Suffering and Sacrifice in the Clinical Encounter
Charles Ashbach
 

Charles Ashbach is a licensed clinical psychologist in the Philadelphia area. His Ph.D. is from Temple University and has post-doctoral certification from the Washington School for Psychiatry. He is a founding faculty member of the International Psychotherapy Institute (IPI), Bethesda, MD and is co-author of the books: Object relations, the Self and the Group as well as co-author of Suffering and Sacrifice in the Clinical Encounter.

His focus is on the theory of narcissism and the ways in which this force becomes central in both the individual experience of trauma and the in the development and decay of cultures and societies. He has presented on psychoanalysis and clinical issues in the United States, Europe and Panama.

 
Suffering and Sacrifice in the Clinical Encounter 

Charles Ashbach



To view Charles' website click here.

Suffering and Sacrifice in the Clinical Encounter

For information on ordering through Amazon, PLEASE CLICK HERE.

Suffering and Sacrifice in the Clinical Encounter is an exploration of the long standing clinical problems of intense resistance to what Freud (1923) termed the "negative therapeutic reaction" or NTR. It offers clinicians a new paradigm for understanding the "battles" of especially traumatized patients and how the treatment is structured along religious and mythical lines associated with "human sacrifice." 

The depressed and sado-masochistic patient seeks to avoid the guilt, shame and hopelessness of his developmental experience and "reassign" his failures to the therapist understood to function as "scapegoat surrogate." Clinical approaches suggest new pathways of encounter and relationship.


Richard Koenigsberg’s work on the psychic foundations of cultural phenomena draws upon a bedrock of psychoanalytic thought on the unique elements of group and social life. Following Freud’s 1921 study on group (mass) psychology and Bion’s work utilizing Klein’s ideas on the paranoid-schizoid phase of mental-emotional development,

Dr. 
Koenigsberg has published groundbreaking books and articles showing how cultural formations emerge out of the deepest personal experiences and phantasies of individuals. He shows how links between the individual and the collective operate under a lawful set of phantasies, anxieties and psychic transformations.

Through a careful analysis of Nazism, Koenigsberg demonstrates that the terror and helplessness of the German people were transformed through the lens of National Socialism— into a perverse ideology characterized by delusional omnipotence, narcissistic expansion—and the idea of a new and transcendent Germany.

The guilt, shame and helplessness of having lost WW1 and suffered the ignominious terms of the treaty of Versailles were to be magically erased. Violence was the flame that sealed the hearts and minds of the German people, “freeing” them from caring and moral conscience. With the power of an imagined perfection, the State, the people and their leaders became a single psychic object--positioned to activate the greatest orgy of murder and destruction the world had ever known.

By tracing the development of primitive dimensions of mind and emotional experience, Dr. Koenigsberg shows how the collapse of normal attachments and personality structure led to a ruthless model of collective life built around the figure of the omnipotent idealized leader. The transformation of the individual from a separate, limited and vulnerable entity into the super-ordinate collective paved the way for an immense distortion of regressive imagination: omnipotent power, invulnerability and immortality.

Through the reciprocal processes of introjective and projective identification, the group creates the leader—and the leader offers himself up to the group as a ferocious figure of grievance, perverse love and unimagined retaliatory power. The delusion of the group as an actual, living entity empowers the subject to feel at one with it—and thus to think and feel as one heart, one will and one goal: power, vengeance and victory.

Freud explained delusion as a tear in the ego. The growth and expansion of Nazism—as well as the pathology of the Nationalistic State in today’s America— demonstrate how large and apparently “civilized” collectives shed their veneer of sophistication to protect against the threat of madness. The in-group needs to evacuate the “badness” that haunts it. This is accomplished through the creation of “scapegoat surrogates” (as described by Rene Girard in Violence and the Sacred). What is limited, fallible and vulnerable must be jettisoned. The primary target is often an unrepresented minority that is unable to defend itself.

These groups become figures of sacrifice: the “bodies” placed upon the altar of culture—to suffer the scourge and punishment for sins and crimes the majority secretly feel is their responsibility. The search for the beautiful, pure and perfect demands labeling the out-group as immoral filth or vermin. Not merely as bad people, but as forms of biological disease.

In our book Suffering and Sacrifice in the Clinical Encounter, we demonstrate how individual patients who have suffered the loss of emotional contact, bonding and attachment with primary figures—may fall into a painful condition of sado-masochistic depression. The lost love object is reconstituted narcissistically under the aegis of an ideal and delusional figure of perfect love and devotion.

Pursuing the ideal object, the patient resists therapeutic efforts built around accepting the path of partnership and mutuality with the therapist—and seeks instead to establish what Freud termed a “private religion”—where rituals and ceremonial aspects of treatment are hijacked and used to petition an unseen figure of absolute power and perverse love.

Through the power of unconscious phantasy this “god-object” is used to bring about the magical reconstitution of a lost, nostalgic world. A magical-religious delusion is created as an antidote to the psychological and emotional burdens of loss, pain and the acceptance of responsibility.

A violent process of sacrificial destruction is substituted for the gradual process of therapeutic transformation that occurs through grief, mourning, insight and re-integration of the self.

The process constructed by the traumatically disorganized patient draws energy from the primal phantasy of "human sacrifice," where the destruction of a messianic or heroic figure is felt to propitiate the guilt of the “secret self,” allowing re-establishment of a lost, golden era of innocence and happiness.

The patient uses the never-ending battles of resistance to make aggression and frustration the energy that drives the self away from sorrow and the experience of the trauma and toward the seductive ideal of perfection. Klein shows how the patient that refuses to “own” responsibility through the working-through process—is unable to release his creativity through acts of reparation and love.

In The Psychoanalysis of War, Franco Fornari coined the term the “paranoid elaboration of mourning” to describe how groups—upon encountering unbearable experiences of catastrophic loss— are unable to grieve and accept their guilt and responsibility for the tragedy confronting them. They project it outward as vengeance, always directed against the most vulnerable groups.

The horrors of 9-11 for the United States led to the unending “paranoid elaboration of mourning” that became the decades-long quagmire of middle Eastern wars. Unable to bear the horrors of our collective conscience, we were moved to create a process of evacuation and enactment—at an impossible cost in terms of blood and treasure.

Dr. Koenigsberg has constructed a lens through which to see the ways that collectives, in times of loss and traumatic tragedy, act like a psychotic individual fending off madness and fragmentation—through projection, violence, delusion and sacrifice.

From our clinical perspective we have identified how traumatized individuals seek to act like chaotic and mad groups and to “arm” themselves with resistance, delusion and disagreement. In order to hold the seeming overpowering forces of guilt, shame and self-hate at bay, our patients attempt to “force” the enemy (the therapist) to carry the unbearable burden of responsibility and self-hate.

Empowered with this new and radical understanding, the therapist can better appreciate the plights of especially problematic patients—and understand why he/she prefers the eternal “combat” of unsuccessful treatment—rather than accept the reality of the tragedy of the lost object and face the task of finding a new way to form relationships and be in the world without the original object.

Suffering and Sacrifice offers therapists the containing matrix of the analytic field that provides a vehicle for uncovering primitive conflicts and the reconstitution of the self in the aftermath of such insight. Thus, a solution might be fashioned whereby guilt, shame and unbearable loss can be borne,“suffered” (as Bion would say) and endowed with meaning and significance. The “agony” of sin, failure or crime can be transformed into symbolic understanding and emotional experience--a courageous and vitalizing experience of engaged partnership that leads to a new beginning.