Search

Beginning with the observation that a good integration of soma and psyche is often missing in our work with severely disturbed analysands, two concepts are discussed that focus constellations of bodily encoded unconscious material, which needs a specific form of working-through. The concept of encapsulated body engrams referring to defence structures revolving around the inhibition or disorganization of an affective bodily impulse is outlined. The imbalance arising this way is perceived as a foreign body within the body-self. These engrams are repetitive and are not susceptible to symbolic transformation. Parallels between the encapsulated body engram, the autistic objects (Tustin, F. 1980. "Autistic Objects." International Review of Psycho-Analysis 27: 27–39) and Freud's theory of inhibition (Freud, S. 1926. "Inhibitions, Symptoms and Anxiety." SE 20: 77–175) are discussed. To unblock encapsulated engrams, body feelings emerging in the chain of associations are understood as attempts to communicate. In a process called somatic narration these perceptions are contextualized with other bodily sensations. The working-through of this material in transference and countertransference is described in the light of Lombardi's concepts (Lombardi, R. 2017. Body- Mind Dissociation in Psychoanalysis – Development after Bion. New York: Routledge). Two case reports precede the theoretical discussion. The paper begins with the observation that a good integration of the soma and psyche is often missing in our work with severely disturbed analysands; two concepts are then discussed that focus on constellations of bodily encoded unconscious material which need a specific form of working through. The author proposes the concept of encapsulated body engrams to refer to the defense structures revolving around the inhibition or disorganization of an affected bodily impulse. The dysfunctional imbalance that arises this way is often perceived as a foreign body within the body-self. These engrams are highly repetitive and are not susceptible to symbolic transformation. Parallels between the encapsulated body engram, the autistic objects (Tustin, 1980) and Freuds theory of inhibition (Freud, 1926) are discussed. The paper argues that body feelings emerging in the chain of associations are attempts to communicate and to unblock encapsulated engrams. In a process called somatic narration, these perceptions are then contextualized with other bodily sensations. The unfolding and working through of this material in the transference and countertransference is described in light of Lombardi's concepts (2017). Two case reports are explored. [ABSTRACT FROM AUTHOR]

This paper highlights some aspects of the conceptualization of trauma in psychoanalysis and introduces the three subsequent papers by Bernard Chervet, Jan Abrams and Howard Levine. It focuses on the interchange between external and internal reality, the construction of traumatic defensive organizations and the role of reparation and guilt in overcoming the repetition compulsion. [ABSTRACT FROM AUTHOR]

This research addresses the initial reception of Lacanian ideas in Uruguayan psychoanalysis. Lacanian ideas arrived in Uruguay in the 1960s in a context in which Kleinian thought prevailed. This paper studies the relation between Kleinianism and Lacanianism by analyzing discursive phenomena. The corpus used for this study was built from a variety of sources: theoretical-doctrinal papers, clinical cases, media publications, seminars transcripts, and institutional documents. The discursive materials presented here show the different controversies, crossroads, compromises, and demarcations that characterized the reception of Lacanian ideas in a context of Kleinian predominance. [ABSTRACT FROM AUTHOR]

This paper presents evidence that Bion's epistemological contributions drew on the work of R. B. Braithwaite, a British philosopher of science, more than has generally been acknowledged. Braithwaite introduced the "scientific deductive system", a term Bion adopted. It proposed that empirical scientific methods could be applied to immaterial subjects of study, including "unconscious mental processes" (Braithwaite 1953, ix). Bion's private work journal, collected in Cogitations, documents Braithwaite's direct influence throughout its entries, particularly in one dated 10 January 1959, entitled "Scientific method" (Bion 1959b). This paper reviews relevant elements of Braithwaite's work, and examines Bion's "Scientific method" and samples from his epistemological work to argue that one of Bion's goals was to bring an empirically based scientific model to psychoanalytic theory and clinical practice. More than a matter of academic interest, Braithwaite's work lends pragmatically useful context to understand Bion's theoretical and clinical intentions in greater depth. It also suggests the main reasons why his project did not come fully to fruition, which led Bion to turn from the scientific deductive system towards his later developments. [ABSTRACT FROM AUTHOR]

Bernd Nissen has been developing a metapsychology of hypochondria and ‘autistoid’ states for 20 years, working within the Kleinian object relations tradition to formulate the earliest events of psychic life. His imaginative work shows careful thinking about early catastrophic developmental experiences which may lead to various forms of psychopathology. In the current paper, Hypochondria as an actual neurosis, Nissen extends his progressive work on hypochondria and joins his evolving theory of autistoid encapsulation to a revival of interest in Freud's concept of actual neurosis, the experience of unrepresentable early trauma, the problems of historicization, and to Winnicott's description of the fear of breakdown. I first summarize Nissen's theoretical work in the area of hypochondria and autistoid encapsulation, and then comment on his current paper including the challenge of historicization in unrepresented states. Finally I consider the question of parsimony in Nissen's metapsychology. [ABSTRACT FROM AUTHOR]

Translations of summary The influence of nannies and other significant caregivers on a child's psychological and emotional development may be profound and if unrecognized may contribute to psychopathology in adulthood. However, the significance of the nanny has been relatively neglected within the psychoanalytic literature. In this paper I will discuss the impact of early caregivers other than the biological mother on the psychic development of the child, and the role of the nanny within the family dynamics as a figure attracting powerful unconscious phantasies and unwanted projections. These ideas will be illustrated by a detailed account of a year-long observation of an infant who had a succession of several different nannies in her first three months before her parents employed a more permanent nanny. It is proposed that the baby's emerging attachments to her two primary caregivers, mother and nanny, developed in parallel and influenced each other, with observable impact on her behaviour and developing personality. The paper concludes with a review of the place of infant observation within psychoanalytic training and how the experience of witnessing the earliest infant-caregiver relationships in an extra-analytic setting both refines understanding of developmental theory and builds a foundation for psychoanalytic practice. [ABSTRACT FROM AUTHOR]

Translations of summary Did Winnicott replace or transform Freud's metapsychology? The author's aim is to explore more deeply the views developed in a previous paper based solely on Winnicott. Here the author draws on other studies to respond to two questions recently posed by Fulgencio concerning the meaning of the term metapsychology and the existence of a new topography in Winnicott's work. For many authors, Winnicott does not reject Freudian metapsychology and says nothing new in this field; in the field of paediatric anthropology, however, he focuses on dependence, and in the field of the living embodiment of the drives on being and self as different from ego. But Green notes the existence of a third topography, that of self/object, and also examines the vicissitudes of being by isolating the concept in Winnicott's work. For the author, however, being seems in continuity with his whole anthropological and ontological perspective; and when Winnicott introduces environmental factors of which the infant is unaware, he also introduces a heuristic distinction between early and deep: there is thus neither a rejection nor a reformulatation of the metapsychological theorization, but rather a coexistence of two paradigms. [ABSTRACT FROM AUTHOR]

Translations of summary This paper is an attempt to deal with some questions raised by the so-called 'compulsion of destiny' constellation. In presenting the standpoints of Freud and of psychoanalysts who after him were concerned with this problematic, the author takes the view that several aspects of the configuration merit further discussion. Accordingly, the dynamics of repetition compulsion, the complexity of the projective strategy, the coexistence of passive and omnipotent trends are considered. Concerning compulsive repetitions the dimension of drive intrication is underlined, thus moderating the understanding of this clinical entity as mainly related to death drive trends. Projection is understood as serving complex psychic demands. The coexistence of passive and omnipotent trends is envisaged, as manifested in phantasies of submission / participation of patients to a force that exceeds human limitations. For certain cases the consonance of somatic and psychic experiences is noted. Finally, elements from the material of two cases are presented which pertain to the problematic of the compulsion of destiny in which random events are submitted to heavy psychic necessities. [ABSTRACT FROM AUTHOR]

As is well known, Freud described the clinical practice of psychoanalysis as the 'loam' of his cultural-theoretical work, an assessment which is shared by many psychoanalysts up to the present, including the authors of this paper. The complex interplay between unconscious phantasies on the one hand, and the real experiences arising from the new possibilities opened up by prenatal diagnostics on the other, is described with reference to a report of an intensive, long psychoanalysis with an analysand from a family burdened with a genetically transmitted illness (haemophilia). The holding and containing function of the analyst enabled this analysand, despite traumatic experiences with the miscarriage of a healthy child triggered by a prenatal diagnosis and the later abortion of a haemophiliac baby, nevertheless to have the courage to go through another pregnancy and give birth to a healthy girl. The intensive clinical investigation of the unconscious phantasies, conflicts and traumas around the prenatal diagnostics proved to be not only therapeutically fruitful for the analysand, Ms F. It also facilitated insights into those individual chances and risks which appear to be an integral part of the opportunities presented by todays prenatal diagnostics and, through them, it lead to a cultural-critical look at the ambivalence of medical-technical progress. These insights, which are only attainable through psychoanalysis, can represent a distinctive contribution of psychoanalysis to a multi-disciplinary dialogue with medical practitioners, geneticists, ethicists and health policy-makers. By referring to a large EU study on 'Ethical Dilemmas due to Prenatal and Genetic Diagnostics', this paper gives a practical example of such a discussion. Ms F. was psychoanalytically interviewed as part of this study, 16 years after the conclusion of her analysis. The summary of these interviews, which is set against the account of the treatment, offers an impressive insight not only into the long-term effects of a psychoanalysis under very particular personal circumstances, but also into the lasting consequences of decisions made in the context of prenatal diagnostics. Finally, the results of the individual case study are brought together with the clinical outcomes of the EU study, and some considerations are formulated concerning the protective and risk factors facing women during and after prenatal diagnostics. The paper is an appeal to psychoanalysts, with their specific competence in dealing with unconscious phantasies and conflicts and their high level of professionalism in dealing with traumatised patients, to get involved in fresh dialogue with prenatal diagnosticians and their patients. [ABSTRACT FROM AUTHOR]

The underlying concern of this paper is that psychoanalysis as practised today is in danger of losing its specificity and so losing its way. The author suggests this is possible for three reasons: the problem analysts face in responding to the strong emotional demands the great majority of patients necessarily place on them, the unintended consequences of the apparent success of 'here and now technique' and the absence of good clinical theory. The paper mainly discusses the author's ideas about some core elements of the clinical theory that all psychoanalysts must use when they are working and proposes (at the risk of being facile) some relatively simple heuristics related to them which are meant to be helpful. Recalling Kurt Lewin's maxim that 'there is nothing so practical as a good theory', he will suggest that continuous reflection on how one is using theory in daily practice is highly practical, if the theory is good enough. Theory in fact is a necessary 'third' in psychoanalytic practice which, if kept in sufficient working order close enough to clinical experience, provides an ongoing and very necessary check on our sense of reality. But, of course, as a third it can, like reality itself, be the focus of both love and hate with equally problematic consequences. The paper starts with a clinical example of a difficult but apparently successful analysis reaching its end, which will be used throughout the paper to illustrate and elaborate the theoretical ideas set out. [ABSTRACT FROM AUTHOR]

This paper identifies three points on a continuum of levels of analytic work and levels of meaning. The thinking arose out of many years of work with autistic and borderline children, who were not able, for reasons of profound ego impairment, to respond to the more traditional explanatory interpretation as a method of ascribing meaning. Their capacity for introjection was limited. The author suggests that a prior level - lending meaning via description or amplification - is more effective in helping them to think. The paper argues that this second method, where appropriate to the patient's developmental and psychopathological level, need not be seen as inferior to or less complete than the former type. A third, more intensified level of work - an urgent insistence on meaning - is illustrated with a patient where the deficit was not only in the ego, but in the self and the internal object. The suggestion is that the issue at this third level - with emptied out patients - concerns, not thinking about feeling, nor even identifying feeling, but gaining access to feeling itself. The paper involves an attempt both to elaborate certain of the author's earlier ideas on technique and to consolidate these into a wider schema of priorities. [ABSTRACT FROM AUTHOR]

This paper argues that if one considers just a single clinical moment there may be no principled way to choose among different approaches to psychoanalytic technique. One must in addition take into account what Aristotle called the final cause of psychoanalysis, which this paper argues is freedom. However, freedom is itself an open-ended concept with many aspects that need to be explored and developed from a psychoanalytic perspective. This paper considers one analytic moment from the perspectives of the techniques of Paul Gray, Hans Loewald, the contemporary Kleinians and Jacques Lacan. It argues that, if we are to evaluate these techniques, we must take into account the different conceptions of freedom they are trying to facilitate. [ABSTRACT FROM AUTHOR]

Research on psychoanalytical education within the IPA may be clarified by reflecting on the ethic behind each of the three main models (Eitingonian, French and Uruguayan). In fact, the ethic underpinning psychoanalytical education, whatever the model, is confronted by irreducible conflicts between transmitting psychoanalysis by means of analytical experience or by means of academic teaching. Transmission by experience is essentially based on the ethic of psychoanalytic practice, which is difficult to regulate through institutional standards, whereas the academic aspect can be evaluated by objective and public criteria. The importance of both aspects and their relative weight in the training process depend on the conception of psychoanalysis underlying each model. This paper will look primarily at the French training model, the essentially analytical aspects of which favour the transmission of the very ethical foundations of psychoanalytic practice itself: the application of the method both as a working tool and as a tool of evaluation. It presupposes expanding the observation and analysis of transference beyond the framework of treatment to that of supervision. From this analysis, the paper will attempt to demonstrate how the French model proposes dealing with the inevitable conflicts between transmission by means of analysis and training by means of apprenticeship. [ABSTRACT FROM AUTHOR]

This paper recovers the notion of the sacrifice of sexuality as the central, tragic, element of the oedipal structure. This notion has been largely abandoned in the psychoanalytic literature that has tended to reduce the oedipal structure to processes of exclusion. The paper traces the development of the theoretical and clinical transformations of Freud ’s ideas on the role of the father and suggests that they allow us to more fully comprehend the Oedipus complex proposed by Freud. A paradox is explored: the killing of the father is, in Freud ’s view, the requirement for the creation of the social order which, from then on, prohibits all killings. The father, however, has to be killed metaphorically only, as the actual exclusion of the father lies at the origin of so many psychopathologies from violence to the psychoses and perversions. The paper analyses the fundamental asymmetry that is present in the Oedipal structure and suggests that the three elements of the oedipal triangle constitute the law (of the dead father, that institutes the sacrifice of sexuality), desire (for the lost object) and identification (with both father and mother). Two clinical examples are discussed. In the first, one can identify a perverse structure in which the father has been murdered; in the second, there is a progressive construction of the dead (symbolic) father in the analytic process. [ABSTRACT FROM AUTHOR]

A publishing cohort of Kleinian analysts – Rosenfeld, Segal and Bion – implemented Klein’s (1946) notions of projective identification and the ‘paranoid ’ and ‘schizoid ’ positions in the understanding of a group of psychotic disorders. The author differentiates Klein’s (1946) paper from its revised version of 1952, maintaining that it was Rosenfeld’s clinical work during this period that helped to centralize Klein’s redefinition of projective identification. The stage was set for Segal ’s contribution in terms of ‘symbolic equations,’ where the psychotic’s attack on the breast left him incarcerated in internal torment and persecution, where things-in-themselves were confused with what they symbolically represented. Segal in turn linked psychotic to normal, paranoid–schizoid to depressive positions, where by means of projective identification and symbolic imagination, the patient could arouse feelings in the analyst related to sadness, guilt and loss. Bion assumed that psychotic pathology reflected disordered thinking, when the severely disturbed used language as a mode of action. The psychotic was profoundly confused between the use of thought and action in the natural world – where thought was required, he preferred action and vice versa. Bion also drew upon projective identification in a new, broader way, so that analysis could now become more of an intersubjective, bi-directional field of projective and communicational influence between patient and analyst. The paper concludes with the impact of the work of Rosenfeld, Segal and Bion and variations on the technique of analyzing psychotic states in terms of the patient’s early history, transference and countertransference. [ABSTRACT FROM AUTHOR]

This paper will focus on the concept of ‘absence’, which describes a continuum of non-responsiveness and misattunement of the environment in the stage of absolute dependence; it refers to concepts like lack, failure, non-recognition, impingement, neglect, tantalizing, ranging to mental, physical and sexual abuse. An extreme external absence causes shock and fear. The automatic survival response is an inner absence, an intrapsychic absence, a dissociation of parts of the self. The external and the inner absence are the negative image of each other. The concept of absence points to the synchronicity of outer and inner reality and portrays the non-responded-to needs of the self. This point of view of the development of psychopathology of the self on the basis of massive dissociation is inherently an intersubjective-field-theory. As the inner absence is created as a reaction to an absence of the other, in analysis – the analyst has an active role in reviving it. This paper will explore the language of absence, that is, the derivatives and consequences of these situations in the inner realm, and in the relations with the analyst. It is the author’s contention that understanding and speaking this language has important clinical and technical implications. Understanding the language of absence enables the analyst to recognize its intersubjective and its intrapsychic presence, to provide an environment that allows for its revival, and to facilitate and regulate the annihilation anxiety that awakens when dissociated self-states are experienced. When the absence is present, i.e. when the traumatic experience and the dissociated reactions to it are experienced in an attuned relationship, it is rendered with meaning, symbolization, and validation, and enables the survival mode of dissociation to be relinquished. [ABSTRACT FROM AUTHOR]

Loewald's 'Waning of the Oedipus complex' is a watershed paper in the history of psychoanalytic thought. By means of a close reading of Loewald's paper, the author frames, discusses and clinically illustrates his understanding of Loewald's reconceptualization of the Oedipus complex. The principal elements of Loewald's reformulation include: 1) the idea that the tension between the pressures of parental infl uence and the child's innate need to establish his own capacities for originality lies at the core of the Oedipus complex; 2) the notion that oedipal parricide is driven, most fundamentally, by the child's 'urge for emancipation.' Parricide involves a revolt against, and an appropriation of, parental authority; 3) the idea that the child atones for the act of parricide by internalizing a transformed version of the child's experience of the oedipal parents. This results in an alteration of the very structure of the child's self (i.e. in the formation of the superego as the agency of autonomy and responsibility); 4) the notion that, in the child's appropriation of parental authority, he in reality 'kill[s] something vital in them … [thus] contributing to their dying' and to the succession of generations; and 5) the idea that the incestuous component of the Oedipus complex involves, in health, the creation of a transitional incestuous object relationship which, over the course of one's life, mediates the interplay between undifferentiated and differentiated aspects of self and relatedness to others. The author concludes with a comparison of Freud's and Loewald's conceptions of the Oedipus complex. [ABSTRACT FROM AUTHOR]

In this paper, the author sets out to distinguish anew between two concepts that have become sorely entangled--'trauma' and 'narcissism'. Defi ning 'narcissism' in terms of an interaction between the selfobject and the self that maintains a protective shield, and 'trauma' as attacks on this protective shield, perpetrated by bad objects, he introduces two attractors present in trauma--'the hole attractor' and the structure enveloping it, 'the narcissistic envelope'. The hole attractor pulls the trauma patient, like a 'black hole', into a realm of emotional void, of hole object transference, devoid of memories and where often in an analyst's countertransference there are no reverberations of the trauma patient's experience. In the narcissistic envelope, on the other hand, motion, the life and death drive and fragments of memory do survive. Based on the author's own clinical experience with Holocaust survivors, and on secondary sources, the paper concludes with some clinical implications that take the two attractors into account. [ABSTRACT FROM AUTHOR]

It has been difficult to know what does and does not constitute competent psychoanalytic work and so equally difficult to assess when it is being practised and when it is not. This makes difficult any form of disciplined evaluation of the outcome of training, which has a series of problematic outcomes for psychoanalytic practice, psychoanalytic institutions and the relationship to allied disciplines and professions. In this paper, the author considers how far it might be possible to devise a framework for assessment of training programmes within a disciplined psychoanalytic pluralism. The aspiration is to develop a transparent framework, based on an empirically supported demonstration of analytic capacity. The framework needs to be sensitive and subtle, and to be able to withstand challenge. It needs to take cognisance of the twin facts that there is more than one way to practise psychoanalysis and that it is necessary to avoid 'anything goes'. Drawing on an ongoing project undertaken by European IPA institutes, the author describes some of the problems colleagues have been experiencing in European institutes, because they have not had available transparent criteria for assessment. He outlines a preliminary form of a proposed method for making more transparent and supportable assessment. The author intends for this paper to inspire hope, enquiry and debate. [ABSTRACT FROM AUTHOR]

This paper examines some of the mechanisms through which interpretation aimed primarily at increasing conscious awareness can nonetheless produce unconscious changes, the latter being deemed the basic aim of psychoanalysis. The concept of valency or motivational weight of the interpretation is proposed to assess which forces of the various motivational systems the interpretation mobilizes (hetero/self-preservation, sensual/sexual, attachment, narcissistic, psychobiological regulation etc.), on which of the above-mentioned systems interpretation relies, and which would oppose therapeutic intervention and why. Certain conditions are also analyzed that could explain the so-called 'change through the analytic relationship', pointing out that, despite the major differences between this form of change and change through interpretation, both of them would share certain mechanisms. This conclusion leads to the need to qualify the idea that interpretation would be exclusively aimed at declarative memory, with no effects upon procedural memory. The paper examines the potential consequences for therapeutic techniques derived from recent fi ndings in neuroscience on so-called labile state memory, and proposes the coupling of experiences as one of the analytical instruments used for therapeutic change. A clinical vignette is included to illustrate some of the theoretical and technical aspects considered. [ABSTRACT FROM AUTHOR]

This paper examines the parapraxes made by, to or about Jewish-identifi ed individuals discussed by Freud in Psychopathology of everyday life. Each of these errors and slips is occasioned by what he terms a 'mésalliance' between a Jew and a Gentile. Such incidents of distorted language betray unresolved ambivalences and unformulated anxieties endemic to Jewish-Gentile interaction in Freud's Vienna. First, the disturbed relationships between German-speaking Gentiles and their threatening Doppelgänger, the Jews, are analyzed by means of Freud's analysis of the 'uncanny' and an examination of the particular restrictions placed upon the 'offi cially' emancipated Jews in the Habsburg Empire, especially with regard to intermarriage. Then, the paper turns to Freud's discussions of explicitly Jewish-identifi ed individuals and their limitation to illustrating parapraxes associated with what should be the most pleasurable and intimate relationships between Jew and Gentile, namely sexual and connubial relations. His focus upon this confl icted conjunction diagnosed the intrinsically problematic character of Jew-Gentile interaction in his Vienna. [ABSTRACT FROM AUTHOR]

When Freud founded the International Psychoanalytical Association (IPA), he wanted a network of local groups responsible for psychoanalytic training. The groups would function as 'headquarters whose business it would be to declare: "All this nonsense is nothing to do with analysis; this is not psychoanalysis".' Today, with psychoanalytic pluralism, Tuckett (in press) has asked 'Does anything go?' He has pointed out that the psychoanalytic community has been increasingly willing to accept within its ranks apparently very varied approaches to theory and practice, and that this increasing diversity has many negative consequences for psychoanalytic institutions and especially for training schemas. The aim of this paper is to give an example of psychoanalysis that 'did not go', and how that led to a shaky start for the new Danish Psychoanalytical Society, with confusing boundary relations between psychoanalysis and psychotherapy and no training institute. Beginning with the written psychoanalytical contribution of the three founders of the Danish Society, the paper will try to identify factors that contributed to the 'shaky start'. The paper will also examine how stones were removed from the path, thus paving the way for the members of the Society to discover 'competent psychoanalysis'. [ABSTRACT FROM AUTHOR]

In this paper the author addresses some problems concerning the relation between attachment theory and psychoanalysis and sketches the outline of a Freudian theory of attachment, based on the ideas ofthe Hungarian psychoanalyst Imre Hermann. First, he elucidates the fundamental divergence behind the insults and misunderstandings that have dominated the debate between attachment theory and Freudian psychoanalysis: they differ radically in their conceptions of temporality and of the relation between psychopathology and human nature. Second, the author presents Hermann's work on 'Clinging--Going-in-search' (1976) as a theoretical model in which the findings of attachment theory can be integrated in a theory of psychopathology that is radically dimensional and that preserves the methodology of Freudian psychoanalysis. In the third part of the paper, the author discusses the question of whether Hermann's 'clinging instinct' is a primary instinct in the Freudian sense, and whether it is an interesting alternative for Freud's 'death instinct', as Hermann claims. [ABSTRACT FROM AUTHOR]

In this paper, the authors report on the transition to young adulthood (18-25) in the highest functioning 18 individuals in our cohort (GAF " 90) from a prospective longitudinal study of 76 lives followed from birth. These 18 individuals provide as clear a view as possible into the inner lives of people least distorted by psychopathology. This gives us a more crystalline photograph of psychic structure: the precipitant of family, society and psyche itself. Using a standard DSM IV criterion, Global Assessment Functioning (GAF), provides phenomenological homogeneity, but leaves us with heterogeneity of inner life. The 18 individuals had relatively rare drug or alcohol use and less sexual partners. Vocational functioning exceeded intimacy. Four had tumultuous pathways into adulthood. Nine were crossover cases, coming from sub-optimal mothering, with significant variation in gender distribution and intrapsychic structure. The paper discusses factors facilitating and inhibiting development and the nature of memories. [ABSTRACT FROM AUTHOR]

Taking as its starting point Klein's concepts of 1957, this paper stresses certain characteristics of envy that have not yet been taken into account in psychoanalysis. Klein described the conflict between envy and gratitude as inherent in the human being; she suggested an interesting link between envy and admiration, but never developed this idea in her theory. The hypothesis that we put forward in this paper is the existence of a particular intolerancerelated to envyof one's own capacity to recognise the valuable aspects of the object. This situation leads to the paradox that the same faculty that allows the patient to appreciate the good qualities of the object is at the same time the source of unbearable pain. The capacity to recognise the good aspects of the objectwhether they are perceived or attributed by projective identificationcannot be accepted as a valuable aspect of the self and is taken as a proof of the self 's unworthiness. We think that the description of this intolerance towards admirative appreciation introduces a change in the understanding of idealisation simply as a defence against envy and enriches the conflict expressed in the immediacy of the transference countertransference. [ABSTRACT FROM AUTHOR]

The theory of the Oedipus complex as Freud formulated it rests on the following pillars: the child's characteristic sexual and aggressive impulses concerning the parents, phallic monism, and the castration complex. This paper reviews the context in which Freud discovered the Oedipus complex, as well as Freud's theory. It then examines the proposals of later authors whose general Oedipal theories differ from Freud's in an attempt to point out both their possible correlations and confrontations with Freud. It includes Klein's pre-genital Oedipal theory, Lacan's structuralist reinterpretation, Bion's reconception of the complex under the knowledge vertex, Green's generalized triangulation theory, Meltzer's notions of the aesthetic object and sexual mental states, and Chasseguet-Smirgel's archaic Oedipal matrix [ABSTRACT FROM AUTHOR]

While 'splitting' is a familiar concept, its meaning is not as self-evident as is commonly assumed. In different contexts, it refers to different phenomena and is supported by different understandings of psychic dynamics. In this paper, the author presents four different conceptualizations of splitting, which capture the essential aspects of contemporary psychoanalytic discourse on the concept. There is a dissociative kind of splitting, which involves splitting off, in the face of trauma, whole personalities, which to some extent remain accessible to consciousness; there is a disavowal kind of splitting that splits off our awareness of disturbing realities or their meanings in our efforts to avoid the inner restraints imposed by repression; and there are two forms of splitting of the object into good and bad-one focusing on the splitting of representations of the object due to ego weakness and environmental determinants, and the other on the splitting of the mind itself in a primarily destructive act aimed at sparing the good from the destructiveness of our death instinct. All four conceptualizations have their origins in Freud's writing and then are further developed in the work of later analysts. The author argues that understanding the nature of these various conceptualizations of splitting can contribute to analytic theory and practice. It also sheds light on the essential nature of analytic approaches and how they offer different perspectives on the unity and disunity of man's basic nature. [ABSTRACT FROM AUTHOR]

Freud's interest in the impact of death on the living goes back further than Mourning and Melancholia (1917e, [1915]). In Totem and Taboo (1912-13) Freud noted the ambivalence of the emotions we experience in relation to the dead. In this paper, I focus on Mourning and Melancholia as a landmark in the understanding of both the normal and psychopathological aspects of mourning and depressive processes in human beings. Mourning and Melancholia bridges Freud's first and second topographic theories of the psychic apparatus and constitutes for many authors the foundation of his theory of internal object relations. With this psychoanalytic understanding of mourning as a framework, I discuss 'special mourning processes,' such as the those confronted by psychoanalysts in Argentina when treating the relatives of thousands of people who were 'disappeared' by the military dictatorship in the 1970s; they are 'special' in the sense that the external reality [which] constitutes the starting point of the psychic mourning process, as described by Freud, is absent. I argue that the 'absent-presence' of the body as an enigmatic message initiates a special mourning process that bears certain characteristics of, and is isomorphic to, Laplanche's seduction theory. [ABSTRACT FROM AUTHOR]

While Bion's 1967 memory and desire paper reflected a crucial episode in his clinical thinking during his epistemological period, it was also central to his evolution as a Kleinian psychoanalyst who worked with seriously disturbed adult patients. The author explicates and contextualizes these claims with a new archival document, the Los Angeles Seminars delivered by Bion in April 1967, and the full-length version of Notes on memory and desire. Bion here instigated a radical departure from years of theory-laden work when he made his clinical work and ideas accessible to a new audience of American Freudian analysts. While this new group was keenly interested to hear about Bion's clinical technique with both borderline and psychotic patients, there were varied reactions to Bion's ideas on the technical implications of the analyst's abandonment of memory and desire. Both the Los Angeles Seminars and Notes elicited responses ranging from bewilderment, admiration to skepticism amongst his audience of listeners and readers. These materials also however allow for a more complete and systematic presentation of important ideas about analytic technique - and while his ideas in this domain have been long valued and known by many psychoanalysts, this contribution stresses the crucial aspect of the reception of his ideas about technique in a particular American context. American analysts gained a much more explicit idea of how Bion worked analytically, how he listened, formulated interpretations and factored in the analyst's listening receptivity in the here-and-now. The author concludes with a consideration of the importance of Bion's American reception in 1967. [ABSTRACT FROM AUTHOR]

This paper provides an overview of narcissistic personality disorders as they present clinically along a spectrum of severity ranging from the best functioning forms of pathological narcissism to the most threatening to the patient's psychosocial and physical survival. It proposes a general interpretive psychoanalytic stance with all these clinical syndromes that range from standard psychoanalysis to a specific psychoanalytical psychotherapy for the most repressive and life threatening conditions that may not respond to standard psychoanalysis proper. This general psychoanalytic approach is placed into the context of related developments in contemporary psychoanalytic understanding of pathological narcissism and its treatment. [ABSTRACT FROM AUTHOR]

The author reviews some clinical experiences of the treatment of personality disordered patients suffering from internal domination of ego functioning by a defensive pathological organization. In particular, the function and purpose of perverse, sadistic attacks by the organization on the ego are considered and questions pertaining to technique are raised. It is suggested that different forms of sadistic, subjugating activity by pathological organizations may denote differences in intent borne of the type and severity of the psychopathology of the individual. Patients with severe narcissistic psychopathology for whom object contact has become associated with the arousal of intense psychotic anxieties seem more likely to be subjected to an invasive, annihilatory imperative by the pathological organization, the purpose of which appears to be to obliterate the experience of contact with any differentiated object, to avoid emotion and to use coercion to enforce a primitive identification by the ego with the psychotic organization in the mind. Certain patients with less severe narcissistic psychopathology, yet for whom object contact can also be associated with the arousal of psychotic anxieties due to intense or persistent conflict with the object, sometimes expressed as organized sadomasochistic clinging to a punishing and punished object (for example, in certain borderline or depressed patients) exhibit sadistic attacks that serve less to annihilate object contact and more to intrusively control and punish the object. Observations of these phenomena have been made by a number of psychoanalysts in recent decades and these contributions are discussed. This paper is addressed primarily to the implications for technique with such patients, particularly a need for triangulation of their experiences of oppression in order to loosen the controls over the ego by the pathological organization. [ABSTRACT FROM AUTHOR]

The defences provoked in the analyst by the anxieties associated with the difficult tasks of 'assessment' and 'selection' for psychoanalysis can result in a tendency to think in terms of 'hurdles to be cleared' by potential psychoanalytic patients, rather than 'opening the gates'. This can result in a diminution of the analyst's capacity to enlist and sustain a psychoanalytic stance. Only within a psychoanalytic frame can a meaningful psychoanalytic process unfold, at all stages of a potential patient's movement from their first contact through to, possibly, entering into an analysis. The author illustrates the value of this thinking by describing the work of the London Clinic of Psychoanalysis where there has been a shift of emphasis in psychoanalytic consultation towards working with individuals on their potential to initiate a psychoanalytic process, and away from the sole aim of 'selection of a suitable patient'. In this paper, the author notes that when institutional culture and practice supports psychoanalytic identity, this makes it more possible to recognize and articulate the anxieties provoked by the 'emotional storm' inevitable in psychoanalytic consultation, and the draw towards unhelpful enactment that may otherwise obscure the initiation of a psychoanalytic process that may or may not result in analytic treatment. Illustrative case material from the Clinic is presented. [ABSTRACT FROM AUTHOR]

Freud's initial formulations viewed psychoanalysis as working towards the rediscovery of psychic elements - thoughts, feelings, memories, wishes, etc. - that were once known - represented in the mind, articulatable, thinkable - but then disguised and/or barred from consciousness. His subsequent revisions implicated a second, more extensive category of inchoate forces that either lost or never attained psychic representation and, although motivationally active, were not fixed in meaning, symbolically embodied, attached to associational chains, etc. Following Freud's theory of representation, the author conceptualizes these latter forces as 'unrepresented' or 'weakly represented' mental states that make a demand upon the mind for work and require transformation into something that is represented in the psyche, if they are to be thought about or used to think with. This paper describes, discusses and presents illustrations of this transformational process (figurability),that moves intersubjectively from unrepresented or weakly represented mental states to represented mental states, from force to meaning, from the inchoate to mental order. [ABSTRACT FROM AUTHOR]

This paper is a meditation on the potential and problems of establishing and maintaining loving and passionate relationships, drawn from a lifetime of struggling with these issues in the course of doing analysis. It describes interferences with the capacity for mature sexual love as reflecting various psychopathological conditions. These limitations include a variety of psychological restrictions determined most frequently by masochistic, narcissistic and paranoid personality features. Clinical case material illustrates both mature and disturbed capability for love relations. [ABSTRACT FROM AUTHOR]

We start by stressing the idea that the process itself of constructing the symbol in its different components and its vicissitudes is centrally important to contemporary psychoanalysis as symbols are essential for thinking and for storing emotional experiences in our memory and for conveying our affects to others and to ourselves. Our implicit idea is that internal attacks are not directed only at the internal objects, but also include attacks on the structure or forms of the mental representations before and while they become constituted in symbols. It is by this means that destructive impulses invade the processes of symbolic construction. Symbols can lose their plasticity and thus silence the emotions and therefore cut off the patient from their meanings. Our clinical material allows us to increase our understanding of how the formal qualities of symbols operate in mental life, and how they can interfere in the capacity to work through emotional experiences. Finally, our reflections based on the analysis of a patient with difficulty in relating with the meanings of the symbols he produced will highlight the importance of the analyst's reverie along the process of formulating an interpretation. This paper is also part of a development in the study of the process of reverie. [ABSTRACT FROM AUTHOR]

Perversion had been viewed as oedipally determined and in a reciprocal relationship with neurosis. In our widening scope, however, pre-oedipal and traumatic contributions have been increasingly emphasized. While both perspectives represent aspects of clinical reality, the tendency has been to overlook sexual and aggressive drive derivatives, with their related conflicts, object representations, and symbolic enactments, even though they may make significant contributions to the analytic situation. These latter, 'classical' patients have what I consider 'organized' perversions: complex, evolved, neurotic-level, stable psychopathological formations that may be distinguished from borderline or near psychotic syndromes enlisting perverse mechanisms to ward off disorganization. This paper will review Freud's work, briefly consider some recent trends in conceptualizing perversion and perverse mechanisms, characterize organized perversion, and present clinical material to illustrate its evolution, clinical manifestations, and analysis. Transsexualism, overtly similar to transvestism but not functioning as an organized perversion, will serve as a point of contrast. [ABSTRACT FROM AUTHOR]

The author attempts to develop some of the basic models and concepts relating to mourning processes in psychotic patients on the assumption that situations of loss and mourning are key moments for psychoanalysis, psychotherapy, and therapeutic approaches in general. Secondly, he reminds us that 'mourning processes in psychotics' are not always 'psychotic mourning processes', that is to say, that they do not necessarily occur within, or give rise to, a psychotic clinical picture. These ideas are illustrated by a number of sessions and vignettes concerning two psychotic patients in psychotherapeutic and psychoanalytic treatment. In theoretical terms, it seems vitally important in this context to combine a relationship-based approach within a framework of special psychoanalytic psychopathology with an updated view of processes of mourning and affective loss. A fundamental requirement at clinical level is to determine the role to be played by psychoanalytically based treatments in combined, integrated or global therapies when working with psychotic patients. For this purpose, the paper ends by outlining a set of principles and objectives for such treatments. [ABSTRACT FROM AUTHOR]

Having reviewed certain similarities and differences between the various psychoanalytic models (historical reconstruction/development of the container and of the mind's metabolic and transformational function; the significance to be attributed to dream-type material; reality gradients of narrations; tolerability of truth/lies as polar opposites; and the form in which characters are understood in a psychoanalytic session), the author uses clinical material to demonstrate his conception of a session as a virtual reality in which the central operation is transformation in dreaming (de-construction, de-concretization, and re-dreaming), accompanied in particular by the development of this attitude in both patient and analyst as an antidote to the operations of transformation in hallucinosis that bear witness to the failure of the functions of meaning generation. The theoretical roots of this model are traced in the concept of the field and its developments as a constantly expanding oneiric holographic field ; in the developments of Bion's ideas (waking dream thought and its derivatives, and the patient as signaller of the movements of the field); and in the contributions of narratology (narrative transformations and the transformations of characters and screenplays). Stress is also laid on the transition from a psychoanalysis directed predominantly towards contents to a psychoanalysis that emphasizes the development of the instruments for dreaming, feeling, and thinking. An extensive case history and a session reported in its entirety are presented so as to convey a living impression of the ongoing process, in the consulting room, of the unsaturated co-construction of an emotional reality in the throes of continuous transformation. The author also describes the technical implications of this model in terms of forms of interpretation, the countertransference, reveries, and, in particular, how the analyst listens to the patient's communications. The paper ends with an exploration of the concepts of grasping (in the sense of clinging to the known) and casting (in relation to what is as yet undefined but seeking representation and transformation) as a further oscillation of the minds of the analyst and the patient in addition to those familiar from classical psychoanalysis. [ABSTRACT FROM AUTHOR]

In this paper the author describes some of the clinical features encountered in patients who seem to ‘nurture’ a persistent grievance. He gives clinical examples, and discusses the nature of the powerful underlying dynamics. He suggests that contained within the patient’s grievance is a set of phantasies that constitute the expression of his fear and hatred of reality, particularly the reality of the oedipal situation, the child’s relationship to the creative parental couple, which Money-Kyrle (1968, 1971) has characterised as an essential element of ‘the facts of life’. The phantasies the patient has evolved serve to protect him from envy and jealousy, anxiety and guilt. The primitive oedipal phantasies on which the grievance rests also contribute to the excitement and gratification that are characteristic of the grievance. The analysis of the underlying state of mind helps to account for the persistent grip the grievance has on the patient, and the way this interferes with development. [ABSTRACT FROM AUTHOR]

This paper describes the characteristics of subjective time (in contrast to objective time), with particular reference to a specific form of pathological experience and relation to the passage of time in patients with narcissistic personality undergoing psychoanalytic treatment. The clinical manifestations and technical approach to this pathology of time experience are outlined in the context of illustrative clinical vignettes. [ABSTRACT FROM AUTHOR]

Unlike other concepts such as 'illusion', 'capacity to tolerate frustration' and 'libidinal investment', the concept of faith has not yet found a well-defined position in psychoanalytic theory. Bion focused on faith and placed it in an unusual context: scientific work. Through the Act of Faith a researcher can give some consistency to certain ideas, hunches or intuitions that may appear during observation, though he cannot represent them by existing theory. Through the Act of Faith an analyst can 'see', 'hear' and 'feel' those mental phenomena, the reality of which leaves no practising psychoanalysts in doubt, even if they cannot represent them by current formulations. In this paper, the author aims to expand Bion's proposals into the clinical and therapeutic fields. In the first part, the author examines how faith and trust overlap, and how they depart from each other, and he gives an example. Faith possesses an igniting and driving force which trust doesn't possess to the same extent. In the second part, the author looks at F as a psychic function of the analyst, which aids him in supporting a depressed and hopeless patient while waiting for the return of the patient's desire to live. In the final part, he focuses on F from the patient's point of view and studies the transformations of F that may occur during an analysis. [ABSTRACT FROM AUTHOR]

This paper discusses and illustrates some technical implications of D. Liberman's contributions to character analysis. Psychoanalysis is an extended conversation, and character structure is expressed linguistically as part of an interactive linguistic fi eld. Liberman's notions of linguistic styles and communicative interaction defi ne a unique analytic surface from which to examine the syntactic, semantic and pragmatic aspects of character. The presence of a rigid and defensive linguistic style refl ects resistance and communicative impasse within the transference and countertransference matrix. A fully interactive communicative experience integrates all aspects of the conversation and allows both participants to take part in a shared semantic fi eld, the precondition to the generation of new meanings. Liberman suggests responding to miscommunication by means of a methodical linguistic attitude. Various such complementary responses are explored through several vignettes, with a particular focus on the interplay of the epic and narrative modes. [ABSTRACT FROM AUTHOR]

The aim of the paper is to study the theoretical and technical tools for psychoanalysis adapted to an infantile analysand's requirements. The author presents the case of a 6-month-old boy with his mother in psychoanalytical sessions four times a week; the analysis was terminated after six weeks. After the fi rst two sessions the disturbances between the infant and the mother disappeared from everyday life but continued with increasing intensity as an emotional storm in the sessions during three weeks up to a 12-day break. During and after the break everyday life continued without disturbances. After the break the emotional storm continued in the sessions but abated and was replaced by playing. The infant's creation of a 'fort-da' game with his pacifi er indicated a transformation of the mental functioning. The analysis could then be terminated. The study of the process indicates good reasons to adapt psychoanalytical concepts to the prerequisite of the infantile personality and to use the concepts of 'unconscious', 'infantile repression', 'substitute formation', 'return of the infantile repressed', 'infantile transference', 'splitting', 'xKy', 'reverie' and 'containment' as some of the theoretical tools for understanding the infantile personality in a clinical psychoanalytical setting. [ABSTRACT FROM AUTHOR]

In this paper the author reviews Freud's study of Schreber's Memoirs and the Memoirs themselves from a perspective of nearly 100 years. He argues that Schreber's illness began as a melancholic depression but quickly developed paranoid features which subsequently escalated into a gross paranoia which nevertheless retained its depressive and hypochondriacal base. Finally the chaotic fragmentation became organized under the dominance of an omnipotent narcissistic organisation which led to a clinical improvement without any relinquishment of his delusional beliefs. As a subsidiary theme he examines the role of gaze in Schreber's object relations and argues that gaze was used to project into his objects, then to scrutinise the object to see if the projections had been received and tolerated, and finally as an expression of dominance. His urgent demand for relief provoked an omnipotence in his objects which he was then able triumphantly to frustrate and which ushered in a struggle over dominance in the course ofwhich Schreber was abused and humiliated. He was unable to find an object who could contain his distress and these factors contributed to the failure to tolerate guilt and to work through his depression. [ABSTRACT FROM AUTHOR]

This paper discusses the main findings of a prospective study based at the Cassel Hospital, a centre dedicated to the psychoanalytically informed residential treatment of severe personality disorders. The resultsshowing that significantly greater improvements on a number of outcome indicators were found in patients exposed to the psychoanalytically informed treatment programmes compared to a general psychiatric approach based on management and pharmacotherapy aloneunderscores the importance and the centrality of the psychoanalytic input in the treatment of severe personality disorders. However, the results of the study also suggested that some features of long-term hospital treatment might carry the risk of iatrogenic and anti-therapeutic effects for a sub-group of patients with severe borderline core pathology. The authors present the clinical and psychodynamic implications of the study results based on an understanding of the internal and interpersonal mode of functioning of borderline patients. [ABSTRACT FROM AUTHOR]