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Chapter Five - Epistemological and Methodological Preconditions for a Gestalt Therapeutic System

Gilles Delisle Karnac Books ePub


Epistemological and methodological preconditions for a Gestalt therapeutic system

In the preceding chapter, we analysed the theories of Perls, Hefferline and Goodman (1951) and Fairbairn (1954) with respect to four fundamental questions of Greenberg and Mitchell (1983) and concluded that the compatible and complementary natures of these two theories could indeed facilitate fruitful interactions and integrations.

Both theories share a relatively rare unitary vision of consciousness. For both, contact and relation are the primary realities. Contact zones, be they oral, anal, etc., as in psychoanalysis, or visual, tactile, etc., as in Gestalt, are functions that permit the initiation and development of contacts and relations. In both, the Self is seen as possessing its own energy and oriented toward the real Field from the very beginning.

The two theories, as we have seen, present numerous complementarities, in the sense that an area neglected by one will be developed by the other, in mutually respectful ways. For example, as already noted, Perls et al. are silent on the important question of development, while Fairbairn advances a theory of development based on early interactions with the mother, a theory consistent with Gestalt thinking in that there is a passage from infantile dependence (confluence) to mature dependence (contact within the Field). Again, as we have seen, the Gestalt theory of the organism/environmental Field throws a remarkably clear light on the processes by which the Self interacts with the environment, but neglects the structural aspects of a Self that is considered essentially as a unified spatial-temporal event occurring at the contact boundary. In contrast, Fairbairn focuses on the developmental processes that permit an understanding of the intra-psychic dynamics underlying that interaction. However Fairbairn, in turn, does not elaborate, as do the Gestalt therapists, on the object relation modalities that allow the internal object to persist and regenerate.

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Medium 9781855750142

5 Hypothesizing

David Campbell Karnac Books ePub

We think it is helpful to make a distinction between a systemic hypothesis or formulation, and a working hypothesis. A systemic or overall hypothesis represents the therapist’s view on the connection between beliefs, behaviour and relationships that he or she arrives at after working with the family. A working hypothesis is a tool which enables the therapist to interview the family and explore certain beliefs, behaviours and relationships which eventually lead to an understanding of the meaning which the problem acquires in the wider system. As such it is a set of ideas that stimulates the curiosity of the therapist (see Cecchin 1987) and leads him into certain areas and not others. It also enables him to make connections between his own thinking and the feedback he receives from the family. For example, with the Johnson family, the initial working hypothesis based on the referral information was as follows:

The boys and the mother in the family seem close and the father somewhat peripheral. Maybe Mrs Johnson married a husband who could be a father for herself, and maybe Mr Johnson wanted an organizing mother as a wife so he could get on with his career. Now the first child is leaving home and the status quo is being challenged; also, as the boys get older, they may want to get closer to father. This tentative explanation allowed the therapist to explore the meaning for family members to present relationships and behaviour, and to generate new information from family members about the way they see and experience relationships.

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Medium 9781855753488

CHAPTER ONE: Introduction: the context. A perspective on work organization in the twentieth and early twenty-first centuries

Lisl Klein Karnac Books ePub

In 2006, the winner of the Best Actress award in the Hollywood I Oscars said, “I just want to matter and live a good life and make work that means something to somebody.” In 2003, a young woman who had just landed an exciting, well-paid job that she had very much wanted, was already looking beyond it and said, “It will look good on my CV afterwards.” In 1944, a German refugee servant girl could see nothing beyond her situation and found comfort in a hymn, “Lord of the pots and dishes”. In their very different circumstances, and with their very different perspectives, all of them were looking for meaning in their work.

Work has always been central to human existence, though its content as well as its meaning for individuals and their societies continue to change and evolve as historical, technical, and economic circumstances change. In this chapter I present some of the background to the papers in this volume, which arose at various times during the second half of the twentieth century and the beginning of the twenty-first century. It is, of course, impossible to be comprehensive, and it would be foolish to try. I provide some indications of context where I know about it. That means that the more detailed historical background tends to have a European and British focus. It also means that I need to give some of my own background, to explain both why this has been such a preoccupation—not as an interesting topic for academic study, but as a vital aspect of human and social life—and how the papers arose.

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Medium 9781782200024

Chapter Twelve - Orpheus, Eurydice, Blanchot: Some thoughts on the Nature of Myth and Literature

Sanja Bahun Karnac Books ePub


Orpheus, Eurydice, Blanchot: some thoughts on the nature of myth and literature*

Lyndon Davies

The myth of Orpheus and Eurydice has always been a staple of western European culture, a thematic and symbolic resource for writers, craftsmen, and artists in every age and genre. Even now, in our post-modern era, it's apparent that the tale has lost none of its fascination for creative practitioners; in fact, if anything, it's more popular than ever: poets, composers, painters, choreographers, dramatists—at the moment everyone seems to want a piece of Orpheus.

The more you look into it the more you begin to feel that maybe this particular yarn has been done to death, but then there always seems to be something more to say about it, and it always seems to have something more to say about us. As a story it covers so many of the human bases: love, joy, loss, fear, mourning, disintegration, and no doubt this is one of the reasons for its popularity. But at the same time it seems so apposite to the artist's situation, so congruent with the inner shape of the creative process, not least in its depiction of a consuming passion, a commitment potentially destructive in its intensity. At bottom you could say it's a story about death, and about the search for reparation for that potentially catastrophic event. Reparation, that is, through the power of art. Orpheus loves Eurydice, who dies, so Orpheus goes down into Hades to rescue her. By the beauty of his song he charms the infernal gods into releasing her, then loses her again by defying the gods' injunction not to look back. Orpheus' search for reparation, beginning from the sense of an irreparable loss at the surface of things, echoes the human drama in a civilisation whose validating rituals have been drained of power. But it also parallels the artist's humiliating search for the true poem, the true painting, the truest song, the one that completes the chain of yearning, if only for the merest particle of a moment.

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Medium 9781855753532

CHAPTER EIGHT: Trauma, memory, and the brain

Anne Kearns Karnac Books ePub

In my early teens I, like most other Americans, was bombarded night after night on the six o’clock news by the atrocities taking place in Vietnam. It was hard to imagine then that anything good would come out of America’s extended ‘police action’ there. Once the Americans pulled out of Vietnam and turned their attention to the Middle East, and to the oil that replaced Communism as the new national obsession, Vietnam was rapidly forgotten. In New York, where I lived, returning war veterans were usually honoured by a hero’s welcome complete with what’s known as a ‘ticker-tape’ parade through the financial district. This did not happen for the Vietnam veterans until ten or so years after they came home, once someone made the connection that the way the young men who had fought in Vietnam were ignored on their return by a nation that was on some level ashamed to acknowledge them contributed to their posttraumatic experience. Just like the soldiers who returned from the First World War suffering from ‘shell shock spurred an interest in the clinical treatment of trauma, so id the Vietnam vets. Three out of four who had experiénced heavy combat with its associated atrocities suffered symptoms of what came to be known as post-traumatic stress disorder (PTSD).

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Medium 9781855758698

5. Book Review of Psychanalyse de la Musique (1951)

Heinz Kohut Karnac Books ePub

Much of the psychoanalytic literature on music, sparse as it is, has escaped the author’s attention (e.g., Ferenczi’s [1921] classical description of the use of music in the course of psychoanalytic therapy). In other respects, too, the book is often sketchy, and can hardly be called a monograph in the usual sense. The author, who seems to be pedagogue, psychoanalyst, poet, and musician, composed the volume from several articles written during a period of five years, which may account for some of its unevenness.

The two greatest weaknesses of Michel’s approach are insufficient documentation and—even more detrimental — an almost exclusive preoccupation with genetic id psychology, which leads to an overly schematic classification of composers according to the classical stages of the development of the libido. He is most convincing where he does not try to establish genetic links from scanty biographical data, but restricts himself to the connections between the composer’s character and his work: Stravinsky, e.g., is orderly, tyrannical, and opinionated; he has an exaggerated disgust for bad odors; the anal components of his compositions are aggressive rhythms, cruel harmonies, and a predilection for percussion instruments; his use of brass instruments to play his sweetest melodies is rightly recognized as a form of magical undoing of destructive tendencies through music. Excellent, too, is the chapter on Johann Sebastian Bach and the historical conservatism of the superego. An unconscious yet active Catholic medieval superego enforced a political as well as an artistic compromise after the Reformation had externally succeeded. Politically, submission to the Pope was replaced by submission to the prince; in the artistic sphere, the dominance of plastic art with its symbol of medieval anonymous collectivism, the cathedral, was replaced by a cathedral of sounds, the music of Bach. Michel corroborates his theory by pointing out that during the Reformation the musical style in the Protestant countries changed, with Schutz, from the former Flemish influence to the Italian (Catholic) tradition.

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Medium 9781780491929

Preface: The Moving on Groups

Sue McNab Karnac Books ePub

Sue McNab

Some years ago, the Moving On Group started as a multi-family group working with families where a young (and at times not so young) adult has got “stuck” living at home with their parents as a result of mental health difficulties. For some families, psychosis has taken over their lives: for others extreme anxiety, Asperger's syndrome, and obsessive–compulsive disorder means that they are, as yet, unable to take up an independent lifestyle. Sometimes, the young adults come to the meetings, but more often the parents come on their own.

The group, based on systemic principles, offers a facilitated space to share stories about their situations and worries, to offer mutual support, and to find ways of living alongside chronic struggles if they cannot be moved beyond. Its members might describe it as a “sort of family” where people can bare their souls safe in the knowledge that they will be understood and accepted. They tell each other their individual family stories, report progress or lack of it, and witness and take pride and pleasure in the “high points” of others’ progress even when their own situations are highly stressful and painful. The quality of listening within this group is quite exceptional and moving to witness.

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Medium 9781855753921


Joseph Schwartz Karnac Books ePub

Rachel Wingfield

Is our capacity to tolerate frustration directly linked to our capacity to experience sexual pleasure? This provokes all sorts of questions. Is tolerating frustration the same thing as anticipating pleasure? I am wondering why anticipating or experiencing an increasing intensity of pleasure would be conceived of, or experienced as, frustration? Is that inevitable? Or does the very fact that arousal is experienced as frustration tell us something about that person’s own developmental history?

As an interesting exercise I asked colleagues and friends to imagine, in fantasy or memory, an experience of the most delicious sexual passion. I approached a range of people: male and female, gay and straight. I got a diverse range of responses, a range of experiences: some people imagined giving pleasure to their partner, rather than aiming towards orgasm for themselves; others thought about the moment of orgasm itself, and of feeling fully satisfied. Some thought about having sex, others about realizing for the first time their desire for someone, and the excitement of that promise of connection.

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Medium 9781855759428

CHAPTER TWENTY TWO Exile and bereavement

Jean Arundale Karnac Books ePub

Barbara Hart


It has been pointed out by Grubrich-Simitis (1984) in relation to the survivors of the Holocaust, that whereas in psychosis a disruption of inner reality is experienced, for the survivor the catastrophe is an actually experienced external event, though with massive effect on the internal reality. It is the collision of external and internal realities which I will examine in considering the impact of bereavement in the context of the multiple traumas of exile. While this collision is a feature of bereavement in general, there are particular factors, internal and external, which have an effect on the mourning process in exile and increase its difficulty.

Psychological implications of exile

The experience of exile itself has been characterised as one of multiple bereavement (de Wind, 1971; Munoz, 1981; Grubrich-Simitis, 1984) in terms of loss of country, status, activity, cultural reference points, social networks, and, above all, of family.

There is also the commonly experienced sense of ‘lost time’, i.e. hopes, ambitions, expected life-pattern disrupted, for example, by periods of imprisonment or being in hiding, or by discriminatory laws. These losses are often experienced simultaneously as a massive, pervasive trauma, or cumulatively.

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Medium 9781855752436

7. Some reflections on comparing obsessional neurosis and autism

Joan Symington Karnac Books ePub

Mauro Morra

Mauro Morra compares obsessional neurosis with autism, which always has obsessional features. He finds that omnipotent control is the underlying structural element shared by both, and he comments that Meltzer sees them as the same—both involving an attack on certain mental capacities. An autistic nucleus is illustrated in four clinical cases ranging from childhood to adulthood. The chapter includes comments by Frances Tustin, who suggests that the over-closeness between mother and infant is sensual, not emotional.

I have always been struck by the fact that there are certain similarities in the symptoms of adult obsessional neurosis and child autism, which undoubtedly are two separate disorders. The main common features that we can find both in the literature and in our practice are the withdrawal of affects and the presence of obsessional tendencies.

On the question of whether the presence of common symptoms in the two illnesses is fortuitous or whether there is, on the contrary, some underlying similarity in personality structure, I do not have a definitive answer, but I am inclined to think that there are some important common features in both those organizations of the mind.

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Medium 9781780491110

Chapter Eight - The Oedipus Complex and the New Generations

Pierre Benghozi Karnac Books ePub

Philippe Robert

When the primal pack became a group and began to be structured by the prohibition of incest, guilt and a feeling of belonging came to provide the framework for bonds of alliance and friendship. Have couples and families really changed since this founding event? As we try to answer this question, let us first recall many psychoanalysts’ views on the supposed changes in psychopathology. As early as the 1950s there seemed to be far fewer cases of hysterical pathologies, and even of so-called “classic” neuroses. Conflict between the ego and the superego seemed to have been replaced by a depressive relationship with an unattainable ego ideal. People were already speaking of new pathologies, as Ehrenberg points out in his work (2010) La Société du Malaise.

In a parallel movement, but one belonging to the same register, a more and more culturalist has been developing. This was already present in the work of Erich Fromm (1971) and Karen Horney (1937); it becomes very significant—though there it takes a different form—in the works of Alexander (1930) and Hartmann (1939).

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Medium 9781782203490

Chapter Eleven: Reflections on the Treatment of Dissociative Identity Disorder and Dissociative Disorder not Otherwise Specified—a Closer Look at Selected Issues

Valerie Sinason Karnac Books ePub

Richard P. Kluft

Coons (1986) followed up the work of twenty clinicians, each treating one patient with dissociative identity disorder (DID), then called multiple personality disorder (MPD), for an average of thirty-nine months. Nineteen had not treated DID before. Twenty-five per cent of their patients achieved and sustained complete integration as defined by five of the six criteria used in Kluft's studies (Kluft, 1984a, 1986). Others had achieved partial integrations, or complete integrations that proved unstable. Two-thirds were reported much improved. Psychodynamic psychotherapy and hypnosis were the primary therapeutic modalities. Treatments averaged only one session per week, half the intensity currently recommended (International Society for the Study of Trauma and Dissociation, 2011). No other study offers comparable insight into therapeutic encounters between non-specialist therapists and stringently diagnosed DID patients. Coons’ patients resembled the early cohorts reported by Kluft (Kluft, 1984a, 1986), an experienced therapist employing similar therapeutic techniques.

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Medium 9781855758773

CHAPTER TWELVE: Learning, development, and psychopathology: applying chaos theory to psychoanalysis

Fred M. Levin Karnac Books ePub

Fred Levin

“Nothing in nature is random … A thing appears random only through the incompleteness of our knowledge”

(Baruch Spinoza, cited in Gray & Davisson, 2004)

“Our job is not to penetrate … the essence of things, the meaning of which we … [cannot perfectly] know anyway, but rather to develop concepts which allow us to talk in a productive way about phenomena in nature”

(Niels Bohr, cited in Nielsen, 1977)


This chapter assumes the reader’s knowledge of Priel and Schreiber’s work (as covered in Chapter Eleven). It begins with a review of the pioneering contributions regarding how best to apply chaos theory to psychoanalysis. However, in spite of the increasing number of publications on the subject, there remains an urgent need to make this difficult subject more readily understandable by individuals (read here, psychoanalysts) not trained specifically in mathematics.

A lone American reviewer (Levenson, 1994), and both of the British reviewers mentioned in Chapter Eleven, Gardner and Denman, are quite skeptical that anything useful for psychoanalysis will ever come from chaos theory. However, the majority of the authors covered strongly disagrees and sees great potential for chaos theory benefiting our field: In the United States Galatzer-Levy (1978, 1995, 1997) and Moran (1991) describe the utility of chaos theory in explicating development, quantitative to qualitative shifts, and the importance of recognizing fractal-like signatures in psychoanalytic clinical material; Levin (1996a, 1997a,b) believes chaos theory offers a unique vocabulary and perspective which can further our understanding of learning, development, and psycho-pathology; Forrest (1991a,b, 1995, 1996a) explores the vast domain of artificial intelligence and chaos theory, finding much that can be positively applied to developmental psychology and psycho-pathology; Gleick (1987), Moran (1991), and Spruiell (1993) explain nonlinear dynamics (another name for chaos theory), raising a broad range of theoretical issues; Sashin (1985) and Sashin and Callahan (1990) demonstrate stunning but generally as yet unappreciated results86 employing unique affective response models, and these need amplification; and Moran (1991) and Galatzer-Levy (1995, 1997) have each made thoughtful integrations, the most important of which appears to be the idea that psychoanalytic process reduces psychopathology by adding complexity to mental functioning. In this regard, Palombo (1998), writing about coevolution,87 sees dreaming as “the edge of chaos” (p. 261), resulting in nothing less than the adaptive reorganization of memory (i.e., learning), just as we have indicated seems a reasonable conclusion from the experimental literature.

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Medium 9780253334114


Alfred C. Kinsey Indiana University Press ePub

The specific sources of the reported, recorded, and observed data utilized in making this volume are described in the present chapter. The use that we have made of the previously published studies on human sexual behavior is also described. Since the data reported in our series of case histories constitute an important part of this volume, the nature of those data is described in some detail in this chapter, and critical tests of the reliability and validity of the case history data are also presented here.

All of the case histories in this study have been obtained through personal interviews conducted by our staff and chiefly by four of us during the period covered by this project. We have elected to use personal interviews rather than questionnaires because we believe that face-to-face interviews are better adapted for obtaining such personal and confidential material as may appear in a sex history.1

Establishing Rapport. We believe that much of the quality of the data presented in the present volume is a product of the rapport which we have been able to establish in these personal interviews. Most of the subjects of this study—whatever their original intentions in regard to distorting or withholding information, and whatever their original embarrassment at the idea of contributing a history—have helped make the interviews fact-finding sessions in which the interviewer and the subject have found equal satisfaction in exploring the accumulated record as far as memory would allow. Persons with many different sorts of backgrounds have cooperated in this fashion. Females have agreed to serve as subjects and, on the whole, have contributed as readily and as honestly (p. 73, Tables 3–8) as the males who were the subjects of our previous volume. Apart from rephrasing a few questions to allow for the anatomic and physiologic differences between the sexes, we have covered the same subject matter and utilized essentially the same methodology in interviewing females and males.2

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Medium 9781780491332

Chapter Eight - Wetlands (Feuchtgebiete)—or: Rage, Body and Hysteria

Ingrid MoesleinTeising Karnac Books ePub


Wetlands (Feuchtgebiete)—or: rage, body and hysteria

Thomas Ettl

Les genous sales sont le signe d'une fille honnête.”

—Brouardel, cited by Freud, 1913


This Chapter deals with eighteen year-old Helen, protagonist of the novel Wetlands by Charlotte Roche, a 2008 bestseller. Helen seems the likely representation of a young, modern form of hysteria. With her licentious, permissive sexual life she is trying to solve her various problems. She looks for confirmation that she is desirable, tries to master her excitement resulting from her Oedipal phase and hopes to comfort her loneliness as a child of divorce. Moreover she wants to explore her body, to complete her body image and finally to restore the unity of the anatomic, visible body and the sensitive body (Leib), which was destroyed by her mother's hygiene rituals. With a very painful self-mutilation she seeks to gain control over her parents. They should re-unite as a couple, so that Helen can feel herself as a child of love, which is required for her narcissistic balance.

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