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CAPÍTULO 6 - ¿Hay modelos complementarios de la mente en “Lo inconsciente” de Freud?

Akhtar, Salman Ediciones Karnac ePub

Bernard Reith

Freud en su consulta

Cuando leo a Freud, me gusta imaginármelo en su consulta, inmerso en una sesión analítica y reflexionando sobre preguntas tales como: ¿Qué está pasando aquí? ¿Cómo puedo entenderlo? ¿Cómo estoy yo implicado en ello?

Leyendo “Lo inconsciente” (1915e) con esta imagen de él en la mente, encuentro en ello algo más que el modelo topográfico del cual este texto se considera generalmente como la declaración suprema. Entre las líneas del modelo topográfico, Freud podría haber estado tratando de encontrar su camino hacia un modelo transformacional de la pareja analítica. Este modelo transformacional de dos personas sería complementario al modelo topográfico de una sola persona y añadiría una dimensión extra. Por supuesto, no estoy sugiriendo que esta fuera la intención manifiesta de Freud, pero sí creo que, en retrospectiva, podemos verlo en funcionamiento como un tema implícito.

Siguiendo algunos pasajes paso a paso, voy a tratar de mostrar la interacción que se da entre los dos modelos. El modelo topográfico se describe en las partes de la II a la VI del artículo de Freud, pero está incorporado en muchos otros pensamientos interesantes y se incluye en su Parte I de introducción y su exploración de la psicosis en la Parte VII, como una joya en una caja forrada de seda.

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CHAPTER EIGHT. Touching the patient

Akhtar, Salman Karnac Books ePub

Andrea Celenza

To touch the coarse skin of a tree is thus, at the same time, to experience one’s own tactility, to feel oneself touched by the tree.

—David Abram (1996, p. 68)

Anew patient1 extends his hand at the end of our first session. He has never had treatment before and I don’t want to offend him. I shake his hand, establishing a ritual that defers the problem for another day. I am uncomfortable with the handshake, though. It is not my practice2 and I wonder if the touching will lead to other expectations of tactile contact. Even if not, I know the meaning of this innocent gesture (at least that’s what I surmise at this moment) could change, for him as well as for me. A simple social convention now could take on more complex meanings as intimacies deepen over time. I do not know him well enough yet to speculate about his wish to make contact in this way. We go on like this for several weeks, ending each session with a handshake.

A month into the treatment, he begins a session with a statement that he must tell me about his sexuality and that he is embarrassed to face me while he does this. I ask if he might prefer to use the couch and explain to him that one of its functions is to bypass that feeling of shame: he might feel more able to speak when he doesn’t have to look at me. He lies down and almost immediately tells me about his enjoyment of sadomasochistic scenarios with women. Some include enemas, some include whips. All involve the woman penetrating him anally with her fingers and other objects. He admits he likes the pain.

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Sheri Hunt

Akhtar, Salman Karnac Books ePub

Sheri Hunt is an adult, adolescent and child psychiatrist and psychoanalyst and is certified by the American Psychoanalytic Association. She is on the faculty of the Seattle Psychoanalytic Society and Institute. Her interest in writing and poetry led her to becoming a, editorial board member of The American Psychoanalyst. She has been editing its poetry column for over ten years. Dr. Hunt has had numerous publications ranging from medical topics to essays and poetry. Her inspirations include family life, her work, which deeply immerses her in the inner worlds of patients young, middle aged and old, and the mountains, islands and waterways of the Pacific Northwest.

You look sleep’s

Sheer, black glassy drop

Spit in its eye

And jump!

Like crossing a street

When it’s not your turn

And you feel air then steel

Whizz neatly by

In a single carbonized gasp.

A night’s sweated ice

Wakens you with a yell

Not sure where blankets end

And you begin.

But, it must have been

A helluva fight.

Purple mottled sky bruises

Where wet has left sugared marrings

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PARTE I: “Lo inconsciente” (1915e)

Akhtar, Salman Ediciones Karnac ePub



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CHAPTER THREE. Changing the frequency, length, and timing of sessions

Akhtar, Salman Karnac Books ePub

Frances Salo

This chapter selectively reviews and considers some of the potentially profound aspects of a change in the temporal framework of sessions in analysis and psychotherapy. It aims to explore interventions that many analysts make, sometimes feel that they are “forced” to make, and assess any risks and potential benefits. The dialogue in the analytic space has special features stemming from the special device of analytic time (Puget, 2009), “a time out of time” (Kurtz, 1988, p. 990). When the analyst alters the temporal framework, with its fixed times, length and number of sessions, it affects the patient’s sense of self as a continuity in lived experience through time, through its reverberations of the patient’s history. While a number of analysts have generously shared details of such interventions, for reasons of confidentiality many have not been named.

The analytic session offers the patient the possibility of becoming conscious of his or her unresolved relationship with time (with their history and experience, unresolved pre-Oedipal, Oedipal, and transgenerational conflicts) (Milmaniene, 2009). The set time and length is an essential part of the frame, and the temporal structure of the setting allows the different temporalities of the patient’s internal world to become conscious to the patient and the analyst. Containing and challenging the patient is what underlies the high frequency of analysis (Rose, 1997). The importance of the temporal framework is far removed from any implications about the use of time as trivial, as often explored in literary works. There is extensive literature on psychoanalytic perspectives on the sense of time and of timelessness in the uncon-scious—the only temporal dimension the unconscious takes is that time does not pass (Pontalis, 1997). There is similar literature on the part that time plays in analysis (e.g., Arlow, 1986; Green, 2002; Hartocollis, 1983), and on the meaning of time within the culture (Akhtar, 1999a, 1999b). In comparison, detailed literature as relevant to the focus of this chapter is relatively less; while references to it permeate the clinical literature it may not have been examined as fully as it might have been.

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