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Chapter Eleven: A new Freudian synthesis: reflections and a perspective

Andrew B Druck Karnac Books ePub

Norbert Freedman

With the publication of this volume we are celebrating 100 years of Freud's manifest presence in America. It was in 1909 that Freud delivered his Clark lectures on “The Origin and Development of Psychoanalysis”. While Freud's teachings had been well-known, and indeed they had led to the invitation by G. Stanley Hall, president of Clark University, these papers have marked the constant presence of his work in the United States. This past century has brought with it a marvellous history of reworking and reformulation. These modifications have reached their culmination during the second half of the 20th century, particularly in the work of those second generation analysts who embraced an object relations perspective, namely, Kohut, Balint, Winnicott, and Loewald. It is on the shoulders of these contributions that this current new 21st century contribution has been built.

The title “A New Freudian Synthesis” is evocative and provocative as well. It is evocative because it immediately conjures up the question: “What is Freudian about these papers?” It is provocative because it also elicits the question: “In what ways are they no longer Freudian in the original sense?” And the title of this book challenges us to arrive at a synthesis that might tell us how divergent views can be brought under one umbrella.

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Chapter Four: New developments in the theory and clinical application of the annihilation anxiety concept

Andrew B Druck Karnac Books ePub

Marvin Hurvich 1

My interest in annihilation anxieties (AA) goes back to a 1980 clinical observation that recalcitrant symptoms in more disturbed patients are often underlaid by defended anxieties concerning annihilation and threats to survival. Analytic scrutiny revealed that these anxieties included apprehensions of being overwhelmed, dissolved, invaded, or going insane. In addition to constructing a research instrument to measure the extent of these anxieties in clinical populations (Benveniste, Papouchis, Allen & Hurvich, 1998; Hurvich, 1989; Hurvich, Benveniste, Howard & Coonerty, 1993; Hurvich & Simha Alpern, 1997; Hurvich, Allen, & Mcguire, 2006a; Levin & Hurvich, 1995), I embarked on an intensive study of the psychoanalytic literature that revealed a consequential incongruity concerning annihilation fantasies and anxieties (Hurvich, 2003). On the one hand, there were hundreds of references to the correlates of survival-related apprehensions. On the other, formulations of such anxieties tended to be relatively undeveloped, and accorded little conceptual status in standard current mainstream theoretical works. Recent compendia of psychoanalytic theory and practice (Goldberger, 1996; Gray, 1994; Moore & Fine, 1995; Nersessian & Kopff, 1996; Person, Cooper & Gabbard, 2005) rarely mention these phenomena, or refer to them only in passing. I concluded that an important set of anxiety contents and experiences were either being overlooked or remained undeveloped in serious mainstream theorizing. Although these compendia did deal with psychic trauma, a closely related concept, they neither related psychic trauma to the psychoanalytic theory of anxiety nor reached any kind of consensus regarding its definition. Exceptions include the work of Krystal (1968, 1988) on Massive Psychic Trauma and volumes edited by Furst (1967), and Rothstein (1986), among others. A recent statement by Andre Green (2006) is congruent with my observation that there has been a failure to develop the implications of annihilation anxieties. Green wrote that issues such as fears of annihilation, primitive agonies and nameless dread are mentioned “in relation to theory with regard to a hypothetical appearance during the childhood of patients, but their clinical description in the adult has been given little detailed attention in clinical psychoanalysis” (p. 42, italics added).

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CHAPTER THIRTEEN: Method and findings: the case of Ms Y: the patient and her analyst within the context of a recorded psychoanalysis

Norbert Freedman Karnac Books ePub

Norbert Freedman, Richard Lasky, and Rhonda Ward

At the time of this research, Ms Y was a professional woman in her thirties, and a mother of a three-year-old boy and a newly adopted infant daughter. She and her husband were residing in a suburban community in the US Midwest, enjoying a secure income. About six years prior to this study, she began a twice weekly psychotherapy and in her second year of treatment converted to a four-times-a-week psychoanalysis.

According to the analyst, the tone of the treatment shifted dramatically during the first two years of the analysis. The initial transference, one of non-engagement and affective withdrawal, developed into a sadomasochistic transference and then into one that was explicitly erotic. This intensity, one of over-engagement, seemed to have been a defence against the initial schizoid-like position, though, as the treatment progressed, acute neurotic conflicts also surfaced. It was at this stage that we entered the study of the treatment process.

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CHAPTER FIVE: Reminiscing and recollecting

Norbert Freedman Karnac Books ePub

Jamieson Webster and Norbert Freedman

Let us revisit the Effectiveness Study where we encountered ten patients who elected to speak to Dr V, an analyst, about their earlier experience in treatment. The group had been divided in half with respect to their scores on the Effectiveness Questionnaire: five patients experienced the treatment as satisfactory and the other half reported a sense of dissatisfaction. Once more, we ask the question: what is meant by effective treatment?

In further studies of these patients and their recall narratives with Dr V, the division five and five holds over a number of telling categories with satisfaction correlating with measures of reflective functioning (Fonagy, 1995), secure attachment (Roy, 2007), absence of annihilation anxiety (Hurvich, 2002), and high referential activity, as measured by the referential process (Bucci &Maskit, 2007). One might conclude that satisfaction with therapy is a good quantitative indicator of the success of a treatment with all the concomitant benefits: more secure attachment to the therapist, decrease in anxiety, a widening of one's self-reflective capacities, and so on and so forth.

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CHAPTER TWO: Patients' representations of the therapeutic dialogue: a pathway towards the evaluation of psychotherapy process and outcome

Norbert Freedman Karnac Books ePub

Jesse D. Geller, Donna S. Bender, Norbert Freedman, Joan Hoffenberg, Denise Kagan, Carrie Schaffer, and Neal Vorus

The next three chapters explore the hypothesis that the operationalizing and measurement of the construct “representations of the therapeutic dialogue” can serve as a valid source of evidence about the outcomes of psychoanalytic therapy and the internalization processes whereby psychoanalytic therapy becomes and remains an adaptive resource in patients’ lives after termination.

The research strategy we have adopted to explore this central idea is based on our shared commitment to three basic operating premises:

1. We conceive of representations of the therapeutic dialogue as the intrapsychic equivalents or analogues of the types of verbal and nonverbal exchanges patients have with their therapists. As early as 1926, Freud came to the view that the very essence of psychoanalysis is that it is a conversation in which “… nothing takes place between [the patient and the analyst] except that they talk to each other” (1926b, p. 187).

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