Davies contributes to the development of relational theory by formulating and illustrating what occurs during especially difficult moments in an analytic exchange. In understanding enactments, Davies importantly underscores the contribution of both the analyst's and patient's >bad objects.< This author attempts to build bridges between Davies' language and concepts anchored in object relations theory and this author's language and concepts based in contemporary or relational self psychology, including the integration of cognitive psychology. In addition, this author delineates the use of the >empathic,< >othercentered,< and >analyst's self< listening/experiencing perspectives to explicate the case material and to provide alternative understandings and pathways for psychoanalytic work. The thesis set forth is that the use of different listening/experiencing perspectives expands choice for the analyst when working in difficult moments of the clinical exchange.
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 the clinical example presented by Pizer in his paper.
This paper explores the influence of Indian philosophical and spiritual thought on the psychoanalytic contributions of Emmanuel Ghent. The Indian intermingling of lower and higher, sensual and spiritual, and erotic and enlightened creates an alternative model to the hierarchical Western Platonic notion of sublimation as embraced by Freud. The author discusses an elaboration of the Indian position in Ghent's work on surrender and in his explorations of the contributions of D. W. Winnicott. In particular, this author posits that the Indian concept of the relationship of tapas, or restraint, to kama, or desire, influenced Ghent's thinking on the therapeutic action of psychoanalysis.
This paper distinguishes three types of Freudians and argues that Rothstein incorrectly identifies himself as a compromise formation theorist. There is a short depiction of nonclassical Freudian position, and this position is juxtaposed with Brenner's version of Freudian theory and technique. There is a detailed critique of Brenner's version of compromise formation theory and the clinical implications of this theoretical position. The discussion concludes with a description of intersubjectivity and distinguishes two meanings of the term. One meaning is both compatible with and enriches contemporary Freudian thought, while the other polarizes positions and is not easily accepted in any Freudian position.
The author presents an intense exploration of damage, disappearance, masochism, surrender, control, and faith in a single case. The patient experiences her damaged and disappearing self beyond anything anyone can relate to. She connects to a paper by Emmanuel Ghent that seems to address those more intact than she, yet feels tantalizingly close to his concerns. Ghent's paper refers to her therapist, and through it she peeps into her therapist's soul and the hell of wondering if damage she knows can be shared.
In our response to Pizer's paper, we underscore the importance of discerning when to more deeply and conjointly explore emergent intersubjective moments in the therapeutic exchange. Pizer states that he would not now proceed clinically in the same way that he conducted his first treatment of his patient Rebecca, which occurred prior to his receiving full analytic training. However, he questions whether the therapeutic engagement would have advanced as well as it did if he had not offered various sponsoring and sheltering provisions to his patient. We believe that a more reflective and self-aware Pizer could have both supplied the provisions that Rebecca so desperately needed and more actively explored the meanings of their experiences together. Further discussion is needed regarding how impasses result when deepening analytic reflection and interpretation are not used to negotiate the multiple and paradoxical relationships that develop in treatment. In addition to training and consultation, we need to identify and utilize various ways to better understand what interferes with our capacity to negotiate the balance between remaining true to our own subjectivity and being enough of what our patients need us to be.
Commentaries by Edward Khantzian and Henry Krystal allow me to elaborate the role of dissociation in addictive disorder, and its misguided place in the design of many therapeutic strategies to overcome it. Promising direction for the treatment of the characters and symptoms of drug-dependent patients lies in the application of developments in current analytic theory and technique. Such developments include familiarity with enactment, dissociative and projective processes, and work in a two-person frame to enable treatment to encompass and reach more of the patient.
An assumption made in this paper and explored for its clinical implications is that an act of chronic drug use often marks or serves to implement an underlying omnipotent self-state. Psychoanalytic work with substance users, as compared with other approaches, trains attention on these omnipotent states and makes use of the transferential exchange as a therapeutic tool. States of omnipotence are particularly examined here in the context of recent attention to dissociation as an organizing force in the personality, and in the configuration of the transference – countertransference of the treatment relationship. A case illustration is used to apply current thinking on dissociative and projective processes, and their role in enactment in the therapeutic exchange, to illuminate the frequent interplay of omnipotence and helplessness in analytic work with substance-using and other patients.
What is a selfobject?
(2005)
This discussion examines the theme of time as it is experienced by someone who has suffered a loss, in an attempt to understand and differentiate certain contrasts in these authors' approaches to theory and technique. The discussant argues that the frame is a vital tool in helping the analyst to gain access to the differential interplay between awareness of mortality and our flight from it. Finally, the discussant asks whether certain prevalent relational themes, such as mutuality, empathy, and the ubiquity of enactments, have contributed to an atmosphere in which attention to the frame can recede.
This paper begins an examination of the complex relationship between psychoanalysis and Buddhist psychology and the practice of meditation. It describes in a series of episodes the ordeal of one patient during a Buddhist meditation retreat. She is asked during the course of the teachings to confront her own inevitable death, and in so doing finds herself simultaneously enduring the agony of a psychic death or collapse originating in earlier trauma. The narrative and subsequent discussion, using the language of psychoanalysis, aim to capture the conflictual yet generative aspects of the interplay between these two invaluable disciplines.
Thinking Differently Principles of Process in Living Systems and the Specificity of Being Known
(2005)
What Grounds Creativity?
(2005)
Burton's response to discussions by Krystal and Khantzian addresses the manifestation and engagement of aspects of bad objects in addictions treatment and acknowledges the broader relationship between compulsive behaviors and dissociation. In addition, Burton presents thoughts on cross-disciplinary communication and an emergent relational metapsychology and its potential impact across schools of psychotherapy.
Relational perspectives on the nature of self and the unconscious have transformed how we can understand addictions and substance use problems. Addictions have received little attention in the contemporary literature and therapeutic approaches outside of psychoanalysis have been skeptical of psychoanalytic approaches. It is my contention that viewing substance use problems through the lens of a relational/multiple self-state model offers new clinical possibilities resulting in greater success in treating these patients. In this model, addictive behavior is seen as embedded in dissociated self-states. Therapy focuses on helping the patient to move from dissociation to a true multiplicity and a decreased dependence on substances.
Secret Pleasures: A Discussion of Maroda's >Legitimate Gratification of the Analyst's Needs<.
(2005)
Bucci's model of emotional communication, developed in the context of her theory of multiple coding and the referential process, is applied to Knoblauch's microanalytic report of his experience of the patient and himself and their interactions during a single session of an ongoing treatment. The referential process is a bidirectional function connecting the diverse sensory, somatic, and motoric representations of the subsymbolic system with imagery and words. The process operates partially and to varying degrees within both participants in the case presented here, the dissociation among systems is severe, and emotional communication within the dyad occurs at first primarily in subsymbolic, bodily forms. Where gaps in the referential process exist for the patient, the analyst's own experience and associations operate to evoke new connections for her we see this process in moment-by-moment glimpses of the analyst's experience and his interactions with the patient. Gaps in the reader's knowledge, and possibly the analyst's knowledge, of the patient are discussed.
Images of Trauma: Pain, Recognition, and Disproval in the Works of Frida Kahlo and Francis Bacon
(2005)
In. Reply to Altman's and Schellekes's questions and discussion, the author explores in more depth his own theoretical-technical point of view in order to clarify – chiefly in the light of a modern application of Ferenczi's and Heimann's way of thinking – the rationale for the selection of clinical facts in his paper.
Locating Culture in the Psychic Field: Transference and Countertransference as Cultural Products.
(2005)
The author discusses Arnold Rothstein's paper >Compromise Formation Theory: An Intersubjective Dimension< and challenges his definition of intersubjectivity. She offers a perspective in which the import of intersubjectivity theory is less to dissolve the notion of objectivity than to grasp processes of mutual engagement, regulation, and recognition. While it is true that the recognition that the analyst is also a subject and therefore does not have exclusive knowledge is an important shift in the psychoanalytic paradigm, the author suggests that the intersubjective is far more encompassing than this. Intersubjective theory emphasizes the active creation of consensus or conflict about reality rather than merely the recognition that the analyst's perspective on reality is subjective. This cocreation produces a different emotional experience of connection, not merely a change in the quality of insight. Finally, Rothstein's case illustrates how he responds to the need for recognition and regulation. He shows us how focusing on the procedural allowed him to make an intersubjective shift, not simply an intrapsychic interpretation of compromise formation.
This paper is an effort to describe and express and the tension between the observing mind and the >wisdom mind,< which has its taproots in the deep and unformulated experience of connectedness. Nominally about the process of writing as a psychoanalyst, it is more like my personal >Credo< in relation to the work of psychoanalysis, the work of writing, and the work of living with contradictions – life. In it I try to bring together disparate reflections, to illustrate in the writing itself the process of making >many into one.< Because so much of this essay relates to themes in Mannie Ghent's work, including his work on surrender and his >Credo,< it seemed to be appropriate to offer it to readers of this issue dedicated to his memory.
This article examines a debate concerning the exegesis of the story of the garden of Eden and the tree of knowledge, as told in Genesis. Two contradictory interpretations of the garden narrative are examined, the first as the story is elucidated by the psychoanalyst and social theorist Erich Fromm and the alternative interpretation by the Talmudic scholar and philosopher Rabbi Joseph Soloveitchik. This article compares and contrasts their exegeses and the respective implications of each view. The controversy, which has profound implications, reflects differences in world views concerning the good life, autonomy and relatedness, assertion and submission, will and surrender, obedience and rebellion, independence and interdependence, subjectivity and intersubjectivity. Links are drawn to a variety of contemporary psychoanalytic theories, developments, and controversies.
In this commentary on Arnold Rothstein's >Compromise Formation Theory: An Intersubjective Dimension,< I address some of the limitations of compromise formation theory in addressing issues of intersubjectivity. Namely, compromise formation theory does not address intersubjectivity as a principal motivation it takes up mutual regulation but not mutual recognition or other aspects of intersubjectivity it does not place the intersubjective matrix at the center of clinical psychoanalytic understanding and it does not sufficiently examine clinical concerns regarding the patient's conflicts regarding intersubjective contact with the analyst. I then discuss Rothstein's clinical vignette in an effort to provide an alternative understanding of the therapeutic action of Rothstein's clinical interventions. Drawing on the work of the late Lloyd Silverman, I present an intersubjective explanation that highlights the analyst's compassionate understanding of the patient's conflicts and acceptance of the pleasure in the patient's impulses, achieved through the analyst's own personal and subjective struggles.
I argue that on both the small-scale level of the interpersonal relationship, and the large-scale level of society, the manic defense makes it difficult to care about others, and so militates against a sense of social responsibility. I address four basic questions: what is the nature of social responsibility? What is the nature of the manic defense? How does the manic defense interfere with the potential for social responsibility? And, on a more general level, what are the issues with respect to methodology for efforts such as this one to link psychoanalysis and social theory?
Fragmenten Fromm
(2005)
Commentary: Gene-Environment Interplay in the Contept of Genetics, Epigenetics, and Gene Eppression
(2005)
Attaccamento e sessualità
(2005)
Frommovo pojmovanje religije
(2005)
Erich Fromm (1900–1980)
(2005)
Tausend verschiedene Dinge
(2005)
During the first twenty years that Freud spent creating his theory, he assumed that most of the functions responsible for creating mental-thought structures were organized according to two different forms or principles of thought. He called these forms >primary process< and >secondary process<. The >secondary process< is identified with rational thinking and the ego, and it is easy to follow the changes that this concept underwent in the works of Freud that followed. The concept of >primary process<, on the other hand, disappeared from his later works with no explanation. This article traces the changes that the >primary process< underwent in Freud's thinking and examines the connection between his analytical technique and his research method. A close study of the changes that the >primary process< underwent reveals that Freud's developmental thought process included concepts whose directional changes may be termed >regressive<.
The existence of man is distinguished by its split state: man stands in the middle of life yet still has an awareness of his own death. He has to compensate whatever is missing in him naturally at the societal level, created as culture, and at the individual level through creativity. Rank investigated the human 'creative drive', the anthropological aspiration to express oneself in creative works, and to overcome the fear of death with its help. Freud admired poets and artists, whose achievements he could not psychoanalytically access, but he considered science superior to the harmless and na ve arts. There are two anthropological radicals: premature birth and the consciousness of death. Freud's massive fear of death made it difficult for him to acknowledge the problem of death appropriately. In Rank's concept, the development of human creativity contributes towards the fear of death being alleviated so that the knowledge of death can be integrated into life; creativity belongs to the fundamental opportunities of man that may enable him to find a way through neurosis. Failure is as much a part of life as is creativity: those who do not experience and accept life in its tragic dimension are denied creativity. Only a creative person who accepts his partial failure finds the strength to continue to be creative without his imperfect work leading to the ritual repetition of the same thing again and again, that is, getting stuck in recidivism.
This paper suggests that the interplay between transference and countertransference is considered to be a valuable channel of communication. The author puts an emphasis on the containing function of the analyst. The patient strives for an experience of an object (analyst) that tolerates and copes with the patient's projections. There are some moments when analysts feel themselves to be invaded, controlled or abused by their patient's products. As Bion has postulated, this situation takes the form of a sojourn in the analyst's psyche. Clinical vignettes are given to provide support for the ways in which the analyst contains and elaborates the projections of the patients in his or her own mind and the therapeutic role that these processes have.
Psychoanalysis is questioned in the public debate and in the managed care system. The Swedish experience of negotiating with representatives of the public welfare system clarifies how important it is to have a wide network. The author argues that there is great risk that psychoanalysis will sink back into the private sphere if psychoanalysts cannot accept a third party to support the treatment situation. Were this to be our future, the choice of becoming a psychoanalyst would be more a choice of vocation than a choice of a profession. This line of thought related to the first medical revolution is the introduction of scientific medicine within a socio-economic context in which the main part of medical care is organized in a private setting. Sigmund Freud's consulting room was firmly situated within the private sphere. Although through his entire life he struggled to get psychoanalysis officially recognized, and thereby strived to place it within the public sphere, the original concept of psychoanalytical treatment was related to the family as a unit of production. Within this unit, Freud invented the analytical setting. The second medical revolution is the introduction of a general social security system of welfare including the main part of medical-health care. In Sweden, as in many Western welfare societies, psychoanalysis was included in public insurance systems. The third medical revolution is the introduction of methods for assessment and accountability, with the consequence that the main part of the medical health sector is organized by managed care methods. These methods question whether or not psychoanalysis should be included in public welfare systems.
We psychoanalysts – as split subjects – are not immune to charismatic leaders who preach violence against selected targets depicted as the cause of all evils. Freud, in Group psychology and the analysis of the ego, alerted us against such leaders, who can manipulate by transforming us into an uncritical mass. This would be the social equivalent of the perverse pact in repressive desublimation between the superego and the id at the expense of the ego: the latter is put to sleep, and the superego exhorts the id to do violence and regress. Socially, these perverse pacts often take place with the superego represented by charismatic leaders who foster identification with themselves, put the egos of their audiences to sleep through manipulation and thus address an amorphous mass that they can direct towards violence and destruction. An event in which such a phenomenon apparently occurred will be discussed to show how urgent it is to revisit psychoanalytic writings on these matters in order to withstand the temptation to be herded by manipulative leaders. This will certainly protect psychoanalysis and allow for its transmission. It is up to us to exercise the critical analysis that psychoanalytic tools equip us for so that we can detect such summons to perverse pacts and denounce them.