American Journal of Psychoanalysis最新文献

When reality is too much to bear, bodymind unity can fracture, creating self-deceptions, distortions, and disguises of emotional experience that amount to unconscious lies. Without clarity regarding what is real and what is imaginary, emotional truth is difficult to discern. Lies disrupt the development of a subjective sense of self, making it difficult to trust sensations, emotions, or thoughts. In the absence of this trust, a patient may form a delusion that they do not exist. Working psychoanalytically with patients traumatized in infancy and early childhood requires the analyst to experience a somatic link between herself and the patient, thereby enabling a process that was inhibited and, in some cases, nearly aborted to resume functioning. Clinical material is presented illustrating a negative hallucination of not existing following an emotional experience that could not be borne as well as bodymind dissociation that separated the patient's psychic pain from her childhood narrative. The author concludes that these methods of coping with trauma prevent the grieving necessary for truth to become bearable and the mind to grow.

This paper explores how the allure of magical thinking and groupthink contrasts with intuition of emotional truth. Since truth can terrify, the author suggests that a longer learning curve is needed to apprehend what Bion (1970a) called the "evolving O" of the analytic session. Traumatized patients are described as dream weavers who spin webs of partial truths and lies around their true selves. For the analyst, untangling these webs involves what Bion (1970b) calls an "act of faith." Clinical material is presented to show how groupthink and other concretions of thought can, under favorable circumstances, be transformed on the wings of psychic truth. Alternatively, uncontained violent emotions can become calcified, creating a carapace over the chrysalis of the patient's true self. The author concludes that the analyst's desire for a particular treatment outcome can unwittingly lead to the formation of an adhesive web where healthy analytic culture becomes a cult. Paradoxically, it is only when there is equal attention to emotional truth and lies that a trajectory of growth is likely to evolve.

The paper explores the concept of truth in Bion's theory and in the post-Bionian context of the analytic field. Truth is addressed on three levels: epistemological, metapsychological, and clinical. Bion criticizes positivism in psychoanalysis, and the same vertex when it appears in psychoanalysis itself, stating that the search for truth at all costs is similar to the arrogance and stupidity of the psychotic part of the personality. He revolutionizes the analytic concept of truth by orienting it to the function of the emotional linking between analyst and patient rather than to content. Post-Bionian analytic theory further develops these concepts. In a field or radically intersubjective perspective, the author emphasizes the shift from an "I/you" perspective to a "we" perspective. The treatment is less about the abstract search for supposed truths and more about the truth being expressed in the process of emotional and affective attunement.

What if the author were to position herself as a liar? Not of conscious lying, but an ignorance of what is so close to our collective noses that as psychoanalysts we miss it. Drawing on Harari's (2011) description of liberal ideology, the author suggests that our contemporary psychoanalytic focus on feelings, countertransference, and intuition is more determined by our cultural era than generally recognized. It is suggested that prevailing ideology may at times serve a defensive function. The author discusses a 1970s clinical seminar in which Bion observes that the presenting analyst's attention to feelings is "excusing" the patient (and himself). A second example, from Bion's Cogitations (1991), underscores the complexity of being sensitive to a patient's feelings without gratifying narcissistic demands. A final example is taken from the author's work in which there was a pressure to allow the patient's infantile feelings to determine the analysis. It was subsequently recognized that neither the patient's feelings nor the analyst's understanding were the site of authority in the analysis. Rather, authority lies in the analytic process itself.