Reflections on the role of the analytic setting in the light of COVID-19

There have been many reflections, both individual and collective within our Institutes, on the effects on our work with patients caused by COVID-19 and the requirement to move suddenly from the setting of our own consulting rooms to working with patients online (see also, the previous issue of this Journal). This paper focuses on what we have learned from these experiences that can add to our knowledge about the role of the setting in analytic work. Drawing on Bleger’s (1967) seminal paper highlighting the usual setting as a mute projection carrier for primitive wishes and affects, the paper explores how different patients have reacted to the loss of the analyst as the guardian of the setting and in particular as an embodied presence. Some key questions and challenges for both patients and analysts during the pandemic, when ‘the setting begins to weep’, are explored.     

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 technologically-mediated self: reflections on the container and field of telecommunications

This paper contains reflections on the use of the imagination in technologically-mediated therapy and analysis. As part of the individuation process the psyche is seen as needing to adapt to new technological ways of communicating. The notion of a technologically-mediated self is posited describing a self which can only be apprehended through, and by, the use of telecommunications. This self is seen as identical to the in-person self, a subset, or superset of it. There is a revisioning of our notions of the container and the field in this work performed through technological-mediation. The need to engage the imagination in approaching this kind of work is emphasized in order to create an imaginal play-space in which the body will be deeply affected. Some thoughts on how the process of individuation might look through such analytic work is presented.     

La terapia de conducta en el tratamiento de la anorexia nerviosa ¿eficaz o peligrosa?

RESUMEN

Por el peligro físico que supone y los delicados matices de sus alteraciones, la anorexia nerviosa constituye un verdadero reto para los procedimientos tradicionales en la práctica clínica. El uso reciente de técnicas de terapia de conducta se ha visto también contestado por su supuesta peligrosidad para las personas que padecen esta importante alteración. En este artículo se revisan los principios fundamentales que sustentan este tipo de terapia y sus implicaciones en la salud del enfermo. Al final del artículo se presenta un breve estudio de casos tratados con terapia conductual.     

Rabindranath Tagore and Freudian thought

The paper draws our attention to the Indian poet and philosopher Rabindranath Tagore's notion of psychoanalysis. Focusing on the period between 1926 and his death in 1941, during which Tagore had not only met Freud but had also spoken to several persons on psychoanalysis, the author has unearthed a mass of archival material, primarily in Bengali, and translated most of it into English for the first time, in order to show how Tagore's opinion regarding Freudian thought gradually changed from severe criticism and a near complete rejection to appreciation, especially of its good use in literature and literary criticism. The author has also identified a number of literary works, both prose and verse, from the final years of Tagore's life and tried to document the extent of influence of Freudian thought on their composition. In short, the author explores a significant interdisciplinary area that has not been looked into either in India or abroad.     

Rivers of milk and honey ‐ an exploration of nurturing the self in a Russian context

This paper is an exploration of the relationship between nurturing in all its contexts ‐ among them, the nursing couple and the therapeutic relationship ‐ and the evolution of an individual self. The ideas are illustrated by a case vignette of a Russian patient. An attempt is made to show that when the self as an integral unity of body and soul is addressed in the analytic setting, ‘nutritional dreams’ emerge as expressions of the self‐in‐action. Certain psycholinguistic features of the Russian cultural context are described which suggest a link of meaning between development of the self and secure parenting. This linguistic association may facilitate the process of self‐centering.