Clearly recognized by researchers in the field as one of the major long-term sequelae of childhood trauma, discussion of the process of dissociation remains embedded in the classical psychoanalytic literature and is not often referred to in contemporary psychoanalytic writing. This article attempts to update the definition of dissociation in accordance with contemporary research on traumatic stress and posttraumatic stress disorders and to demonstrate the manifestations and impact of dissociative phenomena in the psychoanalytic treatment of adult survivors of childhood sexual abuse. Several points are emphasized: (1) treatment of the adult survivor of childhood sexual abuse involves recognition of the simultaneous coexistence and alternation of multiple (at least two) levels of ego organization (2) at least one level represents, in split-off form, the entire system of self- and object representation, including unavailable, affectively loaded memories and fantasied elaborations and distortions originating in the traumatogenic abusive situation and (3) there is present a kaleidoscopic transference-countertransference picture that shifts illusively but can often be understood as based on the projective-introjective volleying of a fantasized victim, abuser, and idealized, omnipotent savior.
A Poetics of Change
(1992)
The psychoanalytic exploration of the analyst's erotic counter-transference has remained a subject rarely addressed in open colle-gial dialogue. This paper addresses this professional reticence as a manifestation of two interwoven resistences. The first, an avoidance of the physiologically based substrata of self and object organization growing out of certain preconceptions derived from a structural-drive model. And the second, an unwillingness to view the parent/analyst as a full participant in the child's romantic oedi-pal struggles. An alternative formulation based on a reconfigured, relational model of mental structures is suggested. Here the physical experience of self in relationship to a host of significant internalized others becomes a meaningful organizing component for both the patient and the analyst, one that must be incorporated into the ongoing exploration of transference – countertransference manifestations. Likewise, the unfolding oedipal situation between parent and child, patient and analyst, is viewed from the perspective of a two-person model within which the shared symbolic participation of both becomes a necessary prerequisite for the kind of resolution that lays the groundwork for mature love. A clinical example in which the analyst felt it necessary to disclose the presence of erotic countertransference is explored from several perspectives.
This article analyzes the current controversey over the iatrogenic implantation of sexual abuse >pseudomemories< during psychoanalytic treatment. It includes a critique of contemporary memory >research< and an elaboration of the concept of traumatic dissociation, bringing it into the framework of relational theory. Specific clinical examples are used to illustrate why adult survivors of sexual abuse are so vulnerable to dissociative rather than repressive defensive structures. In the context of a long clinical vignette, the analyst's countertransference is explored as a fulcrum for the counterbalancing effects of traumatic memory, dissociation, and constructivism.
In this article I explore the concept of a postoedipal adult sexuality and its role in the erotic transference-countertransference processes seen in psychoanalytic treatment. This concept challenges the fundamental assumption that, whenever erotic feelings enter the psychoanalytic space, the analyst always stands in the role of the oedipal parent. It suggests that clinical choices made from within an oedipal model often fail to recognize certain significant developmental changes. An extended clinical example is provided.