(Note this is an updated post that I wrote years ago on my personal blog. I’ve expanded the original post and it is worth the re-read.)
In Seminar XI, Lacan argued that whenever the subject who is supposed to know (SSK) exists then so will transference. The typical neurotic patient will grant the analyst his trust, and thus allow him to assume this position of knowledge. Furthermore, as soon as the analyst is the positioned as the SSK, “he is also supposed to set in search of unconscious desire” (Four Fundamental Concepts, p. 235). The patient comes into analysis assuming that the analyst has some sort of understanding of his symptoms. Of course, this is untrue. Psychoanalysts are not mediums and have no special intuitive capacities. This belief of the patient is the very thing that often motivates him to enter analysis. The patient interprets the analyst’s interventions as information from the SSK, sometimes granting the analyst omniscient powers.
I’ve been thinking more about Lacan and the way we sometimes attribute certain characteristics to different people (e.g the analyst as the SSK). In social groups, especially group therapy, it is very common that a scapegoat emerges. Generally, this person sticks out in the group as being different and thus worthy of hate. The group tends to project their hatred onto this individual and treats this contaminated group member as a “leper” who must be kept at a distance. Inevitably, the group turns against this one person and alienates the person from the group. Scapegoating is a universal phenomena and it can take many forms. Continue reading “The Subject-Supposed-to-be-Awkward and Group Dynamics”
This weekend I read Franco De Masi’s text Vulnerability to Psychosis. It’s an interesting object relations account of psychosis. In chapter six he addresses the relationship between the psychotic individual’s auditory hallucinations and the superego. The psychotic superego is often punitive, persecutory and excessively critical. Many individuals who have psychotic experience have command hallucinations such as “You should hurt yourself because you’re pure evil.” Interestingly, command hallucinations are particularly common for individuals who experienced serious childhood abuse. In this chapter De Masi draws a fascinating parallel between the God of the Book of the Job and the psychotic superego.
De Masi writes: “Blind with wrath and haughtily insistent on His right to dispose of His creatures as He sees fit, God hurls Himself upon Job and yells at this mere worm crawling in the dirt who dares to ask for explanations of His behavior. Before such an arrogant and narcissistically touchy God, Job appears as a desperate and devout person; the violence of his words against God is dictated more by exasperation that by rebellion. Everything would be assuaged if he would only understand the link between sin and punishment. The story of Job can, in my view, also be understood as the description of a relationship between the ego and the psychotic superego during the course of a psychotic breakdown, in which the protagonist, like my patient, finds himself expelled from the state of well-being and flung on to a dung-heap, a prey to a destructive and accusing voice…The psychotic patient is more like Job: he has to confront a threatening world that is out to annihilate and terrify him rather than to make him feel guilty. The God of Job demands subjection without even allowing him to understand the reason for the wrath and the origin of the sin: the patient in this phase therefore has to face not so much guilt as terror” (P 120-121).
De Masi then connects this experience with Klein’s understanding of the infant in the paranoid-schizoid position who attempts to negotiate the terrifying and chaotic world. At this stage, Klein understood the infant as trying to survive the annihilation anxiety generated by the infant’s powerful death drive. Bertram Karon has also described schizophrenia as a “chronic terror syndrome” where the patient is contending with horrifying realities that threaten their very existence. Job’s experience with the arbitrary and vengeful attitude of God parallels the psychotic individual’s experience with their auditory hallucinations. Often the psychotic individual is taken by complete surprise by the unpredictable and inexplicable ridicule of the menacing voices.
Bonus points for readers who can find other Biblical stories that nicely illustrate psychoanalytic principles.
Over the last month I’ve been reading through Melanie Klein’s published works in Love, Guilt and Reparation and Other Works 1921-1945. Tonight I had the joy of reading her paper “Symposium on Child-Analysis” (1927) which is a response to Anna Freud’s critique of Klein’s play technique with children. I wanted to describe some of Klein’s intriguing arguments and then describe how Kleinians have a radically different way of approaching analysis for patients from all populations: children, adult neurotics and psychotics.
Continue reading “A Kleinian Appreciation”
Freud once wrote, “But you will be able to convince yourself that much will be gained if we succeed in transforming your hysterical misery into common unhappiness. With a mental life that has been restored to health you will be better armed against that happiness” (Breuer & Freud, Studies on Hysteria, p. 306). Freud was clearly no optimist when it came to mental health. For Freud, society generally serves to discourage our natural libidinal and aggressive wishes through the creation of various social prohibitions that demand our drives be sublimated into healthy, socially acceptable channels. Freud never believed that psychoanalysis promised happiness. Instead, psychoanalysis is a quest for truth through the analysis of the patient’s unconscious wishes and beliefs.
Continue reading “Psychoanalytic Views of Mental Health”
The analyst’s posture in analysis is supposed to be driven by three aims: neutrality, abstinence, and anonymity. I want to focus specifically on neutrality. Read any psychological textbook and one always happens upon the same critique that neutrality is impossible. Freud was not always neutral, which should come as no surprise considering his case studies are all stories of failure not success. Relational analysts have emphasized two-person psychology and critiqued Freud’s neutrality as being robotic and inhuman.
I want to talk about the importance of neutrality or indifference. People going into the mental health profession tend to have certain proclivities to be caring and empathic. Of course, these attributes are necessary and can help the psychotherapist greatly who is engaging in difficult work. I wish I could find the quote from Freud that goes something like this: “the worst thing you can do is care too much about the patient”. This might strike some as odd. Aren’t psychotherapists supposed to care about the well being of others since their work is driven by a sense of benevolence? To explain why caring too much can severely hinder therapy, I want to use Klein’s idea of projective identification. This is a controversial idea that combines a couple of different notions such as: projection, introjection, and identification. Continue reading “The Importance of Neutrality in Psychoanalysis”