapsychological assumptions of classical analysis and created a deeper meta-level thinking about psychological splits, including how splits can develop between assumed opposites. In the clinical moment, insight into meta-level process rests on an epistemological change in the relation between subjective and objective. Horney was an early pioneer in examining the dialectical unity of these presumed opposites. A specific proposal for training and teaching candidates in the science of subjectivity will be advanced. Systemic clinical insights in the assessment and treatment of patients are offered, as well as systemic uncovering of cultural assumptions of Western society which can impede analytic exploration of psychic conflict.     

“The end of history ” and the fate of the philosophy of history

The “end of history” by Fukuyama is mainly based on Hegel’s treatise of the end of history and Kojeve’s corresponding interpretation. But Hegel’s “end of history” is a purely philosophical question, i.e., an ontological premise that must be fulfilled to complete “absolute knowledge.” When Kojeve further demonstrates its “universal and homogeneous state,” Fukuyama extends it into a political view: The victory of the Western system of freedom and democracy marks the end of the development of human history and Marxist theory and practice. This is a misunderstanding of Hegel. Marx analyzes, scientifically, the historical limitation of Western capitalism and maintains, by way of a kind of revolutionary teleology, the expectation of and belief in human liberation, which is the highest historical goal. His philosophy of history is hence characterized by theoretical elements from both historical scientificalness and historical teleology.     

Discussion: The Narcissism of Small Differences — and Some Big Ones

A broad range of characterologically difficult patients present for treatment in psychotherapy groups. Despite different clinical presentations, including features of the schizoid, borderline, and narcissistic personality disorders, these patients share a common developmental failing. Specifically, these individuals have failed to attain object constancy and the associated stable internalization of tolerably ambivalent representations of the self, and of the other, in relationship with one another. Splitting mechanisms predominate over integrative ones, as primitive defenses are utilized to deal with the individual's powerful needs and fears related to engagement and intimacy. These maladaptive interpersonal styles are clearly illuminated in group therapy, but often to the exclusion of the latent, intrapsychic derivatives of this behavior, with detrimental effects. This paper examines the group therapy of such patients from the perspective of object relations and self psychology theories, models that provide the essential link between the interpersonal and the intrapsychic worlds.     

Does Dispositional Aggression Feed the Narcissistic Response? The Role of Narcissism and Aggression in the Prediction of Job Attitudes and Counterproductive Work Behaviors

Purpose

The purpose of this study was to extend the personality and work-related outcomes literature by examining: (1) the effects of narcissism on job satisfaction, organizational commitment, and counterproductive work behaviors and (2) the moderating effects of dispositional aggression on the narcissism–counterproductive work behaviors relationship.

Design/Methodology/Approach

Multi-wave data were collected from 381 workers employed in a variety of work settings within the United States.

Findings

Narcissism had consistent main effects on job satisfaction, organizational commitment, and counterproductive work behaviors after controlling for the personality characteristics agreeableness, conscientiousness, neuroticism, and aggression. Aggression moderated the relationship between narcissism and counterproductive work behaviors, such that the positive relationship between narcissism and counterproductive work behaviors was stronger when dispositional aggression was high.

Implications

This study provides greater clarity regarding the role of narcissism within job attitudes and behaviors, shows that dispositional aggression strengthens or amplifies the narcissistic response for counterproductive work behaviors, and provides a platform to further explore narcissism and aggression within the workplace.

Originality/Value

This study found that narcissism consistently predicted unique variance in work-related criteria after the effects of agreeableness, conscientiousness, neuroticism, and aggression were controlled. It also found evidence that aggression moderates the effects of narcissism on counterproductive work behaviors. This study is the first to directly examine these effects.     

The Symbol and the Theory of the Life-World: “The Transcendences of the Life-World and Their Overcoming by Signs and Symbols”

This essay presents a phenomenological analysis of the functioning of symbols as elements of the life-world with the purpose of demonstrating the interrelationship of individual and society. On the basis of Alfred Schutz's theory of the life-world, signs and symbols are viewed as mechanisms by means of which the individual can overcome the transcendences posed by time, space, the world of the Other, and multiple realities which confront him or her. Accordingly, the individual's life-world divides itself into the dimensions of time, space, the social world and various reality spheres which form the boundaries or transcendences that the I has to understand and integrate. Signs and symbols are described as appresentational modes which stand for experiences originating in the different spheres of the life-world within the world of everyday life, within which they can be communicated, thereby establishing intersubjectivity. Schutz's theory of the symbol explains how social entities – such as nations, states or religious groups – are symbolically integrated to become components of the individual's life-world. The following paper reconstructs Schutz's concept of the symbol as a crucial component of his theory of the life-world, which is seen as an outstanding phenomenological contribution to the theory of the sign and the symbol in general.     

Narcissism and the non-equivalence of self-esteem measures: A matter of dominance?

Previous research reveals a substantial degree of variability in the extent to which narcissism (as measured by the Narcissistic Personality Inventory or NPI; Emmons, 1987) and self-esteem (measured using a variety of self-report scales) are associated. Data from 329 college students provided support for the hypothesis that the variability in associations between narcissism and different measures of self-esteem may be explained in part by the degree to which a given self-esteem measure is related to dominance. These results have important implications for research on narcissism and self-esteem, as well as the broader issue of how self-esteem is conceptualized and measured in psychological research.     

The “Activist Client”: Social Responsibility,the Political Self,and Clinical Practice in Psychotherapy and Psychoanalysis

The idea of the “activist client” is intended to be taken both literally and metaphorically—applying to some extent to a wider range of clients than actual activists. The paper develops a set of ideas about a “political turn” in psychotherapy and psychoanalysis, using the tag “the inner politician.” There is a focus on working directly with political material in the session, and the pros and cos of this practice are reviewed. Wider issues such as social responsibility and social spirituality are discussed, as well as an exploration of the limits of individual responsibility. Some specific topics covered in the paper include the political roots of depression, difficulties with the concept of the therapeutic alliance from the point of view of democratic perspectives on clinical work, and a challenge to the unquestioned valuing of empathy (based on a reading of therapy though a Brechtian lens). There are numerous clinical examples.