Mark Solms Does One Size Fit All Part 2

every patient that comes to us for psychoanalytical help is suffering and the structure of all of their suffering can be generalized like this that there there's something which they can't manage something they can't cope with it can be a great variety of things but there's something that they can't manage in their lives which they've tried to exclude from the equation of how they live their lives they've tried to get rid of it put it out of mind which in the old terminology means you know rendering it unconscious excluding it from the system consciousness but let's forget the old terminology and come back to what it really means which is that there's something that the patient can't cope with and they're excluded from there from the mental sphere from there from the way that they the things that take account of when they try to live their lives the symptoms come from the fact that that doesn't work and the thing that they've tried to exclude comes back the coming back of what well of what can't be coped with is what causes the symptoms it's an extremely useful formulation you know that's why I'm starting out now by reminding you of that yet again try something you can't cope with you exclude it as if it weren't there and only because it doesn't succeed the exclusion you have symptoms which is the coming back of the thing you can't cope with then you've got a symptom that you can't cope with and that and that sends you to seek professional help now I'm using that kind of terminology because I'm about to go into theory so I'm wanting to use as as colloquial a sort of way of putting it as possible in order for us to not glaze over and think theory I am now going to go into deep theory I'm going to start out by reminding you that there that we have a basic model of the mind which is the absolute essence of the psychoanalytical way of thinking which is that the person is in conflict that they have that they're dealing with competing demands that there are things that come at you from all sides that you have to deal with and they're not dealing with themselves you have to deal with them so you have this dynamic struggle between on the one hand the things that you want and need and the things that you can actually get in reality and you are in between those two things that's the critical the the fundamental psychodynamic model that you all of us have competing for the mental work that we have to do which is the living of our lives we have cut we have this this this conflictual situation on the one hand they're things that we want and need and on the other hand is what we can actually get out there in the world why it's so difficult is because the things that we want and need are out there in the world and you are the one who has to balance these things find a way of meeting your wants and needs in your actual life in the world you have to engage with the world because the things you want to need are out there that's the crux of our model now I'm going to start moving into abstraction and remember please what I've just said because that's not much of an abstraction you know it's not it's not very technical but that really is all that this is about we are by dint of being living creatures faced with this with this dynamic struggle of trying to meet our needs which come at us non-stop we always want to need things those those things never go away because we're living creatures we have once and needs and then out there in the world is where we have to try and satisfy them and the world's not there for us the world is there for itself the only the only difference between the only the only differentiation one needs to draw in regard to this this world being there for itself is that there are some people some objects as we call them some objects we use the word to refer to the fact that it's not me it's not the subject it's an object something out there in the world some of them thank heavens good lord be praised some of them care about us and that starts with our parents all being well that's what parents are so terribly important in psychoanalytical theory and childhood is so terribly important because that's when you're the most helpless you're the most helpless at the beginning because you don't know the foggiest thing about how to meet your needs in the world so thank God for parents who care about you they are not indifferent to you why because they see you as a bit of themselves and then that carries on in adult life all being well and this doesn't by any means go without saying in the people who love us after after our parents so that's why our love life is so important finding people who care about you and who love you is terribly important because the rest of the world doesn't give a about you and your wants and your needs now you this you that I'm talking about we call it the egg er in psychoanalysis it's a slightly unfortunate fact that we call it the ego because immediately as I say you glaze over now is going to talk about egos and things as a matter of fact in the German it's the the word is me or I so at this this sort of abstract language doesn't apply in the original in the original Freudian texts but for all sorts of reasons that have nothing to do with us today in the English we speak about Diego so now I'm gonna draw on this piece of paper a map of a mind you know which has got things called Eggers and whatnot they're abstractions please remember it's just a way of describing of mapping us in our in our lives in our struggle to meet our once and needs in life it's just it's just a convenient shorthand before I go into drawing this convenient shorthand I must say two things the first is I'm going to put it as simply as I can absolutely simply I know you all highly learned it people you know and I'm not demeaning you to by doing this I'm doing it because I believe that it is extremely complicated and I want to read kindling you you're extremely simple understanding because in order for us to deal with all the complexities the simple map is terribly terribly helpful it's like that little what do you call those things in your car these days little simplified map of captain telling you where to go you know this is this is one of those things GPS the other thing I want to say before doing this very simple map is you're not going to recognize it entirely as the one that you learnt at school because I've changed it a little bit I've changed it a little bit firstly in order to make it simpler but not overly simple in the sense that I'm distorting it if I'm a post for a moment for good for a good cause I must remind you I am the official translator of Freud complete works I understand Freud very very well better than anyone I know so when our oversimplified believe I mean please have confidence that you are learning it from an expert and even if it looks different from what you learnt at school this is an expert talking simple as it might seem it's correct okay it's trustworthy the last thing I must say is that it's slightly different from what you learnt at school because as I said earlier in response to Adrienne's question there's some things which I think need to be said differently so what I'm saying here is not 1900 Oh 1923 it's 2008 it's my product of my efforts over my increasingly long lifetime to make sense of it all and I'll now give it to you with love and kisses yes Diego that's us me and in the case of your patients them but they're the same as us here or their needs and their wants that we call the a go this forgive me we call drives drives or instincts in stretches translation or things which have became actually it's changing again but for a long time they were a very taboo subject or sort of old-fashioned fuddy-duddy out-of-date conception in psychoanalysis it's changing thank heavens but whether it's changed or what hasn't changed the fact of the matter is they they're we are biological creatures we are animals it's as obvious as anything that that's what we are we were not made in God's image in seven days or however it worked and plunk there to do good deeds we evolved from mammals and primates into ourselves and we are animals which means we have biological urges and needs and that's what in psychoanalysis we conceptualize under the heading of drives in psychoanalysis we we and this this applies to just about just about but not every but just about every school of psychoanalysis speaks of their being broadly two types of drive there are libidinal drives or erotic drives or life drives and there are destructive drives or death drives as I said to you before the break my original discipline is one of the neurosciences and this happens to be an area a case in point of what I said earlier when I said that there's an enormous amount the learned about the mind outside of psychoanalysis and it should be no surprise to learn that this part of the mind you're in a much better position to learn about it in the neuro bar in the neurobiology than you are in psychoanalysis to divine through the thickets of the mind and experience of an individual human being lying on your couch what the fundamental drives are that motivate them as an instance of Homo sapiens is much less likely to get to the full picture than simply doing experiments and seeing oh let me tweak this and see what it does to the animals behavior so there's been an enormous amount of progress in the neurosciences as regards these things I'm not going to go into all of that because this is a seminar on technique so I think for present purposes that is actually sufficient to just stick with the generalization that there are destructive drives and there are loving drives they are felt by the ego as hatred and desire or something of that kind here's the objects that's the world reality the drives are trying to be met in reality that because that's the only place that they can be at birth we don't have an egg er what is an egg Oh a Nega is as I said it's in experiencing me but it's more than just an experiencing me it's a structure it's a thing that grows it's a thing that is the repository of your experience of being in the world it's your autobiography if you will it's highly individualized it is unique to you it is the it is the sort of sum of the representations of your experience of trying to meet you needs in the world which is what your life boils down to in the theoretical beginning there is only an experiencing me it hasn't yet got any memory it hasn't yet got any any knowledge that hasn't yet built up any assumptions based in how the world actually works for you at that theoretical effective moment we say there's no anger now there's a little bit of controversy about this point in our theory in different schools of our theory for our purposes that doesn't matter a hell of a lot hell of a lot I'm quite happy to call it a theoretical fiction that there's a point at which there's no me and then me gets built let's just say there's a very rudimentary me and me gets built it makes no difference the main thing to understand is that the Egger the me the individual the personality is shaped by learning what works and what doesn't work in terms of meeting your needs in the world that's what it's there for it's there to learn from experience that's why we have memory that's why we have representational systems as they call it in nerve in meta psychology it's to represent retain the benefits of past experience in the beginning in the theoretical beginning before this thing has formed beyond just experiencing before it's got any kind of structure any shape based on only on a real knowledge of how you actually can meet your needs in the world we speak of the drives being totally in charge the drives a destructive one let's call this the destructive one and this one the libidinal one they according to this theory create a world I want this thing so I've got it that's how that's how we believe it works at the beginning you picture what you want as being what now of course it doesn't work and then comes the whole long difficult process of of getting your illusions to fit all your delusions to fit in with how things really work this is theory we'll come back to reality later this mode of functioning that I've just described where you have delusions where you you say I want I need therefore I have this totally omnipotent creating of annalisa natori delusional world is psychosis that's the essence of what psychosis is so this is a psychotic level of functioning where you create the world omnipotent Li then you start to develop a Nega Diego at this primitive stage of development in the earliest months and years of life his feeble is ignorant is not yet accurately portraying how your needs really get met in the world it's an evolution from that psychotic level of functioning where you just delude yourself that you've made it like you want it to be only to find it doesn't work when you start finding it doesn't work you start building up a sense of how the world actually functions and because the Diego is still so immature at that point because it's this structure is still so weak relative to the great power of the drives which stay as powerful from the military born until the military die these very powerful drives are much stronger than the ager at that point and remember I said you feel you experience your drives as emotions as the broadly speaking loving feelings and hating feelings so the primitive ego is dominated by feelings hating feelings I don't want that I hate that I want to get rid of that which is driven by these drives aggressive destructive forces which are there for a good reason I'll just quickly say for a moment to going back to neurobiology it's there for a very good reason there are things in the world which do you want to do you harm you know you need to have forces you need to have inbuilt capacities to deal with them the basic principle is a version get it away withdraw from that if it comes back kill it you know it's a matter of life and death the things that want no want you want you want to destroy you it's life or death it's um it's you or them so these forces are there for a reason destructive forces and they start building up hateful feelings toward the world and so you start representing the world pictures of the world which you hate bad things we call them bad objects which we've internalized in the kleinian terminology they're bad objects likewise we build up good objects things that satisfy us again I hardly need to tell you from a biological perspective it has to be so you have to learn which things actually meet your needs and what do you do you feel attracted to them you what you wish to you wish to be with them you wish to incorporate them you wish to unite with them these are the things that are life-giving and life preserving these are the things which are anti life which you have to destroy if you're not to be destroyed yourself that we call good objects this we call bad objects at this level of functioning dominated by you emotions dominated by these drives which have no relationship to each other these drives are absolutely independent forces coming from a mindless it we call this in contradistinction to the ager the mean there's the it the it is it it's not me it's a thing it's a biological thing which just just drives through you these powerful emotions in the ego you build up pictures of those things which are good which satisfy your libidinal or loving or or wanting or needing drives and you build up a picture of taking them into yourself quite separately from those you build up a picture and it's good that they separate this is an absolutely important distinction which things are good those are the ones I I approach which are the things that are bad those are the things I avoid those are the things I seek to get away from me these are the things I seek to take into me that is absolutely adaptive to speak again as a neurobiologist that there should be such a thing it's the most important distinction that you can ever make what's good and what's bad what's going to meet my needs and what's going to destroy me what do I want to take into me and want to what do I want to get as far away from as I possibly can so we speak at this stage of development because of that powerfully adaptive need to distinguish what's good from what's bad we speak of splitting it's a splitting of the world at the classification of the world according to how it makes you feel and how you feel about it we call it splitting and because what's good we're attracted to and seek to have close to us and you combine and unite with we speak of introjection in regard to good objects and new tortoise mutandis because in the case of these objects we want to get rid of them we'll get as far away from them as we possibly can we speak of projection those things I want away these things I want yeah splitting therefore goes together with hand-in-hand with in projection and projection they're the same thing they're just the different aspects of the same thing that level of functioning I've told you we call psychotic this level of functioning that I've just described to you we call narcissistic I've just described the stage this was called the stage of a loosen a tree wish-fulfillment and Freud this is the stage of primary narcissism in Freud psychotic narcissistic in Kohut client I've told you speaks of bad and good objects in this split narcissistic Eggar Colette speaks of self objects and that's a very important term very valuable term because it helps to remind us that these objects are in fact inside the Egger they're parts of the self but some of those parts we are trying to relegate to the outside world like bad feelings like burps and farts and hunger and wit nappies burning rashes all these bad feelings we're trying to get rid of them trying to get away from them which means trying to exclude them from the sphere of me conversely here this this horrible feeling that you're trying to get rid of called hunger can be replaced by this wonderful thing called the breast which you then taking to yourself you feel this is the thing I want this is what I'm going to take into me through my mouth or through whatever usually the mouth is the easiest way to get things into you especially when you a little neonate is basically the only thing that works is the mouth so introjection and projection is absolutely fundamental to this narcissistic mode of operation but the feelings like hunger actually are part of you so you turn it you experience it as a bad thing which you want to push out into the world and turn into an object that doesn't mean it really is an object so you experience the world at that point as a hateful thing a bad thing causing you bad feelings that's why you that's why you're getting rid of it that's why you're projecting it out into the world but in reality from the point of view of the third-person observer the adult us we look at that and we say that is inside the maybe it's a bad object in the baby the baby experiences it as a bad object it's out there but it's actually a part of itself which is why the term self object is so valuable the term is more easy to see it's more easy to see the value of the term with regard to the good objects there's the breast I wanted inside of me even though it's an object I experience it as part of myself I want to take it into myself it's an ideal thing it's a wonderful thing I want to be united with it I want to I want to have it on demand it's one step away from a militant hallucination you know that I wanted on behind so I could on demand so I create the illusion of it being there which doesn't work this one here I wanted on demand so I take it in to me so that I can have it under my control when I need it or make it part of my omnipotence fear of myself it's a self object which I experience as part of myself and this is a self object which I experienced as part not of myself that's my aim in relation to these objects that's the essence of narcissism now I've said that climb speaks of bad objects and good objects bad objects and good objects are hardly need to say or absolutely bad and absolutely good that's in the nature of splitting it's in the essence of splitting and as I told you it's there for good reason there should be no ambiguity about what's good and what's bad Klein also spoke of this as the primitive super-ego that is to say the part of your own self that is in fact hateful and felt to be an object something out there in the world it's that's it it's fundamental to these objects that you're trying to get them out there in the world for it for the reasons I've already told you and won't repeat but it is a sad fact that it's actually inside of you there are bad things that you feel that are part of life that you can't get rid of they're inside of you and I Speaker of nepi wretches and hungers and burps and thoughts but at carries on as we all know to our great sadness and distress bad things just get more and more they're there and bad things about ourselves that we gradually discover ship look at me I've got big ears you know now I've learned that what am I going to do about that the other boys teased me you know all these things you don't want them to be there but they're there all of those things you try to get rid of but you can't this is why Klein calls this the primitive super-ego this what I'm going to say to you now it's because it's a part of your own Egger which is experienced as not me but something which is bad but something which is hateful at something which is alien and experienced as not on my side and fundamentally not of me and yet sorry it is in you she calls that the primitive super-ego Freud didn't call it the primitive super-ego Freud called it nothing amazingly there is no concept in Freud for this thing although if you read the paper on negation you'll see that he knew it was there but he had no term for it why well for a hell of a lot of reasons not least of them that Freud mainly focused on the strife Klein mainly focused on that one why did she mainly focus on that one because that was the one that was left this thing Freud had a name for he called it the pleasure Eggar he also called it in a slightly different context the ego ideal the ego ideal the repository of your narcissism the perfect version of yourself the thing that you really truly wish you could be only that this level of functioning this narcissistic level of functioning is covered partially therefore by Freud's concept of the super-ego this is the primitive super-ego clients version of what is going to become the super ego and this is the ego ideal which is also part of the super-ego in Freudian theory but neither of these concepts is properly resolved in Freud bring me the analyst who can explain to me where how the concept of an ego ideal fits properly with the concept of a super again I'll show you 55 contradictions this simple formulation that I'm giving you here resolves those contradictions this level of the mind is narcissism it's it's part of what we're going to think of what Freud was is going to call the super-ego I'll make it clearer in a moment the world doesn't really work like this as we all know they're parts of ourselves as I said our big ears or small will ezel the fact that we can't compete with the main manner that countered school or the fact that our fathers are so big and strong and we feel that puny little 90-pound weakling and after our fathers then the others too who make us feel small and bad these things exist although at the level of the narcissistic Eggar the baby ager primary narcissism Egger which is better than psychosis but acknowledges these things exist but it pushes them away into the object it isn't really like that therefore it can't work because they're not in the object they're in you they're bad feelings attached to you really bad things about yourself and your life and your experience of yourself which make you feel bad they they like it or not mutatis mutandis for this one there are things out there in the world which bring you every joy and happiness known to man problem is they out there in the world and it doesn't mean that they're gonna bring that joy and happiness to you you try to bring it into your world into your life into your experience of yourself you try to make it something constantly available to you like your hands and your and your feet are something that's me is the only thing or at least it's W got the best chance of being able to count on it if it's yours and it's you you can you can call on it on demand but it doesn't really work like that actually objects are out there in the world the good ones the good ones that you want and need and depend on and desire so this level of ego functioning has to be replaced by a more realistic level of ego functioning which our pen is running out is up there Freud calls this the reality ager he also calls it Diego this is the crowning achievement of development it's called the reality ager because it represents the world as it actually is with all of its frustrations and disappointments all of your own lacks and deficiencies as much as you don't want it to be so it is the reality ager learns to come to terms with how things actually work it is in a word emotional maturity this is emotional immaturity it's how you want things to be and it revolves fundamentally about what is me and what's not me trying to make not me all the things that you don't want and trying to make me all the things that you do want on an illusory basis so much so that there are self objects yeah they're parts of the object that are in fact part of yourself as you experience them as they're an object but they're really part of yourself and these they're really part of the object but you experience them as part of yourself that's how you wish it was that has to be replaced by how it actually is they're splitting gets replaced by whole object relationships what Freud calls object love which is where you recognize the thing I love is an object the thing I love is separate from me I love her even though I am NOT I can't have her on the mound even though she frustrates disappoints abandons gilts me when it happens the reality a go in its emotional maturity feel sad that mourns the loss that recognizes its vulnerabilities and its dependencies in lieu of those feelings which are absolutely inescapable in the face of how the world really works objects in all of their capriciousness disappointment sadness vulnerability dependency in in in recognition of those feelings Melanie Klein called this level of functioning the depressive position it's bloody sad it's depressing the way the world works and coming to terms with that is maturity it's health then the different things that you can do and they come in three forms and here are three forms of psychopathology when I said to the extent that you could that you can't cope you know it's nothing to hold against ourselves it's bloody difficult life's difficult because as I said you know you have these absolutely boundless needs and very strong feelings of love and hate and they have to be directed toward objects in the world and the objects in the world hate you too they hate you back and the ones that you love don't necessarily love you back it's a bloody hard task to make it work that requires mental work you know that's what maturation is that's what health is doing the bloody hard work of coping with the world as it is which includes coping with all the things about that that you don't want and all the things about yourself that you don't want why do we do it because sometimes we do go get what we want and that's integrated into it too and I realized there's an in critically important detail I've I've slightly skimmed over which I'll quickly elaborate on before I come back to the point that I'm at now about how hard the aygos task is I spoke of the paranoid schizoid position in the depressive position and I spoke of the splitting here and the whole object relationships yeah what I should have made more explicit fundamental to kleinian theory is that as this develops as a sense of reality evolves and matures so you come to recognize that's that's not only sometimes but frequently the things that you love are the same things as the things that you hate the mother who frustrates you is the same mother that you adore the father who threatens you is the same father that you admire the same father that you want to be like in the case of a typical case of the boy so you have to come to terms with your ambivalence toward your objects when you recognize that your object is both good and bad and come to terms with that limitation there is no ideal love except in Mills and Boon which is at the level of narcissistic fantasy in reality you know it's all a little bit more messy than that and ambivalence needs to be tolerated it's not nice that the objects that you love are also constantly bloody one annoying you not not they're not under your omnipotent control they're not there for you only thank heavens for parents and thank heavens for love partners you know they're there for you more than the rest of the bloody rabble but they're not there only for you they're there first and foremost for themselves and that's insulting and frustrating and difficult to come to grips with but come to grips with it you must so to return to the main theme that Eggers task is very difficult you can see why you can see how therefore it's not something to hold against it that it sometimes fails in its tasks especially in childhood why especially in childhood because as I've said already that's when you're least you have the least resources the least ergo resources because an eggo is something that evolves it learns from experience if you are confronted by some hugely difficult mental task in early as childhood if this conflict conflictual situation that I've described and as you can see there many of them then there come terms that you just conquered and that happens a hell of a lot more then it's much more likely to happen then than it is to happen now it can happen now there are awfully traumatic things that happen to us in life and in fact the older we get we start to become more subject to those things again but the formative the formative sacrifices that the Egger has to make in order to be able to get by or in the earliest years of life which is why childhood is so important it's not because Freud said I know what let's make a theory the childhood is important you know it's kind of like obvious less to be important and your parents therefore the only ones you love you at that point lets out and they don't love you perfectly we know they're important to you not because Freud thought it up so there are three main ways in which the ager gives up the ghost the first and most common and happiest solution that can find is its drives making all these demands coming through its primitive layers in the form of strong wishes strong once and strong dislike strong hates coming at them can't meet them in reality and says I can't deal with us I'm leaving that out as long as I leave that out I can deal with the rest and that's called repression repression is sending a piece of Egger back down a strong desire connected to the world that's what I want but you can't for the life of you get it and it keeps coming at you that's what I want and it keeps getting you into trouble you know you can't cope with it it's a it's an impossible demand you said okay I don't want it you do actually you always do actually so it comes at a price because you do actually and you pretend you don't you've repressed it likewise with strong hates you can repress strong aids - you know I want I want my father out of this picture he causes me nothing but trouble but Jesus is big and I don't know how to get rid of him but I want to you know what am I going to do I know what I won't wanted anymore I'm giving that up out of the picture I don't think like that anymore it's repression big fat word very simple very obvious very kind of like predictable process repression comes at a price because you excluding part of the facts those desires remain there but now you can't meet them because you're saying they're not there you have deluded yourself your life becomes restricted and limited by degrees the more you repress the more limited you are the more the more in equipped you are to deal with the world because you're leaving off the facts art but at least you're still dealing with the world if you didn't leave those facts art it's worse you're overwhelmed you're absolutely overwhelmed so it's better than that you're only a little kid critically important at that stage you're only a little kid you got to exclude it you can't cope with it you're not in a position to make the world fit in with your wants and your needs your loves and your hates you can't do it so you know why try that is repression that is not neurosis it is only a neurosis when the repression fails so because those ones are still there those once and needs are still there banging on the door what do you do you build up defenses against them no I don't hate him I love him you know I don't want to murder my brother I love my brother I'm gonna protect him he's gonna become my little mascot I'm gonna defend him you know to the hilt in the scrum plagues on the playing grounds reaction formation that's called for example intellectualization rationalization turning it into its opposite identification with the aggressor and so on and so on there's a very boring book called the ager and the mechanisms of Defense which you can read I won't list them anymore the important thing is that you build up these defenses against the repressed because the repressed is constantly threatening to return those defenses the shaping of your character is just that it's this it's the origin of character difficulties or character traits a very important part of our personalities how we shape I ago the store tiger in order to help it to keep those things batten down the repressed that's the meaning of the word defense this is repression that's not a defense in the same level of conceptualization as all the other mechanisms of defense they are what Freud calls after pressure in his paper on repression its primary repression and then there's after pressure keeping it down there so now what do you do if you're a repressed desire or a repressed impulse do you say okay I'm giving up in their ways because you come from here from these guys these guys never give up their God himself ordained these guys they're very much more powerful than you they are your biological living substance you are compelled you're compelled to go forth and multiply you know you need to you want to it's nice you're never going to tell yourself I'm gonna stop wanting and they are always going to be things that you just cannot tolerate that you are going to annihilate you know one way or another there's things that are gonna get to you that you're going to hate you know and those hatreds once you've got them you've now Festa you know they they're resentments burning beneath the way the the threshold of awareness stay there and they're constantly trying to get out that's why you have to have these character defenses to keep them down but because down here things work omnipotent Lee because it's not realistic this psychotic world you can make anything you like into anything you like by mechanisms that Freud called the primary process displacements condensations symbolization x' you just transfer the impulse from one object onto another one and say okay I'll have it there instead it's better than nothing from the point of view of the psychotic aid the omnipotent did that Brooks no frustration ever so it's constantly trying to come back at you if you're lucky you can your defenses hold and that's your character that's what makes you into the character that you are it builds character young man or it might pop out and it won't pop out in the place where you originally popped it down it will pop out somewhere else where you don't expect it where you least expect it in the most absurd irrational places that is transference neurosis it's transferred and it has popped through so it's neurotic it's come back at you the repression has failed it's the return of the repressed what do you do then when the thing has come back at you popped back in do you say okay okay bloody hell let it stay no no no not at all you carry on chronic now it's panic stations you know that's like the Titanic has hit the iceberg it's pouring in you know what are you gonna do close the bullet let it in there but close yeah you know that's that's what you do so the repressed has returned and you have desperate measures to keep on battling it down so you've still got a conflict the repressed popped up in a transferred place and you still trying to keep it down that is called a compromise formation the symptom is that thing the symptom is the repressed that's popped out and your attempt to batten the down as a last desperate measure they frequently are absurd these symptoms they certainly are most unwelcome by the rest of the Egger and so what do you do you found Trevor lubber and you say I believe you'd offer analysis okay so there your neurotic patient comes along with his or her symptom in town seeking help so neurotic transference neurosis neurotic functioning is at that level level one the second set that's called and the mechanism of it is repression that failed the return of the repressed the repressed transferred that's why it's called transference neurosis that's the first thing that go wrong that can go wrong but in this the ego the mature eager the reality agar is still in charge another thing that you can do is you can withdraw from the reality a girl you can say this is too difficult for me this level of functioning Archon cope with I'm going down to another level of functioning I'm regressing to narcissism this is much more difficult you know it's a much more difficult balancing act so I regress to narcissism very important to recognize is that some people never get that far in the first place so you don't only get regressions to narcissism you get fixations at narcissism but when it's a regression to narcissism it's called secondary narcissism in Freud when you never got beyond it its primary narcissism or that part of you that never got beyond it and it also can be only a part of you that regresses to it but to the extent that that is in charge to that extent you have a narcissistic disorder which means that you are splitting I mean not a narcissistic disorder I beg your pardon a narcissistic organisation it's not yet a disorder a narcissistic organisation where you split and project and interject function according to your emotions rather than according to reality you function according to your wants rather than your accepting how it is and that necessarily means that you start to make things all good and try to be those things in projection and you make things all bad because you've split because it's much easier then all those complicated business of trying to deal with all the ambivalences and ambiguities and complexities and the bad things you project the problem with narcissistic organizations is that this bad object that you're trying to project is stuck to you you can't actually really project it so Freud says in no sin neuroses there's a rent between the ego and the it that's repression in the case of narcissism there's a rent between the ego and the super-ego but it's now a primitive ager a narcissistic Egger and idealized agar and narcissistic me a perfect meal which is therefore a self object me a taking in of everything about the world that's good making it back into yourself and conversely trying to project everything that's bad a primitive super-ego but you can't really project everything that's bad so there's a rate between the ego and the super-ego but it's a narcissistic ager and it's primitive super-ego that's where the rent is that's where the breakdown occurs it's because the bad won't stay in the object and the good in the object stays in the object so the splitting fails the attempt to get rid of the bad object fails these patients are troubled by very severe superiors primitive super egos when they're inside of them small wonder that they're trying to get them outside of them small wonder that they paranoid paranoia is one of the prototypes in Freud of a narcissistic pathology another one is melancholia melancholia is when the primitive super-ego won't go out stays inside of you it is prior powerfully destructive force by one part of you directed against another part of you that's melancholia self-hatred something that's hated as much as the worst object in the outside world but it's actually inside of you and it's extreme a trait it's not dislike it's not ambivalent it's blindly murderous hatred it's deathly its it is excruciating the unbearable melancholia now because the term narcissism has acquired other meanings in our contemporary taxonomies we speak of narcissistic personality disorders and we speak of borderline personality disorders as if these are two different things let me quickly say here that this is an inherently unstable organization the-the-the-the in trajectory of projective attempts in relation to these self objects these these artificially extremities good and bad objects because the world doesn't really work that way because things are not really absolutely good or absolutely bad and let's still do those absolutely good things coincide with your beloved self and all the absolutely bad things coincide with the hatred external reality it's an inherently unstable organization and just as so is a repression always threatening to come back and when it does you have a neurotic symptom so to you in a narcissistic organization the bad object is always threatening to come back and you're constantly having to deal with this very precarious balance and borderline disorders are a result of that of that precariousness that inherent instability because in here you're dealing with two different parts of yourself it's a more profound instability than trying to keep a desire art at least you know this is me and that's you know this other thing which is actually it I'm putting back there where is here it's a confusion between yourself and the object it's fundamental to what splitting projection and introjection are a confusion between self and object so you're constantly banging into the object and into parts of yourself that you thought were objects and it's a mess and you're constantly trying to desperately get it back into the split which is never gonna work that's a borderline disorder in one's in the sense of the DSM for borderline personality disorder there's another meaning of the word borderline which is on the borders of psychosis to which I now move if you're functioning at that level you're narcissistic I must say before I go down to level three I've said that if your sessions are successful then you're not neurotic you're limited in some we're restricted in some way you're repressive type you know but you don't doesn't mean you're neurotic you don't have symptoms you're getting by you know one way or another if this level of organization is successful you are perverted and in many forms of addiction the same thing happens what that means is you've managed to distort your ego just as you do in character the formation of character defenses now you have what we call character pathology where you've distorted the thing like in splitting in such a way that it works it's a contradiction to two mutually incompatible truths and you hold them both to be true you have your cake and you eat it too like a psychopath or a pedophile and who suffers not you you're fine because you've construed it in Freud's wonderful word artfully you've artfully construed things so that it can be black when it looks black and it can be white when it looks white and it can be the same thing which is not possible but you've you've artfully construed it so that it is possible you do have control over the object really successfully you've made the object into what you want it to be and you've convinced yourself it is like that and you've got the object to fit in with you who suffers not you the object society in the case of psychopathy children in the case of pedophilia your body in the case of addictions but you've managed to convince yourself that's not you or it's not true and allow somewhere else you know it's true somewhere else you know it's not true doesn't apply to me those are successful narcissistic disorders or sort successful narcissistic organizations and they very seldom come to us because they're not suffering they frequently sent to us and it's not just a matter of like in England when you sentence to psychoanalysis of the Portland clinic because you're a pedophile and when I say sometimes they're made to come to you it can be much subtler forms of it you know like your spouse says she'll only stay with you if you go to therapy ok so that's another artful thing I can do I can go to therapy haha you know that works that doesn't mean you in therapy like the patient do suffering and con cope and asks for your help I'm only going to keep on giving you your pocket money if you go to therapy you know stop buying bucker ok now we come down to psychosis yeah in perversions you know let me make this clear because I think maybe I didn't make it clear I'm distinguishing here I've spoken about repressions which work with character defenses which limit you but which work so you know there you become an accountant and you find you know I'm making a joke you become a nun you know or something you become a philosopher you know intellectualize all of it will be blue in the face and you find everyone else is sort of like oh but you know you're fine the-the-the neurosis occurs when the repressed returns and you can't keep it down now likewise there's and there's a distinction here to be drawn between narcissistic organizations which are stable and successful and narcissistic disorders not with narcissistic neurosis as for it called them which are unstable they're not working the fundamental problem the fundamental instability is that you can't make the bad stay in the object and the good stay in you the bad keeps on threatening to come back so you have paranoia or it's back melancholia oh it's switch switch switch switch you know borderline organized borderline disorder but if you manage to construe the split artfully in other words make character alterations where you shift things you know them but you don't know them you prepare to break through to twist and distort the rules as perverts do as many addicts do as Psychopaths another character sociopaths do then it works so that's not a narcissistic neurosis in the sense that the patient is suffering and comes to you for analysis it's a narcissistic organisation that's what Freud conceptualized under the heading of character disorders it's a very broad category which means that you have manipulated the structure of your mind in a way that's not really truthful you know that fudges things but you allow yourself to get away with it is slippery the other people suffer the other people suffer like hell there's a man in Austria yeah but his daughter downstairs what a wonderful object to have completely and Natalie under your control do you feel guilty and bad not a sausage did he come for analysis no you got caught they can sustain it for a lifetime and that's the one that got caught we don't know how many others there are in Austria they haven't been caught yet you know but but I don't want to create the impression that it never happens that you have a suffering pervert to that extent they are now suffering from a narcissistic disorder and there you can analyze them but they you know there's there's many more the way to make your narcissistic organization work is to do it in those ways that's why those disorders tend to to be fairly stable and don't come to us for treatment and the object suffers the ones that are unstable or not perversions and severe addictions and and psychopathy and to that extent they therefore called something else and those are the ones that do come to us but they come to us with a very particular aim in mind which I'll come to you much rather when these guys coming to you because they say doctor I've got a problem will you help me this one says I'm gonna use you to make my situation better you know because that's the way that they function but that's what we're coming to you now the last disorder is psychosis I mentioned psychosis for two reasons but first I must tell you sort of the opposite I know it's not common for you to see psychotic patients in your private practices so I'm not going to spend as much time on it but you sometimes do so for that reason we do need to spend some time on it and psychoses are sometimes encapsulated you know they can emerge in the treatment or it can be just a part of the patient's functioning and you then need to know what you're dealing with so I'm telling you about it for that reason but most of all I'm telling you about it in order for you to see what it's not because so many things are called psychotic mechanisms in our literature these days and it's just a complete misnomer that causes real confusion many of these things are called psychotic mechanisms and they simply are narcissistic mechanisms and should therefore be called that so I'm also wanting to make here as I said what what is not a psychosis by telling you what a psychosis is a psychosis just like a neurosis and a narcissistic disorder functions in two stages it's a it's an attempt to cope with something that the patient that the Egger the self the me can't bear and then it doesn't work so the thing that can't bear needs to be dealt with all over again this is called disavowal the first mechanism the first step what is it what was what is meant by disavow whereas in a neurosis the ego withdraws itself from a piece of its own organization and pushes it down into the it that's called repression in disavowal what the patient does is the very opposite in its in his or her in the Eggers task of trying to balance remember that's what it's all about balance its needs and once with the fact that the things it needs and once are out there and difficult to get that's mental work that's the egos job that's what the ego is therefore in a neurosis the ego sacrifices the drives pushes them down in a repression in a psychosis the first step is that does the opposite of sacrifices reality it withdraws itself from reality now in a manner of speaking and it's not just a manner of speaking narcissistic organization is halfway toward a psychosis because it's the same thing halfway you're not denying reality completely you're not disavowing reality completely obliterating your knowledge of it what you're doing is turning it into a reality which is more in line with your emotional needs but nevertheless it's still a reality you live in the world of internal objects down here rather than hold objects real objects appear so but in psychosis that goes that one step further and Freud says this very clearly and I don't know how many people have understood this but when you work with psychosis you see it Gary is a psychiatrist he works he knows what I'm talking about I know some of you have psychotic patients on there Marion or sent you one so you know some of you are know I've seen it and I'm gonna illustrate it for you just now but it is a profound a profound process the first thing is the patient withdraws from reality on the outside it looks like that just that they was drawing from reality they are withdrawing they becoming withdrawn they become passive or they become kind of inert they become kind of absent they're not there this is called the negative symptoms of a psychosis once it's once it's declared itself but frequently they don't call attention to themselves you know it's not noisy patients just withered away they have profound disabilities these patients but they're not psychotic and I'm not talking about DSM for you know this this I mean in the psychodynamic sense of the word the psychotic symptoms haven't appeared the psychotic symptoms are in the DSM four sense of the word the positive symptoms that's the noise that's the trouble once you withdraw these structural eyes your entire gur if it's a total psychotic organization you have completely obliterated everything that you know about the world and every means you have for knowing about the world you have destroyed your mind your mind becomes the outside world to you then what happens is now you're functioning at this level at the psychotic level and what happens then is as Freud said the the it creates a delusion that applies a delusion like a patch over the rent between itself and reality so it replaces the piece of ager and it can be just a piece facted morphed and then not is just a piece that's why you can get encapsulated psychosis or more commonly you get psychotic more or less big psychotic symptoms but there's still a part of the patient who is in touch with reality very important for our technique but the part that's missing because the drives still need the objects and because you're now functioning at the level of an omnipotent organization you create new ones those are the illusion ations and the delusions those are the symptoms of a psychosis it's the thing it's the conflict between drive and reality coming back again because now you've created a new reality and the problem is it's not real you know that's why all of this ego maturation had to occur in the first place because it doesn't work it's profoundly dysfunctional profoundly disabling profoundly built you know ill these patients are very very very disabled and sick people and they are pathetic tragic cases where the delusions are constantly at absolute loggerheads with the world which doesn't go away as much as they said it's not there anymore it's still there and now they don't have the Egger apparatus to deal with it because they've destroyed it so the two things lost two lost things I want to say before I finish this um we have over here relative health and neuroses and narcissism and psychosis and its depth of pathology it's worse more severe the further you regress the more you give up everything that you've developed to cope with life you are more ill the more you go down the hill and I want to put that into drive theory terms because it's an important part of what happens clinically with these patients down here drives don't have to fit with each other you can feel pure love pure hate absolute demand doesn't care about reality doesn't matter these are biological processes they're just there you know they don't have to make sense or be compatible or even be manageable they then stay there they're like the stars in the heavens are there at this level you're starting to try to bring them into conjunction with a representation of the world it's a representation of the world that's very wonky but it's a representation of the world actually it's internal objects they're objects they're not delusions they're not magical omnipotent creations but they split so the drives although they're beginning to be brought into conjunction with reality they're not brought into conjunction with it with each other and for that reason they don't work in reality because in reality you have to bring them into conjunction with each other because in reality they both exist and you can't have the one without the other in reality so the problem of ambivalence for example you know our hater the bad mother our lover the ideal mother they're the same person hello doesn't work in psychosis it's a part of reality that the patient can't cope with now entry and the patient withdraws from reality excludes reality from the equation but it but because we can't exclude reality it has to create a new reality which is the symptom which bangs into the actual reality of catastrophic consequences now in reality the ego is always struggling with all three of those things and this is a fundamentally important point in terms of the question that we that we have prompted this whole seminar which was what do we do with cases who are mixed in reality we are all a mixture of all of those things not in our pathology but in our conflicts we're all struggling with reality we're all struggling with our drives our once and desires and we're all struggling with parts of ourselves that we wish weren't there and parts of the object that we wish were in ourselves but aunt its where the rent occurs that's what the ager decides to sacrifice that determines the structure of the pathology you can't have a Nega that simultaneously gives up on itself and sides with the ED and also Institute's repressions there's nothing there to be repressing the repressed is the opposite you know it has as I said I'm giving up on repression big time I'm going to become just the drives that's psychosis you can't have a mixture of a psychosis and neurosis you know the pathology is a psychosis the big-ticket item you know to the extent that the ego has to make a choice it produces one pathology or another that's the big-ticket item the part that's left is still in conflict the symptoms come from one direction or another those are though that's the illness that's the psychopathology that you're struggling with and then there's an ego that store has psychotic mechanisms neurotic mechanisms narcissistic mechanisms which which you know which is to a greater extent or working you know the part that's left so it's not as if you're not going to find all of those things in the patient but the task in taking your bearings in what you're dealing with is to make is to make a decision what where has Diego decided what has Diego decided to sacrifice or to put it in other words you know what is the thing that the this person couldn't cope with the thing that I can hear see this patient can't cope with is it is it something about reality that they couldn't cope with and therefore making as if it's not there is it something about their own once and desires they can't cope with and they're making as if it's not there or is it something about themselves that they can't cope with that they're making as if it's not there now these are rules of thumb you know I really at this point cross the line between simplification and oversimplification there are rules of thumb it's a little little sort of phrase that you can hold in your mind to try and sort of beginning to make sense of what you're dealing with but in the interests of not oversimplifying too much I'm now going to give you some case examples very brief little sketches these are these are all patients that I that I personally have known not yet not all of them have are treated I'll tell you two of them I haven't treated I'll tell you about those when I get to them okay one is a patient and also you must know since since I left London and came back here I don't see any ordinary psychoanalytical patients I work in a hospital in a neurology ward so that distorts somewhat my current clinical experience but in London I had an ordinary psychoanalytical practice with five times a week to once a week patients so I've drawn from the full range of those patients but obviously the police oh my god it's coming back yeah but I've because I've chosen from the full range of patients that I see there's an over-representation of the kinds of cases that you guys probably don't see that much okay first one and I'm just trying to give you the absolute call formulation so that you see what I mean this is the first example of a transference of a transference neuroses and neurotic and a neurotic disorder this patient came to me with a tick it goes like this that's his symptom and he tells me that what brings it what makes him have the tick is whenever he feels so put upon he's being he's being forced to do something he's being made to accept something that he doesn't want so when is that work for example and it has to deal with his boss the tick comes a hell of a lot it was very embarrassing it's not something that it's ridiculous it makes him look ridiculous he feels ridiculous he feels humiliated so now you see the the oversimplification of what I said about the rule of thumb because you might say so this guy has got problems about you know there's some part of himself that he can't cope with but that's the symptom no patient can cope with this symptom is not a part of themselves in the sense of the word the patient doesn't experience it as a part of himself the experience it is this completely ridiculous thing that he has to do now in really pure cases really pure neurotic cases that's a hallmark that they experience the symptoms that the horrible phrase is a Gerdes tonic it's something that they feel you know is not me it's it's it's it's abnormal it's something it's an overwhelming anxiety you know it's a bad thing that's something I don't it's Penix it's a need to wash my hands all the time you know it's a symptom they experience it as a thing separate from themselves it's coming as it as it happens from the edge it is separate from themselves it's something they have separated from themselves and push down into the it and your your guiding light is that it's a one toward desire now in the analysis of this patient which I saw for a good few years and I'm gonna fast-forward through the analysis because now I'm just wanting to tell you the structure of his pathology the analysis of this symptom revealed that the underlying the core repressed impulse was a wish to be alone with mum he wanted to be alone in a blissful orgiastic lee ecstatic Union absolutely exclusively with mum and the feeling is he's being pulled away from her all the time he's been forced away from all the time and he's shaking it off I know it sounds ridiculously old-fashioned I chose it because I know it sounds ridiculously old-fashioned but it's true it's real this patient came to me for analysis was this thick that was the underlying repressed impulse and he doesn't have a tick anymore it's gone now is that the whole structure of his difficulties no of course not you know and I'm just giving you the absolute core thing but just in order to illustrate that it doesn't that that the disorder isn't just the cool thing it let me first of all make make her make her second point about the theory for it said all of our repressions are decisive repressions except in traumatic neuroses the decisive repressions happen in childhood in early childhood because that's when the egos feeble that's when it has to on cope with its once and it's desires it's got no capacity to meet them in the outside world so it has to give up on them repressions are rife in earliest childhood he then says other things that happen later on in life which threatened to bring back the repressed get secondarily repressed they get pulled down by the repressed was the way he put it say anything that's too closely associated with the repressed gets also repressed only because of the association with the first repression that's a general principle which again you know gives me no pleasure to sound like a 100 year old theorist really believe me I only tell you these things because I've seen them with my own eyes and I've cured patients like this and I even dare to use the word the patient this patient's symptom disappeared and as it happens I know I followed him up years later because as a result of his analysis partly he was able to marry and have a child and the child was you know nature working as it does completely indifferent to us was very impaired very disabled and he came back to me with his very disabled child and I was able to speak to him about how things had gone for him many years later and his tick never came back and it didn't come back because we analyzed it like this this is what it was all about now that was much more flicks the net the the repressed fantasy and that's what it is it's a repressed fantasy not transferred whenever anybody tries to get him to do something that's you know that he doesn't want to do it evokes this scenario father is trying to take me away from mother what what happened was also this symptom makes him look ridiculous you know said this remember what I said that there's a compromise formation in every neurotic symptom yes partly it's like myself you know Chucky shrugging you off but at the same time it reduces himself as a as a desirable Oh what's the word not so much desirable as proud man you know he's not he looks like an idiot you know I mean a tic it really looks it makes you look ridiculous you're constantly humiliating yourself and in his analysis that was very important and by the way it went the other way around the analysis of course we didn't start with an understanding of the tick we ended with an understanding of the tick one layer above that was an understanding through their analysis that he felt inferior and that the tick made him feel more inferior he felt inferior to these men these bosses and these colleagues and and other men in the transference me who at that stage of the analysis he decided was South African and in his mind South Africans Colonials are much more mature they're more male than Europeans sorry Gary but that was this patient's view earlier on in his analysis he thought that I was Dutch you know it changed but at that stage I just want to I just want to make clear that how these harbours at the the structure of the neurotic thing isn't just oh say yes the repressed fantasy you know and that's the whole patient's personality above that there was this layer of him castrating himself and then there was a whole other excrescence of this patient's disorder which had a repressed homosexual desire in relation to his father which was then the secondary repression this thing then got pulled down it was first of all the one side of the of the symptom was shrugging father off shaking him off refusing him defying him and it was it in those situations that the symptom came out but in a way that makes himself give up makes himself look the fool and in the fantasy and in unconscious there things fantasies proliferate because now it's underneath its unconscious in his unconscious fantasy now he was like he was like the mother he was like a girl and that was his second chance so now if he can't have mother well he'll have father he'll be like father was the first one giving up on that okay I'll be like mother and there was another layer of his analysis and it was a very big repressed man to see that and it was a big part of the analysis big part of his transference to me was that I was trying to dominate him in the way that had a homosexual panic attached to it initially that was a layer that we had to get through just because I say I'm aware of how old-fashioned all the things I'm telling you I want to tell you one other thing about this patient and these sorts of experiences really impacted on me you know I really on the truth loving person you know really made a huge impression on me this patient in the context of analyzing this whole constellation he had the experience of his penis in inverting and going into his body he felt it and he said and when I made accurate interpretations when I say when I made interpretations that started to touch on this repressed material he would he would say stop hitting on me stop hitting my experience that it blows you know that I was I was hitting him and he felt his penis retracting and inverting felt it you know he's not he's not a psychoanalytic student he's an Argentinean bookkeeper fact was what this guy was you know he he I know that you think everybody in Argentina is in analysis but this guy was living in England and he was completely uneducated in analysis and I'm slightly I'm realizing I've wasted myself by my own petard because I'm trying to disguise it a bit so it makes it sound like he's more likely to have known about another he knew nothing about it he admired me because I was a scientist he said he liked the way that I was there he came to me because I was a scientist you know he'd done research and he's like I'm a a proper man I'm not one of these women Lee psychoanalysts and so on that's why I came to me he wasn't about to want to create a symptom you know in order to gratify me that Freud was right there's an absolutely vivid feeling fantasy of castration touched on by going into this material and absolutely remarkable disappearance of the symptom with an analysis of the repressed but I also want to point out here is a patient who has bodily feelings imagining you know that his penis is inverting is that a psychotic mechanism well you know it's like one but by no means but no but no one length of the imagination can you describe this man as psychotic he's lying there saying dr. songs you know I feel as if this is happening not it is happening you know it's a very different thing but I'm making the point there that it's a very complicated nuanced picture I'm trying to sort of and I'm giving you just the smallest little vignette you know the smallest little knots and yet little construction about this patient but I hope you can see what I mean by a neurotic structure there's a repressed fantasy from earliest childhood it's it's he's in conflict the conflict is about do I want this do I want that you know I know what I can't cope with that it's gone and then he finds himself in the same scenario throughout life from the age of five his tick came and he finds himself throughout life in the same situation wherever he's wanting something and a male figure is forcing him to not have it and rather do his own work or do whatever and he develops the stick the tick is the return of the repressed that's what it was in this patient and that had everything to do with his eatable constellation with castration anxieties all of the classical stuff and it was removed by analysis and and it will come back later to the technique technical elements of what such an analysis involves

Channel: Therapy Route

Views: 8,967

Keywords: psychoanalytic model, psychoanalysis, psychodynamic, psychopathology, clinical psychology, psychotherapy, therapy, mark solms

Id: dtAuL8u4ncA

Length: 94min 45sec (5685 seconds)

Published: Mon Dec 03 2018