A patient's unconscious fantasy of being her mother's dead baby emerged during the course of a long analysis, and was understood asherexpression andexplanation, constructedandelaborated throughout her development, of a fundamental and formative early infant state and experience. This patient's identification with a baby who had died before she was born was connected to her major complaint, a pervasive feeling that she could not act with intention, and to her obsessive ruminations, compulsive actions, and masochistic attacks on her body. The bodily based aspects and focus of these defenses were autistic-like, self-directed activities that can be understood as having their roots in what was experienced as catastrophic loss in the earliest weeks and months of life. Infant research, particularly on contingency detection, is especially useful in clarifying the ways in which these defenses may form, and in reconstructing and tracing the trajectories and intricate transformations of body ego, self- and other representations, and defenses from their earliest beginnings to their current manifestations in patients' fantasies and symptoms.
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References
1.
Alvarez, A. (1999). Widening the bridge. Psychoanalytic Dialogues9:205—217.
2.
Arlow, J. (1969). Unconscious fantasy and disturbances of conscious experience. Psychoanalytic Quarterly38:1—27.
3.
Bach, S. (1985). Narcissistic States and the Therapeutic Process . Northvale, NJ: Aronson.
4.
——— (1994). The Language of Perversion and the Language of Love. Northvale, NJ: Aronson.
5.
Bahrick, L.R., & Watson, J.S. (1985). Detection of intermodal proprioceptivevisual contingency as a potential basis of self-perception in infancy. Developmental Psychology21:963—973.
6.
Balint, E. (1963). On being empty of oneself. International Journal of Psychoanalysis44:470—480.
7.
Beebe, B., & Lachmann, F. (1988). The contribution of mother-infant mutual influence to the origins of self- and object representations. Psychoanalytic Psychology5:305—337.
8.
——— ——— (1994). Representation and internalization in infancy: Three principles of salience. Psychoanalytic Psychology11:127—165.
9.
Bergman, A. (1999). Ours, Yours, Mine: Mutuality and the Emergence of the Separate Self. Northvale, NJ: Aronson.
10.
Bick, E. (1968). The experience of the skin in early object-relations . International Journal of Psychoanalysis49:484—486.
11.
Broucek, F. (1979). Efficacy in infancy: A review of some experimental studies and their possible implications for clinical theory. International Journal of Psychoanalysis60:311—316.
Cooper, A.M. (1988). The narcissistic masochistic character. In Masochism: Current Psychoanalytic Perspectives, ed. R.A. Glick & P.I. MeyersHillsdale, NJ: Analytic Press.
14.
Decasper, A., & Carstens, A. (1981). Contingencies of stimulation: Effects on learning and emotion in neonates. Infant Behavior & Development4:19—35.
15.
Field, T. (1994). The effects of mother's physical and emotional unavailability on emotion regulation. Monographs of the Society for Research in Child Development59(2/3):208—228.
16.
——— Healy, B., Goldstein, S., Perry, S., Bendell, D., Shanberg, S., Zimmerman, E.A., & Kuhn, C. (1988). Infants of depressed mothers show “depressed” behavior even with nondepressed adults. Child Development59:1569—1579.
17.
Fonagy, P. (1991). Thinking about thinking: Some clinical and theoretical considerations in the treatment of a borderline patient. International Journal of Psychoanalysis72:639—656.
18.
Fraiberg, S. (1982). Pathological defenses in infancy. Psychoanalytic Quarterly51:612—635.
19.
Freedman, N. (2001). On de-symbolization: The concept and observations on anorexia and bulemia. Paper presented to the Institute for Psychoanalytic Training and Research.
20.
Freud, S. (1911). Formulations on the two principles of mental functioning . Standard Edition12:213—226.
21.
——— (1923). The ego and the id. Standard Edition19:12—66.
22.
Gergely, G. (2000). Reapproaching Mahler. Journal of the American Psychoanalytic Association. 48:1197—1228.
23.
——— (2001). The obscure object of desire: “Nearly, but clearly not, like me”: Contingency preference in normal children versus children with autism. Bulletin of the Menninger Clinic65:411—426.
24.
——— Nadasdy, Z., Csibra, G., & Biro, S. (1995). Taking the intentional stance at 12 months of age. Cognition56:165—193.
25.
——— & Watson, J. (1996). The social biofeedback model of parental affect-mirroring . International Journal of Psychoanalysis77:1181—1212.
26.
——— ——— (1999). Early socio-emotional development: Contingency perception and the social-biofeedback model. In Early Social Cognition: Understanding Others in the First Months of Life, ed. P. Rochat.Hillsdale, NJ: Erlbaum, pp. 101—106.
27.
Green, A., & Stern, D. (2000). Clinical and Observational Psychoanalytic Research: Roots of a Controversy. London: Karnac Books.
28.
Hoffer, W. (1949). Mouth, hand and ego-integration. Psychoanalytic Study of the Child3:49—56.
29.
——— (1950). Development of the body ego. Psychoanalytic Study of the Child5:18—23.
30.
Kernberg, O. (1967). Borderline personality organization. Journal of the American Psychoanalytic Association15:641—685.
31.
Koos, O., & Gergely, G. (2001). A contingency-based approach to the etiology of “disorganized” attachment: The “flickering switch” hypothesis. Bulletin of the Menninger Clinic65:397—410.
32.
Krueger, D. (1988). Body self, psychological self, and bulimia: Developmental and clinical considerations. In Bulimia: Psychoanalytic Treatment and Theory, ed. H. Schwartz.Madison, CT: International Universities Press.
33.
Lewis, M., Alessandri, S.M., & Sullivan, M.W. (1990). Violation of expectancy, loss of control, and anger expressions in young infants. Developmental Psychology26:745—751.
34.
Mahler, M.S. (1958). Autism and symbiosis: Two extreme disturbances of identity. International Journal of Psychoanalysis39:77—83.
35.
Meltzer, D. (1975). Adhesive identification. Contemporary Psychoanalysis11:289—310.
36.
Novick, K. (1990). Access to infancy: Different ways of remembering . International Journal of Psychoanalysis71:335—349 .
37.
——— & Novick, J. (1987). The essence of masochism. Psychoanalytic Study of the Child42:353—384.
38.
——— ——— (1991). Some comments on masochism and the delusion of omnipotence from a developmental perspective. Journal of the American Psychoanalytic Association39:307—331.
39.
Ogden, T. (1989). On the concept of an autistic contiguous position . International Journal of Psychoanalysis70:127—140.
40.
Pally, R. (1997a). How brain development is shaped by genetic and environmental factors. International Journal of Psychoanalysis78:587—593.
41.
——— (1997b). Memory: Brain systems that link past, present and future. International Journal of Psychoanalysis78:1223—1234.
42.
Schwaber, E. (1998). The nonverbal dimension in psychoanalysis: State and its clinical vicissitudes. International Journal of Psychoanalysis79:667—679.
43.
Spitz, R. (1961). Some early prototypes of ego defenses. Journal of the American Psychoanalytic Association9:626—651.
44.
——— (1965). The First Year of Life: A Psychoanalytic Study of Normal and Deviant Development of Object Relations. New York: International Universities Press.
45.
Tronick, E.Z. (1989). Emotions and emotional communication in infants . American Psychologist44:112—119.
46.
Tustin, F. (1980). Autistic objects. International Review of Psychoanalysis7:27—39.
47.
——— (1984). Autistic shapes. International Review of Psychoanalysis11:279—290.
48.
——— (1986). Autistic Barriers in Neurotic Patients. London: Karnac Books.
49.
——— (1988). Psychotherapy with children who cannot play. International Review of Psychoanalysis15:93—106.
50.
Watson, J.S. (1966). The development and generalization of contingency awareness in early infancy: Some hypotheses. Merrill-Palmer Quarterly12:123—135.
51.
——— (1972). Smiling, cooing, and “the game.” Merrill-Palmer Quarterly18:323—339.
52.
——— (1994). Detection of self: The algorithm. In Self-Awareness in Animals and Humans: Developmental Perspectives, ed. S. Parker, R. Mitchell, & M. Boccia.New York: Cambridge University Press.
53.
Weil, A. (1970). The basic core. Psychoanalytic Study of the Child25:442— 460.
54.
Winnicott, D. (1949). Mind and its relation to the psyche-soma. In Collected Papers: Through Paediatrics to Psycho-Analysis. London: Tavistock, pp. 243—254.
55.
Wolff, P.H. (1996). The irrelevance of infant observations for psychoanalysis . Journal of the American Psychoanalytic Association44:369—392.
