Journal of the American Psychoanalytic Association

The purpose of this work is to explore the phenomenon of negativism and the analyst's response to it during the course of analytic work with a patient in whom negativism is a central behavioral pattern. Melville's short story, "Bartleby the Scrivener," describing in telling detail the response of a sympathetic lawyer to profound and pervasive negativism in his legal scribe, is discussed as a literary analogy to the analyst-analysand dyad. Aspects of the concept of negativism within psychoanalysis are discussed. The potential usefulness of understanding certain unexpected countertransference responses to pervasive negativism is explored, as this is a relatively neglected area of psychoanalytic technique. A case is presented describing the analysis of a patient whose character, like Bartleby's, is a mixture of profound negativism along with schizoid, obsessional, and masochistic elements.

Four psychologies currently significant in psychoanalytic thinking are described. An attempt is made to (a) advance developmental proposals describing how the phenomena of each of the four achieve motivational status in the intrapsychic life of the individual and (b) develop a model for the understanding of personality organization across the four psychologies, based on the development of personal hierarchies that establish which issues are superordinate and which subordinate. Taken together, these two points are used to suggest that the four psychologies may not simply represent differing perspectives on intrapsychic phenomena (though they do that, in part) but that they also, simultaneously, represent relatively independent ways in which intrapsychic life is organized.

Secondary revision is a highly provocative concept arising out of Freud's attempts to explain the construction of dreams, but it remains relatively ill-defined. It includes three related, yet by no means identical aspects of the process by which the dream acquires its more or less final form during the experiencing, the remembering, and the telling. It represents one of the most interesting hypotheses dealing with the fluid world between sleeping and waking, a field which still presents us with a host of unanswered questions.

Secondary revision not only reflects the higher levels of the dreamer's mental functioning superimposed on his biological substructure, but it also operates as a sensitive indicator of the cultural factors which have helped mold his personality. These factors include both the subculture of the analytic situation and the impact of society in the larger sense. I make reference to individual dreamers in analysis and to the world of dreams recorded in the past from our own and other cultures.

The forced termination of psychoanalysis, such as occurs when the analyst makes a geographic move, uniquely disrupts the analytic setting. This paper recounts the author's experience of terminating a full-time private practice of psychoanalysis and psychoanalytic therapy for such a move. The limited literature on the subject is reviewed with a focus on the use of technical variation in the forced termination situation. The author delineates three areas of interaction with patients where technical variation proved in her experience to be of value: dealing with countertransference and counter-reaction, providing information about the move, and the consideration and process of referral for continued therapy. As opposed to what would be predicted from a classical psychoanalytic perspective, the use of such technical maneuvers seemed to facilitate rather than impede analytic work. These variations in technique served at crucial times to maintain the analytic alliance, to preserve the patient's capacity to recognize and make use of transference, and to provide avenues for resolving past traumas in the transference and the actual loss of the analyst. The concept of the analyst as a new or useable object is proposed as providing a theoretical framework for understanding these observations.

Material is presented from three cases, where analysis of repetitive dreams of feeling embarrassment at being partially or totally naked was an important feature of the treatment. The indifference by the other people in the dream to the dreamer's nakedness was initially linked to perceived transference slights at the hands of the analyst, and later to repeated episodes of actually being treated indifferently at the hands of the parents. This indifference was related to latency or adolescent attempts by the patients to gain love or attention from the parents by exhibitionistic means.

The stereotypical presentation of the manifest content of these dreams is seen as evidence for their underlying traumatic roots. Such dreams are likened to the typical examination dreams described by Freud, which have also been noted by others to have traumatic roots. This finding is consistent with my own work with certain repetitive manifest dream configurations and with Freud's (1920) reevaluation of his theory of dreams in Beyond the Pleasure Principle, wherein he noted that dreams of patients suffering from traumatic neurosis often manifestly repeated the traumatic situation in an attempt to master it retrospectively.

This paper, in an earlier form, received the Casuso Essay Award of the Florida Psychoanalytic Society in 1984. Accepted for publication March 10, 1987. The author thanks Drs. Floyd Rosen, Joseph Lichtenberg, Alan Zients, Gene Gordon, Robert Gillman, Stanley Needell, and also Mmes. Penny Freed-man and Lynn Siegel for their assistance.

This paper seeks to heighten awareness of pseudostupidity and the potential analyzability of patients who manifest it by defining and explicating it, reviewing the literature, and presenting in detail the psychoanalytic treatment of a pseudostupid patient. Pseudostupidity is caused by an inhibition of the integration and synthesis of thoughts resulting in a discrepancy between intellectual capacity and apparent intellect. The patient's pseudostupidity was determined in part by his need to prevent his being more successful than father, i.e., defeating his oedipal rival. Knowing and learning were instinctualized. The patient libidinally and defensively identified with father's passive, masochistic position. He needed to frustrate the analyst as he had felt excited and frustrated by his parents' nudity and thwarted by his inhibitions. He wanted to cause the analyst to feel as helpless as he, the patient, felt. Countertransference frustration was relevant and clinically useful in the analysis. Interpretation of evolving relevant issues led to more anxiety and guilt, less pseudostupidity, a heightened alliance, and eventual working through. Negative therapeutic reactions followed the resolution of pseudostupidity.

This paper delineates a form of heterosexuality whose underlying psychological structure resembles that of perversions. It is characterized by: idealization of instinctual processes, whereby the ego subordinates the object to the actualization of the instinctual event itself; heightened narcissism in an otherwise neurotic ego organization; multiple intrapsychic uses of the object; a special kind of defensive organization; an experienced victory over the superego and associated elevation of certain aspects of the ego ideal; and a resultant alteration in the nature of close interpersonal relationships.

I use clinical vignettes from both male and female patients in psychoanalysis to focus on the phenomena in question. The thinking of Chassequet-Smirgel, Freud, Khan, Rangell, Socarides, and others is used in an attempt to gain an encompassing perspective. It is emphasized that patients demonstrating this form of heterosexuality do not possess a perversion per se, but demonstrate a character neurosis which integrates certain perverse mechanisms into its defensive organization. These mechanisms can be isolated and studied in psychoanalytic treatment, with the potential for illuminating their defensive and mood-regulating functions, and eventual working through and resolution of the intrapsychic conflicts underlying them. Some comments on the implications of this form of sexuality for our contemporary culture are included.