American Journal of Psychoanalysis最新文献

Ferenczi's concept, the confusion of tongues between the child's language of tenderness and the adult's language of passion, explains that the child feels physically and psychically helpless and alone in the presence of an aggressor who disavows the traumatic acts, creating confusion for the child whether the traumatic experience happened at all. Fully dependent on the adults, the child adopts by introjecting the guilt and hate of the aggressor, in order to maintain the relationship with the adults. The confusion of tongues situation is linked to Ferenczi's complex construct, the identification with the aggressor, in understanding external traumas. With the concept of "autistic-contiguous position," Ogden identifies an area of pre-symbolic experience of a sensory nature, mainly centered on the surface of the skin as the starting point of mental life. These two concepts may permit us to be in touch with attitudes and beliefs in the exploration of individual and group defense mechanisms against climate change and environmental disasters. Using psychoanalytical knowledge, we can try to help people who are reluctant to fully acknowledge the seriousness of climate change, and so to change damaging behaviors in our relationship with the nonhuman world. The author critiques the repeated terrifying and bombarding images on TV and the Internet which would intend to inform about crises and disasters in the world, instead, those images paralyze psychic functioning. He describes how climate terrorism promotes the emergence of persecutory and primitive anxieties, even the activation of psychotic defenses. They foster the difficulties of getting in touch with deep-seated anxieties and remove a sense of responsibility and awareness of one's own participation in the creation of the damage.

The author makes a distinction between the expressive Soto Zen practice of shikantaza (just sitting, only sitting) that was promulgated by Eihei Dōgen, (1200-1253) the founder of the Soto Zen Buddhist school in Japan and various instrumental/facilitative and "quietist" contemplative practices. Different contemplative practices reflect and express the underlying assumptions, guiding principles and goals of different traditions. How clinicians understand and relate to any contemplative practice will in turn influence how such practices influence the clinical encounter. Instrumental/Facilitative and "Quietist" assumptions and approaches to practice continue to exert an influence on the practitioner both consciously and unconsciously. The ensuing discussion describes and provides a review from a psychoanalytic perspective, the advantages and disadvantages of these different approaches to contemplative practice with a specific focus on shikantaza in relation to the psychoanalytic encounter.

Supervision of psychoanalytic therapy practitioners can be divided into three career developmental phases. Novice therapists need instruction about mental functions that make dynamic techniques efficacious. Journeyman therapists do better when technical matters regarding conflict and defense are the focus. Supervision of master therapists allows for more free-flowing mutual associations, intersubjective interchanges, and mutual attainment of interpretive approaches.

The unanticipated appearance during psychoanalytic supervision, conducted in the Hebrew language, of the uncommon expression "gathering the transference" spoken in Hebrew-le'e'sof et ha-transference-sparked my own desire to explore the history of the concept and its value, via the etymology of the English verbs "gather" and "harvest," and of the Hebrew verb le's'sof (to gather). Antithetical meanings of the Hebrew root a'saf, and some particulars of the biblical laws pertaining to gathering and harvesting fields, such as the "forgotten sheaf," expose new dimensions of "gathering the transference" that are not explicit from the English term and its roots. Comparison is made to Heidegger's concept of listening as "gathering."

This paper describes several character disordered patients who had suffered considerable childhood neglect and who subsequently harbored conscious beliefs in their fundamental badness. This seemed related to a grandiose sense of their own destructiveness, which in turn evoked enormous guilt and reinforced their certainty that they were bad. This delusional certainty fueled sadomasochistic ways of relating to self and others and self-destructive preoccupations. The paper explores the multiple functions which the delusions of badness serve and the technical challenges involved when working in depth with such persons.

Patients often ask questions to which they already know the answer. Despite their ubiquity, little is written about understanding or handling them. The following paper uses Speech Act Theory and the concept of "cosigning" to present a theoretical understanding of patients' questions about the obvious along with three clinical vignettes to demonstrate their technical management. The unconscious intent behind such questions can be inferred by analyzing their effects on the analytic process, the analyst's moment-to-moment countertransference, and the pressure they exert on the analytic relationship. The optimal response to cosigning questions depends on the particular dynamics which necessitate their use. For patients who can mentalize their behavior, direct interpretation or observation followed by interpretation can be used. For patients whose mentalization capacity is limited, consciously playing along with the questions can serve as a preamble to offering interpretations of the motives behind them.

Pleasure in the human being has always been a major theme, associated with pain, excess and needs, determining many moral dilemmas, including the ethics of medical, social, and educational intervention. The rhythmic movement between the multiple pleasurable experiences, the effort to retain them or avoid different pains present themselves in the mental structure as a key approach in the evolving way of learning and integrating reality and influences the development of the symbolic capacity. This paper shows the evolutionary place and the function that pleasure itself has had in the clinical field, as well as some of the main pleasures of becoming and being a psychoanalyst.

In this article we consider the question of homeostasis and memory from the perspectives of neuroscience and psychoanalysis. Our aim is to describe a link between homeostasis/dyshomeostasis, memory/language, and violent acting out. Our study is based on clinical observations concerning two groups of persons: those who were incarcerated for perpetrating non-premeditated murder and those who were victimized by violent trauma in their lives. The clinical findings, combined with the analysis of the relevant literature and research, demonstrate that the dyshomeostatic state, through a positive homeostasis, can drive the person to restore the balance by their usual coping mechanisms and thereby generate negative homeostasis. These acts-all violent, non-premeditated, and forms of desubjectivized acting out-stem from being outside language on account of two pathological extremes of memory, its absence or its excess. Aided by neuroscience and the results of our clinical findings, we support the practice of recalling and strengthening memory traces of trauma in psychotherapy.