Psychic Security: Its Origins, Development and Disruption

Int J Psychoanal , 2004

The concept of trauma currently occupies a central position in interdisciplinary dialogue. Using the concept of psychical trauma as a bridge, the author attempts an interdisciplinary dialogue with psychiatry, biology and neuroscience. Beginning with the concept of psychical trauma in Freud, the author reviews the evolution of Freud’s thinking, and links it with the ideas of Ferenczi and post-Freudian psychoanalytical authors. From a different framework, he considers the present state of research on post-traumatic stress disorder in current psychiatric nosography and attempts an interdisciplinary approximation to the concept of psychical trauma. Interesting ideas like the traumatic situation, trauma spectrum and psychopathological spectrum emerge, which enable a better understanding of the concept of psychical trauma through its relatedness, as a bridge connecting a broad psychopathological range extending from normality to psychosis. The ensuing possible relative loss of nosographical rigour is more than compensated by the resulting increased understanding and enlarged therapeutic possibilities. In the second part of the paper, the author attempts a dialogue with neuroscience, taking into account new advances in current research on emotion and memory, and making them compatible with the psychoanalytical concept of trauma. In this sense, the paper underlines the importance of emotion and crucially of memory, regarded as a fundamental axis of the subject explored in this paper. Here a substantial distinction which is pertinent for analytical work appears: declarative memories versus non-declarative or procedural memories. In a concluding discussion the author argues that, taking into account the implications of these current notions regarding a number of theoretical and technical aspects, psychoanalysis currently holds a privileged position, both in its potential for prevention and regarding the treatment of patients, in so far as, through interdisciplinary dialogue, psychoanalysis can be receptive to and be enriched by the contributions of other disciplines, just as it enriches them with its own contributions.

This paper outlines a historical and critical survey of the contribution of psychoanalysis and other 'psycho-sciences' to our contemporary understanding of Holocaust trauma. It argues that the theme of mass traumatisation effects originates in the use of psychiatric knowledge and procedures during the First World War. As part of the war machine, psychiatry had special functions in the mobilisation of the masses as well as in the treatment and rehabilitation of those soldiers who suffered from 'shell shock' and later developed 'traumatic neuro-sis' or 'war neurosis'. The main task of psychiatrists at that time was to cure these soldiers as quickly and effectively as possible – in order to send them back to the same dangerous circumstances , which had caused their symptoms in the first place. In treating war neurotics, brutal punitive methods such as painful electric shocks were frequently used. Based on archival sources, and on the correspondence between Sigmund Freud and Sándor Ferenczi, the application of these methods is illustrated here through the example of a Hungarian military doctor, Viktor Gonda. The majority of army doctors regarded war neurosis as a character deficiency, a sign of a 'feminine' character. It was thought that this kind of 'male hysteria' could also affect 'healthy' soldiers, destroying their will, determination, patriotism, and heroism. By contrast, the psychoanalytic conception of war neurosis developed by Sán-dor Ferenczi in Hungary and by Karl Abraham and Ernst Simmel in Germany was intended to be a humanising alternative to the dominant, mainly 'punishing' and torturous procedures applied by mainstream military psychiatry. Psychoanalysts emphasised the importance of understanding the patient's symptoms, assuming that their explanation originated in the patient's life history and unconscious motives rather than exclusively in external, physical causes. The psychoanalytic approach to war neurosis anticipated later debates on the nature of individual and collective psychological traumata. This paper surveys the impact of the First World War on the development of the theory and technique of psychoanalysis , including the concepts of Freud, Ferenczi, Melanie Klein, Abram Kardiner, and others. After the Second World War, psychoanalysis was preoccupied with the exploration of the 'Nazi mind', the specific psychological and characterological traits of war criminals, their supporters, and their collaborators. This paper argues that the existence of a Holocaust trauma as a separate group of symptoms was for a long time not really acknowledged. The focus only shifted from perpetrators to victims in the 1970s, due to the introduction of the diagnostic category of PTSD (post-traumatic stress disorder) into the vocabulary of psychoanalysis. This paper, however, argues that the concept of PTSD preserved, in some ways, the dominant discourse of First World War psychiatry, continuing, in a subtler way, to stigma-tise or blame the victims.

Journal of Physiology-Paris, 2010

In this paper, we look back at some of the earliest psychoanalytic approaches to trauma. The theoretical feasibility of reconciling psychoanalytic and neurobiological accounts of the effects of severe stress is examined. First, several epistemic considerations about the concepts of falsifiability and complexity in science are discussed with regard to neuroscience and psychoanalysis. We report the decisive discussions and descriptions of shell shock and hysteria that laid the foundation for the modern notions of dissociation and posttraumatic stress disorder (PTSD). We particularly underline the differences between ''traumatic memory", which merely and unconsciously repeats the past, and ''narrative memory", which narrates the past as past. Then, the construction of the modern concept of PTSD is described and the classification of conversion and dissociative disorders is questioned. In the next section, several recent neurobiological findings in patients with PTSD are reviewed. We place particular emphasis on cognitive impairment and cognitive bias relative to threatening stimuli, and on a general pattern of facilitated and heightened activation of the amygdala for threat-related stimuli, which are both recognized symptoms of PTSD. A possible meeting point between Cannon's and Freud's theoretical concepts is discussed in the frame of a deregulation of the stress system which helps not only to regulate homeostasis but also to adjust behaviour to external threats. We conclude that, although psychoanalysis and neuroscience may reciprocally complement and enlighten each other, their objects and methods, and thence their concepts, are fundamentally different.

The International Journal of Psychoanalysis, 2008

… : An Interdisciplinary Journal for Psychoanalysis and …, 2003

This paper offers some theoretical possibilities for synthesizing psychoanalytic and neurobiological approaches to understanding the effects of severe psychic trauma. The paper argues that biological and psychoanalytic perspectives can enrich and enhance each other in our attempt to understand and ameliorate the damaging consequences of trauma. The findings of biological researchers and the observations of psychoanalysts are integrated, as they apply to two functions that are damaged by trauma: the capacity for representation and the capacity for self-regulation. These capacities are interdependent and interactive. Disrupting either will affect the other. The combined result of this disruption can profoundly alter subjective experience. The paper discusses how helping patients to symbolize traumatic experiences, affect, and other mental states and helping patients regulate physiology and affect through nonverbal, affect-regulating interactions, and through the use of medication, lead to an improved capacity to symbolize, to experience meaning, and to relate and can lead to a subjective sense of increased strength.

This paper examines, from a personal and clinician's perspective, the interrelation between trauma and memory. The author recalls his autobiographical memories and experiences on this two concepts by linking them to other authors thoughts. On the theme of trauma, the author underlines how the Holocaust-Shoah has been the trauma par excellence of the twentieth century by quoting several writing starting from Rudolf Höss's memoirs, Nazi lieutenant colonel of Auschwitz, to the same book's foreword written by Primo Levi, as well as many other authors such as Vasilij Grossman and Amos Oz. The author stresses the distortion of German language operated by Nazism and highlights the role played by the occult, mythological and mystical traditions in structuring the Third Reich,particularly in the SS organization system and pursuit for a pure " Aryan race ". Moreover, the author highlights how Ferenczi's contributions added to the developments of the concept of trauma through Luis Martin-Cabré exploration and detailed study of the author's psychoanalytic thought.

The International Journal of Psychoanalysis, 2008

This paper is devoted principally to a case history concerning an analytic process extending over a period of almost ten years. The patient is B, who consulted the author after a traumatic episode. Although that was her reason for commencing treatment, a history of previous traumatogenic situations, including a rape during her adolescence, subsequently came to light. The author describes three stages of the treatment, reflected in three different settings in accordance with the work done by both patient and analyst in enabling B to own and work through her infantile and adult traumatic experiences. The process of transformation of traumatic traces lacking psychic representation, which was undertaken by both members of the analytic couple from the beginning of the treatment, was eventually approached in a particular way on the basis of their respective creative capacities, which facilitated the patient's psychic progress towards representability and the possibility of working through the experiences of the past. Much of the challenge of this case involved the analyst's capacity to maintain and at the same time consolidate her analytic posture within her internal setting, while doing her best to overcome any possible misfit (Balint, 1968) between her own technique and the specific complexities of the individual patient. The account illustrates the alternation of phases, at the beginning of the analysis, of remembering and interpretation on the one hand and of the representational void and construction on the other. In the case history proper and in her detailed summing up, the author refers to the place of the analyst during the analytic process, the involvement of her psychic functioning, and the importance of her capacity to work on and make use of her countertransference and selfanalytic introspection, with a view to neutralizing any influence that aspects of her 'real person' might have had on the analytic field and on the complex processes taking place within it.

International Journal of Psychoanalysis, 2008

This paper is devoted principally to a case history concerning an analytic process extending over a period of almost ten years. The patient is B, who consulted the author after a traumatic episode. Although that was her reason for commencing treatment, a history of previous traumatogenic situations, including a rape during her adolescence, subsequently came to light. The author describes three stages of the treatment, reflected in three different settings in accordance with the work done by both patient and analyst in enabling B to own and work through her infantile and adult traumatic experiences. The process of transformation of traumatic traces lacking psychic representation, which was undertaken by both members of the analytic couple from the beginning of the treatment, was eventually approached in a particular way on the basis of their respective creative capacities, which facilitated the patient's psychic progress towards representability and the possibility of working through the experiences of the past. Much of the challenge of this case involved the analyst's capacity to maintain and at the same time consolidate her analytic posture within her internal setting, while doing her best to overcome any possible misfit (Balint, 1968) between her own technique and the specific complexities of the individual patient. The account illustrates the alternation of phases, at the beginning of the analysis, of remembering and interpretation on the one hand and of the representational void and construction on the other. In the case history proper and in her detailed summing up, the author refers to the place of the analyst during the analytic process, the involvement of her psychic functioning, and the importance of her capacity to work on and make use of her countertransference and selfanalytic introspection, with a view to neutralizing any influence that aspects of her 'real person' might have had on the analytic field and on the complex processes taking place within it.

International Forum of Psychoanalysis, 2003

Disruption and loss characterise the life of the person who has undergone extreme traumatisation (torture, concentration camp, etc.), especially when he/she lives in exile. This presents new challenges both in understanding trauma and massive traumatisation and in treating it. When planning and conducting treatment, it is of special importance to take into consideration the mental survival strategies that the person has developed. These are mental capacities that aim both at developing methods of avoiding the pain of re-experiencing and at achieving solutions to the dilemmas posed by the posttraumatic phase. The latter often consists of aborted attempts at mentalisation and integration of traumatic experiences. The traumatised person will often experience the therapeutic encounter as threatening because of fear of re-experiencing and re-traumatisation, and also because having experienced atrocities disturbs or damages the capacity for developing a trusting relationship. This paper discusses the complexities of the consequences of this situation and describes a model for a psychoanalytic approach to the treatment of these patients, focusing on the disturbance of symbolisation and mentalisation caused by trauma. Treatment must address this and provide a setting where experiences that have been insufficiently symbolised (expressed in somatisation, acting, non-verbal characteristics of speech, procedural aspects of transference, etc.) can be placed in context through a process of historisation.

2018