Glen Gabbard - One and Two Person Models of Analytic Understanding

"In this communication, I have sought to identify an integrative direction for contemporary psychoanalytic thinking. No sensible observer would dispute the idea that the analysand has pre-existing characteristics based on a lifetime of unique experiences that can be observed by others with some degree of consensus. On the other hand, the observations are inevitably filtered through the analyst's subjectivity. Similarly, the analyst's subjective impressions are influenced by the interpersonal pressure emanating from the patient to conform to various transference objects that the patient is re-creating in the analytic setting.

Hence one implication for technique is that I disagree with Renik's dictum that 'even an implicit pretence of objectivity on the analyst's part is to be avoided' (1993, p. 566). The presence of the analyst's subjectivity does not automatically eliminate the validity of that analyst's outside or object-based perception. In the case of Ms A, I was able to marshal evidence, from both my own countertransference reactions and the reactions of others as she described them, to reach a useful conclusion about the impact she had on others. I was then able to share my observation about the unconscious intent of her erotised transference by relying on a mixture of my own responses and data gathered from her experiences of other men. Hence I was 'objective' in the sense of being an object in her world as well as in the sense of gathering data to reach a plausible conclusion. Part of my subjectivity in the situation was a conviction that I had something useful to share with her based on reasonable evidence.

The integration I am advocating is not simply one involving objectivity and subjectivity. It is also a brief for an informed dialectic between modern and post-modern thinking and between a one-person and a two-person perspective. The fact that an analysis takes place in the context of a relationship cannot be ignored. Neither can we dismiss the fact that the composition of the patient's internal world and the nature of that patient's intrapsychic conflict ante date the beginning of the analysis. What is to be avoided is a conviction in the analyst that a specific a priori truth is already known at the outset of the treatment and that the task is simply to point the patient in the proper direction. An analyst who listens with an openness to surprise, a degree of patience and a measure of theoretical flexibility will usually find that a unique form of psychoanalytic truth emerges. Meaning is both constructed and discovered. In a totally different context nearly four centuries ago, Francis Bacon is alleged to have said, 'One who begins with certainties shall end in doubts; but one who is content to begin with doubts shall end in certainties'."

Glen Gabbard (1997). A Reconsideration Of Objectivity In The Analyst. International Journal of Psycho-Analysis, Vol. 78, pp. 15-26

Rosemary Gordon - Aggression and the Death Instinct

"If the Freudian death instinct be regarded as expressing itself in a striving towards the removal of boundaries and divisions, then one must reject the view that aggression is derived from this same instinct. For the function and purpose of much aggression is to divide and separate; and this, it seems to me, makes aggression relevant, and in fact vital and necessary, to the development of the ego, and also to its preservation. Etymologically, aggression means "going towards", and this implies that there is something that can go, and an object towards which one can move. Winnicott (1958) also seems to have reached a similar conclusion when he explains in his paper on "Aggression in Relation to Emotional Development" that, at a certain stage in analysis, patients may value their aggressive experiences more than their erotic ones; for these aggressive experiences help them to divide the "me" from the "not-me" and so create a feeling of "real". The same point is made by Searles in his studies of schizophrenics and their mothers. He argues that the hatred and destructiveness of the schizophrenic are in fact a defence against the temptation to fall back into the symbiotic and undifferentiated mother-child unity. "The schizophrenic illness now becomes basically revealed as representing the child's loving sacrifice of his very individuality for the welfare of the mother who is loved genuinely, altruistically" (Searles, 1958, p. 570). Although Searles's remarks can be translated into less poetic language—"sacrifice" and "altruism" seem inappropriate concepts to apply to a schizophrenic with minimal ego development—yet the underlying assumption appears most relevant and important. This mother-child unity is surely the earliest object of aggression; and the aggression is directed as much at the external mother as at the internal "need" for the mother, at the internal "cry baby". It may be contended that aggression is the stronger, the more possessive the external and real mother, or the more dominant the inner and regressive need for union. Where the ego is vulnerable, love may indeed be felt as a threat. Ralph would much rather hate than love me, and Bridget shows real terror if she becomes aware of good feelings, of affection. It is aggression that creates boundaries, and so defends against disintegration, unconsciousness, death.

This view of aggression might help to explain such a symptom as hypochondriasis: one of my patients, a very schizoid man of 31, with severe hypochondriacal features, one day began by complaining that he could not readily remember what went on in our sessions. Was he likely to get "objective" knowledge from his analysis, he asked. Later in the same session he told me a dream: in it there is a cement-mixer, and during the lunch-hour he eats some of this cement. It is hard and dry and lies heavily inside him. His associations led us on to discuss the difference between a good and a bad feed. In a good feed the food disappears from conscious awareness. A bad feed gives pain and indigestion, but through the pain one keeps track of what goes on inside. One is thus armed against surreptitious invasion. This point was recently made quite explicit to me by a hospitalized schizophrenic girl who remarked: "I would rather have indigestible food. Indigestible food keeps your brain active. Then I know I have eaten it. I like to suffer." Pain, therefore, has value in paranoid reactions; it is a watching that guards against absorption, union, and unconsciousness. This leads one to think of the popular remark: "I had to pinch myself to make sure I was awake." May not hypochondriacal symptoms be a sort of "pinching oneself to know one is awake", that is, alive and conscious? The fact that such symptoms feature prominently in the menopausal depressions, a mental illness that occurs at the stage of life when death becomes an ever-approaching reality, reinforces my suspicion.

Psycho-analysts have often described themselves as essentially dualistic and hence dynamic, because of their concept of two opposed primary instincts. Jung has been criticized by them for his monistic view of libido. But possibly this difference between the two schools is merely a question of arguing from different levels of abstraction and interpretation. In Two Essays on Analytical Psychology, when discussing Freud's theory of the death instinct, Jung remarks that "What Freud probably means is the essential fact that every process is a phenomenon of energy, and that all energy can only proceed from the tension of opposites" (Jung, 1943, C. W., 7, p. 28). Ultimately eros and thanatos are only parts of the general life process, just as anabolism and catabolism are interdependent functions of the metabolic process. And though Jung may reject an over-riding dualism in terms of two principal and opposed instincts, he is in fact very much alive to the essential conflict which is at the root of all behaviour and experience. For instance, in his discussion of death and of man's attitude to it, he has perceived both wish and fear, both attraction and repulsion. In Symbols of Transformation he describes life as "a constant struggle against extinction, a violent yet fleeting deliverance from ever-lurking night. This death is no external enemy, it is his own inner longing for the stillness and profound peace of all-knowing non-existence, for all-seeing sleep in the ocean of coming-to-be and passing away" (Jung, 1912, C.W., 5, p. 355 f.).
　

When Freud acknowledges the inevitable interdependence of eros and thanatos, when he postulates that they always work together and that every act is the product of their joint operation, he comes close to the position that Jung has taken. For it is surely true that every event brings both birth and death. The death of one cell is the birth of the two daughter cells. Paula Heimann (1952) sees such cell division as the work of the life instinct; and so it is—from the point of view of the daughter cells. But the mother cell has been split and so its identity has been destroyed. The growth of cells has always seemed to me a most useful analogy, for here life and death lie so closely together that they coalesce. The whole process is really one of transformation. "No new life can arise, say the alchemists, without the death of the old" (Jung, 1946, C. W., 16, p. 256). Let us take, for example, love, which psychoanalysts regard as the expression of eros. Basic to the experience of love is an aversion to separation. Thus the drive for union, here described as the death instinct, plays an important part. And indeed, the most intense expression of love, orgasm, is often experienced and described as a death-like state, as a loss of boundary, of identity; there is a merging with the loved object, or a merging with the loved object into some even greater unit. Frigidity, or the fear of orgasm, may often be an expression by a weak ego of a fear of dissolution, a dissolution which, it suspects, is irreversible. One must assume that, in these cases, aggression and the forces that make for separation are feeble; only withdrawal from the seduction of union can safeguard identity. This, in fact, is what the schizophrenic does in toto.

Since death is one link in the chain of transformation it is felt essentially as a paradox. After writing the first draft of this paper, I felt that death was in fact a trickster: approach him from one side and he turns round and makes you feel absurd and confused. I was reminded of a story that the Yoruba of Nigeria tell about their trickster, Elegbara, a story I enjoy: Elegbara, they say, walks down the boundary of the farms of two friends; he is wearing a cap that is black on one side and white on the other; and he causes the friends to become enemies because they argue over the colour of his cap.

Having followed the trail of Freud and Flugel, having arrived at the notion that death is union, is boundary-less non-being, is "chaotic nonentity", a term Laing has borrowed from Blake to describe the schizophrenic condition, we arrive at the point where love is seen as closer to death than to life. And yet, the avoidance of this love, this death, leads to death through immobility. But surrender to love also leads to death—in the coniunctio; for as Jung writes in The Practice of Psychotherapy (1946, C.W., 16, p. 256): "When the opposites unite, all energy ceases; there is no more flow." And, he continues, quoting Avicenna, "… the corruption of one is the genesis of the other …" and "The corpse left over from the feast is already a new body, a hermaphroditus" (ibid., p. 258). I believe that Jung holds the key to the paradox with his claim that the theme of death and re-birth is a fundamental and basic psychic fact, nor does he avoid putting great emphasis on the necessity of this death, this corruption, this putrefaction which must happen and which must be suffered before a rebirth can take place.

Death, the coniunctio, the state of union and wholeness, is, in part, desired and sought by all. But dying, that is corruption, means leave-taking, loss, surrender, and sacrifice, and most of us try to escape it. Neurotics and psychotics try to escape it by creating a situation in which they have nothing to sacrifice. But, if there is no dying, there can be no transformation. Only the denial of death is really death.Conclusion

The death instinct is not a silent instinct as Freud has claimed. Its attractive force, its dynamism, betrays itself in man's capacity to suffer voluntarily a hero's death, and to experience the ecstasy of self-abnegation, be it in the surrender to an ideological cause, in love, or in the experience of the mystic."

Rosemary Gordon (1961). The Death Instinct and its Relation to the Self. Journal of Analytical Psychology, Vol. 6, pp.119-135

Nancy McWilliams - The Maternal-Paternal Dimension and Analytic Technique

"The foregoing is intended to shed some light on our confusing literature on technique. A review of major writers about the psychoanalytic art will reveal that, from the earliest history of the psychoanalytic movement, theorists have tended to split along lines that can be construed as predominantly maternal or paternal. While not all areas of disagreement between analysts of different persuasion reduce to a motherly-fatherly tension, in the realm of technique, it seems frequently to be one of the covert lines of dispute.

Analysts that I would characterize as paternal are those who emphasize interpretation, confrontation, the systematic examination of defenses, and the inevitability of internal conflicts in the face of a difficult reality. Maternally oriented practitioners emphasize holding, the expression of understanding, affective resonance, and facilitation of grief. Paternal therapists are inclined to see patients as actors who keep on, by the operation of the repetition compulsion, recreating a dilemma of their own unconscious choosing. Maternal therapists have a propensity to see patients as reactors to parental failures to understand, who have been hurt and need attention to their wounds before they can move on developmentally in a natural, more or less unconflicted way. Paternal clinicians stress the importance of the analyst's boundaries, discipline, expertise, distance from contaminatory countertransference, denial of instinctual gratifications, and stimulation of ego development, while maternal ones stress flexibility of technique, intuition, the capacity for deep understanding via countertransference reactions, repair to developmental injuries, and the therapist's function as auxiliary ego.

If my deductions about the centrality of both motherly and fatherly processes in good psychotherapy are correct, then effective practitioners always ultimately combine elements of each parental position. Freud, for example, has tended to evoke in his readers (partly because of his stimulating, didactic tone, partly because of his stress on the father's position in the oedipal triangle, and doubtless for other subtle reasons as well) a preponderantly paternal image. He tended to educate his patients authoritatively, to confront them, to expose actively their defensive processes, to stress the inevitability of ordinary, nonneurotic suffering, and to disparage as regressive the yearning toward fusion with a fantasied omnipotent Other. Yet, the same Freud stressed the importance of flexibility and tact, and was recalled fondly by many patients for his attitude of sympathetic kindness (H. D., 1944; Blanton, 1971; Kardiner, 1977; Lipton, 1977). Similarly, the Ferenczi who is noted for his emphasis (e.g., 1928) on the more maternal processes of comforting, holding, encouraging, and maintaining sympathy and tact above all other considerations was the same man who had devised the "active technique" (1920) by which the analyst's deliberate prohibitions and injunctions would stimulate resistances, increase the severity of inner conflict, bring it to consciousness, and purportedly thereby shorten the treatment.

The psychoanalytic community nonetheless, and with some justification, seems to perceive different therapists at a preconscious level as either primarily maternal or basically paternal in style, and it is my contention that many of our debates about technique reflect a preoccupation with this hidden polarity. The Freud-Ferenczi arguments of the late 1920s can be seen as the first in a long line of parallel disagreements, not so much about the theory as about the art of psychoanalysis; specifically, whether it should manifest a more motherly or fatherly dynamism....

I could extrapolate further, but let me simply invite the reader to reflect on how dialectically the argument about appropriate psychoanalytic technique has evolved over the last decades, and how frequently the dialectic has contained maternal and paternal polarities. If my thesis that both attitudes are necessary is sound, it becomes clearer why our efforts to evaluate which position is ultimately "correct" have been doomed.

Returning to the question of what is effective therapy, let us consider instances of disappointment and failure in the analytic endeavor. When psychoanalyses fail, frequently it is because one of two types of things has gone wrong. Either the analyst has been experienced as disproportionately and unempathically paternal (distant, critical, challenging, depriving), or the converse, as disproportionately and unempathically maternal (indulgent, infantilizing, nonstimulating). With insufficient devotion, the patient feels a lack of love; with insufficient integrity, a lack of respect."

Nancy McWilliams (1991). Mothering and Fathering Processes in the Psychoanalytic Art, Psychoanalytic Review, Vol. 78, pp. 525-545.

Peter Mudd on Death and Transference

"The theoretical model I am proposing suggests that the fear of death or of the self-preservational drive is the prime mover in object relations, that field where the internal and external worlds penetrate each other and intermingle to create the psychological structures and the sustaining illusions that govern our lives. Identity, or what Jungians call persona, and its fraternal twin, the shadow, as well as the constructed conscience which Freud termed the superego, are all spawned by the ego's struggle with the paradoxical nature of the self, the light and dark of life and death. The death experience is propulsive, catalytic and continual. Most often it operates from the unconscious depths and influences our every action, but it must be allowed to break the surface of consciousness if life is to unfold in some approximation of its completeness. Mortality underlies relations with the self and with others and facilitates, often quite unpleasantly, the psyche's compensatory/self-regulating process which reaches its pinnacle in the capacity which Jung termed the transcendent function. I shall propose to you that the transcendent function is built on the prototypical experience of living through the threat of physical death, and is nothing short of the ego's achieved capacity to die repeatedly an ongoing series of conscious voluntary psychological deaths in the service of individuation. Further, I will propose that it is human relationship which provides the sacred space within which we learn to die and which enables the transcendent function to evolve into an operational psychological reality. Nowhere is this more true than in the analytic relationship....

In essence then, the countertransference is a living embodiment of the conscious capacity to die which, in my opinion, is synonymous with the central dynamic feature of the transcendent function. As Jung states: ‘In actual practice, therefore, the suitably trained analyst mediates the transcendent function for the patient, that is, helps him to bring conscious and unconscious together and so arrive at a new attitude. In this function of the analyst lies one of the meanings of the transference’ (Jung 6, p. 74). This process of holding through the acceptance of the self projection, stable dosing response and therapeutic dying leads from transference pathology to the eventual emergence of kinship libido which can be re-imagined as the recognition of the common fate of mortality and the empathy that results from that shared recognition. In death we can recognise our utter equality."

Peter Mudd (1990). The Dark Self: Death as a Tranferential Factor. Journal of Analytical Psychology, Vol. 35, pp. 125-141

　

Freud - Remembering, Repeating and Working Through

"What interests us most of all is naturally the relation of this compulsion to repeat to the transference and to resistance. We soon perceive that the transference is itself only a piece of repetition, and that the repetition is a transference of the forgotten past not only on to the doctor but also on to all the other aspects of the current situation. We must be prepared to find, therefore, that the patient yields to the compulsion to repeat, which now replaces the impulsion to remember, not only in his personal attitude to his doctor but also in every other activity and relationship which may occupy his life at the time—if, for instance, he falls in love or undertakes a task or starts an enterprise during the treatment. The part played by resistance, too, is easily recognized. The greater the resistance, the more extensively will acting out (repetition) replace remembering. For the ideal remembering of what has been forgotten which occurs in hypnosis corresponds to a state in which resistance has been put completely on one side. If the patient starts his treatment under the auspices of a mild and unpronounced positive transference it makes it possible at first for him to unearth his memories just as he would under hypnosis, and during this time his pathological symptoms themselves are quiescent. But if, as the analysis proceeds, the transference becomes hostile or unduly intense and therefore in need of repression, remembering at once gives way to acting out. From then onwards the resistances determine the sequence of the material which is to be repeated. The patient brings out of the armoury of the past the weapons with which he defends himself against the progress of the treatment— weapons which we must wrest from him one by one.

We have learnt that the patient repeats instead of remembering, and repeats under the conditions of resistance. We may now ask what it is that he in fact repeats or acts out. The answer is that he repeats everything that has already made its way from the sources of the repressed into his manifest personality—his inhibitions and unserviceable attitudes and his pathological character-traits. He also repeats all his symptoms in the course of the treatment. And now we can see that in drawing attention to the compulsion to repeat we have acquired no new fact but only a more comprehensive view. We have only made it clear to ourselves that the patient's state of being ill cannot cease with the beginning of his analysis, and that we must treat his illness, not as an event of the past, but as a present-day force. This state of illness is brought, piece by piece, within the field and range of operation of the treatment, and while the patient experiences it as something real and contemporary, we have to do our therapeutic work on it, which consists in a large measure in tracing it back to the past....

The main instrument, however, for curbing the patient's compulsion to repeat and for turning it into a motive for remembering lies in the handling of the transference. We render the compulsion harmless, and indeed useful, by giving it the right to assert itself in a definite field. We admit it into the transference as a playground in which it is allowed to expand in almost complete freedom and in which it is expected to display to us everything in the way of pathogenic instincts that is hidden in the patient's mind. Provided only that the patient shows compliance enough to respect the necessary conditions of the analysis, we regularly succeed in giving all the symptoms of the illness a new transference meaning1 and in replacing his ordinary neurosis by a ‘transference-neurosis’ of which he can be cured by the therapeutic work. The transference thus creates an intermediate region between illness and real life through which the transition from the one to the other is made. The new condition has taken over all the features of the illness; but it represents an artificial illness which is at every point accessible to our intervention. It is a piece of real experience, but one which has been made possible by especially favourable conditions, and it is of a provisional nature. From the repetitive reactions which are exhibited in the transference we are led along the familiar paths to the awakening of the memories, which appear without difficulty, as it were, after the resistance has been overcome."

　

Sigmund Freud (1914). Remembering, Repeating and Working-Through (Further Recommendations on the Technique of Psycho-Analysis II). The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XII (1911-1913): The Case of Schreber, Papers on Technique and Other Works, pp. 145-156