AFFECT,SYMPTOM, FANTASY,DREAM: CLINICAL AND THEORETICAL CONSIDERATIONS

A symptom being studied in the process of analysis can be seen as not unlike the unconscious affect it sprang from. The author presents a case in which a symptom, premature ejaculation, was analogous to the unconscious affect of guilt, which itself seemed to be a premature defensive transformation of a deeper current of anger. Guilt was interpreted as if it were a psychic premature ejaculation, a defensive derailment of anger. Fantasy and dream seemed to be engaged in similar transformations, with a fantasy of “premature incarceration” not unlike the symptom itself in its analogous functioning. Analysis of affect, symptom, fantasy, and dream in complex, integrative analytic process led not only to resolution of the symptom itself, but also to a deeper understanding of the mind's complex functioning in general.     

Postponing trauma: The dangers of telling

Surviving a major historical trauma has consequences that are difficult to live with. Survivors who remain silent are often condemned to a desiccated existence, a dried‐out life, a death in life. Survivors who speak out run an even greater risk. Telling their ghastly tale may trigger somatic consequences, psychotic episodes, or even suicide. As to the psychoanalytic cure, the free association it requires carries its own danger: negative therapeutic reaction in sometimes extreme forms. Avoidance of horror may turn into avoidance of life itself. Awful as it may seem, this avoidance of life may represent a victory over a menacing chaos. Should we as analysts accept the risk of endangering such a victory, no matter how unsatisfactory? The psychoanalytical injunction to speak out may trigger an upsurge of shame and terror. Is subjectivation always possible? This paper is about what happens when denial and splitting strategies are suspended, when ‘crypts’ are opened. Is there an analytic ‘poros’ allowing for a controlled return of affects? Is there a therapeutic solution to the problem of telling a wreckage without being caught in it? The dangers of ‘telling’ will be discussed in regard to new analytic strategies and new interpretive registers. When the ‘silent psychic sharing’ proves insufficient, some analysts go so far as to take part in the shame, share the grief, ‘lend their own psyche’, become a ‘double’ of the analysand, accept the existence of ‘sanctuaries’. To what effect?     

Encountering the dream: Intersecting anthropological and psychoanalytical approaches

The human dream has been a central and contested therapeutic resource for the various schools of psychoanalysis and psychotherapy. However, anthropology has been less concerned with human dreaming, though many anthropologists have studied indigenous peoples' dream theories as a consequence of the importance that such people gave to their dreaming. During the twentieth century there has been a fertile interaction between psychoanalytical approaches to dreaming and pertinent anthropological studies. This paper situates these interconnected disciplinary approaches to dreaming in the context of the historical development of thinking about culture and dreaming. The dream is considered as a multiple human resource. Discussion focuses on a fourfold approach to the dream: as therapeutic and existential encounter; as potential social knowledge; as cultural template; and finally as reflexive opportunity. Overall, the paper asserts the centrality of the dream as both a cultural and therapeutic resource.     

On talking-as-dreaming

Many patients are unable to engage in waking-dreaming in the analytic setting in the form of free association or in any other form. The author has found that 'talking-as-dreaming' has served as a form of waking-dreaming in which such patients have been able to begin to dream formerly undreamable experience. Such talking is a loosely structured form of conversation between patient and analyst that is often marked by primary process thinking and apparent non sequiturs. Talking-as-dreaming superficially appears to be 'unanalytic' in that it may seem to consist 'merely' of talking about such topics as books, films, etymology, baseball, the taste of chocolate, the structure of light, and so on. When an analysis is 'a going concern,' talking-as-dreaming moves unobtrusively into and out of talking about dreaming. The author provides two detailed clinical examples of analytic work with patients who had very little capacity to dream in the analytic setting. In the first clinical example, talking-as-dreaming served as a form of thinking and relating in which the patient was able for the first time to dream her own (and, in a sense, her father's) formerly unthinkable, undreamable experience. The second clinical example involves the use of talking-as-dreaming as an emotional experience in which the formerly 'invisible' patient was able to begin to dream himself into existence. The analyst, while engaging with a patient in talking-as-dreaming, must remain keenly aware that it is critical that the difference in roles of patient and analyst be a continuously felt presence; that the therapeutic goals of analysis be firmly held in mind; and that the patient be given the opportunity to dream himself into existence (as opposed to being dreamt up by the analyst).     

The canary in the mind: on the fate of dreams in psychoanalysis and in contemporary culture

Dreams have been central in the birth and evolution of psychoanalysis. This paper explores the remarkable story of the relationship between dreams and psychoanalysis as a modern version of the long history of dreams in most healing traditions. But psychoanalysis seems to have turned away from dreams as central inspiration in a way parallel to the general culture’s turn away from dreams and the reality of inner life. Yet modern postindustrial culture is transfixed by a version of “dream life” in ways just beginning to be understood (e.g., in the transformation of ancient interest in the inner screen to the external screen). Working with dreams in psychoanalytic psychotherapy was a creative and revolutionary act for our forebears. It is even more so today, in ways that are discussed in this paper.Dr. Paul Lippmann is training and supervising analyst and faculty member at the William Alanson White Institute and faculty member of the NYU Postdoctoral Program in Psychotherapy and Psychoanalysis. He is also Director of the Stockbridge Dream Society.     

The capacity to symbolise: Ideas and implications

Through a literature review and clinical examples of session material and dreams, this paper explores aspects of the origin and development of the capacity to symbolise. The literature review considers Freud’s thinking on symbols in dreams, hysteria and obsessional neurosis, Klein’s discovery of the importance of unconscious phantasy, Bion’s ideas on the psychotic part of the mind and Bick’s seminal ideas on skin as an important symbolic boundary between psyche and soma. The clinical material in this paper is used to demonstrate the capacity to symbolise, reasons for the impairment of this capacity, and how the translation of symbols through interpretation in a therapeutic setting can enable the symbols to acquire meaning. It includes examples both of the author’s work with adults and of other clinicians’ work with a child and an adolescent in a psychotic state of mind. The paper’s aim is to consolidate the idea that the capacity to symbolise grows out of an optimal early parent/child relationship and that the awareness of the significance of the symbols when they have been interpreted is of crucial importance.     

The Incongruity of Congruence

SUMMARY

This paper examines Satires concept of congruence and the possibility of a “Tao of communication” in historical, social, and cultural context. The author then suggests alternative strategies for facilitating mutual understanding among couples     

Does globalization affect our dreams? An inquiry into the subject matter of dreaming

Abstract

Does globalization affect our dreaming? This would be the case if dreams, in an increasingly globalized world, showed a decrease in characteristic cultural traits. I maintain however that the specific culture of the dreamer is not relevant in dreams in the first place. Any effect globalization may have on us is therefore not essential to the subject matter of dreaming.

Following Martin Heidegger's philosophical analysis of human existence, dreams are found to deal with emotionally relevant issues of our existence with which we have difficulties to come to terms. Matters of normality which are felt to be matters of course are not a topic in dreams. Consequently, normal cultural features only become a topic for dreaming in some form of negation of their normal function. An impressive dream-report, centering on a denied handshake, serves as an illustration.

In conclusion, it is stated that dreams are concerned with those very individual responses to general human issues which do not comply with the collectively accepted so-called “normal” responses of the specific culture. Our cultural identity is only of very marginal interest in dreams. Dreams spring from and point to the psychoanalytic identity of the dreamer.     

‘No entry’, an invitation to intrude,or both? Reflections on a group of anorexic patients

This paper describes the twice‐weekly psychoanalytic psychotherapy of a young woman who had undergone major bowel surgery in her early 20s, with no clear medical indication for the surgery. Whilst the concept of ‘No Entry’ described by Williams ( 1997a , b ) aptly describes many features of more ‘typical’ anorexic patients, this paper describes a particular group of anorexic patients, referred by their physicians for multiple medical procedures; and proposes there is a group of anorexic patients, repeatedly referred for medical investigations, into whom particular types of entries occur. These are entries into the body ‘legitimized’ as medical, with a trajectory towards multiple procedures, examinations and surgical operations. Other entries (outside the medical setting) may occur in a state of altered consciousness, under the influence of alcohol or drugs, such that any wish for intrusion is disowned and denied. In both sets of events, intrusion is both invited, and consciously denied. The case example illuminates some of these features, and aspects of the countertransference are also described. Attention is drawn to relevant research focusing on surgical intrusion. Finally, there is an exploration as to how such patients may invite intrusions into the body through surgery and medical procedures.