Verdi's Rigoletto: The dialectic interplay of the psychic positions in seemingly 'mindless' violence

In this paper the author demonstrates the interplay of the psychic positions (paranoid-schizoid and depressive, alongside more primitive mental states) as they may appear in experiences of overwhelming anxieties relating to fragmentation and disintegration. These are examined in relation to the appearance of what has been described in the literature as 'mindless' violence. The vehicle for this demonstration is Verdi's opera Rigoletto , which the author examines using Fonagy and Target's model for the understanding of mindless violence. The opera is 'read' as a case study of the protagonist, using the drama as a reflection of Rigoletto's internal object representations. The author attempts to extend Fonagy and Target's model to include primitive mental states, in order to understand 'mindless' violence as a result of collapse of the dialectical relationship of the psychic positions, leading to the violent act as a desperate attempt at re-establishing a sense of self. From this perspective, the moment of the violent act may be seen as use of an autistic object and as supplying of autistic shape. The violence is ultimately directed against the already fragmenting self, especially cherished parts of it, however it may enable acknowledgement of repudiated, unmentalised emotions previously experienced as a void.     

Psychotherapy of an adolescent presenting a mystical delusion: an illustration of splitting processes and their consequences

The paper discusses the psychotherapy of an adolescent who, during a psychotic breakdown, developed a mystical delusion on a religious theme. Splitting processes and the narcissistic defences that accompany them are illustrated. After showing how the patient had recourse to splitting and how the split-off parts of the ego took refuge inside an internal object, the ego's efforts to make contact once more with these split-off aspects and to reintegrate them are highlighted. With the help of certain concepts developed by, for example, Rosenfeld and Meltzer - specifically those relating to the organization of internal groupings or 'gangs' and their destructiveness and the compartmentalization of internal objects - the author shows how certain particularities of the patient's internal world can be understood in terms of these splitting processes. In addition the clinical material presented raises several technical questions, in particular those relating to dissociative processes and delusion or delusional theories as they become manifest in the treatment.     

I Working with dissociative dynamics and the longing for excess in binge eating disorders

In this paper the author describes her work with a woman who, in her mid 20s, sought analysis for her non‐vomiting binge eating disorder. The paper explores how two aspects of Jung's view of the psyche as healthily dissociable were used to think about the potential for change contained within the explosive, aggressive energies in this patient's bingeing. The resultant approach takes the patient's splitting defences, dissociations and self‐destructive behaviour as a point of access to her unconscious. Seen in this way, these behaviours contain the seeds of recovery and are the starting point for analysis rather than defences against it. The paper also brings a number of Jungian and post‐Jungian ideas into conversation with aspects of contemporary thinking about subjectivity, identity and the longing for excess developed by Leo Bersani and Judith Butler.     

The impossible reparation

This article discusses the phantasy of returning to the past and symbiotically merging with the mother, which, in an autistic patient, constituted an attempt of impossible reparation. This mode of reparation resulted in a cycle in which any attempt to repair the inner experience by contact with an external object was destined to be disappointing because of the desire for an infantile connection without separateness. The author reviews the literature on reparation and emphasises recent developments resulting from work with Autism Spectrum Disorder children who are far from the depressive position and who have difficulty bearing separateness. The author recognises an essential positive aspect of reparation independent of the ability to perceive the object as separate and suggests that when working with very primitive emotional states, it seems suitable to use a wider definition for what can be considered essentially a primitive reparative act or a precursor for reparation. Next, the author discusses the significance of a phantasy of impossible reparation in an autistic girl with emphasis on the importance of considering the reparative aspects of this defensive phantasy to enable development. Finally, the author relates to the despair that occurs in both analyst and patient when the phantasy is not transformed.     

Selecting a patient or initiating a psychoanalytic process?

The defences provoked in the analyst by the anxieties associated with the difficult tasks of ‘assessment’ and ‘selection’ for psychoanalysis can result in a tendency to think in terms of ‘hurdles to be cleared’ by potential psychoanalytic patients, rather than ‘opening the gates’. This can result in a diminution of the analyst's capacity to enlist and sustain a psychoanalytic stance. Only within a psychoanalytic frame can a meaningful psychoanalytic process unfold, at all stages of a potential patient's movement from their first contact through to, possibly, entering into an analysis. The author illustrates the value of this thinking by describing the work of the London Clinic of Psychoanalysis where there has been a shift of emphasis in psychoanalytic consultation towards working with individuals on their potential to initiate a psychoanalytic process, and away from the sole aim of ‘selection of a suitable patient’. In this paper, the author notes that when institutional culture and practice supports psychoanalytic identity, this makes it more possible to recognize and articulate the anxieties provoked by the ‘emotional storm’ inevitable in psychoanalytic consultation, and the draw towards unhelpful enactment that may otherwise obscure the initiation of a psychoanalytic process that may or may not result in analytic treatment. Illustrative case material from the Clinic is presented.     

The impact of death on the family system

The impact of death on the family system creates a structural void that requires homeostatic adjustments. This paper describes bereavement adjustments in the family system. The author proposes that a family member may be stuck in one of the phases of grieving, which contributes to the homeostatic utilization of one or more of these adjustments. These homeostatic adjustments provide a matrix for abortive grief which may have transgenerational consequences. The author further proposes two stages of grieving in addition to those given by Bowlby (1979, pp. 82–83) and Parkes (1972); that of transformation and actualization. The family system or family-community system may hinder or help the bereaved family grieve, or make the homeostatic adjustment. Judeo-Christian values and rituals are described as relevant to this process.     

Psychoanalytic identity and the external world: Interaction between psychoanalysis and health service systems in Sweden

Abstract

This paper continues the exploration of the clinical phenomenon of analytic contact. The author demonstrates, through case material, the essential ingredients of psychoanalysis to be not frequency or use of the couch, but rather the moment-to-moment analysis of the patient's transference state and phantasies of what it means to establish relational contact with their objects and with themselves. The nature of the treatment can be shaped, prevented, perverted, or fostered by the patient's phantasies and unconscious conflicts into something more analytic or less analytic. Interpretation needs to include the exploration of the patient's attempts to change the treatment into something that is often a replica or a repetition of archaic object relations. The typical patient in psychoanalytic treatment is struggling with rather profound pathology and as such tends to create a significant stand-off with the analyst when analytic contact is forming. Analytic contact is often threatening to these patients in very primitive and alarming ways that must be gradually understood and interpreted if the treatment is to survive and remain a primarily analytic journey rather than be transformed into a more supportive counseling or a pathological re-enactment of conflictual phantasy states.     

Another language,another place: To hide or be found?

The author examines some specifi c features of the analytic encounter when both patient and analyst are émigrés from the same cultural and linguistic background. This can result in splitting processes that operate silently and are diffi cult to reach, but can also provide rich material, as they offer the couple the opportunity to work through the pain and the guilt over what is lost—ultimately the lost mother—murdered and betrayed. Working through the split faces the analyst with important technical considerations, bearing in mind that the shared cultural identity can conceal itself in the more undifferentiated features of the couple's psyche and be projected on to the setting. As such, it needs to be put to analytic scrutiny if the treatment is to avoid a stalemate. These are specifi c cultural defences deployed in the problematic existential encounter with the foreigner other within oneself. Using clinical material from two cases, the author shows how the couple's access to a dual linguistic signifying system can enrich the analytic dialogue, but can also result in enactment. Careful monitoring of the transference-countertransference relationship is essential to the progress of the analytic work.     

Disablism,Identity and Self: Discrimination as a Traumatic Assault on Subjectivity

The international disability movement has favoured a political strategy which relies on historical materialism, eschewing subjective aspects of disability. From this perspective, rehabilitationist and psychological constructions of the subjectivities of disabled people are rejected as victim‐blaming pathologisation. Recently, feminist work has begun to explore psychological aspects of the lives of disabled people, within various paradigms. Drawing loosely on ideas from psychoanalysis, this paper explores the impressions left on subjectivity by symbolic assaults often associated with the disabled identity, thus connecting intra‐psychic and socio‐political arenas. The conceptual ideas employed emerged from psychoanalytically oriented group psychotherapy with severely physically impaired adults performed by the first author. The authors argue that the ongoing nature of socially engendered trauma suffered by disabled persons perpetuates marginality, through internalization of self‐punitive psychological defences, which corrode the entitlement necessary for an assertive political movement. Surviving in a world which continually questions one's belonging, leaves little personal resources for debunking oppressive social phenomena. Material as well as discursive changes are essential if internal narratives are to be reclaimed, overcoming the subjective imprints of ongoing social trauma. Copyright © 2015 John Wiley & Sons, Ltd.     

Permeability and Demarcation in the Psychoanalytic Process Functions of the Contact‐Barrier1

Introjection, identifi cation and projection are concepts that designate processes in which something is being put into or taken out of something else. These processes presuppose the overcoming of some form of separation between two entities. The permeability or impermeability of a fi ctive boundary between the representations of subject and object set the emotional tone of their coexistence. There are moments of complete diffusion, in which subject and object can no longer be differentiated, and moments of autistic enclosure in which the individual can no longer be reached at all. Permeability and demarcation result from the processing of stimuli carried out by the ‘contact‐barrier’, as an ego function. Stimuli of internal, libidinal or aggressive origin, as well as ‘im‐pressions’ of external origin, are classifi ed and processed with the aid of various kinds of factors arising from coagulated object‐relational experiences. Whereas for Freud the contact‐barrier regulates the quantity of energy and founds a topographical structure, Bion understands the contact‐barrier as a psychic function that simultaneously regulates boundary demarcation and making contact. In the psychoanalytic process, the contact‐barrier created by patient and analyst regulates the events in the transference and countertransference. An awareness of the struggle for contact and demarcation at the dynamic boundary representations that are constantly being recreated by both partners in the analytic process may be helpful in our clinical work. The author presents an examination of the ways in which patient and analyst make contact and demarcate the boundaries, which provides a better understanding of the dynamics of transference processes. He demonstrates this in relation to clinical material.     

Sitting through the emptiness

This article explores clinical encounters with experiences of the ‘empty ego’ which arise from early relational trauma. The ego’s emptiness is held in repetitious complexes and arises out of affectively charged experiences between self and other which remain split-off from awareness. This kind of consciousness is viewed as dualistic, separating non-dual subjectivity from its dualistic objects of consciousness. In contrast, what I am calling healing void states of non-dualistic consciousness, when admitted to awareness, allow the individual to dis-identify from the traumatizing representations of self and other through an experience of non-duality. In contrast to an objectified, dualistic emptiness of the ego, healing void states come about in moments of non-dual, unified consciousness. These states occur in the ego-Self relationship by linking the ego’s dualistic awareness in chronic subject/object splits to ones of non-dual pure consciousness. The healing void state is always incipiently present and potentially able to bridge the ego-Self connection in bogged-down treatment. The paper explores potential integrations with non-dual models of consciousness such as Vedantic and Kashmir Shaivism, among other mystical traditions. A combined Vedantic-Jungian understanding can provide a transcendent bridge that integrates Eastern concepts of non-duality in treating emptiness.     

MUTUALITY AND ONE-SIDEDNESS IN KJELL ASKILDSEN'S THE DOGS OF THESSALONIKI: THE PSYCHOLOGY OF EVERYDAY LIFE

The aim of this paper is to bring to the fore how a talented writer is able to describe everyday human relationships in a way that makes visible their most central, underlying dynamics. After reviewing some of the psychoanalytic literature, the author presents a collection of short stories by the Norwegian author, Kjell Askildsen. These works illustrate how the fear of incest, sado-masochistic, exhibitionistic, and addictive defenses can play the rôle of “directors” of human dramas. Askildsen, with relentless accuracy, decribes a longing for reciprocity and defences against it. In such a conflict, reciprocity is felt dangerous and only momentarily fulfilled, and defences are necessary.     

SOME DIFFICULTIES IN THE ANALYSIS OF A WITHDRAWN PATIENT

The author discusses some difficulties that arose in the analysis of a seriously disturbed patient who found talking about himself extremely problematical. He defended against awareness of conflicts, ideas and affects while being tormented and overwhelmed by them. He seemed to have acquired an inhibited character that was not, however, schizoid. He related to others in a wary, quarrelsome, yet passive way. It became apparent that his sense of identity was confused. Attention to archaic fantasies led to the uncovering of a parthenogenetic unconscious fantasy involving identification with his mother and the attempted eradication of the mental function of his father. Experiences of differentiation led to extreme anxiety including risk of failure of ego functions with the arousal of latent psychotic anxieties. Interpretation of the content of sessions became possible only after several years: until then interpretation of defensive processes aimed at preventing contact or change predominated. Disclosure of 'unofficial' communications by the patient, expressed as lapses of vigilance by his severe superego, revealed his crises and feelings. These idiosyncratic, muted appeals for help became a vehicle through which interpretation of content and its transference meaning became possible. Some confusing transference and countertransference experiences in the analysis are described.     

“0–20 ÅR I PSYKOANALYTISK PERSPECTIV”

The subject of this article is body-related linguistic identity and the need for a “word man”, i.e., an author or a psychoanalyst, to stay in close contact with that identity. The account describes the journey of the author and other persons from word to linguistic identity.     

Deep Diving: Imagination,Intuition, and the Interpenetration of Minds

How do we help patients who come to us without access to feelings and without curiosity about themselves and others? The author suggests that the analyst’s imagination and intuition provide a channel or medium through which to apprehend aspects of the patient’s internal life, make contact and communicate with younger parts of the patient, and provide containment to these parts of the person. As the analyst engages her imagination in this way, communication channels open and shared states of consciousness between analyst and patient are created, thereby facilitating the interpenetration of minds and the opening up of previously closed object worlds. In the course of this work, compassion serves as a vehicle for truth, penetrating previously closed object relational systems. This kind of work poses risks for the analyst.     

Anaesthesia or psychotherapy: Eradicating thoughts or working them through

The author presents two sessions from the analysis of a depressive narcissistic doctor, which are characterised by a mixture of co-operation and pseudo-co-operation. The dialogue is in parts intellectualised, complicated, lifeless and schizoid. Points at which the patient shows surprising insights are then partly denigrated by him, on the basis that change is not to be expected. Semi-lifeless contact assists the defensive claustrophobia that he experiences in meaningful contact. It becomes very clear that he is then afraid of entering into an openly aggressive conflict that entails the existential threat of object loss. However, this has so far been avoided. The secret pleasure in an anal-narcissistic, sadomasochistic addiction to doubt persists in the partial denigration. The patient's artificially maintained self-doubt and doubt of the object reinforce a genuine confusion that consists in never knowing exactly what lies behind the helpful and needed object.     

Once More Unto the Breach: Type B Physicalism,Phenomenal Concepts,and the Epistemic Gap

Type B, or a posteriori, physicalism is the view that phenomenal-physical identity statements can be necessarily true, even though they cannot be known a priori—and that the key to understanding their status is to understand the special features of our phenomenal concepts, those concepts of our experiential states acquired through introspection. This view was once regarded as a promising response to anti-physicalist arguments that maintain that an epistemic gap between phenomenal and physical concepts entails that phenomenal and physical properties are distinct. More recently, however, many physicalists have lost confidence in the view, and have proposed less promising defences of physicalism—or have become outright sceptical about its prospects. I argue here that these physicalists have underestimated the resources of Type B physicalism and are thereby retreating too quickly—or fighting battles that have already been won.     

Beyond the representation field

Abstract

This article outlines the importance of representation and several Freudian concepts such as Vorstellung, Trieb, and word and object representations. The author refers to the division of the analytical process into two main fields: the field of representation, and the field of the Real, which is characterized by impossibility. He then states that this field is the proper field of psychoanalysis. The author presents two clinical vignettes in an attempt to demonstrate the significance of the analytical act as a tool to deal with such extreme psychic situations.     

Early Childhood Traumatic Development and Its Impact on Gender Identity

The author clarifies issues of gender identity typical to contemporary Western societies. Nowadays, we tend to emphasize self-autonomy as the main target of the individual's development. In adolescence this may cause many questions as to the adolescent's conception of his or her gender and sexual identity. These questions are the outcome of early development, and thus early traumas may impact the entire gender development. In this context, trauma includes not only major violations such as sexual abuse, terror attacks, and so forth, but also comprises events heretofore considered minor.