Essay // Psychoanalysis: History, Foundations, Legacy, Impact & Evolution

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Photographie: Danny D’Purb © 2008

History and Background

In contemporary psychology, the psychoanalytic movement’s place is both unique and paradoxical. Focussing on the study of the mind as a “software” running on the brain as the “hardware”, psychoanalysis remains the only discipline that truly focuses on the mechanism and processes behind our thoughts. Unlike empirical behavioural science and other “cogno-sciences” that can be fairly barbaric and obstinate in the forced application of the rigid mathematical and reductionist systematic procedures embedded in the classic scientific method when dealing with an entity as complex and organic as the human mind; psychoanalysis has remained focussed in understanding human psychology by capturing it in all its details, depths, dimensions and linguistic aspects.

The scientific method although a proven mathematical approach to inquiries in the hard sciences [e.g. biology, medecine, physics, chemistry, astrophysics, material science, astronomy, etc], shows its limitations when used as a tool for psychological inquiry in the measurement of variables that are incredibly hard to measure such as emotions, values, motives, desires, libidinous intensity or dreams. It is also fair noting that humans are different from simple organisms, molecules or robots, hence psychoanalysis remains the only discipline focused on the mind [the software] assuming that most human beings have a physiologically healthy brain [the hardware].

However, modern sciences have discovered how abnormalities in the brain’s physiology due to birth defects or injury may result in behavioural problems linked to a deficient mind due to the defective brain [hardware] at its disposal. Hence, nowadays most good intellectuals in the field of psychoanalysis would likely be a better psychologist with an in-depth knowledge of the physiology of the brain, i.e. the major areas affecting core functions such as speech [Wernicke and Broca’s], vision [the occipital lobe], and motor abilities [parietal lobe], etc.

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This is because some psychological problems may on rare occasion be caused by brain injuries or physiological abnormality due to virus, trauma, stroke or injury. In those cases where such a scenario materialises, the psychotherapist may refer the patient to a neurosurgeon who may be more appropriate to inspect the extent of the problems on the defective brain [hardware] which may lead to a clearer perspective of the limitations being imposed on the mind of the affected individual and how it impacts processes such as the conscious, the preconscious and the unconscious [based on Sigmund Freud’s 1st ground breaking theory of mental life, the Topographic Model, which was also adopted by Jacques Lacan who argued convincingly that post-Freudian psychoanalysts had swayed too far from the fundamental concepts and turned psychoanalysis into a confusing genre].

However, as we are in the developmental stages of conception of the organic theory, a theory that takes the focus on the individual organism’s creative ability to another level, we are going to remain focussed on the mind. The organic theory was inspired by the brain’s magnificent ability to learn any age, and thus give the individual human organism the ability and freedom to define, create, redefine, recreate and shape itself based on its inherited and acquired abilities, desires and personal constructionist developments throughout its life – yes, the individual does have choices and these impact the person’s internal working model of mental life and the person as a whole along with his or her environment.

While psychoanalysis remains one of the most widely known schools of psychology it is perhaps not universally understood. The founder of psychoanalysis, Sigmund Freud is perhaps one of the most famous psychologist of the last century even if his chosen discipline, psychoanalysis, has little in common with the other schools of thought and psychology.

Psychoanalysis views the mind as an active, dynamic and self-generating entity, and this is in the German tradition of mental life [it was also a founding assumption for Jean Piaget as he developed his Theory of Cognitive Development in Children]. Freud saw psychoanalysis as a revolution of the mind that had to disturb the consciousness of the world, and viewed the unconscious as a reservoir of impulsive force repressed in the biological depths of the soul.

Exploding Raphaelesque Head - Salvador Dali (1951) dpurb d'purb website

« Tête Raphaélesque Éclatée » par Salvador Dali (1951)

It is also important to note that Freud was trained in hard sciences, yet his system shows little appreciation for systematic and reductionist empiricism. As a physician, Freud used his observational skills to build his system within a medical framework, basing his theory on individual case studies. He did not depart from his understanding of 19th-century science in the effort to organise his observations, neither did he attempt to test his hypotheses rigorously through independent verification. As he testified, he was psychoanalysis and did not tolerate dissension from his orthodox views. Nevertheless, Freud had a tremendous impact on 20th century psychology, perhaps more importantly, the influence of psychoanalysis on Western thought, as reflected in literature, philosophy and art, significantly exceeds the impact of any other system and school of psychology.

 

The Active Mind

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Photographie: Danny D’Purb © 2012

Going back to the philosophical foundations of modern psychology in Germany during the 17th, 18th and 19th centuries, we found that the tradition of Leibniz and Kant clearly emphasised mental activity. This is in contrast to British empiricism, which assumed the mind to be a passive entity [such as a sponge that simply soaks in what is thrown at it]. The German tradition held the most logical and creative assumption that the mind itself generates and structures human experience in characteristic ways [being « active »]. Whether through Leibniz’s monadology or Kant’s categories, the psychology of the individual could be understood only by examining the dynamic, inherent activity of the mind.

Throughout the years, as psychology evolved into an independent discipline in the latter part of the 19th century under Wundt’s tutelage, the British model of mental passivity served as a guiding philosophy. Clearly, Wundt’s empiricistic formulation was at odds with German philosophical precedents, recognised by both Stumpf and Brentano. Act psychology and the psychology of non-sensory consciousness represented by the Würzburg School were closer to the German philosophical assumptions of mental activity than to Wundt’s structural psychology. The Gestalt movement encompassed these alternatives to Wundt’s psychology in Germany. Eventually, as the rational outcome guided intellectuals, Wundt’s system was replaced by Gestalt psychology, turning into the dominant psychology in Germany prior to World War II – one based on a model of the mind that admitted inherent organisational activity.

The assumptions underlying mental activity in Gestalt psychology were highly qualified, where construct for mind involves the organisation of perception, based on the principle of isomorphism, which resulted in a predisposition toward patterns of personal-environmental interactions. The focus on organisation meant that the way of mental processes, not their content, was inherently structured. In other words, individuals were not born with specific ideas, energies, or other content in the mind; rather, the organisational structure was inherited to acquire mental contents in characteristic ways. Accordingly, the Gestalt movement, while rightly rejecting the rigidity of Wundt’s empiricistic assumptions and concepts, did not reject empiricism completely [as a technique to study some basic and easily defined variables (such as traits) and their relation(s) to others]. Instead, the Gestaltists advocated a compromise between the empiricist basis of British philosophy and the German model of activity. Consequently, this opened psychological investigation to the study of complex problem-solving and perceptual processes.

Consistent with the Gestalt foundations, psychoanalysis was firmly grounded in an active model of mental processes, however it shared little of the Gestalt commitment to empiricism. Freud’s views on personality were consistent not only with the activities of mental processing suggested by Leibniz and Kant, but also with the 19th century belief in conscious and unconscious levels of mental activity. In acknowledging the teachings of such philosophers as Von Hartman and Schopenhauer [Read the Essay on our Review of « Die Welt als Wille und Vorstellung »(The World as Will and Idea), Freud developed motivational principles that depended on energy forces beyond the level of self-awareness.

Schopenhauer

Arthur Schopenhauer (1788 – 1860)

Moreover, for Freud, the development of personality was determined by individual, unconscious adaptation to these forces. The details of personality development as formulated by Freud are outlined below; however, is also important to recognise the fundamental basis of Freud’s thinking. Psychoanalysis is based on the implication of mental activity further than any other system of psychology. As a major representative of a reliance on mental activity to account for personality, psychoanalysis is set apart from other movements in contemporary psychology. In addition, psychoanalysis unlike the other branches of psychology, did not emerge from reductionist empirical research that stubbornly tries to apply mechanical scientific methodology to measure complex non-physical abilities; rather it was the product of the applied consequences of clinical practice [i.e. it was a force that was born on the field to treat mental problems as they surfaced throughout human history].

 

The Treatment of Mental Illness

Besides being the founder of the psychoanalytic movement in modern psychology, Freud is also remembered for his efforts in pioneering the upgrade in the treatment of mental and behavioural abnormalities, and was instrumental in psychiatry’s recognition as a branch of medicine that specifically deals with psychopathology. Before Freud’s works in attempting to devise effective methods of treating the mentally ill, individuals who deviated from socially acceptable norms were usually treated as if they were criminals or demonically possessed. Although shocking controversies in the contemporary treatment of mental deviancy appear occasionally, not too long ago such abuses were often the rule rather than the exception.

The treatment of mental illnesses was never a pleasant chapter in Western civilisation and it has been pointed out many times that abnormal behaviour is often mixed up with criminal behaviour as with heresy and treason. Even during the period of enlightenment during the European Renaissance, the cruelties and tortures of the inquisition were readily adapted to treat what we nowadays qualify as mental illness. Witchcraft continued to offer a reasonable explanation to such eccentric behaviour until recent times. Prisons were established to house criminals, paupers, and the insane without any differentiation. Mental illness was viewed as governed by evil or obscure forces, and the mentally ill were looked upon as crazed by such weird influences such as moon rays. Lunatics or “moonstruck” persons, were appropriately kept in lunatic asylums. As recently as the latter part of the 19th century and the beginning of the 20th century, the institution of for the insane in Utica, New York, which was progressive by the standards of the time, was called the Utica Lunatic Asylum. The name reflected the prevailing attitude toward mental illness.

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« Dr. Philippe Pinel at the Salpêtrière », 1795 by Tony Robert-Fleury. Pinel ordering the removal of chains from patients at the Paris Asylum for insane women

Reforms in the treatment of the institutionalised insane were slowly introduced during the 19th century. In 1794, Philippe Pinel (1745 – 1826) was appointed the chief of hospitals for the insane in Paris, and managed to improve both the attitude toward and the treatment of the institutionalised insane. In the United States, Dorothea Dix (1802 – 1887) accomplished the most noticeable reforms in the treatment of the mentally ill. Beginning in 1841, Dix led a campaign to improve the condition of indigent, mentally ill persons kept in jails and in poorhouses. However, these reforms succeeded in improving only the physical surroundings and maintenance conditions of the mentally ill; legitimate treatment was minimal. [Even today, in 2019, the US seems to have more people with eccentric behaviours and with questionable mental stability, for example, Donald Trump, who has been singled out as being mentally ill by more than one. See: (1) The Dangerous Case of Donald Trump, (2) Trump Is ‘Mentally Ill’ Says Former Vermont Governor and Doctor Howard Dean, (3) American psycho? Donald Trump’s mental health is still a question, (4) Psychiatrist: Trump Mental Health Urgently Deteriorating & (5) Stanford’s Zimbardo asks: Is President Trump mentally ill?

Confidence in US

Around the world, favorability of the U.S. and confidence in its president decline / Source: Pew Research Center

The US has more women in prison than China, India & Russia combined

According to the International Centre for Prison Studies, nearly a third of all female prisoners worldwide are incarcerated in the United States of America. There are 201,200 women in US prisons, representing 8.8 percent of the total American prison population. / Source: Forbes

Most people in prison

Highest to Lowest – Prison Population Total / Source: World Prison Brief

Efforts to develop comprehensive treatments were plagued by various quacks, such as the pseudoscience developed by Mesmer that dealt with the “animal spirit” underlying mental illnesses [although it may be true today if expressed as a metaphorical description to some of the behavioural manifestations of some mental disorders in some individuals].

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« White Dogs and Tootsie Pops » by Marie Hughes

Similarly, the phrenology of Gall and Spurzheim advocated a physical explanation based on skull contours and localisation of brain functions – which was of course also wrong.

Gradually however, attempts were made to develop legitimate and effective techniques to treat emotional and behavioural abnormalities. One of the more productive investigations involved hypnotism and was pioneered by a French physician, Jean Martin Charcot (1825 – 1893). Charcot gained widespread fame in Europe, and the young Freud amazed by his abilities, studied under him, as did many other talented physicians and physiologists. He treated hysterical patients with symptoms ranging from hyper-emotionality to physical conversions of underlying emotional problems that the patient could not confront when conscious.

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Une leçon clinique à la Salpêtrière (1887) » with Jean Martin Charcot in Front (A Clinical Lesson at the Salpêtrière) par André Brouillet à l’Université Paris Descartes

Another French physician in Nancy, namely Hippolyte Bernheim (1837 – 1919), developed a sophisticated analysis of hypnosis as a form of treatment, using underlying suggestibility to alter the intentions of the patient. Finally, Pierre Janet (1859 – 1947), a student of Charcot, used hypnotism to resolve the forces of emotional conflict, which he believed were basic to hysterical symptoms. However, it was Sigmund Freud who went beyond the techniques of hypnotism to develop a comprehensive theory of psychopathology from which systematic treatments evolved. Later, Jacques Lacan (1901 – 1981) would pulverise the tradition inherited from hospital medecine which consisted of displaying  a patient before an audience of practitioners or students and asking questions whose deeper meaning was supposed to escape the patient. The actors in this ceremonial, the patients, trained by years of confinement, actually produced all the symptoms that the masters of the asylum expected of them. Lacan shattered this clinic with his gaze in order to give a voice to the mentally ill. Jean-Bertrand Pontalis said: « Lacan était extraordinairement courtois avec ses malades, les traitant pas du tout comme des patients d’asile – c’est la moindre des choses, mais ce n’est pas toujours le cas – comme des êtres humains et les amenaient peu à peu, créant une atmosphère de confiance, à les laisser parler très très librement. Pour l’anecdote, c’est assez savoureux, je me souviens qu’une fois il y avait une femme qui était paranoïaque qui se plaignait qu’on l’a suivi partout, « On me suit, on me suit, on me suit, on me suit partout… », Lacan à la fin lui dit, « Ne vous inquiéter pas chère madame, je vais trouver quelqu’un pour vous suivre » entendant par la, un médecin qui pourra lui traiter. Comme si lui-même, dans ces années-là était en train d’inventer et de s’inventer. Nous participions en accord avec lui en résonance avec lui à un mouvement inventif. » [French for: « Lacan was extraordinarily courteous with his patients, treating them not at all like asylum patients – to say the least but this is not always the case – like human beings and gradually, creating an atmosphere of trust, he led them to let them speak very, very freely. For the anecdote, it’s quite tasty, I remember that once there was a woman who was paranoid complaining that she was followed everywhere, « They follow me, they follow me, they follow me, they follow me everywhere… », Lacan at the end said to her, « Don’t worry dear lady, I’ll find someone to follow you » hearing by this, a doctor who will be able to treat her. As if he himself, in those years, was in the process of inventing and inventing himself. In agreement with him, we were participating in an inventive movement in resonance with him. »]

 

A Biography of Sigmund Freud

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Sigmund Freud (1856 – 1939) / Image: Freud Museum London

Since psychoanalysis as we know it today is hugely influenced by the foundations laid by Sigmund Freud, it is worthwhile to have an understanding about the major points in his life. Sigmund Freud (1856 – 1939) was born on the 6th of May 1856 in Freiberg, Moravia, at that time a norther province of the Austro-Hungarian Empire, today a part of the Czech Republic.

Freud was the eldest of 8 children, and his father was a relatively poor and not very successful wool merchant. When his business failed, Freud’s father moved with his wife and children [as many jews are accustomed to migrating to better places in the quest for a better life and income] first to Leipzig and then to Vienna when Freud was 4 years old. The young Freud remained in Vienna for most of the rest of his life, and his precocious genius was recognised by his family, and he was allowed many concessions and favours not permitted to his siblings. For example, young Freud was provided with better lighting to read in the evening, and when he was studying, noise in the house was kept to a minimum so he would not be disturbed.

Freud’s interest were varied and intense, and he showed an early inclination and aptitude for various intellectual pursuits. Unfortunately, Freud was a victim of the 19th century Jew-dislike which was obvious and severe in central and Eastern Europe after the numerous accounts of Jews being banished from places all over Europe due to their occult and violent religious practices on Christian infants [e.g. human sacrifices] along with their known habits in monopolising the majority of the press businesses to then distort news and heritage to their agendas and economic advantage.

However, although Freud was an atheist and more scientifically minded, his Jewish birth precluded certain career opportunities, most notably an academic career in university research. Indeed, medicine and law were the only professions open to Vienna Jews.

Freud’s early reading of Charles Darwin intrigued and impressed him to the point that a career in science was most appealing. The closest path that he could follow for training as a researcher was an education in medicine. Hence, Freud entered the university of Vienna in 1873 at the age of 17. However, because of his interests in a variety of fields and specific research projects, it took him 8 years to complete the medical coursework that normally required 6 years.

Eel

In 1881, he received his doctorate in medicine. While at university, Freud was part of an investigation of the precise structure of the testes of eels, which involved his dissecting over 400 eels. Later, he moved on to physiology and neuroanatomy and conducted experiments examining the spinal cord of fish. While at Vienna, Freud also took courses with Franz Brentano, which formed his only formal introduction to 19th century psychology.

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After waiting for Freud for about 4 years, his fiancée, Martha Bernays, a jewish girl from a business family and the grand-daughter of a famous Rabbi in Hamburg, married him. While she did not show great interest in Freud’s intellectual pursuits, her younger sister Minna became a very close intellectual partner of Freud. Carl Jung one of Freud’s intellectual ally who would become one of his firmest critic would even later say that he learned from Minna that Freud was in love with her and their relationship was very “intimate” – although we have no factual confirmation of such. She was so close to the young couple, that she moved in with them in the 1890s to set up was has been “jokingly” called a “ménage a trois”. As for Martha, she was also a charmer, intelligent, well-educated and fond of reading who as a married woman ran her household efficiently and was almost obsessive about punctuality and dirt. Firm but loving with her children, French analyst René Laforgue said that she spread an atmosphere of peaceful joie de vivre through the household. Shortly after Freud’s wedding, he recognised that a scientific career would not provide adequate income, since anti-Jewish sentiments were strong around Europe and this worked against Jewish advancement in academia even if Freud himself was not a practising Jew or had any religious sentiments. So Freud reluctantly decided to begin a private practice. Although the young couple were very poor in the early years of their marriage, Freud was able to support his wife and his growing family, which eventually included 6 children. The early years in private practice were very difficult, requiring long hours for a meagre financial reward that basically did not challenge him. Freud was also an atheist and did not want psychoanalysis to be seen as a purely Jewish endeavour, and his close network although were mainly Jewish later slowly grew to incorporate European intellectuals where some of the most significant would disagree with some of his assumptions and leave his circle after keeping only a few of his fundamental concepts about the theory of mental life.

During his hospital training, Freud had worked with patients with anatomical and organic problems of the nervous system. Shortly after starting private practice, he became friendly with Josef Breuer (1842 – 1925), a general practitioner who had acquired some local fame for his respiration studies. This friendship provided needed stimulation for Freud, and they began to collaborate on several patients with nervous disorders, most notably the famous case of Anna O., an intelligent young woman with severe, diffuse hysterical symptoms. In using hypnosis to treat Anna O., Breuer noticed that some specific experiences emerged under hypnosis that the patient could not recall while conscious. Her symptoms seemed to be relieved after talking about these experiences under hypnosis. Breuer treated Anna O. daily for over a year, and became convinced that the “talking cure”, or “catharsis”, involving discussion of unpleasant and repulsive memories revealed under hypnosis, was an effective method in alleviating her symptoms. Unfortunately, Breuer’s wife became jealous of the relationship; that would later be called positive transference of emotional feelings to the therapist”. This would later be explained as patients falling in love with the new object [in this case, the psychoanalyst] at which they redirect feelings and desires retained in childhood at characteristic stages of therapy. This looked suspicious to Breuer’s wife. As a result, Breuer terminated his treatment of Anna O. Freud was also very professional with his clients and never had any mistresses or took advantage of his female patients. In opposition to positive transference, the psychoanalyst may also face negative transference in treatment with patients, which refers to aggressive affects, definitions that would also be taken by Lacan who criticised Ego-psychology for defining transference simply in terms of a range of affects. Lacan explained that transference does not refer to any mysterious property of affect in patients, and even when it reveals itself under the appearance of emotion, it only acquires meaning by the virtue of that very precise dialectical moment in which it is produced; that is to say that transference with patients often manifests itself in the form of strong affects, such as love and hate, but it does not consist of such emotions, it is part of the structure of the intersubjective relationship of patients in praxis with the psychoanalyst at that very moment. Lacan saw the Symbolic aspect of transference, which is repetition, as a feature that helped the treatment of patients since it reveals the meaningful signifiers of the personal history of Subjects, while the Imaginary aspect (love and hate) during treatment acts as resistance to psychoanalytic praxis.

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Jean-Martin Charcot (1825 – 1893) / Charcot first began studying hysteria after creating a special ward for non-insane females with « hystero-epilepsy ». He discovered two distinct forms of hysteria among these women: minor hysteria and major hysteria. His interest in hysteria and hypnotism « developed at a time when the general public was fascinated in ‘animal magnetism’ and ‘mesmerization' », which was later revealed to be a method of inducing hypnosis.
Charcot argued vehemently against the widespread medical and popular prejudice that hysteria was rarely found in men, presenting several cases of traumatic male hysteria. He taught that due to this prejudice these « cases often went unrecognised, even by distinguished doctors » and could occur in such models of masculinity as railway engineers or soldiers. Charcot’s analysis, in particular his view of hysteria as an organic condition which could be caused by trauma, paved the way for understanding neurological symptoms arising from industrial-accident or war-related traumas.

In 1885, Freud received a modest grant that allowed him to go to Paris to study with Jean-Martin Charcot for 4 and half months. During that time he not only observed Charcot’s method of hypnosis [which he never managed to master as Charcot did] but also attended his lectures, learning about the master’s views on the importance of unresolved sexual problems in the underlying causality of hysteria. When Freud returned to Vienna, he gave a report of his work with Charcot to the medical society, but its cold reception left him with resentment that affected his future interactions with the entrenched medical establishment and its rigid and reductionist methods at understanding and solving the problems of the mind.

Freud continued his work with Breuer on hypnosis and catharsis, but gradually abandoned the former in favour of the latter, being not very gifted with hypnotic techniques, but also for 3 major reasons regarding its effectiveness as a treatment with general applicability. First, not everyone can be hypnotised; hence its usefulness is limited to a select group. Second, some patients refuse to believe what they revealed under hypnosis, prompting Freud to conclude that the patient must be aware during the step-by-step process of discovering memories hidden from their accessible consciousness. Third, when one set of symptoms were alleviated under hypnotic suggestibility, new symptoms often emerged. Freud and Breuer were moving in separate directions, and Freud’s increasing emphasis on the primacy of sexuality as the key to psychoneurosis contributed to their break. Nevertheless, in 1895 they published Studies on Hysteria, often cited as the first work of the psychoanalytic movement, although it sold only 626 copies during the following 13 years – perhaps due to the lack of sophistication and interest in the workings of the mind at that particular point in history, or the level of the academic discussions that may not have been adequate for the intellect of the average mind at the time.

Freud’s preferred method of treatment, catharsis, involves engaging with patients and encouraging them to speak of anything that comes [occupies] their mind, regardless of how discomforting or embarrassing it might be. This “free association” took place in a relaxed atmosphere, usually on the classic psychologist couch in a reclined position to promote comfort. The main reason behind the logic of catharsis and free association is that – like hypnosis – it would allow hidden thoughts and memories to manifest in consciousness. However, in contrast, to the method of hypnosis, the patient would be aware of these emerging recollections. Another ongoing process during free association is “transference”, which involves emotionally laden experiences that allow the patient to relieve earlier, repressed episodes. Since the psychoanalyst is often part of the transference process [as mentioned earlier where the repressed emotions are often redirected onto] and is often the object of his patients’ emotions, Freud recognised transference as a powerful tool to assist patients in resolving sources of anxiety. Lacan proposed that it is important to also understand that although the existence of transference plays an important part for psychoanalytic treatment, it is not enough by itself, it is also necessary for the psychoanalyst to deal with the transference in a unique way, this is what differentiates true psychoanalysis from suggestion because the psychoanalyst refuses to use the power given to him by the transference. Lacan believed like any other interpretation, the analyst must use all his « art » in deciding if and when to interpret the transference and must above all avoid gearing his interpretations exclusively to interpreting the transference; the analyst must know exactly what he wants to achieve by such an interpretation and it should not rectify his patients’ relationship to the vague concept of « reality », but instead maintain analytic dialogue. Transference is the displacement of affect from one idea to another and Freud viewed it as a positive factor that helps the progression of treatment since it provides a way for patients’ history to be faced in the immediacy of the present relationship with the analyst; the way patients relate to the analyst is revealing as they inevitably repeat earlier relationships with other meaningful others [especially those with the parents or parental figures] – this logic is underlined in the theory of attachment of John Bowlby. Jacques Lacan later remarked that if transference with most patients often manifests itself under the appearance of love, it is first and foremost the love of knowledge (savoir) that is concerned. Transference is the attribution of knowledge to the Other, the assumption that the Other is a Subject who « knows » [Le Sujet supposé savoir], and as soon as that « knowing » Subject appears, we have transference. Lacan used Plato’s symposium to illustrate the relationship between analysands (i.e. patients) and the analyst; Alcibiades compared Socrates to a plain box which enclosed a precious object, just as Alcibiades attributes a hidden treasure to Socrates so patients see the object of their desire in the analyst (i.e. « objet petit a » in Lacanian terms). The psychoanalyst must sometimes situate himself/herself as the substitute for objet petit a in the course of psychoanalytic praxis. Lacan also identifies the compulsion to repeat with the symbolic nature of transference, the symbolic determinants of all Subjects, and this helps the progression of treatment by revealing the meaningful signifiers of Subjects’ personal history; he also locates the essence of transference in the Symbolic and not in the Imaginary, although it clearly has powerful imaginary effects.

In 1897, Freud began a self-analysis of his dreams, which evolved into another technique important to the psychoanalytic movement. In the analysis of dreams, Freud distinguish between the manifest content [the actual depiction of the dreams] and the latent content, which represented the symbolic world of the patient. In 1900, he published his major work, The Interpretation of Dreams. Although it sold only 600 copies in eight years, it later went through eight editions in his lifetime. In 1901, he published The Psychopathology of Everyday Life, the book in which his theory began to take shape. Freud argued that the psychology of all people, not only those with neurotic symptoms, could be understood in terms of the unconscious forces in need of resolution.

When his reputation as a pioneer in psychiatry started to grow due to his prolific writings, Freud attracted admiring followers, among them was the notable Carl Jung. In 1909, G. Stanley Hall, president of Clark University, invited him to the United States to give a lecture series as part of that institution’s 20th anniversary. The lectures were published in the American Journal of Psychology and later in book form, serving as an appropriate introduction to psychoanalytic thought for American audiences.

As psychoanalysis was perceived as radical by the medical establishment, early believers form their own associations and found the journals to disseminate their competing views. However, Freud’s demand for strict loyalty to his interpretation of psychoanalysis led to some discord within the movement [perhaps for the betterment of the field itself as many branches kept the fundamental concept of unconscious (Id), pre-conscious (SuperEgo), and conscious (Ego) but fused other theoretical and scientific perspectives to explain and treat a range of mental illnesses]. Carl Jung broke away in 1914, so that by the following year, three rival groups existed within the psychoanalysic movement. Nevertheless, Freud’s views continued to evolve. Impressed by the devastation and tragedy of World War I, Freud came to view aggression, along with sexuality, as a primal instinctual motivation. During the 1920s Freud expanded psychoanalysis from a method of treatment for mentally ill or emotionally disturbed persons to a systematic framework for all human motivation and personality.

In 1923, Freud developed cancer of the jaw and experienced almost constant pain for the remaining 16 years of his life. He underwent 33 operations and had to wear a prosthetic device. Throughout this ordeal however, he continued to write and see patients, although he shunned public appearances. With the rise of Hitler and the anti-Jewish sentiments that arose with his campaigns with the National Socialists, Freud’s works were unfortunately singled out as they were not seen as a scientific endeavour but rather as a Jewish science, and his books were burned throughout Germany. However, Freud resisted fleeing from Vienna. When Germany and Austria were politically united in 1938, the Gestapo began harassing Freud and his family. President Roosevelt indirectly relayed to the German government that Freud is an intellectual who must be protected. Nevertheless, in March 1938 some thugs invaded Freud’s home. Finally, through the efforts of friends, Freud was granted special permission, but only after promising to send for his unsold books in Swiss storage so that they could be destroyed. After he signed a statement saying that he had received good treatment from the police, the German government allowed him to leave for England, where he died shortly after, on September 23, 1939.

 

An overview of the Psychoanalytic System based on Freud’s Research

Before our in-depth examination of psychoanalytic theory, it is important to recognise that the theory has an unusually broad focus. Psychoanalysis contains a theory of personality, but it also offers theoretical tools for understanding culture, society, art and literature. It is also a clinical theory that aspires to explain the nature and origins of mental disorders, and that is associated with an approach to their treatment. To give some more sense to Freud’s breadth, consider that he wrote on topics as diverse as the meaning of dreams and jokes, the origins of religion, Shakespeare’s plays, the psychology of groups, homosexuality, the causes of phobias and obsessions, and much more besides. Even as a theory of personality, psychoanalysis is primarily an account of the processes and mechanisms of the mind, rather than an account of individual differences.

In addition to its breadth of focus, the psychoanalytic theory has many distinct components that have also been modified and explored by a range of skilled psychoanalysts, making it hard to integrate into a single unitary model of the mind since they are inter-connected in complex ways.

Freud’s views evolved continually throughout his long career in the collective result of his extensive writings as an elaborate system of personality development. Personality was described in terms of an energy system that seeks an equilibrium of forces. This homeostatic model of human personality was determined by the constant attempt to identify appropriate ways to discharge instinctual energies, which originate in the depths of the unconscious. The structure of personality, according to the psychoanalytic model consists of a dynamic interchange of activities energised by forces that are present in the person at birth. This homeostatic model was consistent with the prevailing views of 19th-century science, which saw the mechanical relations of physical events studied by physics as the term of scientific inquiry. Freud’s model for psychoanalysis translated physical stimuli to psychic energies or forces and retained an essentially mechanical description of how such forces interact.

As the writings on the dpurb.com website are the foundations for the Organic Theory of Psychological Construction, we are going to be focused not on the later structural model which repositioned the Unconscious, Conscious and Pre-Conscious across the Id, Ego and SuperEgo, but with the first topographic model (1900 – 1905) adopted by both Carl Jung and Jacques Lacan. This model, has been more influential and is more flexible in accommodating competing view points about the structure of mental life across individuals.

The topographic model refers to the levels or layers of mental life. Freud proposed that mental content – ideas, wishes, emotions, impulses, memories, and so on – can be located at one of the three levels: the Conscious (later known as the Ego), the Preconscious (SuperEgo) and the Unconscious (Id), . It is important however, to understand that Freud use these terms to describe degrees of awareness and unawareness, but also to refer to distinct mental systems with their own distinct laws of operation. Unconscious cognition is categorically different from Conscious cognition, in addition to operating on mental content that exists beneath awareness. To convey this point, the three levels of the topographic model was referred to as the ‘systems’ Cs., Pcs., and Ucs.

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The Topographic Model


The Conscious (which would later be known as Ego with a partial unconscious side, and also “Le Moi” in Lacanian Theory)

Consciousness is merely the proverbial ‘tip of the iceberg’ of mental activity. The contents of the Conscious are simply the small fraction of things that the person is currently paying attention to: objects perceived, events recalled, the stream of thought that we engage in as a running commentary on everyday life. [This is the main focus of most other branches of Psychology such as Biological Psychology and Cognitive Psychology]

 

The Preconscious (which would later be known as the Super-Ego, le « Grand Autre » in Lacanian Theory)

Of course, not all of all mental life happens under the spotlight of awareness and attention. There are many things to which we could readily pay attention to but do not, such as ideas or plans we have set aside or memories of what we were doing last week or yesterday. Without any great effort these things or events, which in the present are out of consciousness, can be made conscious. Those form the domain of the Preconscious.

The boundary between the Conscious (Ego) and the Preconscious (Super-Ego) is a permeable one. Thoughts, memories and perceptions can cross without great difficulty according to the momentary needs and intentions of the individual. They also share a common mode of cognition, which in psychoanalysis is known as the ‘secondary process’. Secondary process cognition is the sort of everyday, more or less rational thinking than generally obeys the laws of logic.

 

The Unconscious (which would later be known as the Id, L’inconscient or the « Ça » in Lacanian Theory)

The Unconscious (Id) is perhaps one of the most celebrated theoretical concepts in psychoanalysis’ legacy. However, Freud did not invent or discover the unconscious as is sometimes claimed – versions of the unconscious had been floating around intellectual circles for some time – but Freud gave it a much deeper theoretical analysis than anyone before him. Freud distinguished between mental contents and processes that are descriptively unconscious and those that are dynamically unconscious. The descriptively unconscious simply exists outside consciousness as a matter of fact, and therefore include Preconscious material that can become conscious if it is attended to. Freud’s crucial contribution was to argue that some thoughts, memories, wishes and mental processes are not only descriptively unconscious, but also cannot be made conscious because of a countervailing force keeps them out of awareness. In short, mental life that is dynamically unconscious is a subset of what is descriptively unconscious, one whose entry to consciousness is actively thwarted. The Freudian unconscious corresponds to the dynamic unconscious in this sense.

Freud held that the Unconscious contains a large but unacknowledged proportion of mental life that operates according to its own psychological laws. The barrier between the Unconscious (Id) and the Preconscious (SuperEgo) is much more fortified and difficult to penetrate than the border between the Preconscious (Super-Ego) and Conscious (Ego). In addition, it is policed by a mental function that Freud likened to a “censor”. The censor’s role is to determine whether the contents of the Unconscious would be threatening / objectionable or socially unacceptable to the person if they became conscious. If the censor judges them to be dangerous in this type, the person will experience anxiety without knowing what caused it. In this case, these thoughts become wishes and so on, and will be normally be repelled back into the Unconscious, in a process referred to asRepression” [it is fundamental and very important to understand that Repression is something else than a conscious judgement which rejects and chooses]. Unconscious material, by Freud’s account, has an intrinsic force propelling it to become conscious. Consequently, repression required an active opposing force to resist it, just as effort is required to prevent a surf board made of white foam to rise to the surface when it is submerged in the ocean. Under the constant pressure of Unconscious material bubbling towards the Preconscious, the censor cannot possibly bar entry to everything. Instead, it allows some Unconscious material to cross over the barrier after it has been transformed or disguised in some way so as to be less objectionable and more socially acceptable. This crossing might take the form of a relatively harmless impulsive behaviour, or in the form of private fantasy, the telling of a joke, or in a slip of the tongue, where the person says something ‘unintentionally’ that reveals to the trained eye and mind the repressed concerns and wishes [such as that of a psychoanalyst – as Jacques Lacan proposed: repression can take the form of a metaphor and the skilled psychoanalyst must be able to decipher a chain of clues with a great deal of verbal dexterity where crossword puzzles may help in training. Lacan also viewed the Grand Autre (Preconscious/Superego) as the discourse of the Unconscious]. Psychoanalysis focuses on how phenomena such as these can be interpreted, the process that involves uncovering the unconscious material that is concealed within their “disguises” [i.e. forms].

To Freud, dreams represent a particularly good example of the disguised expression of the Unconscious wishes. They offered, he wrote, “the royal road to the Unconscious”. One reason for this is that during sleep, the sensor relaxes and allows more repressed Unconscious material to cross the barrier. This material, transformed into a less threatening form by a process referred to as the “dream-work, then takes the shape of a train of images in the peculiar form of consciousness that we call dreaming. It is believed, that each dream has a “latent content” of Unconscious wishes that is transformed into the “manifest content” (or dream narrative) of the experienced dream. In psychoanalytic praxis with patients, the interpretations of dreams takes the same road, but in reverse, in order to decode the transformations rendered by the dream work so as to bring out the latent content based on the manifest content. Freud described the « latent contents » as made up of « latent thoughts« , a term that was always used in the plural form and never precisely described, but the context of its usage seems to suggest that it connoted representations, affects, wishes and conflictual patterns that are all profoundly marked by infantilism and fantasy [e.g. having super powers and flying while dressed in a nylon costume]. Latent thoughts also contain whatever supplies the dream’s « raw material »: the days residues, somatic sensations, and excitations that directly impact instinctual impulses. The transformation carried out by the dream work has to allow the Unconscious wishes during the wake state to be fulfilled during the dream while concealing the elements of threat they contain. If the latent content is not concealed sufficiently through the “dream-work” process, the sleeper will register the threat and be awoken [sometimes in shock and sweat], and to avoid this shock the dream-work may alter the identities of the people represented in a wish, for example, if an individual has an Unconscious wish to harm a loved one, the dream work might produce a dream in which the individual instead harms someone else or in which the loved one is harmed by another person, neutralised in this way, the unconscious wishes find conscious expression in the dream. Freud explained that « latent thoughts » were generally preconscious; they are used by the dream work because they are a relay point and medium for unconscious cathexes [i.e. objects (or ideas) that have a quantity of psychical energy attached to them; to say that an object or idea is « libidinally » cathected means that it is charged with sexual energy deriving from sources internal to a patient’s psyche; the Id (Unconscious) or the instinctual pole of personality is said to be be the source all types of cathexes]. Dreams also showcase the distinct form of thinking that operates in the Unconscious: Primary processthinking, which unlike the secondary process than governs the Conscious (Ego) and Preconscious (Super-Ego), shows no respect for the laws of logic and rationality. In primary process thinking, something can stand for something else, including its opposite, and can even represent two distinct things at once. Contradictory thoughts can coexist and there is no orderly sense of the passage of time or of causation. Basically, primary process thinking captures the magical, chaotic qualities of many dreams, the mysterious images that seems somehow significant, the fractured storylines, the impossible and disconnected events. To Freud, dreams are not simply night-time curiosities, but reveal how the greater part of our mental life proceeds beneath the shallows of conscience.

 

Foundations of the later “Structural” model: concepts to consider and synthesise with the Topographic Model

We are now going to have a look at the later version of Freud’s psychoanalytic theory where the Unconscious [this time referred to as the Id] is still the fundamental concept, however decades later in 1923, another 3-way dissection of the mind was proposed. This time Freud called it the Psychic Apparatus and the 3-way dissection of the mind was defined in terms of distinct mental functions instead of levels of awareness and their associated processes.

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The Structural Model of the Psychic apparatus

In original German, the terms Es (Id), das Ich (Ego) and Über-ich (Super-Ego) were used. As we take a look at these structures, it is important to remember that they were not proposed as real underlying entities, but rather as a sort of conceptual shorthand for talking about different kinds of mental processes. Our aim here is to synthesise the logical concepts of the Structural Model with the earlier Topographic Model of the Unconscious (Id), the Preconscious (Super-Ego) and the Conscious (Ego), however although it is convenient to talk about the Id, Super-Ego and Ego “doing” such-and-such or being “in charge of” so-and so, it is important to remember that they were not intended to refer to distinct sub-personalities within the individual.

 

The Id (Unconscious, das Es / Inconscient / Le Ça)

The Id [completely/dynamically unconscious] represents the part of the personality that is closely linked to the instinctual drives that are the fundamental sources of motivation in Freudian theory. According to Freud, these drives are chiefly sexual and aggressive in nature. On one hand we have the “life instincts” concerned with preserving life and binding together new “vital unities”, the foremost expression of this concern being loving sexual union. Opposed to these life instincts, on the other side, we have the set of “death instincts”, whose corresponding concern is with breaking down life and destroying connections, its goal is a state of entropy or nirvana, where there is a complete absence of any form of tension [motivation] – the most obvious form of these instincts were aggressiveness expressed inward towards the self or outward towards others. Freud proposed that these instinctual biological drives were powered by a reservoir of instinctual “psychic energy” grounded in basic biological processes; the sexual form of this energy was referred to as libido. Although the unconscious Id is a biological underpinning, its contents are manifested in psychological phenomena such as wishes, ideas, intentions, and impulses. These phenomena are therefore sometimes described as “instinct- derivatives”. Some of these phenomena are innate, whereas others have been consigned to the Id by the process of repression. All of the Id’s contents, however are unconscious. Freud proposed that the Id operated according to what he called the “pleasure principle” which states that the Id’s urges strive to obtain pleasure and avoid “unpleasure” without delay. Unpleasure results from increased accumulated excitation and pleasure results from its reduction. Lacan used the term « Jouissance » to describe an excessive quantity of excitation that has the potential to take the Subject to that extreme point where the erotic borders upon death and where subjectivity risks extinction; the « pleasure principle » tries to prevent such savage scenarios [To Lacan, the pleasure principle is a commandment — which can be phrased — « Enjoy as little as possible. » The pleasure principle leads the subject from signifier to signifier, by generating as many signifiers as are required to maintain at as low a level as possible the tension that regulates the whole functioning of the psychic apparatus]. One of Lacan’s contribution to the debate on feminity advances the concept of a specifically feminine jouissance which goes beyond the phallus: a jouissance of the order of the infinite like mystical ecstacy where women may experience this without being conscious about it. Therefore the pleasure principle serves to reduce tension and to return the psyche to a state of equilibrium or constancy. Pleasure, in Freud’s understanding, represented a discharge of libido or instinctual energy which is accompanied by a release of tension. The Id is not in contact with the rules or structures of individuals’ environment [i.e. the Symbolic rules of civilised society], but rather relates to the other structures of personality, the Ego & the Superego [conscience] that in turn must mediate between the Id’s raw instincts and the external world; immune from reality and social convention, the Id which is guided by the pleasure principle, seeks to gratify instinctual libidinal needs [that are simply biological] either directly through a sexual experience, or indirectly by dreaming or fantasizing. The latter, indirect gratification was called the primary process [governed by the pleasure principle] and has its own « rules » [e.g. allowing contradictions in logic] that differ from Ego functions and conscious thought. The exact object of direct gratification in the pleasure principle is assumed to be determined by the psychosexual stage of the individual’s development [as explained in 3rd part of the essay on The 3 Major Theories of Development], however the legitimacy and precision of this theory has been questioned and revised over the years and it gave way to the more empirical Theory of Attachment of John Bowlby. In short, the Id strives to satisfy its drives enabling immediate, pleasurable release of instinctual energy. It is the most primitive and least accessible structure of personality. As originally described by Freud, the Id is psychic energy of an irrational nature, and in the form of libido, it can manifest itself and be of a sexual character that is incestuous, uninhibited, savage, irrational and boundless, which instinctually determines unconscious processes. In psychoanalysis, this natural, wild and irrational urge is assumed to be present in all human beings. Elisabeth Roudinesco pointed out that Freud had distinguished that in humans it is the desire for incest and not the horror of it, that eventually leads individuals to forbid themselves from expressing it while also rejecting it; that is to say that in healthy, civilised and psychologically stable individuals with a well developed conscience [i.e. Superego] there is a respect for the symbolic laws that govern human relationships ethically [Lacan proposed that these symbolic structures are primarily governed by language] and which involve abiding by a structure that respects shared social values that sustain a functional human civilisation, i.e. the passage from raw and savage nature [Id] to civilised culture [Super Ego]. Many modern psychoanalysts believe that repression, masturbation and sublimation are inescapable in order to manage the raw and wild instincts of the Id and to channel them in more productive endeavours that are in the best interests of individuals and civilised society.

 

The Ego (Conscious & partially unconscious, Ich / Le Moi)

The Ego, is a mental function and complicates the picture of immediate gratification that the Id strives for. The Ego, a “psychic agency”, arises over the course of development as the child learns that it is often necessary and desirable to delay gratification. The bottle or breast does not always appear the instant that hunger is first experienced, and sometimes it is better to resist the urge to urinate at the bladder’s first bidding if one is to avoid the unpleasure of wet pants, embarrassment, and a parent’s howls of dismay. The Ego, often called the “executive” of personality because of its role in channeling Id [unconscious] energies into socially acceptable outlets [ego is believed to start developing between the ages of 1 and 2 as the child confronts the environment]. The Ego crystallises out this emerging capacity for delay, and in time becomes a restraint on the Id’s impatient striving for discharge. However, it cannot be an inflexible restraint. Its task is not to delay the fulfilment of wishes and impulses endlessly, but to determine when and how it would be most sensible or prudent to do so given the demands of the external environment at a particular time. It operates, that is, on the “Reality principle”, which simply requires that the Ego regulate the person’s behaviour in accordance with external conditions [at a given time or place according to certain rules or laws or conventions, and of course this changes as society redefines “reality” in terms of what it acceptable and not]. Freud emphasized that the Ego is not the dominant force in the personality [unlike Ego psychologists in the US state], although he believed it should strive to be. A famous statement of Freud regarding the goal of Psychoanalytic treatment is “Where Id was, there Ego shall be”. By his account, the Ego not only emerges out of the Id in the course of development – beforehand, the infant is pure Id [instinctive and irrational] – but it also derives all of its energy from the Id. Freud had a gift for metaphor, and he likened the Ego’s relation to the Id as a rider’s relation to a wilful horse. The horse [Id] supplies all of the pair’s force, but the rider [Ego] may be able to channel it in a particular direction. Fortunately, this “rider” [Ego] has a repertoire of skills at its disposal. Freud proposed that the Ego could employ a variety of “defence mechanism” in the service of the reality principle. These mechanisms come in a diverse range, and all represent operations that the Ego performs to deal with the threats to the rational expression of the person’s desires, whether from the Super-Ego or the external environment. These Ego defence mechanisms are common processes in everyday mental life, and many of them are carried out by the Ego unconsciously, showing that there is an unconscious part in the Ego. The Ego being governed by the reality principle, is aware of environmental demands and adjusts behaviour so that the instinctual pressures of the id are satisfied in acceptable ways, and the attainment of specific objects to reduce libidinal energy in socially appropriate ways was called the “secondary process” [the “primary process” being the Unconscious (Id)]. Some of the most well known defence mechanisms are denial, isolation of affect, projection, reaction formation, repression and sublimation.

 

The Super-Ego (Conscious & partially unconscious, Über-ich / Le Surmoi / L’Autre / Le Grand-Autre)

The differentiation of the structures of personality, called the Super-Ego, is believed to start appearing by the age of 5. In contrast to the Id and Ego, which are internal developments of personality, the Super-Ego is an external imposition. That is the Super-Ego is the incorporation of moral standards perceived by the Ego from some agent of authority in the environment, usually an assimilation of the parents’ views as the child develops – both positive and negative aspects of these standards. The Super-Ego’s emergence complicates the task of the Ego in regulating the expression of the Id’s impulses in response to demands and opportunities of the external environment. The Super-Ego represents an early form of conscience, an internalised set of moral values, standards, and ideals. These moral precepts are not the sort of flexible, evolving, reasoned, and discussable rules of conduct that we tend to imagine when we think of adult morality, however, instead they tend to be relatively harsh, absolute and punishing; adult morality as refracted through the immature and fearful mind of a child. The Super-Ego therefore represents the shrill voice of societal rules and restrictions, a voice that condemns and forbids many of the sexual and destructive wishes, impulses and thoughts that emerge from the Id. The positive moral code is the Ego ideal, i.e. a representation of behaviour for the individual to emulate. The conscience embodies the negative aspect of the Super-Ego, and determines which activities are to be taboo. Conduct that violates the dictates of the conscience produces “guilt” in healthy individuals. Hence, the Super-Ego and the Id are in direct conflict, leaving the Ego to mediate. The Ego now becomes the servant of three masters: the Id, the Super-Ego and the External Environment [Societal Rules]. It is now not enough to reconcile what is desired with what is possible under the circumstances because now the Ego also needs to take into consideration what is socially prohibited and impermissible. Instinctual drives must still be satisfied; which is a constant, however the Ego now attempts to satisfy them in a way that is flexibly “realistic” – that is, in the person’s best interests under current conditions – but also “socially” permitted. These prohibitions are often very unreasonable and inflexible, rejecting any expression of the drive with an unconditional “NO”, either because the moral structures of a particular “culture” are intrinsically rigid, atavistic or unsophisticated, or because the child’s internalisation of these structures is simply black-and-white, without any grey area to compromise for an adequate expression of the drive. Thus, the Super-Ego imposes a pattern of conduct that results in some degree of self-control through an internalised system of rewards and punishments.

Given the demands that it faces, the Ego can either find a way to express the Id’s desires successfully, or its attempts to arbitrate can fail. In this case, psychological trouble is likely to follow. If the Id wins the struggle, and the desire finds expression in a more-or-less unaltered and primitive form, the person may experience guilt or shame: the Super-Ego’s sign that it has been violated, and may also have to pay the price of a short-sighted, impulsive action. If on the other hand, the Super-Ego wins the struggle and dominates a person excessively, that individual may become overly rigid, rule-bound, uncreative, unquestioning, anxious and joyless. The forbidden desires may well go “underground” and manifest themselves in symptoms such as anxieties, compulsions or in occasional “out-of-character” impulsive behaviour or emotion.

 

Intrapsychic Conflict: the Roots of Personality

The major motivational constructs of Freud’s theory of personality was derived from instincts, defined as biological forces that release mental energy. Hence, from the account of the Unconscious (Id), the Conscious [and partly unconscious, Ego) and the Preconscious (Super-Ego), it implies that conflict within the mind’s opposing forces is inevitable, because the demands of society – or “civilisation” – are generally opposed to the natural instincts and drives of human beings. Indeed, intrapsychic conflict is one of the fundamental and defining concepts of psychoanalysis. Conflict within the mind is at the root of personality structure, mental disorder, and most psychological phenomena [e.g. artistic expressions of various forms]. The goal of personality is to reduce the energy drive through some activity acceptable to the constraints of the Super-Ego [Preconscious].

Freud classed inborn instincts to life (eros) and death (thanatos) drives. Life instincts involve self-preservation and include hunger, sex and thirst. The libido is that specific form of energy through which life instincts arise in the Id. The death instinct (Thanatos) may be directed either inwards, as in suicide or masochism, or outwards, as in hate and aggression. The notion that personality equilibrium must be maintained by discharging energy in acceptable ways, leads to anxiety which plays a central role. Essentially the view is that anxiety is a diffuse fear in anticipation of unmet desires and future evils. Given the primitive character of Unconscious (Id) instincts, it is unlikely that primary goals are ever an acceptable means of drive reduction; rather they are apt to give rise to continual anxiety in personality. Freud described three general forms of anxiety.

(i) Reality (or Objective) Anxiety
(ii) Neurotic Anxiety
(iii) Moral Anxiety

Reality or objective anxiety, is a fear of the real environmental danger [e.g. heights, depth, fire, etc] with an obvious cause; such fear is appropriate as it has survival value for the organism. Neurotic anxiety comes about from the fear of potential punishment inherent in the goal of instinctual gratification. It is a fear of punishment for expressing impulsive desires. Finally, moral anxiety is the fear of the conscience through guilt or shame in healthy individuals. In order to cope with anxiety, the Ego develops defence mechanisms, which are elaborate, largely unconscious processes that allow a person to avoid unpleasantness and anxiety-provoking events. For example, an individual may avoid facing anxiety by self-denial, conversion [whereby the anxiety caused by repressed impulses and feelings are ‘converted’ into a physical complaint such as a cough or feelings of paralysis], or projection, or may repress thoughts that are a source of anxiety into the unconscious. Many defence mechanisms are described in the psychoanalytic literature, which generally agrees that although defence mechanisms are typical ways of handling anxiety and maintaining a sense of psychological stability, they must be recognised and controlled by the individual himself/herself for psychological health. Lacan sees « defence » as being on the side of the Subject [being stable symbolic structures of subjectivity].

Denial

Refusing to acknowledge that some unpleasant or threatening event has occurred; common in grief reactions

Isolation of Affect

Mentally severing an idea from its threatening emotional associations so that it can be held without experiencing its unpleasantness; common in obsessional people

Projection

Disavowing one’s impulses thoughts and attributing them to another person; common in paranoia

Reaction formation

Unconsciously developing wishes or thoughts that are opposite to those that one finds undesirable in oneself; common in people with a rigid moral code

Repression

Repression is one of the most basic concepts in psychoanalysis. It involves repelling threatening thoughts from consciousness, to confine them in the unconscious.

Freud distinguished between: (i) primal repression [a « mythical » forgetting of something that was never conscious, an ordinary « psychical act » by which the unconscious is first constituted. Lacan saw this as a structural feature of language, its necessary incompleteness, the impossibility of ever formulating the « truth about truth » (because human language is limited and can never capture and completely express the Unconscious), the symbolic signifying chain of the unconscious where linguistic discourse originates];

and (ii) secondary repression [concrete acts of repression whereby some idea or perception that was once conscious is expelled from the conscious (E.g. motivated forgetting; common in post-traumatic reactions). Lacan saw secondary repression as a specific psychical act by which a signifier is elided from the signifying chain, it is structured like a metaphor and involves the return of the repressed, since repression does not destroy the ideas or memories but merely confines them to the unconscious, the repressed material is liable to return in distorted form, in symptoms, dreams, slips of the tongue, etc. To Lacan, it is always the signifier that is repressed, never the signified, which corresponds to Freud’s view that what is repressed is not the « affect » (which can only be displaced or transformed) but the « ideational representative » of the drive. Lacan proposed that repression is what distinguishes neurosis from other clinical structures – psychotics foreclose, perverts disavow and only neurotics repress]

Lacan maintained that it is very important not to confuse repression with the conscious judgement of a Subject that rejects and chooses.

Sublimation

The concept of Sublimation was first introduced by Freud in 1905 in his essays on Sexual theory. Sublimation is the act of unconsciously deflecting raw, irrational and uninhibited sexual and aggressive impulses/drives towards different, socially acceptable expressions and human activity [e.g. artistic creations, sports and intellectual work] that has no connection to sexuality but gets its power from the psychic energy in the sexual drive [la pulsion sexuelle]. Sublimation thus works as a socially acceptable escape valve for excess libidinal (sexual) energy which would otherwise have to be discharged in socially unacceptable forms [e.g. perverse behaviour] or in neurotic symptoms. This means that complete sublimation would spell the end of all perversion and neurosis. While Freud believed complete sublimation might be possible for some particularly refined or cultured people, Lacan pointed out that absolute/complete sublimation is not possible for human beings, [since all healthy humans with a healthy brain, a functional hypothalamus and sexual organs will experience sexual urges and feelings] and that perverse sexuality to satisfy the drive is possible and accessible (e.g. prostitution, perverse behaviour, private fantasies, etc) but must be sublimated because it is prohibited or badly viewed by civilised society and is also not in the individual’s best interests. Lacan follows Freud in emphasising the fact that the element of social recognition is central to the concept of sublimation, since it is only when the drives are diverted towards this civilised dimension of shared social values that they can be said to be sublimated. This dimension of shared social values allows Lacan to tie in the concept of sublimation with Ethics. [Note: Perversion to Lacan is not simply a savage and grotesque natural means of discharging the libido, but a highly structured relation (reaction) to the manifestation of the sexual drives [instinct/need], which are in themselves in the form of language in civilised people rather than simple biological urges/drives. Lacan also revised Freud’s initial view that sublimation simply involves the redirection of the drive to a different (non-sexual object), but explains that the initial object that the drive was directed at does not change but only its position in the structure of fantasy [for the Subject] changes, i.e. only the nature of the object to which the drive was directed changes not the object itself; this is made possible because the drive is “already deeply marked by the articulation of the signifier”. In the average psyche, the sublime quality of an object is thus not due to any intrinsic property of the object itself, but simply an effect of the object’s position in the symbolic structure of fantasy for a particular Subject.]

Table 1: A List of The Most Common Defence Mechanisms

Freud placed great emphasis on the development of the child because he was convinced that neurotic disturbances manifested by his adult patients had origins in childhood experiences. And as the last model proposed by Freud, the Genetic Model, explains, the psychosexual stages are characterised by different sources of primary gratification determined by the pleasure principle. Freud basically wrote that the child is essentially autoerotic. The genetic model has been previously described in the 3rd section of the essay, The 3 Major Theories of Childhood Development. [Please refer for more details]

However, the genetic model in psychoanalysis has been extensively revised and many of the concepts have given way to other theories [such as the Bowlby’s Theory of Attachment] nowadays that consider other sides in the development of personality. Other theories of peronality have also shown how personality continues to evolve and only stabilises around the age of 30. However, the genetic model of Freud laid the groundwork for other theorist such as John Bowlby and Mary Ainsworth who based their guiding principles to uncover the theory of attachment on pre-oedipal developments first mentioned by Sigmund Freud. These attachment types have been discussed in the Essay, The 3 Major Theories of Childhood Development, and although it may not be completely true for all people, the logic behind the psychosexual stages should always be considered to some extent when analysing clients along with attachment types – not to forget to assess the self-reflective abilities of the person, since this has been proven to have more impact on self-adjustment related to adult personality, emotional intelligence and attachment types.

 

The Relationship between the Topographic Model and the Structural Model

It is important to assimilate the knowledge from the structural model and synthesise them with the topographic model. It can be seen that although the later model is conceptually distinct from the first model, they do map onto one another to some degree. The content of the Id, of course, lies firmly within the Unconscious, and is forbidden from entry to the consciousness unless disguised in the form of dreams, slips of the tongue, symptoms, and so on. However the Ego is not completely conscious unlike many ego psychologist may claim along with cognitive psychologist, as it has a strong Unconscious component, given that a great deal of psychological defence mechanisms are conducted instantly out of awareness, and hence is sometimes inaccessible to introspection by the patient – hence requiring a skilled psychoanalyst to guide therapy and treatment. The Super-Ego also has an Unconscious fraction, reflecting as it does and often “primitive”, and irrationally punishing through rigid morality – at least as much as it reflects our reasoned beliefs and principles. Although many concepts have been revised and alternative treatments relating to mental illness have also been devised by other schools of thought in psychology, the sheer complexity and uniqueness of the psychoanalytic system has formed a remarkable achievement. Indeed, Freud even had to invent new terminology to express his thoughts, and these terms have become an accepted part of our vocabulary.

Psychisme: Les théories de Freud ont-elles évolué? (2013)

 

Psychoanalytic Evidence: From the perspective of Empirical Methodology (Mainstream Science)

Freud ardently believed along with all good psychoanalysts that psychoanalysis is a science, not an empirical science, but a science of the mind that slices not with blades or questionnaires, but with concepts through the linguistic and philosophical realm of a patients subjective reality. It is also fair to consider that Freud himself was an accomplished biological scientist before he developed psychoanalytic theories. Biological ideas are interwoven in his work, as is his concepts of drive, instinct, and psychic energy. Nevertheless, the methods that he used to obtain evidence for the psychoanalytic theory were very different from the reductionist and empirical methods used by the government institutions, laboratory scientists or the statistical psychologists with their quantified questionnaires exploring basic “traits”. As an anatomist and physiologist, Freud made systematic observations of living and dead organisms, and conducted controlled empirical experiments. Hence, he must have come to the same conclusion as ourselves, which is, mental life cannot be fully explained by the mechanical explanations, although a lot can be learnt from understanding the physiology of the brain, but the “software” itself, that generates the mind, is an entity that empirical science comes short in terms of its methodologies. Hence, as a psychoanalyst, Freud introspected and speculated about his own mental life, and listened closely to what his patients told him during sessions of psychoanalytic therapy. It is quite clear, that dissecting an eel is completely different from dissecting a personality with all its complexities, and that observing the stream of one’s consciousness or another’s speech [i.e. discourse] is very different from conducting a controlled experiment with observable variables. So, psychoanalytic evidence is clearly unlike the evidence on which most “hard physical sciences” are based.

However, it is important to understand that the critique of psychoanalysis from the methodology of empirical science may not be rational. Because psychoanalysis was never intended to be a mechanical « hard » science, although it learns from neuroscience and cognitive-psychology of certain very basic aspects of the physiology of the brain and its functions. These questions about Empirically Supported Treatment (EST) came to the forefront of psychotherapy literature in 1993, when Division 12 of the American Psychological Association worked to publish a list of criteria for what constitutes EST (Chambless, et al., 1996; Task Force on Promotion and Dissemination of Psychological Procedures, 1995; Taskforce on Psychological Intervention Guidelines, 1995). A list of treatments were published that we empirically supported and very few psychodynamic treatments were included, nor were interpersonal or humanistic therapy included. Not surprisingly, these guidelines and list became anything but unifying for psychotherapists and psychotherapy researchers.

Freud Dessin

Westen, Novotny and Thompson-Brenner (2004) made some important critiques of the literature on ESTs. They noted that ESTs are often designed for a single, Axis I disorder, and patients are screened to maximise their homogeneity and to minimise their diagnostic comorbidity. Treatments are manualised and brief, and outcomes are assessed often by reductions in the primary symptom reduction for that particular disorder. Westen et al. suggested that EST researchers always tend to assume the following:

  • Psychopathology is highly malleable
  • Most patients can be treated for a single problem or disorder
  • Psychiatric disorders can be treated without much attention to underlying personality factors
  • Experimental methodology used to develop ESTs has ecological validity in clinical practice

Westen et al. (2004) basically contended that these assumptions are not valid, not to say wrong. There is considerable diagnostic comorbidity, making most patients ineligible to participate in EST research trials. There also is considerable stability of psychopathology of psychiatric symptoms, even after “successful” completion of EST. And clinicians of all theoretical orientations see patients well beyong the time allotted in treatment manuals (see Morrison, Bradley, & Westen, 2003; Thompson-Brenner, Glass, & Westen, 2003; Westen & Morrison, 2001 for an excellent review of these issues).

Norcross (2002a) offered an additional perspective on why the EST literature has been so controversial. First, he explained that EST research rarely addresses the fact “that the therapist is a person, however much he may strive to make himself an instrument of the patient’s treatment” (Orlinsky & Howard, 1977, p.567 as cited by Norcross 2002a). This idea has been demonstrate very well in empirical literature. For example, Wampold (2001) concluded in a meta-analysis of psychotherapy studies that the qualities of the therapist play a much stronger role in the outcome of treatment that does the treatment itself. Second, Norcross stated that therapy research has savagely neglected the important question of studying the therapy relationship. Instead, the focus has been more on the application and mastery of a technique (not a relationship). Third, who the patient is affects treatment outcome. As attention has been directed towards the study and implementation of psychotherapy techniques to different categories of disorders, small attention has been given to the patient characteristics that affect outcome, such as comorbid conditions, capacity for insight, and a history of interpersonal relatedness.

Psychoanalytic and psychodynamic therapies certainly are related to these issues. Analytic and Dynamic models of therapy are very focused on the behaviour and qualities of the therapist, with special attention to issues of the therapeutic alliance, neutrality, transference, and countertransference.

Freud's Couch at Freud Museum London

The couch that started everything: Freud’s psychoanalytic couch at the Freud Museum in London

It is important to also consider that one’s training in how to conduct psychoanalytic or psychodynamic psychotherapy is focused on how therapists present themselves and how patients respond to this. Such a focus automatically puts the therapeutic alliance at the centre of attention, something that has taken on more interest over the years (Fairbairn, 1952; Greenberg, 1986, 2001a; Pine, 1998; Stolorow, Atwood & Brandchaft, 1994; Wallerstein, 2002). Psychoanalysts have also recognised that the personality and qualities of the patient affect how therapy should be conducted (e.g., Gabbard, 2000, 2004); that is, one approach to working with patients does not fit all patients. Furthermore, many psychotherapists have been reluctant to allow their therapy relationships to be subject to empirical investigation (Bornstein, 2005), as a form of respect for the privacy of their clients, making it very hard to provide more objective data that the support the validity of psychoanalysis. In contrast, other schools of thoughts derived from the behavioural school and the medical fields have very willingly offered their data for empirical investigations.

Often accompanying this philosophical criticism regarding scientific testability is a factual criticism that psychoanalysts have seldom tried to test their theories scientifically. This criticism may have some truth to it, however many psychoanalysts have responded to the call for more scientific inquiry by asserting that it is unnecessary and that clinical evidence of the treatments curing mental illness of various types is quite sufficient.

FIGURE B - SUCESS RATES WITH ADULTS & CHILDREN

Success Rates of Psychotherapy with adults and children, and Therapy from other schools of thought [traditions] based on Effect Sizes from Meta-analyses / Source: dpurb.com

Other psychoanalysts have argued that scientific support for their theories is irrelevant. Psychoanalysis, they suggest, is not an empirical science, but a science of subjective experience and linguistic dissection, so it is inappropriate to judge it by the mainstream reductionist empirical scientific standards of modern day academia.

Many see psychoanalysis as a “hermeneutic” discipline, an approach to interpretation which is rather like a school of literary criticism or biblical scholarship. To them, psychoanalytic theory is a way to decipher mental life, an interpretative technique for uncovering meaning. Its goal, they say, is to understand psychological phenomena in terms of their underlying reasons rather than explaining them as objective science in terms of causes. Some have gone so far as to suggest that the goal of psychoanalytic understanding is not to ascertain literal or scientific truth – for example, what “truly happened in a person’s past to make them the way they are today” – but instead to formulate “narrative truth”, a story that gives coherent meaning to the person’s experiences [from their perspective in terms of what matters to them] (Spence, 1980).

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Photographie: Danny D’Purb © 2018

What Jacques Lacan clearly meant by a complete reconstitution of a subject’s history as the aim of psychoanalysis, is that « history » is not a simple objective sequence of past events, but the present synthesis of the past as it is subjectively perceived and interpreted by the continously evolving Subject in his/her uniqueness. Lacan’s used the term « après coup » [retroaction, i.e. how the present affects the past] and pointed out that linguistic discourse itself is structured by retroaction, since only when the last word of a sentence is uttered or read that the initial words gain meaning; with retroaction also comes « anticipation« , which refers to the way in which the future also affects the present, and like retroaction, anticipation also structures linguistic discourse, since the first words of a sentence are ordered in anticipation of the words to come. Jacques Lacan also pointed out how in the « psyche » [mind], present events affect past events [i.e. retroaction]; because the past is simply a set of stories in the mind of an individual that is edited and reinterpreted in the light of new experiences and information of the constantly evolving Subject in his/her uniqueness; most healthy individuals with desires, sculpt the stories of their past experiences to make it work towards their development; they take a particular perspective to extract meaning and significance from their past experiences [in terms of what matters to them and what does not] so that they contribute towards their development, progress and desires [See the Essay: The Concept of Self]. Lacan also pointed out that psychoanalysis is not concerned by what most empiricists would call the « real past » as an objective sequence of events devoid of subjective signification, but rather with the way these experiences exist in the psyche/mind of a particular individual and how he/she interprets (i.e. perceives) and reports them in order to find out what holds significance for a particular Subject and what does not.

We can thus conclude that there will always be something “uniquely special” about psychoanalytic evidence, for all its empirical flaws. A completed psychoanalytic treatment may sometimes [depending on the type of patient] occupy four or five sessions each week over a period of several years, amounting to perhaps 1000 hours in which the analyst listens closely to the patient’s innermost thoughts. These thoughts, often too intimate and raw to be shared even with loved ones, range widely over the patient’s personal history and lived experiences. They are recounted in a wide variety of mood-states and frames of mind. These millions of spoken words and feelings may not represent the kind of systematically and objectively collected data on which the scientific theory of personality [that the hardcore empiricist loves] can easily be built. However, it is hard to declare that the analyst does not understand the patient’s personality better than someone who might interpret the patient’s responses, dashed off in a matter of minutes, to a trait questionnaire. Indeed, there is something valuable about psychanalytic evidence, but it is very hard to build an empirical theory out of it since we are not dealing with matters of hard sciences [e.g. biology, medecine, physics, chemistry, astrophysics, material science, astronomy, etc], but the mind of human beings that embodies their whole existence and worlds.

 

Empirical Evidence for the Existence of Unconscious Processes

More and more psychoanalytic thinkers and sympathisers are starting to find creative ways to test psychoanalytic hypotheses in rigorous empirical ways to conform with academic science, despite all the difficulties that this involves. This research is now very extensive, and therefore difficult to summarise. However, a broad conclusion can be drawn from it: specific Freudian claims typically fail to receive experimental support but do work in treating mentally ill patients in clinical practice. What Freud learned from his clinical practice is that sexuality always involves a dimension of the impossibility of reaching « total » satisfaction for any Subject, and in order to achieve some satisfaction it is necessary to renounce total satisfaction, this renunciation is one of the references to the concept of « castration », where castration is a condition for satisfaction. Castration refers to the separation installed by the Oedipal law in both sexes and thus is a requirement of civilised culture; it is the positive side of the prohibition of incest, this instinctual renunciation, is the structuring function in the resolution of the Oedipus complex and is necessary for all cultural achievement.

Freud elaborated three possible outcomes for the « castration complex/anxiety » in women: (i) a total repudiation of sexuality; (ii) the adopting of a masculine position and the repudiation of penis envy; and (iii) motherhood as a treatment of penis envy through the symbolic equation of penis equals child. As for males, Freud believed that the castration complex/anxiety serves to free the boy from the Oedipus complex; it is the prohibition of the primordial object [i.e. the mother(s) or mother figure(s)] and leads to a lack in individuals which will orient them to look elsewhere [i.e. go out into the world and seek a true partner], and in this way, desire is inaugurated; for a number of psychoanalysts however, the « castration complex » of Freud did not have the major structuring role in the construction of sexual difference and they instead turned to other explanations, such as biological and developmental theories.

The concepts of Penis envy [According to Freud, woman’s desire to have a child is rooted in the envy of the man’s penis. When a girl first realizes that she does not possess a penis, she feels deprived of something valuable (symbolically), and seeks to compensate for this by obtaining a child as a « symbolic substitute » for the penis she has been denied. Even though the girl may at first resent the mother for depriving her of a penis and turn to the father or father figure in the hope that he will provide her with a symbolic substitute (i.e. a child), she later turns her resentment against the father when he does not provide her with the child as substitute. Freud argues that penis envy persists into adulthood, manifesting itself both in the desire to enjoy the penis in sexual intercourse, and in the desire to have a child (since the father or father figure does not provide her with a child, the woman turns to another man instead). On this particular component of psychoanalysis, Lacan follows Freud, arguing that the child always represents for the mother a substitute for the symbolic phallus which she lacks (a type of lack known as « privation »). However, Lacan emphasized that the symbolic substitute for the phallus (i.e. the child) never really satisfies the mother; her desire for the symbolic phallus persists no matter how many children she has. The mother’s basic dissatisfaction and sense of privation is perceived by the child from very early on; the child realizes that she has a desire that aims at something beyond her dual relationship with him, the imaginary phallus. The child then seeks to fulfil the mother’s desire by identifying with the Imaginary phallus (or by identifying with the mother imagined as possessing a phallus, i.e. the phallic mother). In this way, the « privation » of the mother is responsible for introducing the dialectic of desire in the child’s life for the first time. Alfred Adler argued that the concept of « penis envy » should not be expressed literally but symbolically as women’s frustration at not being able to match male dominance in society, i.e. the phallus as representing male dominance in society. Karen Horney contested the claims of penis envy, which seems to suggest that some concepts may not apply to everyone, hence the wide scope of psychoanalytic theory to suit different developmental cases], Castration Anxiety and Repression, cannot be demonstrated easily through the simple methods used for mainstream science and empirical experiments in a laboratory, although some effort has been made. A study at the Harvard Medical School in Boston at the Massachusetts Mental Health Centre involving college aged women [ranging from 17 to 43 years old] and men [ranging from 18 to 23 years old] carried out by Rosalind Jones in 1994, tested the Freudian theory claim that the « natural » development of feminity involves the woman’s substitution of the wish for a baby in place of her original wish for a penis [i.e. penis envy]. In the study, the pregnancy message used was « Reproduction. The birth of a child. I should become pregnant. Entering my uterus. Entering my womb. I could become pregnant. To be fertilized. Becoming pregnant. The contraceptive field. To become pregnant. I could become pregnant, big with child »; the original penetration message was « I feel opened up. Things are getting through. It gets into me. I am opened up. Things are getting into me. I am sensitive. I feel things inside of me »; and the Revised Penetration message was « I feel opened up. He is getting through. He gets into me. I am sensitive sexy. I feel him moving into me. He is getting into me. » Consistent with Freud’s speculation about the phallic significance of pregnancy for women, Jones (1994) found that female subjects who were exposed to the subliminal pregnancy message produced significantly more phallic imagery responses to inkblots than did women in any other experimental conditions (p<.01).

Dreaming also does not seem to always preserve sleep by disguising latent wishes, and there is very little empirical evidence to back up the theory of Psychosexual stages, although it influenced the Theories of Attachment devised by John Bowlby. More « general » Freudian concepts however have often received a good deal of scientific support. There is today, plenty of evidence to suggest the existence of unconscious mental processes, for the existence of conflict between these processes and conscious cognition, and for the existence of processes resembling some of the defence mechanisms. Two illustrative studies can support his work. First, Fazio, Jackson, Dunton and Williams (1995) found that people who sincerely profess to having absolutely no racial prejudice can be shown to associate negative attributes with Black faces more than White faces in a laboratory task. This finding which has been replicated countless times by social cognition researchers, shows that the conscious attitudes of individuals may conflict with their “implicit” attitudes [unconscious]. Second, Adams, Wright and Lohr (1996) hooked male subjects up to a daunting instrument called the penis plethysmograph, which measures sexual arousal by gauging penile circumference. It was found that men who reported strong anti-gay (homophobic) attitudes demonstrated an increased arousal when shown videos of homosexual acts, whereas non-homophobic men did not. This finding seems to reveal some form of defence mechanism consistent with the psychoanalytic view that homophobia is a reaction formation against homoerotic desires. However, none of these illustrative studies can be considered as completely conclusive, and all have been controversial and subjected to various interpretations. For example, anxiety, shock, or anger rather than sexual arousal may have caused the increased penile blood flow of Adams et al.’s homophobic subjects.

These experiments prove that with enough creative ingenuity, some psychanalytic propositions can be scientifically tested. Doing so should contribute to the important task of sifting what is worth retaining in psychoanalytic theory for strict empiricists of the hard sciences.

 

Unconscious Processes: Integrating Cognitive Neuroscience and Psychodynamic Theory

In various ways, the evidence for the existence of mental processes that are outside of direct conscious awareness are apparent in every scenarios of life. Here are some examples:

  1. We sometimes cannot remember the name of a particular person of importance, only to be able to recall it hours or days later at a time and place when knowing the name is not required
  2. Despite one’s intention to offer some control over the process, dreaming appears to occur at its own timing and pace.
  3. On September 11, 2001, and the days following, many Americans watched hours of news report focussed on the same attacks on the United States. Although deeply upset by the contents, many individuals could not stop themselves from watching these videos, saying that it was as if something in them drew them to reports in spite of conscious awareness of disbelief and outrage
  4. Many patients who seek psychotherapy are unable to stop unwanted behaviours or interpersonal problems, despite conscious awareness of their harmfulness to them and their life. These problems range from relatively simple [e.g. drinking too much alcohol] to relatively complex [e.g. placing oneself in situations in which one is often taken advantage of or obsessing about one’s body image if certain kinds of fattening foods are consumed].

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Other examples are evident too, simple exercises that can be easily performed. For example, consider when 3 lines are drawn in the shape of a triangle with the ends of each line however, not touching one another, leaving a small gap between all their extremities. We can come to realise that, depending on the space between the lines, the image is instantly perceived as a triangle by the individual, a triangle with missing edges; 3 lines that are coming together like a triangle, or just 3 lines at different angles.

When taking into consideration perceptual phenomena such as this [i.e. an example of the Gestalt principle of closure], it is evident that the mind does the following very quickly, without conscious awareness of how the process occurs, yet meaning and understanding are formed.

  • Takes in sensory information
  • Determines what the information is
  • Assembles the information in such a way that a percept or concept is formed
  • The percept or concept is “perceived” and “understood”

The evidence for the existence of unconscious processes is widely known in cognitive psychology. In a seminal paper in the American Psychologist, Shevrin and Dickman (1980) demonstrated how conclusions from the studies of selective attention, cortical evoked potentials, and subliminal perception provide support for the concept of an unconscious mind and posit that “no psychological model that seeks to explain how human beings know, learn, or behave can ignore the concept of unconscious psychological processes” (p. 432). They also noted that the initial stage for processing all stimuli occurs outside of consciousness and that it affects what is known consciously. This early stage is different in how it operates from conscious cognition, and conscious cognition necessarily occurs after considerable preconscious processing. Years, later, their conclusions and ideas appear to be no less true.

 

Empirical and Cases Studies Demonstrating Unconscious Processes

In studies of subliminal perception, which began in 1950s, the processing of unperceivable stimuli and its effect on behaviour has provided interesting results about the unconscious mind. Shevrin and Fisher (1967) subliminally presented participants with a picture of a pen and knee just prior to falling asleep. When they awoke from rapid eye movement (REM; dream stage) sleep, participants’ associations to their dreams were of a pen or knee or included less rational kinds of associations (a finding that had been well demonstrated in past sleep studies). These included words that sound like pen or knee, such as pennant, hen, or neither. In contrast, those who awoke during non-REM sleep, which had been associated with few dreams or dreams that were more rational, had associations such as penny (pen + knee) or related words, such as nickel and dime.

Shevrin (2006) noted that this study demonstrated that 2 levels of unconscious processing – irrational and rational – were taking place. He deduced that once inhibitions [e.g. defences] weaken – in this case, being awakened from sleep – more rational processes are overtaken by irrational ones. Surprisingly, the more irrational process observed in this study produced content similar to what was found in severe types of psychopathology: repetition and clanging. In a follow-up study with the same methodology, Shevrin (1973) presented participants with the same stimuli, this time while they were fully awake and more proximal to entering the sleep state. Again, they found a similar pattern of results in which the type of associations produced varied depending on when participants were awakened.

Even more interesting results were described by Shevrin and colleagues (Shevrin, 1988; Shevrin, Bond, Brakel, Hertel & Williams, 1996; Shevrin et al., 1992), who set out to demonstrate that unconscious and conscious processes operate differently. In these studies, patients were selected who had either pathological phobic reactions or extended grief. They were then assessed via interview, and 4 psychoanalysts listened to the interviews carefully. By way of consensus, the psychoanalyst researchers derived a conceptualisation of the core conflicts for each patient; then went on to select the patients’ words that they believed captured the patients’ conscious experience of the symptoms and words that represented unconscious conflict. These words along with unrelated words were then presented both subliminally and supraliminally to the patients, who were then asked to classify them as belonging together. Using event-related potentials to detect patients’ ability to classify or respond to words in similar ways, the researchers found that words representing unconscious conflicts were correctly classified only when presented subliminally and that the reverse was true for supraliminally presented words; they were correctly classified only when presented supraliminally. Here, we find some sense to Lacan’s deductions regarding the unconscious being structured like language and the linguistic dexterity that psychoanalyst should be able to handle to decipher and understand the fullness of the patient’s mind [conscious and unconscious].

Shevrin (1996) concluded, “…When [these studies are] taken in combination, [they] show that unconscious psychological causes affect consciousness in a qualitatively different way… and that unconscious conflict has an existence independent of the psychoanalyst’s inferences from conscious manifestations, an independence supported by brain correlates” (p. 591, italics in original). Shevrin also published reviews of research showing an association between subliminal perception and dreaming (Shevrin, 1986) and subliminal perception and repression (Shevrin, 1990).

In a more recent meta-analysis from more than 100 studies of subliminal perception, Weinberger and Hardaway (1990) found that psychodynamic material presented subliminally had a noticeable and predictable effect on behaviour, suggesting very clearly that unconscious processes affect overt behaviour. For instance, studies by Silverman and colleagues (Silverman, 1983, 1986; Silverman, Bronstein & Mendelsohn, 1976; Silverman, Kwawer, Wolitzky & Coron, 1973; Silverman, Lachman & Milich, 1982; Silverman, Ross, Adler & Lustig, 1978) found that subliminally presented messages of Oedipal content (e.g., “Beating dad is okay”) to male participants yielded more competitiveness in a subsequent dart-throwing game than non-Oedipal messages. [Note: Freud proposed that at the Oedipal stage, a competition between father/son and daughter/mother takes place, before it is resolved in the child gradually adopting the same-sex parent’s values as his/her own in the development of an early form of Conscience (Super-Ego/Preconscious)]

Bradley and colleagues (Bradley, Mogg & Millar, 1996; Bradley, Mogg and Williams, 1994, 1995) performed a series of studies in which words related to depression (e.g. misery, grief, despair) are subliminally presented to individuals who fall into 3 groups: those meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for major depression, those with subclinical levels of depression and those operating as controls. They consistently found that on implicit memory tests, depressed and subclinically depressed individuals correctly identity words related to depression more often than those who are not depressed. Although their findings have not been consistently replicated for patients suffering with anxiety, studies with depressive patients suggest that a level of processing occurs below conscious awareness that increases individuals’ awareness of and identification of depressive material. Clinically, it would suggest that to effectively treat and manage depression, addressing issues related to unconscious sensitivity to depressive material is very important. Given the relatively high relapse rates for depression and other disorders that are treated with methods focussing more on conscious awareness – via cognitive and behavioural therapies (Westen & Morrison, 2001) – it seems that attention to unconscious processes has the potential to effectively address some depressive disorders.

Eagle (1987) provided support for the notion of unconscious processing in studies of perceptual illusions and dichotic listening, a type of selective attention task. For instance, in the Ames room experiment (Ittleson & Kilpatrick, 1951), the ceiling and floor were not parallel, and the 2 subjects stood either towards the front or back of the room. This led perceivers to believe that the people very different in size , despite the fact that they were not. In the dichotic listening task (Lewis, 1970), individuals heard 2 different messages in each ear but were trained to attend to just one of those messages. When asked to repeat what was heard in the trained ear, individuals had less of a reaction time in producing the words when the words in the other ear were semantically similar [the meaning was synonymous / it meant the same thing]. This means that, there was a facilitative effect on performance when a semantically similar word was processed (unconsciously) in the “unattended” ear.

Further studies of patients who have experienced brain injuries provide interesting clinical observations that support the presence of unconscious processes. Milner, Corkin and Teuber (1968) reported the famous case of a patient known as H.M., who had undergone surgery on his medial temporal lobes to control very severe seizures. We nowadays know that just below the this part of the cortex lies the hippocampus, which is considered as an important anatomical locus for learning new information and storing it in working and long-term memory. Because of the damage done to the medial temporal lobes by the procedure, H.M. failed to remember anything that was new to him past surgery. H.M. however could remember information if he rehearsed it, although it was quickly lost if he was interrupted.

One interesting consequence of this procedure was that H.M. appeared not to have lost all “affective” components of certain experiences. For instance, H.M. had the occasion to visit his mother, who was hospitalised. After leaving the hospital, he had no recollection of visiting her, although he had the idea that something may be wrong with her. H.M. experienced other events like this, demonstrating well that implicit learning was still occurring for “affectively charged” situations and that the unconscious effects of this learning could be identified in everyday life.

Later studies of unconscious affective processing have suggested that there are at least 2 neural pathways that process affective information (LeDoux, 1989, 1995, as cited in Westen, 1999). One of these pathways originates in the thalamus and transmit sensory information to other brain regions, whereby emotional meaning is attached to the information. The other pathway, also originating in the thalamus, sends the sensory information to the cortex, where higher levels of emotional processing and emotional meaning are executed.

Mark Solms has reported some exciting work on the effects of unconscious processes on commonly observed clinical syndromes (e.g., Solms, 2000a, 2000b, 2001, 2002, 2004). Solms has taken a very active role in recent times in integrating the findings of neuroscience and psychoanalysis, which has created a relatively new discipline of study known as neuro-psychoanalysis. An interesting set of case of studies has been provided (Solms, 2000a) on patients who have experienced a strike on the right temporal lobe in the region, where the middle cerebral artery lies. In these case studies, psychoanalytic theory and treatment is integrated into the neurological understanding of the deficits the patients are experiencing.

Right hemisphere syndrome is a neurological disorder consisting of 3 major symptoms: ansognosia, neglect and spatial perception and cognition deficits. Anosognosia is the indifference or outright denial of an illness, which in the present case was the loss of the use of the patient’s left arm and side. Neglect occurs when patients ignore their paralysed limb and side. Patients often feel disgust when they are compelled to attend to the left side of the body, sometimes experiencing a sense of revulsion.

The spatial and cognitive deficits observed consist of defective facial recognition, imperceptions of facial emotion, environmental disorientation, and various kinds of apraxia [the inability to complete an activity involving muscle movement]. There are various theories about the emotional deficit in patients with right hemisphere syndrome. One theory suggests that the stroke affects attentional arousal that is mediated through activity in the right perisylvian region of the temporal lobe, which consequently gives rise to anosognosia and neglect. Another theory has focused on the fact that the left hemisphere is more involved with positive emotional processing and the right with more negative emotional processing. Since, the right hemisphere is damaged in this case, anosognosia and neglect occur because there is little to no processing of negative effect in the right hemisphere. A final theory states that it is the right hemisphere that is dominant for the perceptual representation of bodily states, which include more somatic or visceral perceptions. When this part of the brain is damaged or compromised, the brain can only rely on past somatosensory representations of bodily states, which provide the patient that there is no deficit or problem.

Solms (2000a) described Mr.C., a 59-year-old engineer who experienced right hemisphere syndrome after complications from a mild stroke. Only part of the visual field of the patient was remaining and he would not attempt to compensate for it [i.e. neglect], and he also ignored sensory stimulation that occurred on the left side of his body [anosodiaphoria]. He ignored and minimised his paralysed left arm, referring to it as being “like a dead piece of meat, but not it’s just a little bit lame and lazy” (p.71). Other deficits existed due to right parietal damage.

Mr.C. was “aloof, imperious and egocentric” (Solms, 2000a, p.72). He seemed unconcerned about others and would sit blankly at times staring into space. However, on occasion he would burst into tears or look as if this were the case. These periods however, were brief yet stood in stark contrast to the emotional coldness that he often presented with. During one physical therapy session, Mr. C. was making very little progress in learning how to walk. The physiotherapist reported to the treating psychologist that Mr. C. seemed “indifferent to the errors he was making, and he simply ignored her when she pointed them out to him” (p.74). In a session next day, Mr. C. told the psychologist that the physiotherapist indicated that he had been making mistakes, sounding as if he was confession something. Then, he said that another therapist had asked him to do some activities with blocks but that he could not do it. At this point, the therapist replied to Mr. C.:

 

“…it was difficult for him to acknowledge the problems his stroke had left him with, but it seemed that he was now more able to see them. Mr.C., carried on… [saying] his physiotherapy was “okay” but that his arm had not progressed to the degree that he required. Then, at this point, he suddenly  withdrew from conversing… and began to exercise his left hand and arm with the right one. [The therapist] commented that is seemed as if he could not bear the wait, and wanted his arm to be completely better instantly… [He replied] “I just don’t want my left arm to get weak from non-use.” [The therapist then replied] perhaps it was too painful for him to acknowledge what he was on the verge of recognising a moment earlier – namely that his arm really was completely paralysed – and that the question of whether it would recover or not was largely beyond his control. This comment provoked an instantaneous crumpling of his face and a burst of painful emotion accompanied by pre-tearfulness. [Turning to the therapist] he said in desperation “but look at my arm [pointing to his left arm] – what am I going to do if it doesn’t recover? (pp. 74-75)

 

Solms (2000a) noted that this case demonstrates how unconscious material that was too painful to acknowledge was accessed through careful interpretations. Furthermore, the case example controverts the theory that these patients lack negative emotions or have no awareness of their bodies and their deficits. In Mr. C’s case, it is clear that implicit processes were at work and that the emotional response originated out of the complex, associative networks were formed by this patient’s unconscious processing of the painful loss of his bodily integrity.

Transference phenomena can also be better understood in the light of recent findings in cognitive psychology. To understand transference phenomena, Westen and Gabbard (2002b, pp. 103-104) highlighted important ideas in recent studies of cognitive processing.

  1. More representations consist of memory traces that are multimodal, which include semantic, sensory and emotional components.
  2. Representations of self and other exist as potentials for activation. Because there are potentials, they are subject to modification, which will interact with new knowledge, further developing the self and other representations.
  3. Memory networks consist of semantic, episodic and procedural knowledge, along with differing affects and motives.
  4. Unconscious procedures to manage emotions are defences and may be triggered outside of awareness. Co-occurring motives and affects may also be activated, such that the person may not be aware of either one or the defence being used.
  5. Conscious representation are some of many representations that get activated. Consciousness is a serial processing system, whereas multiple parallel processes get activated that are not available to consciousness.

As may be observed in these principles, Westen and Gabbard (2002b) suggested that transference phenomena represent a dynamic, ongoing process that occurs at the conscious and unconscious level. Because multiple cognitive events occur at one time, transference phenomena can be highly complex phenomena and can represent one of many possible reactions to the therapist, as well as other meaningful individuals in the patient’s life. In fact, multiple transferences can occur. For instance, a patient may feel particularly challenged by his work and may experience some feedback from his female supervisor about his recent difficulties with his job. Suppose the patient’s mother took great strides to help him whenever he felt frustrated in his school activities or work, such that he came to unconsciously expect her to provide assistance during challenging times. At work the patient may have experienced the supervisor’s comments as an invitation for help and assistance. Should no help be forthcoming, the patient would become irritated and disappointed with such a difficult supervisor. Likewise, suppose that this patient’s father was unavailable to help him. He may have to come to view male authorities as uncaring and disinterested in his plight. Thus, in his present treatment, the patient may find himself feeling scared and anxious towards his male therapist when talking about his recent disappointment with the supervisor. An exploration of his interaction with his supervisor may elicit anxiety in the patient towards his therapist whom he experiences as a disinterested and uncaring male. Likewise, he may feel very frustrated towards the therapist who is not willing to tell him how to manage his interactions with his supervisor, reflecting a maternal transference to the therapist who unconsciously should be offering help and assistance quickly and without much effort on the patient’s part.

 

The Psychoanalytic Account of Motivation

The account of human motivation, resting on sexual and death instincts, has been a big talking point for critics of psychoanalysis from the very beginning. Jung’s departure from the psychoanalytic movement was largely caused over disagreements over the motivational concepts. Jung questioned the centrality of sexuality and argued for the importance of spiritual motives. Alfred Adler on the other hand proposed a basic desire for social superiority and a “will to power”. Later writers within the psychoanalytic tradition also sought to expand the theory of motivation to include drives for mastery and competence, and for interpersonal relatedness.

In general, there has always been 2 major issues, the first is whether the sexual and death instinct are plausible sources of human motivation. Second, whether they are sufficient explanations of motivation, or whether additional motives that are not reducible to these drives are needed.

With respect to the first issue, it may be hard to deny [from a universal and organic standpoint] that sexual wishes and drives are powerful sources of motivation, especially if we include “sexual” desires as a part of loving relationships and for bodily pleasure. From a biological and evolutionary perspective it could not be otherwise, since reproductive success is the basic currency of individual genetic fitness, not to mention species survival [in all species including primates and mammals].

From this perspective, the psychoanalytic emphasis on sexual drives – an emphasis shared by no other personality theory – is a very strong point of the psychoanalytic theory, even if we are allowed to disagree and investigate some particular claims that may not apply to some individuals regarding the effects of the Psychosexual stages in childhood as proposed by Freud [which inspired John Bowlby’s Theory of Attachment], or discuss the other drives that are non-sexual [e.g. Romantic love and its expressions].

Romantic Love dpurb site web 2019.jpg

From the same evolution standpoint, a death instinct directed inwards towards self-destruction is questionable. However, this negative judgement on the death instinct, which is shared by many contemporary psychoanalysts, does not mean that we need to dispense with the idea of aggressive drives. Aggressiveness could be theorised not as a form of self-destructiveness, but rather as a way to strive for social dominance [among a particular frame, circle or group], i.e. to fend off “attackers” in defence of one’s own “territorial grounds” or to assert one’s personal choice or interest.

The second issue is whether sexual and perhaps aggressive drives are broad enough to capture the full range of human motivations. The answer, is clearly not. Since, we also have drives for achievement, approval, non-sexual relatedness, creativity, self-esteem, and so on? The other question is biologically-based motives that “push” us towards certain kinds of behaviour enough? Do future-oriented motivational concepts, like goals and personal ideals not “pull” us towards desirable endpoints? When these questions are raised, basic Freudian account of motivation may seem limited in their scope, leaving out motives that are socially shaped or personally determined. However, the issue is not so easily resolved, since psychoanalysts may agree that motivations beyond the instinctual drives are required to describe how our behaviour is guided, however it may still be argued that all these motivations are simply multiple layers of the very same instinctual drives. For example, achievement striving could be described psychoanalytically as a socially shaped motive that is underpinned and powered by aggressive urges [that are applied in different forms to achieve our goals, i.e. not in a physically violent manner, but competitively in multiple sophisticated social ways]. On the same note, creativity might be understood as a sublimated expression of individuals’ sexual drives [e.g. artistic creations], based on some unconscious desire for unifying and making connections that Freud saw as the hallmark of life instincts.

Victor Hugo La Musique

Traduction(EN): « What we could not say and what we could not silence, music expresses. » -Victor Hugo (1802 – 1885)

However, even if the claim that human motivation is ultimately based on a few instinctual drives that govern all living organism, it would still be more enlightening and accurate to patients to describe their motivation in a more complex way, i.e. expressed to meet the sophisticated and multi-layered human societies we live in. So, in the end there is no objective or empirical way to establish the question of motivation with a clear “true or false” – we will have to use logical reasoning and theories about what drives “life” forward.

Documentaire: L’invention de la Psychanalyse (1997)

 

The 2 Major Disciples of Psychoanalysis: Carl Jung and Jacques Lacan

The psychoanalytic movement was largely the invention of Sigmund Freud, and his influence far exceeds that of his early followers who subsequently tried to modify psychoanalysis. The major principles of psychoanalysis were redefined and reinterpreted until by 1930 the movement was fragmented into competing views. Nevertheless, those writers who departed from Freud’s speculation retain the basic model of psychoanalysis that conceived of personality in terms of an energy reduction system with three levels of awareness that is the conscious [that contains the Ego], preconscious [that holds the Super-Ego] and the unconscious [the wild Id]. The psychoanalytic movement has been very active since Freud’s death in 1939, and has led to many new theoretical developments influencing all schools of psychology rather than standing still as we have just covered regarding the reconciliation of some fundamental concepts with Cognitive psychology and Neurosciences.

 

Carl Jung (1875 – 1961)

Carl Jung

One of the most fascinating and complicated scholars of this century, Carl Jung (1875 – 1961) was born to a poor family in a northern Swiss village. He managed to gain entrance to the University of Basel and received a doctorate in medicine in 1900. Jung spent most of the rest of his life in Zürich, teaching, writing and working with patients. After reading The Interpretation of Dreams in 1900, Jung began corresponding with Freud and finally met him in 1907. Eventually he accompanied Freud to America in 1909, where he also lectured and introduced his own work to American audiences. However, Jung began to apply psychoanalytic insights to ancient myths and legends in search for the key to the nature of human psyche. Such independent thinking did not meet with Freud’s approval, and there is also some speculation that the Jung made a critical analysis of Freud’s personal life that may have contributed to tensions between them. Freud secured the post of the first president of the International Psychoanalytic Association for Jung in 1911, but by this time their rift was beyond healing. Finally, in 1914, Jung withdrew from the Association and severed all interactions with Freud due to the over-emphasis of the defining stages of infant sexuality among other aspects of pure Freudian theory. Jung continued his own interpretations of psychoanalysis and made several expeditions to study primitive societies in Western United States, Africa, Australia and Central America. His prolific writings on subjects ranging from anthropology to religion provided novel insights to age-old problems of human existence from the psychoanalytic perspective.

Jung’s “Analytical psychology” refined many Freudian concepts and emerged as the first major alternative to Freudian theory (1900); however, Jung retained Freud’s terminology [Unconscious, Conscious and Preconscious], and as a result the same terms often carry different meanings. Jung (1912) renamed the Id as the Personal Unconscious, the Ego as the Personal Conscious [although the term Ego also appears in some of Jung’s writings], and the Super-Ego as the Collective Conscious [although the term Persona also appears in some of his writings]. After that Jung’s (1912) analytical psychology also added the Collective Unconscious to Freud’s (1900) structure of personality which is part of the Id.

Jung, like Freud, believed that the central purpose of personality is to achieve a balance between conscious and unconscious forces within the personality. However, Jung described two sources of unconscious forces. What is the personal unconscious, consisting of repressed or forgotten experiences similar to Freud’s preconscious level. The contents of the Personal Unconscious [Id] are accessible to full consciousness. Jung’s Personal Unconscious held complexes, which were groups of feelings with a defined theme than give rise to distorted behavioural responses. According to Hall and Lindzey (1970), “… a [complex] is an organised group or constellation of feelings, thoughts, perceptions, and memories which exists in the Personal Unconscious” (p.82). Unlike archetypes [which reflect the cumulative experiences of the entire human race, Homo Sapiens], Complexes reflect each individual’s unique experience. For example, a boy who repressed negative emotions about his mother could become an adult with the complex, experiencing intense feelings and anxieties when images or stimuli associated with motherhood are encountered [because they are dominated by their mothers], for e.g. some mothers might offer nourishment only after – not before – their babies stop crying, thus communicating the unconscious message that the mother is all-powerful.

The second source of unconscious forces in to Jung’s theory, is the Collective Unconscious, more powerful source of energy that contains inherited contents shared with other members of a particular group, i.e. it consists of aspects of personality, common to all humans, that we have inherited from our ancestors. Jung here was talking about individual similarities and not differences in personality. As the personal unconscious has complexes, the collective unconscious has archetypes, defined as primordial images evolved from human beings primitive ancestry of specific experiences and attitudes passed on over centuries [after all humans did evolve from basic primates to the sophisticated beings were now are]. Hall and Lindzey (1970) define archetype as “…a universal thought form (idea) which contains a large element of emotion” (p.84). Although modern science has shown that direct environmental influences has more power in shaping the individual mind, some aspects may be retained from evolutionary psychology although it is important to consider the fact that human societies are constantly evolving in more ways than one. At the time that Jung devised his theory however, he listed such archetypes as birth, death, unity, power, God, the devil, magic, the old sage and the earth mother. As Weitz (1976) noted, according to Jung’s Analytical Psychology, archetypes equip humans to interact with particular aspects of their physical and social worlds in a particular manner, thus archetypes are adaptive from an evolutionary standpoint. For example, Jung (1912) contended that all humans possess a “mother figure” archetype that not only gives them readily accessible image of a generic mother at birth but also predisposes them to interact with their actual mothers in a particular manner [e.g. crying, sucking]. Solomon (2003) noted that in Jung’s Theory, collectively experienced archetypes provide basic themes around which personally experienced complexes are organised. For example, all individuals are born with a readiness to seek nourishment from their mothers (the mother archetype), some individuals may find that their mothers use this readiness against them (mother complex).

The notion of a collective unconscious in personality that provides the individual with patterns of behaviour fits well with Jung’s preoccupation with myths and symbols. Jung believed that the adequacies of a society’s symbols to express archetypal images are an index of the progress of civilisation. [e,g, the Ancient Greeks who after sophisticating their society through the evolution of their values, philosophy & educational system, saw peasants turn into conquerors, sculptors, poets and artists who even went on to colonise countries that later changed the history of those who colonised them in timeless ways / See: L’épopée de la Grèce antique (2016)].

Jung focussed on the middle years of life, when the pressures of sexual drives supposedly give way to anxiety about the more profound philosophical and religious issues of the meaning of life and death. By reinstating the notion of the spiritual soul, Jung argued that the healthy personality has realised the fullness of human potential to achieve self-unity and complete integration. According to Jung, this realisation occurs only after the person has mastered obstacles during the development of personality from infancy to middle age. Failure to grow in this sense results in the disintegration of personality. Accordingly, the person must individualise experiences to achieve a “transcendent function” by which differentiated personality structures are unified to form a fully aware self.

Both Jung (1921) and Freud (1905) wrote about libido, or psychic energy, that presumably fuels individuals’ behaviour, however Jung viewed libido in a less sexualised form. Jung redefined libidinal energy as the opposition of introversion – extraversion in personality, bypassing Freud’s extreme sexual emphasis. Extraversion forces are directed externally to the people and the environment, and then nurture self-confidence. Introversion leads the person to an inner direction of contemplation, introspection and stability. Jung (1921) believed that all individuals are capable of experiencing introversion as well as extraversion over time, however, individuals at any particular point in time may be characterised as experiencing either introversion or extraversion. The opposing energies must be balanced for proper psychological functioning, sensation, thinking, feeling and intuition. An imbalance between extraversion introversion is partly compensated for in dreams. Indeed, for Jung dreams have important adaptive value in helping the person maintain equilibrium. Jung has been praised for developing a dichotomy of flow of psychic energy [i.e. introversion vs extraversion] that has been recast as one of the major personality traits in various trait theories [for empiricists who believe the main focus should be the “conflict-free” conscious part of the ego, to which many basic concepts of Cognitive Psychology can be applied].

In addition to introversion versus extraversion as a pair of opposing directions of flow of psychic energy [i.e. inwards versus outwards], Jung (1921) postulated that thinking vs feeling and sensing vs intuition represent 2 pairs of opposing modes of adaptation and functioning.

As Jung grew older, his writings increasingly came to emphasise mysticism and religious experiences, domains usually ignored by mainstream empirical psychology. Out of all the early founders of psychoanalysis, Jung held views in sharpest contrast to those of empiricism. However, he offered a unique treatment of critical human issues that had not been systematically studied by psychologists and still remain in the realm of speculative philosophy. Perhaps Jung was more of a philosopher than a psychologist, nonetheless he provoked and confronted issues not readily accommodated in other systems of psychology.

 

Jacques Lacan (1901 – 1981)

Jacques Lacan

One of the most famous post-Freudian development, especially popular in Europe and South America, was initiated by the colourful French psychoanalyst Jacques Lacan. Lacan was the son of a successful oil and soap salesman from Paris. His mother was a firm Catholic and his younger brother entered a monastery in 1929.

The two early philosophical influences of Jacques Lacan were Spinoza & Nietzsche:

(i) Baruch Spinoza (1632 – 1677)

Baruch Spinoza dpurb site web

Traduction(EN): « Joy is man’s passage from less to greater perfection. » -Baruch Spinoza

Spinoza is known as the philosopher of nature and human passions who identified the concept of « God » and Nature. Spinoza proposes that wisdom is the intellectual love of the true God, immanent to reality [that is, scientific studies of Nature are to understand the forces that govern the creations of « God », e.g., medicine, etc.]. Spinoza is considered a Cartesian, i.e. a disciple of Descartes. Spinoza believed in Ethics as a geometrical method that manifests the philosopher’s will to proceed in a rigorous manner, as mathematicians do; he strives to express in Ethics, in an objective manner, the fundamental essence of all things, in other words, the basis of understanding. In Spinoza’s philosophy, Ethics does not designate a moral code, but the true knowledge of the true concept of « God », immanent to the world [which is said to be contained in the nature of a being and does not come from an external principle], the practical science of what is: a single substance, absolutely infinite, of which we are only modes. Spinoza’s concept of « God », the object of Ethics, has nothing to do with that of the Judeo-Christian religion, a principle transcendent to the world – Spinoza does not believe in transcendence. So, we see oppositions to Nietzsche which Jacques Lacan also synthesized with his more modern theories of the psyche. Spinoza did not believe in transcendence and expelled any anthropomorphic representation of the divine [Note: Anthropomorphism is the attribution of characteristics of human behaviour or morphology to other entities such as gods, animals, objects, phenomena, even ideas]. God is nothing else but an absolutely infinite Being, composed of an infinity of attributes, a unique Substance [the Substance designating what is in itself and conceived by itself]. Therefore, God identifies Himself with this substance and designates the whole of reality or Nature, understood as the unity of things and the only Being to which realities relate: Deus sive Natura – God or Nature [a united and infinite nature]. Of this unique substance, of this Nature being one with God [although not interchangeable], human intelligence grasps only two Attributes, Extension and Thought (L’Étendue et la Pensée), the Attribute being defined by Spinoza as what the understanding perceives as constituting its essence. In this perspective, the particular objects of the world represent modifications of the infinite Substance that is Nature [i.e. God’s transcendence], in other words « modes« , that is, affections of this substance. Thus, each particular creature appears as a mode of God, as being in something else, by means of which it is conceived. This tripartition of Substance-Attribute-Mode allows us to grasp the meaning of the concepts of Nature-naturing (natura naturans or Nature-naturante) and Nature-natured (natura naturata or Nature naturée). Nature naturing for Spinoza is God himself, as he is in himself and conceived by himself, as the producer of all reality, i.e. as doing what nature creates/does. Nature natured is considered as everything that follows in the nature of God and his attributes, that is to say, everything that is produced by the Substance of God as he is in it through it. The problem with Spinoza’s system is that it was absolutely deterministic; the infinite attributes of God necessarily produce certain effects, and Spinoza assumes that nothing is given by chance in nature. In Spinoza’s magnum opus, The Ethics (L’Éthique), he speaks of absolute necessity, which has the meaning that everything is already determined by divine Nature to produce an effect [in modernity we know from empirical research that natural and environmental determinants combine to define humans]. Spinoza sees contingency [in other words, what cannot be] simply as a defect in our understanding, a lack of real knowledge. The essence of human nature lies in an active element in all of us that Spinoza calls “conatus”, the effort by which everything strives to persevere in its being, i.e. a natural inclination to strive toward preserving an essential being, where virtue/human power is defined by success in this preservation of being by the guidance of reason as one’s central ethical doctrine, with the highest virtue being the intellectual love or knowledge of God/Nature/Universe. When the “conatus” becomes self-conscious, it is called “desire”, which is therefore identified with « appetite » accompanied by consciousness itself. Thus, conatus and desire correspond to the dynamic affirmation of our being. We find here some link to Schopenhauer’s philosophical meditations about the “Will” and also Lacan’s focus on “Desire” being at the heart of psychoanalytic praxis. However in Spinoza’s reflections, human desires are modified by the intervention of external environmental causes, since we are subject to the action of forces to which we are bound, being all a part of Nature, and it is from this effect that passions are born, passive modifications of our being; this is linked to Lacan’s concept of “chaine signifiante” [signifying chain] which is the structural basis of the unconscious and the roots of linguistic discourse and speech. The two fundamental passions are sadness and joy from which the other passions derive: sadness is the passage to a lesser perfection, while joy is the passage to a greater perfection. Spinoza believed that man’s life is marked by the sad procession of sad passions [hatred, envy, jealousy, la mauvaise foi, etc.] which reduce man to a state of servitude, of passivity; this is where the philosopher comes in, whose responsibility it is to heal man from his sad passions: to make him maître (master) of himself.

Auguste Dumont - Génie de la Liberté (1836) Or dpurb site web

« Génie de la Liberté » par Auguste Dumont, 1836

In Spinoza’s philosophy, virtue is acquiring true knowledge of our passions through the right ideas and notions. Therefore, the virtuous discovers the dynamism that animates him, which allows him to regain the power of the conatus: to know reality and to reach the fullness of existence [Virtue and life are thus inseparable]. The wise man is therefore the one who reaches true knowledge and, in this way, achieves the fullness of existence. The wise man lives under the regime of reason, in this way the Spinozist citizen also finds the agreement and unity of his semblables (fellow men). Therefore, the state must be rationally created, because only the rational state opens the way to freedom, according to the laws of human nature, that is to say, aware of the infinite nature of humanity. Spinoza seems to be situated in the democratic thought where all have equal rights with total freedom of opinion, thus the destiny of free men, living under the regime of reason, in a free city, is outlined. By gaining access to la connaissance vraie (true knowledge), man again becomes a God for man. So, we can see that Spinoza is a rigid penseur de système (system thinker), allowing man to free himself from his illusions and find and accept his place in Nature. Spinoza’s philosophy is not only intellectual but also practical and truly powerful: wisdom is acquired through knowledge; joy is maintained through the search for good passions. Thus, man can persevere in his being.

(ii) Friedrich Wilhelm Nietzsche (1844 – 1900)

Friedrich Nietzsche dpurb site web

Traduction(EN): « The greatness of man is that he is a bridge and not an end. » – Friedrich Nietzsche

Nietzsche is the philosopher of the “will to power”, conceived as creation and vital fullness, as the overwhelming affirmation of life. What is essential is our world as it is joy and will-power. As for the illusion of the afterworlds, Nietzsche hunts it down in all its forms. Nietzsche can be considered a moralist above all. It is clear that Nietzsche’s philosophy is one of the most complex thoughts, a complexity linked as much to his poetic and aphoric writing as to his refusal to situate himself clearly in the philosophical tradition, and we find this in Lacan who was also a literary and profound writer with a singular thought, a synthesis of several schools of thought, where the mediocre reader finds himself in the middle of a nightmare when trying to read it and may even start to question the level of his own intellectual abilities, his place and purpose in the universe. Unseizable, Nietzsche’s writings must be approached like a mountain, a slow progression. Nietzsche diagnosed the essence of the mortal crisis of our time: he described it, in its main characteristics, and in a quasi-clinical manner. He studied it at various levels and, in so doing, often announced with the greatest precision what was only beginning to emerge at the end of the nineteenth century; this fatal disease of modern times, ours, is nihilism, the reign of the absurd, of Nothing (« nihil », as the etymology tells us). Nihilism or the absence of sense, makes becoming a purposeless process and all traditional ideals lose their value. Nihilism, this « Nothing » symbolizes the death of the Divine and the Suprasensible in man [Nietzsche’s death of God can be interpreted symbolically as the death of sensitivity and goodness in man]: we have killed him [the Divine], Nietzsche sometimes tells us, and darkness is now the lot of our world. This death of the Divine as seen by Nietzsche also announces a new dawn in our time: the coming of the « Last Man » which signifies the completion of nihilism. The « Last Man » designates the most despicable thing in this world: the one who is powerless to create and love, the individual totally enslaved and enjoying a programmed and petty « happiness » – he thus hops on the surface of the earth. Lacan, like myself, did not completely follow Nietzsche, but used some of the concepts of the German of the time and then refined them in the field of psychology for the twentieth century. Concepts of metaphysics are sometimes exaggerated in a negative way by Nietzsche, and the advances of our era make some of his views obsolete. One of Nietzsche’s exaggerations seems to be the origin of metaphysics, which he believed to be the by-product of the suffering and resentment of those unable to create positively, and which also engendered moral values [good and evil]. We see that Lacan did not take up everything from Nietzsche, but showed originality by relying on what was worth keeping in our modern world and which could be synchronized with his psychology based on the creative force of language in the Cartesian Subject [i.e. based on Descartes’ model: « Je pense, donc je suis »]. However, we still have concepts of Nietzsche that are in the name of positive creation, and the perfection of the individual and society, and they still have a place in modern philosophical thinking such as those of Jacques Lacan, which assimilate reason, logic, empiricism, metaphysics, genetics, and human and societal evolution.

La matière de leur création, de leur pensée ou de leur écriture dpurb site web

Credits: D.R / Centre Pompidou  « Le festival Hors Pistes dédié chaque année à explorer les images en mouvement et rencontrer celles et ceux  qui en font la matière de leur création, de leur pensée ou de leur écriture… » Source: FranceCulture, 2020

Lacan synthesized Nietzsche’s influence with the strong constructionist and linguistic logic of his pychoanalytic theory, which directs us towards a system of thought where sophisticated and civilised individuals orient, identify and group themselves by « psychical » understanding, connection and similarity, with language [i.e. the communicative discourse and/or speech] as a founding pillar, and not by the atavistic logic of the simple physical/biological illusions of the imaginary since this brings us, human beings, closer to animal psychology; the reasoning behind Lacan’s theory suggests that civilised individuals should see others as semblables [fellow men] not based on the physical but on the « psychical », with a founding pillar being language; the individual should rise above the illusions of solidarity of the physical to embrace the psychical. This is avant-garde and synchronised with the reasoning of science and discoveries of the 19th century with the contributions of Darwin, Freud and Kant. Nietzsche’s inspiring concept is that of « The Will to Power » (Volonté de Puissance) which should not be interpreted by the simple mind as the appetite for power or the spirit of domination or competition, because this would be to conceive or understand it in a very restrictive or destructive way. To Nietzsche, « The Will to Power » is a set of essentially competitive impulses [in the « mediocre »], but also the very movement of creative transcendence [in the noble soul of the « aristocrat » – the term was used by Nietzsche in its essentially spiritual meaning to design the best, that in his times, were individuals from the aristocracy, being those who had a privileged access to the best teachers, institutions and collections of books, which has since changed into mostly vast, yet simple, inheritances of wealth and land; hence in our present society the « aristocrat » term could define the gifted and valiant mind with a wealth of knowledge, profoundly educated, cultivated, creative and consciously connected with the positive values of humanity and nature, i.e. with the ability to shape and have a lasting impact on generations]. This « Will to power » can also mean the struggle for life and also spiritual fullness and existential superabundance. « The Will to Power » is an ambivalent notion that cannot be reduced to its most superficial or trivial forms or manifestations; in its noblest dimension, it is a vital, plastic, destructive but also creative force [which seems to be connected to Shiva, the Hindu god, and Dionysus, his Greek equivalent in the phallic cult according to Alain Daniélou (See the Essay: History on Western Philosophy, Religious cultures, Science, Medicine & Secularisation)]. To understand the essence, it is the body of man [of the human being] that we must take as a reference point, for the body is wisdom and reason, which can be defined as intelligent dynamism, the organic faculty of understanding and thinking: every organism thinks and it is permissible to speak of an unconscious bodily thought [for after all, it is through the senses available from the different organs acquired through the multiple facets of the evolution of the human body that man sees, hears, discovers, smells, touches, tastes, reads, feels, expresses a wide range of emotions, learns, thinks, writes, creates and gains an understanding of human existence and the wider environment (i.e. the natural world), and adjusts to optimise his « psychical » experience].

Friederich_Nietzsche par Edvard Munch,1906

« Friedrich Wilhelm Nietzsche » par Edvard Munch (1906)

Nietzsche seems to rehabilitate the unconscious as a psychic reality beyond the clear and transparent grasp of oneself. The authentic « Will to Power » as affirmation and fullness reveals, within its creative superabundance, the true field of life and transcendence.

« Puisse chacun avoir la chance de trouver justement la conception de la vie qui lui permet de réaliser son maximum de bonheur. »

French for: « May everyone have the chance to find just the right conception of life that allows them to achieve their maximum happiness. »

– Friedrich Nietzsche

For Nietzsche, among the creations of life is, first and foremost, Art, which Nietzsche conceived in a much more global and dynamic form, where it becomes an invention of harmonious forms, a production destined to embellish the whole of human existence. Nietzsche conceals ugliness, he humanises or hides everything ugly. This set of materials and signs created by the artist who manifests an ideal of beauty is only an appendix of this production of forms that is art in general, this “ivresse de la vie”: a will to exist through harmonious forms. The field of creative life includes artistic activity, authentic work, and generally everything that concerns the positive edification of values: work, the shaping of all things, linked to joy, but does it differ profoundly from the miserable labour for gain? To the powers of life are also attached the authentic moral values, those created by the best,  « les maîtres » (the masters) who are in the vital current of the « Volonté de Puissance » (Will to Power). Thus, Nietzsche’s thought is elitist: the beautiful creative individuality is opposed to the vile herd [the mass]. This « elitist » morality, i.e. this creative act, this triumphant affirmation of values, an affirmation that takes place in joy, is a thousand leagues away from the morality of the « slaves » [metaphor], which is linked to the resentment that gives birth to negative values and “la mauvaise foi” (nastiness, hatred, evil, etc.). What should the man in a world devoid of the divine values believe in? Believe in yourself, in your own power, free yourself from all dominant morality and ideology and follow your own path: become who you truly are and desire – this is what Friedrich Wilhelm Nietzsche would have said. Nietzsche calls for exceptional people to no longer be ashamed in the face of a supposed morality-for-all, which he deems to be harmful to the flourishing of exceptional people. He cautions, however, that morality, per se, is not bad; it is good for the masses, and should be left to them. Exceptional people, on the other hand, should follow their own « inner law »; a favorite motto of Nietzsche, taken from Pindar, reads:

« Become what you are. »

Le Voyageur contemplant une mer de nuages (Der Wanderer über dem Nebelmeer) Caspar David Friedrich d'purb dpurb site web

« Le Voyageur contemplant une mer de nuages » (Der Wanderer über dem Nebelmeer) par Caspar David Friedrich, 1818

In what he considered to be the zenith of his philosophical creation, « Also sprach Zarathustra » [Thus Spoke Zarathustra], Nietzsche portrays the path of a wise man who only addresses himself, a nomad who accepted the disappearance of the divine among men as a personal liberation, a being who freed his mind completely of the burden of ultimate truths, a hermit who did not need anyone anymore and who had overcome hatred and resentment, living in harmony with himself and the cosmic forces of nature: an Übermensch (un Surhomme/an Overman).

It is to be noted that « Thus Spoke Zarathustra », Nietzsche’s magnum opus, completely opposes and rejects the unscientific notion of a superior or pure group or organic composition (i.e. « race »), but instead focuses on the superior individual [organism] who can appear from anywhere as an agent and expression of the cosmic forces of nature.

Les Forces Cosmiques de la Nature: l’Océan (2020)

Yet, while there are no superior groups but only superior individuals, we may still reasonably argue that there are languages that are superior since they offer the ability to interact with a wider audience, but also because these languages offer an entry point and the gift of belonging by creating a social bond to the specific social environments they originate from; environments that may also be considered as superior if the way they are organised [i.e. philosophy, educational system, values, culture and government] lead to more chances of individual human development and life satisfaction, mainly due to the progressive outlook and heritage of their sophisticated and evolving institutions and the way they are managed. However, it is important to understand that any individual speaking in a superior language does not automatically lead to everything being said in that language to be worthy of consideration because while the communicative patterns (i.e. language) of human primates vary from regions, the IQ and creativity of the individuals do not, as the Organic Theory clearly states. Jacques Lacan also reached a fairly similar conclusion since he also distinguished the speaking Subject of the enunciation [i.e. how words are pronounced] from the Subject of the statement [i.e. the genuine message of the discourse], which suggests that in order to evaluate the true worth of any linguistic discourse, it is the genuine message that should be extracted; in other words, it should be translated in the appropriate language of the reader/listener so that its true value and meaning can be assessed. Thus, individuals who intend to share their wisdom and contribute to the world’s development would have an advantage in adopting and mastering a communicative pattern (i.e. language) deemed superior by the fact that it comes with modern human values and is weaved in the fabric of a more refined and sophisticated intellectual, psychosocial, philosophical and artistic heritage [e.g. French, which is the most desired and most spoken second language in the UK and in Germany] since it would be understood by the wider audience of the civilised world, where the major intellectual and cultural evolution/revolution takes place. It may also be useful for the majority of anglophones and fellow English people out there who hardly know their own cultural evolution, to point out that there is French on the emblem of the British monarchy. The words, « Dieu et mon droit » have been the motto since the time of Henry V (1413 – 1422), and since those times old English is not the language of the English elite anymore which resulted to the use of words and expressions of French and Norman origin that are now widely used in the English language.

Anglais VS Français Habsburg d'purb dpurb site web

Traduction(EN): « The English language is a shotgun: the shot is scattered. The French language is a rifle that shoots bullets, precisely. » -Otto von Habsburg

So Nietzsche rightly concluded that there are no superior groups, but only superior individuals that come from the wider human population and together these individuals constitute the force that shapes civilisation; this conclusion had unconsciously acknowledged what science would certify about a century later in 2018, as a genome-wide association meta-analysis in 267, 867 individuals identified 1,016 genes linked to intelligence, which is a highly heritable trait and a major determinant of human health and well-being (Savage, Jansen, Stringer et al., 2018). Before Nietzsche, no philosopher had placed so much emphasis on the individual perspective; he restored the existential mission of philosophy by detaching himself from all the irrational conventions of his time, abandoning lengthy theoretical papers to redact concise reflections on the way of living one’s own life. Nietzsche’s philosophy is centred around the personal sphere of the individual.

In modern times, with the advances of psychology, we can conclude that a superior psyche will include a superior understanding, judgement and vision as the French psychologist, Monique de Kermadec also pointed out regarding « l’adulte surdoué » [i.e. the gifted adult]. The criterion of authenticity always appears to be linked, in Nietzsche’s view, to the affirmation and creative power of life. Nietzsche uses the god Dionysus [whom the French orientalist Alain Daniélou connects to Shiva for his cycle of destruction and creation as an equivalent] as a symbol of life, the most overflowing being of life, who in Nietzsche’s thought embodies the process of “becoming” as destruction and creation; Dionysus is sensuality, the enjoyment of a force that destroys but also generates/creates. The term dyonysism refers to the identification with the principle of ecstasy and life. Thus arises the Übermensch (Overman/Surhomme) for Nietzsche, who faced with the death of the divine, nihilism and the « Last Man » [which designates what is most despicable in this world, the one who is powerless to create and love, i.e. the individual totally enslaved and enjoying a programmed and petty « happiness », those who think that this symbolic death of the divine means nihilism and pure destruction], will have to face these despicable « Last Men »; one could therefore see the Übermenschen (Overmen/Surhommes) as agents of the divine rising to counter evil and the decline of the positive values of civilization; the concept of the Übermensch also seems to share some similarities to what Monique de Kermadec qualifies as l’« Adulte Surdoué » [The gifted adult].

Video: Monique de Kermadec : L’adulte surdoué : bien vivre sa douance (2012)

Freud Entouré par des Idiots dpurb site web

Traduction(EN): « Before you diagnose yourself with depression or low self-esteem, first make sure you are not surrounded by idiots. » – Sigmund Freud

For Nietzsche, the earth is no longer in the hands of the divine, but in the hands of those despicable « Last Men, » and the outrage against the earth is now what is the most dreadful. Nietzsche fights against immorality in the name of immoralism, and shows us that the death of the divine is not enough to animate the world with a new morality, and that without the will to power [if it is animated by a weak will], « morality » can turn into nihilism [a nothing, or the absence of sense that makes “becoming” a purposeless process where all traditional ideals lose their value]. The construction of a new morality will be so superior to the old one that it calls, according to Nietzsche, new men, Übermenschen (Overmen/Surhommes), and this new morality will be precisely the « Will to Power ». In order to clarify the concept of Übermensch (Overman/Surhomme) let us clear up misunderstandings by explaining what the Übermensch (Overman/Surhomme) is not, here is a negative definition:

« All beings up to now have created something beyond themselves that is superior to them. What is the ape for man? That is precisely what man must be for the Übermensch (Surhomme/Overman) »

Nietzsche in his time was not an evolutionist, which has changed in our time, and therefore not in possession of the data on the genetics of Übermenschen (Supermen/Surhommes), he conceived of the emergence of the Übermensch (Overman/Surhomme) by the man who surpasses himself: a transcendental man who surpasses himself to become what he really is deep down.

Ubermensch Surhomme Superman dpurb site web

The notion of the Übermensch (Overman/Surhomme) is the backdrop of Nietzsche’s philosophy, it is from the Übermensch (Overman/Surhomme) that Nietzschean thought makes its entrance and all his other themes must be understood from this notion. Thus, to Nietzsche, by pushing back the forces of reaction, of simple negation, those linked to the « NO », by surpassing himself towards those of life and positive creation, man transcends himself towards the Übermensch (Overman/Surhomme), towards a superior human type, free of mind and heart. The Übermensch (Overman/Surhomme) is for Nietzsche the meaning of the earth, the next term of evolution. It is also very important to avoid any misinterpretation of Nietzsche’s « Übermensch » (Overman/Surhomme) which has been wrongly caricatured over the years, it is not specifically or solely about the « blonde beast » of Germanic myths as it is often portrayed by ignorant and mediocre journalists and the masses. After Friedrich Nietzsche’s death, his sister Elisabeth became the curator and editor of Nietzsche’s manuscripts, reworking his unpublished writings to fit her own German nationalist ideology while often contradicting or obfuscating Nietzsche’s true philosophical orientation which were instead explicitly opposed to antisemitism and nationalism but promoted a more universal ideology. Through her published editions, Nietzsche’s work wrongly became associated with fascism and Nazism; 20th century scholars contested this interpretation of his work and corrected editions of his writings were soon made available. Nietzsche’s thought enjoyed renewed popularity in the 1960s and his ideas have since had a profound impact on 20th and early-21st century thinkers across philosophy—especially in schools of continental philosophy such as existentialism, postmodernism and post-structuralism—as well as art, literature, psychology, politics and popular culture. Nietzsche’s philosophy is thus organized around a few major concepts: that of the Übermensch (Overman/Surhomme), the Dionysian and, of course, the Will to Power.

Documentaire: Schmutte, H. (2016). Nietzsche : entre génie et démence. ARTE. [Notice: If the video cannot be viewed from your region, we recommend using HOLA VPN (Click Here, it is FREE!)]

Let us add, finally, the concept of the Eternal Return (any state of the universe returns periodically and this seems to be an intelligent metaphor that explains the state of matter in the universe, constantly being recycled and reshaped). Nietzsche thus (like Lucretia or Spinoza) drew a philosophy of joy, creation and vital fullness. Nietzsche celebrated life and stressed that the secret of the greatest enjoyment is to live intensely and dangerously. Today, Nietzsche’s work and intellectual contribution are considered as revolutionary for its time, however in the very beginning they were not appreciated and recognised for their true worth by his contemporaries; the philosopher struggled to live with his publications and found himself on the fringes of society without any income or fixed accommodation at 35 years old, which had turned out to be a point of no return for him after he put an end to his teaching activities, adopting a nomadic life and living in modest accommodations. An amazing achievement for Nietzsche was the fact that he was named professor even though he had not completed his thesis.

During Jacques Lacan’s studies at the Collège Stanislas he was introduced to the work of Baruch Spinoza & Friedrich Nietzsche, and draws from his years in uniform, the intimate conviction that the most violent psychological wounds and sufferings always arise within communities apparently subjected to the greatest normality. Lacan had felt misunderstood by his father, who had destined him to a business life. He thus enters the modernity of the twentieth century by way of an intellectual rebellion, eager to explore the essence of « madness » whose shadows he had perceived in his own family, Lacan turned to psychiatry. In 2001, Elisabeth Roudinesco said: « Il faut voir l’apport de Lacan comme un tableau moderne. Lacan n’est plus dans l’univers classique des représentations mais dans l’univers de la peinture moderne. C’est la peinture de Picasso par rapport à la peinture classique (…)  toute la modernité est passée. » [French for: « Lacan’s contribution should be seen as a modern painting. Lacan is no longer in the classical universe of representations but in the universe of modern painting. It is Picasso’s painting in relation to classical painting… all modernity has passed. »]

Lacan-carte d'étudiant.jpg

During the early 1920s, Lacan actively engaged with the Parisian literary and artistic avant-garde movements. Having met James Joyce, he was present at the bookshop where the first readings of passages from Ulysses in French and English took place, shortly before it was published in 1922. Lacan also had meetings with Charles Maurras, whom he admired as a literary stylist, and he occasionally attended meetings of Action Française (of which Maurras was a leading ideologue), of which he would later be critical on some aspects that he firmly disagreed and considered as outdated, such as the positivist sociology of Maurras which presents the subject as a simple product of his « milieu » [circle], derived from his culture which was even pushed to absurd extremes by Édouard Pichon to theorise about a « national unconscious ». Lacan was more avant-garde and perhaps unknowingly embraced future psychological advances of neuroscience by founding his logic on the thesis of German biologist and philosopher Von Uexküll who convincingly argued about the multitude of determining factors of the environment and not simply the basic evolution of species, but on the sophisticated elaboration of language [discourse / langage] which identifies the development of the individual psyche to a social structure.

In his famous « Rome Discourse, » Lacan stated: « Le symbolique, l’imaginaire et le réel, les trois registres par lesquels j’ai introduit un enseignement qui ne prétend pas innover, mais rétablir quelques rigeurs dans l’expérience de la psychanalyse, les voilà, jouant à l’état pur dans leurs rapports les plus simples. » [French for: « The symbolic, the imaginary and the real, the three registers through which I have introduced a teaching that does not claim to innovate, but to re-establish some rigour in the experience of psychoanalysis, here they are, playing in a pure state in their simplest relationships.]«  In that same discourse in Rome in 1953 addressed to the Société Française de Psychanalyse, Lacan denounced the way that the role of speech in psychoanalysis had come to be neglected by contemporary psychoanalytic theory, and argues for a renewed focus on speech and language. This remains one of the fundamental modification from Freudian conception: the human being is linked to language. The founding statement of Lacan’s theory defines psychoanalysis as a practice of speech and a theory of the speaking subject. Lacan asserted that psychoanalysis is distinguished from other disciplines in that the analyst works on the Subject’s speech [i.e. linguistic discourse], pointing out that Freud often referred to language when he was focusing on the Unconscious; after all language is the « talking cure » and is constitutive of the psychoanalytic experience. It would be impossible to understand the concept of « madness » without analysing the true reasoning behind it through language and to know if it is « madness » or subjective construction and interpretation that is stable in a particular Subject’s psychical realm. It is the emphasis on language [linguistic discourse] that is regarded as the most distinctive feature in Lacan’s theory which also criticises the way other forms of psychoanalysis tend to play down the importance of linguistic discourse and instead emphasise « non-verbal communication » of the analysand (e.g. body language, etc) at the expense of speech. To Lacan this is a fundamental error for the following main reasons. Firstly, all human discourse is inscribed in a linguistic structure [whatever the language]; even body language is a form of language with the same structural features. Secondly, the aim of psychoanalytic praxis is to articulate the truth of one’s desire in speech [i.e. linguistic discourse] rather than in other forms – the fundamental rule of psychoanalysis is based on the principle that linguistic discourse is the only way to the Subject’s « truth ». Thirdly, linguistic discourse through speech is the only tool and means of access that the psychoanalyst has, since no one can read minds. Any analyst who does not understand and master the way speech and linguistic discourse work does not understand psychoanalysis itself.

Lacan proposed that like the words uttered by God in Genesis, speech is a « symbolic invocation » which creates ex nihilo, « a new order of being in the relations between men. » Lacan distinguished « la parole pleine » [full speech] from « la parole vide » [empty speech] in 1953. La « parole pleine » [full speech] articulates the symbolic dimension of language; it is a speech that performs [qui fait acte]. La « parole pleine » [full speech] is defined by its identity with that which it speaks about, it is one full of meaning. « La parole vide » [empty speech] is one that simply has signification. The aim of psychoanalytic praxis is to articulate « la parole pleine » [full speech], which can be hard work; « la parole pleine » [full speech] can be quite laborious (pénible) to articulate. The speech act also contains the essence of efficacious transference, which involves an exchange of signs that transforms both the speaker and the listener. Each time a man speaks to another in an authentic and full manner, we find in a true sense, « symbolic transference » – a process that takes place and changes the nature of the two beings present. The Symbolic dimension of language is that of the signifier and full speech, the true discourse of the Other [Big Other / Grand Autre / Superego], the Unconscious. The Imaginary dimension of language is that of the signified, signification and empty speech, the wall of language which interrupts, distorts and inverts the discourse of the Other [Big Other / Grand Autre / Superego]; Lacan proposed that language is as much there to be found in the Other [Grand Autre / Superego] as to drastically prevent us from understanding him. It is important to note that language has both a Symbolic and an Imaginary dimension; there is something in the symbolic function of human discourse that cannot be eliminated, and that is the role played in it by the imaginary [which is shaped by the Symbolic]. Psychoanalytic theory claims that speech is the only means of access to the truth about desire; a particular type of speech without conscious control termed « free association ». The ethics of psychonalysis enjoin analysands [patients] to recognise their own part in their sufferings, so that the psychoanalyst can then help them work through their problems and psychical barriers.

Lacan developed psychoanalytic theory in radically new directions that relied heavily on linguistic theory and other intellectual trends in the late 20th-century France, such as the structuralist movement. It was proposed that the Unconscious is structured like a language, so that its operations can be likened to linguistic phenomena [e.g. repression was likened to a metaphor]. Hence, to uncover unconscious material the psychoanalyst must decipher a chain of clues with a great deal of verbal dexterity. Lacan also held that the ego [le Moi], although conscious and able to orchestrate a wide range of operations, is not a complete organ of self-control as Ego psychologists from the US claim, but largely also an unstable and ultimately illusory sense of personal unity. To Lacan, our sense of wholeness is a fiction and our selves are profoundly “de-centred” around a tissue of identifications with people [and characters] we have known [directly or indirectly exposed to – this extends to the arts, fictional characters, mentors, etc].

Lacan’s (1973/1977) version of Psychoanalytic Theory pointed out that Ego Psychologists [e.g. Anna Freud, Heinz Hartmann, Erik Erikson] and Object Relations Theorists [e.g. Melanie Klein, Donald Winnicott and Ronald Fairbairn] had strayed too far from Freud’s original (1900, 1923) original version of psychoanalytic theory. This is even in direct contrast to Jacques Lacan’s own mentor, Ego Psychologist Rudolph Loewenstein who was also a close associate and collaborator of Ego Psychologist Heinz Hartmann.

 

« Pendant un certain temps, on a pu croire que les psychanalystes savaient quelque chose, mais ça n’est plus très répandu (rires). Le comble du comble, c’est qu’ils n’y croient plus eux-mêmes (rires), en quoi ils ont tort, car justement ils en savent un bout, seulement, exactement comme pour l’inconscient dont c’est la véritable définition, ils ne savent pas qu’ils le savent. »

French for: « For a while, you might have thought that psychoanalysts knew something, but it’s not very common anymore (laughs). The worst thing is that they no longer believe it themselves (laughs), in which they are wrong, because they know a bit of it, only, exactly as for the unconscious, of which this is the true definition, they don’t know that they know it. »

-Jacques Lacan, Conférence de Louvain, 1972

 

Lacan, however, seems to have set the record straight in accentuating the fundamental and widely accepted foundations of psychoanalysis by advocating a “return to Freud” [not Anna Freud’s (1923) version of Ego Psychology], but rather to Sigmund Freud’s Topographic Model of the 1900 that defined the mind into 3 levels of awareness, i.e. the Unconscious [Le Ça], the Preconscious [Le grand Autre] and the Conscious [Le Moi].

Rocha (2012) noted that Lacan (1973/1977) was especially concerned with the Unconscious [l’inconscient, le « Ça », the « It », the ID] as the “ideal worker” within individuals’ personality structures. In a 1973 television interview, Lacan famously argued that the Unconscious does notthink, nor calculate, nor judge; the unconscious simply works!” Lacan contended that like the ideal worker in a capitalist society, the Unconscious generates a product in compliance with rigid, hierarchical rules and regulationsin particular, the product of unthinking and unquestioning in the fulfillment of individuals’ desire – which seems like something psychoanalysis should address and change for a humane, intelligent and creative civilisation.

As for dreams, Lacan stressed that dreams are important products of the Unconscious [l’inconscient, le « Ça », the « It », the ID] that allow individuals tofeel” [at least during the sleeping state] that they have fulfilled their desire, however, dreams may also contain anxiety-provoking contents that individuals do not desire. As Meyer (2001) interestingly pointed out, in Lacan’s psychoanalytic theory, the problem of the Unconscious [l’inconscient, le « Ça », the « It », the ID] in finding expression is the problem of discourse with the “Other” [Le grand « Autre », the big « Other », Preconscious Superego in the domain of the symbolic]. Indeed, infants enter the world without knowing how to communicate their desire to caregivers via language, with its own rules and structure. It is also to be noted that in Lacanian Theory of Psychoanalysis, infants’ desire arises from the “loss and longing” that they experience when they are separated from their caregivers [especially their mothers or mother-figure in most cases] – precisely the person from whom the infants first learn early forms of basic communication [language] since the helpless infant’s needs are met after his/her various demands are expressed in sounds and specific actions. Waintrater (2012) also pointed out that in Lacan’s Theory, individuals’ desire are not solely tied to infantile sexuality. If anything, Lacan’s concept of unconscious desire complements John Bowlby’s (1969) concept of infants’ need for attachment. Lacan uses the term « Manque« , French for « Lack » which is always related to desire. It is a lack which causes desire to arise [desire is the metonymy of the lack of being (manque-à-être)], however the precise nature of what is lacking [i.e. symbolic lack] varies from one individual to another. In 1955, when the term « Manque (Lack) » first appears, it designates first and foremost « manque-à-être » [want-to-be] which is the « lack of being« , hence what is desired is « being », i.e. not the lack of this or that, but the lack of « being » whereby the being exists, this lack of being [manque-à-être] is the heart of analytic experience and the very field in which the neurotic patient’s passion is deployed. An important distinction to be noted is between the lack of being [Manque-à-être / want to be] which relates to desire, and the lack of having [Manque-à-avoir] which relates to demand.

 

Distinction between Need, Demand & Desire

Need

In the context of this distinction, « need » comes close to what Freud referred to as « instinct » (Instinkt); that is, a purely biological concept opposed to the realm of the drive (Trieb), it is an appetite which emerges according to the requirements of the organism and which abates completely (even if only temporarily) when satisfied. The human subject, being born in a state of helplessness, is unable to satisfy its own needs, and hence depends on the Other [usually a role occupied by the mother in most cases] to help it satisfy them. In order to get the Other’s help, the infant must express its needs vocally; need must be articulated in demand. The primitive demands of the infant may only be inarticulate screams, but they serve to bring the Other to minister to the infant’s needs. However, the presence of the Other soon acquires an importance in itself, an importance that goes beyond the satisfaction of need, since this presence symbolizes the Other’s love. Hence demand soon takes on a double function, serving both as an articulation of need and as a demand for love. However, whereas the Other can provide the objects which the subject requires to satisfy his needs, the Other [usually mother at this stage] cannot provide that unconditional love which the subject craves. Hence even after the needs which were articulated in demand have been satisfied, the other aspect of demand, the craving for love, remains unsatisfied, and this leftover is desire.

The concept of a pre-linguistic need is thus merely a hypothesis, and the subject of this pure need is a mythical subject; even the paradigmatic need of hunger never exists as a pure biological given, but is marked by the structure of desire. Nevertheless, this hypothesis is useful to Lacan for maintaining his theses about the radical divergence between human desire [which is inscribed in the Symbolic order] and all biological categories; need is thus an intermittent tension which arises for purely organic reasons and which is discharged entirely by the specific action corresponding to the particular need in question.

 

Demand

Lacan argues that since the infant is incapable of performing the specific actions that would satisfy its biological needs, and hence Lacan bases the distinction on the fact that in order to satisfy his needs the infant must articulate them in language; in other words, the infant must articulate his needs in a « demand » [for them to be met by the mother who will perform the specific actions]. However, in doing so, something else is introduced which causes a split between need and demand; this is the fact that every demand is not only an articulation of need but also an (unconditional) demand for love. Now, although the Other to whom the demand is addressed (in the first instance, the mother) can and may supply the object which satisfies the infant’s need [e.g. the breast to satisfy the child’s hunger], she is never in a position to answer the demand for love unconditionally, because she too is divided. The result of this split between need and demand is an insatiable leftover, which is desire itself. It is this double function which gives birth to desire, since while the needs which demand articulates may be satisfied, the craving for love is unconditional and insatiable, and hence persists as a leftover even after the needs have been satisfied; this leftover constitutes desire. In the seminar of 1956-7, Lacan argues that the cry of the human infant — its call (l’appel) to the mother — is not merely an instinctual signal but is « inserted in a synchronic world of cries organized in a symbolic system. » In other words, the infant’s screams become organized in a linguistic structure long before the child is capable of articulating recognisable words.

Demand is thus intimately linked to the human subject’s initial helplessness. By forcing the patient to express himself entirely in speech, the psychoanalytic situation puts him back in the position of the helpless infant, thus encouraging regression.

« Through the mediation of the demand, the whole past opens up right to early infancy. The subject has never done anything other than demand, he could not have survived otherwise, an we just follow on from there. » However, while the speech of the patient is itself already a demand (for a reply), this demand is underpinned by deeper demands (to be cured, to be revealed to himself). The question of how the psychoanalyst engages with these demands is crucial. Certainly the psychoanalyst does not attempt to gratify all of the patient’s demands, but nor is it simply a question of frustrating them.

 

Desire 

Lacan follows Spinoza in arguing that « desire is the essence of man. » Desire is simultaneously the heart of human existence and the central concern of psychoanalysis. However, when Lacan talks about desire, it is not any kind of desire he is referring to, but always « unconscious » desire. This is not because Lacan sees conscious desire as unimportant, but simply because it is unconscious desire that forms the central concern of psychoanalysis. The aim of psychoanalytic praxis is to lead the patient to recognise the truth about his/her desire. It is only possible to recognize one’s desire when it is articulated in speech. Hence in psychoanalysis, « what’s important is to teach the subject to name, to articulate, to bring this desire into existence. » However, it is not a question of seeking a new means of expression for a given desire, for this would imply a expressionist theory of language. On the contrary, by articulating desire in speech, the patient brings it into existence.

« That the subject should come to recognise and to name his desire; that is the efficacious action of analysis. But it isn’t a question of recognising something which would be entirely given. … In naming it, the subject creates, brings forth, a new presence in the world. » [adds to reality what was previously not there through language]. This seems to have a link to Schopenhauer’s concept of the « Will » which he proposed can be understood through the potential of the human brain so that as it is kindled by a spark it brings the whole world as idea into existence [Freud was inspired by Schopenhauer and so was Lacan indirectly]; knowledge proceeds from the « Will » which here is « Desire » – knowledge that is either from the senses or is rational as it is destined to serve the will in its aim of expressing itself.

However, there is a limit to how far desire can be articulated in speech because of a fundamental « incompatibility between desire and speech; « it is this incompatibility which explains the irreducibility of the unconscious (i.e. the fact the the unconscious is not that which is not known, but that which cannot be known). « Although the truth about desire is present to some degree in all speech, speech can never articulate the whole truth about desire; whenever speech attempts to articulate desire, there is always a leftover, a surplus, which exceeds speech. »

It is important to distinguish between desire and the drives. Although they both belong to the field of the Big Other, hence are within the Symbolic field/order (as opposed to love which lies in the imaginary field/order but still has effects in the symbolic order, love requires reciprocity, but the drives only pure activity), desire is one whereas the drives are many. In other words, the drives are the particular (partial) manifestations of a single force called desire (although there may also be desires which are not manifested in the drives). There is only one object of desire, object (petit) a, which is represented in any object which sets desire in motion, especially the partial objects which define the drives [The « objet petit a » is the leftover behind the introduction of the Symbolic dimension in the Real, it denotes a surplus meaning and enjoyment which has no « use value » but persists for the mere sake of enjoyment; it is linked to the illusory/imaginary concept of semblance]. The drives do not seek to attain the objet petit a, but rather circle round it. The object (petit) a is not the object towards which desire tends, but that which sets desire in motion. It plays an increasingly important part in Lacan’s concept of psychoanalytic praxis, in which the psychoanalyst must situate himself/herself as the substitute for objet petit a, i.e. the cause of the analysand’s [patient’s] desire. The universal feature of desire is commonly evident in hysterics [hysteria has changed in appearance nowadays but has not disappeared], being people who unconsciously sustain another person’s desire and convert another’s desire into their own. So, in the psychoanalytic praxis/treatment of hysterics, the most important part for the psychoanalyst is to discover the place [i.e. not the physical or anatomical locality, but the psychical locality / The « Other » scene in Lacanian terms] from which the patient desires [i.e. the Subject with whom he/she identifies] and not simply the object of the patient’s desire. Desire is not a relation to an object, but a relation to a lack (Manque-à-être / Lack of being). A major point from Lacan’s discourse on desire is that desire is a social product constituted in a dialectical relationship [i.e. which is embedded in linguistic discourse] with the perceived desires of other subjects.

Alexandre Kojève, whose seminars were followed by Lacan and also other intellectuals de « premier plan » of the time such as Maurice Merleau-Ponty, Georges Bataille, Jean Hyppolite and  Raymond Queneau gave the example of the Oedipus complex to point out that desire is essentially desire to be the object of another’s desire; Kojève argued that this is illustrated for the first « time » during the Oedipus complex, when the young developing subject desires to be the object of the desire of the first « Other » in his life [which is usually the mother or a mother figure in most cases], when the subject desires to be the object of desire [symbolic phallus] of the mother. Lacan argues that the child must detach himself from the imaginary relation with the mother in order to enter the social world; failure to do so can result in any one of various peculiarities ranging from phobia to perversion.

One of Lacan’s most often repeated formulas is: « man’s desire is the desire of the Other [i.e. the Big Other/Superego]. » This can be understood in many complementary ways, of which the following are the most important. Desire is for the thing that we suppose the Other desires, which is to say, the thing that the Other lacks. Hence, the subject desires from the point of view of « another »; the object of man’s desire is simply an object desired by someone else, which in most cases is the main reason why the object becomes desirable, and unfortunately not because of the natural quality of the thing in itself [Note: this is of course applicable to the common majority, since the consciousness of individuals with superior reflective abilities and philosophical values will likely lead them to perceive, think and behave differently].

Desire is essentially the « desire of the Other‘s [i.e. Grand Autre’s / Superego’s] desire », which implies both the desire to be the object of another’s desire, and the desire for recognition by another. Desire is essentially a desire for recognition.

Lacan takes this idea from Hegel, to state:

Desire is human only if the one desires, not the body, but the Desire of the other. . . that is to say, if he/she wants to be ‘desired’ or ‘loved’, or, rather, ‘recognised’ in his/her human value. . . . In other words, all human, anthropogenetic Desire . . . is, finally, a function of the desire for ‘recognition‘.

On love and desire, the former is a metaphor, while the latter is metonymy; love is located in the imaginary order but generates effects in the symbolic order where desire is located. We do find some similarities between love and desire in Lacan’s work since it is assumed that both can never be fully satisfied [i.e. insatiable]. The structure of love as « the wish to be loved » is also identical to the structure of desire in which the subject desires to become the object of the Other’s desire. Love involves an imaginary reciprocity, since to love is also to wish to be loved.

Desire is metonymy, and hence a constant force which can never be fully satisfied [because humans tend to have other desires once one is achieved and also because Desire may not only arise from Lack but may also be a productive force in itself]. Desire is the constant ‘pressure’ which underlies the drives and keeps individuals moving forward towards progress [with the right choice(s) and/or the right guidance]. As Elisabeth Roudinesco said: « Lacan est un penseur sceptique et en même temps passionné, c’est-à-dire l’engagement, la possibilité de croire encore en quelque chose, c’est-à-dire au désir, existe, donc il ne faut pas désespérer le Sujet mais la seule chose qui peut compter c’est l’éthique du désir, puisqu’il ne nous reste plus que ça : ne pas céder sur son désir ; ça c’est l’héroïsme Lacanien. » [French for: « Lacan is a sceptical and at the same time passionate thinker, that is to say commitment, the possibility of still believing in something, that is to say, in desire, exists, so one should not abandon the Subject, but the only thing that can count is the ethics of desire, since that is all we have left: not to give up on one’s desire; that is Lacanian heroism. »]

In order to achieve the desire for recognition all Subjects must impose the idea that they have of themselves on others (i.e. the rest of the humanity); this leads all individuals in a form of personal fight [which not necessarily violent, but rather a dialectical discourse] with the rest of humanity for recognition and pure prestige; Lacan argues that it is only by risking one’s life for recognition that one can prove that he is truly human. Lacan introduced « la dialectique du maître et de l’esclave », to use the metaphors « Master » and « Slave » to point out that human civilisation is only possible because we have those who direct (Masters/Maîtres) and those who receive directions (Slaves/Esclaves); civilisation would not be possible if it was composed of only masters or of only slaves, both are required and play a fundamental role in the advancement of civilisation. A Subject can both be a master and a slave, i.e. a master to one, but at the same time a slave for another in a different domain. To Lacan, the master signifier is that which represents a particular Subject for all other signifiers but can never represent the Subject completely since there is always some surplus which escapes representation.

 

The 3 Registers: Real, Imaginary and Symbolic

Firstly, the « Real » is not « reality », and there is no « objective reality » because there is only a subjective « reality » that holds significance for any individual Subject, and this subjective reality takes shape by its knots with the Imaginary and the Symbolic register [both conceived from the Real, which also then ties itself to the 2 other registers] that the Subject identifies with linguistically. It is in this sense that Lacan is a formidable realist and ties himself to all the great Realist Schools of Philosophy. The Real is a domain outside the symbolic Subject, the Real is the domain of the inexpressible since it does not belong to language. The Lacanian « Real » contains the « Lack » which generally manifests itself in real nothingness. To indicate that something is lacking, requires the assumption that it is possible for it to be present, which introduces the Symbolic domain into the Real. The « Real » simply stands for what is neither symbolic nor imaginary and is never truly known; it is mediated by the 2 orders of the Imaginary and the Symbolic; thus while the Real is present, these uncanny objects are treated as alien, meaningless and reminders of the symbolic lack in the subject’s identity formation; and « lack » is what causes desire to arise, which leads to the Subject’s unique development and growth.

Lacan said:

« L’inconscient reste le cœur de l’être pour les uns, et d’autres croiront me suivre à en faire l’Autre (symbolique) de la réalité. La seule façon de s’en sortir, c’est de poser qu’il est le réel, ce qui ne veut dire aucune réalité, le réel en tant qu’impossible à dire, c’est-à-dire en tant que le réel c’est l’impossible, tout simplement . »

French for: « The unconscious remains the heart of the being for some, and others will believe they follow me to make it the Other (symbolic) of reality. The only way to get out of it is to pose that it is the real, which does not mean any reality, the real as impossible to say, that is to say as the real is the impossible, quite simply. »

Jean-Bertrand Pontalis who was psychoanalysed by Lacan, assisted to his presentations while also participating in the famous seminars that he transcribed the résumés. Pontalis said: « On est un peu perdu et on se dit c’est peut-être génial, c’est peut-être moi qui comprend rien, ça me rappelle que d’ailleurs Lacan disant – alors qu’il y avait au début de ses séminaire des gens comme Maurice Merleau-Ponty, Jean Hyppolite venait, Paul Ricœur et bien d’autres – je l’entends encore dire – peut-être pas s’adressant à eux mais l’auditoire en général : « Mais enfin, vous allez commencer à l’ouvrir votre comprenoire ? » Voilà, donc je ne peux pas dire que ça m’émeuve, parce qu’il a quand même un côté comédien même très comédien, il en remet un peu comme il en remettait dans sa vêture, avec ses vestes, ses cols Mao à l’époque et puis ensuite les fameux cigares torsadés. » [French for: « We’re a bit lost and we say to ourselves that maybe it’s great, maybe it’s me who doesn’t understand anything, it reminds me of Lacan saying – while at the beginning of his seminars there were people like Maurice Merleau-Ponty, Jean Hyppolite came, Paul Ricoeur and many others – I still hear him say, perhaps not addressing them but the audience in general: « But finally, you will begin to open your understanding? » So I can’t say I’m moved, because he still has a comedian side, even very comical, like he used to portray with his clothes, with his jackets, his Mao collars at the time, and then the famous twisted cigars. »].

Jacques Lacan jeune.jpg

Jacques Lacan (1901 – 1981)

Christian Jambet explained how the real is « nothing », but gets its subjective significance from knots with the imaginary and the symbolic register of the individual Subject: « Le nœud était là pour essayer de transmettre, pas simplement le réel comme vérité ou le réel comme indicible, mais le réel comme ce qui est là dans sa plus grande nudité et sa plus grande insignifiance. La chute d’une ficelle et en même temps son enroulement. Qu’est-ce qui reste quand ça se défait ? Un rien. Et en même temps que ce rien forme la chose la plus complexe, c’est-à-dire tous ces nœuds du langage ont quoi nous sommes pris et qui tissent notre vie. » [French for: « The knot (Borromean) was there to try to transmit, not simply the Real as truth or the Real as unspeakable, but the real as what is there in its greatest nakedness and insignificance. The fall of a string and at the same time its knots. What remains when it unravels? A nothing, and at the same time this nothing forms the most complex thing, that is to say, all those knots of language that we are caught in and that weave our lives. »].

Lacan psychanalyse noeud-borromeen danny d'purb dpurb site web.jpg

Le Noeud Borroméen (The Borromean Knot or Chain) / We could refer to this figure as a chain since it involves the interconnection of several different threads. Although a minimum of three threads or rings [Real, Imaginary & Symbolic] are required to form a Borromean chain, there is no maximum number; the chain may be extended indefinitely by adding further rings, while still preserving its Borromean quality

Secondly, we have the Imaginary register/order which is the domain of the formation of the Ego in the mirror stage by identification with the counterpart [or specular image, i.e. the little other (petit autre)] and this dual illusory relationship between the Ego and the counterpart is characterised by narcissism and alienation. Lacan also accused the major psychoanalytic schools of reducing psychoanalysis to the imaginary domain where the Ego lies. Although the imaginary is structured by the symbolic, the Imaginary register is the dimension of the human subject which is most closely linked to animal psychology; this means that in man’s imaginary, the relation has deviated from the realm of human nature and shifted to the realm of image and imagination, deception and lure [sexual behaviour is especially prone to the lure in animals, which is straightforward]. The principal illusions of the imaginary register are those of wholeness, synthesis, autonomy, duality and similarity, which is in fact untrue and deceptive.

Thirdly, we have the Symbolic register/order [which is constructed largely via language and discourse] and which is one of the aspects of the Subject that is revealed via the individual’s dreams. The Symbolic register is the fundamental cornerstone for Lacan; the Subject’s relationship with the Symbolic is at the heart of psychoanalysis. Psychoanalysts are essentially practitioners of the symbolic order [i.e. civilised culture and the symbolic are thus imposed on raw nature]. Lacan criticised the psychoanalysis of his day for ignoring the symbolic register and reducing everything to the imaginary order of the Ego, and this for Lacan is a betrayal of Freud’s most basic insights; « Freud’s discovery is that of the field of effects, in the nature of man, produced by his relationship to the symbolic order« . Lacan argues that it is only by working in the Symbolic field that the psychoanalyst can produce changes in the subjective position of the patient and foster progress and growth; these changes will also structure the illusions produced by the Ego [le « Moi »] in the Imaginary order, since the Imaginary is influenced by the Symbolic. As Elisabeth Roudinesco pointed out: « ces illusions existent, elles forment notre psychisme ; nous vivons dans un monde d’illusions, de représentations et qui nous marque à vie et qui resterons d’ailleurs » [French for: « these illusions exist, they form our psyche; we live in a world of illusions, of representations and which marks us for life and will remain so for the future…« ].

Un monde d'illusions Elisabeth Roudinesco Jacques Lacan danny d'purb dpurb site web.jpg

« We live in a world of illusions… » -Elisabeth Roudinesco, 2001

Hence, a well adjusted psyche will allow the Subject to generate the appropriate illusions in the imaginary register of the Ego [Le Moi] that are synchronised with the true Subject [i.e. true product of the Symbolic register tied by language(s)] and his/her desires which has its roots in and is structured by the « scene » [i.e. NOT physical or anatomical locality, but PSYCHICAL locality] of the Other [i.e. Big Other/Grand Autre/Superego] where language and discourse originate. The well adjusted Imaginary of the Ego [le Moi] reflects the individual’s desires and unique personality, and contributes to growth since it allows the Subject to imagine creatively while regulating the wild desires of the Unconscious [ID / It / Ça / Inconscient] according to the symbolic laws of the Big Other [i.e. Grand Autre / Superego under the ID]. The balance between these 3 domains [ID – Superego – Ego] differs from one individual to the other leading to differences in personality.

Structural components [or registers/orders] of the Subject that are revealed via dreams are the Imaginary and the Real. Lacan argued that the psychanalyst’s interpretation of dreams can be viewed as analogous to a linguist’s translation of a language, unearthing the meaning that particular symbols hold for an individual [e.g. a client in psychotherapy or an individual seeking psychoanalytic guidance to enhance themselves]. Lacan noted that a specific difficulty that arises when psychoanalysts interpret the content of clients’ dreams is that, by the time the clients have awakened a large portion [if not most or all] of the dream has vanished, and this can be problematic if clients are reflecting on dreams that they experienced several year (decades?) ago. According to Lacanian Theory, Marder (2013) noted that dreams are oriented towards future interpretation, by dreamers themselves or by someone else (e.g. Psychoanalysts). Hence, truly important content are likely to survive clients’ transition from sleeping to waking states.

Lacan also pointed out as Stockholder (1998) noted, that Freud’s (1923) Structural model, i.e. the later version of his Psychoanalytic Theory with its dictinctions among Id, Super-Ego and Ego had distorded the true meaning of the first Topographic Model. And perhaps rightly observed, since the Ego which was meant to be conscious, revealed an unconscious element in its ability to instantly generate defence mechanisms outside the awareness of the patient, when before the function of the Ego was just one component present in the Conscious, i.e. the Ego [le Moi], was a part of the « Conscious », as a level of consciousness and not assumed to be a distinct mental functions as part of the new 3 part dissection [ID, SuperEgo and Ego]. However, they can be synthesised and enhanced, as we are doing with Freud, Jung and Lacan along with other discoveries in the realms of Neuroscience and Cognitive-Psychology to explore the psychology of the singular organism and its powers of definition to a level that no other psychologist has attempted to before our endeavour.

Lacan’s theory relocates the ID [Ça / L’Inconscient / Symbolic], Super-Ego [Surmoi, Le grand Autre: the big Other / Symbolic] and the Ego [Moi / Imaginary order] across the Unconscious, Preconscious and Conscious.

 

The Subject: Uniqueness in the speaking being, le parlêtre

Although psychoanalytic praxis has powerful effects on the ego, it is the Subject, and not the ego, on which psychoanalysis primarily operates. Different from the ego, the Subject is a product of the symbolic Grand Autre, i.e. the « Big Other » [Superego under the influence of the ID]. The Subject means no more than « human being » and in 1953 Lacan establishes a clear distinction between the Subject and the Ego which remained a one of the most fundamental distinctions in his work.  Whereas the Ego is part of the imaginary order, the Subject is part of the symbolic.

Lacan distinguished between 3 kinds of subject. Firstly, we have the impersonal subject, independent of the other, the pure grammatical subject, the noetic subject, the « it » of « it is known that ». Secondly, we have the anonymous reciprocal subject who recognises himself in equivalence with the other (ego reflection / petit autre / little other). Thirdly and finally, we have the personal subject in his uniqueness completely constituted by the act of self-affirmation. It is the third sense of the term subject, i.e. the personal subject in his uniqueness that constitutes the focus of Lacan’s work, and this also seems to be in line with our philosophy of construction and singularity in the creation of the individual. Lacan’s subject is the « subject of the unconscious », i.e. it is a product of the expression of the unconscious through the symbolic « Grand Autre » [Superego]. Lacan argues that this distinction can be traced back to Freud: « [Freud] wrote Das Ich und das Es in order to maintain this fundamental distinction between the true Subject of the unconscious and the Ego as constituted in its nucleus by a series of alienating identifications. A complex and unique domain such as the subject should not be objectified or reduced to a thing; « What do we call a subject? Quite precisely, what in the development of objectivation, is outside of the object. » References to language come to dominate Lacan’s concept of the subject from the mid-1950s on. It is very important however to distinguish the term « language » when reading the translations of Lacan’s work in English since the inexistence of some words in English make the translation from French inaccurate. Most importantly, in the French language we have two terms that both translate to « language » in English, these are the French terms « langue » [which refers a specific language, e.g. French or English] and « langage » [which refers to the prosody, expressive, grammatical and communicative structure of the language being used, the discourse of a particular Subject from any « langue » (specific language) since all « langues » (specific languages) come with different levels of structure, being a universal feature], it is the latter term « langage » referring to the general structure of the communicative pattern and linguistic discourse and not « langue » that is of interest to Lacanian psychoanalysis, i.e. the content of the discourse. So, it is important to note that in English, the term « language » in Lacan’s writings most often refers to  the French term « langage » [i.e. the structure and content of the communicative pattern or discourse] and not « langue ». Linguistic discourse (le langage) is a single paradigm of all structures and the basic units are the signifier; the unconscious is a treasury of signifiers in the Symbolic structured like language that finds expression to define the Subject where discourse becomes a social bond. Lacan distinguishes the Subject of the enunciation [i.e. how words are pronounced] from the Subject of the statement [i.e. the genuine message of the discourse] to show that because the Subject is essentially a speaking being (parlêtre), he/she is inescapably divided [i.e. by different forms of communicative patterns]. Language is a constantly evolving domain and not a nomenclature [i.e. not complete, sealed, strictly and methodically organised], beyond its use for conveying information, language is foremost an appeal to an interlocutor. In the early 1960s Lacan defines the subject as that which is represented by a signifier for another signifier; in other words, the subject is an effect of language and in philosophical « discourse » it denotes an individual self-consciousness; linguistic discourse is a mediating element that allows the Subject to attain his desired recognition from others [i.e. the rest of humanity] while creating a social bond; this perfectly illustrates Lacan’s thesis about the determination of consciousness by the Symbolic register. « The subject is a subject only by virtue of his subjection to the field of the Other [Grand Autre / Big Other / Superego / from the Symbolic register]. »The philosophical connotations of the term « Subject » are particularly emphasised by Lacan, who links it with Descartes’s philosophy of the cogito: « Je pense donc que je suis » [I think therefore, I am] – « in the term subject . . . I am not designating the living substratum needed by this phenomenon of the subject, nor any sort of substance, nor any being possessing knowledge in his pathos . . . nor even some incarnated logos, but the Cartesian subject, who appears at the moment when doubt is recognised as certainty. » The fact that the symbol of the subject, S, is a homophone of the Freud’s term Es (‘Id’) illustrates that for Lacan, the true subject is the subject of the unconscious [i.e. the impact of the expression of the instincts and language of the unconscious through the SuperEgo/Big Other/Grand Autre on the subject and ego – which differs in individuals. Lacan forced us to admit that we all have mental automatism. We all have, deep inside us, this inner voice that will inhabit the language [or languages] with which we will speak. Perhaps a good example of the expression of the unconscious inner voice is through music, which Lacan saw as a fundamental language of our unconscious thoughts, and therefore the bearer of an enigmatic knowledge, i.e. a form of language that would therefore have a meaning, corresponding for example to that of the different emotions that satisfy the various states of mind and that possibly supports an imaginary form of communication]. In 1957 Lacan strikes through this symbol to produce the symbol $, the « barred subject, » thus illustrating the fact that the subject is essentially divided; the division of the subject by different forms of communicative patterns.

Niklos Koda Tome 7 Magie Blanche et Le spiborg - Mort et Déterré

Déssins: « Niklos Koda » par Olivier Grenson & « Mort et Déterré » par Jocelyn Boisvert et Pascal Colpron

L’Autre [Grand Autre / Big Other / Superego] as an early form of conscience from the Symbolic order/register & the mysterious origins and social bond of language [Speech / Linguistic discourse]

Lacan distinguishes between the Superego and the ego-ideal and argues that in most cases the primary function of the Superego is to repress sexual desire for the mother or mother figure in the resolution of the child’s early Oedipus complex and following Freud he also argues that the Superego is an early form of conscience that develops from the Oedipal identification with the father but also incorporates the maternal origins of an archaic form of the superego [conscience] derived from Melanie Klein’s thesis. Hence, Lacan proposed that in most people, the Oedipus complex is a process which imposes Symbolic structures on sexuality and allows the Subject to emerge – the imposition of culture on nature. When Lacan returned to the subject of the Superego [Grand Autre / Big Other] in his 1953-4 seminar, he located it in the symbolic order, as opposed to the imaginary order of the ego: the superego [i.e. Grand Autre] is essentially located within the symbolic plane of speech and has a close relationship with the « law » [law here does not refer to a particular piece of legislation, but to the fundamental principles which underlie social relations, i.e. a set of universal principles which makes social existence possible, the structures that govern social exchange, for e.g. gift giving or the formaton of pacts. Since the most basic form of exchange is communication [e.g. the exchange of words, the gift of speech], the symbolic « law » is fundamentally a linguistic entity/dimension, it is the law of the signifier. This law then is revealed with an order of language – the symbolic order itself. Lacan argues that the « law » is human because it separates man from other animals by regulating sexual relations that are among animals, unregulated. It is the law of the pleasure principle which commands the subject to « Enjoy as little as possible » and maintains the subject at a safe distance from the « Thing » (the forbidden object of desire), making the subject circle round it without ever attaining it because if the subject transgresses, it is experienced as suffering/evil – it is fortunate then that the thing is usually inaccessible and/or out of direct reach; the thing is impossible to imagine, it is unknowable and beyond symbolisation]. The « law » as such is a symbolic structure which regulates subjectivity and in this sense prevents disintegration of the wholeness of the individual’s psycheThe law of the superego however is believed to have a senseless and blind character of pure imperativeness and simple tyranny, so it is at one and the same time the law and its destruction, the Superego [only partially conscious] is thus the « big Other » which imposes a purely oppressive morality on the neurotic subject but also the will-to-enjoy and is related to the voiceThe big « Other » must be considered a locus in which speech is constituted, it is thus only possible to speak of the « big Other » as a subject in a secondary sense where a psychoanalyst may occupy this position and thereby « embody » the « Big Other » for a patient / analysand.

In arguing that speech originates not in the Ego or even in the Subject, but in the partially unconscious « Other » [i.e. Big Other / Grand Autre / Superego], Lacan is stressing that speech and language are beyond conscious control, they come from an other place/scene [i.e. psychical localities], outside consciousness, and hence « the unconscious is the discourse of the big Other » [i.e. the effect on the subject of speech that is addressed to that subject from elsewhere, by another subject (forgotten or unknown) from another « scene », i.e. psychical locality] and belongs wholly to the symbolic order. As Christian Jambet pointed out, this means that the fragments of discourse that the individual will articulate has its roots in the big Other’s scene(s) [i.e. NOT physical or anatomical locality, BUT PSYCHICAL localities], which is precisely the treasure of signifiers where language – which is very real – is structured, along with the individual’s desires. In 1969, Lacan begins to use the term « discourse«  to denote a « social bond » founded in language; an incredibly rational observation because there is nothing more social than language – the vital ingredient in any form of social activity. [Note: This leads to individuals not sharing anything in common with others in their direct geographical environment, because different individuals will be connected to different psychical localities.]

Parlez-vous Lacan

Gillett (2001) noted that, in Lacan’s view, language does not perfectly convey individuals’ desire to other persons, partly because individuals do not fully understand their own desire, and partly because language is an inherently social medium that can lead to misunderstanding as well as understanding between individuals and other persons. Language however is a very powerful social medium [as can be seen also from the essay, The Concept of Self]

Le Langage et la Réalité danny d'purb dpurb site web 1600.jpg

Traduction(EN): « There will always be something special about language because language creates reality. Language reveals the truth of the subject and adds to reality what was not there before. Hence, the difference between truth and reality is that truth adds to reality what was not there before. Empiricists who study traits should never forget that constructs would not exist if they had not first been created through language. Hence language, creates reality! » -Danny J. D’Purb

Jacques Lacan saw the unconscious [ID / Le Ça] as a structure of language whose formal logic unfolds in the manner of a Bach flute or a poem by Mallarmé and argued that the unconscious is structured like language. In the unconscious [i.e. the place where the treasure of signifiers is] as well as in the acquisition of language, individuals may follow rules regarding the use of symbols without having deliberately learned [and without having overtly been taught] those rules [something “special” and even “mystical” about language]. In addition the unconscious [like language] is regarded as a “network of signifiers”, a history of signifiers that shape the subject; the term signifier (le significant) referring to any symbol that is used [on its own, or in combination with other symbols] to stand in for, or to represent, something else [the signified – le signifié]. In conceiving the « big Other » as a place/scene, Lacan alludes to Freud’s concept of not physical or anatomical locality, but « psychical locality« , in which the unconscious is described as « the other scene ». In Lacanian terms the « other scene » is the big Other. The term « scene » was used by Lacan to denote the imaginary but also symbolic theatre in which the Subject plays out his fantasy; a fantasy which is however firmly built on the edifice of the Real [i.e. the world] and shaped by the symbolic order. The scene of fantasy is a virtual space which is framed, similarly to the scene of a play which is framed by the proscenium arch in a theatre, whereas beyond the frame lies the « real » space where the world is. Lacan uses the notion of « scene » to distinguish between 2 processes: (i) Acting out, and (ii) Passing to the Act. Since, the scene is symbolic and built on the real, the process of « Acting Out » takes place within the frame, i.e. inside the scene and is inscribed in the symbolic order; whereas the process of « Passing to the Act » is an exit from the scene, a crossing over from the symbolic into the real. It is highly likely that the impact of the arts, education, exposure and personal development has an important role to play in the development of the partially unconscious « big Others » and « the other scene ». The greatest child psychologist of all time, Jean Piaget argued that all forms of social interaction [which also includes artistic exposure] in the process of learning play an important role in « cognitive growth ».

This also leads to the important question of the « use » of art. Art is a very lucrative business in the 21st century with the wide range of outlets available digitally to deliver the works to the consumer/audience; but what are we consuming? What is the effect that we look for when we fully process the artworks that we choose? What happens after complete psychical digestion by the different psyches among us? Art is used to mark history, to leave a trace, not of the events, but of the line of thought of those living at the time it is focusing on. Back to the fundamentals of philosophy, the famous quote « je pense donc je suis » [French for: « I think therefore I am »] from Descartes explains to us that man is gifted with a conscience unlike animals. It is because we are organisms with the ability to think that we are human beings. Spinoza argued that we all have a conatus, an identity that is unique to each of us; the horse runs, the human being thinks. It is hence essential to question oneself, to meditate on a particular topic or another in order to blossom and thrive as human beings. Art is praxis, like philosophy it is an activity that produces no added value and has no other purpose other than the « perfecting of the agent » as Aristotle put it – it is an activity that allows for this work of reflective meditation. In this sense, a painting cannot be considered as a mere decoration as it is not a question of finding it « beautiful » or « ugly », but it implies a work of reflection and a particular mental visualisation. Of course, art does not speak to everyone. Serge Gainsbourg pointed out that we have 2 types of art: major and minor ones. Major art forms are those that only the trained mind can understand: architecture, painting, the classics and poetry; For example, this piece by the French philosopher and winner of the 1927 Nobel Prize in literature, Henri Bergson ( – ):

« L’état suprême de la beauté, c’est la grâce. Or, dans le mot grâce, on entend aussi la bonté. Car la bonté, c’est la générosité d’un principe de Vie qui se donne indéfiniment. »

– Henri Bergson

Then we have the Minor art forms, which are those that speak to everyone. It is obviously difficult to perceive, interpret and explore the knowledge, layers of meaning and wisdom in artistic literary compositions if we do not have a good vocabulary and a deep understanding of literary voice [i.e. tone and mood], linguistic style [i.e. Imagery, Simile, Metaphor, Personification] and aural imagery [i.e. Alliteration, Assonance and Onomatopoeia] ; similarly it would be hard to understand all the hard work behind the construction of a cathedral if we do not have any understanding of architecture, although nothing prevents us from appreciating its grandeur and contemplating it at length; this is also applicable to painting which is linked to a profound understanding of scales, light, reflections, shadows, colours, paints, textures and brush strokes. Going by Metry Sephora’s straightforward way to understand a work of art, we can firstly ask ourselves what it is about; what is the painter presenting to us? What do we see in the distance? Secondly, how is it all represented? [Techniques, colours, materials, movements] What do we see from up close and what feelings are elicited? Thirdly, it is about the moment the art work mirrors us. Sometimes we are already touched and are able to evade by imagining the setting presented to us, we reminisce about moments experienced and we reflect on a particular topic. In some other cases, the art work does not touch us and we have to question ourselves deeper, through the life of the artist; why did the artist represent this? What was going on in his/her life at that particular time? In what context did he/she realise it? What was the train of thought of the time?

Les Fenêtres [Windows] par Robert_Delaunay (1912)

« La Fenêtre » par Robert Delaunay. 1912 [de la série « Les Fenêtres »] / Musée de Grenoble

The above painting is « La Fenêtre » [The Window] » by the French painter Robert Delaunay (1885 – 1941) completed between 1911 and 1912 which is part of the series, « Les Fenêtres [Windows]« , which include 13 paintings inspired by the reading of « La loi du contraste simultané des couleurs » written in 1839 by Gustave Chevreuil; we know that the Delaunays created a cultural movement on their own and Blaise Cendrars (1887 – 1961) and Guillaume Appolinaire (1880 – 1918) were great admirers of their work which is part of the Cubist movement. This painting also inspired Apollinaire for his poem also entitled « Les Fenêtres » [Windows] where the writer tried to create a simultaneity between words as Delaunay does with colours. The painter seeks the original essence of colour, while the poet seeks the original essence of words. If we were to analyse this work, we could first observe the mixture and contrast of colours, it is not linear as a Mondrian art work, but still keeps a sense of organisation since the shapes do not spread in every direction, with different shades of blue and orange dominating the work. Secondly, we can conclude that it is rectangular and is a work of oil on canvas measuring 45.8 x 37.5 cm kept at the Musée de Grenoble and that the paint is smooth with movements executed naturally making it pleasant and relaxing to the eyes. Thirdly, based on the life of the painter we know that Robert Delaunay was part of a generation of avant-garde artists who were particularly prolific on the artistic scene between 1912 and 1914, representing the cubist and neo-impressionist movement, and that he was inspired by the scientific works of Chevreul on colours, by the work of Seurat and also that of Cézanne. At that time in the early 20th century, modern painting had tended towards abstraction, and in 1912 Apollinaire diagnosed the birth of a new pictoral art: « The new painters paint paintings where there is no longer a real subject ». By 1912, Delaunay had turned to orphism which led to the series of painting containing « La Fenêtre » [The Window]. More specifically orphic cubism had been distinguished from scientific cubism in 1912 by Apollinaire during the exposition of the Section d’Or, with the term orphism clearly linked to his poem « Orphée » (1908) which deals with pure poetry – a sort of « luminous language ». Another interpretation of this term is proposed: the name makes the analogy of the painting with music.

Peindre avec la musique DnP danny d'purb dpurb site web

Indeed, at the start of the 20th century, music represented modern art par excellence, perfectly abstract, therefore pure as a universal art form, with a totalising function. Music could unite all the arts, as in Wagner’s operas with the concept of the Gesamtkunstwerk [i.e. A total work of art characterized by the simultaneous use of many media and artistic disciplines, and by the symbolic, philosophical or/and metaphysical significance it holds. This use stems from the desire to reflect the unity of life]. Robert Delaunay and his wife indeed created a cultural movement around them, through works concentrated on the arrangement of colours on the canvas seeking pictorial harmony. We all have a conatus, for some it is art, for others it is literature, drama and poetry, readers out there should perhaps try to find theirs?

So, getting back to the big Other [SuperEgo / Grand Autre], it is is always « lacking » something for the subject and the mythical complete and perfect Other does not seem to exist. In 1957, when Lacan introduces the algebraic symbol for the barred Other (A), lack comes to designate the lack of a signifier in the Other [It is Lack that causes Desire to arise]. Lacan introduces the symbol S(A) to designate « the signifier of a lack in the Other. [Note that Lacan uses the term « Grand Autre » with capital A which here is referred to as the « Other » with capital O, i.e. the « big Other » and not the « petit autre » which is the reflection or projection of the Ego [counterpart and specular image] in the imaginary order referred to as the « other » or « little other », « o » « petit autre » « a ».]

 

Lacanian Terms: L’Inconscient [Id], L’Autre [Grand Autre/Big Other/Superego] & Le Moi [Ego: its birth and the Mirror Stage]

To clarify Lacanian terms, firstly, we have the « inconscient« ; being the unconscious ID in the domain of the symbolic which is the unconscious origin of the individual’s discourse, the symbolic « it » or « Ça » beyond the imaginary ego: man is lived and spoken by the unconscious « it » or « Ça ». Hence the phrase which Lacan frequently uses when discussing the unconscious ID, « it speaks » (le « Ça » parle). Hence, Lacan argued that the concept of the unconscious was badly misunderstood by most of Freud’s followers who reduced it to being « merely the seat of instincts« , and against this simplistic biological mode of thought Lacan argued that the unconscious is not simply the seat of instincts but is also and primarily linguistic because we can only grasp the unconscious when it is explained and transformed into words. One should see in the unconscious the effects of speech on the subject, as it is the determination of the subject by the symbolic order. The unconscious is a kind of memory in the sense of a symbolic history of signifiers [i.e. a treasure chest full of signifiers where discourse originates] that have determined the subject in the course of his/her life. Psychoanalysis involves unearthing the meaning that particular symbols hold for an individual. What this seems to suggest is that the unconscious absorbs a wide range of signifiers (signifiants) [that symbolise something else, « le signifié » or « signified » in a deeper exploratory sense] throughout the subject’s life and these later find expression and guide desires through the Superego [Grand Autre / Big Other / the symbolic discourse of the unconscious] and in turn symbolically shapes the imaginary creations of the Ego [Moi] and define the Subject according to his abilities to achieve his desires – the outcome differs depending on the subject’s individual creativity and intelligence.

Le Penseur par Auguste Rodin (1882) dpurb site

«Le Penseur» par Auguste Rodin (1882) représente un homme dans une réflexion profonde, semblant utiliser toute son intelligence pour résoudre un problème.

Since it is an articulation of signifiers in a signifying chain, the unconscious is a kind of knowledge (symbolic knowledge, or savoir) – an « unknown knowledge. » For the Cognitive-Behavioural mind, these signifiers may be considered as « stimuli » [received in different forms, e.g. visual, auditory, mental] however their reception and their responses are completely unconscious and generate effects in the depth of the mind [unconscious] that cannot be measured or seen [the nightmare of the empiricist]. Hence, the unconscious is the location of a chain of signifiers [that stand for something else in a signifying chain] that define the subject through the course of his/her life and where linguistic discourse originates.

We then have the « Moi », which is the equivalent of the Ego, a formation in the imaginary order as opposed to the Subject [le parlêtre as explained above, which is the true product of the symbolic order]. The Ego is a méconnaissance [a failure to understand/recognise, which is also the structure of paranoiac delusions] of the Symbolic, the Ego is the seat of resistance and is structured like a symptom at the heart of the Subject, the human symptom par excellence, the mental illness of man. Méconnaissance is to be distinguished from ignorance: whereas ignorance is a passion for the absence of knowledge, méconnaissance is an imaginary misrecognition/misconstruction of a symbolic knowledge (savoir) that the Subject does possess somewhere. The structural homology between the ordinary constitution of the Ego and paranoiac delusions is what leads Lacan to describe all knowledge (connaissance), in both neurosis and psychosis, as « paranoiac knowledge. » Lacan also argued that the proponents of Ego-psychology betrayed Freud’s radical discovery by relocating the ego as the center of the subject. In opposition to this school of thought, Lacan maintains that the ego is not at the center, that the ego is in fact an object. ‘ The ego is a construction which is formed by identification with the specular image in the Mirror stage and is thus the place where the subject becomes alienated from himself, transforming himself into the counterpart. Malin (2011) pointed out that in Lacanian Theory, a major event in infants’ personality and social development is the mirror stage, when infants enter into language as a uniquely human form of interaction with all caregivers in the child’s environment [although infants are not likely to consciously experience language prior to age 2]. As Luepnitz (2009) noted, Lacan believed that infants often enter into language at a crucial point when they literally recognise themselves in a mirror, with caregivers [i.e. can include others such as teachers rather than direct parents] pointing to the reflection and approvingly saying to the infants, “Look, that’s you!” – even if infants are unlikely to remember the event in itself.

Rene Magritte - Not To Be Reproduced (1937)

« Not to be reproduced » by René Magritte, 1937

And as Hivernel (2013) noted, the 2 major outcomes of the mirror stage are the emergence of the Subject, a product of the symbolic order (i.e., individuals’ gradual awareness regarding their uniqueness) and the others (i.e. individuals’ gradual awareness regarding the rest of humanity, to whom they are connected to varying degrees). The other major outcome of the mirror stage is the birth of the Ego [Le Moi, the imaginary formation], and infants may experience joy at this moment, which occurs (and, in fact, is necessary) before infants can truly understand the power of symbols in language. However, one of the unfortunate outcomes of the mirror stage was that infants gradually begin to look outward, and not inward in search for identity; and such external orientation toward individuals’ own identity is doomed to fail. This seems to make perfect sense even from the objective and mechanistic outlook that the Organic Theory considers; i.e., any organism whose reality or sense of it is based on the geographical mental conditioning of a group of organisms [about 4 or 5] will have a limited perspective of reality and lack a wider outlook of the world as it truly is. Unlike US Ego psychologists who considered the Ego as the dominant component that should be worked on and strengthened, Lacan argued against such irrational therapy because the ego is the « seat of illusions » and to increase its strength would only increase the subject’s alienation, the ego is the source of resistance to psychoanalytic treatment and strengthening it would increase those resistances [i.e. all obstacles that arise during psychoanalytic praxis and interrupt its progress, when the subject breaks the fundamental rule of saying everything that comes into his mind]. Lacan argued that the true goal of psychotherapy should be therapists’ unearthing the clients’ unconscious desire via the “talking cure” of psychoanalysis – not strengthening the Ego mindlessly, as this may leave individuals in a state of delusion without an Ego adjusted to their abilities – and may even lead to individuals allowing their Ego [imaginary moi] to dominate the Super-Ego [Grand Autre, Big Other] and favour irrational release of the ID’s [Inconscient / Ça] psychic energy without any remorse or rational control. Because of the imaginary fixity of the Ego, it is resistant to all subjective growth and change and to the dialectical movement of desire, hence, by undermining the fixity of the ego, psychoanalytic treatment aims to restore the dialectic of desire and reinitiate the « coming into being » of the Subject, a product of the Symbolic. This is in direct contrast to the Ego Psychologists’ perspective. Lacan criticised ego-psychology as practised in the US for confusing the concept of « Resistance » with that of « Defence », and his distinction differs from Anglo-American psychoanalysis. Lacan explained that Defence is on the side of the subject whereas Resistance is on the side of the object. Defences are relatively stable symbolic structures of subjectivity while resistances are rather transitory [periodic / like a phase] forces which prevent the object from being absorbed in the signifying chain [of signifiers]. Resistance belongs to the « imaginary » order of the Ego and not to the symbolic level of the true Subject, because in the symbolic order of the Unconscious, there is no resistance, but only a tendency for repetition. Hence, resistances are « imaginary lures » of the Ego which the analyst must be wary of being deceived by. This is why Lacan maintained that the aim of analysis can never be to strengthen the Ego because this would increase imaginary resistances. Ego psychology shifted emphasis on overcoming the resistances of patients and this was heavily criticised by Lacan who thought that this lead to an « inquisitorial style » of psychoanalysis that sees resistances as based on the « fundamental ill will » of the patients, which is not always the case; this to Lacan overlooked the structural nature of resistance and reduces analysis to an imaginary dual relation. Lacan encourages the « analysis of resistances » but only on the condition that this phrase is properly understood, in the sense of « knowing at what level the answer should be pitched« ; what Lacan means is that the crucial thing is that the psychoanalyst should be able to distinguish between interventions that are primarily oriented towards the Imaginary and those that are oriented towards the Symbolic and know which are appropriate at each moment during psychoanalytic praxis with patients. Lacan argued for « Structural Resistance », which is not a question of ill will on the part of the patient but is a resistance that structures, and it is inherent in the analytic process. Resistance is due to a structural incompatibility between desire and human speech [i.e. discourse] and hence Lacan points out to a certain irreducible level of resistance which can never be overcome, that is, even after the reduction of resistances, there is a residue – which may be what is truly essential for a particular Subject. This irreducible « residue » is essential since it is respect for this residue by psychoanalysts that distinguishes true psychoanalysis from mere suggestion. Psychoanalysis to Lacan, respects the right of the patients to resist suggestion and indeed values that resistance. When the Subject’s resistance opposes suggestion, it is only a desire to maintain the Subject’s true desire, and as such it would have to be placed in the realm of « positive transference ». Lacan points out that while psychoanalysts cannot and should not try to overcome « all resistances », they can minimise them or at least avoid exacerbating them. To do this, psychoanalysts could recognise their own part in the resistances of their patients since to Lacan, there is no other resistance to analysis than that of the analyst himself. The patient’s resistance is always that of the analyst, and when a resistance succeeds it is because the analyst is in it completely, i.e. because the analyst understands. Hence, the analyst should always follow the rule of neutrality; psychoanalytic treatment works on the principle that by not forcing the patient, resistance is reduced to the irreducible minimum, thus, analysts should avoid all forms of suggestion.

Finally, as already explained above, we have the « Grand Autre » or simply « Autre » [Capital A] or « Big Other » which is the preconscious Superego also in the domain of the symbolic register; being the discourse of the unconscious. The big « Other » designates an otherness that transcends the illusory otherness of the imaginary because it cannot be assimilated into the psyche through identification, Lacan equates the big « Other » with language and the « law » [i.e. the structures that govern social exchange] and hence the big « Other » is inscribed in the symbolic register, and indeed the big « Other » is symbolic because it differs for each subject and is the symbolic order which mediates the relationship with a particular subject. The little « other«  is a reflection or projection of the ego [le Moi], it is the counterpart and the specular image, unlike the « big Other » which is in the symbolic order, the little « other » is inscribed in the imaginary order of the Ego.

 

The concept of Adaptation and Psychoanalysts as the Grand Autre [Big Other / Superego]

Lacan also questioned whether the ego of the psychoanalyst gives the measure of reality to the patient in trying to adapt the latter. Because if so, this would turn the analyst [who are also different in terms of talent, creativity and vision from one person to another] into the arbitrer of the patient’s adaptation to reality, hence the analyst’s own understanding [or lack of understanding] of reality would be assumed to be absolute and perfect where he would be considered as the perfection of adaptation compared to the patient [as is the case in Ego-psychology practiced in the USA]. This to Lacan turns psychoanalysis as an exercise of power and social control where the analyst forces his own particular view of reality onto the patient and this is not psychoanalysis but suggestion. This Lacanian refusal to force an adaptation of the ego to reality is in direct opposition to the « Ego-psychology » of the US psychoanalytic movement that Lacan accused of wrongly reading the works of Freud. Lacan regards it as simple to understand why the adaptation theme was developed by European and Jewish psychoanalysts who had emigrated to the USA in the late 1930s, and this is simply because these analysts felt not only that they had to adapt to life in the USA, but also that they had to adapt psychoanalysis to American tastes [i.e. to fit the average american psyche]. One of Lacan’s fiercest criticism is based on the following argument: the notion of « adaptation to reality » is founded on the creatively irrational and naive empiricist epistemology that wrongly assumes an unproblematic notion of « reality » for all Subjects, as an objective and self-evident given, this discards what psychoanalysis has discovered about the construction of reality by the Ego on the basis of its own « méconnaissance » [i.e. subjective understanding of reality]. So when the analyst assumes that he is better adapted to the vague notion of « reality » than the patient, he has no other option but to fall back on his own Ego’s interpretation of reality, since it is the only « reality » he knows, this leads to the distorted and simplistic definition of « the part that thinks as we do » as being the healthy part of a Subject’s Ego. This practice of Ego-psychology turns psychoanalysis as an exercise of prepackaged suggestion to mould the psyche of individuals to these analysts’ own « idea » of reality in order to fit a simplistic mainstream model in line with the requirements of the mechanical philosophies of empiricist epistemology and industrialisation. The inability of the analyst to sustain a praxis authentically, as is usually the case, results in an exercise of power.

The simplistic biological concept of adaptation [as often assumed in simple deterministic animal psychology] can be problematic when applied to psychoanalysis since in evolutionary biology it is assumed that organisms/animals are driven to « adapt » themselves to fit their environment and hence implies a harmonious relation between the Innenwelt (inner world) and Umwelt (surrounding world). The observation of animals in nature or in laboratories tends to guide the reasoning of many empirical scientists who are simplistic and biologically oriented, it is important to ask a few questions. For example, which animals to focus on as models to be inspired by? In nature, we have many animals who mate for life and are monogamous [e.g. albatrosses, bald eagles, barn owls, penguins, beavers, shingleback skinks, gibbons (primates), wolves, swans & french angelfish]. On the other hand, we also have other animals such as common pheasants, lions, gorillas, tigers, red deers, elks, and hamadryas baboons (primates) who have a different mating system, where the fittest male mates with multiple females to ensure the constant enhancement and fitness of future generations; and hence are polygamous.

Maladies Génétiques.jpg

Image: Degenerates / Some controversial doctors under the Third Reich proposed that the curse of diseased genes destroy entire families, and that degenerates can only give birth to their similars. It lead to sterilisation that was supposed to prevent them from spreading their misery to innocent children [as the aim was a strong and genetically healthy people], and also the « Aktion T4 » program which was mass involuntary euthanasia. Certain German physicians were authorised to select patients « deemed incurably sick, after most critical medical examination » and then administer to them a « mercy death » (Gnadentod). From September 1939 until the end of the war in 1945; from 275,000 to 300,000 people were euthanised in psychiatric hospitals in Germany and Austria, occupied Poland and the Protectorate of Bohemia and Moravia (now the Czech Republic). The Holy See announced on 2 December 1940 that the policy was contrary to the natural and positive Divine law and that « the direct killing of an innocent person because of mental or physical defects is not allowed » but the declaration was not upheld by some Catholic authorities in Germany. In the summer of 1941, protests were led in Germany by the Bishop of Münster, Clemens von Galen, whose intervention led to « the strongest, most explicit and most widespread protest movement against any policy since the beginning of the Third Reich », according to historian Richard J. Evans.

Hence, this poses questions to the simplistic biological perspective of adaptation: should humans follow the latter polygamous animal model and select the fittest and smartest males through physical and intelligence tests and use their sperm to inseminate all women on earth desiring to have children [or vice-versa or in combination with the eggs of the fittest and smartest females to help couples conceive]; could this reduce malformations and other ugly diseases?

Population en bonne santé d'purb dpurb site web.jpg

Image: Physically healthy females exercising

Or should we follow the monogamous model of the bald eagle, penguin, barn owl, swan, wolf and French angelfish? Based on our evolutionary history, it seems that we humans are monogamous by design due to the size of our brains that allow us to build sophisticated relationships and also experience complex emotions [that animals cannot due to the limited biological architecture of their brain that is optimised for survival and hunting], and hence, humans should not follow animals blindly but use some aspects that we may learn from the study of animals in nature with great precautions to help humans live a better life [for example: giving a choice of healthy sperm and egg donors to couples who cannot conceive or fear passing down incurable and other debilitating diseases] and gradually create a genetically healthy civilisation.

Bébé Gorille Albinos avec son ami d'purb dpurb site web

Image: Baby Albino Gorilla with his friend

François Rabelais, the french doctor, writer, monk & priest seems to have phrased it well in his magnum opus, Pantagruel (1694): « Science sans conscience n’est que ruine de l’âme. » [French for: « Science without conscience is nothing but the ruin of the soul »]

So, the idea of harmony between the inner world (Innenwelt) of the organism and its environment (Umwelt) which is implicit in the concept of adaptation from the simplistic biological perspective [e.g. in animal psychology] is innaplicable to human beings since man’s inscription in the symbolic order re-shapes and restrains his natural behaviours and instincts [i.e. because of civilised society and the sophisticated and multi-layered aspects of human life, man cannot allow himself to follow his wild instincts blindly as animals do in nature], and this means that « in man, the imaginary relation [to nature] has deviated » [the nurture VS nature debate]. This is different for all animal machines who tend to be strictly riveted to the conditions of the external environment, whereas in the human being we have a « certain biological gap ». So, compared to the simplistic biological perspective of animal adaptation where the organism follows its wild instincts and not human reasoning, we can suggest that humans are essentially « maladaptive animals » and this may well be for the betterment of our lives since we live in a sophisticated society and not in the wild nature (la nature sauvage) like animals, where meeting basic needs is a constant struggle in a matter of life and death.

Yet, adapting to the Umwelt (surrounding world) in human psychology is not the ultimate path of perfection because it is not designed to meet all of the true desires of human beings [as Freud suggested, intrapsychic conflict is inescapable because of the demands of society] and hence does not guarantee the complete satisfaction and enhancement of the individual [being highly complex beings with huge brains and different personalities that seek different goals], especially when the Umwelt (surrounding world) itself which is assumed to be « reality » is not a simple objective thing [such as for animals in nature] but is itself a product of the Ego’s fictional misrepresentations and projections. Therefore to Lacan it is not a question of adapting the Ego to reality, but of showing the imaginary « Ego » that it is only too well adapted since it assists in the construction of that very reality and hence the task of the psychoanalyst is rather to subvert the patient’s illusory sense of adaptation since it blocks access to the unconscious, and hence gain access to it. In 1955 Lacan states that « the dimension discovered by analysis is the opposite of anything which progresses through adaptation » and hence refused to explain human phenomena and mental life in terms of adaptation. To Lacan, and many inspired by his views, it is more about « adjusting » than adapting, i.e. adjusting to be functional in our chosen path/field based on our individual characteristics and abilitiesLacan maintained that psychoanalytic intervention should not aim to adapt the Ego to reality, and this seems reasonable since « reality » is a social construct under constant change as we primates are evolving and adapting to the discoveries of our constantly changing civilisation, but also because the Ego is an imaginary formation as opposed to the Subject which is the true product of the symbolic. To Lacan, psychoanalysts should adopt the role of the « big Other » [Grand Autre / Super-Ego) in therapeutic interventions as a counterpart to the client’s « Subject », thus making it possible for clients to peer beneath their own conscious (typically not completely true narratives), into their unconscious (and “true”) desire(s) [and perhaps guide or help the patient to realise their dreams within the realms of reality in civilised society].

Lacan’s suggestion seems to give the individual the creative freedom to create himself through language and discourse, exist and be unique within the reasonable limits of a mentally adequate and healthy person, while only adjusting his behaviour to be able to function and exist in his chosen individual world without losing his individuality. Since reality and culture are social constructs that are always changing through collaboration, the individual can both be shaped by them and also shape them [for e.g. human culture teaches a child how to use a fork and a knife to eat, but it can also be shaped by an individual if he invents/discovers something or adopts a philosophy that affects/inspires human cultures. In the past smoking was allowed everywhere and it was common culture to see people and even doctors smoking in public buildings, but since we found about the harmful effects of cigarette smoke, today culture has been reshaped and smoking is banned indoor in most public places. The invention of the mobile phone has also affected human culture and behaviour when before people used public phone boxes]; this concept of being shaped by and also shaping human cultures is known as mutual constitution and is reflected in the artefacts of all societies through the arts, literature and languages [as we explained in the Essay: The Concept of Self].

 

Challenging the established procedures of Psychoanalytic Practice

Lacan was also innovative and challenged the established procedures of Psychoanalytic practice [which promoted multiple sessions lasting an hour or more apiece, across several years] to advocate brief, impromptu [i.e. unscheduled] therapy that could be completed in a matter of minutes.

As early as 1950, Lacan had questioned the ritual of the 55-minute timed sessions imposed by the IPA as intended to preserve patients and students in training from the all-powerful transference of the masters; Lacan pulverized this rule. He invented the rule of the session of variable duration that leads the analyst to intervene in the cure by caesuras or by interpretations so that the analysand explores his unconscious fantasies more rapidly and wastes less time in uttering empty words.

« La psychanalyse est une pratique délirante, mais c’est ce qu’on a de mieux actuellement pour faire rendre patience à cette situation incommode d’être homme. C’est en tout cas ce que Freud a trouvé de mieux. Et il a maintenu que le psychanalyste ne doit jamais hésiter à délirer »

French for: « Psychoanalysis is a delirious practice, but it is the best we have at the moment to make this uncomfortable situation of being a man bear with patience. It is in any case the best Freud found. And he maintained that the psychoanalyst should never hesitate to be delirious »

Ornicar. (1977). Ouverture de la section clinique. Bulletin périodique du champ freudien. 9, 13.

The decision of Lacan to adapt sessions according to the Subject’s abilities and individuality seems logical and is based on Lacan’s concept of « the time for understanding« . Lacan’s approach to the questions of time remains one of his distinctive features. In Lacan’s paper « Logical Time » (1945), he distinguished between logical time and chronological time. Logical time has a tripartite structure, the 3 moments of which in every subject are:

(i) the moment of seeing [i.e. perceiving]
(ii) the time for understanding
(iii) the moment of concluding

Lacan explains that these 3 moments are not constructed in terms of objective chronometric units, but in terms of an intersubjective logic based on a tension between hesitation and urgency. Logical time is the intersubjective time that structures human action and varies from one individual to another based on their abilities. This seems logical since the main factors that influence successful therapy are the relationship between the therapist and the client, but also the aptitudes of the client [which varies from one individual to another depending on their intelligence, reflective abilities, understanding and will power].

Nous En France - Sarkozy - d'purb

Traduction(EN): « Us in France, we are different from others. To live, we have to drink, eat, but also to cultivate ourselves. » -Nicolas Sarkozy

Since Lacan’s theory is mainly based on French society – one with a history of challenging the limits of the individual in the name of excellence – it seems fair to acknowledge his opinions [in a sense that not all patients require multiple sessions depending on their individual characteristics, response to the relationship with the psychoanalyst, understanding of their own mental condition and desires and reflective abilities] as rational, economical, time-saving and flexible in accommodating individual differences.

In 1971, Maria Belo, a Portuguese psychoanalyst, had decided to do an analysis with Lacan after her sister’s suicide, which turned her life upside down. She would say:

« La qualité de sa présence faisait que ça déclenchait un travail, chaque séance déclenchait un énorme travail analytique en moi et quand j’arrivais chez moi, j’écrivais des lettres de plusieurs pages que chaque fois j’allais mettre dans sa boîte à lettres (…) Je pense aussi que ce que Lacan faisait avec les séances très courtes était très lié à ce qu’il était. Si on pense à cette époque, la grande époque de l’école Freudienne où il était mythifié par beaucoup de gens que, il avait vraiment besoin, par rapport au transfert, de secouer les gens et de faire des trucs que personnes d’autres n’a eu raison de faire après. »

French for: « The quality of his presence meant that it triggered work, each session triggered an enormous analytical work in me and when I arrived home, I wrote letters of several pages that each time I would go to put in his mailbox (…) I also think that what Lacan did with the very short sessions was very much linked to what he was. If we think back to that time, that great era of l’École Freudienne where he was mythified by many people that, in relation to transference, he really needed to shake people up and do things that no one else did afterwards. »

 

« Le transfert c’est l’amour. On se demande simplement : pourquoi est-ce qu’on aime un être pareil ? Pour l’instant je laisse la question en suspens… »

French for: « Transference is love. We simply ask ourselves: why do we love such a being? For the moment I leave that question open… »

-Jacques Lacan

 

However, partly as a reaction to Jacques Lacan’s criticism of Ego Psychoogy [as practiced in the United States], and partly as his advocacy of brief, impromptu therapy, the US-oriented International Psychoanalytic Association, majorly Anglophone and not very open to the virtuosity of Lacanian speculation, barred Lacan from training future psychoanalysts. For the IPA, brief therapy is unacceptable, they wanted to consider accepting Lacan’s teaching as long as he remained in the IPA as a philosopher and/or a theorist but definitely not as a trainer of students.

LesFrancaisNapproventPasLaPolitiquedesUSA

A majority of 80% of French citizens are wary of the US and do not approve its politics / Source: Le Figaro

Lacan found himself in a situation that had never been that of Freud: he found himself in a situation where he would become the director of his school, that is to say that by later founding l’École Freudienne de Paris in 1964 he would exercise functions that Freud never exercised. Lacan was at the same time the master of thought, the analyst, the political leader of his school, and was responsible for all the functions, whereas Freud had delegated political power to his disciples.

« Je fonde – aussi seul que je l’ai toujours été dans ma relation à la cause psychanalytique – l’École Française de Psychanalyse (…) dont rien dans le présent ne m’interdit de répondre personnellement la direction…»

French for: « I am founding – as alone as I have always been in my relationship to the psychoanalytic cause – the École Française de la Psychanalyse (…) whose direction I am personally responsible for as nothing in the present prevents me to do so…. »

– Jacques Lacan

Hence, criticized by the IPA, proponents of a rigid legislation, Lacan left the Société Psychanalytique de Paris which was frequented by Marie Bonaparte who thought she was the only heiress of Freud whose memory she piously celebrated with the support of the IPA.

Lacan then participated in 1953 with Daniel Lagache, François Perrier, Serge Leclerc and Wladimir Granoff in the creation of the Société Française de Psychanalyse ; his friend Françoise Dolto, founder of a new psychoanalytical approach to childhood, gave him her support. La Société Française de Psychanalyse would become a sophisticated cultural melting pot for all the youth of that generation and Lacan would train them by being, in the words of Elisabeth Roudinesco, « l’analyste, le contrôleur, le maître, l’initiateur, l’éveilleur » [French for: « the analyst, the controller, the master, the initiator and the awakener »] through his seminars which took place at the Sainte Anne Hospital followed by the presentation of the mentally sick. Lacan became the great renovator and the great re-inventor of psychoanalysis in France. That generation felt like the pioneers of something new around Lacan, but they would have also liked to remain in the IPA, in its Freudian legitimacy, of which they were no longer a part of since their masters had resigned. The characteristic of Lacan was that he contested the whole practice of the IPA that was trying to be Freud. Lacan is the only one to suggest a return to the origins of Freudian theory, i.e. not post-Freudism. Thus at that point, Lacan posed himself as the re-founder, and an intellectual who was transgressive since Lacan would not respect any irrational IPA rule, which of course humiliated the IPA who could not digest Lacan and his perspectives, and perhaps also unable to grasp the sophisticated subtleties of Lacan’s theory which had its origins in the French heritage. Unique in its kind, the École Freudienne de Paris would allow Lacan to place the desire to be an analyst at the heart of the training of didacticians. Jean-Bertrand Pontalis declared: « Comme si lui-même (Lacan), dans ces années-là était en train d’inventer et de s’inventer. Nous participions en accord avec lui en résonance avec lui à un mouvement inventif. » [French for: « As if he himself (Lacan), in those years was inventing and inventing himself. In agreement with him, we were participating in an inventive movement in resonance with him.« ]

Furthermore, despite [or perhaps because of?] the IPA’s decision to bar Lacan from training future psychoanalysts, the proportion of Psychoanalysts adopting a Lacanian perspective has only grown since Lacan’s death in 1981with half or more of the world’s psychoanalysts adopting Lacanian concepts. Jardim, Costa Pereira and de Souza Palma (2011) applied Lacanian Theory to understanding the personality disorder of Schizophrenia [formerly known as “madness”], interpreting a case study [along with fictional examples from literary works] in terms of failure to achieve an integrated Ego from infancy onwards. McSherry (2013) argued that Lacan’s Theory of Psychoanalysis could benefit mental health nursing practice since various forms of personality disorders [including but not limited to Schizophrenia] can be understood readily in terms of Lacan’s theory.

Lacan described woman as a « symptom of man » that enters the psychic economy of men as the cause of their desire. This has led to debates among feminists: some saw his theories as a way of challenging fixed concepts of sexual identity while others believe that the concept of symbolic order reinstates the inequality of the sexes, and the privileging of the phallus simply repeats alleged misogynies of Freud.

The British psychoanalyst Juliet Mitchell who was one of the first to introduce Lacan’s system of thought to the Anglophone crowd thought that his work was misinterpreted and misused for a political purpose for the left and for feminism; Mitchell suggested that a possible reason for this could have been due to the « stupidity » of the English crowd, unable to grasp the subtleties of Lacan. Malone (2012) noted that Lacan was ambivalent towards the growing tendency for empirical clinical psychologists to align their discipline with the hard sciences [e.g. Biology, Medecine, Physics, Chemistry, Astrophysics, Material Science, etc] and not with the humanities [e.g. Literature, Poetry, Music, Art (Sculpture, Painting and others), Drama (Theatre), etc], and viewed psychoanalysis as ideally informed by both the humanities and by the sciences.

Documentaire: Jacques Lacan, La Psychanalyse Réinventée (2001)

Lacan has been hailed as the “French Freud” who has established a tradition of French psychoanalysis that rivals American and British psychoanalysis in terms of international influence. Although Lacan’s theory has been cast as a uniquely French theory [culturally and linguistically speaking], it has nonetheless struck a chord with many [and, perhaps, most] of the world’s most influential modern day psychoanalysts, shattering perceptions across languages and cultures worldwide. Perhaps unsurprisingly, a decade later, much psychoanalytic research in the US itself will seem to confirm Lacan’s perspectives as discussed above.

After the publication of his writings in 1966, Lacan became a recognized thinker, admired by his students and hated by his opponents. At L’École Normale, the salle Dussane, a large crowd flocked to listen to him.

« Quand je comprenais je trouvais ça génial… »

French for: « When I figured it out, I thought it was great… »

-Françoise Dolto

The writer Philippe Sollers lyrically describes the harmonies and dissonances of the main stage of Jacques Lacan’s seminar:

Philippe Sollers sur Lacan - danny d'purb dpurb site web.jpg

« Lacan monte à la tribune comme une gravure de Dürer (Albrecht), drôle de Saint, drôle de moine chevalier prêcheur d’un autre âge. Lacan c’est de la lenteur ponctuée, du soupir, de la passion tortueuse, de l’envolée, de l’anecdote, de largo, de la moquerie, de l’insulte, du tonnerre intermittent, du pinaillage à n’en plus finir, de l’ennuis massif, du mot d’esprit, du sublime. Il y a Lacan mystique, Lacan chancelier, Lacan l’ancêtre, Lacan Don Juan, Lacan Satan, Lacan charlatan, Lacan malicieux, Lacan généreux, Lacan vaniteux, Lacan persifleur, ronchonneur, hurleur, murmureur, souffleur, séducteur ; il y a Lacan cigare et Lacan mouchoir, Lacan accablé, Lacan vraie, l’étonnant et que ça donne comme la nervure exacte d’un gai savoir. » -Philippe Sollers

French for: « Lacan rises to the platform like an engraving by Dürer (Albrecht), a strange Saint, a strange knightly monk preacher from another age. Lacan is punctuated slowness, sighing, tortuous passion, flight, anecdote, largo, mockery, insult, intermittent thunder, endless nitpicking, massive trouble, witty words, the sublime. There is mystical Lacan, Chancellor Lacan, Lacan the ancestor, Lacan Don Juan, Lacan Satan, Lacan charlatan, malicious Lacan, generous Lacan, vain Lacan, Lacan persifleur, grumbler, howler, whisperer, blower, seducer; there is Lacan cigar and Lacan handkerchief, overwhelmed Lacan, true Lacan, the astonishing and that which gives like the exact vein of a cheerful knowledge. » -Philippe Sollers

 

Jacques Derrida would say:

« Je n’imagine pas que quelqu’un qui était engagé comme il l’a été avec une telle passion de la vérité là où le sens même du mot vérité était si difficile à faire entendre, je n’imagine pas qu’une telle personne ait pu vivre autrement que tragiquement (…) ce qui m’a aidé à résister à toute réponse agressive à Lacan, je pensais que cet homme avait une responsabilité tragique à assumer et quel que soit sa parade, son paraître, son apparat, etc… les scènes qu’il faisait, il devait y avoir de la blessure secrète là et je l’ai ressenti et je l’ai respecté. »

French for: « I cannot imagine that someone who was engaged as he was with such a passion for the truth where the very meaning of the word truth was so difficult to convey, I cannot imagine that such a person could have lived any other way but tragically (…) which helped me to resist any aggressive response to Lacan, I thought that this man had a tragic responsibility to assume and whatever his parade, his appearance, his pomp, etc., the scenes he made, there must have been some secret wound there and I felt it and I respected it. »

Jacques Lacan dpurb site web.jpg

Jacques Lacan (1901 – 1981)

Jacques Lacan addressing the audience of the Grande Rotonde of the University of Louvain, the 13th of October 1972:

« La mort est du domaine de la foi, vous avez bien raison de croire que vous allez mourir bien sûr ; ça vous soutient ; si vous n’y croyez pas, est-ce que vous pourriez supporter la vie que vous avez ? Si on n’était pas solidement appuyés sur cette certitude que ça finira ? Est-ce que vous pourriez supporter cette histoire ? »

French for: « Death is a matter of faith, you have good reason to believe that you are going to die of course; it sustains you; if you don’t believe in it, could you bear the life that you have? If you weren’t firmly supported by the certainty that it will end? Would you be able to bear it? »

Conclusion: Legacy, Impact & Evolution of Psychoanalysis

Psychoanalysis is a unique movement in psychology that grew out of the same German model of mental activity that produced act psychology and the Gestalt movement. However, psychoanalysis received its immediate expression through the needs of the mentally ill. Psychoanalysis was born as a clinical discipline, not an academic development based on empirical methodology to fit a particular field’s reductionist requirements for acknowledgement. For this reason, psychoanalysis, especially as proposed by writers after Freud, gives the impression of an ad hoc movement that develops as particular problems arise – it could be seen as adaptive and constantly evolving. Psychoanalysis did not adhere to the commitment to the reductionist empirical methodology expressed in those mechanical systems of behavioral studies generated by academic research. Psychoanalysis set out not to simply study basic observable behaviour [e.g. in animals studies], but to study the psychic apparatus that constitutes the human mind which obviously guides and impacts behaviour. Hence, there was and still is little interaction between psychoanalysis and those systems grounded on empiricism and reductionist methodologies that are stubborn in trying to capture an entity as the mind when most of the constructs cannot be seen or touched, or accurately measured. Stated quite simply, psychoanalysis and the other schools of psychological models do not speak the same language.

Although different and hardly understood by common mainstream empirical and academic psychology, psychoanalysis did assume a dominant role in psychiatry. This is completely understandable in light of the origins of psychoanalysis as a response to clinical problems as they manifested themselves. Indeed, psychoanalytic writings enjoyed an almost exclusive position in psychiatry and clinical psychology until the 1960s, when behaviour modification and mechanical and reductionist Pavlovian derivatives based on Behaviourism [such as Cognitive Psychology] began to compete as an alternate model of therapy for behavioural adjustment [Read: the Essay on the Origins of the Cognitive Behavioural Model: Biological Constraints in Learning, which also suggests an unconscious drift in other animals].

Pavlov Dog Labs

Psychoanalysis continues to exert a marked influence on art, literature, and philosophy. This influence reflects major contributions of Freud: his comprehensive analysis of the unconscious. On the same line, literary and artistic expressions are interpreted in light of the unconscious activities of the artist as well as the unconscious impressions of the perceiver. Psychologists today may choose unconscious motivations or simply to refer to subliminal or subthreshold activities. However, any truly comprehensive theory of psychological activity can no longer be limited to conscious aspects of behaviour. Although some psychologists may disagree with some Freudian concepts and interpretations, Freud did identity some dynamic processes that influence the activity of the individual: processes that psychology cannot ignore anymore.

As mentioned earlier, psychoanalysis has a unique position in the history of psychology. Freud did not develop a theory that generated testable hypotheses or other empirical implications. Yet, on another level, Freud accomplished what few other theorists have: He revolutionised attitudes and created a new set for thinking about personality. The findings of other more empiricist theories of personality disturbance have often confirmed many of Freud’s observations. If his views do not meet the criteria of empiricistic study, they nevertheless mark a man of genius and insight, whose influence pervades people’s thinking about themselves in ways that few others have achieved.

The psychoanalytic theory is an enormously complex and ambitious one, and it aims to make sense of a much broader array of psychological and social phenomena than other theories, and does so with a collection of explanatory concepts. Hence, the sheer range and scope of psychoanalytic theory, and its aspiration to be a total account of mental life, should be recognised and applauded. In comparison, all other schools of psychology to study personality look decidedly timid and limited in focus. Even if other approaches tend to have more empirical foundations and hence more credential in academic psychology, they tend to leave out much of what we might want to include in a comprehensive theory of human behaviour. To many intellectuals and lay people alike, any account of personality that does not acknowledge that humans are like psychoanalytic theory portrays us, i.e., driven by deeply rooted motives, inhabiting bodies that bring us pleasure and shame, shaped by our early development, troubled by personal conflicts, and often a mystery to ourselves – is fundamentally limited.

While the empirical limitations are a fact, some of these problems are due in part to the intrinsic difficulty of what psychoanalytic theory tries to explain. Others could be partially overcome if researchers made a more concerted effort to determine which psychodynamic ideas stand up to closer, “scientific enquiry”. However, psychoanalysis cannot be judged only by empirical perspectives, and it would be a mistake to abandon it impatiently, given how much a suitably revised and empirically updated theory of psychodynamics in the future might deepen the studies of personality.

Even for all its failings to the empirical scientist, on some aspects, psychoanalysis is at least partly responsible for several important and scientifically respectable ideas that has always had a kernel of truth and was later developed by other researchers. While Freud’s idea of the dynamic unconscious remains controversial, it can no longer be disputed today that unconscious cognition is now a fact and an uncontroversial idea in cognitive and social psychology, where huge volumes of research now explore non-conscious or “implicit” attitudes. We now know from neuroscientific research that the brain has networks for both explicit and implicit [unconscious] learning as Yang and Li (2012) found after examining the neural correlates for these 2 types of learning on artificial grammar sequences. We have brain networks of different connectivity that underlie explicit and implicit learning. While both processes involve activation in a set of cortical and subcortical structures, the study found that explicit learning engages a network that uses the insula as a key mediator whereas implicit learning evokes a direct frontal-striatal network. Individual differences in working memory also differentially impact the two types of sequence learning.

 

*****

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Essay // Philosophical Review: “The World as Will and Idea”, by Arthur Schopenhauer (1818)

Schopenhauer &amp; Nietzsche

Arthur Schopenhauer (1788 – 1860) & Friedrich Nietzsche (1844 – 1900)

Schopenhauer, a pessimistic philosopher, focused on the dark side of life and mental evils and cruelty, which he considered inevitable and that we as psychologists, intellectuals and masters of the mind view as mental disorders that have a negative effect on both the character of the affected and the human environment at large exposed to the vile side of human nature.

This negative view of man’s behaviour and role in life was a sharp contrast to the other more euphoric philosophers who marked the spirits of the generation before him, and who embraced a more idealistic and perhaps a slightly exaggerated euphoric side of man’s mind and character. Though Schopenhauer’s work originally gained little attention at the time it was published [perhaps being too avant-garde for the atavistic institutions of his time], he expressed an interpretation of the world that was dragging and opposed the great ideal of who went before him, such as Victor Schelling and Hegel on some very important points but did not deny expressions of art such as the romantic movement in its various forms.

Schopenhauer who never refrained from publicly criticising people and ideas he disliked was very vocal in his complete contempt for these men, and regarded himself as their great opponent in the ring of the leaders delivering the “Real truth” to mankind and civilisation. Schopenhauer’s work in many ways could be viewed as an extension of another famous German philosopher, namely Immanuel Kant, who preceded him by one generation, delivering his major philosophical work, “a critique of pure reason”. Schopenhauer worked out a system in which reality is known inwardly by a kind of feeling where intellect is only an instrument of the will: the biological will to live and where process rather than result is ultimate.

Schopenhauer’s pessimism lies in his very strong rejection of life. In fact, this rejection is so strong that he even had to address the question of suicide as a solution to life. He fortunately also rejected this “solution” to life, this rejection to life reflected influences with roots in Eastern philosophy, particularly Buddhism, and it is one of the most significant aspects of his work that he was the first Western philosopher to integrate Buddhist thought into Western philosophy. His preoccupation with the evil of the world and the tragedy of life was also somewhat reminiscent of ancient Hindu philosophies. His writings helped to stimulate in Germany an interest in Oriental thought and religion, which can also be seen in the work of many later German philosophers.

In “The World as Will and Idea”, Schopenhauer also considered the important question of the function of art. The value of arts to human life in far more depth than any of his predecessors, and even graded each of the arts, such as music, poetry, architecture [etc], from most important to least important. For that reason, his book had not only a profound effect on future philosophers, but also artists, particularly poets and composers, such as the enigmatic Wagner, who felt indebted to him and sent him a letter of gratitude when he was first introduced to Schopenhauer’s work.

Tristan und Isolde (John Duncan 1912 Symbolism)

Image: Tristan and Isolde (1912) by John Duncan

It is believed that Wagner’s popular opera “Tristan und Isolde” in particular, shows Schopenhauer’s influence as a philosopher who believed that music was the highest form of art, an idea that of course, Wagner found pleasing and so the composer began to think of himself as a prime example of Schopenhauer concept of a genius. People in other fields of the arts were also influenced by Schopenhauer, including the novelist Thomas Mann. Schopenhauer’s ideas had the unique ability to influence not only philosophy but many other fields of human endeavour and expression. Within philosophy itself, Schopenhauer never founded a school of thought “per se”, but his influence instead was in stimulating other philosophers towards a particular line of thought, which varied with the individual and his or her response to Schopenhauer’s writing. His writing had a major impact on the German philosopher Nietzsche, who was also a friend of Schopenhauer’s admirer, Richard Wagner. Nietzsche shared the idea that life is tragic and terrible but can sometimes be transformed through art. Nietzsche was also the man famous,for his concept of the Ubermensch “Superman”, which later helped to inspire the German National Socialist movement and eventually the founding pillars of the Third Reich of Adolf Hitler.

The Apollo Belvedere (Ancient Sculpture) - Vatican Museum - Roma

Image: Apollo Belvedere (Sculpture Ancienne), Musée du Vatican, Rome /Apollon est le dieu grec des arts, du chant, de la musique, de la beauté masculine, de la poésie et de la lumière. Il est conducteur des neuf muses. Apollon est également le dieu des purifications et de la guérison, mais peut apporter la peste par son arc ; enfin, c’est l’un des principaux dieux capables de divination, consulté, entre autres, à Delphes, où il rendait ses oracles par la Pythie de Delphes. Il a aussi été honoré par les Romains, qui l’ont adopté très rapidement sans changer son nom. Dès le ve siècle av. J.-C., ils l’adoptèrent pour ses pouvoirs guérisseurs et lui élevèrent des temples.

So, these three names Schopenhauer, Wagner and Nietzsche are often linked and are also associated at times, through no fault of the men themselves with a dark period of human history.

“The world is Will and Idea” begins with the famous line, “The world is my idea” when Schopenhauer says the world is his idea, he is referring to the relationship between an “object” and “the subject” [i.e. The person [subject] who sees or senses the object]. As an example, he did not mean that an apple is identical with your abstract concept of an Apple, he means that the apple as perceived by you exist only in relation to you as a person or “the subject” who perceives it. Its reality is only in what you perceive, it is what you perceive it to be so.

La Pomme Pourrie (Rotten Apple)- Apparence &amp; Personalité d'purb dpurb site web

So, the world is my idea means that a whole visible world and its sum of total experience is “object” for a “subject”, its reality consists in appearing to be perceived by a subject. This theory of the world of idea was taken and developed from Kant’s philosophy, but the second part of Schopenhauer’s philosophy “The World as Will” is completely his own and expresses his very unique interpretation of human life. Briefly, this interpretation says that the will, « the will to survive and live » is the strongest force in man and everything else is subordinate to it. His conception of the supreme wisdom of life is one of resignation to the power this “will” has and the tragic results of it.

Arthur Schopenhauer was born on February 22nd of 1788 in Danzig, Germany, he was the son of Henri Floris Schopenhauer aged 38 and Johanna Henriette Trosiener who was then 19 years old. His father was a wealthy merchant and banker who had already planned for his son to become a business man before his birth, and hoped Arthur would follow in his steps. He was also an independent minded man who moved his family from the city of Danzig when it was taken over by Prussia in 1793. The new family home was in Hamburg. Schopenhauer left to visit England and other countries, on the understanding that when he completed his tour, he would begin work in a business. Schopenhauer, then 16 years old, kept his promise but he had no attraction to business and when his father died, he got consent from his mother to continue his studies. In 1809, he entered the University of Göttingen to study medicine, but he changed to philosophy in his second year, as he put it “life is a problem and he decided to spend his life contemplating it”. He also studied at Weimar where he lived with his mother until he became estranged from her.

Schopenhauer had a moody, irritable temperament and could be violent in his passion. At the university, Schopenhauer developed an affection for Plato and visited Berlin to hear the lectures of contemporary philosophers Johann Gottlieb Fichte (1762 – 1814) and Friedrich Schleiermacher (1768 – 1834). Fichte was the first transcendentalist idealist and Schleiermacher was a founder of modern Protestant theology. Schopenhauer found Fichte’s comment, “No one could be a true philosopher without being religious” absurd and retorted that no man who was religious turns to philosophy since they have no need for it [a questionable statement when religion (e.g. Christianity) does not cover all the aspects of the experience of life in detail, or study God’s works methodically through the lens of science and rationality, to understand the further implications in the betterment of the human world].

Rodin - Hands (Musee Rodin, Paris)

Image: « Les Mains » par Auguste Rodin

Schopenhauer left Berlin when Prussia rebelled against Napoleon. He never developed strong German patriotic values and sentiments [perhaps never given a chance or a reason or support to do so at the time], and always regarded himself more as a cosmopolitan without any strong national affiliation. He went into retirement to write his first dissertation called “On the fourfold route of the principle of sufficient reason”, which was published in 1813 and earned him a doctorate at Vienna. The poet Goethe congratulated Schopenhauer, and in return he wrote an essay called « On Vision and Colours » which supported Goethe in his stand against Isaac Newton. But the dissertation, although it won the admiration of Goethe, went practically unnoticed. The author however always considered it the groundwork and essential introduction to his philosophy. Shortly after he published his dissertation, Schopenhauer met an Oriental scholar, Friedrich Majer (1771 – 1818), who introduced him to Indian philosophy and literature. He maintained an interest in Indian philosophy throughout his life, and as an old man, he meditated on the Upanishad, part of the Vedas [the sacred script of the Hindus]. He would later associate his theory of the world of ideas with the Indian doctrine of Maya [to the Indians, Maya is illusion or the world as an illusion]. To Schopenhauer, this meant that the individual subject and object he wrote were “Maya”, all at the end.

For 4 years between 1814 and 1818, Schopenhauer lived in Dresden, which is where he wrote his masterpiece “The World as Will and Idea”. He sent the manuscript to his publishers and left for an art tour of Italy. The book was published the following year in 1819, and although it received attention from some philosophers, it sold very few copies. This was a disappointment to the author who felt sure it contains the secret of the universe.

This failure did not kill his eagerness however, so he returned to Berlin and started lecturing. By now he was 32 years old. He deliberately scheduled his lectures for the hour at which the philosopher Hegel was also accustomed to lecture – planning to compete with the master. But his lecturing career was a failure and Schopenhauer gave it up after only one semester. His ideas seemed at odds with the dominant spirit of the time.

Dolly_the_Sheep

Schopenhauer roamed around a bit and then settled in Frankfurt in 1833, he read European literature and scientific books and journals looking for illustrations or confirmations of his theories. He frequented the theatre and also continued writing, publishing on the Will of nature and winning a Norwegian prize for an essay on freedom. He failed to win a similar prize from the Royal Danish Academy of the Sciences for a separate essay on ethics; they disapproved of his disparaging remarks about other philosophers. These two essays were later published together in 1841, under the title “The two fundamental problems of Ethics”.

In 1844, Schopenhauer published a second edition of “The world as Will and Idea”, which contained 50 new chapters. In the Preface, he took the opportunity to make a strong statement of his views about university professors of philosophy, which were of course not admiring. In 1848 there was an unsuccessful revolution in Germany. A revolution from which Schopenhauer had no sympathy whatsoever. But after the failure of this revolt, people were more willing to consider a philosophy which emphasised the evil in the world in which preached the rejection of life for the route of contemplation. Schopenhauer’s popularity was on the rise. In 1851, he published a collection of essays that dealt with a wide variety of topics, and finally in 1859, he published third edition of the “World as Will and Idea” with more supplements. In the last decade of his life, the author finally became a famous man, all kinds of visitors with all kinds of philosophies came to see him and to enjoy his brilliant conversations. Lectures were given on his system at the University, the very university he has attacked, a sure indication that he had finally achieved success. Schopenhauer has spent a long, lonely life of reflection and only after his works were ignored for many years that he attained fame and reputation. He died in September 1860, at the age of 72.

Schopenhauer by Mitch Francis

Image: Arthur Schopenhauer (1788 – 1860) by Mitch Francis

As a man, Schopenhauer was cultured, broadly educated, eloquent and articulate, witty and conversational, and a very talented writer, but he was also opinionated, egotistical, and often quarrelsome. His remarks about other philosophers were assaulted and his remarks about women in general were so scathing that they had to be deleted from his book by his editor. He was obsessed with the suffering of humanity, but did nothing to alleviate it. He himself made the comment that it is no more necessary for a philosopher to be a saint than it is for a saint to be a philosopher, and he never tried to prove otherwise. But, in the final analysis he was exactly the man he needed to be to write what he wrote. His pessimistic and grim interpretation of life are not very likely to have come from a man of infallible kindness or tolerance, and that interpretation of life played a significant role in the development of human thought and philosophy by inspiring both similar and opposing viewpoints which forced humanity to re-examine itself yet again.

 

Now is a summary of the text of “The World as Will and Idea

The world is my idea. This truth applies to everything that lives and knows, but only man can reflect on it and bring his abstract consciousness to it. It becomes clear to him when he looks at the sun that what he knows is not a sun, but an eye that sees the sun, not a nurse but a hand that feels the earth. This truth is by no means new, it was a fundamental text of the Vedanta philosophy of the Hindus, it was also part of the reflections of the French philosopher René Descartes and finally it was also clarified by the philosopher George Berkeley – although neglected by Kant. But this view of the world as idea is one-sided and must be balanced by another one which is the impressive and awful truth that the world is my “Will”. The world has necessary hands, the subject and object. The object and the subject that perceives it operate together. If one were to disappear, then the whole world would cease to exist. All objects have universal forms and either space, time and causality or the relation of cause and effect as Kant has demonstrated, they may be discovered and known apart from the objects in which they appear, as an expression of reason or the principle of sufficient reason. But what if our whole life is but a dream, or how do we distinguish between dream and reality? Kant tried to answer this question by stating that the connection of ideas, according to the law of causality, constitute the difference between them. But the long life dream in distinction from our short dreams has always had complete connection, according to the principle of sufficient reason. We are such stuff as dreams are made on and our little life is rounded with a sleep.

Life and dreams are leaves of the same book, the book we read through and the one whose leaves we turn idly to read a page here and there. Any system of philosophy that starts with the object has to deal with the whole world of perception, the most consistent form of these philosophies is simple materialism. It regards time and space and matter as existing absolutely. It ignores the relationship to the subject in whom these ideas exist, then it takes a law of causality as its guiding principle: causality exists by understanding alone. Materialism seeks the most simple states of matter and then tries to develop all other states from it. It ascends from mere mechanism and chemistry: the chemical properties and attractions of objects. It ascends to vegetable and animal life, to sensibility and thought. But, the thoughts and knowledge reached through materialism in a long, laborious process, assumed from its starting point that there was a subject or perceived matter: eyes that side, hands that felt it and understanding that knew it.

This system of philosophy which opposes this materialism is idealism, which instead starts with the subject and then tries to derive or reach the object from the subject, but it overlooked the fact that there can be no subject without an object, like materialism this idealism begins by assuming what it is supposed to prove later. The method of Schopenhauer’s system is different from both of these, for it starts from neither object nor subject, it starts from the idea. The idea is the first form of consciousness and its essential form is the antithesis or opposite of subject and object. For each one of us it is our own body that is the starting point in our perception of the world and we consider it like all other real object simply as an idea, the understanding which develops ideas could never come into being if there were no simple bodily sensations from which to start. If the thinker were no more than a pure knowing subject without a body like a winged cherub that is all spirit, he would not be able to know the nature of the world. He would be like a man going around a castle getting to its façade and trying in vain to enter it, all reality would be a riddle, but because the subject of knowledge is also an individual with a body and a bodily nature, the world becomes revealed, it is revealed in the will. Every true act of the will is a movement of the body for the action of the body is nothing but will expressed through an object. The body is the object, my body and my will are one. The double knowledge which each one has of his body out of idea and inner will becomes the key to the nature of the world. Phenomenal existence, the existence we perceive with our senses, is an idea and nothing more. Real existence or the thing in itself is will.

die welt als wille und vorstellung

Will is a term that applies to both the highest and lowest in man’s nature, it is that which drives us to pursue the light of knowledge and it’s also that which in nature strives blindly and dumbly to survive. Both come under the common name of will, just as the first dim light of dawn in the rays of the full midday are both called sunlight. If we consider the impulse with which waters hurries to the ocean, or the way in which a magnet turns to the North Pole, or the eagerness with which electric poles seek to be united or the way a Crystal takes form, we can recognise our own nature, for the same will describes the inner nature of everything that is in the world. The world as will is one, it knows nothing of the multiplicity of things in the outer world: the world of perception, the world of time and space. Notions like more or less, don’t exist to it, it knows nothing of quantities or qualities. For this reason, it cannot be said that there is a small part of the will in a stone or a large part of the will in a man. Relations like this between part and whole belong to the idea of space which does not apply to the will. In reality, the will is present in its entirety and undivided in every object of nature and in every living thing. Yet in terms of its objectification, that is, its external expression, it has different grades in inorganic matter, in vegetation, in animals and in man. The lowest of these appear in the most universal forces of nature, in the form of gravity, rigidity, elasticity, electricity and the like, which are in themselves manifestations of the will, just as much as human actions are. The higher grades are seen in man where the will takes the form of individuality and consciousness. It is here that the will shows its second side. For in the human brain lies the potential of comprehending the will, so that as it is kindled by a spark it brings the whole world as idea into existence. In this manner, knowledge proceeds from the will, knowledge that is either from the senses or is rational and is destined to serve the will in its aim of expressing itself. In all beasts and in most men, knowledge remains in subjugation to the will, yet in certain individual men, knowledge can free itself from this bondage so the subject of knowledge exists for itself as a pure mirror of the world. As a rule, knowledge remains subordinate to the will and grows on the will [so to speak] as a head on the body. In the case of the beast, the head is directed towards the Earth where the objects of its will are. But in the case of man, the head is elevated and set freely upon the body as in the Apollo Belvedere where the head of the guard stands so freely on his shoulders that it seems delivered of the body and no longer subject to it.

The transition from the individual’s knowledge of particular things to the knowledge of the idea takes place suddenly. It happens when the knowledge of the will changes someone into a pure will-less subject of knowledge, contemplating things as they are in themselves. If raised by the power of the mind, a man leaves the common way of looking at things behind and forgets both his individuality and his will, then he becomes a pure “without will” timeless and painless subject of knowledge – this appears in the genius. For when Genius appears in a man a far larger amount of the power of knowledge comes to him than is necessary for the service of his will. This extra knowledge is free and purified from will: a clear mirror of the inner nature of the world. All willing arises from want. The satisfaction of a desire ends it, but for one wish that is satisfied, there remain 10 which are denied. No attained object of desire can give lasting satisfaction, for it is likely alms thrown to a beggar that keep him alive today that misery may be prolonged tomorrow.

Attending to the demands of the will continually occupies and influences our consciousness. But when we are lifted out of the endless stream of willing, we can comprehend things free from their relation to our will without any personal interest or subjective opinions, and then the peace we have been seeking comes of our own accord. For we are, at least for the moment, set free from the miserable striving of the will – the wheel stands still. There is no more slavery to the will. It is the function of the fine arts to express this freedom from will or the different grades along the way. Matter as such cannot be an expression of the idea but when it is expressed through an art like architecture, its characteristics of gravity, cohesion and hardness, the universal qualities of stone appear as a direct but low grade of the objectified or expressed will. In the building nature reveals itself a conflict between the gravity of the building and the rigidity of the structure of the support, as in the simplest form of a column. The problem of architecture, apart from practical utility, is to make this conflict appear in a distinct way so that the building material instead of a mere heap of matter bound to the earth is raised above it, so that the roof example is realised only by the means of the columns or arches which support it. The pleasure that comes from looking at a beautiful building lies in the fact that the viewer is set free from the knowledge which serves the will and is raised to the kind of knowledge which comes from contemplation that has no will.

Woman and Man Roman Sculpture

The highest grade of the expression of the will is found in anything that reflects human beauty in a way which reveals the idea of man. No object transports us so quickly into will-less contemplation as the most beautiful human form. We know human beauty when we see it, but true artists can express it so clearly that it surpasses even what we have seen. In the genius of a sculptor, we find a representation of what nature intended to express, so that if you were to present his statue to nature, he would say “This is what you wanted to say!”

danaide-le-baiser-par-auguste-rodin

Image: « Danaide » & « Le Baiser » par Auguste Rodin

Painting as an art has character as well as beauty and grace for its object, for it attempts to represent the will of the highest grade in the idea of humanity. This, however, can be an abstract form of the concept known as the picture attempt [as it does at times an allegorical painting] to represent something other than what is perceived. In poetry the relationship is reversed, for here what is given directly in words is the concept that leads readers away to the object of perception, this is done through metaphors, similes, parables, allegories and the like. The aim of all poetry is the representation of man. When it is a representation of the poet himself, we have the lyric. The lyric poet reveals himself in joy or more often grief as the subject of his own will, but along with this as the sight of nature impresses him, there is the awareness of himself as the subject of pure will-less knowing, and his joy now appears as a contrast to the stress of desire: desire imposed on him by his will. Epic poetry portrays man in a more historical context in connection with significant situations in human life. Drama in the form of tragedy is not only the best of poetic art, but the most significant in terms of this system of philosophy because it is the strife of the will represented at its highest grade of objectivity, it becomes visible in human suffering that is brought about by fate or error or wickedness, in which the will lives on while people fight against and destroy one another. The tragic effect in poetry may be produced by means of a character of extraordinary evil such as Iago in Othello or Creon in Antigone or by blind fate as in the Oedipus Rex of Sophocles or by circumstance and the situation in which the character finds himself such as Hamlet. In the tragic character we can observe how the noblest of men – after a long personal conflict and inward suffering – come at last to renounce the pleasures of life and the particular goals once so keenly fought for, instead the character joyfully surrenders to life itself. It is in this sense that Hamlet renounces life for himself but askes Horatio to remain a while and to – in this harsh world – draw his breath in pain to tell Hamlet’s story and clear his name.

Shakespeare's Hamlet Tragedy

Beginning with architecture in which gravity and rigidity reveal the lowest grade of the conflict of the will with itself and ending with tragedy where this conflict reaches its highest grade, we have considered the arts and how they represent the will and the idea, but music stands quite alone, cut off from all the other arts, since it’s not a mere copy of any idea of existence in the world. Music is as direct an expression of the whole will as the world itself is. Nature and music are two different expressions of the same thing, and so music speaks a universal language. In the deepest tones of harmony in the bass we recognise the lowest grades of the will, for bass is in harmony with the crudest matter on which all things rest and from which they originate. The higher complimental parts of music are parallel with animal life and in the melody of high voice singing we recognise the high grade of the will in the effort and intellectual life of man. The pleasure we received from beauty, the consolation we get from art and the enthusiasm of the artist, rest on the fact that whereas existence in the world is something sorrowful and terrible, the contemplation of the world as idea is both soothing and significant. But in the case of the artist, the contemplation of beauty doesn’t quiet the will and it doesn’t provide a pathway out of life as does the resignation of the saint. The deliverance from the will only occurs when – tired of the game – one renounces life and gets a grasp on what is real. When the will – this blind and incessant impulse of nature – becomes conscious in man, it is recognised as the will to live. Man may affirm or deny it. He affirms the will to live when – having seen it as that which has produced nature and his own life – he then adds his own desires to it. The denial of the will to live occurs when the awareness or consciousness of it means the end of desire. The phenomena of the world – that what we see and perceive – no longer motivates the will, for the comprehension of the world as idea has freed the will and allowed it to be silent. It the essential nature of the will: nowhere free and everywhere powerful – to strive endlessly towards satisfaction that it is incapable of getting. Just as in nature, gravitation is the ceaseless striving towards a mathematical centre and this striving will not stop even if the whole universe were rolled into a single ball. In the same way the solid will become a fluid, the fluid will become a gas, and the plant – restless and unsatisfied – will strive through ascending forms until it goes to seed where it finds a new starting point.

All nature is a struggle in which war is waged that is deadly to both sides. All striving is in vain, and yet it cannot be abandoned and all this is identical to what appears in us. In us, the blind striving of nature becomes the will to live, but it is self-conscious will: we are aware of it! The fate of this will is in keeping with its striving nature in the face of constant obstacles and hindrances, and anyone who will consider the character and destiny of the will to live, will be convinced that suffering is essential to all life.

« Sadeness Partie I » par Enigma / Album : MCMXC a.D. (1990)

Ad Augusta Per Angusta

Translation (EN): « Has grandiose results by narrow lanes » / Source: Le Petit Larousse 2018 / Les locutions étrangères gravées dans nos mémoires ont la magie des formules oubliées dont le charme va croissant lorsque l’alchimie des mots nous est plus mystérieuses. Elles ont l’autorité de la chose écrite. / Mot de passe des conjurés au quatrième acte d’Hernani, de Victor Hugo. On n’arrive au triomphe qu’en surmontant maintes épreuves.

From where then did Dante take the materials for his hell? From the world! And when it came to describing the delights of heaven he had an insurmountable task, for the world could offer him no proper material. The fatal assertion of the will to live has produced man’s body and the desire to preserve and perpetuate it. So the assertion of the will is really the assertion of the body. In such assertion, we find the source of all egoism and all wrongdoing, but such selfhood is really an illusion due to a false philosophy in which the individual imagines he lives to himself alone. He is really only a product of the one will to live. Just as a sailor sitting in a boat trusting to his frail barque in a stormy sea, so it is that in the world of sorrows man sits quietly, trusting to the principle of individualisation and separateness, in which he only knows things superficially or as they appear to him, but when he comes to understand that the one will to live exists in all men alike, he realises that the difference between those that inflict suffering and those that bare it is only a perceived difference that is not real.

Eugène_Delacroix La Barque de Dante (1822) d'purb dpurb site web.jpg

« La Barque de Dante » par Eugène Delacroix (1822)

In truth, the evil man is like a wild beast, who frenzied and excited, unintentionally buries its teeth in its own flesh, injuring itself as it tries to injure another. But no matter how veiled and evil man is by illusion, he still feels the sting of conscience, which creates a sense that the gulf which seems to separate him from others isn’t real. As all hatred and wickedness rely upon egoism and as egoism rest on the assertion of the will to live, so do all goodness and virtue spring from the denial of the will to live. The will turns around and no longer asserts itself but denies its own nature instead. Man then denies his own nature as expressed in his body and no longer desires sensual gratification under any condition. Voluntary and complete chastity is the first step in the denial of the will to live. But then the human race would die out, and with it the mind in which the world is reflected, and without a subject of knowledge, there would be no object, there would be no world. To those in whom the will to live has turned and denied itself, this world of ours with all its sun and milky ways is nothing [dead inside].

 

These are some of the ideas and the basic themes presented in Schopenhauer’s “The world as Will and Idea”, a very lengthy work that of course includes many other ideas and elaborations of the ones we have mentioned. But the essence of Schopenhauer’s philosophy can be found in a few basic point.

 

To begin with, he sees the will of man, and specifically the will to survive as the dominant force in the universe and slavery to this will is the root of all evil. Man and all other creatures are subservient to their will to live. In exercising his will, man inflicts all kinds of cruelties and evil. Schopenhauer first examined these cruelties in the world of nature, spending a lot of time on the way in which animals of one species prey on those of another. Then he moved onto man and says, “the chief source of the most serious evils which afflict man is man himself”. Whoever keeps this last fact clearly in view sees the world as a hell which surpasses that of Dante, through the fact that one man must be the devil of another. Schopenhauer uses war and various other cruelties such as industrial exploitation, bravery and social abuses to back up his claim. Schopenhauer had no sympathy for the revolution of his time because he felt the state was justified, exactly because of the cruelty of man. It existed to make the world a little more bearable than it would otherwise be. He did not consider the state government divine, but he considered it necessary [a view he may have been willing to revise had he been alive in 2018 with democracy falling apart and not being properly applied, leading to evil, unethical, unscrupulous and unskilled street politicians getting into positions above their understanding].

Schopenhauer believed we can do something to alleviate suffering but it is pointless to think that we can change the fundamental character of the world or of human life. If war was abolished for instance and if all of men’s material needs were met, they would eventually still resort to conflict – “it is their nature”. He is quick to condemn the optimism or idealism of other philosophers who disregard the dark side of human existence, or who try to justify it as rational. To Schopenhauer these dark aspects of life were not secondary feature, they were the most significant aspects of human life in history. On this basis, he created his theory of The Blind and Striving Impulse, he called the Will. Then, he looked around and found support for his theory in the inorganic, organic and human phenomena of life.

Unquestionably, Schopenhauer held a one-sided vision of the world, but because of its one-sidedness and exaggeration it served as a counterbalance to philosophers like Hegel who focused attention on the glorious triumph of reason throughout history and he tended to dismiss evil and suffering with elaborate, evasive, phrasing. Schopenhauer did offer 2 ways of escape from the slavery to the will. One was the path of contemplation, which is the way of art and the other was the path of asceticism, of renouncing the world in one’s personal desires or will. He did believe that the human mind could develop beyond what was required just to satisfy his physical and material needs, it could develop a surplus of energy over and above what was needed to fulfil its biological function. When that happened, man can use the extra energy to escape the life of desire and striving, of assertion of the ego, of conflict, none of which brings him satisfaction anyway. In transcending the Will through art [expressing it with insight], Schopenhauer was very specific about which art forms served what purpose, and in defining which were superior to others. Not surprisingly, the supreme poetic art is tragedy, for tragedy reveals the real character of human life expressed in dramatic form or as he said the unspeakable pain: the wail of humanity, the triumph of evil, the mocking mastery of chance and the irretrievable fall of the just and innocent. But art and contemplation, besides reflecting on the evil of life, can also open a door that becomes perhaps the only hopeful point in Schopenhauer’s entire book. This door is opened when man can see through the veil of Maya [illusion]. Maya, being the Hindu concept for the illusionary nature of the world and life. It is Maya [illusion] that causes to see separateness and division where there is none, but Schopenhauer also believed that man had the intellectual capacity to develop gradually a site that penetrated Maya, and raised some questions that made even a glimmer of hope seem a little bright. What is the purpose of achieving such virtue? What happens afterward?

To start with, the man who denies the Will treats the world as nothing, for the world is just the appearance of the will, which he denied. So it is true that when the will denies itself, our world with all its sun and Milky ways is nothing as Schopenhauer said, then what happens at death? Schopenhauer is convinced of the finality of death. “Before us”, he says “there is indeed only nothingness”. Death or the withdrawal from the world means the extinction of consciousness, In life, he reduces existence to thin thread, and at death, it is finally destroyed. The man who denies his will to live reaches the final goal, which is to not live. Schopenhauer does leave one last hope beyond the grim disappearance of consciousness and of the world, admitting that it is possible that ultimate reality, which he called the thing in itself may possess attributes that we do not know about and that we cannot know. This reality would not be a state of knowledge since there would not be a subject and an object [that phenomenal and illusionary relationship that is required for knowledge], but it might resemble some experience that cannot be communicated and to which mystics refer to, but only in obscure vague ways. So, in the end like all great philosophers must, Arthur Schopenhauer admitted that he did not have all the answers but he thought he had some, and ultimately it is the questions his answers posed to others that became his most significant contribution, for the role of the philosopher and of philosophy itself is not only to solve our problems, but also to express points of views that stimulate us to further thought and consideration on human nature and the meaning of life, in that, he was incredibly successful.

Schopenhauer sur Le Style

« Style is the physiognomy of the mind. It is a more reliable key to character than the physiognomy of the body. » – Arthur Schopenhauer

­­­

 

Mis à jour le Mercredi, 4 Décembre 2019 | Danny J. D’Purb | DPURB.com

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Essay // Developmental Psychology: The 3 Major Theories of Childhood Development

TheoriesOfDevelopment

Source: An Introduction to Developmental Psychology by Slater & Bremner (Blackwell:Oxford, 2nd Edn, 2011)

THE 3 MAJOR THEORIES OF DEVELOPMENT

In 1984, Nicholas Humphrey described us as “nature’s psychologists’” or homo psychologicus. What he meant was that as intelligent social beings, we tend to use our knowledge of our own thoughts and feelings – “introspection” – as a guide for understanding how others are likely to think, feel and hence, behave. He also argued that we are conscious [i.e. we have self-awareness] precisely because such an attribute is useful in the process of understanding others and having a successful social existence – consciousness is a biological adaptation that enables us to perform introspective psychology. Today, we are confident in the knowledge that the process of understanding others’ thoughts, feelings and behaviour is an ability that develops through childhood and most likely throughout our lives; and according to the greatest child psychologist of all time, Jean Piaget, a crucial phase of this process occurs in middle childhood.

Developmental psychology can be characterised as the field that attempts to understand and explain the changes that happen over time in the thought, behaviour, reasoning and functioning of a person due to biological, individual and environmental influences. Developmental psychologists study children’s development, and the development of human behaviour across the organism’s lifetime from a variety of different perspectives. Hence, if we are studying different areas of development, different theoretical perspectives will be fundamental and may influence the ways psychologists and scholars think about and study development.

Through the systematic collection of knowledge and experiments, we can develop a greater understanding and awareness of ourselves than would otherwise be possible.

 

Focussing on changes with time

The new born infant is a helpless creature, with communications skills that are limited along with few abilities. By 18 – 24 months, the end of the period of infancy – this scenario changes. The child has now formed relationships with others, has gained knowledge about the aspects of the physical world, and is about to undergo a vocabulary explosion as language development leaps ahead. At the time of adolescence, the child has turned into a mature, thinking individual actively striving to come to terms with a fast changing and complex society.

The important contribution to development, is maturation and the changes resulting from experience that intervene between the different ages and stages of childhood: the term maturation refers to those aspects of development that are primarily under genetic control, and which are relatively uninfluenced by the environment. An example would be puberty, and although its onset can be affected by environmental factors such as diet, the changes that occur are genetically determined.

 

Development Observed

The biologist, Charles Darwin, notable for his theory of evolution, made one of the earliest contributions to our understanding of child psychology in his article “A biographical sketch of an infant” (1877), which was based on observations of his own son’s development. By the early 20th century, most of our understanding of psychological development was not based on scientific methodology as much was still based on anecdotes and opinions of qualitative analysis, a method that strict empiricists have never managed to grasp or like. Nevertheless, knowledge was still being organised through both observation and experiment and during the 1920s and 1930s the study of child development started to grow as a movement, particularly in the USA with the founding of Institutes of Child Study or Child Welfare in university centres such as Iowa and Minnesota. Minute observations were made of young children in their developmental phase along with normal and abnormal behaviour and adjustment. In the 1920s Jean Piaget started his long and passionate career in child psychology, blending observation and experiment in his studies of children’s thinking [refer to essay].

The observations carried out in naturalistic settings was soon criticised by the empiricists of the behavioural movement in the 1940s and 1950s [although it continued to be the method of choice in the study of animal behaviour by zoologists]. This led to many psychologist carrying their experiments under laboratory conditions with statistical methods, and such experiments although come with some advantages from the perspective of empirical statistics, they do have limitations and drawbacks [e.g. on measuring qualitative aspects of personality such as emotions, values, etc]. It should be noted that much of the laboratory work on child development from the 1950s and 1960s has been described by Urie Bronfenbrenner (1979) as “the science of the behaviour of children in strange situations with strange adults”.

Schaffer (1996, pp. xiv – xvii) notes other changes in the methods in which psychologists now approach child development, such as the importance in understanding the processes of how children grow and develop rather than simply outcomes, and to integrate findings from a range of sources at different levels of analysis – for example meaningful others, community [geography, socio-linguistics, arts, etc] and culture [religion, nationality(ies), education, class, etc).

In the course of this essay, we will be integrating perspectives to make the most of the findings in distinguishing differences in personality, by reflecting on the links to be made by psychologists between the concept of the child’s “internal working model of relationships” and discoveries about the “theory of mind”.

It is fundamental to acknowledge that psychology itself is mostly based on accurate approximations due to the statistical methods used and the problematic nature of the qualitative variables measured, and not precision. And with this in mind, we should accept the complementary virtues of various different methods of investigation and gain a sense that the child’s process of development and the socio-behavioural context in which they exist are closely intertwined, each having an influence on the other.

 

Defining development according to world views

Intellectuals and researchers who study development also have different views on the topic, that is, the way in which development is defined, and the areas of development that are of interest to individual researchers generally orients them towards specific methodologies and philosophy when studying development.

We are now going to look at the 2 main views in the study of development given by psychologists who hold different views or sometimes combine elements of both, like ourselves, being firmly on the organic perspective of development and construction.

A world view [also known as paradigm, model, or world hypothesis] can be characterised as “a philosophical system of thinking, perceiving and feeling [ideas and more] that serves to organise a set or family of scientific theories and associated scientific methods” (1986, p. 42).

They are beliefs we adopt because it aligns with our values, and these are qualitative and often not open to common reductive empirical tests – that is precisely why we believe them!

Lerner and others note that many developmental theories appear to fall under one or two world views: organismic and mechanistic.

 

Organismic World View

The organismic world view which is the main view that we adopted to be the foundation of the Organic Theory, is one that sees a human being on earth as a biological organism that is inherently active and continually interacting with the environment [all aspects and dimensions], and therefore helping to shape its own development. The organismic worldview emphasises the interaction between maturation and experience that leads to the development of new internal, psychological structures for processing environmental input (e.g. Getsdottir & Lerner, 2008).

As Lerner states: “The Organismic model stresses the integrated structural features of the organism. If the parts making up the whole become reorganised as a consequence of the organism’s active construction of its own functioning, the structure of the organism may take on a new meaning; thus qualitatively distinct principles may be involved in human functioning at different points in life. These distinct, or new, levels of organisation are termed stages…” (p.57). A good analogy would be qualitative changes that take place when the molecules of two gasses hydrogen and oxygen, combine to form a liquid, water. Many other qualitative changes happen to water when it changes from frozen (ice) to liquid (water) to steam (vapour). Depending on the temperature, these qualitative changes in the state of water are easily reversed, BUT in human development the qualitative changes that take place are very rarely, if ever, reversible – that is, each new stage represents an advance on the previous stage, and the organism [human being] does not regress to former stages.

Irreversible

The main argument is that the new stage is not simply reducible to components of the previous stage; it represents new characteristics that were not present in the previous stage.

For example, the organism appears to pass through structural changes during foetal development [See Picture A].

PA Development of the human foetal brain_A_v2.jpg

PICTURE A. Development of the human foetal brain / Source: Adapted from J.H.Martin (2003), Neuroanatomy Text and Atlas (3rd ed., p.51). Stamford, CT:Appleton & Lange.

In the initial stage [Period of the Ovumfirst few weeks after conception] cells multiply and form clusters; in the second stage [Period of the Embryo – 2 – 8 weeks] the major body parts are formed by cell multiplication, specialisation and migration as well as cell death; in the last stage [Period of the Foetus] the body parts mature and begin to operate as an integrated system [e.g. head orientation towards and away from stimulation, arm extensions and grasping, thumb sucking, startles to loud noises, and so on (Fifer, 2010; Hepper, 2007)]. It is important to understand that similar stages of psychological development are postulated to happen after birth also, and the individual from one stage to another is different with new abilities that cannot be reversed.

Jean Piaget is perhaps the greatest and best example of a successful organismic theorist. Piaget suggested that cognitive development occurs in stages and that the reasoning of the child at one stage is qualitatively different from that of the earlier or later stages.

Partir en Livre Bibliothèque nationale de France dpurb d'purb site web

Image: Bibliothèque Nationale de France

The main job of the developmental psychologist who believes in the organismic worldview [like ourselves] is to determine when [i.e., at what age?] different psychological stages operate and what variables and processes represent the different between stages and determine the transition between them.

 

Mechanistic World View

From the mechanistic world view, it is assumed that a person can be broken down into components and can be represented as being like a machine [such as a computer], which is inherently passive until stimulated by the environment [this view seems to be more in line with the early British thinkers about the brain]. Human behaviour is reducible to the operation of fundamental behavioural units [e.g. habits] that are acquired in a progressive, cumulative manner. The mechanistic view assumes that the frequency of behaviours can increase with age due to various learning processes and they can decrease with age when they no longer have any functional consequence, or lead to negative consequences [such as punishment]. The developmental psychologists job here is to study environmental factors, or principles of learning, which determine the way organisms respond to stimulation, and which results in increases, decreases, and changes in behaviour.

Quite unlike the organismic world view, the mechanistic world view sees development as reflected by a more continuous growth function, rather than occurring in qualitatively different stages, and the child is believed to be passive rather than active in shaping its own development and its environment. This mechanistic view is generally embraced by behaviourists and cognitive-behaviourists who function on a reductionist philosophy based on the limitations of the scientific method when faced with understanding psychology and the mechanism of mind; instead they tend to focus on measurable behaviour and treat the brain as an information processing centre with a highly similar logic to a computer. The mechanistic view while being fairly grotesque due to its reductionist values, has revealed to be very practical in the study of human-machine interaction and along with new cognitive methods, it has helped to enhance the design of technological equipment to improve human experience in a wide range of areas.

As for us, we are mostly on the perspective of the organismic school of thought but refuse to completely dismiss all the mechanistic world view’s elements, because some of it can be embedded as secondary cognitive processes carried out by the conscious or preconscious areas of the mind when appraising stimuli from an organism’s environment. Hence, some elements can be embedded in understanding interaction with basic objects and elements of an organism’s “external” [not internal] environment, but to fully base our thoughts and behaviour on a mechanistic world view would arguably be irrationally reductionist.

 

Theories of Development

 

“Es gibt nichts Praktischeres al seine gute Theorie.”

–Emmanuel Kant (1724 – 1804)

 

“There is nothing so practical as a good theory.”

-Kurt Lewin (1944, p. 195)

 

Human development is complex and it would be irrational to expect a single universal theory of development that could do justice to this complexity, and indeed no theory of development attempts to do so. Each theory attempts to account for only a limited range of development and it is often the case that within each area of development there are competing theoretical views, each attempting to account for the same aspects of development. We shall see below some of this complexity and conflict in our account of different theoretical views.

First of all, it would be helpful to understand what is implied by a “Theory” in the field of developmental psychology. A theory of development is a scheme or system of ideas that is generally based on evidence and attempts to explain, describe and predict behaviour and development. So, from this account, it is quite clear that a theory aims to bring order to what might otherwise be a chaotic mass of information – and hence why there may indeed not be anything more practical than a good theory.

We usually deal with at least 2 kinds of theory in every area of development, we have the minor theories [that are generally concerned with very specific and narrow areas of development such as eye movements, the origins of pointing and so on], and we have the major theories which are the ones we are primarily interested in as they attempt to explain large areas of development.

They have been divided in 3 groups for the purpose of this essay, with cognition, emotion and motivation in focus:

(I) The Theory of Cognitive Development of Jean Piaget


(II) The Theory of Attachment in Emotional Development by John Bowlby


(III) The Genetic/Psychosexual Model of Development by Sigmund Freud

 

__________

 

(I) The Theory of Cognitive Development (Jean Piaget)

The theory of cognitive development we are interested in is that of Jean Piaget who saw children as active agents in shaping their own development,  and not simply blank slates who passively and unthinkingly responds to whatever the environment throws at them or treats them to [an assumption that is insulting to human intelligence, hence why we do not subscribe blindly to the passive school of thought but only consider some elements related to very basic cognitive processes].

This suggests that children’s behaviour and development is motivated largely intrinsically (internally) rather than extrinsically (externally).

For Piaget and intellectuals with a firm belief in the mind as an active entity, children learn to adapt to their environment and as a result of their cognitive adaptations they are now better able to understand their world. Adaptation is an act that all living organisms have evolved to do and as children adapt, they also gradually construct more advanced understanding [internal working models] of their worlds.

(1919) Jaroslava &amp; Jiri by Alphonse Mucha (1860 - 1939)

(1919) Jaroslava & Jiri, The Artist’s Children by Alphonse Mucha (1860 – 1939)

These more advanced understanding of the world reflect themselves in the appearance of new stages of development. Piaget’s theory is the best and most accomplished example of the organismic world view, and it portrays children as inherently active, continually interacting with various dimensions of their environments, in such a way as to shape their own development.

With this assumption in mind, Piaget’s theory is also often referred to the Constructivist Theory.

[IMPORTANT NOTE: For a detailed account of Jean Piaget’s Theory of Cognitive Development, please read the essay…]

 

__________

 

(II) The Theory of Attachment in Emotional Development (John Bowlby)

If we pick up a new born baby , he/she will respond without any difference to us or to any other person. However, after 9 months, the same baby will have developed one or more selective attachments and will discriminate familiar faces to unfamiliar ones. So, if we were to pick up the baby again, we may face scenarios where he/she displays anxiety or cries, but if the mother or father picks her/him up, the baby will be reassured and pacified.

This section will explore and give an account of the development of attachment relationships between infants, parents, and other close primary caregivers. The significance of such attachments for development in adult life will also be considered, with its implication for the philosophy of education in sculpting the minds of tomorrow, along with some research on parenting styles analysing some of the factors affecting successful and less successful parenting.

 

The Development of Attachment Relationships: Attachment as an innate drive

The infant’s expression of emotions and the caregiver’s response to these emotions is the fundamental foundation of John Bowlby’s Theory of Attachment. Bowlby’s (1958, 1969 / 1982, 1973, 1980) theory was inspired and influenced by an exciting and creative range of disciplines including psychoanalysis, ethology and the biological sciences. Before Bowlby, the main assumption and view of the infant-mother attachment was that it was a “secondary drive” or a side-product of the infant associating the mother with the provision of physiological needs, such as hunger [Picture B – breast feeding image].

Breastfeeding Mother

PICTURE B. Early theories of infant-mother attachment suggested that it was a secondary drive resulting from the mother satisfying the infant’s primary drives, such as hunger. / Photography:  Jo Frances

Bowlby defied this logic, and argued convincingly that attachment was an innate primary drive in all infants, and while his theory went through many revisions over the years, this argument remained fundamental.

In Bowlby’s first version of his theory of attachment (Bowlby, 1958), the emphasis was on the role of behaviours resulting from our instincts [on how behaviours such as crying, clinging and smiling served the purpose of eliciting a reciprocal attachment response from the caregiver]:

There matures in the early months of life of the human infant a complex and nicely balanced equipment of instinctual responses, the function of which is to ensure that he obtains parental care sufficient for his survival. To this end the equipment includes responses which promote his close proximity to a parent and… evoke parental activity.

(Bowlby, 1958, p. 346)

However, in the 1969 version of his theory (1st volume of his trilogy, Attachment and Loss),  Bowlby focussed on highlighting the dynamics of attachment behaviour, and switched to explaining the infant-mother tie in terms of a goal-corrected system which was triggered by environmental cues rather than innate instinctual behaviours. Whether attachment is instinctual or goal-corrected, we know that it eventually leads to the infant maintaining proximity to the primary caregiver.

Bowlby acknowledged that the development of an attachment relationship was not dependent purely upon the social and emotional interplay between infant and caregiver. Since we can only observe attachment behaviour primarily when the infant is separated from the caregiver, it is logically dependent upon the infant’s level of cognitive development in the ability for object permanence [i.e. the ability to represent an object (living or non-living) that is not physically present within the child’s proximity].

This seems to synchronise partly with Piaget’s outlook and theory of cognitive development, and indeed Bowlby was inspired by Jean Piaget, and based his argument on Piaget’s (1955) contention that this level of object permanence is not attained until the infant is approximately 8 months old. Furthermore, while children would be able to recognise familiar people before such age, they would still not miss the attachment figure and thus display attachment behaviour until they have reached the level of cognitive sophistication that comes with the ability to represent absent objects [and people, who are in the same class].

 

The Phases of Attachment: Development of Attachment Relationships

Let us imagine a classic example of a mother and child [about 1 – 2 year-old] in a park. What we might observe is that the mother is seated on a bench while the infant runs off to explore the area. Periodically, the child may be seen to stop and look back at the mother, and every once in a while may even return close to her, or make physical contact, staying close for a while before venturing off again. In most cases, the infant rarely goes beyond about 60 metres from the mother or primary caregiver, who may however have to go and retrieve the child if the distance gets too great or if the need to leave is imminent.

The scenario here from a developmental psychologist’s perspective is fairly simple; the infant is exploring the environment it is being exposed to inquisitively, and is using the mother as a “secure base” to which to return periodically for reassurance. This is one of the hallmarks of an “attachment relationship”. These observations of children in parks were made by a student of John Bowlby, Anderson (1972) in London, and the development of attachment has been described in detail by John Bowlby (1969).

Bowlby (1969, p. 79) described 4 phases in the development of attachment and subsequently extended it to a 5th.

The phases are:

I. The pre-attachment phase (0 – 2 months) is characterised by the infant showing hardly any differentiation in their responses to familiar or unfamiliar faces.

II. During the second phase (2 – 7 months), the foundations of attachment are being laid. Here infants start to recognise their caregivers, even if they still do not possess the ability to show attachment behaviours upon separation. The infant is also more likely to smile at the mother or important caregivers and to be comforted by them if distressed.

bebe-mange-puree-de-fruits.jpg

III. Clear cut attachment behaviours only start to appear after 7 months. At this phase, infants start to protest at being separated from their caregivers and become very wary of strangers [so called stranger anxiety] – this is often taken as a definition of attachment to caregiver and this onset of attachment happens from 7 – 9 months.

IV. When the attachment relationship has evolved into a goal-corrected partnership (from around 24 months / 2 years of age), [i.e. when the child also begins to accommodate to the mother’s needs, e.g. being prepared to wait alone if requested until the mother returns]. This is an important change because before this phase, the infant only saw the mother as a resource that had to be available when needed. Bowlby saw this as characterising the child at 3 years of age, although as mentioned from 2 years old babies can partly accommodate to verbal requests by mothers to await for her return (Weinraub and Lewis, 1977). From this phase onwards, the child relies on representation or internal working models of attachment relationships to guide their future social interactions.

V. The lessening of attachment is noticed as measured by the child maintaining proximity. The characteristics of a school-age child, and older, is the idea of a relationship based more on abstract considerations such as affection, trust, loyalty and approval, exemplified by an internal working model of the relationship.

Bowlby viewed attachment as a canalized developmental process where both the mainly instinctive repertoire of the new born and certain forms of learning are important in early social interactions. Certain aspects of cognitive sensori-motor development [as supported by Jean Piaget] are also fundamental for attachment. Until the developing infant can master the concept of cause-effect relations, and of the continued existence of objects [incl. persons] when out of sight, he or she cannot protest at separation and attempt to maintain proximity [note the importance of object permanence in emotional development and internal working models]. Hence, sensori-motor development is also a canalised process, and it should not be in opposition to an ethological and a cognitive-learning approach to attachment development.

 

Attachments: Between whom?

Many articles and textbooks have characterised the attachment relationship as mainly focussed on the mother (e.g. Sylvia and Lunt, 1981), and this may not be completely true, since many studies have suggested that early attachments are usually multiple, and although the strongest attachment is often to the mother, this need not always be so.

In a study conducted in Scotland, mothers were interviewed and asked to whom their toddlers showed separation protest (Schaffer and Emerson, 1964), the proportion of babies with more than 1 attachment figure increased from 29% when separation protest first appeared [about 7 – 9 months] to 87% at 18 months [1 and half year old]. It was also found that for about one third of babies, the strongest attachment seemed to be to someone other than the mother, such as father, or other trusted primary caregivers. In most cases, attachment were formed to responsive persons who interacted and played a lot with the infant; basic caregiving such as nappy changing was clearly not in itself such an important factor; and similar results were obtained by Cohen and Campos (1974).

UglyLeeches

Peinture: Sandrine Arbon

Studies in other cultures also support this conclusion, for example in the Israeli kibbutzim, young children spend the majority of their waking hours in small communal nurseries, in the charge of a nurse or metapelet. In a study of 1- and 2- year-olds reared in this way, it was found that the infants were very strongly attached to both the mother, and the metapelet; either could serve as a base for exploration, and provide reassurance when the infant felt insecure (Fox, 1977). In many agricultural societies, mothers tend to work in the fields, and often leave infants in the village, in the care of grandparents, or older siblings, returning periodically to breastfeed. In a survey of 186 non-industrial societies, it was found that the mother was rated as the “almost exclusive” caretaker in infancy in only 5 of them; hence other persons had important caregiving roles in 40% of societies during the infancy period, and in 80% of societies during early childhood (Weisner and Gallimore, 1977).

 

The Security of Attachment

Early infant-caregiver attachment relationships and the internal working models are the main aspects of Bowlby’s theory of attachment and have been given the greatest attention, with researchers developing 2 of the most widely used measuring instruments in developmental psychology to investigate Bowlby’s theoretical claims: the strange situation procedure to assess the goal-corrected system that evolved from the early attachment relationship, and the Adult Attachment Interview to assess internal working models.

Bowlby’s theory was focussed and interested with the making and breaking of attachment ties, probably because his experiences of working as a child psychologist exposed him to the negative consequences for emotional development of severe maternal deprivation [such as long term separation or being orphaned].

Nowadays, researchers and intellectuals are generally less concerned with whether a child has formed an attachment [since any child who experiences any degree of continuous care will become attached to the caregiver], but are rather more interested in the quality or security of the attachment relationship. This important shift in emphasis was due to the empirical work of Mary Ainsworth.

Ainsworth interest in the concept of attachment grew after working with Bowlby in London during the 1950s. Later, she moved to Uganda to live with the Ganda people where she made systematic observations of infant-mother interactions in order to investigate Bowlby’s goal-corrected attachment systems in action.

One factor that struck Mary Ainsworth (1963; 1967), was the lack of uniformity in infant’s attachment behaviour, in terms of its frequency, strength, and degree of organisation. Furthermore, these differences were not specific to Gandan infants, since she replicated these findings in a sample of children in the USA when she moved to Baltimore. These variations in attachment type had not been accounted for by John Bowlby’s Theory and hence, this led Ainsworth to investigate the question of individual differences in attachment.

Mary Ainsworth experience of working with Bowlby, along with her rich collection of data harvested over a period of many years, put her in a unique position in the development of attachment as an empirical field of research. Her contribution led to attachment issues becoming part of mainstream developmental psychology, rather than being simply confined to child psychiatry, and behind this achievement was an investigation of the development of attachment under normal family conditions and by developing a quick and effective way of assessing attachment patterns in the developmental laboratory.

Although the strange situation procedure (Ainsworth & Wittig, 1969) circumvented [found a way around] the need for researchers to conduct lengthy observations in the home, it was not developed simply for research convenience, but because there are problems in trying to evaluate attachment type in the child’s own home environment. For example, if a child becomes extremely distressed upon the mother moving to another room in their own home environment, this may be an indication of a less than optimal attachment achieved, because if a child feels secure then such a separation should not trigger any distress. The extensive experience of Ainsworth in observing infant-mother interactions enabled her to identify the situations that we most crucial in attachment terms, and therefore formed the basis of the strange situation procedure.

 

The Strange Situation Procedure

Ainsworth and her colleagues then developed a method for assessing the attachment strength of an individual infant towards her mother or caregiver (Ainsworth et al., 1978). The method is known as the Strange Situation, and has been widely used with 12 – 24 months old infants in many countries worldwide. To sum up, it is a method for checking in a standardised way, how well the infant uses the caregiver as a secure base for exploration, and is comforted by the caregiver after a lightly stressful experience.

The strange situation assesses infants’ responses to separations from and subsequent reunions with, the caregiver [mother here], and their reactions to an unfamiliar woman [the so-called “stranger”]. In the testing room, there are only 2 chairs [one for the mother and one for the stranger] and a range of toys with which the infant can play.

TA - The Strange Situation Procedure

Table A. The Strange Situation Procedure

As Table A shows, the episodes are ordered so that the infant’s attention should shift from the exploration of the environment to attachment behaviour towards the caregiver as the Strange Situation proceeds. The most crucial points are the infant’s responses to the 2 reunion episodes, and form the basis for assessing an infant’s security of attachment. The coding scheme for security attachment was developed by Ainsworth et al. (1978) and describes infant behaviour according to 4 indices:

1) Proximity-seeking
2) Contact-maintenance
3) Resistance
4) Avoidance

Referring to Table A, in a well-functioning attachment relationship, it would generally assumed that the infant would use the mother as a base to explore [Episodes 2, 3 and the end of Episode 5], but be stressed by the mother’s absence (Episodes 4, 6 and 7;  these episodes are cancelled if the infant is overly distressed or the mother wants to return sooner]. Special attention is also given to the infant’s behaviour in the reunion episodes (5 and 8), to see if her or she is effectively comforted by the mother. Based on those measures, Ainsworth and others distinguished a number of different attachment types.

The 4 primary ones are:

Type A – Insecure Avoidant Attachment

Insecure-Avoidant (Type A) infants display high levels of environment-directed behaviour to the detriment of attachment behaviour towards the caregiver [i.e. Avoidant (A) – avoids caregiver and explores environment]. The Insecure Avoidant Types display little if any proximity-seeking behaviour, and even tend to avoid the caregiver, by averting gaze or turning or moving away, if the caregiver attempts to make contact. Throughout the whole process of the Strange Situation, Insecure Avoidant infants appear completely indifferent toward the caregiver, and treat both the latter and the stranger is very similar ways; hence, these infants may show less avoidance of the stranger than of the caregiver.

Note that conversely, the (Type C) Insecure Resistant / Ambivalent Attached infants show high levels of environmental-directed behaviour to the detriment of the caregiver [the complete opposite to Type A].

Type B – Secure Attachment

When the dynamics of the attachment relationship is a balance between environmental exploration and attachment behaviour directed towards the caregiver [See PICTURE C], then the securely attached infants are considered as having the right balance.

PC Attachment as a balance of behaviour TA

PICTURE C. Attachment as a balance of behaviour directed toward mother and the environment. Source: Adapted from Meins (1997).

 

The presence of the caregiver in the pre-separation episodes affords them the security to turn their attention to exploration and play, with the confident knowledge that the caregiver will be available for comfort or support should it be required. However, attachment behaviour is triggered in securely-attached infants during the separation episodes, leading to seek contact, comfort, proximity or interaction with the caregiver when they return. Securely attached infants may or may not become distressed upon separation from caregivers, and this makes the infants’ response to separation a relatively unreliable and poor indicator of attachment security. However, regardless of their response to separation, securely attached children are marked by their positive and quick response to the caregiver’s return, displayed generally by their readiness to approach, greet and interact with the caregiver.

It important to note that Type B [Secure] Attachment is the only “secure” attachment in the group, all the rest are insecure attachment types, and in contrast to Type B, they have their balance of infant attachment tipped to either extreme [i.e. Avoidant (A) – avoids caregiver and explores environment / Resistant (C) – avoids environment and exhausts caregiver]

Type C- Insecure Resistance / Ambivalent

Insecure-resistant infants are over-involved with [to the point of exhausting] the caregiver, showing attachment behaviour even during the pre-separation episodes, with little or no interest in exploring the environment. The Insecure Resistant (Type C) infants tend to become extremely distressed upon separation, however, the over-activation of their attachment system hampers their ability to be comforted by the caregiver upon reunion – this leads to angry or petulant behaviour, with the infant resisting contact with and from the caregiver [in extreme cases this manifests itself as tantrum behaviour where the caregiver may sometimes be hit or kicked by the infant].

Type D – Insecure Disorganised

Besides the original 3 categories mentioned above distinguished by Ainsworth et al. (1978), Main and Solomon (1986, 1990) established a fourth category, Type D [Insecure Disorganised Attachment] for infants whose behaviours appeared not to match any of the A [Avoidant], B [Secure] and C [Resistant/Ambivalent] categories. These insecure-disorganised infants look disoriented during the strange situation procedure, and display no clear strategy for coping with separations from and reunion with their caregivers. Infants classified as insecure-disorganised may simultaneously display contradictory behaviour during the reunion episodes, such as seeking proximity while also displaying obvious avoidance [e.g. backing to which the caregiver or approaching with head sharply averted]. Insecure-disorganised infants (Type D) may also react to reunion with fearful, stereotypical or odd behaviours [e.g. rocking themselves, ear pulling, or freezing]. Main and Hesse (1990) argued that, although the classification criteria for insecure-disorganised attachment are diverse, the characteristic disorganised behaviours all include a lack of coherence in the infant’s response to attachment distress and betray the “contradiction or inhibition of action as it is being undertaken” (p.173).

Main and her colleagues (1985) believe the Type D [Insecure-disorganised ] is a useful extension of the original Ainsworth classification.

There are many subtypes of these main types, however most studies do not refer to them, and in older studies, type D babies [who are often difficult to classify as they do not show a clear pattern] were ‘forced’ into 3-way and 4-way classifications.

In most cases, type B babies (secure – considered as most desired, i.e. “normal” / although debated] are compared with types A and C [inscure-avoidant and insecure-resistant/ambivalent], and the type B [secure-attachment] tends to be seen as developmentally normal, or advantageous. Many criticisms have been made of the attachment typing resulting from the Strange Situation procedure (Lamb et al., 1984), particularly of the earlier work that was based on small samples, and of the normative assumption that “B is best”. They also pointed out the procedure only measures the relationship between mother and infant, and not the characteristics of the infant. Since attachment security is the dyadic measure, infant-mother attachment type is not necessarily the same as infant-father attachment type. In fact, many studies have found that the attachment type to father is not related to that with the mother; meta-analyses (Fox et al., 1991; van Ijzendoorn and De Wolff, 1997) found a very modest association between the two.

However, the strange situation procedure is today a commonly and internationally used technique. One of the most important test of utility of attachment types is that it should allow us to predict other aspects of development, and we now have considerable evidence for this (see Bretherton and Waters, 1985 and Waters et al., 1995, for reviews).

Kochanska (2001) followed infants longitudinally from 9 to 33 months and observe their emotions in standard laboratory episodes designed to elicit fear, anger or joy. Over time, type A (Avoidant – towards caregiver) infants became more fearful, type C (Resistant/Ambivalent – exhausts caregiver) infants became less joyful, type D (Disorganised – does not fit in A, B or C behavioural categories) infants became more angry; whereas type B (Secure) infants showed less fear, anger or distress. Using the strange situation procedure, secure attachment to mother at 12 months has been found to predict curiosity and problem solving at age 2, social confidence at nursery school at age 3, and empathy and independence at age 5 (Oppenheim et al., 1988), and a lack of behaviour problems (in boys) at age 6 (Lewis et al., 1984).

Is the Strange Situation valid across populations worldwide?

Van Ijzendoorn and Kroonenberg (1988) provided a cross-cultural comparison of strange situation studies in a variety of different countries. In American studies, some 70% of infants were classified as securely attached to their mothers (type B), some 20% as Type A, and some 10% as Type C. However, German investigators found that some 40-50% of infants were of Type A (Grossman et al., 1981), while a Japanese study found 35% to be of Type C (Miyake et al., 1985). These percentages do raise the question about the nature of “insecure attachment”: is it a less satisfactory mode of development or are these just different styles of interaction?

Takahashi (1990) argued that the Strange Situation must be interpreted carefully when it is applied across cultures. He found that Japanese were excessively distressed by infant alone episode (episode 6 – Table A), because generally in Japanese culture babies are never left alone at 12 months. This is the reason why fewer Japanese babies scored B (Secure). It is also important to note, that there was no chance for them to show avoidance (and score A – insecure avoidant), since the mother seeing the level of distress went straight on without hesitation to pick up the baby. This may also be possible explanation as to why many Japanese babies were C (Insecure Resistant/Ambivalent) at 12 months [still they are not at 24 months, nor are adverse consequences apparent]. This distortion can be avoided by virtually omitting episode 6 (see Table A) for such babies. Rothbaum et al. (2000) do take a more radical stance, in comparing the assessment security in the USA and Japan. They argue that these two cultures put different cultural values on constructs such as independence, autonomy, social competence and sensitivity; such that some fundamental tenets of attachment theory are called into question as cross-cultural universals.

Cole (1998) suggested that we need information of the geographical trends in socio-behavioural patterns [culture, heritage, language, arts, etc] under study if we are to understand the nature of the everyday interactions that shape the development of young children in relation to their caregivers. The strange situation may be a valid indicator but we at least need to redefine the meaning of the categories “avoidant, secure and resistant / ambivalent” according to the geographical socio-behavioural patterns [culture]. He also argued that although it is a standardised test, strange situation is really a different situation in different environmental circumstances. However for successful use of the strange situation in a non-western culture [one that is not of Western European heritage], we can take a look at the Dogon people of Mali.

Infant-mother attachment among the Dogon of Mali

The study we are about to discuss is a very rare one among its kind which took place among the Dogon people of Eastern Mali, a primarily agrarian people living by subsistence farming of millet and other crops, as well as cash economy in towns [see PICTURE D].

PD - Dogon mother spinning cotton with child on her lap

PICTURE D. Dogon mother spinning cotton with child on her lap

The study was carried out in 2 villages with a total population of about 400, and one town population of 9000, with the researchers attempting to get a complete coverage of infants born between mid-July and mid-September 1989. Not all infants could take part, due to relocation or refusal, and the researchers excluded 2 infants who had birth defects, and 8 suffering from severe malnutrition. In addition, after recruitment two infants die before or during the two-month testing period. Finally, 42 mother-infant pairs took part and provide a good quality data. The infants were 10 to 12 months old at the time of testing.

The Dogon are a polyamorous society, and mothers typically live in a compound with an open courtyard, often shared with co-wives. There was some degree of shared care of infants, about one half were cared for primarily or exclusively by the mother, about one third primarily by the maternal grandmother with a mother however being responsible for breastfeeding (see PICTURE E).

PE - Dogon mother breastfeeding her child

PICTURE E. Dogon mother breastfeeding her child.

Breastfeeding is a normative response by the mother to signs of distress in in the Dogon infants. Three related features of infant care in the Dogon – frequent breastfeeding on demand, quick response to infant distress, and constant proximity to the mother or caregiver – are seen as adaptive and there is high infant mortality [as in some other traditional African cultures].

The researchers have several objectives in mind, they wish to see if the strange situation could be used successfully in Dogon culture; one distribution of attachment types was obtained; whether infant security correlated with maternal sensitivity – a test of the Maternal Sensitivity Hypothesis; whether infant attachment type related to patterns of attachment-related communications in mother-infant interaction – the test of what the authors call the Communication Hypothesis; and to see if frightened or frightening behaviour by the mother predicted disorganised infant attachment.

Three situations were used to obtain relevant data, the behaviour being recorded on videotape in each case. One was rather new – the Weigh-In, part of the regular well-infant examination, in which the mother handed over the infant to be weighed on a scale – and mildly stressful separation for the in, especially in Dogon culture. The other two were more standard – the strange situation, carried out in an area of courtyard separated off by hanging mats; and two 15 minute observations in the infant’s home, and the mother was cooking, bathing/caring for the infant.

The following data were obtained:

  • Infant attachment classification (from the strange situation)
  • A rating of infant security on a 9-point scale (from the strange situation)
  • Mother and infant communication related to attachment, coded by 5-point Communications Violations Rating scales (from the Weigh-in)
  • Maternal sensitivity, rated in terms of promptness, appropriateness and completeness of response to infant signals (from the home observations)
  • Frightened or frightening behaviours by the mother, such as aggressive approach, disorientation, trance state, rough handling as if baby is an object, on a 5-point scale (from the home observations and the Weigh-In).

[REMEMBER!!!! [although we are quite sure you know this already] : “r” is known as the correlation coefficient and tells us 2 things: (i) Direction of Relationship + or – & (ii) Strength of Relationship : +or- .1 is a small effect / +or- .3 is a medium effect / +or- .5 is a large effect | and p-value is the critical decider of whether to reject Null Hypothesis( i.e. the scenario we rightly thought would be opposite to our predictions) if p small enough (if p < .05 we say results were statistically significant, if p < .01 we say it is HIGHLY statistically significant) we reject the Null Hypothesis [both cases].

The strange situation was found to be feasible, following quite standard procedures. The distribution of attachment types was 67% B (Secure), 0% A (Avoidant), 8% C (Resistant/Ambivalent), and 25% D (or on a forced 3-way classification, 87% B, 0% A and 13% C). This is quite unusual in having no avoidant (A) classifications; D is high but not significantly greater than Western norms.

The Maternal Sensitivity Hypothesis only received weak support. The correlation between infant security and maternal sensitivity was r = 0.28, and with p < .10; the difference in means between attachment classifications was not statistically significant (B=5.26, C=5.00, D=4.20).

The Communications Hypothesis did get support. Infant security correlated -.54 with Communications Violations (p < .001), and the attachment classifications differed significantly (B=2.66, C = 3.50, D = 3.89; p < .01).

Finally, frightened or frightening behaviour by the mother correlated r = -.40 (p < .01) with infant security, and was particularly high in children with disorganised attachment (B= 1.23, C = 1.33, D = 2.35; p < .01).

Besides demonstrating the general application of the strange situation procedure in a nonwestern group with socio-behavioural patterns very different to our own, the findings provides support for the Communication Hypothesis. The case here would have been stronger if the different kinds of communication patterns for each attachment classification had been described in more detail. For example, that insecure resistant / ambivalent (C) attachment type infants would be inconsistent and often unable to convey their intent, or to terminate their own or another’s arousal, whereas insecure disorganised (D) attachment type infants would “manifest contextually irrational behaviours and dysfluent communication” (p. 1451). As it is, the main findings show that insecure infants show more communications violations, do not describe the detailed typology. Indeed, since some of the Communications Violations rating scales were of “avoidance, resistance and disorganisation” (p. 1456), there is a possible danger of conceptual overlap between this scale and the attachment classifications.

Although support for the Maternal Sensitivity Hypothesis was we, the correlation of r = .28 is in line with the average of r = .24 found in the meta-analysis by De Wolff and Van Ijzendoorn (1997) on mainly Western samples. The researchers used a multiple regression analysis to examine the contributions of both maternal sensitivity and mothers frightened/frightening behaviour, to attachment security. They found that the contribution of maternal sensitivity remain modest, whereas the contribution of mothers frightened/frightening behaviour was substantial and significant; ratings of maternal sensitivity do not normally take account of mothers frightened/frightening behaviour, and the researchers suggest that this might explain the modest effects found for maternal sensitivity to date.

The absence of avoidant (A – avoids caregiver and favours exploration) type infants is interesting and the researchers argue that, given the close contact mothers maintained with the Dogon infants, and the normal use of breastfeeding as a comforting activity, it would be very difficult for it Dogon infant to develop an avoidant strategy [this may have some similarity with the low proportion of A-type in Japanese infants). If avoidant (A) attachment is a rare or absent when infants nursed on demand (which probably characterises much of human evolution), this might suggest that A type attachment was and is a rare except in Western samples in which infants tend to be fed on schedule, and often by bottle rather than breast, so that the attachment and feeding systems are effectively separated.

Most Dogon infants showed secure (B) attachment, but 25% scored as disorganised (D) [though mostly with secure as the forced 3-way classification]. The researchers comment that the frightened or frightening behaviours were mild to moderate, and did not constitute physical abuse. But why should mothers show these sorts of behaviour at all? An intriguing possibility is that it is related to the high level of infant mortality prevalent in the Dogon. About one third of infants died before five years of age, and most mothers will have experience in early bereavement. Unresolved loss experienced by a mother is hypothesised to disorganised (D) attachment; perhaps, frightened behaviours are more rational or expected, when the risk for infants are so much higher.

This study to great efforts to be sensitive to the geographically specific socio-behavioural patterns (culture) of the venue, when using procedures and instruments derive mainly from Western samples. A Malian researcher assisted in developing the maternal sensitivity coding, and Dogon women acted as strangers in the strange situation procedure. The Weigh-In and home observations were natural settings. The authors comment, however, that future work might make more effort to tap the perceptions of mothering and attachment held by the Dogon people themselves, in addition to the constructs coming from Western psychology.

(True, M. M., et al, 2001)

 

Back Home in the West: Why do infants develop certain attachment types?

Enfant en train de lire

Individual differences in the caregiver’s sensitivity to infant’s cues were the earliest reported predictors of attachment security. Ainsworth and colleagues (Ainsworth, Bell & Stayton, 1971, 1974; Ainsworth et al., 1978) found that mothers who responded most sensitively to their infants’ cues during the first year of life tended subsequently to have securely attached infants. The insecure-avoidant (Type A) pattern of attachment was associated with mothers who tended to reject or ignore their infants’ cues, and inconsistent patterns of mothering were related insecure-resistant/ambivalent (Type C) pattern of attachment. Although further research has largely supported this link between early caregiver sensitivity and later attachment security, the strength of the relation between these factors has not been replicated. For example, De Wolff and van Ijzendoorn (1997) conducted a meta-analysis to explore the parental antecedents of attachment security using data from 21 studies involving over 1000 infant-mother says, and reported a moderate effect size for the relation between sensitivity and attachment security (r = 0.24), compared with the large effect (r = 0.85) in Ainsworth et al.’s (1978) study. This led De Wolff and van Ijzendoorn to come to the conclusion that “sensitivity cannot be considered to be the exclusive and most important factor in the development of attachment” (p. 585).

It seemed that the construct of sensitivity might have been responsible for the result, so we return to Ainsworth et al.’s (1971, 1974) original definitions in order to have a better understanding of predictors of attachment security. In this research, we were particularly influenced by Ainsworth’s focus on the caregiver’s ability not merely to respond to the infant, but to respond in a way that was consistent with the infants cue. For example, Ainsworth et al., (1971) describe how mothers of securely attached infants appeared “capable of perceiving things from the child’s point of view” (p. 43), whereas maternal insensitivity involve the mother attempting to “socialise with the baby when he is hungry, play with him when he is tired, and feed him when he is trying to initiate social interaction” (Ainsworth et al., 1974, p. 129). Meins et al. (2001) verse argued that the critical aspect of sensitivity was the caregiver’s ability to “read” the infant’s signals accurately so that the response could be matched to this passive cue from the child.

baby-bebe-d'purb dpurb site web.jpg

In order to test this proposal, Meins et al. (2001) obtain measures of mothers’ ability to read their 6-month-olds’ signals appropriately (so called mind-mindedness), and investigated the comparative strength of mind-mindedness versus general maternal sensitivity in predicting subsequent infant-mother attachment security. Meins et al. reported that maternal mind-mindedness was a better predictor of attachment security 6 months later than was maternal sensitivity, with mind-mindedness accounting for almost twice the variance in attachment security than that accounted for by sensitivity.

This seems like a strong conclusion, since the genetic factors have been accounted for and do not contribute to attachment type as van Ijzendoorn et al. (2000) argued that it has a modest if any influence on attachment type. This can be confirmed from a twin study conducted by O’Connor and Croft (2001) when they assessed 110 twin pairs in the strange situation and found concordance of 70% in monozygotic twins and 64% in dizygotic twins – not significantly different. The model suggested estimates of only 14% of variance in attachment type due to genetics, 32% to shared environment, and 53% in non-shared environment.

A study of attachments formed by babies to foster mothers (Dozier et al., 2001) found as good a concordance between mothers’ attachment state of mind (from the Adult Attachment Interview, see below) and infant attachment type from the strange situation, as for biological mother-infant pairs, once again suggesting little genetic influence on attachment type.

So, it is fairly accepted today that mothers’ mind-mindedness is an important construct and it is defined as the mother treating her infant as an individual with a mind, instead of just an organism or small creature with needs to be satisfied. The emphasis should be on responding to the infant’s inferred state of mind, rather than simply their behaviour. In a longitudinal study of 71 mother-infant pairs, they found that maternal sensitivity (responding to infant cues) and some aspects of mind-mindedness, especially appropriate mind-related comments by the mother, measured at six months, both independently predicted security of attachment at 12 months. True et al., (2001) also found evidence that mothers’ frightened or frightening behaviour may also contribute independently to attachment security (Refer to Dogon Study above – Picture D and Picture E).

We should also take note that a huge amount of variance in attachment type appears to be related non-shared environment, and this cannot be explained by generalised maternal sensitivity. It is highly probable that, mothers are more sensitive and behave differently to some infants than others, depending on birth order, gender and infant characteristics, suggesting the need for family systems on these issues (van Ijzendoorn et al., 2000).

 

Attachment Beyond Infancy & The Internal Working Model

The attachment theory proposes that children use their early experiences with their caregivers to form internal working models (Bowlby, 1969 /1982, 1980) which incorporate representations of themselves, their caregivers, and their relationships with others. These internal working models will then be used by the child as templates for interacting with others. Consequently, because of the sensitive, loving support that securely attached children’s caregivers have supplied, these children are self-confident and have a model of themselves as being worthy; they therefore expect others to behave in a sensitive and supportive fashion. Conversely, given the patterns of interaction typically experienced by avoidant and resistant infants, insecurely attached children expect people to be rejecting, or inconsistent and ambivalent when interacting with them.

The strange situation measures security of attachment in terms of behaviours; especially how the infant behaves at a reunion of the separation. The strange situation procedure is generally used with infants between the ages of 12-24 months old. For 3 – 6 year-olds, variants of the strange situation, such as a reunion episodes after separation, have been used with some success (Main and Cassidy, 1988).

Research during the last 10 years has seen attachment become a life-span construct with corresponding attempts to measure it at different developmental stages (see Melhuish, 1993, for a review). It has been revealed that as infants grow older, in Bowlby’s 4th and 5th stages, attachment relationships become less dependent on physical proximity and overt behaviour, and more dependent on abstract qualities of the relationship such as affection, trust, approval, internalised in the child and also in the adult.

Research has revealed that it is useful to think of internal representations of the relationship in the child’s mind; the child is thought of as having an internal working model of his or her relationship with the mother, and with other attachment figures (Bowlby, 1988; Main et al., 1985). These are characterised as cognitive structures embodying the memories of day-to-day interactions with the attachment figure. They may be ‘schemas’ or ‘event scripts’ that guide the child’s action with the attachment figure, based on their previous interactions and the expectations and affective experiences associated with them.

Different attachment type would be expected to have differing working models of the relationship. Secure (Type B) attachment would be based on models of trust and affection [and a Type B infant would be able to communicate openly and directly about attachment-related circumstances, such as how they felt if left alone for a while]. By contrast, a boy or girl with an Insecure Avoidant (Type A) attachment may have an internal model of his/her mother that leaves the child without any expectancy of secure comforting from the latter when he/she is distressed [the mother may in fact reject his/her approaches]. The child’s action rules then become focused on avoiding her, thus inhibiting approaches to her that could be ineffective and instead lead to further distress; and this can be problematic, as there is less open communication between mother and son, and their respective internal working models of each other are not being accurately updated.

Insecure Resistant / Ambivalent (Type C) infants might not know what to expect from their mother, and they in turn would be inconsistent in their communication with the latter and often unable to convey their intent.

PF - Boy by Land Rover - from Separation Anxiety Test

PICTURE F. Boy by Land Rover: A picture from the Separation Anxiety Test

Over the last 15 years, researchers have attempted to measure attachment quality in older children [as much as the empirical methods allowed them to do in terms of construct validity and internal consistency], by trying to tap in to their internal working models (Stevenson-Hinde and Verschueren, 2002). One of the methods used involved narrative tasks, often using doll-play; children use a doll family and some props and complete a set of standardised attachment related story beginnings. Another method used has been the Separation Anxiety Test, in which children or adolescents respond to photographs showing separation experiences [see Picture G for an example]. The child is questioned about how the child in the photograph would “feel and act”, and then how he/she [the participating child] would feel and act if in that situation (Main et al., 1985). This test was found to have a good rater reliability and consistency for 8 to 12-year-olds. Large differences in responses between children having clinical treatment for behaviour disturbance and a normal control group was found (See Table B)

TB - Two Protocols from the Separation Anxiety Test

TABLE B. Two protocols from the Separation Anxiety Test

Securely attached children generally acknowledge the anxiety due to the separation but come up with feasible coping responses; insecurely attached children generally deny the anxiety, or give inappropriate or bizarre coping responses.

 

The Adult Attachment Interview

The internal working models of relationships can normally be updated or modified as new interactions develop. It is likely possibility that for younger children, these changes must be based on actual physical encounters. However, the Main et al. (1985) suggested that in adolescents or adults who have achieved formal operational thinking [Jean Piaget’s 4th and final stage at around the age of 12 as explained in our essay], it is possible to change / modify their internal working models without the need for such direct interaction. In order to measure attachment in older adolescents and adults, they developed the Adult Attachment Interview. This is a semi-structured interview that proves memories of one’s own early childhood experiences. The transcripts are coded, not on the basis of experiences themselves, so much as on how the person reflects on and evaluate them, and how coherent total account is [Adults’ attachment classifications are not based on the nature of their actual childhood experiences, but on the way they represent these experiences, be they good or bad]. They are also generally asked to describe their childhood relationships with mother and father, and to recall times when they were separated from their parents or felt upset or rejected. There are specific questions that also deal with experiences of loss and abuse. According to their responses during the AAI, Allsopp placed into one of the 4 attachment categories: (i) Autononous, (ii) Dismissing, (iii) Preoccupied [Or Enmeshed] and (iv) Unresolved

 

(i) Autonomous Attachment

Autonomous adults are able to give coherent, well-balanced accounts of their attachment experiences, showing clear valuing of close personal and meaningful relationships [note meaningful subjectively to the individual]. These adults classified as autonomous may have experience problems in childhood, or even had a very difficult or abusive upbringings, but they can generally have an open conversation and talk openly about the negative experiences and most seem to have managed to resolve any early difficulties and conflicts. In contrast to the open and balanced way in which autonomous adults talk about childhood experiences, adults in the remaining three categories have incredible difficulties in talking about attachment relationships.

 

 (ii) Dismissing Attachment

Dismissing adults deny the importance of attachment experiences and insist they cannot recall childhood events and emotions, or provide idealised representations of the attachment relationship that they are unable to corroborate the real-life events. [i.e. dismiss attachment relationship as of little importance, concern or influence

 

(iii) Preoccupied [or Enmeshed] Attachment

Preoccupied adults lack the ability to move on from the childhood experiences, and are still overinvolved with issues relating to the early attachment relationship [generally preoccupied with dependency on their own parents and still struggle to please them].

 

(iv) Unresolved Attachment

The final category is reserved for adults who are unable to resolve feelings relating to the death of a loved one or to abuse they may have suffered [people who have not come to terms with a traumatic experience, or work through the mourning process]

It is to be noted that, people from lower socio-economic groups are slightly more likely to score as Dismissing. However the large difference is in people receiving clinical treat, the great majority of whom do not score as Autonomous on the AAI.

 

Are attachments stable over time? From Infancy to Adult Attachment Type

The main question should be asking ourselves is does the security of attachment change the life, or does infant-parent attachment set the pattern not only for later attachment in childhood, but even for one’s own future parenting? As attachment has become lifespan construct, these questions have generated considerable research and debate.

Many studies have now spanned a period of some 20 years to examine whether strange situation classification in infancy predicts Adult Attachment Interview (AAI) classification as young adults (Lewis et al., 2000; Waters et al., 2000). The outcome is varied, but some of these studies have found significant continuity of the 3 main attachment types; that is, from Secure to Autonomous; Avoidant to Dismissive, and Resistant (Ambivalent) to Enmeshed. Several studies have also found relationships between discontinuities in attachment classification, and negative life events such as the experience of parent divorce.

 

Relationship between Adult Attachment Interview (AAI) and Infant-Parent Attachments

Adult Attachment Interview (AAI) and classifications have been found to relate systematically to the security of the infant-parent attachment relationship. Autonomous parents are more likely to have securely attached infants, and parents in the 3 non-autonomous group. Dismissing, Preoccupied and Unresolved are much more likely to form insecure attachment relationships with their infants. This relationship has been identified for both patterns of infant-mother (e.g. Fonagy et al., 1991; Levine et al., 1991) and infant-father (Steele et al., 1996) attachment. Furthermore, unresolved maternal AAI classification has been identified as a predictor of insecure-disorganised attachment (Main & Hesse, 1990; van Ijzendoorn, 1995). Thus, the way in which a parent represents their own childhood attachment experiences is related to the types of relationship formed with their children.

 

Are attachment stable over generations?

On top of the degree of continuity over time for an individual’s attachment typing, there is also evidence for the transmission of attachment type across generations; specially from the parent’s AAI (Adult Attachment Interview) Coding and their infant’s strange situation coding. Main et al. (1985) had reported some evidence for such a link, and indeed the AAI coding system is based on it; it was argued that Autonomous adults would end up with Secure infants; Dismissing adults with Avoidant infants, Enmeshed adults with Resistant (Ambivalent) infants; and Unresolved adults would have Disorganised infants. [See Table C].

TC - Hypothesized relationships between maternal stage of mind (AAI), maternal behaviour, and child attachment type

TABLE C. Hypothesised relationships between maternal stage of mind (from the AAI – Adult Attachment Interview), maternal behaviour, and child attachment type

Van Ijzendoorn (1995) looked at a large number of available studies in the decade since Main’s work and found considerable linkage between adult AAI (Adult Attachment Interview) and infant Strange Situation coding; Van Ijzendoorn argued that this “intergenerational transmission” of attachment may be via parent responsiveness and sensitivity. We discussed above how this is only a partial explanation, and other aspects of maternal behaviour and of the home environment may also be involved.

We have considerable evidence for some degree of continuity of attachment security through life, and onto the next generation; but considerable evidence that this can be affected by life events. An adult’s attachment security can also be influenced by counselling, clinical treatment, or simply by reflection [self mind-mindedness].

Some insight into this matter comes from a study by Fonagy et al. (1994). In a longitudinal study with 100 mothers and 100 fathers in London, who are given the AAI and other measures shortly before their child was born. The strange situation was used subsequently to measure security of attachment, to mother at 12 months and the father at 18 months. As many other studies have discovered, the parent’s AAI scores predicted the Strange Situation scores of the infants. The researchers also calculated the estimates of the amount of disrupted parenting and deprivation which the parents had experienced themselves, and use the measures to find out if these influenced infant attachment, which they did. However, the amount of disrupted parenting and deprivation the parents had experienced interacted strongly with the way in which the parents had dealt with their own representations of their experiences of being parented. Coding the AAI (Adult Attachment Interview), the researchers developed a Reflective Self-function scale to assess the ability parents had to reflect on conscious and unconscious psychological states, and conflicting beliefs and desires. Of 17 mothers with deprived parenting and low reflecting self-function scores, 16 had insecurely attached infants, as might have been expected. Completely opposite to this scenario 10 mothers who had experienced deprived but had high reflective self-function scores, all had securely infants. It was argued that reflective self-function could have the saliency to change the internal working models of people, and also demonstrate resilience to adversity and a way of breaking the inter-generational transmission of insecure attachment.

Adults who experienced difficult childhoods but have overcome early adversity and insecure attachment by a process of reflection, counselling or clinical help, are known as “earned secures”, and could be distinguished from “continuous secures”, who had a positive upbringing and what most might quality as “normal” childhood. Phelps et al. (1998) made home observations of mothers and their 27-month-old children, and found that earned-secures, like continuous secures, showed positive parenting; under conditions of stress, both these groups showed more positive parenting than insecure mothers.

Another fascinating perspective on this issue of inter-generational transmission of insecure attachments would be the Holocaust study (Bar-On et al., 1998; van Ijzendoorn et al., 1999). The Holocaust refers to the experiences of Jews and other persecuted unwanted & unassimilated minorities [who did not want to be Germans] in the concentration camps of World War II to be securely offloaded/deported when Adolf Hitler’s Germany became the Third Reich and when the policies changed to focus on National Socialism and Imperial Intentions of Expansion and Conquest (1939-45).

LittleJewsToBeSentBack

Jew Children: Here we see Jew school children in 1942. They look like younger children who are just beginning school. Notice that at least 2 teachers are with them. By this time the Jewish children had been forced out of public schools. For a short time however, they we allowed to attend schools set up by the Jewish community. At the time this photograph was taken, the transports to the deportation camps had already begun. Often children under 10-years of age were not required to wear the badges, but some of these children look much younger.

Although many revisionist such as the English historian, David Irving, of this dark part of human history are finding out inaccuracies regarding the true people responsible for those massacres [since no evidence has been found of Hitler giving any extermination order] along with other atrocities as evil if not worse than the deaths in concentration camps [for a section of a population that was causing instability to the proper functioning of a nation during times of revolt and huge global conflicts involving economic treaties, Jewish propaganda and ultra-liberal communist migration agendas fused with policies based on business & banking motives] committed by many of the “supposed good guys of the Allies” that involved the rape and murder of innocent children and women, fuelled by pure hate, Bolshevism and Jewish Communism against the native aryans of Germany [i.e. the German Volk/People].

A documentary extract from the diary of Dr. Joseph Goebbels who decided to take a firm stance against the national destruction of Germany (and Western Europe), Christianity, and whom many Nationally oriented thinkers consider to be among the bravest of the last great Christian Aryan men to have walked the earth. [See Aryan Race et aussi Race Aryenne / Also to be noted perhaps quite surprisingly that there were strong ancient Aryan religious & mythological warrior values embedded in the mind of Heinrich Himmler (the Reichsführer of the SS), the person believed to have taken the decision to exterminate the jews (remember the term itself originated from human sacrifices by Jews to their god, Baal), as he told his personal masseur & physician Felix Kersten that he always carried with him a copy of the ancient Aryan scripture, the Bhagavad Gita because it relieved him of guilt about what he was doing – he felt that like the sacred warrior Arjuna, who was simply doing his duty for his people and their future without attachment to his actions]

But, since the majority on this planet have been made to believe one version where all the Jews and the alien army of the allies are the good guys, and all the Germans [including Adolf Hitler] were the blood-sucking vampires who also turned into cannibals on the week ends, we are going to base our comments on this politically correct version that the history books and mainstream publishers prefer. [Politics too nowadays is in serious need of revision; are people really divided into 3 main categories? Left, Centre and Right? I tend to believe that we are above all this and have elements of all 3 embedded in us as modern human beings of the 21st century]

But getting back to the Bedouin cultured civilisation’s distinguished members, i.e. Jews as an example of victims in those concentration camps [that many people have begun to question the evidence used to claims of gas chambers (with a great amount found on territories occupied by Stalin) with many camp detainees reporting being kept in facilities with swimming pools, orchestras and kitchens, the number of casualties, and the true perpetrator of the crimes]. It is believed by most people of the 21st century who have had no other options but to take in their news from mainstream Jewish-owned media, that besides being treated like despicable rats, degraded and tortured, many of the Jews to be deported kept in those camps were killed [some shot like parasitic animals as they tried to escape], leaving behind them orphaned children in traumatic circumstances.

Our question here however in regards to the focal point of this section, i.e. “insecure attachments”, is whether such traumatic experiences could have an impact on attachment, and could this also have been transmitted inter-generationally to the Jewish children scattered around the globe today like modern gypsies? This issue of inter-generational transmission of insecure attachments is the focus of the Holocaust study (Bar-On et al., 1998; van Ijzendoorn et al., 1999). The study we are looking at encompasses 3 generations of Jews, now grandparents, who went through the Holocaust [note that the name Holocaust itself comes from an event involving human sacrifices to the Jewish god, Baal], typically as children themselves who had lost their parents; their children, now parents; and their grandchildren. These generations are compared here with comparable 3-generation families who had not experienced the Holocaust.

It was found that the effects of the Holocaust were evident in the grandparent generations, who showed distinctive patterns on the AAI (Adult Attachment Interview), scoring high on Unresolved, as would have been predicted, and high on unusual beliefs – another predicted effect of trauma and unresolved attachment issues. They also displayed avoidance of the Holocaust topic; a very common finding was that the experiences had been so horrific and disgusting that they were unable to talk about their experiences with their own offspring.

However, inter-generational transmission of attachment type was quite low for this group of Jews. The Holocaust parents (‘children of the Holocaust’) showed rather small differences from controls, scoring just slightly higher on Unresolved on the AAI. This normalization process continued to the next generation (‘grandchildren of the Holocaust’), for whom no significant differences in attachment were found from controls. This seems to suggest a minor trend of  “Unresolved” attachment among these Jews [note that this is linked to Disorganised attachment in infants and today some question whether Type-B Securely attached infants are really the “Best” way to be, and whether other personality characteristics also help shape the individual’s uniqueness throughout life, such as their reflective abilities and internal working models (reshaped by other meaningful events/relationships) – however it is also important to note that attachment types are known to remain and be transmitted over generations for the majority of people with low self-reflective skills and intelligence].

 

Disorganised Attachment and Unresolved Attachment Representation

The pattern of infant attachment classed as “Disorganised” from the Strange Situation procedure, was only acknowledged much later than the other well known attachment types [Secure, Inscure Avoidant & Insecure Resistant/Ambivalent], and appears to have rather distinctive correlates.

It has been noted that Disorganised infants may show stereotypic behaviours such as freezing, or hair-pulling; contradictory behaviour such as avoiding the caregiver [e.g. mother] despite experiencing severe distress on separation; and also misdirected behaviour such as seeking proximity to the stranger instead of the caregiver. These characteristic behaviours are known as signs of Unresolved stress and anxiety, and for these types of infants the caregiver is a source of fright rather than a symbol of safety (See Table C) – (see Vondra and Barnett, 1999, for a collection of recent research).

Van Ijzendoorn, Schuengel and Bakermans-Kranenburg (1999) reviewed a series of studies on Disorganized attachment, and argued that it was mainly caused by environmental factors [i.e. exposure]; although there is also some evidence for genetic factors in Disorganised infant attachment, and it is known to be higher in infants with severe neurological abnormalities [e.g. cerebral palsy, autism, Down’s syndrome] – around 35%, compared with around 15% in normal samples. However, Type-D (Disorganised Attachment) is also especially for mothers with alcohol or drug abuse problems (43%) or who have maltreated or abused their infants (48%). Type-D attachment is not higher in infants with physical disabilities; and it is not strongly related to maternal sensitivity as such, however there is evidence relating it to maternal unresolved loss or trauma [like the Jews of the Holocaust generation as mentioned above].

While the Maternal Sensitivity Hypothesis suggests that maternal (in)sensitivity predicts secure (B) or insecure (A,C) attachment, a different hypothesis has been proposed to explain Disorganised Type-D attachment (See Table C), which is that it is would be the result from frightened or frightening behaviour by the caregiver (generally the mother) to the infant, resulting from the mother’s own unresolved mental state related to attachment issues [e.g. abuse by her own parent; violent death of a parent/or close one; sudden loss of a child].

A study in London by Hughes et al. (2001) compared the Unresolved scores on the AAI (Adult Attachment Interview) for 53 mothers who had infants born next after still birth, with 53 controls [normal mothers], and found out that among the mothers who had previously stillborn infants, 58% scored as Unresolved, compared to 8% of Controls; furthermore, 36% had Disorganised (Type D) infants, compared with 13% of controls. A statistical path analysis [looking at the relationships among all the variables showed that the stillbirth experience predicted Unresolved maternal state of mind, and that it was this variable [i.e. Unresolved state of mind] then predicted infant disorganisation.

The hypothesised behavioural aspects of maternal unresolved state of mind [and Disorganisation in infants] were supported by the study in Mali reported above. A study in Germany by Jacobsen et al. (2000) provided further support in which 33 children were examined along with their mothers at 6 years of age. Disorganised attachment (assessed from a reunion episode) was significantly related to high levels of maternal expressed emotion, defined as speech to the child that was severely critical of them or over-involved with them.

Van Ijzendoorn et al., (1999), in a review, also found that insecure Disorganised (Type D) attachment in infants predicted later aggressive behaviour, and child psychopathology. Carlson (1998) found significant prediction from attachment disorganisation at 24 and 42 months, to child behaviour problems in preschool, elementary school and high school. Taking into consideration the prior links to parental maltreatment and abuse, it is highly likely that the Disorganised (Type D) attachment type will be found to be the most relevant aspect of attachment in understanding severely maladaptative or antisocial behaviour in later life.

 

Origins of the Insecure Disorganised State of Mind

The origins of insecure-disorganised (Type D) attachment is becoming an increasingly researched topic, and this may be due to the fact that early disorganisation (Type D) has been identified as a risk factor for later psychopathology (Fearon et al., 2010; van Ijzendoorn et al., 1999), with studies identifying a link between insecure-disorganised attachment in infancy and behavioural problems in later childhood (Lyons-Ruth et al., 1993; Munson et al., 2001; Shaw et al., 1996).

In Main and Hesse’s (1990; Hesse & Main, 2000) their seminal work led to the argument that these insecure-disorganised (Type D) infants have not been able to establish an organised pattern of attachment because they have been frightened by the caregivers or have experienced their caregivers themselves showing fearful behaviour. This is supported by findings that have linked insecure-disorganised attachment to infant maltreatment or hostile caregiving (Carlson, Cicchetti, Brnett & Braunwald, 1989; Lyons-Ruth et al., 1991), maternal depression (Radke-Yarrow et al., 1995), and maternal histories of loss through separation, divorce and death (Lyons-Ruth et al., 1991).

In a meta-analytic review however, van Ijzendoorn et al. (1999) reported that 15% of infants in non-clinical middle class American samples are classified as insecure-disorganised (Type D), suggesting that pathological parenting practices cannot fully account for disorganised attachment in infants. As highlighted by Bernier and Mains (2008), the origins of attachment disorganisation are very complex, involving factors ranging from infants’ genetic make up to parents’ experiences of loss or abuse, and much remains to be learned about why some infants are unable to form and organised attachment relationship with the caregiver.

 

Links between Attachment & Emotional Development

It is fundamental to understand and grasp the importance of the early stages of life, as the brain’s cognitive patterns are shaped by these early experiences that tend to have a lasting effect on personality. The infant’s earliest mode of exploring and engaging with the world revolves around conveying emotions: fear, discomfort, pain, contentment, happiness.

As we have already explained above in the section exploring the reasons why infants develop particular attachment types, the caregiver’s responses [not sensitivity, but mind-mindedness, i.e. the ability to respond “appropriately” to the cues] to such emotional cues and their representations of their own childhood emotional experiences [generally measured with the AAI for Autonomous, Dismissing, Preoccupied or Unresolved] are accepted as strong predictors of attachment security [i.e. Autonomous – Secure, Dismissing –Avoidant, Preoccupied- Resistant and Unresolved – Disorganised].

With this in mind, it is quite surprising that so little research has been conducted on the relation between security and children’s emotional development.

There are 2 main ways in which links between attachment and emotional development have been addressed:

(i) The research has investigated whether infants’ early emotional experiences predict attachment security

(ii) The researchers have explored whether the security of the infant-caregiver attachment relationship predicts children’s subsequent emotional development.

 

Emotional Regulation and Attachment Security

This section is focussed mainly on how caregivers’ ways of responding to the infants’ emotional cues predict later attachment security.

Mothers of insecure-avoidant infants have been found to withdraw when their infants express negative emotions (Escher-Graeub & Grossmann, 1983). Conversely, mothers of insecure-resistant infants typically find it difficult to comfort their infants effectively, meaning that their responses result in prolonging their infants’ feelings of distress (Ainsworth et al., 1978).

Cassidy (1994) argued that caregivers may enable their children to develop good emotional coping and regulation strategies through their willingness to acknowledge and respond to their children’s emotions. She also argued that secure attachment is characterised by the openness with which the caregiver [mother, father, etc] recognises and discusses the full spectrum of emotions [which leads to the child’s understanding that emotions should not be supressed and can be dealt with effectively]. Insecure-avoidant attachment is generally associated with caregivers failing to respond to their infants’ negative emotions because of their tendency to bias interactions in favour of positive emotional expressions. On the opposite, insecure-resistant attachment is associated with the caregiver amplifying the infant’s negative affect. Cassidy maintained that mothers of insecure-resistant children fail to emphasise the importance of attachment relationships, and therefore adopt strategies that fail to help the child regulate negative emotion, hence, prolonging the need for contact with the mother [or caregiver].

 

Affect Attunement

Cassidy’s views are in synchronisation with other theoretical positions, such as Stern’s (1985) characterisation of sensitive parenting in terms of effect attunement, with the sensitive mother being the type of human being who is attuned to all of her infant’s emotions, is also accepting and sharing in their affective content.

Insensitive mothers on the other hand, undermatch or overmatch their infants’ emotional signals because of their own perceptual biases.

In support of these approaches, Pauli-Pott and Mertesacker’s (2009) investigation revealed that mismatches between maternal and infant affect at 4 months [e.g. mother shows positive affect while her infant demonstrates neutral or negative affect] predicted insecure mother-infant attachment at 18 months. Mind-mindedness is also operationalised in terms of the caregiver’s tendency to accurately interpret the infant’s cognitions and emotions, and has been found to predict later attachment security (Meins er al., 2001). Thus, observations by a mother of her infant displaying surprise in response to a jack-in-the-box, followed by enigmatic comments such as “my infant is surprised” are associated with subsequent secure attachment. In contrast, insecure attachment is related to mothers misreading their infants’ internal stress by, for example, commenting that the infant is scared when no cue to suggest such an emotion is present in the infant’s overt behaviour. In more recent work it has been found that these inappropriate mind-related comments are particularly common in mothers of insecure-resistant infants, with mothers in this group being more likely to comment inappropriately on their infants’ thoughts and feelings than their counterparts in the secure, insecure-avoidant and insecure-disorganised groups.

Evidence suggests that mothers in the insecure-avoidant and insecure-resistant groups are aware of over-controlling and under controlling strategies respectively in coping with their children’s negative emotions. Berlin and Cassidy (2003) followed up a sample of infants who had been assessed in the strange situation in infancy, and questioned the mothers when the children were aged 3 about how they dealt with their child’s emotional expressive, and found that insecure-Avoidant (Type A) group mothers reported the greatest control of their 3-year-olds’ negative emotional expressiveness [e.g. expression anger or fear], whereas mothers in the insecure-Resistant(Ambivalent – Type C) reported the least control of children of their children’s expressing negative emotions.

These findings suggest that maternal behaviours associated with avoidant and resistant attachment that have been observed in infancy are stable and persist into the preschool years.

Security-related differences in the way in which children regulate their emotions are also in line with Cassidy’s (1994) approach. Spangler and Grossman (1993) took physiological measures of infant distress during the strange situation procedure and compared these measures with infants’ outward shows of upset and negative affect. The physiological measures showed that insecure-Avoidant (Type A) group infants were as distressed or more distressed than their secured group conterparts (Type B), despite the absence of overt behavioural distress observed in the insecure-avoidant (Type A) groups infants. It was therefore concluded by Spangler and Grossman that insecure-Avoidant infants mask or dampen their expression of negative emotions as a way of coping with the facts that caregivers are likely to ignore or reject their bids for contact and comfort when they are distressed.

Belsky, Spritz, and Crnic (1996) reported that 3-year-olds who had been securely attached in infancy were more likely to recall and memorise the positive emotional events that had witnessed on a puppet show, whereas insecurely attached children tended to attend and remember only the negative events. On the same note, Kirsch and Cassidy (1997) found that both secure and insecure-resistant attachment in infancy were associated at 3 years of age with better remembering and recall for a story in which a mother responded sensitively to her child than to a story where the child was rejected.

In contrast to the scenario above, insecure-Avoidant infants showed no difference in their recall of the responsive versus rejecting stories. Kirsch and Cassidy also found that 3-year-olds classified as insecure in infancy were more likely than those in secure groups to look away from drawings depicting “mother” – child engagement.

These findings suggest that the positive experiences of secure infants with their caregivers may result in these children attending more to positive emotional events because they are consistent with their attachment security.

 

__________

 

(III) The Genetic/Psychosexual Model of Development (Sigmund Freud)

“For generations almost every branch of human knowledge will be enriched and illuminated by the imagination of Freud” (Jane Harrison, 1850- 1928)

The Genetic Model of Psychosexual Stages

The genetic model that we are now going to explore may not have much to do with genes, and relates more to the “development” of the child. Sigmund Freud proposed that childhood development proceeds through a series of distinct stages to adulthood, each of them with their own themes and preoccupations.

The stages are based on the life-drive present in all organisms, as Freud proposed, and it seems logical from a physician who carried empirical work on the sexual organs of eels, to assume that all organisms have the embedded urge for “life” [i.e the life drive to keep itself and its species alive, which involves sexual selection and the fertilisation achieved through sex] that is primarily sexual but some also argued that it can be interpreted (unconsciously or consciously) in other forms [as flamboyant French psychoanalyst, Jacques Lacan proposed in his Theory with the Symbolic, the Imaginary and the Real] to suit a sophisticated society [e.g. France] with all its dimensions. Freud proposed that the psychosexual stages are understood to be organised around the child’s emerging sexuality.

It is important however to not exaggerate or misinterpret Freud’s assumption and also to remember the logic and vital purpose behind the sexual (life) drive in organisms in its own existence and continuity [breeding]. This is also a very good discussion point for the 21st century as it seems to imply that all healthy organisms should have healthy sexual drives, but whether these should « always » find expression through genital sexual acts with another organism is debatable and questionable from an ethical and moral perspective [especially for those not in a healthy and stable relationship]; hence many psychologists recommend « masturbation » as a healthy and safe alternative in managing excessive sexual desires in both young people and adults.

In the process of the child’s emerging “sexuality”, the term « sexual drive » itself meant more than simply adult genital sexuality, and from a psychological perspective, was broadly referring to a physiological/biological sense of “pleasure in the body” and more to “sensuality”. As many psychologists who based their foundations on some aspects of Freudian perspectives, it is assumed that adult sexuality is nothing more than the simple culmination of an orderly set of steps in which the child’s “psychosexual” focus shifted from one part of the body to another, with these body parts or “erotogenic zones” all having something in common with the generation of pleasure; which are orifices lined with sensitive mucous membranes.

Hence, Sigmund Freud may have adequately proposed in a statement regarding mental health that, “the only unnatural sexual behaviour is none at all.”, taking note once again that the term “sexual” from a psychologist exploring the developmental stages of a child generally tends to refer more to “sensuality”. The erotogenic body parts with orifices and sensitive mucous membranes leads to the infant sensuality being initially centred on the mouth (oral cavity), followed by the anus and then the genitals in early childhood. After some characteristic drama at about the age of 5, the child’s sexuality goes nearly completely dormant for a few years, before re-emerging with a vengeance [a rush of hardly managed sexual feelings] when puberty hits.

As the tradition on the debate of the development of the mind itself as an entity [that reflects in linguistic form the desires, both conscious and unconscious of the human organism] goes on among psychologists in the quest for these answers, we are also familiar with critics [mostly from the reductionist schools of thoughts (e.g. Pavlovian) such as the cognitive-behavioural enthusiasts and the medical department with its accolade, the pharmaceutical industry] who have not been entirely positive about Freud’s contribution to knowledge and are still unconvinced [perhaps due to their philosophy on a kind of methodological epistemology that is lacking to cope with matters of the mind] about the unconscious part of the mind that plays a huge role in our conscious behaviour. This may not be completely negative to intellectuals who subscribe to a version of reality that is embedded in language since critics in many cases have led to systematic investigations [scientific methodology] and until now there is an increasing body of evidence that points to the existence of an unconscious drift/urge/motive that exists in all organisms [e.g. as we noted in the essay about Biological Constraints in Learning by Operant Conditioning and also other studies carried out on priming along with observations of the symptomatic manifestations of certain mental disorders such as OCD and Panic Attacks].

The psychoanalytic theory has been modified by some of the best minds of the psychoanalytic tradition [e.g. Jung, Lacan, and some components adopted by ourselves in the conception of the model of mental life within the Organic Theory] since Freud left the questions open with the freedom of dialogue over the concepts and their expansions and applications throughout various dimensions [e.g. analysing qualitative subjective experiences of the expression of love and passion, or the obsoleteness of politics in modern society, or the impact of animal studies in designing a human world]. However, between all the versions of Freud’s theories, there are 3 components that have never been denied by any great psychoanalyst, which are the 3 structures first mentioned in the early Topographic Model, that is, the Unconscious, the Subconscious and the Conscious. These were later replaced with the Structural Model, which is the popular version that remapped and renamed the concepts, and which includes the (unconscious) id [present in all new born infants which consists of impulses, emotions & desires – id demands instant gratification of all wishes and needs], the (conscious, me) ego [which acts a mediator between reality and the desires of the id] and the (subconscious) superego [the conscience: the sense of duty & responsibility], that adepts such as Jacques Lacan and Carl Jung rejected over the earlier Topographic model [being one that is more flexible for the development of further refined models that also have the option to define the life force in other ways than the questionable specificity of the Structural Model’s id, ego & superego.

 

The 5 Psychosexual Stages

Stage I: The Oral Stage (from birth to 1 year old approximately)

From Freudian assumptions, it is believed that the voracious sucking of infants is not pure nutritional, although the infant clearly has a basic need to feed, it also takes a “pleasure” in the act of feeding, a feeling that Freud did not hesitate to quality as sexual and perhaps more “sensual” at this stage as babies appear to enjoy the stimulation of the lips [in play] and the oral cavity, and will often happily engage in “non-nutritive sucking” when they are no longer hungry and the milk supply is withdrawn. Beyond being an intense source of bodily pleasure – an early expression of later sexuality – sucking also represents the infant’s way of expressing love for and dependency on its feeder [normally it is the mother, but it can also be a primary caregiver that the child is attached to, hence Lacan proposed that the Oedipal & Electra complexes may not only not be true for ALL cases, but the child’s early sexual feelings may be projected on other primary caregivers and not necessarily the direct parents]. The sucking behaviour also serves to a general stance that the infant takes towards the world, one of “incorporation” or the taking in of new experiences.

 

Stage II: The Anal Stage (1 to 3 years old approximately)

At the second stage, the Anal stage, the focus shifts from one end of the digestive tract to the other at it happens at around the age of 2, when the child is developing an increasing degree of autonomous control over its muscles, including the sphincters that control excretion. After the incorporative passivity and dependency of the oral stage, the child begins to take a more active approach to life [note the term active also in line with Jean Piaget’s views on the development of the human child]. Sigmund Freud proposed that these themes of activity, autonomy and control, play out most crucially around the anus as the child learns to control defecation, and learns that it can control its direct external environment, in particular its caregivers attention, by expelling or withholding faeces. Moreover, the child takes a sort of sadistic pleasure in this control, a form of pleasure described as “Anal erotism”. An important conflict for the child during this stage involves toilet training, with struggles/disapproval taking place over the parents/caregivers demand that the child control its defecation according to particular rules. However, the anal stage represents a set of themes, struggles, pleasures, and preoccupations that cannot be reduced in any simple way to toilet-training, as many common psychology students from the wrong linguistic vein are in caricatures of Freud maybe in a defensive act for their lack of linguistic subtlety to understand the mental life and the models that govern it.

 

Stage III: The Phallic Stage (3 to 6 years old approximately)

Gradually, although still in the early childhood years, the primary location of sexual pleasure and interest shifts from the anus to the genitals, where the little boy starts to become fascinated with his penis while his counterpart, the little girl on other side of the gender register, develops a fascination with her clitoris. However, this stage is known as “phallic” and not “genital” because Freud maintained that both sexes were focused on the male organ; “phallus” referring not to the actual physical organ, the anatomical penis, but to its “symbolic value”. Briefly explained, the phallic stage is set as the little boy understanding that he has the penis [which has a symbolic value] which the little girl lacks, and develops the belief that he could possibly lose it. In contrast, the little girl does not have a penis and wishes to have one.

This is the very first time that the difference between the sexes comes into play in childhood development, and the contrast between masculinity and feminity, really becomes an issue for the child. It is also the 1st stage at which Freud’s psychosexual theory recognises sexual differences, and marks the crucial point at which, children become gendered beings [between the ages of 3 – 6].

The little boy’s and the girl’s differing relation to the phallus [remember: the “symbolic value” of it not the actual organ] plays a vital role in unfolding drama that takes place within the family during this stage, somewhere around the age of 3 to 5. It has been dubbed the “Oedipus complex”, after the Greek legend in which Oedipus unwittingly murders his father and marries his mother, his original love-object [remember the attachment period in Bowlby’s along with breastfeeding] after all, as is consequently envious of his father, who seems to have his mother to himself. The boy’s fearful recognition that he could lose his penis [symbolically: “masculinity”] – “castration anxiety” – becomes focussed on the idea that the competing male for the love of the mother[the father], could inflict this punishment on him if the boy’s sexual feelings and desire for the female figure of the caregiving mother is recognised. So, faced with fear, he renounces and represses the sexual feelings and desire, to instead identity with the father, becoming his imitator rather than his rival. In this process, the boy learns about masculinity and internalises the societal rules and norms [e.g. about relationships] that the father represents [the development of the Super-Ego, a sense of duty and responsibility, i.e. “conscience” takes place as the Structural Model suggests].

In the case of the little girl, matters are slightly different, and the developing child soon feels her lack of a penis keenly (“penis envy”) and blames the mother for leaving her so grievously unequipped, and then the father soon turns into her primary love-object [the “Electra Complex” appears as the opposite of the “Oedipus” Complex], and the mother her rival.

A similar process to the little boy now takes place in the little girl’s realm, resulting in the repression of her sexual feeling, desires and love, to shift to an identification with her mother, and hence with feminity. However, given that the girl is not under any “castration” threat, this process occurs under much less emotional pressure than in the little boy’s case. Consequently, perhaps due to this difference in emotional pressure, Freud proposed that the Electra complex was resolved less conclusively and with much less complete repression in girls than in boys, but also that girls tend to internalise a conscience [preconscious, or superego] that is in some ways weaker and less prohibitive and punitive than boys. It is not surprising that such a controversial claim about girls has been highly criticised specially with no scientific evidence to back it up; and is perhaps also one reason why Freud’s account of Oedipal [Electra complex] conflict in women has been the subject of much revision [e.g. by Jacques Lacan].

 

Stage IV: Latency (6 years old to puberty)

After the upheavals of the Oedipus and Electra complexes, the sexual drives go into a prolonged “semi-hibernation”. During the pre-pubertal school years, children engage in much less sexual activity and their relationships with others are also desexualised. Instead of desiring the primary caregivers and original love-objects, their parents, children now begin to identify with them – having structured their understanding of the world. However, this sudden interruption of childhood sexuality is largely a result of the massive repression of sexual feelings that concluded the phallic stage. One of the main consequence of this repression is that children come to completely forget their earlier sexual feelings, a major source [Freud claimed] of our general amnesia for early childhood experiences. Other institutional settings with their own social models such as formal schooling, reinforce the repression of sexuality during latency, leading children to focus their energies instead on mastering “culturally valued” knowledge and skills. Freud observed that the desexualisation of latency-age children was less complete among so-called “primitive” peoples.

 

Stage V: The Genital Stage (from the onset of puberty to death)

The latency period of forced or socially imposed sexual repression ends with the biologically-driven surge of sexual energy that accompanies puberty. This marks the final stage of psychosexual development where it all the previous stages were successfully completed, leaves the person with the ability for mature love with sexual feelings. It is important to note that the focus on sexual pleasure is once more shifted to the genitals as it was before the stage of latency [during the phallic stage (3 – 6 years old)] however, now it is fused with the ability for sensible and true affection for the object of desire [and not simply immature sexual feelings trying to find expression from an inadequately developed brain being projected at the easiest accessible caregiver].

In addition, both sexes are now invested in their own genitals rather than sharing a focus on the “symbolic value” of the penis as it occurred during the “Phallic stage”. The Genital Stage therefore marks the end of the “polymorphous perversity” of childhood sexuality. However, these erotic moments have not completely vanished but are instead subordinated to genital sexuality, often finding expression in other subtle ways [e.g. sexual foreplay].

According to the genetic model of psychosexual stages, we pass through each of the psychosexual stages on the way to maturity. However, we do not pass through them unscathed, and there are many ways in which people have problematic difficulties in particular stages [unable to progress successfully] and when such incidents happen a “fixation” develops. A fixation is simply an unresolved difficulty involving the characteristic issues of the particular stage, and leads to a fault-line in our personality, according to Freudian developmental perspectives.

If the individual failed to receive proper and reliable nurturance and gratification during the oral stage – or alternatively if they were over-indulged – a fixation on that stage may develop. It is believed that when a person is confronted with some forms of stresses, they may revert to the typical immature ways of dealing with the world of that period [at the particular point in time of that stage], this process was referred to as “regression” by Freud.

In some cases, fixations may lead to full-fledged mental disorders: Oral fixations are linked to depression and addictions, anal fixations to obsessive-compulsive disorder, and phallic fixations to hysteria [in severe cases]. Fixations [generally later countered by Reaction Formation] do not simply represent forms of behaviour and thinking that people regress to when faced with difficulties but the whole personality [thought structure] or “character” – the term Freud preferred – may be organised around the themes of the stage at which the person is most strongly fixated. As a result, Freud proposed a set of distinct stage-based character types:

(i) Oral Characters

This category of characters tend to be marked by passivity and dependency [think of the sheep metaphor], and are liable to use relatively immature ego defences such as denial.

(ii) Anal Characters

Anal people tend to be inflexible, stingy, obstinate and orderly, with a preference for defence mechanisms such as the isolation of affect [hide their feelings] and reaction formation.

(iii) Phallic Characters

Phallic characters are generally impulsive, vain and headstrong [think alpha-male prototype] with a preference for a defensive style that favours repression.

It is important to note that this 3-part typology is the closest that the psychoanalytic theory of personality comes to bringing forward an explanation for individual differences in personality from early childhood experiences. A phase of development pivotal to the other 2 mentioned theories which also attribute the foundations of fundamental structures to the period of infancy and childhood, although they all also acknowledge the individual’s ability to shape their own minds and correct their own problematic traits through reflection, and indeed as mentioned in the section on John Bowlby’s theory of attachment mothers with high reflective abilities were able to reshape the internal working models of their children’s attachment style and subsequent emotional development. It is to also be noted how all these 3 theorists although different in their perspectives, have been inspired by each other’s works, the idea of attachment itself was inspired by Freud’s pre-oedipal claims, and Jean Piaget like Sigmund Freud came from the school of thought that viewed the mind as an “active” entity in its development and creation, and not a “passive” entity generated by a ball of soft matter acting like a junction box with scripts for stimuli.

 

Psychoanalysis, then and now

One of the main claims of Freudian theory is that much of what motivates us to move forward in life is determined by the unconscious, and since by the reductionist mind state of the common researcher who sadly only had empiricism to dream of a better life for himself, these unconscious processes cannot be measured [such as moles, weight, fingers, teeth, sheep, cattle, etc], and hence it is often claimed [without much understanding or linguistic abilities or skills in discourse and philosophy] that belief in Freudian ideas is precisely that – beliefs rather than mechanical models based on empirical evidence [e.g. medicine, physics, surgery, chemistry, biology, etc – all the disciplines of the hard sciences].

However, while Freud’s views are almost impossible to test with reductionist quantitative methods, his theories and claims have influenced many psychologists who work with different methodologies and the unconscious processes of the brain are also being backed up by emerging fields that focus on the physiology of the brain [e.g. cognitive-neuroscience].

To illustrate one of those views that are hard to test empirically, consider the Freudian notion of “Reaction Formation”. It is assumed for example that if an individual is harshly [by strict parents] toilet trained as a child then the Freudian prediction would be that the person becomes “anally retentive” [i.e. excessively neat and tidy]. However, if in some ways we do recognise such tendencies in ourselves [once again prompting to the existence of a well developed with reflective and perspective taking abilities fully developed by Piaget’s standards], maybe even unconsciously, then we may react against it [Reaction Formation occurs] and we actively become very untidy.

This suggests that we are in control of ourselves and we have the ability to reverse the effects of our upbringing and early childhood experiences, which means in turn that it is impossible to predict a child’s development despite the fact that the first 6 years from birth are supposedly critical in determining later personality formation [self-reflective people save themselves from the mediocrity of the masses].

Freudian Theory has been of immense importance in pointing out 2 possibilities. One is that early childhood can be immensely important in affecting and determining later development [a position also adopted by other major theorists as we have seen such as Bowlby], and the other is that we can be driven by unconscious needs and desires which we are not aware of [until exposed to the right environmental stimuli that release them from their hidden depths]. Thus, it is assumed that if we not complete one of the childhood psychosexual stages very well, it could reflect itself later in adult disorders such as neurotic symptoms, but we would not be aware of the source or cause of the problem. The only way to come to terms with these deeply embedded problems in the depth of the individual’s psyche that has more saliency than the minor cognitive schemas for basic environmental interactions [e.g. making a cup of tea or a sandwich], is through close intensive sessions of psychoanalysis (see Picture G) in which the analyst peers into the unconscious to try and unravel [discover] the problems that occurred during the patient’s childhood development that is causing the current problems.

PG Psychoanalyst tries to discover what went wrong in your childhood that is causing your current problems

PICTURE G. The psychoanalyst tries to uncover the childhood unresolved issues to find the causes of the current problems.

Whatever its weaknesses are, the psychoanalytic theory remains the most complete theory in terms of depth and detail in capturing the essence of the human mind [soul as metaphor, or psyche], and today there are still many who believe that psychoanalytic theories are fundamental in understanding human development with many theoreticians who have brought forward variations and alternatives to Freud’s proposals on some controversial issues [e.g. Jacques Lacan, John Bowlby and Carl Jung] while many of his proposals have also lead to the scientific discovery of unconscious mental processes.

_____________________________________

 

*****

 

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Essay // Clinical Psychology: Learning Disabilities, Anxiety, Depression & Schizophrenia and the Effectiveness of Psychotherapy

Part 1 of 5 | Children and Adolescents’ Mental Health Services (CAMHS) & Learning and Intellectual Disabilities

ClinP_Descr_Header_01

CAMHS deal with the psychological issues of people under the age of 18. They are a non-specialist service and often refer to other more specialised departments following the initial assessment of patients. The most common cases tend to be adolescents with depression and anxiety whose manifestations are not different to those of adults and so are treated fairly similarly.

Inclusivism in Learning Disabilities

In 1969, Bengt Nirje adopted and developed the concept of normalisation in Sweden and beautifully described it as…

“making available to all mentally retarded people patterns of life and conditions of everyday living which are as close as possible to the regular circumstances and ways of life of society.”

– Nirje, 1980

Learning Disability is not just an impairment in Cognition

The social impairment of Learning Disabilities – US Statute 111 – 256: Rosa’s Law defines the factual impairment, the imposed or acquired disability and the awareness of being different.

The Normalisation Theory

This theory focuses on the mainstream trends of social devaluation or deviancy making. Some categories of people tend to be valued negatively due to their behaviours, appearances and characteristics, and this places them at the risk of being devalued [according to the Normalisation Theory of Nirje on the societal processes he assumed] – people fulfil various social roles and stereotypes.

learning disabilities co ltd ii

As part of the deviancy making or social devaluation, the unsophisticated minds of the masses generally do not mean to stereotype, however they seem to do it unconsciously [the unconscious is a concept Sigmund Freud and Jacques Lacan acknowledged in their psychoanalytic theories of mental/psychological activity and mental health problems linked to psychopathic tendencies in people towards others], i.e. deviant groups with social symbols or images that are at a higher risk of being devalued are the focus of the normalisation theory, which is believed to be done with the aim of providing them with the skills they need and eventually change the status of these deviant groups to functional members of society.

Lutte contre l’illettrisme En 6ème, je ne savais pas écrire mon nom ! (2016)

Society tends to distance itself from deviant groups without any purpose or belonging, however psychologists provide support for the social integration and valued social participation of people with learning disabilities through exercises that involve learning through imitation. This challenges stereotypes within wider society through direct experiences of spending time with people who are affected by learning disabilities.

While psychology evolves and sophisticated and modern theories about intelligence and communication such as our « Organic Theory » take shape, we hope that observations such as this one may be digested and understood by the masses, that is:

« While the communicative patterns [language] in human primates vary with socio-behavioural and geographical patterns; creativity and IQ remain constant and do not change. Intelligence and creativity cannot be stopped because of linguistic differences, since talented and gifted humans do not choose the location of their birth nor their linguistic heritage but still contribute to the enhancement of our civilisation. »

Which concludes that that the intelligence of an invidual when assessed on a range of variables [e.g. perception, fluid intelligence, artistic creativity, reasoning, emotional intelligence, courage, values, etc] cannot be deduced by simply assessing their academic abilities, since human life has various sides to itself. Hence, the true worth and value of an individual may always remain a problem and a mystery to fully assess [since most only assess people on the variables they are interested in, for e.g. a company looking for a secretary will assess the applicant on her ability to handle office politics, and not other abilities essential to exist as a human within civilisation], and this seems to go in line with Jean Piaget’s deduction about the uniqueness of the human organism and mind.

Michel-Ange-Toujours-A-Apprendre-Always-Learning

« I am still learning » – Michael-Angelo at the age of 87 / Image: La Création d’Adam (1508 – 1512)

Neurodevelopmental Disorders & Intellectual Disabilities

Neurodevelopmental disorders are disorders occurring due to the biological dysfunction of the brain that in turn lead to developmental deficits that come in a range that can be very specific to global impairment. These groups however often co-occur together, i.e. one could be affected with Intellectual Disability (ID) and also Autistic Spectrum Disorders. Psychologists are expected to show great care when assessing this group of disorder as they vary in severity. Severity has 4 Specifiers and 3 Domains [Intellectual].

Specifiers: [1] Mild – [2] Moderate – [3] Severe – [4] Profound

Domains [Intellectual]: [1] Conceptual – [2] Social – [3] Practical


Intellectual Domains

The first domain, which is the Conceptual Domain refers to all things learnt at school and required for employment and adequate independent functioning within the community. Secondly, the Social Domain refers to social, developmental and emotional factors associated to age. This manifests in them as being victims of manipulation and abuse by others. Finally, the Practical Domain refers to all skills required to live healthily [also this is subject to interpretation depending on contexts, socio-linguistic and cultural settings].

Intellectual Disability

For one to be qualified as intellectually disabled, we would have to meet all the 3 criteria below:

  • Deficits in intellectual functions, such as reasoning, problem-solving, planning, abstract thinking, judgement, learning [also from experience].
  • Deficits in adaptive functioning that means failure to meet developmental milestones within the socio-cultural standards. Limited function in daily life, participation, communication, independence in multiple environments (i.e. Global).
  • Onset is during developmental period [childhood – another link to the Psychoanalytic theory of Sigmund Freud & Jacques Lacan]


Assessment and Judgement

Careful distinction must be made when assessing patients suspected of suffering from Intellectual Disabilities (ID) between the low end of normal function and ID itself. The most widely used method clinically are IQ assessments and typically suggest any score that is 2 Standard Deviations below the mean [IQ scores of 75 +/-5] and whether the patient has had any clinical experience. Assessment based on the patient’s reasoning in real-life situations are also made. Global Developmental Delay is a term reserved for children under 5 who cannot adequately be assessed, but have missed all their developmental milestones.


Associated Features with Intellectual Disabilities (ID) to look for when diagnosing patients are:

  • Social judgment
  • Assessment of risk
  • Self-management of behaviour – interpersonal relationships and emotions
  • Motivation in school, university or work
  • Lack of communication skills and functional problem behaviours
  • Gullibility [Diagnosis is based on how people and society mistreat them – quite shocking or controversial?]
  • People with Intellectual Disabilities (ID) are also at high risk of suicide


Prevalence of Intellectual Disabilities

In the UK, 1% of people suffer from intellectual disabilities and 0.006% of the population have severe disabilities requiring supported living [that is about 360, 000 people in the UK] – a slight bias with a ratio of 1.6:1 towards males; this is due to the vulnerability of the male brain.


Autism Spectrum Disorders

As psychology evolves more consideration are being given to a dimensional aspect of abnormal behaviour rather than the usual dimensional [i.e. inflexible and sometimes exaggerated in terms of descriptive precisions disregarding individual fluctuations in symptomatic manifestations] constructs of mental disorders. Autistic Spectrum Disorders (ASD) was the first mental disorder to initiate such a shift from categories to dimensions.

  • Autistic Spectrum Disorders (ASD) with Intellectual Disability (ID) = Autism
  • Autistic Spectrum Disorders (ASD) without Intellectual Disability (ID) = Asperger’s Syndrome


Characteristics of Autism Spectrum Disorders

ASD is characterised mainly by deficits in social communication and restricted patterns of behaviour. For a diagnosis of ASD the deficits must appear early in the developmental period [however they cannot be diagnosed until the demands of a particular task exceeds the child’s capabilities] – so more severe it is the earlier it is diagnosed [e.g. Rett syndrome].


[A] Communication in ASD

In ASD, it is common to find persistent deficits in social communication and social interaction across multiple contexts illustrated by:

  • Deficits in social-emotional reciprocity, ranging from abnormal social approach. Failure to initiate or respond to social communications. Reduction in sharing interests, affect and emotions.
  • Deficits in non-verbal communicative behaviours used in normal social interactions. Abnormal or no eye contact, body language or deficits in reading [understanding] gestures. A total lack of facial expression and non-verbal communication.
  • Deficits in developing, maintaining and understanding relationships [e.g. from difficulties in adjusting behaviour to suit context]. Difficulties in sharing imaginative play or in making positive social acquaintances or friends. Hardly any interest in any form or peers.


[B] Behaviour in ASD

It is also fairly normal to notice restricted, repetitive patterns of behaviour, interests, or activities manifested by at least two of the following:

  • Stereotyped or repetitive motor movements, use of objects, or speech
  • Insistence on sameness, inflexible adherence to routines, or ritualised patterns of behaviour. Shows extreme distress at small changes, difficulty in transition, rigidity, insistence on same route taken or foods
  • Hyper or hypo-reactive to sensory inputs or unusual interest in sensory aspects of the environment (indifference or hyper-responsive to pain, temperature, sound, textures, excessive smelling to touching of objects, visual fascination with movements or lights.

ASD may also manifest itself with or without intellectual disability, with a similar scenario for language impairment, and can be associated with medical or genetic conditions or environmental factors [exposure]. ASD can also be associated with another neurodevelopmental, mental or behavioural disorder and can also comprise catatonia.
Features to look out for

  • People with ASD often have uneven profiles or abilities – even the high functioning variants, and this can lead to substantive stress for them
  • They also often have odd motor idiosyncrasies – such as an odd gait, clumsiness and abnormal ambulatory movements.
  • Disruptive, challenging behaviour and injuries are also very common
  • As sufferers of ASD age, they are also more prone to developing anxiety and depression and are likely to end up in a catatonic state


Prevalence

Autistic Spectrum Disorders (ASD) seem to be a genetic disorder, however it involves a variety of genes. 15% of ASD is due to a known mutation in over 90% of concordance studies with twins. Most researchers nowadays suggest that it is inherited and polygenic [lots of genes from genetic ancestry with each adding their weight to the likelihood of the disorder manifesting]. Males are 4 times more likely to suffer from ASD than females, and even high functioning adults with ASD have poor functioning, such as low rates of independent living and employment – older adults tend to become isolated and do not engage in help-seeking behaviours [note that this is different to individuals who may have a solitary personality by conscious choice or a highly selective social circle in personal relationships based on values, in ASD the patients are generally not conscious of the causes of their debilitating condition]

Specific Learning Disorders

Specific Learning Disorders are characterised by the following:

[A] Difficulties learning and using academic skills, as indicated by the presence of at least one of the following symptoms that has persisted for longer than 6 months:

(1) Inaccurate or slow reading
(2) Difficulty understanding meaning in what was read
(3) Difficulties with spelling
(4) Difficulties with written expression
(5) Difficulties mastering number sense, number facts and calculation
(6) Difficulties in mathematical reasoning

[B] The affected academic skills are substantially and quantifiably below the expected level for the chronological age causing interference with academic, occupational or daily living

[C] Learning difficulties begin during school-age years, but will only manifest itself and be diagnosed when the affected person’s capabilities are stretched by demands

[D] It is also independent and not caused by another health or psychological disorder


Specifications of Specific Learning Disorder

SLD generally involves impairment in reading, writing and mathematics. If it is mild in intensity, the person can generally compensate. Moderately affected people however cannot compensate, but will respond to specialist teaching. Finally, severe conditions require specialist teaching in a specialist school as learning will not occur without such arrangements.


Features to look out for in confirming SLD

  • SLD can occur in any individual, even those classed as gifted (IQ 130+)
  • It is usually diagnosed in the early years, but in higher ability individuals it may manifest in odd ways especially when their compensatory methods are undermined
  • Patient generally have difficulties with motor co-ordination
  • It is a life-long condition and does not improve with therapy, but has to be compensated for
  • Patients also tend to have working memory deficits and keep messy environments
  • Early signs include mispronouncing words, struggling to break down words into syllables


Prevalence of Specific Learning Disorders (SLD)

SLD tend to occur in premature children or among societies with a very low birth rate. It is also more common in children with parents that smoke cigarettes [nicotine?] and is 8 to 10 times higher in families with a heritability index of 0.6 and 3 times higher in males [the vulnerability of the male brain once again]. The problems it causes with attention are likely to predict problems with the mathematical and reading components of the brain. SLD usually ends with unemployment, under-employment depression, poorer mental health and suicidal behaviour – support of any kind alters all of these outcomes.

 

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Part 2 of 5 | Anxiety Disorders

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Anxiety disorders are linked to the development of irrational fears of situations that are not life-threatening (Antony & Stein, 2009a). The avoidance of feared situations or experiences also lead to non-adaptive behavioural patterns. People suffering from anxiety disorders generally have fears accompanied by intense physiological arousal displayed by some or all of the following features: accelerated heartbeat, sweating, trembling, sensations of shortness of breath or smothering feelings of choking, chest pain, nausea, numbness or tingling, and chills or hot flushes. Other experiences of dizziness, derealisation (feelings of unreality) or depersonalization (feelings of being detached from the self) are also present in some cases.

In contemporary psychology there are a number of distinctions made between a variety of anxiety disorders based on the developmental timing of their emergence, the classes of stimuli that elicit the anxiety, the pervasiveness and topography of the anxiety response, and the role of clearly identifiable factors in the aetiology [the cause, set of causes, or manner of causation] of the anxiety.

The six main anxiety disorders are described below.


[1] Separation Anxiety

This condition most occurs in children and is generally manifested by a recurrent and persistent fear that is aroused when separation from the parents or caregivers is anticipated or imminent (American Psychiatric Association, 2000; Furr et al., 2009; Pine & Klein, 2008; World Health Organization, 1992). The persistent, excessive worry about losing, or about possible harm befalling a parent is the main characteristic of Separation Anxiety Disorder with nightmares on the similar themes also present in some cases along with recurrent head-aches, stomach-aches, nausea and vomiting. Separation anxiety is also one of the most common causes of school refusal, and sufferers may also display a refusal to sleep without being in close proximity with the parents.


[2] Phobias

Phobic anxiety is the irrational and intense fear aroused when one is faced with an object, event or situation from a clearly defined class of stimuli which is exaggerated in terms of danger posed (American Psychiatric Association, 2000; Blackmore et al., 2009; Hofmann et al., 2009; World Health Organization, 1992). When the person affected is exposed to the phobic stimulus, or anticipates its exposure, panic attacks may arise in adults whereas is children this may lead to excessive crying, tantrums, freezing or clinging. The persistent avoidance of phobic stimuli in phobias is endured with intense distress and this affects an individual’s personal functioning.

In the DSM, specific phobias are subdivided into those associated with animals, injury (including injections), features of the natural environment (such as heights or thunder), in particular situations (such as elevators or flying). These specific phobias are different from social phobias and agoraphobia.

In those affected with social phobias, anxiety is generally mainly aroused by social situations [e.g. public speaking, eating in public where there is the possibility of scrutiny by others and humiliation or embarrassment as a result of acting inappropriately]. In those with agoraphobia, the condition is known to manifest itself with panic attacks in public places, such as being in a queue, or on public transport – hence, these situations tend to be compulsively avoided to prevent the reoccurrence of the panic attacks.


[3] Generalized Anxiety Disorder

One of the main characteristics in general anxiety disorder is the constant feeling that misfortunes of various sorts will occur (American Psychiatric Association, 2000; Bitran et al., 2009; Hazlett-Stevens et al., 2009; World Health Organization, 1992) and the anxiety is not focused on one particular object or situation along with difficulties controlling the worrying process and a belief that worrying is uncontrollable.

General anxiety disorder is mainly composed of nervousness, restlessness, difficulty relaxing, feeling on edge, being easily fatigued, difficulties in concentration, irritability, tearfulness, sleep disturbance and signs of autonomic over-reactivity such as trembling, sweating, dehydrated mouth, light-headedness, palpitations, dizziness and stomach discomfort. [DSM requires some or more of those symptoms to be present]

Case Example of Generalised Anxiety Disorder

Margie, a 10 year old girl was referred to the psychologist after displaying excessive tearfulness in school, the condition which had been gradually amplifying over a number of months and the bouts were unpredictable. Margie would often end up in tears while playing with her friends during break time or when spoken to by the teacher. In the family doctor’s referral letter she was described as a worrier like her mother.

Presentation

in the assessment interview Margie explained that her worries were mainly about a routine daily activities and responsibilities, she would also worry about doing poorly at school and that she had made mistakes which would later be discovered, that her school friend would not like her, that she would disappoint her parents with the way she did her household chores, that she would either be too late or too early for the school bus, that there would not be any space for on the bus and that she would forget her school books. Her worries also extended to health with frequent stomach aches.

The safety of a family also troubled her, she would worry that her house would be struck by lightning, that the river would break its banks and flood the low-lying fens where she lived, washing away her whole house. The future was also a major concern of hers as she worried about failing her exams and being unable to find a satisfactory job, and being unable to find a marital partner or marrying an inadequate person. A continuous feeling of restlessness with the inability to relax was also reported by her.

Family History

The family was very close and Margie was the eldest of four children and the only girl. It was observed during the intake interview that the mother and the father displayed symptoms of anxiety, while the former had been treated with benzodiazepines for anxiety over a number of years. The family also admitted to regularly discuss their problems about their own health and safety and their own worries about the uncertainty of the future.

The father, Oliver was employed by the insurance company and regularly have conversations at the dinner table about the accidents and the burglaries that had befallen his client, and Margie regularly participated in these conversation, being the eldest among her siblings. However the main concern of the parents was about Margie’s tearfulness which they believed was unusual along with her worries and fears which they thought as legitimate. Margie spent a lot of time with her parents’ company but also had a couple of close friends with whom she played at the weekends.

Formulation

Margie was diagnosed with generalised anxiety disorder. The precipitating factor for the condition was not apparent as it had gradually evolved over the course of Margie’s development. The referral however, was precipitated by episodes of tearfulness at school. The predisposing factors in her case comprised of a highly likely possibility of genetic vulnerability to anxiety and exposure to family culture characterised by an excessive concern with safety and oversensitivity to dangerous situations. The ongoing parental conversations about potential threats to the family’s well-being likely maintained the condition along with inadvertent reinforcement of Margie’s tearfulness at school, where her tears were responded to with considerable concern.

The protective factors in the case included good premorbid adjustment, the parents’ and the school’s commitment to solving the problem and the availability of peer group support. [This formulation is diagrammed below]

General Anxiety Disorder Formulation

Treatment

In this particular case, treatment involved family work focused on helping Margie parents reduce the amount of time they spent discussing themes related to danger and threats to their health and safety, and increase the amount engaged in activities and discussions focused on Margie’s strengths and capabilities. The parents were also assisted in coaching Margie into learning relaxation skills and mastery oriented coping self- statements. Eventually Margie showed improvement in her adjustment in school with some reduction in anxiety and tearfulness.

[4] Panic Disorder

In panic disorders, there are recurrent unexpected panic attacks; an ongoing primary fear of further attacks; secondary fear of losing control, going insane, having a heart attack or dying (American Psychiatric Association, 2000; Ballenger, 2009; Hofmann et al., 2009; World Health Organization, 1992). Acute episodes of intense anxiety our experienced in panic attacks, and these reach a peak within 10 minutes. They are characterised by autonomy hyper arousal shown by some of the following symptoms:

– Palpitations

– Sweating

– Trembling or shaking

– Shortness of breath

– Feelings of choking or smothering

– Chest pain or discomfort

– Nausea or abdominal distress

– Dizziness

– Chills or hot flushes

– Parasthesias (Numbness or tingling sensations)

– Derealisation (Feelings of unreality)

– Depersonalisation (Feelings of being detached from oneself)

In panic disorder, patients tend perceive normal fluctuations in autonomic arousal as a stimulus that provokes anxiety, with the belief that these may signal the onset of a panic attack. During a panic attack, patients typically tend to report an irresistible urge to escape the location where the attack occurred and to avoid such situations in the future. Public settings are usually the most common location where panic attacks take place [e.g. queues, public transport, shopping mall, etc] and acute autonomic arousal is only alleviated upon escape from these places or situations – hence secondary agoraphobia often develops when the patient fears leaving the safety of their homes in case of panic attacks occurring in public settings.

[5] Posttraumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) tends to occur after a catastrophic trauma such as a terrorist attack, an armed combat/robbery, a natural or man-made disaster, a serious accident that was perceived to be potentially life-threatening for oneself or others, torture, child abuse or rape.

PTSD is mainly composed of:

– Recurrent intrusive traumatic memories

– Intense anxiety in response to these memories and ongoing hyper arousal in anticipation of their recurrence

– attempts to regulate anxiety and hyper arousal by avoiding cues that trigger traumatic memories and attempts to suppress these memories when they intrude into consciousness (American Psychiatric Association, 2000; Ehlers, 2009; Friedman, 2009; World Health Organization, 1992).

Recurrent, traumatic memories include flashbacks, nightmares, or repetitive trauma themed play in the case of children, and these occur in response to internal (psychological) or external (environmental) cues that symbolise the traumatic event or aspects of it. Since patients with PTSD tend to anticipate the recurrence of traumatic memories, they experience chronic hyper-arousal which may in turn lead to difficulties in concentration, sleep difficulties, hyper-vigilance and irritability. In PTSD, the attempts to suppress traumatic memories and the avoidance of trauma-related situations may turn out to be unsuccessful, when such a scenario occurs, the PTSD person generally experiences an increase in the frequency and intensity of past traumatic memories. Emotional numbing is also quite common in chronic cases due to the frequent attempts to keep the trauma-related memory out of consciousness – this eventually leads to the inability to recall the traumatic memories. To some this may seem like a solution but the cost is excessive since emotional numbing does not only result in the exclusion of trauma-related emotions such as anxiety and anger out of consciousness, but also tender feelings such as love and joy – which cease to be experienced by the patient.

PTSD may also lead to a subjective sense of foreshortened future to the patient and this may also be accompanied by limited involvement in his/her usual activities.

[6] Obsessive Compulsive Disorder

Obsessive Compulsive Disorder (OCD) is generally characterised by distressing obsessions and compulsive rituals that reduce the anxiety associated with those obsessions [like 2 opposing forces] (American Psychiatric Association, 2000; Matthews, 2009; World Health Organization, 1992; Zohar et al., 2009). Obsessions are stereotyped thoughts, impulses or images that are recurrent and persistent. These cause serious anxiety to the patient since they are experience as senseless, uncontrollable and involuntary, and are linked to issues such as obscenity [this does not mean that healthy people with normal sexual feelings in healthy relationships have OCD], violence and danger [for e.g. some people suffer from irrational fears of the possibility of a catastrophe occurring unless symmetry or order is maintained, or there may be fears of losing control and violently raping or assaulting others, or fears of contamination [hygienic].

These compulsions are ritualistic and repetitive accompanied by stereotyped behaviours such as hand washing, ordering and checking or mental acts such as repeating words silently [which some patients feel compelled to do to regulate the anxiety caused by the obsessions], counting or praying [this should not lead to the belief that all people with faith in God suffer from OCD]. Compulsions are generally excessive attempts or unrealistic ways to avert imagined dangers entailed by these recurrent obsessions that are debilitating and are usually recognized as pointless while repeated attempts are made to resist them [once again this seems to be linked to the unconscious yet active component of mental activity and yet again leads us to Sigmund Freud and Jacques Lacan].


Clinical Features of Anxiety Disorders

The 6 anxiety disorders listed above are classified into the domains of Perception, Cognition, Affect, Arousal, Behaviour and Interpersonal Adjustment. In regards to perception, the disorders vary in the classes of stimuli that elicit the anxiety in the patient.

i)Perception

In cases of Separation Anxiety, the separation itself is the stimulus. Where phobias are the condition present, it is specific creatures [e.g. animals], events [e.g. injury], or situations [e.g. meeting new people] that trigger the anxiety. With Generalized Anxiety Disorder [GAD], the interpretation of multiple aspects of the environment end up being interpreted as potentially threatening. Panic disorder is characterised by somatic sensations of arousal such as tachycardia being perceived as threatening since they are treated as the signals that lead to full-blown panic attacks. In people with PTSD external and internal cues that bring back memories of the trauma that led to the condition elicit anxiety. In Obsessive Compulsive Disorders (OCD) stimuli that evoke obsessional thoughts elicit anxiety [e.g. potentially dirty environments or situations may give rise to obsessional ideas about hygiene and cleanliness, and anxiety about contamination.

ii)Cognition

It is important to note that in all 6 of those listed anxiety disorders, that the central organizing theme around cognition is “detection and/or avoidance of danger”. In children with Separation Anxiety there is the irrational belief that the caregivers or parents will be harmed if the separation occurs. In people affected by Phobias there is a constant fear of being harmed by either the feared object or creature, or being in the feared situation [e.g. being bitten by a god – in the case of Dog Phobia OR being negatively judged by meaningless strangers that have no connection or impact on the life of the patient in the case of Social Phobia]. As for Generalized Anxiety Disorder (GAD), patients tend to catastrophize about any features of their environment [e.g. fears of their house being burnt down, or that they will be the victim of a car crash, or punishment for some wrongdoing, they will be forsaken by those they consider as friends, and so forth – they also believe that their worries are uncontrollable. In Panic Disorder, there is the belief that more panic attacks are imminent and that they might be fatal to the patient. In many cases secondary agoraphobia also develops as they individual develops the belief that remaining in the safety of their homes might lower the probabilities of suffering from a panic attack. As for PTSD, there is the belief that as long as the intrusive memories of the trauma are forced out of consciousness, the danger of re-experiencing the intense fear, distress and horror associated with the traumatic event that led to the condition of PTSD can be avoided. Obsessive Compulsive Disorder (OCD) generally leads to obsessions mainly concerned with dirt and contamination; catastrophes such as fires, illness or death; symmetry, exactness and order; religious scrupulosity; disgust with secretions and bodily wastes [e.g. urine, saliva or stools]; lucky or unlucky numbers and extreme, wild, violent and even dangerous sexual thoughts [risk-taking] – the neutralisation of the threat posed by specific obsession-related stimuli is believed to be achieved through being engaged in specific rituals.

iii)Affect

In all 6 of the mentioned anxiety disorders affective states generally follow the beliefs about threat and danger, and these are characterized by feelings of uneasiness, restlessness and tension. In the case of OCD, outbursts of anger may occur if the patient is restricted from executing his/her compulsive rituals or if compelled to approach the feared stimuli; and in children with Separation Anxiety Disorder (SAD) may display aggressive tantrums if compelled to stay in school without their caregivers or parents. In Post-Traumatic Stress Disorder (PTSD), on top of the affective experiences of tension and uneasiness, emotional numbing arises from repeated attempts to exclude all affective material from consciousness.

iv)Arousal

The pattern of physiological arousal varies depending on the frequency of contact with the feared stimuli. In Separation Anxiety Disorders (SAD), hyper-arousal only occurs when separation is anticipated or imminent. In the case of Specific Phobias hyper-arousal only manifests in the present of the feared object or animal. In General Anxiety Disorder (GAD), a pattern of ongoing hyper-arousal can be observed, while in Panic Disorder and PTSD it is moderate followed by brief episodes of extreme hyper-arousal – these occur during attacks in Panic Disorder and when memories of the traumatic event intrude into consciousness in PTSD. In the case of OCD, specific cues related to the obsessions evoke acute and intense episodes of arousal.

In somatic symptoms the extent to which physiological arousal finds expression varies, for e.g. recurrent abdominal pain and headaches are quite common in Separation Anxiety. Sleep problems also occur in most Anxiety Disorders. In Panic Attacks it is also common to notice full blown attacks with sweating, feelings of choking or smothering, shortness of breath, trembling, nausea, dizziness, chest pains, hot flushes or chills, parasthesias, depersonalization or derealisation.

v)Behaviour

All Anxiety Disorders are characterized by avoidance behaviours, and in Specific Phobia, avoidance may even lead to a constriction in lifestyle [using an Injury Phobia as example, the patient may refuse to take part in any form of physical activity [e.g. sports] or ride a bicycle]. In other cases, the patient sometimes become house bound due to his compulsive avoidance, and this generally occurs in Separation Anxiety Disorder, Generalized Anxiety Disorder, Panic Disorder and PTSD. In those with PTSD, the use of alcohol or drugs to alleviate negative affect and suppress traumatic memories is quite common; and in OCD the patients generally engage in compulsive rituals in a desperate effort to regulate their anxiety associated with obsessional thoughts [it may be fair to note the relation between the Anxiety [as the Signifier] and the Obsessional Thoughts [as the Signified] in a Lacanian perspective here to point out the logic behind the flamboyant Frenchman’s model of Mental Activity based on Freud’s initial Topological Model – the Unconscious, the Preconscious and the Conscious]. These compulsions in OCD genereally include washing, repeating a particular action, checking, removing contaminants, touching, ordering and collecting.

vi)Interpersonal Adjustment

All 6 Anxiety Disorders affect interpersonal adjustment in a precise manner. In cases of Simple Phobia, interpersonal difficulties arise only in those situations where the individual does not conform or co-operate with normal activities [deemed social] so as to avoid the feared stimuli [e.g. a brief episode of marital conflict may occur if a husband refuses to enter an elevator at a shopping mall because of his claustrophobia]. Separation Anxiety Disorder (SAD), Panic Disorder (PD), Generalized Anxiety Disorder (GAD) and Post-Traumatic Stress Disorder (PTSD) sometimes prevent young people from attending school or adults from attending work, and in all those situations friends or family relationships may be seriously compromised. In the case of OCD peers or relatives may sometimes attempt to reduce the sufferer’s anxiety in participative actions in the compulsive rituals or in other cases, they may also exacerbate the anxiety by punishing the patient for his or her compulsive behaviour. In extreme cases, these compulsions can become so extreme that the affected person becomes constricted.


Epidemiology, Risk Factors and Course of Anxiety Disorders

Anxiety Disorders are the most common types of psychological disorders, and the lifetime prevalence rate in adults in the US National Comorbidity Survey Replication was 28.8% (Kessler et al., 2005). There is a consensus that Phobias are the most prevalent anxiety disorders and OCD is the least prevalent across a wide range of epidemiological studies (Kessler et al., 2009; Furr et al., 2009). For Phobias, lifetime prevalence estimates range from 6% to 12%, whereas those with OCD fall below 3%. Generalized Anxiety Disorder (GAD) has a lifetime prevalence of 1% to 6 %, whereas Panic Disorder in adults and Separation Anxiety in children range from 2% to 5%. In National representative samples, the prevalence of PTSD ranges from less than 1% or 2% in Western Europe to almost 8% in the US. The great variability is believed to be due to the fact that PTSD rates depend on the prevalence and traumatic exposure within specific locations geographically and the vulnerability of the populations within these countries to developing PTSD – in populations exposed to terrorism the prevalence is 12% – 16% (DiMaggio & Galea, 2006).

In people suffering from Anxiety Disorders, there is also a high risk of comorbidity [i.e. other anxiety disorders may also be present], and up to 1/3 of those suffering from Anxiety Disorders also suffer from another (Kessler et al., 2009) – they may also occur comorbidly with mood disorders in adults as well as children, substance use disorder in adults and adolescents and disruptive behaviour in young people/children (Furr et al., 2009; Huppert, 2009; Zahradnik & Stewart, 2009).  In cases where substance misuse is also present, the use of drugs or alcohol is quite common in managing anxiety.

OCD is also present in a significant proportion of people with eating disorders such as anorexia nervosa. (Halmi, 2010).

We can observe a clear age and gender difference in the prevalence of Anxiety Disorders (Antony & Stein, 2009a; Furr et al., 2009; Kessler et al., 2009) and across most studies that are available, the modal age of the onset in Separation Anxiety Disorder and Specific Phobias is during the developmental phase in childhood [a stage pointed out by both great Western psychotherapists, Freud and Lacan, and also John Bowlby in his observational research on the development of attachment types in children at this critical stage of development], whereas that of anxiety disorders generally happens during adolescence or adulthood. In both adults and children, there is a tendency for more females to suffer from Anxiety Disorders than males, with the exception to this balance being for OCD which has a similar number men and women suffering from the condition although it is the rarest of anxiety disorders.

Anxiety Disorders tend to show a recurring episodic course with a gradual reduction in prevalence over the course of the life cycle (Kessler et al., 2009). It is also worthy to note that most children with anxiety disorders do not grow up to be adults with anxiety disorders or depression, however most anxious adults do have a history of childhood anxiety disorders. There are a number of risk factors associated with Anxiety Disorders and these include anxiety disorders or psychological disorders in the direct genetic network, an inhibited temperament of behaviour, neuroticism as a trait of personality, a personal experience of psychological problems, a history of over-controlling or critical parents, a history of conflict and violence and a history of stressful life events (Antony & Stein, 2009b; Pine & Klein, 2008). In the scenario of Anxiety Disorders, a behaviourally inhibited temperament is generally the tendency from birth – to become nervous and withdrawn from unfamiliar situations and stimuli. Neuroticism is a trait of personality that gradually develops over the life-span, and it is characterized by the tendency to escape negative affect and includes hostility, anxiety and depression in its manifestations.

In those suffering from Post-Traumatic Stress Disorder (PTSD) the additional factors that increases the risk for development include the severity of the trauma, high-life stress following the trauma, low socio-economic status, low support [from friends or those considered as friends], low intelligence and low educational level (Ehlers, 2009; Ozer et al., 2003). In PTSD, dissociative experiences tends to refer to abnormalities of perception, memory or identity such as derealisation [seeing the world as dream-like], depersonalization [seeing oneself from an external perspective or inability to recall important information]. In the case of parents with PTSD, their children are also at a higher risk of developing the disorder (Pine & Klein, 2008).

 

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Part 3 of 5 | Depression

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The states of being happy or sad are adaptive feelings, and many behaviours that lead to happiness among human beings, such as socializing [with the people that matter to the subject], becoming completely absorbed in productive work and developing longstanding friendships that are meaningful around values and loyalty, are important not only for the emancipation of the individual but also for a harmonious and functional society that embraces the « humane » qualities of mankind in all its creative aspects.

Sadness on the other hand is a psychological state commonly preceded by loss [of various kinds, which may range from material objects to valued relationships or abilities/skills and status related to them through accident or disease or other situations], and it is a negative feeling which may also be adaptive, in a sense that it is a reminder to most people [at least for those who are NOT philosophically oriented / cultured or have an understanding of values and loyalty in interpersonal relationships], that valued things or people need to be taken care of if they do not want to lose them in the future, especially the common volatile brain [i.e. the basic Darwinian instinct-guided average brain that lacks reflective abilities, reasoning skills, intuition and insight, while also failing to realises or understand the motivation behind its behaviour until matters have taken a disastrous course]. Sadness is also a way of signalling to others that we as human beings also need care and elicits [to most psychologically healthy human beings with a theory of mind] support that soothes our emotional pain – this is what makes us a superior breed of primates, i.e. our ability to reason and evolve with emotions as a propulsive form of energy for both individual and group, like Alexandre Dumas put it, “Un pour tous et tous pour un!” [French for “One for all and all for one!”].

Some extreme states of mood such as depression and mania are less adaptive than happiness and sadness; and it is now commonly known that during periods of hypomania or mania some patients suffering from Bipolar Disorder [which is characterized by episodes of mania and depression] produce highly creative artistic work (Silvia & Kaufman, 2010). This should not lead us to the conclusion that ALL creative people with extreme ways of exploring and expression their emotions through art suffer from Bipolar Disorder. But for those who do suffer from Bipolar Disorder and produce creative work, this highly valued asset comes at a price, since these individuals generally involve themselves in high-risk behaviours that come with the possibility of severe dehydration and exhaustion during manic episodes.

Seasonal Affective Disorder [or Winter Depression, its colloquial name] is a condition that is believed to be linked genetically to our cave-dwelling ancestors from the prehistoric era, who may have hibernated – an adaptive behaviour for the ancestors. However, in the world of today, depression does not seem to serve any adaptive function, and despite this, it remains a highly prevalent condition that affects up to 25% of the population (Kessler & Wang, 2009); because of this prevalence the main focus of this section will be on Major Depressive Disorder.

Share of population with chronic depression

Share of the population reporting that they had chronic depression / Source: EuroStat

It is quite fundamental to grasp that depression is not simply “feeling sad”, as Major Depressive Disorder is an ongoing condition characterized by episodes of low mood and loss of interest in pleasurable activities along with other symptoms such as poor concentration, fatigue, pessimism, suicidal thoughts, and sleep and appetite disturbance. Depression is a serious public health concern because it radically decreases the quality of life of those affected, is a huge economic burden in terms of reduced productivity [and lack of creativity] among the national work force, and it also has adverse effects on the mental health and adjustment of the children of the depressed people (Garber, 2010; Kessler & Wang, 2009). This section will focus on the clinical features, epidemiology, risk factors and course of depression [suicidal risks will also be discussed].


Clinical Features of Depression

Severity

Depression can be classified as mild, moderate to severe, depending on the degree of impairment

Melancholia

In regards to somatic or melancholic features, in severe depression where there is a loss of pleasure in all activities [known as anhedonia] and a lack of reactivity to pleasant stimuli along with diurnal variation in mood and sleep and appetite disturbance, we tend to qualify such episodes as having melancholic features. Historically [please take note that this is not the case anymore], there was an ongoing view that these symptoms reflected “endogenous”, a genetically determined and biologically based form of depression, as different to a “reactive” depression arising from exposure to stressful life events and environmental adversity (Monroe et al., 2009).

However, the difference between these 2 forms of depression was not supported by empirical research, which instead shows that ALL episodes of depression are preceded by stressful life events, and that in any given scenario, we tend to have a combination of genetic vulnerability and environmental adversity that contribute to the development of depression (Parker, 2009).

Psychotic Depression

When mood disrupting delusions and hallucinations are present, depressive episodes are described as having psychotic features. Mood-congruent delusions are generally firmly held beliefs that are extremely pessimistic in nature and that have no basis in reality [illogical and cannot be explained and justified; for e.g. that a completely innocent individual is guilty of many wrongdoings and deserve to die. Mood-disrupting hallucinations in depression are generally auditory and sometimes involve the hearing of voices in a complete absence of any form of external stimuli [uncontrolled and unimagined and ongoing for months], which has negative advices to the sufferer [e.g. You are a failure, you are guilty of wrongdoing, or evil].

Among children, adolescents and adults, there has been a range of clinical features identified through both clinical observation and empirical research (e.g. Bech, 2009; Brent & Weersing, 2008; Gotlib & Hammen, 2009; Nolen-Hoeksema & Hilt, 2009a). Common clinical features of depression tend to affect the domains of cognition, perception, mood, somatic state, behaviour and relationships. Loss is once again a main thematic feature in depression as pointed out by Psychoanalytic Theories [loss of any kind, e.g. material, emotional, relationship, valued attribute due to sickness/accident, health, etc], and clinical features may be linked to those different domains of mental life.

Perception

In regards to perception, depressed individuals who have suffered some form of loss [internal or external] tend to perceive reality and the world as one where further losses are possible, and individuals who suffer from depression also selectively attend to negative stimuli and features in the environment. This leads them to engage in further depressive cognitive patterns in their thoughts processes and unrewarding behavioural patterns which amplify their depression’s severity – in cases of severe depression, mood-congruent auditory hallucinations are often reported. Hence, depressed people or people with depressive personality traits tend to come across as repulsive and despicable because of their obsessive disposition to only perceive the negative side of everything and every situation that life has to offer [note: this is different to constructive criticism which is normally for a purpose and comes with systematic reasons for enhancement]. Psychologists tend to go with the assumption that such severe perceptual abnormality is present only when patients report hearing harsh critical voices or containing depressive contents [as mentioned above]. These auditory hallucinations are also present in schizophrenia, however they are not always mood-congruent like in depression.

Cognition

Depressed patients tend to describe the world and the fabric of reality of their subjective experience in negative terms, this also include descriptions of themselves and their abilities [e.g. occupational and social accomplishments] – this negative evaluation is often portrayed as guilt for not living up to the standards [they set themselves based on their ‘perceived’ abilities] or for letting others down. They sometimes perceive their direct environments [peers, network, family, work colleagues or school/university] as hostile, apathetic, critical and unrewarding. The future is also described in very bleak terms by those suffering from depression, and they also report little if any hope that matters will improve. When extreme hopelessness is reported is it usually accompanied with excessive guilt for which the patients believe they should be punished – suicidal ideas and intentions may also be declared. In depressive delusional systems, extremely negative thoughts about the self are generally reported with the world and their future entangled in them.

Besides the content and thoughts being incredibly negative and bleak, depressed patients also tend to display concentration problems and logical errors in their thinking. These mistakes in reasoning are also characterized by a tendency to maximise the significance of negative events and minimize the significance of positive ones. Depressed patients also suffer from memory problems and struggle to remember happy events but instead have global over-general autobiographical memories about both positive and negative events. In addition to these, this category of patients also suffer from concentration, attention and decision-making problems that in turn give rise to difficulties managing leisure activities requiring sustained attention and academic or occupational responsibilities.

Affect

The impact on the patient’s affect tends to lead to low mood, and diurnal variations in mood and anhedonia. The depressed mood is usually reported as a feeling of sadness, loneliness, emptiness and despair. Diurnal variations in mood is usually quite common in severe cases of depression, with the patient’s mood generally being worse in the morning or after waking up. In cases of major depression, as a person moves from mild to moderate to severe depression, the increasing number of symptoms along with the intensity can also lead to intense anxiety. Generally, fears are experienced in the form of “Will this get worse? Am I stuck in this living hell forever? Will I ever be myself again? Will I be able to prevent myself from committing suicide to escape? Irritability is also a characteristics of depression, with the patient sometimes expressing their anger at the source of their loss [e.g. anger at a deceased one for abandoning the grieving person or sometimes at the health professional for not being able to alleviate their depressive symptoms].

Somatic State

The changes in the patient’s somatic state associated with depression include the disturbances of sleep and appetite, the loss of energy, failure to make age-appropriate physiological growth, weight loss, pain symptoms and a loss of interest in sexual activities. Commonly, depressed people struggle to find sleep and eat insufficiently due to their poor appetite; these symptoms are known as vegetative features. The sleep disturbances in depressed people generally involve problems trying to sleep, wakefulness at night or early-morning sleep disruption. Other symptoms such as racing thoughts and engaging in depressive rumination while unable to sleep is also quite common. In atypical cases of depression, patients may sometimes oversleep due to a constant feeling of exhaustion and consume excessive food due to an increased appetite or due to the feeling that eating may temporarily reduce their distress.

Medically unexplained chest, abdominal and back pain along with headaches are some of the additional features of depression. In some cases the pain symptoms are some of the first signs that would be reported to the doctor and it is only when the medical investigations of these symptoms turn out to be negative that depression is suspected to be the cause. All the somatic symptoms mentioned are consistent with research: dysregulation of neurobiological, endocrine and immune functions is associated with depression and the sleep is also affected.

Behaviour

Depressed patients are characterized behaviourally by the reduced and slow activity levels [psychomotor retardation] that they display, and are often helpless [without any control over their abilities] about their inability in getting involved in activities that could have helped their condition by bringing a sense of achievement or connectedness to meaningful [those chosen by the individual as a person with significance to him/her – note that it is a choice] people in their life. In rare cases some individual become house bound and immobile; such a condition is known as depressive stupor.

One of the major risks of depression is self-harm [a clear distinction is made between non-suicidal deliberate self-harm and suicidal behaviour]. In non-suicidal tendencies, patients may cut or burn themselves to distract themselves from the depressive feelings. In some cases, some have taken non-lethal overdoses to elicit attention and care from their close ones or to simply gain admission to hospital and remove them from the stressful situations that may have been amplifying their depressive symptoms.

Relationships

Depressed patients generally report a deterioration in their relationships with a range of significant figures in their lives from a wide range of environments [from professional to personal], and describe themselves as lonely, unable or unworthy to take steps to try and engage in some form of contact with others. Surprisingly, when the depressed attempt to overcome their loneliness by talking to others, they tend to come across as repulsive, unpleasant and draining through their depressive behaviour, pessimistic belief and sometimes arrogant narcissistic talks, this drives away those they interact with.

Video: Comment faire avec les gens frustrés ? – Benoit Zwick (2019)


Epidemiology, Risk Factors and Course of Depression

The most common mood disorder is Major Depression, and it has a lifetime prevalence rate of 6 – 25% in international community studies (Kessler & Wang, 2009). In the US National Co-morbidity Survey Replication the lifetime prevalence of DSM-IV Major Depression was 16.6% (Kessler et al., 2005). It is good to note that Depression is less common among pre-pubertal children than adolescents and adults (Brent & Weersing, 2008). Among children the number of boys to girl with depression is equal, however this changes in adolescence and by adulthood; compared with men, about twice as many women have depression (Nolen-Hoeksema & Hilt, 2009b).

In most cases of depression, there are many comorbid disorders also present. In the US, National Comorbidity Replication Survey, 59% of depressed patients suffered from comorbid anxiety disorders and 24% had comorbid substance use disorders (Kessler & Wang, 2009). Depression also tends to follow a chronic relapsing course, with up to 80% of people suffering from recurrent episodes, and it has been found that the median duration of episodes in community samples typically lasts for about 5-6 weeks. In clinical samples depressive episodes tend to last for about 5 to 6 months; the majority of cases however recover within 1 year and about half of patients continue to suffer from fluctuating residual symptoms between those depressive episodes; and for less than 10% of patients, recovery does not occur and chronic depressive symptoms persist and most cases relapse within 5 years (Angst, 2009; Boland & Keller, 2009).

During treatment, as more depressive episodes occur, we tend to notice a decrease in inter-episode intervals and a reduction in the amount of stress required to trigger the onset of further depressive episodes, an issue related to Stress Theories (Boland & Keller, 2009).

NOTE: Stress theories propose that individuals develop depression following exposure to stress. The diathesis- stress theories propose that depression only follows after exposure to stress in people who have specific biological or psychological attributes that render them more vulnerable to stressful life events, and the most vulnerable require the least stress to trigger depression (e,g., Joiner & Timmons, 2009: Joormann, 2009; Levinson, 2009). On the other hand, Stress-generation theory proposes that people with certain personal attributes inadvertently generate excessive stress, which in turn leads to depression (Liu & Alloy, 2010)

The risk factors for depression include a family history of mood disorders, female gender, low socio-economic status involving educational and economic disadvantage, and adverse early family or institutional environment, the depressive temperament, a negative cognitive style, deficits and self-regulation, high levels of life stress, and low levels of support from meaningful others (Garber, 2010; Hammen et al., 2010).

Risk factors for recurrent major depressive episodes identified in the US collaborative depression study of 500 patients, include a history of three or more prior episodes, comorbid dysthymia (often known as Double Depression), comorbid anxiety and substance use disorders, long duration of individual episodes, poor control of symptoms by antidepressant medication, onset after 60 years of age, the family history of mood disorder, and being a single female (Boland & Keller, 2009).

Four small category of people who suffer from depression, deficits the visual processing of light and the season of the year are risk factors for depression (Rosenthal, 2009). These people, who experience regularly recurring depressive episodes in the autumn and winter, with remission in the spring and summer, are generally considered as suffering from Seasonal Affective Disorder. These patients develop symptoms in the absence of adequate light and respond positively to enhanced environmental lighting, often referred to as “Light Therapy or Treatment” (Golden et al., 2005).

In community samples about 3.4% of people with major depressive disorder commit suicide; the rate in clinical samples about 15%; about 60% of completed suicides (studied by psychological autopsy) had suffered from depression (Berman, 2009).

 

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Part 4 of 5 | Schizophrenia

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Before covering the topic of schizophrenia, it is important to take note that the condition is commonly confused to refer to another condition that involves split-personalities, and this is mostly a trend that lives in the world of pop culture and Hollywood. About 40% in the UK equated split or multiple-personality with schizophrenia in a National Survey (Luty et al., 2006). However, after covering this section, we hope that the confusion will be cleared since schizophrenia does not refer to conditions that involve split-personalities [the closest scientific equivalent to this state of being, is a condition known as Multiple Personality Disorder or Dissociative Identity Disorder and are both not as debilitating as schizophrenia with treatment being much more effective].

Schizophrenia refers to a collection of seriously debilitating conditions characterised by positive and negative symptoms in this organisation (Mueser & Jeste, 2008).

Delusions and hallucinations are the principal positive symptoms of schizophrenia. Delusions are strongly held, unfounded, culturally alien beliefs. For example with persecutory delusions, individuals may believe that a group of people conspiring to harm them [this should not lead us to believe that a healthy person with a suspicion caused by the critical analysis of a person or group of people is deluded and is schizophrenic – remember that human beings have individual personalities too]. Hallucinations on the other hand involve experiencing sensations in the absence of external stimuli [e.g. with auditory hallucinations – which are the most common type in schizophrenia – people reported hearing voices that others cannot hear].

The negative symptoms of schizophrenia include flattened affect, alogia and avolition. In the case of flattened affect, the emotional expression of the patient is limited, and with alogia there is an impoverished thought that is inferred from the patient’s speech. Short brief and concrete replies are given to question [this is referred to as poverty of speech], or in some cases speech production is normal but it conveys little meaning and information due to repetition, or being overly abstract [referred to as poverty of content], or being too concrete. When patients suffer from avolition, a lack of goal directed behaviour can be observed. The negative symptoms generally give rise to a restricted lifestyle involving little activity, little social interaction with others and little emotional expression – disorganisation may also affect both speech and behaviour [disorganised, illogical, incoherent, speak are the signs of an underlying formal thought disorder]. Disorganised catatonic behaviour is usually characterised by the complete absence of spontaneous activity or excessive purposeless activity.

Schizophrenia is a debilitating and re-occurring condition that comprises the capacity to carry out normal activities, and also consists of incomplete remission between episodes.  (Hafner & der Heiden, 2008). Symptoms of schizophrenia typically appear in late adolescence or early adulthood, wax and wane over the life course, and have a profound long-term effect on patients and sometimes their families.

Schizophrenia is considered to be the most debilitating of all psychological disorders, since it affects the patient’s capacity to live independently, make and maintain satisfying and enduring relationships, engage in family life, parent children effectively, work productively and enjoy leisure activities. Rates of unemployment, homelessness and imprisonment are very high among people with schizophrenia, although just under 1% of people suffer from schizophrenia, the World Health Organization has rented as second only to cardiovascular disease in terms of overall disease burden internationally (Murray & Lopez, 1996).

Despite these unattractive facts, the scientific advances in our understanding of schizophrenia, along with advances in both psychological and pharmacological approaches to treatment, making it increasingly realistic for people who suffer from schizophrenia to live far more productive lives than were previously possible (Mueser & Jeste, 2008).


Case Example of Schizophrenia

A young man, named Julian was referred for assessment and advice by his doctor. Since returning to his rural home after studying in London for one year, his parents started to worry about his state because of his strange behaviour. After failing as exams, the patient said that he had to ”sort his head out”. Since his return, the parents had noticed a lack of concentration along with incoherent speech during his conversations which happen most of the time – his behaviour was also erratic and unpredictable.

The parents concern grew when Julian suddenly went missing a few weeks prior to the referral. After hours of searching, he was found about 55 Km from their home, dehydrated, exhausted and dressed only in sport shorts, singlet and running shoe. After enquiry, the latter developed the belief that a secret mission in the East had to be undertaken by him; and as he started jogging in the morning, he headed eastwards towards the rising Sun. He even planned to jump onto the car ferry when he reached the coast, across the sea over to Holland, and continue east towards India in his secret mission [reminiscent of a James Bond episode].

Since the episode, Julian has spent much of the time in his room muttering to himself, often becoming quite distressed, and when his parents spoke to him they found it hard to make any sense out of his words.


Family History

Julian was the 19-year-old son of a prominent farmer in a rural English village where the whole family lived in a large amount on an extensive estate. The farm was managed by the patient’s father; who had a traditional authoritarian manner and a positive, if distant, relationship with Julian. While he was incredibly worried about Julian and to the search for him, once the latter was found, the father returned to work unless the care of his son to his wife.

The mother was an artist who dressed flamboyantly, behaved in a theatrical manner and held century, unconventional beliefs [e.g. Conspiracy theories about many issues, was interested in eastern mysticism and believe that faith healing and alternative medicine were preferable to traditional Western medicine]. These characteristics of a personality along with her beliefs affected her treatment of Julian after the ”Running East” episode, where she engaged the latter in intense conversations about mystical meaning of the psychotic experiences that led to him trying to make his way to India on foot. Rather than taking Julian to the accident and emergency department of the local hospital for assessment, she brought him to a feeler and then than homeopathist. It was only of these interventions failed to our view the distress that she took Julian to the doctor, who made the referral to the community mental health team. In the preliminary assessment that was conducted with Julian and both of his parents, the mother responded to the son with intense emotional over involvement (an index of high expressed emotion associated with a relapse in schizophrenia; Hooley, 2007).

With regard to the extended family, according to parents there has never been a family history of psychological disorder. However some members of the mother’s well-to-do family were fairly eccentric and odd, especially her brother, Sedric, and her uncle, William Jr. Williams eccentricities led him into serious conflict with his father, and Sedrick’s odd behaviour underpin his highly conflictual, childless marriage.


Developmental history

Julian on a family farm and went to the local school, his development was what most people would call normal. His Academy former school was above average and he had many friends in his local village, and was a popular child and adolescent who also excelled at cricket. At 18 years old before going to university London, he had no psychological problems.

His first term at college was successful academically and socially, however, the occasional experimental cannabis use that had begun the summer before going to college turn to a regular use once Julian moved to London. During his time at university, the patient also experimented with LSD on a few occasions. In the final term of his first year at college, Julian developed intense fear of exam failure. Other symptoms quickly followed such as difficulty studying effectively and sleeping problems. Julian stopped attending classes regularly and spend more time alone, and was relieved to return home after sitting as exams. Once home he was described as quiet and thought during most of the time prior to the “running East” episode.


Presentation

Julian presented with symptoms such as delusions, hallucinations, disorganised speech and anxiety. At the very start the patient was very reluctant to be interviewed because he believed he had urgent business to attend to in Holland and further afield in India. He also showed signs of being anxiously distressed throughout the interview, explaining that his path was to the east and believed he was being called there by an unknown source. He firmly believes this because of a sign he had seen while out jogging on the morning of the enigmatic “running East” episode. The way in our God will record the sunlight and cast a shadow on the red barn against which it was leaned made a distinctive pattern, which to him meant a special sign indicating that he should go East, first to Holland and then all the way to India. Upon questioning this idea, a clear authoritative voice said that he should leave at once.

At this point in his narrative, stopped mid-sentence and displayed thought blocking, and will strive the topic he was talking about. Upon being asked to continue his story, he began to giggle, and when questioned about the reason behind his amusement, Julian declared to have heard someone say something funny. Julian then spoke about a number of unrelated topics in an incoherent way before experiencing thought blocking again.

Later he expressed the desire to leave soon because people will try to prevent him, as he had heard them plotting about this the day before, and also declare that they had tried to put bad ideas into his head [which he described as frightening]. He was also frightened by periodic sensations that everything was too loud or too bright and coming at him, declaring “it was like doing acid [LSD] all the time… a really bad trip.”


Formulation

In Julian’s case he presented with auditory hallucinations, delusions, thought disorder, anxiety and a significant deterioration in social and occupational functioning which had been present for more than 1 month [symptoms consistent at the time of this essay with a diagnosis of Schizophrenia]. The patient also showed a complete lack of insight and was unable to understand that the voices being heard were hallucinations and that the delusional beliefs were unfounded. Among the major precipitating factors were the experience of recent exam pressure and his transition from living at home to living in London at attending college. The principal predisposing factors were possible genetic vulnerability to psychosis and a history of hallucinogenic drug use.

His psychological condition was maintained by what was likely to be an excessive level of maternal expressed emotion characterised mainly by emotional over-involvement. His delusions were also reinforced by the mother since the latter engaged Julian in long and draining conversations about them. The protective factors in this case were godo premorbid adjustment and a strong family support for the boy.


Treatment

The treatment plan included antipsychotic medication and family will to reduce parental expressed emotion, with an initial brief period of hospitalisation. Julian did recover from his first psychotic episode, and his hallucinations and delusions decrease considerably with medication. Through family Psycho-education, parents develop understanding of this condition and of the requirement of a “low-key” approach to interacting with the boy as he recovered.

However some obstacles were encountered in Julian’s recovery, since he disliked the side effects of the medication, especially the weight gain and reduced sexual drive/function, and so had poor medication adherence – depression also manifested during the remission, when Julian came to realise about the many losses that followed his condition. He was unable to pursue his university studies and thus, could not continue the law career he had dreamed of. He also experienced difficulties in maintaining friendships or to commit to engaging on a regular basis in physical exercises or sports. When his mood was low, Julian would smoke some cannabis to lift his spirits.

The mother found it very difficult to accept the diagnosis of Schizophrenia and continued to hold the belief that his psychotic symptoms were linked to some spiritual or mystical explanation. She even sometimes declared that she thought of her son not as an ill young man, but a gifted seer or a “chosen one” [based on no rational explanation or series of events], and often engaged Julian in intense, distressing conversations about these issues. In the years that followed his initial assessment, poor medication adherence, ongoing cannabis use [which the patient could not tolerate unlike some other users] and exposure to high levels of intrusive parental emotions led Julian to relapse more often than might otherwise have been the case.


Clinical Features of Schizophrenia

A range of clinical features have been identified and associated with Schizophrenia though research and clinical observations (Mueser & Jeste, 2008). The generally concern the domains of perception, cognition, emotion, behaviour, social adjustment and somatic state.


Perception

At the perceptual level, patients suffering with schizophrenia generally describe a breakdown in perceptual selectivity, with difficulties focusing on essential information or stimuli to the exclusion of accidental details or background noise. Most aspects of the environment seem to be salient, however, the inability to distinguish between figure and ground is a serious problem to the sufferer. During an acute psychotic state, internal stimuli such as verbal thoughts are experienced as auditory hallucinations that have the same sensory quality of the spoken word.

Auditory hallucinations can sometimes be experience as extremely loud thoughts, or as thoughts being repeated by another person aloud (thought echo), as voices speaking inside the head or as voices coming from somewhere in the outer environment. The auditory hallucination may occur as third person making comments on the patient’s action, as a voice speaking in the second person directly to the person, or as two or more people talking or arguing – the effect did may also perceive voices to vary along the number of dementia [may be construed as benign or malevolent, controlling or impotent, or knowing or knowing little about the patient, who may sometimes feel compelled to the demands of the voice or not.

When hallucinations are perceived to be malevolent, controlling, all-knowing, where the individual affected feels compelled to obey the demands of the voice, the situation is deemed to be far more distressing than those who do not have these attributes. While auditory hallucinations are the most common features in schizophrenia, hallucinations may okay other sensory modalities too. Somatic hallucinations also often occur in schizophrenia, with many cases including reports of electricity in the body or the feeling of something crawling underneath the skin [these may be qualified as delusional interpretations. For example, a patient reported that the television was activating a transmitter in her pelvis and she could feel the electricity from this closing insects to grow and move around under the skin. Visual hallucinations [seeing visions] are relatively rare in schizophrenia very common in temporal lobe epilepsy.


Cognition

At the cognitive level, delusions are the most common cognitive clinical feature of schizophrenia, and are false, idiosyncratic, illogical and stubbornly maintained erroneous inferences drawn to explain unusual experiences, such as hallucination. [e.g. patient with auditory hallucinations where an authoritative voice commanding the latter to gather the children, was interpreted by the patient that she had been chosen by God to prepare all the children for the second coming of Christ]

Delusions may also arise from unusual feelings associated with psychosis. Persecutory delusions may develop from feelings of being watched. Delusions of thought insertion or thought withdrawal may develop as explanations for feelings that thoughts are not one’s own, or that one’s thoughts have suddenly disappeared. Factor analyses show that delusions fall into 3 broad categories:

Delusions of influence [including thought withdrawal or insertion, and beliefs about being controlled]; delusions of self-significance [including delusions of grandeur or guilt]; and delusions of persecution (Vahia & Cohen, 2008). Delusions may vary in the degree of conviction with which they are held [great certainty to little servant, the degree to which the person is preoccupied with them [the amount of time spent thinking about the belief], the amount of distress they cause.

Particular sets of the may comprise of a confused sense of self, particularly paranoid delusions with the patient holds the belief that they are being persecuted or punished for misdeeds, or delusions of control where there is a belief that their actions controlled by others [e.g. an unknown source or entity].

A lack of insight along with an impaired judgement is quite common during a psychotic episode. This happens when the patient believes that the contents of their hallucinations and delusions are real, and are incapable of coming to terms with the fact that their experiences and beliefs arise from a clinical condition. However in between psychotic episodes, the patient’s insight may improve and in some cases they may acknowledge that their hallucinations and delusions are symptoms of schizophrenia.

Speech in schizophrenic patients is also fairly hard to understand due to the abnormalities in the underlying thought pattern. This formal thought disorder is characterised by

  1. Tangentiality [answers given to questions are off the point]
  2. Derailment [sentences makes sense but hardly any meaning is conveyed by the sequences of sentences because there is a constant jumping from one topic to another, with very loose association between topics and little logic to what is said]
  3. Incoherence [sentences are incorrectly formed so little sense can be made out of them]
  4. Thought blocking [the patient abruptly stop’s in mid-sentence and is unable to complete the train of thought]
  5. Loss of goal [the difficulty in following a logical train of thought from A to B]
  6. Neologisms [inexistent new words are made up that only have idiosyncratic meaning for the patient]

Cognitive impairment or deterioration occurs in schizophrenia and this may either be general or specific. In cases with general cognitive deterioration, we can observe a reduction in overall IQ with many cognitive function also negatively affected. With specific cognitive impairment one or more of the following functions may be impaired: attention, memory, cognitive flexibility, social cognition and executive function, and most commonly the ability and dedication to follow through on a planned course of action. Cognitive impairment remains a better predictor of disability and vocational functioning than positive symptoms.


Emotions

At the emotional level, especially during the prodromal phase, before an acute psychotic episode, anxiety or depression may occur in response to changes in perceptual selectivity and cognitive inefficiency. One of the main functions of relapse prevention is for patients to learn [and eventually master] the ability to identify and manage prodromal changes in affect.

During psychotic episodes that are intense, anxiety or depression may occur in response to hallucinations, delusions, formal thought disorder and other debilitating symptoms. Inappropriate affect may also be present in hebephrenic schizophrenia, where the patient responds to the internal stimuli such as auditory hallucinations [e.g. laughing wildly] and not the external social context. In chronic cases, blunted or flattened affect can also be observed, and in remission [following an episode of psychosis], the sense of loss [e.g. of valued personal relationships, material, career, etc] that comes with increased insight into the reality of the condition may give rise to post-psychotic depression in some cases.

Behaviour

In terms of behaviour, prodromal excitation may occur prior to an acute psychotic episode, characterised by sleep disturbance, impulsive behaviour, and over-reactivity [may include compulsive behaviour]. Avolition also occurs during psychotic episodes with an observable impairment in goal-directed behaviour.

In some chronic cases, it is common to also find catatonic behaviour along with an impairment in the ability to initiate and organise voluntary movement and posture. Catatonia may be either retarded or excited. Excessive purposeless motor activity is the hallmark of excited catatonia and may include stereotypies [repetitive actions], echolalia [repeating the words said by others] or echopraxia [imitating the actions of others] – these tend to occur without the patient being consciously aware of it [not a conscious choice]. In cases where retarded catatonic behaviour is present there is an observable reduction in purposeful activity; patients may display signs of immobility, mutism, adopt odd postures for extended amounts of time, and display waxy flexibility or negativism.

Social Adjustment

A marked deterioration in social adjustment is also common in schizophrenia, and the ability for self-care, appropriate dressing, grooming and personal hygiene deteriorates – patients with schizophrenia often look dishevelled and unkempt. A decline in also commonly present in the domains of education and work with a withdrawal from regular patterns of socialisation and difficulty making and maintaining significant relationships. A deterioration with others also occurs and schizophrenia tends to have a negative impact on parent-child, marital and sibling relationships.

Somatic State

Approximately 50% of people with Schizophrenia also have comorbid substance use disorders and almost 75% have significant health problems, with the most common one being Chronic Obstructive Pulmonary Disease (COPD) [usually due to heavy smoking]; heart disease and diabetes due to obesity; HIV/AIDS and hepatitis B and C caused by unsafe sex and intravenous drug use [e.g. heroin]. These drug and medical problems in schizophrenia are lifestyle problems. However, one the positive side, schizophrenia is associated with reduced rates of cancer and rheumatoid arthritis (Tandon et al., 2008a).

 

Epidemiology, Course, Outcome and Risk Factors of Schizophrenia

International epidemiological studies that have been reviewed have allowed for a number of conclusions to be deduced regarding schizophrenia. We know that [luckily] under 1% of the population suffer from schizophrenia, and the lifetime risk of the condition is about 0.7% (Saha et al., 2005). More men than women suffer from schizophrenia: the male-female ratio is about 1.4:1 (McGrath et al., 2004). Schizophrenia has an earlier onset in males (20-28 years) than in females (28-32 years) (Murray & Van Os, 1998). The rates for schizophrenia have also been found to be similar across countries and cultures when diagnostic criteria are used (Mueser & Duva, 2011).

Schizophrenia tends to follow a distinctive course although a considerable variability exists across cases (Jablensky, 2009; Jobe & Harrow, 2010; Mueser & Duva, 2011, Tandon et al., 2009). The onset of schizophrenia generally occurs in late adolescence or early adulthood and may be acute or insidious [onset generally takes place over 5 years, starting with negative and depressive symptoms, followed by cognitive and social impairment and finally positive symptoms]. Longitudinal studies suggest that there is an early deterioration phase that extends over 5-10 years, a stabilisation phase and a final gradual improvement phase. In over 50 – 70% of cases, the condition follows a chronic relapsing course, typically with incomplete remission between episodes. However, up to 40% of patients show one or more periods of complete recovery with good adjustment for at least 1 year, and  4 – 20% of cases show complete remission.

Psychotic episodes may last from 1 – 6 months, although some cases extend up to 1 year. They are usually preceded by a prodromal period of a number of weeks. Psychotic episodes may be lessened and the severity of the symptoms ameliorated through early detection and the use of pharmacological and psychological treatment. Inter-episode functioning may differ greatly and better inter-episode functioning is associated with a better prognosis. The duration of remission between episodes may be lengthened through the use of maintenance medication and psychosocial interventions to reduce stress and improve coping and illness management.

With treatment, usually positive symptoms (hallucinations and delusions) abate between episodes but negative symptoms (blunted affect, alogia and avolition) can be enduring and are more likely to persist during remission. In the stabilisation phase of schizophrenia, positive symptoms become less prominent, while negative symptoms and cognitive deficits become more prominent. The lifespan of people with schizophrenia is also 9 years less than that of the general population, and this is partly accounted for by the high rate of suicide during the first 10 years of the disorder and the high rate of comorbid medical disorders that also tend to occur along with schizophrenia. About 50% of schizophrenics attempt suicide or self-harm, and about 10% commit suicide (Heisel, 2008; Schennach-Wolff et al., 2011).

One of the greatest risk factors for schizophrenia is a family history of psychosis. Other risk factors make a small contribution to the overall risk within the context of associated with genetic vulnerability. However until now, it is important to note that we still do not have any clear consensus or evidence on how these risk factors operate and whether environmental factors remain a stronger prediction of the onset of schizophrenia than genetic factors that only set a predisposition [risk] of possibly developing the condition. Prenatal and perinatal risk factors, such as maternal flu infection and obstetric complications, are likely to have a negative effect or indirect effect on the development of the nervous system in line with the neurodevelopmental hypothesis that states how those affected by such issues while also being genetically predisposed to schizophrenia are even more neurologically vulnerable to psychosis (Murray & Lewis, 1987). Trauma exposure and most demographic risk factors (being unmarried, low-SES urban migrant) are associated with higher levels of stress and lower levels of social support [which increases the risk of psychosis in the genetically vulnerable] according to the Diathesis-Stress Conceptualisation of Schizophrenia (Zubin & Spring, 1977).

In the short term, relapse is more likely in cases where these is heavy cannabis use [along with poor personal/subjective tolerance of the effects on consciousness], poor treatment adherence, frequent contact with insignificant extended family members who may display excessive negative emotional expressions towards the patient [e.g. criticism, hostility and emotional over-involvement] and exposure to acute stress life events (Jablensky, 2009).

A poor outcome is associated with substance use and a longer period of untreated psychosis in people who have poor premorbid adjustment and an early insidious onset with no clear stressful life event preceding their first treated episode. One of the main traits associated with a poor outcome is “Anxiety”, and people with this stress profile are generally more sensitive to and reactive to life’s stressful events, along with populations living in a developing economy, and family-based stress associated with excessive negative expressions of emotion. The symptom profile predictive of a poor outcome is also marked by severe negative symptoms, cognitive impairment and lack of depressive symptoms.

A favourable outcome in schizophrenia is associated with a range of factors (Bota et al., 2011). These include good premorbid adjustment, and a brief duration of untreated psychosis characterised by an acute onset in response to precipitating stressful life events. A family history of affective problems/disorders [rather than schizophrenia] or little psychopathology and a personal symptom profile in which there are affective as well as psychotic features are also predictive of a good prognosis. A better outcome tends to follow those who have a favourable life situation to return to following discharge from hospital.

 

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Part 5 of 5 | The Effectiveness of Psychotherapy

 

ClinP_Descr_Header_05

The main help that a psychotherapist provides is psychotherapy, a contractual process where professionals with expert knowledge interact with clients to guide and help them in the resolution of their psychological conflicts, emotional imbalance, psychological problems and address mental health and behavioural difficulties [if any]. Psychotherapy can be offered to both adults and children on an individual, couple, family or group basis.

Often psychotherapists offer therapy as one element of a multimodal programme provided by a multidisciplinary team [e.g. a multidisciplinary adult mental health team may routinely offer a multimodal programme of psychotherapy combined with some mild anti-depressant for depression]. This final section will focus on the evidence base for the overall effectiveness of psychotherapy.


Evidence-based Practice

In today’s trend of mainstream clinical psychology where the mechanical model of early behaviourists has been combined with cognitive psychology to become Cognitive-Behavioural Psychology, there has been a gradual shift from practice guided by descriptions of clinical cases [qualitative, detailed and individual] to “evidence-based” practice guided by the results of empirical studies using the statistical methods of science to make inferences about behaviour [that can be measured at least] on the effectiveness of psychological interventions. This movement has started in part due to the influence of policies derived from the medical field which bases itself on evidence-based medicine [i.e. tested with laboratory-rigour and statistical methodology] (Sackett et al., 1996, 2000).

Evidence practice in medicine as it has been applied to psychology [or should we say behavioural science] involves the judicious and compassionate use of the best available evidence to make decisions about patient or client care. In clinical psychology, this involves considering available scientific evidence about “what works” on one side, and the client’s unique problems, needs, rights and preferences on the other; while also making balanced, compassionate judgements (APA Presidential Task Force on Evidence Based Practice, 2006; Norcross et al., 2006).


Meta-analyses

The most persuasive form of evidence as far as the effectiveness of psychotherapy and other psychological interventions are concerned in regards to empirical measurements and statistical methodology, comes from meta-analyses on controlled trials.

Meta-analysis is a systematic, quantitative approach to reviewing evidence from multiple trials while also reducing the impact of reviewer bias since the data from many trials are synthesised using statistical methods.

In a meta-analysis, effect sizes are calculated for each trial and then averaged across all trials to provide a quantitative index of the effectiveness of a particular form of treatment with a specified population. The effect sizes calculated in meta-analyses express quantitatively the degree to which treated groups improve over untreated control groups [A graphic explanation of the calculation of an effect size in given in FIGURE A.

FIGURE A - EFFECT SIZES

FIGURE A. A Graphic Representation of an Effect Size of 1

 

Table A shows a system for interpreting effect sizes, and using it, it may be seen that .9 is a large effect size, and if such an effect size was obtained in a meta-analysis it would mean that the average treated case fared better than 82% of the cases in the control group. It would also indicate that 71% of cases in the treatment group had a successful outcome compared with 29% of control group cases. Finally, a large effect of .9 would indicate that 17% of the variance in outcome would validly be attributed to the effects of the treatment rather than other factors.

Table A - Interpretation of Effect Size

TABLE A / Note: Adapted from Wampold (2001, p. 53). 1. From Cohen (1988), 2. From Glass (1976). 3. From Rosenthal and Rubin (1982). Binomial effect size display, assuming overall success rate of .5, success rate for treated cases is .5+ correlation with outcome/2, and success rate for untreated cases is .5-correlation with outcome/2. 4. From Rosenthal (1994, p. 239), percentage of variance = d²/(d² +4).

Is Psychotherapy effective? If so, how effective?

Mary Smith and Gene Glass published the first major meta-analysis of psychotherapy result studies in American Psychologist in 1977. They included 375 controlled trials of psychotherapy in their analysis and found an average effect size of .68. They concluded that a typical therapy client was better off that 75% of untreated individuals.

Since that seminal study many meta-analyses have been conducted, and in a synthesis of 68 separate meta-analyses of psychotherapy with children, adolescents and adults with a wide range of different psychological problems, Grissom (1996) found an aggregate effect of .75, indicating that the average treated case fared better than 77% of untreated controls.


Effects of Psychotherapy with Adults

The mentioned meta-analysis conducted by Smith and Glass (1977) also included many studies of therapy with children and young people. In the quest to determining the effects of psychotherapy for adults with psychological problems, Shapiro and Shapiro (1982) conducted a meta-analysis of 143 studies of psychotherapy exclusively involving adult populations. This revealed an effect size of 1.03, meaning that after treatment the average adult who participated in psychotherapy fared better than 84% of untreated control group cases.


Effectiveness of Psychotherapy with Children and Adolescents

The results of 4 broad meta-analyses of studies involving children and adolescents under 18 years with a diverse range of psychological problems receiving a variety of forms of psychotherapy provide evidence for the overall effectiveness of psychotherapy with children (Casey & Berman, 1985; Kazdin et al., 1990; Weisz et al., 1987, 1995). These meta-analyses included more than 350 treatment outcome studies. Effect sizes ranged from .71 to .88, with a mean effect size of .77. This indicates that the average treated case fared better than 78% of control group cases.


Psychodynamic Psychotherapy

Within the psychodynamic tradition, a distinction is made between short-term psychodynamic psychotherapy and intensive long-term psychoanalysis. Short-term psychodynamic psychotherapy involve weekly sessions for periods of 6 – 12 months, while Long-term psychoanalysis involves two or more sessions per week, usually lasting for periods longer than 1 year [Jacques Lacan, one of the main psychoanalytic figures in France, broke from other associations to create his own school where he advocated short psychoanalytic sessions that varied ranging from 10 minutes to more, as he argued that the point of therapy is to shape the patient’s consciousness and depending on the person, this can be achieved by a range of ways, e.g. metaphors or word plays that allows the patient to peer into his own psyche and understand himself]

Two important broad meta-analyses have been conducted to evaluate the effectiveness of psychodynamic psychotherapy with adult mental health problems (Leichsenring et al., 2004; Leichsenring & Rabung, 2011). In a meta-analysis of 17 studies, Leichsenring et al. (2004) found that short-term psychodynamic psychotherapy yielded an effect size of .7 for psychiatric symptoms in patients mainly diagnosed with anxiety and mood disorders when therapy was compared with waiting list or minimal intervention control groups. This indicates that after treatment the average treated case fared better than 76% of controls. In this meta-analysis, the outcome for psychodynamic psychotherapy did not differ from that of other forms of psychotherapy in the 14 studies where such comparisons were made.

In a further meta-analysis of 10 studies, Leichsenring and Rabung (2011) found that Long-term psychodynamic psychotherapy involving more than 50 sessions over periods longer than a year yielded an effect size of .54 for overall effectiveness for complex cases with severe symptomatology, comorbid diagnoses, or personality disorders, when long-term psychodynamic psychotherapy was compared with a range of other therapies including Cognitive-Behavioural Therapy (CBT), dialectical behaviour therapy, family therapy and short-term psychodynamic psychotherapy. This indicates that after treatment the average case fared better than 70% of cases treated with other therapies. The gains made during treatment were sustained at 1 to 8 years after follow up.

The results of these two meta-analyses show that short-term psychodynamic psychotherapy is an effective as other widely used forms of psychotherapy, including Cognitive-Behavioural Therapy (CBT), for common psychological problems such as anxiety and depression in adults; and that long-term psychodynamic psychotherapy is more effective that some other forms of therapy for adults with complex mental health difficulties.


Client-centred Humanistic Psychotherapy

Elliot et al., (2004) conducted a meta-analysis of trials of psychotherapy that fall broadly within the client-centred humanistic psychotherapy tradition [over 90 trials of client-centred, experiential, gestalt and emotionally-focussed therapy were included in the analysis]. Clients in these studies had a wide variety of psychological problems including anxiety, mood, eating and relationship distress. The average duration of treatment was 22 sessions, reflecting about 6 months of therapy. An effect size of .78 was obtained, indicating that the average treated case fared better than 78% of cases in control groups. These results indicate that client-centred humanistic psychotherapy is an effective form of treatment for a range of common psychological problems in adulthood.


Overall Effects of Psychotherapy

FIGURE B summarises the results of meta-analyses, described above, of the effectiveness of psychotherapy from a range of different traditions with adults and children. In this figure, where appropriate, effect sizes from multiple meta-analyses have been averaged, and graphed as success rates based on the system given in TABLE A.

From FIGURE B it can be deduced that meta-analyses of psychotherapy trials yield moderate to large effect sizes that range from .65 to 1.02. When expressed as success rates, the results of meta-analyses indicate that 65 – 72% of people with psychological problems benefit from psychotherapy. Thus approximately two-thirds to three-quarters of people who engage in psychotherapy find that it leads to improvements in their mental health.

FIGURE B - SUCCESS RATES W ADULTS &amp; CHILDREN

FIGURE B. Success Rates of Psychotherapy with adults and children, and Therapy from other schools of thought [traditions] based on Effect Sizes from Meta-analyses

Comparison of the effects of Psychotherapy and Medical Procedures

In order to make sense of the overall effectiveness of psychotherapy, it may be useful to ask ourselves: Are the moderate to large effect sizes associated with psychotherapy very different from those associated with the medical and surgical treatment of physical illnesses, diseases and medical symptoms?

In a synthesis of 91 meta-analyses of various medical and surgical treatments for a range of medical conditions, Caspi (2004) found an average effect size of .5. This falls in the moderate range of effect sizes (.5 – .8) and not very dissimilar to the effect size of .75 from Grissom’s (1996) synthesis of 68 meta-analyses of psychotherapy trials mentioned at the beginning of this section. Hence, it may be concluded with some certainty that the moderate effect sizes associated with psychotherapy are similar to those associated with the treatment of medical conditions.


Deterioration and Drop-Out

A consistent finding within psychotherapy research literature is that up to 10% of clients deteriorate following treatment (Lambert and Ogles, 2004; Lilienfeld, 2007). In a review of 46 studies on negative outcome in adult psychotherapy, Mohr (1995) found that deterioration was associated with particular client and therapist characteristics and particular features of psychotherapy. Deterioration was much more common among clients with obsessive compulsive disorder or severe interpersonal difficulties. Lack of motivation and the expectation of benefiting from psychotherapy without personal effort were also associated with deterioration. Deterioration was more common when unskilled therapists lacked the empathy and did not collaborate with clients in pursuing their agreed goals. Failure to manage counter transference appropriately and frequent transference interpretations were also associated with deterioration.

Dropping out of psychotherapy is a relatively common event. In a meta-analysis of 125 studies, Wierzbicki and Pekarik (1993) found a mean dropout rate of 47%. Dropout rates were higher for minority ethnic groups, less educated clients, and those with lower incomes. Thus, we can conclude that about 1 in 10 clients deteriorate following therapy and that marginalised clients with particularly troublesome disorders and negative attitudes to psychotherapy are vulnerable to dropping out of psychotherapy and deterioration.


Medical Cost Offset

So, all the evidence that has been reviewed shows that psychotherapy is effective for a range of problems and populations. However, an important factor regarding the delivery of psychological treatment is the financial implication of it [i.e. the cost to the economy and health services]: How much does it cost to provide such a psychotherapy service? From this financial perspective, two questions would be of interest:

First: Do clients who received psychotherapy use fewer medical services and so incur reduced medical costs? This saving would be referred to as the Medical Cost Offset.

Second: Is the Medical Cost Offset associated with psychotherapy greater than the cost of providing psychotherapy? If so, we would be able to conclude that psychotherapy has a total cost offset.

Findings from meta-analyses and narrative reviews of the cost-offset literature provide explanations on these questions. In a meta-analysis of 91 studies conducted between 1967 and 1997, Chiles et al. (1999) found that psychotherapy and psychological interventions led to significant medical cost offsets. Participants in reviewed studies included surgery inpatients, high health-service users, and people with psychological and substance use disorders who received psychotherapy or psychological interventions alone or as part of a multimodal programme. Chiles and his team found that medical cost offsets occurred in 90% of studies and ranged from 20% to 30%. In 93% of studies where data were provided, cost offsets exceeded the cost of providing psychotherapy. Greater costs offsets occurred for older inpatient who required surgery, oncology, and cardiac rehabilitation than for outpatients who required care for minor injuries and illnesses. Structured psychological interventions, tailored to patient needs associated with their medical conditions, led to greater medical cost offsets than traditional psychotherapy.

In a set of meta-analyses from earlier studies involving Blue Cross and Blue Shield US Federal Employees Plan claim files and 58 controlled studies, Mumford et al. (1984) found that 85% of studies medical cost offset for psychotherapy occurred, and this was due to shorter periods of hospitalisation for surgery, cancer, heart disease and diabetes – particularly in patients over the age of 55. In a review of psychological interventions for people with a variety of health-related difficulties, Groth-Marnat and Edkins (1996) found that medical cost offsets occurred when such interventions targeted patients preparing for surgery and patients with difficulty adhering to medical regimens. Medical offset also occurred for smoking cessation programmes, rehabilitation programmes, and programmes for patients with chronic pain disorders, cardiovascular disorders and psychosomatic complaints.

Three other important reviews of medical cost-offset literature, which focussed largely on mental health problems in adults rather than adjustment to physical illness, deserve mention. In a review of 30 studies of psychotherapy for psychological disorders and drug and alcohol abuse, Jones and Vischi (1979) found that medical cost offsets occurred in most cases. In a review of eight cost-effective studies for substance abuse, Morgan and Crane (2010) concluded that family-based treatments can be cost-effective. In a review of 18 studies of psychotherapy for psychological disorders, Gabbard et al. (1997) found that in more than in 80% of studies, medical cost offsets exceeded the cost of providing psychological therapies. Significant cost-offsets occurred for complex problems and in studies of psychoeducational family therapy for schizophrenia and dialectical behaviour therapy for personality disorders this was achieved by reducing the need for inpatient care and improving occupational adjustment.

Estimated direct and indirect costs related to mental health problems across Europe

Besides the impact on people’s well-being, the report estimates the total costs of mental ill-health at over EUR 600 billion – or more than 4% of GDP – across Europe / Source: OECD Library

Prevalence by mental and substance use disorder 2017 - our world in data

Prevalence by Mental and Substance use disorder / Source: OurWorldinData

The table below provides a brief summary of the data which follows on mental health and substance use disorders

The table provides a brief summary of the data which follows on mental health and substance use disorders / Source: OurWorldinData

Therefore, to conclude with all the evidence reviewed here, it is widely accepted today that psychotherapeutic interventions have a significant medical cost offset. Those who participate in psychotherapy use fewer extra medical services at primary, secondary and tertiary levels and are hospitalised less than those who do not receive psychotherapy.

 

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