Wednesday, June 26, 2013

clinical techniques- imagos- active imagination

In the last few months I've become more and more aware that the idiosyncratic word choices of patients that my 'even hovering attention' feels are significant don't only lead to repressed memories but also lead to encounters of missed maturation (full identifications- trito stages) or re-fusion of the ego ideal to the imago (partial identification- aim-inhibited desire of triangular complexes).

For example, one patient used the expression 'squeaky clean' which seemed out of place a little (she said it with a different tone). I asked for her association and she said boots that are cleaned and polished and shiny. I asked for her association to this and she said the army and from here produced a memory of having tried to enlist. We went on to explore her feelings at that time and why she wanted to enlist and that emotional climate had a lot in common with her current situation which is to continue in her sobriety when she's traditionally been impulsive. Her phallic trito renunciation, which she's never performed is now on the horizon even though wasted energy from earlier defusions will still have to restored to fusion before she'll have the strength.

Another patient gave used the idiosyncratic analogy of me leaving a bunch of pens on the table and telling others not to touch them in order to illustrate how one must deal with someone who is acting childlishly. I asked him to tell me the story (i.e. make one up) of how a father who left his pens on his table is trying to impart a lesson to his son. The patient spent a good 20 minutes of the session explaining how the father would test the son and ask him if he touched the pens to see if he would lie or not (all the while knowing that they had been touched because he left them in an exact configuration). The father would go one route if the son lied, another if he didn't, but in both cases he wanted the son to learn something and cared about him. As always, the test in these cases that the intervention worked is only to see the genuine affect in the response and to notice that there is progressive communication in the following sessions (new topics, talking about more personal things, etc.). I believe this patient was working with the father imago that he needed and felt defused from. I didn't have to wait for the transference to work through this in my person but was able to just witness as he fused it himself.

When one has an altruistic, imaginative patient one has to keep open for magical figures or things in the narrative. When they mention these things active imagination will allow for them to make up story and combining some of the figures with I statements, if they are defused images, or just allowing the figures to heal each other, is valuable.      

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