La traviata and Oedipus

This paper explores the oedipal themes of Verdi's La Traviata, and proposes that it is his masterly treatment of their complexity which accounts for the psychological power of the opera. It is suggested that a particular quality of this opera lies in its ordinariness: no gross psychopathology is displayed, and yet it is mesmerizing. The claims of the eminent musicologist Joseph Kerman are explored that, in opera, music trumps words when there is a conflict between the apparent meanings of the libretto and the feel of the music, with special reference to the famous duet between Violetta (the ‘fallen woman’ – the traviata) – and her lover's father, Giorgio Germont, in which his harsh condemnation of her as conveyed by the libretto text seems to be softened, indeed quite altered, by the music. Other contradictions between the apparently explicit meaning of the text and the implicit sense of the music are also examined. These conflicts are illuminated by John Steiner's theory of two versions of the Oedipus situation, one paranoid–schizoid and the other depressive, which are contrasted with Grunberger's Oedipal views.     

Existential crises in two religious patients: Vicissitudes of faith and the emergence of the true self

The authors present two clinical cases involving an existential crisis which led the patients to lose what had been the foundation in their lives, their faith. Although the therapeutic settings differ – the first patient had a few psychotherapy sessions following a psychotic episode with a mystical background, while the second was in the final stage of analytic treatment – the authors highlight how in both clinical cases a loss of faith becomes a total and urgent crisis of the Self. The fracture which ensues seems to generate an intense engagement of the body which, paradoxically during a loss of faith, induces an experience of ecstasy of the kind that has traditionally been reported. In the first case the experience of ecstasy was lived first‐hand by the patient who thereafter redefined the psychotic breakdown as a “moment of truth”; whereas the second patient, through a deep projective identification, induces an eerie countertransferential feeling of ‘metaphysical’ shortfall in the agnostic psychoanalyst, triggering bewilderment, physical discomfort and awe in him. In both cases the authors believe that the notable somatic involvement may be correlated to a potentially profound and unprecedented contact with the True Self.     

Degrees of entrapment: living and dying in the claustrum

This paper explores Donald Meltzer’s concept of the claustrum, an unconscious phantasy of a space inside the body of the internal mother that has been forcibly entered and occupied. The author proposes that claustrophobic phenomena might be viewed on a continuum from the relatively ordinary to the severely pathological. Following a brief review of the characteristics of Meltzer’s claustral ‘compartments’, this continuum is explored through and illustrated by a psychoanalytic understanding of two films, Coraline, directed by Henry Selick and based on the novella by Neil Gaiman, and The Talented Mr. Ripley, based on the novel by Patricia Highsmith and directed by Anthony Minghella. The degree of entrapment in a claustrophobic world and the possibility of emerging from it into a world of authentic intimate relationships is shown to be influenced by the internal relationship to a parental couple.     

Convergent,Discriminant, and Incremental Validity of the Pictorial Attitude Implicit Association Test and the Picture Story Exercise as Measures of the Implicit Power Motive

The Pictorial Attitude Implicit Association Test (PA‐IAT) has recently been proposed as new measure of implicit motives. We report a study that provides the first evidence for the convergent validity of the PA‐IAT by showing that the PA‐IAT correlates significantly with a standard measure of implicit motives [i.e. the Picture Story Exercise (PSE)]. Discriminant validity of the PA‐IAT was verified in the sense that the PA‐IAT shared virtually no common variance with explicit motive measures. Our analyses revealed that the PA‐IAT and PSE can best be conceived as related but distinct measures. We further showed that the PA‐IAT had incremental validity in predicting performance on a memory recall task over and above the PSE. In general, our results confirm that the PA‐IAT is a valid measure of implicit motives and can serve as valid alternative to the PSE. Copyright © 2012 John Wiley & Sons, Ltd.     

Self-harm as a sign of hope

The author describes psychotherapeutic treatment with a woman who uses severe forms of self-harm to express her hope that she can find real understanding and an environment that can respond to her. She discusses the significance of the earliest experiences of maternal care and the particular importance of the skin; she describes how traumatic breakdowns in early care are unconsciously re-created in later assaults on the body, which serve to communicate distress, anger, protest and the hope that a real attempt will be made to relate to the person who self-harms. Self-harm is viewed not as a suicidal gesture, but rather, as an attempt to preserve life, and to represent and contain unbearable states of minds. The author outlines ways in which self-harm can create a narrative and embody unbearable feelings and unspoken thoughts. It is seen as a form of self-expression and communication, both conscious and unconscious, which is not wholly destructive but has important hopeful and self-preservative aims.     

ROY SCHAFER: A NARRATIVE

The author provides a brief overview of the papers given at the Schafer Symposium in October 2012 by the following six presenters: Henry Schwartz, Richard Fritsch, Rosemary Balsam, Lucy LaFarge, Michael Feldman, and Jay Greenberg. He also highlights some important ongoing themes in Schafer's writing, including theory—about which Schafer takes a unique position—history, and ideas from other disciplines. Schafer prefers continuing explorations over arriving at conclusions, the author notes, and believes that students should remain faithful to their mentors' thinking—until it is time for them to move beyond it.     

‘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.     

Levels of change in parent–infant psychotherapy

This paper offers a way of thinking about the process of parent–infant psychotherapy. I start by outlining some ideas as to what can go awry in troubled parent–infant relationships, and then a way of working with parents with pre-verbal babies. I suggest a model for understanding three interlaced levels at which change might occur if a psychodynamic, systemically sensitive, therapeutic intervention is offered. I describe a particularly challenging clinical case in which a mother and I also worked with video material of her and her son.     

The conceptual distinction between projective identification (Klein) and container-contained (Bion)

This paper describes the use of play in the psychotherapy of a latency child from a severely traumatised background. It considers the meaning of play in relation to the role of the psychotherapist and to psychotherapeutic technique and explores its functions in terms of the child's development. The paper documents the psychotherapist's learning experience about the difficulty of trying to make the ‘right’ interpretations and her consequent realisation of the intrinsic value of play in psychotherapy. In considering these themes, the author explores how, by placing interpretation secondary to play, the therapy enabled the development of the child's creativity and self-agency, facilitating a movement from primarily paranoid–schizoid defences towards the beginnings of a depressive position.     

Psychoanalytic witnessing as a prerequisite to psychotherapy with a severely sexually abused young adolescent male ex-inner city gang member

This paper discusses psychoanalytic witnessing as the prerequisite for psychoanalytic psychotherapy with a severely sexually traumatised young adolescent boy, Dean. This form of witnessing acted as a prior stage for treatment through the psychotherapist acknowledging Dean’s trauma, without seeking to symbolise its registration in the psychotherapeutic relationship. As sexual abuse is about something done to the person, this acknowledging crucially conveys belief in the truth of what has happened to the patient at the hands of the external world. My work with Dean taught me that such acknowledgment allows for such traumatised patients to then feel more able to accept interpretations based upon what they are doing to the external world, encapsulated in the transference to their psychotherapist. Because trauma is often so deeply felt, and leaves patients dissociated or fragmented, seeking evidence of its presence needs keen observation. Here the paper discusses an experience of bodily countertransference that alerted me to the location of Dean’s trauma’s registration in our relationship. Overall, the paper seeks to demonstrate the importance of psychoanalytic witnessing as a form of containment in itself, and the essential basis for psychotherapeutic work using symbolisation and the transference.