FROM CABINET TO COUCH: FREUD'S CLINICAL USE OF SCULPTURE

abstract    This article aims to address and remedy the fact that Freud's clinical use of sculpture has received little sustained attention. After a brief review of the collection, Melanie Klein's clinical use of dolls is discussed as an initial basis for comparison. It then makes a detailed examination of primary evidence found in the published writings and private correspondence of the writer and analysand H.D. (Hilda Doolittle). H.D.'s analysis indicates that Freud used sculpture as an analogue for the 'foreign body' of psychical trauma, treating it as a representation of a representation, or Vorstellungrepräsentanz . The sculptures also served Freud's archaeological metaphor for the 'otherness' of the unconscious in ways that architectural fragments did not. The author then considers H.D.'s hallucination of Athena Nike and Freud's use of his own damaged sculpture of Athena to raise therapeutic questions about her phallic relation to the signifier in the treatment of her writer's block. This case study is further compared to Klein and to Jung in order to differentiate the use of objects in the clinical setting and to mark some of the limits Freud encountered in H.D.'s second analytic session. The author concludes that purely textual examinations of Freud may have greatly underestimated his clinical use of sculpture in recuperating lost memories as fundamental indices of desire.     

Jeffrey Masson and the Assault on Freud

Critical analysis of Jeffrey Masson's book The Assault on Truth has generally been inadequate; neither gleeful welcoming nor cursory dismissal is sufficient to meet Masson's challenge. He reconstructs the events which, he claims, led to Freud's abandonment of the seduction theory of neurosis and argues that this turning away from a'real event'and towards phantasy represents an error from which psychoanalysis has never recovered. This paper argues on the contrary that Masson's historical reconstruction is unsound on its own internal evidence (although his exact thesis is often unclear), and that the theoretical conclusions he draws are based on a gross misunderstanding not only of psychoanalysis and the role of phantasy but also, ironically, of the seduction theory itself. His general reassertion of the aetiological significance of child sexual abuse is therefore misconceived.     

ON SOUNDS, CHILDREN, IDENTITY AND A'QUITE UNMUSICAL'MAN

ABSTRACT In this article I explore, in the context of general psychoanalytic considerations about creativity, the specific place of music in human development. With reference to early auditory experiences, I emphasize the central place that sounds occupy in the formation of a child's separate identity. My thoughts on this subject also give me the opportunity for looking at some aspects of the complex relationship between music and psychoanalysis - two exquisitely auditory experiences - and for providing a historical review of Freud's own ambivalent attitude to music.     

'THOUGH THIS BE MADNESS YET THERE IS METHOD IN'T'1

ABSTRACT Freud's paper on the Schreber Case is considered from a contemporary perspective drawing on the object relations theorists. Some of Winnicott's ideas are used to illustrate how one might understand Schreber's predicament today. Although Freud's views on the role of repressed homosexual longings in the aetiology of Schreber's illness are not endorsed his prescience in the search for meaning in the patient's discourse is applauded.     

Guilty as charged: A response to Anthony S. David

Reading a review of one's own work can be a very unsettling experience. It is not just that the limitations of one's efforts are publicly highlighted. In this case it was also the discovery that the book that I thought I had written is not quite the same as the book that the reviewer appears to have read. Of course, this may be partly my fault. There is usually no opportunity to respond to these kinds of discrepancies, so I am very grateful to have the opportunity to reply to his comments. Much of Tony's critique concerns the style of my book, which he correctly notes is an attempt to summarise my work and the views that I have reached about madness after nearly two decades of research. It is indeed a bit of a monster at 512 pages of text and would have been more of a monster had it not been for the help and advice that I received from Stefan McGrath and his colleagues at Penguin. This length was necessitated by my efforts to justify, in as much detail as possible, a number of claims that I knew would be controversial, especially for my medical colleagues. Hence the nearly 100 pages of references, which I have tucked away at the back, where they are available to the psychologist or psychiatrist who wishes to examine the research in more detail, but where they, I hope, do not spoil the layperson's reading experience.     

Lacan for the Faint Hearted

This paper introduces Lacan to the psychotherapist without using his jargon. He is shown as deeply influenced by the Russian Marxist Alexander Kojeve whose charismatic seminars on Hegel Lacan attended. This helps account for his 'global' perspective in which we are all determined by deep social structures or that 'language speaks us' . Lacan also noticed Freud's writings are shot through with almost hidden uses of Figures of Speech, and this becomes the central plank in his theory that our unconscious processes coincide with the rhetorical workings of language.     

Guilty as charged: A response to Anthony S. David

Reading a review of one's own work can be a very unsettling experience. It is not just that the limitations of one's efforts are publicly highlighted. In this case it was also the discovery that the book that I thought I had written is not quite the same as the book that the reviewer appears to have read. Of course, this may be partly my fault. There is usually no opportunity to respond to these kinds of discrepancies, so I am very grateful to have the opportunity to reply to his comments.

Much of Tony's critique concerns the style of my book, which he correctly notes is an attempt to summarise my work and the views that I have reached about madness after nearly two decades of research. It is indeed a bit of a monster at 512 pages of text and would have been more of a monster had it not been for the help and advice that I received from Stefan McGrath and his colleagues at Penguin. This length was necessitated by my efforts to justify, in as much detail as possible, a number of claims that I knew would be controversial, especially for my medical colleagues. Hence the nearly 100 pages of references, which I have tucked away at the back, where they are available to the psychologist or psychiatrist who wishes to examine the research in more detail, but where they, I hope, do not spoil the layperson's reading experience.     

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.     

FROZEN HARMONIES: PETRIFIED PLACES IN THE ANALYTIC FIELD

In this paper I suggest that here-and-now transference interpretations can be defensive when they keep the focus on the intrapsychic world of the analysand and neglect the unconscious of the analyst and the unconscious-to-unconscious interaction between patient and analyst. Whilst the concept of the analytic field in psychoanalytic literature provides us with a way back to Freud's original consideration of the intersubjective alongside the intrapsychic, this inclusivity has been sustained within the Developmental School of Jungian Analytic thought. To illustrate this I present an adaptation of Jung's model of the transference. Once we engage in analytic work with an individual we are inevitably drawn into a 'dance' together with its own particular rhythms and harmonies. Each analytic couple creates an analytic field from their idiosyncratic energy flow. Within this field, interruptions to the 'dance' occur; mis-steps and disharmonies involve an unconscious refusal within the analyst as well as the patient. Both the dance and the refusal are crucial for the work, and I suggest that our attention needs to be directed here, to the blocks or 'petrified places'. To illustrate how I believe they can be made use of, I provide material from three case examples.     

On ‘The Hatred of Learning from Experience’: A Work Journal Revisited

In January 1999, I started a two-year course in psychodynamic counselling. One of the course requirements was to produce several work journals each term. They could be on any topic the student wished to think about or explore that pertained to the course, be it clinical or theoretical work, or professional/personal development. Three months later, I wrote one on Bion's (1962) concept of ‘the hatred of learning from experience’, after a seminar on his work. In Section 1, I present the work journal itself, in which I described my difficulties with anxiety about the course in relation to this concept: how I felt I needed to be a perfect student who ‘knew everything’; my intolerance of making mistakes; and my hatred of not knowing; in tandem with my envy of others' knowledge. In Section 2, I describe my current understanding of what I was rather desperately attempting to work out in the journal – taking into consideration both my emerging feelings, in light of my own history and state of mind, together with what I had come to understand – that the course was poorly structured and did not provide an adequately safe framework for clinical work and learning. This resulted in my decision to leave. In Section 3, I write about the arduous but ultimately rewarding process of returning to training, eventually culminating in my qualification as a psychodynamic psychotherapist. My final thoughts are presented in Section 4.     

Self‐recognition in everyday life

Introduction: A sample of everyday difficulties was collected, encompassing errors and unusual experiences participants had encountered when recognising their own faces in everyday life, with the aim of characterising similarities and differences between the reported difficulties and the major forms of self‐recognition impairments described in the neuropsychological and neuropsychiatric literatures (prosopagnosia, mirrored‐self misidentification, and Capgras delusion).

Method. A total of 70 participants recalled experiences from memory. Incidents (n = 51) were recorded on questionnaire sheets that were filled out at home. Reports of three categories of incidents were analysed: misidentifications (the participant misidentified her/his own face as being that of another familiar person; n = 5), recognition failures (the participant judged that his/her own face was that of an unfamiliar person; n = 20) and perception of unusual aspects (the participant confidently recognised his/her own face but found that the seen face did not fit well the representation she/he had of his/her own face; n = 26).

Results and discussion. In the reported incidents, experiences showing some similarities to those of patients with prosopagnosia, Capgras delusion or mirrored‐self misidentification were noted. However, across the whole study, no incident involved a failure of reality testing; in contrast to pathological forms of error, in all of the reported incidents from our study the participant realised that a mistake had been made. The importance of decision processes in pathological forms of own‐face misrecognition is discussed.     

Mortality and Finiteness

Using Money-Kyrle's concept of the facts of life, the author takes up the difficulty for a therapist in accepting his mortality and the finiteness of things. He reports two cases of once-weekly psychotherapy during which he had to take a three-month period of sick leave. In the first case, the patient created a timeless prison where the therapist and the patient were fused to avoid separation, which meant, to the patient, violent death. The author describes how his own acceptance of the fear of death helped them to face the patient's murderous hatred. The second case is of a patient with a huge and strong body who denied his own need and dependency. The therapist was at first unaware of being caught up in narcissistic competition with the patient. However, the realization that he was envious of the patient enabled him to accept his own weakness, which in turn helped the patient to show his vulnerability. Finally, the author argues that although it is human nature to deny death, we need to face death if we are to face life. He argues that there is perpetual oscillation between acceptance and denial of our mortality and the finiteness of things.     

The Truth Is, Sir, My Nerves Are Bad'Reflections on Freud's Case of Katharina

SUMMARY. I will revisit Freud's conversation with Katharina on a mountaintop, refer to the recent discovery of her identity, and consider this fascinating short case history in terms of diagnosis, etiology, psychodynamics and interpretation.     

Kafka's trial dilemma: proposal of a practical solution to Joseph K.'s unknown accusation

Numerous interpretations have been proposed to Kafka’s writings, due to their hermetic nature. Psychological interpretations have been the object of numerous psychoanalytical studies, but not of cognitive-behavioral therapy (CBT) studies; nor have there been attempts to propose a solution to Kafka’s inner conflicts supposedly pictured by his characters. In this paper, I assume that Kafka intended to propose a universal principle of self-accusation by human beings. I also assume that self-accusations occur as schemas and core beliefs about the self described by cognitive therapists, and that being aware of such cognitions might permit the patient to organize his or her own defense. Thus, it is possible to set an enquiry to identify the self-accusations and mobilize the characters in the inner tribunal to help the patient judge himself with a more realistic and informed basis. Empirical data supporting this hypothesis as well as the approach I proposed to deal with it are presented in this paper.     

Focal retrograde amnesia and the attribution of causality: An exceptionally benign commentary

Kopelman offers an invaluable and comprehensive review of empirical and theoretical issues relating to focal retrograde amnesia and related conditions. He makes two main points: (1) That many of the published cases of focal retrograde amnesia in fact showed significant anterograde memory impairment, and thus should strictly not be classified as cases of focal retrograde amnesia; (2) that there are hazards in attributing causality in patients with retrograde amnesia, especially those with a major autobiographical component. In the case of his first point, I suggest that his observations are a matter of interpretation, essentially revolving around the defining criteria for the selection of memories to be compared and for regarding one set of memories as "disproportionately impaired" compared to the other. With regard to the second point, however, I largely concur with his observations, adding some reservations of my own. I conclude that although some patients with focal retrograde amnesia may represent a diagnostic dilemma when it comes to attributing causality, those who are shown to have a clear neural basis to their memory loss provide an avenue for exploring the brain's plasticity in accommodating the formation of new memories despite the loss of equivalent old memories.     

The interactive effects of comparative advertising on brand and company image change

The purpose of the present study was: 1) to investigate the effects of two types of comparative advertising--Merit-type (emphasizing positive aspects of their own brand) and Demerit-type (pointing out negative aspects of the rival brand); and 2) to find an effective strategy against comparative advertising of a rival company. Subjects were shown advertisements, and were then asked to evaluate those advertisements (17 items), the brands and company images (3 items) for these two companies. The results are as follows: Comparative advertising, especially of the Demerit-type, was the most conspicuous type of advertising, which also had a significant negative effect on the perception of rival brands. However, this type of advertising also had a negative effect on his own advertising, the brands advertised, and the company itself. Furthermore, it was found that when a rival company uses Demerit-type advertising, it is better not to respond by the same type, but to respond by Merit-type advertising. In such a situation, positive image of his own brand and company become significantly higher.     

Focal retrograde amnesia and the attribution of causality: An exceptionally benign commentary

Kopelman offers an invaluable and comprehensive review of empirical and theoretical issues relating to focal retrograde amnesia and related conditions. He makes two main points: (1) That many of the published cases of focal retrograde amnesia in fact showed significant anterograde memory impairment, and thus should strictly not be classified as cases of focal retrograde amnesia; (2) that there are hazards in attributing causality in patients with retrograde amnesia, especially those with a major autobiographical component. In the case of his first point, I suggest that his observations are a matter of interpretation, essentially revolving around the defining criteria for the selection of memories to be compared and for regarding one set of memories as “disproportionately impaired” compared to the other. With regard to the second point, however, I largely concur with his observations, adding some reservations of my own. I conclude that although some patients with focal retrograde amnesia may represent a diagnostic dilemma when it comes to attributing causality, those who are shown to have a clear neural basis to their memory loss provide an avenue for exploring the brain's plasticity in accommodating the formation of new memories despite the loss of equivalent old memories.     

Structural Studies of Immunoglobulins

In 1946, when I was starting work as research student under the supervision of Dr F. Sanger, the second edition of Karl Lansteiner's book" The Specificity of Serological Reactions'[I] reached England. In it was summarized the considerable body of information available on the range of antibody specificity and much of it was Landsteiner's own work or by others using his basic technique of preparing antibodies against haptenes and testing their ability to inhibit the precipitation of the antisera and t he conjugated protein. Also described in this book was the work in Uppsala of Tiselius and Pederson in collaboration with Heidelberger and Kabat in which they showed that all rabbit antibodies were in the y globulin fraction of serum proteins and that they had a molecular weight of 150.000. This combination of an apparently infinite range of antibody-combining specificity associated with what appeared to be a nearly homogeneous group of proteins astonished me and indeed still does.     

Rescuers and Containers: Fathers and Mothers?

SUMMARY This paper explores the internal images of the feminine Container and the masculine Rescuer and suggests that non containment by a mother figure leads to the search for a powerful male Rescuer. I have hypothesised that it is not until the child or patient can find containment and reduce the longing for an external Rescuer, that he or she can find his or her own inner rescuing capacity.