Psychoanalytic Quarterly最新文献

In this paper I first outline a conceptual compass to think about identity generally before addressing more specifically the question of transgender identity. To this end, I draw on Gilles Deleuze's (1993) related concepts of the rhizome and of the fold. I then argue that the body has always been and is ever-more-so the place for figurating the self, for finding and substantiating identity-hence, the unconscious psychic investments that we have in our bodies are key to our theorizing about any kind of identity. I propose that this focus provides a more productive, generative starting point for thinking about transgender identity specifically than any individual developmental theory because it accommodates the heterogeneity subsumed under the umbrella term transgender.

The terms unrepresented and unrepresented states are increasingly being referred to in psychoanalytic discourse, without our having established a generally agreed upon consensus about their definition, use or meaning. While these particular designations were never used by Freud, a careful reading of his work reveals them to be qualities that characterize the initial state of both the drive and perception. This paper attempts to place these terms in a clinically useful, metapsychological perspective by reviewing their conceptual origin in Freud and examining their elaboration and clinical relevance in the work of Bion, Winnicott, and Green. These concepts should prove especially useful for understanding and addressing problems presented by non-neurotic patients and psychic organizations and will help expand the reach and efficacy of psychoanalytic understanding and technique to increasing numbers of contemporary patients.

Unrepresented states are considered important obstacles to the psychoanalytic process. They describe elements that are beyond the reach of the symbolic network with which psychoanalysis is used to working. The emergence of unrepresented states has often been described as the failure of the caregiver to symbolize the child's emotions and thereby enable the child to connect his or her bodily states to the psychic representation. Psychoanalysis, however, has been reluctant to name the locus of these inscriptions beyond the symbolic network as the body-self. The author proposes to do so and discusses two concepts for describing the dynamics of the bodily unconscious and the therapeutic method for calibrating our technique to unrepresented states. The concept of the encapsulated body engram is used to describe the dynamic structure of the bodily unconscious. Processes of disorganization, petrification, perceptual defense, and secondary self-stimulation form the dynamics of the bodily unconscious. The method of somatic narration systematically examines body sensations of the analysand, reverses the defense processes of the engram, and leads to a reorganization of the body self, which can now find connection to symbolic structures again. This requires a more active analytic stance that responds to the defensive processes with which the subject fends off the threat of annihilation he or she was exposed to in the traumatic engram. A clinical vignette illustrates the mode of operation.

On the evening of October 5, 1955, Bion presented the paper Differentiation between the psychotic and non-psychotic personalities to the British Society of Psychoanalysis. Two days later, on October seventh, Winnicott commented on Bion's paper in a letter and in particular, discussed its clinical material. The author makes use of this exchange to examine how the transformations that took place in Bion's thought and Winnicott's contributions helped bring about a quantum revolution of the psychoanalytic paradigm. These may have facilitated the transition from an epistemological psychoanalysis (where what matters is what the analyst knows and what the patient comes to know about himself) to an ontological psychoanalysis (where the presence of the analyst becomes crucial-everything that the analyst is and the way in which he manages to become the patient's emotional experience). And what we witness in ontological psychoanalysis is a significant clinical transformation in which a theory of technique that focuses on interpretation can coexist with a theory of technique enriched, in the author's perspective, with new tools that make it possible to treat the most severely ill patients.

As Williams (1997) describes, patients with anorexia nervosa have been on the receiving end of intrusive maternal projections and consequently develop a no-entry system of defense. This paper explores how deception may function as an aspect of this system in two ways. First, deception may serve as a self-preservative effort to evade emotional contact with the maternal object, which is experienced as overflowing with projections, and to attenuate accompanying persecutory anxiety. Second, rumination-painful thoughts, feelings, and sensations-about the deception being discovered by the object leverages the mind's hypnoid capacities to construct an omnipotently generated container for the self that further protects the patient from emotional contact with the maternal object's projections. These ideas are illustrated with a clinical case of a patient with anorexia nervosa who engaged in frequent deception.

The author questions the conceptual basis of the unrepresented, a set of terms including: the unstructured unconscious, figurability, and reverie. Because this terminology proposes a profoundly different metapsychology than Freud developed, the author contextualizes the fate of Freud's metapsychology in America and how it was confused with the authority of the classical analyst. Then excerpts of texts by Howard B. Levine, one of the main proponents of the unrepresented, are analyzed to show that the decisive element in Levine's claim of creating meaning for patients is figurability. The author does a close reading and elaboration of French analyst Laurence Kahn's very thoughtful critique of figurability. Kahn's scholarship is brought to bear on Freud's metapsychology, showing how what is at stake are presentations not figures. Figuration and reverie are founded on the projection of referential and narrative coherence onto what is presented by the patient. But the unconscious does exactly the opposite, it presents to consciousness its noncoherent derivatives (presentations). Kahn illuminates Freud's mode of thinking using the critique of figurability as a springboard to show us what is essential in conceptualizing unconscious functioning.

The author investigates bodily aspects of the defense organization in the treatment of a soldier suffering from a war traumatization. The patient reports two situations-a bomb attack and the subsequent confrontation with wounded comrades-that had a traumatizing impact. In the treatment process, a phase of stagnation is described before the shared attention is focused on the bodily perception of the patient. His petrified body feeling ("my body feels like concrete") was systematically examined in the therapeutic process then slowly transformed through shared perception, leading to a process of vitalizing reorganization. This method is called somatic narration. It reverses the defense processes of the encapsulated body engram. This capsule results from the threatening impact of a traumatic event, disorganizing the patient's body-self. This disorganization then is encapsulated through a process of petrification and avoidance of awareness. The therapeutic process is described in detail. The structure of the bodily unconscious is revealed. The process of reorganization of perception and memory is outlined.