Control-Mastery

Abstract

This paper will introduce the theory of Control-Mastery, an empirically supported, cognitively oriented interpersonal theory of psychotherapy. Control-Mastery theory offers a distinctive approach to counter-transference in particular and suggests a unique way to understand unconscious functioning. The theory also provides specific guidelines for conducting psychotherapy as well as a useful framework for understanding the impact of familial as well as cultural context on individual psychological struggles.     

‘I am not crying. I am rubbing my eyes’: Annie and the hollow object

This article explores the relationship between the development of severe eczema and asthma in an eight-year-old girl and her difficulties with experiencing psychic pain and conflict. The author focuses on the transference dynamics that preceded and surrounded the psychosomatic reaction in the session. The observations in this case may explain why patients, despite feeling taken over by intense physical sensations, can display flatness and superficiality of affect giving the appearance that they are emotionally ‘hollow’. The author proposes that these patients experience an emotional sense of emptiness in themselves and in their objects that is the result of a very early defence of dissociation caused by overwhelming anxieties of annihilation that are lived out in and through the body. The appearance of a psychosomatic symptom during the session can follow the emergence of sudden and intense raw hostile feelings towards the primary object, accompanied by a sense of danger and profound anxiety, as the hated object is also desperately needed for the subject’s own physical/emotional survival. The analyst can contribute to triggering these episodes by failing to contain the patient’s projections, which may lead to the patient feeling forced to re-introject unprocessed and unbearable ‘psycho-physical’ emotions. This article discusses the different degrees – and forms – of symbolic functioning in connection to this girl’s experience of her eczema and asthma and their manifestation in the transference relationship to the therapist.     

Book Reviews

Abstract

There are many brief, demanding, aborted cases that no one ever writes about. The typical psychoanalyst or psychoanalytic psychotherapist, however, has many outpatient cases that are shortlived, intense encounters with very disturbed patients. Rather than ignore these encounters as non-analytic or non-instructive, I think these cases add to our knowledge about the mind and its functions. In addition, it is unrealistic to think we can always help a very anxious and disturbed person to enter the treatment process with immediate success. It is more instructive to apply the analytic method and offer the patient what we can and have both analyst and patient learn as much as they can in the time they are able to stay together. Using case material, I show the Kleinian approach to working analytically with these difficult patients. Whether focusing on transference or extra-transference material, the analyst interprets the patient's internal phantasies and anxieties regarding the self and the self's important objects. This analytic stance tends to relieve the immediate anxiety and set the stage for potential self-reflection and the start of basic working-through processes.     

Perversion and infancy and adolescence

Abstract

Studying the works of Freud and Lacan, the authors carried out research on perversion in childhood. Their work covered the perverse polymorphism of infantile sexuality and the perception of the anatomic difference between the sexes that leads the child to create sexual theories and fantasies. The phallic mother and the fetish are viewed as imaginary solutions directly related to the Oedipus and castration complexes. In perversion, a particular position is taken in relation to the Oedipus complex: a serious flaw occurs in the symbolization of the law, and the mechanisms of denial and disavowal take form. Sexuality requires a second “logical time,” separated from infancy by the latency period, in order to confirm (in action) that a fixed position of jouissance (enjoyment) has actually been established. This can only happen in a period after adolescent enhancement. The distinction between perverse traces and a perverse structure is made, taking into account the fact that, in the case of child analysis, the analyst should free the child from the family fantasy and help him/her to build his/her own fantasy.

Campos Santoro V. et al. Perversion und Kindheit und Adoleszenz.

Im Studium der Arbeiten von Freud und Lacan haben die Autoren Forschung über Perversion in der Kindheit gemacht. Die Studien behandeln den perversen Polymorphismus der infantilen Sexualität und die Wahrnehmung des anatomischen Unterschiedes zwischen den Geschlechtern, welche das Kind dazu führt, Sexual-Theorien und Phatasien zu schaffen.

Die phallische Mutter und der Fetisch werden als imaginäre Lösungen angesehen, die sich direkt auf den Ödipus- und Kastrations-Komplex beziehen. Bei der Perversion wird eine besondere Position in Bezug auf den Ödipus angenommen; ein ernsthafter Mangel tritt bei der Symbolisierung des Rechts auf; die Mechanismen der Verneinung und der Verleugnung bilden sich. Sexualität erfordert eine zweite “logische Zeit”, von der Kindheit durch die Latenz Periode getrennt, um (in der Handlung) zu bestätigen, daß eine fixierte Position der jouissance (Vergnügung) sich tatsächlich etabliert hat. Das kann sich nur in einer Periode nach der adoleszenten Verstärkung ereignen.

Es wird die Unterscheidung zwischen perversen Spuren und einer perversen Struktur gemacht, in Rechnung stellend, daß im Fall der Kinder-Analyse der Analytiker das Kind von der Familien-Phantasie befreien sollte und ihm/ihr helfen sollte, seine/ihre Phantasie auszubilden.

Campos Santoro V. Perversión e infancia y adolescencia.

Estudiando los trabajos de Freud y Lacan, los autores han investigado la perversión en la niñez. Los estudios cubren la sexualidad infantil perversa polimorfa y la percepción de la diferencia anatómica entre los sexos, que llevan al niño a crear teorías sexuales y fantasías.

La madre fálica y el fetiche son vistos como soluciones imaginarias relacionadas directamente con el complejo de Edipo y de castración. La perversión, toma una posición particular en relación al Edipo; un fallo importante tiene lugar en la simbolización de la ley; los mecanismos de negación y repudio toman forma. La sexualidad requiere un segundo “tiempo lógico” separado de la infancia por el periodo de latencia, para confirmar (en acto) que una posición fija de jouissance (goce) se ha establecido. Esto solo puede ocurrir en un periodo posterior a la intensificación adolescente.

La distinción entre las huellas perversas y la estructura perversa se ha hecho, teniendo en cuenta que, en el caso del análisis de niños, el analista debe librar al niño de la fantasía familiar y ayudar a el/ella a construir su propia fantasía.     

Therapeutic Work with Trauma,Revictimization, and Perpetration: Bearing Witness,Offering Hope,Embracing Despair

ABSTRACT

This paper offers a case study of a survivor of childhood incest who in adulthood has become a victim of violence in her relationships with chosen partners and is concerned that she herself may be a perpetrator of sexual abuse. It examines selected literature on attachment, dissociation, transference/countertransference, role responsiveness and sadomasochistic therapeutic enactments, the two-system superego model, and the triadic self. The paper focuses on long-term treatment dynamics with survivors of cumulative trauma and explores such psychodynamic psychotherapy issues as the therapist as a perpetrator of violence, the development of sacred space, authenticity, and the importance of both offering hope and embracing despair in this work.     

The ‘frame’ as a container for the erotic transference – A case study

Abstract

This paper discusses various aspects of the psychotherapeutic frame, and explores the importance of maintaining the boundaries of the frame especially when an erotic transferential relationship is present. Many now agree that erotic transference and counter-transference occur in most therapeutic relationships, and yet it is something that therapists often struggle to work with effectively. The author acknowledges her own difficulties in working with erotic transferences and demonstrates why the adherence to the frame is especially significant in these circumstances. A case study is used to illustrate the difficulties of working with the erotic transference within the constructs of a frame and short-term therapy, and how the author's own counter-transference affected the therapy as well as how this was dealt with in supervision.     

Reading Susan Isaacs: toward a radically revised theory of thinking

The author views Isaacs's (1952) paper, The nature and function of phantasy, as making an important contribution to the development of a radically revised psychoanalytic theory of thinking. Perhaps Isaacs's most important contribution is the notion that phantasy is the process that creates meaning, and that phantasy is the form in which all meanings - including feelings, defense 'mechanisms,' impulses, bodily experiences, and so on - exist in unconscious mental life. The author discusses both explicit formulations offered by Isaacs as well as his own extensions of her ideas. The latter include (1) the idea that phantasying generates not only unconscious psychic content, but also constitutes the entirety of unconscious thinking; (2) the notion that transference is a form of phantasying that serves as a way of thinking for the first time (in relation to the analyst) emotional events that occurred in the past, but were too disturbing to be experienced at the time they occurred and (3) a principal aim and function of phantasy is that of fulfilling the human need to get to know and understand the truth of one's experience. The author concludes by discussing the relationship between Isaacs's concept of phantasy and Bion's concepts of alpha function and the human need for the truth, as well as the differences between Fairbairn's and Isaacs's conceptions of the nature of unconscious internal object relationships.     

Serendipity in the Theater: Maude Adams as James M. Barrie's American Muse

A special niche in theatre history is addressed to begin to fill a void in the contemporary creativity literature. The present essay focuses on Maude Adams and James M. Barrie in an attempt to demonstrate that, serendipitously, Adams initially impacted Barrie's creative process, and thereafter became his platonic source of inspiration for the plays he created for her, meriting the belated title of muse. Set change theory is underscored as a plausible cognitive explanation for Barrie's illumination. The psychoanalytic theory of transference is proposed as an underlying mechanism for facilitating the change of mental set during the incubation stage. A brief discussion on a selective theoretical integration from the fields of cognitive psychology, psychoanalysis, and neuroscience is followed by conclusions.     

Symmetric frenzy and catastrophic change: A consideration of primitive mental states in the wake of Bion and Matte Blanco

The author explores the connections between Matte Blanco's notion of symmetric frenzy, i.e. the turbulence characteristic of the deepest levels of mental functioning, and Bion's concept of catastrophic change. For Bion, mental links are retrieved from the formless darkness of infinity. With catastrophic change, emotional violence and the confining nature of representation come into conflict, leaving the subject prey to an explosiveness that paralyses mental resources. Matte Blanco identifies indivisibility as the abyss in which all differentiation ceases; he bases his model on the conflict between symmetry and asymmetry. Infinity, he maintains, is where the first forms of mentalization develop. Both Bion and Matte Blanco emphasize the contrast between the immensity of mental space and the spatio-temporal order introduced by the activation of thinking functions. The author presents clinical material from the analysis of a psychotic patient, stressing the need to encourage both working through the defect of thinking (Bion) and 'unfolding' manifestations of symmetry (Matte Blanco) so as to foster the activation of the resources of thought, meanwhile postponing transference interpretation. He concludes with two later sessions, in which recognition of the analyst in the transference allows the analysand to develop his capacity for containment and asymmetric differentiation.     

Winnicott, Balint, and the Independent Tradition

This article compares and contrasts two main aspects of the work of Winnicott and Balint: their theories of infantile development and their theoretical and clinical work on the use of regression as a therapeutic agent. The relationship of their thinking to aspects of the British Independent Group's theories and clinical work is noted vis-à-vis the basic acceptance of classical theory and technique, acknowledgment and use of some of Klein's contributions, the influence of trauma and the external environment on psychic development and psychopathology, the importance of holding and the setting, and the reintegration of previously split off and lost parts of the self.