Howard B. Levine

Psychoanalysis and Trauma

This article articulates some of the problems that surround the use of the term trauma in psychoanalytic theory and suggests that the key element for a theory of pathogenesis and mental functioning is not the either/or of external versus internal causation or trauma versus drive. Rather, it is an understanding of whether, or to what extent, the raw data of existential experience is or is not transformed into psychological experience. From this perspective, trauma is whatever outstrips and disrupts the psyche’s capacity for representation or mentalization. Absent the potential for mental representation, these events and phenomena are historical only from an external, third-person perspective. Until they are mentalized, they remain locked within an ahistorical, repetitive process as potentials for action, somatization, and projection.

The Analyst's Theory in the Analyst's Mind

Each analyst is inevitably bound to and by his or her theories, to the techniques that follow from them, and to the complex and potentially problematic forces and vicissitudes of psychic life and the unconscious. Given this assumption as a starting point, I will describe and attempt to illustrate, using Ferros Analytic Field Theory, the kinds of theories that may prove most useful to analysts, theories that emphasize process over content and that prepare the analysts mind for their encounters with their patients. These theories are not the provenance of any one school of psychoanalysis, and extend beyond work with neurotic patients to those patients and areas of the mind that reflect weakened or unrepresented mental states and are in need, not simply of decoding and uncovering, but of mutual and intersubjective construction of thoughts, meanings, and links between mental elements.

The Politics of Exclusion

Starting as a movement based on the discoveries of a genius, psychoanalysis aspired to be a science. A deeply subjective method of data gathering, it had to transform new findings into its founders objectively coherent theory or revise it and challenge the founder. Exclusion from the group emerged as scientific judgment and punishment. From early on, when Freud barely distinguished between disagreement and enmity, assessment of new ideas was entwined with narcissistic conflicts. Exclusion not only maintained the relative coherence of the theory—a reasonable, laudable goal—but led to an enhanced in-group motivated to maintain the theory and a devalued out-group that would need to turn the tables. The way was paved for fortification of established ideas and overidealization of new ideas. But the decision by the American Psychoanalytic Association (APA) to accept only physicians for psychoanalytic training extended exclusion to group membership. The result was the establishment of training outside the official APA/International Psycho-analytical Association umbrella. Formation of nonestablishment psychoanalytic institutes not only allowed more heterogeneity of ideas during the rule of orthodoxy but introduced seemingly less hierarchical organizational structures. Ideas embodied in these structures are now advocated by those who find hierarchy too oppressive. The paper ends with an examination of some of these ideas.

The Transformational Vision of Antonino Ferro

I like to think of the analyst . . . as a great storyteller, who knows how to bring to life narremes and stories of the patient and of the field, and is free to detach himself from his psychoanalytic knowledge in order to sail beyond the Pillars of Hercules, beyond the psychoanalytically known, towards new worlds of unthought thinkability and the thoughts in search of a thinker that await us in the Americas of the mind. [Ferro, 2006, p. 6]

The Puzzle of Interminable Treatments

This article explores the phenomena of weakly terminated and/or unending treatments, and their possible unconscious determinants. It raises the questions of whether or to what extent: • the reasons for interminable cases, superficial termination responses and premature endings are predominantly externally or internally driven; • interminable cases, superficial termination responses and premature endings reflect more covert defensive and/or conflictual reasons located within either of the participants or shared by the analytic pair; • the traditional goals of termination and autonomy are actually far more relativistic and culturally bound than analysis originally recognized them to be; • these treatments involve nonneurotic patients, whose problems lie beyond the pleasure principle, and whose treatments require a different understanding of what may be therapeutically possible.