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PubMed1989

Hartmann on adaptation: an incomparable or incomprehensible legacy?

Hartmann's essay sets forth ideas of incomparable value as well as incomprehensible density. While he developed many important concepts which have far-ranging clinical utility even today, his attempt to extend psychoanalysis into a general psychology back-fired because it separated psychoanalytic concepts from analytic data. Because of his lack of clinical material or anecdotal illustration, Hartmann's theoretical scaffolding has been frequently misunderstood and misapplied. This paper re-examines Hartmann's essay in light of current clinical and metapsychological issues, and illustrates some of his more important ideas.

Adaptation, Psychological↗
PubMed1989

[Dreams as a sign of change in alexithymia in psychosomatic patients].

A review of some pertinent literature shows that many authors recommend supportive therapy in psychosomatic patients manifesting alexithymic characteristics. Only when positive changes occur in affect tolerance, psychoanalytic psychotherapy can be attempted. In this article it is demonstrated that the occurrence of dreams can be understood to signify such a change in affect tolerance. A clinical example is given in which psychosomatic (and traumatic) dreams gradually change into dreams in which the ego is trying to master the trauma (traumatolytic function). It is concluded that the occurrence of dreams can be of value in determining changes in alexithymia during psychotherapy of alexithymic patients.

Affective Symptoms↗
PubMed1979

The concept of "classical" psychoanalysis.

In this essay, the term classical psychoanalysis is discussed historically and conceptually. What characterizes classical analysis and distinguishes it from current innovative trends in the practice of psychoanalysis is reviewed from a comparative standpoint. The impact of the widened scope of conditions the psychoanalyst currently includes in his therapeutic work is considered, with special attention to the distinction between psychoanalysis per se in the classical sense and psychoanalytic psychotherapy.

Awareness↗
PubMed1979

Working alliance, therapeutic alliance, and transference.

Examination of the clinical evidence offered by proponents for the concepts of therapeutic and working alliance leads the author to conclude that neither concept is justifiable. Both refer to aspects of the transference that neither deserve a special name nor require special treatment. The related topic of frustration/gratification as necessarily inherent in the analytic situation is also considered.

Awareness↗
PubMed1989

["Spute dich, Kronos, fort den rasselnden Trott..." Reflections on time perception in the psychoanalytic process and at the end of life].

Referring to Goethe's Poem "An Schwager Kronos", the author tries to establish a relationship between the experience of time as lived through in the course of the psychoanalytic process as well as of time as experienced under the impression of the possibly approaching end of one's life. Psychoanalytic theory, however, has only limited possibilities to grasp "time" in psycho-dynamic or psycho-symbolic terms. Nevertheless, the changes in the experience of time, which take place in the course of a lifetime, can often be worked through in a psychoanalytic process focussing on loss, "fear of breakdown" (Winnicott) and hope. This working through contributes to the internalisation of the holding environment, i.e. good inner "saving" objects provided by the therapist. Episodes from Mozart's "Last Year" are used as clinical illustrations.

Attitude to Death↗
PubMed1989

[Functions of the dream--I].

The presentation of the multiple functions of dreams as they are attributed to them today is the aim of the present essay. Contrary to the disdain of the dream by 19th century psychiatrists and the investigators of the physiological concomitants of sleep, recent authors stress the adaptive functions of dreams. Dreaming participates in problem solving and contributes to the restoration of a threatened homeostatic inner balance. In the case of heavily traumatized persons dreaming helps the individual in his defence against the traumatic impetus. Personal and scientific creative processes are largely furthered by dreaming. Only in a few special cases, as in malignant somatic disease, can dreaming become detrimental. Dreaming's full measure of usefulness is, however, developed only when taken into service either by the dreamer or a psychotherapist.

Adaptation, Psychological↗
PubMed1989

[John Huston's film "Freud" (1961)].

Through the analysis of the pictures and of their sequences the author draws the staging of John Huston's "Freud"-film as moulding an unconscious oedipal phantasy. Enlightening and counter-enlightening tendencies of the film are pointed out.

Austria↗
PubMed1989

[Irma--Emma--Martha--Anna. Some additional comments on presentations by K. R. Eissler and H. Thomä].

The author re-examines the significance of the Emma-Eckstein-episode and the Irma-dream with their implications for the theory of psychoanalysis. He follows Eissler and contradicts Schur in his argument that the identity of Irma with Emma cannot be proven and is, in any case, improbable. Neither the proof nor the refutation of this identity are of vital significance for psychoanalytic theory, but only for the suppression of dynamic psychiatry in favour of biological psychiatry.

Austria↗
PubMed1989

[An early, on the borderline between dream and transference, unconscious fantasy of Freud on the psychoanalytic situation (1898). A contribution to psychoanalytic creativity].

Taking 24 hours in the life of Freud, the author shows how significant the interplay of dream, day-dream, unconscious phantasy and transference can be in solving scientific problems. This is documented by using the correspondence between Freud and Fliess on March 9/10, 1898, by taking Freud's dream of a botanical monograph, his day-dream of a glaucoma operation, his remarks on the "real" course of the day, and segments of self-analysis.

Austria↗
PubMed1989

[Comments on the concept of the so-called negative therapeutic reaction].

The author recommends a consistent analytic rather than therapeutical or educational response to the negative therapeutic reaction whenever it occurs in the treatment process. This attitude is especially helpful in cases where strivings for autonomy are active behind the negative therapeutic reaction and where these are jeopardized by the intermingling of the patient's projective identifications with those of the therapist.

Defense Mechanisms↗
PubMed1989

Cardiac preoccupations.

The origins and development of mental representations of internal bodily organs are, in general, difficult to discern. This is so even in the case of an internal bodily organ such as the heart, which is more readily perceived than most other body organs since its beating can be felt and heard. It is even true in the case of individuals in whose psyche the heart comes to play an inordinately prominent role. It was so in the case presented in this paper, the case of a man who was preoccupied with the idea that he was going to die of a heart attack, as his father had. It required a great deal of analytic work to uncover some of the underlying conflict-laden factors which lay behind his cardiac preoccupations. Those conflicts and fantasies that were uncovered derived from many developmental layers, but seemed to be organized around a central bisexual conflict resulting from the threat of castration for both positive and negative oedipal wishes. The two main unconscious mental representations of the heart in his case were as an erect, pulsating penis and as a blood-filled vagina, although other representations such as a bloody anus also existed. A relatively accurate, realistic mental representation of the heart probably evolves slowly during the development of any individual and is probably always distorted somewhat by infantile unconscious concepts along the way. In a situation where a parent has had a cardiac illness, and particularly when this illness occurred during the individual's childhood, the mental representation of the heart can be even more distorted than usual by the developmental conflicts that are intensified by the parental illness.

Adult↗
PubMed1989

Further thoughts about "nothing".

Some meanings of "nothing" are delineated according to their acquisition, confluence, and transformation in the course of the child's development of drives, the ego, and object relations. This sketch is illustrated mainly from King Lear.

Child↗