2015-16 Site Training (London)
Block 1 & 2 – Stephen Gee and Peter Wood
We will be opening a conversation which will last for the 10 weeks. To make this possible Stephen Gee and I will be doing our best to engage an analytical inquiry into the nature of the (counter) transference and how it and its effects might be demonstrated. Stephen will lean more to psychoanalytical theory, I will lean more into psychoanalytical research. Our work will link in with Val’s sessions on the transference later in the year.
Stephen:
What is Countertransference? An indication that the analyst needs more analysis? A valuable clinical tool?
For Freud and Klein it was the former.
From the early 50s a proliferation of theorisations elaborated ‘the Countertransference’ as a key to the analyst’s sense of the patient’s state of mind in the session. With this came an orientation to the ‘hic et nunc’ of the session over and above a tracing back of the ‘symptom’ in the patient’s history. Lacan started a rearguard battle against this trend as part of his insistent return to Freud. The current situation is complex. Positions that were once calls to arms defending theoretical and clinical turf are no longer held with such conviction. This can make finding one’s own way as an analyst more challenging and possibly more interesting. As my titles indicate, clinical advances or illuminations in psychoanalysis are overdetermined but one element is trauma, particular to the subjectivity of the analyst in her/his own historical time and place.
These seminars relate to those earlier in the year on the psychoanalytic field.
Everything is on PEP except Lacan and Beckett and Connor.
Discussion.
Peter on psychoanalytical research.
Nowadays health workers of one sort of another are required to testify to their worth by proving that their practices have ‘demonstrable’ and ‘beneficial’ clinical worth.
The language of the courts has invaded the world of medical treatment, and latterly institutional psychoanalytical ‘treatment’ : There is talk of ‘evidence’, ‘proof’ and the such like. What is more, proof of efficacy is used in much the same way as precedent in the courts; authorities loom large. These movements, in turn, impinge on our own practices.
Along the way, over the 10 weeks, I want us to elaborate, clarify, and differentiate the position of psychoanalyst from that of the researcher. I am not supposing the positions ‘psychoanalyst’ and ‘researcher’ are incompatible, the two places cannot but overlap so we will pause and consider Freud’s notion of the ‘junktim’.
On the research side I will attend to:
- An exploration of the properties of ‘data’ and the sort of data which might be necessary to show psychoanalytical effects.
- Does psychoanalytical research have much to offer?
- the ‘effect’: Is causality anyways, as is commonly understood, a satisfactory way of understanding complex phenomena? Here we might think about the link interpretation and theory. I hope that Anssi Pereraklya can help in his work as a conversation analyst and psychoanalyst.
- We have the phenomenological critique as a backdrop starting the rejection of a Cartesian binary which pretends that researchers can be fantastically separated the data they produce.
The research material will be copied – will inform you later.
Galatzer-Levy et al in Does Psychoanalysis Work?
This dense and well researched text book has much to offer those more numerically inclined. They, quite uniquely, start by asking:
Chapter 1: What is Psychoanalysis?
These writers are however devoted to quantitative methods and some familiarity with this approach will be useful, no matter its problems. This is a paper on a famous study, reading the background first:
Chapter 4: Historical Background
Chapter 5: The Menninger Foundation: Psychotherapy Research Project
Compare this to:
Chapter 20, The Single-Case Study Method
Then, from the same textbook: Some General Problems of Psychoanalytical Research.
We return to Dreher with:
Chapter 4, Conceptual Research, in the Hampstead Index Project
Coming from a phenomenologically-informed perspective we can look at Anssi Peraklya in Conversation Analysis and Psychotherapy, specifically:
Chapter 6: Conversation Analysis and Psychoanalysis: Interpretation, affect, and intersubjectivity. Interesting stuff, very different. Anssi is both sociologist and psychoanalyst.. I think he manages to demonstrate something that the number crunchers can not demonstrate: “minds entwined”. A fascinating exploration of mind-melding.
Block 3 – Chris Oakley
Jacques Derrida and Psychoanalysis.
Reading
Hopefully the seminars will be accessible to those who have done no reading whatsoever. This is not to encourage people not to read, a will to ignorance. Far from it. But merely to recognise that there are times that our preoccupations may be elsewhere. So the aim of the seminars will be to set out a lattice work of spore potential, the mycelium principle, from which who knows what will emerge…and when.
The principle text will be Derrida’s “Resistances of Psychoanalysis” (Stanford University Press 1998), and Benoit Peeters’ “Derrida A biography” (Polity 2013) will provide a backdrop. But the latter is a big read, over 500 pages so other possibilities are Jason Powell’s biography (continuum 2006) and “Derrida reframed” by K.Malcolm Richards (IB Tauris 2008). but one that is so bad it provokes a curious fascination is “Who was Jacques Derrida? an Intellectual biography” by David Mikics (Yale University Press 2009). And of course there are numerous other introductions to Derrida’s initiatives. And finally Gilles Deleuze and Felix Guattari’s “Anti -Oedipus: Capitalism and Schizophrenia” (Penguin Classics 2009) pp 273-382 and, not to be missed, Foucault’s preface.
Block 4 – Val Parks
Transference and Truth: Imaginary, Symbolic and Towards the Real
Though transference has been a key term of psychoanalysis since its inception, there are as many versions of it as there are theoreticians. Without seeking to impose a simplistic conflation on such variety, these seminars will offer a map through some of the terrain. The guiding thread we follow is how and for what purpose to make use of the transference clinically and to consider if it is ever possible to resolve transference. Is it true that “Psychoanalysis Never Lets Go” or is there a ‘beyond’ of the transference?
Block 5 – Peter Nevins and James Mann
Looking at how psychoanalysis treats Privacy in relation to the Self
We are looking at the idea of privacy in relation to psychoanalysis and notions of the self. Why do we need private space and what function does it serve? A friend went into 5x weekly analysis hoping to have the experience of another person ‘really knowing him’ ,hoping to feel more substantial as a consequence of this .When he had concluded his analysis I asked him ‘ did you tell her everything then??’ He smiled and said ‘ of course not, I couldn’t bring myself to say some things’… How much do we really want to be known by another, why is this openness so difficult to bear? We will be examining several papers in which notions of private space feature prominently, from Winnicott through to the work of Masud Khan, Andre Green / Philips and Bersani and finally Judith Butler.
Block 6 – Barbara Cawdron and Keith Armitage
Almost anyone working as a therapist within the NHS or the voluntary sector will experience working with patients diagnosed with Borderline Personality Disorder. A 1998 study put the prevalence rate among adolescent and adult psychiatric inpatients at 49% and 43%, respectively. Yet it remains a controversial and stigmatising diagnosis with traditionally a 3:1 ration of women to men so diagnosed, although some recent surveys indicating an approaching gender balance. Over five weeks we will look at the nosological evolution of the “Borderline” concept within American and European psychoanalysis and some of the disputes around it. We will seek to ask questions of the concept whilst thinking about developing appropriate psychoanalytic strategies for working with those presenting with this diagnosis and associated ways of being.
Moving from the history of this diagnosis, we will look at its future. Some studies put the incidence of histories of childhood sexual abuse amongst those with this diagnosis at up to 75% yet this is under-addressed within psychoanalytic formulations of this “condition” where the focus remains on early mother-child (mother-daughter?) interactions. Indeed, Fonagy et al (2004) describe one of their cases, “Henrietta”, as being “unusual from a psychoanalytic standpoint” because of her history of sexual abuse. Does the ongoing reformulation of some aspects of BPD as Complex Post-Traumatic Stress Disorder clarify its links with abuse, does it offer a relief from stigmatisation for those suffering; does it offer victims a voice that has been silenced by earlier formulations?
Adolph Stern is credited with creating the term Borderline. Writing in 1938, he identified already growing numbers of “Borderline” patients that could not be effectively helped by the classical psychoanalytic technique of the time. Helene Deutsch writing in 1942, approaches the problem from a different angle with her concept of the “as-if personality” who suffers various forms and degrees of dissociation and a failure to achieve “integrated” personality functioning and object-relationships, and which did much to inform subsequent psychoanalytic thinking. Each approaches the condition from different sides of the border; Stern as neurotic disturbance, Deutsch as an expression of psychotic disturbance. Do these early formulations influence more current ones? Can we still learn from them?
It has often been remarked upon that the rise to prominence of “the borderline case” coincided with the diminution of the clinical importance of hysteria and, perhaps, the disappearance of the hysteric from American and European consulting rooms. We will look at two papers that look at the changing face of hysteria during this period and the relationship to borderline phenomena. Khan postulates that the contemporary hysteric experiences a profound dissociation between sexual experience and ego capacities, perhaps as a result of a traumatic mixture of excitement and frustration in early experiences with the mother. He also relates the sexual “actings-out” in his “bad”, grudge-laden hysteric with Winnicott’s anti-social tendency. This will give us further space to think about the forms and meanings of sexual expression and sexuality in the patient identified as “borderline”.
Kernberg mediates an object-relations perspective, strongly influenced by Melanie Klein, for an American readership. He comprehensively addresses the adoption of clinical technique for dealing with what he views as profound intrapsychic and interpersonal disturbance. He views “primitive dissociation” and “splitting” as the characteristic resources of the patient fuelled by a basic aggressivity. The resulting changes to technique focus on the here and now of therapist-patient interaction. We will look at the need for “management” and related concepts of “holding” and “containment
Drawing on attachment theory and neuroscience Peter Fonagy, Freud Memorial Professor of Psychoanalysis at UCL, and his collaborators offers a developmental view of borderline disorders. Like Kenberg, his approach closely focuses upon therapist-patient interaction in the moment. His approach has become the key psychodynamic paradigm with the NHS. The text is a monumental one and we will give detailed readings later. One sidelight, despite the volume’s size, the “unconscious” does not merit a single entry in the subject index. What do we make of its disappearance from contemporary
Moncayo, R (2008) “New Lacanian Perspectives on Depression: From the Presence of Emptiness to the Emptiness of Presence and Development” in Evolving Lacanian Perspectives for Clinical Psychoanalysis: On Narcissism, Sexuation and the Phases of Analysis in Contemporary Culture London: Karnac
A reductive reading of Lacan would dispute, even ridicule, the concept of the borderline disorder, dismissing it as the result of lazy or inadequate diagnostic systems. Picking up again the history of Lacan’s engagement with English middle-group psychoanalysis and the work of Margery Little in particular that Stephen will have introduced earlier in the year, we will float the possibility that Lacan in fact offers something more nuanced. His approach is also reflected in the contribution of the California-based Chilean analyst Raul Moncayo. Those intrigued by Little’s accounts may want to seek out her once hugely controversial account of her analysis with Winnicott. Little describes herself as a borderline patient and describes her hospitalisations and her violence towards Winnicott and her analyst’s attempts support her journey to health.