The countertransference impact of autistic defence in an otherwise neurotic patient

This paper investigates the question of why, in the psychoanalytic psychotherapy of a patient with encapsulated autistic pathology, the steady maintenance of a therapeutically neutral stance can be especially difficult. Transference and countertransference vicissitudes are examined. The author notices that the patient's intolerance of ‘opposites’ (cf. Tustin, 1986), combined with extreme antipathy to having that intolerance noticed, can elicit corresponding, and potentially destabilizing, countertransference reactions. These reactions comprise an unstable tension between co‐existing pressures towards fusion with, or expulsion of, the patient, their co‐existence under further pressure to remain unnoticed. Until perceived, this state of affairs risks collusion with the pressure either to merge with or to expel the patient, and compromises the capacity to notice the detail of the transference process and even to notice co‐existent positive and negative transference images. Detailed clinical illustration is given, including a session where it was difficult to notice the patient's experience of a couple as a combined object. The author finds these observations of bipolar countertransference tensions illuminated by Green's concepts of positive and negative narcissism and of the disobjectalizing function, and specifically accounted for by Ribas's theory of autism as radical drive defusion.     

Narcissism and Performance on Behavioral Decision‐making Tasks

Three studies examined narcissism and behavioral decision making. Decision‐making tasks included the Iowa Gambling Task (IGT; Studies 1–3), Balloon Analogue Risk Task (Studies 1–3), Columbia Card Task (CCT; Studies 2 and 3), and Game of Dice Task (Study 3). To tease apart the contributions of grandiose narcissism (i.e., narcissism found in the general population), pathological narcissism, and narcissistic traits (i.e., grandiosity, entitlement, and exploitativeness) in decision making, we assessed grandiose narcissism in Studies 1 (n = 380) and 2 (n = 244), pathological narcissism in Study 2, and the narcissistic traits in Study 3 (n = 312). Grandiose and pathological narcissism failed to predict decision making regardless of whether or not decision making included immediate feedback. In Study 3, the narcissistic trait of grandiosity (i.e., having an inflated sense of self‐importance) was associated with greater risk taking on the CCT‐hot (i.e., provided immediate feedback), and entitlement was associated with greater risk taking on the IGT. Measurement and applied implications are discussed. Copyright © 2015 John Wiley & Sons, Ltd.     

Discontinuities in the male psyche: waiting, deadness and disembodiment. Archetypal and clinical approaches

The discontinuities of development in the male psyche that are manifested in some analyses in unconscious experiences of inner disintegration are described. Narcissism and a de-somatized relationship to their own presence are the dominant clinical presentation in these patients. The analyst sometimes experiences these analyses as 'dead', as a result of the projection of a 'dead mother' object. The question of how psychic deadness and impotence can be worked with is examined. Clinical experience with these men shows how notions associated with the puer-senex archetype can illuminate the stark realities of a patient's early experiences, particularly in how mother's presence is felt. A theoretical and clinical bridge is proposed between puer and narcissus to frame how a man may unconsciously strive against psychic fragmentation by clinging to an identification with both--in order to remain intact in the face of being caught in a pre-pubescent state which reflects the insecure attachment to mother. The author describes how patients may find a more grounded embrace of reality via the use of the analyst's empathy and a greater potency through work in the transference/countertransference. These strengthening achievements help men to begin to leave the 'dead mother' behind.     

The death of a mind: a study of Shakespeare's Richard III

Some of the most difficult aspects of our work involve our encounters with states of mind which are steeped in and spread violence. In these circumstances, we experience our best efforts to offer empathic presence and thought to avoid being assaulted and obliterated. In these instances, a figure from literature depicting the details in question may come to our aid. In the play popularly known as Richard III,William Shakespeare depicts how the state of mind which is etched by grievance and committed to revenge may impose the 'winter of (its) discontent' upon the sunny dispositions of others' healthy, integrated functioning. Shakespeare masterfully depicts Richard's cunning and malice, but he also illustrates how this vengeful state uses guile and 'changes of shape' to seduce its way past protective boundaries, utilizing the human qualities of trust, open-heartedness and longing as pathways for invasion, betrayal and emotional devastation. This paper will view excerpts of the play's text from a psychoanalytic perspective which suggests that several clear lessons about this obliterative state of mind may be gleaned: that grievance can only operate to spread grievance and destruction; that our open-hearted and trusting qualities do make us vulnerable to such invasion and betrayal, but that our humanity is also the only avenue for rescue from this plight. In addition a clear lesson is offered about the value of protected 'sanctuary', that is, mental space where our most potent tool in these circumstances, our discerning minds, might find residence.     

Relations of proactive and reactive dimensions of aggression to overt and covert narcissism in nonclinical adolescents

In recent years, there has been increasing acknowledgment of the multidimensionality of narcissism and that different types of narcissism may relate differently to other domains of functioning. Similarly, aggression—a frequently discussed correlate of narcissism—is a heterogeneous construct. In this study, the relations of proactive and reactive aggression with overt and covert manifestations of narcissism were examined in a sample of 674 Italian high school students (mean age=15.5 years, SD=2.1 years). Overt narcissism was positively related to both proactive and reactive subtypes of aggression, whereas covert narcissism related only to reactive aggression. Vanity, Authority, Exhibitionism, and Exploitativeness were the components of overt narcissism related to Proactive Aggression (all remained unique correlates when controlling for Reactive Aggression), whereas Reactive Aggression was associated with the Exhibitionism, Superiority, and Entitlement subscales (only the latter was uniquely related when controlling for Proactive Aggression). Aggr. Behav. 36:21–27, 2010. © 2009 Wiley‐Liss, Inc.     

How the disadvantaged appraise group-based exclusion: The path from legitimacy to illegitimacy

Although many forms of differential treatment based on group membership are perceived to be legitimate, disadvantaged group members’ responses to discrimination have been studied primarily in contexts in which such treatment is appraised as illegitimate. This has resulted in an impoverished understanding of differential group-based treatment and a failure to illuminate the processes by which discrimination can shift from being seen as legitimate to being viewed as illegitimate. We discuss the determinants of disadvantaged group members’ legitimacy appraisals and the de-legitimisation process, whereby forms of discrimination appraised as legitimate come to be increasingly perceived as illegitimate. Whether group-based exclusion is addressed collectively or individually depends on socio-structural factors such as the pervasiveness of discrimination, impermeability of intergroup boundaries, and the availability of cognitive alternatives to the status quo. We conclude that understanding the antecedents and consequences of legitimacy appraisals is necessary to develop a comprehensive account of disadvantaged group members’ experiences of group-based discrimination.     

The Whole is Greater: Reflective Practice,Human Development and Fields of Consciousness and Collaborative Creativity

Because Western experiments assume creativity is an individual phenomenon and rarely investigate how trust and openness might build collective resonance, flow, and creativity, the creative whole typically amounts to less than the sum of the parts. The author argues, however, that group creativity increases as members develop, especially through Wilber's (in press) transpersonal stages. He illustrates how organizational leaders have facilitated creativity through reflective practice. Presenting evidence regarding the field effects of collective consciousness, he suggests that our minds and hearts interact in subtle yet powerful ways, which leaders can intuit, to support the emergence of collaborative creativity.     

Clinical Commentary

This paper describes a lengthy period of psychotherapy with a child. This treatment began only after a prolonged contact with other child and adolescent mental health services during which the child's difficulties, which had initially seemed to be ordinary behavioural problems, had proved puzzlingly intractable to a variety of interventions. Subsequent psychotherapy revealed a profound disorder of development which lay bath the Surface presentation. In a climate where Asperger's syndrome is often felt to be untreatable, this paper argues that some children, at least, can benefit from psychotherapy and can be helped towards real mental growth. Asperger's syndrome in children bears some striking similarities to narcissistic personality disorder as described in the adult psychoanalytic literature and this paper discusses some of the theoretical and clinical implications of the innate origins of Asperger's syndrome.