Tragic Knots in Psychoanalysis: New Papers on Psychoanalysis

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This is a collection of published and unpublished papers on clinical, theoretical and applied aspects of psychoanalysis that take up various aspects of unconscious mental processes and conflicts and their expression in the clinical transference and countertransference. These expressions are evidenced in frustration, gratitude and benevolence, competing feelings of being cared for and coerced, disturbed and expanded bodily pleasure, cruelty and forgiveness. Included in this book is a brief history of the author's odyssey through several major contributions regarding the language of psychoanalysis and its narrativity, and the convergence of these with contemporary Kleinian modes of thought.

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CHAPTER ONE: Tragic knots and reality: The reality principle, tragic knots, and the analytic process

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The concept tragic knots emerged within the long history of critical thought about the dramatic genre tragedy, the Weltanschauung known as the tragic sense of life, and the diffuse rubric derived from them- the tragic. To bring tragic knots into line with clinical psychoanalytic thought, I will modify the conception of tragic knots put forth by Scheler (1954), to be mentioned shortly.

Definition: Consciously or unconsciously, a person must confront a recognizably fateful situation that is insufficiently under his or her control. In this situation, that person must choose a course of action while knowing or sensing that the anticipated benefits of each choice will be compromised by painful consequences. However great its potential advantages, achievements, and gratifications, each course of action will involve suffering, impairment, or loss for the self, of the self, or in the lives of loved others. Adding to the gravity of the situation is the person's realizing that many consequences cannot be anticipated. The action chosen may be taken through physical behavior, in speaking out, or silently, as in adopting a consequential emotional position relative to unfolding events. And there is no wayaround acting; even remaining inactive is making a consequential choice. I will regard this kind of situation and action as tragically knotted.

 

CHAPTER TWO: The unconscious: Talking to the unconscious

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Much of our understanding of the clinical analytic process and its effects is derived from continuous study of the verbal and nonverbal dialogue between analyst and ana-lysand. This dialogue takes many forms and it undergoes many changes. A large part of the dialogue is carried on silently and is never fully or accurately communicated. This essay is rooted in the clinical tradition of developing deeper understanding of the clinical dialogue and its effects.

Specifically, I will be taking on two closely related tasks. First is the task of discussing some major manifestations of the modes of unconscious thought within the analytic process. I refer here to the modes that Freud postulated in his paper, “The Unconscious” (1915d). Freud's method of making intelligible what would otherwise remain unintelligible depended on these postulates. With respect to each of the modes I have selected to take up, I will offer some thoughts on what it implies about formulating clinical interpretations. My second task is to revisit some clinically significant vicissitudes of interpretation within the clinical dialogue. For example, as we listen to analysands we anticipate that they will weave our interpretations and other interventions into their unconscious transference fantasies and that, defensively, they will contrive to transform interpretations in ways that vitiate their analytic effectiveness. Equally significant, we assume that countertransferences may contribute to these transformations, and that there are times when the very act of intervening disrupts analytic continuity by switching the ongoing analytic dialogue onto a different and untimely track.

 

CHAPTER THREE: Conflict: Conflict: conceptualization, practice, problems

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Conflict is so well established in ordinary language that it may be said to have been naturalized, that is, to have come to seem a given aspect of the world, a hard fact of reality, one that is encountered or discovered in others and within oneself. Once naturalized, conflict is no longer considered merely one common and succinct way of referring to a certain kind of more or less stressful subjective experience. However, there are other ways to refer to the components of this subjective experience: for example. pursuing irreconcilable aims; being required to make a difficult choice; confused by having set mutually exclusive goals for oneself; and having a difficult time in coming to a decision or in embarking on a course of action without regrets or misgivings.

In ordinary language as well, we tend to refer to conflict's constituents as independently active entities. In this vein, we speak of being beset by conflict, of being torn apart by conflict, weighed down by it, or bogged down in it; we also speak of one wish or ideal contending with another or clashing with it. These figurative locutions add variety, color, and intensity to the clinical dialogue, perhaps most of all by touching on concretely conceived unconscious fantasies.However, we also pay a price for using these locutions, in that by doing so, we implicitly disclaim agency, both the analysand's and our own. We imply that it is no longer persons who do the wishing or who narrate subjective experiences as torn, burdened, and so on; instead, it is as though these subjects are dealing with animated material entities or spaces in their minds, hearts, spirits, guts, spines, and so on. We are thereby referring to all those actions that we feel to be urgent, desirable, dangerous, and so forth as autonomous agents within the self, each propelling us in one direction or another. We are not presenting ourselves as human beings performing actions: wishing for this and that, setting and maintaining certain goals, striving to meet treasured ideals, and choosing courses of action. Thus, these figurative locutions introduce anthropomorphism into psychoanalytic discourse.

 

CHAPTER FOUR: Concern and control: Caring and coercive aspects of the psychoanalytic situation

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The terms coercion and concerned care are so general that they are open to widely different applications; I will be detailing my use of them as I go along. My dwelling particularly on coercion should be understood not as a warning or proscription, but rather as an effort to bring balance and add depth to our understanding of analysands’ multiple modes of experiencing the analytic setup and process. Analysts have not yet adequately emphasized, or even much considered, how these modes can induce in the patient feelings of being coerced and, in the analyst, feelings of being coercive. To begin with, it is not useful to think of coercion and care as single variables or as opposing, dichotomous factors. We analysts are constantly working in complex and fluid contexts that can be deconstructed. Contextual analysis defies dichotomous thinking. In dealing with care and coercion, as with all other significant analytic variables, we are obliged to go on and on analyzing interlocking, multifaceted transferences and countertransferences, all of them expressed or hinted at in fantasies and enactments, some of them typical and expectable and some surprising.The discussions that lie ahead in this essay are these: first, some consideration of concerned care; then, examination of four regular and essential features of analytic work around which coercive experiences and enactments tend to gather. These features are interpretation, the analyst's working in a responsible manner, free association, and collaboration with the analyst. A fifth feature is not ordinarily included in lists of recommended analytic interventions, though not infrequently it makes an appearance in our work, usually inadvertently and subtly, but nonetheless with coercive effect. That feature is reassurance. Manifestly an expression of concerned care, reassurance has a coercive potential through which it may have a paradoxical effect: providing both relief or comfort while adding to the emotional distance between analysand and analyst.

 

CHAPTER FIVE: A pervasive negative countertransference: The countertransference of feeling frustrated

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Who among us analysts has never experienced a feeling of frustration while engaged in clinical work? And who has not sometimes found frustration creeping into our interventions by way of a sharper tone of voice, repeating and explaining interpretations insistently or piling on a series of interpretations in a determined effort to elicit some agreement or a change of attitude or behavior? Or maybe withdrawn into sullen or despairing silence? And then, sometimes regrettably later rather than sooner, discovered that the frustrated response had either become a fresh source of negative therapeutic responses or had been playing into and perpetuating enactments crafted by the patient?

I often find, when reading case reports in the analytic literature and listening to them at meetings or in workshops and supervision sessions, that analysts mention their frustrated feelings. Some of them then go on to comment on this experience as an informative response, one that helps clarify the patient's presumed intractability and the unyielding dread of change that lies behind it. Sometimes these reports mention a patient's wish to provoke a sadomasochistic enactment, what Rudolph Loewenstein (1957) brilliantly referred toas a successful seduction of the aggressor. However, relatively few of these analysts go still further by trying to analyze what they have contributed to their frustrated feeling. Least of all are they likely to examine the roots of their vulnerability to feeling frustrated and acting on it. Instead, what seems to be being communicated between the lines of these one-sided clinical reports are such assertions as these: “Who wouldn't be frustrated?!” or “On my part, I was helpfully intending to gain insight, convey it, or protect it from the patient's dismissal or distortion, as well as to maintain an analytic frame for my efforts, but I just couldn't get through to the patient.” Implied assertions like these justify keeping the analytic focus solely on the patient, and they cut off further analytic inquiry into the analytic moment. They foreclose on the possibility of an adequate inquiry, one that would take into account the analyst's vulnerability and help her or him maintain a more consistent analytic attitude.

 

CHAPTER SIX: Conflictual pleasures: Taking/including pleasure in the experienced self

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In what follows, the experienced self will be conceptualized as a narrative: a tale a person tells both explicitly and, by metaphor and gesture, tacitly; a construction that circumscribes certain versions of that person's characteristics, possessions, relationships, and surroundings (Schafer, 1992). The personal characteristics emphasized vary from person to person; they might take in family and other social affiliations; bodily features and processes; talents, skills, and accomplishments; autobiographical summaries; present personality characteristics; and aspirations for the future. The accounts that constitute the experienced self can be revised; they often are, though some tend to stick fast. Throughout, it is presupposed that these features can be described, discussed, reflected on, and revised only when presented in one or another version or narrative construction.

A person taking pleasure in exercising and reflecting on his or her functional repertoire usually feels-for that moment at least- proud, excited, and self-respectful. However, to a degree and with a frequency that varies from one person to the next, even anticipating these pleasures or certain ones of them, or functioning in a way thatmight give rise to them, can occasion painful anxiety, shame, and guilt. These consequences can then be denied, disowned, projected, turned into their opposites, or defensively revised, as when the self is made out to be undeserving of pleasure and, in extreme cases, to feel secure only when experiencing deprivation and punishment and engaged in self-derogation.

 

CHAPTER SEVEN: Giving and receiving: Gratitude and benevolence

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Gratitude has been tightly linked to envy ever since Melanie Klein published her groundbreaking Envy and Gratitude (1957). Envy is the potentially pathological response to goodness and the good object; as such, it is a prime disruptive influence on personal development and, in its large sense, adaptation. Consequently, followers of Klein have concentrated their theoretical and technical interests on envy. So much is this so that gratitude has been shifted somewhat into the shadows. One might even infer from the relative paucity of writing on gratitude that analysts have tended to take the concept for granted. In their texts, they usually refer to gratitude as a natural, unitary, self-evident response to goodness or generosity.

In Kleinian thought, the prototype of infantile gratification is a good feed at the breast followed by a primal response of gratitude, typically in the form of gestures of reciprocal generosity. For the most part, however, writers on this topic give the erroneous impression that, during analytic sessions, these benevolent responses are so readily blocked or undermined by destructive envy that they promptly disappear from view, leaving the analyst with little to say about them. Indeed, the claims of envy have been consideredso influential that when other disturbed and disturbing experiences invade relationships with good objects, analysts tend to situate them in envious contexts. I refer here to such negatives as disappointment, destructiveness, contempt, ferocious rivalry, and so on.

 

CHAPTER EIGHT: Cruelty and forgiveness: Cordelia, Lear, and forgiveness

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Painful human interactions are often followed by urges to forgive, be forgiving, or seek forgiveness. The insight analy-sands develop into their transferences highlights their finding gratification in constantly reenacting painful interactions. Their new understanding can make forgiveness seem irrelevant; waiving the question of forgiveness might then seem the wiser course to follow. Also thrown into question is whether total forgiveness of self and others can ever be achieved. Shakespeare's The Tragedy of King Lear raises these questions. There we encounter, first, the painful interaction of Cordelia and Lear and, finally, Cordelia's response, “No cause, no cause,” to a dying Lear's begging her forgiveness for having initially treated her cruelly. Cordelia's response seems to be waiving the question of guilt and forgiveness, but could it be wholehearted? In a search for answers, a reading of Cordelia's and Lear's lines is interwoven with interpretations of unconscious conflict that might be considered were one to encounter clinically a “Cordelia” abused by an aging and failing father at a turning point in her womanly development. Unconsciously, it is concluded, unforgivingness persists alongside the loving, insightful waiving of forgiveness madepossible by higher-level ego functioning. Methodological reflections on reading and interpretation are included.

 

CHAPTER NINE: The analyst: On “The metapsychology of the analyst”

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In this essay of 1942, Robert Fliess takes an early, historically significant step toward defining the part played in the psychoanalytic process by the analyst's personality. In his key move, Fliess deconstructs the concept empathy: he proposes that the ego enters into the analysand's subjective experience through trial identification, achieved and processed in a series of steps, and that this identification is effected by the analyst's work ego. That transformed ego is the product of modified ego-superego relations that involve the superego's transfer to the ego of the cathexes reserved for critical self-evaluation; this transfer allows the ego to develop and regulate trial identifications with analysands’ passions and conflicts.

The superego's collaboration with the ego is its permissive response to the ego's having set aside its other narcissistically cathected interests so that it can fulfill its professional and scientific responsibilities. Fliess assiduously situates and articulates his main concepts within the three established metapsychological perspectives: the dynamic, the structural, and the psychoeconomic.

 

CHAPTER TEN: The Author’s Odyssey: You can get here from there

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This paper is a review of my development from psychology intern and research assistant to the psychoanalytic tester and theoretician David Rapaport at the Menninger Clinic in the 1940s, through my career in psychological testing, my psychoanalytic training in the Western New England Institute, and my working successively at the Austen Riggs Center, Yale Department of Psychiatry, Yale Student Mental Health Center, Cornell Department of Psychiatry, and eventually private practice in New York City. During this period, I rose to the academic rank of Professor and the analytic position of Training Analyst. I have written extensively: first on testing, then more or less in turn on psychoanalytic ego psychology, an action language for psychoanalysis, feminist issues, narrative in psychoanalysis, and the contemporary Kleinians of London. This memoir traces the intellectual continuity that characterizes these writings and my continuing development as a psycho analyst-my first ambition and great love.

 

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