Remains to Be Transmitted: Primo Levi’s Traumatic Dream

Drawing on the writings of Primo Levi and the psychoanalysis of Jacques Lacan, the author attempts to conceive psychic trauma as a coalescence of traumas, since this is perhaps the only way to prevent a subject from being forced back into identification with the catastrophic event, whatever that may have been. A recurrent dream of Primo Levi's suggests to the author the way that traumas may have coalesced within Levi. The hope would be to restore the entire significance of what remains from that traumatic event to the speech (parole) of the Other, to the speech of every human, even the most helpless, bruised, or destroyed among us.

Transcending Bitterness and Early Paternal Loss through Mourning and Forgiveness

This paper provides an in-depth account of a clinical path to forgiveness following a complicated, delayed mourning of an early loss by a man now entering old age. The search for mourning and forgiveness in light of extreme bitterness in advancing age is highlighted. Despite the intimate connection between mourning and forgiveness, this paper attempts to highlight important differences in their dynamics and psychological aims. Forgiveness is conceived as work, unconsciously motivated, to safeguard and complement the psychological gains of mourning. The distinct features of forgiveness facilitating psychic reorganization, as well as the adaptive function of refusal to forgive as a defense against melancholia, are discussed. The paper concludes that in this case, the motivation for forgiveness was to repair a powerful narcissistic injury.

Father Hunger and Narcissistic Deformation

The author advances the hypothesis that paternal availability and the relationship between the mother and father are crucial components of evolving character structure in children. He proposes that a kind of narcissistic pathology featuring perverse sexuality may eventuate in the absence of paternal availability and in the presence of a disordered relationship between the parents. He also suggests that the ways in which aggression is or is not modulated and organized are crucial components of this evolving disorder, and that boys are more susceptible to its full manifestation and expression than are girls.

The Wheel and the Ladder: Freudian and Loewaldian Accounts of Individuation

In this paper, I use comparisons of Freud, Loewald, and Plato to explore what it means to individuate and to desire in a world of frustration, pain, and loss. The metaphors of the "wheel" versus the "ladder" present basic images for Freud's tragic conception of a person's emerging into a world of pain, transience and loss, in contrast to Loewald's sense of individuation as an increasing attainment of individual ego and world enrichment, constructed from metabolized grieved objects. I then argue that Plato's Symposium offers comparable visions of the possibilities of love, and that the juxtaposition of Freud and Loewald can be connected to ancient philosophical considerations. The paper begins by examining the implications of the two thinkers' treatments of the "oceanic state" (primary narcissism), then compares these to the speeches of Aristophanes and Socrates/Diotima. The conclusion touches on the relevance of the juxtaposition to the Platonic distinction between philosophy and poetry.

Ego Boundary Deficits and the Negative Therapeutic Inter-Action: A Tale of a Whale, a Whale of a Tale

Defined variously and unsatisfactorily as a worsening of the patient's condition following a correct interpretation, the negative therapeutic reaction is typically blamed on the patient: "the operation was a success but the patient died." For most neurotic patients unconscious guilt objects to progress and activates the need to suffer. For most character-disturbed patients envy cannot bear the analyst's cleverness. However, patients with ego boundary problems-even sectors of psychosis-may require a different explanatory mechanism, where a correct interpretation may be experienced as a penetration and an engulfment, threatening the intactness of the self. A short-term, time-limited, psychoanalytic psychotherapy that went off the rails following a correct but ill-timed interpretation is presented as an opportunity to amend analytic theory, here favoring the interactional over the intrapsychic. Herman Melville helps tell the tale.

Dream Images and Creation

This article links contemporary psychoanalytic theories of the dream, especially Bion's, with the work of the American video artist Bill Viola, who is deeply influenced by altered states of consciousness and produces images of dreamlike quality. We discuss the oneiric and infantile roots of creativity and artistic inspiration, finally taking Viola's monumental artwork The Passing (1991) as paradigmatic of the artist's aesthetic and philosophical elaboration of the relationship between life and death.

Evolution, Shame, and Psychotherapy

Medea, the title character in Euripides' play, murdered her two sons in response to her husband Jason's abandonment. If her behavior can be understood, it is best understood in the context of shame. In an evolutionary context, shame is the affective response to the loss of one's place in the group. This response is related to the neurobiology of pain-not the acute pain experienced through the post-central gyrus, but the chronic, lingering pain that is experienced through the insular and cingulate cortices where homeostasis is regulated "from above." Shame is thus a fall in self-esteem, but shame is also a crisis of homeostasis, a crisis that can lead to drastic and, as in the case of Medea, violent attempts to "repair" the imbalance. Shame is a primitive, evolutionarily preserved response to the loss of one's place in the group.

Exploring the Role of Children’s Dreams in Psychoanalytic Practice Today

AIM

The aim of this research study was to investigate the role of children's dreams in the practice of child psychoanalysis today, and to explore contemporary psychoanalytic understanding of children's dreams.

METHODOLOGY

This pilot study consisted of two stages. The first involved a document analysis of published articles in The Psychoanalytic Study of the Child, making a comparison between those of the early 1950s and the 1990s, in order to see in what way the discourse around children's dreams within the psychoanalytic literature has changed over time. The second stage, based on questionnaires and in-depth interviews, attempted to understand in more detail the way contemporary child analysts, working in the Anna Freudian tradition, think about dreams and use them in their clinical practice.

RESULTS

Results suggest that there has been a decreased focus on dreams in a clinical context over time, and that this may partly be a consequence of changing theoretical models and changes in training. When work with dreams does take place, it appears that child analysts have

Psychoanalytic Reconstruction and Reintegration

Psychoanalytic reconstruction has declined in theoretical and clinical interest as greater attention has been directed to the here and now of the transference-counter-transference field and inter-subjectivity. Transference, however, is based upon childhood fantasy, and is a new edition of unconscious intra-psychic representation and relationships. In this paper transference is viewed as a guide to reconstruction, but transference itself is also an object of reconstruction. Reconstruction is a complementary agent of change, which integrates genetic interpretations and restores the continuity of the self The patient's childish traits, features, fixations, and irrational childish fantasies and behavior point to the necessity for reconstruction. Reconstruction organizes dissociated, fragmented memories, potentiating the further retrieval of repressed memories. Reconstruction is essential to the working through and attenuation of early traumatic experience. Recapture of the past is necessary to demonstrate and diminish the persistent influence of the past in the present, and to meaningfully connect past and present. A case is presented in which reconstruction had a central, vital role in the analytic process.

Motor Action, Emotion, and Motive

The experience, imagery, and fantasy of self in motion play a central part in the dreams, aspirations, and affective life of individuals, and in their growth. Human infants are supplied with an intrinsic drive to move to, with, and against forces and objects in the natural world, for that action maps a developing self into the world. This striving is not derivative from some other drive; it is a motivational force in and of itself intertwined with other essential strivings of the developing individual. Clinical observations and recent findings of developmental and neurobiological studies demonstrate that positive aspects of a person's striving in the sphere of motor control imbue a person's sense of self with qualities of energy, agency, and mastery. And, when thwarted, distorted, or unbalanced in relation to other strivings, one's physicality may also be a locus for conflict and maladaptive defenses. Schemas of self in relation to the world at large and especially to significant others are often encoded in procedural modes of remembering and perceiving, where movement is central. When the analyst is attuned to the experience of motor action in the life of the person he or she seeks to know fully and to help, the appreciation of that person's motives, emotions, and sense of self is deepened and enhanced.

Obsessionality: Modulating the Encounter with Emotional Truth and the Aesthetic Object

Experiences with autistic and primitive mental states have significant implications for our understanding of obsessionality. Consequently, obsessionality is seen as an attempt at a massive simplification of experience, in order to deal with the pain inherent in the encounter with intense emotional experience and with the separateness of an enigmatic object that eludes one's omnipotent control. Moreover, early loss and a precocious awareness of separateness often play roles in the withdrawal to obsessional thinking and verbosity, and to an illusion of omnipotent control of the object. Interpretations focusing on conflicting desires, or linking repressed and displaced parts of the personality with the defenses against them, do not reach these patients in a way that facilitates psychic change. An alternative approach, it is suggested, is to work at primitive, nonsymbolic levels of mental functioning, where experience cannot be verbally communicated and dynamically interpreted, but must first be lived in the here and now of the analysis. This is illustrated through the analysis of a person trying to cope with the experience of early loss by deadening emotion and finding shelter in obsessionality.

Dreams and Age

This work evaluated the association of age and dream reports. The verbal reports of 148 dreams of elderly people ( M age = 75.8 yr.) were compared with 151 dreams of a group of young people ( M age = 22.0). The dreams were analyzed according to the Jungian vision (which looks at the dream as a text produced by the dreamer's unconscious while sleeping), using processing techniques derived from textual analysis. Significant differences were found between the number of words denoting emotion, with the young people reporting more explicit statements regarding emotional states. Significant differences were found also in use of verb tenses. When older people explicitly expressed an emotional state in a dream text, they shifted between present and past tense more frequently than young people. A significant prevalence in the semantic field of visual sense was evident as younger subjects used more sentences referring to sight than the elderly participants.

The Psychoanalytic Interpretation of Symptoms - Evidence and Benefits

Dermatological symptoms are explained in medicine in biological terms. Nevertheless, exploring the life history of dermatological patients can lead to seductive, but non-rigorously scientific interpretations which are of associative, or even symbolic nature. Moreover, associations of physical signs and life events, suggest us to consider our patients as subjects pervaded by the will to communicate not only through language, but also through their body and all its functions and malfunctions. Interpreting symptoms and eventually finding a meaning to the disease must not imply a causative attribution, because the very signification of cause and effect is probably beyond our grasp. Hence, aware of our limits, we should know whether we wish to treat the disease as a whole, considering that the observer (the doctor, the patient or the medicine as a theoretical corpus) is not only an observer from outside, but part of the disease that will be treated or described.

Emotional Boundary Work in Advanced Fertility Nursing Roles

In this article we examine the nature of intimacy and knowing in the nurse-patient relationship in the context of advanced nursing roles in fertility care. We suggest that psychoanalytical approaches to emotions may contribute to an increased understanding of how emotions are managed in advanced nursing roles. These roles include nurses undertaking tasks that were formerly performed by doctors. Rather than limiting the potential for intimacy between nurses and fertility patients, we argue that such roles allow nurses to provide increased continuity of care. This facilitates the management of emotions where a feeling of closeness is created while at the same time maintaining a distance or safe boundary with which both nurses and patients are comfortable. We argue that this distanced or ‘bounded’ relationship can be understood as a defence against the anxiety of emotions raised in the nurse-fertility patient relationship.

Narcissism and Childhood Recollections: A Quantitative Test of Psychoanalytic Predictions

Different psychotherapeutic theories provide contradictory accounts of adult narcissism as the product of either parental coldness or excessive parental admiration during childhood. Yet, none of these theories has been tested systematically in a nonclinical sample. The authors compared four structural equation models predicting overt and covert narcissism among 120 United Kingdom adults. Both forms of narcissism were predicted by both recollections of parental coldness and recollections of excessive parental admiration. Moreover, a suppression relationship was detected between these predictors: The effects of each were stronger when modeled together than separately. These effects were found after controlling for working models of attachment; covert narcissism was predicted also by attachment anxiety. This combination of childhood experiences may help to explain the paradoxical combination of grandiosity and fragility in adult narcissism.

[Shared feeling of therapeutic deadlock in a psychiatric institution]

Therapeutic deadlock in psychiatry is different from other medical disciplines: the feeling of deadlock is inherent to psychiatric care with chronic patients. It is present in different forms in institutional life where it is often shared. Reintroducing processes of speaking and thinking is therefore a priority to treat and relaunch a fixed psychological approach both on the part of the patient as well as the team. Reasserting the "psychoanalytical work as a group" can be a way of understanding situations of deadlock to find new ways of moving forward.

[Deadlock in a crisis unit, from helplessness to containment]

The case of a young woman hospitalised in a psychiatric unit illustrates the deadlock which invades institutional life and presents possible solutions for overcoming it. This deadlock is in fact two-fold: that of the patient and that of the team caring for her. The patient's suffering is echoed by that of the caregivers, whose attempts to re-establish a bond, to give meaning to the procedures carried out, are lost in the meanders of an instability which has been reinforced over time by the pleasure of repetition.

Applied Concepts of Holistic Nursing

As a holistic nurse, the author uses the concepts and processes of exploring clients’ dreams to provoke in them an understanding of life’s issues, including illness and injury. Dreams hold information about spiritual realities, self-development, mythological archetypal themes, and the health of mind and body. Dream research and contemporary techniques for remembering and analyzing dreams guide the author in the work necessary to help her clients achieve health and wholeness through a deeper understanding of themselves through dreams.

THE DEAD-LIVING-MOTHER: MARIE BONAPARTE'S INTERPRETATION OF EDGAR ALLAN POE'S SHORT STORIES

Princess Marie Bonaparte is an important figure in the history of psychoanalysis, remembered for her crucial role in arranging Freud's escape to safety in London from Nazi Vienna, in 1938. This paper connects us to Bonaparte's work on Poe's short stories. Founded on concepts of Freudian theory and an exhaustive review of the biographical facts, Marie Bonaparte concluded that the works of Edgar Allan Poe drew their most powerful inspirational force from the psychological consequences of the early death of the poet's mother. In Bonaparte's approach, which was powerfully influenced by her recognition of the impact of the death of her own mother when she was born-an understanding she gained in her analysis with Freud-the thesis of the dead-living-mother achieved the status of a paradigmatic key to analyze and understand Poe's literary legacy. This paper explores the background and support of this hypothesis and reviews Bonaparte's interpretation of Poe's most notable short stories, in which extraordinary female figures feature in the narrative.

RACE AND RECOGNITION: THE TIME OF OUR SINGING

Literature affords the opportunity to consider the racial fear, hatred and hostility that can flare in moments when the otherness in the human face occludes the common bonds that join us together. Richard Powers' (2003) compelling novel, The Time of Our Singing, highlights ways in which racial tensions continue to haunt us, impeding the efforts of successive generations to heal the wounds and move forward. In the novel, the parents' efforts to move "beyond race" leave their children utterly unprepared for the ways in which race informs and obstruct their experience, as what has been denied returns to haunt them.