Remembrance, trauma and collective memory: The battle for memory in psychoanalysis

Women's experiences of infertility after the Holocaust

Nuremburg trial evidence demonstrated that Nazis sought methods of mass sterilization of Jewish women. Immediately upon arrival at the concentration camps, over 98% of women stopped menstruating. There has been minimal investigation as to the cause(s) of amenorrhea, beyond malnutrition and trauma. The major objectives of this article are to 1) provide an alternate hypothesis to explain women's amenorrhea, i.e., surreptitious administration of exogenous hormones to women; 2) detail survivors' reproductive histories so as to demonstrate long-term sequellae, especially pregnancy losses; 3) provide women's subjective narratives of the short- and long-term experience of reproductive losses; 4) link women's amenorrhea, subsequent primary and secondary infertility and the evidence for the hypothesized causal mechanism, i.e., the administration of sex steroids which might have led to both immediate and long-term reproductive impacts. We conducted telephone interviews from 2018 to 2021 with Holocaust survivors internationally in 4 languages. We collected 93 testimonies from female Holocaust survivors (average age 92.5) or offspring who could provide complete reproductive histories for survivors. The interviews focused on reproductive histories, including amenorrhea beginning in 1942-45, subsequent attempts to conceive, numbers of pregnancies, miscarriages and stillbirths. Ninety-eight percent of women interviewed were unable to conceive or carry to term their desired number of children. Of 197 confirmed pregnancies, at least 48 (24.4%) ended in miscarriages, 13 (6.6%) in stillbirths and 136 (69.0%) in live births. The true number of pregnancy losses is likely much higher. Only 15/93 (16.1%) of women were able to carry more than two babies to term, despite most wanting more children desperately. Amenorrhea among Jewish women arriving at concentration camps was too uniform and sudden to be effected only by trauma and/or malnutrition. Survivors' narratives and historical evidence suggest the role of exogenous hormones, administered without women's knowledge to induce amenorrhea as well as subsequent primary and secondary infertility.

The psychological effects of stillbirth on parents: A qualitative evidence synthesis of psychoanalytic literature

Objective: To review and synthesize existing psychoanalytic literature on the psychological impact of stillbirth on mothers and fathers. Method: This qualitative systematic review followed, as far as possible, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Psychoanalytic Electronic Publishing Archive, the Single Case Archive, and PsycINFO (1999-2019) were searched to identify relevant articles published between 1999-2019 that report clinical material or theoretical considerations concerning the psychological effects of stillbirth on parents, as emerging during classical analytic or psychoanalytic therapy session/journey. A thematic synthesis was performed. Results: 46 articles were identified, providing data on the parents' experiences of grief and gender differences, the detrimental effects on the parental couple's relationship, the mother's identification with the dead baby, the importance for mothers to meet and care the stillborn baby, the mothers' drive for another pregnancy and the fear of further loss, the mothers' ambivalence toward subsequent pregnancy and child, the potential negative effects of unresolved bereavement on subsequent baby, and the replacement of a stillborn child. Conclusion: Our findings reveal there is some psychoanalytic literature providing insight into the psychological dynamics of parents after a stillbirth, with observations that could be used to improve psychological health care practices. One of the main therapeutic tasks was to facilitate parents to create a psychic space where they can bring to life, psychically, their lost and never- really-known stillborn baby, and to let him or her to be part of the on-going family narrative.

Changes over 10 years in the retelling of the flashbulb memories of the attack of 11 September 2001

A flashbulb memory is a highly detailed and vivid autobiographical memory for the circumstances in which one first learned of a surprising, consequential and emotionally arousing event. How retelling of different features of a flashbulb memory changes over time is not totally understood. Moreover, little is known about how the emotional feeling experienced by individuals when they learned about the event modulates these changes. In this study, we explored changes over time in American individuals' retelling of their flashbulb memories of the terrorist attack of 11 September 2001. We conducted textual analysis of 824 testimonies collected from the same 206 individuals 1 week, 11, 25 and again 119 months after the attack. Results showed individuals were more likely to report temporal and emotional details in their retelling early after the event and spatial details in their long-term retelling. In addition, the intensity of emotions felt upon hearing the news about the attack influenced how individuals reported their flashbulb memories over time. Overall, this study provides further support for theories suggesting different rates of forgetting for different canonical features of emotional arousal events.

Sixteen analysands' and large groups' reactions to the COVID‐19 pandemic

The first part of this paper describes 16 analysands' reactions to the COVID‐19 pandemic, from early March 2020 until mid‐January 2021 when this paper was written, when different vaccines for the virus have become available and when the new COVID‐19 variant showed its face. The data come from the author's supervision via telephone of 10 younger psychoanalysts who were treating one or two of these cases. Most of the analysts and their analysands are located in Istanbul, Turkey, others in the United States and one analyst and her patient in Germany. The second part of this paper describes how the initial response to the virus pandemic has increased some of the 16 analysands' investments in their large‐group identities. The pandemic's impact on “border psychology” is also described. Lastly, this paper poses suggestions about the psychoanalyst's role in making helpful suggestions in dealing with the impact of the COVID‐19 pandemic on large groups.

TRAUMA, PREJUDICE, LARGE-GROUP IDENTITY AND PSYCHOANALYSIS

Escaping Nazi annexation of Austria, Sigmund Freud and his family left there in 1938 to live the rest of their lives in exile in the house now known as the Freud Museum in London. This paper is based upon the author's Holocaust Day Memorial Lecture delivered virtually at this museum on January 27, 2021, which marked the 75th anniversary of the liberation of Auschwitz-Birkenau, the largest Nazi death camp. Besides remembering those who were lost during World War II, the content of this paper includes a description of different types of massive traumas, with a focus on disasters at the hand of the Other, and their impact on individuals and large groups. Sigmund Freud's ideas about relationships between communities and countries with adjoining territories, as well as large-group psychology, are updated, and individuals' and large groups' needs to grasp onto large-group identities is explained and illustrated with case reports.

Thinking against trauma binaries: the interdependence of personal and collective trauma in the narratives of Bosnian women rape survivors

In this article, we draw on feminist trauma studies with the aim of deconstructing the theoretical and methodological binary between individual and collective trauma. Based on first-hand interviews with Bosnian survivors of rape, we attempt to ‘think against’ the private/public split that trauma studies work often unintentionally reifies. We draw upon recent methodological innovations that have been influenced by thinkers such as Derrida and Deleuze. Specifically, we work with what Jackson and Mazzei call rhizomatic and trace readings in the threshold. Through a rhizomatic and trace reading of narrative pieces extracted from the interviews, we engage with the following questions: 1) How do we theorise what Davoine and Gaudilliere call ‘the sociopolitical faultlines’ between collective/public accounts of trauma and those traditionally constructed as private/personal? 2) How do accounts of war rape, which narrate the eruption of the past into the present, elucidate the myriad links between the private and public in a number of ways; among others, the echoes or traces of the everyday ‘before’ in subjects’ stories of the monstrous ‘after’? And 3) What is the relationship between the ‘unspeakable’ in the traumatic memories of the survivors and the ‘speakable’ collective memories of traumatic humanmade events? How does the collective desire ‘not to know’ or ‘to forget’ impact on the individual survivor’s ability to reconstitute their post-trauma identity in a personal as well as a social context? The aim of the analysis is to show that the multifaceted nature of the traumatic reality demands a multifaceted approach that resists binary constructions relating to self/other, private/public, individual/collective.

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.

Psychoanalytic Perspectives on the Psychological Effects of Stillbirth on Parents: A Protocol for Systematic Review and Qualitative Synthesis

Introduction: Despite the fact that stillbirth has a broad economic impact on health systems and society and despite the fact that the importance of appropriate psychological and social support for parents has been highlighted, there is still a lack of research exploring the intrapsychic and interpersonal dynamics and issues triggered by the experience of stillbirth. Healthcare professionals attempting to provide effective psychological support to bereaved parents who have suffered perinatal loss continue to struggle to achieve better and deeper understanding of their psychological states and processes. Psychoanalysis could play a key role in improving this situation, but the studies available are confined to journals of psychoanalysis, and there is a lack of synthesis, leaving this knowledge beyond the reach of scientists from other theoretical approaches or disciplines. This protocol proposes the systematic review and qualitative synthesis of articles from journals of psychoanalysis on the psychological effects on parents of stillbirth.

Methods and Analysis: This systematic review will follow, as far as possible, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Psychoanalytic Electronic Publishing Archive (1999–2019), the Single Case Archive (1999–2019), and PsycINFO (1999–2019) will be used to identify relevant articles. The review will include articles reporting clinical material and/or theoretical considerations concerning parent psychological states and processes triggered by the experience of stillbirth, and a meta-synthesis will be performed.

Ethics and Dissemination: Formal ethical approval is not required for this study, as no primary data will be collected. The findings will be published in an international peer-reviewed journal.

In the shadow of Apartheid: intergenerational transmission of Black parental trauma as it emerges in the analytical space of inter-racial subjectivities

Using the construct of projective identification and integrating it with the body of literature on intergenerational transmission of unsymbolized parental trauma, I describe the case of an adult black South African woman called Sibulelo. It is suggested that Sibulelo has unconsciously identified with the disavowed parents and grandparents trauma that they suffered as a result of the system of Apartheid. Such trauma is expressed through her feelings of being dis-located in time and space, as if she is living outside of herself, unplugged from life, and living someone else’s life. The paper details the unfolding therapeutic process in relation to my whiteness in the context of her blackness. This brings into sharp focus an exploration of black-white racialized transference-counter-transference matrix in the context of intergenerational trauma. It is a reflective paper and opens up my own counter-transference, thus foregrounding the notion of therapeutic inter-subjectivity. A further contribution to psychoanalytic theory concerns the role of recognition and being seen as a powerful process in facilitating the symbolization of trauma. In addition, if there is no interruption of the cycles of intergenerational trauma, and therefore no symbolization, it becomes an unconscious familial compulsion to repeat. Moreover, this therapy case highlights the idea that as a traumatised family living within a bruised culture of intergenerational transmission of trauma, such repetition of trauma becomes a cultural compulsion to repeat what has not been spoken or named.

Measuring Intimate Partner Violence and Traumatic Affect: Development of VITA, an Italian Scale

In a global context where the percentage of women who are victim of violence is still high (World Health Organization, 2013), intimate partner violence (IPV) can be considered the most widespread form of violence against women: in such cases violent attacks are perpetuated or threatened by a partner or ex-partner within an intimate relationship, which makes its recognition more difficult. IPV requires specific tools and, although the literature has highlighted the specific role played by some emotions (such as shame, guilt, and fear) that keep women experiencing this violence in a state of passivity and confusion, to date too little attention has been given to the construction of sound instruments able to detect post-traumatic affectivity. Such instruments could facilitate women who have suffered from IPV in recognizing it and in making the responses of women's health services more sensitive and structured. This study illustrates a sequential item development process to elaborate a new self-report instrument (VITA Scale: Intimate Violence and Traumatic Affects Scale) for assessing the intensity of post-traumatic affect derived from IPV. Within a psychodynamic perspective, the scale is characterized by four affects: fear, as a state of alarm elicited by the avoidance of the danger; terror, as a paralyzing state that hinders an active process of reaction; shame as a strong exposure to the other that disarms the individual and the guilt as a defensive dimension aiming at the restoring of the link with the abusive partner. Trough specific methodological steps, a 28-item set was selected and administered to a sample of 302 Italian women who declared themselves as having suffered from IPV. Explorative and confirmatory factor analysis, as well as correlations with well-established concurrent tools were computed in order to investigate its psychometric property. A factorial structure composed of four factors, consistent with theoretical scales and a good internal consistency (Cronbach's alphas from 0.80 to 0.90) emerged. The VITA Scale could be a useful tool for clinicians and researchers to investigate the intensity of the affective state of the woman suffered from IPV. It could be useful to better address the clinical practice and therapeutic intervention planning.

Our Relations to Refugees: Between Compassion and Dehumanization

After the so-called refugee crisis of 2015-2016 European reactions to foreigners had come to the fore and we are seeing xenophobic political and populist movements become increasingly mainstream. The massive rejection of refugees/asylum seekers taking place has made their conditions before, during and after flight, increasingly difficult and dangerous. This paper relates current xenophobia to historical attitudinal trends in Europe regarding Islam, and claims that a much more basic conflict is at work: the one between anti-modernism/traditionalism and modernism/globalization. Narratives on refugees often relate them to both the foreign (Islam) and to "trauma". In an environment of insecurity and collective anxiety, refugees may represent something alien and frightening but also fascinating. I will argue that current concepts and theories about "trauma" or "the person with trauma" are insufficient to understand the complexity of the refugee predicament. Due to individual and collective countertransference reactions, the word "trauma" tends to lose its theoretical anchoring and becomes an object of projection for un-nameable anxieties. This disturbs relations to refugees at both societal and clinical levels and lays the groundwork for the poor conditions that they are currently experiencing. Historically, attitudes towards refugees fall somewhere along a continuum between compassion and rejection/dehumanization. At the moment, they seem much closer to the latter. I would argue that today's xenophobia and/or xeno-racism reflect the fact that, both for individuals and for society, refugees have come to represent the Freudian Uncanny/das Unheimliche.

Trauma, healing and the reconstruction of truth

The author analyzes recent developments in trauma theory, made necessary especially after the massive psychic traumas following World War II and the Shoah. The theories of Freud and Ferenczi are analyzed, especially, their different views of reality and their clinical attitude. When working with survivors of any trauma (from incest to genocide) it is necessary to reconstruct the historical details as carefully as possible, with the appropriate timing. Psychoanalysis is therefore viewed as an ethical and political practice similar to testimony, allowing the reconstruction of truth within the community and interrupting the cycle of the death instinct from one generation to the next.

Healing the wounds of our fathers: intergenerational trauma, memory, symbolization and narrative

This paper explores the history of psychoanalytical approaches to intergenerational trauma, both from the Freudian and from the Jungian schools, and addresses the need when we speak of intergenerational or transmitted trauma to better define the nature and the different categories of trauma with particular reference to extreme and cumulative traumas such as those experienced by the survivors of the Nazi death camps and the Russian gulags. Therapy with survivors and with their children requires a particular adaptation of analytical technique as what is at stake is not so much the analysis of the here and now of the transference and countertransference dynamics which indeed can in the early stages be counterproductive, but the capacity of the analyst to accept the reality of the trauma with all its devastating and mind-shattering emotions without losing the capacity to imagine and to play metaphorically with images, essential if the patient is to be able to create a space for representation.

Reality testing in place of interpretation: a phase in psychoanalytic work with descendants of Holocaust survivors

Repetition of experience endured by the first generation has frequently been observed in descendants of Holocaust survivors. Such repetitions are associated with an erosion of the ability, in the area of the trauma, to distinguish more or less reliably between external and internal reality. This in turn results from the defensive need, in the affected families, to dissociate from such extreme traumatic experiences. Clinical material is presented to show that, at a certain phase in psychoanalytic work with patients belonging to subsequent generations, interpretive activity may need to be temporarily suspended in order to facilitate reality testing and the recognition of the Shoah as an objective historical fact.

The complex nature of exposure to early childhood trauma in the psychoanalysis of a child

When an intense transference relationship evolves during psychoanalysis, sensory and emotional experiences associated with trauma can arise spontaneously. Detailed clinical process material is presented from the psychoanalysis of a six-year-old boy whose severe trauma at age two and a half contributed to his conflicts about aggression and gender identity, impeding his development. A series of analytic sessions during which he spontaneously enacted fantasies, feelings, and defenses associated with the trauma in the immediacy of the transference relationship are used to illustrate how psychoanalysis provided him the safety to rework this overwhelming experience and its aftermath, thereby restoring progressive development. It is hypothesized that while work with trauma was only one feature in an otherwise complex treatment, psychoanalysis provided a sophisticated form of reexposure to developmentally primitive emotions, images, and fantasies that this child had not consciously connected with the trauma. Associated early childhood conflicts pertaining to aggression, separation, and gender identity, warded off with rigid defenses, had become intertwined with the trauma and its aftermath, rendering them otherwise inaccessible.

Memory in dreams

In this paper the author discusses a specific type of dreams encountered in her clinical experience, which in her view provide an opportunity of reconstructing the traumatic emotional events of the patient's past. In 1900, Freud described a category of dreams--which he called 'biographical dreams'--that reflect historical infantile experience without the typical defensive function. Many authors agree that some traumatic dreams perform a function of recovery and working through. Bion contributed to the amplification of dream theory by linking it to the theory of thought and emphasizing the element of communication in dreams as well as their defensive aspect. The central hypothesis of this paper is that the predominant aspect of such dreams is the communication of an experience which the dreamer has in the dream but does not understand. It is often possible to reconstruct, and to help the patient to comprehend and make sense of, the emotional truth of the patient's internal world, which stems from past emotional experience with primary objects. The author includes some clinical examples and references to various psychoanalytic and neuroscientific conceptions of trauma and memory. She discusses a particular clinical approach to such dreams and how the analyst should listen to them.