Vicissitudes in adult life resulting from traumatic experiences in adolescence1

The author deals with the diffi culties in combining the concepts of trauma and phantasy. He evaluates Freudian observations relating to chance and trauma. He considers traumatic effects of chance in relation to the rupture of a narcissistic phantasy of invulnerability. The narrating of traumatic events may awaken in the analyst tendencies to repeat the aggression of these traumatic events towards the subject. The accusatory interpretation can be one of the means by which this repetition is established. The author explores a type of trauma which is essentially related to the disturbance of the structure which contains the ideals of the subject. This disturbance is a consequence of disillusionment resulting from the loss of an object who was the depository of these ideals. Trauma generates a state of mourning for lost ideals. The author describes traumatic events which occurred in a patient's life at puberty; paradoxical behaviours in the patient's parents caused the patient to have new traumas. The reluctance to explore the derivatives of the unconscious, and to investigate possible meaning in symbols, was a central problem in this patient's analysis. The author discusses disturbances in symbolization, and he examines the subject of projective identifi cations that were received by patients from their primary objects.     

The Analyst in the Pharmacy

The merging of medication and analysis has been more widely endorsed in recent years. However, the issue of the analyst needing pharmacotherapy and how its use presses on the analytic frame has not been considered. This essay will look at how the analyst's need for medication threads into the structure of treatment. Issues of stigma and shame triggered by medication use are discussed, as well as the treatment consideration of self-disclosure as an intervention. The author offers both objective and subjective data on this subject, and includes a clinical case example to illustrate how self-disclosure of medication status can offer greater degrees of freedom in a patient's analysis.     

Toni Wolff-James Kirsch correspondence

This paper draws on the letters between Toni Wolff and James Kirsch from 1929-1933 and from 1949-1953 to highlight some aspects of Toni Wolff's relationship with her superviser and former analysand, James Kirsch. Her personality, her approach to her work as analyst, and her relationship with Jung and with colleagues are illustrated with selected quotes from the correspondence.     

A model‐based process to improve robustness in Multicriteria Decision Aiding interventions

A model‐based process is a methodological approach that facilitates interventions in new and ill or not structured problem situations. It is oriented towards improving the robustness of the intervention and its results in an incremental definition of both the problem formulation and the model, in order to reduce the uncertainty that is not only associated with the model parameters but also with the model structure, and sometimes also with the problem formulation. The nature and results of this approach, which consider the interaction between an analyst and the actors of the decision system as the decision aiding core, are proposed in relation to some actual interventions.     

Sibling rivalry,separation, and change in Austen's Sense and Sensibility

The paper explores a process of growth represented in the interplay of Jane Austen's characterizations of Marianne and Elinor Dashwood in Sense and Sensibility, approaching the text through the lens of psychoanalytic theories on oedipal sibling rivalry, separation, and processes of change. A close reading of Sense and Sensibility tracks Marianne Dashwood's repudiation of any ‘second attachment’ as the surface of an unconscious fantasy, denying a rival for the mother's love. A psychoanalytic view contrasts Marianne's lack of separation from her mother, her use of denial and projection, and her near death after losing the man she loves, with her older sister Elinor Dashwood's capacities for depression, reflection, and greater acceptance of loss and separation. The narrative portrays Mrs. Dashwood's identification with and idealization of her daughter Marianne, which contribute to her oedipal sibling ‘victory’. In the language and structure of the novel, the projections, identifications, aggressions, and separations (conscious and unconscious) of the sisters in the vicissitudes of their adolescent loves and rivalries constitute a process of growth. Austen's novel brings to life, with the vividness and coherence of great literature, forces and fantasies in oedipal sibling rivalries, inspiring renewed attention to their subtle presence in the transference and countertransference of the psychoanalytic process.     

A thematic dialogue: towards a conclusion and a follow-up

Following the themed debate that took place after the panel, we reconsidered and explored further our hypotheses in light of the comments made by our colleagues. Clearly, it is the structural approach that underlies both the Freudian primal phantasies and the Jungian archetypes, while taking account at the same time that their approaches are informed by contemporary emergentist theories. Our discussion centred on the divergences in the cases of psychosis and neurosis, on the roles, in turn, of a return to childhood and the play of archaic representations, on the transference and countertransference functions and finally on the need to pay attention to what are deemed synchronous moments in the event.     

Resonance and Ambiguity—about Metaphorical Thinking

This presentation is based on the theory, presented by the author, of the development of the mind and its psychoanalytic treatment as a stage-specific continuum, applicable in principle to all levels of disturbed and arrested mental development. This paper focuses on the nature of attainment and mediation of understanding with psychotic, borderline and neurotic patients, and the significance of successful conveyance of understanding as related to the general goal of psychoanalysis, to achievement of a structural change in the analysand's representational world and, finally, to the question of the main curative factor in psychoanalytic treatment. After discussing all these questions, the author ends up giving the conveyance of stage-specific and individual understanding a central place in all of them. The goals of understanding and psychoanalysis in general seem to be more-or-less identical. Starting and continuing new structuring internalizations in the patient's world of experience is primarily motivated by conveyance of the analyst's stage-specific and individual understanding, and thereby leading to alleviation or elimination of consequences of the developmental arrest. It seems thus warranted to conclude that conveyance of the stage-specific and individual understanding seems to be the central curative element in the psychoanalytic interaction.     

Alchemy in the image of the analyst

The author aims to demonstrate the activation in the transference relationship of a figure representing 'sameness' in a number of forms. In the first clinical vignette, she shows how a child projects his own difficulty symmetrically on to the analyst, with the aim of creating the conjunction of opposites which the psyche needs for its growth.
During the archetypal reworking which adolescence provides we again find this figure of 'sameness' in the foreground, in the phase of homosexual object choice. A second clinical vignette shows how this figure of 'sameness' can be represented in the fantasy or the desire of becoming an analyst.
The author puts forward the hypothesis that this fantasy represents an imago whose characteristics include being a tool for linking feeling and thinking in the inner world; it is constituted in the entre deux , the space between self and other, and, like Winnicott's transitional object, it facilitates the capacity to symbolize. Being 'off centre' with regard to infantile positions in relation to the parental imagos, this imago offers a vantage point for 'evaluation' ( sich auseinandersetzen ) and 'consideration' ( betrachten ). Finally this imago is transistory, because its destiny is to be deconstructed (as shown in the third clinical vignette which concerns an adult patient), in order to be integrated through the work of analysis.     

Working at the frontier and the use of the analyst: Reflections on analytic survival2

Certain connotations of ‘working at the frontier’ for the practicing psychoanalyst and for psychoanalysis are discussed in terms of movement along spatial and temporal dimensions. I then selectively highlight three currently significant frontier areas: moving between psychoanalysis and psychotherapy; psychoanalysis under conditions of terror and social traumatization; and the pursuit of the definitive as against the elusive subject. I suggest ‘the use of the analyst’ as the theme that underlies and epitomizes analytic presence and activity at these frontiers. Psychoanalysts are ‘used’ in innumerable ways, but especially by surviving the destructiveness‐deliberate and unconscious, real and symbolic‐aimed at them. The psychoanalytic presence at these frontiers fashions and reaffirms its unique, life‐embracing stance out of chaotic formlessness.