The Dissociative Mind in Psychoanalysis

Understanding and Working With Trauma

Elizabeth Howell, Sheldon Itzkowitz, Elizabeth Howell, Sheldon Itzkowitz

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781317393504
• Edition: 1
• Topic: Psychology
• Subtopic: Psychoanalysis
• Index: Psychology

The Dissociative Mind in Psychoanalysis: Understanding and Working With Trauma is an invaluable and cutting edge resource providing the current theory, practice, and research on trauma and dissociation within psychoanalysis. Elizabeth Howell and Sheldon Itzkowitz bring together experts in the field of dissociation and psychoanalysis, providing a comprehensive and forward-looking overview of the current thinking on trauma and dissociation.

The volume contains articles on the history of concepts of trauma and dissociation, the linkage of complex trauma and dissociative problems in living, different modalities of treatment and theoretical approaches based on a new understanding of this linkage, as well as reviews of important new research. Overarching all of these is a clear explanation of how pathological dissociation is caused by trauma, and how this affects psychological organization -- concepts which have often been largely misunderstood.

The Dissociative Mind in Psychoanalysis will be essential reading for psychoanalysts, psychoanalytically oriented psychotherapists, trauma therapists, and students.

Part 1 History of complex trauma and dissociative problems in living

Chapter 1 Is trauma-analysis psycho-analysis?

Elizabeth F. Howell and Sheldon Itzkowitz

DOI: 10.4324/9781315679211-2

Among the immigrant psychoanalysts, many who had fled from the terrors of the Holocaust, “Orthodoxy became an armor, the theory became their armor, to leave no opening for some memory, some recognition of what had happened to creep in.”

Dori Laub (quoted in Kuriloff, 2013, p. 43)

The obscuration of trauma in psychoanalysis

A most remarkable thing about psychoanalysis is its checkered response to trauma-generated dissociation. Now one “sees” it, and now one doesn’t. Why can it not be recognized? Why does it disappear from “sight” or thought? Even though psychoanalysis began in the study of dissociation, not long after its inception, Freud redefined the data of psychoanalysis, moving the topic of inquiry away from an explicit exploration of trauma and of dissociated experiences and dissociated mental structure. And for the most part psychoanalysts followed suit, like their forefather, all too often ignoring the importance of exogamous traumatic reality.

A theoretical model of mind acts as a scheme that structures our experience of reality and our understanding of our patients and ourselves. Barnett (1966) explains, “It is a commonplace observation that the psychoanalytic theory one uses influences one’s perception of clinical reality” (p. 88).

Psychoanalysts who privilege repression and the drive-defense-fantasy model of Freud and who think along classical Freudian lines are more likely to attribute symptomatology to conflict between the drive and the defense than the emergence of dissociated material. This is not to gainsay the importance of the drive-defense model or of Freud’s inestimable contribution to understanding the human mind.

The implications of overlooking the impact of trauma are serious because the classical Freudian model filters out, or minimizes, the contributing factor of reality in general and the reality of early childhood trauma causing dissociation and the dissociative structuring of the mind. For the traumatized and dissociative patient then, her reality is likely to be overlooked, misunderstood, misinterpreted as fantasy, or wishes, and/or not to be considered as valid data for analytic inquiry (of course the modern Freudians, among them Ross, Druck, Blum, Bach, Hurvich, Thaler, Vorus, and others, are more and more bringing dissociation into the picture).

Yet, like so many suppressed realities of the experiences of the oppressed, trauma and dissociation went underground. The unconsciously coded language for trauma-generated dissociation became “splitting.” Now dissociation could be talked about without being talked about.

Even Freud’s most influential theories—for example, the Oedipus Complex—can readily and easily be deconstructed in terms of the underlying motifs of the most heinous type of child abuse: infanticide; murder (Ross, 1982). So, the topics of abuse, murder, and dissociation never really went away, they simply became dissociated as an “unseeable” aspect of reality. Especially among the ranks of the intellectual elite, where the classical model of Freudian psychoanalysis, including adherence to the fantasy model, and of the Oedipal complex often prevailed, there has also been inadequate recognition of the power of overwhelming trauma-generated dissociation. Why? Nobody likes to think about it. To talk about this is unpopular, even stigmatizing. To think about it brings up emotional and cognitive conflicts about attachment, not only to abusive attachment figures, but also to power relationships, that is, prevailing powers espousing non-recognition vs. the recognition of abuse of children and others who are less powerful. To openly recognize these reality-based conflicts requires exposing oneself to powerful interests that can destroy one’s credibility, trust in the world, and one’s livelihood (see Chapter 5—this is what happened to Ferenczi). Thus, the denial of exogamous trauma becomes itself a real source of exogamous trauma. To say the least, this is complicated: For many reasons, mainstream psychoanalysis has, both knowingly and unknowingly, obscured the impact of trauma.

Is trauma work psychoanalysis?

The question of whether trauma work is officially, or is “really,” psychoanalysis often comes up for the two of us in our work with colleagues, supervisees, and students, including psychoanalytic candidates. This question concerns several issues, including:

1. the nature of psychoanalytic data;
2. the issue of proper technique;
3. the question of who can be successfully treated using psychoanalytic technique;
4. the principle behind the technique, and finally, and perhaps most importantly,
5. the purpose and expected outcome of the enterprise of psychoanalysis.

The nature of psychoanalytic data

What are the legitimate sources of data for the psychoanalyst? Does trauma as a real interpersonal/relational event in the patient’s life qualify? This question strikes at the heart of the key issue of disagreement not only between and among current schools of psychoanalysis, but also deriving from current media streams, appearing to be from much of mainstream psychology, that disavows trauma and dissociation. This conflict mirrors and repeats a very powerful earlier one: that between two great thinkers, Pierre Janet in France and the “psychoanalytic,” or post-“prepsychoanalytic” Sigmund Freud in Vienna, in their views of the treatment of the disorder of the mind known at the end of the nineteenth century as hysteria. Between 1893 and 1896 both men endorsed the importance of dissociation in hysteria. Janet wrote of the subconscious centers of trauma-related dissociated psychic life as “fixed ideas.” And the early Freud heartily endorsed the premise of dissociation, in his and Breuer’s description of “double consciousness” as intrinsic to hysteria. As is well known and will be further examined in Chapter 3, after 1897 Freud re-oriented the premise that hysteria was a disorder stemming from trauma occurring in the real interpersonal/relational world, shifting his focus to the internal drive- and fantasy-driven “psychic” life of the hysterical patient. In this way “hysterics” were understood to be victims of their own repressed infantile, sexual, and aggressive impulses. In contrast, Janet continued to work with dissociation throughout his life.

In a general sense, “the unconscious” has typically been considered the sine qua non of psychoanalytic data to be unearthed. Then, where do we look for these data of the unconscious? Is it in derivatives of drives and in unconscious fantasy? Or do we encounter it in the dissociated knowledge of trauma, or both?

Once drives and fantasy are privileged as causative, events in the patient’s real life are meaningful primarily as a medium within which fantasy material grows (Levenson, 1981). With this revision the patient’s internal psychic life became the object of inquiry as well as the presumed breeding ground for psychological ills. As Boulanger (2007) notes, “The Freudian subject, by bringing drives under control achieves agency … The battles waged against oneself carry far more weight than indifferent reality” (p. 57).

The repudiation of real experience as relevant data in the classical model of psychoanalysis

Unfortunately, examples of how far the exclusion of real events from the data of psychoanalytic inquiry went include an odd form of Holocaust denial, especially among the survivors who emigrated to the United States. As Prince (2009) notes, “A central theoretical obstacle in attending to survivor dynamics has been the antinomy in psychoanalysis between psychic and external realities … Confronted with overpowering reality, it seems that psychoanalysts retreated to the primacy of infantile phantasy. The connection between Holocaust trauma and the patient is minimized or avoided” (p. 182). The reasons for this were multiple, deeply painful, and sometimes tragic. Kuriloff (2013) describes how “Many European analysts found refuge in America. Their published memoirs chronicle the details of escape and adjustment to their new homes. Most of these accounts, however, do not mention the impact of such ordeals on how they conceived and practiced psychoanalysis itself” (p. 1). Kuriloff, referring to part of an interview with Dori Laub, explains that Laub’s analyst had knowledge about the atrocities visited upon the inmates of the Nazi concentration camps from liberated survivors, “who gave impossibly petrified depositions regarding their experiences during the Holocaust as they recovered in Sweden” (p. 42). Laub continues discussing his own experience in analysis and recollecting the past:

It was then that he [Laub’s analyst] stopped me … He interrupted my descriptions of my idyllic childhood on the banks of the river Bug [in the Ukraine]. Because I was not able to know about it … There were sounds of the Nazi death squads killing Jews on the other side of the river, instead I said I was playing in the green fields with another child and debating whether or not you could eat grass … Soon we figured out this had something to do with hunger … because I was starving.

(Kuriloff, 2013, p. 42)

Kuriloff underscores the point that reality, even when it is traumatogenic, even when humankind is forced to come face-to-face with and endure unrelenting, pernicious, and dispassionate evil in the other, does not qualify as appropriate data for the psychoanalyst, and includes the following:

But Laub says that his analyst was the exception. “Most clinicians didn’t explore these things. It was all about infantile neurosis.” When he began to write about trauma, and co-founded what are now the Fortunoff Archives of Holocaust Testimony at Yale University, Laub told me, “I was non-existent to mainstream psychoanalysts.”

(p. 42, italics added)

During a moving roundtable discussion titled “Last Witnesses: Child Survivors of the Holocaust,” four psychotherapists discuss how their experiences as children during the Holocaust affected their lives (see Brown et al., 2007). In describing one of his analytic experiences, Clem Loew explains:

Yes I understand it was a rough time for you during the Holocaust, but what about actions of your father and what about your mother, and what about the oedipal or what about the pre-oedipal? And it was more about that than acknowledging the trauma of the event of the Holocaust. For many of us, the event of the Holocaust was not really important [to our early analysts].

(Brown et al., 2007, p. 32, italics added)

Sophia Richman, a co-panelist in the discussion, describes herself as an analysand during her first analysis. The dissociation of a traumatized self can clearly be heard by how she described her childhood experiences during and after the Holocaust:

what he [her analyst] wanted to focus on was Oedipal issues. And I talked about my [Holocaust] experience but I talked about it in a very detached way. I was really in a very dissociated state, without realizing that that’s what it was. I would talk about it very mechanically, like these were the facts, this is what happened, this is my childhood. But there was no feeling. I was like a robot … And he … wasn’t able to do anything with that.

(p...

Table of contents

• Cover
• Half Title Page
• Series Page
• Title Page
• Copyright Page
• Table of Contents
• Acknowledgements
• List of editors and contributors
• Introduction
• PART 1 History of complex trauma and dissociative problems in living
• PART 2 Psychoanalytic orientations and the treatment of complex trauma, dissociation, and dissociative disorders
• PART 3 Aspects of psychoanalytic treatment of complex trauma and dissociation
• PART 4 Current research trends in complex trauma dissociation and dissociative disorders
• Index