Psychoanalytic process and thought: Convergence of Bion and Matte‐Blanco1

Using the convergence between Bion and Matte‐Blanco, in this article the author attempts to stress the view of the psychoanalytical method as promoter of expansion of the ability of the patient to think his emotional experiences. After a brief résumé of the ideas of both Bion and Matte‐Blanco, certain points of congruence between the two are emphasised: the way of perceiving the range of phenomena observed by psychoanalysis, intuition as a method for observing this field, the feelings as the raw material for thinking, and the importance of the concept of infinity in psychoanalysis. The way in which the ideas of Matte‐Blanco assist in the understanding of Bion's propositions is highlighted. Following these correlations, the author discusses certain questions pertinent to the psychoanalytical method and proposes a model in which the analyst acts as a mediator/catalyst in the process of revision of the ways in which the patient has organised his emotional experiences and the theories constructed to support these hypotheses. Samples of clinical material are presented.     

BORGES, IMMORTALITY AND THE CIRCULAR RUINS

The author explores ideas surrounding immortality and death focusing on the interplay between their development in two stories by Borges ('The circular ruins' and 'The immortal') and their manifestation in a patient. With the help of Borges's stories, the author addresses the desperate necessity experienced by some individuals to search for immortality. This is not just an expression of the universal wish to live forever but, at a deeper level, arises from the impossibility of bearing the mental pain of experiencing ordinary human vulnerability and loss - death being the ultimate expression of such vulnerability. It is suggested that the relentless pursuit of immortality in such individuals expresses an omnipotent phantasy of ridding the self of the emotional pain and fear that arises through being alive. It leads to a denial of the emotional significance of passage of time, of separation and sexual differences. In actuality, the individual's state of not feeling approximates to a complete loss of human identity and emotional death, with no place for any meaningful others. The individual him/herself becomes a 'mere image', living in a delusional world peopled by him/herself and his/ her projections, and ending up trapped inside the circular ruins he/she has generated. The horror experienced at the stark awareness of the individual's emotional death and the wish to re-establish contact with the good internal objects that have been attacked sets in motion the long process of searching for the recovery of a sense of temporality (that would still include the wish for immortality) and, with it, a sense of identity.     

A practitioner's notes on the free-associative method as existential praxis

Freud's pre-1914 texts demonstrate why he consistently asserted that his free-associative method was the sine qua non of his discipline. Prior to 1914, Freud's theorizing was intimately and inextricably connected to his lived experience with the discovery of this method. After 1914, he became more speculative in this thinking and writing; his models of the “mental apparatus” and its functioning drew increasingly on conceptual sources other than his experience with free association. The four fundamental coordinates of his discipline (the methodical disclosure that self-consciousness is repressive, the nonlinear “time of the mind,” the significance of our sensual embodiment or libidinality, and the formation of the repression barrier by the incest taboo) are all closely tied to free-associative experience. By contrast, post-1914 theoretical preoccupations (from object relations to the structural-functional model, and other formulations generated after Freud's life) are comparatively divorced from such experience. These conceptual edifices imply a conventional depiction of the theory–practice relationship, which is radically challenged by free-associative discourse. The notion of praxis is introduced as contesting the prevailing depiction of practice as an application of theory, and as serving to rescue psychoanalysis from the somewhat “sterile debates” over its scientific status and over the relevance of metapsychological speculation to clinical treatment. Against the normative ideology of theory and practice, the lived experience of free-associative discourse, with its potential for change and healing, can only be understood in terms of this notion of praxis, and this justifies Freud's claim to have initiated “a critical new direction in science.”     

Acting,feeling and thinking: psychoanalytic psychotherapy with Tracey

This paper consists of a case study and commentary which formed a part of the inaugural lecture in a series entitled ‘Working with Psychosomatic Issues’*. The audience consisted of psychoanalytic, body psychotherapy and integrative practitioners. The presentation was divided into three parts, (1) an outline of philosophical themes that inform perspectives on health, illness and psychosomatic phenomena, (2) the case study reproduced below and (3) a summary of Winnicott's work (1960, 1966, 1988) on ‘the indwelling of the psyche in the soma’. The case study describes work with a young woman who harms herself through self-hitting and, in addition, expresses other physical manifestations of psychological distress. The core approach of the practitioner is psychoanalytic. The work is informed also by postmodern sensibilities and phenomenological themes.     

Quality of life

This article gives an overview of the field of psychotherapy in relation to other relevant fields such as body-therapy and spiritual counselling. It is shown how psychotherapy defines itself in isolation from or in comparison with its sister disciplines. Political boundaries between professions are described. The field of transformation is shown to be encompassing not only the health professions, the psychotherapy professions, and the professions dealing with spiritual emergency, but it can also be seen to contain intra-personal, interpersonal and extra-personal (social) dimensions.     

Clinical and psychopathological research on attachment: the contribution of the psychic envelopes model

This paper proposes to put into perspective the attachment model (Bowlby) and that of psychic envelopes (Anzieu) so as to grasp the contribution of attachment theory to the field of psychopathology. Having laid the foundations of the epistemological debate between these two models, relying on a discussion of the stakes inherent in the psychoaffective development approach, the author refers to current forms of psychopathology, which draw massively on the borderline and narcissistic concepts, in order to discuss the sense and benefits of the “skin–ego” model as an alternative and complement to attachment theory. Beyond altering reference models in psychopathology, this debate and related inputs lead to consider therapeutic applications through a combination of the notion of “caregiving group” – a group version of the attachment figure – and the notion of therapeutic offer as a necessary alternative to the ideology of demand.     

Controlling,Avoiding, or Protecting the Object: Three Reactions to the Breakdown of Psychic Retreats

In working psychoanalytically, it is common to encounter patients who need to carefully manage their immediate objects. This is evident in their stories about external life at home, at work, and with friends as well as in how it emerges within the transference. While a frequent theme in many analytic cases, the motives behind this need are varied.

Case material is used to show how these reactions emerge when psychic retreats fail. When unable to find refuge in pathological organizations or psychic retreats, patients are exposed to the worst of paranoid and depressive anxieties with only a fragile foxhole to withdraw into or defend from. In such a precarious psychological state, fantasies of unbearable self and object danger emerge, leading to various forms of acting out, overreliance on projective identification, and perverted images of giving and receiving. These fantasies result in the desire for idealized objects, the drive to resurrect fallen objects, and the need to avoid cruel and attacking objects that have taken over and replaced the sought out ideal.     

Trauma and healing: from ‘furor sanandi’ to ‘animus sanandi’

In his last period (1928–33), Ferenczi tried to complement the ‘negative’ technical principles first introduced by Freud in the 1910s. He introduced diverse and successive ‘positive instructions’, and specific techniques known as ‘elastic’ of ‘relaxation and neocatharsis’, and also made an unsucessful attempt to introduce ‘mutual analysis’. These techniques are implemented around a series of new technical principles including ‘tact’, ‘empathy’, ‘indulgence’, ‘intense sympathy’. All of these positive technical principles and innovations demonstrate the importance of considering the dimension of ‘healing’ in all analytic experiences and the importance of the analyst's functioning as the ‘healer’. The emphasis on the use of these new technical principles is consistent with the emphasis Ferenczi places upon countertransference and traumatic factors in psychopathogenesis.     

Dreaming up the patient in supervision: from the concrete to the symbolic*

This paper discusses the importance of parallel processes within the therapeutic and the supervisory context of therapy with an eight-year-old boy diagnosed with Asperger’s syndrome. During the first months of the therapy, through powerful projective identification, the therapist found herself in the ‘clothes’ of the ‘dead mother’. She was unable to think and feel in the sessions. Deadness could not be symbolised – it was enacted in the sessions. The therapeutic encounter had to start elsewhere: the supervisor’s reverie brought to life the patient’s material in the context of the supervision, allowing thinking to occur, first within the supervisory relationship and only then in the therapeutic relationship. In the context of supervision, the encounter of two mentally alive people could contain anxieties, metabolise them and open the way to mental connections. This encounter facilitated the development of creative thinking of both the therapist and the young patient in the consulting room, which allowed the child to become the subject of his existence and to evolve.     

THE ELUSIVENESS OF MASCULINITY: PRIMORDIAL VULNERABILITY,LACK, AND THE CHALLENGES OF MALE DEVELOPMENT

Reaching beyond the Oedipus prototype to address the unrepresentable vulnerability founded on the boy's infantile helplessness in contact with the mother's body, the author aims to identify the inherent tensions and enigmas of being male. He proposes that both the repudiation of femininity and the overvaluation of phallicity are unconsciously constructed to withstand the fundamental deficiency grounded in the asymmetry of the boy's prephallic relation with his primary object. This bodily based primordial vulnerability, marked by absence and lack, remains elusive—an unsymbolizable experience that provides the archaic matrix for adaptive and defensive phallicism, the oedipal complex, and genital progression. A clinical vignette is presented to illustrate these concepts.