15953 Slices
Medium 9781855750678

"Sum, I Am"

Laurence Spurling Karnac Books ePub

Marika Henriques

In my fantasy the ideal therapist is a happily composed mixture of Jung and Winnicott. Being a mere Jungian therapist, I am falling far short of this imaginal healer. However, I would like to give an instance—of many— when Winnicott was present, so to speak, as the mysterious ”third” in my consulting room.

It concerns A., whom I have seen for several years, and a particular session with her. I look forward to my two hours a week with her. She and I have a strong, positive if not intimate bond, on an emotional and on the working level. This alliance survived the vicissitudes of those times, when I had to alternate between being experienced as her intrusive and violent father and her mentally unstable mother. The latter was as basically emotional absent, as the former was fearfully ever-present in her life. When I think of A., the word confusion springs to mind with its double connotation of chaos and fusion. Separation of any kind, like a sharp knife, cuts through her sharply. Breaks at the beginning were difficult to survive, and sometimes were not She has an uncanny way of knowing about my personal life, accurately intuiting my likes and dislikes, my moods and illnesses. It used to be difficult, at times even impossible, to know where I ended and where she began. This fusion is also true of her primary relationships, particularly with her children and her parents.

See All Chapters
Medium 9781855755055

Appendix E: CcAT child-centred work

Maggie Gall Karnac Books ePub
Medium 9781855752993


Rik Loose Karnac Books ePub

Lacan hardly ever referred to drugs or addiction. One could conclude from this that he wasn’t interested at all or that he didn’t think addiction was important. But, it is important not be too hasty. Hugo Freda has indicated that Lacan made six references to drugs or toxicomania.1 In 1938 in Family Complexes in the Formation of the Individual Lacan suggests that addiction is related to a “lost universal harmony” and that it is an attempt to rediscover the “imago of the mother” (Lacan, 1938, pp. 12-13). In 1946 in “Propos sur la causalite psychique” he relates it to the attempt to resolve the “primordial discordance between the ego and being”; “an unfathomable concession to freedom”, he calls it (Lacan, 1966[1946], p. 187). In 1960 in “Subversion of the subject and the dialectic of desire in the Freudian unconscious” Lacan claims that “the experience obtained under the influence of hallucinogenic drugs” has something to do with wanting to undo the division of the subject, and it pertains perhaps to reaching a state of pure thought, by eliminating the dimension of jouissance. This is something that is akin to Platonic enthusiasm or Buddhist meditation (Lacan, 1977[1960], p. 294). In 1966 in “La place de la psychanalyse dans la medecine” he says that scientific discourse confers a new status onto “tranquilizers and hallucinogenics” (Lacan, 1966, p. 767). The legislators of medical practice impose two duties: “controlled use…of drugs” and “an ethical dimension which moves into the direction of jouissance” (Ibid.). Lacan’s remarks in this round table discussion also imply that toxicomania is following the path of (medical) science and is becoming increasingly dependent on, what he calls, an “epistemo-somatic relationship” to the body (Ibid.). In 1973 in his Seminar Les Non-Dupes Errent Lacan says that “hash is superfluous” and when one considers the immediate context of this remark it actually suggests that hash is not a source of knowledge (1974, lecture from 18 December 1973). In 1975 in the “Culture aux journees d’etudes des cartels” he makes his most famous remark: “there is no other definition of a drug than this one: it is something that permits the separation from the marriage with the ‘little willy’“ (Lacan, 1975a, p. 268, my translation).

See All Chapters
Medium 9781855754324


Jan Abram Karnac Books ePub

1   Boundaries and structure

2   The holding function

3   Personalization

4   Management

A ll the details of maternal care just before birth and immediately afterwards go towards making up the holding environment. This includes the mother's primary maternal preoccupation, which enables her to provide the infant with the necessary ego-support.

The psychological and physical holding an infant needs throughout his development continues to be important, and the holding environment never loses its importance for everyone.

The holding environment includes the father, the extended family, and society at large.

1   Boundaries and structure

Although Winnicott recognized the importance of holding right from the beginning of his work, he did not use the word “holding” until the mid-1950s. During the Second World War, while he was working with Clare Britton, who eventually became his wife, they had both seen the great need for a holding environment in terms of the management and treatment of the antisocial child. (see ANTISOCIAL TENDENCY: 1)

See All Chapters
Medium 9781855756571

CHAPTER TEN: Psychoanalytic treatment of panic attacks

Jean Petrucelli Karnac Books ePub

Psychoanalytic treatment
of panic attacks

Mark J. Blechner, Ph.D.

Panic attacks are a major mental health problem in the United States today. It has been estimated that between 1% and 3% of the general population experience panic attacks during their lifetimes (Schuman et al. 1985; Katon 1996). Patients with panic attacks use up a lot of time in medical practices and emergency rooms, when they show up repeatedly, thinking they are having a heart attack or a stroke or some other medical crisis. Of course, tests have to be run to make sure that they are not really having a heart attack or a stroke, so a lot of time and money is wasted. I think that psychoanalytic therapists should be the first line of treatment for patients with panic attacks, but that is not the case today. The conventional wisdom is that such patients should be sent to a cognitive-behavioural therapist or a psychopharmacologist. This is not good for the patients, and it is not good for psychoanalysts. I will explain why.

I will describe three patients I have seen in treatment. I will summarize what I observed with them and then discuss the theoretical implications of this data. After presenting my own data, I will summarize some of the generalizations that have been made about panic patients and then evaluate them in terms of my own clinical data. I will suggest some ways in which we might revise our theory of panic attacks and test out a newly formulated theory.

See All Chapters

See All Slices