Lung transplantation is a complex psychodynamic process. In a prior study, the authors investigated 40 patients who had just undergone lung transplant operations. Using the analysis of a dream, they elaborated what they termed the "transplantation complex". They also demonstrated that references are made to this transplantation complex in the further interviews of the total sample. In this paper, they examine whether aspects of the transplantation complex in the philosopher Jean-Luc Nancy's essay "The Intruder", in which he described his own heart transplant operation, can also be found in the eponymous work by the filmmaker Claire Denis. In fact, the themes of the transplantation complex appear both in Nancy's essay and in Claire Denis's film (such as fantasies that the donor is killed, that the recipient's body is broken open and that the organs or the donor are devoured). The article closes with some explanations concerning Nancy's "body ontology".

Pregnancy and early motherhood are periods of great psychic demands, in part, due to the various physical changes the mother faces. Women may have a wide range of experiences during this time due to various factors: their early childhood, internal objects, current relationships and environment, as well as their physical state. This paper will explore the experiences of three women, who before starting analysis, had suffered extreme and prolonged physical difficulties in their first pregnancies or post-partum periods, which gave rise to claustrophobic panic and feelings of disintegration. Once in analysis, the three women each went on to have a second baby. Each mother navigated her second pregnancy through a complex process of disavowal of her unborn baby, which I have termed 'creative disavowal' as it allowed an intermediate area which protected them and their baby from the violent bodily experiences, primitive anxieties, and hatred that they felt, as well as opened space for more passionate feelings to unfold and take shape. The analytic work in each case involved giving meaning to the mother's somatic experiences, and containing her intense hostile and primitive unconscious phantasies, whilst also creating space for the psychological or imagined baby to be born and held.

The early Freud recognised a wide range of defences. Between 1894 and 1926, the only defence is repression. Breuer differentiates between and . The former concerns the structure while the latter concerns the psychic content. Freud went on make dissociation coincide with repression by giving importance only to the splitting of consciousness, while for Breuer hysteria is founded on "splitting of the psyche." In 1926 he proposed an enlargement of the field of defences in addition to repression with the recognition of particular defences in phobias and obsessions. This broadening retrieves Janet's concept of dissociation as 'loss of the capacity for synthesis,' which for the early Freud and Breuer occurred in hypnoid states and in the suspension of associative capacities. Contemporary psychoanalysis takes up Freud's initial concept of defences. It retrieves the concept of dissociation considered both as repression and as the inability to integrate experience caused by blocking the fluid dissociative dynamic between multiple states of the Self. Using clinical examples it is therefore proposed that the analytic process simultaneously includes positions of repression as well as positions of dissociation considered as suspension of the patient's and analyst's integrative capacities. Repression concerns the avoidance of conflict, while dissociation suspends the process of access to conflict.

The discussion about the nature of what is achieved in the analytical process gained a significant contribution with Ogden's proposal, which characterises two modi operandi of the psychoanalytic treatment method (one that seeks understanding, and the other that seeks experiences so that the self may integrate and become more profoundly itself). However, he did not focus on describing the different types of experiences of the self, achievable within the analytical process. This article aims to partially fill this gap by drawing on Winnicott's work, associating experiences of Being with the way he conceives of object relations in the context of the analyst-patient relationship, differentiating and characterising the following experiences: am-ness, when the analyst acts as a subjective object for the patient; am-with, when patient and analyst share transitional phenomena; I-am-different-from and I-am-predicated-on, when the analyst is understood as an external object; and I-am-finite, as an experience, perceived or apperceived, by the self in relation to itself, the other, and the world over time. This understanding can broaden the comprehension of the various ways of experiencing and managing transference within the analytical process.

In the spirit of Loewald's synthesis of psychoanalysis and the entwined, temporal-spatial dimensions of being-in-the-world, this paper will explore our historical moment at the cusp of a precarious future. Indeed, we are at the cusp of a great battle for ownership of the future. Building on my previous work, "Falling out of the world", here we will explore existential dislocation, the uncanny, the loss of our taken-for-granted, everyday world - and the longing to find our way back home.

In this paper I explore the issue of time in Freud's writings from different points of view: his linking of time with consciousness, the supposed timelessness of the unconscious, the return of the repressed, the dialectical approach to time in his concepts of bi-temporality and afterwardness, the notion of "transience", and time as a "feeler". I will argue that there is no uniformity in Freud's conception of time, which leaves space for "heterochronicity" and different representations of temporal experience.

This paper is about sexual perversion and its enactment. It is divided into three parts, including, a consideration of William Gillespie's reading of Freud with Klein as the basis on which he formulated a general theory of perversion; a selective reading of more recent works on the psychoanalysis of perversion; and a clinical contribution to the analysis of a case of scopophilia.

Building on the centrality of the Narcissus myth and its cultural and psychological implications, the notion of primary narcissism is discussed against the backdrop of neurobehavioural research on the development of the Self. While the concept of primary narcissism emphasises egocentrism, contemporary research suggests a different understanding of the early stages of self-experience. As Freud anticipated, there is a continuum between pre- and post-natal life: early social connections and relationships, beginning in the womb, shape the developing self. This continuum invites the investigation of foetal life to understand the development of a coherent pattern of relationships with the world. The active engagement of foetuses and infants with the outside world is the of the stages that enable them to live in the world. The quality of postnatal mother-infant relationships and their co-regulation originate in the womb. This suggestion about foetal social life can be seen in part as a development of some of the original insights of psychoanalysis. While emphasizing the importance of narcissism in understanding the Self and its relationship to society, a broader perspective on the early constitutive elements of the Self is needed.

In this paper I describe how a vertical relationship of mutual grievance is commonly set up when the idealised horizontal relationship between infant and mother collapses. Mourning is interrupted if the lost object is internalised as a critical superego making the patient feel inferior and humiliated. He attempts then to turn the tables on the object in a response of manic triumph which creates the vertical, "up or down" world. This pattern is examined in clinical material which seemed to show progress even though the grievances were deeply entrenched. The reasons for the softening of his resentment were examined and the role of the vertical as well as other obstacles to mourning were reviewed.

In this article the author looks at the psychotherapeutic treatment of a patient imprisoned for acts of domestic violence. She describes how the inversion of the drive coordinates (in this case, hypercathecting thrust to the detriment of the aim, which is normally to reduce tension) can herald a surge in mastery, which is then difficult to contain within the ramparts of the therapeutic setting. The sensory dimension at work in the transference is mobilized to illustrate how withstanding mastery can perceptually serve to rehabilitate the aim to the detriment of the thrust. This reorganization of the drive coordinates serves to lower tension against the backdrop of a struggle against the loss of an object whose contours are already very precarious. While violent acting out may indeed be seen as a failure of symbolization, therapeutic work in prison seems to maintain in this restricted space the hallucinatory trace of the lost/found object in the transference. Capturing the object would illusorily circumscribe the risk, but it is precisely through the handling of the meaning and strength of the transference that the patient can be enabled to let go, thereby freeing the lost object, or rather its ghost, in favour of the experience of loss.

The following text addresses atypical eating, building upon previously discussed ideas and enhanced with clinical observations from the analytical process of a young man. Currently twenty years old, he was referred at sixteen by the paediatrician who had delivered him and continued to care for him, and was suspecting "anorexia." The term is within inverted commas as it was not conclusively diagnosed by the doctor or the author of this text. The patient's limited food intake was part of a broader picture of cessation in emotional development. The author proposes significant differences in the primitive relational trajectory at the origins of atypical eating habits of both men and women. Viewing these habits as communications of previously compromised mental states rather than an isolated "disease," the author emphasises the importance of the transferential relationship as a general guiding thread in analytical processes, particularly as a sine qua non condition for augmenting the possibility of favourable evolution of these generally severe and challenging patients. This clinical case thus highlights the analytical relationship as the main modifying factor in Fred's life. The analysis continues uninterrupted, with three sessions per week, during the pandemic online, and again in-person as soon as it was possible to return to the office.

Race, including racism, racial trauma, and racial anxieties, remains contentious for psychoanalysts to consider as a psychic phenomenon. Unlike aggression and sexuality, racism is held in silence and resistance, inhibiting exploration of this aspect of mind. This paper describes how we become raced by exploring the transgenerational transmission of racial trauma, writ large, and its intrapsychic, structuralizing components. By examining how and where the analyst locates themselves racially and working through our resistance and countertransference to this type of exploration, this paper invites us to include these aspects of mind for our analytic use. Using examples from the creative arts and clinical vignettes to demonstrate how being raced is embodied and symbolized in mind as a universal phenomenon opens a therapeutic aperture for clinicians who may benefit from a psychoanalytic, intrapsychic perspective on this aspect of our shared humanity.

The difficulties involved in ending treatment are complex and can present a set of challenges and possibilities for both analyst and patient. When early trauma is part of the clinical picture, ending treatment may very well stir an experience of an earlier attachment rupture or loss. The author presents a case of a long-term analytic patient where an acute enactment crisis occurred causing a pause in ending the treatment. It is proposed that these very 'ending enactments' become necessary, crucially disrupting a bastion (Baranger & Baranger, 2009) formed by the dyad. This tearing/ending of the analytic frame (Bleger, 1967) may, catalyze a 'second look' which revealed a more chronic enactment. Ultimately more deeply buried pieces of the early relational trauma became accessible to the analytic process. The author argues that sometimes this very upheaval is needed to unblock a bastion. Thus, what was sequestered, and unknowable may enter the dyad as an enactment. In this way, insight, and the self-reflectiveness it entails, may occur post-enactment.

The essay delineates a psychic phenomenon of incapacity to remain alive, as depicted in Jean-Charles Fitoussi's movie (2002). The film introduces a provocative thought experiment, illustrating the life of a man who vanishes every other day, only to reappear at precisely the same location twenty-four hours later. The author contends that this narrative serves as a poignant manifestation of the inability to metabolize emotions, thoughts, and memories, leading to their continual evacuation and ultimate loss. The recurrent disappearance of the protagonist diminishes his ability to feel alive, even upon his reentry into the world. This fragile psyche undergoes a potential transformation when the man falls in love, giving rise to the hope that the relationship with another human being may facilitate the integration of both the represented and unrepresented parts of his mind. An analysis of connects the cinematographic structure and the narrative plot to illustrate unrepresented states of severely damaged minds, which are under constant threat of dissolution.

The notion of stability is present in Freud's work. However, the libido theory model limited its use. Kleinian authors have explored this theme in more depth, describing the risks of the loss of ego stability or defensive systems protecting against chaos and mental turbulence. Dynamic systems theory has interested several psychoanalysts since the 1990s, as it seemed to offer a non-deterministic and non-linear model of the human mind. For some, it has a heuristic value as a metaphor for mental functioning; for others it offers the hope of a real formal modelling of metapsychological theories. The author focuses his attention on the forms of stability described in this theory: simple, periodic and structural. He puts forward the hypothesis of transitions from one type of stability to another in the psychoanalytic process, allowing access to the structural stability of representations that retain self-similarity. The analytic situation must offer an open dynamic system between two poles, maternal and paternal, which constitute the strange attractor necessary for the transition from a form of archaic stability to structural stability. Extracts from a child psychoanalysis are used by way of illustration.

Stereotypies currently occupy an important place in the clinical profile of (ASD). Since they are usually described with the notions of , or , it would seem as if were repeated, and could change. In this context, the following question arises: What is it that is repeated in stereotypical repetition? To answer this question, one must turn to clinical vignettes of patients diagnosed with ASD and to the concept of stemming from two different epistemic fields (psychiatry and fractal geometry). Firstly, it is suggested that what is repeated in stereotypies, in particular, is the , since the elements that are unconnected to it change or may change. Secondly, specifically in the context of autism, it is suggested that what is repeated in a stereotypy is .

In this paper I want to trace the complex relationship between grievance and revenge. Both are expressions of the rage that arises in response to feelings of injustice and humiliation, but they differ in the direction that the rage is expressed. In revenge it is outwardly directed, usually as a violent attack, while in grievance the violence is inhibited and the rage is held inwardly in a state of withdrawal. I will use characters and episodes from Richard Holmes' life of Coleridge and from Homer's Iliad to explore this theme, especially with respect to Achilles, whose rage is the chief subject of the Iliad. It is initially expressed as a withdrawal into grievance and subsequently as an active rampage of violent revenge. I will look at the consequences of these different forms of expression of anger and also try to explore what factors enabled the direction of his rage to be so dramatically reversed.

Marie Langer (1910-1987) has been recognised as a key psychoanalyst in the development of Argentine and Latin American psychoanalysis. However, in contrast to the many works devoted to exploring her life trajectory or the varied research on her contribution to institutional or theoretical psychoanalytic discussion, studies on her connection with science fiction (SF) have been anecdotal. Since the mid-fifties, Langer found SF to be a source of theoretical-clinical reflection on psychoanalysis, and a field in which to exercise her creativity by writing SF stories. This article proposes an analysis of Marie Langer's relationship with the SF of her time through an exhaustive review of the literature on this subject. On the one hand, it analyses the interdisciplinary reflections that she established between psychoanalysis and SF, in which she exposed theoretical, clinical, and sociological problems; on the other hand, it examines the literary production of SF that Langer developed in her short stories. This review concluded that her work on SF bears the same hallmark that guided her clinical and institutional relationship with Psychoanalysis: a desire for change.