The "Oceanic Feeling" and Confrontation with Death.

Freud's explanation of Rolland's "oceanic feeling" is reconsidered in the light of similar phenomena that occur in the face of impending death, such as the experiences described by Socrates in Plato's Phaedo, and the aesthetic and transformational experiences described by Christopher Bollas. These phenomena are included in what Karl Jaspers calls "ciphers." Other examples are presented to indicate the need to consider such phenomena in human psychology, phenomena that have been neglected in psychoanalysis due to the profound but arbitrary influence of Freud's analysis of the "oceanic feeling," an analysis based on the outmoded rigid assumptions of classical nineteenth-century science.

What hath freud wrought? Current confusion and controversies about the clinical practice of psychoanalysis and psychodynamic psychotherapy.

This article discusses the current state of psychoanalysis and the challenges to the fundamental premises of Freud's psychoanalysis by those who have shifted to relationship or so-called two-person psychologies in our field. The author begins by briefly describing a parallel to the recent history of psychoanalysis in the sudden rise and fall of scholastic philosophy in the 14th century. He then focuses on contemporary attacks on Freud's psychoanalysis as a science, based on the contention by two-person psychologists that free association by the patient and evenly hovering attention by the analyst are actually impossible. He reviews Freud's idea of psychoanalysis, discusses psychodynamic psychotherapy, both conceived as scientific treatment procedures, and describes the current assault on their metapsychological and epistemological foundations. Returning to the parallel between what happened to medieval scholasticism and what has happened to psychoanalysis, he examines why this happened, and the resulting fragmentation of psychoanalytic practice. The article concludes with suggestions for the integration of various schools of psychoanalysis, reminding us of Benjamin Franklin's warning: "We must, indeed, all hang together or, most assuredly, we shall all hang separately."

Special problems for the elderly psychoanalyst in the psychoanalytic process.

The psychoanalytic process takes on a special ambience when the analyst is clearly elderly. The effects of this ambience on the the aging analyst's patients are discussed, and the sparse literature on the subject is reviewed. Clinical vignettes illustrate a number of these effects on the analytic process. Dealing with these special problems requires not only the analyst's awareness of their existence but a continual monitoring of the transference-countertransference in order to avoid a silent collusion of patient and analyst to pretend these problems do not exist. The dangerous consequences of being unaware of the situation, for both patient and analyst, are discussed. If the influence of the patient's perception of the analyst's aging is ignored, it may lead to destruction of the treatment either through massive acting out or by a hopeless stalemate with or without the development of an endless psychoanalysis.

Introduction: commentaries and author's response to "The rise and fall of the autochthonous self: from Italian Renaissance Art and Shakespeare to Hediegger, Lacan, and Intersubjectivism" by Richard D. Chessick.

This article addresses the unresolved question of the existence of a private core autochthonous self, as it has been described by Winnicott, Modell, and others. The postmodern version of the self has eliminated this concept entirely, relegating the self to a changing and unstable display, or regarding it as totally chaotic, or even an illusion. The question is raised whether by returning to the origins of this notion of a private self and then tracing its apparent dissolution it might be possible to discover some evidence that it still exists. The methodology used is that of obtaining knowledge directly through the arts and the claim is made that because empirical science has clamored to be the only source of knowledge, we have lost what could be obtained by direct intuitive seeing and experiencing the works of creative geniuses. To explore the rise of the autochthonous self this article provides an examination of the shift from Gothic art to Italian Renaissance art, a time which engendered the origin of "man" with his or her elusive private individual self that then became expressed in changing works of art. As this spread north, Shakespeare appeared and similarly invented and illustrated in his characters the private individual self, a concept not appreciated or recognized before the Renaissance. But as science arose and Western civilization began to decline, a corresponding disillusionment with "man" took place. The self began to be viewed as solely a social construction with no core except perhaps a genetic endowment. This was accompanied by a reduction in the concept of the human as a valuable and precious living being and was replaced by regarding the human as an object of control and exploitation. After the Second World War a movement in contemporary United States psychoanalysis gradually replaced the ideas of Freud and his emphasis on the "I" in the psychoanalytic process, with forms of relational therapy, assuming that the self was ab initio intersubjectively formed and could be altered fundamentally by focus on intersubjective processes. The author contends that this attitude makes it less likely for the psychoanalyst to focus on the regressive transferences from which derivatives of the private self arise and to grasp the phenomenological whole of the patient (p. 625).

The rise and fall of the autochthonous self: from Italian Renaissance art and Shakespeare to Heidegger, Lacan, and intersubjectivism.

This article addresses the unresolved question of the existence of a private core autochthonous self, as it has been described by Winnicott, Modell, and others. The postmodern version of the self has eliminated this concept entirely, relegating the self to a changing and unstable display, or regarding it as totally chaotic, or even an illusion. The question is raised whether by returning to the origins of this notion of a private self and then tracing its apparent dissolution it might be possible to discover some evidence that it still exists. The methodology used is that of obtaining knowledge directly through the arts and the claim is made that because empirical science has clamored to be the only source of knowledge, we have lost what could be obtained by direct intuitive seeing and experiencing the works of creative geniuses. To explore the rise of the autochthonous self this article provides an examination of the shift from Gothic art to Italian Renaissance art, a time which engendered the origin of "man" with his or her elusive private individual self that then became expressed in changing works of art. As this spread north, Shakespeare appeared and similarly invented and illustrated in his characters the private individual self, a concept not appreciated or recognized before the renaissance. But as science arose and Western civilization began to decline, a corresponding disillusionment with "man" took place. The self began to be viewed as solely a social construction with no core except perhaps a genetic endowment. This was accompanied by a reduction in the concept of the human as a valuable and precious living being and was replaced by regarding the human as an object of control and exploitation. After the Second World War a movement in contemporary United States psychoanalysis gradually replaced the ideas of Freud and his emphasis on the "I" in the psychoanalytic process, with forms of relational therapy, assuming that the self was ab initio intersubjectively formed and could be altered fundamentally by focus on intersubjective processes. The author contends that this attitude makes it less likely for the psychoanalyst to focus on the regressive transferences from which derivatives of the private self arise and to grasp the phenomenological whole of the patient.

Returning to freud.

In this article I attempt to renew interest in the importance of Freud's work for both the practice of psychoanalysis and in the training of psychoanalysts. I hope to stimulate readers to return to Freud's writings in detail, which seem to be increasingly neglected these days both in training and in the many conflicting contemporary models of psychoanalysis. I propose that the identity of psychoanalysis can still be based on Freud's work, and his approach can form a fundamental center from which there are various channels of divergence that may be useful when the patient seems to need them. But the centerpiece of our training and our orientation, I suggest, should be the basic principles spelled out in Freud's numerous volumes, in spite of the many changes and contradictions and even outright mistakes and cultural blindness he displays in some instances. I proceed to review some of these basic principles in the hope of persuading the reader to return to Freud again. I present these with some commentary from my own 50 years of clinical experience. I briefly review the clinical cornerstones of Freud's approach as developed in his early books, his controversial papers on technique, and his later emendations, which constitute the actual reality of Freud at work in psychoanalysis (that sometimes--and sometimes wisely--violates his papers on technique), and I discuss his notion of curative factors in psychoanalysis. All of this is to revive an interest in Freud's thought and to emphasize the lasting value of his work, both in its contemporary clinical relevance and as the proposed foundation stone of our identity as psychoanalysts.

The interaction of existential concerns and psychoanalytic insights in the treatment of contemporary patients.

Middle-aged and elderly patients have been shown to respond to psychoanalytic treatment, but they present certain characteristic problems not typical of young patients. I discuss these and offer a brief case presentation followed by a general discussion of the role of existential concerns and of their intertwining with psychoanalytic insights and interpretations in the treatment of older patients from our contemporary culture. The particular case of a relatively mild narcissistic personality disorder is used as an example of the kinds of difficulties contemporary psychoanalysts and psychodynamic psychiatrists run into in the current treatment of the aging patient population. The analyst's beliefs and personality are seen as more important than in classical Freudian psychoanalysis, and deliberate attention to the patient's existential concerns and cultural milieu cannot be avoided. A great deal of correction of what Gedo called "apraxias" is necessary, but I argue that in this situation each person must develop one's self in one's own way and without education and intrusion by the analyst. This self development in the face of one's inevitable future is seen as a vital aspect of contemporary psychoanalytic treatment of aging patients, regardless of which of the five orientation channels (that I have discussed elsewhere) are employed. The patient is seen as dealing both with his or her own infantile neurosis that is interfering with adult functioning and at the same time with universal existential human problems that become increasingly pressing as one ages. I contend that the current biological orientation of psychiatry is insufficient to address these difficulties, regardless of what advances we make in psychopharmacology and neurobiology. An exclusive neurobiological orientation can represent what existentialists label an "inauthentic choice" and a retreat from the spirit of humanism.

Implications of the current insolubility of the mind-brain problem for the contemporary practice of psychodynamic psychiatry.

Abstract Even in this so-called era of the brain, there has been no consensual agreement on understanding the genesis of the mind by the brain, the problem that also baffled Freud, the neurologist at the start of his great discoveries. Especially, there has been no progress in solving what is known as the "hard problem," namely, how neurophysiological processes in the brain can produce conscious experiences, feelings, and intentions that constitute the "qualia," the various aspects of the phenomena of consciousness. Some of the predominant contemporary positions on the mind-brain problem, from Freud's Project for a Scientific Psychology to the present day, will be described and some of the technical vocabulary will be explained. I will conclude from this review that the "mysterian" position or some derivatives of it such as "anomalous monism" or "agnostic materialism" are probably the most plausible, given the present state of our knowledge and capacities. The latter two positions suggest that we simply do not know enough about the physical world of matter at this time but eventually perhaps discoveries about the nature of matter may solve the problem. But as of now, the implication of this impasse is that the introspective data of consciousness are ontologically subjective, pointing to the absolute necessity for our studying this data in its own domain through introspection. The most meticulous and thorough method for this study is psychoanalytic psychiatry, which was specifically devised by Freud for that purpose.

The relevance of Hegel's Phenomenology of Spirit to the process of contemporary psychoanalysis.

Do changes in psychoanalytic technique represent progress in knowledge or are they for the most part a sideways movement in tune with the particular changes in the socioeconomic milieu of the day? Hegel raised the question in the area of philosophy when discussing the stages in the development of self-consciousness. For him this was an inevitable development toward a greater and greater self-understanding, going through various phases until Absolute Spirit (Mind) became completely cognizant of itself. This metaphysical conception was the cornerstone of Hegel's thought as first presented in his chaotic masterpiece, Phenomenology of Spirit. In this article I will examine his philosophical vision as expressed in that masterpiece, compare it with that of Freud, and discuss aspects of it that are pertinent to the practice of contemporary psychoanalysis.

The cultural ambiance of contemporary psychoanalysis: a view from Heidegger's study of Hölderlin's hymn, "The Ister".

This article introduces the reader to an alternative method of gathering the truth about the ambiance of our contemporary world, the surround in which both the patient and psychoanalyst are immersed. It introduces the method of Heidegger and illustrates it by his published work on Hölderlin's poem "The Ister." This method, which Heidegger calls "poetizing" will be unfamiliar to most scientists but it has achieved great influence in continental philosophy, psychotherapy, and psychoanalysis. It reveals the mode of Being that we are all currently immersed in, the spirit of technicity. Psychoanalysts must become aware of the immersion in this spirit of technicity both of themselves and their patients, as well as the immersion of their contemporary culture in it, and of the effect this has on both the psychotherapist's countertransference and the patient's and psychotherapist's notion of what constitutes mental health and the goals of psychoanalysis. Emphasis is placed on the value of intuition, reverie, and the arts as sources of knowledge about the patient in the psychoanalytic consulting room that is not obtained by empirical science.

Hermenêutica para psicoterapeutas / Hermeneutics for psychotherapists

O significado e desenvolvimento da hermenêutica moderna são explicados e investigados historicamente, sendo delineadas as controvérsias atuais sobre a aplicação da hermenêutica à psicopatologia, à psiquiatria e à prática da psicoterapia. Além de prover informações básicas sobre este difícil tema, espera-se que os psiquiatras sejam estimulados a explorar e expandir as alternativas hermenêuticas disponíveis para uma compreensão adicional de nós mesmos e de nossos pacientes

Hermenêutica para psicoterapeutas / Hermeneutics for psychotherapists

O significado e desenvolvimento da hermenêutica moderna são explicados e investigados historicamente, sendo delineadas as controvérsias atuais sobre a aplicação da hermenêutica à psicopatologia, à psiquiatria e à prática da psicoterapia. Além de prover informações básicas sobre este difícil tema, espera-se que os psiquiatras sejam estimulados a explorar e expandir as alternativas hermenêuticas disponíveis para uma compreensão adicional de nós mesmos e de nossos pacientes

Long-term psychoanalytic therapy as a life-saving procedure.

A dramatic long-term psychoanalytic treatment of a psychotic character disorder is presented in detail. This patient began therapy with a long standing history of an eating disorder for which she had received many hospitalizations and forms of treatment without any success. She was in a deep despair and as a last resort agreed to a psychoanalytic therapy. During the many years of treatment the eating disorder completely resolved but was replaced by a series of very dangerous accidents that occurred each time she was betrayed and disappointed by a boy friend. This went on pari passu with a deepening understanding of her childhood and her psychodynamics but the middle of the therapy was very stormy and required tenacious efforts to maintain the treatment. The self-destructive behavior was traced to early and profound childhood disappointments and a sense that these were her fault because she was so unlovable and therefore deserved punishment. A dangerous stalemate developed in the treatment after a number of years. The analyst presented the case to colleagues several times and wrote it up in detail, which enabled him to understand his own countertransference and resolve it. This resulted in a dramatic change in the patient and a very favorable and happy ending to this very difficult treatment after 15 years. Although the author believes all patients in psychoanalysis should be approached with as neutral and objective a stance as possible, emphasizing free association and dream material in order to interpret the crucial childhood determinants of the patient's psychopathology, in cases such as psychotic character disorders the outcome clearly also depends on interpersonal factors. The case illustrates the deep partly conscious and partly unconscious interaction between a patient and her analyst over many years of treatment and the profound effect this has on the outcome. It underscores the importance of patients being allowed to heal in their own way and in their own time without intrusion or interference from the analyst. It also demonstrates the crucial importance of long-term psychoanalytic therapy as a life-saving procedure in cases where it is appropriate in spite of the great amount of time and expense involved.

What can psychoanalysts learn from the development of literary theory?

It is no accident that literary theorists and academicians have become very interested in psychoanalysis. There is a remarkable parallel between the development of literary theory from its origins to the present day and the development of psychoanalysis from the time of Freud to now. The same concerns that have troubled critics of art and literature about how to go about evaluating an artwork are the ones most controversial today in the field of psychoanalysis. The questions, for example, of whether beauty resides in the work of art or in the mind of the audience and its parallel in psychoanalysis, whether the material produced by the patient is essentially from the patient or the product of an interaction between patient and analyst, or even whether it is ever possible to interpret any patient material or artwork all the way down to some basic qualities remain unanswered and polemical today.

The human mind in the contemporary world.

The author examines conflicting conceptions of human mentation and human mental development, an area representing an overlapping interest in psychoanalysis and philosophy. Focus is on the question of whether there is any essential aspect to the mind or whether everything is relative, intersubjective, and formed by the culture in which one lives. The irrational and noncognitive aspects of mental life are outlined from the thought of Freud, Nietzsche, and Schopenhauer and their views of the essential springs of psychic activity. The ramifications of these various conflicting conceptions for the practice of psychoanalytic therapy are outlined. The question is addressed of whether it will ever be possible, as in the Enlightenment dream, to improve the human condition and put an end to human violence. The answers to this question are shown to differ depending on the various conceptions of human mentation and human mental development involved. No conclusions are reached; the issues remain unsettled in our time.

What grounds creativity?

"Developmental or ordinary creativity" is distinguished from "genius creativity." The former offers pleasure or distraction. The latter sometimes offers this, but tarrying before the product of genius also brings a new understanding of one's culture, one's self, and even an experience of transcendence. The concepts of Heidegger and of Gadamer are applied to this distinction. All serious artists are seen as manifesting one or more of three aspects: (1) driven by creative genius from the biological furnace of the individual, (2) temporary regressions and exhaustion of ego function, and (3) an anxiety-driven process resting on a constitutional ability to shift levels of ego activities and compromise formations. Falling in love is discussed as another example of creative imagination based on the need to solve psychological discomfort either due to developmental or pathological problems. Creativity in psychoanalytic work is an important factor that needs to be explored in addition to the fact that every country seems to create the approach to psychoanalysis that it needs. Emotional illness is demonstrated as hindering and constricting creativity, not enhancing it as is the popular idea. Some seriously psychopathological artists are able to wall off the pathology and sublimate their conflicts into the production of art, but creativity requires a relatively intact ego; when the ego deteriorates, so does the creative product. An important spring to genius creativity is the nonrecognition of the extremely talented child, which leads to solitary activity and an immersion in ideas and fantasies that, if the person has the requisite talent, is manifested in the expression of truth and beauty through art.

Psychoanalytic supportive psychotherapy of a terrified communist: report of a 37-year treatment.

This is a case report of a 37-year treatment of a victim of the Holocaust. It illustrates the use of psychoanalytic based supportive psychotherapy to enable a severely damaged person to pull himself together and live a respectable life. The case is of special interest because a careful evaluation of the patient's ego functioning was important all through the treatment, and revealed an unusual set of defences. He was able to deal with his rage by taking an extreme Maoist Communist political position, ranting and raving about it, including his hate of America, etc., but at the same time he encapsulated this and focused it in the psychotherapy sessions. In contrast to many such fanatical individuals, he was able to keep himself from acting out these political feelings in any way or to engage in any destructive behavior. This seemed to form an intermediate position that enabled him to function and adapt to our society, get married, find long term respectable employment, and finally retire with savings and a pension. Understanding these ego operations empathically made it possible for the author to tolerate his views without either challenging them or agreeing with them and enabled him to come regularly and utilize supportive psychotherapy.