The latency complex: the dead hand of anti‐development

It is common knowledge that the same phenomena can be viewed in a variety of ways. This paper considers the implications of a constellation observed in some adult patients who have increasingly reminded the author of some of the children of latency age with whom he has also worked. In the literature these patients may also have been thought about in terms of ‘defences of the self’ (Fordham), patients who are ‘difficult to reach’ (Joseph), ‘psychic retreats’ (Steiner), and those who make ‘attacks on linking’ (Bion). They may equally be considered in terms of schizoid, narcissistic or borderline personalities, or as showing features on the autistic spectrum, such as mindlessness and extreme obsessionality. Writers such as Helene Deutsch with her concept of an ‘as‐if personality’, Winnicott with his ‘false self’, and Rosenfeld, discussing the split‐off parts of the personality in narcissistic patients, have also offered much to think about in their consideration of some of these phenomena. This paper proposes yet another vertex – the author's own imaginative conjecture – that is by no means mutually exclusive of any of these others.     

Unconscious phantasy as a structural principle and organizer of mental life: The evolution of a concept from Freud to Klein and some of her successors

Starting with Freud's discovery of unconscious phantasy as a means of accessing his patients’ internal world, the author discusses the evolution of the concept in the work of Melanie Klein and some of her successors. Whereas Freud sees phantasy as a wish fulfilling imagination, dominated by primary process functioning and kept apart from reality testing, Klein understands phantasies as a structural function and organizer of mental life. From their very beginnings they involve object relations and gradually evolve from primitive body‐near experiences to images and symbolic representations. With her concept of projective identification in particular, Klein anticipates the communicative function of unconscious phantasies. They are at the basis of processes of symbolization, but may also be put into the service of complex defensive operations. The author traces the further evolution of the concept from the contributions of S. Isaacs, the theories of thinking proposed by W.R. Bion and R. Money‐Kyrle, Hanna Segal's ideas on symbolization and reparation all the way to the latest approaches by R. Britton, J. Steiner and others, including the understanding of transference and counter‐transference as a ‘total situation’. Points of contact with Freud are to be found particularly in connection with his concept of ‘primal phantasies’. In the author's view, the idea of the transmission and communicative potential of unconscious phantasies enabled these authors to overcome the solipsistic origins of drive theory in favour of a notion in which unconscious phantasies both set down the coordinates of the inner world and form and reflect the matrix of inter‐subjective relations.     

RETHINKING THE ROLE OF SMALL‐GROUP COLLABORATORS AND ADVERSARIES IN THE LONDON KLEINIAN DEVELOPMENT (1914–1968)

The authors historically situate the London Kleinian development in terms of the small‐group collaborations and adversaries that arose during the course of Melanie Klein's career. Some collaborations later became personally adversarial (e.g., those Klein had with Glover and Schmideberg); other adversarial relationships forever remained that way (with A. Freud); while still other long‐term collaborations became theoretically contentious (such as with Winnicott and Heimann). After the Controversial Discussions in 1944, Klein marginalized one group of supporters (Heimann, Winnicott, and Riviere) in favor of another group (Rosenfeld, Segal, and Bion). After Klein's death in 1960, Bion maintained loyalty to Klein's ideas while quietly distancing his work from the London Klein group, immigrating to the United States in 1968.     

At‐one‐ment,intuition and ‘suchness’1

Many senses exist for perceiving sensory experience; there are in turn others which make it possible to perceive emotional experience: intuition is one of these. The author, using W. R. Bion's work, studies intuition psychoanalytically, considering it to be a powerful ‘sense’ in clinical work. He describes the metapsychology of intuition, and proposes models that make it possible to think—from different perspectives— about how to make use of it in an analysis. To this end, he examines a series of useful processes and concepts: growth, tolerance, ‘suchness’, suffering and courage. The author defi nes the intuitive mechanism as a derivation of the renunciation of memory, desire and understanding; such a renunciation, learning from the experience of suffering the pain of facing the Truth in at‐one‐ment, makes it possible to tolerate the frustrations associated with observing the analysand ‘such‐as‐he‐is’. Finally, once immersed in the intelligence of intuition, the author considers ways in which intuition might be linked with concepts, with a view to interpreting the facts that must be transformed in the analysis.     

Understanding ‘Unlikely (20% Likelihood)’ or ‘20% Likelihood (Unlikely)’ Outcomes: The Robustness of the Extremity Effect

Calls to communicate uncertainty using mixed, verbal‐numerical formats (‘unlikely [0–33%]’) have stemmed from research comparing mixed with solely verbal communications. Research using the new ‘which outcome’ approach to investigate understanding of verbal probability expressions suggests, however, that mixed formats might convey disadvantages compared with purely numerical communications. When asked to indicate an outcome that is ‘unlikely’, participants have been shown to often indicate outcomes with a value exceeding the maximum value shown, equivalent to a 0% probability —an ‘extremity effect’. Recognising the potential consequences of communication recipients expecting an ‘unlikely’ event to never occur, we extend the ‘which outcome’ work across four experiments, using verbal, numerical, and verbal‐numerical communication formats, as well as a previously unconsidered numerical‐verbal format. We examine how robust the effect is in the context of consequential outcomes and over non‐normal distributions. We also investigate whether participants are aware of the inconsistency in their responses from a traditional ‘how likely’ and ‘which outcome’ task. We replicate and extend previous findings, with preference for extreme outcomes (including above maximum values) observed in both verbal and verbal‐numerical formats. Our results suggest caution in blanket usage of recently recommended verbal‐numerical formats for the communication of uncertainty. Copyright © 2018 John Wiley & Sons, Ltd.     

‘Ought Implies Can’: Not So Pragmatic After All

Those who want to deny the ‘ought implies can’ principle often turn to weakened views to explain ‘ought implies can’ phenomena. The two most common versions of such views are (a) that ‘ought’ presupposes ‘can’, and (b) that ‘ought’ conversationally implicates ‘can’. This paper will reject both views, and in doing so, present a case against any pragmatic view of ‘ought implies can’. Unlike much of the literature, I won't rely on counterexamples, but instead will argue that each of these views fails on its own terms. ‘Ought’ and ‘can’ do not obey the negation test for presupposition, and they do not obey the calculability or the cancelability tests for conversational implicature. I diagnose these failures as partly a result of the importance of the contrapositive of ‘ought implies can’. I end with a final argument emphasizing the role the principle plays in moral thinking, and the fact that no pragmatic account can do it justice.     

Burial and resurgence of projective identification in French psychoanalysis

Curiously enough, the concept of projective identification was ignored, and even rejected in France for at least two decades after the publication of the founding texts of Melanie Klein and Herbert Rosenfeld. This rejection was due to a critique from child psychoanalysts close to Anna Freud and also from the teaching of Lacan: the first took the real mother–child relation extensively into account, while the latter only saw the internal object as a signifier. The fact that during this period the countertransference was a concept reduced to its negative content no doubt explains this deliberate ignorance. With the dissemination of a broader and more positive conception of the countertransference, a renewal of interest could be observed in the 1980s with references to empathic listening and to the effects of thought‐induction.     

Seeing,mirroring, desiring: The impact of the analyst’s pregnant body on the patient’s body image

The paper explores the impact of the analyst’s pregnant body on the course of two analyses, a young man, and a young woman, specifically focusing on how each patient’s visual perception and affective experience of being with the analyst’s pregnant body affected their own body image and subjective experience of their body. The pre‐verbal or ‘subsymbolic’ material evoked in the analyses contributed to a greater understanding of the patients’ developmental experiences in infancy and adolescence, which had resulted in both carrying a profoundly distorted body image into adulthood. The analyst’s pregnancy offered a therapeutic window in which a shift in the patient’s body image could be initiated. Clinical material is presented in detail with reference to the psychoanalytic literature on the pregnant analyst, and that of the development of the body image, particularly focusing on the role of visual communication and the face. The author proposes a theory of psychic change, drawing on Bucci’s multiple code theory, in which the patients’ unconscious or ‘subsymbolic’ awareness of her pregnancy, which were manifest in their bodily responses, feeling states and dreams, as well as in the analyst s countertransference, could gradually be verbalized and understood within the transference. Thus visual perception, or ‘external seeing’, could gradually become ‘internal seeing’, or insight into unconscious phantasies, leading to a shift in the patients internal object world towards a less persecutory state and more realistic appraisal of their body image.     

Metaphysics of Pain; Semantics of ‘Pain’

Functionalism is often used to identify mental states with physical states. A particularly powerful case is Lewis's analytical functionalism. Kripke's view seriously challenges any such identification. The dispute between Kripke and Lewis's views boils down to whether the term ‘pain’ is rigid or nonrigid. It is a strong intuition of ours that if it feels like pain it is pain, and vice versa, so that ‘pain’ should designate, with respect to every possible world, all and only states felt as pain. Hence, in order to settle the dispute, we need to check which of the two – Kripke's use of ‘pain’ as rigid, or Lewis's use of ‘pain’ as nonrigid – better meets this intuition. I show that, despite crucial differences in both their semantic and metaphysical assumptions, surprisingly, both views meet this intuition equally well. Thus it appears that this question of rigidity cannot, in principle, be solved, and so, at least with respect to this particular dispute, the jury is still out on whether mental states are identical to physical states. 1     

Pentheus rather than Oedipus: On perversion,survival and analytic ‘presencing’1

Following an introductory review of the main developments in the psychoanalytic thinking on perversion, the author focuses on her own understanding of perversion and its treatment, based on the psychoanalytic treatment of patients with severe sexual perversions. This paper uses the term ‘autotomy’ (borrowed from the fi eld of biology) to describe perversion formation as an ‘autotomous’ defence solution involving massive dissociative splitting in the service of psychic survival within a violent, traumatic early childhood situation; thus, a compulsively enacted ‘desire for ritualised trauma’ ensues. The specifi c nature of the perverse scenario embodies the specifi c experiential core quality of the traumatic situation. It is an actual repetition in the present of the imprint of a past destructive experience which is pre‐arranged and stage‐managed; it thus encounters haunting scenes of dread or psychic annihilation while, at the same time, controlling, sanitising and disavowing them. Hence, the world of severe perversion is no longer oedipal, but rather the world of Pentheus, Euripides's most tragic hero‐a world dominated by a mixture of a mother's madness, devourment, destruction and rituals of desire. According to this view, the (diffi cult) psychoanalytic treatment of perversion focuses on patient‐analyst interconnectedness‐brought about by the analyst's ‘givenness to being present’ or ‘presencing’‐at a deep, primary level of contact and impact (the emphasis being on the ontological dimension of experience). This evolving therapeutic entity creates and actualises a new, alternative experiential‐emotional reality within the pervert's alienated world, eventually generating a change in the perverse essence. The author illustrate this approach with three clinical vignettes.     

Variations on the concept of traumatism: Traumatism,traumatic, trauma1

In this paper, the author outlines Freud's fundamental hypotheses concerning the concept of traumatism, then goes on to differentiate three notions (French being a particularly apposite language for such a venture): ‘traumatism’, ‘traumatic’ (in a substantive sense) and ‘trauma’. These three terms correspond to the three turning points in Freud's theory with respect to the concept of traumatism (1895‐97, 1920, 1938). The author evokes also the developments that are due to Ferenczi, particularly in his later writings (1928‐33), where he defi ned and discussed the question of ‘trauma’ in contemporary clinical practice; the author goes on to explore the different variations on this theme as regards mental functioning. He then defi nes, from a metapsychological point of view, the differences between ‘traumatisms’ that have been ‘worked over by secondary processes’, organised and governed by the pleasure‐unpleasure principle (‘traumatism’) and ‘early’ or ‘primary traumatisms’, which interfere with the process of binding the instinctual drives (‘trauma’); states of mind infl uenced by a traumatic imprint (‘traumatic’) are looked upon as belonging to both categories of the above mentioned traumatisms. The author illustrates his hypotheses with a clinical example.     

‘Telepathic’ phenomena and separation anxiety

By discussing a treatment characterized by its difficult ending, the author strives to show the dynamic impact of separation on phenomena that can be seen as ‘telepathic’. Led to develop some inalienable attachment to her analyst in the primary transference, the analysand found herself caught up in the contradiction of her visceral dread of dependency, which compelled her to interrupt the work in progress. She then began to work out her analyst's comings and goings and to run into him in public places, as if to be assured of his immovability. This phenomenon arose with high frequency as the effect of some idealization of the maternal object aiming to deny the spatiotemporal gap. The chance that the experience of rejection via indifference may be repeated also entailed the transferential unfurling of a fantasy involving a double, undifferentiation counterbalancing the lived experience of separation. Furthermore, a ‘telepathic’ dream occurred as confirmation of this twin relationship which illustrates the analysand's refusal to renounce her narcissistic object. Projective identifications, agglutinated ego nuclei along with primitive cross‐identifications could, among other concepts, account for such phenomena which are projective in nature yet real all the same. Such mechanisms could have the power to relay thoughts the moment undifferentiated parts of the ego – if not unborn parts of the self – were activated in a potentially symbiotic zone. Marked by a feeling of dispossession, the analyst's countertransference not only seemed to underscore this hypothesis, it also gave a partial explanation for it. Until the analyst could recognize his own nostalgia for a symbiotic relationship, he had to encourage the occurrence of those unexpected meetings which stemmed from a convergence between the transference and the countertransference.     

The supervisory field and projective identification1

Taking as their starting point the Baranger and Baranger model of the ‘psychoanalytic field’, the authors extend the notion of intersubjectivity in the analytic relationship to the supervision process. They use a practical example of a supervision to show the development of what they term the ‘supervisory field’, formed from the superimposition of the two fields of analyst‐patient and supervisor‐supervisee. They emphasize the interplay of projective identifications with objects emanating from the inner world of the patient that are relived in the analytic relationship and transposed to the supervisory field. They believe that the concept of the ‘supervisory field’ contributes to a deeper understanding of the unconscious processes occurring in the mind of analysand, supervisee and supervisor during supervision, particularly regarding the identification, comprehension and resolution of persistent disturbances in the supervisory process.     

On ‘the fear of death’ as the primary anxiety: How and why Klein differs from Freud

It is well known that Melanie Klein held the view that ‘fear of death’ is the primary source of anxiety and that her position is explicitly opposed to that of Sigmund Freud, who maintained that that fear cannot in any way or form be a source of anxiety. In a previous article on Freud's Inhibitions, Symptoms and Anxiety (Blass, 2013), the author argued that, counter to what is commonly portrayed in the literature, Freud's considerations for rejecting the fear of death as a source of anxiety were based on relational and experiential factors that are usually associated with Kleinian psychoanalysis. In light of this affinity of Freud with Klein a question arises as to the actual source of their differences in this context. The present paper offers an answer to this question. The author first presents some of her earlier findings on what led Freud to reject the fear of death as a source of anxiety and then turns to investigate Klein's considerations for accepting it. This takes us beyond her explicit statements on this matter and sheds new light on the relationship of her views regarding death and anxiety and those of Freud. In turn this deepens the understanding of the relationship of Freud and Klein's conceptualizations of the psyche and its internal object relations, pointing to both surprising common ground and foundational differences.     

Revisioning Fordham's ‘Defences of the self’ in light of modern relational theory and contemporary neuroscience

This paper explores the evolution of Michael Fordham's ideas concerning ‘defences of the self’, including his application of this concept to a group of ‘difficult’ adult patients in his famous 1974 paper by the same name. After tracing the relevance of Fordham's ideas to my own discovery of a ‘self‐care system’ in the psychological material of early trauma patients (Kalsched 1996 ), I describe how Fordham's seminal notions might be revisioned in light of contemporary relational theory as well as early attachment theory and affective neuroscience. These revisionings involve an awareness that the severe woundings of early unremembered trauma are not transformable through interpretation but will inevitably be repeated in the transference, leading to mutual ‘enactments’ between the analytic partners and, hopefully, to a new outcome. A clinical example of one such mutual enactment between the author and his patient is provided. The paper concludes with reflections on the clinical implications of this difficult case and what it means to become a ‘real person’ to our patients. Finally, Jung's alchemical views on transference are shown to be useful analogies in our understanding of the necessary mutuality in the healing process with these patients.     

‘Though he slay me,yet will I trust in him’: a critical reconstruction of Winnicott's theory of value

This paper extrapolates an outline for a theory of value from Winnicott's reflections on war in ‘Discussion of war aims’ (1940). The author treats Winnicott's discussion as an occasion for a critical reconstruction of his theory of life‐values. He discerns an implicit set of distinctions in Winnicott's reflections on war, including different orders of value (existential, ethical, and psychosocial); a distinction between maturity and necessity; and a yet more fundamental distinction between violence and brutality. The paper argues, on the basis of these distinctions, that Winnicott allows for an understanding of one's encounter with the enemy as an ethical relation. The main argument of the paper is that the ethical attitude underpins recognition of the enemy's humanity. On a more critical note, the author argues that Winnicott doesn't adhere consistently to the ethical attitude he presupposes, that in certain passages he privileges the maturity of combatants over the humanity of the enemy.     

The sandwich model: The ‘music and dance’ of therapeutic action

My premise is that a ‘layered’ approach is necessary to understand the process of exchanges that result in therapeutic change. I imagine these processes occurring in three layers – although the number of domains in which change is taking place is actually infinite – such as in a sandwich. The top layer, or top slice of bread of the sandwich, represents a broad view of the change process; it is non‐linear and includes the feature of uncertainty, a general principle of dynamic systems theory. The middle layer, or the meat of the sandwich, is explained by theories that are immediately and clinically useful to a therapist, such as psychoanalytic theories. These are primarily linear theories and use language and symbols to ‘tell a story of what happened’. The bottom layer, or bottom slice of bread of the sandwich, is the micro‐process; this layer includes the moment‐to‐moment patterns of coordinated rhythms that both communicate meaning and provide the essential scaffold for all higher‐level change processes. The micro‐process also requires a non‐linear theory to make sense of its variability and emergent properties. Taking a bite out of the sandwich will include a ‘polysemic bundle of communicative behaviors’ (Harrison and Tronick, 2011). I will illustrate the ‘sandwich model’ with the clinical case of the analytic treatment of a 5 year‐old boy.     

‘THEY KNOW HIM BY HIS VOICE’: NEWMAN ON THE IMAGINATION,CHRISTOLOGY, AND THE THEOLOGY OF RELIGIONS

Newman's gift to Catholic theology is the gift of ‘wisdom’: an ability to discern the shape of the whole, not by way of ‘generalized laws or metaphysical conjectures’ but through the ‘concrete’ and ‘living’ soil of the religious imagination. Newman's elemental trust in the religious sensibilities of non‐Christians and the revelatory roots of ‘natural religion’ proceeds from his view of the religious imagination as the experiential, pre‐verbal, and pre‐conceptual realm of contact between God and human persons always and everywhere. Above all Newman recognizes the salvific character of a life of personal holiness. In this respect the life of Christ exemplifies continuity and not radical interruption with countless human beings outside our usual ken who quietly lead lives of sacramental holiness. Bringing Newman into dialogue with contemporary theologians such as Jacques Dupuis, Roger Haight, Terrence Merrigan, and Thomas Merton, the author proposes four lessons for a theology of religions cast ‘under the light of Wisdom’.     

‘Caesura’ as Bion’s discourse on method1

The author contends that Caesura, one of Bion’s last works, can be read as the equivalent of Descartes’s Discourse on Method. In this compact and complex text, the dictate of ‘methodical’ and ‘hyperbolic doubt’– so called because it is taken to the extreme form of application to the faculty of thought itself – which, for Descartes, represents the fundamental principle of philosophical and scientific research, is reflected in the formula of ‘transcending the caesura’. Bion directs his attention successively to the pairs of opposing concepts that structure psychoanalytic discourse and demonstrates their paradoxical and non‐separative logic. The binary system of producing meaning is deconstructed through the systematic use of non‐pathological – i.e. not static but dynamic – reversible perspective. A viewpoint that appears natural, self‐evident and primary is plunged into crisis and proves to be founded on what the punctuation mark of the slash excludes. Yet the new point of view does not supplant its predecessor, but supplements it. The conceptual opposition is not overturned, but merely destabilized in such a way as to maintain a creative tension that generates new thoughts. By this technique of wrong‐footing the reader, Bion achieves what is tantamount to a Kuhnian revolution: the transition from Freud’s semiotic or evidential paradigm to an aesthetic one, centred on emotional experience – to a ‘science of at‐one‐ment’. Working with the antithetical concepts of censorship and caesura, the author illustrates some clinical implications of this radical shift.