Is psychoanalysis a matter of subjectivation?

We are not born subject but become one, in a two‐and‐fro process between what is played out on the intrapsychic stage and the field of intersubjectivation. The author proposes to examine two of the main movements of psychic life brought into play in this process. In the domain of the ‘subjectivating link’, becoming a subject depends on the relationship with another, authentically taken into account as a desiring subject and not simply as an object for oneself. In the course of history, this intersubjectivation is only internalized as a lasting preconscious predisposition if sufficient trust is established in the possibility of mutual recognition. When this perspective recedes, the subject tends to fall back on narcissistic positions, in search of an end to lack. Such a narcissistic tendency drives the subject to constitute himself by subjugating his objects, striving to rob them of their otherness. A plurality of subject positions will be recognized in every analytic encounter. Psychoanalytic work can allow for a lasting change insofar as it modifies the equilibrium between diverse psychic trends. The multiplicity of the issues at stake in subjectivation allows us to integrate theoretical pluralism while encouraging us to reflect on the diversification of our practices.     

Development and validation of a revised measure of codependency

This study assessed the factor structure, internal consistency, and concurrent validity of a revised instrument, the Composite Codependency Scale (CCS), a 19‐item measure designed to assess codependent traits. Exploratory factor analysis of the CCS, using data from 301 adults from the general population and 49 attending members of Codependents Anonymous (CoDA), yielded three factors: self‐sacrifice, interpersonal control, and emotional suppression. The scale and its subscales exhibited good internal consistency. Consistent with the tenets of the codependency model, higher codependency scores were significantly associated with higher levels of depression, anxiety, stress, and familial dysfunction and lower levels of narcissistic tendencies, self‐esteem, and emotional expressivity. Furthermore, the revised measure effectively discriminated members of CoDA from those in the general population.     

Under the mirror of the sleeping water: Poussin's Narcissus

Examined in conjunction with a close reading of Ovid's Metamorphoses, Nicolas Poussin's four paintings on the preoccupying theme of Narcissus and Echo reflect a developing aesthetic interpretation of its textual source. Poussin's reflective vision supports a radical reappraisal of the enigmatic myth at the heart of psychoanalytic theory and practice, in which Narcissus is construed as a far more object‐related figure that seeks the formative, affirmative mirroring of the other. This in turn encourages a more versatile conceptualization of narcissistic disturbance, in which an etiologically heterogenous constellation of issues stems from a variety of disturbances in the myriad dynamic and developmental aspects of mirroring and attunement: the narcissisms.     

An overview of the treatment of severe narcissistic pathology

This paper provides an overview of narcissistic personality disorders as they present clinically along a spectrum of severity ranging from the best functioning forms of pathological narcissism to the most threatening to the patient's psychosocial and physical survival. It proposes a general interpretive psychoanalytic stance with all these clinical syndromes that range from standard psychoanalysis to a specific psychoanalytical psychotherapy for the most repressive and life threatening conditions that may not respond to standard psychoanalysis proper. This general psychoanalytic approach is placed into the context of related developments in contemporary psychoanalytic understanding of pathological narcissism and its treatment.     

自恋与心理健康:适应性自恋与病理性自恋的不同作用

目的:探讨适应性自恋与病理性自恋对个体心理健康的不同影响。方法:750名大学生完成了一套由自恋人格问卷(NPI)、病理性自恋量表(PNI)和症状自评量表(SCL-90)组成的测验。利用结构方程模型对变量间的关系进行分析。结果表明:病理性自恋的二阶因子自恋易损性对个体心理健康具有显著的负向预测作用,自恋易损性水平越高,个体心理健康水平越低。自恋夸大性和适应性自恋(自恋人格问卷,NPI)对心理健康的正向预测作用达到边缘显著,自恋夸大性和适应性自恋得分越高,心理健康水平越高。结论:病理性自恋的二阶因子自恋易损性对心理健康具有明显的破坏作用,而自恋夸大性和正常/适应性自恋可能对心理健康存在微弱的保护作用。     

Parenting and Adolescent Grandiose Narcissism: Mediation through Independent Self-Construal and Need for Positive Approval

While particular parenting styles and parenting qualities have been linked to adolescent narcissistic tendencies, their association is likely indirect. Parents aim to indoctrinate adolescents with dispositional tendencies, such as self-confidence independence and a focus on peer acceptance, which incidentally manifest in narcissism. The authors investigated whether mothers' and fathers' positive parenting and lax discipline were linked indirectly to adolescent grandiose narcissism through a need for positive approval and independent self-construal. Adolescents (n = 460; 58.5% girls; age range = 15–18 years) completed several measures online. Structural equation modeling revealed that maternal positive parenting and discipline were indirectly linked to grandiose narcissism through adolescents' need for positive approval. Fathers' positive parenting was linked directly and partially through independent self-construal to grandiose narcissism. Fathers' discipline remained directly associated with adolescent grandiose narcissism. Discussion focuses on the nuanced association between parenting and grandiose narcissism in adolescents and the implications for upholding behavioral standards.     

Spiritual barriers to humility: a multidimensional study

Many spiritual and religious traditions view spiritual pride as contrary to humility; however, the rising empirical research on spirituality and humility has involved limited investigation of the variety of spiritual barriers that inhibit a humble disposition. The present study investigated three distinct spiritual barriers (spiritual grandiosity, insecure attachment to God, and hunger for idealisation) as independent predictors of dispositional humility among graduate trainees in the helping professions (N?=?162) from a Protestant-affiliated university in the USA. Results indicated that each construct of interest predicted lower levels of humility when controlling for both spiritual impression management and the other spiritual barriers. These findings supported theoretical assertions of the discriminant validity of each independent variable in predicting lower levels of humility and supported construct validity of the humility measure. Conceptual considerations and suggestions for future research and graduate training are discussed.     

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.     

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.