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Biomedical subjects

R D Chessick

Publications and source records attributed to R D Chessick.

At least 19 recordsLinked to original sources
PubMed1992

On falling in love and creativity.

This paper discusses the ego functioning and self psychological aspects of falling in love and passionate love. These universal and extraordinary phenomena are conceptualized as representing the activity of the creative imagination in solving problems related to coping with intense narcissistic and libidinal pressures. The work of other authors is reviewed and recast into a metapsychological framework involving ego and superego contributions to the experience, and focused on self cohesion. An illustrative clinical psychotherapy case is presented in an effort to understand what has traditionally appeared to be a mysterious and disjunctive life experience, and to explore the creative surge that can be generated by falling in love both in and out of the transference.

Adult↗
PubMed1991

The unbearable obscurity of being.

This cross-disciplinary study attempts to investigate the Being-question: what is the ultimate ground of everything there is? Psychotic solutions to this problem are compared with Kundera's literary approach (On the Unbearable Lightness of Being), and with famous metaphysical solutions. Special attention is given to Heidegger's attempt to grapple with this question, as exemplified in his four- (in the English translation) volume study of Nietzsche--who regarded Being as "a vapor and a fallacy." Psychoanalytic conceptions of the origin of the sense of Being in the mother-infant interaction, and in the ego's ongoing awareness of itself are examined, especially since in psychoses, borderline disorders, and other narcissistic disorders the sense of Being and the ego's experience of itself often are defective. Genetic and dynamic psychoanalytic considerations also clarify the historical preoccupation with the Being-question. It is concluded that only through consensual validation can psychotic solutions be distinguished form solutions having a general sense of validity. The methodology for exploring the validity of answers to the Being-question is contrasted with scientific method, and the necessity for clear exposition--limited by the inevitable boundaries of one's culture and language--is emphasized; for only through a historical process of dialectic can there be hope of eventual consensual validation on solutions to the problem.

Humans↗
PubMed1990

Hermeneutics for psychotherapists.

Hermeneutics as a method of approach has been used differently by many different authors, and in this paper I have reviewed the history and evolving employment of the hermeneutic approach. For the purposes of psychotherapists, the point of hermeneutics is that, in contrast to the natural sciences, it focusses away from the classical notion of the neutral independent observer (or subject or psychotherapist) as detached from the object of his or her study, the patient. All understanding in the human sciences is viewed by hermeneutics as arising out of a fusion of horizons between the investigator and the humans being investigated. The "knowledge" which arises from such an investigation is not some sort of immutable truth or essence, but is context dependent and a function of the "prejudices" which the investigator brings to the investigation. Diagnoses and formulations in the practice of psychotherapy, if the hermeneutic approach is employed, cannot be viewed as disease entities and natural science "facts," but rather as temporary formations that change with changing times, historical eras, cultures, and prevailing prejudices and practices. The problem of a hermeneutic psychiatry would be to steer between the Scylla of naive realism ignoring the major participation of the psychotherapist on the one hand, and the Charybdis of relativism, nihilism, and hopeless skepticism on the other. Much work remains to be done in order to clarify the role and limitations of hermeneutics, and to incorporate it into the clinical practice of psychotherapy, and this work must be done against the prevailing ideology of scientific materialism that characterizes our historical era. A hermeneutic psychiatry offers us the best hope of not losing sight of the methodological horizons that delimit our clinical work, and of widening these horizons so as to provide further understanding of our patients.

Humans↗
PubMed1990

Self-analysis: a fool for a patient?

In this paper I first reviewed the scanty publications on the subject of self-analysis. Although it was recommended by Freud as early as 1910 for every analyst, self-analysis turns out to have many pitfalls and to be quite a complicated and controversial procedure. There is no agreement on the proper technique of self-analysis in the literature, nor is there any discussion of the determinants of the particular choice of technique of self-analysis that is employed, nor even of the reasons why some analysts do not engage in it at all. Using clinical data gathered from written material of many years of self-analysis following the termination of a successful training psychoanalysis, I have attempted to elucidate some of the problems posed by this procedure. These problems are in some ways similar to formal psychoanalysis, but are in some ways contingent on the fact that it is basically a different technique. It is a solitary occupation and therefore suffers from the dangers of disintegration into autism, narcissism, and obsessional rumination. There is no living presence of an analyst to serve either as a transference figure or to make interpretations and stimulate the production of material. The identification with the analyst's analyzing function is far from simple in self-analysis because of the complex nature of the various internalizations of the analyst that take place over years of a formal training analysis. Thus, Ticho (1967) is correct when she claimed that self-analysis is a skill that the analysand has to acquire by himself or herself. An important phase of the beginning of self-analysis involves the working through of the separation from the psychoanalyst and the re-evaluation of the analyst and the analytic process. This results in a heightened sense of independence and autonomy, increased cohesion of the self, and maturation--which is manifested by greater autonomous ego functioning, a more mature sense of identity, and continued transformations of narcissism which highly valuable goals, on the basis of the data I have presented, can be approached through the process of self-analysis. Above all this stands the most important goal of self-analysis, the understanding of one's countertransference reactions. This is especially important in the treatment of seriously disturbed patients who become disruptive, and thus get labeled borderline, often as a response to unconscious countertransference manifestations from the analyst which are then experienced in the self-object transference as failures in empathy.(ABSTRACT TRUNCATED AT 400 WORDS)

Conflict, Psychological↗
PubMed1989

The death instinct and the future of humans.

Freud's notion of the "death instinct" has been conceived of by many subsequent authors in many ways. One of the misuses of it is as an excuse for passivity in the face of the current crisis in human affairs. This paper reviews the "death instinct" concept and attempts to understand the disavowal of the dangers to our species and our planet on the basis of our current narcissistic cultural orientation. It examines the use of praxis by a variety of continental thinkers to counter this disavowal and emphasizes the obligation of all mental health professionals to participate, through direct action and through educational contributions, in the elimination of these evils.

Aggression↗
PubMed1988

Thirty unresolved psychodynamic questions pertaining to feminine psychology.

The psychoanalytic view of feminine psychology is rapidly changing. This paper organizes and presents thirty areas of currently unresolved questions on this controversial topic, as they have appeared in the literature of psychoanalysis and psychotherapy beginning with Freud's original publications, for consideration for future research, study, and discussion.

Body Image↗
PubMed1988

On the unique impact of Richard Strauss's Elektra.

The unique and remarkable impact of the opera Elektra is explored. This opera rests not only on its dramatic portrayal of the oedipal theme, but also on an inspired expression of archaic emotions, prelogical thought, and preoedipal concerns. This accounts for its unique impact, and serves as a warning to clinicians confronted with manifest oedipal material to be sensitive to the diagnostic implications when oedipal material is permeated with more primitive expressions, producing a curious and eerie ambience and much disquiet in the therapist.

Culture↗
PubMed1987

Lacan's practice of psychoanalytic psychotherapy.

Lacan's efforts in the psychoanalytic psychotherapy of patients with structural deficits aim at separating truth, desire, and ideals from each other so that the analysand is freed up to find or create the desire that gives him or her "joy." This paper presents Lacan's use of the "bridge metaphor" towards that purpose, and illustrates the application of Lacan's early concepts in actual clinical work.

Communication↗
PubMed1986

Heidegger for psychotherapists.

"Philosophical anthropology," and a powerful continental movement in philosophy and psychology have greatly influenced the practice of psychiatry in Europe. Martin Heidegger brought this approach to a position of prominence and wide attention and I describe his views pertinent to modern psychotherapy on (a) human living and (b) the epistemological foundation of psychiatry and psychotherapy.

Culture↗
PubMed1985

Psychoanalytic listening II.

This paper employs a rhetorical form designed to clarify and sharpen the focus of the very special stance required--which must be painstakingly learned under careful supervision--in order to effectively tune in to communications coming from the unconscious of the patient. This is the hardest task that must be mastered to become truly empathic and sensitive in dyadic relationships, a unique expertise that marks the psychiatrist as a genuine specialist in medical practice. Regardless of theoretical orientation, neither the form or content of any therapeutic intervention can be appropriate unless it is empathically based. Clinical vignettes illustrate the lack of such empathy, and readings are suggested that enhance our approach to learning this skill, borrowing especially from Kohut and Bion. The great importance of the often ignored "background" of the patient's communication is emphasized, and is illustrated from the field of music in the work of John Cage and Anton Webern. The congruence between this clinical psychiatric problem and the main thrust of Continental philosophy, which attempts to put man back in touch with himself, is described. Suggestions are offered to supervisors how to develop these skills in the novice. Finally, a discussion is presented of the effect on the professional and personal life of the therapist who has not developed these skills, emphasizing the dangers of "burn-out" in therapists and the implicit philosophy of life in a money-oriented practice of psychotherapy. The dangers of not attending to such matters even during residency training are pointed out, in an attempt to raise the consciousness level of the therapist to the extreme importance of background practices both in the patient and the therapist.

Communication↗
PubMed1979

A practical approach to the psychotherapy of the borderline patient.

Guidelines for the ordinary psychotherapist in the day-to-day office treatment of so-called borderline patients are presented. Practical pointers for handling problems of diagnosis, working alliance, transferences, middle phase, and termination are given, followed by a brief discussion of the future of the concept of borderline patient.

Diagnosis, Differential↗
PubMed1977

Effects of the therapist's philosophical premises on psychotherapeutic process.

This article focuses on differences in assumptions forming the philosophical foundations of psychotherapy leading to profound differences in the interpretation of the clinical data of psychotherapy and corresponding variations of basic technique. These differences are not reconcilable because they are directly opposed; only the principle of complementarity, as described in the paper, permits a constructive approach to the antinomies.

Attitude of Health Personnel↗