Abusive Relations and Traumatic Development: Marginal Notes on a Clinical Case

Abstract

This work offers a re-reading of the concept of repetition compulsion in relation to clinical work with patients who were severely traumatized at an early age. Going beyond the limit of the classical concept, which connects repetition compulsion to the death instinct, the function of traumatophilia is enlivened through the hypothesis that the automatisms of repetition may be the expression of the vital core of the Self, in search of the “transformational object.”

By presenting the detailed clinical case of Greta (a severely dissociated patient), the article seeks to show how the vicissitudes of the transformational object are played out in the transference-countertransference relationship, and how they come to life in the field through the creation of characters who are continually generated and transformed in the patient's and analyst's rêveries.

Keywords:

• Dissociation
• traumatophilia
• repetition compulsion
• transformational object

This article is referred to by:

Unlaid Ghosts: A Discussion Of Maria Grazia Oldoini's “Abusive Relations and Traumatic Development: Marginal Notes on a Clinical Case”

Rendering the Repetition: Discussion of “Abusive Relations and Traumatic Development: Marginal Notes on a Clinical Case” by Maria Grazia Oldoini

Response to Commentaries on “Abusive Relations and Traumatic Development: Marginal Notes on a Clinical Case”

Notes

1 Bion highlighted a peculiar misprint in the first edition of Inhibitions, Symptoms and Anxiety, where the well-known Freudian statement would sound as follows: “There is much more continuity between intra-uterine life and earliest infancy than the impressive caesura (censure) of the act of birth would have us believe” (Freud 1926, p. 138). Bion pointed out how curious it was “that this term, ‘caesura’, was misprinted in the original paper by Freud as ‘censure’, so that it was even then – accidentally of course – unconsciously described as a censor, an inhibition” (Bion 1976, p. 121).

2 If on the one hand there is a kind of “necessary” trauma, caused by the analytic device that helps gather together transference phenomena and thus opens the way to the symbolization of trauma in the transference, on the other hand there can be a trauma/setback, due to misunderstandings, lack of unison, and more generally to all those situations when the analyst's response doesn't meet the patient's needs in the here and now.

Hence the difficulty of the analyst, who has to maintain an uncomfortable position which involves being transformed into a traumatic object by the vicissitudes of the analytic field, while at the same time having to protect the patient from the “unnecessary” trauma and remaining attuned to the emotional temperature of the relationship. All this implies that the analyst must monitor the patient's reactions moment by moment, calibrating his interventions according to the patient's capacity to accept them as they come. With the expression “trauma/setback” I am referring to the transference that takes place with seriously ill patients, about which Winnicott (1955-1956, p. 298) wrote: “. . .it is at this point in my work that I found myself surprised. The patient makes use of the analyst's failures. Failures there must be, and indeed there is no attempt to give perfect adaptation; I would say that it is less harmful to make mistakes with these patients than with neurotic patients. . . . The clue is that the analyst's failure is being used and must be treated as a past failure” (italics in the original).

3 If classical theory essentially allowed us to think of the existence of “repetitions of death” (one need only think of the close connection between repetition compulsion and death drive, as postulated by Freud), we might think of the existence of “repetitions of life,” which can be used for therapeutic purposes in the clinical work.

4 Furthermore, the limited mental, affective and cognitive capacity of the patient's container for a long time prevents him from accepting within himself objects which are too saturated, too “good.”

5 “At the centre of each person is an incommunicado element, and this is sacred and most worthy of preservation. Ignoring for the moment the still earlier and shattering experiences of failure of the environment-mother, I would say that the traumatic experiences that lead to the organization of primitive defences belong to the threat to the isolated core, the threat of its being found, altered, communicated with. The defence consists in a further hiding of the secret self, even in the extreme to its projection and to its endless dissemination” (Winnicott 1963, p. 187).

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Notes on contributors

Maria Grazia Oldoini

Maria Grazia Oldoini is a psychiatrist, psychoanalyst, and a full member of the SPI and IPA. She has published articles in psychoanalytic journals, with particular reference to the clinic and treatment of serious pathologies. She has played training roles for mental health workers, for the Faculty of Educational Science and in institutional context. She was a speaker at the 49th IPA Congress, Boston 2015, and in other national and international conference. She is the author of Fearful Symmetry: Spaventose simmetrie. Psicoanalisi e stati primitivi – creativi della mente, 2018, ed. Celid. She currently works in private practice as a psychoanalyst.