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Chapter Nine: Cultivating meaning space: Freudian and neo-Kleinian conceptions of therapeutic action

Andrew B Druck Karnac Books ePub

Neal Vorus

This chapter attempts to address the following question: how does change take place in psychoanalysis, from a contemporary Freudian perspective?

One might think that the answer to such a central question would be rather obvious. In fact, it is remarkably complex and difficult, and likely to be answered in different ways depending on whom you ask. Possible answers include: “making the unconscious conscious;” “learning to self-reflect;” “integrating split-off aspects of personality;” “achieving personalization of self;” “internalizing a good object;” etc. One explanation of the proliferation of these ideas is that it simply reflects the range of pathology that one meets in clinical practice; different patients need different cures. No doubt there is truth to this; it would be remarkably reductionist, and counter to honest clinical experience, to assume that everyone uses treatment in the same way in order to achieve the same results.

However, there is a second factor that this chapter aims to address, and that is the longstanding bifurcation between insight and relationship as curative factors. While there has not always been a contentious divide between these factors in psychoanalysis (see Friedman, 1978b), for the past 50 years or so this has been perhaps the most politicized of therapeutic issues. In this chapter I will briefly review the history of this theoretical divide, then suggest that a path towards common ground on the issue lies in the recent rapprochement between contemporary Freudian and Kleinian thought, particularly as represented in the writings of Ron Britton. Towards the end of the chapter I will present a clinical example to illustrate an application of a contemporary Freudian approach, informed by neo-Kleinian perspectives.

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CHAPTER SEVEN: Meet Mohamed and the method implemented

Norbert Freedman Karnac Books ePub

Marvin Hurvich and Norbert Freedman

The recorded psychoanalytic therapy of Mohamed, a refugee from torture in Somalia, treated in Oslo, Norway is the subject matter of this chapter. We begin with a brief portrait of Mohamed, sketch out our method of analysis of the transcripts of sessions,2 present an account of the major variables of concern, Annihilation Anxiety (AA), and the symbolizing process (Symbolization and Desymbolization), and then return to the theme of our Propo-sitional Method with the question: how to infer clinical change or a process of transformation?

Mohamed was a political refugee from an African country. He was in his early forties and was an active Muslim. He had a wife and six children at the time of his arrest in the mid-Eighties for his association with groups opposing the dictator of his country. He was in prison for nine years, where he experienced severe torture, maltreatment, and under-nourishment, and was also sentenced to death. He was forced to watch the torture of his wife and one of his daughters, as well as to witness torture and other inhumane acts being inflicted on fellow prisoners, including children. A recurrent theme in therapy was his agony about what he had seen the soldiers and prison guards doing to others. This tormented him as did the physical suffering he himself had experienced. He managed, in spite of this, to find some comfort in his religious beliefs all through his time in prison. However, it was a hard blow for him when the authorities circulated a rumour that he had betrayed his comrades during torture.

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Chapter One: Modern conflict theory: a critical review

Andrew B Druck Karnac Books ePub

Andrew B. Druck 1

In this age of psychoanalytic pluralism, an age when, even within the broad contemporary Freudian framework, there is disagreement about essential aspects of psychoanalytic theory and technique, the practising analyst is faced with the problem of putting published material in some context. How is he or she to make sense of papers that state diametrically opposite opinions, often forcefully and dogmatically? Further, how is he or she to identify the commonalities as well as the differences between analysts? I propose to discuss two broad and overlapping ways of contextual-izing the many papers and ideas facing us today. My aim is to make explicit major concerns, assumptions, and difficulties underlying basic Freudian points of view so that the clinician can place theoretical statements and technical recommendations within a broad framework. I will discuss modern conflict theory and an alternative emphasis within the continuum of contemporary Freudian psychoanalysis, which I will call modern structural theory. My emphasis here will be on modern conflict theory. I will save discussion of modern structural theory for the following chapter. I will make liberal use of quotes in my discussion to illustrate my points and to give the reader a greater “feel” for the analysts about whom I am writing.

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Chapter Seven: Anonymity: blank screen or black hole

Andrew B Druck Karnac Books ePub

Carolyn Ellman 1

In this paper I would like to continue some of the work that has been highlighted by Kohut (1971), Bach (2006), and Ellman (1998), namely, the conditions that make for trust and containment in the analytic space. While these authors have written in great detail about how one can enter the world of the patient in order to further their sense of “owning” the treatment, I do not think enough emphasis has been put on the difficulties that ensue when the analyst is seen as entering a space that can seem rigid and cold and shame-inducing. This can happen particularly at some point in the treatment when the patient enters into a three-person system and wishes suddenly to know more about the therapist (Aron, 2006; Benjamin, 2004). When the analyst at that point cannot in some way become more real to the patient (sometimes by answering direct questions) a deep narcissistic wound and rupture may occur. I think this issue is particularly complicated at this time in our history since clinicians tend to (at least on paper) divide up into those that feel they can answer questions and loosen the frame and those that do not (mainly because of a political pull to align with either a Freudian or Relational position). Therefore, I would like to explore (on paper) what it is for a Freudian analyst to sometimes disclose personal information.

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CHAPTER SIX: The Propositional Method for the study of psychoanalytic concepts

Norbert Freedman Karnac Books ePub

Marvin Hurvich and Norbert Freedman

The Propositional Method to be described in this chapter is being presented as a way of generating another kind of evidence for the study of psychoanalytic concepts. Propositions become vehicles for framing this other kind of evidence, for facilitating new clinical observations, and for offering a structure for comparative psychoanalysis. It is both propositional and generative.

The Method to be described is a procedure to highlight the key features of psychoanalytic concepts, through a reliance on clinical observations and clinical generalizations, and an effort to decrease metapsychological language and formulations. It is intended to facilitate a systematic study of psychoanalytic concepts, and their application to the psychoanalytic process.

Concepts are not only elastic, changing over time, but they are also sources of controversy and conflict. They are statements evoking concordance, spelling out what we are thinking, doing, and inferring clinically, and they are sources of discordance. What we look for is a method that offers a genome that can encapsulate both the commonality and the diversity of thought, and then distil it so that it becomes available for analysis within a single frame. With the method in hand, we hope to find a coherent path towards confirmation or disconfirmation, thus enhancing coherence without succumbing to the search for universals.

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