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Delphi International Psychoanalytic Symposium

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Delphi International Psychoanalytic Symposium Powered By Docstoc
					              6th Delphi International
            Psychoanalytic Symposium
                            27-31 October 2004 – Delphi, Greece

              Psychoanalysis and the Human Body:
                 Beyond the Mind-Body Dualism


                                      MAIN PRESENTATIONS

                              Soma and psyche, an indissociable unity
                                                                                        Marilia Aisenstein
    Various philosophical and theological responses have been proposed to get beyond the idea
that thought is necessarily mortal, since it is tied to the body. Hence the notion of an immortal
soul, the seat of thought, not reducible to the uncertainties of the soma. Here I offer some
semantic considerations: "soma", the Greek word for body, took on its present sense of a living
organism only during the Fifth and Fourth centuries B.C. with Hippocrates. Before the Corpus
Hypocratum, the term soma referred to an inanimate body or corpse. "Psyche" originally
signified breath and, by extension, the breath of life and then soul. It is worth recalling that
these semantic shifts occurred at a time when Hippocrates was founding medicine as a
scientific discipline based on objective observation and the study of symptoms (semiology).
    Depending on whether or not psyche-Soma is seen as singular or dual, one may construct
different systems explaining man and the world, life and death.
    The discoveries of psychoanalysis offers, in my view, a perfectly cogent and unique solution
to the famous mind/body problem. In transferring the duality psyche-soma/onto the duality of
drives, psychoanalysis places the origin of the thought process in the body. The definition of
drives - a psychical processing of a sexual somatic excitation - confirms, in the two theories of
drives, a psychophysical parallel to which Freud had drawn attention as early as 1891.
    In "Beyond the Pleasure Principle" (1920), Freud, after distinguishing between "pure" and
organic-lesional traumas, noted that the existence of a circumscribed lesion seemed to protect
the subject from the emergence of a traumatic neurosis. Here Freud discusses the drastic effect
of a painful somatic illness on the distribution and modalities of the libido. He provides a starting
point for our present approach of soma and psyche as an indissociable unit.


                                           Body and Cosmos
                                                                              Janine Chasseguet-Smirgel
    This paper is an attempt to give an account of the first part of my book "Le Corps comme Miroir du
Monde" ("The Body as the Mirror of the World") (Paris: P.U.F end of 2003 coll; "Le fil rouge")
    This book grew out of my thoughts on September 11. I questioned the unconscious motivations of
those who blow up their own bodies in order to blow up other bodies; as we have no opportunity to
have one of those on our couch, I tried to fathom the psyche of some creative geniuses who combine
sadism (often expressed through precise cannibalistic fantasies), suicidal ideas, attempts and
sometimes actual suicide. In addition they identify with Christ and have political beliefs and actions of
an extremist kind. I found in them the unconscious belief that the dismembering of the body (whether
of their own or that of others) is equivalent to a magic ritual, meant for the dislocation of the Universe.
At the same time in those important creative minds, as in the terrorists in the name of Allah, exists the
idea that, in a narcissistic apotheosis, the subject becomes one with God and the Cosmos.




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                             A neuroscience perspective on transference
                                                                                             Glen Gabbard
     Neuroscience research has deepened our understanding of the phenomenon of transference.
Neural network theory has taught us that representations are created by forming, strengthening, or
pruning connections between neurons. These representations are multiple and help dispel the myth of
“the transference” in clinical work. There are multiple transferences that come into play in varying
degrees in every analysis. Similarly, real characterristics of the analyst play a major role in which
representations are activated in any specific dyad of analyst and patient. Hence the constructivist
notion of the analyst’s contributions to the transference is reinforced by neural network theory. Two
distinct memory systems come into play in the creation of transference-both implicit declarative and
implicit procedural elements can be found in the components of transference in the clinical setting. Re-
search findings using functional neuroimaging with borderline patients also suggest neuroanatomical
correlates of transference. Borderline patients demonstrate a combination of hyperactivity of the
amygdala and weakening of prefrontal inhibitory controls. Finally, neuroscience research leads to a
more precise understanding of the therapeutic action of psychoanalysis and the fate of transferences.


                                             Space and Mind
                                                                                           Peter Hartocollis
     The concept of space and its origin has been discussed extensions by philosopher and
psychologists like Bergson, Whitehead and Piaget, but very little by Freud. There is an abstract or
glometric space and a psychological or empirical one. Empirical space is a given of mental life used by
language to describe the image of our relationship with people and other objects around. It carries
along with it the concept of time and of the self, playing a significant role in the determination of self-
consciousness as experienced in normality and in pathology, in the dream and in the psychoanalytic
situation.
     Freud’s topographical model of the human mind gave rise to an introspective narrative that has
been extensively elaborated through spatial rendering of mental activity and the language of
internalization, projection, boundaries, and so on. The triadic nature of the infant’s early experience
with the parental couple has led to the concept of a traingular space, while the concept of the
transitional object has given rise to the idea of a transitional space with holding and containing qua-
lities, which are to be found also in the psychoanalytic situation that sustains the analytic process,
including transference and countertransference.


     The impact of transplantation on body experiences and body concept: psychoanalytic
                               dimensions in our understanding
                                                                                             Horst Kächele
    The impact of defense processes on coping with illness has been shown in many studies.
Systematic studies on patients after bone marrow transplantation, however, have been rare.
    My theoretical understanding of defense process is characterized by a detachment of the drive-
related foundations of the concept; I conceptualize defense as a major tool of the regulation of self-
and object relation and of the body experience and concept.
    By means of defense the ego masters internal conflicts aroused by the external trauma. The stress
of the illness and therapy may well reactivate passed, unconscious conflicts as well as stir up new
dangerous and painful affects which by themselves initiate defensive manoeuvers. The ego has to
balance among the intrapsychic object-related and self-related needs and wishes and the extraneous
demands of the illness and its treatment consequences. The consequences of defenses lead to a
distorted perception of realities and to the exclusion of conflicting self-aspects. It influences cognitions,
emotions, actions and social relations of the patient, especially of hi/her bodily realities after
transplantation possibly leading to a less optimal adaption to the therapeutic necessary situation or
even alleviating the tolerance for unbearable situations.


                                         Soul and Body in Plato
                                                                                       Vassilis Karasmanis
   In this presentation I am going to explore the relation between human soul and body in the
philosophy of Plato. My aim is to focus mostly on the dialogue Phaedo, the central theme of which is




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the immortality of the soul. Plato’s conception of the soul in the Phaedo is quite different than those in
the Republic. In the former the incomposite nature of the soul is asserted in emphatic terms. In the
Republic we have a long and carefully elaborated argument for three parts of soul. What we should
call moral conflicts is, for the Phaedo, a conflict between the soul, conceived as wholly good and
rational, and the irrational passions and desires of the body. The soul appears to be in the Phaedo the
opponent of the body’s fears and desires. The body is presented as a hindrance for the rational
capacity of the soul. The soul must be purified from the body’s infection. Such purification can only be
fully achieved at death. But the life of the true philosopher will be a preparation for and an
approximation to it.


                                    Psychoanalytic affect theory
                               in the light of neurobiological findings
                                                                                           Otto Kernberg
    This presentation will summarize contemporary affect theory from a neuropsychological
perspective, and relate it to the psychoanalytic theory of affects and drives. Abnormally intense
response of the amygdalar system under activation of negative affects, and inhibition of prefrontal
cortex areas related to cognitive control are characteristics of patients with borderline personality
disorders. They express the genetic and constitutional disposition to excessive aggressive affect
activation, and influence attachment behavior. The relationship between the resulting equilibrium
between aggressive and libidinal affects and intrapsychic organization, and the influence of later
developmental stages on this equilibrium will be explored. Finally, this approach will be applied to the
clinical dimension of depressive affect, the interaction between unconscious psychic conflict and
biological disposition.


                                  The human brain's plasticity:
                       A key concept for studying non-conscious decisions
                                                                                        Martha Koukkou
   The guiding theme of psychoanalysis as theory and therapeutic technique is and always was the
necessity of making the Unconscious conscious (thoughts, wishes, fantasies of childhood that are kept
dynamically out of conscious awareness), using Freud's talking cure. How Freud's unconscious and
the unconscious of today's psychoanalysis work, as well as how and why the human brain participates
in a nonconscious way in the manifestation of symptoms that can be treated in psychoanalysis
(neurotic symptoms) is the topic of theory and research of several sciences. Bridge-building efforts be-
tween psychoanalysis and brain research have existed since Freud, and are no rarity today. This talk
presents the basic concepts of a holistic, dynamic systems-based model of the brain's functions that
create biography, i.e. subjectivity and the psychosocially recognizable dimensions of individual be-
havior. The model integrates well-established neuroscience principles, including the brain's
experience-dependent neuronal plasticity. Plasticity concerns the brain's learning and memory
processes that (a) form cortico-cortical connectivity, i.e. neuronal networks which represent individual
experiences and acquired knowledge, (b) manipulate this knowledge and thereby extract out of
experiences personal meaning and cognitive-emotional coping strategies, and (c) using conscious and
nonconscious processes manifest individual thoughts, actions, emotions, decisions, dreams, etc.
These brain functions that at each moment dynamically create the individual's behavior are
summarized in the model as context- and biography-driven information processing operations that
create the subjectivity of mental life. We focus on the innate and extrinsic motivating factors that
determine the personal significance of the experiences. We discuss the role of these factors in
defining the well- or mal-adaptive cognitive-emotional significance of the neuronal representations and
the way with which automated, maladaptive representations may lead the nonconscious
manifestations of symptoms treated in psychoanalysis.


   Differentiation, object relation and “microprocesses” of identification in the mother-infant
                                         bodily relationship
                                                                                               Fred Pine
   The mother-infant relationship is viewed through the lens of their primarily-bodily interaction. A
conceptually organizing developmental line is used to describe movement from global/undifferentiated




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states, through greater differentiation, and on to integration of the differentiated units. Aspects of
Mahler's work, and the current author's revisions and elaborations of that work, are drawn upon to
describe early merger experiences (the "global/undifferentiated" state) for the infant, this state is
present notwithstanding the simultaneous presence of significant indicators of differenttiation. Bodily
bases for the progressively more complete move into a differentiated awareness of self-other
boundaries are also described. And finally, by drawing on ideas from both attachment theory and
object relations theory, the development of an "integration" of the mother/ infant pair -- an "integration"
through the relationship between them -- is described. In this latter discussion, primary attention is
given to the role of identification (of infant with mother) as a process that binds the two together. In this
most fully developed section of the paper, three "microprocesses" of identification are offered as taking
place through: (1) the mother's organizing or disorganizing overlay upon the infant's functioning, (2)
the mother's "magnification" of unconsciously selected specific conflictual processes, and (3) "appeal"
processes in the child (the "magnetism" of unsettled inner states) that selectively adopt offerings from
the surround to be internalized.


                                     The body and sense of reality
                                                                                              Simo Salonen
    The author examines the vital links of psychic functioning with the body. He arrives at the view that
identification with the body and its functions creates the instinctual foundation of confidence in life. The
body thus receives a vital narcissistic meaning. The collapse of this foundation leads to an extreme
emergency endangering both normal psychic functioning and somatic health. Recovery becomes
possible by the restitution of this link in the course of treatment.
    The theme is then approached from the viewpoint of psychic survival by relating it to primary
identification with the early maternal object. The infant finding a human being similar to itself will place
a frame for psychic representation at its disposal. This configuration also represents the first shaping
of reality. The sense of reality becomes linked with it. The collapse of this vulnerable configuration
leads to the dissolution of the sense of reality, and its recovery leads to a new integration. The world
will then be seen with new eyes, as it were.
    The sense of reality depends heavily on solid affect responses presupposing a living touch with the
body. The evolution of these responses takes place in the child’s bodily intimacy with its parents. This
intimacy is however ambivalent in nature. The child has to overcome the unconscious dangers of
separation, castration and loss of love in relation to the parents in order to be able to share in genital
reality as an autonomous individual in the future. The integration of these dangers as a part of human
life is not self-evident as well as the psychic integration of one’s own death the most immediate
remainder of which is the body.


                                   Sensory and/or phantasised body
                                                                                         Thalia Vergopoulo
    The psychoanalyst describes psychoanalytic cases of patients who manifest a severe confusion
between the image of the way they experience their body and the phantasised image of it. In the
beginning of the analytic cure this unconscious confusion of the patients was mainly felt by the analyst
who helped them progressively to realize this great splitting. But when began the main
"interrogations", then appeared the deep regression in analysis with very confused images of their
very first period of childhood, that resembled more to terrifying or wonderful fairy tales than to family
myths. These analysands appeared in their recollections either omnipotent or very weak, with the
exception of one analysand who expressed a severe perverse situation, almost a distructive one, and
who did not stand the analytic process.
    A long process of psychoanalytic treatment of the analytic couple, depending on the cases, will
show us, the paths and the different ways these analysands have chosen in order to construct a more
realistic image of their body and finally of themselves. But it took us even more time to realize what
were the reasons of this body splitting that pushed them so dramatically to avoid the representation of
themselves.




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                                        SPECIAL SESSIONS

                                MIRRORS, BODY IMAGE AND SELF
                                                                                     Paulina Kernberg,
                                                                               Bernardette Buhl-Nielsen
   This presentation will include an introduction to the developmental, diagnostic and clinical
implications of mirrors; next we will outline the history of the current research with adolescents from
observations of toddlers, where mirror behaviours correlated with the quality of mother child inter-
action, the affects expressed and the sense of body self and identity. Video taped illustrations will
accompany the presentations.
   With adolescents, the Kernberg Nielsen Mirror Interview (KNMIR), will be presented by using video
taped cases of a normal adolescent, and a psychotic adolescent part of a cohort of 60 patients and 60
normal adolescents interviewed with this particular technique and other independent measures.
Discussion of the inferences that can be drawn from the mirror interview about body self and self
based on verbal narratives, non verbal and affect states with the use of a rating scale will conclude the
presentation. The potential of the use of the mirror in clinical practice will be delineated.


                                 THINKING WITH THE MIND’S EYE

                                   States of mind, states of being
                                                                                       Michael Parsons
   Psychoanalysis is not only an investigation of states of mind, but also, like art, an investigation of
states of being. Artistic meaning cannot be translated into words, and the non-verbal is similarly
important in psychoanalysis. Analysts listen both to their patients and to the thoughts and feelings that
the encounter with a patient stirs up in them. This inwardly directed listening involves experience
which there is no way of putting into words. I will show how the relation between external and internal
reveals itself in paintings by Constable, Perugino and Raphael.


                          Visual thinking: seeing what Titian saw in 1576
                                                                                           Melanie Hart
   How deeply can we think without words? Titian’s last great painting, The Flaying of Marsyas, is an
astonishingly complex achievement. In this short paper I focus only on the way he uses form, colour
and shape to delineate, in the structure of his work, a profound understanding of psychic growth, of
madness, and of the development of a capacity to think. The tools at his disposal are non-verbal,
abstract and mediated through the body - sight, touch, gesture - but he saw, in 1576, the essentials of
what psychoanalysis has made it possible for us to talk about 400 years later.




                                          ROUND TABLES

                                PSYCHO-SOMATIC DIALOGUES.
                              PASSAGES ON WINNICOTT’S TRACES

                                  Somatization, affect and thought
                                                                                       Clairy Synodinou
   As a subjective, phenomenological experience, affect also represents, within the framework of
Freudian metapsychology, the expression of the energy of the drive.
   Situated at the heart of drives activity, and in that sense movable and changeable, affect seems to
move between/or feed the somato-psychical mechanisms and processes taking place in the main
somatization/thought line. One may uphold that these changes, in their extreme symptoms, beyond
and within, represent limits of the expression of affect as a subjective experience.
   The somatization processes, basic depression, as well as autism, seem to arise from early




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weaknesses in the first alterations of simulations, whose affect is probably one of the initial psychic
forms.
   If autistic defense, just like somatization processes, can be the sign of an early effect of this
changing process, one could assume that both autistic defense and defense through somatization
could represent an attempt to psychic remedy directed at making the elaboration of the narcissistic
bases of the ego and of the psychic functioning possible.


                             The body in the “False self” organization
                                                                                   Ioannis Vartzopoulos
    Winnicott developed Freud’s view that the Ego is first and foremost a body Ego. He not only points
out the continuity of body-mind but also the fact that the psyche takes form in the imaginative
elaboration of physical functioning. He holds that the sense of existing is offered from the aliveness of
the body tissues and the working of the body functions. According to Winnicott the fortunate outcome
of these processes will lead to the consolidation of the True Self. In cases of great disharmony
between the True Self and the Object we have the development of a split off compliant Self, which cor-
responds to the False Self and is equilavent to physic life resigning from the animating role of the
drives, in other words, the relationship with the body.
    The analysand was exposed during her childhood to excessive sensory stimulation, which inhibited
the establishment of the ability to distinguish between fantasy and reality. Her primal phantasies main-
tained a concrete, close to the body character and were deprived of their tentative and integrating
functions. The unconscious wish and imminent threat of the analysand that her primal phantasies will
break through and dominate the reality of her life emerged as a crucial factor in the course of this psy-
choanalysis. A False Self was constructed based on the massive use of magical and obsessive
thinking. The analysand’s body was stripped of its genuine expression and its wishes. In the course of
this analysis the body provided the stage, on which the physic conflicts were played out and worked
through.


                            The reorganization of the maternal instincts
                                  through the process of splitting
                                                                                          Katerina Sofia
    Working with a young woman who had to deal with the anxieties caused by the cohabitation of life
and death fantasies and wishes, I tried to study and demonstrate how these wishes interweave one
into another, how the envy of the parent who gives birth meets the fear of genealogical succession,
which at the same time includes the fear of death. I tried to understand the ways life and death,
interwoven, inhabit the same body, yet allowing it to be creative and relinquishing to it the necessary
physical and mental space so that the possibility of a harmonious interaction with the next generation
might exist, without the fears of annihilation being dominant and destructive. I will try to describe how
this young woman and I worked towards understanding the anxieties and fears that had been
preventing her from conceiving and carrying a baby. This understanding presupposed new ways of
thinking about the relationship she had developed with her mother; this process allowed her to
experience the mother-infant as well as the child-mother relationships in a new, almost enjoyable way.
Thus I believe we were able to comprehend, at least partly, how a life-giving equilibrium can originate
in splittings that generate anxiety.


                            Preverbal traumas, splitting and integration
                                                                                   Sotiris Manolopoulos
   The discussion will start from the material of cases with preverbal traumas. The perceptual
remnants of these traumas activate raw emotional charges which circumvent the preconscious
elaboration, overwhelm the psyche, strike the body and manifest as somatic symptoms. Based on the
works of Freud and Winnicott on the agonies of breakdown and the defense of splitting, we can
conceptualize the efforts for dramatization, symbolization and integration of traumatic ruptures in the
analytic encounter. The splitting between psyche and soma acts against the psychotic merger with the
primary object. The splitting entrenches autistic enclaves of unelaborated primary experiences. How
are we going to bring the splitting within the transference? The non neurotic psychic organizations do
not need to remember after a lifting of repression. They need mutative moments of transference -




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counter-transference resonance in the transitional space of the analytic setting. The transference -
counter-transference actualizations are the field where the two unconscious-preconscious processes
and elaborations resonate and the two partners of the analytic couple conceive, co-write, and co-
construct the analytic object. On their preconscious they realize the work of staging - in the theatrical
scene of unconscious fantasies and dreams - and knowing unconscious derivatives and traumatic rup-
tures. The role of metaphors in this elaboration will be mentioned as well as the access to primary
symbolizations -codes of autoerotism, musicality of primary experiences - the basic soundtrack from
which the speaking words and the functional representations emerge.


               MODERN PSYCHOANALYTIC APPROACHES IN PSYCHOSOMATICS
                                                               Marilia Aisenstein, Athanasios Alexandridis
                                                                        Fotis Bobos, Savvas Savvopoulos
    The psychosomatic theory and clinical practice enriched psychoanalysis with original ideas
(essential depression, operational thinking and life, primary mosaic, automation, programmation and
maternal handling) and with an interesting elaboration of classic psychoanalytic concepts (function
and quality of representations, Preconscious, fixations, death instinct, economic model). The
interventions of the round table aim to present, through clinical and theoretical arguments, the way
these concepts converge into the modern psychoanalytic practice. The main axes of the presentations
will be: in the first case, the primary oral and anal fixations and their inscriptions in different psychic
levels during the evolution of the patient and her therapy; in the second case, the compulsion to act
because of the periodic or permanent collapsus of the psychic functioning due to the deficiency of
representations, and in the third case, the somatic pain as a consequence of the psychic deficiency to
work through the patient’s suffering. The larger frame of the discussion imposes the questions of the
psychosomatic patients’ narcissism and the sadomasochistic investment (cathexis) of the psycho-
somatic symptoms.


                          THE PRESENSE OF THE BODY WITHIN THE MIND
                                 OF THE BORDERLINE PATIENT

                          Sexual aspects of the body in borderline patients
                                                                                       Maria Chatziandreou
   One of the most prominent characteristics of severe borderline pathology is a mechanistic and self
destructive relation with the body, in which the latter is conceived of as non functional, inanimate or
even dead. The view of one’ s body from without, as if the borderline places himself separate from his
body and observes it, is characteristic. The patient experiences his body becoming alive only when he
activates a ritual of perversive order, pertaining to a relation with substances, with food, a paraphilia or
a combination of some of the above. The sexuality of the borderline patients, which is under the
shadow of perversity, prefers skin contact, contact through touch. It concerns a perversive sexuality,
which remains attached to sensations and emotions, rejecting penetration or the bodily depth. In the
end, in severe borderline pathology, the sexual contact fails to provide satisfaction of genetic order
while bringing about a mere satisfaction of psychic order. It is a peculiar satisfaction, since it derives
from a neverending search for satisfaction through perpetual excitation of desire, which is finally
obtained via self-satisfaction and in most cases in the absence of the external object.


                    Contingencies of aggression on a borderline patient’s body
                                                                                             Nikos Lamnidis
    In this presentation, based on the clinical material of a pervert - borderline patient, some
intrapsychic and behavioral routes followed by his aggression will be tracked. This patient came for
treatment because of, painfully experienced, exhibitionistic practices (colored with pedophilic
interests). Special theoretical attention will be allotted to this patient’s internalized object relationships
not only with his father but to scenes portraying, in his mind, ways the father treated (or should treat)
his wife’s (the mother of the patient) sexuality. Aspects of the transference as well as of the real
therapeutic relationship will also be examined as fields of enacting, understanding and transforming
this aggression. It will be shown how the (representation of the) body becomes gradually more
integrated and takes a slightly more central position in the self, as well as how, by experiencing a




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“human” sense of guilt this patient succeeds in partially detoxifying his terrifying internal reality.


                                 Fantasies of catatonic immobilization
                                                                                        Konstantinos Zervos
    This paper describes the course of an analysis of a 30 year old woman. A special characteristic of
the way this woman communicates, that becomes evident soon in the course of her analysis, is the
marked use of visual images. After a brief initial phase of hysteric seductiveness follows a period of
some months where the main concerns of the patient have to do with incidents, memories, dreams
and fantasies of intense aggressiveness and destructiveness. At the same time and gradually, a very
intense transference is established. References to her everyday life, work, friend and parents become
less and less and the analytic relationship, almost split off the rest of her life, becomes her main
concern. The contentious topic is constantly the same: the absences of her analyst during weekends
and vacations. Against the experiences of the slightest feeling of joy or rage, the profound desires and
horrors of merging with the analyst, the inability to control and to understand separation, she develops
fantasies of a rigid, immobilized, frozen, iron, fat or imprisoned body. Considering these fantasies as
rooting in the very early skin and muscular experiences of the patient, the analysis focused on their
function as a stimulus barrier, as a means of strengthening holding and achieving containment, and
last as a means of getting into a process of separation. Four years after the beginning of this analysis
these fantasies take an anal quality. The patient wonders about the reasons her analytic relationship is
split off the rest of her life and considers the contents of this relationship as a smooth, dirty substance
that must be eliminated.


                       Anaclisis: the interdependency between body and mind
                                                                                       Ioannis Vartzopoulos
    The body-mind question is examined from the aspect of continuity versus dichotomy. The concepts
of body Ego, ‘use’ of the body, metaphor and psychosomatic illness offer, among others, the ground
for the investigation of this question.
    Some aspects of a borderline patient’s psychoanalysis are presented supporting the view of a
functional continuity between body and mind both on the figurative and the functional level. The
analysand’s olfactory hallucination was regarded as condensation of the primal scene and
manifestation of the body Ego. His bodily manifestations were not considered as solely regressive
phenomena, rather they seem to constitute the underpinning of psychic functioning. The metaphoric
process presented itself as a psychic manifestation directly related to the bodily sensations. The
psychosomatic illness suggested an interdependency between body and mind via conflict and
unconscious phantasy. The concept of anaclisis as denoting the functional continuity between body
and mind seems to be of pivotal importance in the course of this psychoanalysis.


                                  FROM BODY TO MIND.
                   THE EMERGENCE AND UNFOLDING OF THE HUMAN PSYCHE

                             The emergence and unfolding of the psyche
                                                                                         Judy Gammelgaard
    I shall take as my starting point the concept of the drive as Freud defined it in Three Essays on
Sexuality. We learn from this work that the drive is the "psychical representative of an endosomatic,
continuously flowing source of stimulation" and that it is situated at "the frontier between the mental
and physical." It was the observation, that the sexual drive detaches itself from self-preservative drives
that allowed Freud to conceptualize sex as drive. This means that the psyche -understood
psychoanalytical -emerges with this transformation of instincts into drives.
    While introducing narcissism into psychoanalysis and with his speculations on the destiny of the
drives (Triebschicksale) Freud was forced to change his first theory of drive antagonism. This meant
broadening the view of sexuality turning it into Eros and opposing it to Death, and conceptualizing the
ego as the taming and binding agent of the drives. Turning the sexual drives upon itself the ego both
undergoes a transformation - turning love upon itself and transforms the drives.
    Laplanche has proposed that the movement from Freud's first to his second theory of drives
corresponds to something in the reality of human being calling it "the passage from nature to culture."




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    I shall make a few comments on this passage where "Eros of narcissism takes over the interests of
self-preservation." The ego we may say is founded on the taming and binding of the drives that
originally was organised as archaic and brute sexuality: Winnicott´s "ruthless love".
    The entire process of transforming the drives might be what Freud meant by his saying: Where id
was ego shall be," calling this a "cultivating work". We might also call it sublimation.
    I see Winnicott´s concept of play in this light. While playing the child is engaged in the first project
of sublimating his drives and in the same process unfolding the primitive psyche in love of itself.


                       Nascent body ego and emergent infant-mother matrix.
                        Metapsychological and neurophysiological aspects
                                                                                       Johannes Lehtonen
    The earliest stages of the development of the ego have remained enigmatic in the meta-
psychological conceptualization of psychoanalysis. In The Ego and the Id, Freud stated that the ego is
first and foremost a body ego. He described its nature only in few words by characterizing the body
ego as a psychic projection of the body surface. During the postnatal weeks and months of life, the
mother-infant interaction is based for a considerable period on bodily interaction which is comple-
mented by communicative interplay, increasing in meaning as a function of developmental time.
    Infant-mother bodily interaction culminates in breast-feeding which brings about intense body
surface exchange between infant and mother (sucking & other skin and later also gaze contact) while
providing the infant with satisfaction of its vital instinctual needs. The sensory experiences of the infant
merge with primitive bodily affects of satisfaction and fusion is created between infant and mother.
Simultaneously, a fusion is formed, within the infant, between his/her pertinent sensory processes and
the primitive affects of satiation.
    This metapsychological conceptualization can be paralleled by neurophysiological investigation of
the infant´s brain activity during ongoing breast-feeding interaction. Results from a study, conducted
conjointly between the departments of psychiatry and neurophysiology of Kuopio University Hospital,
have shown that the brain activity of the infant demonstrates a regular change in the breast-feeding
situation, when pre-feeding, feeding and post-feeding brain activity are compared. A concomitant
change in heart rate (acceleration and deceleration) is also seen.
    Our findings support the notion that infant-mother interaction during feeding becomes imprinted in
the activity of infant brain, ensuing in biological internalization of infant-mother matrix within the infant
with obvious consequences to the developmental processes leading from bodily existence to a
nascent mind of the infant.


                                   Body image: gender, race, culture
                                                                                        Ellen Handler Spitz
    In this talk, I will show and discuss images from a popular children's book in the United States and
the United Kingdom ("Willy the Wimp" by Anthony Browne, 1984) that purveys highly puzzling and
distressing messages to young children about the masculine body. Children learn about their own
bodies and about those of others from the cultural products and experiences made available to them
by adults as well as from direct personal experience. Messages that are received and internalised
early on are not easily expunged in later years. Traditionally, psychoanalysts have failed to
acknowledge the power of these differential early cultural influences, but they are powerful and often
prove to have lasting effects on the psyche. As we advance toward the increasing globalization of this
new century, it will be important not to ignore these influences on the young and to take cognizance of
them, for they can profoundly effect the future not only of individual lives but of communities on a
much larger scale.



                                  ORAL FREE COMMUNICATIONS

                                              About dualism
                                                                                          Haritini Andritsaki
   “I concern myself only with problems that exist”. F. Nitze




                                                                                                           9
    Since its appearance and up till now, the issue of dualism has had a political/ ideological
background.
    According to H. Atlan - “the duration and the quality of life comprise a continuous concern for the
doctors and the politicians, for the citizen, while for the biologist life as an object of research does not
exist as such”.
    The prevalence of the dualistic theory could be attributed to the fact that it promotes the knowledge
that comes as a result of revelation - as opposed to the oncoming scientific knowledge that articulates
the object of research.
    The concept of dualism in the development of the homo-sapiens is relatively recent, as it is evident
from the texts of ancient Greek and Jewish mythology (Odyssey and Prophesies). We will try to
demonstrate that the concepts of the “body” and the “psyche” comprise a theoretical construction that
obstructs the exploitation of the new knowledge through technology in the research field and the
clinical practice.
    Our object has become distinct with the help of technology, that has enabled the clear distinction of
materials, by shifting the concepts of macroscopic and microscopic.
    We are to evaluate the elements that have been exposed beyond a dualistic concept, carrying on
the work and the ideas of the founder of psychoanalysis.


                              Some reflections on the occurrence of
                      somatic manifestations during ongoing psychoanalysis
                                                                                  Eli Athanasiadu-Högberg
    During an ongoing analysis, one of my analysands has repeatedly presented somatic symptoms
requiring hospitalisation. Based on my clinical experience, I weigh some thoughts how somatic
symptoms may be understood from a psychoanalytical perspective.
    I relate my understanding of somatic manifestations to drive theory, object-relation theory and their
somatic foundations, since the psyche is also an aspect of cerebral functioning and all psychic
phenomena are also neurochemical processes.
    This case highlights a specific form of split between body and mind where the body is
conceptualized as "foreign" body leading to an ego-body conflict (the body as id). Such conflict leads
to being "outside the body" but in the ego.
    The case also suggests some reflections on the body as a representation of the object, a body-
object that rejects, a non-confirming body.
    I suggest that my analysand's desire for the object, parried by the hatred of the object's persecutory
aspects, has its roots in the projection of her infantile needs. By coming increasingly in contact with
feelings of guilt linked to those projections, her desires are withdrawn and absorbed into the body.
    Finally, I connect thoughts about libido and the death instinct, with two aspects of the Greek
tragedies: the role of fate and the necessity of self-sacrifice, where sacrifice is tied to necessity, a part
of that which is included in the imperative of being human.


                            Mind-Body unity: Psychoanalysis at its limits
                                                                                                Zvi Carmeli
    In the past two decades, the psychoanalytic literature has been critical of what has come to be
referred to as a Cartesian stance: the view that the mind is an entity distinct from the body, and that
behavior and experience are consequences of mental causes. A common theme in this critical
literature is that, while classical psychoanalysis is founded on such a Cartesian position,
developments in our understanding of body and relationship require a shift towards a position of mind-
body unity. In the present paper I will argue that this shift is much more problematic for psychoanalysis
than previously believed. I will center on two main points:
     1. Counter to the claims of its analytic critics, the Cartesian view of the mind is not limited to
         classical psychoanalysis, but rather pervades all analytic approaches. his becomes apparent
         from a close study of the assumptions that lie at the foundations of all of the approaches,
         including relational approaches that emphasize mind-body integration.
     2. The Cartesian view of the mind is pervasive because it is integral to an essential ethos of
         psychoanalysis. According to this ethos, the human being is autonomous and free, and
         although influenced by his concrete historical developmental experience, is not shaped by it
         (in the full sense of that term). The Cartesian theory of mind is the cognitive correlate or
         derivative of this ethos. As such, Cartesianism cannot be abandoned without certain basic




10
         changes taking place in the psychoanalytic perspective on human freedom and its limitation
         by history.
    One conclusion of this paper is that while the anti-Cartesianism that has been gaining force in the
analytic literature may be philosophically tenable and valuable, the considerations that in effect
determine the psychoanalytic position on this issue are not merely philosophical. They are not clinical
either. Rather they go to the very heart of the aims of the analytic endeavor.


                                   Sexual abuse and bisexuality:
                            traumatized body by evidences and fantasies
                                                                                  Carla Beatriz de Souza
    This paper is part of a research project about homosexuality in Brazilian society today. Reflections
and discussions were around the ideas of social relations which take place inside Brazilian society
concerning that question. We conducted clinical research with 30 participants, combining two
instruments: an interview and a projective test - called TAT. One of the most relevant results was the
common narratives of sexual abuse and molestation during childhood and, even later, during
adolescence. Twenty eight of those 30 participants spoke about that type of experience. We chose ten
of the initial thirty interviews for qualitative analysis, what we called case studies. Among those cases,
we connected, more specifically, a strong relation between early experiences of sexual submission,
specially, by parents and relatives with bisexual and homosexual “choices”. This aspect must be
consider from both sides: first, from the epidemiologic point of view, since we can associate those
narratives with homosexual aspects of the individuals inside the society; and, second, concerning the
unconscious and conscious fantasies of seduction and sexual abuse which all of us have subjectively
kept inside our imaginative life. Beyond those aspects, our research shows that there is a possibility of
some kind of connection between experiencing of sexual abuse and bisexual and homosexual
behaviors. We will present a case in which we discuss how the idea of trauma can support a body
representation of sexual expression.


     The ideological evolution of human body in prehistoric art from paleolithic “Venus” to
                           megalithic human figures (statue-Menhir)
                                                                                       George Dimitriadis
    The Human Body as artistic topic nearly appears at the same time with the awakeningof human
being. Testimony, are the prehistoric paintings and graffiti, than from Upper Paleolithic, fill the caverns
wall, cliffs and every imaginable material support, which it could be affected, scratched or colored. To
the end of the eighteenth century the malesian archipelago tribes, accused the western missionaries
to have carried in their culture not the” notion of spirit” that they already possessed, rather that one of
“body”. In fact, for the prehistoric man, the body was not anatomicaly separated and isolated from the
rest of the objective and identified world like individual. For they, the body and in particular the
feminine body is the center of symbolic irradiation, that is, the “space” within the signs are gotten
thicker cosmic order. The prehistoric mentality, in fact, perceives the human body through the
procedures of transformation and trasmutation of the figures. Wanting, to operate in analytical way the
“body immaginery” is necessary to group the artistic production made in three layers: 1. Feminine
bodies, a tutto tondo, as appear the”Venus”, the “Neolithic Matrone” with great buttocks evidenced and
breasts, often embellished with of the signs as V, W, zig-zag, moon scythe, symbols of fecondation,
fertility and regeneration; 2. Feminine male bodies o/e, Early Bronze Age Statue-Menhir hybrid
expression of the neolithic Atlantic megalitism and the Balkan-Danube one; 3. Male and/or feminine
bodies as “praying man” type, appeared in the Neolithic and perduring until the maturity of the Greek
world classic, full loads of movement, freedom and dinamicity.


                            On the genealogy of the mind-body dualism
                                 and its psychoanalytic solutions
                                                                                                 Pasi Falk
   The human body occupies an ambiguous, even a paradoxical role in cultural categorizations --
from the cosmologies of the archaic societies to the discursive and non-discursive practices of modern
Western civilization. It is the most obvious and familiar visible ‘thing’ perceived and yet a blind-spot
which tends to disappear in the very act of perception, or, more generally, in the relatedness to the




                                                                                                        11
outside world. The ambiguous nature of the body may be formulated by means of a number of binary
oppositions which all posit the body in a double role. The body is both the Same and the Other; a
subject and an object, of practices and knowledge; it is both a tool and raw material to be worked
upon. Or, regarded from an experiential and phenomenological viewpoint, the body appears to
oscillate between presence and absence, most paradoxically in the intense ‘feelings’ -- both as
sensations and emotions, the latter of which also are, in the (first and) last instance, bodily modes of
‘being-in-the-world’ (in Martin Heidegger's and Maurice Merleau-Ponty's terms) -- the body seems to
be simultaneously highly articulated and yet in a state of disappearance.
    The mind-body duality is contextualized in this wider topic and its genealogy will be followed from
the platonistic ideas to the cartesian formulation and its aftermath followed by the problematization of
the duality from the late 19th century onward especially in phenomenological and psychoanalytic
thinking. Here the focus will be on the relationship between the following key concepts: the
phenomenological “lived body” (Merleau-Ponty), the psychoanalytical “body-image” and its relation to
other central consepts such as “unconscious” and “ego”. Finally, a third concept , the “body-scheme”,
is introduced giving an emphasized role to the bodily boundaries and its orifices (cf. Anzieu’s “skin
ego”) and opening an alternative (topological) way to formulate “solution” to the mind-body dualism.


                                        Creativity and the body
                                                                                        Dimitris Jackson
   The problem of creativity is approached via exploration of primitive infantile phantasy as described
by Klein, Bion and Meltzer. Meltzer's work on the role of masturbatory phantasy and intrusive
projective identification along with the persecutory anxieties associated with such projections serves
as the basis for the psychoanalytic understanding of the children's fairy-tale, Hansel and Gretel. The
story is seen as a portrayal of the infant psyche's attempt to come to terms with the primal scene and
in particular, with phantasies related to the inside of the mother's body. An inner world that can
become inhabited by a sadistic paternal phallus and lifeless debris or can become a place of creative
and fertile intercourse and imagination.


                              Lord of the Rings, Return of the King:
                          The end of the psychic journey toward the Self!
                                                                                       Arash Javanbakht
    It is believed that the legends, myth, and stories if not all, many of them are the story of the human
psyche or reflection of the human beings psychic elements, evolution, and growth. These products of
the mind are considered as the symbolic language of the unconscious psyche telling its story of
growth, maturation, fails, fears, beginning, and destination Gods of the Olympus were first believed to
be the real Gods of human at the ancient times; then they stepped back to the dark of history and
were believed to be the lack of knowledge of the man of that time and to be superstitions. Again they
are revolving in the modern psychology, not as the real Gods, but as the elements of the psyche and
the symbolic language of the human mind and its evolution. The intrapsychic symbolism shows itself
in the body of the heroes of the myth. In this article I have studied the evolution of the psyche through
the intrapsychic journey in the third book of Professor Tolkien’s Lord of the Rings. I first discuss the
integration of the Anima to the consciousness of Ego, then the integration of the Shadow to that Ego,
and then identification of the Ego with the Self as the final destination of the human psychic growth
and evolution. I will also note the character of the creature Gollum very briefly. The topics discussed in
the article are summarized as:
    1. Arwen the Elf’s death: Integration of Anima into the Ego
    2. The Army of the dead serves the King: Integration of Shadow into the Ego
    3. The King Returns: Identification of the ego with the Self
    4. Gollum, the crawler between the Ego and the Shadow, the conscious and unconscious; and
           its destiny


                    Emotional “indwelling” in the body: the role of the mother
                                                                                          John S. Kontos
   Is an emotional experience of the body possible, if, as Winnicott says “There is no mother”? In a
previous paper (Kontos 2002) on the genesis of subjectivity (i.e. the qualitative aspect of our




12
relationship to ourselves), I referred to several patients who seemed to have no subjective body
sense. They declared, for example, that “I am an outline”, or, “I am a bubble with two eyes”, or, “I am
empty of myself”, or at least, “I am in love, without a body“.
    I attributed these patients’ psychopathology to the absence of subjective investment from their
mother. The mother had no wishes, expectations or fantasies regarding the baby, in which the baby
could invest in and identify with.
    In the analysis of Martha (as I will call a patient) I had the opportunity to study the process of the
subjective investment of the body by the mother, (i.e. in the transference) in some detail. Martha had
severe distortions of the body image and the body sense due to congenital health problems and
surgical operations undergone in early infancy. My experience with this patient contradicts theories of
the enteroproprioceptive investment of the body, that is “from within” (M. Mahler) or theories of the
body as the primary “subject” (Ferrari: Concrete original object) and regard only the role of the mother
to be of catalytic importance.


                     Suffering body and function of language through dreams:
                      the Aelius Aristeides' experience (second century A.D.)
                                                                                             Elissavet Kouki
    Aelius Aristeides was an orator in the Second Sophistic movement period, which flourished during
late antiquity. From his work, which is preserved until today almost in its totality, raise to distinction the
five Sacred Tales. Aristeides was 55 years old when he wrote them. The title, Sacred Tales, refers to
the initiation cults, and means the revelations that a god makes to his worshippers, revelations which
have to remain secret. Here is about the god of medecine Asclepios who was caring for the physical
health and the eloquence of Aristeides, his devout, for at least 30 years. This is the period that is
registered in the Sacred Tales, in a way that the work is characterized by the researchers as the first
extensive autobiography in the history of literature. Though, it is a particular type of autobiography
because there is an hymnological intention, and because it constitutes around the double axis of
diseases and the rhetorical activity of his writer, with joining ring for about 130 dreams.
    Reading this text we have a vivid picture of a case where three spaces -- the real space of the body
(its well-being and its sufferings), the space of the dream (as an imaginary representation and as pre-
diction) and the space of the intellectual creativity (inspiration and himself the rhetorical discourse) --
coincide functioning in a continuous mutual dependence.


                                 New perspectives for psychoanalysis
                                   within ancient greek mythology
                                                                                    David Alejandro Malavé
    Greece has made great contributions to western culture and psychoanalysis. Within these are the
ancient myths of Narcissus and Oedipus from which Freud untangled the secrets of human sexuality,
and also more abstract figures as Eros and Thanatos which explain some compulsive and auto
destructive behaviors.
    Recently the so called post modern pathologies, have opened new fields of knowledge for
psychoanalysis. In this paper I will contemplate some aspects of post modern sexuality and of
massive drug consumption comparing them with ancient myths and rites of the Greek culture.
    From the perspective of gender studies we will revise how the comprehension of sexuality is
becoming more diverse and complex as we include the conceptions of sexual identity, gender identity
and object election into its understanding. The purpose here is to demonstrate that ancient Greek
myths contemplated these complexities of gender identification and sexuality. In the discussion the
mythological examples of some of the sexual variants we see now days, will be presented
    In the second part, collective musical manifestations in which drugs like “extasis” are consumed by
youngsters, will be examined from the perspective of analytical concepts like the death drive and
“jouissance” and then compared with ancient rites for the god Dionysus, during which his followers
reached unspeakable sensations of pleasure, but exposed themselves to physical injury and death.
    The conclusion of this investigation is that, if psychoanalysis opens to the study of ancient myths,
further than those already reviewed by Freud, it may result of great help for the comprehension of
gender studies and some post modern phenomena.




                                                                                                           13
                           Synaeresis of the physical and mental element
                                      - C. Cavafy’s approach
                                                                                            Haris Morikis
    Constantine Cavafy’s poetry is of particular interest to the psychoanalyti thinking, because it
highlights in a particular way specific movements of the psychic apparatus, remaining at the same
time physical par excellence: it derives from the body, the vaulting horse of the drives, and returns
back to it, serving as field where the destinies of instinctual drives unfold, both in a creative and in a
destructive manner.
    In Cavafy’s poems, the body constitutes mainly a source of pleasure, acceptable or illicit. Having
these characteristics, it respectively substantiates time (a concept, around which the Cavafian opus
axially evolves)
² either as a bearer of memory, which abolishes time by automatically fusing present and past, by
     fixation the physical beauty once and for ever to immortality
² or by letting time to act as a super-ego, as punisher, through ageing and through physical decay.
     Thereby, sexuality is directly linked to art, in a particular way:
     “in the wanton ways of my youth
     the course of my poesy was laid down,
     the contours of my art were fashioned”.
The pleasure itself constitutes a preliminary step towards art, not only a desexualized version of it. The
relationship between pleasure and art is a bi-directional one:
    “We, the artists . . . sometimes . . . with tension in the mind,
    and beyond any doubt
    for a short period of time,
    create pleasure which almost seems material”
    This coalescence of the physical and mental element, achieved in Cavafy’s poetry is unique and
becomes feasible only through languages, in the same way as the analytic situation.
    The Cavafian point of view, far from being purely pleasure-seeking, seems to be complementary to
Freudian point of view: One ends up in art also by yielding to pleasure and not only through diversions
towards other, sublimated routes. This, however, can only be realized in the Nachtraeglichkeit and
only by means of a specific quality of memory, which pleasure creates in certain bearers of linguistic
meaning.


                                  Body- Transference- Psychic Pain
                                                                   Ioanna Panagiotopoulou-Achimastos
    The starting point for these thoughts and questions has been the presence and the ‘use’ of the
body in the transference of three female patients, who often left me with the feeling that they were
showing me a “body in pain”, beyond the direct fantasy satisfaction in the transference.
    It was as if these were fantasies adhered onto the body and they somehow completed my
expressed or unexpressed constructions and interpretations. I would say that the body was being
turned into a place and a means of relating to me-the analyst as object. The direct fantasies of
satisfaction in the transference appeared as a defences against the discomfort and the pain which was
being ‘exiled’ onto the body. The psychic structures and the pathologies of the cases mentioned were
similar but not identical. The commonality revolved around issues of bereavement, pivotal to the
relationship with the mother, and as a result of which there was inadequacy of a mothering role from a
very early age. On top of that, the arousing sexual life of the parents established the primal scene as
traumatic: a sense of annihilation, reinforced by a lack of fantasies. The body, which is a place of
senses and the irreversible first encounter with the object, would become a place identified with
danger and its control. The inadequacy of the mothering function was being compensated by a sexual
relationship with the primary object, in such a way that, the equally arousing father would then
foreclose any function of a third. The feelings and emotions were ‘concrete’.
    The exposure of the patients’ body to the analyst’s “eye”, seemingly confirming the “lack” within the
psychoanalytic condition (equivalent to the primal scene), is the encounter par excellence with the
“helpless” which has been displaced onto the “body in pain”. The arousing, traumatic confrontation
with the analyst as an object, is a defence against the “painful”, whereas the violent aggressive
tendencies as well as the arousal are sources of unconscious guilt. This is a guilt “acted out through
the body”, as often happens with emotions in similar cases, and which originally functioned as a
vicious circle, where arousal would trigger guilt, which would then activate the body as its only release,
which in turn would precipitate further arousal etc. The confusion, the difficulty in finding a meaning in




14
the narrative and the analyst’s feeling of constant effort to maintain some form of continuity, were often
present in the counter-transference.
    Throughout the process, the sense of assessment and ownership by the analysands of their
“creations” acted as reparation of the self-erotic function which had been clearly inadequate. Gradually
the “inner” was invested upon and consequently so was the inside of the body, which was no longer a
“place of danger”. The “eye” of the analyst became reassuring and not just threatening any more, the
arousal was decreasing, and the body would become more of a “safe place” in the transference. As
the pain, was now more tolerable, it allowed for a more conscious sense of guilt rather than a guilt
acted out in and through the body.
    I refer to guilt as the feeling which encompasses the acknowledgement of the other as Other and
onto whom “things are being done”. This is the experience of an encounter with the analyst sub-
sequent to the encounter through the “body in pain”. From the analyst’s point of view, recognition of
this new encounter is a thread leading to the recognition of the analysand as a subject member of a
triad and no longer an extension of mother or suffocating inside the primal scene.


                          Pleasure of movement, competition and sports
                                                                           Ricardo Alejandro Rubinstein
   Sports and physical exercise, though very ancient practices, have recently acquired massive
popularity and are now part of the uses and customs of our times.
   Psychoanalytic thinking about this subject has been lacking.
   The author analyses:
a) the relation between culture and sports, the latter viewed mainly as means of freeing, in a
   controlled way, the aggresivity that culture has thwartened from the outset;
b) movement as a source of pleasure, determined by the psyche as well as its defensive function in
   psychosomatic economy, protecting against the irruption of disorganizing processes.
   The relationship between discharge processes and thinking is analyzed. Muscular discharge is not
   viewed as pure psychosomatic discharge, but with a range of representational possibility.
   It occurs passing “through” the soma instead “into” the soma by different ways than psychosomatic
   disease.
   Thinking becomes quite operational during the practice of sports, but presents fantasmatic liaison
   and brings an amount of pulsional satisfaction.
   Also a regressive movement from psyche is considered; - from psyche to soma, - from libido to ego
   (narcissism) and from there to its autoerotic components, - from the domain of reality principle to
   pleasure principle, - from complex ways of thinking to more primitive ones (animism).
c) games and competition, as a possibility to elaborate fantasies, as well as a source of pleasure.
   The sources of rivalry (oedipical, fraternal and narcissistic) are considered.


                       The role of skin ego (moi-peau) as a transitional space
                 in the therapeutic approach of children with learning disabilities.
                      The contribution of the psychoanalytic theory of Anzieu
                             and her application in the clinical practice
                                                                                           Dimitris Sarris
    This work considers the role of the fairy tale and the puppet for the treatment of children with
learning disabilities. The theoretical frame is based on the three fundamental concepts of
psychoanalysis, that is to say the importance of the transitional space (Winnicott) between the
individual and the environment, the Skin-Ego (Moi-Peau-Anzieu) and the envelope psychique
(Anzieu). The sample of this research was constituted by 40 children aged 5-12 years with learning
disabilities and problems of symbolisation. We considered the fairy tale and the puppet as clinical tools
in the frame of drama play. They constitute a containing where the Skin-Ego (Moi-Peau) of the child
with learning disabilities functions as a receptacle. The good and the bad objects are stored into this
receptacle. This way the puppet and the heroes of the fairy tale consist a Skin-Ego (Moi-Peau), which
becomes the medium of the fantasies’ expression. It also constitutes of a particular mental structure to
the child with learning disabilities and problems of symbolisation. Finally, we considered that the
transitional space (Winnicott), which is created in the drama play constitutes (for the children with
problems of symbolization) the particular space of expression of the symbolic and the mental
structures of their thoughts.




                                                                                                       15
     Mechanisms involved in the formation of body and self image in individuals with psychotic
                                           symptoms
                                                                 L Stavrou, KA Zgantzouri, P-D L Stavrou
    The identification of the psychotic individual’s self with the schizophrenic disorder -illustrated in the
statement that ‘’schizophrenia is an I am illness’’- is joined with the individual’s social identity, body
and self image pathology.
    An analysis of the internal, unconscious processes, mechanisms and disturbances involved in the
body and self image construction of individuals exhibiting psychotic symptomatology and especially in
the formation of schizophrenic delusions, is provided in the current presentation. As for body image,
emphasis is mostly given in the alterations experienced by the individual concerning the sensation of
corporeality. Specifically, the distortions in body image, construction and motion experienced by the
individual, as well as his/her subjective experience of body confusion, disembodiment or
depersonalization of some of the body’s parts, are discussed. As for self image, the individual
experiences alterations in consciousness, discontinuity of self-awareness, impairment or loss of ego
boundaries and self destruction, leading him/her to processes such as psychotic projection and ‘’psy-
chotic re-personalization’’.
    It is suggested that the impaired mechanisms and processes involved in the formation of body and
self image in individuals exhibiting psychotic symptoms are the core issues for the construction and
development of these psychopathological symptoms. Moreover, based on the psychodynamic
orientation for the understanding of psychotic symptoms, the authors propose potentially useful ways
for the reconstruction of body and self image through psychotherapy process.


                     Having-a-body or being-a-body vs. not-just-being-a-body:
                      a dialogue of theological ontology and psychoanalysis
                                                                                    rev. Vassilios Thermos
    The nature of soul/mind and its relationship with body remains still one of the most enigmatic
scientific problems. Historical developments have led to obsolescence both materialism (“being-a-
body”) which marked psychoanalysis since its very beginning, and cartesian somatopsychic dualism
(“having-a-body”) which accompanied western civilization for centuries. However a new assumption
has not yet been convincingly articulated. This paper highlights a possible convergence between
psychoanalytic theory and Orthodox Christian Theology, in terms of the former’s shift away from
materialism and “energy” model (especially in object relations theory and in Lacan’s distinction
between drive and desire), and the latter’s gradual development toward a more explicit approval of
body (although sometimes hidden under ascetic terminology) from milestones as saint John of the
Ladder, saint Maximus, and saint Gregory Palamas to contemporary theologians as N. Nissiotis and
D. Staniloae. In these and other authors one notices the affirmation of body as the indispensable
condition for real interpersonal relationships, that between man and God included. Such an ontological
realism about human integrity (“not-just-being-a-body”) takes materialism under consideration but
points to the divine origin of human nature as well. It calls for a genuine dialogue between
psychoanalysis and Theology, both being now more reliable to work for true interpersonal
relationships.


                                 How to get pregnant on mothers lap
                                                                                    Kirsi van Rijn-Nikkinen
    A 31 years old intelligent woman is very seriously struggling with her on the one hand, mother-
child-feelings and -relationship and, on the other hand, with her longing for a sexual relationship with a
man and having a baby. She is looking for a way to be able to combine these two longings without
having success till now. With ambivalent feelings she makes in psychoanalysis a start to look at
herself, to be able to understand what is this all about and comes to realise that the combination of
these two things shall mean offering many aspects concerning her mother-child relationship with her
girlfriend, about which she is yet so keen. The bodily mother-child contact forms maybe the biggest
puzzle for her to solve.
    In her lifestory one cannot find a life-event, which could declare this serious stagnation in her
growth. In this presentation will look at aspects which take part the patient’s life. Also it will be
demonstrated how she is coping with her struggle. Her story does include aspects which may make




16
one think of a soapopera but, unfortunately, this is a real story in blood and flesh.
   The speaker wants to invite you to take part to discuss the hypothetical aspects in trying to
understand the background of the patient’s problems.


                         Freud’s theory and the treatment of the psychoses
                                                                                       Chrissi Yannoulaki
    The relationship of narcissism with psychoses, which was obvious through their categorization by
Freud as “narcissistic neuroses”, can be considered as the beginning of the positioning of psychoses
in a spectrum of psychopathology, ranging from the more severe to the normal.
    Freud posited that the stage of fixation of schizophrenics is that of autoerotism. Regressing to that
stage, the patient finds himself narcissistically disinvested, because he has not received the
narcissistic input that would enable the transition to the state of the unity of the subject.
    The patient has left the stage of narcissistic self-reliance and is searching for an object, but in his
world the object can only be the same as himself. To prevent the patient from running away, the the-
rapist must allow himself to become apparent to the patient as an object that reflects him.
    This cannot be the product of miming, but a movement of the psyche of the therapist aiming finally
to reconstruct the psychotic structure, not to just reflect it.
    A theoretical construct of the events that occur during an individual psychoanalytical psychotherapy
is, for example, the theory of Benedetti on the transitional subject.
    We will present two clinical cases of psychoanalytical psychotherapy of psychotic patients: 1) a
female medical student, who has been on therapy for four years at a rate of two sessions a week and
2) a 40 year old man, who had been on therapy for six years at a rate of two sessions a week. The
results confirm the utility of psychoanalytical therapy for the psychoses.


                               Petrification and animation of the body
                       as representations of unconscious psychic processes
                                                                                      Sylvia Zwettler-Otte
     Opposing two inclinations of the body: being “converted to stone” or being made alive - both
familiar to ancient mythology - I want to pay some attention to their common aim and their interesting
asymmetry.
     Petrification usually is caused by the sight of something terrifying and symbolizes - as Freud
showed (1922, Medusa’s Head) - not only the terror of castration, but also a reparation by displaying a
stiff and obdurate erection. In general, petrification seems always to be connected with the threat of a
loss, leading to the wish to prevent the threatening separation, to stop a dangerous development and
to stop or even reverse time. To freeze a frightening danger might represent the struggle between a
threat and the effort to act against it. Thus petrification contains both: deadening and preserving. In the
ancient myth Niobe, for instance, becomes petrified while all her 14 children are murdered.
     By animation a dead object is brought to life. It is based on the wish to create life, somehow in
competition with the representation of another creator. Prometheus, as an example, blaming Zeus,
shapes stronger human beings who should despise Zeus; or Pygmalion, frightened by licentious
women, prays that life should be inbreathed into the statue he sculptured out of marble.
     While animation clearly means an act of enlivening, based on cathexis, petrification can have a
contradictory meaning:
     a) to deaden, to take away life (decathexis) and
     b) to fight the danger, to make permanent,
an interesting asymmetry in favour of life.




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