The Symbiosis between a Mother and Her Schizophrenic Son in a Group Therapeutic Process

Abstract

In psychoanalytical practice important, but less studied, transformative functions are performed by verbal comments which do not correspond to the classic model of mutative interpretations proposed by Strachey. The Authors describe some characteristics of such clinical situations, without coming into the better known categories of variations in technique. Such enunciations seem not to have a “strong”, (already clearly defined) meaning in the mind of the analyst, but contain rather a “weak” semantic potential, which can only develop with the active cooperation of the patient. In the light of these experiences, the Authors reconsider the general nature of psychoanalytical interpretation and emphasize the intersubjective and dialogical nature of the interpretive work carried out in analysis.     

Can Psychoanalysis be a Science?

This essay proposes to examine a limited number of critical assessments regarding the scientific status of psychoanalysis with reference to intents and purposes, claims and disclaimers, contrasting views of what constitutes a science and the nature of scientific thinking and how these might apply to psychoanalysis epistemologically. It assumes a certain degree of familiarity with criticisms that have been leveled against psychoanalysis from those who insist on absolutist testing for what some call true science, particularly on the part of those who are not practitioners of the art. It wonders about the concern with scientizing by those who actually practice it, or value it in some way or another. It suggests an open minded approach without premature or even warranted closure on the subject of human beings and of ways of getting to know them, let alone understanding them and perhaps being of help to them.     

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.     

Trauma Lives in Speech

The author approaches the topic through infant observation. At the age of eight months the baby moves in the borderland between the physical and the symbolic. When the baby hurts herself, she needs the mother's arms to protect her: at the same time, her budding spoken symbol "mama" is comforting in itself, it carries the memory of the mother's arms. Can speech - tone of voice, rhythm, pauses - and the moments of loss, absence, the losing of self also be intertwined? The author discusses the question of how trauma starts to live in speech through two patients. She talks about "a silent language" which speaks in between the words and sentences - changes the rhythm of speech, makes lose words, tears a hole in speech. This "silent language" talks about trauma, reaches for its very essence - a bodily experience and meaning to the wholeness/disruption of self.     

Controversies and Conflicts in the Institution of "Open" Psychoanalysis: Cases from the History of the Therapeia Foundation

The institution of psychoanalysis has included controversies, dissensions and expulsions at both the theoretical-methodological and personal-organizational levels. There have also been several intra- and intergroup conflicts in the history of psychoanalysis, and in constructing and patterning the future of psychoanalytic knowledge. In the context of Finnish psychoanalysis, the Therapeia Foundation (founded in 1958) met from the start with resistance from official psychiatry and also from the IPA. For example, in the mid-1960s, D. W. Winnicott, as the President of the IPA, supported the orthodox Finnish psychoanalytic study group (later to become the Finnish Psychoanalytical Society), and pronounced that the Therapeia group was too loose and was not strictly able to use the IPA-recognized designation "psychoanalytic." The Therapeia Foundation and its Training Seminar combined classical psychoanalysis and its new versions with existentialphenomenological views, anthropological medicine, research on "social pathology" and even modern theological research. On the basis of their Swiss analytic training, three Finnish psychiatrists, Martti Siirala, Kauko Kaila and Allan Johansson, organized Therapeian training to incorporate sciences and arts, and skills involving the therapeutic "carrying" of burdens. The multifacted nature of open psychoanalysis was seen to find its proper organizational expression when the Training Seminar of the Therapeia Foundation became, in 1974, a Member of the IFPS.     

A Farewell to Countertransference

The "discovery" of countertransference provided a much-needed corrective to the one-sided view of transference and a patient's pathology. Even if its usefulness in the development of psychoanalysis was indisputable, its days are numbered. When I present my clinical work at conferences, I am often asked questions about my countertransference. These questions contain numerous assumptions that are challenged in this paper. Treatment is discussed from a self psychological perspective to highlight the therapeutic value of enabling the patient to engage a selfobject transference. The concept of "projective identification" is also challenged. Systems theory, in which the therapeutic relationship is understood as a co-construction between therapist and patient, is proposed as a more effective model to deal with the issues formerly included under transference-countertransference.     

Choice theories: What are they good for?

Simonson et al. present an ambitious sketch of an integrative theory of context. Provoked by this thoughtful proposal, I discuss what is the function of theories of choice in the coming decades. Traditionally, choice models and theory have attempted to predict choices as a function of the attributes of options. I argue that to be truly useful, they need to generate specific and quantitative predictions of the effect of the choice environment upon choice probability. To do this, we need to focus on rigorously modeling and measuring the underlying processes causing these effects, and use the Simonson et al. proposal to provide some examples. I also present some examples from research in decision-making and decision neuroscience, and argue that models that fail, and fail spectacularly are particularly useful. I close with a challenge: How would consumer researcher aid the design of real world choice environments such as the health exchanges under the Patient Protection and Affordable Care Act?     

Toward a Comprehensive Theology of Divine Action

This paper proposes a fundamental premise for the conversation between science and theology: In our experience of the natural world we encounter an excess of awareness and of meaning that overwhelm our perceptions, language, and thought. We attempt to construct the coherence of our awareness through our science, and we attempt to render it meaningful in our thoughts and language. Metaphor and symbol are primary vehicles for our attempts at meaning. Since its task is to articulate meaning, theology must acknowledge this premise, if it is to engage the sciences adequately.     

Towards an interpersonal understanding of bodily experience

This paper attempts to understand the interpersonal nature of bodily experience. It explores the way the body symptoms we meet in the consulting room, and in everyday life, express and communicate disturbances in our relationships with others. The article seeks to understand how others that are close to us can really get under our skins. The work of the philosopher of the body, MerleauPonty, findings from contemporary developmental psychology, recent psycho-biological studies and psychoanalytic insights are all drawn upon as a way of offering an introduction to contemporary developments in thinking and research on the body.

The article explores the interdependence of body and environment. In particular, the body is always in an interpersonal context with others. Bodies are interdependent; communication is first and foremost bodily. Bodily behaviour and biological functions develop in the context of a relationship. The relationship with the other influences the formation of bodily processes and actions. Clinical examples are drawn upon to illustrate how interpersonal disturbances in development are expressed in bodily symptoms. The difference between a hysterical and psychosomatic body symptom is also briefly addressed.