The Child in the Adult: Narrative and in Henry James and Freud
At the intersection of literature and psychoanalysis, this essay draws on Freud's discovery of the infantile sexual unconscious to explore moments in the late novels of Henry James, in which an adult protagonist both recognizes and disavows the visible evidence of a sexual relationship. The essay considers Hans Holbein's 1533 painting, The Ambassadors, as a possible source for Henry James' choice of title for his 1903 novel: the painting's visual play with point of view touches on the narrative disavowal of what is there to be seen. The essay explores some narrative dimensions of Freud's writing to highlight the dynamic disclosure of the infantile within the adult. The concept of Nachträglichkeit, recognizing the deferred or belated impact of disruptive recurrences in mental life, helps to understand such moments and gives insight, more broadly, into narrative experience. Drawing on Nachträglichkeit as a principle of mental life, the essay explores the resonances of infantile sexuality, fantasy, and trauma in narrative, and more generally, as a resource in creative expression.
The Interpretive Process
The purpose of this paper is to reformulate the concept of interpretation in a way that better reflects the interpsychic and processive dimensions of this concept as increasingly represented in psychoanalytic writings. Implicit in my redefinition is the view that, while the interpretive process is essential to therapeutic action, the notion of is an artificial and problematic way of viewing the work of analysis. In this paper I will review an expanded definition of interpretation as developed through the writings of Hans Loewald and elaborated by more contemporary thinkers such as Sheldon Bach, Ronald Britton, and Antonino Ferro.
The Strange Case of Dr. Freud, Mr. Holmes, and Dr. Watson
Although the comparison between two great Victorian masterminds, Sigmund Freud and Sherlock Holmes, and their respective methods, is in itself not new (see for example Ginzburg 1979, 1980; Brooks 1984; Marcus 1984; Shephard 1985; Spence 1987), it merits further investigation, as it raises important questions regarding the nature and structure of clinical evidence, clinical epistemology, and clinical narration. In this article, the author: refers both to the common cultural background of these two projects (including the of the modern world and the complicated dialog between rationality and imagination) and their common epistemological situation; analyses their and , and characterizes both Holmes and Freud as and . Their operandi are described as hermeneutical procedures, methodologically similar to Charles Sanders Peirce's . Moreover, the author argues that both can be viewed as manifestations of Aristotle's . Finally, the author points out one important difference between Freud and Holmes, namely that in fact is at the same time .
Tran in April: The Analysis of A Transgender Adolescent With Notes on the Metapsychology of Gender Transition
The aim of this article is twofold: firstly, to describe the seven-year analytic treatment of a TG adolescent (F "April" to M "Tran") and, secondly, based on the clinical observations, to propose a reflection on the intrapsychic events linked to gender transition. We could witness during this analysis that the dissonant anatomical sex, which is at the heart of the gender dysphoria, resists mentalization and consequently its psychological integration. The psychic events of transition, understood here on the model of a mourning process, could denote the various strategies necessary to the TG individual to negotiate the obstacle of mentalization.
Kaës' Internal Groups and Actual Groups: A Relational Perspective
Rene Kaës (2007), an influential French psychoanalyst relatively unknown to English-speaking readers, extends the field of psychoanalytic investigation and practice to groups. Building on Klein, Anzeiu, Bion, and Lacan, Kaës presents a dual-axes theory in which early oedipal and complexes structure unconscious dynamics of . According to Kaës, analytic group psychotherapy provides access to the phantasies, affects, and action tendencies contained within internal groups that would be otherwise inaccessible. While a few reference articles have appeared in the English literature, Kaës' bold assertions, core concepts, and praxis have not been subject to critical evaluation. I introduce Kaës' main ideas, demonstrate their influence on my group work, and by comparing two case examples, from his practice and mine, articulate our differences, some of which arise from different conceptions of and approaches to . The discussion continues in the final section which briefly considers the nature of psychoanalytic learning and how we may employ the therapeutic group to reach this goal.
Giving Back What the Patient Brings: On Winnicott's "Mirror-Role of Mother and Family in Child Development"
The author offers a creative reading of Winnicott's (1967) "Mirror-role of mother and family in child development." Winnicott presents the idea that a pivotal experience in the process of the infant's coming into being as himself is the mother's communicating to the infant, by the look in her eyes, what she sees there when she looks at him. In the absence of the experience of being seen, the infant's capacity to feel real and alive atrophies. The author fleshes out Winnicott's thinking by suggesting that just as the infant comes more fully into being as he sees himself in his mother's eyes, so too, the mother comes more fully into being as a mother as she sees herself in the infant's eyes. The paradigm shift that Winnicott has contributed to psychoanalysis is reflected in the clinical work he presents: (1) the goal of psychoanalysis is no longer the enrichment of the patient's self-understanding; rather, the analytic goal is the patient's coming more fully alive to himself; and (2) the analyst helps the patient achieve this end not by making astute interpretations but by allowing the patient to experience the pleasure of making discoveries of his or her own.
Transformations in O Online: Group Process in the Virtual Realm
The authors describe their experiences as members of an international online study group, initiated before the COVID-19 pandemic to read aloud and discuss Bion's (1965) . The three separately authored essays and commentary included here reflect the multifaceted phenomena in which images and voices in Zoom rectangles are transformed into shared emotional experience, the O of the group in Bion's language. These observations show how group members translate online experience into a felt sense of being with others, and suggest that oscillations in the sense of being inside or outside the group demonstrate the dialectical and constantly changing nature of the analytic field in an online group.
What We Do, What We Say, What We Don't Say: Confidentiality In The Publication Of Clinical Writing
Questions concerning analysts' publication of material from the analyses of their patients have troubled the field of psychoanalysis since its inception. Disguise inevitably distorts the clinical material and is often insufficient to protect the patient from recognition. Asking the patient's consent for publication intrudes upon and alters the analytic process. While analysts have largely reached a consensus about the need for in published material, there is still considerable debate about the necessity for obtaining patients' when using their material for publication. In this paper, I will trace the evolving meanings of disguise, and particularly of consent, in the analytic literature. I will place a particular emphasis upon the that underlie the analyst's decision to ask consent from her patient or not to do so, and I will argue that, although decisions on asking consent remain a complex matter, such coherent belief systems should play an important part in analysts' decisions regarding consent. I will illustrate my thought processes and some clinical situations with brief examples, and I will conclude with some practical recommendations, with the hope that these will stimulate further discussion in the analytic community.
"Mourning and Melancholia" Meets : Emptiness and its Relation to Absence
This paper explores how the film illuminates psychoanalytic understandings of melancholia and mourning. The author attempts to unwind the complicated character of melancholia, using Freud as an initial point of orientation, then relying on a few ideas from Klein and later writers. The paper attempts to refine our understanding of the difference between absence and emptiness, especially the difference between being captured in the nothing or deadness of melancholic emptiness, on the one hand, and being alive enough to suffer the absence of a lost object, which bears a potential for mourning, on the other. The possibility of psychic tension between these states is explored. Some implications of the relationship between absence and emptiness for the mourning process are considered. The author uses the film as a resource throughout.
Beginning the Treatment on a Personal Note: Creating Emotional Connection
Psychoanalysis reflects the minds of its creators and is an ethical practice in the sense that the theories with which we psychoanalysts identify are those that reflect what is most important in life to each of us. I present autobiographical material that points to the personal sources, even earlier than my psychoanalytic training, of my conviction that the creation of emotional connection between two actual persons lies at the heart of psychoanalysis and is the key element in the beginning of psychoanalytic treatment. I argue that the beginning of an interpersonal/relational treatment has more continuity with the beginning of non-psychoanalytic relationships than does the beginning of treatment carried out by analysts from other schools. I present what I believe are the reasons for this difference and offer comparisons and contrasts of these ways of establishing a psychoanalytic situation. The article ends with a brief clinical illustration.
A Difficult Beginning: Commencement and Birth in the Analysis of an Adolescent
The author distinguishes between two kinds of beginning, conceptually tied to two ways of approaching the psychoanalytic situation described as and . Through a clinical case, the author shows how her work with a troubled adolescent had two beginnings that corresponded to these types. In this way, she tries to expand on the literature about the focusing on what means in this context. For treatment to succeed, a must emerge, a transformative moment with the potential for significant change. The combined ability to transform the most primitive, somatopsychic pain can be more effective if shared by analysts and patients in a predominantly aesthetic form.
Thoughts on the Beginnings of Psychoanalyses
Musing on the topic of initiating analyses, I began asking myself, what do we experience and what do we mean when we commonly say "an analysis unfolds"? Hans Loewald understood the rhythms of psychic development as , and that an analysis (when it works) also seems to follow that pattern. This paper will focus on appreciating in the analytic process as a way to illustrate narrative and behavioral themes in the analytic dialogue. It will explore how these themes relate to the creativity of analytic unfolding from an initial matrix of psychically overdetermined uncertainties. Analyst, supervisor, and patient can all notice and experience shifts of new forms intermingling with the old. This trope will be clinically expanded and examined (1) with materials from a candidate's first analytic case, (2) with a vignette from a seasoned analyst's beginning case; and (3) a Covid-era beginning treatment. A clinical footnote (dubbed by the author's supervisees "The Balsam Sign") describes a nonverbal mime in the office of a new development occurring within the familiar verbal communication, which may signal a patient's readiness to accept a recommendation to begin an analysis.
Initiating Analysis
Psychoanalysis is defined in this paper as a process that initiates in the analyst's mind with the framing of the patient's material in terms of and . Once the analyst is able to do this, a first level of transformation of experience is effectuated that then must be through interpretation to the patient of what is occurring in their mind as it is lived out in the experience with the analyst. For this author, Bion's model of container-contained complements Freud's transference and resistance model; it also offers an example to his thesis that only within a clear model of mind and a corresponding theory of therapeutic action can the psychoanalyst define for themselves and for their patients a way of knowing that they are doing analysis. The patient's unconscious storm is present from the moment of the first interviews, and the analytic process begins whenever the analyst is ready to experience, think, and talk about it with his or her patient.
Practice and Praxis: Psychoanalysis as an Act of Love
The concept of in psychoanalysis includes the way clinical practice embodies the values on which psychoanalysis is founded. As psychoanalysis evolved from a medical treatment to a process of open-ended psychic development, its underlying values evolved as well. Free-floating attention has many facets, shown in the variety of names given to it. From being a means to an end clinically, it became an implicit statement about the human value of the person being attended to. Clinical vignettes, contributions from philosophers, and examples from literature converge around the idea that the unreserved openness of free-floating attention amounts to an act of love. It is underpinned by the values, which are also virtues, of hope, and faith in the possibility of good; it can also be seen, in non-religious terms, as a form of prayer.
Some Brief Reflections on "Time" from a Psychoanalytical Perspective
An attempt is made to encircle time and the times psychoanalytically. They are understood as the result of the interplay of different psychic systems: Timelessness of the Ucs system (psychic reality), actual time in the Pcpt-Cs (perceptual reality), and vectorial-linear time in the Cs/Pcs systems (reality principle). Time shows itself in the moment of presence, but it can only show itself if there is a temporal antecedent. At the same time, time and space are intertwined, so that the past is initially the place where something happened. However, the interplay of the mental systems with time and space can only develop in the object relationship. A short clinical example of an autistoid perversion illustrates this dynamic.
On "Beginning" in Analysis
While we speak casually about beginning of an analysis, we are also aware that there are different senses of in the context of an analysis. Certain differences surrounding the nature of beginning reflect technical-theoretical debates within the field. But in addition and more broadly, the various senses of represent different of our understanding and experience of analysis. In this essay, I explore some of these dimensions and consider the significance and challenges of throughout the course of analytic work.
The Wisdom of Shadows: Chaos, Disintegration, and Psychic Growth in
is a timeless exposition of humankind's attempt to find meaning amidst the ceaseless turbulence of existence. This entails navigating the disintegrating pulls of nature and harmful human action that exist alongside affiliative, life-promoting gestures shown toward one another. As the predictability and safety afforded by social and two-dimensional psychic constructs collapse, several characters in this play are forced to reckon with the untamed, less organized realms of the mind and natural world. This leads to movements toward psychic paralysis and disintegration, as well as toward growth and interpersonal healing, dynamics that hinge on the characters' internal structuring.
Bion's and Clinical Practice
Wilfred Bion's contributions to psychoanalysis are numerous: his early work on the psychology of groups that grew out of his experiences in the first World War; theories and work on the treatment of psychosis with Melanie Klein and later psychoanalysis with her; and the beginning of his own theoretical and clinical ideas, which nurtured analytic thinking and treatment approaches beginning in the mid-1960's followed by his relocation to the United States (1967). Bion's thinking can be deceptively simple, such as his statement that his third book, (1965), considered by many as exceptionally dense, is about "the communication of both patient and analyst about an emotional experience" (p. 29).
Clinical Evidence, Triangulation of Perspectives and Contextualization. Part 1: The Beginning of Carla's Treatment
We propose to critically evaluate and strengthen the level of clinical evidence in psychoanalysis, using a strategy of triangulating clinical phenomena from different perspectives and increasing contextual knowledge. Insufficient discussion of alternative hypotheses and limited contextual information are two Achilles heels of psychoanalytic case presentations. We examine the concept and quality standards of clinical evidence in psychoanalysis and related disciplines, with particular attention to the contribution of the three-level model (3-LM). We analyze the case of a patient treated with transference-focused psychotherapy (TFP), making explicit the theoretical-clinical agreements and disagreements of the authors. We discuss the strengths and limitations of triangulation and contextualization, concluding that they make clinical work and psychoanalytic writing more reliable, transparent, auditable, and replicable.
Playing, Paradox, and Analytic Activity Between Knowing and Being
The author explores some ways that we help patients to hold paradoxical realities intrinsic to transference and play in analytic work. He suggests that Winnicott's guardianship of the setting for the emergence of playing raises questions about the role of neutrality in an ontological analysis. The author tries to demonstrate some ways that the work of helping patients to hold paradox in play overlaps with a concept that he has earlier referred to as an activity of neutrality. He explores how in the analytic process, understanding and being are two dimensions of the analytic process that work in concert with each other. Often the analyst works quietly in spaces between epistemological and ontological approaches in the holding of paradox.