Search

This paper’s point of entry to the psychoanalytic thinking on early breakdown, catastrophic psychic trauma, and the last scream is an ancient enigmatic Jewish Midrash which creates an analogy betwe...

in this article, I will address the radical departure of Winnicott’s theoretical-clinical ideas from traditional psychoanalytic work, introducing a revolutionary change in clinical psychoanalysis – a transition from “extension” to “scientific revolution” and “paradigm change or paradigm shift” (to use Thomas Kuhn’s terminology of the “Structure of scientific revolution”, 1962). For me, these revolutionary ideas of Winnicott are profoundly important, theoretically and practically, as they provide a formative matrix and a mode of work and transformation that conventional psychoanalytic work does not offer (Eshel, 2013a, 2016, 2017a, 2019a, 2019b).

This paper addresses the radical departure of late Bion's and Winnicott's clinical ideas and practices from traditional psychoanalytic work, introducing a revolutionary change in clinical psychoanalysis. The profound significance and implications of their thinking are explored, and in particular Bion's conception of transformation in O and Winnicott's clinical-technical revision of analytic work, with its emphasis on regression in the treatment of more disturbed patients. The author specifically connects the unknown and unknowable emotional reality-O with unthinkable breakdown (Winnicott) and catastrophe (Bion). The author suggests that the revolutionary approach introduced by the clinical thinking of late Bion and Winnicott be termed quantum psychoanalysis. She thinks that this approach can coexist with classical psychoanalysis in the same way that classical physics coexists with quantum physics.

This paper focuses on trauma, particularly the history of trauma in psychoanalysis—a highly traumatic history. The author suggests, using data unearthed primarily over the past twenty-five years and with reference to Caruth's work on trauma theory, that the psychoanalytic exploration of trauma itself followed a traumatic course and therefore also needed a double, belated emergence to find a “voice” and hearing. This traumatic course had its stormy inception in the early period of psychoanalysis. The work of Sandor Ferenczi, especially in his last years, brought to the fore the crucial importance of actual childhood trauma and its impact on personality and on the analytic treatment. These claims were a daring contradiction of Freud's view that memories of sexual abuse are based on instinct-driven fantasies. Furthermore, Ferenczi investigated daring therapeutic methods for coping with the reliving of traumatic overstimulation, terror, and dissociation in treatment, with the analyst serving as an important r...

This article weaves together three major contributions to the theory of trauma and repetition compulsion: Freud's (1920/1955b) reformulation in “Beyond the Pleasure Principle” of his metapsychological theory regarding the notion of trauma and the compulsion to repeat traumatic experiences and traumatic dreams; Cathy Caruth's (1996) elaboration, based on a dramatic story in Freud's article, of “the voice that cries out, a voice that is released through the double wound”; and Winnicott's (1963/1986, 1965/1989a) unique ideas about the early unthinkable breakdown that has not yet been experienced and has to be relived and experienced in analysis.The author explores the clinical implications of the intricate relation between knowing and not-knowing in facing trauma, which is simultaneously demanding and inaccessible, massively dissociated, and thus never and forever there. In particular, she relates to the profound difficulty of hearing the “voice” of breakdown that cries out from the belated “double w...

This article presents Winnicott's unique theoretical and clinical thinking, and especially his revision of the foundations of clinical psychoanalysis, as a Kuhnian paradigm shift that, as the title of the article indicates, I term nano-psychoanalysis. The title refers to ideas and terminology borrowed from nanoscience and nanotechnology, and particularly to physicist Richard Feynman's 1959 visionary talk that hailed nanotechnology and its radical potential: “There's plenty of room at the bottom—An Invitation to Enter a new Field of Physics.” I have paraphrased and applied it to Winnicott and to psychoanalysis: “There's plenty of room at the bottom—an invitation to enter nano-psychoanalysis,” and regard Winnicott as the originator of nano-psychoanalysis. For Winnicott's psychoanalytic theory, and particularly his clinical-technical theory with its emphasis on regression in the treatment of more disturbed patients, share the fundamental principle offered by Feynman and nanotechnology—that of going back to t...

This discussion addresses two key points concerning Pizer's thoughtful paper about a long-term, difficult analytic process. First, it responds to Pizer's quest for theoretical and clinical concepts that do not limit the analytic work of mature, experienced analysts to interpretive work, but reconnects them theoretically, clinically, and technically with deeply engaging emotional experiences of life-giving, profound transformation through treatment. The author suggests that the clinical theory of therapeutic regression, which was developed and forged within intense and difficult analytic treatments, brings the critical need for fundamental experiences of the analyst's loving and sustaining provision into the framework of the psychoanalytic process and therapeutic action. The discussion further elaborates on the emotional risking and vulnerability—the venture zone, as the author terms it—that creating psychic change implies for both patient and analyst. This venturing by both of them is illustrated through ...

This paper focuses on the becoming of a fundamentally new experience and development in psychoanalytic treatment. It is based on psychoanalytic approaches whose visions of psychoanalytic change theoretically and clinically incorporate the striving for a “new beginning,” “new opportunity for development,” “lifegiver,” and rebirth. The author argues that in creating a profound living transformation during treatment, it is not enough to confront the gap between the patient's unbearable past experiences and the new, more benign relationship with the analyst; nor is the patient's internalizing of this new relationship sufficient. To undergo profound change, the patient's destructive or traumatic split-off core experiences and the ensuing defense organization must be processed and modified within a new, actualized, and more able psychic space that is created by the patient-analyst's deep interconnectedness. This interconnected psychic space becomes the arena in which these unbearable past experiences in...

This paper focuses on the analyst's "presencing" (being there) within the patient's experiential world and within the grip of the psychoanalytic process, and the ensuing deep patient-analyst interconnectedness, as a fundamental dimension of analytic work. It engenders new possibilities for extending the reach of psychoanalytic treatment to more disturbed patients. Here patient and analyst forge an emergent new entity of interconnectedness or "withness" that goes beyond the confines of their separate subjectivities and the simple summation of the two. Using a detailed clinical illustration of a difficult analysis with a severely fetishistic-masochistic patient, the author describes the kind of knowledge, experience, and powerful effects that come into being when the analyst interconnects psychically with the patient in living through the process, and that relate specifically to the analyst's compassion.

The paper puts forward the dimension created by analytic presence and the ensuing patient-analyst interconnectedness in the process of psychoanalytic treatment and change, particularly with more disturbed patients. Working within this dimension, at a fundamental level of contact and impact, opens up new possibilities of extending the reach of psychoanalytic treatment. The analyst's "presencing" and interconnectedness with the patient forge a living therapeutic entity that is not a one-person or two-person psychology, but an emergent two-in-one new entity that goes beyond the confines of the separate subjectivities of patient and analyst and the simple summation of the two. The paper describes the kind of knowledge, experience, and powerful therapeutic potential that comes into being through analytic "presencing" and patient-analyst interconnectedness, and particularly focuses on the chimeric element, or quality, of this interconnectedness. The term "chimera/chimerism"-chosen here for its wealth of mythological, genetic, biological, biomedicinal (chimeric proteins), and psychoanalytical associations-is used in this paper to highlight the complex quality of patient-analyst interconnectedness, especially in difficult, psychotic, psychically foreclosed, dissociative and perverse states. The author offers an extensive clinical account of psychoanalytic treatment of a patient convicted of sex offenses in order to illustrate "presencing," interconnectedness, and the extent and intricate emotional meaning of the extreme chimerism that this kind of (difficult) treatment entailed.

The subject of dream telepathy (especially patients' telepathic dreams) and related phenomena in the psychoanalytic context has been a controversial, disturbing 'foreign body' ever since it was introduced into psychoanalysis by Freud in 1921. Telepathy- suffering (or intense feeling) at a distance (Greek: pathos + tele)-is the transfer or communication of thoughts, impressions and information over distance between two people without the normal operation of the recognized sense organs. The author offers a comprehensive historical review of the psychoanalytic literature on this controversial issue, beginning with Freud's years-long struggles over the possibility of thoughttransference and dream telepathy. She then describes her own analytic encounter over the years with five patients' telepathic dreams-dreams involving precise details of the time, place, sensory impressions, and experiential states that the analyst was in at that time, which the patients could not have known through ordinary sensory perception and communication. The author's ensuing explanation combines contributory factors involving patient, archaic communication and analyst. Each of these patients, in early childhood, had a mother who was emotionally absent-within-absence, due to the absence of a significant figure in her own life. This primary traumatic loss was imprinted in their nascent selves and inchoate relating to others, with a fixation on a nonverbal, archaic mode of communication. The patient's telepathic dream is formed as a search engine when the analyst is suddenly emotionally absent, in order to find the analyst and thus halt the process of abandonment and prevent collapse into the despair of the early traumatization. Hence, the telepathic dream embodies an enigmatic 'impossible' extreme of patient-analyst deep-level interconnectedness and unconscious communication in the analytic process. This paper is part of the author's endeavour to grasp the true experiential scope and therapeutic significance of this dimension of fundamental patient-analyst interconnectedness.

Following an introductory review of the main developments in the psychoanalytic thinking on perversion, the author focuses on her own understanding of perversion and its treatment, based on the psychoanalytic treatment of patients with severe sexual perversions. This paper uses the term 'autotomy' (borrowed from the field of biology) to describe perversion formation as an 'autotomous' defence solution involving massive dissociative splitting in the service of psychic survival within a violent, traumatic early childhood situation; thus, a compulsively enacted 'desire for ritualised trauma' ensues. The specific nature of the perverse scenario embodies the specific experiential core quality of the traumatic situation. It is an actual repetition in the present of the imprint of a past destructive experience which is pre-arranged and stage-managed; it thus encounters haunting scenes of dread or psychic annihilation while, at the same time, controlling, sanitising and disavowing them. Hence, the world of severe perversion is no longer oedipal, but rather the world of Pentheus, Euripides's most tragic hero--a world dominated by a mixture of a mother's madness, devourment, destruction and rituals of desire. According to this view, the (difficult) psychoanalytic treatment of perversion focuses on patient-analyst interconnectedness--brought about by the analyst's 'givenness to being present' or 'presencing'--at a deep, primary level of contact and impact (the emphasis being on the ontological dimension of experience). This evolving therapeutic entity creates and actualises a new, alternative experiential-emotional reality within the pervert's alienated world, eventually generating a change in the perverse essence. The author illustrate this approach with three clinical vignettes.

The analyst's 'sleep' during sessions is a puzzling, troubling, extreme experience, which has rarely been described in the psychoanalytic literature. The author presents a clinical illustration in which her recurring 'sleep' during the sessions was approached as an open, central issue. She attempts to explore, understand and integrate this experience theoretically and clinically, first by reviewing and examining the psychoanalytic literature on the subject and on related phenomena, and then, more particularly, by formulating her own explanation of it. She emphasises being in the grip of the psychoanalytic process, and the immersed involvement and converging of patient and analyst, which generate a conjoint state of deep experiential interconnectedness and impact on each other--in particular the impact of the patient's inner world on the analyst. In this context, the author also refers to the notions of 'the uncanny', 'fear of breakdown' and dissociative self-states and the mitigation of the patient's dissociative self-experience via the analyst's vicarious dissociative experience.