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PubMed1991

Programme notes. 36th IPA Congress, Rome, 1989. The search for common ground: clinical aims and processes.

This paper presents a summary and an overview of the 36th IPA Congress, 'Common ground in psychoanalysis: clinical aims and processes'. The theme emerged from Dr Robert Wallerstein's 1987 Montreal Congress Plenary Address, 'One psychoanalysis or many'. The paper focuses on the three Rome Plenary presentations and their discussions, Wallerstein's presidential address, and the final panel review. A paper presented at the meeting by Charles Hanly, 'The concept of truth in psychoanalysis', which outlines theories of truth: correspondence versus coherence, provides the conceptual tools for considering the different points of view. The author shares Hanly's support for a pragmatically qualified commitment to a correspondence theory of truth.

Humans↗
PubMed1991

The search for common ground: a critique.

The paper discusses the positive and the negative sides of the common ground perspectives as proposed at the Montreal and Rome Congresses. Freud is the origin of the guardian role of the IPA, but the time is over when one man or one small group could dictate what psychoanalysis is and should be. This task has become an ongoing challenge for the total group. Psychoanalysis has to avoid becoming a fourre-tout as well as avoiding being ruled by any sort of dictatorial credo. One ideal way to deal with the unavoidable basic divergences is what Roy Schafer has called comparative psychoanalysis, where each new approach is evaluated in respect to the existing fundamental principles; in the long run, the irrelevant views would fade away. In the second part, the author gives his own idea about the irreducible principles that should define essential psychoanalysis.

Forecasting↗
PubMed1991

Body image, sexuality and the psychotic core.

The mental representation of the body--that is, the body image--is a basic element of the person's relationship to himself as well as to reality. From a developmental point of view the body image only becomes finally integrated to form the basis of the person's sexual and gender identity at the end of adolescence. This final body image can contain distortions compared to the person's real body (as viewed by others) and thus can represent a break with some aspects of external reality. In this paper I use material from the analyses of two patients, one adult and one adolescent, to show the compelling quality of the need to maintain a specific body image, and how it becomes related to their sexuality. I also discuss how, when the body image is one that is distorted, it forms a psychotic core to the personality in that it must affect the person's relationship to external reality.

Adolescent↗
PubMed1991

A perversion named desire.

Inspired by the title of the work, A Streetcar Named Desire by Tennessee Williams, the author argues that desire and perversion are equivalent, based on the following. (1) The notion of infanatile sexuality as polymorphously perverse, and whose components constitute the 'core of our unconscious' and the ultimate 'matter' of unconscious desire. (2) The perspective of narcissism, which establishes desire, supported by the theory that maternity implants an illusion of completeness which culture promotes, despite the fact that such an ideal conflicts with the laws governing the foundation of culture. (3) The resulting forms of the oedipal complex and the castration complex, whether man or woman, imply a visible or unapparent violence with regard to the original 'call' of desire. (4) The traditional structures refer to the possibility of the mother imagining herself as completed by the child: the blocking of that illusion is associated with psychosis; the weakness of the desire, once established, demands, in the context of perversion, the presence of the figure of plenitude. Neurosis prefers its absence on the level of the apparent while insuring its permanence on the unconscious level.

Drama↗
PubMed1991

Patients' theories of pathogenesis.

Certain patients embark upon analytic treatment with well thought out theories regarding the origins of their difficulties. Although there is always some validity to such theories, they turn out to be incomplete and serve to screen painful recollections and pathogenic unconscious wishes and the defenses against them. Two cases are presented to illustrate how analysands use these theories in the service of resistance. Painstaking analytic work is required to elucidate their defensive nature. The narcissistic importance of such theories in maintaining a coherent narrative about one's life in the face of uncertainty is discussed, and technical and countertransference considerations are explored.

Adult↗
PubMed1990

Emotional aspects of infertility and its remedies.

The childhood wish for parenthood when it remains unfulfilled in adult life causes pain to a couple and imposes a strain on their relationship. For a woman's failure to conceive may be rooted in an early unsatisfactory relationship to her mother. The new fertility techniques restore hope to these patients but may not be successful for such women and may also bring new emotional problems in their wake. Spontaneity in sexual relations is constrained, and transference to the doctors who administer techniques, giving or refusing permission for normal sexual intercourse, repeats infantile submission to the powerful parents of the past. Two clinical illustrations are given.

Affective Symptoms↗
PubMed1990

Erotized transference reconsidered: expanding the countertransference dimension.

A reconsideration of the erotized transference from a contemporary perspective has been presented utilizing detailed case material provided by Stoller. The main thesis is that this type of transference, traditionally conceived as a product of a particular kind of patient often felt to be borderline, is better understood as arising in a specific intersubjective context involving both participants in the psychoanalytic situation. The focus is on the intricate interaction of analyst and patient, recognizing that either may serve as a selfobject for the other. This view assumes a more expanded countertransference role than recognized in the earlier literature. The psychoanalytic situation can be erotized by either or both participants. A corollary thesis is that the details of a patient's fantasy should also be viewed as codetermined and that imbedded within it might be the patient's subjective experience of the psychoanalytic interaction. Alluded to peripherally is that the erotized transference in the interaction between male analyst and female patient is, in part, a manifestation of traditional roles assumed in situations involving a male authority figure in close engagement with a female who perceives herself as relatively powerless. This issue has recently received considerable attention from writers who have addressed themselves to the important gender issues in psychoanalysis.

Adult↗