The Milner Experiment: Psychoanalysis and the Diary

The paper reviews what I have called Marion Milner's ‘experimental autobiographical quartet’ of books ‘written under the sign of self‐analysis’, A Life of One's Own (1934), An Experiment in Leisure (1937), Eternity's Sunrise: A Way of Keeping a Diary (1987) and Bothered by Alligators (2012). It explores the relationship between self‐analysis and psychoanalysis in Milner's complex, unclassifiable texts built around diary‐keeping, diary reading and diary interpretation. It situates them in the context of the modernist notion of what Virginia Woolf called ‘moments of being’, reading Milner's various meta‐diaries as ‘experiments’ in relation to the work of other modernist women diarists like Woolf, Nin and Mansfield, as well as the writings of British psychoanalysis. It argues that Milner's project is based on a unique commitment to multiple versions of ‘experiment’, literary and psychological, as well as a conflict between the urge to integration and disintegration played out in psychic and aesthetic terms.     

The Wager of Faith in Fiction and Psychoanalysis: Reading Colm Tóibín's The Testament of Mary

Colm Tóibín's novella The Testament of Mary (2013) offers a provocative re‐imagining of the Virgin Mary's life 20 years after the crucifixion of her son Jesus. Drawing on Richard Kearney's notion of anatheism or a ‘return to God after God’, I use the fictive space opened up in Tóibín's version of the Gospel as a spur to understanding the way in which faith may be conceived of as wager within both fiction and psychoanalysis. Discussing how the reception of the artistic message requires the same spirit of hospitality as does the encounter with alterity within the psychoanalytic relationship, I argue that in both cases we are faced with an existential moment of choice that requires a whole‐hearted willingness to engage with otherness. The implications of Tóibín's story for psychoanalytic work are then explored with reference to developmental processes outlined by Winnicott (1971) in his paper ‘The use of an object’. The paper concludes with a brief discussion of the significance of testimony within psychoanalytic work.     

Jean Laplanche: The Unconscious,The Id and the Other

This paper is an attempt to present Jean Laplanche's interpretation of the Freudian field as one that is driven and shaped by opposing gravitational pulls. These he represents by developing Freud's analogy of the Copernican and psychoanalytic revolutions to demonstrate the successive decentrings and recentrings of the human subject in relation to a primal and formative other at the level of a psychoanalytic theory that is itself alternately both ‘Copernican’ and ‘Ptolemaic’. In doing so, he replicates those movements at work at the level of the formation of human subjectivity. Focusing on Freud's shifting conceptions of the unconscious, the drive and the id, this paper seeks to show how Laplanche radicalizes certain ‘Copernican’ elements of Freud's metapsychology to establish the primacy of the other and the dimension of ‘primal seduction’ in concepts intended by Freud to decentre the narcissistic illusions of the ego, but which are captured by regressive movements of thought, retreating to ‘Ptolemaic’ conceptions of an endogenous, biologically grounded development of subjectivity.     

Wittgenstein's ‘Lighting up of an Aspect’ and the Possibility of Change in Psychoanalytic Therapy

The centrality of language in the psychoanalytic process has been recognized since Freud's time and is common to all schools of psychoanalysis. But despite the use of linguistic and literary terms such as ‘metaphor’ and ‘narrative’, the relationship between the role played by language in the constitution of the subject and how it functions in the process of communication between therapist and patient, in general and as a key to change, remains to be elucidated. Psychoanalysts such as Klein and Segal highlighted the importance of symbols in the constitution of the subject. However, they did not examine what actually takes place in linguistic acts, but their outcomes. I argue that in order to better understand the language‐based processes we need to examine them from a linguistic perspective as this would demonstrate the neutrality of language and its diverse mechanisms. As a case study of the therapeutic process from the perspective of philology, this article examines the possibility of a change in treatment, inspired by variations on Wittgenstein's term ‘aspect’. Building on Wittgenstein's criticism of The Interpretation of Dreams, I propose expanding the use of this linguistic mechanism to include its function in the process of communication during therapy.     

‘Chaos,Through a Veil of Order’: The Dialectic of Theory and Spontaneity in Psychoananalytic Work

The theme of the paper is the quotidian debate about the role of theory in analytic practice. Based on examples from recent psychoanalytic publications, I argue that psychoanalytic theory may influence therapists as ideology, heuristics, or empiricism, or combinations thereof. Bion's eschewing of theory, and advocacy of an analytic stance ‘beyond memory and desire’ as a precondition for psychoanalytic creativity is questioned. Buber's advocacy of I–Thou relatedness is compared with the concept of mentalizing, and related to recent findings in developmental psychopathology. Parallels are drawn between the therapeutic relationship – bringing together theory and spontaneity in a hermeneutic enterprise – and the infant's use of security‐promoting care‐givers.     

Copying,Cloning and Creativity: Reading Kazuo Ishiguro's Never Let Me Go

Kazuo Ishiguro's (2005) dystopian novel Never Let Me Go is set in 1990s Britain, in a boarding school called Hailsham. Through the adult voice of one of the children remembering her time growing up there, the reader gradually learns that Kathy and her friends have been raised as artificially‐generated clones, manufactured to provide body parts for ‘normals’ in the world. The narrative deploys flashback and hindsight in order to interrogate the essentialism of biological origins, raising complex questions concerning the relationship between memory, copying, creativity and selfhood. These topics are discussed through a psychoanalytic reading of Ishiguro's novel where I draw on Apter's (2011) ideas about textual translation, Laplanche's (1999) notion of ‘afterwardsness’ and clinical material to explore the various ways in which memory and identification are implicated in the development of personal identity.     

The Mother,The Psychoanalyst,The Poet and The Artist: Containment and Growth of The Mind

This paper considers the difficulties which humans have in using and developing their capacity for thought. Growth of the human mind, through attunement of the mother's unconscious experience with the infant's, is explored along with the distortions which arise because of aversion to uncertainty and suffering. It then looks at psychoanalysis and the verbal and visual arts in the light of the maternal function, and the way in which they also promote the growth of the mind. Four products of the human mind – an excerpt from an infant observation published in 1998, some post‐Kleinian psychoanalytic clinical case material from the 1980s, John Keats's 19th century Ode to a Nightingale and Lucas Cranach's 1526 painting, Adam and Eve – are used to illustrate some of the similarities and differences among them in giving conscious form to the unconscious.     

Ideas of cure as a predictor of premature termination,early alliance and outcome in psychoanalytic psychotherapy

Objectives. This study examines how young adult patients' ideas of cure prior to psychoanalytic psychotherapy are associated with premature termination, early alliance and therapy outcome. The hypotheses were that ideas about approaching one's problems would be related to fewer premature terminations, higher early alliance and better outcome, than would ideas about distancing oneself from one's problems. Design. Young adult patients (N=46) were interviewed prior to therapy regarding their ideas of cure. Outcome measures were administered pre‐ and post‐therapy. Alliance measures were administered early in treatment. Methods. A typology of the patients based on their ideas of cure was performed using ideal type analysis. Clusters of patients were then rank ordered in accordance to the theoretical dimension ‘approaching‐distancing’. The relation between rank ordered ideas of cure and premature termination was analysed using Mann‐Whitney's U‐test. These ideas' associations with early alliance and therapy outcome were analysed using Spearman's rho. Results. Patients who terminated therapy prematurely were significantly closer to the ‘distancing’ pole regarding ideas of cure, while the therapy completers were more often found near the ‘approaching’ pole. No associations were found between ideas of cure and early alliance or therapy outcome. In addition, patients with attrition due to failure to participate in interviews and complete interviews were significantly closer to the ‘distancing’ pole than those who had completed their research commitments. Conclusions. The positive finding regarding premature termination indicates the importance of negotiating ideas of cure as a part of the initial assessment process. Possible explanations for the negative findings are discussed.     

DONNEL STERN AND RELATIONAL PYSCHOANALYSIS

Relational Psychoanalysis as a paradigm is presented through an exposition of the work of Donnel Stern. Stern's ideas centre around four aspects of clinical theory: the therapeutic conversation; dissociation; enactment; the emergence of new meanings. The impact on Stern of the German philosopher Gadamer's ideas is discussed. Key clinical concepts arising in Stern's work include: ‘true conversation’ as a ‘fusion of horizons’; ‘not‐me’– the repudiated parts of the self which are then enacted in the therapeutic relationship; and the emergence of new meanings when conflict, through mentalizing, is moved from the interpersonal to the intrapsychic sphere. Contrasts and comparisons with traditional psychoanalytic thinking are examined. The key defining feature of Relational Psychoanalysis is its radical interpersonal stance, insisting that there is no such thing as a mind on its own, only a mind‐in‐relationship.     

A Couple's Unconscious Communication: Dreams

The author describes the process of a couple's psychoanalytic psychotherapy, conducted in co‐therapy, through the analysis of some dreams and their associations. The dream analysis will show the common and shared inter‐subjective dimension of the couple that emerged from the psychoanalytic psychotherapy setting. Central notions of this clinical work are those of inter‐phantasizing, common and shared dream space, and couple associative chain. But also the containing model of the psychic envelope can be considered as one of the bases of the theory of a couple's dream space. The author describes the process by which the partners of the couple, and more generally the ‘therapeutic new group’, were able to achieve the unveiling of a denial pact that allowed the couple to add to their family at the time of the birth of their first child with Down's syndrome; but also, and more fundamentally, what has allowed this young couple to cope with the trauma of this birth. The author finally shows how the group working‐through, within the setting of the couple's psychoanalytic psychotherapy, gave new meaning to sensations, feelings and affects of the couple.     

Analysis on Demand

In his book The Piggle, Winnicott describes a psychoanalytic process that began when his young patient was 2½ years old. He saw her for 15 sessions over a period of about 2½ years and he called this type of setting ‘psychoanalysis on demand’. He concluded that a child should either have analysis as daily sessions or be seen on demand. For an analysis ‘on demand’, the young patient needs a high capacity for continuity and linking to bridge the long intervals between sessions. The author examines in relation to the material of Winnicott's creative case presentation how this capacity was communicated to Winnicott by the small child (a kind of primary symbolization) and how these mostly preverbal communications were ‘heard’ (or not) by Winnicott.     

On the Experience of a Melancholic Gaze

This article focuses on Lars von Trier's 2011 film, Melancholia, described as ‘a beautiful film about the end of the world’ and interlocking personal and global tragedy. Drawing directly on her personal emotional response to the film, and referring to her profound incapacity to talk about it for many years after an initial encounter with it, the author turns to a range of object relations psychoanalytic thinkers to consider what such experience has to say about lived emotional relationships to cinema, and its role in shaping and articulating psychological, and affective states. The article touches on debates about the cinematic gaze, and the role of film as a psychological object, and considers whether film might be seen as offering a form of therapeutic encounter for viewers.     

Symbolic and Anticipated: Winnicott's Attention to the Use of Black in the Consulting Room

This article addresses Donald Winnicott's consistent attention to the idea of black and blackness as manifested in his work in the consulting room from the late 1940s to the 1960s. It describes several very different pieces, published and unpublished, where the use of black is recorded in patients’ material and the different directions they open up: skin colour, psychoanalytic research, representations of trauma and serious disturbance. Both Winnicott and this article argue for caution in ascribing any fixed connotation to black and blackness while recognizing its importance across cultures and historical epochs. In one of the articles under discussion, ‘Hallucination and dehallucination’ (1957), Winnicott refers to two male patients drawing with black pencil and I have linked his discussion both to the more general area of modern art and artists who have been interested in black and to contemporary psychoanalytic interest in unrepresented states. I emphasize the complexity of the arenas opened up by Winnicott and argue for their historical importance.     

From Dualism to Dynamism: Fairbairn's Critique of Libido Theory 1930–1950

In 1930 Fairbairn wrote ‘Libido theory re‐evaluated’, which remained unpublished until 1994. It contains the beginnings of theoretical arguments that, I argue, resulted in his more famous 1940s papers. I posit that Fairbairn's 1930 critique of Freud's analytical dualist theoretical foundation is consistent with, and lays the ground for, his later work. Using the papers ‘Schizoid factors in the personality’ (1940), ‘The repression and return of bad objects’ (1943), ‘Endopsychic structure considered in terms of object‐relationships’ (1944), and ‘Object‐relationships and dynamic structure’ (1946), I show how Fairbairn's 1930 critique is relevant to his later propositions and elucidate Fairbairn's metatheoretical assumptions, about which he was not explicit after 1930. I argue that his theoretical propositions arise as a result of his longstanding, consistent critique that led him to replace analytical dualism with dynamical structure. Further, I argue that Klein, and Khan and Winnicott's criticism is unjustified; Fairbairn did not challenge the content of a theory he describes as ‘truths of fundamental importance’, he challenged its theorization. Because it resulted in his important theoretical propositions, Fairbairn's longstanding critique of libido theory is important within the history of psychoanalytic thought and deserves scholarly attention.     

DEHUMANIZATION,GUILT AND LARGE GROUP DYNAMICS WITH REFERENCE TO THE WEST,ISRAEL AND THE PALESTINIANS

Following his participation in a visit by health professionals to Israel/Palestine, the author reflects on the sense of apprehension that accompanied his intention to share his impressions on his return. In this paper he turns to psychoanalysis and the analysis of large group phenomena to discuss socio‐psychological factors that seem to determine the context for discourse in the West relating to the Israel/Palestine conflict. He argues that psychoanalytic theories concerning the unconscious element in inter‐communal conflicts are a useful starting point in understanding large‐group psychological responses to the dehumanization of both Jews and Palestinians. He seeks to understand the anxiety and inhibition that seems to attend reflection on Israel/Palestine in public space in particular, and within the psychoanalytic community. He argues that ‘neutrality’, the proper stance of the clinician in the consulting room, has come to inhibit the profession in its non‐clinical thinking. He proposes that ‘universalism’, the philosophical basis of the extension of the human rights agenda in the years since 1945, provides the appropriate moral underpinning for psychotherapeutic practice.     

The ‘I’ of Elephants and Eyes: Psychotic Signification and Psychoanalysis

Writing as an analysand I argue that without psychoanalytic support psychotic signification may retain the incomprehensibility of a private language destined never to be understood. Using Lacan's (over‐quoted) belief that ‘the unconscious is structured like a language’, I show how his concept of ‘master signifiers’, when applied to the/my unconscious, read by metaphor and metonymy, is particularly helpful in understanding the apparently unintelligible ‘language’ of psychosis. Drawing on my own psychotic material, with reference to a specific ‘master signifier’ in one of my psychotic episodes, I also begin to explore the challenges that the solipsism of psychotic signification presents in the therapeutic relationship.     

Feminine Identity and Female Friendships in the ‘Neapolitan’ Novels of Elena Ferrante

In this paper female‐to‐female friendship as depicted in the Neapolitan novels of Elena Ferrante is used to think about aspects of unconscious relating, and of feminine identity. The two girls in the stories ‘blur’ into one another, in a way that is at times a source of creative strength, and at times a quasi‐psychotic state. The idea of ‘merger’ as characterizing female relationships is considered through the narrative. Friendship stands outside conventional psychoanalytic models of family relating, but Ferrante explores their internal workings, particularly in the developing child and adolescent, and unfolds the importance of their place in growing up, asserting a unique psychic place for the female‐to‐female bond in identity formation. Psychoanalytic ideas of separation and individuation are brought to bear, alongside Juliet Mitchell's work on sibling relationships, and Rozsika Parker's work on the internal ‘other’ necessary for creativity.     

Training and disillusion in Counselling Psychology: A psychoanalytic perspective

In this paper, I argue * that Counselling Psychology's professional identification with pluralism poses significant emotional problems for trainees. An important factor in such problems may be the trainee's sense of disappointment and disillusion that the route to professional and personal self‐transformation will not be achieved via a set of universal theoretical principles and established clinical ‘rules’. I draw on recent psychoanalytic theory to suggest that the task facing trainees involves balancing pluralism, characterized as an ‘external’ third position, with an ‘internal’ third space indexing an awareness of subjectivity and intersubjectivity. Maintaining a dialogical‐dialectical perspective on these two positions allows for a creative space in which the trainee may be transformed from lay helper into professional counselling psychologist via a personal engagement with theoretical, clinical and academic material presented during training.     

Structure and functions of keratin proteins in simple, stratified, keratinized and cornified epithelia

Historically, the term ‘keratin’ stood for all of the proteins extracted from skin modifications, such as horns, claws and hooves. Subsequently, it was realized that this keratin is actually a mixture of keratins, keratin filament‐associated proteins and other proteins, such as enzymes. Keratins were then defined as certain filament‐forming proteins with specific physicochemical properties and extracted from the cornified layer of the epidermis, whereas those filament‐forming proteins that were extracted from the living layers of the epidermis were grouped as ‘prekeratins’ or ‘cytokeratins’. Currently, the term ‘keratin’ covers all intermediate filament‐forming proteins with specific physicochemical properties and produced in any vertebrate epithelia. Similarly, the nomenclature of epithelia as cornified, keratinized or non‐keratinized is based historically on the notion that only the epidermis of skin modifications such as horns, claws and hooves is cornified, that the non‐modified epidermis is a keratinized stratified epithelium, and that all other stratified and non‐stratified epithelia are non‐keratinized epithelia. At this point in time, the concepts of keratins and of keratinized or cornified epithelia need clarification and revision concerning the structure and function of keratin and keratin filaments in various epithelia of different species, as well as of keratin genes and their modifications, in view of recent research, such as the sequencing of keratin proteins and their genes, cell culture, transfection of epithelial cells, immunohistochemistry and immunoblotting. Recently, new functions of keratins and keratin filaments in cell signaling and intracellular vesicle transport have been discovered. It is currently understood that all stratified epithelia are keratinized and that some of these keratinized stratified epithelia cornify by forming a Stratum corneum. The processes of keratinization and cornification in skin modifications are different especially with respect to the keratins that are produced. Future research in keratins will provide a better understanding of the processes of keratinization and cornification of stratified epithelia, including those of skin modifications, of the adaptability of epithelia in general, of skin diseases, and of the changes in structure and function of epithelia in the course of evolution. This review focuses on keratins and keratin filaments in mammalian tissue but keratins in the tissues of some other vertebrates are also considered.