Working with patients with disruptions in symbolic capacity¹

Abstract

This article focuses on understanding and working with patients who have poorly developed symbolic capacity, or for whom symbolic capacity has been disrupted due to trauma, particularly as it pertains to the use of reverie and interpretation in the analytic process. Many patients who present for Jungian analysis will initially present with deficits in symbolic functioning. This situation results in necessary limitations or modifications in utilizing traditional Jungian techniques such as dream analysis, active imagination, sand tray and other expressive art techniques. The initial phase of analytic work with these patients requires a focus on developing their symbolic capacity before traditional Jungian techniques can be utilized effectively. During the paper Jung's concept of 'the symbolic attitude' will be examined as well as the conceptual models of Wilfred Bion and other post-Bionians who outline theories and method for cultivating symbolic capacity and reflective functioning in patients for whom these capacities are impaired or poorly developed.

The Personal and The Transpersonal Psyche: Human Suffering, the Archetypes and the Clinical Encounter

“…Any patient, at any stage of life, may continue to require therapeutic attention related to his or her difficulty in adaption, trauma, and attachment disorders. Ignoring such patients' needs when they do arise could again result in concrete thinking (e.g., Winborn, 2023) on the part of both analyst and analysand.…”

“…In a recent article, Mark Winborn addresses the specific needs of patients with what he refers to as disrupted symbolic capacity. These are patients who, having experienced disturbances in implicit memory as a result of traumatic experience, have a tendency toward “concrete thinking” (Winborn, 2023, pp. 94–95).…”

“…94–95). Citing Plaut (1966, p. 113), he suggests that the “capacity to imagine constructively is closely related to, if not identical with, the capacity to trust” (Winborn, 2023, p. 96). Here we find a link between the capacity to symbolize—the sine qua non of Jungian analysis—and developmental, attachment psychology.…”

“…While more classically‐oriented Jungians tend to eschew the term “technique” as any “manualization” of the work inevitably runs the risk of interfering with the spontaneity of the clinical encounter that Jung endeavoured to protect, Winborn has observed that Jungian analysts in training frequently find themselves at a loss with the patient when not working in dream interpretation or active imagination, or when the patient’s unconscious material does not fit neatly with any ready symbolism (Winborn, 2019, p. 4). Furthermore, he notes that, while candidates in Jungian training are exposed extensively to “myths, fairytales, systems of religion and alchemy” they lack “instruction on how to determine which patients might benefit from a mythopoetic approach and which patients might experience archetypal amplification as intimidating or as a failure of the analyst to acknowledge and empathize with their subjective affective situation” (Winborn, 2023, p. 92).…”

inteligência artificial e o desenvolvimento neuropsicológico de crianças e adolescentes

“…Segundo Cozolino (2016), ter uma testemunha ativa os sistemas sociais do cérebro, levando à consciência de como se é percebido pelos outros e a uma perspectiva mais objetiva sobre a visão egocêntrica do indivíduo. Winborn (2022) relata que atualmente observa-se um grande número de pessoas que permaneceram no pensamento concreto e literal, não sendo capazes de usar adequadamente sua função simbolizante. Assim, o aparecimento do ChatGPT se dá nessas circunstâncias, quando já se nota, há muito, um empobrecimento da vida psíquica.…”