"In the introduction I pointed out Jung's interest in dissociation as opposed to Freud's focus on repression as the mechanism whereby material is kept out of consciousness. I will now turn to attachment theory again to discuss the concept of defensive exclusion and its relationship to the formation of internal working models.
I am aware that I have not yet satisfactorily dealt with the question of the discrepancy between events or people in the real world and the representations of those people or events, which often seem such distorted images of the real world. Drive theory accounts for this quite easily with its model of instinctual phantasy, out of which arise internal objects which do not reflect the external world.
However an alternative model can be derived from attachment theory. Separation anxiety is constantly activated in childhood, activating fears of abandonment and annihilation based on the growing child's sense of dependence and vulnerability. Separation, narcissistic and Oedipal anxieties are defended against by omnipotent and grandiose fantasy and experience is filtered through these defences, so that unbearable fears or events are excluded from conscious attention and awareness. However this does not prevent the fears and the defences from being inextricably bound up with the internalized image or memory of the event, so that the defences become part of the schematized patterns which are being formed in implicit memory as well as the events themselves.
The internal working model (or complex) therefore reflects these fears and defences and so may take a very different form from the person or event in the real world; the degree of distortion probably reflects the relative contribution of fear and defensive fantasy to the internal working model. This provides us with an alternative way of conceptualizing unconscious fantasy from that of instinctual drives.
Internal working models which reflect threatening past experience lead to further defensive exclusion of any encounter which activates the schema, so that there is a withdrawal or avoidance of engagement and relationship. This leads to an inability to learn from new experience and a failure to modify the internal working model, which remains encapsulated and split off from the rest of the psyche, just as Jung described complexes being dissociated ‘splinter psyches’.
Conclusion: Internal psychic reality is formed from the internalization of accumulated past experience of key attachment figures and is not an expression of innate instinctual drives. The concept of implicit memory provides us with an experimentally-based account of the way in which experiences are internalized and stored in a generalized schematic form which is not available to recall or conscious awareness, but which patterns our expectations of, and perception of, present attachments and relationships.
These schematized patterns are equated with the internal working models of attachment theory; the contribution of defensive exclusion to the formation of internal working models is discussed. I also suggest that internal working models have many features in common with the Jungian concept of complexes and a new view of complexes is therefore being proposed." (pp. 527-528)
Jean Knox (1999). The relevance of attachment theory to a contemporary Jungian view of the internal world. Journal of Analytical Psychology, Vol. 44, pp. 511-530
Monday, August 20, 2012
Tuesday, August 7, 2012
Irene Ruggiero - The Unreachable Object?
"It is well known that various models exist to explain the genesis and the structure of the borderline disturbance. One model emphasizes the role of aggression and of envy: they are thought to be characterized by an individual, constitutionally determined threshold (the so-called ‘conflict model’ which dates back to Kernberg’s thought). The other model instead gives prominence to a lack of attunement in the primary environment, which is thought to hinder the formation of those internal structures of self-regulation without which it is not possible to reach a sufficient level of cohesion of the self and become autonomous from archaic relationships with the selfobjects (this is the so-called ‘deficit model’ which emerges from the theories of Kohut). These models have led to divergent views about the most important factors in the therapy. In the ‘conflict model’, stress is placed on the steadfastness of the analytic setting (the stability of which reassures the patient that the analyst can contain and survive his destructiveness), and on the instrument of interpretation (this method allows confronting the patient on the issue of his aggression early in the process). However, the deficit model emphasizes above all attention to the ego-attuned subjectivity of the patient, and endorses the provision of the physiological fusion which was missing in the primary relationship.
Several colleagues (including Casement, 1990; Correale and Berti Ceroni, 1997; Modell, 1988; Monari, 1999), who highlight the opportunity to use both approaches, the ‘empathic’ and the interpretative, seeing these as the development of a single original matrix, believe that a sort of treatment in two phases may be particularly useful. In the early phase, the functions of containment, empathic mirroring and support predominate, with the use of interpretation being held back for the second phase.
This position, in which I recognize myself, is also borne out of the consideration that – as is often the case with traumatized people – in borderline individuals, behaviours and fantasies characterized by a certain level of automatism are present, accompanied by a reduction in the capacity to represent and the overdevelopment of the emotional components. In these moments of sensorial over-excitement, interpretative activities carry a risk of overburdening the patient further, who is already caught up in difficulties of mentalization. Meanwhile the activities of presence and connection assume great importance (Correale, 2006).
I share the position of those (Mitchell, 1993) who maintain that aggression, whilst having its own innate individual potential, is activated in relational and environmental situations that are perceived subjectively as being dangerous, a point which explains the particular sensitivity of borderline patients to minimal variations in the therapeutic environment. If, as I think, traumatic factors play an essential role in the genesis and the emergence of borderline functioning, we need to give particular attention to the microtraumas which can come about in the consulting room and to anti-therapeutic factors which can be attributed to the analyst’s difficulties (Ferenczi, 1932), as well as those activated by the difficulties of the patient. The specific contribution of my work consists in exploring the nature and possibility of using the countertransference in the game of symmetry and asymmetry which is created between the unconscious of the patient and the analyst. This is a game which works, more specifically, when the transference does not only manifest itself through words.
With borderline patients, in whom extensive areas remain unavailable to representation, it is necessary to work at length to cement a narcissistic tissue which is rather frayed. Before being able to use interpretative instruments, it is often necessary to undertake a long piece of analytic work which facilitates the transformation of as yet non-representable elements into representations that can be thought, dreamed and expressed in words.
One of the most specific difficulties that the analyst must confront in this work is the intense amount of destructiveness that these patients bring and activate. Whether this is determined by constitution or whether it represents the outcome of deficient primary relationships, the containment of the – sometimes raging – aggression of the borderline patient constitutes an unavoidable technical knot and a hard test for the analyst. Personally, I share the belief that it is fundamental to provide these patients with the potential to test the analytic setting as trustworthy and authentically containing before interpreting their intense destructiveness, which is often not yet available to thought." (pp. 586-587)
Irene Ruggiero (2012) The Unreachable Object? Difficulties and Paradoxes in the Analytical Relationship with Borderline Patients, International Journal of Psychoanalysis, Vol. 93, pp. 585–606
Several colleagues (including Casement, 1990; Correale and Berti Ceroni, 1997; Modell, 1988; Monari, 1999), who highlight the opportunity to use both approaches, the ‘empathic’ and the interpretative, seeing these as the development of a single original matrix, believe that a sort of treatment in two phases may be particularly useful. In the early phase, the functions of containment, empathic mirroring and support predominate, with the use of interpretation being held back for the second phase.
This position, in which I recognize myself, is also borne out of the consideration that – as is often the case with traumatized people – in borderline individuals, behaviours and fantasies characterized by a certain level of automatism are present, accompanied by a reduction in the capacity to represent and the overdevelopment of the emotional components. In these moments of sensorial over-excitement, interpretative activities carry a risk of overburdening the patient further, who is already caught up in difficulties of mentalization. Meanwhile the activities of presence and connection assume great importance (Correale, 2006).
I share the position of those (Mitchell, 1993) who maintain that aggression, whilst having its own innate individual potential, is activated in relational and environmental situations that are perceived subjectively as being dangerous, a point which explains the particular sensitivity of borderline patients to minimal variations in the therapeutic environment. If, as I think, traumatic factors play an essential role in the genesis and the emergence of borderline functioning, we need to give particular attention to the microtraumas which can come about in the consulting room and to anti-therapeutic factors which can be attributed to the analyst’s difficulties (Ferenczi, 1932), as well as those activated by the difficulties of the patient. The specific contribution of my work consists in exploring the nature and possibility of using the countertransference in the game of symmetry and asymmetry which is created between the unconscious of the patient and the analyst. This is a game which works, more specifically, when the transference does not only manifest itself through words.
With borderline patients, in whom extensive areas remain unavailable to representation, it is necessary to work at length to cement a narcissistic tissue which is rather frayed. Before being able to use interpretative instruments, it is often necessary to undertake a long piece of analytic work which facilitates the transformation of as yet non-representable elements into representations that can be thought, dreamed and expressed in words.
One of the most specific difficulties that the analyst must confront in this work is the intense amount of destructiveness that these patients bring and activate. Whether this is determined by constitution or whether it represents the outcome of deficient primary relationships, the containment of the – sometimes raging – aggression of the borderline patient constitutes an unavoidable technical knot and a hard test for the analyst. Personally, I share the belief that it is fundamental to provide these patients with the potential to test the analytic setting as trustworthy and authentically containing before interpreting their intense destructiveness, which is often not yet available to thought." (pp. 586-587)
Irene Ruggiero (2012) The Unreachable Object? Difficulties and Paradoxes in the Analytical Relationship with Borderline Patients, International Journal of Psychoanalysis, Vol. 93, pp. 585–606
Thursday, August 2, 2012
Hans Dieckmann - Fairytales in Analysis
"Such a favourite fairy-tale could be found in the unconscious of most of the patients I treated over a long period. Not all of them have been common fairy-tales. There were a lot of not so well-known ones from Andersen, Hauff, Brentano and others, and, also, though seldom, stories from modern children's books like Winnie-the-Pooh, Alice in Wonderland, etc. In most cases this material was more or less repressed in the unconscious.
If you ask the patient during the first session you usually get one of the common traditional fairy-tales remembered at that moment, such as Cinderella, Snow-White and the Seven Dwarfs, or Little Red Riding Hood, as the investigations of Wittgenstein (1955) have shown. The really individual favourite fairy-tale will emerge from the unconscious for the first time after some regression into the early childhood has taken place. Sometimes a dream symbol will give the first hint of it, sometimes the associations of the patient during a certain period of childhood. To my own astonishment this material was very individualistic. Among the 50 patients the same tales have been found only two or three times.
It is hardly surprising that one should find, at least in most European patients, a favourite fairy-tale from childhood. As a rule, such tales are among the earliest cultural products taken up by the human soul. In this way the typical imaginings of the culture can be assimilated and the structures of the archetype per se filled out with forms and pictures. On the other hand the main fairy-tale period of childhood is also the time when fundamental neurotic patterns are formed and the first neurotic symptoms come into existence. So we may have here a very important point: that the fairy-tale can tell us something about the basic structure and dynamics of the individual neurosis. It may also show us the organization of ideas and experiences of archetypal forms (Dieckmann, 1967). The partial or total identification of the ego with an archetypal image as the nuclear charge of a complex is one of the principal criteria of neurosis.
On the other hand the healthy ego-complex will only have such identifications in a passing way (Jacobi, 1942). So it is reasonable that we should also find such fixed identifications if the favourite fairy-tales of childhood return to consciousness during the course of analytical treatment. In practice one finds in this way many comparisons between the themes or symbols of the fairy-tale and the symptoms of neurosis." (pp. 22-23)
"It seems to me that a real understanding on the symbolic level of the solution of the problem in the fairy-tale is of great importance also for the analyst. All fairy-tales include individuation processes as is shown by many authors (v. Franz, v. Beit, Jaffé, Dieckmann, Laiblin and others) and they show in a symbolic form different ways of psychic growth and progress. So it may be possible to translate them in a behaviouristic way and to understand them on the objective level. This will lead to complications, because in this case the analyst will unconsciously accept the identification of the patient's ego with the image of the archetype." (p. 28)
"In a large number of patients favourite fairy-tales arise from the unconscious in connection with dreams, fantasies or associations. The main fairy-tale time of childhood is the time in which fundamental neurotic patterns are laid down and the first neurotic symptoms appear. There is a strong connection between these fairy-tales and the symptoms of the later neurosis, the structure of the personality and the patterns of behaviour. Such correlations have been investigated in 50 patients. Examples are presented in this paper.
Fairy-tales are among the earliest cultural products absorbed by the human soul. In this way the typical images of the culture can be assimilated and the structure of the archetype per se filled out with forms and pictures. Therefore the fairy-tale can be used as a diagnostic tool for the determination of the neurotic archetypal fixation.
The material shows the therapeutic value of bringing these images into consciousness and working them through at a symbolic level." (p. 29)
Hans Dieckmann (1971). The Favourite Fairy-Tale of Childhood. Journal of Analytical Psychology, Vol. 16, pp. 18-30
If you ask the patient during the first session you usually get one of the common traditional fairy-tales remembered at that moment, such as Cinderella, Snow-White and the Seven Dwarfs, or Little Red Riding Hood, as the investigations of Wittgenstein (1955) have shown. The really individual favourite fairy-tale will emerge from the unconscious for the first time after some regression into the early childhood has taken place. Sometimes a dream symbol will give the first hint of it, sometimes the associations of the patient during a certain period of childhood. To my own astonishment this material was very individualistic. Among the 50 patients the same tales have been found only two or three times.
It is hardly surprising that one should find, at least in most European patients, a favourite fairy-tale from childhood. As a rule, such tales are among the earliest cultural products taken up by the human soul. In this way the typical imaginings of the culture can be assimilated and the structures of the archetype per se filled out with forms and pictures. On the other hand the main fairy-tale period of childhood is also the time when fundamental neurotic patterns are formed and the first neurotic symptoms come into existence. So we may have here a very important point: that the fairy-tale can tell us something about the basic structure and dynamics of the individual neurosis. It may also show us the organization of ideas and experiences of archetypal forms (Dieckmann, 1967). The partial or total identification of the ego with an archetypal image as the nuclear charge of a complex is one of the principal criteria of neurosis.
On the other hand the healthy ego-complex will only have such identifications in a passing way (Jacobi, 1942). So it is reasonable that we should also find such fixed identifications if the favourite fairy-tales of childhood return to consciousness during the course of analytical treatment. In practice one finds in this way many comparisons between the themes or symbols of the fairy-tale and the symptoms of neurosis." (pp. 22-23)
"It seems to me that a real understanding on the symbolic level of the solution of the problem in the fairy-tale is of great importance also for the analyst. All fairy-tales include individuation processes as is shown by many authors (v. Franz, v. Beit, Jaffé, Dieckmann, Laiblin and others) and they show in a symbolic form different ways of psychic growth and progress. So it may be possible to translate them in a behaviouristic way and to understand them on the objective level. This will lead to complications, because in this case the analyst will unconsciously accept the identification of the patient's ego with the image of the archetype." (p. 28)
"In a large number of patients favourite fairy-tales arise from the unconscious in connection with dreams, fantasies or associations. The main fairy-tale time of childhood is the time in which fundamental neurotic patterns are laid down and the first neurotic symptoms appear. There is a strong connection between these fairy-tales and the symptoms of the later neurosis, the structure of the personality and the patterns of behaviour. Such correlations have been investigated in 50 patients. Examples are presented in this paper.
Fairy-tales are among the earliest cultural products absorbed by the human soul. In this way the typical images of the culture can be assimilated and the structure of the archetype per se filled out with forms and pictures. Therefore the fairy-tale can be used as a diagnostic tool for the determination of the neurotic archetypal fixation.
The material shows the therapeutic value of bringing these images into consciousness and working them through at a symbolic level." (p. 29)
Hans Dieckmann (1971). The Favourite Fairy-Tale of Childhood. Journal of Analytical Psychology, Vol. 16, pp. 18-30
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