Lost to Desire: The École Psychomatique de Paris and its Encounter With Patients Who Do Not thrive

Description

This book covers the work of psychoanalysts in post WWII France with patients beset by somatic problems with little manifest fantasy life, and how their concept of opératoire continues to inform the theory and practice of working with patients in crisis. The author explores what the new concept has elicited in a community of practitioners - close to the École Psychosomatique de Paris - over a period of some sixty years. As a "skin for thought" it facilitated change while preserving coherence, gradually beginning to attract further considerations. Important themes have included: the early groundwork necessary for the configuration of fantasy, the importance of a shared imaginary, the role of denial and obliterated memories as a bond between people, emergency measures of a Me cut off from revitalisation, the effects of the rhythms and atmosphere at the workplace on family life, and the consequences of a crisis suppressed for lack of a holding frame. As psychoanalytic discourse adapted to the challenges, the original perspective changed aspect, moving from a systematic evaluation of what the patients did not produce to what the analyst had to fill in to make sense of the situation. Clashing with the terrain, French psychoanalysts raised important problems about psychic anaemia that are stimulating and deserve cross-cultural discussion. This book will appeal to psychoanalysts in practice and training who wish to learn more about this ground-breaking work on memory and trauma, and how to apply it to their own practice. Cover Half Title Series Information Title Page Copyright Page Dedication Table of Contents Acknowledgements Introduction Sources 1 Fragments of a Debate Sources 2 Background Sources 3 Foundations 1: Pierre Marty Beginnings and Cursus Vitae: From Neurosurgery to Psychoanalysis Early Work: Muscular Armour and Posture Control as Tools in Distance Management Elements of Interactional Expression Beyond Language Object Capture A New Manifesto of Psychosomatic Investigation in the Face of Under-Investigated Lifestyles Towards Understanding Fragile Personality Structure: Business as Usual as a Front ‘Essential Depression’: a Fall in Tonus Without a Narrative A Launchpad for a New Comprehensive System Hierarchical Structures Exposed to Traumatic Events The Importance of Careful Dosage in Therapeutic Response and the Mothering Function Layered Mentalisation ‘Instinct’ as a Vector of Vitality and Its Defeat in Progressive Disorganisation Psychosomatic Psychosomatics as the Heir to Sacha Nacht’s Project A Social Dimension at the Margins of Perception A New Terminology Marty’s Legacy Sources 4 Foundations 2: Michel Fain With Denise Braunschweig Marty’s Original Hunch in a Different Frame: the Mother and the Lover The Early Bath of Affects and the Role of Stimulating Discontinuities The Infant’s Fantasy Life Against the Background of the Parents’ Relationship A Question of Fine Balances Which Can Easily Be Disturbed Premature Maturity as a Heavy Burden Transitionality Provided or Impeded by the Parents Denial as a Shared Bond Muscular Masculinity as a Group Ideal Artificially Engendered Needs That Prop Up the Me’s Economy Going Militant With Nothing Else to Cling to Sinking Into Chronos Being Swaddled in Indifference Fain as a Reader of Puzzles Left by Freud The Psychoanalyst as a Refugee From Worlds Drenched in ‘Banality’ Unfinished Shape, Unmourned by the Mother Sources 5 Basic Mechanisms 1: Nicos Nicolaïdis On the Tracks of Disorganisation The Drama of Gaia and Ouranos Escape From Oppressive Presence The Sway of Early Reality Unprovided With a Representational Handle The Advent of Language Into a World Shaped by Interaction The Power of Historically Contingent Myth A Potential Crisis of Transition In Critique of Supposedly Supra-Historic Structures The Importance for Flexible Building Blocks for Fantasy Potential Dis-Differentiation: Sensitivity Reduced, Complexity on Hold Référent: a State of Affairs That Cannot Be Resolved in a Crisis The Référent as a Retardant of Sublimation Psychoanalytic Aesthetics as a Domain Receptive to the Restraints of the Material Available Remedies Contingent on the Times The Sensation of Lack Mediated by the Inner Worlds of the Mother Attention to Concrete Interactions as a Step Beyond Lacan Sources 6 Basic Mechanisms 2: Gérard Szwec Self-imposed Drudgery in Quest for Inner Calm A Lack of Being Unconscious Early Interactions Out of Kilter Striving for Premature Independence as an Escape Route Alimentary Disorder as an Attempt of Demarcation Absence of Stranger Anxiety as a Warning Signal Camouflaged Early Fault Lines Substitutes for Impossible ‘No’s Putting a Stop to the Capacity to Form Saturated Links Disappearance Into Conformity Cultural Toolkits for Quick Steps Into Mindlessness Object Distance in an Environment Inculcating Self-Impingement Sources 7 Configurations 1: Anna Potamianou The Subject Marooned in Fallow Lands Sustained by Routines Repetition as a Deposit of Relationship: Forgetfulness as a Ritual Offering Attractors Embedded in Force Fields Detrimental to Thriving Repetition as Part of a Residual Shock Absorption System Pain as an Envelope to Contain a Breach Identification Sickness Hope Gone Rancid Resilience at a Rock Bottom Level: the Opératoire as a Process in a Field of Shifting Forces Personal Myth as a Force of Irrigation Civic Space Under Consideration The Voice of Anna Freudians as Background Chorus Can Fire Be Admitted to the House Without a Furnace? Theory as an Aid to Gauge the Potential of Situations Sources 8 Configurations 2: Jean Benjamin Stora Shocks That Kill Shared Symbolic Universes as a Precondition for Communication in Depth Adaptive Measures Put to the Test Buffer Zones Invigorated by the Imaginary Aridity of Mental Links as a Fire-Door Shut on Fright Rehearsals of Trivia of Material Culture as a Re-Affirmation of Shared Bonds Repression of Emotion as a Corollary to a Body Having to Establish New Equilibria The Work of the Psychosomaticien in the Institution as an Enfranchised Outsider Working With the Submerged Potential of Patients Regulatory Ways of Dealing With Tension Illusion Conducive to the Inception of Form? Sources 9 Inquiries: The Work of César and Sára Botella The Vital Difference Between Figurability and Presentability The Dynamic Potential of the Void Held in a Dialectical Relationship Coherence One Level Up A Primal Trace of Lack Perception as an Anchor Imageless States of Terror The Work of the Double Giving Shape to Nightmares in the Psychoanalytic Session A Ghostly Potential of Form and the Role of Conviction Regredience to Untamed Memory The Impact of Child Psychoanalysis The Work of the Double Between ‘Projective Identification’ and ‘Partners in Thought’ The Non-Communicating Central Self Building Transitional Space for Survivors Poverty in Theory and the Non-Inevitability of Hegelian ‘Aufhebung’ Possible Sense That Is Not Latent A Cultural Frame to Hold Potential Space Sources 10 Second Thoughts: Claude Smadja Marty’s Divergence From Previous Models Reconsidered 40 Years Later A Need to Address Simplifications The Me Turned Pauper Low ‘Subjective Density’ and Low Levels of Aversion The Opératoire Subject as a Crowd Unto Him/herself A Narcissism Invested in Codes of Behaviour Actual Neuroses Revisited Regression Impeded by an Ambient ‘Pure Culture D’instinct De Mort’ Self-inflicted Compliance With an Imperative of Calm Links to Revitalisation Disrupted in Conjunctures of Hurt Somatic Diseases: Cause or Effect of Narcissistic Depletion Somatic Illness as the Only Point of Contact With Psychoanalysis The Psychoanalyst Faced With the Autonomous Logic of the Body The Structuring Role of Intergenerational Processes The Psychoanalyst Faced With the Autonomous Logic of the Environment The Psychoanalyst Faced With Cultures Alien to Him/herself A Situationalist Dimension of the Opératoire The Interlocutor Pushed Against His/her Ignorance Sources 11 Entanglements: The Forgotten Pre-History of the Opératoire The Antecedents: Patients’ Work in Psychiatry – a Means to Energise or to Subdue? Lessons Drawn: Increased Attention to Rhythm, Suitability and Context From the Observation of Patients at Work to the Investigation of the World of Work Extra Muros Casualties of the Work Place Towards Rallying the Public: the Work of the Mental Health League Dissenting Voices: Louis Le Guillant A Different Emphasis: François Tosquelles Claude Veil’s Third Way The Waning of the Movement Towards New Foundations Sources 12 Indispensable Extensions: Christophe Dejours Two Threads of Development: Attachment Versus Libidinal Subversion The Mill by the Waters: Irrigation Won From the Torrents of the Wilds Towards a Situated History of Selective Numbness: Zones Gone Cold The Subject Pushed Against Its Own Unresponsiveness Putting Fantasy at Bay for the Sake of the Job The Costs of Maintaining Defensive Shields Splitting as Core of a Third Topography The Amental Unconscious The Amental – a Reservation of the Pulsion De Mort? The Gendered Distribution of Suffering Work as the Second Arena Central to Self-Fulfilment Mental Erosion as a Cumulative Factor in Nefarious Arrangements Akrasia Facilitated by a Split Métis: Applied Social Intelligence as an Act of Covert Infiltration Sources 13 Bridges: Jacques Press Marty Revisited Ferenczi: the Me Assailed by Early Trauma The Obliteration of Shared Memory as a Point of Reference Vicissitudes of Defence and Self-Preservation in a Deficient Environment: Waste-Disposal at Risk The Analyst Put on the Spot: the Need to Discern What Is Missing and to Hear What Cannot Be Said Psychoanalytic Psychosomatics: Towards Finding a Frame for the Encounter Working With Theory: a Paradigm or a Model? A Complement to the First Topography: Elements of a General Theory of Trauma The Emergence of the Intimate Between the Traumatic and the Formless Trauma: General or Specific, Visible or Invisible? Sources Conclusion A Similarity Between the Opératoire and Responses to Survivors’ Trauma The Opératoire as a Response Rooted in a Sense of Place Non Psychic Reality Impacting on the Patient Giving Heed to What Has Been Left Unserviced by Frames Past and Present Finding New Interfaces and Receptive Space Reading the Opératoire as a Probe Into the Permanently Difficult Dented by the Terrain It Is Employed on Towards Developing a Sense of Possible Futures on Which the Past Is Mute Sources Index