Disbelief and Trust in Psychoanalysis - A Case Study

A case of unorthodox psychoanalysis with a 27-year-old woman, during the years 1994-1998 is presented. The patient, Silja, suffered from severe character neurosis with depression. She studied humanities at the University of Helsinki with poor results, because of severe inner demands of perfection. The therapy was unorthodox, because it was necessary to change the method a few times. After two years of psychoanalysis, a life-threatening crisis occurred in 1996, and I was obliged to take a more active role and even give direct advice concerning her studies. This was successful, and she could achieve her B.A., the lower university degree. The change of method was necessary to avoid suicide. In the end we could resume psychoanalysis and analyse what had happened. Suddenly in the summer of 1998 Silja's depression disappeared and her looks improved. Therapy ended in November 1998, when she was ready to try on her own. According to her both the holding and love and also the direct advice were the most important elements in her cure. After a three years' follow-up her condition had further improved, she was married, had a job and was expecting a baby.     

Learning from the patient: The East,synchronicity and transference in the history of an unknown case of C.G. Jung

This article presents the history of one until now unknown case of C.G. Jung: Maggy Reichstein. Born in Indonesia in 1894 in a very aristocratic family, she brought her sister to Zurich to be treated by Jung in 1919, and later she herself was in analysis with him. Jung used her case as example in his lecture in 1937 on the realities of practical psychotherapy, relating it to the process of transference and countertransference. Jung deepened his studies in Eastern psychology after a series of dreams she had, which culminated in the Yoga Kundalini Seminars. She was also the case presented in his article of 1951 on the concept of synchronicity. Jung wrote that her case, concerning synchronicity, remained unique in his experience. Jung also published some of her mandalas. He considered her able to understand his ideas in depth. Reichstein was for Jung an important case, which challenged and triggered his interests in different subjects.     

Rachel's Story: A Transpersonal Experience

This article presents a case study in which a client's transpersonal/religious/spiritual experience facilitated the achievement of her counseling goal. Through the paranormal experience, she resolved several of her conflicts, including a new appreciation of the church from which she had become estranged.     

Learning to read with underdeveloped phonemic awareness but lexicalized phonological recoding: a case study of a 3-year-old

Case studies on very precocious readers are useful for examining what sources of knowledge and processes are necessary in the acquisition of reading. This is a case study of a 40-month-old child with a word reading age of 8 years 6 months. Tests indicated that she had no phoneme awareness beyond initial phonemes, and that her productive spelling was undeveloped. In reading she was highly proficient at rapid phonological recoding, both by correspondences that were contextually sensitive and those that were not. The former determined her high level of irregular pronunciations for irregular consistent non-words. Experiments indicated that she had well-specified orthographic lexical representations. It was concluded that her phonological recoding was an implicit process based on sublexical relations induced from her lexical representations rather than explicitly taught letter-sound correspondences. The implications of the results for major developmental models of reading acquisition are examined.     

Sonya turned her skin outside in

In the case of a young woman, it was evident that she had difficulties in approaching her pregenital experiences during analysis and that she had defended herself against pregenital anxiety. While these defences were aimed at denying and repressing early oral and bodily fantasies end experiences, they had also influenced and inhibited her subsequent bodily and genital development. Psychosomatic symptoms had both absorbed and represented archaic feelings and fantasies which had not found a more precise mental expression. Consequently, her female inner space had been repressed and excluded by skinerotic defences.     

A physically handicapped teenager is helped to own her body

In this paper I am presenting my work with a 15-year-old girl, Nina, who was born premature with congenital feet deformities. Her twin had died at birth, and Nina spent eight weeks in a Special Care Baby unit. She had also suffered from bronchial asthma, which was under control during the months she was in therapy with me.

An attempt to overdose, and a letter she had written to a teacher, brought Nina to our services and to individual psychotherapy. The weekly sessions gave Nina the opportunity to elaborate her mourning for the dead twin and to face her physical problems more realistically. She had coped with these by idealising a beautiful body and giving it, in her phantasy, to her dead sister for whose death she felt responsible. Her identification with characters from horror stories, of which she was an avid reader, was a key to understanding how she felt trapped in her deformed body, to which she would refer in the phrase ‘It doesn't bother me.’ The working through of her feelings of guilt, anger, and envy enabled her to lessen the split and to own her body.     

Kristallnacht: Experiencing Nazi Germany

Lore Zeller, long-time friend and proofreader of Psychological Perspectives, is a first-time contributor to our journal—or any journal. Lore is also something of an icon at the bookstore of the C.G. Jung Institute of Los Angeles, where she has worked, dispensing books and wisdom, for over twenty years. She is eighty-seven years old. Over the past few years she has translated all of the correspondence from her German-Jewish parents and in-laws after she, her husband, and their two-year-old son fled their hometown of Berlin to seek safety in the United States via England. Within a few years of their escape, both sets of parents had perished in death camps. As survivors in Los Angeles, her husband and she helped found the Jung Institute here.

When she mentioned that she had been working on this paper, it was suggested she send it to us for review. After giving the idea some consideration, she eventually overcame her innate shyness — the results of which can be seen in the riveting story that follows.

Lore Haber Zeller is honoring the memory of her parents by using her maiden name with her married name for this publication. —Gilda Frantz     

The Atonement of the Alleged Perpetrator's Daughter: Understanding of Model Scenes and Space Attachment in Analytical Dance Therapy

In this rich paper the analysand Annabelle is sent by her analyst to the dance therapist who reports in great detail how Annabelle manages to throw off and—to a certain extent—integrate not only her own life-long misunderstanding but also those of her parents. The reason for Annabelle's referral was straightforward: the analysis had ground to a halt. Words no longer reached her. The reader is reminded of the emotive-relational-motor clusters described in Chazan's and Shahar-Levy's papers. Body image distortions and space misperceptions curtailed this patient's ability to function. When she began to bring her distress to her analytic dance therapy sessions, she could not associate verbally but made use of props her therapist had in store. As she slowly progressed toward true symbolization and expression, her therapist found herself embroiled countertransferentially. The patient's long-suffering mother was remembered as someone who would, or could, only give partial information about the family's history. The father had been a Nazi and was now blamed for all the suffering the family had lo endure. This fact resonated both with Annabelle's analyst and the dance therapist who managed to take a long look at their own family's records during that troubled time.     

Impediments to the development of attachment

The function of the mother's reverie, as described by Bion, is viewed as a psychological parallel, following birth, to the physical function of the placenta.

Clinical material from psychotherapy with a 3 1/2-year-old girl illustrates that, as long as she maintained the delusion of being attached to her mother's body by a physical placenta, she was hindered from learning to experience herself as a separate individual and from developing normal feelings of attachment and grief over loss.

She was referred soon after her parents' separation when she showed a lack of reaction to the loss of her father. The material suggests that at the time of separation from her father she regressed to an earlier stage where there had already been a failure to work through infantile separation and individuation from her mother

The material reveals stages of her emergence from an illusory state of union, into one in which she could increasingly tolerate her separate existence. There followed an enrichment of her psychological means of communication through the use of imagination and symbolic play. She also became more receptive to her therapist's communications and could increasingly use psychological support to share and face inner pain.     

An Analysis of the Effectiveness of the Intervention

SUMMARY

In this chapter, I examine the specific problem Betty had with her children because, in many ways, it represents the problems most of the volunteers had with their children. Her problem was the most extreme among the participants, and she involved the other volunteers in helping her look for a solution. The vignette that follows comes from my field logs, and it is followed with a layered response from Betty's peers. The vignette offers a close look at Betty's problems with her daughters and the dilemma she experienced in relation to coming to work when her children needed her. Betty told her story to Esther, Dolores, and me one morning in the dayroom.     

“Is Our Daughter Crazy or Bad?”: A Case Study of Therapeutic Assessment with Children

In this paper we present a new model of intervention with documented efficacy that combines psychological tests and assessment methods with therapeutic techniques to promote change in clients. We will discuss Therapeutic Assessment of Children and their families (TA-C) through the case of a 4-year-old girl, Clara, and her family. Clara’s parents were distressed by her uncontrollable rage outbursts and feared she might be “crazy”. The treatment helped to shift the narrative the parents had about Clara and give new meanings to her behaviors. We describe in detail the steps of the assessment and provide a theoretical discussion of the therapeutic processes involved.     

一例使用态度治疗对大学新毕业生神经衰弱的案例报告

大学新毕业生工作适应不良是常见的现象,也是目前大学生就业担忧和顾虑的问题之一。这位刚毕业进入工作岗位的求助者出现了明显的抑郁症状,且在咨询过程中发现其抑郁的根源可以追溯到童年时期,并且有深刻的家庭教育文化背景。诊断为神经衰弱,采用态度治疗和心理稳定化技术后,经过两个月的咨询,求助者的神经衰弱症状基本消失,对自己和未来的态度基本明朗。一个月后电话回访,显示咨询效果良好。     

Infant psychiatry clinic grand rounds. Unresolved grief: A two-year-old brings her mother for treatment

Rebecca was a 2 ¹/₂ -year-old Caucasian female who was brought to the Infant Psychiatry Clinic by her 28-year-old widowed mother. Her mother's chief concern was around parenting issues as well as how to explain to Rebecca the death of her father. This loss occurred when Rebecca was 6 months old and was a source of great pain and unresolved grief to her mother. Central to this case was the chaotic history of Rebecca's mother, who was a victim of incest from the time she was 13 until she was 23 years old. Both of her parents struggled with chronic alcoholism during much of her childhood. It appeared that a factor precipitating the mother's request for help was her struggle to move out of her own mother's home. This outpatient Infant Clinic case involved two primary goals: (1) the assessment of the parent-child relationship and (2) the development of confidence in this “good enough” mother. Vitally important to the process of treatment was the mother's modulation of timing and frequency of sessions. The issue of pacing was carefully monitored as this mother could have been overwhelmed by delving precipitously into her incestuous history. The use of a structured videotape interview to address mother-child interaction and parenting issues was particularly helpful. Referral to an AlAnon group provided the mother with social support as she separated herself from her alcoholic mother and moved toward autonomy in her own parenting role.     

Simone Weil’s Passion Mysticism: The Paradox of Chronic Pain and the Transformation of the Cross

Simone Weil’s theology is deeply connected to her experiences with chronic pain. Pain is paradoxical in that it is an essentially private phenomenon yet it simultaneously demands to be shared with another. Weil’s life and thought exemplify both aspects of this paradox, demonstrating how her pain alienated her from her own body and from others, and how her thought found full expression as she attempted to share experiences with pain. Weil’s experience of pain was transformed in her passion mysticism, the deep connection she felt with the crucified Christ. In this connection, the most unbearable aspect of her pain, the threat, which it presented to her very self through annihilation, was absorbed into the cross and transformed by God’s love. While this did not necessarily diminish Weil’s pain, the meaning it had for her as a person was transformed through an encounter with Christ crucified, in which she experienced God’s suffering along with her.     

Counterfactual discrimination

In counterfactual cases of discrimination, an agent would have treated someone worse had circumstances been different such that instead of being a member of her actual group, she was a member of some other group. The case for considering such cases to be genuine cases of discrimination is bolstered by the fact that we are inclined to say that cases where an agent would have treated someone better had she been a member of another group are discriminatory. But I argue that the cases are relevantly different: in one kind of case, but not the other, a person is harmed. I then consider and reject a number of objections to this suggestion.     

Risk, Rights, and Restitution

In “Imposing Risks,” Judith Thomson gives a case in which, by turning on her stove, she accidentally causes her neighbor’s death. She claims that both the following are true: (1) she ought not to have caused her neighbor’s death; (2) it was permissible for her to turn her stove on. In this paper it is argued that it cannot be that both (1) and (2) are true, that (2) is true, and that therefore (1) is false. How this is so is explained, and the implications of this position regarding the relation between rights and duties is explored.     

Evelyn Underhill (1875–1941): mysticism and worship

This article focuses on some themes in the work of Evelyn Underhill (1875–1941). It is now over a century since she began work on the first version of Mysticism (1911). She was a pioneer not only in the study she undertook for this book, but in the specifically Christian theology she was bold enough to work out from it, with Christ in person the paradigm mystic. The Latin Mass of her day she deemed both as recapitulating Christ's own experience, as well as re-presenting the stability and growth of his ‘Body’ present at the Eucharist. Once recommitted to the Church of England in 1921, at a time of liturgical revision and in a deeply troubled political era, her concentration on Christ's sacrifice led her to embrace pacifism as the world lurched towards World War II. Her theological work, summed up in her final major book Worship (1936), reveals her continuing preoccupation with the question of how Christology integrates with liturgy, and therefore with the living of a distinctively Christian life.     

Psychosomatic aspects of Parkinson disease

In the case of a 58-year-old female patient suffering from Parkinson's disease an accompanying psychotherapeutic treatment was applied because renewed decline of her condition had set in despite an initial success with an L-Dopa therapy. The positive approach disclosed new starting points to the patients which influenced her emotions and led to an improvement of her discomforts. With Positive Psychotherapy the patient got to know an instrument with which she could reappraise existing microtraumas and could better deal with conflicts in her psychologic and social surroundings.     

A Single Intervention: A Visit to the Family

The following letter is reported unchanged except for disguised names. Concern with repairing disrupted relationships of adult members of a family with their own parents has been a matter of growing interest to a number of family therapists; Bowen (1), Boszormenyi-Nagy (2), and Framo (3), among others have stressed the importance of sending family members back to their families of origin. This report makes no effort to formulate the process in any particular theoretical framework (i.e., as reestablishing connectedness after an “emotional cut-off” or rebalancing a ledger of fairness, or whatever) but is intended only to illustrate the kind of outcome one may hope for in prescribing such a maneuver. It is offered simply as a clinical note. The letter needs little prefatory explication. Mr. Jack Newburgher had been a patient in psychoanalytic treatment for four years, with a quite successful outcome. On two occasions in the course of his therapy a joint session had been held with Mr. Newburgher and his wife, Muriel, when changes in his behavior had precipitated crises in the marital relationship. His therapy had terminated about two years before the visit referred to in the letter. Mr. Newburgher had called and asked for a joint consultation with Muriel about an acute family problem they were experiencing. Some — not all — of the background material was described, not nearly as coherently as it is reported in Muriel's letter, but in sufficient detail to make it plain that she was in distress about having to withdraw completely from her parents and that their family was in disarray as a consequence of her distress. The acuteness of the emotional disturbance, against a background of a lifelong adversary relationship between Muriel and her father and a history of ten years of illness on her fathers' part, suggested that the distress was the product of Muriel's anxiety and guilt over a decision to cut herself off completely from her parents. As a consequence, Muriel was urged to visit her family of origin, with the caveat that she might indeed discover them to be malignantly self-centered people indifferent to their effect on her and her family, but that she would at least have the gratification of having tried. The reference to “speaking French” was to the therapist having suggested that, on the other hand, she might find that her parents expressed their feelings in a different modality from her definitions of how feelings should be expressed, much as though their native tongue were French and she were insisting that they must speak to her in English.     

Euthanasia in psychiatry can never be justified. A reply to Wijsbek

In a recent article, Henri Wijsbek discusses the 1991 Chabot “psychiatric euthanasia” case in the Netherlands, and argues that Chabot was justified in helping his patient to die. Dutch legislation at the time permitted physician assisted suicide when the patient’s condition is severe, hopeless, and unbearable. The Dutch Supreme Court agreed with Chabot that the patient met these criteria because of her justified depression, even though she was somatically healthy. Wijsbek argues that in this case, the patient’s integrity had been undermined by recent events, and that this is the basis for taking her request seriously; it was unreasonable to expect that she could start again. In this paper, I do not challenge the Dutch euthanasia criteria in the case of somatic illness, but I argue that both Chabot and Wijsbek are wrong because we can never be sufficiently confident in cases of severe exogenous depression to assist the patient in her irreversible act. This is partly because of the essential difference between somatic and mental illness, and because of the possibility of therapy and other help. In addition, I argue that Wijsbek’s concept of integrity cannot do the work that he expects of it. Finally, I consider a 2011 position paper from the Royal Dutch Medical Association on euthanasia, and the implications it might have for Chabot-style cases in the future.