Reconstruction in A Two-Person World May Be More About The Present Than The Past: Freud and The Wolf Man, an Illustration.

The psychoanalytic process of reconstruction has yet to be examined from the perspective of today's two-person psychologies. Earlier writers on the subject have implicated the analyst and his emotional involvement as influences that may distort the valid recovery of memories, while others have written that the transference and the reconstructed past are interdependent. By contrast with both views, it is suggested here that the reconstructed product itself may reflect the transference-countertransference engagement of the dyad: in some instances, and to some extent in all instances, the scene or story of the presumed past will be a version of the current analytic relationship. In certain cases consideration of the conscious and unconscious emotional entanglements of the dyad will reveal that the reconstruction says more about the analytic present than about the past. Freud's Wolf Man case provides a good illustration of this point. While a broad consensus exists that its famous primal scene reconstruction cannot be veridical, it has most often been dismissed as distorted by Freud's theoretical commitments. A closer examination of the relationship between Freud and Pankejeff reveals that the reconstruction is an accurate rendering of warded-off aspects of the dyad's way of being together. The potential clinical utility of adopting this perspective is that it encourages the analyst to reflect on his clinical reconstructions, interrogating them for clues to otherwise elusive aspects of the current clinical relationship.

On our need to move beyond folk medicine: A commentary on Karen Gubb's paper, "Psychosomatics today: a review of contemporary theory and practice".

In her thoughtful review and synthesis, Karen Gubb overstimates the breadth of resurgent interest among psychoanalysts in psychosomatic medicine. Such a modest revival as there has been reflects primarily the activity of a few authors and editors. Still, after several decades of inactivity following the intense excitement about this subject during the 1940s and 1950s, there has been some renewal of interest, primarily in Europe and among a small group in the United States. The golden age of psychoanalytic psychosomatics came to an end with the failure to find evidence in support of the promising but overly simplistic specificity theories, especially those of Franz Alexander. If we were going to better understand the complex relations between bodily states (including illnesses) and mental phenomena new theories and modes of investigation would be required. Many apparently new theories have been put forward over the past few decades. Of these, Gubb focuses her attention on two that relate somatic illness to failures in linguistic or symbolic elaboration, that is, to failures in the working over or binding of somatic excitations by the mental apparatus. These theories share the attractive feature that they seem consistent with the claim that psychosomatically ill patients are impaired in their language capacities, being unable to put feelings into words (alexithymia) and unable to move to abstract from concrete thinking (pensée opératoire). While apparently new, when closely examined these theories turn out to be but minor variations of one of Freud's own fundamental theories of mind/body, the one explicated in The Interpretation of Dreams and based upon the neurological model of the reflex arc as known in the 19th century. We know too much today about neuronal functioning, brain operations, and the importance of our subtle interactions with others to be satisfied with a superannuated scientific model. If we analysts are to lay claim to a science beyond a quaint folk medicine we need to create new models that are at consistent with our own more advanced findings and those of our neighboring disciplines.

Maurice Sendak's trilogy: disappointment, fury, and their transformation through art.

An overlooked yet central developmental theme of Maurice Sendak's major works is that of resilience. Resilience reflects a child's capacity to transform otherwise crippling traumatic circumstances into his (or her) very means of survival, growth, and positive maturation. An implicit credo of these works is the adage: "What doesn't kill me makes me stronger." The embedded rhetoric of three of Sendak's most important books "argues" that it is by means of a poetic function, of creative imagining, and ultimately through art itself that children may overcome the traumatic circumstances omnipresent during development. The most traumatic circumstances-according to Sendak--are the rages children feel toward the very persons whom they love and depend upon, rages that threaten to disorganize themselves and disrupt vital sustaining relationships. Sendak has said that he is obsessed with one and only one question: "How do children survive?" His answer, engagingly expressed in his trilogy of Where the Wild Things Are, In the Night Kitchen, and Outside Over There, is that children survive by their exercise of creative imagination, of reverie, dream, poetry, music, and exquisite visual representation. Art was Sendak's means of "recovery" from his own childhood; his published works represent his gift to all children.

The reassembly of the body from parts: psychoanalytic reflections on death, resurrection, and cannibalism.

Terror of the dismemberment, disintegration, and decay of the body after death has been represented in ritual, myth, legend, art, and religious belief throughout the ages. So too has the wished-for triumph over these inevitable processes. Commonly, bodily experience after death is represented mentally in cannibalistic ideas of eating and being eaten, which are then countered by the wishful undoing of cannibalistic destruction through its reversal: swallowing as regurgitation, dismemberment as rememberment, disintegration as reassembly. Luca Signorelli's fresco The Resurrection of the Flesh is part of his celebrated group of decorations (1499-1504) of the Cappella Nuova in the cathedral at Orvieto. The doctrinal, iconographic, social, and political contexts of this admired and influential work are explored in order to illustrate how and why this painting represents our greatest fears, along with our triumph over them, as well as our most destructive urges and their reparative counterparts. The photographer Sally Mann has explored these same themes. In What Remains (2003), a series of pictures with accompanying text, Mann documents her exhumation and reassembly of the body of her beloved pet greyhound. Two clinical examples illustrate some ways these concerns (cannibalism and reassembly) may make their appearance in psychoanalytic work.

Refusing the cure: Sophocles's Philoctetes and the clinical problems of self-injurious spite, shame and forgiveness.

Sophocles's Philoctetes (409 BCE) is a dramatic masterpiece unfamiliar to most analysts. The play presents a complex portrait of self-injurious spite of heroic dimensions as it touches on issues of intense shame, feelings of helplessness and the refusal of forgiveness. Sophocles's protagonist, Philoctetes, is a man who, like some of our patients, refuses to be healed. He intends, through his continued sickness and misery, to exact revenge against those who mistreated him. These are recognizable clinical issues, playing roles in every psychoanalytic treatment, issues that may assume a special importance in protracted, stalemated or aborted analyses. There are patients who damage the analyst by damaging the analysis they are in, a malevolent project often undertaken in revenge for wrongs suffered during childhood. This paper links Sophocles's drama to these vitally important clinical considerations through the discussion of a particular case.

Psychosomatic medicine: the divergent legacies of Freud and Janet.

A series of differing explanations of a puzzling case of psychosomatic illness introduces some reflections on a century's history of psychoanalytic interest in the mind-body problem. Freud and Janet explained the physical symptoms of hysteria using radically different models of the mind. Since then Janet's model, banished early on, has returned to haunt the castle of psychoanalysis. The enduring influence of Janet's model on subsequent thought in this field, especially that of Marty and de M'Uzan, Sifneos, LeDoux, and others, is traced, as is the influence of Freud's model on Groddeck, Alexander, McDougall, Fonagy, and others. It is argued that although these models are vastly different at one level of abstraction, at a higher level they share an important set of assumptions.