René Roussillon, PhD, 2016

Rene Roussillon’s Summation of His Work

Since my nomination as a training member of the SPP, I have devoted my activity to the development and diffusion of psychoanalysis both at the University where, for more than twenty years, I have directed the department of clinical psychology, giving it a fundamentally psychoanalytic orientation, and where I have supervised twenty or so theses directly inspired by psychoanalysis, and at the different congresses of the EPF and the IPA (see list attached), in a very large number of conferences in the different component societies of the IPA (see the list of conferences in recent years in England, Argentina, Belgium, Brazil, Bulgaria, Denmark, Spain, Greece, Italy, Lebanon, Poland, Rumania, Russia, Switzerland, Sweden, Turkey, Uruguay), while giving particular attention to diffusing and supporting psychoanalysis in countries where it was emerging or developing (Bulgaria, Lebanon, Poland, Romania, Russia, Turkey). A very important part of my work has also focused on building bridges between psychoanalysis and psychoanalytic psychotherapy work reflecting on the extensions of psychoanalysis beyond the “standard” setting of psychoanalysis

Among my very numerous writings (15 books, some of which have been translated into English, Italian, Spanish, Portuguese, Romanian, Russian, etc., 300 articles or book chapters, 68 of which outside France in foreign languages (see bibliography of the last ten years attached)), I would like to put the accent on those which seem to me to be characteristic of my scientific contribution to psychoanalysis.

While I consider myself primarily as a general psychoanalyst who is passionate about everything that concerns psychoanalysis in all its forms, I have essentially devoted my clinical and theoretical researches to the psychoanalysis of the pathologies of narcissism and in particular to those that have an impact on identity and that bring the “standard”  psychoanalytic situation into difficulty (negative therapeutic reactions, passionate transferences, narcissistic transferences, delusional transferences, etc. (see Paradoxe et situations limites de la psychanalyse, PUF 1991.)

Methodology of research.

Most of my clinical research and all my work has been conducted in the context of a group of intervison research setting (1993-2016). This consists of a group-based “inter-vision” seminar, which enables a psychoanalytic “exploration” of “borderline situations” in psychoanalysis to be carried out. A group of seven psychoanalysts (from France Belgium, Switzerland,) hold meetings with me; the initiative came from a number of analysts who wished to explore their own practice of psychoanalysis in a “group-based inter-vision seminar”. They discuss the treatment of analysands who present specific difficulties related to “borderline situations” in psychoanalysis or other clinical issues.

The seminar group is not part of a basic training programme; the great majority of its members are experienced analysts, acknowledged as such by their respective psychoanalytic associations (IPA).

Presentations to the group are usually made in three phases that can be fairly well identified, their heuristics having progressively been recognized over time. In the first of these phases, the analysand’s past history, as reconstructed by the analyst while the treatment unfolds, is presented to the group. Next comes a presentation of what I am tempted to call the “clinical dimension of the psychoanalytic process”. Then the sessions of the latest week of the analysis are presented in as “verbatim” a manner as possible, together with the interpretations and the interpretative approach favoured by the analyst at that point.

Approximately one month later, the seminar group discusses the sessions that have taken place in the month that has passed since the previous meeting, in an attempt to draw up a clinical and technical assessment and adjustment based on the measurable effects of the inter-vision work done the month before.

I have been able to “accompany” in inter-vision seminars almost more than 200 treatments of borderline cases since the programme was first established more than 20 years ago, covering from six to ten groups (each month).

The model described in the first chapter of the book Agony and its Symbolization (2011) is to a large extent based on that procedure.

On the basis of this research, I have emphasized the paradoxical structure of narcissism which hinders its regulation and tends to substitute paradox and its impasses – in particular linked to the setting-up of splits in the ego – for the organisation of psychic conflicts.
I have also reflected on the link between the paradoxes of narcissism and psychic reflexivity, concerning which I have described three levels : feeling (se sentir) and the greater or lesser difficulty in feeling; seeing oneself (se voir) and the more or less essential difficulty of seeing oneself; and finally, more classically, hearing oneself (s’entendre) and the difficulties in hearing oneself.

At this level my main hypothesis rests on the difficulties in the organization of three “representatives” of drive life identified by Freud: that of the affect-representative, where difficulties in feeling are concerned; that of the thing-presentation (mainly visual in Freud) in connection with difficulties in “seeing oneself”; and that of the word-presentation connected with difficulties in hearing oneself. In exploring the difficulties of relexivity in more depth, I have been led to place the accent on the reflexive organization of the psychic representative:  organization of the form signal-affect for the affect-representative, organization of a thing-presentation of the thing-presentation (the Malleable Medium, see after), organization of a word-presentation of representative activity (“I think”, “I imagine”, “I picture myself”, etc).

Starting from the observation that subjects who feel bad tend to come to analysis in order to “feel better” and to make the analyst feel what they do not feel (or only with difficulty) about themselves; that those who see themselves with difficulty come to “show” themselves and “let themselves be seen” in analysis, to show what they cannot see (or only with difficulty) about themselves – the task of helping them “see well” which colours the transference in a particular way –; and that those who hear themselves badly come above all, which is more classical, to make themselves heard, I have put forward the hypothesis of an important transferential situation in the treatment of the impasses of narcissism in which the analyst is required to be “the mirror of the negative” of the patient. That is, he is confronted with what the analysand rejects from his psyche and with the fact that he identifies with a patient who does not identify with him. I have also shown that alongside the “classical” transference in the mode of displacement, clearly described by Freud, there also develops a transference “via reversal” in which the patient makes the analyst experience what he has lived through and could not tolerate. (This may be considered as a contribution to projective identification aiming to link the latter metapsychologically with unintegrated historical experiences).

I have thus been led to explore the factors that determine the development of reflexivity and of the symbolization that sustains it, those that support it and those that impede it, and in particular the function of the primary environment and its significant objects. By articulating D.W. Winnicott’s ideas on the mother’s mirror function, the question of the “Use of an object”, and those of W.R. Bion on the mother’s α function, I have described a “symbolizing” function of the primary object and focused on the relational particularities that the object must present to carry out this function optimally. The work of symbolization necessary for integrating subjective experiences and for developing forms of reflexivity presupposes that a certain number of psychic and relational needs have been sufficiently satisfied in the first years of life and the significant moments of subjective history.

Based on an analysis of the characteristics and propositions concerning the extension of Marion Milner’s concept of the “pliable medium”, I have described a “pliable medium function” of the maternal environment. The latter is initially sustained by the primary environment, then transferred on to different “material” objects which all play an important role in the different forms of the activity of symbolization (artistic activities, games, elaboration of the transference). It is in the light of all these reflections that I have suggested that, alongside the classical contributions on the symbolization of absence (or secondary symbolization), we should conceive of the first forms of symbolization (or primary symbolization) which have their source in the conditions of the intersubjective encounter − and in particular of the primary encounters. My “Key Note” paper in Boston presented, precisely, the concept of primary symbolization and its particularities − based on sensory-motor functioning, forms without subject or object, etc., − whilst illustrating their pertinence with reference to a clinical case of an adult subject in analysis presenting significant after-effects of infantile autistic defences.
These contributions have numerous consequences for psychoanalytic work.

First of all, they make it possible to put forward a theory of the “standard” psychoanalytic setting but also, beyond that, of the different “settings” of psychoanalytic inspiration utilized in the modifications and extensions of psychoanalytic practice (to children, autists, psychotics, psychosomatic patients, borderline cases, etc.). The setting must “symbolize the work of symbolization” that psychoanalysis offers; it must “say in the form of an act, a thing-presentation” what the method of free association says “in words”, but it must do this work in a way that is adjusted to the specific needs of the subject concerned. The setting and the method thus form a pair which addresses the different levels of psychic processes: primary processes (the setting) and secondary processes (the rule of associativity).

Next, these contributions open up reflection on what psychoanalytic work should contribute to a given analysand; they make it possible to evaluate the singular psychic needs of this or that patient, that is, what he (or she) needs to be provided with so that he can carry out the metabolization and symbolization of his past and present subjective experience.

Finally, they provide reference points concernant the “made to measure” technical handling and attitudes that are particularly adapted to this or that transference situation. They help us to know how to be an analyst/ “good pliable medium” for this or that analysand, allowing us to adjust the interventions to the specific need of giving fresh impetus to the play that is necessary for his process of elaboration.

To conclude, mention should also be made of the importance of my ancillary works devoted to the epistemology of psychoanalysis and to the analysis of creative processes with reference to literary works.

I have given much thought to the question of the interfaces of psychoanalytic thought with other disciplines, and principally the psychology of development (attachment theory and psychology of the infant – D. Stern, C. Trevarthen, B. Beebe, P. Rochat, etc.,) and neuroscience. I have been very active within the CNEP (Cercle Neurosciences et Psychanalyse), for which I have organised a Congress in Lyon on the theme of “Psychic associativity and neuroscience”. My orientation is to try to explore the points of convergence between neuroscientific studies and the major concepts of psychoanalytic practice − memory, perception, transference, mechanisms of deferred action (après coup), psychic representation (représentance), etc. But also to evaluate, on the basis of the contribution of the neurosciences and the psychologies of development, the pertinence of certain models or certain concepts of psychoanalysis. My most recent work is concerned with the question of the qualitative evaluation of psychoanalysis and the methods that need to be deployed to develop it; it examines the idea of two models of qualitative evaluation: one based on play and the other on the models and types of psychic associativity.

Concerning the creative process in art and literature, I have tried to show how the major authors (in particular, William Shakespeare – King Lear, Othello, Richard III; Camus – The trilogy of the negative – The Myth of Don Juan, etc.) have something to teach us all the time about the problematic of narcisism and its vicissitudes.