Conceptualizations of the psychoanalytic process

A demonstrable psychoanalytic process involves elaborate and sustained intrapsychic experiences and phenomena for both analysand and analyst. It also includes a complex and at times subtle interpersonal relationship in which each participant is actively sensitive and responsive to verbal and nonverbal input from the other. These interpersonal experiences stimulate further intrapsychic responses which in turn may have further interpersonal effects. Within the framework of the psychoanalytic situation, these combined intrapsychic and interpersonal responses lead first to facilitative and ultimately to definitive changes in the patient's psychological organization and function. A method for demonstrating a psychoanalytic process is described.     

A MODEL FOR INTEGRATING ACTUAL NEUROTIC OR UNREPRESENTED STATES AND SYMBOLIZED ASPECTS OF INTRAPSYCHIC CONFLICT

In psychoanalytic theory, the importance of actual neuroses—considered to be devoid of psychic content—diminished as Freud and subsequent analysts focused on unconscious intrapsychic conflict. This paper explores the relationship between actual neurotic and unrepresented states, which are believed to be best addressed through attention to countertransference, intersubjectivity, and enactments rather than interpretation of intrapsychic conflict. Models suggesting how actual neurotic states and symbolized intrapsychic conflict may interact with each other and environmental stressors are described. Symbolizing actual neurotic states and establishing meaningful linkages between somatic/affective experiences and intrapsychic conflict are viewed as necessary for effective treatment of many disorders.     

The psychoanalytic process and its components

Certain problems in defining the psychoanalytic process emerged during the five years in which a COPE study group was attempting to clarify the concept. There was agreement about the bed-rock criteria to be included in a definition: e.g., transference, resistance, a dynamic unconscious, intrapsychic conflict, defense, infantile sexuality, insight which causes change, and change which brings insight. The disagreements centered on the locus of the psychoanalytic process, the best way to conceptualize change, and the methodological problem of validating whether specific interventions cause specific claimed effects. Confusion about how to account for the interactional aspect of the psychoanalytic situation in a manner consistent with a one-person psychology emerged as an important source of the difficulty in arriving at a satisfactory definition of the psychoanalytic process.     

The analytic process in psychoanalysis and psychotherapy: from the interpersonal to the intrapsychic level

The current debate over the conflicting interpersonal and intrapsychic views of the analytic process may or may not help us to distinguish between psychoanalysis and analytic psychotherapy. A comparison of psychoanalysis in the English-speaking world--especially in the United States--with French psychoanalysis reveals the features that unite and at the same time divide these different psychoanalytical tendencies, both of which are the heirs to Freud's thought, in terms, in particular, of the setting (couch and chair) and of technique (interpretation, transference analysis and technical neutrality). Whereas all psychoanalytic work belongs within the framework of an interpersonal relationship, that relationship becomes meaningful only when linked to the intrapsychic dimension, which alone can open the way to the unconscious and to infantile sexuality.     

Collusive induction in perverse relating: Perverse enactments and bastions as a camouflage for death anxiety

The author argues that one of the main functions of perverse relatedness is to induce the analyst into becoming the patient's unconscious accomplice in a “perverse pact” against the analytic work aimed at disavowing intolerable aspects of reality. The intense power of collusive induction in perverse relating leads the analyst to participate in transference‐countertransference enactments and to the crystallization of a silent and chronic unconscious collusion between the patient and analyst in the analytic field, stagnating the process (bastion; Baranger and Baranger). The author claims that analysis of perverse pathology should not be limited to interpretation of the patient's intrapsychic functioning but should also focus on the information obtained by the analyst through his participation in collusive enactments; the analyst should also take a “second look” at the analytic “field” to detect underlying bastions. The author reviews the main psychoanalytic contributions that have clarified the phenomenon of collusive induction in perverse relating and as an illustration, describes the analysis of a man with a perverse character; in this patient, one of the main functions of his perverse relatedness was to induce the analyst to become an accomplice in his disavowal of his terror of death. The author highlights the influence of death anxiety in the bastions that develop in the treatment of perverse patients.     

The psychoanalytic research interview: preliminary suggestions

Psychoanalytically informed interview techniques and interview analysis can yield useful psychoanalytic insights about a particular research subject within the space of a few interviews. Basic hermeneutic principles, often used to understand the research interview, are not sufficient for understanding unconscious meaning and intrapsychic processes; they pay little attention to the particular theoretical and technical aspects of the interview needed to create the best conditions for understanding unconscious meaning. The portability of psychoanalytic concepts and their applicability outside the therapeutic setting are considered, after which four epistemological principles are outlined, derived mainly from the narrative tradition in psychoanalysis, that can inform interview technique and the analysis of the interview. Careful attention to feeling states, the search for core narratives, and the exploration of identifications and object relations are isolated as key analytic tasks in the interview analysis. A brief verbatim interview is used to illustrate this process, and methods are suggested to prevent the "wild analysis" of the interview encounter.     

The Unconsciously Constructed Virtual Other

Neuroscience has confirmed Freud's assertion of the primacy of unconscious process in relation to conscious experience. However, unconscious process, for many neuroscientists, is viewed as something that is devoid of meaning. This paper suggests that there are different levels of unconscious process. This conceptualization of unconscious process may help to reconcile the psychoanalytic assumption of a meaningful unconscious with the conception that unconscious process is a meaningless code, a belief held by most neuroscientists. To effect this reconciliation we must return to Freud's earlier theory of unconscious process as described in his Interpretation of Dreams. A dream-like unconscious process, employing metaphor, unconsciously organizes our affective experiences while we are awake.     

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.     

Psychoanalytic interpretations: Word-music and translation

A perspective on psychoanalytic interpretations as a special case of artistic translations (i.e. translations of both content and formal aspects of discourse) is proposed. Mutative interpretations are seen as creative endeavours that always presuppose a prior text, which is itself already a translation. Freud's main uses of the metaphor of translation as an intrapsychic as well as an intersubjective phenomena, their resonance among later psychoanalytic thinkers and their convergence with classic theories of translation are presented. A perspective on psychoanalytic interpretations as an evolving self-other dialect is developed within the framework of Borges's theory of translation and Bakhtin's concept of exotopy. This framework questions the possibility of an original source, proposes the translator's inevitable implication in translation and underscores intersubjectivity as a necessary way towards the translation of absent meanings. The work of translation also highlights the relevance of space and time contexts, as well as the necessary role of a different other for the interpretation of unconscious processes. Differences between theories of translation reiterate contemporary psychoanalytic controversies about the preeminence of the analysand's subjectivity and the intersubjective approach to treatment. Borges's 'The Aleph' and an excerpt of Dora's case offer paradigmatic demonstrations of the limits and possibilities of understanding through translation.     

Unconscious Communication in the Intersubjective Analytic Field at Times of Separation,Loss, and Termination

ABSTRACT

Unconscious communication, like transference-countertransference, is ubiquitous in life and in the psychoanalytic process. Regardless of a clinician’s theoretical perspective, and despite differences in clinical technique, Freud’s advice to turn our unconscious to the patient’s unconscious “like a receptive organ” has guided generations of analysts toward deeper exploration of the countertransference in the intersubjective analytic field (Freud, 1912a, p. 115). In this clinical article, the recognition and use of unconscious communication, from the ordinary to the more extraordinary or uncanny, is described at moments of separation as harbinger of loss and, ultimately, termination. Such moments hold potential for a depth of emotional resonance with and accessibility to our patient’s psychic realities that may otherwise be unavailable due to our systemic defense against a shared existential anxiety that all things come to an end. The emergence of unconscious communication via the analyst’s reverie and dreams are considered an opening of potential space where ending can be conceived as a bearable thought—a transitional organizing experience for the dyad.     

Homophobia is the patient 1

This paper draws on psychoanalytic work with a heterosexual woman who struggles with the conscious and unconscious aspects of her homophobia. It reflects on the limitations of the classical psychoanalytic interpretations of phobia as a symptom in the light of contemporary philosophers such as Levinas, Foucault and Butler. It focuses particularly on the connection between anxiety and the relation to the Other.     

Benign and disruptive disturbances of the supervisory field1

Inspired by Baranger, Baranger and Mom’s notion of psychoanalytic bastion, we describe an unconscious collusion between analytic supervisors and supervisees. This collusion’s purpose is to avoid the anxiety inherent in the psychoanalytic field and that enters unprocessed into the supervisory field. The supervisor/supervisee dyad’s emotional experience can be fleeting, with moderate intensity, but can slow down the process. This can happen sometimes in any supervisory situation. Or it can become permanent and with greater intensity and bring the entire process to a standstill and to a disruption of the supervisory field. We call the first situation a ‘benign disturbance of the supervisory field’, the second a ‘disruptive disturbance of the supervisory field’. We illustrate both disturbances using supervisory material. Our purpose is to show how to detect these disturbances, understand them, and manage them.     

Psychoanalytic perspectives on the treatment of early adolescent girls

Psychotherapy of girls between the ages of 10and 14 years presents specific difficulties which originate in the rapid physiological changes and intrapsychic demands for psychological differentiation, causing considerable anxiety and inner turmoil. The introduction of therapeutic intervention at this juncture is discussed along with its risks, benefits, limitations, possibilities, and implications for psychoanalytic theory.     

The conceptualisation of the psychical in psychoanalysis

This article aims to clarify the psychoanalytic conceptualisation of the psychical, which includes a discussion of the relationship between consciousness and the unconscious. The unconscious is conceived of as being on the border between the so-called 'ego's conscious intending' and a rudimentary body-ego experiencing. Phenomenological ideas on the essence of consciousness are used in order to help delineate the crucial differences between consciousness and the unconscious. Only consciousness is characterised by an awareness of itself, that is; self-consciousness. Furthermore, consciousness is characterised by an intentional, synthesising capacity, whereas the functioning of the unconscious, in its most radical form, is the opposite ofthe intentionality of consciousness. It is argued that the unconscious pre-supposes certain pre-sexual processes, in the form of a body-ego's formation of continuity, coherence and wholeness. The body-ego belongs to the sphere of consciousness/self-consciousness, even if self-consciousness is only given implicitly in the body-ego and not as a fully fledged ego cogito . Attention is drawn to neglected issues in psychoanalytic theorising, namely self-consciousness and the constitution of existence. The importance of this neglected area for the psychoanalytic process is illustrated with clinical examples.     

The capacity to forgive: intrapsychic and developmental perspectives

The topic of forgiveness, despite its importance for the continuity of relationships and for the mental health of the aggrieved party, is relatively neglected in the psychoanalytic literature, perhaps because it is often seen as the province of religion and carries the connotation of reaction formation and inauthenticity. However, genuine forgiveness involves significant intrapsychic work, conscious and unconscious working through of one's anger, and putting the offense into the context of an integrated view of the whole person of the offender. Early developmental structures are the ground on which the relative ability to let go of a grievance depends. While later motives and defenses (e.g., fear of retraumatization, avoidance of shame) may also play a role, these early structures are primary. They are described here in terms of attainment of the depressive position and the development of a sense of secure attachment, the capacity to mentalize, and the ability to mourn.     

The psychoanalytic process: the developmental and the integrative

Psychoanalysis is a treatment that focuses on intrapsychic events and activates integrative tendencies to promote-insights. Almost from the time it originated, however, it was also promoted as a therapy informed by the interpersonal, inducing change through experiences generated within the psychoanalytic situation. In recent years the interpersonal or object relations approach has come to be categorized as "developmental," a term that fosters no end of ambiguities. The resulting confusion compromises the study of the actual developmental process on the one hand and the structure-enhancing features of transactions on the other. This encumbers research on the psychoanalytic process. The author distinguishes the intrapsychic from the interpersonal, the integrative from the developmental, and the two very different realms of psychological activities currently advanced as "developmental."     

The patient's experience of validation in psychoanalytic treatment

The importance of the patient's experience of validation is not a new one in psychoanalytic thinking, and can be traced throughout the literature. However, its role as an essential aspect of the psychoanalytic process, particularly in working with intrapsychic conflict, has traditionally been underappreciated. It is argued that validating interventions have an important role in psychoanalytic treatment, and that they often serve to open up, rather than foreclose, the analysis of transference. Marsha Linehan's conceptualization of the role of validation in Dialectical Behavioral Therapy provides a unifying framework for a more extensive psychoanalytic consideration of validation. After a review of the psychoanalytic literature, a number of conceptual issues are discussed that have complicated thinking about validation from a psychoanalytic perspective. Two clinical examples are presented, one from the author's psychoanalytic practice and one from his own analysis. Both illustrate how active validation by the analyst can play an essential facilitating role in the psychoanalytic process.     

A matter of time: actual time and the production of the past

In psychoanalytic theory, space metaphors are frequently used to describe the psychic apparatus. As for time, it is traditionally invoked under the heading of timelessness of the unconscious, more aptly described as the resistance of the repressed to wearing away with time. This paper examines how the insertion of time into psychic events and structural differentiation form a single process. After looking into the parallelism between phenomenological and psychoanalytic views of time and differentiation, the author draws a distinction between two time categories: chronological versus actual. A clinical example is presented.     

Psychoanalytic treatment of a woman with anxiety attacks and conversion

This case study describes the psychoanalytic treatment of a young woman presenting with symptoms of overwhelming anxiety, panic, and conversion. The emphasis is on technique with detailed reporting on the psychoanalytic process. Attention is paid to transference-countertransference paradigms at critical junctures in the treatment. The role of clinical supervision in the unfolding of the process is described also. This patient developed an identifiable transference neurosis during the course of the treatment, which became the focus of the analysis. Follow-up observations on this patient are also presented, as she returned for a brief course of treatment 4 years following initial termination.