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Centres and Peripheries of Psychoanalysis: An Introduction to Psychoanalytic Studies

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This book is designed to meet the needs of students who seek, in one volume, a text which places emphasis upon core concepts and clinical material,but which at the same time reflects the range of applications in therapy....

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1. Anna Freud: a beacon at the centre of psychoanalysis

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Jean Murray

Introduction

For the student intent on acquiring sound technique in psychoanalytic psychotherapy, there exists a wide range of competing theoretical schools. These schools range from those that claim to foster Freud’s original formulations and his adherence to a drive structural model of psychic functioning, to those that replace the drive model with a quite different conceptual framework, in which relations with others (or “object relations”) form the basis of all aspects of mental life. Within each of these two broad strands there are further differences of approach and related technical modifications—so much so that the beginning psychotherapist often finds it difficult to find a coherent conceptual framework in which to operate at a clinical level. Greenberg and Mitchell (1983) maintain that the various schools of psychoanalytic thought represent quite different visions of reality and, as such, cannot be integrated or combined. They attempt to clarify the clinician’s dilemma by saying that “a theorist’s attitude towards the drives determines his place in psychoanalytical circles” (p. 304). But is this really true? With the creation and elaboration of the structural model, Freud developed the concept of the ego. This heralded the development within classical psychoanalysis of a movement towards recognition of the ego as a powerful organizing aspect of the personality, which is in contact with external reality. This was coupled with discoveries within child analysis that demonstrated the importance of the external world on the development of the child and emphasized the importance of real experiences. Melanie Klein’s entire motivational system remains within the drive structural model; and it was this very adherence to the drives that she used to justify her link with Freud. Finally, within the drive approach, there are theorists such as Mahler, Jacobson, Kohut, and even Kernberg, who purport to espouse the principles of drive theory but use a very different language and propose considerable modifications in technique.

 

2. Melanie Klein and W. R D. Fairbairn: the clinical foundations and explanatory concepts of their theories

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Thomas Freeman

Melanie Klein and Fairbairn have introduced new concepts that are at variance with Freud’s theories of normal and abnormal mental life. Klein postulated that the Oedipus complex has its beginnings in the fifth month of life, while Freud hypothesized that it emerged between the third and fourth year. Fairbairn proposed that the decisive influence in mental development and in mental pathology consists of the child’s endopsychic relationship to the mother. The psychic manifestations of instinct and the conflicts to which they give rise—whether in the spheres of anality or genitality— are secondary to these endopsychic object relations. This is again in direct opposition to Freud who theorized that it is the psychic representations of the instincts (wishes, needs) that drive endopsychic object relations, and not the other way round, as Fairbairn believed. Despite these and other fundamental differences, Klein and Fairbairn did not follow Jung and Adler and break away from the mainstream of psychoanalysis. In fact, both these innovators claim that their additions, emendations, and deletions are a development of Freud’s basic assumptions about mental life. All these changes, claimed as advances in the understanding of healthy and pathological mental life, have had an inevitable influence on the technique of treatment. This led to significant differences in technique of psychoanalytic treatment. In this chapter an account is given of the theories of Klein and Fairbairn, the clinical phenomena on which they are based, and the principal features of their therapeutic methods.

 

3. The concept of transference: an introduction to its role in the psychoanalytic process

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Ruth Freeman

Introduction

The transference is a fundamental concept of psychoanalytic treatment. When considering the transference from a historical and descriptive viewpoint what must be emphasized is (1) that the concept “of transference is one that has developed {and is observable in) the clinical situation of psychoanalytic practice” (Sandler, Holder, & Kawenoka, 1969]; (2) that the transference acts as a searchlight, illuminating the patient’s forgotten past, and allows restitution of the continuity between the patient’s past and present life; and (3) “Psychoanalytic treatment does not create transferences, it merely brings them to light” (Freud, 1905e [1901]) with “transference arisling] spontaneously in all human relationships” (Freud, 1910a [19091).

These statements are of central importance to the understanding of the concept of transference and its role in psychoanalytic treatment. The fact that the transference is observable during the analytic process allows it to be clinically experienced.

 

4. Countertransference: some clinical aspects

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Siobhan O’Connor

In 1910, Freud first wrote of countertransference: an emotional response that arises in the analyst as a result of the patient’s influence on his unconscious (Freud, 191 Od). He had first seen the transference as a resistance and viewed the countertransference similarly. He noted that the psychoanalyst can go no further than his own complexes and internal resistances permit. Unlike his concept of transference, he did not develop the concept as a therapeutic tool—an idea that was to come much later. The concept has also been much broadened from Freud’s original definition. The literature on the subject has led to a much greater understanding of the different emotional reactions occurring in the therapist, but some of it is confusing, particularly for those who have no experience of analysis. I would like to illustrate with clinical examples a link between the emotions of the therapist and their experience with patients. Sometimes this says more about the therapist than the patient, but at times it helps to understand the interaction.

 

5. A psychoanalytic approach to the treatment of the schizophrenias in hospital practice

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Ruth Freeman

Introduction

Burning Mouth Syndrome (BMS) is described as a burning sensation of the oral mucosa, tongue, palate, lips, and pharynx. The aetiology of BMS was first suggested to be multifactorial in the 1930s (Fox, 1935; Schroff, 1935) being due primarily to physical factors (deficiency states, disturbances in salivary and gastric secretions, and local causes including trauma) and secondarily to psychogenic factors.

In the terminology of today, Schroff (1935) and Fox (1935) are, in essence, proposing a psychogenic-physical aetiological continuum for BMS. However, the role of psychogenic causation versus physical causation remains an area of contention for BMS.

Since the prevalence of BMS varies with age (Basker, Strudee, & Davenport, 1978; Hugoson & Thorstensson, 1990) and is five times more common in post-menopausal women (Grushka, 1987), it was proposed that BMS was due to deficiencies in hormones and vitamins. Research has demonstrated that deficiencies due to hormones (oestrogen/progesterone) and vitamins (especially the Vitamin B12 complex) are of subclinical proportions, and replacement therapy may be little more than a placebo effect (Grushka, 1983).

 

6. A psychotherapeutic approach to the understanding and treatment of a psychosomatic disorder: the case of burning mouth syndrome

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7. Freud, religion, and the Oedipus complex: some reflections on the infantile origins of religious experience

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Peter Torney

Since the time of Freud, the religious landscape of late-twentieth-century advanced industrial society has changed considerably. The years following the Second World War have seen the emergence of a plethora of new religious movements and cults, many of Eastern origin (Beckford, 1985, 1986;Wallis, 1984), and the fragmentation of the major Christian denominations into a multitude of sects of various kinds, emphasizing now this and now that element of their traditional religious past (Wilson, 1976). While the main Christian denominations remain on the surface organizationally intact within this burgeoning field of new salvational paths, they appear riven within by conflict as they attempt to adapt their traditional views to the ever-changing demands of modern culture.

In addition, the post-war years have seen the emergence of many new psycho therapies, all purporting to offer their adherents some form of self-transformation. Unlike religion, these latest secular revelations offer a form of “psycho-salvation” (Wallis, 1979) as a solution to the problems of modern living. These new “technologies of the self” for “governing" the modern soul (Rose, 1990) have entered perhaps unwittingly into competition with traditional religion. They, too, line the shelves of the new “religious” supermarket from which individuals can select the appropriate salvational package with which to construct some sense of meaning and purpose in what is fast becoming for some commentators a fragmented “post-modern” world (Frosh, 1991; Lasch, 1991; Sennett, 1977).

 

8. Psychoanalysis and literature: a psychoanalytic reading of The Turn of the Screw

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Ronnie Bailie

It is not for nothing that The Turn of the Screw has attracted more psychoanalytic attention (inter alia, Brooke-Rose, 1981; Katan, 1962, 1966; Wilson, 1952) than anything else that Henry James wrote. Even without the benefit of a psychoanalytic training, the average reader is likely to have a powerful intuition of extraordinary and murky psychological depths in the piece. No need here to get behind the veneer of polite drawing-rooms and elaborate cerebration to the unconscious core, for The Turn of the Screw reads like the relatively undistorted unconscious communication that it actually is. By this I mean that its manifest topics and persons have proceeded no great distance from their latent or instinctual sources. It is a question of congruence: the story fits its unconscious determinants like a glove.

This means that what often opposes the successful or convincing psychoanalysis of art is not encountered here. For sometimes the original instinctual and infantile sources are so heavily disguised and their force so successfully attenuated that only an act of intellectual violence—involving flagrant reductionism or leaden implausibilities—can re-establish the appropriate lost links. It is indeed with the critic and his reader as it is with the analyst and his patient: the patient’s conscious and reasonable ego cannot accept unconscious contents reached by a brutal frontal assault; these can only be arrived at and accepted when the defensive processes of the ego are analysed and ready to receive them. By analogy, the reader of psychoanalytic criticism cannot see violence done to the ego-like outer rind of the work of art—its surface images and situations—without rebelling in some measure against the blind instrument conducting the investigation. But this important issue of tact and plausibility is perhaps more easily handled with James’s famous “supernatural” text. For if displacements, condensations, and over-determinations abound in The Turn of the Screw, they are already clearly visible in the surface elements of the story and are not limited to the secret interplay of these elements with their hidden unconscious antecedents. The key ideas and feelings have not (that is) been banished to the periphery of the story, whose centre is thereby robbed of its instinctual charge and left blank and inscrutable to interpretation. In The Turn of the Screw James’s unconscious speaks directly and in the most distinct tones imaginable.

 

9. Psychoanalysis, cinema, and the role of film in the psychoanalytic process

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Richard Ektns

Introduction

This chapter is situated within two sets of related issues: that of the interrelations between so-called pure psychoanalysis and applied psychoanalysis (Chasseguet-Smirgel, 1992; Gehrie, 1992; Schwartz, 1992; Wallerstein, 1992), and that of the interrelations between psychoanalysis in the training institutes and in the universities (Freud, 1919j [1918]; THERIP, 1993).

I introduce what I have in mind with reference to certain remarks of Freud, Anna Freud, and Ella Freeman Sharpe. I then look at my chosen topic—psychoanalysis and cinema— from the vantage-point introduced. This entails a brief review of the literature, which is followed by the presentation of case material in which one particular film played a significant role. For Freud (1919j [1918]), the universities had everything to gain by including psychoanalysis in the curriculum, in both medical and academic education. At the same time, he thought that the psychoanalyst could dispense entirely with the university without any loss to himself. Writing in 1918, at about the time of the Fifth International Congress in Budapest, Freud (1919) (19181) felt able to say:

 

APPENDIX: A NOTE ON FREUD’S THEORY OF THE DREAM

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Freud’s The Interpretation of Dreams (1900a) is more than a study of the sources of dreams, their purposes, and the mode of their formation. It also presents a psychological theory of the mind based on the phenomena that are to be discerned in the course of dream interpretation.

When dreams are subject to investigation along the lines prescribed by Freud (1900a), it becomes apparent that the dream images (manifest content) are a transformed version of trains of thought no different from those occurring in the waking state. These preconscious thoughts active in sleep (the dream thoughts) are compressed into a compact form (condensation), and their representation is subject to changes of various kinds (displacement). In addition, the abstract (verbal) nature of the thoughts is changed into visual images. The dream is a hallucinatory experience. As Freud (1900a) says, “The dream-thoughts and the dream-content are presented to us like two versions of the same subject matter in two different languages” (p. 277).

 

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