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PubMed1991

Verbal hallucinations in psychotic patients.

"Verbal hallucinations" are sentences that psychotic patients may say repeatedly throughout a conversation which are out of context or unconnected to the topic of conversation. These hallucinations are not the outcome of a remembrance of an experience or an event and do not bring about any emotional relief or catharsis, but they supply valuable information. They resemble Jacques Lacan's description of the psychotic mechanism "Forclusion." This mechanism relates to experiences that did not undergo the process of primary symbolization through language, and experiences where words were attached but were not bound to the language structure. The result being that these experiences did not enter into the unconscious discourse of the subject. This information can reappear as verbal hallucinations in the psychotic patient. In such cases, the therapist, with the assistance of the patient's family, must investigate the meaning of the verbal hallucinations through research into the patient's and family's history in the phase prior to language development. When such a connection is discovered, the therapist must then bridge the hallucinations with the events unknown to the patient but contained in his subconscious. The therapist's role in such cases resembles that of a parent with a child: To translate the subject's experience through language from the physical schema to the body image and symbolic plane and in so doing, give meaning to meaninglessness. In our paper three short clinical cases are presented.

Body Image↗
PubMed1991

Treatment techniques in evolution.

In response to Gabbard's paper, "Do We Need Theory?" the author disputes the suggestion that his early therapeutic successes were theory-specific. He also takes issue with the view that "the analyst's personality is a constant," emphasizing instead the continual fluidity of an effective analytic relationship. While agreeing that atheoreticism is itself a theory, the author differentiates between the universal presence of content as defined by formal psychoanalytic metapsychological theory (e.g., primary instinctual envy, the Oedipus complex) and the centrality of affect attunement that illuminates developmental processes. He cautions therapists to guard against believing that they know "objective reality," and he urges them to assume a "know-nothing" position conducive to eliciting each patient's psychic reality.

Disruptive, Impulse Control, and Conduct Disorders↗
PubMed1991

Analytic interruptions.

The author examines the phenomenon of analysand-initiated interruptions of psychoanalysis by briefly reviewing Freud's treatment of Dora and then describing his own similar experience. The deterioration in Freud's relationship with Wilhelm Fliess may have influenced Freud's handling of Dora's treatment, thereby contributing to the outcome. The author contends that, with his own patient, his plan to end a training analysis influenced his management of transference-countertransference dynamics, thus contributing to the patient's premature departure. The author suggests that there is a special period of countertransference vulnerability for psychoanalysts and psychotherapists.

Adult↗
PubMed1991

A psychoanalytic study of Sophocles' Antigone.

This paper examines, in a detailed and comprehensive fashion, the unconscious motivations of the main protagonists of Sophocles' Antigone and the play's general structure as a psychoanalytically coherent whole. This examination helps to foster an understanding of the conceptual place of Antigone within the Oedipus Trilogy, its relationship to Oedipus Rex, and the complementary character of these two tragedies.

Drama↗
PubMed1991

[Analysis of verbal presentation--a problem in psychotherapy process research].

The special language mode chosen by patients to relate episodes experienced by them is a pointer to the way they cope with their own experiences. Patterns of recognition and coping are evident to the therapist from the organisation of subject matter as modelled by the patient; this supplies significant pointers to the manner in which the patient has organized his emotions and the internal interrelations of these in his mind. Analysis of "language play direction" or "language drama staging" offers a chance to the researcher to follow up the process of stabilisation or productive change going on in the patient's mind, on the basis of the coping models offered by the patients, as it were via a "miniature drama" stage-set, directed and acted by the patient.

Adaptation, Psychological↗
PubMed1991

[Dealing with labyrinths. General practice and research in psychoanalysis--an evaluation].

If psychotherapy research is to yield results relevant for therapeutic practice, it must broaden its receptiveness for the peculiarities of this field and for the methods employed by therapists. The therapist works on-line, while the researcher enjoys the advantage of working off-line. Research in psychotherapy has addressed the world of images and affects, the interactive process, the dependence on models, and the specific manner of information processing characteristic of therapy. The author compares the different ways in which the therapeutic and the empirical settings handle suspicion and error.

Affect↗
PubMed1991

The ontogeny of silence in an analytic case.

This paper concerns the uses of silence by an analytic patient, with particular emphasis on silence as a changing means of communication. The patient's initial use of silence was a way of indicating to me her original relationship with her mother; it also represented an unstated appeal that I grant her a measure of autonomy. Later, silence signalled several stages along the way to the patient's full articulation of her longing to be welcomed, to be enthusiastically enjoyed by me. My role in these later manifestations of silence was that of aiding her in the articulation of hopes and wishes, stifled since early childhood because of an unfortunate series of abandonments and experiences of humiliation. The culmination of this articulation process was the patient's ability to vary a repetitive dream that she had had before the start of her analysis.

Adult↗
PubMed1991

The subject of mind.

Though certain assumptions about the nature of meaning that I call subjectivist go contrary to the general direction of psychoanalytic thought, they are intrinsic to Freud's view of the unconscious as a special mental system with characteristics unique to it. A corollary to this view of meaning in Freud's case is that instinctual processes are a rudimentary form of the mental, providing a genetic base from which 'secondary' mental states derive. I argue that the mental is irreducible to instinct or anything else, and that even in its most rudimentary form, mentality presumes an interaction between creature and the external world, also creature and other creatures, that has an essentially linguistic nature. I claim that psychoanalysis would lose nothing that is crucial to it were it to view subjectivity as something that can only emerge in time; on the contrary it would clarify its own most valuable insights.

Countertransference↗