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conflicts, such as in spite of ‘knowing’ the adaptive choice, being compelled to commit transgressions or exercise poor judgement. The analyst will attempt to understand the disturbance “within” the superego, and the origins of the conflicting identifications. The superego may turn out to be unintegrated (Ticho, 1972), or, undoing – a defense that attempts to erase guilt through rebellious behavior – may be predominant. In such cases, technique to highlight the defenses against harsh superego functioning, i.e., “confrontation” (Compton, Reporter, 1975), may lead to understanding the undoing (going against one’s values), inhibition of judgment, and/or provocation of punishment in some patients (Freud, 1916). On the other hand, patients with superego deficits (‘antisocial personalities’) with a minimal capacity for experience of guilt, may be untreatable (Blackman & Dring, 2016) or marginally treatable with special measures (Kernberg, 1992, 2007). Contemporary ego psychology addresses conflicts and/or specific developmental deficits both in ego and superego functions, thereby allowing for individualization of diagnosis and treatment, incorporating multiple feedback loops in the clinical setting.
III. Bf. Emerging Developments III. Bfa. Creating a Psychoanalytic Mind
In his recent book of the same name, Fred Busch (2013) considers as the essential curative process a shift in a patient’s relationship to his own mind. With the development of a psychoanalytic mind the patient acquires the capacity to shift the inevitability of action to the possibility of reflection. It is an enormous psychic achievement to view one’s mind as a playground for motivations rather than only a representation of reality, and most importantly potentially frees one from the slavery of the repetition compulsion. In this view, psychoanalytic mind is the way towards a deeper understanding of oneself is through one’s own mind - the essence of what psychoanalysis has to offer. Busch presents a specific method that gives greater clarification on how this happens and the methods to bring this about. In broad-brush strokes, the basic paradigm shift in the psychoanalytic method revolves around what Ogden called, “ thinking about thinking”. It has allowed us to better understand unique ways patients communicate or attempt to not communicate. The major changes that have evolved in the classical method can be characterized in the following way: 1. Working with experience near data; 2. Helping the patient learn how to know his own mind is as important as what he comes to know: ‘ Process knowledge’ over ‘State knowledge’ ; 3. Emphasis on building internal representations and structures. 4. Focusing on the unconscious communication in the psychoanalytic hour; 5. Prioritizing understanding what is going on within the session , rather than primarily searching for the past in the present; 6. The significance of understanding the difference when a patient’s language is an attempt to do something, and when it’s an attempt to communicate something; 7. Working within the transference and countertransference ; 8. Analyzing in a way that leads to self-analysis rather than relying on identification with the analyst’s analyzing function. 9. While the analyst’s
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