16 Chapters
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14 On the psychodynamics of drug dependence

Limentani, Adam Karnac Books ePub

AS THE CAUSES OF DRUG dependence are multiform and exceedingly A complex, I shall refer to them only briefly in this essay. Many readers, perhaps, have some idea as to what causes drug addiction, and concurrently will hold definite views on how to prevent or treat it.

It is hard to maintain an unbiased and balanced attitude to the problem, which inevitably attracts the attention of the press because of its tragic consequences. The ordinary person will rightly become emotional if he or she is at the receiving end of thefts perpetrated to obtain drugs. The euphoria resulting from drug-taking stimulates vandalism and attacks on persons, often causing understandable public outcry.

In general, the epidemic which has hit the world during this second half of the century has caused a great deal of thinking which has not yet come to fruition. In the past, it was generally accepted that the compulsion to take drugs was linked with psychopathic characteristics. Nowadays only the more severe cases are thought to have a pathological nucleus with a clearly defined mental disturbance. Even then we must distinguish them from those cases where there is physical or mental stress, and we shall often be confronted by a temporary disability. The anxious person will take any drug; the psychopath will turn to whatever drug accelerates the mental processes; whilst the persistent use of morphine is suggestive of a psychotic disturbance on a depressive background.

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3 A re-evaluation of acting out in relation to working through

Limentani, Adam Karnac Books ePub

IT SEEMS LOGICAL that any discussion on acting out, in order to be meaningful, would have to be related to the concept of ‘working through’. There are few aspects of our daily analytical work which are more challenging than acting out and more directly pointing to the necessity and arduousness of working through the patient’s resistances, as Freud (1914) has warned us. The problem is not only that the tendency to act out needs constant attention by the analyst but also that disturbing episodes of acting out may well occur in the course of working through anxieties and conflicts under apparently quite satisfactory circumstances. I am referring to those optimal conditions where analyst and patient work well together and, of course, where the analyst has in no way contributed to force the patient to act out as a result of his own incompetence or because of the persistence of unresolved conflicts in himself. However, it would be fair to say that there are many instances when the analyst may unwittingly play a part. The experienced analyst is not only disappointed at seeing years of insightful working through wasted but may even come to the conclusion that the patient’s resistances are intractable to the point of abandoning analysis.

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5 The training analyst and the difficulties associated with psychoanalytic training

Limentani, Adam Karnac Books ePub

TRAINING IN PS YCHOANAL YSIS has been at the centre of debates ever since the International Psychoanalytical Association created a Training Commission in 1925 to control the spreading of ‘wild analysis’ and the troubles caused by self-appointed teachers. The Commission did not last more than a few years, owing to the difficulty in establishing any kind of uniformity of training within the increasing number of psychoanalytic groups.

For the last twenty-five years, psychoanalytic educators have met at two-yearly intervals under the sponsorship of their Association to discuss their work. In 1973 I was invited to chair a conference on the difficulties experienced by training analysts in their capacities as therapists and educators. In that capacity, I entered into a correspondence with senior colleagues from all over the world. The response indicated not only an interest in the topic but considerable anguish aroused by the dual role forced on the training analyst, as well as a need to confide in someone. In addressing the two hundred delegates who attended the conference in Paris, I used many of those statements made to me in confidence, as well as points raised in the course of open discussions by many speakers of different nationalities over the years.

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13 On some aspects of human violence

Limentani, Adam Karnac Books ePub

AS VIOLENCE APPEARS to have a particular attraction for human beings, not all its manifestations should be regarded as abnormal. Let us consider, for instance, acts committed in the course of wars, revolutions, and even terrorism, when a different view will be taken according to the side taken by the observer.

My interest in this theme is derived from a sense of unease caused by serious contradictions about what experts have to say on this topic. Some will argue that any attempt to understand human violence is a waste of time, whilst others insist that we should take into account the rights of individuals against those who wish to protect the interests of the community, and so on. I do not wish to appear an alarmist, even if I refer to the unchecked increase in violence in all kinds of societies right across the globe. On the other hand, I feel that we should not ignore the fact that many of us no longer feel safe in the environment in which we live. The prevalence of violent material offered by the media to the public, whether it is based on fact or fiction, needs to be justified and explained. It is possible that these so-called artistic expressions, or the desire to disseminate the truth, are not harmful; indeed, it will be contended that they provide a useful outlet to the aggressivity of the majority. Others will observe this phenomenon with apprehension and fear. Ernest Jones tried to assume an unbiased position, in 1915, when he posed many questions in his essay on ‘War and sublimation’: ‘In war, things are done by a large number of men on both sides, of a kind that is totally foreign to their accustomed standard of ethical conduct during peace, and the question arises, what is the source of the impulses thus vented and the relationship to the controlling forces of civilized life?’ Jones goes on to note that

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16 Variations on some Freudian themes

Limentani, Adam Karnac Books ePub

AS WE HAVE REACHED the end of a long week in the course of which most of you have been working very hard, I felt that in this address I should offer you something of a diversion. All I propose to do is to share some thoughts that have occurred to me during the last few years on all kinds of subjects that matter a great deal to all of us. I may have already published some of them in one form or another, but the majority of them are casual reflections or old annotations hurriedly scribbled on a scrap of paper in response to contributions from colleagues and patients. What I have to offer could well be regarded as somewhat iconoclastic but wisdom does not come with age, as Bernard Shaw once said. Only experience increases as we get old and that can be oppressive or liberating.

As we approach the end of the century, psychoanalysis appears to become even more difficult than we ever suspected. Some of the changes that have been introduced have certainly not been easy to accept. Yet whenever a more audacious view, possibly a challenge to classical analysis, is put forward, it is de rigueur to quote Freud, no matter how often he had already contradicted or altered that view himself. The haunting thought for most psychoanalysts is: What would Freud have said about this or that?

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