Concept of Psychic Reality and Conflicts between Imagined Entities for a Mental Patient – IV

Reading Time: 5 minutes

Astonishingly enough, after an hour of hesitation, strain, hints of passion, or explicit torment, muteness, imprecations, or beseeching, the patient may rise calmly from his incumbent position, perhaps indicate, however fleetingly, his recognition of the psychoanalyst as psychoanalyst, and go about his business, relatively untroubled, only to immerse himself once again in his creation the next hour. He makes, according to a process of creation determined or made possible by the constraints of the psychoanalysis, something with form, however strange, the shape of which at first is dim, vague, as if seen always from afar through a mist, there, lost, recovered, and lost again through many hours, but in time looming closer, increasingly precise in outline and rich in detail and design. Prof. Ashoka, a renowned psychiatrist, delves deeper, in the fourth part of his erudite research, exclusively for Different Truths.

The disappearance or mitigation of the patient’s symptoms, as well as the relative disappearance from his verbal productions of concern with past or current relationships outside the psychoanalysis, and the obstruction of free association are all related to his increasing preoccupation with his (usually to him unacceptable) conceptions of the psychoanalyst and the psychoanalyst’s attitudes toward, feelings about, or intentions in relation to, himself; with his own (again usually to him unacceptable) attitudes toward, feelings about, or intentions in relation to, the psychoanalyst as so conceived; and with his own efforts to verify his conceptions of the psychoanalyst and to realise his aims or bring about some state of affairs in relation to the psychoanalyst.

It may be, moreover, that, given the conditions described above, these preoccupations of the patient will hold sway over him only or mainly for the period of the psychoanalytic hour. Astonishingly enough, after an hour of hesitation, strain, hints of passion, or explicit torment, muteness, imprecations, or beseeching, the patient may rise calmly from his incumbent position, perhaps indicate, however fleetingly, his recognition of the psychoanalyst as psychoanalyst, and go about his business, relatively untroubled, only to immerse himself once again in his creation the next hour. For the impression is irresistible that the patient creates something, something circumscribed in space and time, something out of the materials of the psychoanalysis. He makes, according to a process of creation—that is, by using — determined or made possible by the constraints of the psychoanalysis, something with form, however strange, the shape of which at first is dim, vague, as if seen always from afar through a mist, there, lost, recovered, and lost again through many hours, but in time looming closer, increasingly precise in outline and rich in detail and design. Freud did not ignore this phenomenon, damn it as a nuisance, or exploit it to noninterpretive ends. His astonishing feat, of course, was instead to discover that this impediment to the psychoanalysis, this obstacle to the patient’s participation in the psychoanalytic situation as defined, was, in fact, a representation of the patient’s conception of his inner world, of psychic reality, of the conflicts between imagined entities (of which his symptoms were still another representation) now quintessentially in the form of the transference neurosis. As such, this representation called for interpretation no less than the patient’s free association verbal productions.

Freud’s psychology would have remained relatively uninteresting if he had continued to consider the patient’s reminiscences, his memories, from which he suffers, to be of actual events. Freud discovered, however, as we have noted, that patients suffer, for example, from phantasies of past experience—not, for example, from actual seductions. A phantasy is a symbol of inner reality in the form of time past, time present, or time future. (Kris has written of the life history as the patient’s personal myth.) The transference neurosis is not a revival of earlier events or relationships, but of the patient’s earlier, perduring conceptions of events and relationships. The transference neurosis is a symbol of these conceptions.

Psychoanalysis, despite its preoccupation with a genetic or developmental frame of reference, despite the historicism of many of its theoretical formulations, is not a of history but a of the symbolising activity of the mind. Psychoanalysis cannot be concerned with the recovery—as a method, it is not suitable for the study — of actual events.

The patient may refer to what is apparently the same event at different times in different contexts during a psychoanalysis. At these different times, the presentations of the event and its elements are likely to differ from each other: details, emphases, conceptions of the event, and the attitudes and feelings aroused by or associated with such conceptions differ. The very history of the patient seems to change as he reconstructs it during different periods of the psychoanalysis. For during these various periods what the event and its elements mean, what the patient made and makes of them, changes. If a history is revived, it is the history of the patient’s psychic reality.

We may or may not infer an actual event at that imaginary point where the patient’s various representations of an event intersect, but that actual event as an entity is not knowable through, nor can it be investigated by, the method of psychoanalysis. The pathogens exorcised by psychoanalysis are not physiological processes nor historical situations but transformations, psychic representatives, of these: mental shades, memories, phantasies, conceptions, what Freud called ideas. Not reality but representations of reality. Not organism but representations of and self. Not object-relations but representations of object-relations as conceived by the patient. Between stimulus and response, between event and behaviour, falls the act of the mind. It is the act of the mind that is the object of study in psychoanalysis.

A rather vulgar notion of psychoanalysis pictures the patient reacting to what he out of error or ignorance regards as signs of danger, and the psychoanalyst—like a keen-eared, sharp-eyed Holmes—reacting to the patient’s verbalisations, appearances, and acts as signs of the patient’s immediate feelings or dispositions. The psychoanalyst’s interventions are presumed to be based on his recognition of signs of the patient’s state in the psychoanalysis as well as his recognition that the patient is interpreting signs ignorantly or erroneously. The psychoanalyst’s interpretations, then, are supposed to rectify the patient’s error and ignorance.

The superficial resemblance between sign and symbol—that each “stands for” something else—has tended to obscure the essential differences between them. A sign is a part of, attached to, or evidence of the presence of, the particular entity or event it signifies. A sign indicates or announces. The interpretation of the significance of a sign usually determines that action and what action shall follow its perception. An elephant’s footprint, a stop light, a dinner bell, a ring around the moon signs. From the sign, we predict the entity or event it signifies. It is also true that from the entity or event, we may predict the sign. The relation between sign and entity or event is “If…, then….” Such a relationship does not hold between a symbol, which begins with an abstraction, and the conception it represents.

(To be continued)

 ©Prof.

 Photos from the Internet

#PsychicReality  #ImaginedEntities #Psychoanalyst #PatientsPsychicReality #MidweekMusing #DifferentTruths

Prof. Ashoka Jahnavi Prasad

Prof. Ashoka Jahnavi Prasad

Ashoka Jahnavi Prasad is a physician /psychiatrist holding doctorates in pharmacology, history and philosophy plus a higher doctorate. He is also a qualified barrister and geneticist. He is a regular columnist in several newspapers, has published over 100 books and has been described by the Cambridge News as the 'most educationally qualified in the world'.
Prof. Ashoka Jahnavi Prasad
Share