From the category archives:

2010

This column also appears in the November/December 2010 issue of The Therapist, published by the California Association of Marriage and Family Therapists (CAMFT).

Abstract: This second in a two-part series explores the ways that the symbolic exploration of film imagery during the brief, one-year analysis of a patient suffering from the effects of very early childhood traumata expanded his capacity to think, engage and begin to integrate unformulated and dissociated aspects of himself for the first time.  Just as elements in a dream clothe the invisible man of the psyche, each movie element and character, by giving voice to personal feelings and meanings in novel and mutative ways, increased the mentalization of lived experience that had never before existed in the realm of conscious thought.

Q and I met four times weekly for a year, sometimes five when his skillfully managed emotional needs overwhelmed his narcissistic and intellectual defensive posturing.  More often, he held forth on arcane philosophical paradigms, epistemology and knowledge and his unabashed love of the ancients whom he imbued with the nearly superhuman qualities and capacities that deify celebrities in our own personality-infected culture.

More specifically, he imbued these archetypal figures with the god-like attributes an infant ascribes to his parents, those powerful people who represent our first gods, parents for whom he held deep unmet and unacknowledged longings that had festered over the years.

Q would talk about almost anything to avoid stirring the annihilation anxiety associated with his own lost infancy and compromised childhood.

Pierrot and harlequin

Like Romulus and Remus, Q suckled on mythology and raised himself, running with a pack of equally unparented boys.   Wielding his sharpened intellect like a monarch’s sword, he was really all alone in his kingdom.  Fortunately, these burnished topics were rich in metaphoric and symbolic imagery that permitted me to access and share his private world.  Though he didn’t know it when we began, I was to become his modern day she-wolf.

Primary, and for Q, mythic maternal themes of abandonment, rage and the wordless poignancy of love nearly grasped and lost informed Q’s brief, year-long analysis, offering repeated opportunities for us to examine and explore his experiences deeply.  Movie imagery and content represented the gateway linking inside and out, me and not-me, my world and his.  It gave borrowed form to what was yet the unformulated content (Stern 1997) of his wordless, inner world.

Despite its brevity, the fact that he was able to sustain a tenuous and conflict-laden connection to me for the duration represented a monumental relational and developmental achievement for Q, surpassing that of any prior association.   We struggled together, and the year exhausted both of us.

Almost immediately, he began enacting the Janus-faced, draining aspects of his stagnant and hopeless dialectic, a conflict characterized by a terrifying urge to flee appended to a powerful longing to immerse himself in my mind and body.

Anxious and confused, Q oscillated wildly between starkly opposing impulses, each fraught with danger and dread.  Flight insured safety but exacted isolation and madness, while relationships offered the comfort of companionship but were untrustworthy and portended abject disappointment.

The Persistence of Memory

The persistence of memory

Psychosis was preferable to abandonment.  Even a whiff sent Q running.  Withdrawal, silence, canceling appointments, “forgetting” or arriving late constituted some of the behavioral language he used to convey the full dimensions of his pre-verbal traumata.  I will leave you before you can leave me.

Our engagement was sometimes as basic and wordless as breathing together, and many sessions were spent in almost total silence.  But it was to become a shared silence, and Q was increasingly less encapsulated in the solipsistic bubble that threatened to devour him.

As our relationship acquired a reliable measure of accountability and consistency, we began to seek precise words to capture and describe unspeakable feelings that had never before been thought or conceptualized in mental terms, only dramatized or projected, what Fonagy (Fonagy 2000 and Fonagy 2002) described as mentalization.

Giving linguistic dimension and form to the amorphous content of lived experience released him from the endless behavioral enactments that condemned him to a stale and deadened life.  Though he fled repeatedly, I sustained and nurtured his dare-not-hope that the fragmented shadows of potential self might coalesce into a real boy.

In many respects, the last time we met was as awkward for Q as the first.  There was so much left to say and no more time.

Having fulfilled his one-year commitment, he was too proud to admit his reluctance to leave or remain.  I was left holding one end of severed and frazzled rope of hope that had bound us.  He had no idea where or how to begin.  I tried to express what he could not.

“Endings are hard, aren’t they?  (Nod)  It’s hard to say goodbye.  We don’t usually learn how to do endings well in life, do we?”

“Yeah.”  He mentioned a friend who had died of cancer.

“I think that we’ll each carry part of the other with us for a long time.”

“Yeah.  You’ve been good to talk to.”

“As have you.  Didn’t exactly know what you were getting into, did you?”

“Yeah, I did.”  A laugh gave him away.

I provided referrals and left future access open-ended.  He mentioned that when he told his parents about his analysis, instead of mirroring delight or offering support, they questioned his financial means.  They were unable to imagine why anyone would sponsor their child, because they rarely did.  He waited until he was nearly out the door to tell me.

Spring leavesShrugging as the shadow of wordless, unformulated feelings (Stern 1997) began to envelope him yet again, Q left ten minutes early.  I listened to his quick footsteps rush down the stairs and watched him drive away for the last time.   Relieved and wistful, I enjoyed a quietly restful moment, noticing with pleasure the spring leaves unfurling on the sycamore outside my window.  A few moments later I heard rustling in the waiting room and went back to work.

Two weeks after our last session as I was driving home from Trader Joe’s, my cell phone rang.  My car filled with groceries, I was thinking about dinner and the preciously guarded private evening unfolding ahead.  Finished with daily responsibilities, the remainder of that warm spring afternoon belonged to me, as pristine and crisp as a clean, blank page.

Though I knew it was Q, I answered the phone with my off-duty greeting, a casual hello.  Accustomed to a more professional announcement, he was thrown off balance, realizing he had entered my private life.  I was not simply waiting for him.  Sensing him stumble, the inflection of my voice rose with recognition, and I welcomed him into conversation.

“How are you?” I asked.

“I’m good,” he responded.

Yes, I thought with some satisfaction, you have acknowledged to yourself that you might miss me a little bit, that our relationship mattered, and you wanted me to know that you were okay.  He did not sound bleak, as he so often did, and I relaxed with relief.

I still hold you in mind.  I will care about you even when we don’t see one another.  Remember…

He was a bit nonchalant though talked for a moment about a pressing legal concern that had been resolved judiciously without serious repercussions as a result of his growing capacity to trust, exercise judgment and control impulsivity.

“Yes, you’ve made a wise choice.  I can see you’ve thought about it,” I said, thought being the operative word.

After a moment or two of quiet, as my foot pressed on the accelerator headed for home, he shifted to another topic.

“I watched That Obscure Object of Desire,” he announced, the real purpose of the phone call.

“No kidding,” I responded with delight.  “Where did you find it?”

“Oh, I rented it,” he answered.

“What did you think?”

Portals to Q’s representational world, conversations about films were always lively, characterized by genuine mutuality and thoughtful dialogue, and I had once recommended Luis Bunuel, a 20th c. master.

Cet Obscur Objet du Desir, a wonderful movie about a middle aged diplomat’s ferocious obsession with a seductive yet withholding young woman, swirled in a maelstrom of political terrorism.

“It was great!” he answered emphatically, “yeah, great.”

Bunuel’s main character, a poised and stately diplomat, was so completely besotted with a provocative young woman that his predictably composed life deteriorated into chaotic, obsessive fantasy.  This transpired as explosive terrorist incidents aimed at his political party increased.

The blue circus

This female character represented what the preeminent object relations theorist, Ronald Fairbairn, (Fairbairn 1946) described as an “enticing or exciting object,” symbolizing sadistic seduction with no hope of connection.  The inaccessible and unknowable mother represents the prototype for this subsequent chase-disappointment dynamic.  Representing Q’s elusive and remote mother, her imago was superimposed onto every subsequent relationship he initiated (and fled).

In fact, this character was a political and emotional terrorist.  To portray his fantasy, Bunuel employed two very different actresses to characterize the young woman, one dusky and voluptuous, the other elegant and lithe.  She was a blank screen for the diplomat’s projections.  He did not know her at all.

There ensued an endless series of enactments of sexual enticements and withholding, whereby the diplomat responded to her overtures and was repeatedly and ultimately frustrated.  Terrorist bombs exploded nearby one after another.

Via film imagery, Q and I witnessed emotional terrorism and the terrors of one’s own repetition compulsion (Freud 1914), the proverbial moth to the flame.

In one seduction scene, the diplomat was delirious with desire in response to the voluptuous character’s overtures.  As her clothing was removed, he believed himself about to embrace naked flesh.  Instead, he found her body bound by a tight corset with a tight stays and boning that could not be undone.  Struggling uselessly to release them, he abruptly collapsed in despair and rage, while she continued to taunt him and laugh.

This was the image of a boy trying to reach his mother’s breasts while she displayed but withheld them.  The boy could only begin to think, “I will never go there again, but if I do, I will leave her before she can leave me.”  And this became part of the emotional template of Q’s relational life.

“It took me a while to get it…that it was the same person, the girl, that he’d used two actresses, he continued.”

“Wasn’t that a great technique?”

“Yeah, it took me a while.”

“I think Bunuel was telling us that this man could not see beyond his own fantasies, only his projections.  We’re really looking at emotional terrorism.”

“Yeah,” he added enthusiastically.  “It was really great.”

By observing these characters and their follies, Q finally “got” what Jacques Lacan (1973) referred to as “the joke.”  Recognizing that his own inner terrorist was far worse than anything “out there,” he shed his hard shell for a moment.  Self-awareness was facilitated, because he could see what the diplomat could not.  Before Q was even aware of his insight, his unconscious mind knew what to do with it.  It took him a while to “figure it out,” but as he did, he tasted psychological liberty.  Q finally got the joke, and he was very pleased with himself.

Las dos Fridas

There were actually two very different women in his life, two maternal paradigms, his mother and her terrorizing imago, and me – imperfect but reliable, available, empathetic and steady.  We were not alike.  He had dented the severe organizing principle warning that everyone was and would always be just another variant of his abandoning mother.  There were two actresses, two possibilities, maybe two outcomes.  Perhaps more.

This moment of possibility represented the fruit of analytic “thirdness” (Ogden 1994), the opening of a shared and generative psychological space, one that bodes creative potential rather than stasis and engenders possibilities that break the rigid dialectic of doer and done-to, what Jessica Benjamin (2004) called complementarity.

It is not simply this or that.  It may be this and that or perhaps something completely different.  Q experienced a nascent awareness that he might end his own psychotic reign of terror.  He might liberate himself from his isolated and rigidly autistic, mechanistic mind-prison.

I turned from the main thoroughfare into my neighborhood, slowing down and shifting my hands slightly on the steering wheel.  A dog trotted across the street.

“I talked to my (attorney) uncle, and he told me what to do.”

He had found a way to bypass mother and access father.  He could observe himself and choose to avoid another episode of terrorizing repetition.  He could call me.

“Well, if you feel like it, when you get the information you need, let me know, and I’ll check it out.  He knew I was familiar with the context of his current circumstances.

“Ok.”

I’m still with you.  I will care about you even after you’ve gone. Perhaps this was a test.  Perhaps it was the final punctuation mark on our unfinished narrative but the beginning of another.

There was nothing left to say.  Pulling into my carport, I offered one last remark.

“I’ll be around.”

“Ok,” he said. “Thanks Mauri-Lynne.”

“Bye now.”

“Bye.”

I hung up the phone, releasing his hand hoping he would reach for others and find reciprocal warmth.  I opened the car door, encircled a big bag of groceries with my arms and went inside to make dinner.

There would be one more phone call some time later from this intensely funny and intelligent boy-man, but by then I had slowly begun to release him and his hold on my mind.  Luxuriating in the lightness of removing my own constricting stays, I felt unbound by the taut maternal preoccupation that had clenched so intensely during the past year.  Our trajectories had crossed and were now diverging.  I was glad for both experiences.

In the car running errands, my cell phone rang, this time from the bottom of a large bag.  I knew immediately it was Q.  I had lost a message shortly before and suspected he’d tried to call earlier.  (He had.)  I answered neutrally, though when I heard his voice, matched his tentative tone with my own enthusiasm.

“How are you?” I asked again.

“I’m good,” he responded, his voice stronger.  “I’m good.”

After a moment of quiet, he continued, “I think of you often.”

I think of you often. In my surrogacy, he had found a tangible realness.  I was no longer simply a projection, a wavering hologram of film pixels.  I had become a tentatively real object that he could access within himself and use productively and reliably, and as I did, he became real, too.  As his projections withered, available inner space opened for the imprint of new interpersonal and self-object experiences.  I had survived, and so had he, and we were both changed.

“Remember when I told you a long time ago that even after you’d gone away, I would continue to think of you?”

“Yes.”

Red boat with blue sails

We shared a sweetly quiet moment.  During that silence, I felt a transient but lofty affection for work and life.  I looked out the car window at the sky, as translucent as a watercolor wash.  I felt hope for him and for me.  At the end of his analysis, Q had managed to reach the beginning of the beginning.    He was trying to do for himself what I had tried to do with and for him.

He was using film imagery on his own as a trellis for self-support and was experiencing an emergent sense of himself as a cohesive being in the making, the resumption of his prematurely truncated going-on-being (Winnicott 1960).  Instead of hitting the replay button on the old movies of his past, I wondered whether he might now produce a new movie with an original script created anew.

We shared an incomplete experience.  Many issues remained unexplored.  We tolerated ruptures and bore anguish together.  An embryonic reflective capacity fluttered.  What emerged was nothing less that the basis for hope.

WARNING! This text is printed for the personal use of subscribers to The Therapist Magazine and/or Inside Out Journal and is copyrighted by Mauri-Lynne Heller.  It is illegal to copy, distribute or circulate it in any form whatsoever without permission of the author.

Benjamin, J. (2004). Beyond Doer and Done to: An Intersubjective View of Thirdness. Psychoanalytic Quarterly, 73:5-46.

Fairbairn, W.D. (1946). Object-Relationships and Dynamic Structure. International Journal of Psycho-Analysis, 27:30-37.

Fonagy, P. (2000). Attachment and Borderline Personality Disorder. Journal of the American Psychoanalytic Association, 48:1129-1146.

Fonagy, P., Gergely, G., Jurist, E and Target, M. (2002).  Affect regulation, mentalization, and the development of the self. New York: Other Press.

Freud, S. (1914). Remembering, Repeating and Working-Through (Further Recommendations on the Technique of Psycho-Analysis II). The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XII (1911-1913): The Case of Schreber, Papers on Technique and Other Works, 145-156.

Lacan, J. (1973) The four fundamental concepts of psycho-analysis. New York. W.W. Norton & company.

Ogden, T.H. (1994). The analytic third: working with intersubjective clinical facts.  International Journal of Psycho-Analysis, 75, pp. 3-19.

Stern, D.B. (1997).  Unformulated experience: From dissociation to imagination in psychoanalysis.  In: Relational psychoanalysis, the emergence of a tradition. Hillsdale, HJ: Analytic Press. (Original work published 1983)

Winnicott, D.W. (1960). The Theory of the Parent-Infant Relationship. International Journal of Psycho-Analysis, 41:585-595.

{ Comments on this entry are closed }

This column also appears in the online edition of the September-October, 2010 issue of  The Therapist Magazine, the publication of the California Association of Marriage and Family Therapists.

Abstract: This two-part series will explore the ways that the symbolic exploration of film imagery during the brief, one-year analysis of a patient suffering from the effects of very early trauma expanded his capacity to engage and begin to integrate unformulated and dissociated aspects of himself for the first time.  Just as elements in a dream clothe the invisible man of the psyche, each movie element and character, by giving voice to personal feelings and meanings in novel and mutative ways, increased the mentalization of lived experience that had never before existed in the realm of conscious thought.

If a myth represents a collective dream, a dream signifies a personal myth written in the language of affect-laden imagery.

Nothing permits us such lush access to the workings of the unconscious mind like a rich dream.  For brief moments, dreamer and analyst breach what Jacques Lacan called the “gap” (Lacan 1977/1978) between conscious and unconscious thought and clothe this mostly invisible psychic man.  Examining each symbolic garment, we are able to apprehend and construe metaphors and personal meanings that might otherwise just flicker briefly like passing afternoon shadows across a dimly lit wall.

The Newborn

The newborn

Dream imagery is potent for significant reasons.  Imagery is the “vocabulary” of an infant’s first post-natal language.  A neonate gazes into his mother’s face as she gazes back, communicating deeply held feelings long before the capacity for spoken language is acquired.  An infant’s first smile is in response to her gaze of acknowledgment.  Because she sees him, he will begin to see himself.

Throughout life we associate enlightened consciousness with insight, creativity with vision.  Even as our modes of verbal communication expand developmentally and refine themselves over time, imagery conveys what words sometimes can’t quite capture.  Jacques Lacan (Lacan 1977/1978) referred to unspeakable (or unspoken) lived experience as the Real.  Sometimes a picture is worth a thousand words.

In our culture, movie imagery is the bridge linking social mythology with personal dreamscapes, connecting inner subjective experience and the cultural collective.  We analyze movie details symbolically and metaphorically as if we were deconstructing a dream.

As a result, we often begin to conceptualize parts of ourselves in new and original ways, perhaps even identifying and claiming dissociated aspects that have never yet been acknowledged or fully mentalized (Fonagy 1981), parts that have lived only through the dramatization of enactment (Stern 2010).  Parts considered “not me” have an opportunity to be transformed into “me.”

During a year-long analysis with Q, a young man who had been abandoned as an infant, long before he’d acquired sufficient verbal language to process or organize his trauma, movie imagery opened up a psychological third space (Ogden 1994) that bridged our worlds.

Without film imagery and art, we might have remained forever isolated from one another, he imprisoned in his tragic past and I in my chair across the room.

He and I often talked about movies when he was struggling to articulate an unbearable feeling or perhaps avoiding one.  The Matrix was one of his favorites, a movie I’d never seen except in fragments on television.  I liked movies about relationships so had never found it appealing.  Just prior to my early summer break, he loaned me his copy, so that the lace-like threads of our connection might not tear.  I tucked it in my briefcase where it remained until the last day of my break.  When I popped it into the DVD player, I felt him enter the room.

The Persistence of Memory

The persistence of memory

This is the dream.  The Matrix is a computer age, film noir movie reminiscent of earlier classics with similar anti-utopian themes.  Soylent Green was the dire environmental prophecy of the 1970’s. The 1960’s dangled ingénue Yvette Mimieux in The Time Machine, both examples of a depraved and desperate future.  Donald Winnicott’s iconic paper Fear of Breakdown (Winnicott 1974) described how the anxiously feared catastrophe looming “out there” in the future had actually transpired long ago.  The Matrix future is portrayed as the degenerate past.

In The Matrix vision of the future, people, like the zombies in one of Q’s recurrent dreams, feed off one another from within the matrix of an artificial, bleakly mechanistic environment.

Lawrence Hedges (1994) described the ways in which people functioning at an organizing/psychotic level prefer objects to people.  Guntrip (1995) examined the mechanistic qualities that characterize affectively withdrawn schizoid states often described by patients as empty and depersonalized.  Capable of living an intellectually efficient but impersonal outer life, Q relied upon fantasy to keep himself alive.  A pseudo-adult, a militarily taut exterior substituted for a more authentic and self-assured manliness.

At this archaic organizing level, Q found safety in the realm of things rather than people, though longed to escape his own matrix web and, therefore, found the movie quite compelling.  He watched it over and over and had several copies.  Infants were manufactured and then cannibalized to sustain the controlling artificial life forms, the reverse of caring human motherhood, whereby the mother nourishes her child.

Woman and Child

Woman and child

We are offered a psychotic, biblical end-time image signifying the loss of the maternal, of purity and empathic human concern, a model as remote from Winnicott’s (1953) good-enough mother as the cold and transparent man in the moon.  Reality deconstructed, it floated unmoored from comforting illusions.

Q struggled to differentiate waking from sleeping states, reality from illusion, believing he was the product of some “higher” agency, convinced that I existed only as a product of his own mind.  Experiencing himself as a non-corporeal entity having no mass or substance, indicative of the unorganized-organizing self that has yet to come into being, he ascribed the same hollow qualities to my existence.  If it doesn’t really exist, it can’t hurt me, I thought to myself as I watched the movie, listened to the dream.   Am I real or am I illusion?  Is there a baby without a mother?  Is there a mother without a baby? “I want someone to give a shit,” Q often said to me.

Q’s original trauma, initiated at conception and concretized when he was six months old, was the initial severing of psychic and then physical connection to mother who, after reproducing selfishly and thoughtlessly (mechanically), found herself unable to care for her infant and gave him away six months later.  He was transported out of state.

End times occur when your mother does not want you, and your (unknown) father wanted you aborted.

This horror becomes the template for your future, depicted as the decrepit past over and over on the screen of your mind, the origin of Q’s belief that he was “too much” for everyone.  His tiny infant self was too much for mother, too much for father.  Yet he loved his mother and raged that his love had been insufficient to keep her bound to him.  “What’s in this for you?” he often asked me.

Q relived this trauma daily, though had adorned himself in hero’s cloaks to disguise his fragility.  His organizing principle* dictated that serviceability and brilliance would garner meaningful interpersonal connections.  “I’m the only sane person in my family,” he often said.  “I try to advise the best I can.  Why else would anyone want me around?” he asked wanly.  Saving others from destruction, he struggled to save himself.   His pain and intellectual expansiveness mirrored an autistic and psychotic inner landscape.  Anguish kept him alive, pain being better than nothingness and the psychic void of emptiness (see Grotstein 1990).

His two-year military enlistment afforded one such opportunity to both enact this role and immerse himself in fraternity.  Q sought surrogacy everywhere, yet self and object constancy eluded him.  There were only particles and waves that dodged substantiality like bad TV reception.

Black pixels coalesced into Darth Vader, the father who abandoned, yet was ultimately able to redeem himself.

Q embodied and acted out both parts, the hero and the unknowable, treacherous, dark father who threatened to abort and consume like Kronos the Titan god who killed his father and devoured his children.

There is a gruesome scene in The Matrix whereby an infant, every orifice penetrated by black tubes, is either being fed liquefied human remains or is itself being consumed, posing Q’s terrible paradox – eat or be eaten – an endless enactment of doer or done-to (Benjamin 2004).  The therapeutic environment offered a third possibility, that of collaboration and co-creation, the possibility of achieving self and object constancy, the hope of experiencing object usage and living viability in an uncontaminated present.

The conclusion of this two-part series will appear in the November/December online edition of The Therapist, Volume 22, Issue 5.

* Deeply held emotional truths driving beliefs, thoughts and behavior that are not necessarily accurate.

WARNING! This text is printed for the personal use of the subscriber to The Therapist Magazine or Inside Out Journal and is copyrighted by Mauri-Lynne Heller. It is illegal to copy or distribute it in any form whatsoever without the author’s permission.

Benjamin, J. (2004). Beyond doer and done to: An Intersubjective View of Thirdness. Psychoanalytic Quarterly, 73:5-46.

Fonagy, P. (1991). Thinking about thinking: some clinical and theoretical considerations in the treatment of a borderline patient. International Journal of Psycho-Analysis, 72:639-656.

Grotstein, J. (1990). Nothingness, meaninglessness, chaos and the black hole – the importance of nothingness, meaninglessness and chaos in psychoanalysis.  Contemporary Psychoanalysis, 26:257-290.

Guntrip, H. (1995 11th printing). Schizoid phenomena, object relations and the self. Madison, Connecticut, International Universities Press, Inc. (Original publication date unknown)

Hedges, L. (1994). Working the organizing experience. Northvale New Jersey.  Jason Aronson, Inc.

Lacan, J. (1977). Ecrits; A Selection. New York: W.W. Norton & Co. (1973). The Four Fundamental Concepts of Psychoanalysis. New York. W.W. Norton & Co.

Ogden, T.H. (1994). The analytic third: working with intersubjective clinical facts. International Journal of Psycho-Analysis, 75, pp. 3-19.

Stern, D.B. (2010). Partners in thought. New York. Routledge – Taylor & Francis Group.

Winnicott, D.W. (1953). Transitional objects and transitional phenomena—a study of the first not-me possession. International Journal of Psycho-Analysis, 34:89-97.

Winnicott, D.W. (1974). Fear of breakdown. International Review of Psycho-Analysis, 1:103-107.

{ Comments on this entry are closed }

This column also appears in the online edition of the July-August, 2010 issue of  The Therapist Magazine, the publication of the California Association of Marriage and Family Therapists.

Abstract:

Adapted from a presentation to the CAMFT Orange County chapter, this third in a three-part series examines the ways applied contemporary psychoanalytic theory, particularly Intersubjective Systems Theory, with its focus on recognition and mutuality, has refined and expanded our understanding of mental processes and clinical interaction, modifying therapeutic dynamics in ways that promote therapist-client resonance.  Exploring the intersubjective matrix of transference-countertransference engagement, specifically the various modes of therapist-client communication, readers will begin to think innovatively about the shared psychological space in which we work.

Part III

Enactment is the language of lived experience, that which has not yet been mentalized and articulated linguistically.

In Part II of this three part series, we explored the use of the analytic third and therapist reverie as specific ways of accessing and understanding the unconscious communication transpiring in the transference-countertransference milieu.  In this final column, various modes of client-therapist communication will be explored.

Spoken Language:

Spoken language, its idiomatic usage and accompanying vocal sounds are modes of communication that convey much more than simple content.  By paying very close attention to these elements, we gain significant clues to unconscious processes.

Jacques Lacan, the French psychoanalyst, proposed that the unconscious was actually structured like a language (Lacan 1973) and that only language could promote psychological change.

Poet's Dream

He also suggested that we are impacted by language before we are born, and this is certainly an accurate assessment of the ways familial organization or beliefs and cultural schemata embedded within our environmental surround begin to sculpt and impress our identity long before we have the capacity to begin to define ourselves.

The following clinical example explores the meaning behind the use of a common idiom.  A patient recently used the phrase “threw me for a loop” several times during the course of a forty-five minute session.  The first time she said it, I simply noticed that she selected that particular idiom instead of a number of others she might have chosen.   When she used it a second time, I began tracking it seriously.

She was describing a distressing recurrent dynamic in which she found herself once again unwittingly embroiled and caught off guard.  “It just threw me for a loop,” she said emphatically and paused briefly before continuing with her narrative.

The third time she used the phrase to describe her subjective experience of surprise, I understood what she was telling me and interpreted, “I think you are telling me that you are going in circles and are caught in a loop that you feel you can’t escape.”  By linking a commonly used idiom to a very personal aspect of her inner world, we arrived at a new understanding that shifted us to a place in the session where we could speak more consciously and precisely about the feelings of circularity and constriction that were deeply embedded in early childhood dynamics.  In that shared moment, unformulated content that had existed on the edge of consciousness had acquired linguistic form.

Another patient arriving for our first session sat in the waiting room filling out forms.  Blah, blah, blah, he read quietly until he reached the paragraph about fees and panicked.  I’d left my inner office door open and invited him to come in when he’d finished.

Anxious that his narcissistic defenses wouldn’t contain his shame, he bleated out to me, “How much are you going to charge me?”  Finding out shortly thereafter that he had been in the military, I decoded his remark to mean that he was really asking are you going to charge at me?  Will you wound me (like my mother)? Will you hurt me? This became an ongoing theme of his year-long, four times a week analysis in which withholding of fees predominated.

Somatic language:

Very early, infantile experience is preverbal, unformulated and encoded somatically.  The capacities to think and use language are developmental achievements acquired over time.

The psychoanalyst Wilfred Bion (Bion 1962) suggested that infants begin to think in order to cope with thoughts, the nascent, unformulated impulses that constitute early mental life.  The infant has not yet learned to use his thought-impulses for thinking.  They are, therefore, encoded and subsequently communicated somatically via projective processes that replicate one of the primary modes of communication used by a mother and her infant.

In a state of maternal preoccupation (Winnicott 1963, 1965), when a new mother has adapted herself entirely to her infant’s needs, she is in a state permitting her to be exquisitely attuned to her baby’s projections.  Decoding them as only she can, she responds empathically by making necessary environmental adjustments, providing the desired warmth, food, holding, touch or gaze.  As the baby develops and acquires more direct means of communication, maternal preoccupation concomitantly subsides.

The Mona Lisa

Maternity

The most profound clinical example of somatic communication that conveyed infantile annihilation anxiety occurred during the analysis of a functionally psychotic and autistic young man.  Imprisoned in his own solipsistic mental isolation, he was capable only of incorporating others into his own tortured mental schema.  My reveries in the analytic third enabled me to gather his (preverbal) imagery and projections, organize them and return them to him in explanatory bite-sized pieces that he could ingest and assimilate.

As he lay supine and still on the couch, speaking in flat, unemotional monotones about superficial concerns, I often found myself filling with unspeakable and wordless dread and terror.  After one such session, I went to the restroom and, as I was washing my hands, felt the building begin to roll and shake.  Recognizing an earthquake, I grabbed the counter edge to steady myself until the temblor passed.  When I regained my balance and could walk, I went directly outside expecting to see other folks congregating.  But I saw no one.

There had been no earthquake, other than the somatically projected transmission of abandonment, the non-verbal communication of what it had been like for this individual to have been discarded at six months of age.  His world fell apart.  Whatever developmental balance or stability he had initially achieved rolled out from beneath him.  My next step was to find ways to articulate this shattering experience that reverberated through every moment of this young man’s life, so that we might speak of it directly, so that we might arrive at new ways of being together.

Dream language:

Freud’s royal road to the unconscious is still paved with gold.  Dreams have always permitted us to clothe the invisible man of the mind in accessible, meaningful and personal ways.

Some patients have more access to dreams than others, and it’s interesting to track the arc of dream content and meaning across the period of treatment, observing how they shift.  With my patient’s permission, I will recount one of her dreams as an example.  What follows is a nearly verbatim record of her dream narrative:

I was in L.A. in a house. It was more a shelter.  A man was there with me.  There was a tornado in the desert –and strong winds.  I was trying to keep the door shut.  My foot is in it.  And then we were blown to smithereens.  I wasn’t afraid, though.  There was a huge light and everything evaporated.  I was very calm.  Like I ended up in a different place and time.

As she spoke, I tracked my own feelings, thoughts, images and reveries in the third.  As she alternated between present and past tense, I was aware that this dream had retained its potent sense of primary process immediacy.  We shifted back and forth in time and dream space.

My first spontaneous idea was that this dream used birth trauma imagery to convey the dreamer’s transition from one psychic space or place to another, from a desiccated and dry place to somewhere else.  I also considered that the desert might symbolize her emotional desertion and neglect as a young child.  Her foot in the door represented a feeble attempt to defend against retraumatization and the emergence of strong affect and memory.

Her quiet response to this interpretation was that the light was calming.  I ceased to exist on one level.  I existed in the light but was invisible. This was the way she described what it felt like to step into psychological space and engage unformulated experience.  Expecting a repetition of past trauma, instead she found calm.  She hadn’t quite yet created a new symbolic form to represent her unformulated content but was in transition and able to tolerate the uncertainty and necessary of creative disorder (Stern, 1983) whipped up and represented by the tornado.  This was also a dream about finally surrendering to authenticity while releasing stringent defenses.  Her foot in the door was an insufficient defense against the more compelling need to give birth to herself.

Because the man in her dream was familiar but mostly unseen, an accompanying entity, we imagined that he represented a deeply held transitional object (Winnicott 1953) supporting her during her psychological travels.  A transitional object, often a blanket or toy, is designated by the young child as the talisman that will accompany her during nascent and experimental forays into transitional (psychological) space.

Helping her individuate from the mommy-baby unit status of early infancy, the baby creatively imbues this object with sustaining elements associated with the nurturing mother.  This is why these poignantly tattered and beloved objects manage to find their way into college dormitories years later.  It is regarded with esteemed affection by parents and children.  Recognized by the infant as not-quite-me and not-quite-mom, it represents transition.

Transferentially, this image might also have represented the active (male) strength our relationship has provided for her in addition to the more feminine aspects of empathy.  Dream images are frequently condensed, and these represented aspects of self that she was beginning to integrate.

Her narrative continued, and she spoke of feeling stuck as she prepared for the state bar exam, dejected that she had lost meaningful direction and purpose.  Tired of giving her talents away, she experienced this dream as a means of redirecting herself.

This patient dreams of houses and rooms frequently, and these are symbols of mind, self and object world.  Transferentially, these motifs may also symbolize my office and her analysis and my capacity to hold and contain her affect, to provide ego strength when needed, to inspire curiosity and help her self-regulate.

My final interpretations were based on my reverie in the analytic third in which I envisioned the scene in the Wizard of Oz when Dorothy and her house are flying through the eye of the tornado, also a metaphor for vaginal birth contractions, in this instance auguring psychological birthing.

I shared my image with her, adding that this leitmotif also illustrated how she was looking for a psychological home.  Someplace to land without killing someone beneath her as a result.  In fact, outworn elements of her inner object world would, indeed, have to die.

Because she has worked with criminals, I added that she was trying to escape her internal prison.  This is a potent dream we’ve revisited several times and will continue to reexamine over the course of her analysis.

Enactments:

Enactments represent the behavioral language of lived experience dramatically expressed within the therapeutic dyad.  They represent unmentalized experience that has yet to be linguistically articulated where it can be examined, understood and altered.

The classical analytic position holds that enactments are indicative of poor treatment or the therapist’s inability to maintain her stance as neutral observer, while more contemporary thinking conceptualizes enactments as not only inevitable, but necessary and creative opportunities for growth.  They portray with immediacy exactly what is transpiring within the therapeutic dyad and are the road maps to mutative interventions.

The blue circus

From an intersubjective position, enactments in the clinical setting represent the co-constructed participation of both therapist and client.  Raymond Friedman and Joseph Natterson (Friedman, R., Natterson, J. 1999) suggested that enactments are “intersubjective inevitabilities” with the therapist as an active participant-observer rather than a more remote neutral observer.

While enactments represent the continuous living out of mostly unconscious fantasy within the therapeutic relationship, they can be identified as brief or extended (Friedman, R., Natterson, J. 1999).  An example of an extended enactment might crystallize around a client’s unconscious need for sponsorship and a therapist’s unconscious wish to be helpful.

The therapist’s contribution represents much more than a simple countertransference response to a client, but the activation of the therapist’s own unconscious material.  As the therapist begins to understand the meaning of the specific dynamics unfolding dramatically, they become useful elements employed in the service of furthering the clinical work.

Deleterious enactments lead to therapeutic impasse and the cessation of relational generativity that facilitates change and growth.  They often have a repetitive and stagnant aura, a scripted feel, and both therapist and client feel like they’re being acted upon by the other.  Reciprocity feels absent.   Jessica Benjamin (Benjamin 1999) described this coercive clinical stalemate “complementarity.”

Within the dyad, impasse enactments are often identified by the mutual feelings of misunderstanding, isolation and frustration they produce.  They can, however, be equally stimulating, as they reveal the near-conscious aspects of the analytic experience that can be more closely examined and interpreted.

Working to access, decode and understand the meanings conveyed by even the most rigid enactment permits the unfolding of significant growth and change.  Irwin Hoffman (Hoffman 1983, p. 73) suggested that enactments may be “paradoxically integral to the emergence of new understanding and of new ways of being in the analytic relationship and in the world.”

However, all enactments unfolding within the clinical setting between therapist and client or patient share in common a subtle blending of old and new features, old because they draw upon unconscious elements from both the patient’s and therapist’s unconscious histories and lives and new because the current dramatization being enacted is unique to them and a specific moment in their relationship.

The patient who had been abandoned as an infant reenacted his lethal rupture scenario in every relationship he ever had.  None had ever lasted more than a few months, and that included work relationships.  This individual was unable to hold a job and was frequently unemployed, impoverished and homeless.  He was dramatizing and communicating that an infant without a mother is homeless.

The salient and tragic feature was that he was reliving the scenario, not changing it.  Living in his truck was a metaphor for mother loss.  He had no psychological or actual home.  Psychological space was for him a terrifying psychic void; he had no inner mother there to support him.

Within a few weeks of beginning a year-long analysis, he began his malignant enactment by canceling or missing appointments, making excuses and arriving late.  His unconscious need for mothering and my unconscious need to fulfill those needs set the stage for the enactments that followed, as he prepared to leave me before I could leave him.

Had I simply pitted my will against his within a rigid dialectic about frame, I would have created a therapeutic impasse, a situation of complementarity from which he would have fled, once again trying to leave mother before she could leave him.  Instead, I used the dramatization as an opportunity to comprehend and convey my empathic understanding of his experience, his terror, his loss and grief.  Enactments permit us to say, “Oh, now I see what happened to you.  Now I understand.  You’re showing me what your life has been like.  We’re experiencing it together, and now we might change the outcome.”

Countertransference:

We are made aware of these unconscious elements by tracking our own feelings, sensations and thoughts.  Our sensory awareness responses are clues to what our client’s are experiencing within themselves and within the shared psychological space of the intersubjective matrix.  The psychoanalyst, Avedis Panagian, once remarked at a conference that we access our patient’s lives and traumas by activating our own.  This is why our reveries, feelings and thoughts, even when they seem unrelated are so vitally important to our work.  They represent an overlapping experiential juncture in the third “we” space, the analytic third (Ogden 1994).

Copyright Warning: This text is printed for the personal use of the subscriber to InsideOutJournal.com.  It is illegal to copy, distribute or circulate it in any form whatsoever.

Benjamin J (1999). Afterward. In: Mitchell S, Aron L, editors. Relational psychoanalysis: The emergence of a tradition, p. 201-10. Hillsdale, NJ: Analytic Press. 496 p.

Bion, W.R. (1962). The Psycho-Analytic Study of Thinking. International Journal of Psycho-Analysis, 43:306-310.

Friedman, R., and Natterson, J. (1999).  Enactments, An Intersubjective Perspective.  Psychoanalytic Quarterly, 68:220-247.

Hoffman, I. (1999). The patient as interpreter of the analyst’s experience.  In: Relational psychoanalysis, the emergence of a tradition. Hillsdale, N.J. The Analytic Press.  (Original work published in 1983.)

Lacan, J. (1973) The four fundamental concepts of psycho-analysis. New York. W.W.  Norton & company.

Ogden, T.H. (1994). The analytic third: working with intersubjective clinical facts. International Journal of Psycho-Analysis, 75:3-19.

Stern, D. (2003).  Unformulated experience: from dissociation to imagination in psychoanalysis. The Analytic Press, Inc. Hillsdale, N.J.

Winnicott, D.W. (1953). Transitional objects and transitional phenomena—a study of the first not-me possession. International Journal of Psycho-Analysis, 34:89-97.

Winnicott, D.W. (1963). Dependence in infant care, in child care, and in the psycho-analytic setting. International Journal of Psycho-Analysis, 44:339-344.

Winnicott, D.W. (1965). The maturational processes and the facilitating environment. London: The Hogarth Press and the Institute of Psycho-Analysis.

{ Comments on this entry are closed }

This column also appears in the online edition of the May-June, 2010 issue of  The Therapist Magazine, the publication of the California Association of Marriage and Family Therapists (CAMFT).

Abstract:

Adapted from a presentation to the CAMFT Orange County chapter, this second in a three-part series examines the ways applied contemporary psychoanalytic theory, particularly Intersubjective Systems Theory, with its focus on recognition and mutuality, has refined and expanded our understanding of mental processes and clinical interaction, modifying therapeutic dynamics in ways that promote therapist-client resonance.  Exploring the intersubjective matrix of transference-countertransference engagement, specifically the co-created space identified as the analytic third and the use of reverie, readers will begin to think innovatively about the shared psychological space in which we work.

Part II

Christopher Bollas: In order to find the patient, we must look for him within ourselves.

Preverbal Experience:

Given that much of what transpires in psychological space is unconscious (because after all, as Donnell Stern suggested (Stern 2003), all thought originates unexpectedly from somewhere beyond consciousness, distinguishing what is kept out of awareness defensively and volitionally from what has simply not yet taken form is axiomatic), we can work on both these levels.

There is a difference between not wanting to know something and simply not knowing it yet.  Donald Winnicott (Winnicott 1975/1945) distinguished between unorganized and disorganized mental configurations.  The individual whose mental life is unorganized has yet to congeal whereas the disorganized individual’s mind was once organized and has come undone.  The former may be ego-syntonic, while the latter ego-dystonic.

These unconscious elements existing as unformulated experience are often preverbal, meaning that they are linguistically inaccessible.  The patient struggling to formulate verbal constructs for affective experience has hit such a preverbal pocket.  This material does not exist as a fully developed notion waiting simply to be discovered like a vein of gold within a mountain.

Preverbal elements have yet to be articulated and are generally experienced as amorphous affects – impulses, feelings, urges, fears, shadowy elements, etc.  They are the sensory bits like Lego pieces that are yet to be consciously molded and integrated linguistically.  Wilfred Bion (Bion 1962) called these unformed elements “beta bits.”  He also proposed that thinking is a way to deal with thoughts – these sensory, inchoate impulses that require formulation and linguistic articulation.

Artists are extremely adept at making use of unformulated experience, though all of life is essentially a work of art.  The poet, Sharon Olds, begins writing when “a poem has formed itself, or its beginning, within me, and it’s time to get a pen and notebook and sit over there on the rocking chair next to the window and try to bring forth that which is within.”

It’s not that the poem was hiding in its complete form in her unconscious; it began as an amorphous, inchoate impulse that she then mentalized and shaped into linguistic form.  The awareness of this urgent sensation represents the welcome but often inconvenient inclination that initiates every act of creative generativity.  It’s a stirring that compels creative action.

Shared Experience:

When we work clinically in psychological space, we are talking about co-creating a shared mind-body experience, a conjoint psychological space wherein we overlap in an attempt to access and understand each other’s subjective world.

This is another feature that distinguishes contemporary psychoanalysis from its more traditional relative.  Rather than simply adhering to a doctor-patient hierarchy, where the latter has all the questions and the former all the answers, we now conceptualize two subjectivities involved in the act of co-creation.  Ideally this relationship is defined by bi-directionality and mutuality, though it necessarily remains asymmetrical.  This interactive dynamic defines the intersubjective matrix or field.

The Analytic Third and the languages of psychological space

The body-mind speaks many languages from the behavioral to imagery to words.  Within the intersubjective sphere of the transference-countertransference milieu, we work to access and decode the many communications that we receive in the service of our clients and patients.

Thomas Ogden (Ogden 1994) defined this working, overlapping “we” space as the “analytic third.”  In his seminal paper, Ogden described how he tracks the moment-by-moment interplay of the oscillating therapist-patient engagement in this intersubjective matrix.  Its prototype is the mommy-baby unit of infancy described by Winnicott (Winnicott 1960) and the emergence of transitional space, yet it is more nuanced and complex, because while we are interacting with what we call the “analytic baby,” the more archaic components of self, we are also with the more intellectually developed adult.  We have to track on all levels.  There is no such thing as an analyst apart from the relationship with the analysand (Ogden 1994).

Beginning to work in the transference-countertransference milieu

We begin to work by attuning ourselves to the paradox our clients and patients bring to us, primarily the hopeful longing for some new relational experience appended like a barnacle to the dreaded expectation that nothing and no one will ever really be different.

The hope that maybe this person will understand is quickly quashed by the fear that the therapist will be just as disappointing as everyone else has been.  And this often includes prior therapists.  And so the transference-countertransference dance begins to develop in psychological space.

Our goal is to decode, organize and clarify the unformulated bits and pieces we receive, to apprehend in our well-trained nets the clues that help us begin to understand and formulate interventions.  We sit with a client, listening and observing with all our sensory organs until we begin to grasp something.  What we experience isn’t yet fully formed; in fact, it may be as unformed as our client’s subjective experience.  In truth, as Bollas suggested (Bollas 1994), we find our client within ourselves, within the greater context of the intersubjective field.

We scroll through the session without knowing what we will find, without preconceived expectations, as Bion (Bion 1970) suggested “without memory or desire,” until we begin to form our own associations.  We have an impulse, a strong feeling, an aversion, a sensation.  And this is how we begin to work in psychological space, the place where you and I overlap and become “we.”  This is the transference-countertransference milieu.

Accessing psychological space

It is impossible to know the unconscious or unformulated directly.  We can only access its derivatives, as they are like clothes on the psyche’s invisible man.

The analytic third is the overlapping psychic sphere wherein discrete subjectivities mingle and exchange communications.  It is the realm where unconscious meets unconscious.

Louis Aron (Aron 2006) has also written about this third space extensively: “What is meant by ‘the third’? The third is a concept that has become popular across a variety of schools of psychoanalysis. It has been developed and extended by some of the leading theorists of psychoanalysis, including Ogden, Green, Benjamin, and a variety of Lacan-influenced writers, but it is often defined ambiguously and inconsistently across schools. For some, the third refers to something beyond the dyad, a context within which we emerge; for others, the third is an emergent property of dyadic interaction, and yet for others, the third is a dyadic achievement that creates the psychic space necessary for reflexive awareness and mentalization.”

Jessica Benjamin (Benjamin 2004) wrote: “My interest is not in which “thing” we use, but in the process of creating thirdness—that is, in how we build relational systems and how we develop the intersubjective capacities for such co-creation. I think in terms of thirdness as a quality or experience of intersubjective relatedness that has as its correlate a certain kind of internal mental space; it is closely related to Winnicott’s idea of potential or transitional space.”

So the third is many things, a space in which communications are exchanged and reformulated, a function of relationship-building and a theoretical concept open to diverse interpretations.

Elements of Intersubjective communication

Reverie and Imagery:

Reverie and imagery give visual, if not palpable, shape and form to elements that swirl in this dynamic and interdependent field of intersubjectivity, particularly crystallizing communication that drifts from unconscious to unconscious, bypassing awareness.  This is the live edge of clinical work, the place where analyst and patient, therapist and client intersect, clothing the unseen communications in ways that make them accessible and amenable to articulation in language.

Mother and child in a boat

This kind of communication best describes the ways a mother intuits the needs of her baby.  Receiving her baby’s projections, she organizes and returns them in tolerable and digestible doses.  Did you ever have to put on a sweater because your mother was cold?

The focus is less on what originates where but on interpersonal co-creation of elements in the overlapping psychological space of the analytic third.

An example from my own practice is my awareness of surrounding airport sounds.  My office is very near the runway, so the sounds of jets taking off are generally background noise.  I only become aware of them distinctly when I sense that my patient’s thoughts or feelings are defensively taking flight, or perhaps they don’t yet have a (linguistic) place to land.  At those moments when I envision planes lifting off the runway, I may ask what thought or feeling just took off, and I will invariably receive a germane answer.  If the answer is “I don’t know,” we collaborate to discern what it might be.  I attempt to put words to mental pictures I receive, and we try them on for size together.

A more imagery-laden example of processing in the third derives from my work with a man who grew up in an Eastern Block country, though has lived in the States for many years.  He’s lost the fluidity of thinking and speaking in his native language yet struggles to express himself precisely in English.  Not only is this frustrating, but it pushes him back to a more archaic means of image-laden, unconscious communication.

Therefore, I experience lots of imagery in the third when we’re together.  On several occasions, I’ve “seen” a winter scenario of cold earth, frozen beneath soggy, fallen leaves and bare trees.  Translating this into emotional language, I offered him the interpretation that he felt like his feelings were suspended in permafrost.  Indeed, they were.  He has always identified himself as being emotionally cold.

Therapists often confuse their random but meaningful thoughts or countertransferential reveries with intrusive distractions that should be discarded, and sometimes they very well may be.  But even that is significant.

The question begging an answer is why did I need to distract myself at that particular moment?  What didn’t the client want me to know or what did he want me to avoid?  What couldn’t I bear to witness?  What must always be left unacknowledged, unformed, unsaid or isolated as dissociated material?  What was too painful to feel?  What really longed to be understood?  Most usually those very thoughts and images have something to do with what is going on within the client’s mind-body.

Recently while sitting with a patient, I beheld in my mind the image of a child prostitute and asked her if she felt like hooker in her marriage.  Indeed, she did, but that was the first time she’d been fully aware of her feelings.  She had communicated this unthought known (Bollas 1987) to me via imagery.  Now we speak of it explicitly, and it is amenable to change.

I frequently tell patients that split off aspects of themselves have lives of their own outside awareness revolving like isolated moons with no way to reconnect.  Our job is to set up a linguistic satellite system so that the moon can communicate with the mother ship.  You can’t enact a lunar landing if you don’t even recognize that a moon exists.

What makes this way of working with unconscious material contemporary are the ways in which it differs from Freud’s schema of the unconscious as the return of the fully-formed repressed, conceptualizing that insight and awareness were sufficient to illuminate the issues and produce change.

More current schemata suggest that unconscious elements are not simply inaccessible as a result of defenses, but unformed.

While insight is valuable, it is equally imperative that we attempt to access and comprehend what is unformulated, thereby facilitating the creative process whereby mental Lego pieces can be assembled and used.  Reverie and the analytic third provide a means for us to achieve that goal.

Aaron, L. (2006). Analytic Impasse and the Third: Clinical implications of intersubjectivity.  International Journal of Psycho-Analysis, 87:349-368.

Benjamin, J. (2004).  Beyond Doer and Done To: An Intersubjective View of Thirdness.  Psychoanalytic Quarterly, 73:5-46

Bollas, C. (1987). The Shadow of the object: psychoanalysis of the unthought known. Columbia University Press, N.Y., N.Y.

Bion, W.R. (1970). Attention and interpretation: a scientific approach to insight in psycho-analysis and groups, 1-130.  London: Tavistock.

Bion, W.R. (1962). Learning from experience. London: Tavistock.

Bion, W.R. (1962). The Psycho-Analytic Study of Thinking.  International Journal of Psycho-Analysis, 43:306-310.

Ogden, T.H. (1994). The Analytic Third: Working with Intersubjective Clinical Facts. International Journal of Psycho-Analysis, 75:3-19.

Winnicott, D.W. (1960). The Theory of the Parent-Infant Relationship. International Journal of Psycho-Analysis, 41:585-595.

Winnicott, D.W. (1975). Primitive emotional development. In: Collected papers:

through paediatrics to psycho-analysis. (pp. 145-156). (Original work published 1945). Basic Books. Locale unknow

{ Comments on this entry are closed }

This column also appears in the online edition of the March-April, 2010 issue of  The Therapist Magazine, the publication of the California Association of Marriage and Family Therapists.

Abstract:

Adapted from a presentation to the CAMFT Orange County chapter, this first in a three-part series examines the ways applied contemporary psychoanalytic theory, particularly Intersubjective Systems Theory, with its focus on recognition and mutuality, has refined and expanded our understanding of mental processes and clinical interaction, modifying therapeutic dynamics in ways that promote therapist-client resonance.  Exploring developmental factors and transitional space, the origins of creativity and an expanded definition of the unconscious to include unformulated experience, readers will begin to think innovatively about the shared psychological space in which we work. [click to continue…]

{ Comments on this entry are closed }

This column also appears in the online format of the January-February issue of The Therapist Magazine, the publication of the California Association of Marriage and Family Therapists.  While it was written for clinicians, concepts discussed are readily accessible to any interested reader.

Abstract:

In this column, Dr. Heller examines the clinical limitations of the Positive Psychology model, particularly the ways in which its limited dimensionality forecloses on the therapeutic process of working through and subsequent integration of strong vitality affects.  Rather than obviating the need for defenses like splitting and projection, this model sustains defensive posturing and induces guilt and shame.  Split off and projected affects often develop an independent life of their own where they continue to be acted out in their unmentalized and pre-articulated state.  Self-injurious repercussions frequently accrue from these repetitively abortive attempts to manage difficult feelings.  Literary, film and clinical material are used to illustrate iconic concepts of Donald Winnicott, Wilfred Bion and Melanie Klein. [click to continue…]

{ Comments on this entry are closed }