Two Phases in the Intervention of Melanie Klein

In 1930, Melanie Klein published an article presenting the case of Dick. Within the framework of the psychoanalytic technique adapted to the clinical treatment of autism, this article contributes elements to a question posed by many psychoanalysts: why did Klein's interventions affect Dick? To that end, Klein's first intervention is divided into two phases: a first naming phase, consented to by Dick; and a second interpretation phase, triggering detachment from the object, anxiety, and stereotypy. The proposal is to understand the emergence of anxiety in the relationship that the second-phase interpretation has with the first phase of naming.

Remembering, repeating and working-through as a step in Freud's ongoing struggle with the "what", "why" and "how" of analytic knowing in the curative process

In this paper the author offers a new reading of Freud's "Remembering, Repeating and Working-through", examining the complex nature of central concepts that Freud presents within it. She demonstrates the text's special role in an ongoing effort of Freud's to articulate and ground the heart of his analytic insight that knowledge cures. While the insight itself is very well-known, the fact that Freud struggled throughout his life with its articulation and grounding is not. The struggle centered on questions pertaining to how analytic knowing could, not only enlighten the patient, but actually change his unconscious dynamics, and why the patient, having already "opted" for pathology in place of knowing would come to accept it; and ultimately, what was the nature of the knowledge offered in analysis and the individual's relationship to it that allowed for such dramatic changes to occur. The author briefly presents some of her earlier work on Freud's struggle with these issues and how Melanie Klein resolved them. It is in this context that she demonstrates how in Remembering, Repeating and Working-through" Freud may be seen to be taking important steps towards developing his ideas on analytic knowing and in ways that anticipate Klein's resolutions. This points to the close tie between Klein's and Freud's thinking on the nature of the analytic process and the person's desire for self-knowledge on which it relies, brings out the richness of this thinking and grounds its value to contemporary psychoanalysis.

A history of eponym usage in hip and pelvis radiography part 1: the paediatric hip

Eponyms, while inherently flawed, remain a constant in medical vernacular, especially in orthopaedic surgery. It is essential to understand how these eponyms came to be named and for whom they were named after in order to know the correct usage and definition of these eponyms. In this first part, we describe the history of eponym usage in paediatric hip radiography; who, when, what, where, and how. We hope to provide a historical perspective of interest, resolve any controversies in semantic definitions, and create a comprehensive library of eponymous terms related to paediatric hip radiography.

Psychoanalytic reflections on the conditions of possibility of human destructiveness

This paper explores the psychoanalytic contribution to the understanding of war. It takes as its frame of reference the conditions of possibility in the human subject that form the basis for the detonation of such extremes of destruction. Starting with key papers of Freud that address this malaise of our "civilization" it goes on to consider the contributions from the Kleinian school (particularly Money-Kyrle and Segal). The argument is situated within a frame of reference which views the psychoanalytic contribution as part of what the author terms an interdisciplinary conversation. The paper concludes with some more general considerations regarding the horrors of our contemporary world.

'Strong clinging to objects': materiality and relationality in Melanie Klein's Observations after an Operation (1937)

This article presents and analyses a set of notes written by the psychoanalyst Melanie Klein following an operation in 1937. The notes, entitled Observations after an Operation, act as a case study of the intersection of psychical, material and social relations as they play out in the immediate aftermath of surgical intervention. Using a close reading method, the article contextualises an analysis of Observations after an Operation by linking it to Klein’s wider corpus of theoretical work. It deals in turn with the representation of anxiety mechanisms in the patient experience, drawing upon Klein’s notes on the similarity with ‘anxiety-situations’ in early childhood; with Klein’s changed relation with both external objects and their counterparts in the individual’s mental landscape; with the role of sensation in phantasy, and the connection to bodily pain; with the doctor-patient relationship and the way this is perceived as being embodied in material objects, played out across two dreams experienced by Klein during her recovery; with the emphasis on illness as a form of mourning; and with the creative potential that the experience offers for a renewed structure of object relations. The article concludes that a greater attention to the role and representation of material objects, using psychoanalytic object relations theory as a starting point, can enhance how we collectively understand and assess the psychical impact of healthcare settings upon the patient. It also invites other scholars across the critical medical humanities to consult and analyse the newly available text upon which this article is based.

A discursive study of the reception of Lacanian ideas and their relation to Kleinianism (Uruguay, 1955-1982)

This research addresses the initial reception of Lacanian ideas in Uruguayan psychoanalysis. Lacanian ideas arrived in Uruguay in the 1960s in a context in which Kleinian thought prevailed. This paper studies the relation between Kleinianism and Lacanianism by analyzing discursive phenomena. The corpus used for this study was built from a variety of sources: theoretical-doctrinal papers, clinical cases, media publications, seminars transcripts, and institutional documents. The discursive materials presented here show the different controversies, crossroads, compromises, and demarcations that characterized the reception of Lacanian ideas in a context of Kleinian predominance.

Towards psychoanalytic contribution to linguistic metaphor theory

This paper lays out a formulation of the psychoanalytical contribution to linguistic metaphor theory. The author's main argument is that psychoanalysis can help enrich and shed light on linguistic metaphor theories, since these have focused on the cognitive aspect, to the exclusion of the role played by affect. Based on the tight link between metaphor and symbol - both configurations of figurative language - the author shall apply ideas sourced from some of the key psychoanalytic symbolization theories, focusing in particular on Klein, Winnicott, and Ogden. The course of exploration will serve to trace the unconscious emotional aspects that participate in the metaphor's mechanism, just as they participate in the symbol's workings. The study leads to the main conclusion that the intersubjective transitional space is of substantial importance to metaphor's constitution, particularly in regard to novel metaphors. Expanding the understanding of metaphor's modus operandi has important implications in conceptual clarification and for an in-depth analytical work, and is of immense significance when it comes to analytical work with patients who suffer impairment of their metaphoric ability.

Good and Bad: Love and Intimacy From Plato to Melanie Klein

Melanie Klein's theories on love outline a complex system of relations-an oscillating dynamic of psychical and emotional tendencies following from both actual experience and fantasies produced by the mind. Her insights are often discussed and applied in psychoanalytical contexts, but the philosophical implications of her theory-especially in relation to Platonic thought-have rarely been discussed. In this article, I will attempt to address this gap by setting out some preliminary yet core considerations shared by both Plato and Klein. First, I will describe some structural parallels between Kleinian and Platonic thought, especially in dialectical terms. Second, I will outline Plato's covert influence on Freud as passing through the teachings of philosopher Franz Brentano. And last, I will discuss intimacy as a struggle between the forces of good and bad, creativity and destruction, and love and hate-suggesting that Klein's conception of love emerges as a moral exigency.

Object Relations in a Love Poem. A psychoanalytic reading of Neruda

This paper is about an interpretation of Neruda's "Poem no 15", one of his most important works of poetry. The author reads this poem as about the painful loss of the loved object, and the struggle to accept this. This work emphasizes the complex relation between denial and mourning, specifically between psychotic anxieties and mechanisms, and psychic growth. Object relations, as described by Klein and Bion, are used for this reading of Neruda's poem. The author makes an effort to link this interpretation of the poem to the effect it has on the reader. The paper suggests that the common interpretation of this poem as a passionate declaration of love for a silent muse could itself express a denial that can be understood by the impact that Neruda's poem has, in which the emotional experience conveyed in the poem can be "lived" by the reader.

Winnicott's theory of playing: a reconsideration

"Playing is itself a therapy," argues Winnicott, in one of the most famous phrases in the history of psychoanalysis. Despite its seductiveness, this paper suggests that this powerful proposition should be reconsidered. Winnicott's extraordinary ability to transmit his theory in jargon-free language should not conceal the singularity of his conception of playing. Questioning the triad of play/playing/game may, therefore, be theoretically illuminating and clinically constructive. After examining (1) the stumbling blocks of Winnicott's concept of playing and the negative part implied by its dialectics, this paper will highlight (2) the markers Winnicott offers us to identify the reasons behind some failures he noted, and (3) their consequences on the reception of play activity in the cure. This will lead us to propose a discontinuity between the play activity phenomenologically speaking (what we call "play") and what Winnicott defines as the event of discovering the self through creative experience (what he calls "playing") in order to rethink the question of what is "therapeutic." Our conclusion that "some types of play without playing may also have a therapeutic function" will show the distance travelled in relation to Winnicott's initial proposition.

CLINICAL WINNICOTT: TRAVELING A REVOLUTIONARY ROAD

The author contends that, contrary to the usual perception that Winnicott followed a linear progression "through pediatrics to psychoanalysis," Winnicott's vision was always a psychoanalytic one, even during his early pediatric work. His place in the development of psychoanalytic theory is highlighted, and the author discusses such key Winnicottian concepts as transitional space, the false self, and the use of the object. Winnicott's unique approach to the form and value of analytic interpretation is particularly emphasized, and his thoughts on the treatment of depression are also addressed, as well as his distinction between regression and withdrawal. Included is a summary of convergences and divergences between Winnicott's thinking and that of Bion.

Towards psychoanalytic contribution to linguistic metaphor theory

This paper lays out a formulation of the psychoanalytical contribution to linguistic metaphor theory. The author's main argument is that psychoanalysis can help enrich and shed light on linguistic metaphor theories, since these have focused on the cognitive aspect, to the exclusion of the role played by affect. Based on the tight link between metaphor and symbol - both configurations of figurative language - the author shall apply ideas sourced from some of the key psychoanalytic symbolization theories, focusing in particular on Klein, Winnicott, and Ogden. The course of exploration will serve to trace the unconscious emotional aspects that participate in the metaphor's mechanism, just as they participate in the symbol's workings. The study leads to the main conclusion that the intersubjective transitional space is of substantial importance to metaphor's constitution, particularly in regard to novel metaphors. Expanding the understanding of metaphor's modus operandi has important implications in conceptual clarification and for an in-depth analytical work, and is of immense significance when it comes to analytical work with patients who suffer impairment of their metaphoric ability.

Interpretation as Freud's specific action, and Bion's container-contained

This is a paper showing how a concept central to the work of Wilfred Bion, and one of Klein's important recommendations concerning the practice of analysis with adults and small children, can both be seen in the light of Freud's earliest formulation of the origin of anxiety and the mother's first responses to her infant in distress. In the paper I suggest that these clinically influential concepts of Klein and Bion show an underlying consistency and affinity with Freud's early ideas about the management of anxiety in the mother-infant relationship, described in two of his pre-psychoanalytic writings, How Anxiety Originates (1894b), and The Project for a Scientific Psychology (1950 [1895]). The specific mode of operation of psychoanalytic interpretation is clarified by the comparisons made, with no attempt to suggest that Klein or Bion based their concepts upon these particular early formulations of Freud's.

'Opening remarks at a practical seminary' by James Strachey

This manuscript, dated 1941, is a class on technique taught by James Strachey to first-year candidates at the British Psychoanalytical Society (BPS), located in the Archives of BPS. As the last of three written manuscripts on transference interpretation, it offers an opportunity to trace the development and subtle shift in Strachey's thinking following his 1934 paper (Strachey, 1934, 1937). The lecture is striking in its precise language, and in the complexity of the issues discussed. Through the use of an optical metaphor, the magic lantern, Strachey illustrates transference, what is therapeutic about a transference interpretation and describes projective identification and some aspects of counter-transference without naming them as such. Strachey makes a persuasive case for careful attention being paid to the analytic situation, the "artificially simplified relationship between analyst and patient" with systematic comparison to psychotherapeutic techniques of support and reassurance, which he argues lead to only temporary and limited results. The author argues that Strachey continues to be influenced by Klein's developmental, technical, and object relational theories as was already evident in his 1934 paper.

Conceptualizing splitting: On the different meanings of splitting and their implications for the understanding of the person and the analytic process

While "splitting" is a familiar concept, its meaning is not as self-evident as is commonly assumed. In different contexts, it refers to different phenomena and is supported by different understandings of psychic dynamics. In this paper, the author presents four different conceptualizations of splitting, which capture the essential aspects of contemporary psychoanalytic discourse on the concept. There is a dissociative kind of splitting, which involves splitting off, in the face of trauma, whole personalities, which to some extent remain accessible to consciousness; there is a disavowal kind of splitting that splits off our awareness of disturbing realities or their meanings in our efforts to avoid the inner restraints imposed by repression; and there are two forms of splitting of the object into good and bad-one focusing on the splitting of representations of the object due to ego weakness and environmental determinants, and the other on the splitting of the mind itself in a primarily destructive act aimed at sparing the good from the destructiveness of our death instinct. All four conceptualizations have their origins in Freud's writing and then are further developed in the work of later analysts. The author argues that understanding the nature of these various conceptualizations of splitting can contribute to analytic theory and practice. It also sheds light on the essential nature of analytic approaches and how they offer different perspectives on the unity and disunity of man's basic nature.

The ideal and the real in Klein and Milton: some observations on reading Paradise Lost

Extracts from Paradise Lost (Milton 1674) are presented to illustrate some ideas of mutual interest to poets and psychoanalysts. In particular, Milton portrays the distinction between the human and the divine in terms of God's perfection and omnipotence, in contrast to man's imperfections. Recognition of this difference can open a painful gap between the self and the ideal, leading to attempts to bridge it via omnipotence. Because we imbue our objects with omnipotence, a similar gap can arise between adult and child and between patient and analyst. Klein's description of the ideal good object highlights similar issues. Both Klein and Milton present the ideal as something important to internalize as a foundation for hope, trust, and belief in goodness, and both emphasize the ideal as something that can be aspired to but not omnipotently realized. Facing this distinction requires a capacity to relinquish and mourn the loss of the good object, as well as the loss of the omnipotence that made possession of it possible.

Clinical success, political failure?

ABSTRACT This paper argues that the dominant language used by the domestic violence movement to conceptualize relationship violence inadequately captures the psychological complexities involved in abusive lesbian relationships. As a corrective, a language based on feminist and psychoanalytic concepts is presented. Against the backdrop of this language, the author reflects on the lived experience of lesbian clients who have come to therapy for relationship violence. It is concluded that a language based on the ethos of postmodern feminism and neo-Kleinian concepts and technique more appropriately addresses the complexities involved in abusive lesbian relationships within a therapeutic context than the polemical language of the domestic violence movement.