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Doing Things Differently

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Doing Things Differently celebrates the work of Donald Meltzer, who was such a lively force in the training of child psychotherapists at the Tavistock Clinic for many years. The book represents the harvest of Meltzer's thinking and teaching, and covers such topics as dimensionality in primitive states of mind, dreaming, supervision, and the claustrum.

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1 - Doing things Differently: An Appreciation of Donald Meltzer's Contribution

ePub

Margaret Rustin

The title of this chapter is intended to draw attention to aspects of Donald Meltzer's ways of working which characterized his practice as a psychoanalyst and which, I think, are important in appreciating his originality. Of course, such observations arise from one's own particular perspective and may not be in accord with the recollections or understanding of others, and it is obvious that doing things differently—which I am interpreting, in part, as Meltzer's characteristic commitment to doing things in his own way—means that there will be conflicting views about whether such differences have a good outcome. This chapter is not going to address the institutional conflicts that were part of the historical picture—in fact, I am sure that I am quite ignorant of much of this history. Instead, I hope to describe things that I have observed both in the years of some personal contact with Meltzer and in reading his books and papers over time, things that have struck me as enlightening and interesting, or sometimes maddening and frustrating features of his work, and which arise from his personal style as a writer and analyst. Perhaps, also, I am going to be doing something rather different from other writers who address his ideas, since their focus is more usually on his clinical contributions.

 

2 - The Relevance of Donald Meltzer's Concept of Nipple-Penis Confusion to Selective Mutism and the Capacity to Produce Language

ePub

Maria Rhode

My aim in this chapter is to explore the bearing of Donald Meltzer's concept of nipple-penis confusion, firstly on selective mutism, and secondly on the articulation of words. I suggest that this concept has great explanatory power, as it seems to be capable of subsuming phenomena that Meltzer (1986a) described in connection with the Theatre of the Mouth as well as the traumatic experiences that can be implicated in selective mutism. It also provides a framework for linking these two areas to the child's character.

I begin by outlining the concept of nipple-penis confusion and then refer to Meltzer's proposed conditions for language development, supplementing this by discussing the child's ability to take psychological ownership of the organs of the mouth. This is necessary for the production of speech and is a process that Frances Tustin's work on autistic children's experience of the mouth allows us to understand to some extent. I shall distinguish different ways in which the paternal part-object can be implicated in traumatic experiences, as these often seem to be the trigger for selective mutism, and contrast various identifications that seem to influence how children may respond to such experiences. I shall also suggest that it may be useful to extend some of Meltzer's formulations on the motives in play in nipple-penis confusion by considering its manifestations on these more primitive levels of trauma and adhesive identification.

 

3 - Point–Line–Surface–Space: on Donald Meltzer's Concept of one- and two-dimensional Mental Functioning in Autistic States

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Suzanne Maiello

“In the early days, there was great pleasure in doing what my teachers taught me to do and finding out that they were right…. But then…there comes a time when you cast off from the pier and into the open sea and are on your own…”

Donald Meltzer, “A Review of My Writings” (2000)

Dimensionality and the human mind: Edwin A. Abbott and Donald Meltzer

Towards the end of the nineteenth century, Edwin A. Abbott published a satirical narrative with the title Flatland—A Romance of Many Dimensions (1884). This modest little book did not achieve great success at the time. It was discovered almost forty years later after Einstein's formulation of the theory of relativity and the introduction of the concept of time as the fourth dimension of three-dimensional space. The story is about a two-dimensional world referred to as Flatland. Its inhabitants are geometric shapes. The main character is a square. He receives the visit of a sphere who takes him to three-dimensional Spaceland. The revelations of Spaceland open the Flatlander's mind to new and unexplored lands. His research is oriented both forwards towards increasing dimensions, and backwards to Lineland and Pointland.

 

4 - Autism reconsidered

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Suzanne Maiello

At the age of 8 years, Donald Meltzer accompanied his parents on a trip to Europe. The young boy was deeply impressed by the beauty of historical buildings on the old continent and wanted to become an architect. Later, as a psychoanalytic thinker, Meltzer continued to use his gift for spatial design by conceptualizing and interpreting psychic phenomena at the meta-psychological level in terms of dimensionality. Following on from Klein's notion of an internal world inhabited by internal objects and, later, Bion's concept of container/contained, the scene was set for the emergence, in 1967 (well before Explorations in Autism) of Meltzer's spatial notions of the geography of the mind, of geographical and zonal confusions, and, later, of the compartments of the internal object and the claustrum.

In Explorations in Autism, the idea of dimensionality of mental functioning became the central notion from which Meltzer's theoretical formulations were to spring and expand. He introduced the chapter on “Dimensionality as a Parameter of Mental Functioning” by stating:

 

5 - Dimensionality, Identity, and Security: Finding a Home through Psychoanalysis

ePub

Louise Allnutt

“Adoption is outside. You act out what it feels like to be the one who doesn't belong. And you act it out by trying to do to others what has been done to you. It is impossible to believe that anyone loves you for yourself.”

Jeanette Winterson, Why Be Happy When You Could Be Normal? (2011)

Being at home

Dimensionality, identity, and security are concepts that I would like to draw together and house descriptively as the experience of “being at home”. In my view, one needs to have developed a clear sense of the dimensions of space and your own place in it alongside a strong and secure-enough relationship to oneself and others to have the opportunity to feel at home, either in terms of “joining the human family”, as Maria Rhode has described it (2008), or in terms of being capable of making transitions and crossing thresholds into different spaces without a sense of losing one's own coherence. My experience of working with one particular patient has highlighted these issues at both a developmental and emotional level, but the absence or presence of “at-home-ness” is something that I find lies at the heart of many clinical relationships, sometimes in relation to oneself, sometimes in relating to others, at times due to concrete displacement and at other times through difficulties related to misrecognition and misperception. My clinical experience with a 2-year-old boy, who came for intensive psychotherapy for three years, brought the experience of being “outside” and the developmental problems of “homelessness” sharply into focus. It is some of this clinical material alongside the theoretical ideas that one can draw from Donald Meltzer, among others, that I would like to discuss here as an example of some of the processes one might traverse in finding a home through psychoanalysis.

 

6 - The Isolated Adolescent

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Carlos Tabbia

At all ages, involuntary and persistent isolation is a matter for concern. At the end of infancy, it may be worrying, but the isolation that appears in adolescence is frequently a symptom of emotional disturbance and can feel deeply alarming for the family. This conflicting developmental period can be better understood psychoanalytically but remains a common topic in the media, which often focus particularly on the influence of electronic games in causing adolescent isolation.

After infancy and latency, puberty emerges with a vigour that can surprise the young person, the family, and his or her friends. Particularly unsettling is the imbalance created by the unintegrated movement of the personality, prone to splitting while sustained by obsessional defences. Puberty also seems to destabilize the physical “centre of gravity”. This is reminiscent of the physical experience that takes place with ice skaters. The Olympic ice skater Yulia Lipnitskaia won a gold medal when she was 15 years old, at the Olympic Games in Sochi, Russia, in 2014. One year later, she had to modify her skating technique because her bodily changes had shifted the centre of gravity she had established over many years of training. While her coaches refer to her physical loss of equilibrium, we might also imagine a loss of emotional balance in the face of the changing states of internal objects.

 

7 - Supervision as a Space for the Co-Creation of Imaginative Conjectures

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Clara Nemas

“So these are my ideas on supervision. You can see [it] is not like a master class in music. It is more of a participation—more like playing in the orchestra; just contributing…”

Donald Meltzer, “On the Nature of Supervision”
(in Oelsner & Oelsner, 2005)

Contact with the work and the person of Donald Meltzer has produced in all who met him not only a strong conviction in the value of the psychoanalytic method and a most vivid approach to our clinical work with children, adolescents, and adults, but also changes to our view of the world, of life, and of the human being. All this made of each contact with Meltzer an emotional learning experience: a K-link, to use Bion's term. But it was in his supervisions—“eye openers”, as Francis Tustin once called them—that one could feel the passion, the capacity for observation, and the “real proof of his experience” and creativity full at work. I must say that none of this would have been possible without the generosity of Benito López, our teacher for so many years, who first introduced us, in Buenos Aires, to the work of Meltzer and, later, to his dear friend, the man himself in person.

 

8 - Keeping Tension Close to the Limit: From Latency Towards Development

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Monica Vorchheimer

“The dream that invents me has its eyes wide open And I close my eyes to look at the world.”

Claude Roy, quoted by Pontalis (2011, p. 16)

A memory

It was during Donald Meltzer's last visit to Buenos Aires that I had the privilege of being supervised by him on a very complicated clinical case that I was treating at that time. A young homosexual woman had been coming for treatment and had developed a very open and intense transference love: “A very complicated woman; very sensual, very erotic, and very homosexual. What is going to happen with her rude demand of and erotic and sensual gratification towards her analyst? We will see. But she seems armed to the teeth against parental care from her analyst.” In this way Meltzer opened his comment and shared with us his usual very interesting ideas; but there was one in particular that I kept in mind, echoing down time. He said: “This could be thought of as resistance, but it is not. I guess that she has opened the door to her pornographic concern and to her masochism and she wants you to feel guilty for having profited from the opened door which allowed you to investigate what has been revealed…. Everything is opened here, there is no resistance.” And later he added, “All the material is now present for Monica to explore as slowly or as fast as she would wish…”.

 

9 - Donald Meltzer's Supervision of Psychotherapy with a Psychotic Child

ePub

Jeanne Magagna

The structure of time is inextricably linked with the concept of hope. In the beginning of a baby's life there is hope, hope for a communion with the mother and father as loving, protective, caring figures. Alongside this hope is a preconception that the breast will meet the baby's requirements to be nourished. As the baby grows and matures, holding on to this hope is both difficult and dangerous; hope can be filled with too much greed to possess all of a mother's and father's life. Hope can involve a constitutional incapacity to tolerate the frustration of waiting for mother's reappearance, filled with rage at mother for not being attuned to the baby's rhythm of communicating needs. Hope is then submerged beneath rage and disappointment with mother. Hope, which promised a future of contentment, then becomes despair. Without hope, there is no sense of the future, just the disappointing present or the yearning for a moment in the past that was experienced as good.

 

10 - The Second Life of Dreaming

ePub

Jeffrey L. Eaton

“[W]hat of the fruitful harvest of those dreams which succeed in grasping the nettle of mental pain, resolving a conflict, relinquishing an untenable position? We will surely wish our hypothesis about dream-life to shed some light on this question of growth.”

Donald Meltzer, Dream-Life (1983)

For Donald Meltzer, dreaming is at the centre of the psychoanalytic experience. He links the exploration of dreams with the efficacy of the psychoanalytic process. Exploring dream-life helps to glimpse the way dreaming contributes to what Meltzer calls “the question of growth”. Here, I offer some personal reflections, inspired by Meltzer, on the fruitful harvest of dreams and dreaming.

The second life of dreaming

What is the fate of the dream, the thing-in-itself, upon waking? The situation is simple: the dream has vanished. In fact, we never remember our dreams. Upon waking, we can collect only bits of evidence that the dream was recently alive and wandering inside us. The fragments and details, the emotions, and the unpredictable residue that lingers from the inventiveness of our dream-life are like the skeletal traces of a fabulous lost beast. The dream itself can never be recovered, relived, or represented in any complete way.

 

11 - On Having Ideas: The Aesthetic Object and O

ePub

Meg Harris Williams

“The new idea presents itself as an emotional experience of the world and the beauty of its wondrous organisation.”

Donald Meltzer (in Meltzer & Harris Williams, 1988, p. 20)

I should like to talk about what we mean by “having ideas”, using, as reference points, Donald Meltzer and three of the Kleinian thinkers who had an influential bearing on his own ideas—Wilfred Bion, Adrian Stokes, and Roger Money-Kyrle—to sketch a composite picture of their idea of how we have ideas. This is equivalent to asking how we learn from our internal objects without being overawed or inhibited by them. These objects are those advanced aspects of the mind that are formed progressively from a complex mixture of external influences, intimate relationships, and innate internal qualities.

Psychoanalysis, Meltzer said, works through holding “conversations between internal objects” (see Williams, 2003, p. 219)—those of analyst and analysand working together to form a symbol for the idea of the current emotional experience. As the definition of mental health shifted to one of self-knowledge, the goal of psychoanalysis changed from one of cure to one of facilitating the formation of ideas, through the creation of symbols. This endeavour is not unique to psychoanalysis: it runs through all artistic disciplines, as it does through life. Meltzer, especially in his later talks and writing, tried to convey the “simplicity” of this process, by which he meant its complexity. But the message itself is a simple one. To quote Martha Harris:

 

12 - Degrees of Entrapment: Living and Dying in the Claustrum

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Pamela B. Sorensen

In his evocative and difficult book, The Claustrum (1992a), Donald Meltzer offers an investigation and description of claustrophobic phenomena. I suggest that these phenomena might be viewed on a continuum from relatively ordinary, with potential to yield to the developmental momentum of object relations both internal and external, to so severely disturbed that the life of the mind hardens into a death of the soul. To illustrate this continuum, I use two films: Coraline, directed by Henry Selick (2009) and based on the 2002 novella by Neil Gaiman, and The Talented Mr. Ripley, directed by Anthony Minghella (1999) and based on the 1955 novel by Patricia Highsmith. These films characterize the predicament at either end of the continuum; they show how escape from the non-life of the claustrum is made possible at the more benign end and how the possibility of exit is foreclosed in the most extreme form of pathology. Studying the films through a psychoanalytic lens brings into focus the critical factor in determining the degree of entrapment suffered by the self caught in a claustrophobic world, devoid of emotional intimacy and filled with dread.

 

13 - Trapped in a Claustrum World: The Proleptic Imagination and James Joyce's Ulysses

ePub

Mary Fisher-Adams

“Oh Jamesy let me up out of this pooh.”

“Molly”: James Joyce, Ulysses (1922b)

In this chapter I look at Ulysses as a description of a claustrum world and how fear and dread can produce, in the so-called “replacement child”, a proleptic imagination that keeps the claustrum dweller imprisoned and paralysed. A link is made with Shakespeare, who is a presence throughout Ulysses and was himself a replacement child.

I had been struck by similarities between two of my patients and James Joyce. They had all lost siblings in early childhood and seem to have felt emotionally cut adrift by the mother's grief at her loss—a feeling marginalized that had extended into adulthood. They all showed particular sensitivity as children and were possessed of a highly active imagination and exceptional literary creativity. Above all, they seemed tormented by fear in the extreme. My two patients came into analysis in their forties still plagued by nightmares of lions, monsters, and dead babies. Most strikingly, both expressed the fear that they had murdered someone and that they remain lethal and shouldn't be allowed out into the world. James Joyce also suffered great fears and nightmares. He spoke of “that skull” that came to torment him at night (Ellmann, 1982, p. 178). He was highly superstitious, had crippling phobias causing fainting fits—afraid of dogs, rats, and water, for example—and lived in fear of thunder and lightning.1

 

14 - A mind of one's Own: Therapy with a Patient Contending with Excessive Intrusive Identification and Claustrum Phenomena

ePub

Tara Harrison

This chapter chronicles the first years of therapy with a patient contending with both external and internal intrusive forces, leaving her struggling to form an authentic, thinking mind. I show how Meltzer's concepts of intrusive identification and claustrum phenomena have provided a crucial framework to help understand this patient's internal system.

Donald Meltzer initially used the term “massive projective identification” (1966, p. 17) to describe the excessive use of projective identification as conceptualized by Melanie Klein. He shifted to a qualitative view with the term “intrusive identification”—that is, an omnipotent phantasy of forceful intrusion into an external or, crucially, an internal object in order to control it, and eliminate its “otherness” (Meltzer, 1986b, p. 69, quoted in Fisher, 1999, p. 233). The aggressive quality of the projections has a significant impact on the internal containing function:

…the violent nature of intrusive identification destroys the container, the place for maternal alpha function. The container is now transformed into a claustrum, a rigid prison brought about by the intrusive process either of active penetration or of being sucked in. [Gosso, 2004, p. 21]

 

15 - Battered Women Lose their Minds

ePub

Cecilia Muñoz Vila & Nubia Torres Calderón

The material presented here comes from a three-year research project conducted by the Psychology Faculty of Javeriana University, Colombia, which took place in a shelter for battered women and their children, in Bogota. The authors of this chapter were supervisors of the project and thesis directors and were responsible for a research group of five students. The dissertations included the presentation of three individual psychotherapeutic process recordings, which were supervised and analysed using the meditative review method described by Bion (1963, pp. 99–100).

In total, we observed 40 women whose abusive relationships since childhood and currently with their spouses were described in detail in these protocols. As the stories of these battered women were reviewed, the research team had the impression that they were entering a territory of human misery and dehumanization that was common ground for these women, their aggressors, and their families, as well as for the neighbourhood they lived in. An atmosphere of despair and rage could be sensed by the research group, as if the psychic weave of the chronicles permeated the way they listened to the distressing stories born out of the presentations. The same thing happened when we reviewed the material for a second time, long after the original discussion.

 

Concluding thoughts on the Nature of Psychoanalytic Activity

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Alberto Hahn

The content of our conference, as reflected in this book, bore witness to Donald Meltzer's enduring relevance, his inspiring ideas, and his attitude of profound respect for patients’ relation to their internal and external world—in particular to the infantile parts of the self. During the conference, we heard repeated mention of Meltzer's legacy as a teacher and a thinker. The breadth of papers showed how important this influence remains, both in our clinical work and in our motivation to explore further the potential and the boundaries of his psychoanalytic insights.

It is in this spirit that I want to address myself briefly to some issues that have found their way into my own clinical work, the supervision of colleagues, and the process of teaching Meltzer's life's work, for over four decades. Meltzer wrote widely about the nature of the psychoanalytic processes he was observing, their theoretical connotations, and their clinical and technical implications, and I think that the foundations laid down in The Psychoanalytical Process (1967) 50 years ago remain a beacon that throws a shaft of light on the worlds of the two parties involved in every analytic process we engage in. This view, which argues that our internal world determines our outlook and creates the possibility of deploying our observational and analytic function on the process, seems to remain a permanent fundamental source of interest and scrutiny. Consequently, I could not conceive of the feasibility of developing an analytic relationship without an in-depth knowledge of the unconscious variables that shape our character and, in particular, our countertransference. This knowledge, which is part of what Meltzer liked to call our “equipment”, seems to highlight questions about the nature of observation and the procedure that takes us ultimately to an understanding of unconscious communications.

 

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