Over five years, from 1919 to 1924, Freud dealt with masochism in three texts written in close proximity: "A Child Is Being Beaten," Beyond the Pleasure Principle, and "The Economic Problem of Masochism." Initially Freud explains masochism as incestuous fixation on the father and regression to pregenital, sadistic ways of loving. Subsequently he considers it primarily as subservient to the death drive. This paper starts from an idea present in two of the three texts, but not developed by Freud, in which he refers to the role that the "qualitative" element of rhythm could play in the occurrence of pleasure in masochism. By means of this element traumatic aspects of the primary relationship with the object could be stored as fantasies in the body. In any staged masochistic fantasies of being beaten or in masochistic perversion, the pleasure of pain would lie in the attempt to "dream" the trauma not only in the imagination but also, "aesthetically," in the body.
Experiences with autistic and primitive mental states have significant implications for our understanding of obsessionality. Consequently, obsessionality is seen as an attempt at a massive simplification of experience, in order to deal with the pain inherent in the encounter with intense emotional experience and with the separateness of an enigmatic object that eludes one’s omnipotent control. Moreover, early loss and a precocious awareness of separateness often play roles in the withdrawal to obsessional thinking and verbosity, and to an illusion of omnipotent control of the object. Interpretations focusing on conflicting desires, or linking repressed and displaced parts of the personality with the defenses against them, do not reach these patients in a way that facilitates psychic change. An alternative approach, it is suggested, is to work at primitive, nonsymbolic levels of mental functioning, where experience cannot be verbally communicated and dynamically interpreted, but must first be lived in the here and now of the analysis. This is illustrated through the analysis of a person trying to cope with the experience of early loss by deadening emotion and finding shelter in obsessionality.
Given that surveys, as well as frequent observations by institute faculty, indicate that many candidates have difficulty finding control cases and maintaining immersion and that many graduate analysts face similar challenges, it would seem that psychoanalytic training does not prepare candidates adequately for finding patients and practicing analysis while in training and, for many, after they have graduated. Although external challenges are formidable, it is by identifying and making use of internal challenges to finding cases that candidates can develop an analytic mind: the identity, approach, and skills necessary not only to graduate but to have the choice to practice clinical psychoanalysis post-graduation. Some of the internal challenges and their manifestations in different phases of initiating analysis (referrals, initial consultation, recommendation) are discussed and two detailed examples are offered to illustrate the productive use of candidates’ countertransferences in finding cases and maintaining immersion. Finally, recommendations for institutional solutions are provided.
Three important areas of current inquiry concerning early trauma—the respective roles of reality and fantasy, age-related capacity for the symbolic representation of trauma, and attachment status—are approached through clinical case reports of three children seen initially at very early ages. The findings are relevant to the issue of whether preverbal infants can experience traumatic events that later are available to interpretation. The focus is for the most part on event traumas—single harrowing, life-threatening experiences—occurring at quite early ages. Three main points are emphasized. First, toddlers and infants (including neonates) can experience intense pain and show symptoms of traumatization. They are capable of experiencing an event as harrowing and life-threatening. Second, these events are capable of being memorialized or symbolically represented, that is, stored in memory in a way that can affect later behavior and learning. Third, how that traumatization resolves itself, or fails to, can be decisively affected by the functioning of the attachment system.
Analysts who conduct trauma-focused treatments have much to learn from Wilfred Bion’s contributions to the understanding and treatment of PTSD. Concepts such as catastrophe and catastrophic change can illuminate the subjective experience of PTSD patients, the beta screen concept sheds light on dissociative phenomena, and, as shown in a clinical vignette, the analyst can use his alpha function to transform the patient’s fragmented raw material into alpha elements. A second clinical vignette shows how during a cognitive intervention the analyst can impart this alpha function to the patient and use his reverie to help the patient assimilate previously intolerable fragments into a coherent narrative. Finally, the idea of knowing mental pain (Bion’s K) is discussed in relation to the processing of traumatic memories.
分析师不可避免地会欲求着与病人的特别体验，这常常导向自性基础上的阻抗。这样的欲望形式是值得思考的。 可以检视一下这五种假设： 1 分析师情不自禁地会有欲望，并想要被分析者认可这些欲望； 2 这些欲望经常标识了分析师的理论信仰和技术性干预； 3 自性的欲望及其影响在分析实践中是普遍存在的； 4 病人经常在留心分析师的各种目的；5 病人常常希望分析师将他的欲望放在一边来倾听自己，以使病人能够深入到自己的利益中去。拉康"二元关系"的概念是这一讨论的核心。新克莱因派关于自性阻抗的位置也将被探究，而"分析性第三者"的概念也成为了这一问题的一个潜在解决方式。由此扩展的一个案例阐明了这些主要观点。
The intrapsychic mechanisms for the intergenerational transmission of suicide are not adequately theorized, though it is well known that a family history of suicide places survivors at increased risk for suicide. The suicide of a family member, particularly a parent, it is hypothesized, marks some survivors with a type of trauma associated with moral injury, which may produce an alteration in object relations with the emergence of what may be called a mysterious object. Under the press of these conditions, survivors may embark on what Apprey (2014) has termed an "urgent errand" in an effort to solve a problem in the anterior generation. Analysands with a history of familial suicide may bring symptoms of moral injury, a mysterious object relation, and a risk for suicide into the transference. The family history, life history, and literary work of the novelist Walker Percy, who had an extensive family history of suicide, provides evidence for the hypothesis linking moral injury, a mysterious object, and an urgent errand in such patients.
This paper addresses the tension between Freud’s emphasis on the intrapsychic world and the emphasis placed by the Boston Change Process Study Group (BCPSG) on real interaction. Freud claimed that the intrapsychic world is primary; the BCPSG claim that interaction is primary. Both assume that these "levels" are discrete domains that can be isolated empirically, and that interact according to regulative rules in the natural world. This assumption reifies the metaphorical concept of mental space and freezes it at the metapsychological level of discourse. From a hermeneutic perspective, we must put these metaphorical concepts in dialogue with the context-specific processes of interpreting the patient’s communication and intervening therapeutically. It then becomes clear that (1) the meaning of the terms "intrapsychic" and "interactive" is context-sensitive; (2) the question of primacy is a pragmatic one that cannot be decided through metapsychological debate; (3) when we say that a behavior or mental process operates on the "intrapsychic" or "interactive" level, we are making a judgment call that is not based on reason (even if our judgment enlists reason in its support). These metapsychological constructs help us think about our experience with patients. However, their meaning exists largely as a potential and is never definitively determined.
This essay treats Freud’s "Observations on Transference-Love," written a hundred years ago, as the quintessential psychoanalytic document, defining the clinical setup, charting its dangers, and providing ethical precepts for guiding treatment. Above all, in the context of those ethical questions, Freud’s paper confronts the immense power and necessary strangeness of the transference—that form of love, or erotic bond, that fuels the healing process. The "potion"—an artificial yet powerfully real attachment—is the agent of a temporary induced blindness that gives access to a region otherwise inaccessible. A dream is presented to demonstrate that process. Freud, in describing this incendiary arrangement, likens it to a fire in a theater. The fire, the author proposes, is in the script.