Conference Presentation at APA’s Division of Psychoanalysis (39)

I’ll be in New York at the end of April presenting at Division 39′s annual spring conference. This year the topic of the conference is Conflict and the dates are April 23-27. I’ll be chairing a panel on April 25th entitled: Childhood Sexual Abuse and Conflicts: The Traumatic Sequelae. I’ll be presenting an individual paper as well that I’ve entitled Pathological Caretaking: Changing Object Relations for Adult Survivors of Childhood Sexual Abuse. Here’s the abstract.

Childhood sexual abuse (CSA) warps the individual’s sense of self and object relations. Adult survivors of CSA internalize a sense of badness and guilt that makes their very existence seem criminal (Ferenczi, 1933), contributing to their belief that they deserve punishment and mistreatment. These internalizations inhibit their ability to form healthy and satisfying relationships. They are severely anxious about attachment and are often counterdependent due to their mistrust of others. They often initiate relationships in which they assume a pathological caretaking role, excessively devoted to partners who can be needy, immature, narcissistic and sadistic. These relationships allow them to disavow their dependency needs and yet still have them vicariously met by taking care of a needy other. In this paper, I will analyze these relational patterns that I have termed pathological caretaking, in which the survivor empties himself of desire (Ehrenberg, 1992), choosing to elevate the needs of the other. Also, I will focus on the ways in which these childhood traumas lead to personality-fragmentation (Ferenczi, 1933) and to the erasure of the true self and the creation of a false self (Winnicott, 1960). Furthermore, I will highlight from my own clinical work how I have used a Lacanian (Lacan 2006) focus on desire to destabilize the fixed relational patterns that render these individuals vulnerable to future victimization.

CHANGE: Social-Psychoanalytic Perspectives Conference Announcement

The Association for the Psychoanalysis of Culture and Society (APCS) is hosting its 2013 Annual Conference at Rutgers University Continuing Education Center, New Brunswick, NJ from November 1-2, 2013.

This conference takes up the issue of change from a social-psychoanalytic perspective: change in our bodies, our minds, our ways of being, our forms of communication, our social structures, and our values.

We seek proposals that investigate what psychoanalysis—in both its theoretical and applied forms—can offer for a better understanding of the meanings, process, and effects of change. Please think broadly about these issues from your own discipline, and consider proposing interdisciplinary conversations that discuss these issues across disciplines, or that invite commentary from a different discipline. Consider, for example, the following:

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On Being a Psychologist

As a psychologist/psychotherapist, I have always found it fascinating the ways in which strangers react whenever I inform them that I’m a psychologist. To avoid awkwardness, I know many psychologists lie about their profession to total strangers. It is interesting to note the ways in which strangers respond to my disclosure. I also think it opens up a window into the ways in which Americans thinks about psychotherapy.

One of the major responses I hear from people is “well, we’re all a little crazy, right?” Cue the nervous laughter. In these moments, the stranger is often dreading some sort of mini psychological evaluation and attempting to avoid my (fantasized) all-seeing eye by demanding that I give him/her a clean bill of health. Here I am being placed in the position of the subject supposed to know. Read the rest of this entry »

Notes on the death drive

Yesterday in the DAAD seminar led by Eric Santner that I’ve been participating in, we talked about Triebe und Triebschicksale and Jenseits des Lustprinzips. Prof. Santner emphasized the fact that the concept of “drive” is more the name of a problem than a solution and the fact that the concept of “death drive” seems particularly problematic and confusing — even down to the name itself. As we turned to the (bizarre!) sections of the text that deal with speculative cellular biology, I shared that I had found it somehow funny that Freud pictured the first living being coming into existence and experiencing it as a huge imposition: “This sucks! I want to go back to being primordial soup!” But once you start down that road, it seems as though there’s no reason not to push the point further. Perhaps consistent matter resented its condition and wanted to go back to being indeterminate quarks, for instance. Then Prof. Santner had a brilliant and hilarious insight: the idea that the question “Why is there something rather than nothing?” could be put forward not as an occasion of wonder, but as a complaint.

It seems that more than death (because after all, the inorganic matter to which the living being wants to return is precisely not “dead”), what’s at stake in the death drive is a kind of persistent refusal, an inert “no” that must constantly be overcome. Zizek of course puts this refusal forward as the only possible ground of political change, and it seems that there is justification in Freud’s text insofar as he associates the death drive with the Wiederholungszwang or repetition compulsion that pushes neurotic patients to relive the painful experience that has (mis)shaped them — but it’s all in order ultimately to refuse that particular vicious cycle and shape themselves differently.

I wonder if we can make a connection to the Heideggerian being-toward-death here. What drives Heidegger to investigate the phenomenon of death, at least in my reading, is not so much that death is the “end” and therefore “completion” of a human life, but rather that death as such is a potentiality that always necessarily remains potential, that can never be actualized. After all, once “my” death occurs, “I” no longer exist. The problem with a human life in progress, from Heidegger’s ontological perspective, isn’t so much that it’s “not over yet” as that it contains potentiality, which is a distinct mode of being that the classical ontological categories have a particularly hard time grappling with. Being-toward-death is his way of articulating and grasping that potentiality so as to get a complete grasp of Dasein’s peculiar mode of being (as actuality and potentiality). Just as with Freud’s death drive, the emphasis on death as such may be partially misleading or distracting, but there’s a moment of truth insofar as “death” names a radical negativity in human life. For both Freud and Heidegger, then, it would be this negativity that gives us access to the potentiality to do something other than our automatic daily routines of neurosis or everydayness.

The Subject-Supposed-to-be-Awkward and Group Dynamics

(Note this is an updated post that I wrote years ago on my personal blog. I’ve expanded the original post and it is worth the re-read.)

In Seminar XI, Lacan argued that whenever the subject who is supposed to know (SSK) exists then so will transference. The typical neurotic patient will grant the analyst his trust, and thus allow him to assume this position of knowledge. Furthermore, as soon as the analyst is the positioned as the SSK, “he is also supposed to set in search of unconscious desire” (Four Fundamental Concepts, p. 235). The patient comes into analysis assuming that the analyst has some sort of understanding of his symptoms. Of course, this is untrue. Psychoanalysts are not mediums and have no special intuitive capacities. This belief of the patient is the very thing that often motivates him to enter analysis. The patient interprets the analyst’s interventions as information from the SSK, sometimes granting the analyst omniscient powers.

I’ve been thinking more about Lacan and the way we sometimes attribute certain characteristics to different people (e.g the analyst as the SSK). In social groups, especially group therapy, it is very common that a scapegoat emerges. Generally, this person sticks out in the group as being different and thus worthy of hate. The group tends to project their hatred onto this individual and treats this contaminated group member as a “leper” who must be kept at a distance. Inevitably, the group turns against this one person and alienates the person from the group. Scapegoating is a universal phenomena and it can take many forms. Read the rest of this entry »

The Repression of Sexuality in Contemporary American Psychoanalysis

Two weeks ago I had the pleasure of reading Conci’s biography of Harry Stack Sullivan entitled Sullivan Revisited – Life and Work: Harry Stack Sullivan’s Relevance for Contemporary Psychiatry, Psychotherapy and Psychoanalysis. It’s a wonderful work that contextualizes the radical innovation of Sullivan’s contribution to interpersonal psychoanalysis. Sullivan is the grandfather of contemporary American psychoanalysis and Stephen Mitchell recognized his work as foundational to the contemporary movement. Sullivan began his work at Washington DC’s storied St. Elizabeths Hospital. He then went on to work at Sheppard Pratt Hospital, outside of Baltimore. While at Pratt, he began a therapeutic wing for young male psychotics who recently had psychotic breakdowns. He collaborated and influenced Frieda Fromm-Reichmann’s work at Chestnut Lodge, a hospital located in the DC suburbs (in Rockville, MD).

What was interesting about Conci’s story about Sullivan’s theoretical and therapeutic innovations was the ways in which he re-worked psychoanalytic theory. Although he relied heavily on Freud’s notion of transference (which he re-named) and had an appreciation of unconscious processes, Sullivan was innovative in stressing the social nature of human beings. Sullivan (like many other early dissenters such as Fromm, Thompson, Fromm-Reichmann, etc) argued that Freud had overemphasized the sexual in human nature. Sullivan also collaborated with many social scientists, believing that the cultural and political background greatly informs the ways in which society understands mental illness.

Although I greatly appreciate Sullivan’s contribution to the theory and treatment of schizophrenia (along with the other notables in the interpersonalist tradition such as Fromm-Reichmann and Searles), I was astounded to find how quickly these psychoanalysts dropped sexuality from their theory. Read the rest of this entry »

The Psychotic Superego and God

This weekend I read Franco De Masi’s text Vulnerability to Psychosis. It’s an interesting object relations account of psychosis. In chapter six he addresses the relationship between the psychotic individual’s auditory hallucinations and the superego. The psychotic superego is often punitive, persecutory and excessively critical. Many individuals who have psychotic experience have command hallucinations such as “You should hurt yourself because you’re pure evil.” Interestingly, command hallucinations are particularly common for individuals who experienced serious childhood abuse. In this chapter De Masi draws a fascinating parallel between the God of the Book of the Job and the psychotic superego.

De Masi writes: “Blind with wrath and haughtily insistent on His right to dispose of His creatures as He sees fit, God hurls Himself upon Job and yells at this mere worm crawling in the dirt who dares to ask for explanations of His behavior. Before such an arrogant and narcissistically touchy God, Job appears as a desperate and devout person; the violence of his words against God is dictated more by exasperation that by rebellion. Everything would be assuaged if he would only understand the link between sin and punishment. The story of Job can, in my view, also be understood as the description of a relationship between the ego and the psychotic superego during the course of a psychotic breakdown, in which the protagonist, like my patient, finds himself expelled from the state of well-being and flung on to a dung-heap, a prey to a destructive and accusing voice…The psychotic patient is more like Job: he has to confront a threatening world that is out to annihilate and terrify him rather than to make him feel guilty. The God of Job demands subjection without even allowing him to understand the reason for the wrath and the origin of the sin: the patient in this phase therefore has to face not so much guilt as terror” (P 120-121).

De Masi then connects this experience with Klein’s understanding of the infant in the paranoid-schizoid position who attempts to negotiate the terrifying and chaotic world. At this stage, Klein understood the infant as trying to survive the annihilation anxiety generated by the infant’s powerful death drive. Bertram Karon has also described schizophrenia as a “chronic terror syndrome” where the patient is contending with horrifying realities that threaten their very existence. Job’s experience with the arbitrary and vengeful attitude of God parallels the psychotic individual’s experience with their auditory hallucinations. Often the psychotic individual is taken by complete surprise by the unpredictable and inexplicable ridicule of the menacing voices.

Bonus points for readers who can find other Biblical stories that nicely illustrate psychoanalytic principles.

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