11923 Chapters
Medium 9781855758612

Chapter Nine: The capacity to say no and psychosomatic disorders in childhood

Karnac Books ePub

Gérard Szwec

The conquest of negation significantly enriches object relations. Initially, the instinctual drives can be discharged only through direct muscular activity. Once children develop the capacity to make judgements, with the possibility of saying “yes” or “no”, they can discuss and negotiate. Their options are no longer limited to fight and flight, and the reality principle prevails over the pleasure principle. Saying “no” in order to signify one's opposition to the object, to counter the other person, is a landmark stage in the organization of the mind and the development of social relationships.

It is generally accepted that children who cannot communicate their refusal of something to someone else have to find some other way of doing so—one that involves the body.

However, since there is a whole range of physical phenomena that could be seen as the body's response as a substitute for “no”, I must make it clear that my intention here is not to discuss what generally goes under the heading of “body language” such as one sees in hysterical conversion with a symbolic meaning. I am talking here about the body that is somatically ill, not the erotic body.

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Medium 9781782204244

Two Types of Writing and Ego Function

Moncayo, Raul Karnac Books ePub

Wednesday 11 May 1976

Two types of writing and ego function The knot of four in neurosis and psychosis

The Borromean knot must be written. Why? Because the knot as well as the signifier is a support for thought or for non-thinking or appensee (the a as a privative a). Writing is a doing which gives support for and precipitates thinking.

The Bo (Borromean) knot must be written in order to get something from it.

Lacan describes two types of writing:

Writing with the signifier and writing degree zero or in a state of erasure. It does not cease from being written and does not cease from not being written.

This is the characteristic of the NoF emerging from the Real as a unary trace. On the one hand a trace is written, on the other hand, the trace is a unary form of negation because it negates and erases what it negates. It is an affirmation that negates the unmarked or the Real by marking it with a trace or mark. The unmarked refers to the outside meaning, but also to the generation of pure desire and the object cause of desire that is both signified and negated at the same time. The NoF as Signifier, the phallus/objet a, and the desire of the mother as signified are written but they also wind back to something Real beyond signification. This Real does not cease from not being written and yet the signifier never stops writing it. What I am calling writing degree zero (following Barthes’ (1953) title), is the writing of the Borromean knot, that incorporates the unsayable into its structure.

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Medium 9781782201557

Chapter Twelve: Healing and the End of Therapy

Tangolo, Anna Emanuela Karnac Books ePub

The concept of healing and mental health

Psychotherapy is supposed to end when the objectives established in the contract are achieved, and, consequently, when the problems due to which one began one's personal analysis and one's treatment path are solved. The therapist and the patient both have in mind an idea of how therapy is supposed to end and it is important to explore these representations and make them explicit.

For the therapist, the idea of the end of the therapy is associated with the theoretical model she is following, as this model generally includes in its guidelines ideal levels of maturity, healing, and autonomy. Besides, the therapist is also conditioned by her personal ideals and philosophical inspirations, and by the concept of health and change that she pursues.

For the patient and client, the idea of the end of therapy is more subjectively connoted and must be explored from the very beginning, during the phase in which the therapeutic contract is defined.

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Medium 9781780491196

Chapter Seven - Diagnosis and Treatment in Psychoanalytic Psychotherapy

Karnac Books ePub

Matthias Elzer, Wolfgang Merkle, Hermann Schultz, and Alf Gerlach

The initial interview

Matthias Elzer

In general, psychotherapy is a conscious and intentional process of interaction that can be described as follows.

Before we start any kind of psychotherapeutic treatment, a diagnostic phase to assess the patient's complaints and illness is necessary. The initial interview is a very important and interesting first step towards understanding the patient and clarifying the indication for treatment.

In his paper “On beginning the treatment” (1913c), Freud compared psychoanalytical treatment with the game of chess, where we can learn only the beginning and the end of the game by reading books. This means that we can learn how to begin a therapy by systematically using techniques. Nevertheless, Freud did not describe any technique for an initial interview; he used the first weeks as a test run for therapy.

Influenced by psychiatry, some concepts of a structured interview were developed, for example by Gill, Newman, and Redlich (1954) and Kernberg (1981). Psychoanalysis offered different forms of therapy (psychoanalysis, psychodynamic, or psychoanalytic psychotherapy, short-term therapy, group therapy) not only for patients with neuroses, but also for patients with severe personality disorders, and psychosomatic and psychotic disorders. The questions of indication and contraindication were raised when considering the most suitable form of psychoanalysis for each case.

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Medium 9781780491523

Chapter Nine - Drug Dreams and the Neuropsychoanalytic Model of Dreams

Colace, Claudio Karnac Books ePub

Drug dreams and the neuropsychoanalytic model of dreams

Neuropsychoanalysis analyses the “…internal psychological structure of the various changes in personality, motivations and complex emotions that occur following a damage to different cerebral structures” (Kaplan-Solms & Solms, 2000, p. 62) (see also Solms & Turnbull, 2002; 2011). One of the most important applications of this approach is the study of the dreaming process (Solms, 1997). In this chapter, I shall describe how the study of drug dreams might contribute to prove the validity of neuropsychoanalytic findings concerning the dreaming process. In fact, drug dreams represent a real exemplification and, at the same time, a clinical support to Solms's neuropsychological model.

The neuropsychoanalytic model of dream

Neuropsychological studies on dreaming are based on the observation of subjects who, due to a lesion in a specific brain area, have changed their way of dreaming. These studies suggest which brain structures are involved in the ordinary process of dreaming, that is, the cerebral organisation of dreaming (Solms, 1995, 1997, 2000, 2011).

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