Security, Separation, Recognition and Power

Introduction

Power is an implicit thread in the discourses that inform many aspects of our social and political life. Power relations are rarely equal or symmetrical. Indeed, it would seem to be an indisputable fact of social and political life that power relations are inherently asymmetrical, including, of course, the relationship between the therapist and the patient, notwithstanding the concept of mutual reciprocal influence (Aron, 1996). Frankel (2002) argues that the asymmetrical exercise of power is intrinsically traumatic because it induces fear of isolation and emotional abandonment. Asymmetry in power relations gives rise to evaluative questions: is power being used in a benign, constructive way, or in a malign, harmful way? If the effect on the other is malignant, how witting or unwitting, explicit or implicit, conscious or unconscious are the processes involved? Moreover, what mental states underlie the abuse of power - fear, shame, hate? Sullivan (1953, 1962) has argued that we are all involved in subtle and not so subtle “security operations” in our interpersonal lives wherein one person’s sense of safety and security is established at the expense of the other person’s. In extreme cases, as Searles (1993) and Laing & Esterson (1964) have shown, people in close relationships may use their greater power effectively to drive the other person crazy.

Socio-cultural factors

At a societal level, we need to consider the impact of powerlessness on the mental health of persons from ethnic minorities who are alienated from the mainstream white culture by institutionalized racism. Extending Freud’s (1917) theory of melancholia to the experience of Asian-Americans, Eng & Han (2001) argue that racial melancholia underpins everyday experiences of immigration, assimilation, racialization and group identity. In the therapeutic relationship, implicit and explicit power relations are likely to emerge into the foreground when the dyad consists of people who differ in terms of race, class, gender and sexual orientation. The resulting struggle for domination, however subtle, may reflect historical inequalities and a legacy of denial of the other’s subjectivity by those in power (Benjamin, 1988, 1995; Fletchman Smith, 2000; Mitchell, 1996).

Following Ferenczi (1933), Frankel (2002) conceptualizes this process in terms of a mutual identification with the aggressor, with each person vying to gain a sense of security by controlling the dangerous other. From this perspective, identification with the aggressor is directed towards undoing the sense of powerlessness and fear of abandonment that each partner in the dyad experiences, however unconsciously. This defence may also operate in everyday life in relation to those who have power and authority over us. In the therapeutic situation, we need to question to what extent we can tolerate difference, remain open to learning from the patient and allow him or her to impact on and transform us (Casement, 1990; Ghent, 1992).

On a wider stage, the power wielded by what may be termed sociopathic political leaders may be seen, for example, in Romania under the Ceausescu regime. The passive collusion by the Romanian people with the mad socio-political “reality” seemed to be paralleled in the power relations operating in the country’s social systems, including the family system. Subsequently, as we know, the masses, in a demonstration of “people power”, deposed Ceausescu and he and his wife, Elena, were killed. Miller (1991) roots Ceausescu’s tyrannical abuse of power in the context of his traumatic childhood, arguing that his political career was governed by the idea of “redemption through destruction” (p.105). She suggests that his desire for revenge was motivated by a determination to gain the recognition denied to him as a child by his abusive parents. Accepting that the meaning of behaviour is, in part, culturally or environmentally organized and mediated, Miller’s (1991) example emphasises the need to consider the way in which the wider socio-political context interacts with psychological development; how, as therapists, our internalization of, and identification with, external power structures and cultural institutions may influence the therapeutic relationship.

The Agentic Self

Milgram (1974) draws a distinction between an autonomous mode of functioning, in which the person views him or herself as acting out of his own purposes, and an agentic state, wherein the person comes to see him or herself as an agent for executing the wishes of another person. The shift from self-agency to the agentic state is triggered by the act of defining a person of higher social status as part of an authority system of relevance to the subject. An authority system consists of a minimum of two persons sharing the expectation that one of them has the right to prescribe behaviour for the other.

Milgram (1974) found that there is a transition from the moment when the person stands outside an authority system to the moment when he or she is inside it. This may include crossing a physical threshold into the authority figure’s domain. There is a sense that the authority figure ‘owns’ the space and that the subject must comply and conduct him or herself fittingly. Importantly, entry into the authority figure’s realm of authority is voluntarily undertaken. The psychological consequence of this is that it creates a sense of commitment and obligation which binds the subject to his or her role in the process. There is general agreement not only that the authority figure can influence behaviour but that he or she ought to be able to do so. Thus, power comes about in some degree through the consent of the person over whom the authority figure presides. As Milgram (1974) emphasises, once the subject grants this consent, its withdrawal proceeds at great social cost. In the light of these findings, it may be accepted that the potential for the abuse of power in the therapeutic situation is substantial.



Power and Intersubjectivity

Exploring further the issue of power in the therapeutic setting, relational and intersubjective theorists such as Mitchell (1993, 1996, 1997) and Benjamin (1988, 1995) argue that there has been a paradigm shift from a one-person drive theory model to a two-person relational model, with a concomitant shift in the role of the analyst from that of a neutral, anonymous all knowing expert to that of an active co-participant whose countertransference provides an important source of information about both his or her own and the patient’s subjective experience. From this perspective, intersubjectivity refers to our experience of the other as separate and having an equivalent centre of self. A shared reality comes to be established by means of a subtle intertwining of both intra-psychic and interpersonal processes (Benjamin, 1995). Thus, psychological meaning is negotiated and co-constructed in the here-and-now through interaction in the intersubjective field, rather than being regarded as universal and biologically inherent, as in drive theory (Mitchell, 1993).

In terms of power, the relational analyst openly acknowledges that his or her theories, patterns of thought and systems of ideas have an important influence on the therapeutic process. Indeed, the personal attributes of the analyst are viewed as playing a significant part in organizing and integrating the patient’s material, thereby providing shape and structure to his or her inner world (Mitchell, 1993, 1996). It is also assumed that this process is mutual and that the patient will change the therapist as part of a continuous process of bi-directional influence in the intersubjective field (Aron, 1996). An interactional conceptualization of the therapeutic process is consistent with the findings of infant research (Beebe & Lachmann, 1992, 2002) and challenges the view of countertransference as a static, intermittent event occurring in reaction to the patient’s transference. Mutual reciprocal influence, however, does not imply equal influence, in that the relationship can be mutual without being symmetrical (Aron, 1996). The therapist’s struggle to understand and recover from “mistakes” and re-enactments without becoming defensive or inauthentic is seen as a central aspect of the therapeutic relationship leading to mutual recognition and change (Aron, 1996; Frankel, 2002; Mitchell, 2000). Mitchell (1993) compares this model to that employed by Freud (1905) in his brief analysis of Dora. Despite Freud (1905) being fully aware that Dora had been profoundly betrayed by those she most trusted, his theoretical frame led him to focus on intra-psychic neurotic conflict, thereby invalidating her subjective experience and perpetuating, in the countertransference, her victimization by the men in her life.

Frankel (2002), however, notes that no technique can eliminate the inherent power differential in the therapeutic relationship or the therapist’s unconscious use of this relationship for good or ill. Mann (1997) argues that the therapist’s open recognition of his or her erotic desire and subjectivity indicates a mature awareness of the differentiation between self and other which may help to preclude the sexual abuse of the patient. However, he cautions against disclosing such erotic feelings to the patient. By contrast, Aron (1996) advocates allowing the patient access to the therapist’s subjectivity, in terms of disclosing his or her thoughts, feelings and fantasies. He argues that this leads to an acknowledgement by the patient of the therapist as a separate subject. This intersubjective aspect of the therapeutic process may protect the patient from passively complying with, and submitting to, the therapist’s power and authority. More generally, Aron (1996) and Benjamin (1992), respectively, point out that an awareness of the way in which our own subjectivities and theoretical orientation influences and limits the multiple possibilities of the therapeutic relationship merely raises new problems of power, in terms of a tension between mutuality and asymmetry, and thorny questions about what the analyst knows and does not know.

In discussing “knowledge as power”, Benjamin (1992) cautions against idealizing a stance of not-knowing in reaction to the old classical ideal of analytic certitude. Indeed, Winnicott, in his final paper, contends that the therapist can hold up the patient’s progress “because of genuinely not knowing”. For example, he argues that the patient’s “clinical fear” of a future breakdown is, in fact, the fear of a breakdown that has already happened but which has “not yet been experienced”. He suggests that the patient needs to be told about this crucial aspect of his experience (Winnicott, 1974: 176-177). Disclosure of the kind advocated by Winnicott (1974) may be seen as prefiguring the intersubjective technique of selectively revealing the therapist’s subjectivity. In this context, Frankel (2006) acknowledges the reluctance in contemporary psychoanalytic circles to diagnose the patient out of fear that this kind of “knowing” may negate or obliterate the patient’s subjective experience. This notwithstanding, he argues that diagnosis is an idea that cannot easily be given up because people do have distinctive personality characteristics and limitations that endure over time. He posits a relational model that includes the concept of “diagnosis-of-the-moment”: an interactive process that informs how the therapist responds moment-by-moment to the patient’s changing self-states and multiple ways of organizing experience. Aron & Anderson (1998) emphasise the way in which what the therapist knows is informed by his or her observation of the patient’s body, in terms of gesture, facial display and posture. Similarly, Orbach (1995, 1999, 2004) highlights the use of the therapist’s body countertranference to register and understand the patient’s implicit affective states and communication of unconscious material.

Developmental Issues

Influenced by Winnicott (1960) and the findings of more recent empirical developmental studies by Stern (1985) and Beebe and Lachmann (1992), Mitchell (1993) argues that deficiencies in caregiving in the earliest years interfere with the emergence of a fully centred and integrated sense of self and development of the person’s own subjectivity. He suggests that in many respects the good enough caregiver-infant relationship constitutes the prototype of a therapeutic model in work with adults – that the analytic process is redolent of the subtle intersubjective, communicative and regulatory processes that take place between the caregiver and child.

From a relational perspective, the inner world is viewed as developing through these mutually reciprocal influences, and the mind as being composed of relational configurations developed in interaction with others. Similarly, Fonagy (1999) argues that the child’s experience of self becomes meaningful in the context of the caregiver’s response to his or her expressions of psychological states, in terms of intentionality, thoughts, feelings, desires and beliefs. When this intersubjective process is less than optimal because of the abuse of power in the child-parent relationship, the transmission of trauma across generations (Fonagy, 1999; Holmes, 1999; Peck, 2003), or the parent’s compromised capacity for mentalization (Bateman & Fonagy, 2004; Fonagy et al., 1995; Slade, 2005), the child may identify with the aggressor (Ferenczi, 1933; A. Freud, 1993) and develop a false self (Winnicott, 1960).

Anna Freud’s conceptualization of identification with the aggressor differs from Ferenczi’s earlier formulation in significant ways (Frankel, 2002). She views identification with the aggressor as a defensive process whereby the child transforms him or herself “from the person threatened into the person who makes the threat” (p. 113). For Anna Freud, the change from the passive role to the active role is a means of assimilating “dissociated” traumatic experience which is turned into “an active assault on the outside world” (p. 116). By contrast, Ferenczi (1933), based on his work with adult survivors of childhood sexual abuse, argues that identification with the aggressor is a response to an overwhelming threat in situations where there is no physical escape. The abused, helpless child becomes oblivious of him or herself, identifying with the menacing aggressor and passively gratifying his desires. In subordinating him or herself to the aggressor, the child disappears, being transformed into the image that the aggressor has of him or her. As Frankel (2002) notes, both forms of identification with the aggressor may be in operation simultaneously, being used to adapt to a threatening external reality, as well as to cope with disturbing inner feelings that arise as a result of a threat to the self.

Ferenczi’s (1933) concept addresses similar issues to Winnicott’s (1960) false self organization. This defensive structure comprises a compliant, acquiescent way of organizing self-experience and is constructed in reaction to developmental conflict in the infant-caregiver relationship (Mills, 2003). Not infrequently, the caregiver’s needs for safety and security take precedence over the child’s needs to explore and express his or her affective states (Peck, 2003). In such instances, the child withdraws from self-generated spontaneity and, instead, conforms to the imposed images and needs of the caregiver upon whom he or she depends for love, protection and security. In suppressing vital aspects of self-experience, the child adopts an alien reality and inauthentic mode of being and relating (Mills, 2003). Indeed, Winnicott (1987) contends that, in a phenomenological sense, the child ceases to exist in those moments when the parent fails to greet his or her spontaneous gesture. Moreover, he argues that the caregiver’s failure to mirror the child’s current state leads to an internalization of the caregiver’s actual state, which then becomes an alien part of the child’s nascent self-structure (Winnicott, 1967).

In a relationship with a caregiver who is frightened and/or frightening, either because of suffering unresolved trauma and entering dissociative states, or because of being actively abusive, the child incorporates the parent’s feelings of rage, hate and fear, together with an image of him or herself as toxic and frightening. “This image must then be externalized for the child to achieve a bearable and coherent self-representation”, (Fonagy, 1999, p103). In a relational matrix of this kind, the child may develop a disorganized pattern of attachment and an internal working model of self and other that is multiple, fragmented and dissociated (Liotti, 1999). Lacking a coherent, organized strategy for coping with the stress of separation, the child regulates his or her fear and anxiety by becoming increasingly aggressive and controlling in relation to the primary caregiver (Hesse & Main, 2000; Lyons-Ruth & Jacobvitz, 1999; Solomon, et al., 1995). If unresolved, this parent-child controlling relational dynamic is carried into adulthood and enacted in the person’s intimate relationships, particularly in contexts involving separation and loss (Renn, 2003, 2006, 2007).

From a Winnicottian perspective, the insecurely attached child develops a false self. This defensive organization reflects a lack of recognition, affirmation and validation by the caregiver of the child’s subjective experience and authentic sense of self. The false self functions as a “caretaker self” to protect the potential true self (Winnicott, 1960, p.142), operating defensively by splitting off separation anxiety, fear of abandonment and dread of self-annihilation (Mills, 2003). The prevalence of the false self phenomenon in contemporary society, in the form of obdurate, merged attachments to internalized inauthentic and constricted relational configurations, has led Mitchell (1993) to assert that pseudo-normality is the clinical problem of our time.

Aggression, Maternal Subjectivity and Mutual Recognition

To balance these views, Kraemer (1996) argues that Winnicott (1947) does not address sufficiently the discomfort normative hate can generate in the mother, or the conflict the mother feels in owning her desire for power and control. Kraemer (1996) points out that, in using a developmental model in work with adults, consideration of the mother’s subjectivity is largely absent or ignored. Just as the therapist’s experience of herself and her patient is now increasingly recognized, Kraemer (1996) argues that there is a need to recognize the complexity and ambivalence of the mother’s reactions to her baby’s affective communications, including multiple and oscillating self-states and a confused sense of power and powerlessness. She suggests that fear of exploiting and abusing the baby may direct the mother away from acknowledging more fully how much she needs the baby to meet her own needs and desires. Kraemer (1996) contends that similar power dynamics may be enacted between analyst and patient in the therapeutic relationship.

In this context, Benjamin (1995) questions to what extent any aspect of subjectivity may be privileged as the truer, authentic part in relation to which other parts are false or inauthentic. However, influenced by Winnicott (1947, 1960, 1971), she amplifies Mahler’s (1985) theory of separation-individuation, stressing the role that aggression plays in the development of intersubjectivity. Benjamin (1995) argues that mutual recognition and intersubjective relatedness are not inevitable aspects of infant development but, rather, are developmental achievements linked to the quality of the mother-infant relationship, which may either be oppressive and controlling or facilitating and liberating. The struggle for recognition brings forth aggression and thus separation which fosters a symbolic space between mother and child. The mother’s task is to balance the constant tension between assertion of the self and recognition of the other. Benjamin (1995) sees this developmental process as the necessary basis for non-coercive intersubjectivity, noting that relatedness is characterized not by continuous harmony but by continuous disruption and repair (Beebe & Lachmann, 1992). When the process of mutual recognition breaks down because of conflict in the mother-infant relationship, experience is organized predominantly intra-psychically rather than intersubjectively, the upshot of which is a struggle for power (Benjamin, 1995).
Separation, Identity and the Role of Trauma

Mitchell’s (1993) theoretical position, as summarized above, resonates with the respective ideas of McDougall (1990), Bollas (1994) and, in particular, Fairbairn (1952), who argues that all psychopathological developments in the adult are based on a failure to attain psychological differentiation. Fairbairn (1943a, 1943b) views the failure of this developmental accomplishment as deriving from feelings of insecurity stemming from separation anxiety. Authors as diverse as Khan (1979), McDougall (1990), Schore (1991, 1994, 2001) and van der Kolk (1989, 1994) view the persistence of a disturbed form of child-parent interaction as constituting cumulative developmental trauma.

Influenced by Mahler et al. (1985), Stoller (1986) and Stubrin (1994) respectively contend that the mother’s inability to facilitate the child’s separation and psychological differentiation results in self-alienation and identity diffusion, particularly in a relational matrix in which the father is weak, powerless or absent. These theorists view such relational dynamics as linked to a form of adult psychopathology in which dissociated hatred and hostility are acted out in perverse or neo-sexual ways, arguing that the primary motivation for such activity is the desire to separate and form a distinct identity. The role of the father in helping the child to separate from a disturbed relationship with the mother is seen as a vital aspect of the child’s relational experience (Campbell, 1999; Khan, 1979). Indeed, Fonagy & Target (1999) argue that the perspective of the father as a third object may provide the child with a second chance to develop a secure psychological self. In line with Stoller (1986), Litowitz (2002) contends that non-sexual defensive motivation may take on a sexualized nature when the person’s sense of self is endangered and under threat. Frankel (2002) argues that identification with the aggressor is a widespread phenomenon and one that is by no means restricted to people who have suffered severe trauma. He concludes that “some degree or element of trauma has played an important role in the lives of many people in whose histories trauma does not appear prominent” (p. 117).

The prevalence of more overt forms of malignant parental power, in the form of neglect and sexual, emotional and physical abuse, has been comprehensively documented in the abuse and trauma literature. For example, Davies and Frawley (1994) and Bromberg (1998), respectively, have shown how a relational matrix characterized by abuse can lead to the development of multiple self-states. Here, traumatic experience is dissociated and encapsulated within the personality as a separate, non-reflective reality cut off from authentic human relatedness. Fonagy (1999) contends that unresolved trauma destroys the capacity to reflect on and appraise the mental states that give meaning to subjective experience and social behaviour. Davies (2004) argues that in work with survivors of sexual abuse, the therapist is required to make “multiple shifting diagnoses” in response both to the vicissitudes of the patient’s self-states and to the different roles that the therapist him or herself is drawn into enacting in the transference-countertransference matrix. In this context, it needs to be kept in mind that powerlessness is a key feature of trauma, and that dissociation in reaction to trauma walls off access to self-experience and emotional connection with others.

Power, Intersubjectivity and the Role of Security

As Frankel (2002) emphasizes, the work of Bowlby (1969, 1973, 1980), Fairbairn (1943a, 1943b) and Sullivan (1953, 1962) suggests that our most basic need is attachment. Given this, I would argue that security is more salient and significant than aggression in promoting non-defensive separation and psychological differentiation and, thereby, the child’s innate potential for mutual recognition and intersubjective relatedness. Indeed, while normative levels of aggression may promote autonomy and independence, uncontained or disavowed aggressive behaviour may be seen as motivated by fear, shame, rage and hate. Such negative affective states are contained and tempered by a consistent and reliable process of interactive regulation and the repair of inevitable disruptions in the child-parent relationship (Beebe & Lachmann, 1992, 2002; Schore, 1991, 1994, 2001). Infancy research indicates that it is this intersubjective process, together with the parent’s high capacity for reflective functioning, which promotes security and enables the child to regulate the tension between attachment and separation, and thus explore his or her own mind in relation to the mind of the other as a differentiated psychological self (Fonagy & Target, 2005; Grienenberger, et al., 2005; Slade, 2005). In reconsidering Mahler’s (1985) theory, Lyons-Ruth (1991) suggests that the first two years of life should be reframed from a separation-individuation process to an attachment-individuation process.

The lack of an internal sense of security deriving from the breakdown of attachment processes constitutes cumulative developmental trauma. The child whose subjective experience has consistently been negated or obliterated is likely to defensively avoid knowing the thoughts and feelings in the mind of the other for fear of discovering a hostile or malevolent intent and a reflection of the self as bad and shameful (Fonagy et al., 1995; Knox, 2001, 2003), and, more frightening still, as not existing at all. As Fonagy (1999) and Holmes (1999) argue, the parent’s unresolved traumatic and fearful states of mind can be transmitted to the child, leading him or her to experience states of disorganization and dissociation, even though he or she has not been directly abused or traumatized. Thus, social referencing and the sharing of differentiated emotional states, key aspects of intersubjective relatedness, are precluded (Stern, 1985). In a relational matrix such as this, the child’s capacity to be alone - to forget the mother in the confident expectation that she will be available when remembered - fails to develop (Winnicott, 1958). The consequent hyper-vigilant need to monitor and adapt to the other’s affective states leads to a confusion of self with other (Ferenczi, 1933).

Conclusion

In my view, developmental experiences of the kinds outlined above account for the frequency of Frankel’s (2002) clinical experience relating to the role of trauma, Winnicott’s (1974) clinical finding of a widespread fear of breakdown, and Fairbairn’s (1952) theory that the revival of traumatic scenes re-traumatizes the person. Clinically, such early pre-verbal phenomenological experience appears to consist of implicitly encoded and stored emotional memories (Orange, 1995; Schacter, 1996) imbued with a pervasive sense of fear and dread - what Winnicott (1974) calls “primitive agonies”. In terms of Bion’s (1984) theory, the caregiver has not been able to enter the requisite state of reverie to contain, transform and give meaning to her infant’s inchoate anxiety and terror. The inability to symbolically represent and reflect on traumatic states of mind motivates a controlling attitude to self and other in later life, resulting in a constriction of self-knowledge and shallowness in the quality of relationships with others. The capacity to play with ideas in an imaginative way is lost. Instead, thinking takes on a concrete quality with a frightening equivalence between internal states and external reality (Fonagy & Target, 1996; Holmes, 2005).

The subsequent activation of state-dependent dissociated traumatic memories generates existential anxiety that oscillates between fear of engulfment and fear of abandonment (Renn, 2006, 2007), states of mind that may be expressed somatically (Krystal, 1988; McDougall, 1989; van der Kolk, 1989, 1994). These states, fantasies and patterns of expectancies organize the person’s subjective experience in everyday life and emerge in the therapeutic relationship, being apparent in the patient’s expressive behaviour and narrative style, which, typically, is characterized by a sense of impending doom and catastrophe, as Joseph (1989) graphically describes. As a consequence of these vulnerabilities, the person’s conscious coping strategies and fragile unconscious defensive structure may fragment in adulthood, particularly at moments of intense interpersonal stress when the self is felt to be endangered by loss of the primary attachment figure or love object. In such a context, the person’s tenuous capacity for recognition and reflective functioning is compromised. There is a tendency to identify with the aggressor (Ferenczi, 1933; A. Freud, 1993) and wield power in a malign, coercive way in order to control the other and restore a sense of safety and security to the self.

The activation and externalization of dissociated self-states deriving from attachment trauma involving separation, loss and abuse overwhelms the person’s regulatory and reflective capacities. The ability to take the other’s perspective is severely compromised when aspects of the current relationship corresponds too closely with the original dissociated developmental trauma. Re-traumatization of this kind, allied to a sense of shame, despair, powerlessness and threat to the self, may culminate in extreme expressions of power and domination in the form of physical and sexual violence (Renn, 2003, 2006, 2007). In terms of Benjamin’s theory, such a struggle for power reflects a breakdown in the intersubjective dimension of experience: the other is not recognized as a separate self with an equivalent centre of subjectivity but, instead, is related to predominantly as a toxic transferential object from the intra-psychic world (Benjamin, 1995).

REFERENCES
Aron, L. (1996). A Meeting of Minds: Mutuality in Psychoanalysis. Hillsdale, NJ: The Analytic Press.
Aron, L. & Anderson, F.S. (eds.) (1998). Relational Perspectives on the Body. Hillsdale, NJ: The Analytic Press.
Bateman, A. and Fonagy, P. (2004). Psychotherapy for Borderline Personality Disorder: mentalization-based treatment. Oxford: Oxford University Press.
Beebe, B. & Lachmann, F.M. (1992). The Contribution of Mother-Infant Mutual Influence to the Origins of Self- and Object Representations. In Relational Perspectives in Psychoanalysis, N.J. Skolnick & S.C. Warshaw (eds.), 83-117. Hillsdale, NJ: The Analytic Press.
Beebe, B. & Lachmann, F.M. (2002). Infant Research and Adult Treatment: co-constructing interactions. Hillsdale, NJ: The Analytic Press.
Benjamin, J. (1988). The Bonds of Love: Psychoanalysis, Feminism and the Problem of Domination. New York: Pantheon.
________ (1992). Psychoanalysis as a Vocation. In Psychoanalytic Dialogues, 7 (6), 781-802. Hillsdale, NJ: The Analytic Press.
________ (1995). Recognition and Destruction: An Outline of Intersubjectivity. In Like Subjects, Love Objects: essays on recognition and sexual difference, 27-48. New Haven and London: Yale University Press.
Bion, W. (1984). Elements in Psycho-Analysis. London: Routledge.
Bollas, C. (1994). The Shadow of the Object: Psychoanalysis of the Unthought Known. London: Free Association Books.
Bowlby, J. (1969). Attachment and Loss, vol. 1: Attachment. London: Pimlico.
________ (1973). Attachment and Loss, vol. 2: Separation, Anger and Anxiety. London: Pimlico.
________ (1980). Attachment and Loss, vol. 3: Loss, Sadness and Depression. London: Pimlico.
Bromberg, P. M. (1998). Standing in the Spaces: Essays on Clinical Process, Trauma and Dissociation. Hillsdale, NJ: The Analytic Press.
Campbell, D. (1999). The Role of the Father in a Pre-Suicide State. In Psychoanalytic Understanding of Violence and Suicide, R.S. Perelberg (ed.), 75-86. London: Routledge.
Casement, P. (1990). On learning from the patient. London: Routledge.
Davies, J. M. & Frawley, M. G. (1994). Treating the Adult Survivor of Childhood Sexual Abuse. New York: Basic Books.
Davies, J. M. (2004). Reply to commentaries. In Psychoanalytic Dialogues, 14: 755-767. Hillsdale, NJ: The Analytic Press.
Eng, D.L. & Han, S. (2001). A Dialogue on Racial Melancholia. In Bringing the Plague: Toward a Postmodern Psychoanalysis, S. Fairfield, L. Layton & C. Stack (eds.), 269-278. New York: Other Press.
Fairbairn, W.R.D. (1943a). The Repression and Return of Bad Objects (with special reference to the “War Neuroses”). In Psychoanalytic Studies of the Personality, D.E. Scharff and E. Fairbairn Birtles (eds.). London: Routledge.
________ (1943b). The War Neuroses: Their Nature and Significance. In Psychoanalytic Studies of the Personality, D.E. Scharff and E. Fairbairn Birtles, (eds.). London: Routledge.
________ (1952). An Object Relations Theory of the Personality. New York: Basic Books.
Ferenczi, S. (1933). Confusion of tongues between adults and the child. In Final Contributions to the Problems and Methods of Psycho-Analysis, M. Balint, (ed.), E. Mosbacher, (trans.), 156-167. London: Karnac Books.
Fletchman Smith, B. (2000). Mental Slavery: Psychoanalytic Studies of Caribbean People. London: Rebus Press.
Fonagy, P., Target, M., Steele, M., Steele, H., Leigh, T., Kennedy, R., Matterson, G., et al. (1995). Attachment, the reflective self, and borderline states: the predictive specificity of the Adult Attachment Interview and pathological emotional development. In S. Goldberg, R. Muir & J. Kerr (eds.), Attachment theory: social, developmental and clinical perspectives, 223-279. Hillsdale, NJ: The Analytic Press.
Fonagy, P. (1999). The transgenerational transmission of holocaust trauma: Lessons learned from the analysis of an adolescent with obsessive-compulsive disorder. Attachment & Human Development, 1, (1): 92-114.
Fonagy, P. & Target, M. (1996). Playing with reality: I. Theory of mind and the normal development of psychic reality. International Journal of Psycho-Analysis, 77: 217-233.
________ (1999). Towards Understanding Violence: the use of the body and the role of the father. In Psychoanalytic Understanding of Violence and Suicide, R.S. Perelberg (ed.), 53-72. London: Routledge.
________ (2005). Bridging the transmission gap: An end to an important mystery of attachment research? In Attachment & Human Development, 7, (3): 333-343.
Frankel, J. (2002). Exploring Ferenczi’s Concept of Identification with the Aggressor: Its Role in Trauma, Everyday Life, and the Therapeutic Relationship. In Psychoanalytic Dialogues, 101-139.
________ (2006). Diagnosis-of-the-Moment and What Kind of Good Object the Patient Needs the Analyst to Be: Commentary on Paper by Neil Skolnick. In Psychoanalytic Dialogues, 16 (1): 29-37.
Freud, A. (1993). The ego and the mechanisms of defence. London: Karnac Books.
Freud, S. (1905). Fragment of an Analysis of a Case of Hysteria. Standard Edition, 7: 1-122.
________ (1917). Mourning and melancholia. Standard Edition, 14: 243-258.
Ghent, E. (1992). Process and Paradox. In Psychoanalytic Dialogues, 2 (4): 135-160. Hillsdale, NJ: The Analytic Press.
Grienenberger, J., Kelly, K. & Slade, A. (2005). Maternal reflective functioning, mother-infant affective communication, and infant attachment: Exploring the link between mental states and observed caregiving behaviour in the intergenerational transmission of attachment. In Attachment & Human Development, 7 (3): 299-311.
Hesse, E. & Main, M. (2000). Disorganized infant, child, and adult attachment: collapse in behavioural and attentional strategies. Journal of the American Psychoanalytic Association, 48, 1097-1127.
Holmes, J. (1999). Ghosts in the consulting room: An attachment perspective on intergenerational transmission. Attachment & Human Development, 1, (1): 115-131.
________ (2005). Notes On Mentalizing – Old Hat, Or New Wine? In British Journal of Psychotherapy, 22 (2): 179-197.
Joseph, B. (1989). Addiction to near-death. In Psychic Equilibrium and Psychic Change: Selected Papers of Betty Joseph, M. Feldman & E. Bott Spillius (eds.), 127-138.
Khan, M. (1979). Alienation in Perversions. London: Karnac Books.
Knox, J. (2001). Memories, fantasies, archetypes: an exploration of some connections between cognitive science and analytic science. In Journal of Analytic Psychology, 46 (4): 613-635.
________ (2003). Archetype, Attachment, Analysis: Jungian psychology and the emergent mind. Hove: Routledge.
Kraemer, S.B. (1996). Betwixt the Dark and the Daylight of Maternal Subjectivity: Meditations on the Threshold. In Psychoanalytic Dialogues, 6 (6): 765-791.
Krystal, H. (1988). Integration and Self Healing: Affect-trauma-alexithymia. Hillsdale, NJ: The Analytic Press.
Laing, R.D. & Esterson, A. (1964). Sanity, Madness and the Family. London:Tavistock.
Liotti, G. (1999). Understanding the Dissociative Processes: The Contribution of Attachment Theory. Psychoanalytic Inquiry, Vol. 9, No. 5, 757-783.
Litowitz, B.E. (2002). Sexuality and Textuality. In Journal of the American Psychoanalytic Association, 50 (1): 171-198.
Lyons-Ruth, K. (1991). Rapprochment or approchment: Mahler’s theory reconsidered from the vantage point of recent research on early attachment relationships. Psychoanalytic Psychology, 8: 1-23.
Lyons-Ruth, K. & Jacobvitz, D. (1999). Attachment disorganization: unresolved loss, relational violence and lapses in behavioural and attentional strategies. In Handbook of Attachment: Theory, research and clinical applications, J. Cassidy & P.R. Shaver (eds.), 520-554. New York: Guilford Press.
Mahler,M.S., Pine, F. and Bergman, A. (1985). The Psychological Birth of the Human Infant: Symbiosis and Individuation. London: Karnac Books.
Mann, D. (1997). The Psychotherapist’s Erotic Subjectivity: Transference and countertransference passions. In Psychotherapy: An Erotic Relationship. London: Routledge.
McDougall, J. (1989). Theatres of the body: A psychoanalytic approach to psychosomatic illness. London: Free Association Books.
________ (1990). Plea for a Measure of Insanity. London: Free Association Books.
Milgram, S. (1974). Obedience to Authority. London: Tavistock Publications.
Miller, A. (1991. Nicolae Ceausescu’s Vision of Redemption. In Breaking Down the Wall of Silence, 97-113. London: Virago Press.
Mills, J. (2003). A phenomenology of becoming. In Understanding Experience: Psychotherapy and Postmodernism, R. Frie (ed.), 116-136. London: Routledge.
Mitchell, S.A. (1993). Hope and Dread in Psychoanalysis. New York: Basic Books.
________ (1997). Influence and Autonomy in Psychoanalysis. Hillsdale, NJ: The Analytic Press.
________ (1996). Gender and Sexual Orientation in the Age of Postmodernism: The Plight of the Perplexed Clinician. In Influence and Autonomy in Psychoanalysis. Hillsdale NJ: The Analytic Press.
________ (2000). Relationality: From Attachment to Intersubjectivity. Hillsdale NJ: The Analytic Press.
Orange, D.M. (1995). Emotional Understanding: Studies in Psychoanalytic Epistemology. New York: The Guilford Press.
Orbach, S. (1995). Countertransference and the false body. In Winnicott Studies 10. London: Karnac.
________ (1999). The Impossibility of Sex. Harmondsworth: Allen Lane.
________ (2004). The John Bowlby Memorial Lecture 2003: The body in clinical practice. In Touch: Attachment and the Body, K. White (ed.). London: Karnac.
Peck, S.D. (2003). Measuring sensitivity moment-by-moment: A microanalytic look at the transmission of affect. In Attachment & Human Development, 5 (1): 38-63.
Renn, P. (2003). The link between childhood trauma and later violent offending: the application of attachment theory in a probation setting. In A Matter of Security: The Application of Attachment Theory to Forensic Psychiatry and Psychotherapy, F. Pfaefflin and G. Adshead (eds.). London: Jessica Kingsley Publishers.
________ (2006). Attachment, trauma and violence: understanding destructiveness from an attachment theory perspective. In Aggression and Destructiveness: Psychoanalytic Perspectives, C. Harding (ed.). Hove: Routledge.
________ (2007). Stop Thief! But What Has Been Stolen and By Whom? Discussion of Paper by John Bowlby. Attachment: New Directions in Psychotherapy and Relational Psychoanalysis, Vol. 1, No. 1, 71-77.
Schacter, D.L. (1996). Searching for Memory: the brain, the mind, and the past. New York: Basic Books.
Schore, A. (1991). Early superego development: the emergence of shame and narcissistic affect regulation in the practicing period. In Psychoanalysis and Contemporary Thought, 14: 187-250.
________ (1994). Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development. Hillsdale, NJ: Lawrence Earlbaum.
________ (2001). The Effects of Early Relational Trauma on Right Brain Development, Affect Regulation and Infant Mental Health. In Infant Mental Health, 22: 201-269.
Searles, H. (1993). The Effort to Drive the Other Person Crazy: An Element in the Aetiology and Psychotherapy of Schizophrenia. In Collected Papers on Schizophrenia and Related Subjects. London: Maresfield Library.
Slade, A. (2005). Parental reflective functioning: An introduction. In Attachment & Human Development, 7, (3): 269-281.
Solomon, J., George, C. & De Jong, A. (1995). Children classified as controlling at age six: Evidence of disorganized representational strategies and aggression at home and at school. Development and Psychopathology, 7, 447-463.
Stern, D. (1985). The Interpersonal World of the Infant: a view from psychoanalysis and developmental psychology. New York: Basic Books.
Stoller, R.J. (1986). Perversion: The Erotic Form of Hatred. London: Karnac Books.
Stubrin, J.P. (1994). Sexualities and Homosexualities. E. Reneboldi (trans.). London: Karnac Books.
Sullivan, H.S. (1953). The Interpersonal Theory of Psychiatry. New York: W.W. Norton.
________ (1962). Schizophrenia as a Human Process. New York: W.W. Norton.
van der Kolk, B.A. (1989). The Compulsion to Repeat the Trauma: Re-enactment, Revictimization, and Masochism. Psychiatric Clinics of North America, 2, 389-411.
________ (1994). The body keeps the score: Memory and the evolving psychobiology of post-traumatic stress. Harvard Review of Psychiatry, 1, 253-265.
Winnicott, D.W. (1947). Hate in the countertransference. In Collected Papers in Psychoanalysis. New York: Basic Books.
________ (1958). The capacity to be alone. International Journal of Psycho-Analysis, 39: 416-420.
________ (1960). Ego Distortion in Terms of True and False Self. In Maturational Processes and the Facilitating Environment: Studies in the Theory of Emotional Development. London: Hogarth Press.
________ (1967). Mirror-role of the mother and family in child development. In The predicament of the family: A psycho-analytical symposium, P. Lomas (ed.), 26-33. London: Hogarth Press.
________ (1971). Playing and Reality. London: Tavistock.
________ (1974). Fear of Breakdown. In The British School of Psychoanalysis, G. Kohon (ed.), 173-182. London: Free Association Books.
________ (1987). The Spontaneous Gesture: Selected Letters of D.W. Winnicott. F.R. Rodman (ed.). Cambridge, Massachusetts and London: Harvard University Press.

Counselling Directory is not responsible for the articles published by members. The views expressed are those of the member who wrote the article.

Share this article with a friend

Written by Paul Renn

I am a relational psychoanalytic psychotherapist and author in private practice in central and south west London (see below in 'Extra Information' for details of my practice addresses). I am accredited by the United Kingdom Council for Psychotherapy (UKCP). I work with individuals, offer couples counselling and also supervise counsellors and psychotherapists. I also work as a life coach.… Read more

Written by Paul Renn

Find the right counsellor or therapist for you

All therapists are verified professionals.