Unconscious fantasy and theories of cure

It has long been known that patients' wishes for cure by analysis give expression to unconscious wishes for instinctual gratification which originate in childhood mental life. Patients sometimes develop theories about how they believe analysis attains its ends; these are likely to affect the way they behave in the analytic situation, and analysis of them may therefore constitute an important contribution to progress in the analysis. Two illustrative cases are presented; in both, the unconscious determinants of the patients' theories turn out to be infantile sexual fantasies connected with their uncon scious wishes for instinctual satisfaction. It is further suggested that analogous unconscious fantasies also influence the theories of analysts and other therapists about how analysis works. In some instances these factors, while not affecting theory formation explicitly, may, without being recognized as doing so, contribute to decisions regarding the modification of analytic technique. Awareness of that possibility may aid analysts in assessing the indications for such proposed modifications.     

Alienating identifications and the psychoanalytic process1

The transmission of psychic life from one generation to the next can result in unconscious, alienating identifications when the parents have not been able to elaborate a process of mourning for their own childhoods. In this article, the author describes the nature of these identifications, constructed around insufficiently symbolized experiences, as revealed during the psychoanalytic process. These unconscious, alienating identifications raise some arduous technical problems for the psychoanalyst as they lead the patient to carry out complex enactments that erase the normal transference markers. The psychoanalyst may then be tempted to resort to pejorative theoretical concepts, such as the death drive. And yet, unknown to the analysand, the insufficiently symbolized psychic elements contain a potential for transformation that may lead to reconstructions and dis‐alienating interpretations. The author distinguishes between alienating identifications and fantasies of identification when the latter transiently appear during the psychoanalytic process. These identification fantasies symbolically register the emotional experience undergone during the analytic sessions and contribute to the integration of insufficiently symbolized psychic elements. These theoretical considerations are fully illustrated by the clinical report of some analytic sessions.     

Sadomasochism in the neuroses conceived of as a pathological compromise formation.

Masochistic phenomena in adults are discussed as derivatives of conscious and/or unconscious fantasies. These masochistic fantasies are always associated with conscious and/or unconscious narcissistic and sadistic fantasies. These fantasies, like all fantasies in adults, are conceived of as compromise formations. After a selected review of the literature, analytic data are presented to highlight the clinical advantages of a contemporary elaboration of the structural hypothesis for the understanding of sadomasochistic and sadonarcissistic phenomena.     

Unconscious fantasy (or phantasy) as clinical concept

A clinical phenomenology of the concept ‘unconscious fantasy’ attempts to describe it from a ‘bottom‐up’ perspective, that is, from the immediate experience of the analyst working in session. Articles of psychoanalytic authors from different persuasions are reviewed, which taken as a whole would shed some light on how the concept of unconscious fantasy takes shape in the analyst's mind during the session with the patient. A clinical phenomenology in three steps is described. Each step is illustrated by clinical material. Current controversies around the concept of unconscious fantasy (or phantasy) are still trapped in the discussion about if and how they are really unconscious. The strategy to describe from a ‘bottom‐up’ perspective the process of how the analyst's mind embraces the idea that an emerging phenomenon in the relationship with the patient can be defined as ‘unconscious fantasy’, allows us to elude the question as to whether or not we believe that unconscious fantasies exist at all, since we are neither required to assert or deny such a prior existence in order to describe the process of elaboration which, in the end, does formulate a fantasy as fantasy.     

Das Drama des begabten Kindes und die Suche nach dem wahren Selbst

The clinical material for this study of female fantasies stems from a specific psychoanalytical situation where the analyst and the analysand are pregnant at the same time. The impact of this situation is powerful. The emergence of archaic fantasies is facilitated in transference and countertransference. Fantasies of damage to the baby or to the procreative function may emerge very vividly in the double pregnancy setting and working through these fantasies becomes possible. It is suggested that these fantasies are typical female castration fantasies and manifest the fear of the mother's revenge and punishment for forbidden oedipal wishes. The double pregnancy setting may sensitize the analyst to her pregnant analysand's unconscious communication and yet blind the analyst in some areas to the protection of her own baby. The duality of phallic strivings in the girl's psychosexual development is discussed. They may be employed as a defense against specific feminine anxieties, such as fear of retaliatory attacks on her inner space and its fertility: the female castration anxiety. They may also be constituents of her sexuality, coexisting with inner genital strivings. The co-existence of phallic and inner-genital strivings in the female psyche is always conflictual.     

A modest proposal: (re)defining unconscious fantasy

The author argues that unconscious fantasy, properly defined, necessarily represents the three-dimensional intersection of wishful thinking (fantasy), veridical perception of the environment (reality), and the naive cognition of childhood. It is proposed that, although attachment theory developed out of the intent to capture the unalloyed reality of dyadic experience, that experience is inextricably entangled with the other two components, wishes and naive cognition, and furthermore, that the behavior of children in the attachment paradigm can only be accounted for by positing the existence of underlying unconscious fantasies. In making these arguments, the author also addresses the development of unconscious fantasies and their relationship to compromise formations and trauma.     

Unconscious fantasy in context: The work of Jacob A. Arlow

For Jacob A. Arlow, understanding unconscious fantasies was central to his clinical work. These fantasies are to be found at the core of those eruptions that break without warning into our ordinary lives, whether in the form of hysterical symptoms, daydreams or nightmares. What, however, could an unconscious fantasy be on a theoretical level, beyond a vehicle for discharge? Although partly unconscious, such fantasies are sometimes composed of fixed verbal content with a high degree of internal organisation. Unconscious fantasies therefore pose many challenges to understanding.     

Unconscious fantasy: a reconsideration of the concept

Despite general agreement about the clinical importance of unconscious fantasy, the concept itself has remained unclear. After reviewing Freud's work on the subject, the conceptual dilemma is specified: where in current psychoanalytic theory do we place this important, dynamically repressed, structuralized mental content? Three conceptual paths have been followed in attempting to deal with this problem. The first emphasizes the structural, tripartite model, discarding topographic concepts. The second replaces the structural model with a schema model borrowed from academic psychology. The third combines the structural and topographic models. None of these approaches is entirely satisfactory and without problems. Because of their central role in mental life, unconscious fantasies deserve careful definition. They should be distinguished from conscious fantasies and daydreams as well as from the process of fantasizing. They are differentiated from other varieties of unconscious content by their enduring quality and their organized, storylike quality reflecting the distortions typical of the primary process. As dynamically unconscious templates from the childhood past, they shape subsequent compromise formations and are relatively impervious to new experience. The development of psychoanalytic theory from a macrostructural to a microstructural emphasis is discussed in relation to the unconscious fantasy concept.     

The other between fear and desire – countertransference fantasy as a bridge between me and the other

This paper attempts to show how unrepresented rupture/injury of primary expectations of the early relationship is reactivated in the analytic process. This becomes perceptible especially as unconscious fear and a specific defence described as ‘living behind a glass-wall’. The author, however, postulates the existence of an inherent dialogical-dyadic principle in the psyche, which she calls archetypal hope, and shows how this principle may become active in the analytical space. These aspects of analytical treatments are sketched with two vignettes, in which unconscious processes of exchange cause the analyst to experience unrepresented states. The author describes how the analyst is gradually able to experience and understand this, and how this understanding finally – without first becoming explicit – becomes effective in the analytical space. Special attention is given to the analytic attitude. A readiness to accept and move into regression and a receptivity to attune to the early sensory experience of the analysand is regarded as essential. Through this the analyst gains access to the inner space of the analysand and, through bodily experience and pre-symbolic processes, the unrepresented may thus become figurable. The reverie and countertransference fantasies are understood as a bridge: they connect the analytic pair. However, the reverie also creates the transition between that which was not – the absent representation – and that which wants to emerge. It thus bridges the personal unconscious (implicit expectation) and the archetypal (the archetypal hope). Through this, the space of hope may become a space of possibility, and help bridge the chasm between the experienced and the hoped-for.     

The Whole and the Parts: Working in the Analytic Field

Field concepts have been imported from physics into psychology and philosophy, in the work of writers such as Kurt Lewin and Maurice Merleu-Ponty. In psychoanalysis, they are found in the work of Harry Stack Sullivan, Enrique Pichon-Rivière, and Willy and Madeleine Baranger. They are essential for relational analysis, where everything than happens in the analytic situation is considered to depend on both parties of the analytic relationship. The analytic situation is understood as a two-person setup, in which neither party can be conceived without the other, because they are inescapably bound and complementary. This is called a “dynamic field,” and it corresponds to an experiential configuration that changes and evolves in time. Insight is better understood as a restructuring of the field, a gradual development of both parties' understanding of their shared unconscious situation. In this paper I discuss the main ideas posed by the Barangers, as well as my own, and present a clinical vignette to illustrate the phenomenology of the field.     

One form of self-analysis

Beginning with Freud, psychoanalysts have discovered media through which they may achieve a self-analytic experience (for example, by use of dreams, fantasies, reveries, memories, and even visual images). Each of these media is a kind of "fiction" created by the analyst that provides an imaginative space where he or she may gain access to unconscious life. The author demonstrates how a generative self-analytic experience may be accomplished through the medium of psychoanalytic writing: a fictional autobiographical form of writing through which a self-analytic experience is created that has much in common with the analytic experience created by the analyst and analysand.     

Anxiety, signal anxiety, and unconscious anticipation: neuroscientific evidence for an unconscious signal function in humans

A central tenet of psychoanalysis, and arguably of any comprehensive theory of mind, is the existence of a psychological unconscious. Years of clinical investigation into the nature of unconscious processes have facilitated the development of psychoanalysis as a clinical method. Empirical investigations of unconscious mental processes, however, have lagged behind clinical inquiry. With few exceptions, attempts to understand unconscious processes using rigorous experimental controls have remained sequestered in scientific domains other than psychoanalysis, where they have proliferated recently. In view of this recent upsurge of research on unconscious processes outside of psychoanalysis, efforts to integrate such knowledge into general theories of psychopathology and clinical investigation are critical. In this paper, an interdisciplinary approach is taken to the study of one aspect of unconscious mental functioning--what Freud originally termed signal anxiety. Signal anxiety is examined using information from cognitive psychology and learning theory, psychophysiology, behavioral neuroscience, and psychoanalytic theory. Though the original concept of signal anxiety is supported by recent research, it is concluded that signal anxiety is probably best thought of not as the affect of anxiety but as a subset of unconscious mental processes that have a signal function of anticipating danger. Such unconscious anticipatory processes are a general feature of the mind that includes responses to both real and imagined (neurotic) appraisals of a situation. The neurophysiological structures and processes associated with unconscious anticipation in humans are just beginning to be understood.     

Some technical problems of countertransference

There are several aspects of the psychoanalytic interaction that foster the emergence of countertransference. First is a persistent identification with the patient, based primarily on the sharing of unconscious fantasies. Then there is the evocative power the patient's material may have upon latent unresolved conflicts in the analyst. Finally, the analytic setting itself may evoke a broad range of countertransference responses. Particular attention must be paid to those interventions of the analyst which represent attempts to divert his own and the patient's attention from emerging derivatives of the conflicts. There are many clues that should alert the analyst to the possibility of interfering countertransference.     

The Analyst as Comic and the Comic in Analysis: Reply to Commentary

This discussion elaborates aspects of the use of humor and jokes in clinical psychoanalysis. The use of humor, like dreams or other symmetrical processes, facilitates the patient's development of the capacity to symbolize unconscious experience and mitigates the need to evacuate unconscious experiences and fantasies into the external world. In focusing on specific clinical interventions I highlight three dimensions of the process: the concept of coconstruction in the emergence of humor in the psychoanalytic relationship, the authority of the patient's psychopathology and affective and cognitive development, and the analyst's willingness to take the risks of self-exposure and possibly hurting the patient implicit in the use of humor and jokes in the analytic relationship. Different forms of humor are described in relation to the different clinical situations, including mutually created jokes, caricatured enactments, cartoonlike images, and self-depreciating commentary on the analytic process. In using jokes and humor in psychoanalysis we introduce the possibility of pleasure within an intense, intimate moment which allows for the transformation of unacceptable aspects of both patient and analyst as they become joined within a broader human experience.     

When the analyst is physically ill: Vicissitudes in the analytical relationship

Something that happened to one of the authors recently led them to refl ect upon what the analyst's falling ill may represent and the problems it may give rise to in the analytic relationship. Such an eventuality injects a massive dose of the analyst's personal reality into the analytic space, thereby allowing the patient a glimpse of images of vulnerability, frailty and loss, and mobilizing emotions, fantasies and defences in both the analyst and the patient. The authors' survey of the literature ranges between two different theoretical perspectives intrapsychic and intersubjective that, in their most radical formulations on technique, call for maintaining either the strictest neutrality and anonymity or symmetrical relationality. In both cases, that which is denied is the unconscious communication that enables the analyst, irrespective of his conscious intentions, to allow either parts of himself or inner objects of the patient to act in the relationship. In closing, the authors shall illustrate the concept discussed through three clinical vignettes.     

THE ‘MEDEA FANTASY’: AN UNCONSCIOUS DETERMINANT OF PSYCHOGENIC STERILITY1

The author begins by pointing out that myths have always been powerful vehicles for the projection of ubiquitous unconscious fantasies. Having noted the importance of certain male protagonists of the Greek myths in Freud's theories, she observes that their female counterparts exert an equal fascination and suggests that the Medea myth as recounted by Euripides can be invoked to elucidate a central unconscious fantasy found to underlie the psychogenic frigidity and sterility of several of her female patients. The manifestation of this ‘Medea fantasy’ is illustrated by a clinical account in which a dream is analysed. The author next summarises the Medea story as told by Euripides and attempts a psychoanalytic interpretation of it. She draws attention to features of the ‘unconscious truth’ inherent in the myth that were shared by all the members of her group of patients. A case history then shows how the progressive understanding and working through of the Medea fantasy led to a change in the analysand's experience of femininity and enabled her to have children. It is postulated that both early infantile sexual fantasies and repressed memories of early objectrelations traumas such as maternal depression combine with ubiquitous bodily fantasies to produce the unconscious Medea fantasy.     

“With you I’m Born Again”: Themes and Fantasies of Birth and the Family Circumstances Surrounding Birth as These are Mutually Evoked in Patient and Analyst

Themes of birth and rebirth, being born and born-again, can be readily observed in clinical psychotherapy and psychoanalysis even as they remain undertheorized. A clinical case is presented that traces the first four years of an analysis as seen through the lens of four consecutive supervisory experiences. This paper explores the central importance of fantasies and narratives of one’s origins and birth and the observations, fantasies, and expectations generated by one’s family circumstances at the time of birth. The paper examines birth narratives, fantasies, and myths of origination by following a clinical case across four supervisions. The patient’s birth-related fantasies are shown to interact with the analyst’s concordant and complementary fantasies as the analyst interacts with a series of supervisors in the process of being born as an analyst. The analyst’s personal birth narrative is linked to his fantasies about being born professionally as an analyst, and these are shown to interact with the patient’s birth fantasies. The paper suggests the ongoing significance of unconscious fantasy within the framework of contemporary relational psychoanalysis.     

Commentary on Paper by Lawrence J. Brown

Brown's historical overview of post-Kleinian psychoanalysis traces key steps in the evolving and diverse practice of working in the psychoanalytic situation while regarding it as a two-person field. The Barangers' “The Analytic Situation as a Dynamic Field” is central to his narrative. I develop my understanding of the originality of their contribution in theorizing a situational unconscious, and of their continuing relevance for thinking about analytic listening and intersubjective collaboration. Brown presents a countertransference dream of his own along with the dream of a patient as an example of the Barangers' concept of the “shared unconscious fantasy” of the analytic couple. A detailed alternative reading of Brown's clinical vignette reveals an absence of fit with the Barangers' views on collaboration in the analytic situation. Some uses of Bion's “dreaming” and “becoming” are implicitly questioned as they risk encouraging the idealization of special states over process.     

ACUTE ENACTMENT AS A 'RESOURCE' IN DISCLOSING A COLLUSION BETWEEN THE ANALYTICAL DYAD

The author discusses various aspects of the function of enactment in analytical practice, reviewing the concept, then describing a borderline patient with whom the analytic process seemed to be developing productively. Following a change in the setting, an intense, acute enactment took place. Understanding this led to observation of an unconscious collusion, in which a symbiotic relationship had been established between the patient, the analyst and his family, as a chronic enactment. This relationship had prevented the analyst from touching on highly destructive unconscious fantasies and archaic traumatic situations. Comprehension of the enactment enabled the collusion to be dissolved. The author suggests that, besides the resistance aspect, the collusion may have been useful in strengthening the patient's mental mechanisms and trust in the analytical work, which required some time. The acute enactment arose, unveiling the collusion, when the patient and the analyst felt able to face the terrible feelings related to the triangular situation. He speculates that both enactments may occur in the analysis of these kinds of patients, as part of the 'natural history' of the analytical process, and their function is to relive archaic experiences in the analysis, also with the aim of working them through. Finally, the author proposes a classification of enactments: normal, pathological, acute and chronic.