Medium 9781780491172

The Anatomy of Regret

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Anatomy of Regret has a highly clinical focus, with cases that illustrate how critical psychic change can emerge from the mourning of the grief of "psychic regret". This book highlights the developmental achievement of owning the guilt of aggression, and of tolerating insight into the losses one had produced. The author uses the term "psychic regret" to capture the essence of the process of facing regret consciously. This is in contrast to the split-off and persecutory dynamics of unconscious guilt. Unconscious guilt exposes itself through visceral and cognitive impingements, which are related to internal world enactments, and it relies on unconscious avoidance of the pain and loss involved in facing psychic regret.Dr Kavaler-Adler's theory of "developmental mourning" is illustrated in this book through in-depth lively clinical processes (cases and vignettes). The reader is able to witness how those who have faced consciousness of their resistances to experiences of loss and guilt (as referred to by Melanie Klein in her theory of the depressive position) go through the critical psychological transformation, which allows for authentic psychic change. This is a psychological change that has "meaning" and "meaning creativity" within it.Anatomy of Regret weaves the themes of psychoanalysis in its early days with those of current practice. It simultaneously offers vivid case examples, where theory becomes a retrospective way of organizing the progress in the clinical work, and in the lives of patients. Dr Kavaler-Adler addresses both theoretical and clinical conundrums, as she offers the opportunity for readers to immerse themselves in the journey from internal emptiness to both internal and external richness.

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Chapter One - Developmental Transformation of Aggression within Mourning

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CHAPTER ONE

Developmental transformation of aggression within mourning

Psychoanalytic theories on aggression in the developmental mourning process

Sigmund Freud, in his classic 1917 paper, “Mourning and melancholia”, wrote of the adhesive tie of the self to this object in terms of the libido sticking adhesively to its lost object. This pertained to his picture of the normal mourning process, as opposed to the pathologically arrested mourning that he described in the psychologically paralysed “melancholic”. It was only in the case of the melancholic that Freud (1917e) addressed the issue of aggression. He did so in relation to the defensive use of aggression within the melancholic, who was arrested in his need to mourn due to the psychological block created by defensive aggression. For the melancholic, according to Freud (1917e), the aggression which he related to drive and instinct was unconsciously felt as hatred towards the lost others. In Freud's “melancholic”, the lost love object was thought to be irrevocably lost, as in death, not symbolically lost as in psychological separation and its developmental evolutions. Freud brilliantly deduced that the melancholic continually attacks himself with self-recriminations, while defensively turning his hatred towards the lost other against himself (masochistically). This defensive self-attack observed by Freud can be seen by those of us who have worked extensively with resistances to mourning in the clinical situation as the key resistive block to any normal mourning and letting-go process. This contrasts highly with the normal mourner observed by Freud, who was capable of tolerating the painful and slow work of mourning, consequently gradually letting go of the adhesive libido tie to the lost other.

 

Chapter Two - Conscious Regret in Clinical Treatment Engendering a Critical Turn Towards Love and Creativity Healing a Schizoid Woman and her Family: The Case of Sharon

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CHAPTER TWO

Conscious regret in clinical treatment engendering a critical turn towards love and creativity, healing a schizoid woman and her family: the case of Sharon

Acritical distinction between Kleinian object relations theory and that of other schools of object relations thinking, particularly in the USA, is that Kleinian thinking (1940) is attuned to the element of existential guilt as a factor in psychic change. By contrast, the other schools of object relations thinking focus on the affective element of loss alone as having developmental significance in relation to healing trauma and resolving developmental arrest.

Mahler's (1967) object relations theory, for example, speaks of the capacity to tolerate the grief of loss as a pivotal determinant of separation–individuation. Mahler does not speak about guilt as interacting with loss in her view of psychic change evolving from the navigation of the separation–individuation phases of development, even though she does acknowledge a range of mourning experience to be natural for separation–individuation to take place. Mahler speaks of a mild form of depressive affect experience, which she calls “low keyedness” (Mahler, Pine, & Bergman, 1975). Such low keyedness takes place in normal and timely separation–individuation processes, where there has been the internalisation of good enough mothering and mother bonding. A more intense form of grief takes place when separation–individuation has been arrested. This more intense form of grief has been called an “abandonment depression” by Masterson (1976, 1981), who follows Mahler's (1967) theory and schema of development, particularly in pathological cases of developmental arrest. Another object relations theorist, the British theorist Michael Balint (1979), speaks of mourning in his “basic fault” cases of pre-Oedipal developmental arrest. Bowlby (1969, 1980), likewise, speaks of normal mourning for psychic development, as well as psychic change. Masterson (1971–1985), Balint (1965, 1979), and Bowlby (1963, 1969, 1980), like Mahler (1967–1975), do not mention the pain and anguish of guilt as an existential and affective aspect of mourning and grief. They only refer to grief in terms of object loss. Fairbairn (1952), another object relations theorist, speaks of relinquishing old object relations ties in a traumatic separation process, but refers more to exorcism of bad objects than to any mourning process. When Fairbairn uses the word “guilt”, he refers to a spurious or false form of guilt that is essentially a masochistic defence of self-blame, a defence which serves to deny the demonic or “bad object” aspects of the real parent. Authentic existential guilt is never dealt with by Fairbairn.

 

Chapter Three - From Crime to Regret: An Affect-Level View of Psychic Transformation and the Capacity to Love

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CHAPTER THREE

From crime to regret: an affect-level view of psychic transformation and the capacity to love

Identification with the aggressor was originally understood as an ego defence mechanism, as described originally by Anna Freud (1936) in her book, The Ego and Its Mechanisms of Defense. The more profound role of this psychic dynamic could not be understood until psychoanalysts had a larger view of psychic change in terms of developmental growth in object relations theory. As an overriding personality dynamic and as a character defence, rather than merely as a neurotic defence mechanism, “identification with the aggressor” can be seen to operate on the psychic fulcrum of addiction to an old and primal object. In essence, one identifies with the original parent object's hostile aggression towards oneself; that is, any aggression that disrupts basic self needs for good-enough object connection, and continually enacts this hostility either against the self or against another. If one enacts the hostile aggression towards another, it is usually an intimate other upon whom one feels emotionally dependent, one who, in part, serves as a displacement figure for the original parent to whom one is still profoundly tied. The identification becomes an attempt to hold on to the original object, and to seek the love one feels deprived of, by becoming like the depriving object.

 

Chapter Four - Tolerable and Intolerable Regret: Clinical Transformation of the Intolerable into the Tolerable

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CHAPTER FOUR

Tolerable and intolerable regret: clinical transformation of the intolerable into the tolerable

Intolerable regret in the mother and validation for the daughter

In classical psychoanalysis, we have been taught to not reassure patients. What does this mean? Why this caution? My understanding of this caution has been that the patient needs to struggle with his/her conflicts over his own impulses, to find his/her own resolutions by consciously confronting impulses that formerly were unconscious or out of control. The analysand needs to have this process without any interference in it. Whatever the patient's struggle, he/she needs room for it. The patient needs the psychic space, analytic space, and transitional space to struggle with his/her own dilemmas. To not offer reassurance is thought of as allowing such space. Refraining from offering reassurance also allows patients to experience that the analyst is not afraid of their experience. When a psychoanalyst does reassure a patient (and this happens probably more often than we admit), it is mostly our countertransference enactment of a rescue fantasy. Perhaps, getting the patient off the hook is a way of gratifying our own wish to restore our own inner harmony, through a gesture that seems kind and compassionate at the time. Perhaps in this way, we attempt to create reparation for ourselves; reparation with our internal parent, through projecting that parental other on to the patient.

 

Chapter Five - Facing the Ghost of Failures in Mothering. Regret Evolving into Love and Play: The Case of Anastasia, Part I

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CHAPTER FIVE

Facing the ghost of failures in mothering. Regret evolving into love and play: the case of Anastasia, Part I

In the course of an analysis, profound psychic transformations evolve as psychic regret is consciously confronted. This involves the opening up of depressive position capacities for viewing things increasingly from another's subjective perspective, for differentiating that perspective from one's own, and for facing one's insatiable hungers, referred to as “greed” by Klein (1957). The case to be offered illustrates how psychic regret made conscious can lead to growth in self-agency and self-reflection, to an awareness of yearnings for intimacy, to an awareness of psychic and interpersonal space, as well as to the awareness of the phenomenal aliveness in “just being together”. Other insights into an awareness of one's own needs and motivations arising through regret involve awareness of one's own grandiosity, and of one's sense of missing something within that is revealed to be an early connection with the primal other: the pre-Oedipal mother. Cognitive capacities for differentiation are enlarged as self-reflection is expanded through the grief-laden insights that come with regret. In this way, defensive distancing from both internal and external object relations connections can be retraced to the past in terms of a repetition of early disruption in object relations bonding with the mother. The past and present can be sorted out. There is also a new growth in a capacity for containment of instinctual impulses, as well as for compassion for the other, and a sustaining of a more full whole object capacity to love.

 

Chapter Six - The Interaction of Negative Transference and the Mourning of Regrets in Psychic Transformation: The Case of Anastasia, Part II

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CHAPTER SIX

The interaction of negative transference and the mourning of regrets in psychic transformation: the case of Anastasia, Part II

In the second part of the case of Anastasia, a combination of intrapsychic and external object relations dynamics is demonstrated. More specifically, this second part illustrates that when primary negative transference constellations in treatment are actively contained and processed by the psychoanalyst and interpreted with discrete selectivity, the core motivation for the analysand's compulsions towards behaviours that have resulted in much pain and anguish (related to psychic regret) can be revealed to the analysand. Thus, the interplay between the transference work of traditional psychoanalysis and the “developmental mourning” work of object relations psychoanalysis can be seen to interact in profoundly critical ways for our clinical work.

Pivotal moments of psychic change and psychic integration can also be seen to evolve along the dimension of a developing journey that highlights the affective interplay of guilt as grief, object loss related to regretted character behaviours, and the enraged hate of negative transference that is often expressed through sadistic behaviour within the treatment process. The psychoanalyst can understand these pivotal moments as an interplay of grief and aggression within an overall developmentally progressive mourning process. The analysand can be introduced to visualising his own vivid developmental and psychic journey, as self-integration and separation–individuation both proceed.

 

Chapter Seven - The Grief of Regret Motivating Commitment to Marriage in a Woman: Sarah's Extramarital Affair

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CHAPTER SEVEN

The grief of regret motivating commitment to marriage in a woman: Sarah's extramarital affair

Commitment that is fully realised at a psychic level is not so often achieved.

Couples who have early loss and trauma in their lives are particularly prone to defend against full commitment to one another. In spite of this, when the losses can be faced and mourned, increasing degrees of commitment and sustained intimacy can be achieved. Equally important to mourning early losses, however, is the mourning of the grief of regret related to failures in commitment. The full conscious experience of one's regret concerning shortcomings in commitment can actually become the turning point of a marriage. The case of Sarah illustrates this.

Sarah entered psychotherapy for the first time after being married for fourteen years. She realised that she had never fully been able to commit to her husband. She told me that she wanted to understand her difficulties in making a commitment to a husband. She had kept a journal of her thoughts and feelings, and wanted to read this journal to me once she chose me as her psychoanalyst. She hoped that by sharing all of her intimate thoughts, she would be able to receive help in understanding what propelled her away from her husband, both earlier in their marriage, and during the affair. She also hoped to come to understand how losses earlier in her life, such as the death of her older brother when she was fourteen, might have made her involvement with her husband difficult. She told me that she had been very close to her older brother when she was young, in a way that she had never felt with her younger brother, or with her sister. She also told me that she had re-experienced memories of being close to him and of losing him. She said that remembering him was very painful. She said that her feelings of loss had stayed with her over a long period of time.

 

Chapter Eight - The Grief of Regret Allowing Commitment in Marriage in the Man: The Case of Oscar

ePub

CHAPTER EIGHT

The grief of regret allowing commitment in marriage in the man: the case of Oscar

When we look at parallel worlds in relation to men and women, we look at Sarah, and now at Oscar. Both found a deep sense of spiritual and emotional commitment to their marriages through the transformational crucible of existential regret, which was precipitated by an extramarital affair. Both faced their mortality in the threatened loss of their primary loved one, their spouses. Both found the deep primal connection at home after looking for it with an outside other. Both suffered an agony of grief over the potential loss they provoked by their own betrayals. Both faced themselves through looking into the cold visage of their own betrayals and finding their injured hearts crying out to love. Both came to cherish the marriages they had formerly sought to escape from. Both found themselves through finding the other, and also found the other through finding themselves. In finding a home within themselves through the grief process, they found a home in their marriages and reowned their sexuality in that sphere of love.

 

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