Analytic Mind Use and Interpsychic Communication: Driving Force in Analytic Technique, Pathway to Unconscious Mental Life

The Innate Capacity for Representing Subjective Experience: The Infant's Mind is Neither Primitive nor Prerepresentational

The author cites the prominence of theories that locate serious adult psychopathology in the preverbal infant's inability to formulate or represent traumatic experience. The work of two such authors, H. Levine and D. B. Stern, is briefly considered. The frame of reference for this investigation is that clinical and academic research findings are highly relevant to psychoanalytic theorizing. It is argued that when such findings are considered, a view of the infant with "primordial and unrepresented" states of mind has little evidence to support it. In fact, research findings summarized herein point to an opposite view: that of the "competent infant," one with highly accurate perceptual discrimination capacities and an innate ability to register and represent subjective experience in both procedural and declarative memory, even prenatally. Given the infant's competencies, it seems implausible to hold that representational deficits are at the heart of serious adult psychopathology, which is instead seen to be the result of defensive maneuvers against unknowable and unspeakable truth rather than the absence of a preverbal representational capacity. Current research findings seem to pose a significant challenge for psychoanalytic theories that espouse "primitive mental states"; "unrepresented," "unformulated," or "unsymbolized" experience; or "nonconscious" states.

Return of the Repressed: Revisiting Dissociation and the Psychoanalysis of the Traumatized Mind

Psychoanalytic treatment is often indicated when trauma and its psyche/soma companion, dissociation, severely disrupt symbolic functioning and associative linking. After Freud's initial thinking on these matters, repression replaced rather than supplemented dissociation (which occasions segregating units of experience) as the primary defensive response to severe trauma. Because psychoanalysis had "repressed" the salience of dissociation as actively motivated (though passively experienced), an unnecessary schism has occurred between trauma theories and mainstream North American psychoanalysis, and within psychoanalysis itself. To fully restore dissociation's role in primitive mental states and provide a more integrated approach to technique, it is necessary to comprehend the triadic nature of trauma, which entails economic/drive, structural conflict and deficit, and object-relational factors. For a treatment model that addresses defensive dissociation in the here and now, primary and secondary dissociation must be distinguished, with each differentiated from splitting and repression. Technique requires addressing unconscious, repressed fantasies associated with the "trauma," object-relational patterns that interfere with linking, and psycho-economic issues that have disrupted ego functioning. A clinical example illustrates both the analyst's persistence in suffering the dead, eerie space of dissociated trauma and efforts to find language that helps structure the patient's somatic and enacted expressions (and accompanying dissociative and repressive processes) by which traumatic experiences are registered and conveyed.

Gazing Back, Playing Forward: Contemporary Psychoanalytic Musings on the Relational Essence of Hypnotherapeutic Action

To build bridges between hypnosis and contemporary psychoanalysis, this article addresses how hypnosis, when used in psychotherapy, facilitates curative action through its relational essence. The author's extensive experience with hypnosis, psychotherapy, and psychoanalysis orient the narrative toward the unconscious patient-therapist interaction, with particular attention paid to the ethics of the inherent hypnotic seduction. Whether used primarily in relief-oriented ways or geared toward more transformative therapeutic aims, powerful unconscious factors are in play for both patient and therapist and are explicated to illustrate the interactive and frequently unformulated, intersubjective factors that facilitate effective, psychotherapeutic hypnosis. Consequently, therapists attuned to such intersubjective dynamics can make use of their own internal mental activities to understand a patient's current state of mind and level of developmental functioning, and thereby subsequently formulate mutative interventions. For instance, because hypnotizability reflects the ability to play in imaginative space, the regression promoted in hypnotherapy may activate both an illusion of omnipotence and its optimal disillusionment through the relational context. This requires going beyond more traditional, procedural ways of bifurcating hypnotic interventions as being either direct or indirect and instead further distinguish hypnotic interventions in accordance with their maternal and paternal relational dimensions. Arguably, then, the skillful hypnotherapist needs to maintain a coupling interplay between the maternal, maximally receptive and the paternal, more active modes of functioning within hypnotic play space.

Searching for the analyst's reveries

Over the last 20 years the post-Bionians have begun nothing less than to spell out the beginning of the metabolizing process (reverie) in the analyst's mind that takes place with under-represented mental states. This bold attempt leading to new discoveries, and its many possibilities for understanding patients, seems to have obscured differences amongst leading post-Bionians with regard to how they see the forms of reverie, and how they might best be worked with. With Bion's perspective as a background, this paper explores three approaches, and how they differ with regard to whether one follows the views of early or late Bion. Technical issues associated with these views are raised. A clinical example is offered as one way to use reverie.

Mentalizing countertransference? A model for research on the elaboration of countertransference experience in psychotherapy

As a construct, the elaboration of countertransference experience (ECE) is intended to depict the implicit and explicit psychological work to which therapists submit their experiences with clients. Through ECE, defined as a mentalizing process of a particular kind, therapists' experiences are presumed to acquire and increase in mental quality and become available for meaning-making and judicious clinical use. In this paper, we claim that such an ongoing process facilitates engagement with common therapeutic factors, such as the therapeutic alliance and countertransference management, enhancing therapist responsiveness in psychotherapy. We synthesize relevant literature on countertransference, mentalization, and, in particular, therapists' mentalization, informed by a systematic literature review. As a result, we propose a model for assessing ECE in psychotherapy, comprising 6 diversely mentalized countertransference positions (factual-concrete, abstract-rational, projective-impulsive, argumentative, contemplative-mindful, and mentalizing), 2 underlying primary dimensions (experiencing, reflective elaboration), and 5 complementary dimensions of elaboration. Strengths and limitations of the model are discussed.

THE MISSING FATHER FUNCTION IN PSYCHOANALYTIC THEORY AND TECHNIQUE: THE ANALYST'S INTERNAL COUPLE AND MATURING INTIMACY

This paper argues that recovering the "missing" paternal function in analytic space is essential for the patient's achievement of mature object relations. Emerging from the helpless infant's contact with primary caregivers, mature intimacy rests on establishing healthy triadic functioning based on an infant-with-mother-and-father. Despite a maternocentric bias in contemporary clinical theory, the emergence of triangularity and the inclusion of the paternal third as a separating element is vital in the analytic dyad. Effective technique requires the analyst's balanced interplay between the paternal, investigative and the maternal, maximally receptive modes of functioning-the good enough analytic couple within the analyst-to serve as the separating element that procreatively fertilizes the capacity for intimacy with a differentiated other. A clinical example illustrates how treatment is limited when the paternal function is minimized within more collusive, unconsciously symbiotic dyads.

THE VIBRANT CHALLENGES OF CLINICALLY EFFECTIVE PSYCHOANALYTIC MINDEDNESS

In addressing the central challenges of developing and maintaining the analyst's psychoanalytic mindedness, this paper focuses on two particularly challenging core components of clinical effectiveness not so easily developed despite the rigors of the tripartite training model. The first is the analyst's receptivity to unconscious communication, which entails the analyst's curiosity, acceptance of human nature, doubt, restraint, narcissistic balance, and integrity. A brief clinical vignette illustrates this. The second factor is recognizing and managing the inherent disappointments and narcissistic challenges in working psychoanalytically. The author maintains that the ability to lose and subsequently recover one's analytic mind entails discipline, courage, and faith that only experience can provide.

Unconscious Fantasy and The Priming Phenomenon

This paper is the third in a series of investigations into (1) the nature and development of unconscious fantasy, (2) its place in a contemporary model of mind that, parenthetically, suggests a possible solution to the problem of theoretical pluralism, and (3) its mode of operation in the mind. The aim of these investigations is to update the notion of unconscious fantasy, an indispensable construct in psychoanalytic theories that assume out-of-awareness mentation, and to situate that construct within contemporary views of mental functioning in disciplines such as philosophy of mind, cognitive science, and developmental psychology. At the same time, data accessible only through psychoanalytic work challenge these fields with findings that indicate the need for further investigation. This paper argues that experimental evidence on the phenomenon of "priming" lends support to one of the seminal claims in our field, one frequently attacked as an outmoded shibboleth: that is, that the past matters, whether encoded in declarative or in procedural memory. In common parlance, we are "primed" to respond to some situations in predetermined ways; the past primes us to experience the present in often unique and personal ways. There is evidence too that the priming mechanism and the encoding of subjective experience in declarative and procedural memory operate from very early in life.

GEORG GRODDECK: "THE PINCH OF PEPPER" OF PSYCHOANALYSIS(.)

The life and works of Georg Groddeck are reviewed and placed in historical context as a physician and a pioneer of psychoanalysis, psychosomatic medicine, and an epistolary style of writing. His Das Es concept stimulated Freud to construct his tripartite model of the mind. Groddeck, however, used Das Es to facilitate receptivity to unconscious communication with his patients. His "maternal turn" transformed his treatment approach from an authoritarian position to a dialectical process. Groddeck was a generative influence on the development of Frieda Fromm-Reichmann, Erich Fromm, and Karen Horney. He was also the mid-wife of the late-life burst of creativity of his friend and patient Sándor Ferenczi. Together, Groddeck and Ferenczi provided the impetus for a paradigm shift in psychoanalysis that emphasized the maternal transference, child-like creativity, and a dialogue of the unconscious that foreshadowed contemporary interest in intersubjectivity and field theory. They were progenitors of the relational turn and tradition in psychoanalysis. Growing interest in interpsychic communication and field theory is bringing about a convergence of theorizing among pluralistic psychoanalytic schools that date back to 1923 when Freud appropriated Groddeck's Das Es and radically altered its meaning and use.

Monsters, dreams and madness: Commentary on 'The arms of the chimeras'

Considering Freudian and Post-Freudian approaches to the intersubjective Beatrice Ithier puts the work of Michel de M'Uzan and Thomas Ogden in comparison. To this comparison I add a consideration of the work of Christopher Bollas. The highly creative clinical approaches these three theorists take is shown to be informed by their elaborations of the Freudian notion of unconscious communication and by new approaches to the issue of identity. Attention is paid to differentiating traumatic from fanciful chimeras; and to the experience of the analyst undergoing the sorts of transformations requisite to entering this psychic space marked by fluid exchanges of being and becoming, wherein analyst becomes patient, new subjects are created through shared dreams, and through which monsters appear.

The analyst's way of being: recognizing separable subjectivities and the pendulum's swing

Whether the analyst finds the patient's emerging transference affectively tolerable or intolerable plays an important role in the analytic couple's negotiation of the configuration that the transference-countertransference relationship ultimately assumes. If the analyst is deeply repelled by transference-related roles to which he is assigned, patient-ascribed attributions, or projection-drenched interactions, he may react in violent protest, engaging in enactments that say more about his separable subjectivity than about the intersubjective situation. While there has been a recent trend to view enactments as a crucial aspect of psychoanalytic technique, this trend risks overlooking the way in which the analyst's way of being comes into play in the treatment.

Unconscious fantasy as a special class of mental representation: a contribution to a model of mind

Philosophers of mind and cognitive psychologists have proposed that "mind" consists of myriad mental representations, namely, conscious and unconscious representations of belief/desire intentions. It is argued here that unconscious fantasies constitute a subset of the domain of mental representations, those concerned with conflicting wishes, affects, and defensive maneuvers. This proposal anchors the unconscious fantasy construct in a model of mind that accords with contemporary academic views in cognitive and developmental psychology and philosophy of mind, thus allowing psychoanalysts to enter into dialogue with those disciplines. Given this formulation, unconscious fantasy might well serve as a theoretical construct that applies to a large group of theories that share certain criteria regarding mentation. An analyst would then be at liberty to commingle insights from a menu of different theories without committing metatheoretical malpractice, resulting in a principled version of theoretical pluralism. Published case material from Kleinian, close process monitoring, and self psychological perspectives demonstrates how this redefined unconscious fantasy construct can encompass two major types of interventions that analysts make: content and process interpretations.