Affect, Representation and Language

Between the Silence and the Cry

Howard B. Levine

• Publisher: Routledge
• Year: 2021
• Print ISBN: 9780367774318
• eBook ISBN: 9781000471663
• Topic: Psychology
• Subtopic: Clinical Psychology
• Index: Psychology

This book presents and elaborates on the rationale and implications of the transformational dimension of psychoanalysis. In so doing, it attempts to extend psychoanalytic theory and practice beyond neurosis and beyond what were formerly thought to be the limits of analytic understanding. Its theoretical vision sits at the crossroads of the thinking of Freud, Bion, Winnicott, Green and the Paris Psycho-Somatic School. Other sources include the contributions of contemporary French psychoanalysts such as Laplanche, Donnet, L. Kahn, P. Miller and the Botellas, along with the work of Alvarez, Scarfone, Ferro, Ogden, and more.

In re-examining the very epistemological foundations of psychoanalysis and their implications for a theory of psychic functioning, it follows upon and extends the radical implications of Freud's 1937 Constructions paper, the thoughts of Bion on intuition and Winnicott's understanding of the working through of the consequences of early pre-verbal environmental failure. In so doing, it makes a case for psychoanalysis as a powerful treatment for borderline, primitive narcissistic, post-traumatic and other character disorders and conditions – including perversions, addictions, psychosomatic, autistic and panic disorders.

By presenting a revised metapsychology that is Freudian, contemporary and clinically near, Affect, Representation and Language. Between the Silence and the Cry offers practitioners at all levels of analytic experience a way of understanding and treating the expanding range of patients and disorders that present for treatment in our modern era.

Chapter 1 Psychoanalysis and subjectivity A personal note

DOI: 10.4324/9781003171331-2

There is a crack in everything.

That’s how the light gets in.

Leonard Cohen (1970)

I

Psychoanalysts gravitate toward the theoretical positions that they favor, not only because those theories possess some clinical usefulness, explanatory value and perceived correspondence with “truth” as they believe that they have experienced it but because those favored theories also fit in some fashion with analysts’ personal needs and past history, with how they construe and wish to construe the world and its ways. It is no accident, then, that I have become interested in the dialectics of separation and union, self and other and the emotional interpenetration of the analytic couple; in the places where words may go missing and fail to represent and convey the thoughts and experience of the speaker; in the unrecognized and unacknowledged performative use of words as concrete actions and memories-in-feeling; in the impossibility of the analyst’s ever achieving a state of pristine and absolute objectivity; in the implications of the analyst’s subjectivity; in the ways in which that subjectivity flows, in part, from the patient’s inner world and helps shape and create the phenomena of the patient’s experience of the analytic process; in the analyst’s struggle to recognize inevitable moments of countertransference feeling and enactment as being of potential value; and in the unending struggle to transcend and transform the unrepresented and weakly represented inscriptions associated with trauma and the pre-verbal period of infancy and to bring order to, make sense of and contain and control some small part of the inchoate, vast and formless void within us.

These preoccupations spring not only from my clinical struggles and experience but from deeply personal roots, as well. I believe, however, that the observations and insights to which they have led go beyond the solipsism of my own wishes and needs and may be of value to others. It is in this spirit that I offer the ideas and experiences that follow, fully aware that this book, as perhaps all books written by and about one’s experience as a psychoanalyst, will reflect a deeply personal journey, one that has taken place at the intersection of psychoanalysis as it has evolved as a field, as it is or was understood – or misunderstood – by me, and the inevitable changes that I have experienced as the result of immersing myself in the lifelong task of and commitment to the study of the mind, my own as well as that of my patients.

I was drawn to psychoanalysis, in part, because of a significant early emotional loss, one that left me feeling restless, incomplete and in search of something. My maternal grandmother, to whom my mother was extremely close, died in the seventh month of my second year. Although never corroborated by family lore and certainly not remembered by me as an ideational “event,” I have developed a strong conviction that this loss precipitated a significant depressive withdrawal on my mother’s part that had profound effects on my emotional development. After much reflection, analysis and life experience, I have come to believe that although in terms of historical reality, the early emotional loss was that of an object, in an important sense of psychic reality, what I felt to be missing and what I have been continuously striving to recover and create has also turned out to be some aspect of my self.

In trying to formulate and speak analytically about what I believe that I have lost and what I have been seeking, I am confronted with a seeming dilemma. What do I view as bedrock: self or object, object or self?

How a given analyst or theory answers this question can have far-reaching consequences for any description of the psyche and conceptualization of its development, for analytic clinical theory and technique. Historically, in our profession, different choices have led to different theoretical emphases and different analytic schools of thought – ego psychology, object relations theory, self psychology, relational psychoanalysis, and so on. What I shall emphasize is that particularly at the level of emerging psychic structure, self and object, object and drive develop from a common matrix and form indissoluble pairs. Each helps constitute and is revealed by the other (Green, 2005a). While complex and intimately connected to the fate and functioning of the drives, the relationship of self and object, particularly at the origins of their psychic representation and as they emerge from some unintegrated, unstructured infantile state or become structured in the analytic interaction, is reciprocal, dialectical and kaleidoscopic.

The complexity and interconnection of self and object has not always been clearly appreciated in psychoanalytic theory. Perhaps the origins of this inattention began with an emphasis on Freud’s (1911a) initial contention that in relation to drive satisfaction, the object was relatively interchangeable and therefore by implication the least important element in the sequence “drive-frustration-desire-satisfaction.”

From our current perspective, we can now see that this description fit within a certain view of Freud’s topographic theory, with its emphasis on what was psychically represented. It applied best to neurotic patients, whose psyches were conflicted, but well organized and structured. These patients possessed more or less well-functioning emotional regulatory capacities and demonstrated robust linkages between word presentations and thing presentations, and between primary and secondary processes.

For better or for worse, however, contemporary clinical experience has repeatedly taught us that this degree of psychic organization and the functional capacity that it supports cannot always be assumed to be present. More often, we are faced with patients and those parts of our patients’ minds (and sometimes our own!) in which the connections between words and things, primary and secondary process and the constitution, continuity and separation of self and object are not the starting points for analytic treatment, but instead its goals. To the extent that the treatment process goes well, these attributes will appear as emerging phenomena that are highly dependent on the specificity and the actual nature of the external object (e.g., the analyst): its receptivity and responses and the interactions that these determine.

Freud, himself, was aware that not every patient was “neurotic” and thereby suitable for the treatment method he was discovering. Thus, early on, he distinguished “transference neuroses” from “actual neuroses” and “narcissistic neuroses” and at times he seemed to believe that only the truly neurotic were suited for his therapeutic method. It was not until the revolutionary reformulations of 1920 and after, as Freud began to lay the groundwork for our appreciation of the radical discontinuity that exists between represented (neurotic) and unrepresented (non-neurotic) mental states, that analysis could begin to more fully develop in new directions, ones that were already indicated and implied in many of Freud’s own early writings. As it did so, analysts began to more closely consider the formulations, interventions and clinical stances needed for the successful treatment of non-neurotic patients and sectors of the mind.

These matters have been taken up at length by many authors, foremost among them for me, Bion (1962b, 1970), Winnicott (1962, 1971) and, especially, Andre Green (1975, 1980, 2005a, 2005b). Following Green’s close reading of Freud – and in line with my own experience (e.g., Levine, 2012) – I have come to accept that there is a radical discontinuity between the drive dominated, unstructured sections of the id and unconscious ego and the word-embedded, structured sectors of the conscious and preconscious mind. This discontinuity determines markedly different challenges to clinical theory and technique that are presented by neurotic and non-neurotic (borderline) patients and states of mind. It is reflected in two different, often-interlaced modes of discourse and communication.

To put it simply, the neurotic is able to semantically describe and recognize descriptions of their inner states and feelings, because they can more or less put their feelings into words. In contrast, the non-neurotic patient unconsciously relies on speech as action in order to transmit and induce emotions in their objects. This non-verbal (para-verbal) form of communication poses considerable challenges for analysts and our “talking cure.”

Despite these challenges, however, and in contrast to Freud’s initial impression, my clinical experience has convinced me that psychoanalysis is an appropriate treatment for both sets of conditions, neurotic and non-neurotic – which, parenthetically, should be expected to occur together in any given patient to various degrees. What has not always been recognized, however, is that the work of psychoanalysis may be quite different for the two groups of patients and/or mental states. What is crucial may depend on whether or to what extent the issues at hand concern what is already represented and can be expressed in words, saturated in regard to ideational meaning, and involve the uncovering of what is hidden, disguised or forgotten versus the very difficult problems of how to foster and participate in a relationship that will help make a portion of previously silent, inchoate forces verbalizable; how to organize and help bind previously unnameable terrors; and how to help catalyze and create the emergence of psychic structure and a true sense of self.

If our theories are to aid us in our struggles to engage with, understand and help all of our patients, the non-neurotic as well as the neurotico-normal, they must clearly alert us to both sides of this discontinuity and divide. They must not be restricted to formulations and descriptions that apply only to neurotic patients, nor must they valorize one side of the seeming dichotomies that we face – one person versus two person psychology; intrapsychic versus relational; self versus object; drive versus object; and so on – at the expense of the other. Instead, our theories must recognize and take into account that, in addition to being opposites at some points of development, at others, these seemingly dichotomous terms form dialectical pairs that at some level are inseparable.

In retrospect, much of my clinical work has been conducted at or beyond the limits of neurosis. This has involved attempts to address these complex issues and to discover with each patient a unique therapeutic course that could address the difficulties that arise in relation to both neurotic and non-neurotic states of mind. I think that I can now see the extent to which my early experiences of loss and its consequences, in conjunction with my clinical experiences, have drawn my attention to these problems of infans, allowed me to try to forge a particular language in which to think about and express their vicissitudes for my self as well as for my patients and have informed a number of the important themes that have engaged my professional interest. It is these problems and themes to which I have turned in the writing of this book. I have been supported in this task by the observation that many others, analysts as well as patients, have had analogous personal experiences and have been encouraged and assisted by my attempts to write and speak about them. Ultimately, these experiences have come to form the kernel of something that, having been lived through myself and recognized in others, I have come to value as important life events.

These are not, by any means, the only terms in which emotional experience and growth can be formulated or achieved, nor are they meant to supplant the more usual iterations of psychoanalytic clinical and developmental theory, although they may prove to comprise an important component of them. Rather, I offer the thoughts that follow as a complementary perspective, a point of entrée from which to approach other theories and an additional lens through which to view the clinical encounter (see also Levine, 2010a, where I propose a two-track theory of psychoanalysis, transformational as well as archeological).

II

If we stop a moment and think about the development of psychoanalysis from the perspective of missing self and/or missing other, we may discern a basic, recurring narrative theme, one that might almost be described as one of our “foundation stories,” told and retold in various “dialects” by the different iterations of theory and schools of psychoanalysis throughout the history of our field. A core element of this story is that psychopathology and symptomatic distress occur when something vital goes missing – from one’s awareness, from one’s self, from one’s facilitating environment, from one’s ability to use one’...

Table of contents

• Cover
• Half Title
• Series Page
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Series editor's foreword
• Acknowledgements
• Foreword - When something vital goes missing
• Introduction: Freud's theory of psychic functioning and its relevance to the analytic process
• Chapter 1 Psychoanalysis and subjectivity: a personal note
• Chapter 2 Freud's theory of representation and the expansion of analytic technique
• Chapter 3 Clinical implications of unrepresented states: effacement, discourse and construction
• Chapter 4 The fundamental epistemological situation
• Chapter 5 Psychoanalysis and the problem of truth
• Chapter 6 The analyst's authority: suggestion, seduction, compliance and influence
• Chapter 7 Trauma, process and representation
• Chapter 8 Making the unthinkable thinkable: Autism, ASD and representation
• Chapter 9 Word, body, thing: on the movement from soma to psyche
• Chapter 10 Psychosomatics and unrepresented states
• References
• Index