Saturday, February 11, 2012

psychoanalytic basics: transference and world-views

I’d like to share a conceptual tool that should make it easier to talk about how regressed your patient is. The Moderns seem to talk about the Oedipal or object level neurotic and everything before that is narcissism. Meadow talks about the patient having no object in awareness to symbiosis with the object and gradual separation to the point where the analyst will receive an object transference. The analyst with a lot of experience may intuitively grasp this but it doesn’t do much for the novice. In Totem and Taboo Freud uses the history of worldviews (Weltanschauung) that will allow us to examine the transference and discourse of the patient to convey the patient’s regression:

At the animistic stage men ascribe omnipotence to themselves. At the religious stage they transfer it to the gods but do not seriously abandon it themselves, for they reserve the power of influencing the gods in a variety of ways according to their wishes. The scientific view of the universe no longer affords any room for human omnipotence; men have acknowledged their smallness and submitted resignedly to death (Totem and Taboo, p.88)

Freud simply examines these worldviews by the decreasing amount of narcissism they represent. In primary narcissism, in which the child is its own ideal there is omnipotence (animistic stage). In secondary narcissism ego and object libido emerge as impulsive connections with an outside power which is greater that the individual (religious stage). Lastly, in science one appeals to one’s peers in the reproducibility of the experiment and individual narcissism is reduced and the beautiful sentiments surrounding another world in which those suffering in this world will have bliss in the next is substituted for finitude.

There are two important corrections to make to these world-views. The first is that Freud wrongly attributes omnipotence to the child in primary narcissism as if the ego was fully developed and had a place for an ideal and it just happened to select itself first. Later analysts like Lacan and Hartmann corrected this by introducing the concepts of the mirror stage and self-representation which represent the child being able to take itself as an object in a new way (i.e. an ontogenetic development). Edith Jacobson writes:

Freud describes the megalomanic attitudes of children, primitives, and schizophrenics, their belief in the omnipotence of thoughts and in the magic of words, as evidence of “primary narcissism”. Actually, however these attitudes appear to be manifestations of beginning “secondary narcissism” or, as we should rather say, of preoedipal stages of ego formation and of a beginning establishment and cathexis of self and object images… To these stages the psychotic ego appears to regress (The Self and the Object World, p.102).

Thus, when you experience a true narcissistic transference in which the patient wants to believe you are identical to him it has nothing to do with him believing he is omnipotent. As soon as megalomania or extreme idealization of that analyst occur the patient is in secondary narcissism or the religious stage. In animistic religions primitive tribes simply externalize human motivations, feelings, and sensations in to nature (i.e. anthropomorphize). The psychotic patient in primary narcissism does the same to the analyst. One of my patients at field placement asked how old I was and when I deflected he told me 69 (his age) and when I ask him questions about the mundane things he brings up he’s always quick to ask me if I like the same food as him or whether I’ve been to the same places. Another one of my patients is always mentioning the degrees that the people around him have and how the head social worker sent me to him and that she doesn’t make mistakes. He’s in a realm where there is power and an ideal. He idealizes others and goes throughout the rest home talking to different staff members (an object cathexis as opposed to narcissistically inflating himself in an ego cathexis). However, he occasionally brings up his magic abilities, such as picking winning lottery numbers or tickets for people and feels that I am ungrateful and using him as a ‘stepping stone’ because I’ll add his knowledge to my own and write a book that will make me famous and rich.

The second correction to Freud’s analysis of world views is that individual narcissism doesn’t simply disappear after the child renounces its incestuous desires towards the mother and accepts ‘the law’ of the father. After the mother is given up as a sexual object by the boy and girl they turn towards the father and this longing Freud equates with both religious longings for God as well as the relation with the father imago which also creates the devil (Freud, ‘A Seventeenth-Century Demonological Neurosis’). In other words, the end of the religious stage will always deal with matters of good evil and personal sin for those with an emphasis on object drives or with glory, pride, and narcissistic injury for those with an emphasis on ego drives. Our use of the word shame covers both these positions i.e. “Aren’t you ashamed your younger brother beat you in an arm wrestle” or “You should be ashamed of yourself for saying such dirty words”.

Although science does appear historically after the great monotheistic religions of good and evil have their day it is certainly still not fully accepted within any culture. The president must be religious to get elected, psychoanalysis (the science of the mind) is not accepted in universities, and the social sciences suffer from post-modern fragmentation. Freud clearly recognized that no culture was ready to fully accept psychoanalysis and that it’s acceptance represented the danger of it being watered down. He also recognized that after individual narcissism (i.e. the secondary narcissism of various ego ideals) a social ideal was formed that it was possible to derive narcissism from:

The satisfaction which the ideal offers to the participants in the culture is thus of a narcissistic nature; it rests on their pride in what has already been successfully achieved... On the strength of these differences every culture claims the right to look down on the rest… The narcissistic satisfaction provided by the cultural ideal… can be shared in not only by the favoured classes, which enjoy the benefits of the culture, but also by the suppressed ones, since the right to despise the people outside it compensates them for the wrongs they suffer within their own unit. No doubt one is a wretched plebian, harassed by debts and military service; but, to make up for it, one is a Roman citizen, one has one’s share in the task of ruling other nations and dictating their laws (Freud, Future of an Illusion, p.13).

In a more contemporary view, one can be a piece of white trash with massive credit card debt and harassed by child protective services but one is American! And, even though you don’t have a passport and have never travelled anywhere else you know that America is the best place in the world. Historically, science had its beginnings along with nationalism the marked the bourgeoisie’s replacement of medieval guilds and the church’s grip on intellectual life with capitalism. So, while we bring the schizophrenic into an object transference after moving past shame, the neurotic who has accepted ‘the law’ has to be moved beyond his social narcissism and compulsive adherence to norms. He has turned his ‘magical’ and impulsive relations to secondary narcissism into fantasies but he suffers from compulsive problems related to identity and social narcissism. Here I have a patient who could never leave her husband. She “loves” him but no longer feels passionately about him or enjoys sex with him. When I question her general ideas of expectations of their families and friends and pleasant things about the arrangement come up. She feels something is lacking in her life and she just plans for vacations which are never really satisfying. The sacrifice of the magical self (ego drives) or magical world (object drives) in the neurotic means that he is committed to identities and his transference is based upon the analyst having recognized credentials and prestige within society. Historically speaking, the world-view of science will only come into existence once this social narcissism has been overcome and neither corporate interest, national boundaries, nor post-modern relativism interfere with science.

In sum, we are dealing with three types of transference:

-primary narcissism in which the patient externalizes his own attributes to the analyst just as what is human is externalized into nature in animism

-secondary narcissism in which the patient idealizes the analyst or is the possessor of magic and wants to be admired or mirrored just as gods are worshipped and either have children with humans or grant mortals power in religions.

-social narcissism in which the patient accepts the opinions of the elite in the groups he belongs to as worth more than his own and the analyst is deferred to because of his education or dismissed because his lack of it just as September 11th meant that all Muslims were bad and racism writes over the individuality of a person in favour of their group identity.

There are, of course, interesting sub-phases of these general groups. For example, the shame I mentioned in relation to religions of good and evil. There would also be states before the animistic transference in which transference just touches upon the analyst like light on a window. Anyway, I hope this sketch might allow you to convey your impressions of your patients in a more satisfying way.

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