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10: How belief in God affects my clinical work

Salman Akhtar Karnac Books ePub


Neville Symington

God as the Infinite

Belief in God lies at the core of all religious denominations. Thera-vada Buddhism is an exception to this general rule, and for this reason it is sometimes described as a Philosophy rather than a Religion. My belief in God affects my clinical work, but how? What follows is a personal statement: it is the way this belief affects my work in the consulting-room. It contains no statement about how such a belief may affect someone else, nor is it a recommendation for other clinicians.

Mystics, such as Meister Eckhart and the author of The Cloud of Unknowing emphasize that the reality of God is obscured through the word God. The word conjures up in the mind an image that blinds me to the reality that the word God is supposed to designate. Thus the word makes the reality foggy. The way in which a word can disturb our understanding has been emphasized by Wilfred Bion, by the philosopher Frege, and also by G. K Chesterton, who said this:

Atmosphere ought not to affect these absolutes of the intellect; but it does…. We cannot quite prevent the imagination fromremembering irrelevant associations, even in the abstract sciences like mathematics. [Chesterton, 1933, p. 180]

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Chapter 7. Friendship

Salman Akhtar Karnac Books ePub

Leo Rangell


The subject to which I shall address myself today is that special form of object relations designated as friendship. As was the case with other subjects I have approached in recent years, such as a study of the state of poise (Rangell, 1954), or the quest for ground in human motivation (Rangell, 1955), or a survey of the role of object relations in psychoanalysis (Rangell, in Ritvo, 1962), the present subject has in common with all these the qualities of ubiquity and a certain diffuseness. This circumstance prompts me to characterize these areas as the psychological sea or air around us. They are all of such a nature as to fill the very interstices of psychic life, as a result of which they tend to become invisible and elusive. The task then has been with each of them to get a grip, to identify the phenomenon, to outline its periphery and borders, and, hopefully, to describe its central core.

It is astonishing how little has been written in the psychoanalytic literature on this perhaps most frequent of all human relationships. The references which do exist are generally glancing, scanty, and en passant. There is, to my knowledge, scarcely a psychoanalytic study centred on this subject in depth. Most of the existing studies have been written by psychologists, psychiatrists, group workers, or social scientists, and appear generally in works on educational psychology or mental hygiene. Khanna (1960) recently reviewed the literature on friendship in adolescence, mostly of American and Indian sources, and found concern mainly with friendship patterns and with factors conducive to social acceptance and rejection. The subject of friendship does not appear in the index of any of the volumes of The Annual Survey of Psychoanalysis.

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Medium 9781782204916

Chapter Four - Death of Sibling

Salman Akhtar Karnac Books ePub

Frederick H. Lowy

Bereavement through the death of a sibling shares the features associated with grief and mourning that follow all significant losses. There is a large general literature that discusses these as well as a rich professional/academic literature, from Freud (1917e) through Kubler-Ross (1969) to Volkan (1981) and other contemporary writers. Yet the death of a sibling, whether in childhood or adulthood, frequently also exhibits features that differ. This chapter will focus on these differences which often are not acknowledged or even recognized. The psychoanalytic, psychiatric, and clinical psychological literatures contain fewer specific references to sibling loss than might be expected; the death of a sibling, after all, is by no means rare at any time and becomes more common as one ages. As a number of authors have pointed out, no other major loss is so neglected, although in recent years there have been efforts to fill the gap (for example, Akhtar & Kramer, 1999; Edwards, 2010; J. Mitchell, 2003). By contrast, the impact of the loss of one's parent or one's child has been the subject of very many published case reports, considerable formal research, and much theoretical consideration. Fanos (1996), among others, has pointed out that “When a child dies, siblings experience a unique loss of their own with little societal recognition of the impact” (p. xi).

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Medium 9781780490250

9: Negation, negative capability, and the work of creativity

Salman Akhtar Karnac Books ePub


Antonino Ferro

Freud (1925h) argues that negation entails an intellectual acknowledgement of what has been repressed even when the essential part of repression—or in other words, its emotional counterpart—remains. Of course, even stronger defence mechanisms than negation also exist, such as the Jekyll-and-Hyde sort of splitting or “hyperbole” (Bion, 1965) whereby affect is violently expelled and lost “in space”. It goes without saying that the other side to negation is affirmation, whether this comes from the analyst’s interpretive activity or from the patient himself.

In this chapter I consider these defence mechanisms as gradations of the same phenomenon. This is not because I think there is no point in looking at the differences, the specific characteristics, and even their various degrees of seriousness, but because I think it is more useful to offer some reflections on a common antidote to these defence mechanisms: the negative capability of the analyst in Bion’s (1970) understanding of the term taken from Keats’s letter (1817) to his brothers, George and Thomas. The key point of this capability is knowing how to be in a state of doubt without having to saturate it immediately with answers—in Keats’s words, “being in uncertainties, mysteries, doubts, without any irritable reaching after fact and reason”. Or, in Bion’s terminology, being for a long time in the paranoid-schizoid position but free from persecution.

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CHAPTER SIX. Refusing to listen

Salman Akhtar Karnac Books ePub

“Psychoanalysis is justly suspicious. One of its rules is that whatever interrupts the progress of analytic work is a resistance.”

—Sigmund Freud (1900a, p. 517)

Spring 1978. I am a junior faculty member in the Department of Psychiatry of the University of Virginia’s School of Medicine. I am considering psychoanalytic training and want to apply to an analytic institute. But I am hesitant. Real and imagined burdens of time and money are not what bother me. I am fearful of rejection, entertaining all sorts of scenarios in which the institute will refuse me entry. Feeling stuck, I seek the counsel of Dan Josephthal, who is a supervisor of mine. He is a warm man with a radiant smile and a twinkle in his eyes. He is solidly grounded in reality and unpretentious. There is also a matter-of-fact sort of tenderness about him. In short, he is a mensch.

We arrive at an Italian restaurant near his office the next day. After we have placed our orders and exchanged a few pleasantries, he looks at me keenly and says, “Tell me why would you not apply for analytic training?” I mumble something to the effect that I fear I might be rejected. He seems puzzled and asks me, “Why?” As I open my mouth to reply, he raises his hand indicating me to stop and says, “I am not interested in listening to those kinds of reasons.” His warmth and friendliness tell me that his shutting me up is not from rudeness. It is actually an act of fatherly tenderness, a nudge to momentarily pull me out of my silly neurotic inhibitions. I get the point he is making. By refusing to listen to (what he rightly anticipated to be) my misplaced self-castigation, he cleaves my ego into an experiencing and an observing section. In effect, he makes an interpretation, telling me that I should not allow my neurotic anxieties to come in the way of my academic growth. Two days later, I mail my application to the psychoanalytic institute.

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