The concept of psychical trauma: A bridge in interdisciplinary space1

The concept of trauma currently occupies a central position in interdisciplinary dialogue. Using the concept of psychical trauma as a bridge, the author attempts an interdisciplinary dialogue with psychiatry, biology and neuroscience. Beginning with the concept of psychical trauma in Freud, the author reviews the evolution of Freud's thinking, and links it with the ideas of Ferenczi and post‐Freudian psychoanalytical authors. From a different framework, he considers the present state of research on post‐traumatic stress disorder in current psychiatric nosography and attempts an interdisciplinary approximation to the concept of psychical trauma. Interesting ideas like the traumatic situation, trauma spectrum and psychopathological spectrum emerge, which enable a better understanding of the concept of psychical trauma through its relatedness, as a bridge connecting a broad psychopathological range extending from normality to psychosis. The ensuing possible relative loss of nosographical rigour is more than compensated by the resulting increased understanding and enlarged therapeutic possibilities. In the second part of the paper, the author attempts a dialogue with neuroscience, taking into account new advances in current research on emotion and memory, and making them compatible with the psychoanalytical concept of trauma. In this sense, the paper underlines the importance of emotion and crucially of memory, regarded as a fundamental axis of the subject explored in this paper. Here a substantial distinction which is pertinent for analytical work appears: declarative memories versus non‐declarative or procedural memories. In a concluding discussion the author argues that, taking into account the implications of these current notions regarding a number of theoretical and technical aspects, psychoanalysis currently holds a privileged position, both in its potential for prevention and regarding the treatment of patients, in so far as, through interdisciplinary dialogue, psychoanalysis can be receptive to and be enriched by the contributions of other disciplines, just as it enriches them with its own contributions.     

Beyond the image

By imposing itself as the dominant model of modern medicine, the biomedical model leaves little or no place for the psychical/subjective dimension of illnesses. The author presents a clinical case illustrating the essential contribution psychoanalysis can make to understanding the causes of a serious neurological disorder of indeterminate origin, its psychic determinism and its unconscious dimension. This original contribution argues in favour of the idea that understanding the development of neurological disorders associated with an unexplained lesion cannot be reduced exclusively to the organic level, and must not overlook the notion of unconscious. More generally, it emphasizes that body and mind form an integrated inseparable unit, thus breaking with the traditional dualistic conception of the human being.     

Configurations of time,the body,and verbal communication: Temporality in patients who express their suffering through the body

This paper focuses on the study of temporality used as a clinical pointer to processes of affect regulation in patients who express their suffering through a discourse driven by bodily allusions. Differences between symptoms revealed by body language that conveys an experience of conflict (psychoneurotic symptoms) and somatizations are reviewed. Somatization is examined as a benchmark for the failure to resolve states of tension. The body in the session is conceptualized as a speech event. The body is considered as a psychical construction organized in the exchanges with a fellow human‐being. It is thus established as a support for subjectivity. Two discourse registers are described: the discourse of the evoked body and the discourse of the perceived body. The study of Greek mythology allows us to distinguish two different types of temporality : Chronos and Kairos. Chronos represents chronological whereas Kairos subjective time. Both are present in the subject; but if greater mental disorganization supervenes, Chronos predominates as it paves the way for a defence against suffering, designed to avoid the unbearable meaning of ceasing to be. Adherence to one or other mode of temporality signals different conceptions of analytic work. The topics addressed are illustrated by various clinical vignettes .     

Who Dares,Speaks: Critical psychotherapy and the poetics of suffering

It is proposed that a critical psychotherapy could be developed by combining ideas from psychoanalysis with concepts from poetics, as Lacan originally suggested. Taking a narrative and personal style, and using examples of two men silenced by trauma and a clinical vignette, the author combines Laplanche’s psychoanalytic concept of fourvoiement with some examples of the poetics of ambiguity as an example of how such a critical psychotherapy could develop. Studying how words express more than their literal meaning is combined with the idea that we are continually going astray from the original decentring concept of the unconscious that Freud introduced to psychotherapy.     

Disablism,Identity and Self: Discrimination as a Traumatic Assault on Subjectivity

The international disability movement has favoured a political strategy which relies on historical materialism, eschewing subjective aspects of disability. From this perspective, rehabilitationist and psychological constructions of the subjectivities of disabled people are rejected as victim‐blaming pathologisation. Recently, feminist work has begun to explore psychological aspects of the lives of disabled people, within various paradigms. Drawing loosely on ideas from psychoanalysis, this paper explores the impressions left on subjectivity by symbolic assaults often associated with the disabled identity, thus connecting intra‐psychic and socio‐political arenas. The conceptual ideas employed emerged from psychoanalytically oriented group psychotherapy with severely physically impaired adults performed by the first author. The authors argue that the ongoing nature of socially engendered trauma suffered by disabled persons perpetuates marginality, through internalization of self‐punitive psychological defences, which corrode the entitlement necessary for an assertive political movement. Surviving in a world which continually questions one's belonging, leaves little personal resources for debunking oppressive social phenomena. Material as well as discursive changes are essential if internal narratives are to be reclaimed, overcoming the subjective imprints of ongoing social trauma. Copyright © 2015 John Wiley & Sons, Ltd.     

Working through the question of the phallus to the other side commentary on Bracha Lichtenberg‐Ettinger's paper

The work of Bracha Lichtenberg‐Ettinger implicates psychoanalysis as a political, clinical, and aesthetic project and draws theoretically from each of these domains. As part of her challenge to psychoanalysis, Lichtenberg‐Ettinger questions the Lacanian and Freudian preoccupation with the phallus. She queries the degree to which the psychical amplification of the phallus remains blindly tied to the penis and a masculine incarnation. She supplements this phallogocentric positioning with the concept of a matrixial subjectivity grounded in the intrauterine coexistence of mother and child. The womb and its possibilities indicate another relationship between the I and the non‐I based on forms of relating that do not revolve around the dichotomy of exclusion and merger. As part of her critique of phallogocentrism, the author repudiates the absoluteness of a phallic presence versus castrated absence and the binaries in conceptualization to which this configuration leads.

The following commentary is deeply in sympathy with this project and appreciates the great reach of Lichtenberg‐Ettinger project. Her project requires great care, however, as it tries to redefine formations of subjectivity through the Real of bodily difference. Further, it is not fully clear how matrixial subjectivity is situated with respect to certain questions raised by the phallus. More specifically, if the phallus represents a moment that structures one's relationship to speaking and to repression, a clearer articulation of the place of these moments in a matrixial subjectivity might create a more productive dialogue with the most innovative aspects of Lacanian psychoanalysis.     

Consultation from the Consultant's Perspective

This presentation examines psychoanalysis from the standpoint of fictionalism. Fictionalism maintains that all aspects of human experience are creations of imagination, that mind‐made realities constitute for human beings their sole realms of existence, and that it is only about these realms that anything at all can be known. No other knowable realities exist. Fictionalism is an aesthetic orientation that considers these imaginative constructs artistic renderings that are aesthetically formed and experienced, and that must be comprehended and evaluated aesthetically. Furthermore, it regards these artistic constructs as works of fictions—invented textual realities woven by the perpetual interplay of multitudinous signifiers into ever‐changing psychical configurations. From a fictionalist's perspective, “truth”; becomes, paradoxically, a manifestation of fiction. The term fiction intends not only to underscore the radical divergence of fictionalism's philosophical perspective from realism's but to emphasize its reinterpretation of the materialities realism posits as also inventions of imagination. Fictionalism does not, however, simply reverse the hierarchy and valuation of the real/fiction dichotomy but modifies the very understanding of this dichotomy's conceptualization and, by reinscribing realism as itself a form of fiction, even diminishes some of the antagonism inherent in this age‐old rivalry. Rooted deep in psychoanalytic tradition, realism's role has been complex, inconsistent, contradictory, and often embarrassingly naive. Fictionalism contests the many postulates of realism that psychoanalysis has incorporated so fundamentally into its theory and technique. Focusing primarily on transference, I argue not only that this phenomenon has been misconstrued within a realist framework but that most of the other features of psychoanalysis have been as well because psychoanalysis is basically a fictional enterprise.     

Bound Together: How Psychoanalysis Diminishes Inter-generational DNA Trauma

The American Journal of Psychoanalysis - The concept of intergenerational transmission of trauma plays a fundamental role in psychoanalysis. While it is known that intergenerational trauma can be...     

Politics,Identity, and Social Change: Contested Grounds in Psychoanalytic Feminism

This essay engages in a debate with Nancy Fraser and Dorothy Leland concerning the contribution of Lacanian-inspired psychoanalytic feminism to feminist theory and practice. Teresa Brennan's analysis of the impasse in psychoanalysis and feminism and Judith Butler's proposal for a radically democratic feminism are employed in examining the issues at stake. I argue, with Brennan, that the impasse confronting psychoanalysis and feminism is the result of different conceptions of the relationship between the psychical and the social. I suggest Lacanian-inspired feminist conceptions are useful and deserve our consideration.     

Biographical truths and their clinical consequences: Understanding ‘embodied memories’ in a third psychoanalysis with a traumatized patient recovered from severe poliomyelitis

The relationship between ‘narrative’ and ‘historical–biographical truth’ in psychoanalytic treatment has become the subject of many controversial debates in recent years. Findings of contemporary memory research have lead to great scepticism as to whether therapists are able objectively and reliably to reconstruct biographical events on the basis of their observations in the therapeutic situation. Some authors even claim that psychoanalysts should concentrate exclusively on observing the here and now of the patient′s behaviour within the transference relationship to the analyst. In this paper it will be discussed whether the baby has been thrown out with the bathwater in this debate. Centred around the insights from a third psychoanalysis with a patient who suffered from a severe case of childhood polio, the hypothesis will be discussed that working through the traumatic experience in the transference with the analyst, as well as the reconstruction of the biographical–historical reality of the trauma suffered, prove to be indispensable for a lasting structural change. Integration of the trauma into one′s own personal history and identity is and remains one of the main aims of a psychoanalytic treatment with severely traumatized patients. The reconstruction of the original trauma is indispensable in helping the patient to understand the ‘language of the body’ and to connect it with visualizations, images and verbalizations. The irreversable wounds and vulnerability of his body as the ‘signs of his specific traumatic history’ have to be recognized, emotionally accepted and understood in order to live with them and not deny them any longer. Another important aspect in psychoanalysis is to develop the capability to mentalize, in other words, to understand the intentions of central (primary) objects related to the trauma. The concept of ‘embodied memory’ might be helpful in understanding precisely in what way ‘early trauma is remembered by the body’. Observing in detail the sensory‐motor coordinations in the analytic relationship enables one to decode the inappropriate intensity of affects and fantasies which match the original traumatic interaction and are revealed as inappropriate reactions in the present, new relationship to the analyst.     

Zum Problem des Traumabegriffes in der Psychoanalyse

The concept of psychic trauma has undergone an inflationary extension in recent years. Various authors cite real stress situations as the reason for psychical disorders and no longer regard them as part of a syndrome (“Psychotraumatology”). Trauma is expressly raised to the level of an influencing factor with an absolute status as a pattern that serves to explain psychical experience and behavior with no need for further explanation or reflection. In the present article, the author describes and criticizes these trends in research, and as a reminder to the existence of alternative models he considers the view elaborated by Fenichel, in which trauma can be understood not as the reason for certain after-effects, but as the result of various influencing factors. On the basis of the studies by Hillel Klein and the works of Jean Améry, it is shown that even extreme stress situations are processed by the afflicted persons as life experiences of their own. These drastic real events are analysed expressly not only with regard to the pathogenic effect by which they flood the subject’s ego. It is shown that these experiences encounter an individual, specific and highly varied subject by virtue of his constitution and life history, and are processed in an individual way by him. The assumptions about a regularly occurring, distinct and supraindividually valid effect of real events, therefore, have to be rejected. It is the author’s conviction that the use of the term trauma is unacceptable if the analysis of effects of real events fails to take into consideration the individual’s personality structure and life experience and the perceptual attitudes and sensitivities determined by them. The author calls for applications of the term trauma to be reconsidered in view of the ways in which its meaning has been stretched and overdetermined as described here.     

SOME THOUGHTS ON PSYCHOANALYSIS AND ETHICS

The author attempts to establish a framework for understanding the contribution of psychoanalysis to ethics through examining the work of certain philosophers, especially Kant. After reviewing the development of Freudian thought and going beyond the ‘psychoanalysis and/or psychiatry?’ question, he asserts that the space of the psychoanalytical cure revolves around an ethical problem. Thus, the limits of analysis should be determined by the subject's capacity for developing a structure of belief in the unconscious, with the concomitant capacity to go beyond equivocation in respect of an ethical conflict that underlies all cases where psychical suffering is manifested. Indeed, only human beings are called upon to deal with an ethical paradox “equally a logical one”which could be stated thus: there is Good in Evil and Evil in Good. This ethical paradox is the consequence of human subjection to the constituent laws of the Oedipus complex, which distances the human being, in his/her dealings with Evil and with Good, from any naturalist stance. In respect of the cure, then, we must take into account that Evil does not proceed from any particular drive‐based characteristic, but is rather the expression of specific subjection to an unconscious Other, towards which it directs its affects. Finally, the author proposes a principle that emerges from the preceding discussion: let us not impute to or place in the Other our own subjective splitting or pain at existing.     

The specifi city of torture as trauma: The human wilderness when words fail1

The author attempts to situate the specifi city of torture‐understood as the product of political violence and of totalitarian states‐within the historical framework of the concept of trauma in psychoanalysis. When the mind and social ties are simultaneously affected, the intrapsychic and transpersonal aspects of the suffered damage intertwine in a complex and unique web. The author aims to dismantle the notion of victim, considering it both stigmatizing and inaccurate. The goal is not just to identify the after‐effects and the disabilities suffered by those affected by torture, but also to integrate their experiences and their narratives into a life project. Rather than individual psychopathology, this essay refl ects upon those phenomena of suggestion and hypnosis that are at work in human groups under ordinary conditions and that are exacerbated under social crises, following the Freudian axis developed in Group psychology and the analysis of the ego.     

‘Yes,we have bananas!’1

This paper takes as its starting point ‘identifying markers of Latin American psychoanalysis’. The authors see this theme as a compromise between two diverging approaches. On one hand, the conference at which the content was presented provided the opportunity for Latin American psychoanalytical thinking to be discussed and, as a reward to the best papers, to be published. On the other, both the conference and the reward are more indicative of the observer's biases than of the object's peculiarities. The authors consider that the conference mistakenly focused on the search for minor differences (secondary identifi cations) instead of looking for invariances (identities). Considering that uncertainty, pluralism and complexity are issues relevant to the whole of psychoanalysis in its current stage of development as a scientifi c discipline, the authors think that treating these elements as ‘identifying markers of Latin American psychoanalysis’ is evidence of prejudice brought about by a coloniser‐colonised relationship. To develop their argument, the authors discuss a paper on editorial criteria by Tuckett as a clinical case, and use an episode of Brazilian history as further illustration. They address issues such as conformity to cultural patterns; the search for certainties and proofs; the domination of some groups over others; and editorial power‐more specifi cally, its infl uence on the acceptance or rejection of scientifi c ideas. These issues have distracted attention away from the fundamentals of psychoanalysis by introducing other, extraneous aims. Publication plays a key role in feeding a possibly vicious circle wherein only a small proportion of scientifi c contributions manages to reach a wide audience‐exactly those contributions that conform to established patterns. The act of publication turns that portion into offi cial knowledge, while unpublished ideas become increasingly excluded.     

Working with severely traumatized,chronically depressed analysands

Surprisingly often in the psychoanalyses of chronically depressed patients, depression represents an unconscious attempt to psychically cope with unbearable psychic pain following severe traumatisation: dissociative states, a chronified psychic state of shock, a disappearance of emotions, an emptying of the self and the object relationships, as well as a disappearance of the psyche in the body are among the possible consequences. The treatment of these difficult groups of analysands can also frequently bring analysts to the limits of the endurable. Often related to this is the repeated danger of denying the trauma, and a re‐traumatisation of the analysand in the analytic situation. The lecture discusses the fact that in comparison with other therapeutic approaches, psychoanalysis has a highly differentiated conceptualisation of the psychic determinants and the treatment of chronic depression at his disposal. However, in order to retain its creativity and innovation as a scientific discipline and to be thus perceived in the non‐psychoanalytic world, it must constantly further develop its conceptualization by way of systematic and extra‐clinical research – as is witnessed in the insufficient conceptual account of severe traumatisation during the genesis of chronic depression. In this connection, several exemplary examples from extra‐clinical studies in the sphere of psychotherapeutic research, neurobiology, epigenetics and embodied cognitive science will be accounted for. As will be treated in the final part of this paper, of no less importance are the conceptualizations in clinical research on psychoanalysis, which are based on meticulous, careful analyses of trauma reactivation in the transference, and understanding and working through them in the analytic relationship.     

Determinism, possibility, and ethics

This essay reexamines the age-old "determinism-free will" problem from a psychoanalytic perspective. The first section recapitulates the author's (1985) earlier argument on the nature of causation in psychoanalysis; the second part examines the compatibility of determinism and freedom; and the final section looks at the ethical ramifications of the issues at hand. The author exposits his adherence to universal determinism and attempts to answer the question, "What sort of possibility and ethics are permitted in a deterministic universe?"     

Originary Temporality and Existential Commitment: A Defense of Heidegger's A Potiori Claim

Being and Time's fundamental ontoogy and existentialism both rest on the A Potiori Claim, which states that originary temporality is, although non‐sequential, a genuine and basic concept of time from which we derive our more ordinary, sequential concept of time. In this paper, I develop a new reading and defense of this claim against the readings of William Blattner, which ties originary temporality too tightly to the particular roles and identities we live out and must therefore find Heidegger's project a failure, and Tony Fisher, who implies that our various roles and identities hang together in time in a merely accidental and non‐rational way. On my reading, originary temporality is the structure of Dasein's characteristic activity of existential commitment. Through this activity, we each work out, in our own case, what it takes to embody the capacity for sense‐making, at all. Here, the non‐sequentiality of originary temporality reflects the way in which commitments are revised and sustained through time, while the sequence of nows derives from our need to embody our commitment in a single life that negotiates among the practical demands that our various identities make of us.     

On the early history of male hysteria and psychic trauma

This paper discusses the influence of Jean-Martin Charcot's views on Sigmund Freud's early theory of hysteria and the notion of psychical trauma. We consider the early history of both psychical trauma and male hysteria, for in Charcot's view traumatic hysteria and male hysteria are identical. Freud's two 1886 lectures on male hysteria, delivered after his return from Paris, are crucial to the subject because they present Freud's first impressions of Charcot and his teaching. Some of the ideas presented in the two lectures foreshadow Freud's later generalization of the etiological role of trauma and his theory of the role of psychical trauma in the genesis of hysteria; that is, each hysterical symptom is due to a psychical trauma reviving an earlier traumatic event—the so-called principle of deferred action (Nachtraglichkeit). Several arguments substantiate the thesis that Freud's notion of psychical (sexual) trauma was developed in reference to Charcot's notion of traumatic hysteria, and that the early psychoanalytic theory of psychical trauma is clearly indebted to Freud's encounter with Charcot's male traumatic hysterical patients. The discussed Freudian development points out the major role of (physical) traumata in eliciting psychopathological pictures and in this way is of definite historical relevance for the present-day discussion on the traumatic nature of the so-called multiple personality syndrome and other dissociative disorders, and post-traumatic stress disorders.     

Psychoanalysis,science, and art: Aesthetics in the making of a psychoanalyst1

This paper critically examines the relationship of psychoanalysis to science and art. Its point of departure is Michael Rustin's theorizing. Specifically, in considering the possibility of a psychoanalyst's having an aesthetic orientation, the author analyses: 1) the difficulty of there being any connection between psychoanalysis and science because science's necessarily presupposed subject‐object dichotomy is incompatible with transference, which, beginning with Freud, is basic to psychoanalysis; 2) the complex relationship between psychoanalysis and aesthetics using Maurice Merleau‐Ponty's philosophical perspective as well as Luigi Pareyson's theory of aesthetics; 3) the Kantian foundations of the psychoanalytic notion of art as the ‘containing form of subjective experience’ 4) intersubjectivity, without which clinical practice would not be possible, especially considering matters of identity, difference, the body, and of sensory experience such as ‘expressive form’; 5) the relationship of psychoanalysis and art, keeping in mind their possible convergence and divergence as well as some psychoanalysts' conceptual commitment to classicism and the need for contact with art in a psychoanalysts's mind set.     

The jouissance of the other and the prohibition of incest: a Lacanian perspective

The authors describe how Lacan diverged from classical Freudian concepts to arrive at an alternative model of psychoanalysis. In a discussion that also addresses the concept of the mirror stage and Lacan's use of language, the authors show how the Lacanian concepts of jouissance and the prohibition of incest contribute to this model, which can be successfully applied to the psychoanalytic treatment of more seriously disturbed patients. A clinical vignette is presented to illustrate the latter point.