Between The Real And The Imaginary: Truth And Lies In The Psychoanalytic Encounter.

When reality is too much to bear, bodymind unity can fracture, creating self-deceptions, distortions, and disguises of emotional experience that amount to unconscious lies. Without clarity regarding what is real and what is imaginary, emotional truth is difficult to discern. Lies disrupt the development of a subjective sense of self, making it difficult to trust sensations, emotions, or thoughts. In the absence of this trust, a patient may form a delusion that they do not exist. Working psychoanalytically with patients traumatized in infancy and early childhood requires the analyst to experience a somatic link between herself and the patient, thereby enabling a process that was inhibited and, in some cases, nearly aborted to resume functioning. Clinical material is presented illustrating a negative hallucination of not existing following an emotional experience that could not be borne as well as bodymind dissociation that separated the patient's psychic pain from her childhood narrative. The author concludes that these methods of coping with trauma prevent the grieving necessary for truth to become bearable and the mind to grow.

The unwelcome child and a lack of acceptance of new ideas.

Ferenczi's idea of the unwelcome child and his death instinct is used as a background for discussing the treatment of adult patients who do not expect to be received and understood and who turn their aggression back upon themselves, destroying their will to live. When these patients enter analysis, they are very difficult to reach because they have internalized an obstructive object (Bion, 1958). Further, I have linked the unwelcoming of a child to the hatred of the new idea. The paper highlights the deadening defenses that arise in response to awareness of premature separateness between mother and baby, inevitably experienced by an unwelcome child. Coming alive involves suffering the pain of the original loss. To avoid this pain, patients reject anything new, and become stuck in monotonous, seemingly lifeless, patterns where new ideas and new ways of being threaten the static order. This includes the threat that relationship with the analyst brings.

No Words To Say It: Trauma And Its Aftermath.

Trauma survivors suffer from unmediated access to primal undifferentiated positions of the psyche. This access, unmediated by symbolic representation, but represented in the body, disrupts the normal trajectory of development and of relationship. Survivors have no words to communicate this experience. Without words, trauma torments them, because it cannot be borne, grieved, and released. Without access to the usual defenses against unpleasant feelings and ideas, survivors are left isolated and confused, unable to enjoy their lives. These primal states are an aftermath of trauma resistant to treatment because they are outside the symbolic positions of the mind. A clinical example is used to demonstrate the loss of language during breakdown and the function action serves in analytic sessions.

Terrified by suffering, tormented by pain.

Ferenczi's understanding of the primitive defenses required to cope with trauma, such as introjection, identification with the aggressor, atomization and reckoning, supports the author's clinical observations of patients who introject a pain mother. Introjecting a pain mother assures that the terrorism of the original external event of a suffering mother keeps the internal suffering going, resulting in being tormented by pain. Such an introjection creates technical difficulties for the analyst. A clinical case is presented to demonstrate.

Somatic Countertransference as Evidence of Adhesive Identification in a Severely Traumatized Woman.

This paper discusses the use of somatic countertransference as a means of learning about the patient, about projective and adhesive identification and about the object relating nature of the most traumatized and withdrawn part of the personality. It assumes an elemental knowledge of British Object Relations and uses clinical material to illustrate the hypotheses that somatic countertransference is an indicator of a very elemental communication occurring from the aspect of the psyche that is united in a body mind or mind body. The paper assumes that this body mind was object seeking at birth and perhaps before. Because these early aspects of the personality are non verbal and non conceptual, the analyst must rely not only on the verbal material in a session but on the emotional and sensual experiences within the transference and the countertransference. Such reliance requires a faith in one's own intuition without a certainty that one is "right." Because speaking of such early experience is difficult, often writers and analysts appear more certain than they are. This is a hazard of this type of analytic work. What I am writing about is conjecture or imagination or dream, but I am suggesting that such dream work is a valuable tool for analysis.

Introjective identification: the analytic work of evocation.

This paper focuses on a particular counter-transference process-introjective identification and the evocation it enables. Introjective identification enables evocation because it engages the analyst's radical openness to the experience of the patient at the most primordial level. The accumulated wisdom of Ferenczi and those who followed him is used to discuss the role of introjective identification in the treatment of patients with non-neurotic structures.

Infantile trauma, therapeutic impasses and recovery.

Throughout his writings Ferenczi examines the role of the mother-infant relationship in healthy development as well as the difficulties that occur when that relationship is problematic. This paper using Ferenczi and Bion as theoretical background explores the clinical development of impasse in the treatment of hard to reach patients. These patients present special difficulty for analysis because they are not self reflective although they can be addicted to "processing," which is in lieu of emotional connection. Impasse occurs when the analyst does not detect the mimicry involved in processing. The paper offers the idea of recovery, rather than repair, in that such patients have "gone missing" in infancy. Recovery of lost potential can be found in relationship with the analyst and with significant others.