CONSCIOUS CHANGE AND CHANGING CONSCIOUSNESS: SOME THOUGHTS ON THE PSYCHOLOGY OF MEDITATION

ABSTRACT This paper investigates some aspects of consciousness by drawing on the psychology of meditation. Three states of mind are described: semiconsciousness, consciousness and, following the mystics, the possibility of a consciousness which transcends ordinary ego awareness. Some experiences of three authorities on Christian spirituality - Augustine of Hippo, Evagrius of Pontus and Teresa of Avila - are explored in the light of psychoanalytic reflections provided by Erikson, Jung, and Winnicott.     

SOME THOUGHTS ON SUPERVISION

The practice of supervision is increasingly seen today as a pedagogic activity in which knowledge and skills are transmitted from one party to another. Debates around supervision, however, have historically been concerned with a number of other issues, most notably transference and countertransference. We examine the central arguments of these debates in the psychoanalytic tradition, and discuss some of the theoretical and clinical consequences that follow from them. Taking unconscious dynamics into account forces us to recognize that supervision cannot be seen as a ‘neutral’ exercise of accumulating knowledge, but rather confronts both supervisee and supervisor with significant questions about their own position and self-image.     

SOME THOUGHTS ON WORKING WITH REGRESSION IN PSYCHOANALYTIC PSYCHOTHERAPY

This paper on regression during psychoanalytic psychotherapy is largely based on my experience of working with a patient who became profoundly regressed, going back into early infantile states of being. Due to concerns about confidentiality in a therapy which after several years is ongoing, I am only able to refer to the case in a general way; there will be a spectre at the centre of the paper. However, the impact of my experience has informed my thoughts and ideas about the phenomenon of severe regression, and has given birth to this paper. I will explore the dilemmas inherent in including confidential material in a published paper. I want to emphasize the importance of a thorough assessment of patients likely to regress, going on to consider the role of the therapeutic setting. I will talk about adjustments I have found it necessary to make in basic analytic technique in order to accommodate the extreme vulnerability of a regressed patient. I hope to contribute to the discussion among psychotherapists about the value and efficacy of a regressive experience, as well as its dangers, and, lastly, to consider the place that regressive phenomena hold in general psychoanalytic thinking.     

SOME THOUGHTS ON SCHREBER (AND FREUD): DEPRESSION, PARANOIA AND A DELUSIONAL SYSTEM

ABSTRACT Freud's paper on Daniel Paul Schreber is a seminal psychoanalytic text (Freud 1911). In it, he sets out his argument that Schreber's paranoid delusions arose from repressed homosexuality. This paper reconsiders the case of Schreber from a contemporary perspective chiefly by studying, as did Freud, Schreber's autobiographical Memoirs of My Nervous Illness (Schreber 1903), but also by drawing upon more recent biographical information. It follows the view put forward by Lothane (1992), and recently elaborated by Steiner (2004), that Schreber's illness was originally depressive in nature, and then progressed to paranoia and finally to a settled delusional system. It reviews many of Freud's insights, contending that although some, such as his understanding of the mechanism of paranoia and the manner by which a delusion of persecution is converted into a religious delusion of grandeur, have stood the test of time, others, such as the causal relationship he proposes between homosexuality and paranoia, do not.     

CAMBRIDGE,BLOOMSBURY AND PSYCHOANALYSIS

A vignette on the life of Adrian Stephen with whom I began an analysis in 1946, which ended with his death after 18 months. Adrian was the younger brother of Virginia Woolf, a member of the Bloomsbury Group many of whom had been Apostles at Cambridge. In the 1920s Adrian and his wife Karin qualified in medicine in order to train as psychoanalysts. He featured in a novel by Betty Miller, On the Side of the Angels. His biography is by Jean MacGibbon. Adrian was an important participant in the Freud/Klein Controversial Discussions.     

TRADITION,PSYCHOANALYSIS AND THE THERAPEUTIC COMMUNITY

This paper addresses fundamental aspects of the notion of tradition in order to try to understand the foundations of the therapeutic community by drawing on the philosophy of Hans‐Georg Gadamer and the psychoanalytic thought of Jacques Lacan. The authors argue that, although a Kleinian reading of the therapeutic community has been dominant, a hermeneutic approach can enrich our understanding through its emphasis on language, community and dwelling. This leads to a discussion – with the use of case examples drawn from the authors' work in therapeutic communities for the severely mentally ill – of memory, community and remembering, full speech, and the intersubjective nature of being (Heidegger's Mitsein) which situates us not just within tradition but within a specific set of traditions.     

ATTACHMENT THEORY AND PSYCHOANALYSIS: A RAPPROCHEMENT

ABSTRACT Attachment Theory, itself an offspring of psychoanalysis, can play a significant part in helping to link contemporary psychoanalysis with developments in neurobiology, neoDarwinism and infant research. Some highlights of this research are presented. Interpersonal experience in infancy impacts on the developing brain. Patterns of insecure attachment can be related to classical psychoanalytic defence mechanisms, but are seen as ways of maintaining contact with an object in suboptimal environments. The Adult Attachment Interview establishes different patterns of narrative style which can be related to parent-child interaction in infancy, and has confirmed many of psychoanalysis's major developmental hypotheses. With the help of two clinical examples, it is suggested that attachment ideas can help with clinical listening and identifying and intervening with different narrative styles in therapy.     

ENACTMENT: SOME THOUGHTS ABOUT THE THERAPIST'S CONTRIBUTION

ABSTRACT This paper examines three instances of enactment, which occurred in the early stages of a thrice-weekly therapy. The emphasis is on both the origins and consequences of the therapist's contribution. Particular attention is paid to the unconscious nature of enactment, as a phenomenon that can precipitate both a refusal and an actualization of the patient's transference; the former, in this case, leading to further acting out and the latter to malignant regression.     

PLURALISM IN CONTEMPORARY PSYCHOANALYSIS: THEORY AND PRACTICE

abstract    As this paper was originally delivered as the British Journal of Psychotherapy Annual Lecture, I have retained the spoken tone of the original. In contemporary physics, cosmology and philosophy, there is now a recognition that no single paradigm or theory can represent reality and growing credence in the idea that learning is advanced more rapidly through a pluralistic model. This paper argues that the same applies to psychoanalysis and the psychoanalytic psychotherapies. It explores the value given to the recognition of difference in contemporary Independent, Lacanian and post-Kleinian thought and the psychopathology attributed to single vision, and argues for the urgent need to engage in constructive cross-paradigmatic discussion.     

CONSCIOUSNESS, THE SELF AND THE ISNESS BUSINESS

ABSTRACT This paper considers consciousness from the point of view of extreme materialism, which asserts that everything is physical and extreme idealism, which asserts that'the world is my idea'. Attempting to avoid dualism, I argue that there is no fundamental ground of being and that consciousness is a no-thing. Science can explain its mechanisms in terms of'propositional knowledge'but this is distinct from the'experiential knowledge'that refers to the domain of meaning (psychic reality). Although consciousness is omnipresent and infinite, it is surrounded by the further infinity of the Unknown. Together these comprise the totality that Jung called'the Self'. The paper concludes with some reflections on the experience of Being in'the Isness Business'.     

EFFECTS OF POSTURE ON PLASMA VOLUME AND SOME BLOOD CONSTITUENTS

When the posture was changed from horizontal to vertical, or the reverse, the alteration in plasma volume and in the levels of haematocrit, haemoglobin, and plasma protein was much greater in patients with oedema or low plasma protein or albumin concentrations (“the pathological group”) than in patients without these abnormalities (“the control group”). This larger fluid shift, and the larger concentration changes dependent on it, are explained in terms of Starling's hypothesis.