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In this commentary, I thought it would be interesting to offer a neuropsychoanalytic perspective on the clinical material. Neuropsychoanalysis is an attempt to think bilingually - a yoking together of neurological ways of understanding the brain with psychoanalytic ideas about the mind. It may be useful to consider the clinical implications of thinking in this way when considering the material provided.
When presented with clinical material, there are four questions to ask about the patient in order to work neuropsychoanalytically. I will therefore ask each question in turn and attempt to offer as full an answer as I can.
Question 1 - What Feeling Does the Patient Suffer From?
Pauline appears to suffer predominantly from PANIC/GRIEF but I think it would be fair to say there is probably some FEAR and RAGE mixed in there too. (I italicize these affects as they refer specifically to three of Jaak Panksaap's seven Basic Affects, the other four being LUST, CARE, PLAY and SEEKING.)
Another way of answering this question is to ask which need is currently not being met? I think it is the need to feel safe with someone and to be able to rely on them. Both Pauline's history and also her behaviour in the reported session would suggest this is problematic for her.
Question 2 - What Unconscious Prediction Does the Patient Use to Meet that Need? (This is Enacted in ‘the Transference’, Broadly Defined)
Neuropsychoanalysis makes the assumption that the problems we encounter in our relationships recur because they are automatized solutions to problems we encountered early on in our lives. They are automatized solutions because they were effective in coping with conflictual emotional experiences in the past and they have become unconscious ways of relating. As they are unconscious, we are not aware we are using these ‘solutions’ to predict the way others will treat us. But we do.
In Pauline's case, she uses the unconscious prediction that she will be left to solve her uncertainty about whet