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But at the Same Time and on Another Level: Psychoanalytic Theory and Technique in the Kleinian/Bionian Mode

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'This work is organized as a primer and handbook, a "beginning", to elucidate general principles on how the psychoanalyst or psychoanalytically informed psychotherapist may optimally provide and maintain the setting for the psychoanalysis, listen to and process the analysand's or patient's free associations, and ultimately intervene with interpretations - principally from the Kleinian/Bionian perspective, including the contemporary London post-Kleinians and today's Kleinians and Bionians elsewhere. This present work seeks to follow in that tradition in respecting the foundational work of Klein's original contributions and demonstrating how they naturally emerge into contemporary (post-)Kleinian and "Bionian" thinking.' - From the Introduction

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Bridges to other schools and to psychotherapy

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The evolution of psychoanalytic technique

Freud's (1896d) first theory of psychoanalysis was a reality-oriented one that was characterized by the notion that neurotic symptoms were caused by buried traumatic sexual memories. His second theory emphasized the effects of inherent infantile psycho-sexuality, resultant unconscious phantasies, and the organizing importance of the Oedipus complex. However, the pivotal change in the second theory was that of psychic determinism: that is, the psychic ownership of agency (Freud, 1950 [1887-1902], 1905d). The third theory of psychoanalysis was that of ego psychology (A. Freud, 1936; Hartmann, 1939). Klein's concepts of psychoanalysis, however, despite the bitter criticism she suffered at the hands of contemporaneous Freudians-that is, that she was a heretic-were very closely related to Freud's orthodox analytic principles-and arguably a faithful continuation of them, even with their retrospective extensions into the early oral stage. It is an extraordinary irony that Klein's work was-and continues, in my opinion, to be-the most authentic continuation of orthodox Freudian thinking, now at a time when many of those orthodox principles have been all but discarded by Freud's direct, legitimate successors. David Rapaport (1959) once stated: “Melanie Klein's psychology is not an ego psychology but an id mythology” (p. 11). Although he meant this to be a dismissive and sarcastic criticism, he had no idea how right he really was and what high praise he was bestowing on Klein. It took a long time for classical Freudians to appreciate the critical importance of the Kleinian emphasis on unconscious phantasy.

 

Psychoanalysis and psychotherapy

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In this chapter I discuss (a) the differentiation between “psychoanalysis” and “psychotherapy”, (b) the differentiation between “psychoanalytic psychotherapy” and “psychoanalytically informed psychotherapy”, (c) the need for the analyst to be able to function both as a psychoanalyst and as a psychotherapist during an analysis, as well as (d) the need for the psychotherapist to function both as a psychotherapist and as a “psychoanalyst” during psychotherapy.

Differentiation between psychoanalysis and psychotherapy

There have been many attempts in the past to differentiate psychoanalysis from psychotherapy. The most commonly mentioned differentiating factors are the frequency of sessions and the intensity and clarity of transferential involvement. These criteria are based on the assumption-undoubtedly a valid one-that the greater the frequency of sessions, the greater the possibility of therapeutic regression (in the service of the ego) and, along with it, the more extensive the access to the analysand's unconscious. One must remember that in the earlier days of psychoanalytic practice, when “orthodox id analysis” was in its hegemony, the analyst was enjoined, first of all, to be silent and allow the analysand's associations to flow, and then only to interpret negative transference when it had become a resistance to the flow of associations (Fenichel, 1941). Furthermore, Freud (1917 [1916-17]) had stated that psychoanalysis could not treat a psychoneurosis per se, only a transference neurosis. Consequently, the analyst had to forbear treating conscious problems or issues that the analysand brought in the manifest content of their associations and await the gradual development of the transference neurosis. Meanwhile, as the field of psychotherapy evolved, the therapist dealt not only with the patient's symptoms but also with his current “issues”, both on a more direct basis and on the level of the patient's conscious and preconscious awareness.

 

The evolution of Kleinian through “post-Kleinian” to “Bionian” technique

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An important issue that needs to be addressed is the evolution of Kleinian thinking over the years. We must remember that Klein had been analysed by Sándor Ferenczi and Karl Abraham and trained in the “orthodox”-not yet “classical”-Freudian tradition, that of id analysis as well as child analysis, and her own unique contributions were extensions of or even reactions to the tenets of that Zeitgeist, those of logical positivism and psychic determinism. It is probable, in my opinion, that if Abraham had lived longer, Klein would have been recognized as his foremost representative. It was he, after all, who added unconscious object relations phantasies to Freud's autoerotic phases of infantile development (Abraham, 1924). Whereas Freud's conception of drives was that they were primarily peremptory and seeking discharge, Klein, following Abraham and like Fairbairn, began early on to believe that drives were inseparable from the object to which they were dedicated. When one reads her Narrative of A Child Analysis (Klein, 1961), one sees an orthodox revisionist at work. Her latter-day descendants, at least in London, now seem to speak a softer language (Spillius, 2001). Klein's immediate followers, the most important of whom are Susan Isaacs, Paula Heimann, Wilfred Bion, Roger Money-Kyrle, Herbert Rosenfeld, Hanna Segal, and Donald Meltzer, all made impressive expositions, extensions, and revisions of her work. Klein's training in child analysis was largely responsible for the emphasis on infantile states of mind in her technique.

 

The first generation: Isaacs, Heimann, Riviere, Sharpe

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Susan Isaacs

Susan Isaacs, one of Klein's earliest followers, was a child analyst. Her seminal contribution was “The Nature and Function of Phantasy”, which to this very day remains the defining work on the subject (Isaacs, 1952). During the “Controversial Discussions” between Anna Freud and Melanie Klein and their respective followers, this contribution was chosen for presentation because it was believed that unconscious phantasy was the key to Klein's theories. It still is.

Paula Heimann

Paula Heimann's work on introjection, like Isaacs' on phantasy, remains the fundamental work on that subject. She also became a pioneer in finding that the analyst's own countertransference constituted an “analytic instrument” and was probably instrumental in Bion's (1962a, 1962b) development of his theory of container/contained.

Ella Freeman Sharpe

Ella Freeman Sharpe, like Paula Heimann and Susan Isaacs, was one of Klein's original followers. She is known for a number of contributions to Kleinian theory and technique as well as dream analysis (Sharpe, 1951).

 

“In search of a second opinion”: the task of psychoanalysis

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The putative task of psychoanalytic treatment has been pondered over by Freud and other analysts. The consensus of received wisdom seems to be to make the unconscious conscious-but this formulation needs revision. While it is advisable to disinter the contents of the repressed, dynamic unconscious-since it once was conscious-one cannot bring to consciousness the content of the unrepressed unconscious. Furthermore, I believe that the repressed, dynamic unconscious is located within the topographical coordinates of System Pcs. Then what is the function of psychoanalysis and psychoanalytically informed psychotherapy, if it is only in part to make the unconscious conscious? Bion's frequently stated answer was to “render a second opinion” to the analysand for him to realize what he already unwittingly knew all along. Actually, Freud himself said something similar-that we never really learn for the first time, that we relearn-that is, realize, what we knew all the time-unconsciously.

I add another concept of Bion's, that of the transformation of the Absolute (impersonal) Truth about Ultimate Reality to finite, personal, emotional truths about oneself and one's experiences. That, to me, is the answer to the question of what is the task, the mandate, as it were, of psychoanalysis.

 

The analytic project: what is the analyst's task?

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Establishing the analytic setting and atmosphere and maintaining the frame and the “analytic covenant”

The task of the analyst is to create and maintain the analytic atmosphere, setting, and frame and to facilitate the progress of the analysis so that the “analytic passion play” can optimally and effectively take place. In the course of the analysis he-not unlike Michelangelo-finds himself intuitively penetrating the raw undeveloped stone in which his analysands are imprisoned and seeks to release their “forgotten” as well as their yet-to-be developed selves from their imprisonment (López-Corvo, 2000a, 2006b; Grotstein, 2007). The technique he uses-tolerance, patience, containment, suspension of knowledge, “negative capability”, holding, interpretations, and so on-serve both to attune the analysand emotionally and to “exorcize” him of his ancient persisting demons. It is important to realize, I believe, that within the confines of the analysis itself a demon (often but not always bad or malevolent internal object) is not so much a demonin-itself but a disguised helpful karmic messenger whose alleged symptomatic threat is but a wake-up call to attract both the analysand's and analyst's attention about “unfinished business” in the ever-evolving internal world of psychic reality. I connect this idea to my hypothesis that, in the end, psychoanalysis constitutes a passion play, and its “players” include daimons (internal objects) that are cast as symptoms, among other roles.

 

Some notes on the philosophy of technique

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Ithink it is important for the clinician to be aware of how his philosophical attitude towards the analysand and towards the method of his analytic technique affects the analysis. I am not so much referring only to which analytic school the analyst belongs to as to how he conceives of the analysand-over and above transference-countertransference considerations. We unknowingly hold the patient within the embrace of our preconceptions, personal as well as professional- that is, our value systems. The analytic school the analyst belongs to can have some bearing on this issue. An orthodox Freudian or a Kleinian may emphasize the inherent hedonism, destructiveness, disingenuousness, and assumed omnipotence of the analysand ("original sin"), for instance, and may also conceive that the fate of the analysand is constrained to his internal and external objects, which define the infant as well as the analysand. A Kleinian koan might read as follows: the analysand has become what he believed he has done to his object (via projective and then introjective identification).

 

The psychoanalytic session as a dream, as improvisational theatre, and as sacred drama

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The psychoanalytic session can be thought of as a dream in its own right (dreams are continuous by night and throughout wakefulness, according to Bion, 1970) and is consequently interpretable via dream analysis. Freud (1911c) states that in an analytic session the dream should be treated no differently than the analysand's free associations (p. 92). Bion seemed to think the same and actually expressed this idea to me on more than one occasion. In my own psychoanalytic work and in my supervisions I take this idea for granted. Thus, a dream reported during a session constitutes, in turn, a dream within the dream and is contextualized within the associative matrix of the preceding and succeeding associations to the dream in the session. In other words, the dream within the dream and the surrounding associations “inter-associate” holographically.1 Asking the analysand for associations, although a valid intervention on the part of the analyst, runs the risk of isolating the dream and lifting it from its matrix and context as well as awakening the analysand from his analytic preconscious trance.2

 

Psychoanalytic dependency and regression

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Analytic dependency and regression are closely related to one another, especially when the dependency experience is archaic, infantile, and pathological. Regression is generally insignificant in mature dependency.

My original training in psychoanalysis emphasized the many manifestations and elaborations of the Oedipus complex (the infantile neurosis), the many instinctual-drive factors of unconscious motivation, and especially realistic traumatic happenings in childhood that became repeated in the transference via the repetition compulsion. Furthermore, there was always an emphasis on sexuality (not always “infantile”) and on castration anxiety. I can still recall how often my “latent homosexuality” was dealt with by my analyst in my training analysis. The analysand's feelings of dependency on the analyst, whether the former was male or female, were generally taken up in the oedipal mode as sexual desire for the analyst's penis. It was only when I entered my Kleinian analysis that the experience of dependency deepened to longings from much earlier stages, and sexuality was mainly considered to be a pretentious egalitarian defence against the dreaded hierarchy-and thus vulnerability and shame-of infantile dependency on the breast. More to the point, from my reading of the Kleinian point of view, analysis uncovers one's basic irrefutable fact of being dependent generally, not just on the analyst-although especially on him during the course of the treatment.

 

The Kleinian conception of the unconscious

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Klein's theories and technique were formulated during the hegemony of orthodox (pre-classical) psychoanalysis and constituted an offshoot of it-or perhaps, in the minds of some, a reactive heresy to it-but nonetheless it became defined by it. The System Ucs from which Klein had begun was the same, consequently, as that of orthodox analysts during the dominance of the topographic model. In 1923, shortly after Klein began her theorizing, analysts were generally dealing with components of System Ucs,1 by which was meant primarily the unrepressed unconscious and the repressed dynamic unconscious.

After Freud's conceptualization of his second topography, the structural model (ego, id, and superego) (Freud, 1923b), along with his exploration of the psychology of the ego, it is as if he had turned his back on his immortal discovery, that of the unrepressed unconscious-a direction that both Klein and Lacan were to lament. Klein remained loyal to Freud's unrepressed unconscious and elaborated the schizoid mechanisms,2 principal among which were splitting, projective identification, idealization, and magic omnipotent denial as the vehicles for its operation (as retrograde extensions of Freud's repression). Put another way, much of Kleinian analysis-one can see this unmistakably in Klein's (1961) Narrative of a Child Analysis-is constrained by the prime consideration of derivatives from the unrepressed unconscious in addition to the repressed dynamic uncon116

 

The “once-and-forever-and-ever-evolving infant of the unconscious”

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Kleinians, post-Kleinians, and Bionians seem to assume the putative presence of an “analytic infant” within the analysand, one who in some ways corresponds to the infant of actual infancy and in other ways to an ongoing, ever-present, ever-evolving infant, which represents the “analytic subject of the unconscious” (Grotstein, 2000)-the most subjectively sensitive and vulnerable aspect of the analysand at any given moment. Though rarely discussed in this light, it constitutes the Kleinian “analytic third”-the common focus for analysand and analyst during the session.

It is the subjective “registrar of agony or anguish” (Grotstein, 2000). The once-and-forever infant is also a silent judge of how he is being treated by the self as well as by his parents and by the analyst, how each of them abides by the unwritten covenant or trusteeship that vouchsafes his being an honoured and sacred guest in their home or consulting room. I name it the "once-and-forever-and-ever-evolving infant of the unconscious", who is, I believe, the "ineffable subject of the unconscious". It is analogous to the id, though more as proposed by Nietzsche (1886) and Groddeck (1923) than by Freud. Their connotation is more that of a personified “alter ego”, a “second self”, or “Other”, as is the case with Lacan, an entity possessing subjectivity-a true "alter ego".

 

The concept of “aloneness” and the absence and presence of the analyst

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The concept of being left alone needs some discussion. During the hegemony of the paranoid-schizoid position, which is characterized by the emergence and predominance of persecutory anxiety, mother's presence seems to keep the infant's experience of bad objects (derived from the operation of the death instinct) at bay. Upon her departure, these bad objects become released, fill the space created by her absence, and thereupon dominate the infant's psyche as persecutory objects (which the Greeks called the “Furies”). These bad-object images are created by the projective identification of the frantic infant's protests and hatred of being left alone, along with omnipotence and wilfulness (intentionality) into its image of its mother, who becomes confused with the infant's own omnipotent wilful hatred and thereupon becomes internalized as an omnipotently and wilfully persecutory object. It may also be, as I have suggested, that these concrete badobject images are spontaneously released in the mother's absence and emerge from archetypal sources-that is, Plato's Ideal Forms, Kant's noumena, as incarnations of the death instinct, or Jung's archetypes.

 

Notes on the unconsciouses

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Ishould like to continue my discussion of the unconscious at this juncture. Before a discussion of unconscious phantasies, I will prepare the way by presenting some preliminary views of their host, the unconscious. I wish to superimpose the perspectives of vitalism and teleology, and especially entelechy, onto the traditional conception of the unconscious in order to lend new dimensions and perspectives to our understanding of it. The concept of unconscious mental life acquires more breadth, depth, and credibility when it is contemplated from the consideration of vitalism rather than of "scientism"-that is, drives. Vitalism, which is actually a holographic concept, predicates that the unconscious is an organic living system, as “Gaia” is for the Earth, and is a dwelling that is inhabited by indivisible numinous presences, phantoms, and/or demons who constitute the permanent cast of an ongoing unconscious dramatic series in repertory, otherwise known as phantasies, myths, and dreams that highlight and play out ontological themes from the “dailies” of our normal lives in a veritable cinematographic “mixing room”.

 

The overarching role of unconscious phantasy

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In the Kleinian/Bionian way of thinking, all internal transactions within the infant, between infant and mother, infant and world, and between objects in the world are represented as unconscious phantasies. All defence mechanisms themselves constitute unconscious phantasies about the interrelationship between internal objects, and between them and the self. Unconscious phantasies constitute moving narrative images and arise during the pre-lexical hegemony of imagery (Shlain, 1998). They and the objects that they choreograph are believed to be concrete (actual), since they originate during the hegemony of that stage of infant development that can be characterized as a “cyclopean” or “oneeyed”, absolutist perspective, which has been termed by Freud (1924d, p. 1791) and then Segal (1957, 1981) as “symbolic equations”. Perhaps one can better comprehend the Kleinian/Bionian use of phantasy in the following way:

A. Unconscious phantasies are the initial sensory (usually visual but also auditory and other) narrative transformations of inner and outer sense impressions or stimuli.

 

The ubiquitousness of object relationships

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Kleinians believe that the subjective aspect of the mind is dominated from birth by relationships with objects,1 both internal and external, as well as by part-objects and whole objects. Impulses are always object-dedicated for Kleinians rather than peremptorily discharging, as in the classical system. Defence mechanisms likewise always constitute phantasied object relationships: repression, projective identification, denial, splitting, and so on can be seen as the operation of one group of internal objects upon another or upon the self. In repression, for instance, one can surmise that the subject represses by splitting off an intolerable thought or affect and thereupon projecting it into an actual or phantasied object-container, which is then introjected, or into an already internalized object, where it is now “identified”-that is, located and thus repressed. Thus, to a Kleinian, internal objects constitute the “anatomy” of the internal world, and phantasy, the relationship between self and objects, its “physiology”. Further, it must be remembered that the Kleinian internal object is generally constituted as a compound object, including: (a) the infant's image (representation) of the external object, and (b) the affects, impulses, and so on that the subject has projected into this image of the object.

 

The Kleinian version of epigenesis and development, and Klein's theory of the positions

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Klein originally followed the orthodox/classical protocol of the sequences of autoerotic epigenesis (i.e., oral ↣ anal ↣ phallic). Her thinking about development is best captured by Susan Isaacs in her paper on phantasy (1952), where she presents the concept of the "principle of genetic continuity"-namely, that developmental sequencing evolves through the oral ↣ anal ↣ phallic phases, that is, from the beginning of life. The orthodox and classical schools of analysis, on the other hand, long held that the (phallic) Oedipus phase is the prime position of infant development because, according to their thinking, it represents the first true object relationship, objectless primary narcissism being its forerunner. The Oedipus complex, according to them, retrospectively constellates (organizes and gives meaning to) the pre-genital stages of development. Yet it must be remembered that Abraham (1924) had constructed a protocol of autoerotic development parallel with progressive part-object development. What Freud and orthodox and classical analysts derived from his seminal work was the validity of the existence of orality and anality, but they seemed to have disregarded the object-relations aspects except in so far as they believed that they were oedipally derived retroactively.

 

Klein's view of the death instinct

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Freud (1920g) conceived of the death instinct as an antagonistic counterpart to the life instinct, which included (a) the aggressive aspects of his older concept of the libidinal instinct and (b) the repetition compulsion.1 His biological conception of it may have been partially defensive, according to Segal (1993, p. 55). He conceptualized that its raison d'être was the achievement of constancy with regard to the pleasure-pain principle (Nirvana principle)-that is, to achieve biological constancy, for which death is the analogue. He associated it further with the experience of the aggression of the severe superego (Freud, 1930a) and suggested that all guilt feelings come from it. He also postulated that one aspect of it remained with the individual to cause primary masochism and that another aspect was projected outward into the primary object. Klein out-Freuded Freud in virtually concretizing his concept of the death instinct. She believed that the infant clinically suffers from an anxiety whose inchoate roots sprang from its peremptory emergence. From a practical standpoint the death instinct was considered by her to be the culprit in virtually all defence operations. It can be personified (after it becomes projected into objects and then re-introjected) as a primitive, peremptory, severe, hateful, destructive superego. She also believed that the infant's inchoate anxiety was due to the quantity of the death instinct that it was constrained to absorb. Klein (1933) states:

 

The Kleinian view of defence mechanisms

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Classical psychoanalysts have tended to emphasize the importance of repression largely because the protocol of their theory of technique issued from the central position of the Oedipus complex in the phallic phase and its constellating importance in organizing early mental life as regressive elaborations of it. Klein's theory of the Oedipus complex is far more extensive retroactively than that of the classical: she extends the Oedipus complex back into the second oral stage of infancy and as emerging simultaneously with the onset of the depressive position. As a result of her work with infants and the “infant within the child” as well as the “infant within the child within the adult” (Segal, personal communication, 2001), she came to recognize a cluster of two sets of anxieties, persecutory anxiety in the paranoid-schizoid position and depressive anxiety or guilt in the depressive position, and defences against them (defensive object relations). There is another major distinction between the two schools' usage of "defence mechanisms": Classical analysts speak of them as “mechanisms”, whereas Kleinians, while acknowledging the term “mechanisms”, actually think of them as the activities of unconscious phantasies of conflicting object relations.

 

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