Friday, March 9, 2007

Transference In Lymphoma




Sincerity and Other Works. Collected Papers
by Donald Meltzer


E s difficult to do justice to a book of this magnitude, in size and depth of nearly 600 pages long, compiled 34 articles written during the last 40.
Some of these are very short texts, while others could be a book in themselves. This is especially true for "Sincerity" text which takes its name from the library: written in 1971, has more than a hundred pages and no fewer than 33 texts written before and after that year, between 1955 and 1989, which are built around him.
The entire work reveals in turn, some of the profound changes in thinking Meltzer over all these years of work and analytical thinking.

In an attempt to trace the evolution of analytical thinking of the author, we can define a first phase of his work as essentially clinical, with a particularly intensive activity in the area of \u200b\u200bchild analysis and composition analysis of various adult items published in the International Journal of Psycho-Analysis.
This first period of play ends with the Psychoanalytic Process (1967), which describes the stages of child development in a way completely different from the classical form of 'stages' of evolution. 'Sincerity' contains the essential clinical material and the reflections on which these ideas were originally based.

For starters, the writing of 'Kleinian Child Psychiatry summarized in 55 pages classes and seminars given by Meltzer with Esther Bick in 1960 at the Tavistock Clinic, with the cooperation of John Bremner, Edna O'Shaughnessy, Dina Rosenbluth, and Frances Tustin. Also displayed some clinical studies of adult patients described with a wealth of detail and rigorously tested in Kleinian terms. Many of these writings illustrate with unusual depth aspects of analytical work that could be achieved in Kleinian analysis at that time.
While clinical descriptions made following the latest theories of Melanie Klein, particularly the concept of envy, and ideas about Rosenfeld's confusion, their descriptions are heavily stamped his own genius, show an interest and special insight regarding the specific characteristics of early relationships between mother and baby, and its importance to the rest of life, including sexual development.
These announce a second term in Meltzer's work in which he embarks on a more personal aspect of his research, concluded in Sexual States of Mind (1973). This brilliant review of psychoanalytic theory of sexuality, also marks the origins of the influence of personality and the thought of Bion in Meltzer, giving a framework for research and reflection was much more innovative than it seemed at first. This is because Bion appears in the wake left by Klein and particularly guided by the theoretical tools of the depressive position, the paranoid-schizoid, and projective identification. However, in describing the aspect of "normal" projective identification and to show is that at the root of the formation of the thought process, Bion created a revolution in psychoanalytic thought.

What he did, in fact, was re-introduced the role of the object and the external reality within the analytic theory, which seemed to have disappeared once all after Freud abandoned the seduction theory. But a long way still needs to be traveled before reaching that point and Meltzer successive contributions reflect particularly well certain aspects of this development, which is more common in most analytical schools.
States of Mind Sexual aspects distinguishes the 'adults' of psychic structure, based on the use of introjective identification, aspects of 'child', which have remained under the control of the mechanism of projective identification.
On the other hand, the book offers a new conception of perversions, based on 'negativity' as destructive and envious attitude toward sexuality and creative good parents (his conception of negativism suffers after some changes after the theoretical development in relation to autism).
The Meltzer hundred pages devoted in 1971 to establish the notion of "sincerity" in psychoanalysis are a reflection of his views at that time, and at the same time define the conditions for a newest and most revolutionary aspects of his work concepts such as objects and the aesthetic conflict or the 'Claustrum'. The hundreds of pages are in fact a distillation work and the work of Meltzer.

The author uses three plays of Harold Pinter - The Dwarfs, The Birthday Party and The Homecoming "and makes a commentary analyzing them with an inimitable analytical virtuosity, such as that used to analyze and think dream material. This text reveals the author's gifts as a writer and the deep bond that keeps his work with those of novelists, philosophers and moralists, and proclaim a 'methodological superiority' of psychoanalysis on the arts, theology or philosophy. His statement that the so-called superiority of the analytical method 'is in the discovery of truth' to any price 'must be taken with great care: "Analyst and patient alike must-determined to spare normal Themselves Neither One Another in this pursuit" (Sincerity, pp. 194-5). This would make very little gravity and excessive psicopatogenia of psychological distress, which, as appears more and more in his theoretical reflections.

Through the concept of 'sincerity', original in psychoanalysis, the author is really studying the vicissitudes of the developing sense of identity. Meltzer
distinguishes three types of inner experiences involved in the sense of identity according to the mode identification that states: narcissistic, projective or introjective. The author points out the Freudian definition of 'consciousness as an organ of perception of psychic qualities' and shows that from his point of view, any part of the self can take control of this body of consciousness and, through its possession, temporarily maintain hegemony on behavior. The party or parties established organization like this will dominate the sense of identity. There is a profound and vital reference, from my understanding of his writings in relation to the link between consciousness and identity as a "center of gravity 'of the self.

The notion of self indicates the general direction of his own existence with greater success than the structural concepts of self, it, and superego. Winnicott's notions about the false and true self have much in common with the concept of sincerity Meltzer (preferred use of the word 'authenticity' in French translations).
incidentally This concept gives a total twist to the theory of the formation of symbols to achieve a vision of development based on the creativity of the combined object: the child will explore the outside world with the pattern of the parent bodies, finding new objects to mean that the internal model can give. This 'seeing as' no enviste both the external world with meaning at first, but gathers and gathers in the parental objects with new forms, and therefore with new meanings, to enrich the concept and reality of the combined. From this rich source of meaning can be, secondarily, to return to external objects. (P. 245)
This has the consequence that the meaning of a dream is revealed by its symbolic translation, whereas sleep should be thought of in a metaphorical and poetic language, because the richness and vitality of but that image can not be impoverished by the abstract prose translation ... rediscovers the dream image that amnesia child has so deeply repressed, 'the Infantile wonder, the Aesthetic sense, the hunger of the mind'.

The concepts of object and aesthetic conflict appear so clear: 'I am inclined to think, "Meltzer concludes,' that the language of dreams is perhaps the lingua franca of the key emotions and aesthetics." However, this progress of thought is possible only after the different perspectives of psychological distress that were open to contributions from about autism. However
novel conceptions in 'Sincerity' about self development and evolution internal objects are, in any way, leaving out the reality of the object and the subject's interactions with their environment as they occurred historically and were consigned to memory. Today we know from the work of development theorists such as Daniel Stern (The Interpersonal World of the Infant) that the baby has many more capabilities than what could have imagined before - in particular, it makes a very good assessment of reality perceives and internalizes consequently according to their experience, this is really a process of 'learning by experience. " Currently the site of the fantasy can not be valued solely in terms of instinctual (life instinct and death), but interaction is more or less evenly between the subject and its environment (for example, according to the degree and quality of 'attunement' described by Stern, or 'the beauty of the meeting', described by Bégoin 'between the cathexis of the baby and the mother, properly combined with that of the father').
The underlying symbolic process thinking, develop freely only when these exchanges are sufficiently harmonics, and the capacity for independent thought depends on this freedom. In his absence, the growth potential psychic gets caught in the 'claustrum' projective identifications pathological.

Meltzer used the three works of Pinter to prove in a way just as alive as if it were his clinical sessions. The Dwarfs illustrates the struggle between narcissism and object relations, showing how in the analytical process, the structures children are released one after the other parts of the domination of destructive when they are able to establish a sufficiently strong alliance with the good objects ( which corresponds to the definition of the depressive position). This work is both the smallest and the key to the other two. For him, The Birthday Party is a comprehensive illustration of the regressive processes that culminate in the way mental illness delirium; like this at birth, but a negative birth, which is connected with envy as described by Klein and is taken up by Bion in his concept of negativity, which would later be described by Meltzer in entirely different terms, after studying anxieties related to the annihilation of the sense of existing in infantile autism and following the match with the idea of \u200b\u200badhesive identification of Esther Bick. The eighteenth chapter of the book covers to read about adhesive identification made by Meltzer in 1974, where he makes a very interesting review of the history of the concept of identification in Freud and his own research, done in parallel to that of Esther Bick. The work of autism can be regarded as the turning-point in the work of Meltzer after Extended Metapsychology: Clinical Applications of Bion's ideas (1986), and laid the groundwork for his latest and most revolutionary period, dedicated to the discovery and description of the object and aesthetic conflict (The apprehension of beauty: The role of aesthetic conflict in development, art and violence, 1988), which speaks of the problem of love and destruction in completely new terms.
Taking into account the work of Frances Tustin, negativity is now more like a desperate reaction catastrophic result of the intensity feelings of depression (the type of primary depression). As a result, the subject is fundamentally unable to bind with sufficient strength and security to the world of good objects because the world is felt to be totally inaccessible (as described by Milan Kundera in Life is Elsewhere).
In contrast, Meltzer believes The Homecomming as a wonderful illustration of the developments described in the analytical process on the threshold of the depressive position. The author shows how the integration of self and objects characteristic of the work of the depressive position is reflected in the development of a work in progress towards a more 'sincerity'. Meltzer says he is shocked to find how Pinter's work is directed towards an analytical interpretation.
For this reason appears to fully justify this study about the sincerity, as representative of the originality and fertility Meltzer was chosen as the title for this collection of texts. These articles include important comments on the contributions of other analysts, is one on the concept of 'misconception' of Money-Kyrle, which is illustrated with a clinical staff, there is another on 'The diameter of the circle' of Bion and the collaboration of Meg Harris Williams of the famous trilogy Memories the Future.
In the first, Meltzer describe its pattern of thought to the 'military' by Bion who had the opportunity to learn in the seminars given in the last year of life. The three texts in the three volumes of memoirs of the future can be very useful in understanding the final stage, enigmatic work of Bion. They are a useful addition to reading the third volume of Kleinian Development (1978).
One text, "The psychoanalytic process, 20 years later (1986) is particularly interesting because it shows the major changes that occurred in his practice as a consequence, or perhaps source, their theoretical position changes. After 35 years of teaching experience and concludes that the fundamental nature of the practice and process of analysis has not changed, and receives only a change of emphasis. The precision in understanding, and therefore the interpretation is no longer a crucial factor to bring the evolution of the transfer under the 'accuracy'. This is just one of the quantitative factors in development economics. The economy depends on the modulation and change of psychological distress, which is different for Meltzer of anxiety.
's description had been 20 years before of the analytic situation now seems much more limited and rigid in their current practice. For example, now he prefers to begin the analytic work gradually, with only two or three sessions a week, until the need for more sessions to be recognized by both parties, patient and analyst. You also agree to make changes in hours of meetings, unless it has an adverse analytical work. It emphasizes the idea that all analysis is a test analysis. Also supports the idea that the analyst 'deserves' the love interest and even that is subject to the patient.
Meltzer had already worked the problem of impasse on the threshold of the depressive position. In one of the papers compiled in this book, '68 years speaks of the impasse is based on the denial of a qualitative distinction between child and adult, and is manifested in a demand for mutual idealization between patient and analyst, with certain specific differences between male and female patients (p.157).
This seems to be based on a very basic level of feeling to exist for some patients, for whom the threat of annihilation anxieties awakened termination catastrophic in severity and there may emerge only at this time.

This can be Freud discussed the problem from several points of view in 'Analysis terminable and interminable'. Freud connects the last resistance to what he called the biological bedrock (penis envy in women and the rejection of the passive position in humans) in other words, the 'repudiation of femininity' in both cases. In each case, we can say that the resistance prevents the integration of sexual identity. It can be said that what Freud identified as the "repudiation of femininity 'is in fact based on the horror and terror of depression, whereas depressive emotions in both sexes seem to be contained in that part of the character identified as female. This leads to a different conception of the action and the nature of the destructive impulses in the psyche. Instead of associating violence with the nature of the drive, there is a violence that betrayed the existence of a core of despair in the heart of the self: a fundamental desperation of not being able to develop, not to achieve development.

most significant in my personal experience is directly linked to the chapter about the sincerity that gives its name to the collection. I think that would require a study seminar for just that text. It presents a phenomenological conception of sincerity and its links with different emotional and mental states. Meltzer

proposed as central thesis that the process of giving meaning to emotional experiences is associated only slightly with two aspects of personality structure: first, splitting processes in self and other, objects to the integration of internal.
a reflexion ago to call attention to the problems of openness between patient and analyst, the central problem in human bonds.

One of the most profound virtues of the analytic situation lies in exploring the unique opportunity offered by the language of emotionality.
The convergence between the material of the dream, the direct emotional experience in the transfer and collection process and reconstruction of past relationships, challenges to both patient and analyst, to find through word of vehicles that can adequately promote the experience to understand and be understood.

In Meltzer's experience, the word "sincerity" has appeared as a single value term, and highlights dominate on alternatives such as honesty, truthfulness, integrity, honesty, openness, etc. Other scientific considerations or a more historical vein were also considered to account for a relatively unexplored aspect of intimacy in human relationships and communication, they need a new term to try to define what unexplored. 'Honesty', for example, has a history of using moralizing. 'Truth' has been used in different ways in different philosophical writings. 'Integrity' means a tone too characterological. 'Openness' seems to imply an aggressive side of criticism. 'Open' has no reference to the emotional.

The premise is that mental acts necessarily involve concepts, concepts that involve judgments. Concepts, and judgments about them, relate to modes of perception and various symbolic forms in which unconscious fantasy shapes the essential emotional processes.
is based on our ability to give a intensionality our concepts, feelings or thoughts, which is experienced as gradients of sincerity in our consciousness of ourselves. This aspect of mental state can only be properly sensed by introjective identification and produces changes in the emotionality of confidence. Meltzer
distinguishes narcissistic modes of identification as "variations in the emotion of distrust."

is essential to ask the question: to what extent the disease involves a failure in the sincerity?

seeks to establish a connection between the ability to tell the truth, identity and sense of identity as a component of meaning that he would attribute to the word sincerity.

Psychoanalysis seems to have outlined three different types of inner experiences that carry a sense of identity. The first of these is in the individual field of infantile aspects of the narcissistic personality organization (as opposed to states of integration). The second refers to forms of narcissistic identification, of which have only been studied forms of projective identification. And finally, the introjective identification process in which adults appear aspects of personality and differentiates itself from the infantile aspects of its structure.

The mind develops through the dimension of time, and none of their experiences is lost. The model archaeological stratification is not a successful model because it involves the loss of vitality of those structures, which due to their immaturity, are being buried by more sophisticated ones, which are superimposed.
These have not lost their vitality, and its capacity for action, as illustrated on one side with the phenomenon of sleep and the other with most of the regressions. What actually happens is a function of splitting and integration in the context of internalization, where relatively defined periods of development of the self is gradually detached from each other through the grieving process one hand and repression on the other, disassociating external objects for internal objects, conduct transactions transactions dream life.

qualitative aspects of sincerity, linked to components constructing the meaning or sense of identity tied to children's structures reflected in the experience of what we experience as 'Deep' versus 'surface' in the mental states of others, and connect with what is known technically as recognition or denial of psychic reality. Denial is basically denying the existence of structures and children's internal objects which are so tightly bound.

elements experience a sense of identity developed through introjective identification processes (and from identification with internal objects that make up the ego ideal) that lies in the emotions of the depressive position, especially the gratitude and desire to be valued, have a tone of aspiration which is very different from feeling self-generated immediately and delusional projective identification. Lack of certainty, humility, openness to questioning are aspects of the personality of people we are admired for their ability to be sincere.

We take identity as a category ideal (due to great difficulty for a causal definition) considered the sum total of experience for which the current sense of identity can claim as an asymptote. As that trend is going in a straight line indefinitely approaching a curve, the identity, but never find it definitely.

This link between memory and sense of identity is the central key to an intuitive view about the quality of sincerity as an aspect of character, even objects. If after a while we found that a person renounces a facet of personality that had previously shown, does not remember saying "that" or deny having seen "such and such", or have altered the response of his account yesterday-today are forms of trade that hurt our confidence and can also lead to distrust.

This is perhaps important to remember that trust is closely related to love and dependence on children's levels, and internally, with predictability in adult relationships and therefore provides what determines our confidence.




Intestinal Pain More Condition_symptoms

Psychotic Core



M. The Psychotic Core Eigen


Some Main Ideas

* Understanding the psychodynamics of madness is essential in therapy for most patients no matter what your specific condition. Diagnosed as psychotic patients actually represent a very small portion of the general population. But now, states and psychotic attitudes may appear in a wide range of emotional states. Borderline and narcissistic personalities are two examples of self disorders that require the analyst's attention to the dimension "crazy" life.

* This text takes ideas of Freud, Jung, Searles, Laing, of Object Relations (especially Winnicott, Bion and Ekin), and the psychology of the self. Its aim is to describe and critique the basic ideas in relation to their understanding of psychosis. The fundamental insight that madness makes the existence of man, can not be ruled out. A study of this kind inevitably becomes an exploration of self.

* The description of Freud on narcissism was inspired by psychotic states. Religious thinkers have traditionally been associated with the grandeur of madness and evil, but Freud studied the phenomenon of self inflation with incredible precision. The investigation of a heinous and intolerable sensitivity to slight and fragility, vulnerability and tenacity of narcissistic characters gives much light on psychotic states and vice versa.
In a very important measure, the quality of therapeutic work with narcissism depends on the vision and understanding we have of psychosis.

Analyst with later work as Kohut and Winnicott, emphasized that the grandeur and idealization were a normal part of development at different times; But what kind of beings arise and build wounds infinite power, What kind of being is overestimated and is constantly devalued as part of his eternal drama?

* Winnicott sums up the depth of what is at stake with the idea that neurosis is often a mask of psychosis.
One can have an analytic experience apparently with good results, the patient can function and feel better in several areas and have a more successful life, and yet often beneath all these gains, there remains a persistent and sharp feeling that something is wrong, and be haunted by the feeling that life is a sham. For Winnicott, the madness is associated with a sense of falseness of their existence. In some cases, the possibility of being alive can depend on the ability to cope with psychotic anxieties.

* The work of Bion, like Winnicott, focuses on the sense of catastrophe that holds the psychotic experience. The way in which one is linked with that which is beyond the limits of self, can make the difference between health and insanity.
* The common practice barriers against the destructive effects of self - expression, rise. The individual and his madness may overwhelm or alarmed to find that the communication-and communication in its most subtle, it is possible. One can speak of the lie they live. One can glimpse the terrifying depths of the self - deception and failure to cure. And yet, one can be improved, one can become more capable, more rich, more tolerant. One finds a way to move toward the center itself. One finds a way to move beyond yourself.

* This book is a burnt anger, self - poisoning insidious, horrible vacuum, misuse of wit, sharp inability to keep up with their own heightened awareness, the self-giving spirits and objects, a crippling shyness, an infernal torment, the overall sense of catastrophe, loss and rebirth of the self in fantasy scenarios in their wealth and their poverty found in the psychotic experience .

* The meaning of the book is to help us relax our eyes. The scary has its own beauty, their own ecstasy and should not enter into the ways of the mind as if it were not there. Its value lies in helping us to fear a little less what dwells within ourselves, in a non-destructive, but achieves enrich the quality of our ability to have experiences.

* the idea is debated whether or not a psychotic seed in every human being, the fact is that psychosis is one of the phenomena of human life that lead us to limit what we can experience. Changes and freezes the preconceived notions of what is possible. In psychosis which usually take it as material, is treated as immaterial, and vice versa. Psychosis is that we find the hard moments, and at the same time, the greatest fluctuation of symptoms. It is as if the mind, in a very short period, became a movie in fast motion, going at full speed through thousands of mental sequences, unable to choose and keep a to achieve distinction ... maybe, if you try them all, can finally choose any combination in which to live, or be able to breathe forever in unlimited freedom. The person in psychosis feel desperately trapped. The dualities that make up human experience are separate and exaggerated. At certain moments it seems that your mind dissolves, and looking wildly anything I can find, can not leave anything out of the relentless pursuit of who knows who. Can not rest until I see it. And that all dissolves and starts again without any opportunity to build on experience. One lives to himself as a kaleidoscope does not evolve.

* According to Freud, every aspect of development contributes to the way the individual organizes the meaning and is affected by this sense, while his work was developing his vision of narcissism, wrote that psychosis may be the key to understanding the ego. Developed the idea of \u200b\u200bprimary narcissism as a framework to put the two main characteristics of psychosis, megalomania and "detachment" from the outside world (like loss of boundaries). Freud's self inflation associated with idolatry, figurative image of the enormous capacity of the ego to lose himself in objects. In different forms of identification, the ego can be like his subject, "is itself deposited the object, or placing the object within itself. Plotted ways in which the ego and the object could "symbolism of, and how this forms the basis for a mystical experience or ocean. Wrote about hypnosis, love, the army and the church as a vehicle for a kind of dependency that obliterates the boundaries of self.
The fundamental link between megalomania and dependency is an issue that will take many hours of analysis.

* Talk of six major components of psychosis, or six basic ways in which the psychotic process organizes the basic materials of personality: hallucinations, dementalisation, the question of borders or boundaries, hatred, epistemology and processing to the contrary.

* Hallucinations: In a sense, the ability to hallucinate is universal, the ability to produce a hallucinatory state seems to be part of our ability to produce pictures and words. And there are some universal trends in construction: the ability hallucinatory seems to oscillate between the divine and the demonic (Apollo - Dionysus) contains erotic obsessions concerning fecal or it is divided between the extremes of absolute power and absolute helplessness have the tendency to make demands and give orders. The hallucination points to the immediate gratification, not the thought. The problem of mental pain is fundamental: the meaning is imagined pleasure, wherever there is pain.

* dementalisation: Among our earliest defenses is the ability to stay on target or even fall into a stupor. The mind is numb themselves against the emotional pain. The mind responds to pain, if necessary, through emptied of itself. The mind can try to get rid of itself it to get rid of the pain that is causing it.

* Borders: The Case of psychosis reach of their own boundaries of self and where there others is of utmost importance. In everyday life, a certain lack of distinction of the boundaries between self and others is to some extent understood. Makes communication possible. In the case of psychosis, natural tissue between the self and others can become a terrifying experience to dissolve or invasion.

* Hate: Freud wrote about how the self is torn apart when their hatred is contained and diverted. The agent described and traumatic experiences in terms of aggression beyond words, as "stab the heart." Klein found that the organization psychotic hatred took a decisive, It also plays a role in organizing the infant's response to pain.

* Epistemology: If psychology studies mental processes, the epistemology investigates these processes say about the nature of truth or reality. Perhaps nowhere else's idea of \u200b\u200bhow it constructs the reality is more relevant than psychosis.

* Reversal: Transformation to the contrary: Freud suggested that this defense was so basic that seems to precede the development of traditional defenses. A further development of these defenses are more able to change the direction of the pulse and change their valence. In the psychosis this capability becomes spiral and hardens. It becomes a permanent mental condition which transforms the whole experience in what is not.