45TH IPA CONGRESS, BERLIN 2007
REMEMBERING, REPEATING & WORKING THROUGH IN PSYCHOANALYTIC FAMILY THERAPY
Nicolo, Anna Maria, Italy, (Presenting); Losso, Roberto and Ana P., Argentina, (Presenting); Scharff, Jill, U.S.A., (Presenting); Scharff, David, U.S.A.; Puget, Janine, Argentina, (discussant)
Abstract:
This panel offers three presentations on the theme of intergenerational transmission of trauma and psychopathology in families, and of the role of psychoanalytic family treatment in replacing repetition with remembering, through processes of working through. The first presentation, “Repeating and remembering in psychotic and perverse families,” describes how analytical work in a family setting shows the difference between individual remembering and remembering as a collective shared reconstruction. It describes the way many mechanisms structure family memory, beginning with family rites and myths. Daily family interaction and shared relational functioning also embody ways of acting instead of remembering, establishing primitive aspects of family mental functioning. The presentation illustrates how, in families with seriously ill members, enlarging a font of family history helps reconstruct voids in members’ selves through work on the breakdown of symbolization that characterizes psychotic or perverse functioning. As family history is reconstructed in therapy, its connection with each individual leads to increased capacity for articulating individual history. The second presentation, “Transgenerational repeating, transgenerational working through, and shared family unconscious working through of fantasy,” extends the Freudian concept of repetition compulsion, introducing the concept of transgenerational repetition: Repetition is produced through generations, constituting transmission-repetition. Such transgenerational transmission (which the authors’ term “trophic transmission”) is necessary for development of the psychic apparatus, and understanding its role allows us to institute a process of transmission working through. The presentation compares the concepts of intrapsychic working through, intersubjective, intergenerational and transgenerational working through, describes obstacles to this in “dysfunctional” families, and introduces the concept of shared family unconscious working through of fantasy. A clinical case illustrates how exploring the fantasy that a real death and the concrete presence of a corpse would “permit” the working through of mourning the family had not been able to work through for three generations. Finally, a fifteen minute video of analytic family treatment presents excerpts from therapy of a family seeking treatment for an adolescent’s school phobia. Family treatment revealed that her phobic anxiety was a condensation of her mother’s history of childhood incest, and of the family’s patterned attempts to prevent repetitions of this history, leading to unconscious transmission of severe anxiety to the next generation. The video demonstrates how family symptomatology represents the family’s pattern of repeating instead of remembering. It then shows working through: Interpreting family transference resistance facilitates replacing repetitive patterns of defense against sexual trauma in previous generation, thereby enlarging family capacity for mentalization and growth of narrative memory.
DISCUSSION
Janine Puget
. - Theories and frame of reference
We will discuss several papers related with family therapy which enables us to take into account similarities and differences between each paper. But also their approach and intervention are different.
The three are all related to secrecy, to the unspoken in the childhood of one of the family members, or in the cases of Lossos, we will have to add the specific question of the mourning of a desaparecido since they never admit the possibility of his death.
All the papers presented have to deal with death, one because of suicide and suicide attempt, in the other, it has been the suicide of a brother and also of a cousin, and in the third one because of the future possible death of one of the family members and the suicide of one of the family members. In addition to that, in two presentations, the effect in the current ongoing family relationship of child abuse, as an unspoken event, is significant.
I think the three presentations are based on the trauma theory and the working through theory and that is coherent with putting their history center stage. That is how Freud began when he built his psychoanalytical theory.
. – It is interesting to quote this kind of similarity, that is, the importance of one event in the childhood of one of the members of the family organization. This is, without any doubt, related to the idea of determinism as an important factor of conflict in the family structure. Also, of course, it is in accordance with the importance of unconscious transgenerational transmission. And I would add that it concerns the pathology of the family organized in such a way that one of the members could be used as a scapegoat.
I will propose that this is based on a frame of reference in which determinism is fundamental. But, in my opinion, this could be a kind of distortion we acquired from individual psychoanalysis. Let me clarify what I mean. When we are looking for an event which will determine and explain the present, maybe this will be an obstacle to finding out what is going on today. And also this would suggest that we imagine that a family is the sum of one and one and one subject. That is they constitute a homogenous whole.
What I would ask myself is if this is sufficient to explain what is going on in the family and if this could explain the complexity of what I call the interchange from which the specific subjectivity of a specific family arises. I will explain what I mean
It may be possible to combine this model with another one. Let’s imagine a family as the result of what is happening now. And this will enable them to build places in accordance with what a family needs to be a family. This will happen if it is possible to take into account the other and its otherness. This will involve a person speaking and accepting that he/she will be listened to by an other, to accept that between each member of a family or group, there will always be something which is unspoken, and to also accept that complementary interchange always reduces the effect of otherness. In this way we could focus our attention both on free association, which links the past with the current scapegoat, and also to look for the effect of the hazardous connection between each family member. The consequence of the latter will be a suppressive issue and the generation of new production.
The scapegoat
The Lossos’ have in mind that one of the participants of the family is a kind of representative of the illness of the family, the depositary of this illness, of the mourning not yet terminated. This is more or less what many years ago Pichon Rivière introduces when he spoke of the psychodynamic of a group. In this case it was the little girl, Cristina who was at risk. She had difficulty in breathing. The question was how to introduce air into this family, air to be able to interchange, to accept the other and more than that, to listen to what is said?
In Anna N’s case it was one of the family members, a girl, as she was representative of her mother who had been abused in her childhood.
A possible clinical path has been to go within the family story since both, husband and wife, has had their own story concerning death and people who disappeared.
In Sharffs’ case it is not so obvious. In a way the father illness, at a certain moment, could act as a scapegoat.
Mourning elaboration
In the three cases, the evolution of the families has been based on the possibility of speaking of the unspoken, but there are differences between each approach and I will attempt to highlight these differences. However what they do have in common is related to the importance of the elaboration of a traumatic situation and, of course, this has something to do with intergenerational transmission.
The Lossos describe two periods in the evolution of this family: one very risky, which involves the possibility of the death of one of the family members, and the other period they describe as boring, as the representation of a specific period of mourning and as Eduardo said to summarize: “its better not to talk”. This could also be a way to express the lack of interchange between them, and the representation of this specific mourning so well described by Pelento and Braun in Argentina. It is mourning without a body, a mourning without an end and, that is why the therapist said that “nothing was happening”.
The therapist has in mind that the working through of a mourning, which comes from an other generation, will originate a new movement in the family, which could be a family which is frozen and now begin to thaw out.
In David and Jill’s paper, in my opinion, one of the problems is to discover how the body illness of one of the family members is registered or not registered within a family, and what kind of new mechanisms are aroused. It is striking to observe that one of the major difficulties is to accept something unacceptable: the present illness of the father. In consequence, this destabilizes each member of the family from a kind of stable position and family organization. They try to keep this stable position in order to avoid death anxiety and all what that means.
But that is why as always happen in our clinical experience, the presentation has been oriented to illustrate how, in families with seriously ill members, enlarging a font of the family history helps reconstruct voids in members’ selves through work on the breakdown of symbolization that characterizes psychotic or perverse functioning. As family history is reconstructed in therapy, its connection with each individual leads to increased capacity for articulating individual history. That is what David and Jill proposed.
And that is why instead of looking for the comprehension of this present situation, they focus their attention toward the discovery of the unspoken and secrets and the family therapy enabled the mother to speak of this unspoken or to put into words what has been repressed or denied.
Transmission
This is linked with the vicissitudes of the interesting theory of transmission and enables us to observe how the unspoken is discovered when the extreme situation they had to face rises to the surface.
It seems that in Sharffs’ material, the sick body of Nate generated the possibility of remembering and putting into words an event which has been repressed and suffered by Nancy during her childhood. Maybe this happens because it permits her to transport himself into her past and, also, because the present has some similarity with this abuse. This would explain some of the functioning of this family as well as the difficulty in accepting Nate’s illness. Maybe I could suggest that this has been a diversion of the anxiety caused by the present situation to a past event of one of the family members.
Anyhow, to speak of how Nate feels is not easy because he says the way he looks is not how it used to be. For example, he appears unshaved. And unshaved means at that moment to be ill, to have a skin problem and, therefore, not being authorized to shave.
To admit
They mention quite often the word “admit”. It is, of course, difficult to admit that the prognosis is uncertain. Undoubtedly, uncertainty is part of life but in some circumstances it is unbearable since it is associated with death. They don’t know the signals which indicate what will happen, what is unexpected and, when they will have look for a hospital…That is why Nate says that he cannot accept “that nothing could be done about it”.
What does admit mean in this context? Maybe that is what they are expecting to find out in the therapy. They will have to accept, to find a space in their mind, to incorporate this new event, or as David S. said, to share views of what this illness is really like. And for this process the figure of abuse is a good one.
I imagine that a relationship, in any context, requires that each subject accept the otherness and the alienness of each one. This imposes a constant diversity of signification. And that is why, when this is not possible because it’s not tolerated, people try to annihilate what is different in order to avoid being disturbed, in other words, they avoid being invaded by what overwhelmed their capacity to tolerate.
In the three cases we are discussing today, something of this kind, I mean of the difficulty to accept what exceeds the capacity to absorbs the otherness, is present.
And Nate as well as Nancy as well as the children intend to avoid this disturbing otherness: that is the illness and also the sadness of each one. That is why, for example, Nate complains that Nancy gets upset about it and Nate tries to talk her out of it.
I will link the difficulty to admit with abuse and, in consequence, I would like to analyze the multiple signification of abuse. Abuse could also signify as well the imposition of the father’s body, the sexual abuse in the childhood of Nancy, the abuse of power exercised by Nancy in regard to the contact allowed by her consciously or unconsciously with their children.
In the Lossos’ case, abuse is also social violence, which leads to the constitution of disappearance (desaparecido) and the suicide and suicide attempt of the mother and grand father.
In Anna’s case it could be what caused the helplessness of a child, and probably the suicide of two family members could have something to do with helplessness and the abuse of power.
So what is it that is impossible to put into words? We have several examples. In Sharffs case, it could be to speak of death and the father’s death because it’s too cruel, and in consequence, it has been transferred to the past, to remembering an event and a past experience. In Anna’s case, it seems that each member of the family has been the depositary of one fragment of the history of the father or the mother. In Lossos’case, it is difficult to speak of disappearance and also of suicide since it is too recent.