Sunday, May 31, 2015

CHAPTER SIX - SUBLIMATION OF SHAME













Enhancing Sublimation When Working With Distress from Shame

We want to utilize moments when the analyst and patient can recognize they are both seeing an adult behavior pattern that is distressing for the patient. Our goal is to notice any discordant temporal and rhythmic patterning.  Progress can be made if they can draw a connection to the patient’s earlier strategies for dealing with challenging aspects of their caregiver environments. Together, patient and therapist, desublimate the unnecessary, destructive coping strategies. Sublimation, in the psychological sense, is the process of transmuting our urges into acceptable thoughts, feelings and behaviors. A sense of coherence, congruence and compatibility requires us to construct easily followed internal guidelines for behaviors related to our most primitive instincts.

A transformation, or dynamic reorganization, takes place as a patient sees and releases the restrictions of their early childhood thoughts and feelings of shame. This catharsis, and resulting feelings of relief or freedom, need to be a center of organization for the rest of analysis.  Shame structures need to be explored early in therapy because they are mutable, and also indelible.  As analysis continues, later forming distressing self-states will need dynamic reorganization.  The words in this paper are chosen to be accurate in chemistry, neuroscience and attachment theory. The objective of this explanation is to help therapists provide a developmental second chance for their patients. In general, softening up of defensive structures is this developmental second chance. The end product sought after in primary affect centered analysis is an enlivened use of sublimation by both therapist and patient.

Sublimation might be thought of as an ability to imagine. The way the patient and the therapist imagine the future will influence their self-images in the present.  A major portion of their deeply felt self-images were formed before they were six years-old. Sublimation always appears dualistic.  At a deep, mysterious level it contains the death/murder instinct and the wish to belong.  We emerge self-concepts that allow the tension between this independence and dependence to coexist.  When the child senses they have not lived up to their parent’s expectations of them (shame) they defend themselves at deep levels.  They protect their desire to go-on-being. The defense of sublimation can provide flexible options to keep alive their vitality affects as they move into new social environments, or it can create pain, as with shame.  The therapist can blindly collude with the patient in disjunction or conjunction around these deep seeded feelings.  Our plan is to identify and soften these periods of false resonance, or dissonance, and allow understanding to deepen and expand.  We are seeking what Stern (1995) calls ‘present moments’.  He postulates that ‘present moments’ are infused with vitality affects, that they are the smallest molar unit of psychologically meaningful relational experience that exhibit temporal and rhythmic patterning, and that they operate at an implicit/procedural ‘core’ level of consciousness.

All parent/caregivers of our patients, and us, have areas they are unable to participate in the above-mentioned rhythmic give-and-take. The more unaware these parents are to their deficits the more rigid and powerful the defense which develop to cope with them.  Part of the current self-images of the therapist and patient will include how they began to think and feel about themselves when their caregivers could not provide “good enough” care.  In these situations, when the child expresses an instinctive/primal need that is not satisfied, he/she develops a strategy of internal attempts at regulation.  This can be a moment of unhealthy sublimation which happens over and over again as the caregiver environment fails to tend the baby’s basic need. Thus creating a deficit in implicitly generating and integrating of another way Stern defines ‘a present moment’; “the basic fabric of lived experience created in continuous small packages of interactions with others”.   That “basic fabric” becomes a self-story of inadequacy

We want to utilize moments when the analysts and patient can recognize they are both seeing an adult behavior pattern that is distressing for the patient. Our goal is to notice any discordant temporal and rhythmic patterning.  Progress can be made if they can draw a connection to the patient’s earlier strategies for dealing with challenging aspects of their caregiver environments. Together, patient and therapist, desublimate the unnecessary, destructive coping strategies. Sublimation, in the psychological sense, is the process of transmuting our urges into acceptable thoughts, feelings and behaviors. A sense of coherence, congruence and compatibility requires us to construct easily followed internal guidelines for behaviors related to our most primitive instincts.

A case example of healthy growth of sublimation is a 26 year old single female who has a new way of envisioning her mother. Between her 41st and 42nd session of therapy she talked with her mother on the phone.  She told her Mom she has been attending therapy.  Her mother became defensive and distracted.  Her mother immediately presented her with an example of why she could not connect with her. When patient was an infant finished nursing she would cry until her mother laid her down.  She then would become calm and content. As my patient said this to me she admitted to feeling this was an example of something being wrong with her at birth.  Mom and daughter had colluded in this deep view my patient had of herself.  She left the session connecting her mother’s current distractibility with her likely inability to attend to her daughter.  This new way to imagine her baby/mother system allows her a different sense of her baby self.  Her deepest feeling of early childhood shame occurred setting on the curb outside of grade school long after all the other children had been picked up, waiting for her mother or maternal grandmother to pick her up.  Her mother’s mother and the patient’s mother had more important things to think about than her.  It is easy to imagine both mothers being distracted nursing their babies. Understandably this young woman developed a highly distressing anxiety disorder, with a strong desire for perfect union followed by, ”breaking down” , when she felt unattended to. “Is not anxiety therefore in the last analysis a feeling of the power of the death drive, a beginning of death (starvation)?” The Clinical Diary of Sandor Ferenczi on June 3, 1932

  
Relational psychoanalytic treatment can be especially successful in areas of adult verbalized, desomatised systems. These systems easily become structuralized, starting with pre-verbal affect and identity reactions, then later forming around internally verbalized patterns of shame.  The high volatility of primary affect states can be an advantage or a disadvantage.  My therapy process is designed to utilize this volatility to allow rigid, distressing patterns to precipitate out (become conscious); new behaviors and more flexible patterns to emerge.  “A developmental second chance”, or change in our disposition. Our shame structures are among the earliest patterns to precipitate out. They are among the most dominate, repetitive and painful affective states.  In the heat of observation these shame patterns have little or no value, except to have allowed us to have survived the deficits in our caregiver environments. 

The occurrence in the therapy room of the dyad identifying a break in attunement caused by their shame structures is the most profound moment in the early analysis. It announces the end of the first stage of treatment.  Noticing discord in analyst and/or patient, around moments of awareness of shame, becomes the bedrock for discovering deeper layers of organizational distress.  A new, felt sense of attunement and ability to re-regulate occurs when the patient utilizes awareness of shame to not repeat problematic behavior patterns with the analyst. This allows the emergence of different choices.  It is the necessary foundation for exploring Winnicott’s Authentic Self, Jung’s Shadow or Nietzsche’s source of human dignity.

Subliming a Tear of Shame
Subliming Shame


To move fantasy into action

In the physical sense sublimation is the transition of a substance directly from the solid to the gas phase without passing through an intermediate liquid phase. Sublimation in the psychological sense is the process of transmuting our urges into acceptable thoughts, feelings and behaviors.  The reverse process of sublimation is desublimation, or deposition. The act of solidifying and habituating some of our urges from our innermost self through desublimation is necessary for us to interact with the world around us.  The depository of these solidified organizations of our character, become our dispositions.  At the core of our disposition are our primary affect states. These primitive states have patterned themselves into our later forming dispositions with ever increasing complexities and many overlapping influences as we developed as humans.  Disposition is most changeable (volatile) in the latest developing cognitive realm.  Shame is the simplest of the primitive affect states to identify and the most searingly distressing.  The components organized inside us around ideas that we are inadequate, flawed or bad can be desublimated out to purify our access to our sovereignty.


The thoughts, feelings and behaviors our dispositions permit are the solid and liquid form.


Deposition, also known as desublimation, is a thermodynamic process, a phase transition in which gas transforms into solid. This is what early forming patterns of shame or inadequacy do to us.  These feelings desublimate from our phantisizes, to become rigid, repeatable and eventually habituated.


One example of deposition is the process by which, in sub-freezing air, water vapor changes directly to ice without first becoming a liquid. This is how snow forms in clouds, as well as frost and hoar frost on the ground. Another example is when frost forms on a leaf. For deposition to occur, thermal energy must be removed from a gas. When the leaf becomes cold enough, water vapor in the air surrounding the leaf loses enough thermal energy to change into a solid. Deposition in water vapor occurs due to the pureness of the water vapor. The water molecules containing only Hydrogen and Oxygen; are therefore, able to lose large amounts of energy before forming around something. When the leaf is introduced, the supercooled water vapor immediately begins to condensate, but by this point is already past the freezing point. This causes the water vapor to change directly into a solid. Psychologically this is what William Blake calls “Experience”.  We cannot go back to “Innocence”.


Now let us see what we know about the development of shame and how that development is involved with language.


"Shame, or blushing, is evident in infants at 10-12 months old.  The neural-circuitry we utilize for blush develops with the occipital cortex, which is the seat of our language development".(Feldman, Greenbaum, & Yirmiya, 1999, p. 223) “Face-to-face interaction, emerging at approximately two months of age,  are highly arousing, affect-laden, short interpersonal events that expose infants to high levels of cognitive and social information.  To regulate the high positive arousal, mothers and infants…..synchronize the intensity of their affective behavior within lags of split seconds.”  Schore, A 2012, p.231 “developmental neuroscientists have observed that a milestone for normal development of an infant brain occurs at about 8 weeks.  This is the onset of a critical period during which the following take place: Synaptic connections in the occipital cortex are modified by visual experience (Yamada et al., 2000); infants as young as 2 months show right hemispheric activation when exposed to a woman’s face; and particular areas of the right hemisphere are timed to be in a plastic and receptive state at the very time when polysensory information that emanates from faces is being attended to most intensely by the infant" (Tzourio-Mazoyer et al., 2002). (Schore, A, 2003, p. 152) quote from (Krystal 1988) "proposed that all later-developing affects evolve out of a neonatal state of contentment and a state of distress that differentiate into two developmental lines, an infantile nonverbal affect system and an adult verbalized, desomatised system".  Especially the "adult verbalized, desomatised system is easily structuralized, starting with pre-verbal affect and identity reactions, then later forming around internally verbalized patterns of shame.  The volatility of primary affect states can be an advantage or a disadvantage.  Therapy is designed to utilize volatility to allow rigid, distressing patterns to precipitate out and new behavior to emerge. A developmental second chance.


Desublimation is going from harmonized, integrated internal environments (phantasies) to fixed dispositions. The sublime, we are looking for in therapy, is bringing the dyadic, ambience pressure of investigation of our two dispositions to the point of allowing phantasy to be re-materialized and to be communicated.  Under the heat of the benign investigation of the therapeutic alliance, our disposition can volatilize.  Sublimation has the dual appearing aspect in the spiritualization of the body and the corporatizing of the spirit.


As humans, we must delude ourselves to believe we have overcome our emptiness.  The vacuum at the core of our being is intolerable to us.  We find or create signifiers of support.  Our going-on-being depends upon a reflected sense of ourselves, accomplished in a felt sense of attunement. The hole of the feeling of emptiness needs to be seeking an existing and desirable 'love object', which is unreachable (and therefore experienced as something missing).  All of this is dependent on our subjectivity's expectation to re-find the lost object in the mistaken belief it will continue to satisfy us.


Are those of us who gave up on finding our mothers before we could habituate the desire to "re-find" that filler of emptiness (our phantasized Mother), more realistic? My mother had severe post-partum depression.  She often sat staring out the kitchen window for hours.  I developed a flattened lumbar curve from arching my back to get away from her non-responsive face. Two years later my brother was born and she became nearly catatonic. Solid reality began taking the place of phantasy. Robin Williams seems like another example of this.  Super real.  Exquisite awareness of the unattainability of transcendence.  Playfully holding the terror of almost touching.  Painfully aware of a deep sense of where other people know to laugh at themselves and him.  Lenny Bruce might have been closer to this flame.  


Sublimation is a technique used by chemists to purify compounds. A solid is typically placed in a sublimation apparatus and heated under vacuum. Under this reduced pressure, the solid volatilizes and condenses as a purified compound on a cooled surface (cold finger), leaving a non-volatile residue of impurities behind. Once heating ceases and the vacuum is removed, the purified compound may be collected from the cooling surface.[3][4] For even higher purification efficiencies a temperature gradient is applied, which also allows for the separation of different fractions. Typical setups use an evacuated glass tube that is gradually heated in a controlled manner. The material flow is from the hot end, where the initial material is placed, to the cold end that is connected to a pump stand. By controlling temperatures along the length of the tube the operator can control the zones of recondensation, with very volatile compounds being pumped out of the system completely (or caught by a separate cold trap), moderately volatile compounds recondensing along the tube according to their different volatilities, and non-volatile compounds remaining in the hot end. Vacuum sublimation of this type is also the method of choice for purification of organic compounds for the use in the organic electronics industry, where very high purities (often > 99.99%) are needed to satisfy the standards for consumer electronics and other applications.



































The Epistemology of Sublimation in Medicine

Modern psychoanalytic therapy is beginning to utilize understanding of treatment of primary affects in order to help people understand their distress.  We help them identify and regulate the defenses they use around their primary affects of shame. Our treatment processes need to effectively include work to visualize patients’ early forming self-concept; such feeling flawed, bad or inadequate.  I see sublimation as resting point in psychoanalytic search for relief from suffering from primary affects, such as, shame and disgust.

Sublimation, in a relativistic sense, eats at the core of Western medicine, and Freud's narrow, mechanicalized ideas about it.  Hippocrates and the early Greek ideas of medicine in 400 B.C. understood medicine through the use of Vital Force and would embrace a more inclusive, mysterious view of sublimation. Claudis Galen, who in the second century A.D. became the greatest authority in medicine for the next five hundred years, is more accurately called "The Father of Western Medicine". He introduced "The Treatment of Opposites", the idea of fighting off pathogens with substances that competed with them. Freud's ideas grew out of allopathic understanding of medicine. The ancient Greeks viewed disease as disharmony, with healing aimed at restoring balance. Relativistic sublimation would have been obvious to them.

One reason that sublimation is a key notion in psychoanalysis is that from a therapeutic point of view, successful psychoanalytic treatment ideally aims at sublimation, inasmuch as sublimation is seen as a necessary condition for full psychic health. By bringing to conscious light hitherto repressed drives, desires, and wishes, energy that has previously displayed itself in unpleasurable symptoms may be harnessed and directed to more productive and felicitous ends. And indeed, at first glance, sublimation might seem a clear enough concept. It can involve the redirecting of a repressed sexual drives toward a nonsexual aims.

As Nietzsche himself nicely puts the point: “The multitude and disaggregation of impulses and the lack of any systematic order among them results in a ‘weak will’; their coordination under a single predominant impulse results in a ‘strong’ will: in the first case it is the oscillation and lack of gravity; in the later, the precision and clarity of direction” (KSA 13:14[219]). Sublimation, for Nietzsche, is the key means to such concerted expression and, hence, to overcoming resentment.





Sublimation according to Ferenczi ==
“It is not easy to conceive how the same being who is determined by passions from without should also be determined by reason from within….Can passions be annihilated or can they be spiritualized?
“Freud tried to define all sublimation and all striving for perfection as unfulfillable wish impulses, which must remain forever unsatisfied, as though they were compensatory and consoling fantasies and actions.  A special investigation and observation of the conversion of passion into logic and ethical self-control, then into positive pleasure taken in growth and development [Gedeihen] everywhere (this means in oneself, as well as in the environment) led to the assumption that there are possibly two distinct processes involved in sublimation, that is to say, in the pleasure taken in well-being and development; mutual kindness and tenderness

 Sublimation according to Jung ==
C. G. Jung believed sublimation to be mystical in nature, thus differing fundamentally from Freud's view of the concept. For Freud, sublimation helped explain the plasticity of the sexual instincts (and their convertibility to non-sexual ends). The concept also underpinned his psychoanalytical theories which showed the human psyche at the mercy of conflicting impulses (such as the super-ego and the Id, ego and super-ego|id). Jung criticized Freud for obscuring the alchemical origins of sublimation and for attempting instead to make the concept appear scientifically credible:
 “Sublimation is part of the royal art where the true gold is made. Of this Freud knows nothing, worse still, he barricades all the paths that could lead to true sublimation. This is just about the opposite of what Freud understands by sublimation. It is not a voluntary and forcible channeling of instinct into a spurious field of application, but an alchemical transformation for which fire and prima materia are needed. Sublimation is a great mystery. Freud has appropriated this concept and usurped it for the sphere of the will and the bourgeois, rationalistic ethos.”Carl Jung, Letters, ed. By G. Adler and A. JaffĂ© (Princeton University Press; Princeton, 1974), vol. 1, 171
This criticism extends from the private sphere of his correspondence (as above) to specific papers he published on psychoanalysis:
“Freud invented the idea of sublimation to save us from the imaginary claws of the unconscious. But what is real, what actually exists, cannot be alchemically sublimated, and if anything is apparently sublimated it never was what a false interpretation took it to be.” C. G. Jung, Dreams: (From Volumes 4, 8, 12, and 16 of the Collected Works of C. G. Jung),(Princeton University Press, 2012), p.100

Sublimation as  resting point in the psychoanalytic search for relief of suffering from primary affects, such as, shame.

All sublimations involve an expression of a pent-up quota of affect.
In the case of sublimation reached through psychoanalytic treatments, typically, the ideational component becomes available for conscious apprehension. However, in all sublimations, therapeutically achieved or otherwise, the force component is expressed in behavior.

One reason that sublimation is a key notion in psychoanalysis is that from a therapeutic point of view, successful psychoanalytic treatment ideally aims at sublimation, inasmuch as sublimation is seen as a necessary condition for full psychic health. By bringing to conscious light hitherto repressed drives, desires, and wishes, energy that has previously displayed itself in unpleasurable symptoms may be harnessed and directed to more productive and felicitous ends. And indeed, at first glance, sublimation might seem a clear enough concept. It involves the redirecting of a repressed sexual drive toward a nonsexual aim.1
As Nietzsche himself nicely puts the point: “The multitude and disgregation of impulses and the lack of any systematic order among them results in a ‘weak will’; their coordination under a single predominant impulse results in a ‘strong’ will: in the first case it is the oscillation and lack of gravity; in the later, the precision and clarity of direction” (KSA 13:14[219]). Sublimation is for Nietzsche the key means to such concerted expression and, hence, to overcoming ressentiment.22
Treating people who have concerns around feelings of shame is effectively done by working with sublimation

“Freud invented the idea of sublimation to save us from the imaginary claws of the unconscious. But what is real, what actually exists, cannot be alchemically sublimated, and if anything is apparently sublimated it never was what a false interpretation took it to be.” C. G. Jung, Dreams: (From Volumes 4, 8, 12, and 16 of the Collected Works of C. G. Jung),(Princeton University Press, 2012), p.100

Shame needs to be an early focus of therapy processes.  Our early development is organized around our primary affects. An understanding of sublimation is required to soften the defensive structures around feelings of shame and disgust. Ferenczi (1932) explained sublimation as “A special investigation and observation of the conversion of passion into logic and ethical self-control. Then into positive pleasure taken in growth and development [Gedeihen] everywhere (this means in oneself, as well as in the environment) led to the assumption that there are possibly two distinct processes involved in sublimation, that is to say, in the pleasure taken in well-being, development, mutual kindness, and tenderness.”



Sublimation, in a relativistic sense, eats at the core of Western medicine, and Freud's narrow mechanicalized ideas about it.  Hippocrates and the early Greek ideas of medicine in 400 B.C. understood medicine through the use of Vital Force and would embrace a more inclusive, mysterious view of sublimation. Claudis Galen, who in the second century A.D. became the greatest authority in medicine for the next five hundred years, is more accurately called "The Father of Western Medicine". He introduced "The Treatment of Opposites", the idea of fighting off pathogens with substances that competed with them. Freud's ideas grew out of Galen's allopathic understanding of medicine. The ancient Greeks viewed disease as disharmony, with healing aimed at restoring balance. Relativistic sublimation would have been obvious to them.

Nietzsche provides us with the idea that sublimation serves to qualify the effects of our own naturalistic critique by revealing how and why our animal bodies and drives can now be practically affirmed as a new source of human dignity.






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