Sabina Spielrein: out from the shadow of Jung and Freud

Abstract: Since the 1982 publication of Aldo Carotenuto's book, A Secret Symmetry: Sabina Spielrein Between Jung and Freud, there has been renewed interest in the life and work of Sabina Spielrein. She was Jung's first psychoanalytic case at the Burghölzli Hospital in 1904, and was referred to several times in The Freud/Jung Letters. Spielrein recovered, enrolled in medical school, and went on to become a Freudian analyst. Her most famous paper, published in 1912, ‘Destruction as a cause of coming into being’, was referred to by Freud in 1920 in relation to his Death Instinct theory. In the few Freudian publications on this controversial theory since 1920, Spielrein's contribution is consistently omitted. Jung also neglected to refer to her ‘Destruction’ paper in his early 1912 version of ‘Symbols of transformation’, even though he had edited her paper and had promised to acknowledge her contribution. He did refer extensively to Spielrein's first paper, her medical thesis, ‘On the psychological content of a case of schizophrenia’, published in 1911, as yet unpublished in English. In her paper Spielrein sought to understand the psychotic delusions of Frau M, a patient at the Burghölzli, much in the style of Jung's ‘Psychology of dementia praecox’ (1907). The purpose of this paper is to explore to what extent Spielrein's Frau M paper, and its companion ‘Destruction’ paper, make an original contribution to both Jung and Freud's emerging theories on the possible creative versus destructive outcomes of neurotic or psychotic introversion, culminating in Jung's concept of the ‘collective unconscious’ (1916) and Freud's concept of a ‘Death instinct’ (1920).     

Beyond transference,countertransference, the silences and the opinion1

The author examines several works of an intersubjectivist trend, as well as writings by Hanly, Cavell and Bion, defending many of the named psychoanalysts' viewpoints. These viewpoints are expressed in the search and the struggle for truth, recognizing, like Popper, that truth exists but that we cannot know with certainty whether and when we touch upon it, only that this endless effort merits a lifetime's work because it is the attempt at an encounter with ourselves‐the true encounter. The author explains the criticisms by Green of Jacobs, and defends the maintenance of ‘a certain possible neutrality’ (Eizirik). He poses some questions with regard to Ogden's ‘third subject’, considering it, among other aspects, from the supervisory point of view, which may demonstrate the existence of ‘a certain possible objectivity’ of the emotional confl ict. He develops some criticisms concerning silence as an interpretative action by Ogden, and summarizes two case histories. Both were unconsciously attempting to manipulate the analyst intensely‐one of them to get the analyst to intervene in his love life, and the other to interrupt acting out.     

Transferences Toward the Co-Therapist Couple: Triadic Relationships and Selfobject Needs

This paper examines transferences toward the male/female co-therapists within a developmental context, using concepts from self psychology, intersubjectivity, and infant research. In addition, it proposes that some individuals have selfobject needs specifically related to the parental unit, so triadic relationships can influence one's development. Clinical examples elucidate the repetitive and selfobject dimensions of the transferences within the intersubjective field formed by the triad of a patient and the male and female co-therapists.     

Nymphea: from psychic breakdown to the emergence of subjectivity

In the first part of the paper the author presents an account of the analysis of a woman who is psychically extremely disturbed. This clinical presentation focuses on the unfolding of the transference process, and on the countertransference difficulties encountered during the course of the treatment which lasted more than ten years. In the second part of the paper the author proposes a theoretical approach to the breakdown experienced by the patient, and puts forward the hypothesis that there was insufficient differentiation between her internal objects and the archetypes, and that this prevented the development of symbolization. The author proposes the idea of a collapse between internal and external objects, which destroys the space necessary for representation and symbolization that normally arise between the two poles of the object. The account of this transference process between the analyst and the patient is thus seen as the account of the (re)construction of true internal objects, and of the resumption of a symbolic process to make possible the development of subjectivity.     

Touching Mortality, Touching Strength: Clinical Work with Dying Patients

This paper outlines some of the special stresses that must be shouldered by clinicians—physicians, nurses, chaplains, social workers, pastoral staff, and others—whose work focuses on dying and extremely vulnerable patients. The utility of a theory of generative death anxiety as a framework for interpreting the nature of these special stresses is suggested. Three common burnout reactions are examined. The paper concludes that positive acceptance of personal mortality may help clinicians avoid burnout and lead to better therapeutic practice. This framework for interpreting therapeutic practice demonstrates the integral role spirituality plays in work with this particular patient group.     

“The Dead”

Gabriel Conroy, central to James Joyce's novella, The Dead, keys the reader's experience of the evening portrayed. A third-person narration allows for distance, but Gabriel's closely depicted thought processes and actions, and his insistent self-consciousness, shape the story. As such they invite psychoanalytic interpretation and reward it. Gabriel's shocking discovery and reaction to it can be seen to be informed by rendered psychodynamics and a credible internalized past. Joyce and Freud, actual contemporaries, can be seen as contemporaneous in imagination as well.     

A case study of borderline anxiety andthe process of analytic transformation

Borderline patients present particular treatment problems and require close, devoted understanding of their often chaotic and shifting intrapsychic conflicts. Many of these patients act out, making it difficult to maintain an analytic process. In fact, many terminate early on. When they do stay for longer periods, they exhibit particular constellations of defense, anxiety, and conflict. One extensive case report is used to examine the overlapping cycles of treatment with this population. Frequently, self-destructive acting-out is present in the transference and extratransference. This acting-out is often followed by the self-destructive, antichange attitude of the death instinct. These ways of relating to the self and the object are mobilized within the vehicle of projective identification and are best understood as primitive defenses against core fantasies of loss and persecution. These issues of loss and fear are the final and vital phase of treatment with borderline patients, who are often able to make major fundamental changes in their internal sphere, but only if patient and analyst can tolerate and understand these three levels of intrapsychic experience.     

Abandonment, Religion, and Male Melancholia: A Psychoanalytic Study of Archpriest Avvakum's Religious Autobiography

The present study is a psychoanalytic reading of Archpriest Avvakum's autobiography and takes its cue from some observations made by Russian and Ukrainian historian Edward Keenan, who offered a tentative diagnosis of manic-depression to describe Avvakum's personality. In my view, Donald Capps's analysis of religious male melancholia supports Keenan's observations, and I argue that Avvakum carried his childhood experiences and conflicts over into his later religious life. His religious life manifested a series of transferences and displacements, with Mary the Mother of God, God the Father, and the Church functioning as his loving or positive relationships with his family; and Patriarch Nikon and his followers embodying everything he feared and resented about his own childhood—change and abandonment.     

THE USE OF THE ANALYST AND THE SENSE OF BEING REAL: THE CLINICAL MEANING OF WINNICOTT'S “THE USE OF AN OBJECT”

“The Use of an Object and Relating through Identifications” (1968) represents Donald Winnicott's theoretical and clinical legacy. The author develops this concept from a clinical point of view, through the analysis of a woman with psychotic functioning. He reflects upon the dramatic quality of risks inherent in the processes linked to the use of the object with seriously disturbed patients. He explores different meanings of the analyst's survival, linking it to the analyst's response. The processes of the use of the object—that is, the encounter between the patient's potential destructiveness and the analyst's capacity to respond through his own judicious subjectivity—let the patient experience the analyst's capacity to keep his own subjectivity, authenticity, and creativity alive. It is starting from the traces of this live object that patients gradually form their own personal sense of being real.