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CHAPTER THREE. "I won't stand next to you when you throw bombs": addressing the perverse in the patient

Bernardine Bishop Karnac Books ePub

Lorraine Colledge

Introduction

Working with highly perverse patients without corrupting the therapy is a frequent challenge for psychotherapists. There is an ongoing dilemma of needing to bring the perversity into the consulting room so that it can be known and understood, while simultaneously protecting the therapeutic process from becoming perverted. This paper describes work with a patient who had developed highly perverse internal structures and mechanisms as a way of surviving physical and sexual abuse, and details the ensuing developments and challenges in the transference relationship. It explores the initial use of the therapist as a good object who could bear to hear the horrors which had been survived, and then details the ways in which the perversity became more overt within the consulting room. The therapist was cast as helpless victim in the face of a perverse onslaught, and entreated to join a perverse partnership. The paper posits the existence of a “pseudo-victim” false self that was central in the maintenance of the internal perverse structures. The central interest lies in turning the patient’s attempts to pervert the work into an advantage for the therapeutic process.

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Medium 9781855759763

CHAPTER SIX. An absence of mind

Bernardine Bishop Karnac Books ePub

Jennifer Silverstone

This paper is an attempt to understand autistic and false-self states through both the body and the mind. My thesis will be that where there is an absence in the mother’s internal world of the baby in her mind, the identity of the baby becomes vulnerable both in the mind of the mother and in the mind of the child. The absence of thought about and around the baby both in the internal world and later in external reality can produce a state of mind where thinking is experienced as dangerous in the developing child. The body thus becomes a form of expression and a defence against thinking and somatizing in various forms takes on the possibility of a deeper meaning. The sensations of the body are concretized and can become a means of expressing the unbearable. Sensation replaces thought and can be seen as a defence against thinking. The body becomes a metaphor for the whole self. The self as a thinking self is hidden and defended against by the capacity of the body to distract the mind.

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Medium 9781855759732

CHAPTER SEVEN. Paying for love in the helping professions: contradictions inherent in charging fees for psychotherapy

Bernardine Bishop Karnac Books ePub

Steven Mendoza

There are those who assume that there are inherent contradictions in charging fees for psychotherapy and there are those would not hold any contradictions to be inherent in charging fees. I think of those for whom inherent contradictions are implicit as those for whom charging is inconsistent with the aspect of loving. I think that loving here means acting to benefit others from the motivation of a state of mind enjoying the blissful enhancement of emotion and thought which comes from knowing that one is doing good. Paradoxically, of course, the process of psychotherapy may entail, for the psychotherapist, feelings which are anything but beatific, such as inadequacy, impotence, frustration, rage, shame and guilt. Better, then, we should be paid for such love in some other coin than a toll of gratitude that would block the very psychotherapy it paid for. Hence Winnicott’s (1947) formulation, not of love but of hate, as restricted in the countertransference to the two prerogatives of charging for sessions and of ending them on time.

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Medium 9781855759473

CHAPTER TWO. Love, the aesthetic conflict and the self

Karnac Books ePub

Patricia Allen

In 1988 Dr Donald Meltzer and Meg Harris Williams wrote a book on “the role of the aesthetic conflict in development, art and violence”. The Apprehension of Beauty added a new dimension to psychoanalytic thinking on development at that time. It was a dimension which suggested that Meltzer’s thinking was close to the work of another great innovator, Dr Michael Fordham. While Meltzer’s ideas grew from within the Kleinian tradition, Fordham was a follower of Jung. Fordham’s work as a child psychiatrist and, later, analyst, led him to postulate a theory of early development. His model was based on Jung’s concept of the self as the totality of the psyche with its personal and collective aspects and he demonstrated its relevance to infancy. Thus, Fordham brought to analytical psychology a coherent model of development. Whereas Jung’s idea was of a self becoming active in mid-life through the process of individuation, Fordham’s theory was that there exists a primary self, a primary state of integration, a psychosomatic unity, which deintegrates and reintegrates as the infant instigates a relationship with his mother. In The Apprehension of Beauty, the authors write imaginatively of the mental life of the foetus and the new-born. They say:

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CHAPTER FOUR. Impasse and empathy

Bernardine Bishop Karnac Books ePub

Robert Royston

Introduction

This chapter proposes that there is a level at which analytical meaning is boundaryless and universal, that there is no problem about communication across cultural, gender, lifestyle and political divides, and that in the analytical encounter, if it is operating in a certain mode, chalk can understand cheese with no serious obstruction or problem. It is argued that such communication is achieved through a level of understanding that passes through barriers, making contact with the seemingly un-contactable, and that the mode is empathy. This will be illustrated with reference to work with an abusive patient demonstrating the working of this analytical mode, and if s capacity to transcend difference.

Of course there are surface difficulties. In the consulting room and elsewhere we are told or hear things that are strange to us. What is bush medicine, or obeah? What is Kataze root? Why was a child half blinded by a cricket ball treated with local applications of mother’s milk? Alien practices, alien cultures. An Italian-American film director, interviewed on television told how as a boy in New York he could have become a Mafioso. These were men who were special, respected, rich, connected with other awesomely special men. But the director didn’t try to work for them and the fact he didn’t, he says, means nothing in terms of difference between him and them. He happened to take a different fork in the road.

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