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- 2002 (424) (remove)
A discussion of the apocalyptic dimensions of the World Trade Center disaster, this paper considers some first-hand reports of the towers burning and collapsing, as well as the author's own experience that day watching events unfold and discussing these horrors with his patients. Several conceptual ideas are developed, including the varied ways people experienced the disaster in terms of >zones of sadness< the organic nature of the way the disaster unfolded the language of the victims in terms of underlying rhetorical structures of response and psycho-historical considerations that suggest, in part, why the disaster was such a collective trauma.
The discussions by Pizer and Brandchaft are so different in tone and focus that I answer them separately. Pizer invites dialogue about the relationship between identification and dissociation, which I pursue further with him. I then briefly consider his therapeutic model, which emphasizes the negotiation of paradox, in the light of the identificatory divisions in self-experience that my model highlights. Finally, I address his concern that I bypassed the >crunch< of the repeated relationship in the case example of Jonathan. I argue that the stance I ultimately adopted was my way of bridging the paradoxes presented by Jonathan. Brandchaft couched his discussion as a dismissive attack, prompting me to defend myself while trying to engage in a dialogue about substantive issues. I respond to his criticisms regarding my epistemological position, my use of the concepts of identification and projective identification, and the process and outcome of my treatment of Jonathan. The bottom line is that the differences between our perspectives are not, as Brandchaft contends, those between an objectivist, causally >unidirectional< model and an intersubjective one, but rather those between two versions of intersubjectivity.
This paper addresses the postmodern critique of unified-self theories that argues that the self is not unified but multiple, not a static entity but in constant flux, not a separate center of initiative but intersubjectively constituted. The author proposes that there are two kinds of division in self-experience: the dissociative divisions of multiple-self theory, and a division, akin to the divisions between Freud's structural agencies, between what are here termed the >intersubjective self< and >primary subjective experience.< In contrast to dissociated self-states, which occur in different moments in time, these two dimensions of self-experience occur simultaneously indeed, what is most important about them is their relationship. The author suggests that it is this intrapsychic relationship, as it occurs in a given psychological moment, that determines the qualities of self-experience that are emphasized in unified-self theories: such qualities as cohesiveness versus fragmentation authenticity vs. falseness vitality versus depletion optimal versus nonoptimal self-regulation and agency versus feeling one is at the mercy of others. Furthermore, a major organizer of the intersubjective self is early identifications, especially >identifications with the other's response to the self.< The implications of these concepts for therapeutic action are discussed and illustrated with an extended account of an analytic case.
Language and the Nonverbal as a Unity: Discussion of >Where Is the Action in the >Talking Cure<?
(2002)
Some thoughts on self-disclosure and the danger-safety balance in the therapeutic relationship
(2002)
The letter to the September 11, 2001 terrorists is analyzed in an effort to understand the state of mind of a religious suicide-killer. The letter has a solemn, serene, even joyful tone that is infused with love of God and a strong desire to please Him. The author suggests that incessant incantation of prayers and religious sayings while focusing attention on God led to a depersonalized, trancelike state of mind that enabled the terrorists to function competently while dwelling in a euphoric state. On a psychodynamic level, the theme of father–son love is used to explain the ecstatic willingness of the terrorists to do what they saw as God's will and to follow transformations from (self) hate to love (of God), and from anxiety and discontent to the a narrowly focused fear of God. Homoerotic bonding and longing, coupled with repudiation of >femininity,< are explained as an inability to >kill< the primal murderous father, as the mythological Primal Horde. Freud's description of sons' (group members') hypnotic love for their father leader (which, that when not reciprocated, turns into masochistic submission), seems pertinent for the understanding of the sons' >return< to an archaic, cruel father imago. >Regression< to the father is compared with classical maternal regression.
This paper is a response to an essay by Drew Westen. The author agrees with many of Westen's arguments about problems in the psychoanalytic literature and adds that the psychoanalytic literature has always been a problem for psychoanalysis. If we think of psychoanalysis as an ongoing experiment, then its >trials< are all the analytic sessions that have been conducted. Our >literature< has never systematically drawn on those. Westen critically scrutinizes certain habits that, in his view, haunt our literature, but that we do not explicitly note or disown as conceptual contrivances we mean to get rid of, while they are often misguiding clinical thinking and practice. I suggest that a fascinating question riding below the waves of Westen's paper is why patients and analysts accept this situation. I suggest that we all treat psychoanalysis as wisdom, art, relationship, skill, and something other than the application of established scientific findings because we recognize and accept it as that kind of human activity. It is unclear if patients care whether or not their analysts are scientists, but it is clear that analysts are not optimistic about sifting the research literature and finding clear clues to more effective clinical thinking, work, or writing.
Despite the recent interest in erotic countertransference and self-disclosure, little has been written about these phenomena when both analyst and patient are the same gender. Since homoerotic feelings can surface in any treatment, regardless of the participants' sexual orientation, this may well be a phobic avoidance that restricts many treatments, as well as our profession. I propose that the analyst's awareness of homoerotic feelings in the countertransference – including struggling with ways to express them – ultimately can create an atmosphere of safety. I offer an extended case example of one man with whom I colluded to ignore frightening aspects of his sexual fantasies. It was only by using my erotic countertransference, especially at a charged and pivotal moment, that I was able to help the patient begin to integrate split-off aspects of his sexuality.
Louis Sander's bold and ambitious theoretical synthesis deserves careful attention from psychoanalysts of all persuasions. Sander's cutting-edge approach draws on infant observation research, nonlinear dynamic systems theories, and current biology, physics, and other >hard< sciences. He is rethinking the psychoanalytic approach to psychic structure, motivation, and therapeutic action. In so doing, he updates Freud's project of linking psychoanalysis with scientific paradigms, but without reductionism, epistemological naivete, or an implicit antipsychological attitude. Sander emphasizes the dynamic relationships between elements in systems. His method draws parallels between the different levels of the functioning of natural systems, starting with the basic >biological< level of cells and organs and moving toward the psychic and interpersonal phenomena that are of greatest interest to psychoanalysts. In this way, he opens a window for a broad and inclusive >relational metapsychology.<
As a way of integrating emerging knowledge of biological systems, developmental process, and therapeutic process, we identify principles in the process of exchange between organism and its context of life support that are present at all levels of complexity in living systems, from the cellular to the organization of consciousness. These principles range from specificity, rhythmicity, recurrence, and pattern to coherence, wholeness, and a relative unity in the organization of component parts. By proposing that these principles are also governing the exchange between mother and infant as they negotiate a sequence of essential tasks of adaptation, or >fitting-together< between them over the first years of life, the author suggests that the biological level becomes integrated with the developmental. A sequence of adaptive tasks extends from specificity of recognition in the newborn state, to recognition of inner awareness, purpose, and intention – shaping conscious organization. The bridge to the therapeutic level is constructed as therapist and patient build increasingly inclusive and coherent moments of recognition between themselves at the level of conscious organization, which act as corrective experiences, bringing the patient's own senses of >true self< and of >agency-to-initiate< to new levels of validity and competence.
In this article I. Reply to commentaries on my paper, >Brief Relational Psychoanalytic Treatment.< The discussants have raised a number of thoughtful and discerning questions that provide me with an opportunity to clarify some of the major points in my original article and to elaborate on certain issues in greater depth. Some of the key questions addressed in my. Reply are: (1) How is the tension between the emphasis on openness and receptivity and the time-limited nature of treatment negotiated in Brief Relational Psychoanalytic Treatment? (2) To what extent does an emphasis on openness and receptivity interfere with the process of establishing a productive focus? (3) How does one resolve the tension between the desire for change and the need for acceptance? (4) What are the therapeutic implications of regarding the mind as embodied and what roles do emotion and bodily felt experience play in the change process? In addition, I take up the question of whether or not adhering to a constructivist epistemology is incompatible with conducting and valuing psychotherapy research.
In this article I describe an approach to brief psychoanalytic treatment that is consistent with many of the key principles of the relational tradition. In this approach the treatment process is conceptualized as an ongoing cycle of therapeutic enactment, disembedding, and understanding, enactment and disembedding. Particular emphasis is placed on the use of countertransference disclosure for purposes of facilitating the collaborative exploration of relational scenarios that are being unwittingly enacted between patient and therapist. The influence of the brief time frame on the treatment process is explored and differences between the current approach and other approaches to brief psychoanalytic treatment are examined. A case is presented to illustrate the approach, and a number of questions are explored regarding the nature of change in short-versus long-term treatments.