Laudatio auf die Preisträger
(1999)
Le Coq-Héron
(1999)
Since its formulation by Bleuler in 1911, the generalisation of the term >autism<, mainly due to its use by Kanner in 1943 and its remake by authors of Kleinian inspiration, implies problems which mislead us, blurring our perception and understanding of clinical realities. Our psychoanalytical possibilities can be enlarged by a clear knowledge of the history of psychoanalysis, a dynamic approach to psychiatric classification and to problems related to our conception of the setting. On the basis of a case history the author shows how a child and its family worked through major autistic symptoms and proposes new approaches to some psychoanalytical concepts.
This article, which analyses a crime that took place in the city of Brasilia in 1997, is based on two separate and correlated hypotheses. Firstly, this crime reveals a fact about psychic structure: the >real< dimension irrupts through acts. Therefore, psychoanalytical practice must contemplate the >real< dimension. Secondly, we would like to pose two questions. Is it necessary for today's psychoanalysts to be aware of and involved with contemporary events? If the analyst ignores modern dialectics, what kind of symbolic involvement can he establish with the lives of the people he analyzes? Being committed to contemporary symbolic culture signifies that we must relinquish the comfortable division between good and evil. Acts of violence, performed by human beings, necessarily indicate both >enjoyment< and >truth<. In the symbolic dimension, we understand and comprehend; in the symbolic dimension, we are reasonable. But, not all acts fall within this pacifying register. If we consider these two aspects: on one hand, the analyst's responsibility to the patient, in regard to symbolic commitment and, on the other hand, the irruption of violent and senseless acts, this would mean that as analysts, we find ourselves lacking a certain neutrality, contrary to the position defended by some analysts.
There are many reasons why psychotherapy supervisees are prone to narcissistic vulnerability, in which feelings of self-esteem are challenged. In the supervisory process, the supervisee reveals his clinical ability, basic intuition and personal feelings, creating a powerful experience of self-exposure. Ego ideals towards which he aspires, compound this basic vulnerability. These ideals are challenged by the dual nature of mastery involved in the task of becoming a psychoanalyst. As a therapist, the supervisee is required to perform as something of an authority – if he is not yet an expert, he must appear to know a good deal more than the patient who is seeking his help, displaying some degree of mastery. As a student, he is clearly less knowledgeable than his supervisor, and, in the supervisory relationship, he displays his mastery in a very different way. There he is, at once, the >knowing< therapist and the >unknowing< supervisee. This paper examines the role of ego ideals and self-exposure in the experience of the supervisee, and explores special problems that occur with supervisees who present with narcissistic character defenses. Case vignettes are used to illustrate these ideas and implications for supervisory interventions are explored.
A essência psíquica do homem resulta de dicotomias existenciais que nascem da debilidade biológica da espécie e que naturalmente impulsionam os indivíduos a desenvolverem suas potencialidades éticas intrínsecas. Porém, uma vez na sociedade capitalista alienadora, o homem perde o espontâneo amor à vida e transforma-se alternativamente em terrível amor à morte.
On intimacy between men
(1999)
In this essay, I argue that it is in the very process of establishing a personal relationship to psychoanalytic theory and to the profession that one becomes a psychoanalyst. If our identities as psychoanalysts are established through our relationships to the psychoanalytic community, and to the values and ideals established by this society and embodied in its theories and practices, then psychoanalysis itself functions as the Third to analysts’ dyadic relationships with their patients. Although contemporary psychoanalysis emphasizes the subjective, the intersubjective, and the unique relational matrix, the view presented here of the psychoanalytic relationship as always existing within the context of the psychoanalytic community and its history provides a context that allows us to place some (relatively objective) constraints on what we mean by psychoanalysis, and these restrictions are imposed not only by the individuals directly involved (subjectively) but by a wider set of forces, including not only contemporary influences, but the voices of history and tradition as well. Idiosyncratic, personal, and subjective factors (the romantic vision of psychoanalysis) must be continually counterbalanced by more general, objective, and impersonal considerations (a classicist vision), and, among the analyst's many professional responsibilities, one is to manage the polar tension between these forces. The analyst's only hope in managing this tension comes from the very fact that he or she can rely on the sustaining background of professional allegiances to theory and community, psychoanalytic values and beliefs. The exploration of a clinical vignette from the perspective of three different supervisors illustrates how the theoretical and the technical form a complex system of mutual influence with the personal, the subjective, and the intersubjective and how, in the teaching and practice of psychoanalysis, these factors need to be considered together as functioning in complex and often elusive ways.
On making rules: Toward a reformation of the dynamics of transference in psychoanalytic treatment
(1999)
In the last decade Bowlby's ideas on attachment have been taken up with tremendous flourish within psychoanalysis in general and by feminists, journalists, and politicians. This paper explores this new turn and suggests some historic reasons for the convergence between feminist ideas, politics, and attachment theory. While welcoming the wider dissemination of an attachment paradigm, it cautions against the too easy uptake of ideas that may be less than congruent with the fundamental challenge that attachment theory poses for conventional psychoanalytic models of the mind.
I take this occasion to reflect on the relation between the flourishing attachment tradition established by Bowlby's work and the psychoanalytic tradition. I want to show how Bowlby's virtual expulsion from mainstream psychoanalysis in the early 1960s makes some sense in terms of the history of psychoanalytic ideas, as he was several steps ahead of his own time. I then consider the ways in which other major psychoanalytic authors, W.R.D. Fairbairn and Hans Loewald, as well as the American psychiatrist Harry Stack Sullivan, struggled with the same problems Bowlby did. There is now a marked receptivity among psychoanalysts to the same ideas that earned Bowlby his place, along with Fairbairn and Sullivan, in the psychoanalytic Gulag. Finally, I consider the way in which an integration of these different angles on the same phenomena can be helpful both conceptually and clinically.
Free association allows the emergence of novel formulations about self and, along with them, new insights, but it needs to modulate the risks of chaos and the compromising of mental integrity on the one hand and the arrest of growth on the other. Interpretation acts to contain and hold associative pressures and so helps maintain the patient's mental integrity, but it limits associative freedom by being necessarily inferential. In addition, in current interpretative strategies, analytic progress depends on the patient's ability to associate. This ability may be poor for longer or shorter periods during analysis. To help resolve these difficulties, a strategy of associative dialogue is proposed and clinically illustrated. The proposed strategy draws on the associative abilities of the analyst. This paper elaborates the way in which two basic forms of associative dialogue – bold and focused analysis – may facilitate the negotiation between freedom and continuity in analytic discourse.
This paper discusses one family's struggle with domestic violence involving three generations. In this case, coercive negative maternal attributions interacted with parent-to-child projective identification, which resulted in the child's internalization of parental perceptions involving confusion around danger and protection from danger. Projective identification occurs as readily from a parent to a child as from a child to a parent. As is illustrated, when the parent's use of projective identification is excessive, it has severe implications for the whole of the child's psychic development (Lieberman, 1992, 1994, 1997, in press Seligman 1993, 1995, this issue Silverman, Lieberman, and Pekarsky, 1997).
Using a naturalistic design, 44 patients in psychoanalysis were examined with regard to qualitative and quantitative outcome of therapy. The results were compared with those from 56 dynamic and 164 inpatient therapies. Comparison of symptoms, diagnoses, and motivation prior to therapy led to the conclusion that the patient groups treated within these settings differed greatly. For this reason randomisation appeared to be an inadequate strategy for comparing groups in different therapeutic settings. Using different outcome criteria, it could be demonstrated that psychoanalysis patients on the whole attained good therapeutic results. The outcomes were the best in comparison with the other two therapy categories investigated. The use of different outcome criteria and observer perspectives (patient and therapist) led to therapy results with clear-cut differences. In the patient view, the main effect was cessation of psychosomatic, anxiety- and depression-related symptoms. The therapists furthermore reported clear-cut changes in the scales depicting relationship variables. The study presents success rates obtained on the basis of different outcome criteria and discusses them with special emphasis on the methodology of recording outcomes. The paper concludes by making recommendations for psychoanalysis studies yet to be planned.
Paradox and process
(1999)
In this paper I am tracing the history of countertransference and how it has informed the current debate about self-disclosure as a pivotal instrument of analytic work. Now that the analyst's >subjective factor< has been understood as a central influence on the analysand and as a vital source of information about the analysand's intrapsychic life, I argue that certain currents in the relational school of psychoanalysis confuse the analyst's subjectivity with his personality. While becoming more >real< with a patient may enliven a stale analytic dialogue, it ought not be confused with, or take the place of, an analysis of unconscious desires and phantasies. I claim that a two-person psychology can exist only within a tripartite structure in which the analyst does not lose sight of his complex function of being the carrier, observer, and conveyor of the unconscious currents holding both participants in check.
Passion, Responsibility, and >Wild Geese< Creating a Context for the Absence of Conscious Intentions
(1999)
Passionate Love
(1999)
A gendered person lives in and creates a gendered body. Through the sexual life of the couple, two gendered bodies come together. In this paper, I draw on case material to illustrate how a multitude of sensations associated with what it feels like to be a man or a woman is aroused, affirmed, and created as one dimension of sexual experience. I suggest that these gender sensations may be organized through the three psychological positions – autistic-contiguous, paranoid-schizoid, and depressive. The movement among all three positions gives different shapes to sensory-based gender experience – each position making its own unique contributions to the qualities of what it feels like to be a man or a woman. In one case, I consider the possibility that gender transformation occurred through an unconscious intersubjective erotic third – the body of the couple – created between the patient and her husband.
The author situates the development of Ogden's clinical theory over the past 20 years within a philosophic scheme. Ogden (1986, 1989), in using Hegel to deconstruct the Cartesian objectivist assumptions of classical psychoanalysis, goes beyond Hegel to create in Subjects of Analysis (1994) a new synthesis that is similar to aspects of Merleau-Ponty's phenomenology of intersubjectivity. This regrounding allows for the introduction of the analyst's prereflective and sensuous experience through reverie in the cocreation of an intersubjective >third.< The author illustrates how Ogden's solution to the problem of alterity transcends the debate over one-person versus two-person psychologies by producing a truly dialectical, postclassical psychoanalytic theory of intersubjectivity that is neither a one- nor a two-person psychology.
Peuchet on Suicide,
(1999)
Peuchet: vom Selbstmord,
(1999)
Playing with boundaries.
(1999)
Recent contributions to the psychoanalytic literature suggest that the classical focus on psychosexuaiity has been lost. This charge is both wrong and right. After briefly surveying the evolution of psychoanalytic thinking on sexuality and reviewing the concept of libido, this essay retrieves the word Lust from the footnotes to which Freud consigned it and remodels it into a new idea. The proposition is put forth that a postclassical theory of sex compatible with contemporary clinical and theoretical practice can emerge once sexuality is rethought in the ambiguous, potential space between Lust and libido.
The analyst's identification with his or her profession and its ethos may profoundly influence the patient's treatment in subtle and less subtle ways. A particularly noteworthy instance of this is the impact of the patient's knowing that he or she is the subject of the analyst's writings. I present illustrative material from a patient in intensive psychotherapy who had pronounced reactions, especially evident in her dream imagery, to my having written about her. This material and the issues it highlights are discussed from the vantage point of the analyst's professional self and psychoanalytic discourse, which together constitute a >third< dimension vis-à-vis the therapeutic relationship. I consider what a Lacan-inspired perspective (Muller, 1996) might contribute to a relational understanding of the impact of the analyst's professional aspect.
Post-Jungian Dialogues
(1999)
This paper develops a Bakhtinian dialogical perspective on the psychoanalytic discourse in general and on the concepts of true and false selves (Winnicott, 1960b) in particular. Bakhtin's assumptions about the origins of dialogicality in children's development are compared to Winnicott's ideas about the origins of true- and false-self processes. This comparison leads to a characterization of the false and true selves as different genres of the narrated self – the epic and the novel – each with its specific configurations of experience and temporality. Moreover, psychoanalysis is conceived as a unique phenomenon that centers on the internal and most of the time simultaneous dialogues that take place in each of the two participants. This perspective underscores the impact of the analyst's subjectivity on the analytic process as well as the multiplicity of the patient's and the analyst's selves. In this context, therapeutic change can be seen most of the time as a transformation of genre and not necessarily as a modification of contents. Free association allows for the transgression of the basic rules of narrativity, thus facilitating a generic shift. A dialogical relation between the openness of free association and narrativity's coherence is suggested. Life by its very nature is dialogic. To live means to participate in dialogue [Bakhtin, 1963, p. 293]. A word like >self< naturally knows more than we do [Winnicott, 1960a, p. 158].
Postmodern theory and critiques currently exert a considerable influence on psychoanalytic theory, particularly in regard to the revision of a theory of sexuality and gender. This article reviews some of the critiques and alternative views of sexuality proposed by various postmodern theorists such as Butler, Jameson, Baudrillard, and Foucault. After conducting a critical comparison of these critiques and alternatives with contemporary analytic revisionist theory, I contend that, despite the useful aspects of postmodernism's critical cultural perspective, some postmodern positions run directly counter to certain key psychoanalytic tenets about human agency and the existence of an inner psychic world or selfhood. Furthermore, I believe that, despite the laudable politics of many postmodern writers to promote a greater diversity of nonpathologized sexual experience, the atrophied views of agency and selfhood depicted in the postmodern writings reviewed in this essay cannot support an approach that is concerned with clinical treatment or with describing processes of psychological transformation. A case vignette is provided illustrating the main arguments of the paper.
Stoller proposes two fundamentally contradictory conceptions of core gender identity. This paper urges that we accept the first, a relational conception: Core gender identity develops in the context of unambiguous sex ascription at birth and the virtually infinite number of daily infant-parent interactions permeated by all the conscious and unconscious meanings the child's gender has for its parents. The implications of this conception are explored in four contexts. The first shows that a recent case of sex reassignment, purporting to demonstrate a neurological base for gender experience, does not do so. The second argues that children's core gender identities as >girls< or >boys< are as diverse as the meanings that their genders have had for their interaction partners (usually the parents). The third emphasizes the priority of infant-parent interactions in core gender identity development and in the gendered meanings that children's genitals have for them. The fourth argues for the rejection of the >disidentification< hypothesis rooted in Stoller's second and unsupported conception of core gender identity and in Mahler's conception of separation?individuation, which might usefully be replaced by Lyons-Ruth's conception of attachment-individuation.
Promises, promises.
(1999)
La proyección, desde referentes marxistas y humanistas, de los principales conceptos del psicoanálisis aplicados al ámbito de la acción de la persona y de la situación social constituye una línea de pensamiento e investigación fructífera para la solución de los problemas de la sociedad contemporánea. La importancia metodológica de categorías holísticas como la de Proyecto de Vida, construída y aplicada en diversas investigaciones por el autor podrían aportar, desde los referentes teóricos que se expresan, a la complejidad del campo de conocimiento y tranformación humana de la sociedad.
This paper addresses the gender of the analyst as an important factor in the shaping of the analytic experience. Specifically, it focuses on the notion that female analysts bring something different from what male analysts bring to the analytic dyad and that this influences and shapes the analysts’ translation of the patients’ experience – determining treatment course and therapeutic enactments. It begins with the idea that, for some men, working with a female analyst may ease the processing and metabolization of their aggression – allowing for a (re) integration of it with their sexuality and desire. The clinical material of a male analysand who sought treatment from a woman analyst is used to explore this idea within a post-Lacanian framework incorporating Kristeva's work on the maternal chora, the imaginary father or third, and the journey that the infant must make from the real to the symbolic, from biology to desire.
Freud's characterization and dismissal of the >symbolic dream interpreting< of his time – his idiosyncratic distinction between that metaphoric form of interpretation and what he called the >scientific< mode, and his subsequent asymmetrical focusing on the latter – seriously skewed his presentation of the nature and history of the Western dream tradition. It obscured the facts that an old theory regarded the dream as the unmasker of the hidden psychic life and that a venerable hypothesis that it could bring to light licit and illicit unconscious desires had not been forgotten by Freud's fin de siècle contemporaries. For many years, his injunction against the use of symbolism, except in the case of the sexual, had an inhibiting effect on psychoanalysts’ free use of manifest dream interpretation.
Psychoanalysis as a vocation
(1999)
In this centenary of Freud's The Interpretation of Dreams it is important to revisit this classic, to discuss why it is a classic, to consider what has been learned since its publication, and to discuss what changes in our understanding of dreams and dreaming are called for. To this end, we briefly discuss some of the main themes of the book. Then we review both changes in psychoanalytic thinking and theory and the results of many studies made possible by the discovery of the electro-encephalographic changes that occur during sleep and their relevance for understanding dreams and their function. We suspect that Freud would have been delighted to know about this explosion of information about the physiology of dreaming. With this in mind, we consider the need for modification of some of Freud's theories while noting that his basic contribution, that dreams are meaningful and understandable, has been amply confirmed. We then discuss these observations in relation to how we approach working with dreams.
Psychoanalysis, dissociation, and personality organization reflections on Peter Goldberg's essay
(1999)
In this paper, I consider the feeling of interiority as it evolves within the treatment relationship. A capacity to access and sustain one's interiority reflects a sense of personal solidity within which the validity of subjective process and privacy is taken for granted. When this capacity is relatively undeveloped, individuals rely on the >other< (including the analyst) to help them contact, elaborate, or manage their affective experience. Quite paradoxically, the analyst's active investigation of dynamic or intersubjective process may obfuscate rather than clarify this core difficulty. I suggest two alternative approaches to the treatment situation that stand in some tension and yet also complement each other. One emphasizes the >active< investigation of dynamic and dyadic process, wherein the analyst works interpretively and/or around relational issues. The other is organized around the >interior< dimension of the treatment experience, emphasizing the patient's need to develop or manage her affective process in the relative absence of input from the analyst. Two clinical situations are described, the first illustrating the use of silence with a patient whose difficulties involved affect articulation, and the second involving a patient whose need for affect regulation made her highly dependent on the analyst for soothing.
Psychoanalytic Expertise
(1999)
The experience of selfhood is that of struggle, between conflicting demands, inevitable dilemmas, and shifting allegiances toward deciding what is for us. The complex nature of this struggle often makes the boundaries between health and sickness ambiguous. Therapeutic work is significantly dependent on the capacity to engage with such struggles. This is illustrated by two striking examples of successful work, as well as my own two analyses, and other clinical material.