Self-harm by omission: A question of skin containment

Abstract

This paper explores the phenomenon of ‘self-harm by omission’ and its relationship to other kinds of self-harming behaviour and to disturbances of psychic skin functioning (Bick, 1968 Bick, E. 1968. The experience of the skin in early object relations. International Journal of Psychoanalysis, 49: 484–486. [PubMed], [Web of Science ®] , [Google Scholar]). Process material from work with a patient ‘Kate’ is introduced to illustrate and clarify the matters under consideration. The conceptual framework provided by psychic skin theory is described, with particular reference to the defences of ‘toughening’ and ‘porosity’ and their relevance to understanding different kinds of self-harm. Arising from this work, suggestions are advanced with regard to further development and an extended range of application of a ‘skin containment’ conceptual framework.     

Making room: Developing reflective capacity through group analytic psychotherapy – in the analyst and in the group. Part one

Abstract

This paper is in two parts. This, the first part, traces the inter-related development of trainee group analyst and training group during the first nine months of the group's life. The influence that personal group analytic psychotherapy, supervision and theoretical learning have on the trainee are also considered in relation to the development of the group and its members, many of whom suffer from narcissistic and borderline disorders. The metaphor of ‘making room’ is used to explore the efforts of analyst and group to contain the chaotic, confused and unbounded projective identifications of its members. In this way, amidst the crowded turbulence of the group, a space begins to open up in which, slowly and painfully, the capacity for reflection may emerge.     

Counter-narratives in context: The role of the organisation and broader culture in psychic splitting among South African survivors of intimate partner violence

Chronic trauma, shame and psychopathology, as well as the association between them, are acutely understudied, both in South African and internationally. The focus of this article is on chronic trauma of a particular kind, intimate partner violence (IPV) and the development of a specific form or shame-related psychopathology, the splitting of self and how this splitting may be further facilitated or exacerbated by the contexts in which people live. The (counter) narratives of three women are presented. These (counter) narratives demonstrate the presence of both a concealed and shameful authentic self, and the socially conforming projected false self, two polarised parts of the psyche. It is argued that the organisational context, a shelter for survivors of IPV, which has a strong ethos centred around advocacy and human rights and which promotes a strong message of personal empowerment and agency, may unintentionally exacerbate the psychic split in women who have been subjugated at a broader (predominantly patriarchal) cultural level their whole lives. Participants’ resistance narratives were often characterised by inconsistencies and contradictions which oscillated between supporting mainstream cultural narratives and organisationally driven, active resistance against the cultural context from which they came. However, resistance narratives often felt thinly veiled and inauthentic, which is one of the problems with interventions in resource constrained settings which are necessarily time-limited. To fully and completely counter the cultural message that has been the focus of participants’ lifelong gendered socialisation, long-term and in depth interventions at organisational level are needed. These ideas are not only relevant to the South African setting, but have wider application internationally.     

The Dracula killer: A psychobiographical illustration of the Schahriar syndrome model for serial murder

This psychobiographical study of Richard Trenton Chase (1950–1980), a serial murderer, has the aim to uncover the psychic mechanisms characteristic of his functioning. The study included primary and secondary data sources. All materials collected and analysed, were published and publically available. The Schahriar syndrome model served as the conceptual framework for data framing and interpretation. Findings suggest that Chase exhibited five primitive psychic mechanisms namely: omnipotence, sadistic fantasies, ritualised performance, dehumanisation and symbiotic merger. The Schahriar syndrome model has utility to explain the psychological functioning of a serial murderer.     

Narcissism, hypochondria and the problem of alternative theories

This paper is an experiment in conceptual integration and clinical theory testing. Its argument is that narcissism and sexual object love develop from a single source and continue to interact during childhood development and adult life (Freud) and that drives in their oedipal and other formations are not merely disintegration products of narcissism (Kohut). Material from two analyses, supplemented by material from two others, indicate that narcissistic injury was a significant factor in the neuroses of these patients but that aggressive and libidinal conflicts were also decisive such that their hypochondriac symptoms were compositions of their interacting causality. As a result these neuroses are negative instances of Kohut's theory of narcissism. The hypochondriac symptoms as they emerged could not have had the structure and dynamics they actually had nor could the analytic process these patients underwent have achieved the far-reaching and durable amelioration of these symptoms that occurred. On the positive side, these analyses are but two inductive instances that support Freud's theory. However, one major difficulty of the faddishness of psychoanalytic theorizing is that much of worth is lost from general theories that turn out not to be supportable. The clinical material from these two cases which disprove basic elements of self-psychology metapsychology also require adjustments to classical theory that integrate the contributions of self-psychology to psychoanalytic clinical theory.     

Psychotic withdrawal and the overthrow of psychic reality1

The author attempts to distinguish between the world of fantasy and the imagination (which fuels our capacity to ‘dream’) from a withdrawal into fantasy. In this withdrawal, the foundations of which are laid in childhood, a dissociation from psychic reality starts and from it the delusional world arises and constitutes the adult illness. During therapies of adult patients who have experienced a psychotic state, it is often possible to reconstruct the state of infantile withdrawal and understand how their dissociation from reality was ignored or unknowingly encouraged by their parents. Children destined to develop psychosis enter into the dissociated world not just as a defence against anguish or loneliness, but also for the pleasure of experiencing a delusional self‐suffi ciency and a gratifying omnipotence in which anything is possible. Mental workings that take place in the withdrawal do not follow the rules governing normal psychic functioning. Those fantasies cannot be either repressed or ‘dreamed’ in order to be transformed into thoughts. These psychopathological structures, which develop early and autonomously, have to be understood during analytical therapy in their origins and ‘deconstructed’ in order to help the patient to escape from their dominion. By means of clinical examples, the author tries to shed light on the possible ways of reaching patients in their psychotic shelters, thereby helping them to re‐emerge into a psychic reality.     

Talking and Thinking With Our Hands

ABSTRACT— When people talk, they gesture. Typically, gesture is produced along with speech and forms a fully integrated system with that speech. However, under unusual circumstances, gesture can be produced on its own, without speech. In these instances, gesture must take over the full burden of communication usually shared by the two modalities. What happens to gesture in this very different context? One possibility is that there are no differences in the forms gesture takes with speech and without it—that gesture is gesture no matter what its function. But that is not what we find. When gesture is produced on its own and assumes the full burden of communication, it takes on a language-like form. In contrast, when gesture is produced in conjunction with speech and shares the burden of communication with that speech, it takes on an unsegmented, imagistic form, often conveying information not found in speech. As such, gesture sheds light on how people think and can even play a role in changing those thoughts. Gesture can thus be part of language or it can itself be language, altering its form to fit its function.     

Jung and Pauli

In his early theories of the structure of the psyche, psychic energy and psychodynamics, Jung was influenced by William James's understanding of the complementary insights of depth psychology and the discoveries of subatomic physics, and his concept of field in physics and the study of the subconscious. In his relationship with Freud, Jung initially struggled with a sexually-based drive theory. But he gradually came to conceive libido as a quantitative concept, a psychic analogue of physical energy. In their own languages, both C. G. Jung and Nobel physicist Wolfgang Pauli explored the evolution of scientific thought from the naive insights about process in alchemy through Newtonian causality, space-time theories of relativity to quantum mechanics. Jung had access to thirteen hundred of Pauli's dreams. The first four hundred were basis for his research into alchemical symbolism in a modern psyche. In a later collaboration, Pauli supported Jung's synchronicity principle as scientific, and Jung fostered Pauli's understanding of the archetypal and collective factors in the psyche. They each explored the interconnections between the energies of psyche and matter, and the possibilities of acausal order and synchronicity. Pauli's ground-breaking discoveries gave scientific demonstration of alchemical intuitions. Through him, alchemical and archetypal insights entered the discourse of physics. Through Jung, the apprehensions of microphysics entered our psychological language and thought.     

The numinous and immanent nature of the psychoanalytic subject

In the Freudian and Kleinian conception of unconscious mental life, credence is given to the existence and functioning of peremptory instinctual drives as the putative causation of all mental life, yet they are denied an organization or a personality. It is especially when we come to the notion of how dreams are created or how the free associations of an analytic hour are orchestrated that we begin to wonder about the hidden order, the cryptic intelligence or presence, that seems to cohere our chaos and present it to us in mystically encoded forms for us to translate.
In this contribution it is posited that there is a numinous or ineffable subject of the unconscious which organizes our mental life and which unconsciously registers everything that happens to us. Mysteriously connected with this is the immanent subject of conscious/preconsciousness which registers the impact of stimuli from the external world but which has contact with the numinous subject.     

TEILHARD'S TWO ENERGIES

Abstract. Resolution of the entropy‐evolution problem was a significant issue for Pierre Teilhard de Chardin throughout his scientific career. Although never truly satisfied with his solution, he proposed that all energy must be psychic and contain two components. Tangential energy is related to physical energy. Radial energy in some way accounts for increasing complexity and consciousness in evolution. Analysis of developments in thermodynamics, statistical mechanics, and information theory show that Gibbs free energy contains both calorimetric and noetic components, thus validating Teilhard's intuition.