In each analytic dyad, the analyst and the patient can differ in numerous ways. Even when they belong to similar racial, ethnic, or religious groups, significant differences can exist that sometimes never get talked about. To understand the meaning these dissimilarities have for a patient and how he or she uses them, starting with the most superficial and accessible and moving toward the deepest underpinnings, is one of the tasks of an analysis. In this chapter, I will discuss sadistic transferences expressed toward me by three male patients. These transferences were superficially linked to my ethnicity (a Muslim from Pakistan), their feelings about it, and the difference it created between us. In each analysis, however, the deeper and more personal meanings of this sadism were revealed over time. I will focus both on how my analytic functioning changed and deepened in the aftermath of “9/11”1 (which allowed me to recognise and work with my patients' sadism more helpfully) and how the material patients brought into their analyses with me was profoundly affected and altered by the events of 9/11 and the regional and world events that followed—a sociopolitical reality that became woven into patients' expression of personal conflicts.
The work in clinical practice with patients in long-term analysis can provide a continuous incentive to elaborate some points that arouse interest in further investigation.
As we know, the communication of each patient during the analytic session shows the level of mental development at which this patient is operating at that moment. In some mental organisations, more primitive states prevail, whereas other mental states are more developed. In my view, it is essential that analysts try to identify the level of mental development of their patients in order to get through to them. The understanding of the material offered by the patients is directly related to the levels that the analyst has reached, of his own mental state, through his life experiences, his analytic experiences, analytic work with other patients, and his own personal analysis. However, it is not always possible for the analyst to apprehend what the patient is trying to communicate. As I present in this chapter, there are several factors which make this a difficult understanding.
We must not cease from exploration and the end of all our exploring will be to arrive where we began and to know the place for the first time.
—T. S. Eliot
Early in this book I shared many aspects of effective emotional discipline both for dealing with current challenging situations and for increasing your capacity for meeting future challenges. These included key requirements and decisions for making a commitment to its practice; fundamental characteristics, paradoxes, and limitations involved; and especially the central role of choice for gaining the power to choose how you feel.210
I also described the key steps for creating a comprehensive process for practicing emotional discipline in response to emotionally challenging situations. Such a process is intended to be a central part of learning to more systematically practice emotional discipline in your life and at work. I pointed out that the process can and should be modified to fit your particular life circumstances. Although I described in detail a complete generic version of such a process in Chapter 1, for the sake of convenience, the process is summarized again in the box on the next page.
Part 1. 1919: Freud's position in regard to both his personal circumstances and psychoanalysis
Part 2. A section-by-section commentary on Freud's original contribution
Part 3. A clinical vignette as the basis for a discussion of masochism and its clinical manifestations
Part 4. The increasingly disquieting real-world situation in which the scenario is analogous to the fantasy of the child being beaten—that of the battered child who is ill-treated most often by the father, but occasionally by the mother
Part 5. The fantasy structure and the reality structure; similarities and differences
FREUD AND PSYCHOANALYSIS IN 1919
In 1919 Freud was sixty-three years old. World War I had ended the year before, and 1919 began with the Versailles peace conference. The Allies imposed severe terms on Germany and Austria. The end of the war did not signal the end of the belief in violence as a quick solution to Europe's political, social, and economic problems. Vienna was experiencing the repercussions of social change, an upsurge of nationalism, the uprooting of large sections of the population, and increasing disappointment and resentment at the Treaty of Versailles and the economic and financial crisis. It was a time of great political turbulence, which would eventually culminate in the harsh European dictatorships of the 1930s (Kinder and Hilgemann, 1973).