The empathizing–systemizing (E–S) model of autism and psychoanalytic theories of truth,play and symbolization

Little psychoanalytic material or theory features today in psychological work on autism and autistic traits and vice versa. Baron-Cohen's (2003) empathizing–systemizing (E–S) model of the autism spectrum posits two main clusters of autistic features: those surrounding impaired empathy, and those surrounding heightened systemizing behaviours. (Baron-Cohen, 2009) speculates that the common root of these two clusters is the individual's concept of truth. Psychoanalysis has addressed the related issue of internal and external reality since (Freud, 1897) differentiated ‘psychic’ from ‘historical’ truths. This could be of interest to those espousing the E–S model from a cognitive paradigm, as a ‘truth’-oriented cognitive style in autism may develop interdependently with the individual's experience of internal and external realities. Psychoanalysis has developed further ideas of relevance to the E–S model surrounding play and symbolization, the latter being an often-overlooked aspect of Wing and Gould's (1979) triad of autistic features. Seen from a psychodynamic perspective, the E–S model might provide a means to increase therapists' awareness of milder autistic traits amongst service users and analysands. Equally, it could offer a tool to structure empirical research into psychodynamic therapy with autism spectrum conditions.     

Christer Sjödin interviews Jan Stensson

Abstract

The author examines different definitions and applications of the terms “psychic energy” and “libido.” With regard to the “psychic energy” terminology, he shows that its application and usage relate in particular to the perspective of Brenner and not to Freud's definition. He argues that Freud uses the term “psychic energy” as a synonym for “libido,” and not “libido” as a synonym for “psychic energy.” It is demonstrated that in Freud's view, up until 1914, “libido” relates to manifestations of bodily sexual tensions, and subsequently this term applies to the manifestations of sexual energy in the psychic field. The author rejects this change in terminology and also challenges Freud's attempt to use dynamic-economic considerations as an explanatory device for epistemological reasons. Freud's concept of energy is inconsistent with the meaning of energy as defined in the physical sciences, and whereas the metapsychological topographical, dynamic, and structural viewpoints have a solid foundation in the representational world to which the psychoanalytic process affords unique access, this is not true of the economic viewpoint. It is claimed that bodily tensions only exist in the representational world in the form of affects, so that, in the author's opinion, the economic viewpoint should be abandoned in favour of an affective one. In the context of the endeavour to obtain pleasure and avoid unpleasure adduced by Freud, this viewpoint focuses on the relationships between affects and the different elements of the representational world, thereby serving as the subject of metapsychological investigation.     

The clinical revolution of the ‘wise baby’

In an historical context focused on a close examination of the complex relationship between Freud and Ferenczi, the author shows Ferenczi's contribution to the evolution of psychoanalysis. He describes how his ideas and his therapeutic sensitivity anticipated modern clinical thought (for example, Winnicott and Bion), especially the understanding of borderline and narcissistic pathology. The paper considers the following topics: transference and countertransference; early affectivity; the different psychic trauma; phenomena connected with dissociation; the healing factor of the analysis.     

RICOEUR'S PHILOSOPHY AND ITS IMPLICATIONS FOR PSYCHOANALYSIS

In differentiation of early and mature shame, the phenomenological content of shame changes with the development of a stable self-state. In this hypothesis, early shame refers to a person's dependence upon mirroring himself and in being mirrored by an outer object, while mature shame refers to introspection and self-reflection. From a developmental psychological point of view, the connection between self-development and mirroring is expounded. Mirroring is defined as a psychic dialectic process between the inner psychic reality and the outer reality. Early shame is connected to dyadic mirroring, which refers to attachment and empathy. Mature shame is connected to triadic mirroring, which refers to separation and reflection. Early shame emerges from discrepancies between the infant's expectations of a complementary affective response and the mother's response, and is defined as an early marker of differences in the mother/infant unit. It is argued that early shame in smaller ‘doses’ has a regulating function on self-development by maintaining the psychic dialectic process, while in larger ‘doses’, it has a disturbing effect on the self-development, resulting in pathological shame. In the therapeutic process, early shame appears as shame scenarios illustrated in the text by a clinical vignette.     

The Ojibwa Vision Quest

Like other Algonkian-speaking groups, the Ojibwa traditionally sought personal relations with guardian spirits whom they encountered in visions, as a rite of passage into status as adults. Visions were sometimes sought as early as age three or four, and were generally accomplished no later than puberty. The procedures for cultivating visions blended practical and ritual elements. The procedures were both explained informally and portrayed in myths and belief-legends. Roheim interpreted vision quests in keeping with Freud's general theory of religion, as evidence of fixated Oedipus complexes; but a pathologizing interpretation is inappropriate. Detailed analyses of both boys' and girls' self-reports readily support diagnoses of healthy genitality, rather than Oedipal fixation. Vision quests are better regarded as manifestations of ego ideals, leading in most cases to improved ego–superego integration.     

Catch 22: the inflammatory nature of insight

I will describe a man I saw in psychoanalytic psychotherapy with a history of serious drug abuse and violent psychotic episodes. At the start of therapy my patient had little capacity to tolerate the anxiety, depression or the inevitable frustrations involved in facing reality. Over time and with the support of the therapy he was able to increase his capacity for self observation noticing the way he withdrew from the world of shared reality into psychotic states of mind in order to avoid painful feelings of rage, humiliation and shame. In the book ‘Catch 22?, Joseph Heller described the paradox of pilots who wish to claim insanity in order to avoid fatal flying missions, while the authorities maintain that in claiming insanity to avoid suicidal missions the individual demonstrates a sane awareness of the insanity of the missions! This insight is deemed to be evidence of the individual’s sanity and consequently their plea of insanity is denied. In this paper, I will show how Mr. A’s developing capacity for reflective functioning lead to a ‘Catch 22’ as the insight he needed as part of the process of recovery threatened to overwhelm him with depressing realities about the extent of his illness.     

A Review of “Trauma and Human Existence: Autobiographical,Psychoanalytic and Philosophical Reflections”

Abstract

The author sets out to locate Bion's model of the mind within the developmental history of psychoanalysis, from Freud to Klein to Bion, using biographical material and clinical case examples, to illustrate Bion's concepts of container/contained, his understanding and use of projective identification, his extension of the use of the countertransference, and his differentiation between the psychotic and non-psychotic aspects of the mind. Links, and attacks against linking are discussed, as well as Bion's thoughts about learning versus knowing, being versus becoming and his emphasis on the essential importance of the development of the capacity to think.     

Psychoanalytic application and psychoanalytic integrity

In this article, the author offers an analysis of psychoanalytic application, defined as the breaking of new conceptual ground in some field of knowledge whereby the new idea is conceived, and later articulated, with the aid of reference to analogous phenomena in psychoanalysis. It requires apt analogy based on competent understanding of the applied field and of psychoanalysis. Only when the relevant differences between the applied and psychoanalytic fields are grasped can the extent of certain parallels emerge. The thinking by analogy that comprises psychoanalytic application may be intuitive and implicit, but should be susceptible of explicit theoretical elaboration that specifies, precisely, the point(s) of correspondence between psychoanalysis and the applied field in relation to a precise specification of their relevant differences. Applied psychotherapy at the interface of the internal and external worlds (historically rooted in casework) is employed as a model. By analogy with Donnet's concept of the analytic site, the author proposes the concept of the psychodynamic (case)work site, and elaborates it for that applied field in order to elucidate the proposed principles of psychoanalytic application.     

ON BECOMING ABLE TO PLAY: INDIVIDUAL CHILD PSYCHOANALYTIC PSYCHODRAMA AND THE DEVELOPMENT OF SYMBOLIZATION

In this paper, the authors analyze the relevance and transformative potential of individual psychoanalytic psychodrama in the treatment of children with severe impairments in symbolization. Central features of this modality, including promoting the representation of early traumatic experiences, are presented and discussed. Specific features include double‐envelope containment of the co‐therapists’ group and play leader, consequent diffraction of the transference‐determining portrayal, gradual integration, and initial figuration of coexisting split‐off fragments. Drawing on in‐depth clinical material, the authors show how psychodrama tempers the potentially traumatic effects of the encounter with the object, allowing these patients to access the transitional area of play.