Thursday, July 9, 2020

Psychoanalysis as Education -Adam Phillips

In his 2004 essay Psychoanalysis As Education Adam Phillips draws fascinating parallels between Lenin and Freud. He writes that Lenin, through education of the proletariat about Marxism, hoped to make conscious their exploitation by the bourgeoisie, while Freud hoped to make conscious unconscious desire. Both the working masses and the psychoanalytic patient were apparently leading lives dictated by things outside their conscious awareness. Both needed to be educated by an omniscient, if somewhat inflexible, other to pay attention to their particular blindspots. Phillips writes, “Education, like psychoanalysis and politics, is the art of attention seeking.” 

Lenin believed in education and pedagogy as a force of change -- for revolution -- despite the irony that education was also considered bourgeois. To benefit, people would then need to be malleable. While it is true that we can have a powerful effect on one another, Lenin did not seem to consider the idiosyncrasies of human desire. Freud, however, was very interested in desire. Freud’s understanding of the peculiar desires of individuals may have been the outcome from and the development of free association. Unlike traditional Leninist education (inform and get outcome), psychoanalysis’ “Free association is at once a new kind of information about the self, and a new way of learning about the self…[with] no preformed content [and] no predictable outcome.”

Phillips sees psychoanalysis as a contribution to the debate on education (more than to medicine) for it is “an opportunity to explore the ways in which people inform each other.” Why, for example, do patients not make use of the new knowledge presented to them? Phillips says it is because annoying interpretations may be experienced as impositions or ‘impingements’ (Winnicott) or, worse, as trauma. He also notes, as Freud did, that the object of desire, along with suffering and stasis, is the past and its forbidden objects of desire. [I prefer to think that people do not seek suffering but connection, and they have learned through experience that suffering is the price paid for connection. I also think of Bromberg’s ‘staying the same while changing,’ that is, that patients, while expanding and acquiring new parts of themselves, do not wish to lose the former parts of themselves, even the sad and dysfunctional parts. Thus, we need the old and the new in conversation with one another, held in tension.]  

Phillips [questions] whether psychoanalysis is free from persuasion and suggestion, yet sees the analyst as a new, different kind of teacher, “A teacher who does something that lets the patient let himself know about himself.” Phillips also questions Freud’s analogy of the psychoanalyst as teacher, superior, a lover of truth, and, thus, exempt from sham and deceit. Freud saw psychoanalysis as an education meant to overcome resistance. Freud said psychoanalysis was an “after-education,” unlearning (resistances) and relearning (satisfactions). Respectively, life is risks evaded and risks courted, says Phillips.

Phillips remains loyal to traditional psychoanalysis when he writes, “If there is a subject of psychoanalysis it is whatever obstructs speaking and listening.” [Traditionally, the obstructions were ‘resistances’ and the purview of defense analysis by ego psychologists. But perhaps Phillips intends a broader array of obstructions: the dissociation of the analyst? the lack of developing a ‘secure base’ from which to explore the inner world?] Contemporary and elegant, he adds, “Listening to speak and listen...experiments with wanting and being wanted, because wanting and being wanted are always an experiment. But unlike scientific experiments they can never be replicated.”

Phillips does note, as he says Freud noted, that “love is the greatest educator” -- even forbidden incestuous love has something to teach -- and this love as teacher is in keeping with parenting, and with research in education which shows that students learn better when they like their teachers and when their teachers like and believe them to be educable.

Monday, June 22, 2020


Artist Tucker Nichols of San Raphael, California appeared on the PBSNewshour  Arts and Culture series CANVAS on 5-8-20. He spoke of how the experience of being sick is isolating so he sends flowers, paintings of flowers, that is, from loved ones of sick people. In this time of Corona, he has had so many requests, he now has to post pictures of his paintings of flowers on line:

  He writes:    
  Flowers for the ventilator operators
        Flowers for the hospital janitors
        Flowers for the bare handed mail carrier      
        Flowers for the neighbor who sits in her window on patrol
        Flowers for elastic waistbands
        Flowers for the dishwasher
        Flowers for for you if you are the dishwasher
        Flowers for someone who left in an ambulance but still no update
        Flowers for the kids who are realizing none of the grown ups know how this is going to play out
        Flowers for the frazzled woman at the post office directing the other customers to maintain their six foot perimeters while trying to keep her place in line
        Flowers for New York City
        Flowers for anyone in any hospital for any reason
        Flowers for your mother
        Flowers for anyone stuck at home without flowers today

Monday, June 8, 2020

Letter to Colleagues on recent events

Dear members of TBPS,

Writing this, I notice it is difficult to find the right words, a sound interpretation for the events that have recently taken place. Perhaps it is not about having the right words or interpretation but listening and bearing witness that is of importance. As psychoanalysts and psychoanalytic psychotherapists, we seek to understand. We seek to hold, contain, and transmute what is brought to the therapy session so that others may grow. It is our duty to bear witness to the pain, suffering, feelings of betrayal and rage following the recent killings of members of the black community and the intergenerational trauma the black community has faced. It is our duty to look within ourselves, at our privilege, our preconceived notions, our biases, at our countertransference and transference, in the face of such tragedy. Lastly, it is our duty to bring what is in darkness into the light (“where id was there ego shall be”), despite the difficult conversations it may create. Through these difficult conversations we can affect our community. If ever there was a time, this is the time to do what we do best: listen, empathize, and support to create change.

Below you will find a link to the American Psychoanalytic Association’s statement regarding racism and recent events:

Warm regards,

Joseph Assouline, Psy.D.
Tampa Bay Psychoanalytic Society, President-Elect

Friday, May 8, 2020

Identification with father is not 'penis envy'

Benjamin brings feminist and gender theories to traditional psychoanalytic theory by tackling the problematic concept  of penis envy. She reinterprets the Freudian concept of "penis envy” by noting that a little girl bulwarks her striving for agency and subjectivity by identifying with the father -- classically thought of as the ‘wish to be masculine.’ She posits that the female (and male) child identifies with the preoedipal father as the idealized subject who possesses agency and desire separate from the mother’s.  Identification with the father and the otherness he represents is a normal developmental step for children of both sexes. [Freud’s idea that penis envy is the sine qua non of female sexual development is a gross error in his attempts to understand female development. Note that terms such as penis envy or phallus are androcentric.]   

Possession of otherness by the father has been conflated with the possession of the penis, phallic power. The penis  becomes a symbol for the girl’s wish to be like the father in subjectivity and the wish that the father recognize the child as a like subject. It is the failure of the preoedipal father to recognize and welcome the girl’s (and boy’s) normatively developmental need to identify with the father --and not the little girl's realization of anatomical difference--that leads to penis envy. This failure by father risks later impairment of the girl’s subjectivity and agency and may lead to later masochistic submission to an idealized male. This disallowal of identification is also a disallowal of cross sex identifications and, as such, limits the richness available from multiply gendered identifications and expressions.

In the TBIPS Gender course there is much coming to terms with gender fluidity and being comfortable with the unfamiliar. Euripides Gravas noted that identification denied leads to envy. Jennifer Schafer mused about the possible multiple configurations of genders available as parental figures. Stamatina Kaidantzi explained that it is not the sex or gender identification of the non-caregiver parent but it is the otherness, the separateness from the caregiver, with all the comings and goings from home, that propels the preoedipal child’s wish --akin to the ‘love affair with the world' -- to identify with that other parent. Even in the absence of a second parent, that otherness exists. In addition to the caregiver/mother’s ability to ‘survive’ -- which, according to Winnicott, places her outside the fantasized omnipotent control of the infant and makes her external and a subject in her own right, and thus worthy also of identification -- the father may well be a solidifying identification for the child’s agency and desire, that is, for her subjectivity. Little girls do not feel inferior and certainly not because they are different from father; they just want to be different from mother while still retaining likeness.

Benjamin, J. (1991). Father and Daughter: Identification with Difference — A Contribution to Gender Heterodoxy. Psychoanal. Dial., 1(3):277-299.

Saturday, May 2, 2020

Quarantimes and the After Times

In these ‘Quarantimes’ we long for the ‘Before Times’ and anxiously wonder what the ‘After Times’ hold for us. One author, Kelly Corrigan, on the PBSNewsHour April 29, 2020 in the feature “IMHO,” said about our future: 

    Sometimes, when I feel outmatched by the thing in front of me, … I tell myself the story of what happened as if it’ s over and I nailed it. … I told myself the story of the pandemic of 2020...: At first it was awful, nothing but bad news on top of bad news. But, then, we rose up. We made soups and stews for old people, and dropped them off so they felt included and secure and nourished. We read books to children over the internet. We stepped outside at the end of the day and played music and clapped so that each of us knew we were not alone. We sent pizzas and Chinese food to E.R.s to sustain both our hospitals and our restaurants. We called old friends and told them things we’d forgotten to say. ‘I miss you;’ ‘ I still think of you;’ ‘ Remember that time?’ 
    We turned up, allof us, on our screens to keep businesses afloat and, in so doing, were exposed to the more tender elements of our colleagues’ lives. Pets and children were now, to our mutual benefit, in the frame. People figured out they didn’t need fancy equipment to exercise. We stopped flying around and jumping in cars for no reason. Everyone planted things they could eat. We played cards with our families. We had long conversations. We identified what kind of learning can be delivered on line. We discovered that teaching is the most complex, high impact profession known to man, and we started compensating our teachers fairly for their irreplaceable work.* Everyone voted after Corona virus. Kids who lived through the virus valued science above all. They became researchers and doctors, kicking off the greatest period of world positive discovery and innovation the planet has ever seen. We came, finally and forever, to appreciate the profound fact of our shared humanity and relish the full force of our love for one another. 

*[I would add that not only teachers, but other essential workers, such as food workers and suppliers, first responders and frontliners, sanitation workers and many more--most who are among the lowest paid-- will also be compensated fairly at the level they really deserve.]

Wednesday, April 29, 2020

Masculinity is about organizing identifications, not about disidentifying

There has been an important revision to the traditional idea that the development of masculinity requires a little boy to disidentify (Greenson, Stoller) with his preoedipal mother. This revision is a relational and intersubjective one. Diamond brings to the discussion of the development of the boy’s masculinity the emphasis on the importance of the quality of attachment relationships and the capacity of the mother “to recognize and support both her son’s maleness and his father’s presence” and the capacity of the father to allow “a reciprocal identification” with his son. 

The confrontation of the mother’s subjectivity in the separation-individuation phase is a narcissistic blow to a child who now realizes s/he does not possess omnipotent control over mother. If we recall that identifications come about to preserve what has been lost, then the loss of omnipotence vis a vis the mother is for the little boy more traumatic than for the little girl because he has been pressured by the culture since birth to give up his feminine identifications; as Diamond writes, “the pressure to renounce gender-inconsistent traits is greater for boys.” A boy must adapt to this “pre-oedipal disruption;” how he adapts is dependent on the quality of attachments and on pre-oedipal identifications. If these are insufficient, the boy may do so by disavowing his need for his mother and by disavowing femininity itself.

Disidentifying with mother, then, becomes a pathological resolution to loss of the preoedipal dyadic connection with mother, and loss of omnipotence, and to being forced to denounce feminine traits. It can lead to a fragile phallic centricity meant to hide the need for and loss of mother and of omnipotence. This rigid masculinity constrains the boy’s experience of himself and others, and truncates the multiple possibilities of the self.

Corbett (2009b) advocates for fluidy, ambiguity, and multiplicity of gender identifications and expressions. He questions diagnostic authority when it adheres to the binary classification of gender. Corbett  (2009a) also provides a clinical example of the relational influence of the development of masculinity when he reenvisions the dynamics in Freud’s case of ‘Little Hans’ by bringing to light possible domestic violence as well as Hans’ mother’s reluctance to have children in the first place. 

Corbett, K. (2009a). Little Hans: Masculinity Foretold. Psychoanal Q., 78:733-764.
Corbett, K. (2009b). Boyhood femininity, gender identity disorder, masculine presuppositions, and the anxiety of regulation. Psa Dial  19(4):453-470.
Diamond, M. (2004). The shaping of masculinity: Revisioning boys turning away from their mothers to construct male gender identity. IJP 85: 359-380.

Wednesday, April 22, 2020

More on Gender Identifications

Freud, in Mourning and Melancholia (1917; SE:14), posited that ungrieved loss along with ambivalent identification lead to melancholia. Butler  uses this Freudian idea in her Melancholy Gender (1995) [see post of 4-14-20] and made the very important contribution to gender studies and to psychoanalysis that unmourned homoerotic longing (unmourned because its loss must go unrecognized in a heterosexual culture) constructs melancholic gender identifications with this lost, same sex love object. [Benjamin reminds us that not all identifications come about through exclusion (repudiation, disavowal) or by abandoned love, but come also through inclusion (recognition).]

Jay adds some interesting modifications to Butler’s ground breaking theory. Jay (2007a) refines gender identifications by noting that not all gender identifications are melancholic and she demonstrates that ambivalence is an important component for melancholy gender to develop. Jay also writes (2007b) that Butler does not take into account the ways homoerotic love plays out differently for boys and girls: “Butler does not make a distinction between unavowed loss [in girls] and preemptive foreclosure [in boys].” 

Heteronormatively gendered girls have, then lose, their homoeroctic longing for the same sex parent; Boys, on the other hand, from birth, are prohibited by heteronormative culture from homoerotic longings and so never have this loss to unmourn. [Benjamin, however, also reminds us that the unconscious, having no capacity to hold ‘no,’ does not deal in exclusions, so even what is excluded is represented somewhere in the unconscious mind.] A girl’s identification (to recapture what is lost or to disavow the loss) with mother -- because the loss of homoerotic love is unmourned -- becomes melancholic, whereas boys, having had these homoerotic longings foreclosed, develop anxiety, obsessive-compulsively performing masculinity lest they appear feminine or homosexual in a heterosexual society.

The ambivalence for a little girl in coming to identify with the ‘second’ sex “... suggest[s] that femininity becomes melancholic, at least in part, because the internalization of the feminine places the little girl not just in a disagreeable, one-down position but in an ambivalent, double bind: on the one hand, she internalizes the mother as her only route to preserving same-sex love yet, on the other hand, this feminine identification may reduce her to passive object status.” 
She notes a different, less circuitous, path for boys: [Because] “boys tend to take mother, not father, as their first love” … “For males, then, heterosexual object-choice is often experientially continuous from the pre-Oedipal through the Oedipal stages.” 

Benjamin, H. (1998). Shadow of the Other. Intersubjectivity and Gender in Psychoanalysis. Routledge, New York and London
Jay, M. (2007a). Individual Differences in Melancholy Gender Among Women: Does Ambivalence Matter?. J. Amer. 
      Psychoanal. Assn., 55(4):1279-1320. 
Jay, M. (2007b) Melancholy femininity and obsessive-compulsive masculinity: Sex differences in melancholy 
      gender, Studies in Gender and Sexuality, 8 (2): 115-135.

Tuesday, April 14, 2020

Gender Performance, Gender Melancholy

Judith Butler, like Foucault (social construction of gender in The History of Sexuality, 1976) before her, stresses the performativity of gender. Gender identities are not constitutive but rather  are constructed from repeated performances of gender norms. Butler critiques compulsory heterosexuality and its binary dictates, and sees no need to pathologize performances that do not conform to norms. She critiques as well core gender identity: There is no core identity, only attributes of identity constructed from citation of cultural norms. Normative gender performativity requires the splitting of stereotypical feminine and masculine traits (such as dependency/agency; passivity/activity) which must be repudiated to attain normative gender identity. These binary heterosexual constructs  are performed, while the unmourned, lost homosexual components are barred from performance, and the more entrenchedly their loss is disavowed, the more intolerant of them in others one becomes. Viewed this way, it is normative femininity and masculinity which are pathological for they are sustained by splitting and projection. Performance of them is both symptomatic as well as bulwarking of cultural norms.

Butler  emphasizes a second contribution to the construction of gender identities: Gender identity is constructed from lost and ungrieved homosexual love (e.g. the boy for his father, the girl for her mother) which results in melancholy gender. Melancholy gender results both from repudiation of that of the opposite sex split off as the ‘other,’  as well as from repudiation of same-sex love objects whose loss remain unmourned. Relying heavily on Freud’s Mourning and Melancholia (1917; SE:14), Butler accepts Freud's theory that the ego is constructed from internalization of lost (because forbidden) love objects. This forbidding of love objects in the oedipal period is preceded by the taboo on homosexual love. In repudiating this same sex love, normative femininity and masculinity are embued with melancholy.  (Freud, of course, denying the importance of relationships, reduced this to the intrapsychic, cementing the one-person psychology.) 

Lynn Layton updates Butler to a two person psychology by reminding us that norms are conveyed in a relational matrix and come in a multiplicity of competing norms. Layton critiques Butler stating that dominant norms are not always repressive, and also that internalized relationships are varied and “do not necessarily conform to dominant norms.” Instead of melancholia as described by Freud, Layton sees a resemblance closer to Lacan’s ‘narcissistic’ development of identity: “the Lacanian ego is a structure built on the refusal to mourn losses.”

Layton connects dysthymia to the pain from disappointing relational patterns [insecure attachments?]. This, she says, is what creates melancholy, not -- as Freud, in Civilization and Its Discontents (1930, SE: 21) noted -- a trade off to be part of civilization. Instead, “dysthymia is produced by narcissistic intergenerational relationships that do not tolerate difference…”  She further states, in a beautiful tribute to intersubjectivity, “Difference that does not reduce to sameness (Irigaray, 1985) is only produced in relationships where self and other are both subjects, in relationships of mutual recognition (Benjamin, 1988). In this mode of relating, identifications are not solely forged from a refusal to mourn, the ego is not a substrate of such identifications, and performances of gender or anything else need not violate self or other.”   

Butler, J. (1995). Melancholy Gender—Refused Identification. Psychoanal. Dial., 5(2):165-180.                                                 
Layton, Lynn. (1997). The Doer behind the Deed. Gender and Psychoanal., 2(2):131-155

Sunday, April 5, 2020

Grief in the Time of Corona

David Kessler, a grief specialist and author of “Finding Meaning: the Sixth Stage of Grief,” interviewed on Amanpour & Company on Mar 26, 2020 says, “We’re grieving the world we have now lost: our normal life, our routines, seeing people, our work. Everything has changed. ...That normal world is probably gone forever...a change we didn’t want...a loss of our world. Our world as we knew it has died and we’re feeling the sadness. if we name it [grief] it allows us to be sad, to feel those emotions… [As every therapist knows] Our emotions need motion. We need to feel them. Suppressing them isn’t going to work.”

Moreover, we, for the first time in history, are facing so many tragedies as a result of Covid19 without being able to mark deaths with funerals and memorials. We are isolated with our sadness and loss, a hallmark for creating trauma. Kessler says, “... a death needs to be marked when it happens” and recommends that we have virtual funerals for shared grief. In addition, he recommends that we stay in the present moment [e.g. ‘I have food today.’ or ‘ My loved ones are safe today.’] to avoid anticipatory grief [where we might imagine horrible future things such as imaging illness and poverty befalling us and those we love]; and that we find what we can control such as following guidelines: washing hands, staying at home or staying at least six feet apart.

“This is really a time for us to truly become a truly become our brothers’ and sisters' keeper...a moment for us to share what we have.” Having spent time with Mother Teresa, Kessler shares what she noted: that sometimes poverty in America is ‘worse than ours. Here, if a person has one banana, they share it with everyone while in the USA one may have many bananas and not share them.’ Kessler recommends we create an online network to check in on neighbors, find out what people need and what can be shared, to deliver food, for example, to doorsteps (and then step back six feet).

Kessler knows from his work with Elizabeth Kubler-Ross that the five five stages of grief: denial, anger, bargaining, depression and acceptance, are not linear, and not easy, and that everyone traverses them differently. (Keesler fears that many in the world [Bolsonare of Brazil, until recently, Trump of the USA] are stuck in denial.) From the death of his own son, Kessler found that acceptance was not enough. He introduces the 6th stage of grief, that of meaning. He contemplates: What is there to learn? Where do we find hope? Can we bring about Post traumatic growth instead of PTSD? He says, “We can’t let people die and not find something honorable to bring forth to the future about them.” He gives the instance of his son: In kindergarten his son was voted “most likely to be a helper” which never came to full fruition due to his son’s death at age 21. For Kessler his son’s death brought about his book which now helps others and that gives meaning to his son’s death for his son has now, indeed, become a helper.

Stay safe, everybody. Be strong. Be kind.

Thursday, April 2, 2020

Goldner Contemporizes Gender

Gender, “a necessary fiction;” “a false truth;” “an artifice,” is assembled and constructed from our unique history of relationships both expressing our traumas and losses and preserving our earliest relational paradigms. Gender is not an essence, not an identity, but is constituted kaleidoscopically by cultural, especially family, messages. Normative gender masks our multiplicity and requires that we alienate parts of our subjectivity, thereby doing violence to the self. The myth of a stable gender, like the myth of a unitary self, is a pathological compromise, a carapace, which limits the breadth of possible experiences and expression. Giving up parts of ourselves, including the homoerotic longings for the same sex parent, engenders melancholy.

Freud, in conflating biology (anatomical sex), sexuality and gender, gave us the triple legacy of derogation of women, normative heterosexuality, and dichotomous gender. The division of normative gender into the dichotomy feminine/masculine sets up a hierarchy and power differential where agency is masculine and where misogyny and homophobia reside. Feminist theory, skeptical of essentialism and this artifical division, claims that the gender polarity exaggerates differences and suppresses similarities. The excitement of the erotic is housed in otherness, in the unknown, not just those of the partner, but in confronting the exotic, unkown other selves in the muliplicitous self.

Goldner, V. (1991) Toward a critical relational theory of gender. Psa Dialogues, 1:249-272. 
Goldner, V. (2003) Ironic gender/Authentic sex. Studies in Gender and Sexuality, 4:113-139.

Wednesday, March 25, 2020

Gender Development

In this time of self and imposed quarantine and isolation, TBIPS’ classes continue on in their communion and discussion. This morning the Gender course participants concentrated on Benjamin’s (1995) trajectory of gender development. Remembering that gender is fluid, not fixed, and that the socially constructed binary (masculine/feminine) creates a power differential within this hierarchy, health, then, is the ability to hold in tension difference/sameness and to stand in the space of the multiplicity of genders and selves. How might one develop such a capacity?

Benjamin explicates four phases of gender development: 1) nominal gender-identification formation;2) early differentiation of identifications in the context of separation—individuation; 3) the preoedipal overinclusive phase4) the oedipal phase. 

Early on, children may have nominal awareness of gender differentiation or [?] nominal identification. With developing awareness, the child becomes “overinclusive,” wanting to possess both (perhaps  partly out of envy) and begins to have identifications with both. In the preoedipal rapprochement phase boys and girls identify with father, his otherness, subjectivity with its agency and desire. [We are here not discussing the otherness the mother brings in adding to the dyad her thinking as a third.]  This otherness of the father now becomes part of the child’s self identity (made up of multiple identifications) and is utilized to aid seeing self as different from mother. Benjamin (1991) states the importance for the girl of this identificatory love, different from object love, for the father, with identificatory love as a precursor to object love. Rejection by the father of identificatory love, or its disallowal by the mother, impedes the boy's identification with the father. For the girl, these impediments to identificatory love may lead to diminished agency and desire. The child, beginning to ascertain the meaning attributed to gender difference, begins to fall to one side of the gender binary. In the early oedipal phase, phallic phase, the binary split seems reified and the other is repudiated. Repudiation heralds loss, a giving up (denial, dissociation, split) of parts of the self. In healthy development, the late oedipal phase can allow for an increased capacity to hold the tension between differences and likeness, and to regain them, the capacity being further consolidated in adolescence.

Stamatina Kaidantzi asks: If identifying with the rapprochement father opens the space for otherness for both the boy and girl, is it then easier for the girl to maintain this otherness for she is also like the mother? The girl is both other than the mother and similar to the mother. The boy is other than the mother but is also like the one who confers the otherness, while the girl gets otherness from someone not like her. The boy does not have a sharply demarcated otherness because he is also similar to the other. This may explain why masculinity is more precarious. Euripides Gavras notes how the (positive) oedipal boy attacks the father to gain the opposite sex love object. Perhaps the boy also attacks the father in service of bulwarking the boy’s otherness. 

Benjamin, J. (1995). Sameness and Difference: Toward an “Overinclusive” Model of Gender Development. Psychoanal. Inq., 15(1):125-142.
Benjamin, J. (1991). Father and Daughter: Identification with Difference — A Contribution to Gender Heterodoxy. Psychoanal. Dial., 1(3):277-299.

Sunday, March 8, 2020

Trauma and Psychosis: Gorney's take on Davoine/Gaudilliere on Lacan

On Saturday, March 7, 2020, the Tampa Bay Psychoanalytic Society hosted James Gorney, PhD who introduced us to the delightful work of Francoise Davoine and Jean-Max Gaudilliere. In their book History Beyond Trauma we learn that trauma is a place, a crossroads much like the one where Oedipus meets Tiresias, which is opened up with the therapist as ‘therapon.’  Gorney tells us that a therapon in ancient Greece was one’s battle “buddy” who keeps the warrior spiritually and physically up for the task at hand, like the manager in the corner of the ring who attends to the boxer between rounds. [The dictionary defines therapon as “an attendant (minister) giving ‘willing service’... a faithful attendant who voluntarily serves a tender, noble way.”  I think these aptly apply to our work.] 

In Part I ‘Lessons of Madness,’ Davoine and Gaudilliere emphasize the relationship between social trauma, intergenerational trauma, and the historical effect on the traumatized individual. Like Lacan, they see psychosis as the foreclosure of the Symbolic, existing in the realm of the Real, only able to be represented in the Imaginary’s delusions and hallucinations. What I found most intriguing was their approach to psychosis: Psychosis is the mode of investigation, claiming that trauma is at the root of ‘madness’ and lives in unrepresented states. Thus psychosis is a means of research, with its co-investigator the analyst. Madness, employed as the means of research, investigates the disavowed signifiers of trauma. Signifiers are relational and ensure entry into the Symbolic order. [According to Gorney, the “symbolon” in ancient Greece was a gesture, breaking a vessel between two allies, each fitting together a broken shard, to pledge their mutual hospitality.] The psychotic symptoms are the markers, pointing to the place of unspeakable trauma. “Trauma speaks to trauma and only to trauma.” The analyst must also be with the trauma within. [Gorney gave a lovely metaphor for projective identification: it is the hat of the patient hung on the hook of the analyst.] Davoine and Gaudilliere claim trauma must be “inscribed” to be remembered and brought into a social link. [I wonder if the Boston Change Process Study Group would agree that symbolization of any kind is always necessary, given that a change in implicit relational knowing can occur procedurally without inscription.]

Because trauma is a “war zone,” in Part II ‘Lessons from the Front,’ we learn of four principles drawn from work of  WWI American psychiatrist Thomas Salmon: proximity, immediacy, expectancy, and simplicity. Proximity opens up the space for safety and trust amidst the chaotic trauma. Gorney: ‘I am here with you. We are in this together.’ It is not just the physical proximity, but the willingness to take up the battle together, side by side, and to take care of one another, the therapon. It is also the survival [Winnicott] of the analyst. Medicating symptoms, without investigation and research, is the opposite of proximity. Immediacy allows us to live in the temporal context of the patient’s urgency. Gorney: ‘I will meet you at the place of pain and anxiety.’ Gaudilliere saw madness as the potential for hope and reintegration, the place to begin. Davoine saw delusion as a way of knowledge. Expectancy “constructs a welcome to the return from hell.” Gorney: ‘I say “yes” to you.’ It is the interpersonal place with a trustworthy other of mutual respect, a “primal affirmation,” the validation that yes, something horrible happened. Simplicity refers to speaking directly without jargon. Gorney: ‘I will tell it to you like it is.’ The therapon communicates, always respectfully, without moralizing, without reassuring, without showing-off cleverness, speaking honestly and slicing through the Imaginary.

[Gorney’s rich clinical examples (not related here for confidentiality’s sake) were beautiful, poetic, and moving and I recommend you read his papers.]

Davoine, F. and Gaudilliere, J-M. (2004) History Beyond Trauma. New York: Other Press.