American Journal of Psychoanalysis最新文献

In this thought-provoking exploration, the author examines Grotstein's seminal work, "The Seventh Servant: The Implications of a Truth Drive in Bion's Theory of 'O'" (2004), and its relevance to the psychoanalytic concepts of truth and lies. Drawing on Bion's K-link and Klein's epistemophilia, the paper argues that Grotstein's concept of a "truth drive" is part of a transformative paradigmatic shift in psychoanalysis, emphasizing a focus on ontology and the process of being with the analysand. The commitment to truth in psychoanalytic practice demands ongoing examination, open-mindedness, and a willingness to embrace bodily sensations, proto-emotions, and new thoughts. Grotstein proposes that the truth drive is a universal human force that compels individuals towards emotional growth and explains why analysands can accept the analyst's interpretation of painful psychical realities. The intersection between curiosity and evolving 'O' exceeds epistemophilia, bridging knowledge and the unknown for optimal truth-seeking. The paper briefly explores the connections between Heidegger's "Dasein," "Aletheia," and Foucault's "Parrhesia," further supporting Grotstein's discovery. Additionally, it addresses the challenge of distinguishing healthy truth pursuit from pathological manifestations and presents a captivating clinical vignette illustrating Grotstein's response to this question. Finally, the paper delves into Bion's puzzling observation that all thoughts as ordinarily known are lies, augmenting the notion of universal emotional truth and its complexities in the clinical context.

The term developmental trauma (DT) refers to the impact of stressful events which occur cumulatively within the child's relevant relationships and contexts, and usually early in life. According to several authors, DT depends on the caregiver's inadequate intersubjective recognition of one or more aspects of the evolving individual's identity. In the clinical and empirical literature, the study of therapists' developmental trauma, and how it might constitute a relevant variable in the clinical exchange, seem to be underrepresented. In this paper, through the analysis of the supervision process of a clinical case, we show how the therapeutic relationship may implicitly take the form of a "dance" between the patient's and therapist's DT, that prevents the therapist from intersubjectively attuning with the patient; and how a supervision process peculiarly focused on the therapist's DT can effectively promote this attunement and a good clinical outcome.

This paper attempts to deal with a specific kind of pathological identification-"raw object identification"-which tends to appear as concrete physiological phenomena, trying to escape meaning and integration. These somatic manifestations stem from early traumatic experiences with a meaningful object and entrap-as revealed through analysis-specific significant qualities of that object. A massive splitting ensues between body and mind, self and object, relation and identification. Certain properties of the object are then experienced as a foreign body in the subject and are defensively identified with. Thus, raw object identification is often manifested in stubborn bodily symptoms.

In hopes of contributing to the developing self-critique of relational analysis, I offer a case that illustrates a modified approach, one informed by current dialogue. The patient described had considerable unmet selfobject needs and a schizoid sensitivity to intrusion, engendering the question explored: How do two minds meet if one is largely relationally dissociated and acutely vulnerable when integrated? A premature emphasis on intersubjectivity would have obscured the patient's narcissistic needs and reinforced her tendency to retreat. Suspending the goal of intersubjectivity allowed for a regressive process to occur, and for contact to become safe before analyst and patient paved the way for future mutual relatedness.

The author proposes that group identifications have been under-appreciated by individual psychodynamic psychotherapists in their conceptualization of normative individual development. He identifies the routes by which the child begins to internalize small and large groups during the early years of identity formation. Through individual therapy vignettes, the author suggests modifications to customary technique so that developmental shortcomings in group attachment security can be shored up. He offers some guidelines for the individual therapist so that group experiences are accounted for as the clinical narrative is written. Finally, he distinguishes patients who may require additional group-level interventions to address their avoidance of group participation.