Facilitating Supervision: Projective Identification, Containment, Reverie and Enactment in the Supervisory Relationship

Dr. Vered Mosek-Eilon

The supervisory experience has the potential to enable the unfolding of the unconscious levels of its participants. The emotional-experiential atmosphere during the supervisory hour is sustained by the containment of complexities of the transference-countertransference processes. These dynamics continue to condense and merge due to the interconnections amongst the supervisor, supervisee and patient. A facilitating supervision generates a dialectic environment. The inherent paradox of the therapeutic and/or the supervisory relationship, emanating from what each participant brings to the relationship, is revived when the supervisory hour allows for the assimilation and processing of the beta-elements. Clinical illustrations demonstrate the 'working through' of essential mechanisms in the dynamics of psychoanalytic psychotherapy and supervision, such as containment, projective identification, reverie and enactments. In this manner, the supervisory environment facilitates unconscious communication and clarifies the way in which the beta-elements of the patient interact with the therapist’s container and their internal objects. These vulnerable processes provoke anguish and resistances and spawn silenced and fortified mechanisms. These curtail the potential of transformative processes. Nonetheless, the willingness to remain in this receptive and contained state, enables a development of the emotional-experimental language between the supervisory pair, and brings about images, metaphors and reverie.

Keywords: Supervisory relationship, Projective identification, Reverie, Enactment, Dreaming

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A Mental Form of Second-Skin Formation: Thoughts about Self-Criticism as a Psychic Envelope

Dr. Moran Schiller-Golan

This article wishes to draw a theoretical and clinical line between the psychological construct of self-criticism and the psychoanalytic concept of second-skin formation. Self-criticism deals with the way an individual treats themselves and the tendency to feel inferior and incapable when coming across obstacles or personal failures. A more poisonous and pathological version of self-criticism includes turning feelings of hate, disgust, and contempt towards the self. Second-skin formation is a form of pathological-psychic envelope resulting from impeding internal object relations in early life and which manifests in pseudo-independence as a replacement for object dependence. In the introduction to this paper, I will review common expressions of self-criticism from different psychoanalytic perspectives and elaborate on therapeutic work with these expressions. In addition, I will lay out initial thoughts about the idea that self-criticism can function as a psychic envelope through which an individual – because of failure of the container function – holds themselves in a way that can be mentally harmful, but necessary. My claim is that extensive use of self-criticism in adulthood can be referred to as a mental form of second-skin formation. Using a clinical example, I will try to point out how sometimes theoretical thinking about a patient's self-criticism only as an introjection of a harsh superego, as a pathological introjection of self-and/or object or as bad internal object-relations is not enough to facilitate psychological growth. Therefore, I will demonstrate how treating self-criticism as derived from a deep need of the patient to feel held, gradually enables them to lessen their use of this mental holding in favor of a more beneficial one.

Keywords: Self-criticism, Superego, Object-relations, Psychic Envelope, Second-Skin Formation

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Misunderstanding in Psychotherapeutic Setting: A Psychoanalytic and a Cultural Perspective

Yael Itai Pak

Misunderstanding in clinical practice has been discussed so far in psychoanalytic literature without regarding the social-cultural aspect. On the other hand, the cultural aspect of misunderstanding has been discussed in linguistic literature without considering the specific significance in therapeutic relations, or even in intimate relations. In this article I examine misunderstandings in the therapeutic situation in a multidimensional fashion. Psychoanalysis provides a method of thinking about the intersubjective and intra-subjective aspects, and a cultural perspective adds a social aspect. I focus especially on three cultural influences: the culture of psychoanalysis as per our understanding of its historical mythology, the Israeli culture and in particular, the Jewish Israeli culture and age cohort. Through historical and clinical examples, I suggest differing emotions in interpersonal settings which are relevant to the experience of misunderstanding. By doing that, I hope to create a matrix that will help transform these misunderstandings from being objects of frustration into being objects of analytical investigation. The article suggests a way of thinking about misunderstandings in social context in which the intersubjective and interpersonal are understood against the background of the social-cultural context, with special attention to the Israeli society.

Keywords: Misunderstanding, therapeutic understanding, therapeutic failure, social-cultural influence, history of emotions

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“Spirited Away” – Thoughts on Dealing with Crisis Situations from the Perspective of Melanie Klein's Theory

Anat Hadar Zalstein

Crisis situations which we encounter throughout life, challenge our mental stability, and put to a test our negotiation with uncertainty, distress and loss. Kleinian theory emphasizes the importance and centrality of working through loss and mourning, and thus provides a theoretical frame of reference to these processes in the internal world, through which we experience reality, are influenced by it, and deal with it. Melanie Klein links normal processes of mourning to early situations of loss and shows how early processes of mourning are re-experienced every time we encounter sorrow and loss in later stages of life. In this article I will attempt to address the complex challenges that we face, the early anxieties, object relations and defenses in their different and changing configurations, that are reawaken in these circumstances. I will illustrate this through the story of a girl named Chihiro, the protagonist of the film Spirited away, who faces a transition to a new home and is forced to part with the familiar and beloved one. The film unfolds in a compelling and honest way Chihiro's mental journey, on her way to re-create the good objects in her inner world. 

Keywords: Melanie Klein, Paranoid Schizoid Position, Depressive Position, Unconscious phantasy, Crisis situations

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On Emotional Transformation Through the Use of the Therapist's Poetic Reverie

Rany Levy

One of the central questions in psychoanalytic discourse today is the question of the contribution of therapy to help the patient develop the capacity for thinking. Bion contributed greatly to this discourse by introducing the mental apparatus based on the alpha function that transforms sensations and emotions into representations. Bion used the term reverie to describe the way the mother knows about the contents that are thrown at her from the baby. In this article I will use the philosophy of the French philosopher Gaston Bachelard to expand the possibilities of using reverie in therapy. The poetic reverie allows us to think of the therapist as a creator and the therapeutic discourse as a creative discourse. I will show how the use of poetic reverie during therapy contributes to the formation of images in the patient. I will present Bachelard's way of thinking about the poetic reverie as part of the development of his thoughts on imagination, and the poetic image and as a derivative of the theory of imagination he created. I will also show the possibility of developing the ability to create images with the help of a clinical example and through my dialogue with a patient. I will present a way of working that Ogden described as "talking as dreaming", as another way in which the therapist shares with the patient the images that arose in him for the purpose of developing within the patient the ability to heal.

Keywords: Poetic reverie, Wilfred Bion, Gaston Baechelard, Dreaming

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Psyche and Eros – The Tale of the Mind's Abduction by Sensorial Excess

Or David 

Our growing tendency towards excess or "overconsumption" of sensory stimuli and its effect on the mind is at the center of the article. Whether through screens, eating, drinking, and more, our senses are constantly "bombarded" and at times seek up stimuli, in a serial, simultaneous and intense manner while treatment rooms are filled up with people complaining about their attraction towards the consumption of repetitive and continuous sensory stimuli, leading to a destructive experience of loss of control. This article moves between a theoretical axis and a mythic axis in an attempt to trace the mechanism of action and the effect of sensory excess on the mind. The theoretical axis will touch on psychoanalytic theories concerning the development of the mind from the sensory dimension. I will mainly rely on the original theory of Piera Aulagnier regarding the primal process and its relation to the sensory dimension. The mythic axis will make use of the myth of "Eros and Psyche", as a narrative framework that organizes our thinking about the influence of the sensory dimension on the mind, as well as the ways of overcoming and exiting this infatuation. Finally, a clinical example will illustrate and bring to life the issues discussed in the article.

Keywords: Excess-consumption, the primary process, pictogram, the dream screen, the aesthetic conflict

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