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Psychoanalysis after Freud / Post-Freudian Traditions
A Study Guide Barnaby B. Barratt, PhD, DHS Revised: Spring 2008 BBBarratt@Earthlink.net

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Introduction: Rivaled only by the developments of behaviorism/cognitive-behaviorism, psychoanalysis is unarguably the 20th century’s most influential psychological paradigm, describing the human condition and purporting to heal many aspects of its prevalent distress. Yet what exactly is “psychoanalytic psychology”? From the very beginning, Alfred Adler’s “individual psychology” and Carl Jung’s “analytical psychology,” caused their followers to diverge from Sigmund Freud’s innovations, psychoanalysis has been a fractured, fragmented and profoundly controversial discipline. Often, its claims to “science” have been protected more by institutional affiliation than by the progression of consensual discourse and new discovery. (Moreover, those who have defended the scientific character of psychoanalysis—combating critics who have claimed its doctrines are mere scientism or pseudoscience—have typically referred to notions of “science” that prevailed in the 20th century but that are now, with the advent of quantum realities, seeming outdated.) Looking back on 20th century psychoanalysis, we see numerous theories—many of them notably incompatible with each other—all vying for the possibly honorific title of

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“psychoanalysis.” At the same time, we see a discipline, or community of disciplines, assailed by external criticism over issues of scientific status and therapeutic claims. Yet in so many ways, psychoanalysis has survived and thrived. It continues as a viable clinical enterprise in Europe, even though its inroads into the academic discourse of psychology have been patchy. It has undergone several waves of popularity in the United States, and it has large numbers of adherents throughout Central and South America. Even if—for the time being—we omit consideration of the major contributions of C. G. Jung’s analytical, archetypal and transpersonal psychology/psychotherapy, theories and healing practices going under the label of psychoanalysis comprise a strangely diverse and controversial grouping. The purpose of this “Study Guide” is to provide some coordinates for anyone wishing to navigate through this territory (and it will only address the leading theorists of major trends or schools that influenced the development of the discipline during the 20th century). Even if we look only within the confines of the International Psychoanalytic Association (from which Adler broke in 1911, and Jung in 1913), by the end of the 20th century we find psychoanalysis to be split into many divergent varieties. The dominant “schools” include the Kleinian, Lacanian, structural-functional or ego psychological, object-relational but nonKleinian or “independent”, Kohutian, and relational, intersubjective or interpersonal. But even this list of major divisions fails to incorporate some important variations—exemplified by the heirs to Wilhelm Reich, by the “existential psychoanalysts,” by the post-structural feminists, and others. These divergences are not trivial, they often have foundationally metatheoretical implications, consequences for clinical practice, cultural ramifications and profound ideological and spiritual significance. It is unfortunate that, in the English language, we currently lack a really sophisticated and non-partisan survey of this field and its history—one that would enable the lay reader to understand the ideological, cultural and scientific forces that have rendered psychoanalysis into such a variety of competing and conflicting “schools,” many of which are almost entirely unable to communicate with each other, yet each of which considers itself to be essentially “psychoanalytic.” We lack an accessible and readable, critical guide to comparative psychoanalysis. This Study Guide will not compensate for this lack. But will suggest some of the major trends and variations in a way that will permit the interested student to undertake explorations of his/her own.

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General Study Questions of Psychoanalytic History and Development:  How do psychoanalytic ideas originate and how are they transmitted? In what sense do we consider the phenomena to which psychoanalysis refers (e.g., the unconscious, reality, etc.) there to be discovered, or actually constructed discursively by the participants in a “depth” inquiry?  How might a history of psychoanalytic ideas and practices (one that is focused on the chronology of authors/teachers, practitioners/adherents, schools/institutes) actually obscure the more profoundly paradigmatic and discursive genealogy of psychoanalytic ideas and practices (“genealogy” implying a “history” that is focused on issues of logical-rhetorical structuring and transformation, modes of ideological transmission, and sociocultural determinants)?  What would it mean to claim that psychoanalysis proceeds “rationally”? What defines “psychoanalysis” and how are its internal controversies to be understood or arbitrated (i.e., what levels of philosophical, ideological, cultural, scientific and clinical description can usefully be brought to bear on these divergences)? And what therefore are the limits of inter-translatability between different “models”? Metatheoretical Dimensions: Comparison of fundamentally divergent theories of the human condition requires that some sort of criteria of appraisal need to be brought to bear on the theories being compared. The following are offered as five deeply-interconnected metatheoretical dimensions—or criteria for appraisal or evaluation—that might possibly to useful:  Self, Consciousness and the Unconscious. Does the theory posit, or assume, that the human being once was, now is, or can become an internally harmonious and integrated unit? Or is internal conflict, fragmentation or contradictoriness taken as an inevitable and unavoidable feature of living a human life?  The “Sexual Body.” Does the theory posit, or assume, that the human mind is somehow separate and distinct from the body it inhabits—thereby, subscribing to the epistemology and ontology of a Cartesian type of dualism? Or is the bodymind appreciated more holistically, and its sensuality and sexuality—the “immediate presence of the lived experience of embodiment”—understood to have a foundational pre-conceptual, pre-narratological, and pre-subject/object role in all human psychological functioning?  Individual and Spirituality. Does the theory allow for ontological realms other than those that characterize ordinary, consensual reality? And therefore what forces—
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transpersonal or mechanical—are held as potentially impacting the life experiences or subjectivity of the individual?  Individual and Culture. What is the relationship between “individual and society” posited by the theory? Or, more precisely, within what processes of cultural contextualization and determination does the theory expound the nature of individual psychological functioning?  Awareness and Transformation: What assumptions does the theory make about change processes? And what is the role of awareness, or reflective consciousness, in change processes that affect what might be considered to be “non-epistemological” aspects of the individual’s being-in-the-world—i.e., what is liberatory praxis? Ten Specific Lines of Questioning for a Comparative Psychoanalysis: (1) What categories or boundaries define “psychic reality” or the “field” of psychoanalysis? What are the notions of subject, voice, structure, self or person that characterize the discourse? In what sense are such categories comprehended as necessary or contingent? And how does this bear on implied notions about “clinical facts” as distinct from their discursive theorization? (2) How is time and history held to govern meaningfulness? In what way, and with what limitations, is the past held to influence the present, and how is the repetitiousness of human functioning comprehended at the individual level? What linear, epigenetic, nonlinear and dynamically interdependent, or ahistorical assumptions are operative in the theory? And how is continuity, discontinuity, novelty and recapitulation, and the notion of “return” discussed within the theory of individual functioning? Does the theory allow for the future to influence the present—and in what sense? What theoretical notions encode assumptions about intentionality, future-oriented motivation, and teleology? What significance is the anticipation of non-existence or “death” held to have for the present functioning of the individual? (3) How does the structuring of experiencing and understanding govern meaningfulness? How are different modalities of experiencing/understanding posited, defined and distinguished? And with what theoretical and practical consequences? What is therefore taken to compose “reality”?

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What is assumed to the relation between the entity that produces meanings (or thoughts, feelings, and actions), the entity that enunciates these meanings, and the entity that may reflect upon them? That is, what assumptions are made about matters of agency in psychic reality, and how doe these assumptions connected with whatever is posited concerning the temporality of psychic reality? (4) How does the sensuality or sexuality of the body govern meaningfulness?

What is assumed to be the relation between bodily events (or the “lived experience of our embodiment”) and the contents of self-reflection? Between materiality and awareness? What role is given, if any, to the (spiritual, erotic) energetics of being human? How is the significance of sex and gender differences to be understood? Is a distinction made between the penis and the phallus and what, if any, is the usefulness of this distinction for emancipative transformation from the strictures of patriarchal culture? (5) What, if any, are the limits of order/disorder, organization/disorganization, rationality/irrationality, etc., in relation to the events of psychic reality and the psychoanalytic field? Is any consideration given to ontological realms other than the ordinary and consensual? Is any consideration given to “otherwise” ways of knowing? (6) What discursive practices distinguish psychoanalysis from other modes of conversation and relationship—for example, from ordinary conversation, from rhetorical exhortation, or from other psychotherapeutic dialogues? And what notions of truth or truthfulness are thereby assumed to be inscribed in the process? (7) What conflicts or foundational anxieties are assumed to characterize the human condition, and how are these hierarchized (one being considered derivative of another that is more fundamental, etc)? What assumptions are made about whether they can be overcome or not? What is the role of notions of death or deathfulness, castration or castratedness, and issues of “loss”? What inherent conflicts are posited concerning gender, generation, and generativity? And what assumptions are made about the “motivational” dispositions of the individual toward the remedy of these lacks/deficiencies/conflicts?

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(8) How is psychic change brought about by the psychoanalytic process? How is this process described and what, if any, epistemological role, is given to the patient’s conscious and reflective awareness? What are the constative versus the performative aspects of psychoanalytic “cure” or healing? What is the role played by interpretations, insights, procedures of symbolic realization, rituals and enactments? What assumptions are made about notions such as integration, coherence, adaptation? And what moral, ideological and epistemological assumptions are made about “health” and “cure”? (9) What are the functions, and sources of authority, attributed to the psychoanalyst in the psychoanalytic process, and how are they acquired or deployed? (10) What cultural, ideological, rhetorical or politically commitments are encoded and enacted in practices pertaining to the origination and transmission (establishment and perpetuation) of psychoanalytic ideas, education, and institutional organization? Forces and Factors of Theoretical Divergence: Studying psychoanalysis after Freud raises questions about how disciplines develop, and how what purports to be a clinical science—based on observation and intervention with patients—can diverge and fragment in the manner that psychoanalysis has done from its inception and throughout the 20th century. This is a fascinating case concerning the sociology of knowledge, the vicissitudes of cultural ideology, and the politics of organizations. We might consider five forces or factors which could account for the fragmentation and factionalism that has characterized psychoanalysis:  Genuine “scientific” disagreements within a discipline, the “data” of which are acquired in uniquely private circumstances. The occasional provision of “recordings of therapeutic sessions” does little to allay this problem—simply put, the “science” of psychoanalysis does not have accessible data in the manner that every other science does.  Personal power politics and issues of identification in the process of disciplinary transmission. At least within the International Psychoanalytic Association, the procedure for becoming a psychoanalyst requires personal analysis, usually of great intensity and duration, with a training analyst. Consequently, the powerful processes of

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identification and de-identification (“disidentification”) often affect the theoretical vision and affiliation of practitioners.  Organizational disruptions. Typically, when psychoanalysts disagree they break off relations with each other and establish new institutes. This pattern began early—when Freud established his “Inner Circle” of a ‘few good men’—and characterized the earliest years of the International Psychoanalytic Association, which Freud and Jung founded in 1910. However, it has continued throughout the 20th century. In the USA, in France, and in several South American countries, institute splitting has occurred frequently. The British Psychoanalytic Institute—staying unified and being a home for three divergent training “tracks”—is an exception within psychoanalysis’ organizational history. Also contributing to organizational disruption has, of course, been the Diaspora, etc.  Cultural influences. Psychoanalysis shows the marks of European culture—and particularly its development in the context of two World Wars. Additionally, the impact of secular humanist thinking in the Jewish tradition—as well as of Jewish mysticism—on psychoanalytic ideas has been amply demonstrated. Psychoanalysis has taken difference flavors as it emigrated (from Europe to the United States, and to Central and South America) and as thinkers of different national origins and cultural traditions became involved in its development.  Progress and regress ideologically. There are ideas in early psychoanalysis that were perhaps “before their time,” and as such were propounded and then largely dropped. One example would be Freud’s radical notion of libidinality; another might be the dynamic of repressive consciousness. This is discussed in Barratt’s Psychoanalysis and the Postmodern Impulse (1993), and elsewhere. Frameworks and Phases of Freud’s Thinking: There are at least three frameworks in Freud’s thinking, as well as much debate as to whether these are compatible, inseparable, etc. Energetic: The theory of drives, especially libidinality. Note each drive has an aim, an intensity, an object (or zone), and sometimes is partitioned according to developmental phases (oral, anal, phallic, genital). Controversy over the dualistic position in which aggression is primary along with libido, versus the notion that aggression derives from the frustration of primary drive. Note also the significance of the “pleasure principle.”

Topographic: Conscious/preconscious/unconscious. Note the importance of suppression/repression, the “repression barrier,” and of the “return of the repressed” in this formulation. Also note the methodological significance
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of “free associative discourse” as the way to re-appropriate that which has been repressed. Structural-functional: The ego/id/superego. Sometimes called “ego psychology,” which became more systematic (and less descriptive/phenomenological) in Freud’s thinking by 1923. Somewhat anomalous to these three frameworks is the formulation of the “death instinct,” in Freud’s 1920 book Beyond the Pleasure Principle. This notion has become very controversial, and divides the world of Freudian psychoanalysis. The notion is an important effort to explain the repetition compulsion (why do we unconsciously repeat events/scenarios that are not pleasurable, and even self-destructive?). Schematically (and with some exaggeration), we might say that: in the United States, ego psychology dismisses the death instinct as metaphysical speculation—however, the rest of the Freudian world, embraces the notion but usually interprets it in a Kleinian manner (namely as a statement about primordial destructive/aggressive impulses). There are existential-spiritual and Lacanian interpretations of the death instinct which are yet again quite distinctive. Freud’s work can be divided into several theoretical phases, and it can also be argued that the tone of his theorizing shifted after World War I. Some of the benchmark publications, grouped according to their theoretical relevance and their place in the sequence of Freud’s work, are as follows: 1895 1895 1896 1898 1898 1899 1900 Obsessions and Phobias Studies on Hysteria The Aetiology of Hysteria Sexuality in the Aetiology of the Neuroses The Psychical Mechanism of Forgetfulness Screen Memories The Interpretation of Dreams

1901 On Dreams 1901 The Psychopathology of Everyday Life 1905 Jokes and their Relation to the Unconscious 1905 Three Essays on the Theory of Sexuality 1906 My Views of the Part played by Sexuality in the Aetiology of the Neuroses 1907 Delusions and Dreams in Jensen’s Gradiva 1907 The Sexual Enlightenment of Children 1908 Hysterical Phantasies and their Relation to Bisexuality
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1908 Character and Anal Erotism 1909 Analysis of a Phobia in a Five-year-old Boy 1909 Notes upon a Case of Obessional Neurosis 1910 Five Lectures on Psychoanalysis 1911 Formulations on the Two Principles of Mental Functioning 1911 Psychoanalytical Notes on an Autobiographical Account of a Case of Paranoia 1912 A Note on the Unconscious in Psychoanalysis 1912 Totem and Taboo 1914 1914 1915 1915 1915 1915 1917 1918 On Narcissism Recollecting, Repeating and Working-Through Observations on Transference-Love Instincts and their Vicissitudes Repression The Unconscious Mourning and Melancholia From the History of an Infantile Neurosis

1919 A Child is Being Beaten 1919 The Uncanny 1920 Beyond the Pleasure Principle 1921 Group Psychology and the Analysis of the Ego 1923 The Ego and the Id 1924 1925 1925 1925 The Economic Problem of Masochism A Note on the Mystic Writing Pad An Autobiographical Study Negation

1926 Inhibitions, Symptoms and Anxiety 1926 The Question of Lay Analysis 1926 Dr. Reik and the Problem of Quackery

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1927 The Future of an Illusion 1930 Civilization and its Discontents 1931 Libidinal Types 1931 Female Sexuality 1933 New Introductory Lectures on Psychoanalysis 1936 Letter to Richard Sterba 1937 Analysis Terminable and Interminable 1937 Constructions in Analysis 1939 Moses and Monotheism 1940 An Outline of Psychoanalysis [Posthumously published since Freud died September 23, 1939]

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Notes on the Structural-Functional Model of “Ego Psychology”: In many ways, this is a distinctively U.S. development of classical psychoanalysis, drawing on the “ego psychological” perspective that partitions the mind, functionally, according to ego, id and superego. It elaborates on Freud’s 1923 and 1925 books, and owes much to Anna Freud’s 1936 work, The Ego and the Mechanisms of Defense. Major theorists were MD immigrants of the World War II Diaspora, who arrived in New York in the late 1930s, and whose theoretical contributions begin in the 1940s and continue thereafter, who were supported by Alexander Brill, the founder of the conservative American Psychoanalytic Association. The first generation of theorists included Heinz Hartmann (1894-1970), Ernst Kris, and Rudolf Loewenstein (1898-1976). The next generation was dominated by Charles Brenner and Jacob Arlow. The subsequent generation is active today, and has stewardship of the journal Psychoanalytic Quarterly as well as a major influence on the Journal of the American Psychoanalytic Association. Although this model has dominated psychoanalysis in the U.S.A., its adherent comprise a minority within the International Psychoanalytic Association—the majority of whose members would more plausibly be designated Kleinians, independent object-relationists, or Lacanians. Note that, since the 1950s, this theory has become more sophisticated as the principle of multiple functioning and the principle of adaptation have been developed. The former “principle of multiple functioning” suggests that every psychological event can by found to be the ego’s compromise formation between: reality (as perceived/constructed by the ego) id impulses (sexual and aggressive) superego (and “ego-ideal”) constraints This essentially means that reality/id/superego are very much like putative forces impacting the ego’s functioning—the “putative” here denotes the difference between the earlier versions of this theory, and the more recent versions which are sometimes referred to as “neo-structuralism.” Notice also that in this tradition, contrary to Freud’s early formulations, “the ego” is now very much an organizational entity, rather than a phenomenological one (Ich or “I”). This development has profound philosophical consequences which are somewhat discussed in Bruno Bettelheim’s Freud and Man’s Soul (1982) and in Barnaby Barratt’s Psychic Reality and Psychoanalytic Knowing (1984). Central to the psychotherapeutic techniques based on this formulation is the notion of signal anxiety – the idea that the ego experiences, usually not consciously, anxiety pertaining to an imminent conflict with reality, id or superego, and then acts by using
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one or more of a series of defense mechanisms (see Anna Freud’s 1936 book) to avert the danger. This implies that the repetitious quality of mental phenomena is due to the ego’s inherent need to gain mastery over the conflicts in which it is embroiled. The “principle of adaptation” basically suggests that “the ego always achieves its optimal compromise” between the three forces acting on it. However, in practice, most ego-oriented psychoanalysts confuse this principle of intrapsychic adaptation with environmental adaptation, as discussed in sociology or evolutionary biology – “science” becomes conflated with ideology. Note also that this principle is effectively circular because – given that reality, id, and superego have effects that are contingent on the ego’s ability to be impacted by them – it can always be said post hoc that a phenomenon is an “optimal compromise.” A philosophical critique of structural-functional psychoanalysis is to be found in Barratt’s 1984 book, Psychic Reality and Psychoanalytic Knowing and also extensively throughout the work of Jacques Lacan and his successors. There are other critiques from a depth psychological perspective, pointing out that this formulation tends to underestimate the power and the nature of unconscious forces. Questioning the Klein-Bion Model:  Why might one believe that destructiveness is foundational to the structuring of human functioning? What difference does this belief make to clinical practice or to conduct in everyday life? What are the shifts and nuances of the notion of human destructiveness that occur within the various formulations of this model?  What does this model imply about the boundaries and limitations of rationality (if this can be defined)?  How does paranoid-schizoid functioning appear in clinical practice or everyday life?  What does this model imply about the conditions of change in psychoanalysis, and elsewhere, as well as the limits of any potential for change?  How are oedipal conflicts, and the development of male/female sexualities viewed distinctively in this model? Reading Melanie Klein: Melanie Klein (1882-1960), born in Austria, had a teaching degree, first sought psychoanalysis with Sandor Ferenczi in Budapest, and then was trained by Karl
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Abraham in Berlin (where she moved in 1921), and spend the most productive years in London, where she moved in 1926. Unlike other authors, almost all of Melanie Klein’s writings were brought together in a four-volume collection, The Writings of Melanie Klein (1921-1963). The Volumes are as follows: 1. The Psychoanalysis of Children. 2. Love, Guilt and Reparation, and other works 1921-1945. 3. Envy and Gratitude, and other works 1946-1963. 4. Narrative of a Child Analysis. Melanie Klein’s psychoanalytic theories emphasize not only Freud’s topographic model but, even more significantly, the notion of the “death instinct,” which Klein reworks as a primordial destructive rage innate to every individual. According to Klein, innate destructive-aggressive impulses dominate our earliest or most “primitive” functioning, which involves chaotic, fragmented, and disorganized images or representations of everything there is… This is the “stage” of the paranoid-schizoid position (or level of functioning), which engages what Klein calls manic defenses (defenses that take action, including projective identification, etc). Gradually, the individual becomes more integrated but in so doing recognizes the seriousness of his/her own destructive urges toward that which is loved … this precipitates the individual into the “stage” of the depressive position (or level of functioning), which engages a constellation of more modulated defenses. Also important to note is Klein’s use of the notion of phantasy (spelled in this manner), referring to the “objects” and “part-objects” that populate the individual’s psychic reality. In this theory, Klein uses very concrete notions of symbolization – it is noteworthy that Kleinian analysts will often speak as if the patient (or infant) literally deposits pieces of his/her own inner world into the being of the analyst (or mother). In Kleinian treatment, the analyst acts as a container for all the patient’s projections and projective identifications. Interpretation is then used to compel the patient toward the re-integration of his/her own psychic material, and this serves to move the patient from paranoid-schizoid functioning into depressive functioning. It is also noteworthy that Klein writes often about the individual’s sense of guilt, by which she means that, when entering the depressive position, the individual is mortified by the recognition of his/her own destructive urges and attempts to make reparation for the damage s/he believes has been done to the “object.” Finally, note that in her later theoretical formulations Klein came to write increasingly about primordial envy. Envy (which is essentially very destructive, and dyadically
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organized) is distinguished from jealousy (which is less intrinsically destructive, and triadically organized). The notion of primordial envy implies that we all have deep, underlying impulses to destroy anything good that ourselves do not feel we possess. Here are the papers most recommended if the student is to grasp the distinctiveness of Klein’s thinking: 1920 1921 1922 1923 1923 1925 1926 1927 1928 1929 1929 1930 1930 1932 1933 1935 1945 1946 1952 1952 1955 1963 The Development of a Child The Psychoanalysis of Children Inhibitions and Difficulties in Puberty Early Analysis The Role of School in the Libidinal Development of the Child A Contribution to the Psychogenesis of Tics The Psychological Principles of Early Analysis Criminal Tendencies in Normal Children Early Stages of the Oedipal Conflict Infantile Anxiety Situations … the Creative Impulse Personification in the Play of Children The Importance of Symbol Formation in the Development of the Ego The Psychotherapy of Psychoses The Psychoanalysis of Children The Early Development of Conscience in the Child A Contribution to the Psychogenesis of Manic-Depressive States The Oedipus Complex in the Light of Early Anxieties Notes on Some Schizoid Mechanisms The Mutual Influences in the Development of Ego and Id Some Theoretical Conclusions regarding the Emotional Life of the Infant The Psychoanalytic Play Technique: Its History and Significance Narrative of a Child Analysis

Questioning Winnicott’s Model:  Why might one believe that “transitional experience” is fundamentally important to human development, and what difference does such a belief make to clinical practice or to everyday life?  What might be entailed by Winnicott’s emphasis on the necessary role—in development and in healing—of play, and what implications does this emphasis have for our understanding of the boundary between rationality and irrationality? In this context, what is Winnicott’s understanding of the functions of a psychoanalyst, and how does this differ from both the structural-functional and the Kleinian models?

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 What is a “false self,” how would you know it if you had one, and what could you do about it?

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Reading Donald W. Winnicott: Donald W. Winnicott (1896-1971), born in England, trained and practiced initially as a pediatrician, and developed his theories in a very piecemeal fashion—often in a mostly unreciprocated dialogue with Klein. Winnicott is a highly influential figure in the formation of the so-called “middle group” within the British Psychoanalytic Society, and is a pioneer of a grouping of psychoanalytic theories loosely known as “independent object-relations”—that is, theoretical positions that follow Melanie Klein in being, unlike some Freudians, object-relational, yet are different from Kleinian formulations. For many years—notably in the 1940s and early 1950s—British psychoanalysis flourished theoretically under the tensions between the viewpoints of Klein and Anna Freud (1895-1982). Within the British institute, there was a series of so-called “controversial discussions” between followers of Melanie Klein, who had practiced in London since 1926, and the followers of Anna Freud, who had arrived in London in the late 1930s. These debates revolved around several matters, such as the primacy of aggression, the dating and characteristic of the oedipal complex, etc. Early on there was a “gentleman’s agreement” to divide training opportunities within the British institute into two “tracks.” Later, a third “middle group,” for those students who wanted to sample the perspectives of both Kleinian and (Anna) Freudian psychoanalysis. A variety of psychoanalysts were affiliated with this “independent” group, within which Winnicott was notable. There were a number of other eminent theorists in this group. For example, Ronald Fairbairn (1889-1964) produced a complex theory that is quite different from any other psychoanalytic model. It concerns the way in which the personality fragments. He is also responsible for a model of maturation from “dependence,” through “pseudo-independence,” to “mature interdependence.” Michael Balint (1896-1970) developed several specific theoretical ideas—for instance, about the regressive and thrill-seeking tendencies of the ego’s functioning. He also elaborated the important distinction between phallic and genital sexuality. Subsequently influential “middle school” theorists include eminent contributors such as Masud Khan (Alienation and Perversion), Juliet Mitchell (Psychoanalysis and Feminism), and Christopher Bollas (In the Shadow of the Object). A major contribution of Winnicott’s is the notion of transitional objects, which was later elaborated into the theory of transitional phenomena. The concept of “transitionality” emerged from observations of children, and specifically the developmental use they would make of “security blankets,” teddy bears, other such
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entities. Their transitional character refers not to a shift from one developmental phase to another, although transitional objects do indeed facilitate such development, but more to the fact that these objects both exist in external reality and yet are also imbued with their essential quality from the fantasy realm of internal reality. In this sense, transitional objects constitute an intermediate or liminal reality, halfway between the inner and outer worlds – this is a transitional (psychic) space essential for healthy psychological development, and even for adult functioning. Another noteworthy contribution of Winnicott’s – which is concordant with his notion of transitional space – is his emphasis on the therapeutic importance of play, and the multiple modalities of self-expression (in this it is possible that he was indirectly influenced by Jung). His “squiggle game” became well known as a method of working with children. Winnicott also developed several other notions such as that of the “false self,” which emerged from his work with delinquent adolescents, the importance of the “holding environment” in therapeutic interaction, and the significance of “good enough” qualities in mothering. Winnicott authored at least a dozen books, several of them for nonprofessional readership, and several of them anthologies of his professional papers (some edited posthumously). There are two monographs which describe the treatment of a child (The Piggle), and an adult (Holding and Interpretation). To grasp Winnicott’s core ideas, the reader has to roam through a large number of mostly scattered papers, almost all—but not all—of which are to be found in one or other of his books. The major books, anthologies, and pamphlets include: 1931 1945 1949 1957 1964 1965 1965 1971 1977 1971 1985 1984 1986 1986 1987 Clinical Notes on Disorders of Childhood Getting to Know your Baby The Ordinary Devoted Mother and her Baby The Child and the Family The Child, the Family, and the Outside World The Family and Individual Development Maturational Processes and the Facilitating Environoment Playing and Reality The Piggle Therapeutic Consultations in Child Psychiatry Collected Papers: Through Pediatrics to Psychoanalysis Deprivation and Delinquency Home is Where We Start From Holding and Interpretation Babies and their Mothers

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1987 The Spontaneous Gesture 1988 Human Nature 1989 Psychoanalytic Explorations For a reader wishes to read only Winnicott’s most influential papers, the following are significant, and are to be found in his Collected Papers, in Maturational Processes and the Facilitating Environment, or in Psychoanalytic Explorations: 1931 1931 1935 1939 1941 1945 1947 1950 1951 1954 1954 1954 1956 1956 1956 1958 1958 1960 1960 1960 1960 1961 1962 1962 1963 1963 1963 1964 1964 1965 1966 1967 1967 1968 1968 Fidgetiness A Note on Normality and Anxiety The Manic Defence Aggression and its Roots On Influencing and Being Influenced Primitive Emotional Development Hate in the Countertransference Aggression in Relation to Emotional Development Transitional Objects and Transitional Phenomena The Depressive Position in Normal Emotional Development Metapsychological and Clinical Aspects of Regression… Withdrawal and Regression Clinical Varieties of Transference Primary Maternal Preoccupation The Antisocial Tendency Psychoanalysis and the Sense of Guilt The Capacity to be Alone The Theory of the Parent-Infant Relationship Countertransference String Ego Distortion in terms of the True and False Self Further Remarks on the Parent-Infant Relationship A Personal View of the Kleinian Contribution The Aims of Psychoanalytic Treatment The Development of the Capacity for Concern Fear of Breakdown Two Notes on the Use of Silence The Importance of Setting in meeting Regression The Squiggle Game (revised 1968) The Psychology of Madness The Split-Off Male and Female Elements The Concept of Clinical Regression The Location of Cultural Experience Interpretation in Psychoanalysis Playing…

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1968 The Use of an Object

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Major Writings of Michael Balint and Ronald Fairbairn: Balint’s books and anthologies: 1952 Primary Love and Psychoanalytic Technique 1957 Problems of Human Pleasure and Behaviour 1957 The Doctor, his Patient and the Illness 1959 Thrills and Regressions 1968 The Basic Fault Note also… 1956 Perversions 1961 Psychotherapeutic Techniques in Medicine 1966 A Study of Doctors 1970 Treatment of diagnosis: A Study of Repeat Prescriptions 1972 Focal Psychotherapy Fairbairn’s book: 1952 Psychoanalytic Studies of the Personality Note also Harry Guntrip’s work: 1961 Personality Structure and Human Interaction 1968 Schizoid Phenomena, Object Relations and the Self 1971 Psychoanalytic Theory, therapy and the Self 1951-1975 Personal Relations Therapy: The Collected Papers of H.J.S. Guntrip. Questioning Kohutian Self-Psychology  Why might one believe that a cohesive self and its “selfobjects” is important to human development, and what difference does such a belief make to clinical practice or to everyday life?  How might Kohut’s emphasis on idealizing, mirroring, and narcissistic transferences, as well as his emphasis on narcissistic rage, bear on the issues of psychoanalytic treatment—and offer an understanding of this process that is significantly different from structural-functional or object-relational formulations?  How does Kohut’s contributions refocus the debate over processes of psychoanalytic cure and personal growth? What is at issue in all the controversies over “empathy”?

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Reading Heinz Kohut: Heinz Kohut (1913-1981) was born in Austria, trained in neurology (and later psychiatry), and fled to Chicago in 1939. There he came under the influence of Franz Alexander, and was prominent in the Chicago Psychoanalytic Institute. Throughout his career, he was a member of the American Psychoanalytic Association, but his innovative writings were regarded with some suspicion by the dominant influences in that organization. Central to his formulation of “self-psychology,” which Kohut himself claimed to be a psychoanalytic theory, is the notion that the “Self” acts to maintain its cohesiveness – its sense of stability and coherence – at all times. This is a move away from the emphasis on guilt that characterizes European psychoanalysis, and a break with the structural-functional theory. Kohut places less emphasis on internal conflicts due to the forces of drives, and more emphasis on the vicissitudes of relationships. Kohut’s major theoretical formulation concerns the way in which the Self – which seems to be defined in terms of the aggregate of self-referent representations – maintains its cohesion by the use of selfobjects. “Selfobjects” are “objects” in the sense of the various object-relational theories that preceded Kohut’s formulations. That is, they are internal representations of external entities – usually persons, aspects or parts of persons, or things. The distinctive feature of selfobjects is that they are deployed by the Self to regulate its own functioning – in this sense, they have been compared to Winnicott’s notion of “transitional objects” that are both external and internal (“real” and “unreal”), situated in a “halfway” or liminal “reality” of the subject’s partial creation. The therapeutic power of Kohut’s formulation lies in his proposition that the experience of being understood, rather than insight or understanding itself, is what effects transformation in the clinical process. However, unlike other theories of the self (such as the humanistic perspectives of Carl Rogers), which seek to support the self affirmatively, Kohut’s emphasis is on the importance of clinical interventions which interpret to the patient those moments when selfobjects fail. Thus, schematically, in the course of a Kohutian treatment, the patient will come to use the therapist as a selfobject, and invariably the therapist in his/her designated role as selfobject will, sooner or later, perform unsatisfactorily (inadvertently not deliberately – Kohut stresses this point). This failure tends to unlock feelings of rage on the part of the patient. The interpretation of the reasons for this rage is, in Kohut’s view, crucial to the patient’s ability to grow into a healthier level of Self – one which uses its selfobjects in a more flexible and adaptive manner.
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Another important clinical contribution made by Kohut—and one that is essential to the way in which his theories of the self have gained influence—is his description of different types of narcissistic or selfobject transference. Initially, mirroring and idealizing transferences were described. Later, alter-ego or “twinship” transferences transferences were also discussed. Kohut’s writings are—conveniently—almost entirely published in three books, one of which was edited posthumously, and a two-volume anthology of his papers: 1950-1978 1971 1977 1977 The Search for the Self: Selected Writings of Heinz Kohut The Analysis of the Self The Restoration of the Self How Does Psychoanalysis Cure?

Questioning Lacanian psychoanalysis  How are we to understand the tenet (discovery?) that all human experience occurs in three “registers” of signification? Why does Lacan describe the unconsciojns as the significatory locus of the—capitalized—Other. And what are the implications of this depiction for classical notions about topography, the powerfulness/powerlessness of reflective consciousness, and issues of primary/secondary repression?  Why is Lacan so critical of the “American ego” and of the positivism/empiricism in which he believes the structural-functional model is embedded? How is this criticism reflected in the controversial aspects of his clinical techniques?  What is the phallus, and why is it mistaken for the genitals? Are Lacanian ideas useful for a feminist comprehension of psychoanalysis in particular, and of patriarchal culture in general? Reading Jacques Lacan Although still little known (and disparaged as an incomprehensible maverick) in the United States, the psychoanalytic work of Jacques Lacan (1901-1981) has probably had a more profound worldwide impact on the development of psychoanalysis since Freud than any other individual (with the possible exception of Jung). At the beginning of his career, Lacan was clearly influenced by the surrealist movement, and also came under the influence of Wilfrid Bion and some notable Kleinians (he later repudiated the work of Klein). As he became more deeply involved in promoting his
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avant-garde and celebrated “return to Freud” in the 1960s, the acknowledged influence of structural linquistics and the less acknowledged of Heideggerian philosophy became more evident. The psychoanalytic “rereading” of Freud’s work by Jacques Lacan between the mid-1950s and the early 1970s is extremely complex to grasp. This is partly due to the inherent complexity of rereading Freud through the metatheoretical framework of structural linguistics, and partly due to Lacan’s penchant for believing that he himself spoke “in the language of the unconscious” (i.e., allusively and obscuringly, albeit with allegedly impeccable mathematical logic). What motivates Lacan’s ideas is the conviction that “American psychoanalysis” (which he equated with ego psychology) has lost the power of the unconscious by means of its obsession with an ideology of individualist adaptation and the theory of the ego. Lacan’s central point is that the conscious subject is not the author of his/her own speech (thoughts, actions), but rather “is spoken” by the structure of linguistic possibilities. This makes Lacan’s thinking a transpersonal theory, although Lacan never labeled it as such, and was quite adverse to the transpersonal perspectives of Jungian and post-Jungian depth psychology. The unconscious is structured as a language and it is, for Lacan, a mathematized language – it is also patriarchally organized around the prerogatives of the phallus as signifier of signifiers. It is, in his terminology, the capitalized “Other” (as distinct from the “other” of interpersonal relations). Except in rare moments of psychoanalytic clarity, the ego never knows whereof it speaks, but is spoken by the authorial power of the Other. Lacan divides human experience into three types or “registers.” The Symbolic is the experience of discourse, of representational thinking and speaking. The Imaginary is the specular – and specious – knowledge of recognition as when, allegedly, a child sees him/herself in a mirror and recognizes him/herself as a unit or whole. Experiences in the Symbolic and Imaginary registers are always inextricably inmixed. The register of the Real – which has nothing to do with “reality” in the conventional sense – is experienced essentially in moments of trauma, or intense clarity. These are moments in which the subject realizes itself to be insubstantial and authored from “elsewhere” – moments in which, so to speak, the subject clearly faces its own annihilation. The “Real” thus has much to do with death, or the “death-bound” nature of human subjectivity. Lacan’s imagistic, allusive and deliberately obscurantic use of language has frustrated many translators. Even read in French, he is one of the most complex thinkers to grasp, and his ideas often seem to elude precise formulation. Transcriptions of almost
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all of his annual Seminars are now available in French and many are in translation. Other than these, the two major works available are: 1966 Écrits. 1973 The four fundamental concepts of psychoanalysis. The three major figures involved in post-Lacanian (and post-structuralist) feminism are Julia Kristeva, Hélène Cixous, and Luce Irigaray. Also of interest is the development of deconstructive (feminist, critical) psychoanalysis—see, for example, Barratt’s Psychoanalysis and the Postmodern Impulse: Knowing and Being since Freud’s Psychology (1993). In relation to the postmodern and post-structuralist approach to psychoanalysis, it may be noted that, contrary to many popular misunderstandings, postmodern ways of knowing and being illuminate both the manner in which the subject never merely means what s/he intends to mean – that consciousness is not author of its own discourse – and the way in which timespace is not unitary, equable and linear in the manner assumed throughout the modern era. The modern worldview or episteme emerged from medievalism, and was founded on the cultural structures of: (1) patriarchal domination; (2) the Judeo-Christian-Islamic ethos; (3) the metaphysics of presence (from Greek classical philosophy). The “masterdiscourse” of the modern era is analytico-referential (think of Copernicus, Galileo, Kepler, Newton, as well as Bacon, Descartes, Hobbes, and others), and its major motifs are those of Domination (and subjugation), Conquest, and Possession. In science and in psychotherapy, this means that knowledge is viewed, not as a capacity for awareness, but as … →the ability to predict/control (dominate) the investigated phenomena, →the conquest and diminution of the unknown (“progress”), →the cumulative acquisition/possession of information (as “knowledge”). This has profound implications for the way in which we think about the processes of being human, and of healing the human spirit. The modern episteme is currently in the process of collapse, and postmodern ways of knowing and being are emerging. Questioning somatic psychology (and “bodymind psychotherapy”)  What happened to the “lived experience of embodiment” in 20th century psychoanalysis and in cognitive-behavioral psychology … and why?  Is the distinction between holistic theory qua theory and methods of intervention important to maintain … and why?
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 In what ways might bodily-oriented interventions be a “resistance” to the “making sense” processes of the “talking cure” … and vice versa? Reading Wilhelm Reich and “Somatic Psychology” Wilhelm Reich (1897-1957) is often credited with being the “father” of somatic psychology or “body-based psychotherapy.” This is understandable since he was one of the few psychoanalysts who developed Freud’s early work on libidinality as the foundation of all relational, affective and cognitive (as well as spiritual) development. However, somatic psychology has developed in the past twenty years largely as a reaction against the way in which psychology since Freud became—so to speak— theoretically disembodied. Somatic psychology develops in the late 20th Century largely as a syncretic reaction against the “in the head” quality of the dominant modes of cognitive-behaviorist and psychoanalytic thinking. Influenced by the work of Wilhelm Reich and other radical psychoanalysts, as well as by the humanistic psychotherapeutic tradition, bodymind psychotherapy now includes a wide variety of approaches and “brand name” therapies. Bodymind psychotherapies principally on: →the radical psychoanalytic tradition of Wilhelm Reich and others (bioenergetics), →subsequent psychodynamic therapies, e.g., gestalt therapy, →spiritual and energy-oriented Asian disciplines, e.g., Reiki, meditation, yoga, →western methods of bodywork/somatics, e.g., dance, massage, Rolfing, etc. →philosophical advances in phenomenology, e.g., “phenomenology of the body,” →contemporary findings in the neurosciences, including affect regulation, →ancient traditions of indigenous healing practices, including tantra and shamanism. Significant aspects of its major theoretical perspectives include: → Nonduality or holism of the bodymind … the body is a mode of consciousness, and needs to be listened to rather than controlled. → Repressed meanings – the “memory” of the dynamic unconscious – are stored in the connective tissues of the body, and even at a cellular level. → Traumatic Experiences throughout our socialization, including the multiple traumatic experiences of our early years, induce a culturally-endorsed mode of alienation, in which we live “in our heads” – which means that we live in our mental representations of past/future, rather than in the presence of our “lived experience.”

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There is no single textbook by which to survey the theories and methods of somatic psychotherapy. The following is a brief annotated bibliography covering some major works in the field: Aposhyan, S., Bodymind Psychotherapy. W. W. Norton & Company, Inc., 2004. This is now fast becoming the leading text on its topic (superseding works by Ron Kurtz and Don Hanlon Johnson). However, its focus is entirely clinical, and it does not address somatic psychology per se as the disciplinary basis on which it is grounded. Caldwell, C., Getting our Bodies Back. Shambhala Publications, 1996. This is a work of classic importance in the field and was, at one time, a minor “best seller.” However, its emphasis is on advocating Caldwell’s particular clinical methodology, which she calls the “moving cycle.” Johnson, D. H. (ed.), The Body in Psychotherapy. North Atlantic Books, 1998. This is a great anthology, covering many topics in somatic psychology. However, it is not an introductory work, and its coverage is – to say the least – uneven, and always clinically focused. Rothschild, B., The Body Remembers. W. W. Norton & Company, Inc., 2000. This is another important book, but almost entirely focused on the author’s own clinical experiences and material. Siegel, D. J., The Developing Mind. Guilford Press, 1999. This book has been extensively assigned in classrooms. However, its focus is on how relationships shape the neurobiology of the brain. This is an important text for somatic psychology, but arguably it addresses only one particular issue in the area covered by this specialty. Note also that some bodymind psychotherapies depend on the experience of subtle energies, and require the patient/client’s openness to such experience. See, for example, Richard Gerber’s Vibrational Medicine; James Oschman and Candace Pert’s Energy Medicine; or Richard Gordon, Eleanor Barrow, and Carrie Toder’s Quantum Touch. In psychotherapy, Wilhelm Reich’s work mobilized orgone energy (his term for libidinality) in therapeutic practice, and the influx of other energy systems into the West – such as Usui’s Reiki healing, pranayama (yogic breathwork), and Chinese medicine – has elaborated this trend. Indigenous shamanic methods of healing typically use both visualization or imaginal methods, and energy healing in their therapeutic procedures. Tantric practices use various vibrational methods involving: (1) Breath, (2) Movement, (3) Sound, (4) Visualization, and (5) Touch, tactile sensation or sexual activity. See: Barratt’s What is
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Tantric Practice? (Xlibris, 2006)—or, for an even more passionate exposition, see his The Way of the BodyPrayerPath (2004). These practices are held to facilitate transformation on somatic, emotional, relational, sexual and spiritual levels.

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Questioning existential psychoanalysis/psychotherapy  What is the tension between mechanistic-reductive and humanistic-existential approaches to depth psychology … and is it resolvable?  In what sense is Freud’s description of the human condition one that gives a central place to the image of humans as “meaning-makers” … or in what sense is an emphasis on meaning inherently critical of Freud’s thinking?  What can be said about the role of hope and hopelessness in human functioning … and how is this connected to the issue of living in the present (as contrasted with “living in the past/future)? Reading existential psychoanalysis/psychotherapy Existential philosophy, which is traced to the writings of Kierkegaard and Nietzsche (and sometimes, rather misleadingly, to certain aspects of the writings of Martin Heidegger), flourishes in the French philosophies of Jean-Paul Sartre, Albert Camus, and Merleau-Ponty, as well as the novels of such writers as Dostoevsky and Franz Kafka and Fyodor Dostoevsky. In its application to healing, there are three major figures in European existential psychoanalysis and psychotherapy. Ludwig Binswanger (1881-1966), was a Swiss psychiatrist who studied with Jung, Bleuler, and Freud (with whom he was in psychoanalysis, and with who he remained friends for the remainder of Freud’s life). Binswanger cane under the influence of Edmund Husserl’s phenomenology and Martin Heidegger’s ontological philosophy. His major work, published in 1943 was Grundformen und Erkenntnis menschlichen Daseins. However, the English translations of his papers are more accessible. Also published in English is his account of his psychoanalytic treatment with Freud, as well as their correspondence. Karl Jaspers (1883-1969) was a German psychiatrist, theologian and philosopher, who has had much influence on the latter disciplines. Working as a psychiatrist at Kraepelin’s hospital in Heidelberg, he became critical of this approach to mental illness. His subsequent philosophical writings, which were greatly influenced by Nietzsche and Kierkegaard, addressed issues of freedom, existence and transcendence. Note that Paul Ricoeur and Hans-Georg Gadamer were both students of Jaspers, and both have had much influence on contemporary hermeneutic approaches to psychological phenomena.

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Viktor Frankl (1905-1997), an Austrian neurologist and psychiatrist, was notably a holocaust survivor. He founded “logotherapy” and “existential analysis.” In 1945, he wrote his most influential work, Man’s Search for Meaning. As existential philosophy crossed the Atlantic, it became a notably less pessimistic approach to understanding the human condition. The work of Rollo May (1909-1994) is perhaps an exception to this. A close friend of Paul Tillich, May was influenced also by Kierkegaard and by his collaborations with Ernest Angel and Henri Ellenberger. His most influential book, published in 1969, is Love and Will. As it became integrated into the American “third force” movement in psychology, existential ideas became inmixed with general humanistic and (loosely designated) phenomenological approaches to psychology—for example, the work of Carl Rogers or Abraham Maslow, and the gestalt work of Fritz Perls and Paul Goodman. In many ways, these were the antecedents of what is now called “positive psychology.” Note also the influence that Otto Rank had on many of these developments. The following may be noted: ○ Humanistic (Rogerian) approaches: With a certain amount of hubris, Carl Rogers dubbed his approach person-centered psychotherapy – implying that the prevailing psychoanalytic and behaviorist approaches of his era had largely lost sight of the patient/client as a whole person… Rogers’ principle notion of psychological suffering concerns the discrepancy between the self (which is usually conceptualized as the summation of self-referent concepts) and the ideal self. Health is defined in a future-oriented manner as the condition of self- self congruence – a process Rogers’ referred to as self-actualizing. Rogers’ assumes an inherent tendency toward self-actualization (cf., Maslow’s work), with almost no acknowledgement of the significance of intrapsychic conflict. Developed in a counseling context, this approach emphasizes the creation of a permissive, non-interventive setting, in which acceptance and clarification (warmth and non-directiveness) are the major characteristics of the therapist’s activity. Later in Rogers’ work, the importance of the therapist’s capacity for empathy and genuineness (the therapist’s congruence) were emphasized. Rogerian therapy had significant influence on the relational and interpersonalist schools that emerged within American psychoanalysis. It also generated several other “experiential therapies” including “focusing-oriented psychotherapy” (Eugene Gendlin) and “process-experiential psychotherapy” (Leslie Greenberg and others). ○ Humanistic (Gestalt) approaches: Gestalt therapy developed independently from the Rogerian approach – sharing much with it philosophically but diverging radically in
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terms of the methods of practice. Although developing out of psychoanalysis, Fritz Perls’ approach involves a systemic field theory that emphasizes contact, awareness and growth. Holding the patient/client responsible for his/her feelings and actions is emphasized, and the therapy has a variety of techniques to facilitate this. These often involve imaginary dialogues with others – as, for example, in the well known “empty chair” technique. The therapeutic focus is always on the here-and-now. ○ Humanistic (Existential/Constructivist) approaches: This version of existential humanism specifically emphasizes: (1) Freedom – as opposed to the deterministic trend in much psychology/philosophy. (2) Experiential reflection – which emphasizes the becoming process of being human. (3) Responsibility – in “owning” what one is and what one is becoming. The philosophical roots of this approach are complex – and well worth exploring – but in psychotherapy this approach develops as a rebellion against cognitive-behaviorism and (deterministic) psychoanalysis. It emphasizes the subjectivity and meaningfulness of experience, and thus draws on phenomenological inquiry. Constructivist theories are also many and varied – deriving from psychoanalytic approaches, phenomenological approaches, the maverick psychological work of George Kelly, contemporary cognitivist researches, and existential viewpoints. Contrary to much popular misunderstanding, constructivism stands on a modern philosophical platform and not a “postmodern” one. ○ Humanistic (Visualization/Imaginal) approaches: Although the use of visualization was downplayed in mainstream psychoanalysis (which favored the processes of free- associative discourse and reflective inquiry), the therapeutic significance of imagination and other modes of spontaneous self- expression were always central to indigenous shamanic modes of healing (including Buddhist and Taoist practices), were emphasized by Jung, and elaborated by many of the humanistic approaches such as the gestalt work of Fritz Perls and Paul Goodman. Imaginal practices – including methods such as “voice dialogue” and “body dialogue” – serve to bring disavowed aspects of personality into articulate dialogue and thus function to promote reintegration. There are many variants of these practices including such ancient methods as soul retrieval. ○ “Spiritual” – Mindfulness Meditation approaches: With the popularization of Buddhism in the West, mindfulness meditation and related shamatha or vipassana techniques have been adapted to psychotherapeutic purposes. In these approaches, the patient/client is invited to observe the process of his/her thoughts and feelings, reducing
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his/her attachment to them. This procedure is sometimes said to develop the Compassionate Witness (Sufism), which has similarities and dissimilarities with the conventional psychoanalytic concept of the self-observing ego. A critical issue in understanding these methods concerns the value or lack of value placed on judgmentalism. Some of the “skills” involved in mindfulness meditation when applied in the psychotherapeutic setting are: paying attention, affect tolerance, practiced acceptance, empathy and compassion, equanimity, seeing clearly, exposure of the therapist’s narcissistic needs, overcoming infatuation with theory, and the cultivation of happiness. * * *

To suggest changes, corrections or additions to the above material, please contact Barnaby B. Barratt at BBBarratt@Earthlink.net or telephone: 928.925.8775 (6 am to 6 pm Arizona Time).

The clinical vignettes on the following pages are under legal copyright.

They are offered here solely for the purposes of in-class education and are to be treated with proper professional conduct and ethics.

These materials are not to be shared, copied, distributed or otherwise disseminated without the explicit permission of Dr. Barratt. Their content is not for discussion with individuals (other than those who are currently enrolled in this class).

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A first clinical vignette perhaps to be considered in class: The patient (48 year male, in first year of x3 weekly treatment) comes into a Friday session, looking a little troubled. There is a long period of silence. Then he says, “There is something that is bothering me, but I don’t want to talk with you about it.” Question: What might the therapist say next? And how would theory inform the therapist’s choice between the available possibilities? * * *

A second clinical vignette perhaps to be considered in class: The patient (34 year female, in third year of x4 weekly treatment) hurries into her Thursday morning session, nods “Hello” to therapist (who responds “Hi”) and then gets onto the couch. “I am so rushed this morning,” she says. “I didn’t even have time to eat breakfast.” Then there is a very long silence. “And now,” she eventually says, in a dramatic voice, “I’ve fallen silent.” Therapist: “Perhaps you’re waiting to see if I’ll offer you something to eat.” She giggles as if at a really good joke. “Oh that’s funny,” she laughs, “because as soon as you said that, just as you finished saying it, I remembered that I had a very vivid dream last night. And in my dream there’s an inflatable Chinese doll, and it must be that I have a penis in the dream because I’m fucking it roughly.” The patient proceeds to associate to the dream’s elements: … It’s strange the doll is Chinese, because she doesn’t know any Chinese … the therapist is foreign but that’s not Chinese … an inflatable doll that gets treated so roughly would probably burst and be destroyed … years ago her husband had coerced her to have sex in front of their three-year-old as ‘education’ for him … months ago, in therapy, disturbing memories of seeing her mother and father having sex had started to focus … last session, she dimly recalls the therapist saying something about how she gave away her power, or underestimated herself, something like that, it had bothered her and she cannot remember it precisely. Question: How do you understand this material? What is the significance of its ‘flow’? Why do you think the dream gets ‘re-remembered’ when it does? And what interpretation might you make at the end of the patient’s lengthy associations to her dream?
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A third clinical vignette perhaps to be considered in class: [Therapist is male.] Patient (16 year male, in fourth month of x1 weekly treatment) comes on time and walks ahead of the therapist to the consultation room with a particularly exaggerated amount of swagger. The Patient makes a punching gesture toward the wall, then flips the “in session” sign on the door of the office next to the consultation room (the office of an attractive female therapist, about whom the patient has talked previously). Once in the consulting room, the Therapist asks: “What was that all about?” He says: “I’m just fucking pissed off … I wanna fuckin’ punch somebody … shits just got me pissed off.” I say: “What shit?” He says: “I’m broken up with my fuckin’ girlfriend right now and she calls me on the phone and says [in a mocking voice] ‘I’m seeing this guy and he’s got a car and shit.’ And I’m like ‘Big fuckin’ deal, do what you want, I don’t give a fuck.’ So I call her back [he smiles at me] and say I’m seeing some chick, she’s half Hispanic. And she [meaning the ex-girlfriend] gets all pissed off. I just did that shit to piss her off; I’m not seeing anybody.” Therapist: “Why did you do that?” He responds: “Do what?” Therapist:: “Call her and tell her that.” He says: “’Cos she’s just trying to make me jealous – telling me shit like that. So I thought I’d make her jealous just to be funny and shit.” Therapist: “You don’t think she’s seeing someone?” He responds: “I really don’t care what she does. I really don’t.” Therapist: “Why do you think you called her back?” He says: “What do you mean?” Therapist: “You say that you don’t care what she does but you called her to tell her that you were seeing someone.” He says: “No. She called me. I was driving here and she called me. I was looking at a car so I didn’t hear it ring. I got back, saw that she called me, and I called her back.” Question: Clearly this is a sequence in which the therapist could be said to have made several ‘mistakes,’ but what exactly are they and why might they have occurred?

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A fourth clinical vignette perhaps to be considered in class: [Therapist is female.] Patient (62 year male, in fifth year of x1 weekly treatment, recently increased to x2) begins the session by saying: “Well, I was looking at some of the ‘divorce books’ – the ones that help you get through the stages of divorce. Like there’s denial, then anger, then acceptance, etc. And I was thinking that in my marriage I expressed my feelings to Sarah but she wouldn’t listen. Then I tried to express myself to Martha, and it didn’t do any good. So those relationships ended painfully. Now I’m afraid to be with someone else because I’m afraid of getting hurt. So I’m holding in my feelings again. I don’t want to let anyone else know if I am interested in them.” Therapist: “That’s a rather intellectual description of some of what you felt. It ties things up in a neat package. But I think things have been more complicated. You remember that even before Sue you were having difficulties expressing and acting on your feelings for girls and women. With Sarah, and at times with Martha, you kept all your feelings inside and got depressed. Sometimes you didn’t know what you were feeling.” Patient: “I guess that’s true.” Therapist: “Do you have any thoughts why you simplify things and tie them in a package like this?” Patient: “I’m not sure, I guess that’s what I do, I think I try and make sense of things.” Therapist: “Yes, you’re very good at that. In this case, I think you’ve left out a great deal of your emotional experience. I think maybe when we look more closely at your feelings, you become anxious and uncomfortable in some way.” Patient: “You’re right…there was a point last session when I felt at sea, like when I’m scuba diving, and I can’t quite understand what I’m feeling.” Therapist: “Let’s stay with this. When you are in that ‘at sea’ state, what do you think you are feeling? What are you uncomfortable about?” Patient: “I guess feelings of love, affection, sex. I’m not sure why.” Therapist: “I think you are afraid of what will happen if you feel these, perhaps you feel that feeling and acting are the same or almost the same thing.” Question: Clearly this therapist does not have a conspicuously “somatic” orientation, so how might this patient’s opening remarks be handled differently, and why do we imagine that our approach might be more beneficial? Additional question: What is the proper emotional engagement that a therapist should have with a client/patient … and what is “empathy”?

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A fifth clinical vignette perhaps to be considered in class: Patient (22 year male, in fifth month of x1 or x2 weekly treatment) walks slowly into the office, sits on the couch, and after a long pause says: “I stopped taking my medication.” Therapist: “You did?” Patient: “The doctor didn’t get back to me. I called on Wednesday and he didn’t get back until today. So I called my old psychiatrist and made an appointment with him. It will be good to see a new psychiatrist.” Therapist: “We can talk about that. But I think we should learn more about your stopping your medication. It is very dangerous to stop taking prescribed medication without the guidance of a physician. Why do you think that you stopped without talking with me or the psychiatrist first?” Patient: “I didn’t think it was any big deal.” Therapist: “Why not?” Patient: “I don’t know.” Therapist: “Everything is important to talk about in here – especially something as serious as this.” Patient: “I was so tired all the time.” [Long pause]. “I was sick of feeling that way. Maybe the new psychiatrist will put me on the medication I was on before.” Therapist: “This isn’t a new psychiatrist for you. You have seen him many times before. But it sounds like you want something new to come out of seeing him.” Patient: “Yeah. It makes me mad. I wish they could put me on something that would make me feel better. Every time they say that this should help and then it doesn’t. I’m thinking that there isn’t anything to help me.” Therapist: “It must be troubling to think that there isn’t help for you.” Question: What can be learned about transference, countertransference, and empathy that might be useful in reconsidering this sequence of interactions?




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For Students at Pacifica Graduate Institute Winter/Spring 2008 The following are the details of the course syllabus and arrangements: A. Course Description This course will offer an overview of the major traditions of psychoanalytic and  psychodynamic theory and treatment that were initiated by Freud’s work or that  – in some specific sense – have their roots in Freudian methods of psychological  inquiry and healing.    A major emphasis of class discussion will be on the significance of different  traditions firstly as contributing to the mission of healing the soul, and secondly  as contributing to our understanding of the interrelations between psyche and  culture.  In a sense, this will be a window on one fundamental dimension of the  intellectual history of the Twentieth Century.


Course Objectives 1. Students will be able to define and discuss the major factors contributing to  the seminal significance of Freud’s thought in terms of the multiple traditions  that have developed from his work. 2. Students will be able to describe, evaluate, and demonstrate their ability to  compare and contrast the following theoretical approaches: 2(i) 2(ii) 2(iii) 2(iv) 2(v) 2(vi) 2(vii) 2(viii) Object­Relations (Melanie Klein) ‘Independent’ Object­Relations (D. W. Winnicott) Self­Psychology (Heinz Kohut) Ego Psychology/‘Structural­Functional’ (Hartman, Arlow, Brenner) French Structuralist (Jacques Lacan) Post­Structuralist (i.e., Deconstruction and ‘French Feminism’) Somatic/’Body Psychotherapy’ (Wilhelm Reich and thereafter) Existential­spiritual perspectives

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3. Students will be able to identify key factors involved in generating informed  decisions as to whatever sort of future study and training they might wish to  pursue within any of these traditions.


Course Schedule/Activities The above objectives will be achieved by means of lecture and class discussion,  as well as a self­directed program of intensive reading.


Course Assignments (1)  Prior to class, please review the required reading and arrive in class ready  with notes and questions.  If you have to miss class, you are advised to withdraw  from the course and take in another year.  In addition to the readings listed  below there will be class handouts and some material filed electronically. (2)  Participation in class discussions and other activities is required.  Participation will be assessed in terms of consistent and alert attendance, quality  of contributions to class discussion, and similar evidence of having mastered the  required reading material.   (3)  Submission of a 10 to 12­page paper, written in APA­style, indicating your  professional engagement with at least one of the theoretical approaches covered  in this class.  Further details of this assignment, including the due date/deadline, will  be given in class.  You are encouraged to discuss you plans for self­directed  study and paper­writing with the Instructor as frequently as you feel will be  helpful.  Please do not exceed 12 pages without the Instructor’s “okay.”   


Required Reading Session I: Mitchell, S., & Black, M.  (1995).  Freud and beyond, A history of modern psychoanalytic thought. Basic Books. Please read pages 1-169. ISBN-10: 0465014054 ISBN-13: 978-0465014057

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Session II: Hughes, J. (1989). Reshaping the psychoanalytic domain. University of California Press. [Chapters 1, 2, 3, 5]. ISBN-10: 0520071883 ISBN-13: 978-0520071889 Session III: For this third session, you are at choice as to what reading you do from the  recommended reading list.  You are required to inform the Instructor as to  what you actually read, and to give evidence in class of whatever you have  gained from your reading.


Recommended Reading Bankart, C. P.  (1996).  Talking Cures: A History of Western and Eastern   Psychotherapies.  Wadsworth.   ISBN­10: 053434383X ISBN­13: 978­0534343835 Buirski, P.  (Ed., 1994).  Comparing schools of analytic therapy.  Jason Aronson.  [Chapters 1, 2, and 3, 7, 8, 9, 10, 11 – This book is only obtainable as a used  copy…try Amazon.com for a cheap copy]. Cushman, P.  (1996).  Constructing the Self, Constructing America: A Cultural   History of Psychotherapy.  Addison­Wesley.   ISBN­10: 0201441926 ISBN­13: 978­0201441925 Ehrenwald, J.  (1991).  The History of Psychotherapy.  Jason Aronson. ISBN­10: 0876682808 ISBN­13: 978­0876682807 Elliott, A.  (1999).  Social theory since Freud: Self and Society after Freud.   Routledge.   ISBN­10: 0415271630 ISBN­13: 978­0415271639 Fromm, E.  (1941/1994).  Escape from freedom.  Owl Books. ISBN-10: 0805031499 ISBN-13: 978-0805031492 Klein, M.  (1964).  Love, hate, and reparation.  New York, NY: Norton. ISBN-10: 0393002608 ISBN-13: 978-0393002607 Reich, W.  (1949/1980).  Character analysis (3rd enlarged edition).   Farrar Straus.

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ISBN-10: 0374509808

ISBN-13: 978-0374509804

Rieff, P.  (2006).  The Triumph of the Therapeutic: Uses of Faith after Freud. Intercollegiate Studies Institute.     ISBN­10: 1932236805 ISBN­13: 978­1932236804 Rothstein, A.  (Ed., 1985).  Models of the mind: Their relationships to clinical work.   International Universities Press.   ISBN-10: 0823634108 ISBN-13: 978-0823634101 Tallis, F. (1999). Changing Minds: The History of Psychotherapy as an Answer to Human Suffering. Sage Publications. ISBN-10: 030470363X ISBN-13: 978-0304703630


Assessment Class participation:  18% — 5% for attendance on each of the three class sessions  plus a discretionary 1% for quality of contributions to class discussion. Final paper:  82% — following customary grading rubric in accredited  institutions, this consists of 57% for the focus, development and organization of  the paper (19% each respectively), and 25% for style and conventions (consistent  use of APA format, spelling and grammar, etc.).  Following customary procedures:  94­100 = A,   90­93 = A­,   87­89 = B+,  84­86 = B,   80­83 = B­,   70­79 = C.  
Final paper or Request for Incomplete Form is due postmarked on or before:  J Track:  April 9, 2008 K Track:  April 23, 2008 Papers must be sent hard­copy, in impeccable APA style and format, by USPS to: Barnaby B. Barratt, PhD, DHS, PO Box 10937, Prescott, Arizona 86304­0937. Please be sure to include the course number and group on both the title page and the  envelope.  It is recommended that you put sufficient postage on the envelope. 


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Incompletes Students are allowed four incompletes per academic year. Students must submit a   request for an incomplete on or before the assignment due date. Incomplete work for this  class is due postmarked on or before: J Track:  June 23, 2008 K Track:  June 30, 2008 When you complete the paper send it directly to Dr. Barratt and be sure to send a copy of the   Grade Change Form along with your paper.

Plagiarism Pacifica expects all students to complete assignments in accordance with the Honesty  Policy published in the Student Handbook.  Plagiarism from any source (i.e., book,  internet, fellow student, newspaper, etc.) is a serious breach of academic honesty,  subject to dismissal from Pacifica Graduate Institute.  It is assumed that students will  do separate written work for each course.  If you wish to use similar material for  different courses, you must first obtain explicit permission from your instructors.


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