A Discussion of Lachmann's “Humour and Spontaneity”

Throughout psychoanalytic history, the apparently ubiquitous nature of aggression has been considered, with questions raised on both theoretical and clinical levels about whether aggression is most usefully regarded as innate, reactive, or learned, and whether it is most effectively treated with confrontation, empathic attunement, or interpretation. Several years ago I participated in a symposium, later published in Psychoanalytic Inquiry (2001), in which all of these questions were addressed from a widely pluralist perspective, revealing, I think, the state of the art at that time. No consensus was reached about the nature of aggression then, but we did gain a greater understanding and appreciation for its underlying complexities. More recently, the publication of Frank Lachmann's book Transforming Aggression: Psychotherapy with the Difficult-to-Treat Patient has elevated our understanding of aggression another notch.

In this paper I consider the analysis of a patient whose form of aggression matches the description of what Lachmann has termed eruptive, that is, a form of aggression that appears biologically derived and driven, in contrast to other forms that are more easily conceptualized and understood as reactive. Lachmann writes that this drive-like appearance of aggression in some individuals is a consequence, not of average, expectable development, but of specific early traumatic circumstances. Such individuals demonstrate a process in lived experience by means of which reactive aggression is transformed into this eruptive form. He lists five predisposing factors to eruptive aggression: (1) a developmental history that included experiences of abuse, deception, and neglect; (2) early failure to establish self-soothing and affect-regulating capacities in dyadic interactions; (3) sexualization; a sexual expression invoked for