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Landscapes of the Dark

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In this important new collection of essays, Jonathan Sklar argues that the founding tension between Freud's commitment to interpretation and Ferenczi's extra parameter of 'being in the experience' has a central place/key role to play in contemporary psychoanalytic debate, and that this tension can best be understood by returning to the place of trauma in psychoanalysis. Taking this debate into the heart of the clinical setting, a set of extensive, penetrating and often disturbing case studies examine the evocation of the real as early trauma for many patients and its subsequent mental development - a case of schizophrenia, a man with a severe Tic (spasmodic Torticollis), and a neurotic with a somatic resistance to ending a long analysis.

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CHAPTER ONE. The rebirth of history and trauma in psychoanalysis

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She gathered up all the fragments
But could not make them fit.

Anna Akhmatova (1912, p. 100)

The papers contained in this volume span some twenty-five years’ practice in psychoanalysis. They are written from the point of view of a psychoanalyst nurtured within the British Society and, in particular, the Independent tradition that stretches back to the clinical and theoretical dialogues of Freud and Ferenczi through Winnicott and Michael and Enid Balint towards the twenty-first century. During this time, the British Psychoanalytical Society has moved from being a Society of three theoretical strands comprising the Independent, Contemporary Freudian, and Kleinian groups to one that has given up the “gentleman’s agreement” in order to be one group in one Society. Presently, education in the Institute is suffused with a surfeit of “here and now” analysis with a considerable loss of analytic interest in free association and history. The atmosphere is now one in which a senior analyst in the Society can state, “I have come to bury Free Association not to praise it” (McDermott 2003, pp. 1349–1356) without inhibition or concern for the historical part played by that concept in the development of psychoanalysis. Often, the main focus is on the manifest content of clinical material rather than what lies behind the surface—the depth of the latent unconscious meanings of the dream and the meanderings of free association in the clinical work. The papers in this volume highlight the value and everyday use of history in order to retrieve analytic traditions which, like that of free association, have been pushed aside.

 

CHAPTER TWO. Formulation of interpretations in clinical practice

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Lear: Who is it that can tell me who I am.
Fool: Lear’s Shadow.

William Shakespeare, King Lear

Analysis is an interaction between two people. The patient brings his own highly individual difficulties and sufferings to the analyses, which are the affects and intellectual thoughts referring to his unconscious object relationships. The analyst brings what he hopes is a sound and adequate technique, which also must be highly individual. We know this from the diversity of points from which an analyst can set off in one of several directions, especially if we can agree no single way is correct on the analytic journey. The analyst has to make an interpretation in such a way as to lower the patient’s resistance, through an understanding of the conflict in the patient’s mind. Yet this seemingly simple idea can be undertaken in different ways.

A great deal of the analytic work is expected, by both parties, to be accomplished in words—the patient telling his story through free association and the analyst speaking heris interpretation to make the unconscious conscious. What the patient cannot say, he brings by way of enactment, in what he does during his life in analysis, in the analytic hour, as well as the enactment of the dream in the session. Congruently, the analyst also brings to the session much that is not said, but can be thought of as a particularity called “the holding environment”.

 

CHAPTER THREE. Hysteria and mourning-a psychosomatic case

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Of course missing a mistress and the jealousy that lingers on afterwards are physical illnesses just as much as tuberculosis or leukaemia. Ye t we need to distinguish among the physical maladies between those that are caused by a purely physical agency and those that act on the body only through the media of the intellect. Above all, if part of our intellect that serves as a medium of transmission is memory—that is if the cause is annulled or removed—however cruel our suffering is, however deep seems the disturbance wrought on our organism, it is extremely rare, given the power of thought to renew itself or rather its inability to remain unchanged, unlike bodily tissues, for the prognosis to be unfavourable.

—Marcel Proust, The Fugitive (1925, p. 608)

In Studies on Hysteria, Freud and Breuer write about tracing “the most various symptoms which are ostensibly spontaneous and as one might say, idiopathic products of hysteria are just as strictly related to the precipitating trauma” (Breuer & Freud 1893–1895, p. 4). They go on to describe various illnesses, including disorders in the nature of tic. There have, however, been very few case reports in the recent literature on the treatment of such cases.

 

CHAPTER FOUR. Trauma, psychosis, and regression: the psychoanalytic treatment of a schizophrenic patient

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… I woke to find myself in a dark wood,
for I had wandered off from a straight path.

—Dante, The Divine Comedy, Canto 1

The issue of regression has always been a matter of intense controversy in the British Society. There has been much conflict around the idea that the analyst may be acting out his own difficulties towards the patient rather than being in the experience of part of the patient’s unconscious object-relatingness. Much of the heated misunderstandings arise from where the analyst is located in the clinical scene. The analyst, watching the patient unfold his material and then interpreting it, is in a different locus from the analyst being alongside and together with his analysand. The difference is even more stark if the analyst expects and understands that the patient is “doing something” to the analyst, often in the negative sense, rather than inevitably being part of the exploratory analytic pair. A modern argument about the forces of regression wonders how the analyst can want to worsen the patient’s already precarious balance by allowing such a direction to occur. As if such an analytic journey is too dangerous—or should the question be dangerous for whom? Yet for some analysts, regression has been imagined as the equivalent to the gratification of a warm cuddle between a mother and a baby in order to make things better. Regression seen from such a position is regarded as superficial and certainly not going deep in an analysis. Furthermore, it is linked to the anxiety that gratification is linked to dependency and that such a behaviour leads to the idealizing of the transference.

 

CHAPTER FIVE. Daydreams, dreams, and trauma

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When they were building the walls, how could I not have Noticed! But I never heard the builders, not a sound. Imperceptibly they’ve closed me off from the outside world.

—C. V. Cavafy, Walls (1896, p. 3)

This paper will examine the damage that early trauma can inflict on dream states. For some severely traumatized patients, there can be an ongoing failure of dream work. The affect from both the past and the present can fail to even be mobilized and, as such, psychic energy is withdrawn from the dream machine. So the same dream whirrs round again and again repetitively, but devoid of the possibility of a creative drive.

The repetitious nature of such dreams is often unnoticed by the patient. The analyst may regard them as familiar yet flat and unyielding to further knowledge or exploration, as if they contain a resistance to dream interpretation itself. Attempting to understand and make connections beneath the surface structure of the repetitious manifest content can lead to change in the patient. Identity organized around trauma but with unconscious control exercised against any felt emotional life can often be noticed in the countertransference. If changes can occur in the affect system of the patient, the emergence of closer contact with reality can result.

 

CHAPTER SIX. Psychosomatics and technique

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It is generally well known that out of the crews of Whaling vessels few ever return in the ships on board of which they departed.

—Theodore Foster, A Cruise in a Whale Boat, and Adventures
in the Pacific Ocean (1979, p. xv)

At the age of eight, the writer Aharon Appelfeld witnessed the pogrom in his hometown of Czernowitz. He saw the murder of his mother and, separated from the rest of family, survived by scavenging in the forests. Remembrance was complicated, he thought, by his having been too young a child to process much of what he saw. The past remains entirely physical for him: “etched inside my body but not in my memory” (Appelfeld 2005). More than half a century later, his feet still cause tension in his legs and this pain instantly transfers him back to his years in hiding. The very act of sitting or standing can conjure up hellish visions of packed railway stations; rotting straw or the call of a bird trigger visceral memories deep within his body.

The capacity for free association is both protected and inhibited by the movement of affect into the body, which acts as a container and can deflect away from the mind with its complexity of thoughts and associative strands. A particular part of the body with its physicality, such as a feeling of body rigidity or a certain sequence of movements, can contain that which must not be felt and integrated in the mind.

 

CHAPTER SEVEN. Somatic resistance to termination: the contemporary use of “active” technique

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In Europe no one knows how to scream anymore … since they do nothing but talk.

—Artaud (1936, p. 75)

Miss A. never really wished to end her analysis. She had been in analysis five times a week for nine years. Much work had been achieved, and she had developed from being a gauche, hypochondriacal, and shy young woman to obtaining a prestigious senior management position and getting married. Analysis had reached a plateau. It worked, it was ongoing, but a deep sense of unconscious stuckness pervaded the atmosphere. Reviewing my countertransference over a period of time elucidated my boredom. So much work had been done. Her early obsessional symptoms had been worked through, leading to greater maturity and a more settled object choice. Unconscious guilt had been faced in relation to her parents and siblings, and her passive fatalistic acceptance of life had given way to a thoughtful, active marriage in which interpersonal difficulties could be spoken about, argued, and dealt with. Yet the ennui in the clinical spectrum pointed to the missing piece of the analysis; the necessity of a real ending.

 

CHAPTER EIGHT. The life cycle of the psychoanalyst: reflections on a seminar for newly qualified analysts

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Jonathan Sklar and Michael Parsons

The use of the word “freedom” is one of the surest indices of the user’s general ultimate ideal of life, of what to want and what to avoid … one of the most faithful indicators of where a man stands.

—Isaiah Berlin (2006, p. 207)

This chapter highlights the concept of the psychoanalyst’s life cycle, extending from qualification, through the prime of an analyst’s career, to retirement and beyond. The details of the life cycle emerged from the experience of leading a seminar to help recently qualified analysts think about the development of their analytic identities. Issues which first appear in the post-qualification period continue to present themselves in different ways throughout an analyst’s working life. The idea of this life cycle has not been much articulated, particularly with regard to its later stages. Bringing an analytic career to a close raises practical and emotional questions which are not easy to discuss openly. Two ideas which are emphasized are, first, that the analytic life cycle needs to be seen as an organic whole and, second, that the external practicalities of an analyst’s professional life need always to be considered in terms of how they express the analyst’s internal sense of his or her analytic identity.

 

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