Interweaving the Symbolic and Nonsymbolic in Therapeutic Action: Discussion of Gianni Nebbiosi’s “The Smell of Paper”

Gianni Nebbiosi’s paper speaks to therapeutic action in a new key in the challenges of finding communion with a hard-to-reach patient. He achieves this through the creative interweaving of the nonsymbolic, his mime and music, and the symbolic, which attains greater purchase through painful personal reckoning in concert with his increasing awareness of previously unformulated states within and between each member of this particular analytic dyad. Central to this paper is the move from an empathic stance to greater complexity for each of the dyad. Distinguishing between empathy and recognition is germane. Particularly as we witness the transformation through therapeutic action of empathic presence to recognizing presence that permits the emergence of a more complex empathy—an achieved empathy that incorporates feeling and knowing the multiple, more deeply held, and often paradoxical aspects of our patients and indeed of ourselves as these play out in intersubjective space.     

“There Was a Child Went Forth” Commentary on Paper by Steven Stern

In this discussion of Stern's rich and thoughtful contribution to the dialogue between unified- and multiple-self theories, I refer to his earlier conceptualization of repeated and needed relationships. I thus highlight how his current model strikes me as shifting his emphasis toward identificatory factors, both in development and in clinical process, and away from the working through, or negotiation of, repetitions of relational configurations. Through Stern's clinical examples, I engage dialogue about how his construct of an “intersubjective self” relates to the qualities of multiplicity he accounts for in his theory. And I consider the implications for clinical technique of favoring identificatory influences over the analyst's living through the experience of transference repetitions with the patient and thereby introducing ameliorating responses from within, rather than from a stance more external to, embeddedness in transference–countertransference repetitions.     

The Protective Skin of the Analyst’s Case Formulation: Commentary on Paper by Tom Wooldridge

The contours of every psychoanalytic process are shaped by its case formulation. This discussion of Tom Wooldridge’s paper (this issue) of the long-term, psychodynamic treatment of a patient with severe anorexia provides opportunity to demonstrate that formulation derives from aspects of the clinician’s clinical education and personal growth. Wooldridge’s metaphor of the containing functions of the entropic body is extended to include particular paternal functions that an analyst provides his patient and that are suggested in the dialogue of this clinical material. Psychoanalytic case formulation distinguishes it from other aspects of an integrated treatment plan for eating disorder patients; in particular, clinician and patient discover important metaphors and elaborations of personal history that assist in recovery. Thinking through a case from different lenses provides real gratification for the psychoanalyst and a bulwark to assist in potentially life-saving work because of its protective and enriching functions. Drawing upon the metaphors Wooldridge expands upon such as secondary skin formations and the entropic body, I suggest that clinicians who work in the field of eating disorders could draw great benefit from learning more about what psychoanalytic case formulation offers patients. Detailed, evocative case examples such as the one Tom Wooldridge puts forward may be one way to reach this important audience because they bring to life many of the unique features of contemporary psychoanalysis.     

“Generative Co-Constructions”: An Exploration of the Analyst’s Influence and Desire: Commentary on Paper by Richard Almond

In this commentary on Almond’s (this issue) paper, in which he asks us to consider ways in which his personality/history/psychodynamics played a significant role in his younger women patients becoming pregnant, the author questions Almond’s premise that we can know what “real-life effects” we have on our patients, when so much that occurs in psychoanalysis happens in mutually unconscious and procedural realms. In addition, the author critiques Almond’s archaic and reductive conceptions of gender and sexuality, which feel particularly problematic as they interpenetrate with his fantasies of his impact and pivotal role in their pregnancies.     

Identifying with the Other—A Conflictual,Vital Necessity: Commentary on Paper by Jay Frankel

Frankel's paper is related to issues in the study of multiple personality, as well as to the dilemmas of identification in psychoanalytic training. The main point raised in this discussion is that the generalization that all identification is related to fear is untenable and that a continuum should be recognized between identification with the other in a close relationship as a constructive building block of one's identity and a traumatic identification with the aggressor that results in alienation.     

Freud and the Psychoanalysis of Telepathy: Commentary on Claudie Massicotte’s “Psychical Transmissions”

Freud was interested in and eventually accepted the diverse forms of telepathic communication as psychoanalytic rather than occult phenomena, particularly as manifested in dreams. Massicotte revisits the topic of Freud and his interest in the occult in a manner that invites serious reconsideration of this aspect of his work, long the subject of intense controversy in the history of psychoanalysis. In my response to Massicotte’s paper I argue that Freud’s interest in telepathy or thought transference belongs to his psychoanalytic theories of the unconscious and transference. His approach to telepathy parallels his approach to religious beliefs: He accounts for both as creations of the human mind as individuals attempt to make sense and meaning of their real experiences. What Freud meant by telepathy is what contemporary psychoanalysis refers to as unconscious communication, and the strange, often inexplicable forms it takes in clinical contexts. For Freud, instances of telepathy or unconscious communication are to be understood contextually and relationally, revealing important data about the nature of affectively charged human relationships.     

Discussion of “Hysteria and Humiliation”: Commentary on Paper by Sam Gerson

This commentary describes certain differences in how Relational and Contemporary Freudian analysts approach both the conceptual dynamics of hysterical functioning and its clinical management. The discussion shows how, despite considerable agreement between these two groups concerning the critical importance of a receptive other for the successful buildup of virtually every aspect of mental life (not to be confused with the concept of co-creation), they also have quite substantial differences; differences that are rooted in contrasting basic assumptions about the ways in which fantasies, unconscious transference displacements, and self-regulating repetitive processes are set up in the mind. The discussion also illustrates how the clinical management of hysteria differs considerably depending on whether what is taking place in the consulting room is conceived of as an autonomous, repetitive process that the patient brings to the treatment and repeats (one way or another) over and over again, or whether it is conceived of as co-created, belonging to the minds of both persons in the room, even if not in equal measure or equal ways.     

Nebbiosi’s Third: A Discussion of Gianni Nebbiosi’s “The Smell of Paper”

Gianni Nebbiosi’s clinical paper is discussed as music to the hammer of the commentator’s ear. Three overlapping points are presented. The first centers on Nebbiosi’s tone of voice with his analysand Teresa. The second point is about music and psychoanalysis. The final point is about Nebbiosi’s free association to Beethoven’s Third Symphony.     

The Internet and Its Discontents—or Diamonds are a Girl’s BFF: Commentary on Danielle Knafo’s Paper “Guys and Dolls: Relational Life in the Technological Era”

In this discussion, I contrast Knafo’s worry about online inhumanity with a perspective informed by Katherine Hayles’s humanistic work on cybernetics, the posthuman, and the technological unconscious. Drawing upon my own writing about cyberobjects and reality, I argue that Knafo’s claim that “technology has invaded our intimate lives” is wildly overstated and that it hinges upon a curious manipulation of a false active/passive binary that is then used as a litmus test for perversion. I challenge Knafo’s “evolutionary” and materialist claims with reference to the intercourse of perversion and neoliberalism.     

Commentary on Robin Wooffitt’s Paper “Poetic Confluence: A Sociological Analysis of an Enigmatic Moment”

The author, who is a sociologist and psychoanalyst, comments upon Wooffitt’s analysis of poetic confluence. Using conversation analysis of moments of interaction where one interlocutor says something that bears a strong resemblance to what has just been in the mind of the other interlocutor, Wooffitt suggests that this form of communication has its function in the neutralization of the mental contents of this other interlocutor. In light of material presented by Schegloff in his earlier work, this appears to be a partial function of poetic confluence but not something that is there in all instances. On a conceptual level, psychoanalysis and sociology have had several moments of rapprochement in history. Wooffitt’s plea for dialogue is different: rather than focusing on conceptual linkages between the two disciplines, he proposes meeting through empirical studies of the intersubjective and interactional basis of mental phenomena.     

The Man of the House: Commentary on Thomas Burkhalter’s “Foregrounding Masculinities in Psychoanalytic Psychotherapy”

Thomas Burkhalter is complemented on so vividly bringing the reader into his personal struggles to find a true masculinity in the unforgiving context of contemporary South Africa where White masculinity is associated with apartheid. The struggle to be free of old identifications with the patriarchal order and gender binaries saturate the paper, and attention is drawn to the lingering presence of older conceptions of masculinity as a monolithic concept that leaves women as victims and nurturers and the male as dominant. Burkhalter’s clinical vignette is examined and found to illustrate well his struggle and to capture the vulnerability to genderized enactments and the enduring presence of the old order manifested by a reliance on defense analysis that constrains his construal of Mr. Jones’s statement that he is “after all the man in the house.” Potential alternative meanings of this phrase that foreground grief, hope, and a plea for companioning in pain are offered and a deeper engagement with Mr. and Mrs. Jones’s conscious and unconscious worlds is encouraged.     

The Sleeping Beauty and the Therapist’s Gaze: Commentary on Hours and Mayers’s Article on Finding a Path toward Re-Enchantment

In their article, Hours and Mayers make the case that in the imaginary world of fairy tales children have an opportunity to engage and symbolize and also to reflect on the experiences and motives of imaginary characters. This was the case with 8-year-old Barbara who responded to the fairy tales that were narrated to the group by joining in and beginning to share her ideas and reactions. In this commentary, it is argued that it was not just the experience of enchantment that enabled Barbara to begin to listen more attentively to the stories and to engage with her peers. It was also her experience of the narrator's gaze, the therapist who wanted to tell a story to her to make her feel enchanted by all the images and emotions stories can evoke to anyone who listens to them.     

How to Come to Terms With the Shadows of the Past in the Treatment of Third-Generation Patients: A Commentary on Orna Guralnik’s Paper “The Dead Baby”

The peculiarity of Orna Guralnik’s case study lay in the fact that the German patient whose grandparents were Nazis and whose parents were in their ideas affected by Nazi ideology is being treated by a Jewish analyst. Both patient and analyst belong to the so-called third generation. In my commentary I emphasize the significance of processes of transgenerational identification, and I try to show how a countertransference enactment developed in this treatment. The burden of the traumatic history of the Germans and the Jews was, in this case, too heavy and preoccupied the analyst. Such countertransference enactments occur repeatedly during psychoanalytic treatment when the subject is about involvement in the Holocaust and Second World War and its consequences for subsequent generations.     

Facing the Lively Unity of Difference: Heidegger’s Thoughts on Nietzsche’s Philosophy of Eternal Return and the Self-Overcoming Power of Thinking

Human Studies - This article examines Heidegger’s thoughts on Nietzsche’s philosophy of eternal return and the self-overcoming power of thinking. Scholarly commentators argue that...     

The Ego and the Yid,Revisited: Commentary on Daniel Gaztambide’s “A Preferential Option for the Repressed: Psychoanalysis Through the Eyes of Liberation Theology”

In this commentary on Daniel Gaztambide’s “A Preferential Option for the Repressed: Psychoanalysis Through the Eyes of Liberation Theology” we discuss the Ego and the Y(id) to emphasize the otherness of the unconscious. In the idiom of racial anti-Semitism, the Y(id) was the personification of the feminine, the infantile, the irrational, the perverse, the primitive, and of “Blackness.” Gaztambide rightly refers to psychoanalysis’s marginal and progressive origins and to the role of Freud’s own racial identity as a Jew in producing that marginality. However, we caution against Gaztambide’s metaphorical equation of psychoanalysis and prophecy, and contend that psychoanalysis is at its best when it occupies a position of thirdness, critiquing both from within and without.     

Commentary on Federica Melandri’s “Milk and Tears”

ABSTRACT

Dr. Melandri’s use of the 2001 Revised Diagnostic Profile to assess 5-year-old Leo brought forth different emphases than Anna Freud’s original Diagnostic Profile (1965). Dr. Melandri’s explicit sharing of how she reacted to and felt in Leo’s presence is far more explicit. Another difference is how fluently Dr. Melandri integrates metapsychology with diverse clinical theories to describe Leo’s development. Had the original Diagnostic Profile been used, there would have been greater emphasis on libidinal phase development, such as orality, anality, phallic, and oedipal development, not to mention dynamic and structural achievements. This essay asks: “what’s at stake?” regarding these different emphases. The author concludes with a few remarks in general about the 2001 Revised Profile, including comments about the fate of Freud’s and Anna Freud’s radical vision.