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Medium 9781855754386

CHAPTER 10: Conclusions

Sansone, Antonella Karnac Books ePub

In this book, I have explored the philosophical framework of dualism and its formative infuence on the development of psychoanalytic psychosomatics. I have highlighted Winnicott’ s work on the psyche-soma as a break from the dualistic tradition that, unlike the work of existential analysts, resides within an object-relations perspective. I have built on Winnicott’ s work, on Pines’ thinking about a woman's unconscious use of her body, and on Kleinian and post-Kleinian visions, to highlight the benefts of baby massage classes as what I believe should be an integral part of psychotherapeutic work with parents and infants.

My exploration of certain philosophical and theoretical issues within psychoanalysis has been in the service of “building a home” for clinical work with parents and infants and for infant observation settings. Such a home should be built upon the three following principles:

1. It should combine a phenomenological perspective based on a vision of a unifed psyche-soma, with an object relations perspective, in order to draw connections between individual infant and individual adult experiences.

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Medium 9781782200123

Chapter Ten: Why can being a Creative Couple be so Difficult to Achieve? The Impact of Early Anxieties on Relating

Karnac Books ePub

Mary Morgan

Many couples struggle to relate in a creative way in which their relationship is potentially a resource to them, emotionally, cognitively, and physically. In order to function as a creative couple there needs to have been some favourable psychic development, particularly those developments in the early relationship to the primary object, oedipal development and adolescence. These developments come together later in a way that makes a creative couple relationship possible (Morgan, 2005).

Thought about in this way, one might see that the therapeutic challenge in working with couples is in helping the couple bring together and develop aspects that are there in some form, but have not yet come together in a way that allows a creative couple relationship. For other couples there are early difficulties in relating, especially in regard to the primary object, in which any intimacy is felt to be extremely difficult, even dangerous. The relationship to the primary object, usually the mother, is key, both because for most of us it is the only other relationship of such closeness prior to the intimate adult couple, and because this relationship at the earliest stage of psychic development is formative. It therefore functions as a crucial part of the template for later intimate relating. If, for example, the mother has been overly intrusive, projecting her own psychic contents into the infant or alternatively too distant and unavailable, the infant will carry this experience into later relationships. Even when the relationship to the primary object was good enough, other elements in later psychic development have to come together and lead to creative couple relating (See Morgan, 2005). For some, these elements have not developed sufficiently or exist in distorted and damaged ways, resulting in many difficulties for the adult including a most uncreative couple relationship. Such couples present a real challenge to the couple therapist. This chapter will offer a series of vignettes of work with such a couple.

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Medium 9781912573196


Ogden, Thomas Karnac ePub


Instead of returning to the diner as was her pattern after her previous visits to the drugstore, Marta made her way directly to the dry goods store. She selected a pair of leather work gloves and some leather shoelaces. The next thing she knew she was on the street again, and had no memory of who had been at the cash register or of having opened her purse to pay for her purchase. She looked at her hands to see if she was carrying a bag that contained work gloves and shoelaces, and if so, what sort of bag it was. She saw in her left hand a brown paper bag. She peered inside and saw the work gloves and laces that she had intended to buy, which reassured her that she was not losing her mind. Nonetheless she worried that she might have appeared strange or said something nonsensical, or worse yet, said something about why she was buying these things. She wondered if she was dreaming and would soon awaken to discover that her life was quite simple and conventional. What a gift that would be—but her life had never offered up gifts of that sort.

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Medium 9781855754744

Symptoms of stress

Young, Courtenay Karnac Books ePub

Some of the most frequently experienced physical symptoms of people in anxiety or stress are headaches and migraines. There are many other symptoms of stress, but these seem to top the list. It is very easy to reach for an analgesic (pain-killer): there are plenty to choose from. However, these can also be symptoms of something starting to be seriously wrong. Would you ignore a little flashing light on your car dashboard display?


Headaches and migraines are very different. Headaches are usually experienced as an ache or pain in the head, or as if there is a tight band around the head. You can usually carry on doing things with a headache, though you might need to use some medication. They may arise from a short-term problem: stress, worry, too much alcohol, etc. Headaches can also be a symptom of an underlying problem and so, if you experience constant or persistent headaches, go to see your GP.

Here are a couple of background checks: is the headache part of a hangover? Too much alcohol dehydrates you and destroys your reserves of vitamin C: so try drinking a couple of large glasses of orange juice, or have a smoothie, and the headache may well disappear relatively quickly. Have you had too much chocolate, coffee, etc? People who are sensitive to caffeine can easily experience headaches because of this. Again, caffeine dehydrates. Drink plenty of water. Drink plenty of water anyway: at least 1.5–2 litres per day.

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Medium 9781855758117


Ierodiakonou, Charalambos Karnac Books ePub

Aristotle describes erotic love in the chapters of Nicomachean Ethics in which he examines the subject of friendship. Indeed the definition he gives to this type of love is made in comparison to friendship; a laconic definition: “Being in love (eros) is a kind of excessive friendship” (1171a). He explains this similarity by adding that in both friendship and love a person cannot have a close bond with more than one. It is a fact of life, he says, that an erotic love should be unique, like it happens in bosom companions.

The Stagirite connects erotic love with youth. His arguments are based on the similar behaviour of young people with that of those in love. In doing so, he proves himself remarkably observant regarding age changes and emotional conditions: Young people are inclined to get in love driven mostly by their emotions and passion. Their aim is pleasure, as it happens in friendships of youngsters. In both cases, these bonds are often temporary and feelings may change within one day following what the moment brings. Yet with the passing of years, tastes change and consequently different kinds of associations are sought. Young men become friends or get in love quickly, while old men do not.

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Medium 9781780491639

Chapter Six - Playing and Survival

Brenner, Ira Karnac Books ePub

“A hundred children—a hundred individuals who are people—not people to be, not people of the future, not people of tomorrow, but people now…right now…today”

(Korczak, 1967, p. 254)

Of the roughly six million unanswerable questions that may be asked about the Holocaust, one of the most perplexing pertains to the nature of “play”. While it is indeed amply documented through diaries and journals, as well as survivor testimonies, photographs, artwork, and poetry, it is not yet possible to have a full understanding of the meaning, purpose, and capacity to play under the conditions of sadistic, dehumanising, genocidal persecution. A young girl in the Warsaw ghetto simply put it this way:

When I am in play, I forget my hunger. I forget that outside are such evil Germans even existing. Early in the morning I rush to the child care center and I wish that the day would never end, because when it is getting dark, we all have to return home. In my room it is so full with dark shadows and black fear. (Eisen, 1988, p. 101)

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Medium 9781855753709

CHAPTER SIXTEEN: Is the brain more real than the mind?

Karnac Books ePub

Mark Solms


This paper reflects on the place of psychoanalytical thinking in a scientific context in which mental illness is increasingly being reduced to physiological and chemical factors. A small series of neurological patients with severe emotional disturbances is presented, in order to demonstrate that emotional symptoms can be neither described nor explained in physical terms. Even in cases where an organic aetiology is indisputable, physiological factors can only be invoked to explain somatic symptoms and the physiological correlates of mental symptoms. The mental symptoms themselves can only be understood psychologically.

There can be no doubt that mental phenomena are somehow related to physical and chemical processes. The mental effects of drinking alcohol (as opposed to water) suffice to prove the point. Yet, psychotherapists get uncomfortable when they are asked to consider the relationship between the mental phenomena they deal with in their patients, and the physical processes occurring in their brains. To think about their patients in this way seems somehow inhuman, and to miss the most essential point of what they are doing. It is as if the very foundations upon which they base their way of thinking about and helping their patients has been brought into question. Behind the question—what is the relationship between the mental phenomena that you deal with in your patients, and the physical processes occurring in their brains?—psychotherapists detect an implicit challenge. This challenge is based on the assumption that the brain is “more real” than the mind.

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Medium 9781782201984

Chapter Thirteen - Unlistenable

Wilson, Scott Karnac Books ePub


By definition, it ought to be impossible to produce literally unlistenable music, unless it were produced at frequencies that were audible only to dogs or aliens, in which case it would be listenable at least to them. At a certain point fairly early in his career, Masami Akita, the “Godfather” of Japanese noise-music otherwise known as Merzbow, consciously set out to produce a music that was accessible, designed to be heard, and yet was unlistenable in the sense of unmasterable, uncompletable, too formidable to encompass. (Akita, in Woodward, 1999, p. 40). It would be affirmed as music, but of such a degree of dissonance and discordance as to be unlistenable even to the avant-garde cognoscenti familiar with Varese, Cage, musique concrète, Stockhausen, free jazz, or, indeed, fans of the extremes of rock, Hendrix at his wildest, the Who at their most auto-destructive, heavy metal, industrial metal, grindcore, death metal…By reputation and critical reception, Merzbow exceeds them all.

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Medium 9781782200956

42 - Tokyo: When a “Splitter-Upper” Goes too Far

Covington, Coline Karnac Books ePub

Hired by a husband to seduce his wife, Takeshi Kuwabara made the mistake of falling in love…

Prosecutors in Tokyo called this week for Takeshi Kuwabara to be given a seventeen-year jail sentence for the murder of his lover, Rie Ishohata. This was no ordinary love affair gone wrong. Kuwabara had been hired by Rie's husband to seduce her in order to obtain grounds for divorce. In short, Kuwabara was what the Japanese call a “splitter-upper”. He made the fatal mistake of falling in love with his client's wife.

Kuwabara worked for one of the wakaresaseya—meaning “splitter-upper”—agencies that have multiplied in Japan over the past few years. The agents are basically private detectives who go a step further than your traditional gumshoe: they don't simply spy on their prey, they enter their lives in disguise in order to split up relationships. An initial consultation may cost 10,000 yen—about £70—and costs then escalate depending on the complexity of the case.

In the case of Kuwabara, he managed to engineer an encounter with thirty-two-year-old Rie as she was shopping in her local supermarket in a northern suburb of Tokyo. Calling himself Hajime, he innocently asked where he could find a shop that sold good cheesecake. They got to talking, one thing led to another, and they became lovers. The couple were eventually photographed entering a “love hotel”, all arranged behind the scenes by Kuwabara himself.

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Medium 9781780491295

CHAPTER EIGHT. Specificity of psychoanalysis and psychoanalytic sychotherapy

Perez-Sanchez, Antonio Karnac Books ePub

Definition of the problem

Before studying the subject of the decision as to the best kind of treatment for the patient, which we shall see in the next chapter, I think that the consideration of a previous issue—upon which this decision is based—is inevitable. Whatever options are chosen will depend on the therapist’s idea of the specificity characterising each one of them, particularly concerning the choice between psychoanalysis and psychoanalytic psychotherapy. As no unanimous agreement exists in this respect, I think it is necessary to include this chapter, in which I shall go over the state of the issue and define my position.

The need to mark the boundary between psychoanalysis and psychotherapy was noted by Freud in 1914, in order to differentiate it from the other psychological techniques of the time, such as suggestion and hypnosis. That which defines psychoanalytic method, he says, are those techniques that attempt to understand transference and resistance, and he adds,

Any line of investigation which recognises these two facts and takes them as the starting-point of its work has a right to call itself psycho analysis, even though it arrives at results other than my own. (Freud, 1914d, p. 16)

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Medium 9781904658580

7. The Altered Surroundings

Pennick, Nigel Aeon Books ePub

The chapel is the only major building that was built according to the plans of Henry’s projected college. Fuller, in his church history, writes ‘The whole college was intended conformable to the chapel: but the untimely death (or rather deposing) of King Henry the Sixth hindered the same’. Stow, in his Chronicle, says ‘I suppose that if the rest of the House had proceeded according to the chapel already finished as his (Henry VI – N.P.) full intent and meaning was, the like College could scarce have been found again in any Christian land.’

For many years, the only college buildings were the chapel and Old Court. Brick Building, south-east of the chapel, was built in the seventeenth century, and completed in 1693. It lasted until the nineteenth century. The separate timber-frame bell tower fell into disrepair and was removed in the eighteenth century. The site of the bell tower, thirty yards from the west door, appears as ‘crop-patterns’ in aerial photographs. Early artists’ depictions of the college show a pair of bowling greens next to the river, the space between them and the chapel being exactly the size of the cloister direct ed by the founder, but never built. These disappeared at the laying out of King’s Lawn in 1772.

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Medium 9781782203025

4 - Dreaming the Analytical Session: Between Pleasure Principle and Reality Principle

Karnac Books ePub

Roosevelt M. S. Cassorla

The analyst can feel lost and helpless when working with patients whose symbolisation capacity is deficient. The difficulty can be increased if the patient discharges raw elements into the analyst, attacking his capacity for dreaming and thinking. The analyst might be aware of what is happening but often his perception is numb. In these situations non-thought elements are not contained by the analyst who also discharges them. Occasionally he can give them back to the patient in raw state. Some impasse or interruption of the analysis might happen, sometimes traumatically. If the analyst recovers his mental functions he might later become aware of what happened.

In this chapter, based initially on Freud (1911b), I discuss post-Kleinian and Bionian developments regarding some technical aspects that allow us to deal with patients who have deficiency in their thinking capacity.

The development of the dreaming and thinking capacity

Freud (1911b) in “Two principles” states that “Neurotics turn away from reality because they find it unbearable—either the whole or parts of it” (p. 218).

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Medium 9781855751347

CHAPTER SEVEN. “And now for something completely different…”

Coltart, Nina Karnac Books ePub

When we consider how important supervision is thought to be during the training of a psychoanalyst or psychotherapist, it is surprising how little has been written about it. A lot of weight is ascribed to the supervisors’ reports during training, and yet this job, which demands high skills, may be comparatively new ground when one has clambered up the hierarchy far enough to be asked to do it. It is almost as if it has a special sort of privacy about it, which even experienced practitioners are reluctant to open up and write about; this is so even in the case of analysts who are perfectly prepared to write clinical papers that may be very revealing of themselves at work with patients. I recently attended a meeting of training analysts of the British Society at which the subject under discussion, supervision, possibly threw a little light on this in the sense that writing about supervision may betray that we do, at times, exert “undue” influence on our students. A particular aspect—choice of supervisors—was discussed at length, and the problem of the extent to which the training analyst influences the choice of his/her student came up. It was suggested, discussed, and then actually proposed that the analyst should never make any sort of influential suggestion to the student but should allow absolutely free choice. This seemed to me impossibly idealistic, to a degree that is totally unrealizable. Psychoanalysts, however well-analysed and self-aware, are only human and have their share of opinions, prejudices, likes and dislikes, rivalries and favouritisms. In fact, in some ways I believe we are a rather disabled profession, disabled in the sense that some of our ideals, and perhaps neutrality and not being hampered by these human attributes, are so inordinately difficult to maintain. Too often, one can become aware that illusions and self-deception grow in the attempt to reach or maintain ideals. And the further up the hierarchy we go, the greater our authority in our own limited sphere, and the fewer the checks and balances; truly, it becomes a case of quis custodiet ipsos custodies?

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Medium 9781855758520

CHAPTER ELEVEN: Severely traumatized patients' attempts at reorganizing their relations to others in psychotherapy: an enunciation analysis

Freedman, Norbert; Geller, Jesse D.; Hoffenberg, Joan; Hurvich, Marvin; Ward, Rhonda Karnac Books ePub

Sverre Varvin and Bent Rosenbaum

Several attempts in psychoanalysis have been made to arrive at a comprehensive understanding of symbolization processes leading from “raw” sense and perceptual impressions to mental representations, and further on to the establishment of emotional and symbolic meaning. The understanding of these processes is highly important when it comes to trauma. Post-traumatic states are dominated by deficits in mental processing and disintegrated images, thoughts, and feeling states that haunt the traumatized. The personality changes as a result of adaptation to these changes in the mental condition. This tends to diminish or incapacitate ego-functions, such as the ability for emotional regulation and symbolization.

In dealing with trauma it is of central importance that our psychoanalytic understanding covers the whole range from nonverbal, not-understandable, unconsciously sensed or apperceived mental states to a narrative integrating capacity with contained emotions, subjective truth, and the ability to take a third position, that is, the ability to reflect on one's own mental states.

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Medium 9781855756106

CHAPTER NINE: Desire and fantasme: A pathway (II)

Eidelsztein, Alfredo Karnac Books ePub

According to Lacan, the fundamental idea that reveals the nature of the relationship between desire and fantasme is that the neurotic expects desire to become “I desire this”, and the fantasme’s maneuver has to do with this purpose. There is no neurotic subject (as such) able to go beyond the question posed to the Other (which is in turn an answer to the Other’s question: “Che vuoi?”): “What do you want of me? It is a structural limitation.

Through the formula “What do you want of me?”, Lacan is telling us two things: first of all, that desire does not belong to the subject, it is not “the subject’s”. And secondly, that in so far as the subject is desired by the Other (since the desire of the Other is also unconscious) “it (the Other) does not know it”. The Other “does not know” what the subject is for it. And if the Other does not know it, the subject is most unlikely to know it.

In the human world—as it is established for the neurotic subject— desire, as a psychoanalytical concept, inscribes the function of lack both at the level of the desiring subject and at that of the desired object.

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