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Showing papers in "International Forum of Psychoanalysis in 1995"


Journal ArticleDOI
TL;DR: In this paper, it has been hypothesized that because of the automaticity of learned procedures underlying character pathology, character change can best be accomplished by intervening at the procedural level, and that such interventions are optimal when they are noninterpretive and occur within the context of an interac...
Abstract: Two types of memory processes, declarative and non-declarative have been identified by cognitive scientists. Cognitive science is currently making a distinction between 1) declarative memory and non-declarative memory. This paper is concerned with one type of non-declarative memory, procedural memory. Declarative knowledge refers to the things we know such as names, places, dates. Procedural knowledge is information associated with a highly practiced schema or action which is usually not conscious when the sequence is activated. The implications of procedural knowledge for psychoanalytic treatment are now beginning to be explored. This paper is a further step in this exploration. It has been hypothesized that because of the automaticity of learned procedures underlying character pathology, character change can best be accomplished by intervening at the procedural level. This paper suggests that such interventions are optimal when they are noninterpretive and occur within the context of an interac...

11 citations


Journal ArticleDOI
TL;DR: Self psychology is an evolving and non-unitary theory as mentioned in this paper, and selfobject needs include mirroring (acknowledgement and affirmation), idealizing (protection, safety, and admired qualities), and twinship (a feeling of essential li...
Abstract: A schematic overview of the theory and practice of self psychology is presented with a particular focus on what the author believes to be the most important contributions to psychoanalysis. It is recognized that self psychology, as with all psychoanalytic approaches, is an evolving and non-unitary theory. Fundamental features of self psychology are: 1. the consistent use of the empathic mode of observation, that is, to listen and understand from within the vantage point of the patient; 2. the primary motivation which involves strivings to develop and maintain a positive cohesive sense of self; 3. that each person has unique pre-wired “givens” included in the concept of the nuclear self; 4. that each person has selfobject needs which refer to the use of the object for the development and regulation of a positive sense of self; 5. that selfobject needs include mirroring (acknowledgement and affirmation), idealizing (protection, safety, and admired qualities), and twinship (a feeling of essential li...

11 citations


Journal ArticleDOI
TL;DR: In this paper, a former analysand but not a psychoanalyst herself, gives an account of her own history as a child during the II World War in Finland, and compares her own experiences with those of other warchildren whom she has met or read about.
Abstract: The author, a former analysand but not a psychoanalyst herself, gives an account of her own history as a child during the II World War in Finland. She was one of the 70,000 children who were sent to Sweden during the war. She reflects on how repeated separations, both from her biological parents and from her foster-parents have affected her in her adult life, as it became clear to her in psychoanalysis. She compares her own experiences with those of other warchildren whom she has met or read about. She also reports on how former warchildren in their forties and fifties, who until then had remained silent, suddenly began to feel the need of giving voice to their experiences and meeting others who could understand what they had been through. Common features among many former warchildren seem to be the lack of a feeling of strong identity, a sense of worthlessness, a need to be in control, an inability to be trusting and to form or maintain close relationships. Underneath a yearning for love can be ...

9 citations


Journal ArticleDOI
TL;DR: In this article, the authors summarize the stories of three serial killers, Henry Lee Lucas, Randall Woodfield, and Theodore Robert Bundy, based on reports and interviews conducted by journalists, forensic psychologists, and law enforcement officials.
Abstract: A serial killer is born when early experiences of abuse, deprivation, and deception lead to a specific fantasy system and motivations. The premeditation before the killing, its viciousness, and its apparent motivelessness mark the serial killer as the personification of evil. We summarize the stories of three serial killers, Henry Lee Lucas, Randall Woodfield, and Theodore Robert Bundy, based on reports and interviews conducted by journalists, forensic psychologists, and law enforcement officials. These cases illustrate the range of socio-economic backgrounds, educational levels, charm, sociability, manipulativeness, economic deprivations and advantages, as well as the extent to which physical and sexual abuse characterize the serial killer's history. We hold that utilizing the five motivational systems proposed by Lichtenberg provides a comprehensive perspective to investigate the motivations of the serial killer. These five systems organize the fantasy that combines needs for self assertion and...

9 citations


Journal ArticleDOI
TL;DR: The distinction between having mode and being mode would seem to be the basis of the Frommian clinical approach, which finds its main application in the "center-to-center" relatedness between analyst and patient as mentioned in this paper.
Abstract: The distinction between having mode and being mode would seem to be the basis of the Frommian clinical approach, which finds its main application in the “center-to-center” relatedness between analyst and patient. The analyst can understand the patient because he/she experiences what the patient experiences. The dialogue is based on emotional and conceptual responses and reactions which are reciprocally communicated; both identities come into play. Psychoanalytic treatment which is not inspired by biophilia can only compile an inventory of data upon data, imposing interpretations and reconstructions. Biophilia makes psychoanalysis an art because it is applied to living things. The psychoanalytic session can save itself from the having mode by addressing the patient's living memory, which represents the past relived in the present, according to the being mode. The author comments on a psychoanalytic session.

7 citations


Journal ArticleDOI
TL;DR: The Unconscious is structured like a language as mentioned in this paper and the client is a highly persuasive being who, unknown to him or her self uses the figures of speech studied in the ancient discipline of Rhetoric.
Abstract: The ideas of Jacques Lacan are too often idealised or vilified. This article sets out to give a just appraisal of his famous aphorism: “The Unconscious is structured like a language”. No familiarity with the ideas of Lacan is presupposed. The key idea is that the client, like all human beings is a highly persuasive being who, unknown to him or her self uses the figures of speech studied in the ancient discipline of Rhetoric. Thus the work of the analyst is partly directed to “seeing through” the rhetoric of the client. The pioneering use of rhetoric in psychoanalysis by Ella Sharpe to portray the dreamer as a poet is used to open the way to Lacan according to whom the client's signifiers form a “text”—that the client is a poem written by the workings of language. The conclusion is reached that his global view of language apart from being over ambitious conceals the Hegelian view that we are all being thought by the Absolute mind and raises the question whether Lacanianism is Marxism by another name.

6 citations


Journal ArticleDOI
TL;DR: In this paper, the authors present two clinical vignettes as a starting point to understand the transsexuals unrelenting demand for sexual reassignement, and they make a conclusion that the so-called transsexual choice appears to have been the only solution that the child of the past was able to find, in order not only to acquire a sense of sexual identity but also to attain the conviction of their identity as a separate individual.
Abstract: Among the many expressions of human sexuality, transsexualism is perhaps the most striking manifestation of the inexorable quality of a solution to sexual conflict which appears to go against nature. How are we to understand the transsexuals unrelenting demand for sexual reassignement? Taking two clinical vignettes as a starting point, the author presents his reflexion on the form of relationship that the infant, destined to become a transsexual, establishes in his or her mind at the very beginning of psychic life. The significance attached to “masculine” and “feminine”, as transmitted by the parents, is then studied for its effect upon the identificatory processes. The central thesis of this paper is that the so-called transsexual choice appears to have been the only solution that the child of the past was able to find, in order not only to acquire a sense of sexual identity but also to attain the conviction of his or her identity as a separate individual.

5 citations


Journal ArticleDOI
Abstract: The destiny of the learning processes in the context of the psychoanalytical training systems was investigated. The emotional experiences of those learning and those teaching in this system have a decisive influence on the learning of psychoanalysis. As a first step, the concept of learning through experience, taken from Bion, is presented. Subsequently, the manifold and conflicting experiences are discussed, which those participating in the training system experience. The dialectic of fragmentation on the one hand and inner and outer integration on the other hand are discussed in detail. A number of factors are noted, which make it difficult to find ways of relating the different learning processes in psychoanalytical training to one another in a clear and differentiated manner.

4 citations


Journal ArticleDOI
TL;DR: In this paper, case vignettes are offered to illustrate five principles of self psychological treatment the author believes are generally accepted by self psychologists: 1. The centrality of the empathic vantage point for analytic observation, 2. Alterations in the sense of self must be recognized and understood.
Abstract: Case vignettes are offered to illustrate five principles of self psychological treatment the author believes are generally accepted by self psychologists. A sixth principle is included, contributed by self psychologists informed by intersubjectivity. They are: 1. The centrality of the empathic vantage point for analytic observation. This requires a shift in the listening stance from observing from the outside to observing from the inside. The analyst attempts to listen from within the context of the analysand's subjective reality in order to understand his experience. 2. Alterations in the sense of self must be recognized and understood. 3. When ruptures occur between patient and analyst (selfobject bond), such ruptures are analyzed. 4. From a technical point of view, the careful exploration of both the state of the selfobject bond, and the meanings to the patient of the analytic activity needs to be carefully examined and understood by both patient and analyst. 5. Defensive activities are though...

4 citations


Journal ArticleDOI
TL;DR: This paper presented Elke Muhlleitner's Biographisches Lexikon der Psychoanalyse (Biographical Lexicon of Psychoanalysis) and comments on her first evaluations of this comprehensive data.
Abstract: The paper presents Elke Muhlleitner's Biographisches Lexikon der Psychoanalyse (Biographical Lexicon of Psychoanalysis) and comments on her first evaluations of this comprehensive data. It illustrates, by reference to the early members of the Psychologische Mittwoch-Gesellschaft (the Wednesday Psychological Society), the heuristic value of the collected material for dealing with the issues and hypotheses related to the history of science.

4 citations


Journal ArticleDOI
TL;DR: In this paper, the psychoanalytic psychotherapeutic process of these borderline depressives is elucidated by presenting clinical fragments of several psychotherapy cases, where the process goes through periods of activation of the patient's depressive or primitive mental functioning, reflecting on the therapist's countertransference.
Abstract: A certain subgroup of borderline patients often presents depressive symptomatology (either chronic or periodic) and an underlying borderline personality organization. In this article, the effort is directed at elucidating the psychoanalytic psychotherapeutic process of these borderline depressives by presenting clinical fragments of several psychotherapeutic cases. The process goes through periods of activation of the patient's depressive or primitive mental functioning, which also reflects on the therapist's countertransference. The capacity of the therapist to tolerate and elaborate on his patient's projections, facilitates the development of the therapist-patient communication and plays a significant role in the therapeutic outcome itself.

Journal ArticleDOI
TL;DR: In this paper, the authors explore two seminal essays which deal with this complicated and elusive topic of Oedipal mastery: Freud's classic essay of 1924, "The Dissolution of the Oedipus Complex,” and Hans Loewald's paper, “The Waning of the Odipus complex, written fifty-five years later in the light of subsequent psychoanalytic theory.
Abstract: What is the fate of the Oedipus complex? Is it ideally resolved once and for all, or is it continually reworked and transformed throughout subsequent stages of development? Most psychoanalysts would agree that the Oedipus complex is universal, but that also, it cannot retain its original form How and why this change occurs, as well as what achievements are gained as a result of Oedipal resolution will be the subject of this paper As a basis for discussion, I will explore two seminal essays which deal with this complicated and elusive topic of Oedipal mastery: Freud's classic essay of 1924, “The Dissolution of the Oedipus Complex,” and Hans Loewald's paper, “The Waning of the Oedipus Complex,” written fifty-five years later in the light of subsequent psychoanalytic theory The topic of the fate of the Oedipus complex speaks to the essential issue of the continuity vs the discontinuity of human development Although Freud did indeed acknowledge the importance of our archaic past, the idea that t

Journal ArticleDOI
TL;DR: In the field of psychoanalysis, it is simply not possible to discuss contemporary psychoanalysis without invoking Freud as mentioned in this paper, and Freud's monumental and long lasting contribution to the clinical understanding of hysterical symptoms is increasingly relegated to the status of a superfluous antique.
Abstract: As we look at the evolution which has occurred in the field of psychoanalysis over the last fifty years, it is simply not possible to discuss contemporary psychoanalysis without invoking Freud. Our conference, of course, is dedicated to contemporary psychoanalysis; therefore, it is entirely appropriate for us to explore this topic. Early contemporary psychoanalysis, I would suggest, began with the gradual evolution of the libido theory. Subsequently, contemporary psychoanalysis increasingly concerned itself with the early pre-oedipal dyadic relationship between mother and infant as well as the concomitant development of the ego. Finally, Freud's monumental and long lasting contribution to the clinical understanding of hysterical symptoms is increasingly relegated to the status of a superfluous antique. Analysts who are familiar with the ongoing contemporary significance and utility of Freud's early conceptualizations concerning the dynamics of hysteria and its treatment understand that the sympto...

Journal ArticleDOI
TL;DR: In this paper, a theoretical speculation of the origin of artistic creativity is presented, drawing on concepts from Reichian bioenergetics, phenomenology and existential psychology, Otto Rank, and the gestalt therapy approach of F.S. Perls.
Abstract: Starting from the perspective of Blake's notion “Energy is eternal delight,” this study is a theoretical speculation of the origin of artistic creativity which expands Freudian theory in a new direction. Since Freud admitted that “the nature of artistic achievement is inaccessible to us psychoanalytically,” an alternative theory of the aesthetic appreciation of art and nature as well as artistic creation is presented drawing on concepts from Reichian bioenergetics, phenomenology and existential psychology, Otto Rank, and the gestalt therapy approach of F.S. Perls.

Journal ArticleDOI
TL;DR: In this paper, a review of the development of the concept of conflict throughout the history of Freudian psychoanalysis is reviewed, and the analytic and synthetic aspects of conflict theory are explored and the role of conflict in personality organization and pathogenesis is clarified.
Abstract: Unconscious conflicts are at the center of Freudian psychoanalytic inquiry, in the psychoanalytic situation as well as in the theory of personality and pathogenesis. The core dynamic formulation, intrapsychic conflict resulting in new psychic formation, is addressed in the paper in the following steps. First, the development of the concept of conflict throughout the history of Freudian psychoanalysis is reviewed. Next, the analytic and synthetic aspects of conflict theory are explored and the role of conflict in the development of personality organization and pathogenesis is clarified. Then, the contemporary extensions and elaborations of structural theory are presented. To illustrate analysis focused on conflict, clinical material covering the phases of psychoanalytic process is highlighted. From the beginning stage of analyzing the patient's initial diffuse state of indifference and “weirdness”, analysis proceeds to address primary and secondary symptoms of impotence and exhibitionism and under...

Journal ArticleDOI
TL;DR: A survey of psychoanalytic training can be found in this article, where the authors make a survey of some of the recent literature on psychotherapy training and point out that personal analysis, supervision and theoretical/clinical seminars are the same as in the early days of psychoanalysis.
Abstract: In this article, which was an introductory paper at a conference on psychoanalytic training (Psychoanalyse Lehren und Lernen) organized by Deutsche Psychoanalytische Gesellschaft in Gutersloh in October, 1994, the author makes a survey of some of the recent literature on psychoanalytic training. He points out that the three cornerstones of psychoanalytic training (personal analysis, supervision and theoretical/clinical seminars) are the same as in the early days of psychoanalysis. Attention is drawn to the dual aim of the training: the “production” of psychoanalytic practitioners and theorists. The author indicates positive and negative similarities between psychoanalytic institutes and religious institutions: the maintenance, development and transmission of systems of thoughts within a certain system of rules and regulations, and the risk of orthodoxy and dogmatism. He discusses the importance of the unconscious environment within psychoanalytic institutes and its influence on the candidates. Ar...

Journal ArticleDOI
TL;DR: In this article, the authors address the urgent need for structural changes in the transmission and training of psychoanalysis in Rio de Janeiro, which is motivated by the need to protect and preserve the so-called training analyses from the negative, often paranoid, institutional transference influence which necessarily develops and interfers with these, when the latter are 'institutionalized', that is, placed within the structural framework, controlled and administered by the training institutes of the classical model.
Abstract: Based on a critical analysis of certain pioneering episodes of the history of psychoanalysis in Rio de Janeiro and guided by the fallacies and failures of the classical training model which local history has revealed, the author addresses the urgent need for structural changes in the transmission and training of psychoanalysis. Such change in training is essentially motivated by the need to protect and preserve the so-called training analyses from the negative, often paranoid, institutional transference influence which necessarily develops and interfers with these, when the latter are 'institutionalized', that is, placed within the structural framework, controlled and administered by the training institutes of the classical model. The author presents and discusses the preliminary experience obtained with the Forum model of the Circulo Psicanalitico do Rio de Janeiro. In essence this model reflects our views that training and control analyses are the sole and unique responsibility of the individua...

Journal ArticleDOI
TL;DR: In this paper, the authors discuss the theoretical issues involved in this work, particularly the ideas of Trigant Burrow, an early American analyst who believed in species connectedness, and David Bohm's theory of implicate order.
Abstract: Dr. Montague Ullman's work with dream groups is the main subject of this paper. After detailing his method there follows an account of the author's experience in a dream workshop run by Dr. Ullman. The theoretical issues involved in this work are discussed, particularly the ideas of Trigant Burrow, an early American analyst who believed in species connectedness, and David Bohm's theory of implicate order. Dr. Ullman's intention to return to the healing process in dreams to ordinary people is connected with the author's paper “Thoughts on the Healing Process.” The implications for psychoanalysis of these holistic ideas are considered.


Journal ArticleDOI
TL;DR: In this article, a subjective account of war-time experience of the evacuation of Finnish children to Sweden is given, where certain patterns of traumausation appear, especially in the psychological defences clearly related to separation, alienation and frequently, the need to change language.
Abstract: An unusual subjective account of war-time experience of the evacuation of Finnish children to Sweden. In retrospect, certain patterns of traumausation appear, especially in the psychological defences clearly related to separation, alienation, and frequently, the need to change language. I compare and contrast the Finnish experience with evacuations in the UK, which were overall less traumatic. Some psychoanalytic sources are supplied, relevant to the experiences, and to the characterological sequelae in the adults later. I criticise the majority of the post-war “scientific” reports on the data. Special reference is made to the value of the Finnish and Swedish War-Children's Societies.

Journal ArticleDOI
TL;DR: In this paper, the concept of super-ego and conscience are used separately, together and interchangeably, making the distinction between "parentally derived punitive super ego and the conscience derived from the empathetic connection with the nurturing parent" allows us to speculate more creatively.
Abstract: Dr. Knapp, in her discussion of Psychoanalysis and Ethics, focuses on “the true roots of Jewish ethics” and on “Freud's obsession with Moses. “Dr. Fieldsteel comments on a particular aspect of the paper which reflects the long-standing confusion in much of psychoanalytic writing and thinking. The concepts of super-ego and conscience are used separately, together and interchangeably. Making the distinction between “parentally derived punitive super-ego and the conscience derived from the empathetic connection with the nurturing parent” permits us to speculate more creatively. It allows for a possibility of healthy super-ego development and for the capacity for mature socially related ethical development. Dr. Knapp's paper raises many questions about both the theory and practice of psychoanalysis in terms of broader ethical issues.

Journal ArticleDOI
TL;DR: This issue of the International Forum of Psychoanalysis was developed under the editorship of Valerie Tate Angel in collaboration with Helen Adler and Janet Droga as mentioned in this paper and was published in 1989.
Abstract: This issue of International Forum of Psychoanalysis was developed under the editorship of Valerie Tate Angel in collaboration with Helen Adler and Janet Droga

Journal ArticleDOI
TL;DR: In this article, Sorter draws attention to cognitive, behavioural and interpersonal elements largely neglected by classical psychoanalysis and suggests that procedural memory was formed and operates unconsciously, touching upon the very nature of the unconscious.
Abstract: In working with procedural memory Dr. Sorter draws attention to cognitive, behavioural and interpersonal elements largely neglected by classical psychoanalysis. Contemporary psychoanalysts no longer regard behavioural, cognitive and interpersonal aspects of experience as secondary to drive related dynamics. Instead we consider them potentially causative of self structure to the same degree as conflict related and motivational dynamics. Suggesting that procedural memory was formed and operates unconsciously, Dr. Sorter touches upon the very nature of the unconscious. Both in current psychoanalytic literature and in neurobiological research, we find evidence that all experience starts being unconscious and that only a very small part ever becomes conscious. This process of selection has little if anything to do with repression, and so a method that centers on lifting repression would miss the bulk of unconscious material. Examining the psychoanalytic interaction in the context of an emphatic relati...

Journal ArticleDOI
TL;DR: The erotic in clinical treatment, deeply embedded as it is in the transference-countertransference matrix, is delineated and explored in this paper, where the authors discover and rediscover Eros' essentially paradoxical essence as both provocateur, dangerous "mischief maker" to cohesive force.
Abstract: The erotic in clinical treatment, deeply embedded as it is in the transference-countertransference matrix, is delineated and explored in this paper. As we journey through Eros' mythic tradition, to Plato's symposium, and on to Freud's “Observations on Transference Love”, we discover and rediscover Eros' essentially paradoxical essence as both provocateur, dangerous “mischief maker” to cohesive force—a source of universal cohesion. Struggling with Eros' fundamental dialectics, we experience the rich potential of translating its “disruptive” reverberations into relational-dynamics. What has remained in the realm of the dangerous, an enemy to insight, the dread of acting out, is brought to light. We talk in complex ways of the unique impact one human being can have on another. This impact includes the erotic: a world of desire, longing, surrender; the wish for penetration, merger, intimacy; the fear of engulfment and ultimate rejection.

Journal ArticleDOI
TL;DR: In this article, the authors present the case of an adolescent who, already in the process of having to face up to the loss of an infantile state -as happens to every adolescent -is obliged also to face the death of a loved one.
Abstract: This paper concerns the subject of “loss”, and the way “loss” is dealt with. A loss occurs which may be related to a real object - such as the death of a loved one - or to anything else which may represent a lost object, such as a stage or a function lost in life. Thus in adolescence, one has to face the loss of an infantile state. Being alive, growing up, developing oneself presupposes losses and gains. One loses something in order to gain something else. This paper attempts to examine the subject, both in its theoretical and clinical aspects. In its theoretical aspect, I bring forward the points of view of Sigmund Freud, Melanie Klein and Wilfred Bion, concerning loss and how one deals with it. In its clinical aspect, I present the case of an adolescent who, already in the process of having to face up to the loss of an infantile state - as happens to every adolescent - is obliged also to face the death of a loved one. Besides, the process of analysis itself presupposes that a person, in order t...

Journal ArticleDOI
TL;DR: This article found that Freud overlooked the true roots of the Judaic ethic, which appeared only after defeat by the Babylonians had dismantled the Jewish State, and disempowered the monarchy and theocracy, providing room for more democratic ideas, incorporating concepts of social justice.
Abstract: Freud's disdain of ethics, which he equated with religious commands, inhibited psychoanalysts from writing on this topic for many years. He proposed the internalization of parental commands as the genesis of superego, the agency responsible for conscience, and the internalization of the Deity (through the Second Commandment), as the genesis of a spiritualized religion. Both ideas were consequences of Freud's biblical exegesis, his identification with Moses, and his conflictual feelings regarding his own Jewish identity. It is the view of this paper that Freud overlooked the true roots of the Judaic ethic, which appeared only after defeat by the Babylonians had dismantled the Jewish State, and disempowered the monarchy and theocracy, providing room for more democratic ideas, incorporating concepts of social justice. A review of the writings of cognitive theorists finds that they emphasize freedom as the prerequisite for ethical thinking, an origin which the current paper finds as parallel with the...

Journal ArticleDOI
TL;DR: The two-person model of the psychoanalytic situation has been proposed in this article as a potential rapprochement between the personal and more classical views of psychoanalysis.
Abstract: For half a century Interpersonal psychoanalysis has developed relatively independent of the tradition of Freud and his followers. The Interpersonal movement was founded by Harry Stack Sullivan, Clara Thompson and others who believed that the psyche could not be understood as an entity that evolves without input from the external environment. The Interpersonal view is that interactions between people influence every aspect of the individual's experience, and that no person can be studied without simultaneously noting the ongoing impact between the observer and the observed. This line of thought has led to conclusions concerning personality, psychopathology and clinical technique that depart from traditional psychoanalysis. The paper illustrates a number of these differences, emphasizing that the current emergence of the “two-person model” of the psychoanalytic situation offers a potential rapprochement between the Interpersonal and more classical views.

Journal ArticleDOI
TL;DR: The status of the concept of "unconscious fantasy" is ambiguous in Freud's writings and to this day still debatable within the psychoanalytic community as mentioned in this paper, and it has been argued that what we call "unsimplicit fantasy" perhaps cannot have the character of a pre-existing psychological content in the unconscious.
Abstract: The status of the concept of unconscious fantasy is ambiguous in Freud's writings and to this day still debatable within the psychoanalytic community. Taking Freud's article of 1919—“A child is being beaten”—as his starting point, the author develops a tripartite theoretical model on the basis of Freud's analysis of a masochistic fantasy. In a second stage, this model is applied back onto some central points in that same text. Departing from Freud's own words that the unconscious phase of the fantasy “never had a real existence”, it is argued that what we name “unconscious fantasy” perhaps cannot have the character of a pre-existing psychological “content” in the unconscious. Instead, it must be seen as an unrealized potential belonging to the future rather than to the past.

Journal ArticleDOI
TL;DR: In this paper, the authors emphasize the need of knowing the frame of orientation in which the interaction between the host and the disease takes place, and emphasize the important contributing role of helplessness and powerlessness as well as of tedium, indifference and rage, rage which usually covers up fear.
Abstract: This paper emphasizes the need of knowing the frame of orientation in which the interaction between the host and the disease takes place. It is not the same to regard falling ill as a result of moral transgression, as a divine punishment, or as a simple cause-effect process—these frames implying the passive impotence of the host—as to conceive disease as another of those inevitable contingencies of life such as pain, ageing and death that can be lived as testing our mettle. Experience of patients with organic diseases in hospitals, as well as examples taken from medical reviews, emphasize the important contributing role of helplessness and powerlessness as well as of tedium, indifference and rage, rage which usually covers up fear.