The Paradoxical Place of Enactment in Psychoanalysis: Introduction

Ringstrom's “comparison of relational psychoanalysis and intersubjective systems theory” exhibits a category mistake that renders the core of his argument logically incoherent.     

Waking Dreams

Although they have been infrequently reported in the literature, spontaneous visual images in therapy sessions have a long history in psychoanalysis. In this paper, I present three clinical examples in which patients experienced such visual images. These images were spontaneous in that they felt like they emerged “out of the blue,” from another self-state. The person experienced the images while knowing they were images; for this reason, they might be called “waking lucid-dreams.” These waking dreams provided a channel for the expression and communication of emotional states otherwise excluded from our relationship, from the “me–you” patterns that had prevailed at the time of the images. These images, and their potential role in personal growth, have something to “say” not only about relatedness, meaning-making, and referential activity, but also about affect regulation and mentalization.     

The Last Time: Commentary on Paper by Stuart A. Pizer

Pizer presents poetic details of his patient's complex therapy and analysis. This commentary examines one moment in the treatment that may have violated the potential in potential space. The question is raised as to the impact of such a moment.     

The Analyst's Uses of Theory and the Theory the Analyst Uses: Reply to Commentary

Where Slochower focuses her discussion on the analyst's multiform uses of theory, I focus my response on how the theory we each use informs a quite different way of understanding what is at issue for my patient in the apparent disengagement that marks her quest for help. More broadly, I consider how the theoretical perspective Slochower brings to her rendering of my clinical understanding and position makes for a reading that diverges significantly from my own view of what transpired in the treatment process I present.     

Applications,Implications, Complications: Reply to Reviews by Elkind,Gerson, and Levine

The author appreciates the careful reading and thoughtful reviews by Sue Elkind, Sam Gerson, and Howard Levine. Elkind's review particularly captures and articulates many of the key ideas in the book Building Bridges: The Negotiation of Paradox in Psychoanalysis and creatively applies concepts of negotiation, paradox, an inherently multiple “distributed self,” and metaphor in her own work consulting on treatment impasses. Gerson incisively focuses on the core idea of recognizing, accepting, and bridging differences and contradictions in personal, and national, perspectives; he also articulates an understanding of the attempt of relational analytic writers to bridge the intrapsychic and the interpersonal with due recognition of each. The author replies extensively to Levine's comparison of Pizer's work with that of Semrad and other “classical” analysts and challenges Levine's premise that a relational perspective, grounded as it is in a two-person contextual psychology, ignores or devalues interpretation, insight, free association, and autonomous mental functioning. Quoting from clinical material in his book, Pizer presents the outcome of a “relational” analysis in terms of the patient's increased access to internal “potential space,” unconscious experience, curiosity, and reflectiveness about the mental life of self and other, and an increased ability to value personal experience in relationship and in solitude.     

Homoerotic Countertransference The Love That Dare Not Speak Its Name?

Despite the recent interest in erotic countertransference and self-disclosure, little has been written about these phenomena when both analyst and patient are the same gender. Since homoerotic feelings can surface in any treatment, regardless of the participants' sexual orientation, this may well be a phobic avoidance that restricts many treatments, as well as our profession. I propose that the analyst's awareness of homoerotic feelings in the countertransference—including struggling with ways to express them—ultimately can create an atmosphere of safety. I offer an extended case example of one man with whom I colluded to ignore frightening aspects of his sexual fantasies. It was only by using my erotic countertransference, especially at a charged and pivotal moment, that I was able to help the patient begin to integrate split-off aspects of his sexuality.     

Community-Based Participatory Research for Improved Mental Health

Community-based participatory research (CBPR) focuses on specific community needs, and produces results that directly address those needs. Although conducting ethical CBPR is critical to its success, few academic programs include this training in their curricula. This article describes the development and evaluation of an online training course designed to increase the use of CBPR in mental health disciplines. Developed using a participatory approach involving a community of experts, this course challenges traditional research by introducing a collaborative process meant to encourage increased participation by special populations and narrow the parity gap in effective mental health treatment and services delivery.     

Gamma flicker elicits positive affect without awareness

High-frequency oscillations emerged as a neural code for both positive affect and fluent attentional processing from evolutionary simulations with artificial neural networks. Visual 50 Hz flicker, which entrains neural oscillations in the gamma band, has been shown to foster attentional switching, but can it also elicit positive affect? A three-faces display (2-female/1-male or 2-male/1-female) was preceded by a 50, 25, or 0 Hz flicker on the position of the odd-one-out (i.e., the target). Participants decided on the gender (Block 1) or on the subjective valence (Block 2) of this neutral target in an approach-avoidance task, which served as an implicit affective measure. Only the detection of 25 Hz flicker, but not of 50 Hz flicker, was above chance (Block 3). Faces primed by invisible 50 Hz flicker were explicitly evaluated more positively than with 25 Hz or 0 Hz. This gamma flicker also facilitated approach reactions, and inhibited avoidance reactions relative to 25 Hz and 0 Hz flicker in Blocks 1 and 2. Attentional switching was, moreover, enhanced by the 50 Hz flicker. According to the Affect–Gamma hypothesis, also in biological neural networks, high-frequency gamma oscillations may code for positive affect.     

Reason,emotion, and love

Wittgenstein's private language argument is interpreted as an example of a kind of transcendental argument which, if valid, explains why a certain concept must possess certain features. Cognition and affect are shown to require each other by an application of Bennett's account of what beings capable of true cognition must be capable of, and the necessity of certain emotions to the existence of any rules in a community is argued in similar fashion. Hume's account of love and admiration being rejected, an account of love, intended to explain some of love's familiar features, is defended, and various proposed additions to the analysis are rejected. The idea of love is linked to those of value, agency, and the transcendental self by argument showing that each of these ideas requires all of the others. Finally, the idea of love is linked by a direct argument to that of the transcendental self.     

Hegel on Legal and Moral Responsibility

When Hegel first addresses moral responsibility in the Philosophy of Right, he presupposes that agents are only responsible for what they intended to do, but appears to offer little, if any, justification for this assumption. In this essay, I claim that the first part of the Philosophy of Right, “Abstract Right”, contains an implicit argument that legal or external responsibility (blame for what we have done) is conceptually dependent on moral responsibility proper (blame for what we have intended). This overlooked argument satisfies the first half of a thesis Hegel applies to action in the Encyclopaedia Logic, namely, that the outer must be inner, and thus provides a necessary complement for his more explicit treatment of the second half of that thesis, that the inner must be outer. The claim that agents are only responsible for what they intended to do might appear, at first, to risk conflating legal and moral responsibility and to lack the necessary means to deal with the phenomenon of moral luck, but I argue that if it is properly situated within the whole of Hegel's philosophy of action it can be saved from both of these consequences and so take its place as an essential component of Hegel's full theory of moral responsibility.