The day the clock stopped. Primitive states of unintegration,multidimensional working through and the birth of the analytical subject

This paper is based on one idea and built around one clinical experience that helped me to broaden my comprehension of it. The idea, underlying the work of several authors, is that when the analytic field is saturated with primitive and unintegrated mental contents, the analyst’s somatic countertransference is a precious indicator of a deep, dissociated form of communication. The clinical experience concerns the difficult elaboration of a complex, multifaceted countertransference that took place during the early stages of the analysis of a sensitive patient who used to communicate in a very dissociated way and that I found hard to contain. This experience, closely described in the article, led me to formulate the clinical idea that the transference field may be made of distinct layers (psychoid, affective, verbal), and that each one of them may potentially convey dissociated, even contrasting bits of information. The corollary of this is that the analyst should be ready to accept contrasting sensations, feelings and thoughts at the same time, as they might be the basic ingredients of a complex reverie. The analyst could find himself/herself in front of his/her own internal unelaborated multiplicity before a symbolic image may emerge to link the scattered pieces of the experience. Nevertheless, the heart of this paper is not about suggesting an idea, but in the sharing of a complex working through, which fostered the birth of a new, more human relational perspective: the capacity of being together in time, in a transitional space where there is neither total separation nor fusion.     

“Tell me more about this…”: An examination of the efficacy of follow-up open questions following an initial account

In information gathering interviews, follow-up questions are asked to clarify and extend initial witness accounts. Across two experiments, we examined the efficacy of open-ended questions following an account about a multi-perpetrator event. In Experiment 1, 50 mock-witnesses used the timeline technique or a free recall format to provide an initial account. Although follow-up questions elicited new information (18–22% of the total output) across conditions, the response accuracy (60%) was significantly lower than that of the initial account (83%). In Experiment 2 (N = 60), half of the participants received pre-questioning instructions to monitor accuracy when responding to follow-up questions. New information was reported (21–22% of the total output) across conditions, but despite using pre-questioning instructions, response accuracy (75%) was again lower than the spontaneously reported information (87.5%). Follow-up open-ended questions prompt additional reporting; however, practitioners should be cautious to corroborate the accuracy of new reported details.     

Intersubjectivity and the creation of meaning in the analytic process

By means of a clinical illustration, the author describes how the intersubjective exchanges involved in an analytic process facilitate the representation of affects and memories which have been buried in the unconscious or indeed have never been available to consciousness. As a result of projective identificatory processes in the analytic relationship, in this example the analyst falls into a situation of helplessness which connects with his own traumatic experiences. Then he gets into a formal regression of the ego and responds with a so‐to‐speak hallucinatory reaction—an internal image which enables him to keep the analytic process on track and, later on, to construct an early traumatic experience of the analysand.     

SPONTANEOUS REMISSIONS: NORMAN REIDER'S FORGOTTEN PAPER,PART I

Almost sixty years ago, Norman Reider published a paper about spontaneous “remissions” he had observed. He discussed the manner in which psychoanalytic theory provided a way to partially explain these otherwise mysterious remissions or improvements in symptoms, some without benefit of either psychoanalysis or psychotherapy. Especially important were his comments about the negligible role of interpretation or insight in these examples. His conjectures reflected controversies that were current at the time and that remain unsettled. Of special interest is his introduction of some highly original ways to think of applying psychoanalytic ideas to supportive psychotherapy. But few analysts today have heard of this paper. A reconsideration of his paper allows us to be vividly reminded about our enduring and profound confusion about exactly what constitutes a “cure” at all. Spontaneous shifts in the severity of symptoms may be viewed as experiments of nature that we have neglected to investigate as valuable restraints on our immodest therapeutic claims.     

NARCISSISTIC DEFENSES IN THE DISTORTION OF FREE ASSOCIATION AND THEIR UNDERLYING ANXIETIES

This paper examines particular distortions in the process of free association characteristics of patients with narcissistic personality disorders. The author proposes that the dominant narcissistic transference developments typical of the early and middle phases of the analytic treatment of these patients are reflected in these distortions of free association. This paper gathers the various patterns that these defensive distortions present, along with technical interventions geared to deal with them.     

THE ANALYST'S WAY OF BEING: RECOGNIZING SEPARABLE SUBJECTIVITIES AND THE PENDULUM'S SWING

Whether the analyst finds the patient's emerging transference affectively tolerable or intolerable plays an important role in the analytic couple's negotiation of the configuration that the transference‐countertransference relationship ultimately assumes. If the analyst is deeply repelled by transference‐related roles to which he is assigned, patient‐ascribed attributions, or projection‐drenched interactions, he may react in violent protest, engaging in enactments that say more about his separable subjectivity than about the intersubjective situation. While there has been a recent trend to view enactments as a crucial aspect of psychoanalytic technique, this trend risks overlooking the way in which the analyst's way of being comes into play in the treatment.     

The Recaptured Scale Technique: A Method for Testing the Structural Robustness of Personality Scales

Tellegen and Waller advocated a complex and time-consuming scale construction method that they called “exploratory test construction.” Scales that are constructed by this method—such as the Multidimensional Personality Questionnaire (MPQ)—are presumed to be more “psychologically coherent” and “robust” than scales constructed by other means. Using a novel procedure that we call the “recaptured scale technique,” we tested this conjecture by conducting a megafactor analysis on data from the 411 adult participants of the Minnesota Study of Twins Reared Apart who completed the MPQ, the MMPI, and the CPI. We extracted and obliquely rotated 21 factors from a matrix of gender-corrected tetrachoric correlations for the 1,102 nonredundant items of the three omnibus inventories. Robustness of the 11 MPQ scales was assessed by the degree to which these factors recaptured the MPQ item groupings. Our results showed that nine factors were clearly recognizable as MPQ scales and two additional factors represented a bifurcation of an MPQ scale. A higher-order factor analysis of all 21 factor scales yielded five factors that clearly resembled the Big Five. Our results provide strong support for (a) the method of exploratory test construction, (b) the structural robustness of most MPQ scales, and (c) the utility of the recaptured scale technique.     

Metaphysics Within Science: Against Radical Naturalism

In Every Thing Must Go James Ladyman and Don Ross argue for a radical version of naturalistic metaphysics and propose that contemporary analytic metaphysics is detached from science and should be discontinued. The present article addresses the issues of whether (i) science and metaphysics are separable, (ii) intuitions and understanding should be excluded from scientific theory, and (iii) Ontic Structural Realism satisfies the criteria of the radical version of naturalism advanced by Ladyman and Ross. The point underlying those topics is that successful scientific research presupposes metaphysics, and that basic epistemic virtues common to metaphysics and science may allow us—as opposed to what Ladyman and Ross suggest—to increase our understanding of the world and to put constraints on allowable metaphysical theories.     

THE PAST IS IN THE PRESENT: READING THE WORK OF EDNA O'SHAUGHNESSY

Inquiries in Psychoanalysis: Collected Papers of Edna O'Shaughnessy. By Edna O'Shaughnessy; edited by Richard Rusbridger. London/New York: Routledge, 2014. 342 pp.