Showing papers in "Journal of the American Psychoanalytic Association in 1956"

The Personal Myth A Problem In Psychoanalytic Technique

Abstract: In the analysis of certain patients a particularly detailed and careful scrutiny of their life history seems essential in order to achieve meaningful results. In a number of cases in which this procedure proved to be indicated I have gained the impression that these individuals use their autobiographical memories-a term which I borrow from Freud's early (1899) writings-as a protective screen. In some cases this screen as a whole is carefully constructed, and built as some isolated screen memories tend to be (3, 4, 7, 8, 16): the firm outline and the richness of detail is meant to cover significant omissions and distortions. Only after omissions have been filled in and distortions have been corrected, can access to the repressed material be gained. In other cases occurring more frequently, it is not the total life history but only a more or less well-defined period or isolated stretches of the personal history which have been worked up as screen; even then the wellknit structure suggests further and searching investigation. T h e question might well be raised which dynamic and developmental conditions favor the choice of this method of defense. I171iile I shall attempt at the end of this paper to suggest some answers to this question, my starting point is a more specific clinical experience: it refers to a small group OF individuals whose

Vicissitudes of female sexuality.

Abstract: The divergent psychoanalytic theories of feminine sexuality center around the disputed question of early vaginal sensations. Freud (5) consistently maintained that the vagina is discovered at puberty and true femininity accepted only then. A number of other authors-among them Brierley (1, 2), Greenacre (7), Horney (8, 9), Jacobson (lo), Jones ( l l ) , Klein (14, 15), Lorand (16), Muller (18), Payne (19)-modified this view, some finding a good deal of evidence for the occurrence of vaginal sensations in early childhood. In a later paper Freud (6) expressed pessimism concerning the resolution of penis envy in women and of feminine wishes in men. This opinion seems primarily based on Freud’s respect for constitutional and anatomic differences. T h e question why femininity is difIicult to accept may have its ultimate answer in constitutional hormonal differences. The anatomy of organs representing femininity, however, undoubtedly shapes the vicissitudes of feminine sexual development. This paper, based on direct observation of children as well as on analyses of adults and children, is devoted to a reconstruction of feminine genital development. An attempt is made to unify and

Dreams, images, and perception; a study of unconscious-preconscious relationships.

Abstract: In a recent paper (S), I reported the results of a repetition of the classical experiments of Poetzl (19) on dream production following the tachistoscopic exposure of pictures. These experiments demonstrated that those parts of the tachistoscopically exposed I picture which were not consciously perceived appeared extensively in the manifest content of subsequent dreams. I have called the subthreshold process of visual perception involved in these experiments "preconscious perception." It has been shown that during this process an enormous amount of intricate visual material is taken out of the perceptual field and registered as memory trace in extremely brief time intervals such as l/loo or 1/200 of a second. Based upon Poetzl's original findings, I have shown that in the process of dream formation the preconscious percepts or their memory images undergo the following types of transformations and distortions: (1) translocations or displacements of percepts or parts of percepts; (2) condensations and fusions of percepts with one another; (3) fragmentations such that only certain parts of a percept appear in the manifest dream image; (4) rotational displacements of various kinds, such as mirror reversals or rotations of 90"; (5) changes in size which are analogous to micropsias or macropsias; (6) reduplications and multiplications of the percept analagous to polyopia; (7) ignoring of perspective relations, e.g., a percept in the foreground may be fused with a percept in the . 1 Presented in an abridged form at the meeting of The American Psychoanalytic Association, Atlantic City, May, 1955. 2 From the Department of Psychiatry, Mount Sinai Hospital, Xerv York. Acknowledgment is made to the Foundations' Fund for Research in Psychiatry for its generous support of this investigation.

Toward the biology of the depressive constellation.

Abstract: In “Instincts and Their Vicissitudes” (1915) Freud (12) came to the conclusion that “instincts are subordinate to the three polarities which govern mental life as a whole” and states these three antitheses as “subject-object,’’ “active-passive,” and “pleasurepain.” I n the same paper he discussed the anaclitic origin of libido and on this basis proposed that ego instincts and libidinal instincts are not antagonists ab origine. I n 1917 he published :‘Mourning and hlelancholia” (1 3) in which he demonstrated explicitly that a process which is necessary for survival-alimentation-leads to that organization of the mental apparatus which is responsible not only for the pleasure of the mind but also for its anguish. The earlier studies of depression were concerned mainly with conflicts between the individual’s superego and the psychic representations of his experiences during the oral phase of develop ment. On one hand, the rapid development of psychoanalytic ego psychology and, on the other hand, the study of psychosomatic manifestations necessitated a better understanding of growth and maturation. This, however, renewed the problems inherent in the anaclitic nature of psychic energies and brought about a fresh approach to the riddle of depression. More recent studies seek to explain the tendency toward depressive reactions by groping backward into the earliest phases of life in which the maturation of sensory, vegetative and regulative processes include the first processes of mentation. Indeed, these

Will and psychoanalysis.

Abstract: Psychoanalysts of some experience often remark upon the change during recent decades in the patterns of neuroses. And younger analysts gain a similar impression from the discrepancy between the older descriptions of neuroses and the problems presented by the patients who come daily to their offices. T h e change is, of course, from symptom neuroses to character disorders and borderline states. Several p. opositions may be advanced to account for this change. First, i t may be more apparent than real. Neither symptom neurosis nor character disorder can exist in pure form. The one implies the other, the two categories being abstractions from either end of a continuum of neurotic patterns. T h e early analysts, being technically and theoretically unprepared to see character traits as fixed expressions of neurotic conflict, doubtless overlooked the character neuroses in many of their patients. T h e development of ego psychology during the past thirty years has so remedied this deficiency that we now are prepared to discover neurotic character problems in even those patients who seem at first to suffer only from ego-alien symptoms. To the extent that considerations of this kind apply, the change in question is in our point of view rather than in the nature of neurosis. A second factor has to do with the increasing social acceptance of psychoanalysis and the increasing frequency with which troubled people turn to it for relief from the various burdens which oppress their lives. Normality has largely replaced morality as a standard

Crying at the Happy Ending

Abstract: The brevity of this communication does not do justice to the importance of this widespread psychological and social phenomenon. T h e writer is amare of this fact and expects that the readers will be overwhelmed by reactions stimulated by his own experiences. Some might find the writer’s interpretations and suggestions difficult to accept, insuficient, and not covering the subject. However, the conclusions are based on careful, long and painstaking analyses of patients who-in the course of their treatment for other purposes-presented this phenomenon. Encouraged by his findings the writer took the liberty of applying this knowledge to events and cases he did not have the chance to investigate through personal interview. In our culture, tears are usually shed as a result of physical and mental pain, grief, sentimental experiences, exalted scenes, and at the happy ending of a tense or perilous situation. Tears caused by violent laughter or cough have no psychological origin. According to Darwin (l), they are the result of muscular and vascular processes clue to those actions. A man who by cruel fate was stricken from childhood on by several different physical infirmities, who in addition to these traumatic events lost his mother when very young, and was harshly terrorized by a threatening and dictatorial father, developed a painful and paralyzing neurosis. At the end of his long analysis, which he felt helped him a great deal and opened for him the possibility of a happy life, he said to me: “Thank you, you were so

On the experiences of the analyst in the psychoanalytic situation; a contribution to the theory of psychoanalytic treatment.

Abstract: One might venture the guess that to the future historian of science one of the most intriguing features of the present era of psychoanalysis might lie in the following paradox: that while psychoanalysis, both as theory and practice, represents the most advanced form of current thought regarding psychological growth and human relationships, there is, a t the same time, considerable vagueness and disagreement among workers as to what constitute the characteristic operations of this science. If we view this state of affairs in the light of the history of other sciences, particularly mathematics and physics, we find that the problem in psychoanalysis-as sketched ahove-has no parallel in the evolution of those sciences. Indeed, i t is well known that in the natural sciences, a precise definition (description) of the scope and mode of opera-

The dramatic device: a play within a play.

Abstract: T h e dramatic device of a play within a play has proven very effective and has been successfully employed in many plays. Its use, although frequently dictated by technical considerations, may actually be considered to be related to a familiar psychological mechanism seen in dream work, namely, a dream within a dream. Freud, in discussing this subject, wrote: “What is dreamt in a dream after waking from the ‘dream within a dream’ is what the dream wish seeks to put in the place of an obliterated reality. I t is safe to suppose, therefore, that what has been ‘dreamt’ in the dream is a representation of the reality, the true recollection, while the continuation of the dream, on the contrary, merely represents what the dreamer wishes. To include something in a ‘dream within a dream’ is thus equivalent to wishing that the thing described as a dream had never happened. In other words, if a particular event is inserted into a dream as a dream by the dream work itself, this implies the most decided confirmation of the reality of the event-the strongest afil-matioit of it” (1). It is impossible, in this brief communication, to go into great length with regard to either any number of plays or even the complex details of any single one of them. In order to elucidate my point, therefore, I shall limit the paper to one dramatic work which is well known to everyone, namely, Hamlet. We find here an interesting situation in which Hamlet contrives with the players to stage a performance which would test the truth of the ghost’s assertions.

The Problem of Masochism in the Theory and Technique of Psychoanalysis

Abstract: The Chairman, Jacob A . Arlow, introduced the panel discussion with a review of the history of the theory of masochism, describing its role in the development of the dual instinct theory. Anticipating some of the subsequent discussion, he mentioned the observations of Bibring and others, that many analysts employ working hypotheses involving libicio and aggression without accepting the far more inclusive biological speculations which underlie the concepts of Eros and Thanatos. Essentially, such biological speculations are undesirable in the context of clinical discussions, since they involve extrapolations which are incapable of confirmation or contradiction in this setting. ‘ In outlining the problem of this study, the Chairman emphasized that any comprehensive theory of masochism must take into account the essential elements of pain, aggression, femininity and passivity; further, that the term “masochism” should be employed only when pain and unpleasure occur as the necessary conditions for sexual gratification. He summarized and contrasted the work of Loewenstein, Nunberg, Bak, Brenman, Berliner, and Annie Reich, and commented on the provocative speculations of Greenacre on early trauma and excessive stimulation. He suggested that the panel consider the demarcation between sadomasochism and aggression, pointing out that not all selfaggressive acts have a sufficient libidinal component to be considered masochistic, nor does intense aggression directed by the superego and

Scientific Proceedings: Panel Reports The Dream in the Practice of Psychoanalysis:

Abstract: This panel consisted of a number of relatively small presentations and a good deal of discussion of these, all of which added up at the end of the day to a sizable, composite whole. The panel was opened by its Chairman, Sandor Lorand, with a brief initial presentation of “Possible Deviations in the Technique of Dream Interpretation.” While it is not expected, nor is it likely, that we will learn anything new now regarding dream theory, there are many situations today which call for variations in the technique of interpreting dreams. This is due to the widening of psychoanalysis to include different types of neuroses than when Freud first formulated dream theory and technique, such as various character problems, borderline conditions, and the perversions. In this group, the resistances and defenses are frequently too strong to produce or to remember dreams. Among the deviations which may be required, Lorand mentions: (1) I t is frequently necessary to analyze the manifest dream from our knowledge of other related material from the patient. IVhile pointing out Freud’s warning against the interpretation of dreams without associations from the patient, in some cases such interpretations become necessary and may in themselves start a stream of associations which can then yield worthwhile material. (2) Regarding the question of the writing down of dreams, this procedure, too, in these borderline cases is sometimes necessary and helpful. The material thus obtained may yield clues which in themselves will help analyze this particular form of resistance. Freud himself, Lorand reminds us, wrote down his own dreams for later analysis. Following this introductory presentation, Robert Fliess continued

Freud and The History Of Science

Abstract: Freud’s ~\.ork-psychoanalysis-is an aggregate of data, investigative methods, theories, and treatment methods dealing with personality-including illness-and the relation between personality and destiny; or, as Hartmann has put it, it is a scientific approach to the nucleus of the personality. These simple formulations indicate a break with an ancient, deeply rooted tradition, viz., the traditional separation between science, on the one hand, and the humanities, on the other: philosophy, history, politics, which deal incidentally with man, too. This separation had long been institutionalized in the departmental boundaries of academies and universities. T h e distinction was part of the prescientific analysis of reality which underlies our thinking and which we are wont to take for granted like the air which we breathe or the language which we speak. As is the case with many of these categories of thought in the TVestern world, its basic outlines are apparent in fifth-century Athens; they were then personified in the figures of Anaxagoras and Socrates. Anaxagoras, Ionian immigrant to Athens, friend of Pericles, belonged to the school of the Ionian philosophers of nature. Their thinking can hardly be called scientific by any modern standard, but they deserve to be called ancestors of science, or proto-scientists, because they sought to explain the visible world in terms of natural causes; and they had some actual scientific results like the method, discovered by Thales, of measuring the distance of a ship from the harbor. On the other hand, there was the somewhat younger Athenian,

A clinical note on the therapeutic use of a quasi-religious experience.

Abstract: Many phases of the psychotherapeutic process with a child patient were characterized by her intensive preoccupation with religious experience. As used during therapy, these could only be understood as a protective distance device against the developing transference. As treatment unfolded, it became apparent that the distance device itself was one important aspect of her transference which called for special psychotherapeutic intervention, as will become evident in the course of this presentation. Elaine was brought to us at Southard School, at the age of thirteen, against her will, and under the well-sustained pretense of her frightened and guilt-ridden mother that they were making the 2,000-mile trip solely for summer pleasure. T h e mother lacked the father's support in her plan to institutionalize the child. Yet, she told us, despairingly, that she would even disrupt her marriage if necessary, in order to help her only child, whose fantasy life was encroaching so markedly upon her reality hold. A highly gifted, articulate and sophisticated youngster, Elaine was married to Robin Hood in her fantasy. While she soberly maintained that she could adequately distinguish her fantasy world from reality, she nevertheless increasingly restricted her life in order to please the phantom husband. This proud fantasy hero, who fought fearlessly for the needy, was very much the opposite of the cold, hyperintellectual father who withdrew from the marital

Recent books on psychoanalytic technique; a comparative study.

Abstract: There are three publications in the technical literature which stand as landmarks in the history of psychoanalysis: Freud‘s Papers on Technique (ZO), Glover’s Lectures on Technique (30), and Fenichel’s Problems of Psychoanalytic Technique (12). Glover’s Lectures, originally delivered to the students of the London Institute of Psycho-Analysis in 1927-1928 and first published in book form shortly thereafter (31), have reappeared in a revised form, enriched by the author’s increased experience and deepened by the discoveries of the past three decades. This new book, Tlie Technique of Psycho-Analysis by Edward Glover (37), not only offers the student a rare opportunity to review the application of the Freudian method in close association with the theoretical tenets upon which psychoanalysis is founded, but provides the experienced analyst with a cinemascopic view of this vast subject. For the purpose of this essay it also serves as an excellent background for a comparative study of the other recent publications on technique which present deviations from the classical approach: Benjamin Wolstein’s Transference: I ts Meaning and Function in Psychoanalytic Therapy (56), Izette de Forest’s Tlie Leaven of Love: A Deuelopment of the Psychoanalytic Theory and Technique of Sandor Ferenczi (S), and Trygve Braatoy’s Fundamentals of Psychoanalytic Technique (7). . Edward Glover is in a unique position to write on the subject of psychoanalytic technique. Scottish by birth and trained in Berlin, he has always been an assiduous student of Freudian psychoanalytic thought. As a member of the British Group, he was exposed to and

Psychoanalytic curricula; principles and structure.

Abstract: This panel clearly showed the impact of the impressive changes which have taken place in the field of psychoanalytic teaching and training within recent decades in this country, and especially since the end of IVorld IVar 11. These changes reflect the growing influence of psychoanalysis on psychiatry and medical sciences in general, and thereby on young physicians who wish to enter the field of psychiatry. The number of psychoanalytic institutes as well as the number of students in this field has multiplied, so that clearer and more organized thinking about the essentials of psychoanalytic training and the practical implementation of such training has become a necessity. The training in psychoanalysis is clearly changing, for better or worse, from an individual apprenticeship type to a more formalized academic and institutional type of education. This transition, as well as the difficulties inherent in any kind of attempt to impart psychoanalytic understanding and skills to variously motivated students, has created, in all psychoanalytic institutes, a growing need for re-evaluation and reformulation of teaching techniques and of the basic curriculum. The widening scope of psychoanalysis as a treatment method has only increased the problems and perplexities with which all psychoanalytic training facilities are confronted today. Representatives of most of the training facilities were invited to participate in the discussions which in part centered around a paper by Richard L. Frank. The discussion dealt in part with teaching and curriculum problems encountered in various training institutions. As will be seen, the contributions to this panel can thus be roughly divided, on the one hand, into more general considerations of teaching and training philosophy and of problems in the basic training pro-

Our attitude toward greatness.

Abstract: One hundred years ago there came into life a being whose long years of work and insight were to make such contributions to knowledge as profoundly to influence the civilization of every country. And we may safely say that the full impact of that influence has yet to be experienced. TVhoever stands in my place in another hundred years from now will i n his commemorative speech-and I am confident there will be one-be able to report further progress in the assimilation and application of Freud’s discoveries to an extent which it is impossible for us now to predict. And we may well wonder how his attitude to Freud’s personality will differ from our own. Some of us are trying to record the outlines of that personality so as to convey as much as possible of it to our descendants, and it is the difficulties in the way of doing so in a satisfactory fashion that furnishes a theme for our considerations today. T o begin with, we should ask what indeed is our own attitude. Before doing so, however, I wish to draw your attention to two peculiar features in Freud’s achievement which have greatly affected this matter of attitude. T o make them clearer I will contrast them with corresponding features in the achievement of the other great man of science of our period, Einstein. T h e first of the features is the loneliness of Freud’s achievement. That in itself is a measure of his revolutionary originality and also of the pre-eminent degree of courage needed for such a feat. Although I have tried to trace earlier possible influences on Freud’s mode of thought and the casual hints thrown out by previous writers, it still remains true that his work was essentially

Panel Reports: On Sleep Disturbances in Children

Abstract: The last symposium on sleep disturbances was held September 14, 1940 in California. Dr. Otto Fenichel was Chairman and Dr. Anna hIaenchen participated in both the original panel and the present one. Dr. Ernst Simmel, in that early discussion, thought i t an excellent idea to have further discussions on the subject of sleep disturbances, not merely because of the theoretical interest in neurotic symptoms but \"the capacity for sleep as a psychobiological function operates as a means of helping the ego to establish and keep up its instinctual equilibrium.\" He further stated \"schizophrenia may be viewed as a disturbance of the waking condition on a grand scale,\" which was followed up in this present meeting by trenchant observations. The utilization of observational approaches in the young infant through the twoyear-old seemed to afford new material to the long-neglected theme of sleep disturbances. This panel appeared to many of the participants to be a start in pooling knowledge. Further conferences on this subject could be profitably held sooner than another fifteen-year interval. The Chairman, Margaret S. itfahler, opened the meeting by pointing out that sleep as a psychophysiological mechanism was not Freud's prime concern-it was the dream that overshadowed consideration of the setting in which i t occurred. She pointed out that research in child development and child analysis, just as in physiology, affords little knomledge of normal patterns of the sleep cycle or of its individual variations at various ages. She emphasized that except for pavor nocturnus and sleep phobias, we do not know with precision whether we

Affects, object relations and gastric secretions.

Abstract: A paper entitled “The Study of an Infant with a Gastric Fistula,” by George L. Engel and Franz Reichsman, was the main presentation around which this panel was structured. The paper dealt with the concomitant and interrelated studies of gastric secretions, behavior and affects in an infant girl, hlonica (age 15 months), who had a gastric fistula. Engel and Reichsman gave a preliminary report of a case which, when the studies are completed and published, will stand in both its procedural and substantive aspects as a model for the single case study in psychophysiological research.

Re-evaluation of the libido theory.

Abstract: At the beginning of the morning session Robert Wnelder outlined the idea and the plan of the panel. The idea was to concentrate on the clinical rather than on the metapsychological aspects of the libido theory. These clinical aspects he defined as follows: (1) The concept of sexuality is properly not limited to the genital expressions of sexuality, such as cohabitation, but on the contrary, as Freud proposed in 1905 in the Three Contributions to the Theory of Sex, many other activities and propensities of the human organism rightfully deserve to be called sexual as well. (2) As Freud also proposed even earlier, psychoneuroses are primarily due to an inner conflict over sexual drives. That is, the clinical aspect of the libido theory may be said to refer to the doctrine of the crucial importance of infantile sexuality for the development of character, of neurosis, and indeed of all psychopathological phenomena. In this connection Waelder reminded us at both sessions that Freud held to this view throughout his life and expressed it even in his last work, the unfinished Outline of Psychoanalysis, in which he offered the opinion that the time of greatest psychic vulnerability was childhood and that the area of greatest vulnerability was that of the sexual functions. The plan of the panel was that the morning session was devoted to a consideration of the more radical criticisms of the libido theory by those who might be called culturalists or environmentalists. Such critics would discard the libido theory as untenable altogether. The afternoon session was devoted to the discussion of less radical forms of criticism, that is, in Waelder’s words, “criticism which does not question the role of the libido theory as such, but which sees its range of applicability both defined and restricted by the development of psychoanalytic thought in the ,last thirty years, which has been occupied above all with problems of aggression and with ego psychology.”

Indications and contraindications for the application of the standard technique.

Abstract: Despite the great number of papers on technique and its theories, and attempts at conceptualization, there seem to be a paucity of papers devoted to the role of activity in psychoanalysis. I should like to present some clinical problems in technique which necessitate deviation from the standard model as presented by Eissler (7), as well as my theoretical considerations for doing so. I n connection with this whole problem I wonder at the value of continued speculation as to what is psychotherapeutically oriented psychoanalysis and what is psychoanalysis itself. One finds psychiatrists who have a “couch phobia,” who feel that they will be accused of misrepresenting themselves as psychoanalysts if they have a couch in their offices; as if the couch would be the most essential prerequisite for being a psychoanalyst. The very cropping up of papers about this theme of psychoanalysis and psychotherapy reveals the defensive nature of the problem itself. I firmly believe that there is no psychoanalysis without some so-called psychotherapeutic admixture. To be specific, in every psychoanalytic situation, however optimal the transference and countertransference climate might be, there arise situations where the analyst, willy nilly, gives advice, prohibits acting out within or without the analytic situation, suggests, and so on. This may happen even as a result of slight inflections of the voice or by being silent. We have, then, in every analytic situation actually a spectrum of more or less “psychotherapeutic” addition to the psychoanalytic

Some comments on psychoanalysis and dynamic psychiatry.

Abstract: T h e reading of a paper by Frieda Fromm-Reichmann (4) evoked certain relevant thoughts which led to this brief communication. I t is obvious that a full discussion of all the problems implied by Fromm-Reichmann in her paper, in which she tries to delineate the differences and similarities between classical psychoanalysis and dynamic psychiatry would necessarily lead to a lengthy treatise, for it would have to include a discussion of Sullivan’s doctrines. This would go far beyond the scope of this paper and I will therefore limit myself to a discussion of only four points. In her paper Fromm-Reichmann contrasts Freud’s conception of psychosexual development with “the developmental phases of the child’s interpersonal relationships” of dynamic psychiatrists who

Book Section: Sigmund Freud

Abstract: A scientist’s life and personality generally do not arouse such passionate interest as those of statesmen or poets. Freud is an exception. It is fortunate that now, when Freud’s centenary draws more public attention to him as a person, we have received several books which help 11s to understand Freud the man. His work, although produced in the daily treatment of patients, is so much born out of self-observation and self-exploration, is such a singular combination of indefatigable research and of creation out of the innermost self, that to study the man Freud becomes a fascinating part of studying his scientific achievement. These books complement each other. They have already changed the picture that most people had of Freud. He is no longer the calm, cold, rigid scientist, but a man of violent passions in whom, as in all great men, the forces of the unconscious were constantly raging. The Letters to Fliess offer an opportunity to explore the early stages of psychoanalysis. Ernst Kris has written a lucid and penetrating introduction, a guide of great assistance to the reader who tries to follow Freud‘s development from physiology and neurology to