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Chapter Five

Steven J. Ellman Karnac Books ePub

Summary

T his chapter brings together two analysts (Anna Freud and Heinz Hartmann) who were perhaps the two most influential Freudian theorists from 1940-1960 and beyond. Their theoretical efforts were frequently labelled as ego psychology, since the Freudian theory that they promulgated began from Freud's structural theory (Chapter Four). Hartmann and Anna Freud were initially the main explicators of Freud's move to , and their clarification and development of help to make it the dominant theoretical influence in the USA. It is hard to understand the import of both Hartmann and Anna Freud without making some attempt to recreate the atmosphere that faced both these theorists in the mid 1930s.

Freud, at this point in time, was quite ill, and was to die in 1939. Melanie Klein was in England and having a substantial impact on the members of the British Psychoanalytic Society. European psychoanalysis was dominated by Freudian theory, but there was unease about considering Thanatos, or the death instinct (see Chapter Four), a central psychoanalytic concept. The idea of a death instinct, while embraced by Klein, was certainly not finding strong acceptance in the Freudian community. Moreover, while Freud had proposed during the 1920s, few writers (including Freud) had shown the clinical relevance of Freud's newest theory. (Nunberg [1931] extended the idea of ego functions to include the synthetic function. Glover's paper on inexact interpretation in his book on technique [1955] to some extent utilized the new concepts embedded in the structural theory.) It remained for Hartmann and Anna Freud to begin to plumb the implications of . In 1958, Hartmann published Ego Psychology and the Problem of Adaptation, and Anna Freud, in 1936, The Ego and the Mechanisms of Defence (the English translation of which was published in 1946). These two works signalled a much fuller acceptance of the structural theory, particularly in the USA. Both of these volumes paid considerably greater attention to the conscious experiences of the patient. While the main focus of Freudian theory was the unconscious, both Anna Freud and Hartmann made the elementary but necessary point that one can only theorize about unconscious tendencies based on certain conscious experiences or actions. In the language of the structural theory, the unconscious is mediated through the ego and known through the preconscious and conscious aspects of the ego. Both Anna Freud and Hartmann also subtly but decisively rejected the idea of Thanatos, much to the disappointment of Freud. Freud, in “Analysis terminable and interminable” (1937c), noted that a number of analysts did not accept his instinct theory and he seemed clearly upset, particularly since some of the revisionists were his closest supporters.

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1. Freud's Early Ideas

Steven J. Ellman Karnac Books ePub

1

 

Freud's Early Ideas

We begin this volume at a time when Freud is leaving the hypnotic method,1 and beginning to listen and talk to patients in a manner that will shake the foundations of Western Society. Although contemporary analysts frequently draw a sharp dichotomy between psychoanalysis and psychotherapy, we will see that Freud's psychoanalytic technique gradually evolved from his work as a hypno- and psychotherapist. In fact, Freud's method will always remain a mixture of his later, more mature psychoanalytic technique, with ideas he developed in his first therapeutic interventions. As Bernfeld has noted (1949), Freud often saw himself primarily2 as the inventor of the psychoanalytic method and viewed psychoanalysis

first of all as a new technique by which a whole realm of facts, inaccessible before, can be brought to light. It is a new instrument of observation, a new tool of research. In the second place only is it a body of new knowledge gained by the use of the new instrument, [p. 238]

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Chapter Twelve

Steven J. Ellman Karnac Books ePub

Freud in relation to Mahler's concerns

Freud was frequently concerned with how the infant began to learn about the external world. In The Interpretation of Dreams (1900a), he presents his well-known views of the infant, at first primarily or only concerned with pleasure and, later, through deprivation, coming to know about the external world. This conception of how the infant turns from its primary concern (pleasure or tension reduction) to secondary concerns (the outside world) is based heavily on a tension-regulation model. Freud's later views, which are contained in large part in his papers on narcissism and his metapsychological papers (1914c, 1915c), are less centred on a tension-regulation or reduction model. In these and other papers, Freud put forth the guidelines of an interesting theory of early development, but, in this chapter, we can only sketch out some of his ideas (see Chapters Two and Three). Freud sees the early mental development of the infant and child as taking place along three polarities: pleasure-pain, subject-object, and active-passive, an idea that has a developmental unfolding. In early life, pleasure and pain predominate, and Freud maintains that for the infant or child

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Chapter Fourteen

Steven J. Ellman Karnac Books ePub

Summary

This chapter follows Kernberg's theoretical integrations as well as his clinical observations. There is a long section on the borderline syndrome and Kernberg's use of Kleinian concepts. In addition, we look at some of the criticisms that have been levelled at Kernberg over the decades. We present the view that at least some of the criticisms are based on Kernberg's object relations perspective.

The beginnings of an integrative approach

It is a difficult task to attempt to summarize and critique Otto Kernberg's psychoanalytic contributions, for he has presented

1. A version of this chapter has been published previously: Carsky, M., & Ellman, S. (1985). Otto Kernberg: psychoanalysis and object relations theory: the beginnings of an integrative approach. In: J. Reppen (Ed.), Beyond Freud (pp. 257-296). Hillsdale, NJ: Analytic Press.

systematic and wide-sweeping clinical and theoretical statements. His work touches on many, if not most, of the topics that have been of interest to contemporary analysts. Even reviewers who have been sharply critical of Kernberg, such as Calef and Weinshel (1979), have stated that “no other single colleague has been so instrumental in confronting American psychoanalysts with Klein-ian concepts and theories” (1979, p. 470-471). Although there is no question that Kernberg has been strongly influenced by Kleinian concepts, there is also no question that he is attempting to integrate many different parts of what is called the British object relations school, as well as aspects of Freudian thought, ego psychology, and different strands of research in neurophysiology and physiological psychology. This list is by no means complete. Kernberg is strongly interested in affect research as well as research in psychotherapy.

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13. Contemporary Views of Termination

Steven J. Ellman Karnac Books ePub

13

 

Contemporary Views of Termination

Although Freud wrote about endings in analysis, he was not primarily concerned with what contemporary analysts have designated as the termination phase of treatment. Freud does point out that there are not always mutual terminations in analyses, but his interest is in understanding the obstacles that are frequently encountered in the analytic situation. Contemporary analysts have attempted more generally to study the way analyses end.

Jack Novick

Novick relates that mutually agreed-upon terminations are the exception in modern analytic treatment.1 In a review of the termination phase of treatment (1982) he brings up six major termination issues:

NOVICK ON SOME DEFINITIONS IN THE TERMINAL PHASE

Novick's review begins with consideration of the question of premature termination. This type of termination is divided into two clearly defined categories. Those that are decided on by the analyst are designated forced terminations, whereas those initiated by the patient are labeled unilateral terminations. Forced terminations may occur because the analyst moves away, contracts a prolonged illness, becomes pregnant, or even dies. Grouped with these reasons are the more common analytic issues, “a premature decision made by the analyst for countertransference reasons, such as dealing with entrenched preoedipal transference situations, especially those of the sadomasochistic kind, or dealing with seemingly interminable patients” (Novick 1982, p. 330). Similarly, unilateral terminations include such divergent factors as “geographic moves or physical illness, to intensive resistances to the transference” (Novick 1982, p. 330). Although the problem of premature terminations is certainly not limited to analytic treatment or to psychological treatments, there are obviously important reasons to understand the difficulties in the path of mutually agreed-upon terminations.2

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