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Seeing and being seen: Shame in the clinical situation
Abstract
Shame may prevent the patient from emerging from a psychic retreat. As begins to do so he confronts two fears, first of seeing the object more clearly and second of being seen become prominent. Seeing leads to deeper and more distressing feelings connected with guilt and depression as the damage done to good objects is recognized. However it cannot be faced if shame leads to a demand for immediate relief. Shame is a prominent feature of the analytic situation and recognizing this may help the analyst to support his patients to tolerate the discomfort of being seen so that the conflicts about seeing can be worked through. Two clinical examples are briefly discussed. In the first feelings of inferiority lessened as they were analysed and allowed appreciative and depressive feelings to emerge. In the second embarrassment was associated with progress that the patient felt he had made but was embarrassed to admit. It is argued that the analysis of shame in the analytic situation is necessary so that being seen can be tolerated and allow the conflicts over seeing to be worked through.
... , 2022). Once again, those members are using these organizations (and visa versa) as a retreat from the psychic pain, shame, loss, confusion, betrayal, and the unknown which accompanies comprehension of identity and personal circumstance (Steiner, 2015) as well as means to protect their < unconscious > good objects from being destroyed by their bad objects (Klein, 1935.) Those who opt for these paths are forestalling their own personal growth and consolidation. ...
While humans are hardwired to avoid pain and seek good feelings, it has become imperative to override this proclivity in order to properly address the socio-cultural atrocities which are at the heart of the crumbling of American society. This paper delineates the psychosocial reasons why people avoid psychic pain, the multitude of bastions available which enable, aid and abet this shielding, as well as negative consequences of these systemic dynamics. The case for bearing and holding psychic pain and suffering is made with regard to positive personal consequences and social justice dialectical reverberations. The multitude of ways in which the therapist or analyst hold power and privilege within the dyad is reviewed. Bearing sociocultural pain in the therapist’s own transference and countertransference is reviewed and linked to clinical illustrations. Implications for socio-cultural and therapeutic repair are delineated.
... , 2022). Once again, those members are using these organizations (and visa versa) as a retreat from the psychic pain, shame, loss, confusion, betrayal, and the unknown which accompanies comprehension of identity and personal circumstance (Steiner, 2015) as well as means to protect their < unconscious > good objects from being destroyed by their bad objects (Klein, 1935.) Those who opt for these paths are forestalling their own personal growth and consolidation. ...
ABSTRACT
While humans are hardwired to avoid pain and seek good feelings, it has become imperative to override this proclivity in order to properly address the socio-cultural atrocities which are at the heart of the crumbling of American society. This paper delineates the psychosocial reasons why people avoid psychic pain, the multitude of bastions available which enable, aid and abet this shielding, as well as negative consequences of these systemic dynamics. The case for bearing and holding psychic pain and suffering is made with regard to positive personal consequences and social justice dialectical reverber- ations. The many ways in which the therapist or analyst hold power and privilege within the dyad is reviewed. Bearing socio- cultural pain in the therapist’s own transference and counter- transference is reviewed and linked to clinical illustrations. Implications for socio-cultural and therapeutic repair are delineated.
... Psychological change is dependent on the individual's ability to acknowledge their attachment to omnipotent forms of thinking and the excitement that accompanies the capacity to deny reality. This sort of insight involves quite a loss, and the individual must acknowledge that their dependence upon omnipotent forms of thought that attempt to change and deny reality come at a very large cost (Steiner, 2015). Before undergoing gender transition, the individual's expectations of what transition will achieve for them need to be fully explored and understood. ...
Abstract
This paper is based on the author’s experience of working with a particular group of female/male trans children and young people who present a similar clinical profile: a fragile ego prone to fragmentation and concrete thinking. Often, there is evidence of a grievance over the failed ideal object, which is internalized, projected into the body, and then attacked. Faced with the developmental challenge of sexuality at puberty, young adults withdraw to a psychic retreat designed to halt development. This paper focuses on the development of a trans identity in defence against an underlying fear of depressive anxieties and psychic collapse. It describes the ongoing assessment of Joanne, a 19-year-old biological female who wanted to be known as Luke in therapy and wished to transition in the belief that this was the only way she could have a life. The concrete nature of Joanne’s thinking created problems in the therapy, as thoughts were often experienced as physical actions. This paper describes the function of the phantasy that transitioning performs in creating a psychic retreat from the demands of psychological development.
... The patient who has hidden himself in retreat often dreads emerging from it because it exposes him to anxieties and suffering which is precisely what had led him to deploy this defense in the first place. I think that shame had also played a role in Paul's ''psychic retreat.' ' Steiner (2015) talks about how recognizing shame, may help the analyst support his patients' capacities to tolerate the discomfort of being seen so that the conflicts about seeing can be worked through. I wonder if Paul's guilt (internal bad object) over not mourning his mother and stepmother was expressed in his defensive stance manifested by his apparent coldness and distance. ...
This paper highlights the role of music in psychic change through a clinical case. A patient, who was initially distant and cold, started to talk about music. An enactment around the analyst’s comment about a famous conductor, started an exchange of music “notes” that changed the course of treatment. For the analyst, it brought old memories and musical reveries. For the patient, music allowed him to be in touch with undiscovered parts of himself and losses that had not been mourned. There was a mutual personal transformation and expanding awareness of self and other for both participants.
... In fact, Davies (2012) has described shame in situations involving castration anxiety and suggests that, for Oedipus, it may have been part of his reaction to the original trauma. A pre-occupation with shame may then make guilt difficult to examine, and development may be blocked unless the patient can find the support to tackle first the shame, and then the guilt that lies beneath it, (Steiner 2015). It is important that the guilt is neither exaggerated nor minimised, but is recognised as appropriate to the truth of what happened. ...
In the third day of his life Oedipus suffered a violent murderous assault in which his ankles were pierced so that he could be left to die. In fact, he was not only saved, but brought up as their son by the childless King and Queen of Corinth. My hypothesis is that a severe trauma left a significant physical and psychological scar, which was hidden beneath an illusion of a normal childhood. His background, including the cause of the infirmity of his ankles, remained obscure until it was revealed in the course of Sophocles drama. Facing the truth involved an exposure of the way an illusion had served to protect Oedipus not only from the truth of the murder and incest, but also of the fact that he had been severely traumatised. A phantasy of an ideal family commonly may serve as a defence against trauma and, as a result, facing the truth involves relinquishing the idealisation, and this may be experienced as a further trauma. In this paper, I will pay particular attention to the importance of guilt for the victim of early trauma. Severe trauma may block the acceptance of guilt and, hence, prevent the evolution of a benevolent cycle involving forgiveness and reparation.
Humility is of deep significance for the functioning of democratic societies, as it is the psychic basis of the capacity to function in a citizenly way. Its meaning as the opposite of humiliation shows a deep ambiguity in the resonances today of the Latin word humus (meaning ground or soil) which is the source of both terms. Psychoanalytically, this ambiguity can be seen as reflecting a basic choice we repeatedly make in our psychological functioning. On the one hand is the inability to trust others, and the consequent narcissistic illusions of a fully independent self which can escape the humiliation which dependence on others is felt to bring. On the other hand, there is sufficient trust in others to accept the self’s dependence on human society, and so to accept the inevitability of vulnerability and limitation. This toleration of reality involves a state of humility or humbleness. Humility is therefore an antidote to the fear of humiliation, which is a key driver of many forms of violence, including terrorism. The article ends with a consideration of whether strengthening resources of humility could be a helpful contribution to containing violent behaviour.KeywordsEmotional capitalHumilityNarcissismPsychic developmentTerrorismTrust
Gilligan points to the nexus of shame, helplessness and violence to the mind, linked to experiences of violence and helplessness in early life. While shame motivates behaviour that defends against further experience of helplessness, I argue that shame first comes into being as a psychical mechanism protecting the individual from the existential anxiety attending the loss of the capacity to think. The mind’s capacity for thought is constitutively fragile; when it is threatened so too is the coherence of the sense of self, and this provokes a deep anxiety which is unavailable to consciousness but may be discerned in the psychoanalytic setting. Philosophical analysis of the nature of shame, together with psychoanalytic object relations theory, show how shame has the defensive function of making such existential anxiety over into a form that can be represented in thought by making intelligible the underlying fear of the loss of self. The subject’s capacity for thinking is saved, at the expense of a reduced and exiguous sense of self. The shamed self thus preserves itself by misrepresenting an existential anxiety that is object-less, as a persecutory anxiety that entails existence as a dependent subjectivity, in the eyes of a shaming other.KeywordsAidosExistential anxietyObject relationPsychic defencePsychoanalysis
This research examines W. R. Bion’s autobiography ‘The Long Weekend: Part of a
Life (1897 - 1919)’ in which he tells the story of what happened to him during his
childhood, adolescence, and young adulthood including an account of those around
him and what was happening to them, especially in their relationships with him. A
very painful upbringing is portrayed; one that is full of emotional deprivations. The
nature of memory and the autobiographical method, including the text as a partial
and selective account of his schooldays, is considered and viewed as having the
potential to arrive at intimate truths given the condition of interior observation is met.
Psychoanalytic conceptualizations of the adolescent states of mind that Bion recalls
are made using a reverie-informed approach and drawing on contemporary
psychoanalytic writing to add a further perspective to the one he chose to provide.
What is presented is a personal reading of the pre/adolescent states of mind Bion
describes at his Hertfordshire boarding school. The social-contextual aspects of
Bion’s situation who was also a child of his time are also considered and viewed as
providing the clues to the emotional atmosphere he grew up in. The focus is on the
impact of this atmosphere on his interior states. A further argument is presented
that Bion’s descriptions of his pre/adolescent states of mind have unique value to
the understanding of wider experiences of adolescent development, both in his time
and as it is relevant to adolescent development today, especially in its more deprived
instances such as with child psychotherapists’ experiences. Research findings
reveal the ubiquitous nature of adolescent bullying, the importance for boys to have
access to helpful male figures to identify with, the dangers of socio-political censoring
of adolescent boys’ sexuality and the impact of anxiety and deprivation on their
capacities to relate. They also contribute to biographical understandings of the child Bion.
The article covers diverse approaches of the term secret: individual, group, social, transgenerational and psychoanalytical, with reference to various psychoanalysts having reflecting about this topic. The author pays special attention to importance of secrets in the psychoanalytic relationship. Conscious and unconscious secrets are brought into play in transfer-countertransfer, stressing on the importance of tolerating the secrets without forcing its disclosure. The analyst’s capacity to tolerate the unspoken and wait for the timely moments of intervention can allow the development of the internal space in the analytical process.
Disability studies continues to grow as an emerging area of practice and theoretical research, branching out into sundry professions and frameworks. This expansion is leading to perpetual discussion of the more prominent individual (medical) and social models of disability as well as the development of more inconspicuous models. This paper reviews the dominant epistemologies attached to these models of disability with the support of an authentic case vignette from the author’s social work practice. It is argued that the supplementation and immersion of self-determination theory in established and future models of disability will enhance the models’ applicability to professional practice and better reflect the individual’s self. The integration of
self-determination theory to models of disability is presented in multiple diagrams.
Although shame is a central affect running through all phases of psychosexual and social development, it is usually masked by guilt and therefore it is not readily recognised, explored, and understood within the therapeutic situation. Moreover, there is a tendency to treat all shame manifestations as if they operate at the same level. The author proposes the need to distinguish between two qualitatively discrete manifestations of shame states which, albeit intertwined, operate at different levels and require different understanding and technique: a primary, unconscious kind based on psychobiological survival and triggered by a condition of psychic and physical danger, and a secondary, social shame, mainly conscious, based heavily on vision and evoked in social situations. The natural, primary form of shame becomes pathological after catastrophic chronic exposure of the primitive ego to unthinkable anxieties. Such premature rupture of primary skin containment may result in omnipotence-based pathological organisations impeding or precluding acceptance of guilt and need for reparation. Pathological primary shame predisposes the individual to states of pathological secondary shame. When initial traumatic conditions are re-activated and re-experienced in therapy, they may trigger re-enactments and, possibly, a negative therapeutic reaction. Recognising variations and mixed states of primary and secondary shame states, especially when shame is compounded with guilt, can provide guidance in the assessment of the fragility of the ego, and therefore inform our technique and the therapeutic process. This theoretical position is discussed with the help of clinical material from a twice-weekly psychotherapy of a 16-year-old boy imbued with shame compounded with guilt, related to transgenerational objectification and dehumanising experiences.
Does psychoanalysis have anything to say about the emotional landscapes of class? How can class-inclusive psychoanalytic projects, historic and contemporary, inform theory and practice? Class and psychoanalysis are unusual bedfellows but this original book shows how much is to
be gained by exploring their relationship. Joanna Ryan provides a comprehensively researched and challenging overview in which she holds the tension between the radical and progressive potential of psychoanalysis, in its unique understandings of the unconscious, with its status as a mainly expensive and exclusive profession.
Esther Bick introduced psychoanalytic infant observation courses at the Tavistock Clinic in London in 1948 as part of the training for child psychotherapists in order to facilitate clinical training. She thought that being able to observe infantile processes as they developed was a good grounding for psychoanalytic practice, and noted that it was helpful for mothers to have someone visiting who could admire and appreciate their baby. Since then, there has been considerable writing and some research about the value of infant observation to trainee psychotherapists (Sternberg,), but relatively little has been written about the effect of being observed in this way. Watillon-Naveau () wrote about the families she visited after they had been observed; Bekos () did an MA study of three observed mothers. Both concluded that it was an important experience for the observed. This paper endeavours to understand more about what exactly can be perceived in the interrelated and intersubjective communication and feedback loops between the infant, their primary carers and the observer. The author argues for the theoretical possibility of healthy narcissism and for projective identification being a reactive process. The paper considers what learning from infant observation can offer psychoanalytic theory and what clinical implications could be drawn.
Review of book: Melvin R. Lansky and Andrew T. Morrison (Eds.) The Widening Scope of Shame. Hillsdale, NJ: The Analytic Press, 1997, xviii = 437 pp. Reviewed by Karen J. Maroda.
The authors regard the Oedipus complex from the perspective of the ancient myths revolving around Oedipus and inquire whether these myths contain insights pertinent to the origination of the Oedipus complex that may have escaped Freud's attention. They arrive at the conclusion that the myths answer Freud's inquiry of 25 February 1914 on «the extent to which the Oedipus complex is a reflection of the sexual behaviour of the parents» (Nunberg & Federn, 1975a, p. 227). This answer is encapsulated in Fenichel's proposal that «the child's Oedipus complex reflects⋯ that of his parents» (1945, pp. 137f).
Seeing and Being Seen: Emerging from a Psychic Retreat examines the themes that surface when considering clinical situations where patients feel stuck and where a failure to develop impedes the progress of analysis.
For the first time solar astronomers coordinated simultaneous observations of solar activity across many wavelengths.
In this paper the author reviews Freud's study of Schreber's Memoirs and the Memoirs themselves from a perspective of nearly 100 years. He argues that Schreber's illness began as a melancholic depression but quickly developed paranoid features which subsequently escalated into a gross paranoia which nevertheless retained its depressive and hypochondriacal base. Finally the chaotic fragmentation became organized under the dominance of an omnipotent narcissistic organisation which led to a clinical improvement without any relinquishment of his delusional beliefs. As a subsidiary theme he examines the role of gaze in Schreber's object relations and argues that gaze was used to project into his objects, then to scrutinise the object to see if the projections had been received and tolerated, and finally as an expression of dominance. His urgent demand for relief provoked an omnipotence in his objects which he was then able triumphantly to frustrate and which ushered in a struggle over dominance in the course ofwhich Schreber was abused and humiliated. He was unable to find an object who could contain his distress and these factors contributed to the failure to tolerate guilt and to work through his depression.
An extensive literature on shame has not yet sufficiently addressed the nature and functioning of this affect from the psychoanalytic, developmental point of view. This paper tries to lay the ground for such a task.
This paper explores the vicissitudes of shame and its relation to narcissistic rage and escalation of conflict in Sophocles' Ajax. The plot is set in motion by Ajax's shame over losing the competition with Odysseus for Achilles' armor. His shame leads to narcissistic, rage and propels him to vengeance against the social order. Misidentification, an aspect of narcissistic rage, compounds his disgrace by escalating his shame to suicidal proportions when his madness leaves him. His defenses all fail, and his suicide becomes inevitable. Forces that bind him to the social order lose out to those that make of him a humiliated outcast and drive him to kill himself.
This essay presents a new synthesis of Piaget’s psychological and epistemological theory and Freud’s psychoanalytical metapsychology. Both view the individual as an open system, threatened by exterior and interior forces, but preserving the system’s form by struggle and exchange with the environment. An analysis of the subject-object relation (fundamental to both theories), based on clinical studies of the individual’s symbol formation in particular, leads to an integrated view of mental creativity: the sublimation process is viewed as a neogenesis of sexuality, which allows the subject to create theories and representations in relation to sexual, cultural, and social identity.Copyright © 1987 S. Karger AG, Basel
In this paper the author reviews Freud's study of Schreber's Memoirs and the Memoirs themselves from a perspective of nearly 100 years. He argues that Schreber's illness began as a melancholic depression but quickly developed paranoid features which subsequently escalated into a gross paranoia which nevertheless retained its depressive and hypochondriacal base. Finally the chaotic fragmentation became organized under the dominance of an omnipotent narcissistic organisation which led to a clinical improvement without any relinquishment of his delusional beliefs. As a subsidiary theme he examines the role of gaze in Schreber's object relations and argues that gaze was used to project into his objects, then to scrutinise the object to see if the projections had been received and tolerated, and finally as an expression of dominance. His urgent demand for relief provoked an omnipotence in his objects which he was then able triumphantly to frustrate and which ushered in a struggle over dominance in the course of which Schreber was abused and humiliated. He was unable to find an object who could contain his distress and these factors contributed to the failure to tolerate guilt and to work through his depression.
Shame dynamics, after decades of neglect, reappeared in psychoanalytic thinking with increasing prevalence in the last thirty years. Shame that is hidden is an aspect of complex clinical phenomenology that is particularly likely to be missed and hidden further by partial psychoanalytic explanations that drive shame more and more from view. Shame is often hidden theoretically by formulations limiting conflict to conflict between drives or impulses and something opposing them. By contrast, the incompatible idea model propounded by Freud in Studies on Hysteria emphasizes awareness incompatible with the dictates of conscience, and hence is broader in scope and closer to actual experience. Although shame and guilt arise developmentally earlier than does a true sense of morality, these emotions and their unconscious variants become entwined with the individual's sense of morality as development proceeds. The dynamics of shame and guilt are considerably more complex than their phenomenology as overt emotions. Shame emphasizes weakness, vulnerability, and the likelihood of rejection--so much so that its acknowledgment often generates more shame. Guilt, however, since it is action- and power-oriented, often obscures shame and so defends against it.
Seeing and being seen are important aspects of narcissism, where self-consciousness is always a feature, and one which becomes acute when a patient loses the protection of a narcissistic relationship and is obliged to tolerate a degree of separateness. Having felt hidden and protected, he now feels conspicuous and exposed to a gaze which makes him vulnerable to humiliation. This often has a devastating and unbearable quality to it, particularly when it is felt to arise in retaliation to the patient's own use of gaze to establish a superiority which allowed the patient to look down on others. The need to avoid or cut short such humiliation may be so acute that the patient cannot deal with guilt and other emotions connected with loss which might otherwise be bearable. The author argues that development is impeded unless the patient is able to gain support to make the humiliation better understood and hence better tolerated. He describes some sessions from an analysis to illustrate how, in some analytic situations, much of the patient's concern and many of his defensive manoeuvres aim to reduce or to reverse experiences of humiliation. An understanding of the mechanisms involved seemed to enable some development to proceed.
In this paper I briefly review some significant points in the development of ideas on transference which owe so much to the discoveries of Freud. I then discuss some of the subsequent developments which were based on Freud 's work and which have personally impressed me. In particular I mention Melanie Klein's elaboration of an internal world peopled by internal object and her description of the mechanisms of splitting and projective identification, both of which profoundly affect our understanding of transference. Using some clinical material I try to illustrate an important transference situation which I do not think has been sufficiently emphasized although it is part of the 'total situation' outlined by Klein. In this kind of transference the analyst finds himself in an observing position and is no longer the primary object to whom love and hate are directed. Instead he is put in a position of an excluded figure who can easily enact rather than understand the role he has been put in. In this situation he may try to regain the position as the patient's primary object in the transference or avoid the transference altogether and make extra-transference interpretations and in this way enact the role of a judgemental and critical super-ego. If he can tolerate the loss of a central role and understand the transference position he has been put in, the analyst can sometimes reduce enactments and release feelings to do with mourning and loss in both himself and his patient.
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