Yaakov Roitman - Academia.edu (original) (raw)

Papers by Yaakov Roitman

Journal of Child Psychotherapy, 2024

This work elucidates the unconscious destruction of a sense of being as a result of an obliterati... more This work elucidates the unconscious destruction of a sense of being
as a result of an obliteration (in the first generation due to direct
exposure to military trauma) and rejection (in the second generation
due to this trauma being intergenerationally transmitted) of the
internal connection with the female element – as conceptualised by
Winnicott in his book, ‘Playing and reality’. The rejection of this
aspect of the psyche, which is responsible for the experience of
aliveness and being, causes the subject significant confusion in the
sense of aliveness and deadness. The result is that survivors of both
generations become threatened by a sense of aliveness and being – by
life itself. Everything that causes a sense of richness, fullness,
intensity, a feeling of vitality and existence, is perceived to be
a threat, resulting in an unconscious need to reject such states.
These dynamics are explored in the case of an adolescent boy who
was experiencing anxiety about becoming a paedophile. His fear, as
signified by the image of a paedophile, rather than being a response
to the difficulties of his developing sexuality, could be understood as
connected to his father’s dissociated war trauma (the fear that he
might have killed children), and also to a dissociative imperative to
obliterate psychic affiliation with a quiet state of being.

The Psychoanalytic Review, 2023

Bion's notion of the contact-barrier formulates a semipermeable membrane responsible for preservi... more Bion's notion of the contact-barrier formulates a semipermeable membrane responsible for preserving the distinction between the conscious and the unconscious. However, the question of how a newly established contact-barrier manifests itself in dreams remains unanswered. The author proposes that one such manifestation occurs when a patient sees themself asleep in a dream. A case of a severely traumatized woman who had difficulty thinking and being close to others is used to explore these clinical ideas. The author, in response to his reveries in a session, introduced a playful dream-like dialogue between a playwright and his reader. The nature of the communication, in functioning as a barrier, served to protect the patient from a tyrannizing reality: the therapist's sexuality. This intersubjective barrier helped the patient to contact dissociated and damaged parts of herself, and it also facilitated her ability to dream a sense of her own boundaries, femininity, and sexuality.

Journal of Child Psychotherapy

In this work, I explore psychosis as an intersubjective state. Positing the importance of an ear... more In this work, I explore psychosis as an intersubjective state. Positing
the importance of an early traumatic loss of a significant figure,
I describe a situation in which a caregiver is not able to achieve
separateness and unconsciously relates to their child as a replacement
for the beloved lost object. The child unconsciously interprets this
complicated state as a plea to abandon separateness and exist as
a part of the caregiver’s inner world. This act of surrender is
unconsciously phantasised by the child as a means of preserving
the aliveness of the caregiver’s central internal object, which holds
the caregiver’s subjectivity together. In unconsciously fulfilling the
role of protector of his caregiver’s sanity, the child becomes bound by
the psychotic anxiety that demonstrating autonomy will destroy this
state of merger causing the caregiver’s mind to disintegrate. The child
thus feels that he cannot develop himself without risking the
caregiver’s collapse and must therefore become ‘nobody’ or ‘nothing’,
often psychotic and sometimes suicidal. I describe
a continuum of pathology dependent on the caregiver’s ability to
differentiate their child from their forsaken object. I present a clinical
example of psychoanalytic psychotherapy with a five-year-old boy
who suffered from psychotic anxiety about bodily fragmentation, and
the accompanying work with his mother, who was neglected in her
childhood. I discuss the essential elements of playing, which were
crucial in reaching this boy in his psychotic, near-death state. The
implications of this theoretical view illustrate the repercussions of
self-sacrifice on a child’s ability to accept help.

Journal of Child Psychotherapy

For some time, Bion’s unique version of a theory of representation appears to have been overlooke... more For some time, Bion’s unique version of a theory of representation appears to have been overlooked. A close reading of his ideas, however, provides crucial insight into the existence of a concomitant relationship between recognition and representation. To elucidate this notion, I explore the problem of representation and recognition in autistic states, with the use of two clinical cases of child psychotherapy. In both examples, the child’s struggle to coordinate sensorial information was hampering their ability to create a sensorial engram, which if successfully formed would enable a matrix bearing the unique shape of the object to remain, in times of its absence. The process of object recognition is possible when the external object reappears before this matrix and there is a good enough resemblance between them. In contrast, if the child has difficulty coordinating perceptual information and the object fails to assist in this task, an amorphous engram is established in the psyche, to which any entity in external reality can fit. In this way, every inanimate object can become a substitute for a memorable alive object. As a result, a child cannot recognise their significant other and may remain in an undifferentiated state of merger and non-existence.

Journal of Child Psychotherapy, 2022

In this work, I elucidate Winnicott’s principle of ‘mutual playing’ with reference to the treatme... more In this work, I elucidate Winnicott’s principle of ‘mutual playing’ with reference to the treatment of a highly traumatised twelve-year-old boy, whose elder brother had committed suicide. Lamentably, he had discovered his brother’s dead body and following this experience became electively mute, lost contact with his friends, and was compulsively preoccupied with images of murder and death. It seemed that in unconscious fantasy, he believed his envy had killed his brother. He appeared to have lost the ability to imagine, and, in lacking enough contact with reality, was unable to creatively transform his unspeakable pain to comprehend the trauma. I suggest that my use of the countertransference and improvisation supported this young man’s efforts to convert the trauma into living play images. In every session, it was as if I had to become both the playwright and the supporting actor in ‘playing’ the traumatic experience with him. This form of mutual playing helped the patient regain his own ability to play, and his emotional state improved considerably. I utilise and extend Ogden’s concept of ‘talking-as-dreaming’ and suggest that a therapist often has to play from the feeling tone and imagery of the child’s experience, not about it. I suggest that with this approach, playing becomes the dream of the trauma in waking life.

Psychoanalytic Dialogues, 2021

n this reply, I describe the way Dana Amir’s (this issue, 2021) commentary influenced me to consi... more n this reply, I describe the way Dana Amir’s (this issue, 2021) commentary influenced me to consider a new conception of the dream-within-a-dream phenomenon. Instead of a product of the work of the negative that acts to negate a first experience of unity between therapist and patient, I consider it as a manifestation of a contact-barrier that protects the patient’s germinating emotions from the harsh reality of loss.

Psychoanalytic Dialogues, 2021

In this article, the author proposes rereading Winnicott’s clinical case concerning a woman whose... more In this article, the author proposes rereading Winnicott’s clinical case concerning a woman whose sense of loss became a way of integrating her self experience by obliterating her tie to the object and attaching herself to a void. The author extends Winnicott’s ideas on this phenomenon by proposing an intersubjective view of the origins of the obliteration of the object and the roots of the sense of the void in the psyche. Sometimes, a mother, to psychologically survive, must neglect her child. A child unconsciously surrenders to his/her mother’s need to neglect him by obliterating his love for her. Therefore, the obliteration and the void are cocreated states in which the child participates. He abandons his love for her, emptying himself, and perpetuates the emptiness in order not to put a demand in an effort to care for his mother’s psychological safety. These intersubjective dynamics are clinically discussed in the psychoanalytic psychotherapy of a young woman who was unable to grieve.

Journal of Child Psychotherapy, 2021

In the course of a psychoanalytic psychotherapy of a five-year-old girl with cerebral palsy and p... more In the course of a psychoanalytic psychotherapy of a five-year-old
girl with cerebral palsy and profound developmental delay, there
came a time when my reverie experiences often included
memories of Tarkovsky’s autobiographical cinematic free-verse
Mirror. These reverie experiences became forms in which I was
able to contain the patient’s state of nothingness associated with
her undifferentiated state, and to recognise her urgent need for
mirroring of her very existence. In response to these reveries,
I came to think of Winnicott’s ideas on mirroring. I propose the
idea that birth can be understood as a trope of the most
primordial sense of mirroring, created by the link with
a subjective object. I describe the ways in which failures in the
caregiver’s reverie hamper the infant’s psychological birth, which
relies on good-enough mirroring for him to experience himself in
the caregiver’s responses to him. When this fails, what emerges is
a chimeric ghost-self, a self merged with the caregiver’s trauma or
loss. This chimeric ghost is a product of the distortions in the
reflected image. The infant will not be able to be born as himself
until he can differentiate from the ghost. In order to avoid
identification with the ghost, the nature of the parental trauma
needs to be understood by patient and therapist, each helping the
other in this transformative experience.

Journal of Child Psychotherapy , Oct 20, 2020

In this article, I propose that some autistic states can be seen as a defensive organisation util... more In this article, I propose that some autistic states can be seen as a defensive organisation utilised to cope with the threat of the ‘light’ of human contact. An autistic child-patient may perceive the therapist’s separateness as an overwhelming threat, expressed in the way a therapist plays with him. This may feel thus to the patient as a threatening ‘light’. In this work, I argue that the therapist must survive their feeling, involving the idea that the way they are playing with the child-patient is destructive. The therapist must come to recognise that the part of the patient through which he or she perceives separateness is not only a developmental achievement, but also, for the child-patient, a catastrophic change. The therapist’s ability to see the separateness of patient and therapist as a catastrophe helps them be attuned to the child’s fear of the light of human contact. I describe a therapy in which these considerations, alive in my mind as I played with a seven-year-old girl, helped her recover from an autistic-psychotic hallucinatory state. Her growing ability to tolerate separateness helped her develop the capacity for symbolic play and language. After discussing my work with this patient, I go on to elucidate Ogden’s view of the autistic-contiguous position. I suggest that the primordial preverbal interior reactions of the body become the most primal way of signifying reality. On this basis, I develop a set of ideas concerning some intersubjective aspects of autism.

Psychoanalytic Review, 2020

The author discusses Winnicott's concept of the use of an object, illustrating how it was used in... more The author discusses Winnicott's concept of the use of an object, illustrating how it was used in the case of a woman who survived a suicide bomb attack that killed four people. The author as analyst extends Winnicott's and Ogden's ideas by demonstrating in his clinical work that the therapist must survive the patient's unconscious omnipotent belief that her love kills and must maintain his capacity for reverie. The therapist not only has to recover from the pain inflicted by the patient's demand for love, he must also change in response to the feeling of having been destroyed. In the case presented, in order for the process of survival to become real for the patient, the therapist had to discover about himself that he unconsciously shared a common reality with the patient—he, too, was experiencing features of a silenced survivor and experienced an identification with the oppressor.

Psychoanalytic Review, 2017

The author explores the intersubjective aspect of the devolution of melancholia into psychosis, p... more The author explores the intersubjective aspect of the devolution of melancholia into psychosis, particularly as it involves the unconscious intersubjective role of the mother. The author considers the possibility that maternal inability to mourn contributes significantly to the foreclosure of the child's “tertiary processes” (the processes involved in the child's development of a differentiated autonomous self and symbolization). In the clinical case presented in detail in this paper, the child's undifferentiated experience with his mother (who was unable to grieve) left no room for the father as the necessary third element in the child's maturational processes.

Psychoanalytic Review, 2018

The author presents a detailed clinical discussion of his work with a forty-year-old man and a te... more The author presents a detailed clinical discussion of his work with a forty-year-old man and a ten-year-old boy in which he focuses on loss of self-object differentiation in the transference–countertransference experiences while he and these two patients were working with tyrannical internal objects (arising from intergenerationally transmitted trauma). In both of the analytic psychotherapies, the author experiences reveries in which a benevolent paternal figure lovingly supports a child's quest for independence. These reveries are of help to the therapist in recognizing, acknowledging, and accepting the need on the part of both patients to emancipate themselves from unconscious tyrannizing internal objects. The patients had previously experienced their need for emancipation as destructive to their parents and themselves, and consequently too dangerous to attempt.

Psychoanalytic Social Work, 2015

Addressing the infant-mother relationship, Laplanche posited that the maternal unconscious serves... more Addressing the infant-mother relationship, Laplanche posited that the maternal unconscious serves as an enigmatic message to the infant's unconscious. The infant is unable to translate violent maternal imprinting (immersion) of the life rejection, and the message generates a traumatic internal enigma. When this occurs, the infant's ego takes action to avoid collapse and to survive under the influence of a destructive object. Through a clinical presentation, the author argues that this particular psychosis begins when the infant's death instinct binds to primary narcissism to process the enigmatic trauma of maternal rejection. This dynamic uncovers the possibility of the intersubjective nature of the death instinct. The implications of the intersubjective influences of the analyst's own deadness and aliveness and the implications for the treatment of this psychosis are discussed.

Psychoanalytic Social Work, 2017

This article considers a relational perspective regarding the intergenerational transmission of t... more This article considers a relational perspective regarding the intergenerational transmission of the trauma of violence. The psychoanalytic literature suggests that parents often transmit the trauma of violence to their children in the form of projected nameless dread and unmentalized states that interfere with the children's emotional needs and support. The offspring absorbs the trauma, which manifests itself in the form of disorganized attachment and in turn leads to the development of a predisposition toward cocoon-like dissociative states. This study considers two clinical cases that examine the interpersonal dynamics of dissociative processes. The therapist's reverie about his ancestors' survival of depersonalizing violence and Winnicott's concept of the survival and the use of the object help the therapist find his or her identity and gain the relational freedom needed to overcome the dissociative state, thereby becoming an alive subject who is able to help the child patient.

Journal of Child Psychotherapy , 2019

In this work, the author considers reveries to be ‘dream-like-memories’. In the course of a sessi... more In this work, the author considers reveries to be ‘dream-like-memories’. In the course of a session they appear as proto-memory – the therapist’s early traumatic object relations that are recorded in the unconscious at an almost bodily level (a type of unthought known) and which are resurrected between therapist and patient when a similar traumatic subject arises between them. The therapist’s reveries are recollections in the form of dream-like allusions to his past experience. A clinical vignette from the psychotherapy of a child whose father suffered from PTSD (following a wartime experience in Afghanistan and Iraq) is discussed. Dissociative dynamics were repeated in the therapeutic relationship, in the form of an obsessive game intending to preserve the state in which there was no need to remember what had been unconsciously transmitted to the child: his father’s wartime experience. The projection of the primary elements which had been silenced evoked in the therapist allusions to his unconscious identification with his ancestor’s post-traumatic experiences. These allusions helped in overcoming the dissociated state. The role of memory in child psychotherapists’ receptivity of trauma is revisited.

Psychoanalytic Social Work, 2015

When working with severely damaged, neglected, and deprived patients, the analyst relies on the f... more When working with severely damaged, neglected, and deprived patients, the analyst relies on the faith that the intersubjective analytic space can be the site of a live relationship. In this regard, the unique technique of "reclamation" might be used with patients in a moment of imminent danger or of a sense of psychic death and involves an active response to the sense of emergency in countertransference. Reclamation is based on the analyst/ therapist's ability to conduct intersubjective dialogue between the various spaces of internalized object relations, and the author attempts to extend the possibility of its technical application by considering reclamation as intersubjective.

Journal of adolescence, 2014

According to Rapee (1997), maternal social anxiety (SA) is directly associated with adolescent SA... more According to Rapee (1997), maternal social anxiety (SA) is directly associated with adolescent SA because maternal SA causes overprotective and controlling parental behavior. A total of 127 adolescents who were in the process of transitioning to a boarding school for at-risk youth as well as their mothers participated in the current study, 30% of the adolescents had experienced at least one depressive episode; 17.5% had been diagnosed with SA. We analyzed an expanding model of mediation, of maternal SA and depression in which specifically, adolescent self-perception was constructed as a latent factor that was formed by self-reported dominance and self-criticism. The results supported our hypotheses that maternal SA is not directly associated with adolescent SA. Rather, these relationships are mediated by adolescents' self-perception (i.e., dominance and self-criticism). The results call into question Rapee's theoretical arguments and support Gilbert's evolutionary theory.

Journal of Child Psychotherapy, 2024

The Psychoanalytic Review, 2023

Journal of Child Psychotherapy

Journal of Child Psychotherapy, 2022

Psychoanalytic Dialogues, 2021

Journal of Child Psychotherapy, 2021

Journal of Child Psychotherapy , Oct 20, 2020

Psychoanalytic Review, 2020

Psychoanalytic Review, 2017

Psychoanalytic Review, 2018

Psychoanalytic Social Work, 2015

Psychoanalytic Social Work, 2017

Journal of Child Psychotherapy , 2019

Psychoanalytic Social Work, 2015

Journal of adolescence, 2014