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Jumat, 16 Juli 2010

Psychoanalysis, research and science

By Jorge Bekerman
Translated by Andrea Banega

1. The requirement to shorten the interventions and turn them into ten- to twelve-minute-long presentations prompted me to adopt a sort of "minimal format" for this intervention: I chose to state ten one-minute-long proposals, articulated with one another. I prepared the presentation by summarizing the contents of each proposal and by focusing on what I cannot fail to say, rather than on what I would like to say. [1]

2. The issue of the relationship between psychoanalysis and research and science strikes a personal chord: I started my professional career by doing research in Neurobiology, between 1966 and 1975, and from then onwards I devoted myself to the clinical practice of psychoanalysis. "Strikes a personal chord" means that this intervention about psychoanalysis, research and science has –at least partially- a testimonial character.

3. This enables me to pose the following question: is it possible to talk, write or do research about psychoanalysis and leave the testimonial factor aside? In other words: can we talk, write or do research about psychoanalysis leaving aside our own experience of psychoanalysis? Because –at least in the field of psychoanalysis– there is a difference between reading and experience or, if we’d rather put it this way: between theory and practice. Corollary: there is an "anomaly" in psychoanalytic science, insofar as it is a science that is not built without regard to the testimonial factor (whether or not one acknowledges such testimonial factor), although it is certainly not circumscribed to the testimonial factor.

4. The experience may be the professional "experience" of an analyst, experience written here between inverted commas because there is a reason why Freud said that with each patient, the analyst must try to forget what he already knows and listen to each case as if it were the first. This is another example of the "anomaly" of psychoanalytic science, yet at the same time it is an epistemological stance whose originality and efficacy should be underscored time and time again, since no science is built on the methodological premise that that which is already known should be forgotten; rather, the contrary is the case.

5. When we talk about the experience of psychoanalysis we refer especially to each one’s experience as a patient. The most important methodological requirement for Freud regarding the formation of the analyst is that the analyst must undergo psychoanalytic treatment; following this line of reasoning we may add that when talking, writing or researching about psychoanalysis we cannot do without our experience as patients.

6. Thus, research in psychoanalysis is always "research under transference" (positive or negative); first of all, in relation to psychoanalysis itself. This is very hard to defend in the framework of science, insofar as scientific knowledge is built by taking as reference ideals of objectivity and accuracy that may be entirely passed on to the scientific community. Psychoanalytic science (should such a science exist) would be a paradoxical science –as well as a conjectural one.

7. Let me illustrate this point with a clinical vignette. For this purpose, we shall refer to the patient as "Claudia" and to her mother as "Nelly". Nelly, devastated by psychosis, was unable to raise Claudia by herself. But Nelly had two single, childless sisters who helped her as best as they could –not very well, in fact. Once, during the course of her free association, while Claudia was commenting on an argument between her aunts I heard her say: "My three aunts are always arguing." "Three aunts?", I asked, "What do you mean three aunts? Do you not have two aunts?" She remained completely silent for an instant and then declared: "Sure, since I did not have a mother!".

8. "I did not have a mother" is an inaccurate statement that articulates a subjective piece of truth crucial to this subject: "I am three times an orphan".

9. The issue of the truth of the testimonial factor is embedded in psychoanalytic research and science. Yet on the other hand, from the moment it was born, psychoanalysis has appropriated a commitment with the scientific rationale, with that reason which proves capable of getting to the edge of the abyss of what may be known. Unlike magic, which is based only on symbolic efficacy, and unlike religion, based on the promise of an eventual reward, psychoanalysis is based on the materiality of the signifier and its effects. In my case: to solve the alienating "science or psychoanalysis" option in order to work in psychoanalysis without giving up the scientific spirit.

10. As with any type of research, psychoanalytic research is not a one-person task, even though the names of Freud, Lacan, Melanie Klein, Winnicott and others may seem to indicate otherwise. Since it is not an individual task, it is an institutional task, which raises the question of what the requirements would be for an institutional structure to be consistent with the scientific "anomaly" inherent to psychoanalytic work. This might be reduced to the minimalist principle of creating and recreating spaces that include the testimonial factor with dignity, to turn it into the axis around which the research that is consistent with the scientific spirit of psychoanalysis revolves.

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References and notes
1-The author presented this work at the International Congress on Research in Psychoanalysis and Social Science (Investigación en Psicoanálisis y Ciencias Sociales) held in Tucumán, Argentina, on October 6th and 7th, 2006. The original text in Spanish was published by Editorial Letra Viva, on April, 2007 (pp 74-75).

source: http://www.lacanian-psychoanalysis.com

Selasa, 01 Januari 2008

Curing Schizophrenia

Views of Schizophrenia

A simple internet search for the word reveals a profusion of definitions with similar typecasting; e.g. Schizophrenia is “a chronic, severe, and disabling brain disorder...” (NIMHa, 2007), or “a severe, lifelong brain disorder,” (Medline, 2007), or a “disease.”

The reader may perceive something approaching a unanimity of opinion on the idea; i.e., that since this “disease” involves the brain and these authorities have deemed it to be “lifelong,” it must ipso facto be something strictly biological. A host of inferences follow: “it’s all in the genes,” “you’re born with it,” “there’s something wrong with their brains,” “the poor parents,” “medicine can cure them, if only we can find the right medicine,” “there’s no hope,” etc..., etc...

This writer thinks most of these views are about as useful as earlier ideas that people with schizophrenic symptoms were guilty of witchcraft. At least the same National Institute of Mental Health Report listed above candidly admitted:

“…schizophrenia is believed to result from a combination of environmental and genetic factors. All the tools of modern science are being used to search for the causes of this disorder.” NIMHb, 2007.

Nature or Nurture?

In fact, medical science has been looking for a biological cause for schizophrenia for close to a century and has yet to find one. Over that time, many announcements of such “findings” have been made – always accompanied by the greatest publicity, but none were proved to be verifiable.

Another curious fact of this “disease” is that people who have it sometimes spontaneously recover. How then is it a disease? Or a brain disorder? Or lifelong? It is a rare disease indeed where people spontaneously recover and where there is no known physical etiology.

What about the “environmental” factors mentioned; i.e., the family backgrounds of the people who develop schizophrenic symptoms?

Peter Breggin, M.D. (p. 103, et seq.; see generally, 1994) speaks of one of the seminal reports on schizophrenia in the history of psychiatry, the study of the Genain Quadruplets (all of whom had schizophrenic symptoms). He notes that the report of the study recites the potential “biological” evidence for schizophrenia in that case in almost inexhaustible detail – but somehow neglects to consider it noteworthy that the family life of the quadruplets included such horrors as having acid poured on their genitals.

John Modrow, did not suffer the same horrors as the Genain Quadruplets; but did endure a significant amount of craziness from his parents, which he describes throughout his outstanding book “How to Become a Schizophrenic.”

Modrow notes that:
“The claim that most schizophrenics come from perfectly normal families deserves careful consideration… (regarding a case study he presented earlier)… Although the parents in this family appeared to be very ordinary and sensible people, they were later found to be playing with their daughter’s mind, subjecting her to strange ‘telepathy experiments’… it took over a year of investigation to discover those parents’ bizarre behavior.”
1995, pp. 205-206, emphasis original.

In spite of the extreme craziness of his own parents, Modrow still thinks of them as “basically decent and relatively normal” (1995, pp. 206); but also says:
“Had a psychiatrist examined my parents… he would have found… nothing strange or odd… Moreover, had that psychiatrist known my parents intimately for several years he probably would have retained his favorable opinion of them… However… there is no doubt in my mind that their behavior towards me was the major cause of my schizophrenic breakdown.”

Modern Psychoanalysis of the Schizophrenic Patient

It is no accident that the decisive text in modern psychoanalysis is entitled “Modern Psychoanalysis of the Schizophrenic Patient.” (Spotnitz, 1985). Though the theory and techniques in that book are equally applicable to all sorts of mental difficulties, Dr. Spotnitz arrived at those results through his groundbreaking work with schizophrenic patients.

Spotnitz (1985, p. 17) proceeded from the premise that “Regardless of etiology… there is no evidence that the condition is not completely reversible.”

“The operational concept follows: Schizophrenia is an organized mental situation, an intricately structured but psychologically unsuccessful defense against destructive behavior. Both aggressive and libidinal impulses figure in this organized situation… Obliteration of the object field of the mind and fragmentation of the ego are among the secondary consequences of the defense.”

Spotnitz, 1985, p. 57, emphasis original.

As to the “environmental” variables, Spotnitz says:

“It is unnecessary to postulate that a particular type of relationship produced the infantile pattern. It may be in part innate and in part learned. Even in cases where it was taught by the mother, her attitude may not have been pathological; there may simply have been a disequilibrium between her emotional training and the infant’s impulsivity. The dynamics of the mother-child relationship are not uniform in these cases. More significant than whether the parent actually loved, hated, or was indifferent to her infant is the fact that the totality of his environment failed to meet his specific maturational needs…”
1985, p. 68, emphasis original.

In this writer’s opinion, the techniques set forth in “Modern Psychoanalysis of the Schizophrenic Patient” work equally well with other mental difficulties because mental conditions have much in common – they are all part of the human condition.

One could even say that mental difficulties are normal; part of being human - the only question being whether we still function well in spite of our difficulties, or whether those difficulties have reached intolerable proportions, such as with the schizophrenic condition.


The Talking Cure

Many people will use Herculean efforts to appear normal, to distinguish themselves from those with problems, to split themselves off from the idea that they themselves might have any mental difficulties at all.

In spite of the efforts and protestations of these ordinary people, however, skilled observers may have little difficulty seeing the underlying troubles. And, if the troubles reach a stage where they seriously interfere with the individual’s ability to love, work, or play it may be time to seek help.

When we speak of the physical illnesses we tend to think of cure as involving the complete eradication of anything relating to the condition, Not so with mental conditions – in those cases, the cure consists of placing the individual in a position where he or she can love, work and play without serious hindrance – where they can be productive and enjoy life.

The particular weakness of the individual is not likely to be completely eradicated. If a person tends to display in a phobic, or an obsessive-compulsive, or a schizophrenic, or any other way, they could have some resort to their characteristic mechanisms even after being cured. After all, we do not cure people from being human; nor do we seek to.

But, the person who has been competently treated by a modern psychoanalyst will be able to enjoy the whole range of human feelings and action available to the best of us.


References

Breggin, P. (1994). Toxic Psychiatry, New York, St. Martin's Press.

Medline. (May 24, 2007). Service of the U.S. National Library of Medicine and the National Institutes of Health, online at http://www.nlm.nih.gov/medlineplus/schizophrenia.html

Modrow, J. (1995). How to Become a Schizophrenic, Everett, Wash., Apollyon Press.

NIMHa, (March 1, 2007). “Schizophrenia,” National Institute of Mental Health, online at http://www.nimh.nih.gov/healthinformation/schizophreniamenu.cfm

NIMHb, (Jan. 24, 2007). “What Causes Schizophrenia?” National Institute of Mental Health, online at http://www.nimh.nih.gov/publicat/schizoph.cfm#symptoms

Spotnitz, H. (1985). Modern Psychoanalysis of the Schizophrenic Patient: Theory of the Technique, Second Edition, New York, Human Sciences Press.


© 2007, James G. Fennessy, M.A., J.D.
Matawan, New Jersey 07747
E-mail: njanalyst@hotmail.com
http://modernpsychoanalysis.org

The Narcissistic Defense

One of the unique offerings of modern psychoanalysis has to do with its understanding of the importance of “the narcissistic defense.” While it is well known that the narcissistic disorders possess a vast range of defenses available for use, something much more particular is meant when modern analysts refer to “the narcissistic defense.”

Dr. Spotnitz first observed the narcissistic defense during his clinical investigations of schizophrenia, and later successfully applied the concept to treatment of other patients:

“When the patient is frustrated, the appropriate way to discharge his feelings is to put them into words. If he is prevented from doing so when frustrated and feeling deprived by the analyst, he usually bottles up the aggression: in other words, he turns these feelings inward and begins to attack the self. This is referred to as the narcissistic defense.” (Spotnitz, 1976b, pp. 56-57, emphasis original).

Freud’s idea was that the “narcissistic wall… brings us to a stop,” and that “…(o)ur technical methods must accordingly be replaced by others; and we do not know yet whether we shall succeed in finding a substitute.” (1917, p.423). Spotnitz, however. “… discovered that the analyst resolves the adult patient’s repetitive self-attacks by changing the flow of destructive impulsivity.” (1976b, p. 56).

From the root of the word narcissism, it might at first appear that the problem is excessive “self-love,“ yet not all narcissism is “disordered:”
“We commonly recognize the value of narcissism, as well as the vital role it plays in creative activity. If we regard sleep as the quintessence of absorption in the self, we agree that narcissism is essential for self-preservation.
Need I point out that ‘narcissistic defense’ does not involve these kinds of normal activity? What we are concerned with is narcissism in a pathological sense, with self-love that serves as a cloak for self-hatred. The polarities of self-hatred and self-love are linked together in the defensive system, but the nuclear problem is the self-hatred.” (Spotnitz, 1976a, p. 104).

How might an individual develop the narcissistic defense? According to Spotnitz, the foundation is likely to be found in early childhood and:

“… is not total emotional deprivation... The defense seems to originate in a relationship which was gratifying to the infant in some respects, especially in meeting his biological needs for the intake of stimuli, but failed to meet the need of his mental apparatus for cooperation in discharging destructive energy. Nevertheless, he was not totally abandoned; he was sufficiently gratified to develop a strong craving for more gratification and, consequently, to place an unduly high value on the source of this bounty.” (Spotnitz, 1976a, p. 104).

Could it be that for the infant it is a question of survival? In the minds of very young children thoughts may have magical properties. If we have horrible thoughts; i.e., that mother frustrates us, or that we hate her, or worse; even for an instant – mother might leave us forever. Or, our violent thoughts might actually kill her; or maybe if we’re so monstrous as to think those thoughts, she might actually die, as punishment for our bad thoughts. We need to protect her at all costs.

Spotnitz hypothesizes that…
“(t)he infant got to understand that his mother might be damaged by his rage; perhaps she discouraged such reactions by withholding her favors. At any rate, the infantile ego which was not trained to release mobilized aggressive energy towards its object in feelings and language responded to prolonged periods of frustration by internalizing its destructive impulses. Much of the energy that would otherwise have been available for maturational processes was expended to bottle up this impulsivity…
The child who started out to console himself with self-love thus compensates for a specific type of damage incurred in the course of maturation by becoming the object of his own hatred. Sacrificially, he attacks his ego to preserve his external object.” (1976a, pp.104-05).

As with all the other defenses, “(t)he survival function of the narcissistic defense is respected. Though primitively organized, it has served to stabilize his mental apparatus in his interpersonal relations and insulate him against unwanted feeling states.” (Spotnitz, 1985, p. 164).

Modern psychoanalysts have a greater understanding and a wider range of techniques available to outflank Freud’s “stone wall of narcissism,” and “…(i)f the analyst provides the proper environment, the patient will re-experience emotional reactions in his relationship with the analyst that resemble those he had at some point in the past when his maturation was blocked.” (Spotnitz, 1976b, pp. 57-58).

With proper treatment, the narcissistic defense can thus be made unnecessary, allowing patients the full range of options and emotions available to mature individuals.

References

Freud, S. (1917). Introductory Lectures on Psychoanalysis (Part 3) in the Standard Edition of the Complete Works of Sigmund Freud, (James Strachey, et al., Ed., 1953-74), London, Hogart Press and the Institute of Psychoanalysis, 16:243-463.

Spotnitz, H. (1976a). Psychotherapy of Preoedipal Conditions, N.Y., Jason Aronson.

Spotnitz, H. and Meadow, P. (1976b). Treatment of the Narcissistic Neuroses, NY, Man. Center For Advanced Psychoanalytic Studies.

Spotnitz, H. (1985). Modern Psychoanalysis of the Schizophrenic Patient: Theory of the Technique, Second Edition, NY, Human Sciences Press.

© 2006, James G. Fennessy, M.A., J.D.
Matawan, New Jersey 07747
E-mail: analyst@modernpsychoanalysis.org
http://modernpsychoanalysis.org

Modern Psychoanalysis and Religion

One of the first questions on this topic might be: Is it useful to talk about this? The techniques used in Modern Psychoanalysis do not seem to require a religious perspective and the creeds of the major religions do not depend upon psychoanalysis. Additionally, at least some tendencies in each perspective have been noticed to consider the other either unwelcome and intrusive, or with outright hostility.

Certainly, Sigmund Freud's own ideas towards religion would fit in the latter category and at least part of the issue from the psychoanalytic view has been the inability of some to disentangle themselves from Freud's idiosyncrasies on the subject. (See e.g., Zilboorg, 1950; see also Becker, pp. 173-75, 1973).

On the other hand, it is reported that C.G. Jung "... had never, he claimed, had a patient whose neurosis was not due to his lack of religion, nor had he ever cured a patient whose cure was not due to his return to religion." (Bartemeier, p.12, 1995).

Thus, some would agree that there at least enough of an "overlap" between the goals of religion and those of psychoanalysis to warrant discussion. But, if there is to be such a discussion, what should it consist of? Alternatively, what should it not consist of? Who might be benefited by this dialogue?

In this writer's opinion, the only really useless area of inquiry concerns one trying to prove or disprove the other; i.e., advocates of religion and psychoanalysis each adhere to self-sustaining teleological tenets as part of their individual belief systems. By their very nature, these tenets are neither provable nor disprovable by outside sources; though even this should not interfere with an open dialogue if the participants are willing to respect the feelings of others. So, perhaps the dialogue should include anything the participants wish to discuss.

While one would not expect religious instruction to be included in the curriculum of psychoanalytic institutes, or psychoanalysis to be required in seminaries, it would seem to me that each could benefit from some knowledge of the other.

Modern analysts have their own spiritual existence to consider; as well as many patients who come from a religious perspective, or even have religious components integrated into their difficulties with the world. Likewise, religious leaders have their own psyches to consider; along with some followers who would be helped by being able to talk freely in a modern psychoanalytic setting. The institutional structures in place in each of the perspectives could also be broadened by further dialogue.

As a methodology, Modern Psychoanalysis should be well-suited to a dialogue about psychoanalysis and religion because of its emphasis on the role and importance of emotional communications. Individual belief systems are often highly charged with emotion, as part of the person's self-identification process with the world.

These root emotional processes have caused some to notice a correlation between the emotional forces at work in either arena, which "...emerges as the reflective awareness of powerful affectivity rather than as a purely intellectual grasp of logical relations between concepts and symbols." (Cousins, p. 36, 1995).

Perhaps it is time for us to jointly explore these powerful emotional processes.

References

Bartemeier, L.H. (1995, 1976). "Psychoanalysis and Religion," in Psychoanalysis and Catholicism. Wolman, B., ed., NY, Jason Aronson, Inc.


Becker, E. (1973). The Denial of Death. NY, The Free Press.

Cousins, E. (1995, 1976). "The Many-leveled Psyche: Correlation Between Psychotherapy and the Spiritual Life," in Psychoanalysis and Catholicism. Wolman, B., ed., NY, Jason Aronson, Inc.

Zilboorg, G. (1950). Psychoanalysis and Religion. NY, Barnes & Noble.

© 2006, James G. Fennessy, M.A., J.D.
Matawan, New Jersey 07747
E-mail: njanalyst@hotmail.com
http://modernpsychoanalysis.org

Free Association and Resistance

Professor Freud (1913, p. 147) insisted that there was one “fundamental rule” the analyst needed to tell the patient “…at the very beginning:

‘Your talk with me must differ in one respect from ordinary conversation. Whereas usually you rightly try to keep the threads of your story together… here you must proceed differently… You will be tempted to say to yourself: ‘This or that has no connection here, or it is quite unimportant, or it is nonsensical, so it cannot be necessary to mention it.‘ Never give in to these objections… say whatever goes through your mind. Act as if you were sitting at the window of a railway train and describing… the changing views you see outside.’”

This fundamental rule of “saying everything” has since been referred to as “free association.” How do modern psychoanalysts implement this rule?

First, we can say that modern analysts accept that “(e)ven the analytic directive to talk must be viewed as resistance-provoking.” (Spotnitz, 1976b, p. 169).

Spotnitz (1976b, p. 159) commented that one of Freud’s first followers,
“Ferenczi had noted many devices used by patients to resist cure. He observed how difficult it was for the patient to follow the first rule of free flow of ideas until the close of the analysis, and that patients could not understand that free association did not demand complete thinking out of ideas, but complete utterance of what was actually thought.”

Dr. Spotnitz (1976a, p. 78) also recounts that attempting:
"… to overcome the resistance to free association by ‘making use of psychical compulsion’… got Freud into various difficulties. Although time-saving, his approach proved traumatizing to the patient, giving rise to feelings of disturbance, strangeness, withdrawal and the like which inhibited or even blocked communication.”

This classical approach to resistance undoubtedly also caused many patients to be labeled from the very beginning as “unanalyzable” or ‘not suitable for treatment.”

I think it could be said that most modern analysts recognize and respect the patient’s need for the “insulation” (or defenses) that result in resistances. They do not try to “smash through” the defenses and may even help reinforce some defenses until the patient is ready to give them up. This same respectful approach is taken with the question of free association.

Spotnitz (1976a, p. 141, emphasis added) indicates that cooperative behavior would be:
“…that the patient lie on the couch and talk. He is not instructed to free-associate. As the opening move in educating him to do so, he may be asked to tell his ‘ life story’ or simply to talk of his experiences; a severely disturbed individual may begin by recounting how he traveled to the office, what he ate for breakfast, and the like.”

In modern psychoanalysis, the patient’s job is to talk, while the analyst bears the responsibility of helping the patient do so.

In most cases, modern analysts rely on the contact function of the patient’s ego in deciding when and how to help in the patient’s attempts to satisfy this fundamental rule of “saying everything.” This approach helps to safeguard the patient’s developing ego from unwarranted intrusion by the analyst. (See e.g., Fennessy, 2007)

The modern psychoanalytic approach to resistance and free association has had the added benefit of expanding the number of people who may be helped by our methods to the point where “… (w)ith our increasing understanding of the psychological reversibility of the narcissistic disorders, the phrase ‘not suitable for treatment’ has been dropped from the vocabulary of the modern psychoanalyst.” (Spotnitz, 1976b, p. xi).


References


Fennessy, J. (publication pending, 2007). Narcissism and the Contact Function, in PRACTICE MATTERS, A Journal of Modern Psychoanalytic Treatment Technique (Vol. 2)

Freud, S. (1913). Further Recommendations in the Technique of Psychoanalysis (On Beginning the Treatment) in Freud; Therapy and Technique, (Philip Rieff, Ed., 1978), NY, Macmillan Publishing Co., Inc.

Spotnitz, H. (1976a). Psychotherapy of Preoedipal Conditions, N.Y., Jason Aronson.

Spotnitz, H. and Meadow, P. (1976b). Treatment of the Narcissistic Neuroses, NY, Man. Center For Advanced Psychoanalytic Studies.


© 2006, James G. Fennessy, M.A., J.D.
Matawan, New Jersey 07747
E-mail: analyst@modernpsychoanalysis.org
http://modernpsychoanalysis.org

Narcissistic Transference

Freud (1926, pp 52-3, emphasis original) was describing the phenomenon of transference when he said:

The neurotic sets to work because he believes in the analyst, and he believes in him because he begins to entertain certain feelings towards him…. The patient repeats, in the form of falling in love with the analyst, psychical experiences which he underwent before; he has transferred to the analyst psychical attitudes which lay ready within him…

Yet classical analysts soon found that many individuals appeared to be unable to form this type of transference with their analysts. These individuals were then often deemed “unanalyzable,” because of the central role that transference plays in psychoanalysis. (See e.g., Fennessy, 2006).

How can individuals who seem to lack the capacity to develop this “object transference” be helped? Modern psychoanalysts understand that the difficulties experienced by many patients have their origins in the pre-oedipal period. Another way of expressing this is that “(t)he narcissistic patient is arrested at some point or points in approximately the first two years of life.” (Margolis, 1981, p. 149).

Modern analysts are then able to use their skills to build a transference on a narcissistic basis. In this narcissistic transference:
“(t)he patient is permitted to mold the transference object in his own image. He builds up a picture of the therapist as someone like himself – the kind of person whom he will eventually feel free to love and hate.” (Spotnitz, 1976a, p. 109).

Dr. Spotnitz answers the question:

“’Do we want a narcissistic transference to develop?’ We do because in a negative, regressed state, the patient may experience the analyst as being like him or part of him. Or the analyst may not exist for him. The syntonic feeling of oneness is a curative one, while the feeling of aloneness, the withdrawn state, is merely protective. Because traces of narcissism remain in everyone, we seek, when beginning treatment, to create an environment that will facilitate a narcissistic transference so that, first we can work through the patient’s narcissistic aggression.” (Spotnitz, 1976b, p. 58).

Margolis further says that:

“In operational terms… the oedipal patient transfers the images of distinctive objects of his oedipal period onto the analyst, whereas the preoedipal patients transfers onto the analyst the fuzzy and ambiguous images of his narcissistic period… In building the narcissistic transference and eliciting the patient’s picture of the analyst, we are actually eliciting his picture of himself.” (1979, p.140).

Therapists who have any experience with narcissism know that narcissists are often consumed with themselves and themselves alone - given the opportunity they may talk about nothing but their own self-absorptions for years on end. Therefore, it should be apparent that the narcissistic transference will not be come into being on its own – it must be developed through the skills of the therapist.

What does the narcissistic transference look like? Spotnitz (1976a, p. 109) states that:

“On the surface it looks positive. He builds up this attitude: ‘You are like me so I like you. You spend time with me and try to understand me, and I love you for it.’ Underneath the sweet crust, however, one gets transient glimpses of the opposite attitude: ‘I hate you as I hate myself. But when I feel like hating you, I try to hate myself instead.”

Developing the narcissistic transference is normally an emotionally charged process, that proceeds at the patient’s own pace. (See generally, Fennessy, 2007). The training and clinical skills of the modern analyst, including proper use of emotional reinforcement, object-oriented questions and joining techniques, make all the difference between success and failure in nurturing this relationship.

Spotnitz (1985, p. 201) describes the result when the narcissistic transference is successfully developed:

“(w)hen one focuses on the narcissistic patterns and works consistently to help the patient verbalize frustration-tension, object transference phenomena become increasingly prominent… Eventually, the patient’s transferences are aroused by his emotional perceptions of the therapist as a parental transference figure.”

In other words, personality maturation takes place. The symbiotic relationship developed between analyst and patient (See, Spotnitz, 1984, p. 135) may help the patient’s emotional perceptions along. Repeated emotional associations to the mental images of the analyst, as constructed by the patient; strengthen the object field of the mind, or form new neuronal connections.

The greater emotional maturity which results has enduring and important ramifications for the patient in therapy, and in life.


References

Fennessy, J. (publication pending, 2007). Narcissism and the Contact Function, in PRACTICE MATTERS, A Journal of Modern Psychoanalytic Treatment Technique (Vol. 2)

Fennessy, J. (2006). Modern Psychoanalytic Education. (Online at: http://modernpsychoanalysis.blogspot.com, June 08, 2006).

Freud, S. (1926). The Question of Lay Analysis. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XX (1925-1926).

Margolis, B. (1981). Narcissistic Transference: Further Considerations. (Modern Psychoanalysis, Vol. 6, No. 2, 1981).

Margolis, B. (1979). Narcissistic Transference: The Product of Overlapping Self and Object Fields. (Modern Psychoanalysis, Vol. 4, No. 2, 1979).

Spotnitz, H. (1976a). Psychotherapy of Preoedipal Conditions, N.Y., Jason Aronson.Spotnitz, H. and Meadow, P. (1976b). Treatment of the Narcissistic Neuroses, NY, Man. Center For Advanced Psychoanalytic Studies.

Spotnitz, H. (1984). The Case of Anna O.: Aggression and the Narcissistic Countertransference. In M. Rosenbaum & M. Muroff (Eds.), Anna O.: One Hundred Years of Psychoanalysis. NY, Free Press.

Spotnitz, H. (1985). Modern Psychoanalysis of the Schizophrenic Patient: Theory of the Technique, Second Edition, NY, Human Sciences Press.


© 2007, James G. Fennessy, M.A., J.D.
Matawan, New Jersey 07747
E-mail: njanalyst@hotmail.com
http://modernpsychoanalysis.org

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