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CHAPTER TWELVE: A very broad concept seen through a very narrow lens

Norbert Freedman Karnac Books ePub

Norbert Freedman and Rhonda Ward

What we are about to explore is a very broad concept seen through a very narrow lens. The concept is working through and the lens is a specimen from a recorded psychoanalysis. The concept has evolved over decades of psychoanalytic experience and clinically can cover years of analytic work. The lens comprises 25 sessions from the third year of a four-times-a-week psychoanalysis. The concept gets at the very heart of the efficacy of psychoanalytic work, but the lens, hopefully, pinpoints those ingredients that matter. One of those ingredients we have discovered and believe is essential to working through is termed the nodal moment.

In the course of this specimen, the repeated theme of torture can be heard. Torture is desired, feared, dreaded, confronted, imagined, reflected upon, and resolved through contrition. For Ms Y, the patient, torture appears within the context of an anticipated inner storm, a theme running like a red thread throughout the specimen, representing an effort towards transformation.

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Chapter Five: Breakdown and recovery in the analysis of a young woman

Andrew B Druck Karnac Books ePub

Aaron Thaler 1

Breakdown phenomena and related symptoms are common features in psychoanalytic treatment dealing with severe disturbances of continuity and ego-integration. The first part of this paper traces ideas about breakdown and recovery mainly through review of Winnicott's work in this area. The second part describes a period of breakdown that occurred during an advanced stage in the analysis of a very courageous young woman, Ms R. This period, which Ms R came to refer to as “my breakdown,” involved two years of reliving continuous, almost unbearable anxiety, disorientation, and pain which seemed to have been carried from her early childhood. The description focuses especially on a series of transference dreams produced over the course of one year that reflect Ms R's working through these powerful early anxieties on the way to important growth, symbolization, and recovery.

Although it is outside the scope of this paper, readers may look into illuminating papers by Clare Winnicott (1980) and Judith Mitrani (1998) who also applied Winnicott's ideas to examples of breakdown phenomena arising in the course of psychoanalytic treatment.

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CHAPTER ELEVEN: Severely traumatized patients' attempts at reorganizing their relations to others in psychotherapy: an enunciation analysis

Norbert Freedman Karnac Books ePub

Sverre Varvin and Bent Rosenbaum

Several attempts in psychoanalysis have been made to arrive at a comprehensive understanding of symbolization processes leading from “raw” sense and perceptual impressions to mental representations, and further on to the establishment of emotional and symbolic meaning. The understanding of these processes is highly important when it comes to trauma. Post-traumatic states are dominated by deficits in mental processing and disintegrated images, thoughts, and feeling states that haunt the traumatized. The personality changes as a result of adaptation to these changes in the mental condition. This tends to diminish or incapacitate ego-functions, such as the ability for emotional regulation and symbolization.

In dealing with trauma it is of central importance that our psychoanalytic understanding covers the whole range from nonverbal, not-understandable, unconsciously sensed or apperceived mental states to a narrative integrating capacity with contained emotions, subjective truth, and the ability to take a third position, that is, the ability to reflect on one's own mental states.

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CHAPTER FOUR: Representations of the therapeutic dialogue and the post-termination phase of psychotherapy

Norbert Freedman Karnac Books ePub

Jesse D. Geller and Norbert Freedman

The hope and expectation that the ending of an effective therapy will be a prologue to further growth and development occupies a central role in psychoanalytic theorizing. The primary aim of this chapter is to present preliminary findings of an empirically-grounded perspective on the hypothesis that patients will continue to build upon what they accomplished during the course of therapy after termination if they rely on enduring and benignly influential representations of the therapeutic dialogue to serve adaptive functions.

Some of the questions we have been thinking about are:

•  How do memories of a relationship with a former therapist exert their influence on a person's current functioning?

•  How do former patients continue to build upon what they accomplished during therapy after termination?

•  What roles do the experiences of separation and loss play in shaping a patient's post-termination involvements with representations of the therapeutic dialogue that were constructed during the course of therapy?

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Chapter Two: Modern structural theory

Andrew B Druck Karnac Books ePub

Andrew B. Druck 1

I have discussed modern conflict theory and its emphasis on unconscious conflict and compromise. Some of the difficulties with this focus revolve around its narrow definition of aetiology (only conflict and compromise between four narrowly-defined variables), its narrow view of mutative effect (insight into the dynamics of an already developed inner world) and its narrow view of the analyst's role (receiver of transference distortions and interpreter of them). I have stated that one major challenge to this position revolves around the question of what happens to conflict in an inner world that is not fully developed. Under these circumstances, is there a change in the analyst's optimal posture? A second major challenge, then, one that follows from the first, revolves around differing conceptions of the patient-analyst experience. This takes many forms, from the effect of this experience on establishing and maintaining a patient's reflective capacity, to how the analyst uses non-verbal data that he or she receives (often through awareness of countertransfer-ence affect or enactments), to questions regarding the mutative role of this experience.

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