Falling into language life: a montage of pre‐faces in search of a text‐ual body

Clinical work, as all of consciousness, is steeped in and emerges out of language. Language is the medium of our knowing, and knowing the medium of our relating. Language has us; words dream us. For the mythical Navajo as for John of the New Testament, in the Beginning was the Word. Before any kind of distinction of thought, feeling, sensation or intuition comes language – language, not as ‘just words’, but as image. Words are images, and images as encompassing worlds present themselves as and through language. As a determinant of identity, language undermines all cues as to individual subjectivity, Yahweh's ‘I am here’ rendering time and place relative, and subjectivity co‐constituted. This paper is a meditation on language for clinicians in the form that language presents itself, as a meandering flow of consciousness with associations and signposts leading onward.     

Freedom and the psychoanalytic ontology of quantum physics

Jung's paper ‘Synchronicity – an acausal connecting principle’, defining the phenomenon as a ‘meaningful’ coincidence depending on archetypal activation, was published in 1952, together with a conceptually related piece by physicist and Nobel Laureate Wolfgang Pauli entitled, ‘The influence of archetypal ideas on the scientific theories of Kepler’. Slavoj ?i?ek, in The Indivisible Remainder: On Schelling and Related Matters, suggests that, in contrast to any notion of a ‘pre‐modern Jungian harmony’, the main lesson of quantum physics was that not only was the psychoanalytic, empty subject of the signifier constitutively out‐of‐joint with respect to the world, but that the Real in itself was already incomplete, out‐of‐joint, ‘not‐all’. Yet while ?i?ek frequently tries to separate Jung from his own ontology, this paper shows that his ontology is not as different as he suggests. Consistent with our earlier publications on Jung and Zizek, a closer investigation reveals an underlying congruence of both of their approaches. In this paper we show that this affinity lies in the rejection by both Jung and ?i?ek of the ideology of reductive materialism, a rejection that demonstrably draws on quantum physics in similar ways. While Jung posits an inherently meaningful universe, ?i?ek attempts to salvage the freedom of human subjectivity by opposing his Lacanian ‘dialectical materialism’ to reductive materialism.     

Couple Therapy with Veterans: Early Improvements and Predictors of Early Dropout

Family services within Veterans Affairs Medical Centers fulfill an important role in addressing relationship distress among Veterans, which is highly prevalent and comorbid with psychopathology. However, even for evidence‐based couple therapies, effectiveness is weaker compared to controlled studies, maybe because many Veteran couples drop out early and do not reach the “active” treatment stage after the 3–4 session assessment. In order to improve outcomes, it is critical to identify couples at high risk for early dropout, and understand whether couples may benefit from the assessment as an intervention. The current study examined (a) demographics, treatment delivery mode, relationship satisfaction, and psychological symptoms as predictors of dropout during and immediately following the assessment phase, and (b) changes in relationship satisfaction during assessment. 174 couples completed questionnaires during routine intake procedures. The main analyses focused on 140 male Veterans and their female civilian partners; 36.43% dropped out during the assessment phase and 24.74% of the remaining couples immediately following the first treatment session. More severe depressive symptoms in non‐Veteran partners were associated with dropout during assessment. Relationship satisfaction improved significantly during the assessment phase for couples who did not drop out, with larger gains for non‐Veteran partners. No demographics or treatment delivery mode were associated with dropout. Although more research is needed on engaging couples at risk for early dropout and maximizing early benefits, the findings suggest that clinicians should attend to the civilian partner's and Veteran's depressive symptoms at intake and consider the assessment part of active treatment.     

Promoting Recovery Identities Among Mothers with Histories of Addiction: Strategies of Family Engagement

Changes in identity are critical to managing transitions to recovery from substance and alcohol addictions. Identity change is particularly important for mothers, whose recovery processes are often in the context of critical but complex family relationships and societal expectations. But research and practice often underestimate the relational dimensions that promote or inhibit changes in one's identity during recovery. Here we analyze data from a study that involved interviews with 30 formerly incarcerated women participating in a community-based substance use treatment program in the Midwest. Drawing from Constructivist Grounded Theory Methods, our analysis identified three factors shaping levels of engagement with family members: (1) the relational consequences of a shared past; (2) ascribing permanence to the old identity of “addict” versus the ability to see women's capacity to change; and (3) the current provision of caregiving support to participants’ children. Our analysis supports and extends existing research by highlighting how family can both promote and inhibit a recovery identity process. We discuss potential implications for theorizing “recovery” and “identity” as relational and identify key elements to support practices more attuned to the hidden complexity of family support.     

Displacement as trauma and trauma as displacement in the experience of refugees

This paper investigates the relations between displacement, home, trauma and the self in the experience of refugees, which has become an issue of unexpected and far-reaching proportions in recent times. It questions to what extent and under what conditions displacement in the world may be traumatic and how trauma may be considered the effect of an inner displacement. Refugees’ lives are marked by forced migration that is related to a certain suffering due to the changes in their family, relational, social and cultural lives. The paper explores the extent to which these changes can represent a break so significant as to be traumatic. It outlines the way in which traumatic experiences can produce an inner displacement and reorganization of one’s mental life that leads to a focus on traumatic complexes. Under the most severe traumatic conditions, this can be understood as a displacement of the central axis of Self, in which the ego complex yields its position to other complexes, with a deep change in the organization and functioning of self. The experience of refugees highlights the way in which we live in a matrix of conscious and unconscious links between inner and outer worlds that need deeper and simultaneous consideration to understand their implications and mutual resonances for the psyche. Clinical cases of refugees will illustrate some aspects of these interconnections.     

Self,other and individuation: resolving narcissism through the lunar and solar paths of the Rosarium

This paper describes narcissism as our natural, infant-like behaviour, and specifies three characteristics relating to the evacuation and avoidance of distress, to control, and to distancing from relationship. It suggests that the processes of incarnation and individuation represent the development of the early ego and the ‘resolution’ of these narcissistic ways of being, including escape from the ‘mirror trap’. The development of the early, controlling ‘homunculus-ego’ entails the loosening and broadening of ego-identifications and the ego becoming subject to the Self. This is an embodied-relational-social-spiritual process outlined in detail by the full 20 woodcuts of the Rosarium Philosophorum, and specifically the lunar (relational) and solar (self-expressive) paths, which are explored herein. These processes are illustrated with respect to the interaction between infant and caregiver, clinical vignettes and examples from the political sphere.