Current perspectives on psychoanalytic Rorschach assessment

In this article, I present as clear and as updated an account as possible of several of the essential features that comprise a psychoanalytic approach to the Rorschach. Specific attention is accorded the assessment frame, the language of assessment, sources of assessment information, and differing approaches to the interpretation of Rorschach data. The article comes out of a Rorschach tradition begun by Rapaport, extended by Schafer and Mayman, and presently being updated by Leichtman and Smith.     

Bulimia: psychoanalytic perspectives

Bulimia, the syndrome of food binging often followed by purging has been reported to be increasing in recent years. This communication reviews the psychoanalytic understanding of eating disorders, focusing on the pathology of early object relations and later intrapsychic conflicts over incestuous impregnation fantasies. Ancillary symptoms of kleptomania, laxative abuse, and vegetarianism are discussed, and associations with masturbatory conflicts and early adolescent phallic activity, i.e., horseback riding, are elaborated.     

Primo Levi's loneliness: psychoanalytic perspectives on suicide-nearness

To elucidate suicide-nearness, the perspectives of the death drive and narcissism are applied to the writings of Primo Levi. Emerging themes are Levi's struggle to maintain his self-regard from his year as a prisoner in Auschwitz and onward, and his observations on xenophobia, violence, and the need for love. The gradual increase of depressive content in Levi's work is noted, as are his identifications with others who succumbed in the Holocaust or took their lives after surviving it. The conflict between the wish for peace and the need for love is seen as impossible to resolve under the threat of extermination and as reemerging in the prevailing sense of loneliness that Levi described.     

Identification: psychoanalytic and biological perspectives

In recent attempts to bring psychoanalysis into greater contact with other sciences, a number of works have explicated neural science concepts and phenomena--affect, memory, consciousness--for the psychoanalyst. These efforts have helped analysts build a more scientific foundation for their theory and practice. A related task remains--namely, to take psychoanalytic concepts and see how they relate to other sciences. The concept of identification has a long history in psychoanalytic theory. It is seen in parent-child interactions, in teaching and mentoring relationships, and in psychoanalysis and psychotherapy. Neuropsychology and evolutionary biology have explored the phylogenetic precursors of identification, while genetics and infant observation provide insights into individual processes of identification. Finally, neuroscience, particularly recent studies of mirror neurons, offers information about the biological mechanisms of imitation and the relationship of imitation to identification. Findings from these sciences are presented in an effort to further the psychoanalytic understanding of identification, especially its biological underpinnings.     

Some observations on the psychoanalytic process

The author's aim is to delineate the psychoanalytic process and to distinguish it from the psychoanalytic situation, the transference neurosis, "insight," and psychoanalytic technique in general. Freud's 1913 views provide the basis for a concept of the psychoanalytic process centered on the recognition and interpretation of resistances and on the patient's reactions to the analyst's interventions. This clinically observable "unit" of the process is described and compared with Bernfeld's "facts of observation." The proposition is advanced that the process does not come to an end with the termination of analysis. It continues postanalytically in the form of the patient's more objective and more effective capacity for self-observation. The paper closes with a warning about the "pitfalls of perfectibilism" and with a plea for the elevation of the not-so-good analytic hour.     

Some thoughts on the psychoanalytic situation.

This article develops ideas set out in a previous study on the "archaic matrix of the Oedipus complex" versus the fully developed Oedipus complex (their similarities and their differences), applying these to a study of the psychoanalytic situation. The central hypothesis is that there is a correspondence between the psychoanalytic situation and the structure of the mental apparatus. The author supposes that our perception of the world is intimately linked to the primary maternal relationship, to our wish to fuse with the mother once more, and to the accompanying fear such a wish inspires. To deal with this we create enclaves where the regressive wish can be satisfied without fear of ego dissolution. The author suggests that the psychoanalytic situation is one such enclave. She examines its specific features in the light of the structure of the mental apparatus as she defines it.     

Some psychoanalytic reflections on the concept of dignity

After reviewing the pertinent philosophical and psychoanalytic writings on the concept of dignity, this paper proposes three categories of dignity. Conceptualized as phenomenological clusters, heuristic viewpoints, and levels of abstraction, these include (i) metaphysical dignity which extends the concept of dignity beyond the human species to all that exists in this world, (ii) existential dignity which applies to human beings alone and rests upon their inherent capacity for moral transcendence, and (iii) characterological dignity which applies more to some human beings than others since they possess a certain set of personality traits that are developmentally derived. The paper discusses the pros and cons of each category and acknowledges the limitations of such classification. It also discusses the multiple ways in which these concepts impact upon clinical work and concludes with some remarks on the relationship of dignity to choice, narcissism, and suicide.     

Some psychoanalytic viewpoints on neuropsychiatric disorders in children

The author addresses issues interfacing neuropsychiatry and psychoanalysis. He recommends psychoanalysis for children with Attention Deficit, Hyperactivity Disorder (ADHD) and Dysfunction in Attention and activity control, Motility control and Perception (DAMP). He attributes its low status in neuropsychiatric treatment recommendations partly to the fact that psychoanalysts do not always declare their specific field of investigation. The scientific community then assumes that psychoanalysis aims to comment on issues outside its field of investigation, e.g. on neurobiological aetiology. The community therefore fails to discern the psychoanalyst's specific task, to help the child express and work through his conscious and unconscious experiences. Clarity on the analyst's part will improve relations with the scientific community and facilitate a relevant comparison of treatment methods. Another reason for neuropsychiatry's negative attitude towards analysis is its unwillingness to accept that unconscious conflict influences behaviour. With theoretical and clinical arguments, the author argues that unconscious factors must be taken in to understand and to treat the child. Countertransference, often cumbersome with neuropsychiatric children, becomes easier to handle if the analyst is clear about his field of investigation. If he sees through simplistic formulations on aetiology, countertransference gets even more manageable. Psychoanalysis can result in considerable intellectual and emotional development, as illustrated by work with a latency boy with DAMP, autism and slight mental retardation. In his psychoanalytic theoretical framework of the case, the author unites ego-psychological formulations with a Bionian conceptualisation of the thought disturbance.