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Jacques Lacan

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.

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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.

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