Borderline Conditions and Pathological Narcissism

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Envy And Gratitude And Other Works 1946 1963

Freud’s interest in the origins of guilt came relatively late in his work, as he himself acknowledged (1933). It was only after his major clinical accounts had been written that Freud undertook a study of the origins of guilt in Totem and Taboo. In his clinical papers, as well as in his books on dreams and jokes, “disgust, shame, and morality” were simply the counterforces against which sexual longings (libido) contended. Moreover, the origin of these counterforces was at first located in the sexual instincts themselves (see Chapter 4) as sublimations and reaction formations of the sexual instincts. Hostility arose out of frustrated libido; sublimations and reaction formations of hostility (although in the service of the “ego-instincts”) also made use of the energy of the sexual instincts to deflect them into social and moral purposes. In this account, libido theory is the centerpiece of the explanation. Our path might have been easier if Freud had indeed regarded his libido theory as a theory of the emotions (as he said he did in Group Psychology, 1921, p. 90). If one permits libido to stand for the attachment emotions, the origin of hostility and morality in a single source becomes a viable hypothesis. Morality is the affective-cognitive outcome of attachment. Threatened attachment, which first evokes protest aimed at the caretaker—“other,” is then transformed, mainly by identification, into states of shame and guilt that aim at maintaining the attachment.

Totem and Taboo

Analysis terminable and interminable.

This book, for those who may be unfamiliar with this annual publication, is a review of the psychoanalytic literature and includes selections by a number of well-known and consistent contributors to the psychoanalytic concepts in development of children, the psychopathology of children, and the clinical problems involved in the treatment of children. It is of interest, of course, to members of related professional disciplines and will be of greatest value to those pediatricians who are somewhat familiar with the analytic approach and comfortable with the analytic terminology used. Certainly this and the other volumes do constitute an excellent sampling of the significant contributions to psychoanalytic knowledge of the child during the past 15 years. For general interest to the pediatrician in his everyday practice, one might select the first paper in this volume written by John Bowlby on Grief and Mourning in Infancy and Early Childhood . It is discussed and

The Psychoanalytic Study of the Child.

The collapse of socialism in Eastern Europe is an event that has had profound psychological consequences for left-wing psychologists and social scientists committed to the ideal of democratic socialism. So far these events and their psychological expression have not yet emerged explicitly in the psycho-analytic literature. On the other hand, work by left-wing psycho-analytic thinkers, committed to forging personal and intellectual links between marxism and psycho-analysis, are still being regularly published. The most creative and productive of these authors are British, which is not surprising given the co-existence of both an established psycho-analytic community and muscular socialist opposition under a Conservative British government.

The Good Society and the Inner World : Psychoanalysis, Politics and Culture, Michael Rustin : book review

This critical review of the current disputes concerning countertransference enactment systematically
outlines the various issues and the perspectives adopted by the relevant psychoanalytic
authors. In the light of this the ‘common ground ’ hypothesis concerning the
unifying influence of contemporary countertransference theory is challenged. While the existence
of enactments, minimally defined as the analyst’s inadvertent actualization of the
patient’s transference fantasies, is widely accepted, controversies regarding the specific
scope, nature, prevalence, relationship to countertransference experience, impact on the analytic
process, role played by the analyst’s subjectivity, and the correct handling of enactments
abound. Rather than taking a stand based on ideological allegiance to any particular
psychoanalytic school or philosophical position, the author argues that the relative merits
of contending perspectives is best evaluated with reference to close process scrutiny of the
context, manifestation and impact of specific enactments on patients’ intrapsychic functioning
and the analytic relationship. A detailed account of an interpretative enactment provides
a context for the author’s position on these debates.

Enactment controversies: a critical review of current debates.

The first of two articles on bewitchment reports the findings of a qualitative study based on interviews
with a small sample of individuals who believed they had been bewitched. A phenomenological
analysis of the data provided a descriptive account of the psychic reality of bewitchment.
Those understanding their experience in this way attribute misfortune to the malicious intentions and
actions of hated others, who are believed to employ supernatural means to harm their ‘victims’, with
real symptomatic consequences. This supernatural interpretive framework relies on a discursive network
of witchcraft-related gossip, media reports, folklore, and diagnostic confirmation by traditional
healers. Bewitchment beliefs arise within a context of hostile and envious familial and social relations.
Despite the distress accompanying the experience of bewitchment, this supernatural understanding
was found to offer participants a meaningful explanation for negative life events, especially
during times of transition. Muti featured prominently in accounts of ways in which bewitchment is
effected and provides the grounds for the experience of being poisoned or possessed by an evil
entity. Treatment of bewitchment symptoms by sangomas and spiritual leaders is considered to be
superior to that offered by Western medicine.

The psychology of bewitchment (Part I) : a phenomenological study of the experience of bewitchment

This paper reports on a qualitative study investigating clinical psychology programme selectors' perceptions of psychological ‘woundedness’ in the autobiographical narratives of applicants for clinical psychology training. Woundedness was here defined in terms of the ongoing or residual psychological impact of adverse experiences and psychic conflicts. Ten selectors were presented with a sample of applicants' written autobiographical narratives, differentiated by the conspicuous presence or absence of psychological woundedness. The selectors, who were not informed of the specific aims of the study, ranked applicant protocols and were interviewed individually about their impressions of the protocols and the criteria that they used to rank them. Most selectors were positively biased toward ‘wounded’ narratives and suspicious of those in which woundedness was manifestly absent. Although generally disposed to favour wounded applicants, how woundedness was presented, rather than the mere presence of it, was a discriminating feature in selectors' appraisal of wounded narratives. Selectors were concerned that unresolved woundedness may compromise applicants' professional boundaries, impair self-reflective capacity and lead to damaging countertransference enactments. The relative extent to which applicant woundedness appeared to be resolved was significant in selectors' assessment of applicants' clinical training potential. A distinction is thus proposed between obstructive and facilitative woundedness in clinical psychology applicants. Copyright © 2012 John Wiley & Sons, Ltd.



Key Practitioner Message

A sample of clinical psychology programme selectors identified psychological woundedness as a significant feature in applicant autobiographies.
Selectors favoured applicant autobiographies showing evidence of woundedness.
The distinction between obstructive and facilitative woundedness is important in how the selector sample evaluated woundedness.

Psychological Woundedness and its Evaluation in Applications for Clinical Psychology Training

In light of the paucity of literature discussing the systematic instruction of trainee psychologists in psychodynamic case formulation, the author introduces an eight-step method for teaching the theory and application of psychodynamic case formulation. The method involves clarifying the nature of psychodynamic formulations, outlining the characteristics of competent formulations, presenting a conceptually simple structure for organizing case material, exposing trainees to carefully selected written and video-recorded cases, and getting trainees to use their subjective responses to video-recorded initial clinical interviews as a source of useful hypotheses. A case study from the literature is used to demonstrate this formu- lation methodology. The paper concludes with a discussion of both the prerequisites for, and characteristics of, competent case formulation

Gavin Ivey

Papers

The Good Society and the Inner World : Psychoanalysis, Politics and Culture, Michael Rustin : book review

Enactment controversies: a critical review of current debates.

The psychology of bewitchment (Part I) : a phenomenological study of the experience of bewitchment

Psychological Woundedness and its Evaluation in Applications for Clinical Psychology Training

A method of teaching psychodynamic case formulation.