The Annual of Psychoanalysis, V. 25

Jerome A. Winer, Jerome A. Winer

• Publisher: Routledge
• Year: 2021
• ISBN:
  9781134890330
• Edition: 1
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Volume 25 of The Annual is dedicated to the memory of Michael Franz Basch, who achieved distinction as both a psychoanalytic theorist of the first rank and an authority on the nature and conduct of dynamic psychotherapy. A wide range of original contributions bear witness to his theoretical, clinical, and educational interests.A number of papers remind us of Basch's prominence as a self-psychological theorist: Elson's self-psychological reappraisal of self-pity, dependence, and manipulation as self-states; Ornstein's developmental perspective on power, self-esteem, and destructive aggression; Tolpin's review of sexuality from the standpoint of normal self development; and Wolf's discussion of self psychology and the "aging self." Basch's life-long educational concerns gain expression in Goldberg's discussion of clinical teaching, particularly the challenge of leading of case conferences; and Ornstein's and Kay's thoughtful consideration of "enduring difficulties" in American medical education.Additional highlights of the volume include: Fawcett's consideration of the role of pharmacotherapy in psychodynamic treatment; Jaffe's consideration of the applicability of hierarchical models to assessment and intervention in brief psychotherapy; Galatzer-Levy's review of the "witch" metapsychology; Gedo's analysis of mythic themes in the operas Don Giovanni and Der Rosenkavalier; Modell's reflections on metaphor and affects; and Kernberg's discussion of a "new psychoanalytic mainstream, " which he compares and contrasts with a parallel convergence of Kohutian and interpersonal analytic approaches. Many of these contributions incorporate reflections on Basch as a teacher and colleague, and the entire volume is framed by Goldberg's moving tribute. Analysts and psychotherapists sharing Basch's commitment to academic and clinical excellence and his keen awareness of the pragmatic requirements of doing effective therapy will find in Volume 25 a cornucopia of riches.

I


MICHAEL FRANZ BASCH,
M.D., 1929–1996

In Memoriam

Introduction

Arnold Goldberg

Writing an introduction to a volume of essays in honor of Michael Basch is another step in our closing the door on his life. So much of this life was his work that this collected effort of his friends and colleagues, a great deal of which looks back on his scientific contributions, also serves as a marker that sadly shows the direction of our vision.

Although he was terribly proud of the “Michael Franz Basch“ triad, I can only think of him as Mike, and I can only feel that having been able to see this book in his memory would have made him smile and want to edit it for grammatical and punctuation errors. Mike did have this perhaps peculiar combination of strict correctness and generous forgiving. He would dearly have loved every single contribution, but would have suggested a few more references-most probably, to his own work.

I first met Mike as a fellow resident at the Michael Reese Psychosomatic and Psychiatric Institute in Chicago. I found him to be stiff, unfriendly, and aloof as well as warm, funny, and generous. It was not that he was a mass of contradictions. It was all a matter of timing. Over the years I learned that you had to pick your spots with Mike, because he could become so intense and focused on something or other that there could be no easy shifting to another person or issue. But one would then be rewarded with the same sort of complete and wholehearted attention that had caused you to wait in line. Mike did not flit. He was there.

Mike and I remained in a sort of tandem step throughout our entire professional careers. We had one joke to weather all of the obstacles that came between us. He would say that everything I knew or taught or wrote was what I had learned or stolen from him. I would offer the same comment about his efforts. I can now right the injustice by setting the record straight but, of course, that would end the fun. I guess it was about even.

After completing our residencies at Michael Reese we, as did just about everyone, went into private practice and continued on with analytic training. I can now confess that I always felt that Mike Basch was doing everything just the way it should be done and I was not. He had a magnificent office, a lavish home, a cashmere overcoat, and Heinz Kohut as an analyst. However, I think that I can honestly say that the nature of our competition was so intermingled with mutual admiration and affection that I could never want what Mike had, since that belonged to him and was meant for him and not for me. We somehow carved out our personal areas which never collided. Of course, it is possible that he felt that I did everything the way it should be done whereas he did not. That would have been nice.

Mike was the son of a doctor. He and his wife, Carol, turned out three doctors of their own: Gail, Tom, and John. They share his scholarliness, love of learning, and dedication to patients. Mike had the same intensity and focus in being a good father that he brought to everything that he did, but he was quite careful in his selection of his family responsibilities. No record of his mowing a lawn or vacuuming a rug is available, but he could make a cup of tea.

Mike’s professional career went off like a Roman candle with his first book on psychotherapy and continued on with the ones that followed. He became famous. He loved to be invited to lecture and teach, but he hated to go. Either he disliked packing or abhorred traveling or was upset at the disruption of his routine—perhaps all three—but Mike went through elaborate and lengthy correspondences ending ultimately in his turning down numerous invitations to speak all over the country and the world. Perhaps as some sort of substitute he developed a network of friends and colleagues that he wrote to and spoke with regularly: professionals who were not necessarily psychoanalysts and were certainly not known to many of us. Even today I regularly learn of people who had a regular contact with Mike and whom he never mentioned to me, and I feel a little left out.

That last point was another facet of Mike’s personality. He had an incredible respect for privacy, and he had an equally powerful place for it in his own life. Mike never pried, he never gossiped, and he never revealed too much. As sure as I may be that I knew him as well as anyone, I am equally sure that there was an awful lot that I did not know. Perhaps that is because I knew him primarily as a friend, and Mike was able to be devoted to me without my doing as much for him. I regret that, because he was the most loyal and faithful friend that one could have. The rest is silence.

Self-Pity, Dependence, Manipulation, and Exploitation: A View from Self Psychology

Miriam Elson

Pejorative terms, such as self-pity, dependency, manipulation, or exploitation, can be understood as descriptive of the only modes available to an individual who has repeatedly failed to elicit any appropriate responses to needs or wishes that, at the time, are salient to the strengthening of a developing or weakened self.

Self-pity erupts at times of stress. An earlier view assumed that it represented a regressive, defensive reaction associated with a need to confront libidinal or aggressive conflicts aroused by new tasks or wishes. The individual may fear failure and anticipate being undervalued, passed over, or rejected.

In analysis fueled by more traditional theory, the analyst might gently, humorously, or caustically, depending on the phase the analysis had achieved, instruct the analysand “to stop feeling sorry for yourself and grow up.”

The analysand may indeed give up self-pity, both to please the analyst and out of shame at “being found out.” Dependence may become prominent, associated with manipulative or exploitative maneuvers. These traits frequently lead others to avoid individuals burdened in this manner and result in ruptured relationships and isolation. Rather than an opportunity for structure building, failure to achieve an empathic response intensifies the driven quality of self-pity, clinging behavior, and manipulation.

Such self states can now evoke recognition of the following observations. I) Self-pity is the necessary self-state of an individual who has repeatedly sought and failed to find a response to a given affect need. 2) Dependency may reflect an intense reawakening of a search for an idealized figure on whose wisdom, power, and understanding one can rely for strengthening of a weakened self. 3) Manipulation and exploitation of that figure may be seen as a primitive, awkward attempt to elicit a response so long desperately sought and developmentally necessary for maturation and growth.

An immature, weakened, stunted, or endangered self lacks the resilience necessary, when injured, to restore cohesion. In place of solace and support denied by the chosen caregiver, the individual retreats to self-pity. Absence of a timely response to the selfs developmental needs or wishes leaves a deficit in psychic structure. The individual has been deprived of an opportunity to transmute and internalize the necessary self-functions for calming, soothing, reflecting, and planning a new course of thought or action.

Self-pity, dependence, and manipulation do not represent a retreat from forbidden sexual and aggressive wishes. They reflect, rather, a reactivated psychological need for confirming responses that provide _opportunity for the acquisition or strengthening of psychic structure (Tolpin and Tolpin, 1996).

It is now almost three decades since Heinz Kohut undertook his courageous labor, extending over many years, to formulate a theory of human development that came to be called self psychology. Clinically grounded in his own work and in the work of analysts whom he supervised, self psychology was initially considered applicable only to narcissistic disorders. In time, it became a general theory of human development, a description of pathology, and a method of treatment.

Trained as a classical Freudian analyst, Kohut found that the patients he treated were not contending with intrapsychic conflict. Rather, they were extending to him needs and wishes for affirmation, a sense of acceptability as a fellow being, a source of idealized calmness and strength through whom their own capacity for calmness, monitoring anxiety, and regulating self-esteem could take form. They needed his acknowledgment, his response to their striving to feel whole and worthwhile. He called this use of another for kinship, idealization, and validation the provision of a selfobject function. He designated the individual who provides that function a selfobject (Kohut, 1971, 1977, 1984). But it is the inner experience, rather than the person who provides it, that is crucial to his theory.

The concept of selfobject, and the transferences the patient extends to the therapist to recruit a response to needs and wishes, became the organizing framework of Kohut’s theory. The psychic structure that propels the striving to feel whole, worthwhile, and purposeful is brought about through the experience of parental caregivers from a child’s earliest moments and through the widening world of selfobjects, both human and symbolic, across the life cycle (Wolf, 1980).

Kohut used the term selfobject to differentiate what he had observed from overwhelming clinical evidence that, typically, the individuals he treated, or whose treatment he supervised, did not transfer to him, as an oedipal object, incestuous longing or competitive striving. Instead they used his mature structure as their missing structure; they transferred to him their needs and wishes to heal and fill in deficits in psychic structure that interfered with their ability to form and maintain attachments and to pursue meaningful goals. Thus, Kohut differentiated between oedipal conflict, arising from faulty response to the developing child, and the oedipal phase through which all individuals progress.

The selfobject milieu brings about transmuting internalization of selfobject functions into self-functions, which become the unique structure of the individual self. The goal of treatment is the strengthening of that self or freeing of the development process for further growth.

The selfobject experience is necessary for the creation of the self in infancy, the consolidation of the self in childhood, and the sustenance of the self throughout life. Strengthening the self does not focus on symptomatic behavior but rather on the deficit brought about by the absence of timely response to the selfs developmental needs. It is within the self/selfobject matrix, with the therapist providing the new selfobject experience, that an opportunity for a developmental move forward is resumed, and structure repair, rebuilding, or renewal may be rekindled. The core of development and of treatment is the deepening, strengthening, and maturation of the self.

Kohut described the transferences that manifest themselves in the treatment process as the need or wish for mirroring, alter ego or twinship, and a source of idealization. Needs and wishes are exposed to the therapist as a new selfobject in an attempt to secure belatedly the experience of affirmation, acknowledgment, and guidance that earlier selfobjects had failed to recognize and validate as developmentally necessary to the child.

Basch (1980, 1988, 1992, 1995) described these three basic interdependent human needs embodied by the positive transference as the capacity for kinship, or an underlying assumption that one will be sufficiently welcomed and valued to make a meaningful bond possible; the capacity for reliance, or the freedom to feel protected by and to utilize another’s guidance; and the capacity for validation, or the readiness to feel soothed, enriched, and encouraged. Infant research has demonstrated that kinship, reliance, and validation form a developmental hierarchy that has implications for the therapeutic process (Stem, 1985). Unsuccessful attempts to solve problems of everyday life come about through the inability of the individual to secure these necessary selfobject functions, or, when they are available, to make use of them so that they can be transformed into self-functions, monitoring anxiety and regulating self-esteem as the individual formulates and pursues goals. Basch views the therapist as the midwife to the birth of the patient’s self-esteem.

An excerpt from the treatment of a 25-year-old teacher complaining of an inability to form attachment and a painfully restricted social life will illustrate how this comes about.

Eppie would enter a therapy session on the verge of tears. With repeated encouragement, she would describe an incident in which she was overlooked by those from whom she sought friendship. Large and small disappointments were undifferentiated. She would begin to weep silently at first, and then with greater intensity, at times with the abandon of a small child. This was particularly so if the therapist reviewed with her what she might have done to bring about a different outcome, or specific behavior of hers that may have evoked the slight. Only the solace of having her unhappiness acknowledged and her disappointment validated seemed to reduce the intensity of her grief. At such times she would dry her eyes, smile in woebegone fashion, and say, “I don’t know how you can stand me; I’m such a crybaby.”

The therapist would reply, “I think you must have a lot to cry about that is still unsaid. Perhaps these things occurred before you had words to described the feelings, or perhaps there was no one who would listen to you or understand your hurts.”

Basch (1995) calls attention to contentless crying, crying because one “is truly at a loss for words … To be able to describe the feelings, to put words to the event” that provoked the contentless crying, is to achieve a higher level of affect development.

Eppie did indeed have a great deal to cry about. The youngest of five girls, seven years younger than her sibling next in age, she had been born when her mother, weary of childbearing, had joylessly carried the pregnancy to term to fulfill her husband’s hope that this child might be a boy. Left often to the care of her oldest sister, weary of being a “second mother,” Eppie’s appearance was woebegone, dressed as she was in castoffs. The older children would run off and leave her; when she struggled to keep up, they would call out to her, “Here Fido, here Fido,” She would collapse in tears at the roadside and they would angrily wait for her to catch up. She was an unhappy baby, an unhappy child, and an unhappy adult. She was clinging and dependent on others, and her tears were in part manipulative. They were the only tools at her command that ultimately would arouse some recognition from her family, even if no more than the command “Shut up!”

When, repeatedly, instead of scolding, banishment, and abandonment, her therapist could bring to bear her empathic understanding, providing the words that described her feelings of loneliness, of being unfairly overlooked or neglected outright, Eppie would then become very clinging and dependent. Instead of ridicule for being “such a baby,” her therapist would recognize her bids for specific guidance as appropriate needs. How to express one’s needs or wishes, ways that are appropriately taught at given ages in childhood, were not forthcoming from her siblings or her parents.

In the treatment process, exploitation, the seemingly callous or brazen use of another’s presence or power or service, signifies rather that the therapist is experienced as an extension of the self, as a missing structure.

This use of another to enhance one’s self-esteem, or to strengthen oneself for a task that threatens to bring about fragmentation, may be experienced by the selfobject so used as obliteration. The oblivion into which this thrusts the therapist gives rise to countertransference reactions of boredom, sleepiness, or inattention. Such was the reaction of Eppie’s therapist, whose previously unflagging, empathic attunement temporarily gave way. Her therapist became aware of a tendency to feel dreary as Eppie’s hour neared; out of a desperate sense of trying to relieve this ennui, she encouraged Eppie to tell her a bit about what was going on in her teaching. Basch (1995) has pointed out that, in addition to ...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Acknowledgement
• Table of Contents
• Preface
• Contributors
• I Michael Franz Basch, M.D., 1929–1996 In Memoriam
• II Psychoanalytic Theory And History
• Author Index
• Subject Index