Some Brief Reflections on "Time" from a Psychoanalytical Perspective.

An attempt is made to encircle time and the times psychoanalytically. They are understood as the result of the interplay of different psychic systems: Timelessness of the Ucs system (psychic reality), actual time in the Pcpt-Cs (perceptual reality), and vectorial-linear time in the Cs/Pcs systems (reality principle). Time shows itself in the moment of presence, but it can only show itself if there is a temporal antecedent. At the same time, time and space are intertwined, so that the past is initially the place where something happened. However, the interplay of the mental systems with time and space can only develop in the object relationship. A short clinical example of an autistoid perversion illustrates this dynamic.

Kairos and chronos: clinical-psychoanalytic reflections on time.

The present paper attempts to define "time" in clinical-psychoanalytic terms. After brief remarks on time, on timelessness, on times, and on Nachträglichkeit, the treatment of a breakdown state is described. The breakdown from the earliest period of the patient's life first manifested itself in an autistoid perversion. It finally occurred in the transference in a presence moment and could become conceivable as a thought for the patient in a turbulent process. Here two time dimensions became apparent: The timeless state of breakdown unfolds in the treatment in such a way that preforms of temporal experiences precede the event of time in presence moment, from which then the times past, future and present can become. In the presence moment and its sublation in the presentational symbol, not only did the breakdown become psychically real, but time, times, and space emerged, albeit dynamically very differently in the analyst and the analysand: for the analyst, past and place emerged with the presentational symbol, while for the patient, temporal location did not occur in the time "past," but in the place where the perversion was practiced. Past is the place where it happened. For the discovery and use of times, it is necessary for the patient to distinguish the absent object from the retraumatizing one. Then the present absent object becomes the object that was there in the past understanding and will be there in the future. The assurance of this figure of thought is obtained in the use of the object.

Hypochondria as an actual neurosis.

Freud defined hypochondria as an actual neurosis. In this paper the actual neurosis will be interpreted as unbound traumatic elements which threaten the self. In severe hypochondria, breakdowns have occurred, as outlined by Winnicott. The nameless traumatic elements of the breakdown have been encapsulated. The moment these encapsulated elements are liberated, an actual dynamic takes place which threatens the self with annihilation. Projective identification is not possible because no idea of containment exists. The self tries to evacuate these elements projectively, thus triggering a disintegrative regression. However, the object of this projection, which becomes a malign introject, is felt to remove the remaining psychical elements, forcing the worthless residue back into the self. In a final re-introjection, the self is threatened by unintegration. To save the self, these elements are displaced into an organ which becomes hypochondriacal, an autistoid object, protecting itself against unintegration and decomposition. An autistoid dynamic develops between the hypochondriac organ, the ego and the introject. Two short clinical vignettes illustrate the regressive dynamical and metapsychological considerations.

Faith (F) and presence moment (O) in analytic processes: an example of a narcissistic disorder.

Based on Freud's remark that a neurosis can not be slain in absentia, the thesis is established that presence moments constitute the central points in the analytic process. The interpenetrative dynamics between analyst and analysand creates an analytical field, in which a pre-conception is formed. This pre-conception meets the self-revealing psychic world of the patient. This realization is a moment of presence (O) and the analytic third is determined. In this moment, the presence of psychic reality is irrefutable present and can be called by name. The name, which is seen as a presentational symbol, is a creation of the analytic couple, but has its source in the genetic roots of the patient. The presentational arises from the presence, which can then become the representation. F is central in this process and is part of the analytic couple. Based on detailed case material of a narcissistic disorder it is shown that a dynamic that impresses at first narcissistic, can be understood from a different point of view as a struggle for the analytical attitude and belief (F).

On psychic elements in a case of autistoid perversion.

The paper explores the formation of psychic elements from an epistemological point of view, drawing on the work of Bion to examine a clinical case of autistoid perversion. Distinguishing the qualification of psychic elements from the realization of pre-conceptions, the paper argues that psychical elements are constituted through a mutually shared experience of presence, and so they should be understood in a paradoxical way--through being-O and transformations into K. These ideas are explored via a clinical case concerning a patient with an autistoid-perverse organization. The patient had been denied any bodily contact with her parents during her first year of life due to an infection; in later life she exhibited an autistoid coprophilic perversion. During the course of her treatment, as it became possible to break down the autistoid organization, the nameless contents surfaced in a mutually shared experience of presence. The analyst was able to hold on to their meaning, which was unavailable to the patient. The absent analyst, however, turned into the mother who 'put the child down' and was experienced by the patient as a suicidal threat. In being-O, the analyst was able to endure the paradox of being the one who 'put her down' in order not to put her down; the paradox of being-O functioned as a container for the destructive objectal dimension of the state of 'being put down'.

On the determination of autistoid organizations in non-autistic adults.

Psychogenic autistic phenomena occurring in non-autistic adults are being increasingly discussed in the psychoanalytical literature. The author endeavours to determine autistoid organizations, which are understood to be a particular form of pathological retreat. Together with the use of autistic objects, two-dimensional levelling out, the failure of unconscious communication, and of projective identification, a characteristic of these retreats is that they are meant to afford protection against paranoid-schizoid fears of the external and unintegrated states of the internal world. The formation of such autistic reactions should be sought not only in traumatic separations and the inadequate containment of primary objects, but also in constitutional weakening. Intolerance accompanying projective identification and damage to primal fantasies/preconceptions are discussed. In conclusion, a clinical illustration with autistoid and hypochondriacal retreats clarifies some of the aspects discussed.