Hertzmann,Leezah & Newbigin,Juliet (Eds.). Sexuality and Gender Now: Moving Beyond Heteronormativity. The Tavistock Clinic Series. London: Routledge. 2019. Pp. 358. Pbk. £29.99.

In this paper the author argues that trans-identification and its associated medical treatment can constitute an attempt to evade experiences of psychological distress. This occurs on three levels. Firstly, the trans person themselves may seek to evade dysregulated affects associated with such experiences as attachment trauma, childhood abuse, and ego-alien sexual feelings. Secondly, therapists may attempt to evade feelings, such as fear and hatred, evoked by engaging with these dysregulated affects. Thirdly, we, as a society, may wish to evade acknowledging the reality of such trauma, abuse and sexual distress by hypothesizing that trans-identification is a biological issue, best treated medically. The author argues that the quality of evidence supporting the biomedical approach is extremely poor. This puts young trans people at risk of receiving potentially damaging medical treatment they may later seek to reverse or come to regret, while their underlying psychological issues remain unaddressed.     

Understanding and Treatment of Narcissistic Personality Disturbances

The author discusses how sexuality on the one hand develops and changes during childhood, but on the other hand, holds onto the old residues of different, earlier phases. In adult sexuality, there always remain enigmatic, regressive, even borderline emotions and feelings from earlier experiences. These residues make sexuality incomprehensible and primitive, but also offer possibilities for dreams, fantasies and creativity later in life. Autoerotic fantasies, object fantasies, enigmatic knowledge, sexuality fantasies and creative thinking are realised via these developmental residues.     

Contributions of Attachment Research to Understanding Dissociative Attunement

This discussion elaborates the author’s use of attachment theory and research to understanding Susan’s clinical process (see Jacobs, this issue). I have delineated different patterns of attachment, its precursors in infancy, both in infant parent interactions and in parent’s state of mind with respect to attachment. I also link this to how dissociative process can be embedded in a combination of infant disorganization and trauma. I think that clinical applications of the ideas Jacobs and I subscribe to add a great deal to understanding how unformulated experiences with a frightened and frightening parent can lead to a person’s vulnerability to developing dissociative responses to later trauma. The dialogic nature of infant parent attachment experiences can further enrich an understanding of how certain transference–countertransference enactments are manifestations of certain kinds of procedural or relational knowing. In this way, clinicians can further understand the possibilities for psychic transformation as embedded in bearing that which was experienced but which cannot yet be known.     

The internal world of the juvenile sex offender

This paper explores the consequences of the therapist's two successive pregnancies on a female patient. The second pregnancy was felt to be particularly difficult and disturbing. One of the central reasons was that after the patient's birth, the mother had a disabled child, followed by a stillbirth and soon after that the father left to marry another woman. Using Freud's concept of deferred action I will argue that my second pregnancy revised these earlier traumatic experiences.

The patient seemed to have incorporated and identified with a damaged maternal object that at the time of the original trauma was left husbandless, depressed and suffering from panic attacks. Although the therapist's healthy pregnancies seemed to reassure temporarily, it was difficult for the patient to hold onto a view of a helpful and productive therapist, one separate from this damaged internal mother. This was particularly so during and after the second pregnancy, where there was a marked absence of an idea of a third object, a father or a husband, who could help the patient deal with this pregnancy, her only escape was to retreat and act out.

The acting out was in part identification with a fleeing father and in part a defence against the absence of such a third object, so that it was used as a way of avoiding claustrophobic feelings of being trapped with the damaged mother. Her feelings of triumph then produced much guilt, and impeded reparation.

Another important issue that two successive pregnancies bring, are feelings of guilt in the therapist for exposing the patient to two major disruptions. In this patient's case it exacerbated the internal reality of a damaged maternal figure.     

The Subjective Basis of Kant's Judgment of Taste

Kant claims that the basis of a judgment of taste is a merely subjective representation and that the only merely subjective representations are feelings of pleasure or displeasure. Commentators disagree over how to interpret this claim. Some take it to mean that judgments about the beauty of an object depend only on the state of the judging subject. Others argue instead that, for Kant, the pleasure we take in a beautiful object is best understood as a response to its qualities, and that, accordingly, feelings of pleasure or displeasure are no different from other representations, such as colors or smells. While I agree that the judgment of taste is best understood as asserting a claim about an object's qualities, I argue that the distinction Kant makes between feelings of pleasure or displeasure and other representations should not be ignored. I show that one's liking or disliking for an object is merely subjective in the sense that its significance depends on what one has made of oneself through one's aesthetic education. The judgment of taste, then, is merely subjective because one must first become the kind of person whose feelings have the right significance at the right time before one can determine whether an object's qualities make it beautiful.     

The lived experience of inequality and migration: Emotions and meaning making among Latvian emigrants

Based on interviews with Latvian emigrants collected between 2008-2014 in England, Ireland and the USA, this paper asks: How do migrants’ perceptions of inequality in their sending and receiving states, and their associated emotional responses, influence their migration experiences and decisions? This paper finds that inequality is significant, not only in a strictly economic sense, but also in terms of the socio-emotional and cultural dimensions that accompany it. Through an examination of migrants' meaning making, I identify four scenarios of what I call the inequality-emotion tie: resentment and anger towards the ruling elite as unjust; exploitation and feelings of humiliation at work; inability to consume and associated feelings of deprivation and inferiority; and perceived inferiority in daily interactions. Through these four scenarios, I find that the inequality that exists in a migrant's home society creates resentment and anger towards ruling elites and employers, as well as creating perceptions and feelings about the self as inferior. Conversely, the inequality that exists in receiving states, where inequality levels are actually comparable, does not have the same effect. In these countries, migrants described positive experiences with associated feelings of recognition, making a return to the home country less appealing.     

Emotions,feelings and intentionality

Emotions, I will argue, involve two kinds of feeling: bodily feeling and feeling towards. Both are intentional, in the sense of being directed towards an object. Bodily feelings are directed towards the condition of one's body, although they can reveal truths about the world beyond the bounds of one's body – that, for example, there is something dangerous nearby. Feelings towards are directed towards the object of the emotion – a thing or a person, a state of affairs, an action or an event; such emotional feelings involve a special way of thinking of the object of the emotion, and I draw an analogy with Frank Jackson's well-known knowledge argument to show this. Finally, I try to show that, even if materialism is true, the phenomenology of emotional feelings, as described from a personal perspective, cannot be captured using only the theoretical concepts available for the impersonal stance of the sciences.     

The lethic phallus: rethinking the misery of Oedipus

The author rethinks Sophocles' dramas Oedipus the King and Oedipus at Colonus with a special focus on how self- and object-preservative drives are expressed in the protagonist's thoughts, feelings, and actions. What endangered Oedipus' survival at the beginning of his life-the planned infanticide-becomes the disease that later befalls his kingdom and finally culminates in his self-mutilation, which entitles the blinded Oedipus to be cared for by Antigone until he dies. The concept of the lethic phallus demonstrates how trauma and the resultant failure in structuring the lethic energies of the preservative and death drives can result in a specific pathology in which disease is used as a trophy and a means to bind the object in an ongoing caretaker relationship.     

Crafting Sacrality from the tensile life of objects: learning about the material life of prayer beads from a Khaksari Sufi <Emphasis Type="Italic">Murshid</Emphasis>

Sufi mystical experiences and practices are populated with objects. Objects exist among masters as well as disciples and followers regardless of the meanings and significations that practices impose on them. The life of these objects begins before they are enacted into sociocultural and religious relationships, as they are crafted or traded before they take on the overwhelming semiosis ascribed to them by religious-cultural codes or social networks. This article presents an apprenticeship ethnographic journey in which I follow an Iranian Sufi master and, along with him, the tensile life of Sufi prayer beads, or tasbihs. I address prayer beads as an object prior to their gaining of any religious meaning in the networks of everyday life. Tracing the material life of prayer beads reveals how the “objectness” of the rosary preexists the material practices that give it meaning in the Sufi order. Through the approach of speculative realism I examine what it means to study a religious-object-in-itself. I follow the religiously loaded object and its spiritual emergence by way of object-oriented ontology to forgo the meanings and relationships that shadow the objects.     

Phallic narcissism, anal sadism, and oral discord: the case of Yukio Mishima, Part I

Thus far I have explored Mishima's traumatic childhood and the experiences leading him toward misogyny, phallic narcissism, and the drive to murder his own weakness and sexual vulnerability. Mishima suffered the extraordinary trauma of being separated from his parents and sequestered to the sickroom of a psychotic grandmother for the first twelve years of his life. Intense rage over abandonment and impingement engendered a disgust for femininity and the need to escape feminine messiness through homosexual pursuits. Mishima's entrenched feelings of shame and weakness gave rise to phallic narcissistic tendencies, as he idealized powerful men and eventually strove to become a powerful and beautiful male. In pursuing this erotic masculine image Mishima continued to fantasize about murdering his weak and shameful self-image, and commingled this sadistic impulse with fantasies of sexual merger with murdered love objects. Finally Mishima was the murderer erotically eradicating his sexual vulnerability as both subject and object. His suicide was a repetition of this erotic sadistic fantasy. In a further article I will continue the discussion by examining Mishima's fantasies of murdering beautiful and abandoning love objects. I will also address the complex nature of his ritual suicide as fantasy of rebirth, sexual merger, the murder of toxic introjects, and escape from death, decay, and regression to helpless infancy.     

The CARE System in Its Importance in Dealing with Today's Crises1

The CARE system is a gift from Mother Nature, we have it in our biological heritage; it enables us humans—as a basic gift—to help each other in a large, life-serving context, and thus also to counterbalance destruction. It is about a basic human ability, linked to typical behaviour, but also about a basic human need for connectedness. In this paper, I would like to show how the CARE system can be activated as a collective attitude. The CARE system is strengthened by positive emotions. We are currently being affected by many crises and this triggers fear. How can we deal with this better? Fear is countered with hope and the associated positive emotions such as joy, awe, kama muta and others. These emotions and feelings can be consciously encouraged and placed alongside the feelings of fear. But also, when we share the feelings of grief with each other, it triggers an attitude of CARE. We can grieve together for the various experiences of loss that we go through—but we can also imagine together how we envisage a future that is worth living for everyone. An attitude in the sense of CARING has been practised in friendship for thousands of years. It would therefore be possible to move away from an attitude of competing and outdoing, to an attitude not only of recognition, care, and solidarity in human interaction, but also in our connection with nature.     

The internal family and the facts of life

Primitive defensive mechanisms innvolving splitting and projections are an essential process in the development of the infant. However, if these persist into adult life unmitigated by more depressive processes involving introjection and awareness of secure good objects they are shown to be inadequate to the task of coping with life crises, based as they are on the denial and distortion of reality. In this paper, I describe two patients who were seen in very different treatment settings and in whom such mechanisms were predominant. These began to fail when the patients were faced with difficult external events. These caused feelings of panic about impending mental disintegration. I then show how these patients sought to re-establish their primitive defensive structures.     

Undoing trauma: contemporary neuroscience. A Jungian clinical perspective

This paper uses insights from contemporary neuroscience and attachment theory to explore the profound dissociative defences associated with trauma. I discuss the effects of trauma on the emotional, intellectual and imaginative life of the individual and on the development of the self. Based on work with three patients with very different experiences of trauma, the paper offers clinical illustration of 'right brain to right brain' Jungian analysis. I argue that through repeated transference and countertransference experiences dissociative defences may be undone and change brought about.     

“Yeah that Made a Big Difference!”: The Importance of the Relationship between Health Professionals and Fathers Who Have a Child with Down Syndrome

Evidence suggests that medical services do not reflect the increased involvement of fathers in childcare, a discrepancy that can often lead to feelings of exclusion and inequality. Fathers who have a child with Down syndrome may encounter many different health professionals during their child’s life, therefore it is important to consider this relationship, and investigate the factors that influence their experiences. This is particularly important because the limited research focusing on fathers suggest that those who have a child with Down syndrome can experience increased stress levels and lasting feelings of loss and grief. It is therefore important to address their relationships with health professionals, as these may be a significant resource to prevent these feelings. This study used interpretative phenomenological analysis (IPA) to explore the experiences of seven fathers who have a child with Down syndrome, focusing on their interactions with health professionals. The analysis showed that the major factors associated with negative experiences were feelings of exclusion, receiving overly negative information about the condition and a perceived lack of on-going support. Positive experiences were associated with being made to feel like an equal parent, being given direct/clear information and being congratulated on the birth of their child. These results provide an insight into what fathers expect in terms of their own and their child’s care and highlight that health professionals have an important and extensive role in influencing fathers’ experiences of Down syndrome.     

Attachment to God,depression and loss in late life: a longitudinal study

ABSTRACT

Prior research shows that being anxiously and avoidantly attached to God is associated with psychologically problematic outcomes including depressive feelings. However, a clear understanding of how these insecure attachments to God are associated with depressive feelings is still missing. Therefore, a longitudinal study among 329 nursing home residents aged 65–99 was set up to investigate the prospective relation between anxious and avoidant attachment to God and the experience of depressive feelings, as well as whether this relation is moderated by a loss experience. That is, the loss of close relatives can be particularly stressful in late life, challenging existing attachment relationships and placing older adults at risk for depression. Results confirm that insecure attachments to God are distinctly related to depressive feelings, but that this relation is not moderated by a loss experience. Our results also show that depressive feelings predicts attachment to God, instead of the other way around.     

Narratives of trauma,recovery, and growth: The complex role of sport following permanent acquired disability

ObjectivesThe purpose of this study was to explore how participation in sport may assist an individual in working through experiences of physical trauma.DesignAn instrumental, collective case study was used to illustrate the experiences of two men with acquired disabilities.MethodBoth men participated in sport at a high level and suggested that participation was a central feature of their recovery from trauma. Interviews invited participants to describe their lives pre-trauma, the trauma experience, and the recovery process. A narrative analysis was used to focus on the progression of the plot outlined in each participant's story.ResultsOur results exemplify two narrative types: assimilation and positive accommodation. The narrative of positive accommodation demonstrates how sport provided mastery experiences, enhanced relationships, corporeal understanding and enhanced life philosophies. The alternative narrative of assimilation was associated with resilience to trauma. Our case illustrates that such a narrative may be focused on re-capturing previous life meanings and creating an athletic identity using past definitions of sport.ConclusionWhile the narrative of positive accommodation is most frequently associated with posttraumatic growth, our case outlines the occurrence of synchronous positive and negative experiences, even within the same dimensions of growth. The narrative of assimilation demonstrates the challenges presented by the rehabilitation and sporting environments for an individual who aimed to restore their pre-trauma self and pre-trauma beliefs.     

Traumatic origins of intimate rage

I posit that a triad of childhood events found retrospectively in populations of batterers constitutes a powerful trauma source and that many aspects of the personality structure and function of intimately abusive men are best understood from a trauma- response framework. The trauma stressors include witnessing violence directed toward the self or the mother, shaming, and insecure attachment (cf. Dutton; Dutton; Dutton and Dutton). Bowlby (1973) considered insecure attachment itself both a source and consequence of trauma. Since the infant turns to the attachment-object during periods of distress seeking soothing, a failure to obtain soothing maintains high arousal and endocrine secretion. Van der Kolk (1987) considered child abuse an “overwhelming life experience” and reviewed the defenses that children use to deal with parental abuse: hypervigilance, projection, splitting, and denial. Terr (1979) also described driven, compulsive repetitions, and reenactments that permeate dreams, play, fantasies, and object relations of traumatized children. Shaming, conceptualized as verbal or behavioral attacks on the global self, has been found to generate life long shame-proneness or defenses involving rage. A combination of all three early experiences is traumatizing, and evidence exists in adult batterers both for the presence of trauma symptoms and the childhood experiences described above. Conceptualizing the affective, cognitive, and behavioral features of intimate abusiveness from a trauma perspective has many advantages over social learning models. A basis for the internally driven and cyclical aspect of the behavior becomes clearer as does the problems with modulation of arousal, anger, and the high levels of trauma symptoms found in populations of abuse perpetrators. The narrow social learning definition of aggression as a reaction to an appraisal of controllable threat is broadened to include reactions to trauma: uncontrollable-unbluntable-inescapable aversive stimuli.     

Emotion-Focused Therapy for Autism Spectrum Disorder: A Case Conceptualization Model for Trauma-Related Experiences

People with autism spectrum disorder (ASD) report painful experiences through emotional misunderstandings with typically developing peers. There are limited intervention methodologies for ASD on the impact of emotional injuries and how to work with resulting trauma. This paper presents a rational-empirical model of trauma-related experiences with the first presentation of a new case conceptualization model for emotion-focused therapy for ASD. It describes the transformation of problematic emotion schemes through a sequence of emotional processing steps illustrated with a case example. These steps include: overcoming differentiation of core painful feelings (such as loneliness, shame, and fear); autobiographical memory recall of distanced trauma, using a novel method of video Interpersonal Process Recall; and articulation of the unmet needs contained in core painful feelings. This is followed by the expression of an emotional response to those feelings/needs; typically, self-soothing, protective anger and compassion responses offered interpersonally by group members. These emerging adaptive emotions facilitate mentalization of self and other that strengthens intrapersonal and interpersonal agency. This rational-empirical case conceptualization acts as a hypothesis for testing in subsequent trials.     

UNTOLD STORIES AND THE POWER OF SILENCE IN THE INTERGENERATIONAL TRANSMISSION OF SOCIAL TRAUMA*

There are intergenerational secrets and unprocessed experiences that very often don’t have a voice or an image associated with them but loom in our minds nonetheless. What haunts are not the dead, but the gaps left within us by the secrets of others. This paper will look at the conflict that occurs when unspoken events and memories of one generation haunt the next one. It is my contention that the second-generation survivors of trauma can be deeply affected by something that did not directly happen to them. Utilizing my own personal narrative I will examine how being the daughter of a woman who escaped the Holocaust, and her silence about those events affected my personal development and later my work with patients. I will also explore the unspoken secret that a patient’s mother kept from her, paralleling the writer’s mother’s secret.