Losing the Internal Oedipal Mother and Loss of Sexual Desire

This paper aims to examine how it might be possible to use psychoanalytic concepts to explore a deeper understanding of the difficulties with conscious and unconscious same gender sexual desires in psychoanalytic psychotherapy. The author explores how the loss of the unconscious oedipal mother can be manifested as a loss of sexual desire in a couple's relationship. The author suggests that the move from what is referred to as the longed‐for state of being in perfect harmony, to a more realistic state of imperfect harmony can bring about the recovery of an unconscious belief that one can possess the oedipal mother. The move from this fantasy state of merger to a more reality‐based relationship can induce feelings of abandonment and loss, particularly of sexual desire. The implications of this for the transference and countertransference, and the conscious and unconscious nature of erotic desires within the therapeutic relationship are considered. The importance of aspects of technique and the need for non‐pathologizing use of concepts to help clinicians more fully explore formulations and therapeutic interventions are examined. While this paper focuses on lesbian relationships, the relevance of the ideas presented here for other gender pairings is explored.     

THE O OF EMPTINESS AND THE EMPTINESS OF O

In this paper I try to show how Bion's sense of ‘O’ may usefully be seen as similar to the Buddhist notion of emptiness. I try to instantiate some of his ideas and I hope that by doing so I might contribute to the realization in the consulting room of his injunctions. I try to explore a possible difference in interpretation between the terms identity and identification and to use the distinction to suggest how emptiness can clarify the real nature of the ego as Freud accounted of it and how its realization can instantiate ego strength.     

Reappraising Winnicott's The Piggle: A Critical Commentary

This is the second part of an extended paper reviewing the nature of the messages Winnicott wished to communicate to his audience through the psychoanalytic case of The Piggle. ‘Introduction and the Treatment’ (published in BJP 31[2]) set out the work in its theoretical and historical context and reviewed the dialogue which serves as the material for the work. This part provides a discussion and a critical analysis of the case, and an examination of both explicit and less worked‐out conclusions which can be drawn from it. The author considers the case as evidence that therapy with a child can be intensive without being extensive. He highlights Winnicott's emphasis on the importance of play for working through internal conflicts, not merely as providing material for interpretation. Whereas Winnicott held firmly to the efficacy of his commotional interpretations, and the notion that Gabrielle's unconscious dispositions were agentive and intentional, the author argues for an alternative to Winnicott's interpretation, highlighting the use of make‐believe play, the irregular timing of the sessions and the child's own maturational processes as being important elements in her recovery. He suggests that, for Winnicott, these factors were intuitively, rather than conceptually worked out, and, in so being, contribute to the enigmatic nature of the original work.     

Ripley's Game: Projective identification,emotional engagement,and the counselling psychologist

Counselling psychology's dual emphasis on the use of the self as both vehicle of therapeutic change and legitimate focus of inquiry and research is one of the features by which the profession may be distinguished from related fields such as clinical psychology or psychotherapy. This paper discusses the relevance of the psychoanalytic concept of projective identification in understanding the extent, nature and subtlety of the ways in which the therapist's ‘self’ and emotions may be deployed within the therapeutic relationship. Illustrated with reference to the film ‘Ripley's Game’ and a clinical case vignette, Searles's (1978) advocacy of ‘a richness of emotional participation’ within clinical work is discussed in relation to the pluralist philosophy of counselling psychology; implications for the training and personal development of counselling psychologists are also briefly explored.     

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.     

Reading Winnicott Slowly… Winnicott,Language and the Science of Psychoanalysis

The author makes a plea for a reading of Winnicott's writings that searches for Winnicott's way of thinking besides searching for specific ideas and concepts. He addresses the question of Winnicott's language, which, the author suggests, may reveal itself at odds not so much with classical Freudian psychoanalysis, as is often purported, as with an entrenched and dogmatic attitude that reigned in many quarters of the psychoanalytic community around him. A parallel reading of his papers and of his correspondence shows that Winnicott avoided writing in a desiccated, formulaic fashion or in reverence to some leading figure in the psychoanalytic society. He rather opted for thinking his own thoughts and thinking the psychoanalytic experience anew.     

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.     

Speaking Through Action,Acting Through Speech: Acting and Enacting in the Analytic Process

In this paper the author looks at the significance of different forms of action in the psychoanalytic situation. He traces the development of related concepts, going back to Freud's early concept of a ‘symptomatic act’ and the introduction of his concept of ‘acting out’ with the Dora case, through to more modern and complex ideas of enactment. He shows that acting out can have a defensive as well as a communicative function. Actions can be a way of ‘speaking’ to the analyst, of communicating things that cannot be thought or put into words. On the other hand, speech itself can become an action rather than a form of symbolic communication, a way of putting pressure on the analyst to fit in with a projective phantasy. Important theoretical contributions to the concept of enactment, by Sandler, Joseph, Feldman and Tuckett, are described in some detail. Looking at Freud's Dora from such a perspective, the author argues that an enactment developed between Freud and his patient. Detailed clinical material is presented to show how the author uses these concepts in his own analytic work. Finally, the relationship between enactment and containment is discussed.     

A psychoanalytic perspective of endings in therapy: A dance movement psychotherapy case study

This paper is an account of time-limited dance movement psychotherapy in an inner-city London school during my final year of training for an MA in Dance Movement Psychotherapy. I describe the treatment of a traumatised 9-year-old boy using psychoanalytic theories, in particular Winnicott's ideas. This patient suffered at an early age from the drastic separation of his father and, when he was 6 years of age, various dramatic events led to the hospitalisation of his mother due to psychiatric problems. The impending ending of the therapy and the trainee's repetition of a ‘neglectful transference’ triggered powerful memories of traumatic past separations, which aroused deep-seated anxieties in the patient and trainee alike. The work towards a ‘good enough’ ending in the new therapeutic relationship was of great value to the patient's recovery. Parallels are drawn with the trainee's feelings of ending her dance movement psychotherapy course.     

‘You Can Take it With You’: Transitions and Transitional Objects in Psychotherapy with Children Who have Learning Disabilities

This paper will consider what impact a learning disability may have on development and transition in a child's life. With reference to Hollins and Sinason's ‘Three secrets’ (2000), Alvarez's ‘Levels of psychoanalytic work’ (2012), and attachment theory, I will reflect on the development of the self when there is learning disability. The paper will go on to relate Winnicott's paper, ‘Transitional objects and transitional phenomena’ (1953) to the theory and practice of integrative arts child psychotherapy (IACP). In IACP, objects, play and creativity form a central part of the treatment. Drawing on clinical material from my long‐term treatment of two young people in particular, I will link the therapeutic effect of objects with Winnicott's ideas about creativity, aggression, motivation and the expression of self. In the paper I set out how, through the therapeutic use of objects and what I call, ‘object games’ we were able to address the children's experiences of trauma as well as the impact of their disabilities. I will describe the changes I saw in the internal worlds of my patients which in turn led to significant and positive changes in their relationships with self and with others. These changes came, over time, to allow them greater independence and self‐determination in everyday life.     

Time in Motion: Qualities of Temporality Within Psychotherapeutic Psychodynamic Counselling

Our relationship to time is both a developmental and a relational one; an inter- and intra-psychic experience. Exploring how the theories of Freud, Klein, Winnicott, and their successors offer explanations of how the psychoanalytic subject develops and sustains a concept of time and the factors that may hinder this, this essay suggests that different qualities of time, such as continuity, rhythm, repetition and interruption, can reveal themselves through the client's transferential and countertransferential relationship with the therapist. Using fictionalized clinical examples it explores how a bodily felt experience of time was thought about by the therapist/author using Laban movement analysis to support a client in ‘working through’ early material that felt stuck. The exploration of a client's perspective is brought in through the writings of the activist Passerini on her psychoanalytic treatment (cited by Baraitser in Enduring Time) and her experience of trauma's capacity to stop time. The essay also looks at how psychoanalytic ideas of temporality challenge the ‘recruiting’ of time by the wider culture to create more time-efficient late-capitalist subjects but by using ideas from movement studies and a Lacanian influenced time register it is suggested that cultural attacks on subjective experiences of temporality could be challenged within therapy. It is hoped the essay encourages the therapist to become alert to the manifestations of different temporal experiences within the therapeutic relationship and to develop a creative, embodied language with which to explore it with the client.     

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.     

Constructions Revisited: Winnicott,Deleuze and Guattari,Freud

In this paper, I argue that construction is not merely a tool amongst the many that are at the clinician's disposal; construction is the very means and end of the psychoanalytic experience. I reinterpret Freud's classic notion in light of the Winnicottian found object and the Deleuzo‐Guattarian understanding of desire as production. I then go on to deploy two detailed clinical vignettes in order to show how, thus reinterpreted, construction is at its most valuable when it is generative rather than historical. Instead of merely eliciting an accurate representation of a lost experience, construction brings about further associations, interpretations and, indeed, constructions that reshape the subject.     

Teaching,Learning and Bion's Model of Digestion

In this paper the author is using Bion's model of the digestive process, among other models, in order to think about how teaching of theory can be approached as a task and undertaken in practice. Beginning with the ideas of Plato, she discusses how new ideas may be best conveyed, and how psychoanalytic theory teachers (using the teaching of Melanie Klein's ideas here to make her points) may make what they teach acceptable and ‘digestible’ to students. She uses some material from a theory group as well as a baby observation group, and concludes that in group teaching the responsibility for the taking on and elaboration of ideas – a process of digestion – is shared by the teacher and by the group. As psychoanalytic workers need to be able to ‘manage uncertainty’ in daily practice, this state of mind can usefully also be held by the theory teacher. The process of digestion will vary according to the composition of any group, drawing out different facets of understanding in both ‘teachers’ and ‘learners’, and may well draw on other vertices beyond that of psychoanalysis. These links will aid the process of digesting ideas, and will also be evident in the author style, structure and content of this paper.     

On Food,Faith, and Psychoanalysis: Isak Dinesen's Babette's Feast

Isak Dinesen's novella Babette's Feast tells the story of how a small, quarrelsome Lutheran community in Norway comes to be transformed by the arrival of a stranger, the French cook Babette. In her deceptively simple tale, Dinesen adopts explicitly Eucharistic language and imagery to convey the connection between eating and faith, exploring via rich use of metaphor the way in which we come to be inhabited and nourished by the other. In this paper, I follow Dinesen's sacramental perspective by offering the Catholic notion of transubstantiation as a model for furthering psychoanalytic theorizing about the presence of the other within. Following an outline of Dinesen's story, I draw on work by Freud, Abraham and Torok, and Kristeva to explore differing notions of unconscious identification, incorporation and the metaphorical basis of subjectivity. I develop these ideas through a discussion of the central celebratory dinner given by Babette and conclude by considering some of the implications of the story for psychoanalytic practice.     

Where is the Baby From,Why is it Here? Creative Ways of Working with Dissociated States in Private Practice

Through one clinical example involving complex post‐traumatic stress disorder, this paper explores the ways in which the psychoanalytic psychotherapist may need to find creative ways of working which incorporate findings from neuroscience whilst holding the basic frame and methods of the traditional psychoanalytic approach. This entails bringing knowledge of how the body (including the brain) works into the consulting room. In particular, the author describes ways of accompanying the patient during florid flashbacks to chronic and severe childhood abuse and of using grounding techniques afterwards, so that anxiety levels can be sufficiently contained for the necessary therapeutic work to take place. The role of supervision is also explored in terms of how the dynamic of rescuer/victim/persecutor may be played out in the supervisory relationship. Unusually, some of the patient's own reflections, written at the end of the therapy, have been incorporated into the paper. Consideration is given to whether departures from standard psychoanalytic technique constitute boundary violations or useful enactments, which can be seen as a form of creativity which enables the work to move on.     

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.     

Dream Work in Clinical Practice: Guidelines Toward a Triangular Situation

Since the publication of Freud's Interpretation of Dreams over a century ago, there has been a surprising dearth of systematic treatment in the psychoanalytic literature on ways to address dream interpretation in practice and in training. It is argued here that dreams remain a royal road to the unconscious and that understanding can be enriched through the application of a methodical approach which incorporates a range of different theories (despite their having generated major rifts in the history of psychoanalysis). In earlier research, I developed a four-part sequential ‘model in theory’ for organizing, comparing and integrating contributions from different theorists to dream interpretation. The present article reports on the model's usefulness for examining case material. Analysis of three case vignettes from experienced clinicians revealed that the model's constructs hold good for examining real-life dream material, which also suggests its applicability as a basis for training. Further work with the vignettes gave rise to a related ‘model in practice’ for understanding dream work in therapy as a triangular situation in which the dream, the patient, and the practitioner have distinct roles. Applying these models to case material, as illustrated in this paper, indicates their potential for further exploration, and to use in the structure, design and practical implementation of learning and training that specifically addresses work with dreams.     

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.