Posted by Dr. Vollmer on November 13, 2014
Stephen Mitchell, http://en.wikipedia.org/wiki/Stephen_A._Mitchell_(psychologist), says that “clinical psychoanalysis is fundamentally about people and their difficulties in living, about a relationship that is committed to deeper self-understanding, a richer sense of personal meeting, and a greater degree of freedom.”
There is no mention of diagnoses, or psychopathology, but rather his emphasis is on the universal need to grow and develop as a human being. To leave one’s idiom, as Christopher Bollas says, http://en.wikipedia.org/wiki/Christopher_Bollas.
“In Being a Character, Bollas also argued that everybody had their own idiom for life—a blend between the psychic organisation which from birth forms the self’s core, and the implied logic of the familial way of relating into which we are then raised.[8)
As adults, Bollas considered we spend our time looking for objects of interest—human or material—which can serve to enhance our particular idioms or styles of life—perpetually “meeting idiom needs by securing evocatively nourishing objects”. Being willing to risk exposure to such transformational objects was for Bollas an essential part of a healthy life: the readiness to be metamorphosed by one’s interaction with the object world.
The contrast was a refusal of development and self-invention, of open-endedness: the state of psychic stagnation. Bollas saw in what he called the anti-narcissist a willed refusal to use objects for the development of his/her own idiom, and a consequent foreclosure of the true self. The result can lead to what Adam Phillips called “the core catastrophe in many of Bollas’s powerful clinical vignettes…being trapped in someone else’s (usually the parents’) dream or view of the world”.
Miley, once again, comes to mind, as the anti-narcissist described above. She does not seek out new relationships, resulting, as Dr. Bollas says, in a “foreclosure of the true self.” Miley’s “depression” as some might call it, is more deeply thought about in terms of inhibitions in the ego, resulting from deep fear of guilt, which in turn, cause loneliness and despair. It is not that medication cannot help Miley, because antidepressants do give her relief from her tense emotional state, but they do not give her permission to pull back from taking care of her parents, and allow herself personal growth through new, meaningful relationships. The guilt that Miley feels serves to inhibit her from pushing out from underneath her unconscious constriction. Miley, by her report, has difficulties in living, which through our relationship which is committed to looking at the underlying dynamics of her suffering, she and I can come to an understanding of her inhibitions and thereby allow herself to make more choices, and thereby give her a greater sense of personal freedom. Freud said that the libido was working so hard in repressing unconscious thoughts, in Miley’s case of her unconscious guilt for not devoting her life to her parents, that there was no room, no broadband, left for her libido to exert its power towards feeling desire and love. Psychotherapy, Freud would say, involves working at lifting the repression, so that the libido is free to expand outwards. Miley’s issue with “psychic stagnation” seems a much more fitting description than “Major Depression”.