From dissociation to reverie: A theoretical and clinical model of dissociation.

摘要

In this study, I draw from psychoanalytic theory, published case studies, and clinical material of my own (disguised to protect patient confidentiality) to develop a theoretical and clinical model of dissociation. The central thesis of this study is that dissociation can be attributed to failures in the dialectical processes that constitute the subject as a creative, desiring agent who dwells within the psychic "spaces" of self-reflective awareness and symbolic thought.; In Part I of this study, I examine Winnicott's theory of the maturational processes of infancy in order to elaborate a conception of the subject as being constituted in dialectical interchange with an "other." In Part II, I draw upon examples from literature and film (including T. S. Eliot's poem, "The Love Song of J. Alfred Prufrock," and Woody Allen's film, The Purple Rose of Cairo) to present a contextual analysis of dissociative phenomena. I then present my own theoretical model of dissociation, and define how the operation of dissociative defenses, adopted by the (deconstituted) subject to guard against "unthinkable" anxieties, can be thought to result in the collapsing of the psychic "spaces" of self reflective awareness and symbolic thought. I further consider in Part II the question of how trauma may disrupt the semiotic processes which sustain these "spaces," such that the (deconstituted) subject's capacity to generate meaning is diminished.; In Part III, I focus on the clinical implications of the new model of dissociation presented in this study. Here I develop the hypotheses that (i) within the framed "space" of the psychoanalytic setting, the analyst's capacity for reverie provides a means of access to the patient's dissociated (non)experience; and (ii) the analyst, through "holding" and "handling" the "unthought" elements of this (non)experience in such a way as to effect its transformation, through metaphor, into symbolic forms which can be shared, facilitates the patient's integration of hitherto "unlived" (non) experience. The patient's participation in the process of patient's discovering and symbolizing the latent meanings of this (non)experience in relation to an "other," I suggest, fosters the "healing" of the patient's hitherto "unthought wounds," and restores access to the "spaces" of self-reflective awareness and symbolic thought.