Psychic reality and the nature of consciousness

Abstract

In this paper we make the case for a psychoanalytically informed reconsideration of the phenomena of consciousness. Classically, following Freud, who viewed consciousness as merely a reflection or perception of unconscious mental activity, psychoanalysts have tended to regard a focus on conscious experience as potentially reductionistic and at risk of overlooking the mind's deeper structures. We describe the case of Mr K, a patient who experienced disturbances of consciousness that forced us to consider the possibility that the capacity to experience ourselves as conscious, intentional agents in a coherent world of objects is not merely a modality of perception but rather a maturational and developmental achievement that to some degree depends on adequate experiences of caregiving and is vital in ensuring the possibility of human communication. As such, it is a capacity that is vulnerable to experiences of neglect and maltreatment. We suggest that as well as compromising the capacity to think about one's own and other people's feelings, such experiences may have the further adverse consequence of leading the individual to experience and risk becoming conscious of certain dangerously maladaptive, destructive states of mind which in normal development remain inaccessible to conscious experience. Phenomenologically, such states of mind are experienced as fragmentation and disturbances of consciousness. We discuss the clinical implications of these reflections and the limitations they place on psychoanalytic work in the context of their impact on the work with Mr K.

Mentalizing, Epistemic Trust and the Phenomenology of Psychotherapy

“…These are key elements that enable the social cooperation, social learning and the construction of a network of relationships that make culture and its transmission possible [6]. We have argued, in a similar vein, that human consciousness evolved to allow us to share our experiences, to communicate a "shared narrative" on which relationships, social ties, and group cohesion can all be built [7]. We become conscious of those aspects of the world which others reflect on as well, and this applies equally to our internal subjective world [7].…”

“…We have argued, in a similar vein, that human consciousness evolved to allow us to share our experiences, to communicate a "shared narrative" on which relationships, social ties, and group cohesion can all be built [7]. We become conscious of those aspects of the world which others reflect on as well, and this applies equally to our internal subjective world [7].…”

Attachment, Neurobiology, and Mentalizing along the Psychosis Continuum

“…Whereas before puberty the domains of sexuality and aggression were less integrated in the agentive sphere of the individual, their potentiation through pubertal development gradually brings novel possibilities: procreation and potentially causing enduring harm through one’s aggression. This poses an inherent challenge for mentalizing during adolescence, as body-states associated with new experiences of sexual and aggressive arousal remain without fully regulatory second-order representations, unlike other forms of affective arousal stemming from basic emotions which have been mirrored throughout childhood and internalized in the self-regulatory repertoire (Target, 2007; Fonagy, 2008; Fonagy and Allison, 2016; Fonagy and Luyten, 2016). This makes new arousal states in adolescence prone to poorly regulated thought and behavior, especially in situations of stress (Fonagy and Luyten, 2016).…”

Mediators in the Association Between Affective Temperaments and Suicide Risk Among Psychiatric Inpatients

“…According to the definition provided by Peter Fonagy and Anthony Bateman, mentalization refers to "the ability to reflect upon, and to understand one's state of mind" (Bateman & Fonagy, 2012); "to have insight into what one is feeling, and why"; and is assumed to be an important coping skill that is necessary for effective emotional regulation (Bateman & Fonagy, 2012). Previous research has demonstrated that difficulties with emotional regulation are one of the primary characteristics of personality disorders (Fonagy & Allison, 2016;Petersen, Brakoulias, & Langdon, 2016). However, only a few studies have investigated mentalization in affective disorders (Fischer-Kern et al, 2013;Power, Iacoponi, Reynolds, et al, 2007;Santos et al, 2017).…”