ABSTRACT
Using the long-term practice of psychoanalytic psychotherapy to exemplify the mind-body problem, Alan Michael Karbelnig begins by establishing non-dualistic and perspectivist foundations. He proceeds to explain the intricacies of psychoanalytic practice. Four basic mental phenomena are emphasized: namely, the unconscious and its manifestation in the repetition compulsion, transference, and dreams (or other signifiers of the unconscious). He then proposes an analogy to lovers, exorcists, and critics for understanding the nature of psychoanalytic work. He further shares private details of three medical incidents, which he developed over the course of a decade occupying these social roles and explores the mind-body interactions likely contributing to his medical crises. Furthermore, Karbelnig elaborates upon the unique mind-body interactions involved in his work—disappointing patients, absorbing intense emotional states, and involvement in countertransference enactments—through a vivid description of a typical morning at work. The examples include one patient experiencing abrupt, unexpected marital separation, another re-living exposure to the New York 9/11 attack, and a third expressing wild spikes of idealization and devaluation towards him. Clinical psychoanalytic work risks triggering psychoanalytic practitioners’ childhood traumas, unmet need states, unresolved conflicts, and neurobiological vulnerabilities. The chapter concludes with reflections on the extremely interpersonal, even intimate nature, of psychoanalytic work. It renders practitioners’ heart-minds and psyche-somas subject to the slings and arrows of projection, introjection, empathy, and identification.
