The American quantum physicist David Bohm (1917-1992) argued that there is a fundamental difference between a sporadic act of revelation and one that represents a true creative act. The latter begins with the compilation of a new basic order, which in turn defines new structures with a greater tendency to wholeness and harmony. The creativity of this work relates to the pretension to order, in a new form, different ways of interpreting the dream reality. For this purpose, I am going to present a structure that demonstrates the complexity that operates in this process.
My clinical practice left psychoanalysis and passed through mind-body therapies, returned to psychoanalysis in its most relational dimension and it has now evolved into analytical psychology. Starting from a certain chaos it has increasingly become a deeply integrative practice. My vision of integrative has nothing to do with combinations without order or reason that is realised in purported models of integration – very common in certain orientations that are defined as humanist – nor with formulations presented as a synthesis but basically what they do is totally change the form, which is very common in certain analytical practices that interpret with a Jungian terminology but with a deeply Kleinian reference.
My integrative perspective is strongly influenced by the vertex notion put forward by W. Bion. I consider that psychic reality has different angles and these correspond to clinical interventions that affect heterogeneous dimensions. The integration I propose doesn’t refer to the combination or union of theories, but the consideration that each of them can account for certain aspects of psychic reality.
I distinguish six dimensions:
1.- Cognitive dimension
With this dimension we work on the patient’s mentalization vulnerabilities (the ability to understand the mental processes of others and oneself). The objective is to reactivate mentalization when it has been lost or damaged during the development of a psychopathological process. The contributions of Bateman and Fonagy are fundamental.
2.- Topographic dimension
This Consists of making the unconscious conscious. In this I include Freudian drive theory, Kleinian contributions about partial object relations, the analysis of unconscious organizational processes in relational psychoanalysis theory and the Jungian theory of complexes, integrating in the latter some aspects of Adlerian individual psychology.
3.- Psychodynamic dimension
This focuses on the analysis of the defences and reactive formations that appear in the ego, while at the same time emphasising the need to establish new agreements between the different psychic instances (id, ego and superego). We find this approach in early psychoanalytic work that describes unconscious parts of the ego, as shown in the work of A. Freud, W. Reich and H. Hartmann.
4.- Abreactive dimension
This dimension relates to the discharge of affections and emotions, as we find in some Reichian inspired psychotherapeutic work or in humanistic psychology.
5.- Relational dimension
This is based on the importance of an analytical collaboration that helps the patient to construct a more consistent and flexible personal identity by providing the possibility of a corrective emotional experience. This dimension began to develop with the analytical practices of S. Ferenczi; H. S. Sullivan’s interactional psychoanalysis; W. R. Fairbairn and D. W. Winnicott’s object relations; H. Kohut’s self psychology psychoanalysis; and has continued with the relational psychoanalytic work of R. Stolorow, S. Mitchell and J. Coderch, among others.
6.- Existential dimension
This last dimension is related to the ability to give meaning to the life experience through direct work with the unconscious, helping our patients to connect with the sources of their creativity. It was developed mainly by Jung and enriched by some of his disciples, such as von Franz. We can also point out the contributions of existential psychology.