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PubMed1992

Psychoanalytic contributions to Holocaust studies.

The purpose of this presentation is to provide a comprehensive overview to a wide audience of how effects of trauma incurred by victims of Nazi persecution during the Holocaust may affect survivors and their children. In doing so, one has to accept that powerful defences employed by survivors themselves and the world about them led to a 'latency period' which delayed investigation of the late sequelae of Holocaust trauma. Bridging the gap was stimulated by the passage of indemnification legislation by the Federal German Republic which enabled mental health professionals to investigate these possible effects. Psychoanalytic theories of trauma had to be reconsidered in the light of these inquiries. Further study revealed that the effects of massive and cumulative trauma may be transmitted to the second generation. Recurrent themes and conflicts in children of survivors have been described. Clinical illustrations have been provided to illuminate some aspects of problems encountered in treating members of a traumatized group. Finally, issues involving unresolved mourning and questions of commemorating the Holocaust have been considered.

Adult↗
PubMed1992

Psychic change and developments in the theory of technique in adolescent analysis: the handling of perverse levels of transference.

The paper presents some of the characteristics of the analytic process in an adolescent with homosexual behaviour. The technical peculiarities of this kind of treatment are compared with those of adult patients with similar pathologies. The difficulties arising from complex acting-out behaviour in which the family take an active part, the role of secrecy, and the handling of the erotization of the transference through the verbal interchange are discussed on the basis of the clinical material presented. The characteristics of a strongly split transference, with a dissociated perverse level, imply specific difficulties in maintaining a workable analytic setting; the strategic choices with which the analyst is faced to be able to attain it, and its clinical implications are discussed.

Adolescent↗
PubMed1992

Ambiguity as the route to shame.

In patients who have been exposed to extreme conditions, shame is connected with a dilemma of identity: it is indicative of the patient's conflict over his alienation, his adaptation to and familiarization with the conditions offered by an unacceptable frame. Bleger's (1967) theoretical model, with the concepts of the symbiotic link, ambiguity and the ambiguous position (which precedes the classical Kleinian positions), dynamically combines the problem of the frame or context with that of the capacity of discrimination between the ego and its objects. Ambiguity is characterized by the adaptability, malleability, permeability and non-conflictuality which it confers on the personality. Shame appears as an alarm signal concerning ambiguity, connected with the ego's need to maintain its internal conflictuality, its capacity for integration and its sense of continuity. Experiences of dependence and passivity, or ones which touch upon the dilemma between true and false, private and public, ethics and aesthetics, etc., may give rise to feelings of shame. In this paper it is suggested that a common denominator for the many different factors of shame may be found in the dynamics of ambiguity.

Adult↗
PubMed1992

The evolution of Freud's theory about dreaming.

Freud revised his theory of dreams significantly. First, he discovered the role of the id in dreaming. He hypothesized that the function of dreaming is to gratify an infantile sexual wish, in accordance with the pleasure principle, and thereby to preserve sleep. However, he learned later that anxiety generated by recent events plays a greater role in stimulating dream formation than he had thought and that some dreams actually generate anxiety. These clinical observations caused him, in large part, to revise his theories of dreaming, of anxiety, and of the mental apparatus.

Dreams↗
PubMed2005

[From Rambo-Jesus to well integrated masculinity].

The contribution deals with drawings of an eleven year old boy. He is in the transitional phase from preadolescence to adolescence. The atmosphere at home is very aggressive due to the prolonged divorce of his parents, which has been going on for three years. Because of this the typical development in this phase of growing up is made much more difficult for him. The youngster finds himself in an intensive loyality conflict with his parents. In his opinion any kind of aggression is negatively connoted. Therefore he cannot use his aggressions in a positive way neither to promote his self-development nor to become independent. His ability to symbolize was initially inhibited and could be released in the act of drawing during therapy. The boy's way from denial to showing his inner conflicts is described in the contribution.

Adolescent↗
PubMed1992

[Importance of countertransference in the initial psychoanalytic interview].

The author points out the responsibilities and difficulties an interviewer faces in the initial psychoanalytic interview and discusses different theoretical positions in dealing with countertransference. Apart from "free floating attention" and "free floating responsiveness" he emphasizes the important diagnostic and therapeutic factor of "free floating introspectiveness". Finally, with a clinical example, he demonstrates that countertransference should already be taking place at the beginning stage of an interview.

Countertransference↗
PubMed1992

The development of the work ego in the beginning analyst: thoughts on identity formation of the psychoanalyst.

This developmental process by which analysts consolidate their professional identities after formal training is a topic which has not been discussed sufficiently in the psychoanalytic literature. The aim of this paper is to elucidate the process of identity formation with particular emphasis on how the 'work ego' of each analyst is formed through various experiences which help the practitioner wed theoretical knowledge with clinical experience. Emphasis is given to the psychic reality of the newly graduated analyst, the integration of theory and practice, and the importance of countertransference experiences in the understanding of clinical material. A thread running through the paper is the modification of each analyst's 'psychoanalytic work superego' in the direction of greater flexibility and openness, such that he/she may work comfortably with a variety of patients. In this regard, an examination is undertaken of stereotyped beliefs and practices which many analysts learn during their training, which must be modified in order to acquire a secure professional identity.

Ego↗
PubMed1992

Some superego conflicts in the analyst who has suffered a catastrophic illness.

This paper, originally part of a panel (in a somewhat different form) on life stresses of the analyst, focuses on some of the superego conflicts of the analyst who has suffered a catastrophic illness. The interplay between ego and superego functioning is examined, particularly in reference to how superego conflicts cause the ego to become subordinated to drive-related aims and to superego demands from which it would ordinarily have more autonomous distance. Some of the issues which are conflictual for analysts who have suffered a catastrophic illness and which have a tendency to be played-out in the treatment include: problems of self-esteem regulation; regressive alteration of identifications; reinstinctualization of identifications and of object relations; alterations in the ego-ideal; disruptions of other narcissistic regulatory processes; and the above mentioned subordination of ego functions, especially in regard to its synthetic, reality testing, and other autonomous capacities. Examples are presented of how these conflicts may be dynamically operative in unconsciousness, how they may enter into consciousness, and how they might be expressed in the treatment.

Aggression↗
PubMed1992

Freud's Jocasta and Sophocles' Jocasta: clinical implications of the difference.

Evidence is presented that the Jocasta Sophocles depicted in Oedipus Rex is significantly different from the Jocasta of Freud's synopsis of the play. Sophocles' Jocasta prefers her son to her husband and this preference results in parricide and incest. The clinical implications of this difference are discussed in relation to a group of patients whose mothers resembled Sophocles' Jocasta. The analysis of one such patient is briefly presented. All these patients had difficulties at work and in their psychosexual development. It is argued that these difficulties resulted from the mother's attitude interfering with the dissolution of the Oedipus complex and that quite severe pathology does not necessarily mean pre-oedipal conflicts.

Adult↗
PubMedDate not supplied

[How postmodern youths find their way into life--views on imaginative psychotherapy of adolescents].

The author describes the course of an adolescent psychotherapy with guided affective imagery (Leuner 1985) using the therapeutic material of a 15 year old female adolescent with a severe depression und automutilative behaviour. She considers this therapeutic method as very useful especially for severely disturbed adolescents, because the method enhances the creativity of the patient and enables him to express traumatizing experiences in a symbolical form thus facilitating their integration.

Adolescent↗
PubMedDate not supplied

[Autism and infantile psychosis. Theoretical and clinical contributions of the psychoanalysis].

This article describes the different theories of various authors that have tried to explain, from the psychoanalytic theory, the early childhood autistic disorder described by Leo Kanner in 1943. Autism differs from other childhood disorders and is characterized by a significant disconnection. This article sustains that there are two different lines of thought. One that explains the disorder as a regression during a normal phase of development; and the other as an early defense in response to extreme situations. These two theories are present in all the current considerations about autism as a theoretical debate that goes beyond the clinical observation and determines the direction of the cure.

Autistic Disorder↗