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"Unavoidable Satisfactions": The Analysts Pleasure

Analysts have often described their work as depriving, painful, and hard to endure, while its pleasures have been the subject of little commentary. The real history and ongoing temptations of boundary violation long ago made the gratifications of psychoanalytic work a matter of anxiety. Analysts’ pleasure in their work was problematized. Some of this problematizing is necessary because of real risk, but much of it is not only unnecessary but misleading and destructive. Psychoanalysts pursue achievement of a unique form of human intimacy, yet acquired habits of professional modesty and humility have encouraged the illusion that analyzing can occur without desire or ambition on the analyst’s part. These habits have made it difficult for analysts to openly discuss what they get from the intimacy of analyzing that yields its pleasures. Our field demands that analysts deny that the work provides much more than pain (at least until the conclusion of an analysis), but psychoanalysis both misunderstands and misrepresents itself if we cannot speak of the distinctly broad range of pleasures available in analyzing.

The Relevance of Bionian Thinking to the Treatment of PTSD Patients

Analysts who conduct trauma-focused treatments have much to learn from Wilfred Bion’s contributions to the understanding and treatment of PTSD. Concepts such as catastrophe and catastrophic change can illuminate the subjective experience of PTSD patients, the beta screen concept sheds light on dissociative phenomena, and, as shown in a clinical vignette, the analyst can use his alpha function to transform the patient’s fragmented raw material into alpha elements. A second clinical vignette shows how during a cognitive intervention the analyst can impart this alpha function to the patient and use his reverie to help the patient assimilate previously intolerable fragments into a coherent narrative. Finally, the idea of knowing mental pain (Bion’s K) is discussed in relation to the processing of traumatic memories.

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Dr. Radut