The Creative Mystique: From Red Shoes Frenzy to Love and Creativity (Book Review)

Author:  Kavaler-Adler, Susan
Publisher: New York: Brunner-Routledge, 1996
Reviewed By: Frank Summers, Winter 2002, pp. 50-56

Interview With Susan Kavaler-Adler
Dr. Susan Kavaler-Adler is the author of three books and 40 articles related to her view of mourning as a developmental process (“developmental mourning”) that is fundamental to self integration as well as to psychic change and transformation throughout one’s lifetime. Her unique integration of British and American object relations theory can be seen throughout her writing, fully defined as a theoretical perspective related to “developmental mourning” in her first book The Compulsion to Create: Women Writers and Their Demon Lovers (Routledge, 1993, Other Press, 2000). Dr. Kavaler-Adler’s focus on a well-known brilliant women writers in this book and on brilliant women writers and artists in her second book, The Creative Mystique: From Red Shoes Frenzy to Love and Creativity (Routledge, 1996) allows her to explore how the creative process can be the focus of progressive mourning for self integration and reparation or can be the captive of a demon lover complex (an object relations view of pathological mourning and psychic arrest) in those that fail to mourn due to developmental arrest from trauma in the primal stage of self development.

Dr. Kavaler-Adler’s third book, in press with Routledge, goes deeper into the clinical area than these two books, while further elaborating her theoretical perspective, in relation to Freud and the British theorists. This book, Mourning, Spirituality, and Psychic Change: A New Object Relations View of Psychoanalysis, extends the clinical application of Dr. Kavaler-Adler’s theories that can be seen in her first two books with in-depth descriptions of the developmental mourning process in dialectic with transference work in analysis, and with the interactive engagement of the psychoanalyst and analysand. The following interview focuses primarily on the thesis of the first two books, but touches on the third book at the end.

Dr. Summers: What would you say is the primary message of your work?

Dr. Kavaler-Adler: The primary focus of my work is on the use of the psychoanalytic situation to promote a developmental mourning process that allows self integration, self differentiation, separation-individuation and the growth of capacities for both love and creativity to take place. In my first two books I focus on women artists and writers who attempted to use the creative process for psychic development and for psychic reparation and healing. I found that these brilliant and well-known women often failed in their attempt to use the creative process for psychological purposes without undergoing an adequate clinical treatment. Curious to understand why, I used the extensive research I did on the biographies and creative work of these women to describe the repetition of primal trauma as it appears in the work and lives of these women as a demon lover complex. This demon lover complex appears in themes of muse-god figures who continually turn demonic when the woman artist seeks merger with them through their self-expression in creative work. In a creative moment of ecstasy, Emily Bronte yearns to merge with a vague male phenomenon, who in her fantasy is the muse inspiring her creativity and her life as she attempts to live life within her creative work. The female poet cries: “My outer sense is gone. My inner essence feels!” Expecting to be rescued from the pain involved in living within a traumatized body by the deified fantasy muse, she surrenders to an ecstatic state of bliss, only to be rudely and abruptly dropped into the hell of submission to a masculinized other to whom she has offered up all her power, as it exists in a state of manic erotic desire and craving. The poem turns from merger with an inspiring muse to the possession of the male that extinguishes the independent voice of the female poet. The next image of the poem is of a tombstone in a cemetery. Transcendence has failed and possession results, when the woman displaces all her own potential power into the fantasy figure of the male muse-god through projective-identification.

Her compulsion to do so stems back to her own traumatic self-disruption during the toddler years of separation-individuation. The repetition brings loss of voice, and thus of life, for the female poet. The demon lover theme is complete in a continuing cycle that creates the demon lover complex, (as seen throughout the work and life of a multitude of women), when the yearning to merge with an omnipotent fantasy god results in possession and/or abandonment leading to the ultimate denouement of death. This is a death at the hands of the demon lover, who is a projected combination of mother and father part object internalizations, along with the split off aggression and eroticism that cannot yet be tolerated at the level of psychic fantasy, unless expelled onto paper or canvas. The woman’s failure to mourn the early trauma results in this object relations phenomena of a psychically fixed pathological mourning state.

Women artists, just like other women, need a psychoanalytic/object relations treatment to recover from the psychic arrest that can feel like an endless paralysis in creativity and in life, when loving relationships continually fail. Yet, the very artists and writers who are so affected may reject clinical treatment due to certain societal and cultural myths. I deconstruct two of these myths in The Compulsion to Create. The first is that you have to be crazy or depressed to profoundly create. The second is that you cannot enter psychotherapeutic treatment because you need to preserve your psychopathology in order to be crazy or depressed to create. In truth, a clinical process that includes the developmental mourning of abandonment depression trauma will be the primary route to an enhanced creativity. Treatment can allow the artist’s creativity to be finally liberated from its compulsive and diminishing repetition, as mourning heals the splits and dissociations due to the trauma and allows the artist to understand her primal dilemma so that she can create a life in the world that can nourish both her and her work.

Dr. Summers: How do you think people use the creative process?

Dr. Kavaler-Adler: How people use the creative process depends on their developmental issues (desires, conflicts, and traumas). For women with early trauma, during the first three years of life, when the self is first being formed, their basic psychic development is disrupted in a critical way. These traumatized souls are driven to create to externalize an internal division within the self that they are unconsciously trying to repair. They often create in a state of manic intensity, which is reflected in their creative process and in the characters in the content of their work. They often attach to the creative process itself as if it’s the early mother.

If these individuals cannot consciously face and mourn their early trauma, they repeat it continuously, both in their life and in their work. Those most traumatized often try to give up their external life altogether and to live within the virtual world of their creative work and creative process (Emily Bronte, Emily Dickinson). On the pages of their work they endlessly live out their hope for love and life and the failure of this hope. Emily Dickinson describes the demon lover parent/god who possessed, abused, and abandoned her in her fantasy as “the metallic god who drilled his welcome in,” and the deity who “lets loose one thunderbolt” that “scalps [her] naked soul.” Like any addiction, such absorption in sadomasochistic fantasy takes over and destroys life. The woman artist seeks an unavailable, idealized man within the fantasy realm of her work in a futile effort to repair the disrupted self.

By contrast, I have found that women artists who have had good enough development in their first three years of life are able to mourn and repair themselves through their own creative work, independent of clinical treatment. At least to a certain extent they can tolerate the grief of mourning in their work, since the aggression related to it is less primitive and disruptive to their symbolic capacities than it is for those traumatized. They can succeed at symbolizing the figures whom they need to separate from, since they are equipped with whole object attachment in their internal worlds. Through their symbolic capacities, they are able to mourn losses that are often at the level of Oedipal disillusionment where separate rather than merged objects are found. Also, they suffer the pain of love that involves differentiated male figures of human rather than god-like or monster-like proportions. Two such women artists are Charlotte Bronte studied in The Compulsion to Create and Suzanne Farrell of the New York City Ballet studied in The Creative Mystique, who had Ballanchine as a masculine muse whom she does not convert to a demon.

Those who do not internalize an early holding environment cannot mourn. For example, Anne Sexton tried, but couldn’t mourn properly. Although she was creative and highly productive, her creativity was not able to contain, symbolize and thus help her mourn her early trauma. Even though she sought therapeutic treatment, the lack of understanding of the borderline personality and of object relations work on the part of one legitimate clinician caused the failure of treatment and caused exacerbating countertransference enactments. In the second treatment, Anne Sexton succeeded at enacting a masochistic submission to a male psychiatrist who enacted the role of the demon lover, heralding the Greek tragedy of her eventual suicidal demise, as she repelled the husband who loved her. Two chapters on Anne Sexton in The Creative Mystique go into careful detail of the failed clinical attempts and the abuse in the clinical situation that replayed the demon lover cycle.

Dr. Summers: How do you see mourning as a developmental process?

Dr. Kavaler-Adler: Mourning helps the child go through the separation-individuation process and to thus achieve self-integrity. The child needs to let go of the primal parents and life long mourning may be involved, but critical separation-individuation stage mourning is essential. The more pathological the parenting and the more disrupted the early maternal bonding the harder it will be to let go, because then no adequate internalizations will be formed to create an inner blueprint for new and future relationships to be created. If mourning does not take place, development is arrested.

Dr. Summers: What do you see as happening when the child gives up his/her dependence on the parent?

Dr. Kavaler-Adler: If adequate internalization has taken place, the child develops capacities for many forms of psychic dialectic that are the core of psychic health. In The Creative Mystique I speak of psychic health in terms of a “love-creativity dialectic,” which is a free flowing interchange between connection to one’s internal world for the expression of creative work and the connection to others through the intimacy of interpersonal relations in the external world. This psychic dialectic operates in parallel with dialectics between mind and body, and between personal voice and other directed empathy, as well as other psychic dialectics, as spoken about in the work of Sheldon Bach. When one form of dialectic is arrested by splitting so are the other forms of psychic dialectic. When someone deflects a whole part of themselves into the other through projective-identification, rather than interacting with or being with the present other, this is a sign of failed dialectic due to pathological splitting from early trauma.

However, if there has been enough sustained affect contact between the parent and child during the formative stages of self-development, a dialectic between self and object takes place that becomes internalized. This dialectic takes place internally between the self and the lost other represented in the internal world during the mourning process. If no blueprint for self and other relating has been established the internal dialectic needed for mourning cannot take place. Without the dialectic of mourning, there is no renewal of love for a potential new object, and creativity is arrested as love is arrested. The psychic dialectic is needed for both love and creativity, and the dialectic of mourning is needed for both to be re-born when the shock of object loss threatens to abort the flow of internal process. If there has not been enough relating between parent and child, this developmental process is disrupted, and all the other dialectics of healing and of living are never established.

Dr. Summers: And then?

Dr. Kavaler-Adler: The early trauma leads to a build-up of more bad than good internal objects, leading to an excess of sadomasochism. Then there is not enough psychic space for the pathological internalized objects, and they cannot be contained. The result is an abandonment depression (Masterson) related trauma. In this situation, the child cannot mourn. She needs therapy to develop the capacity to mourn the early loss of objects. Charlotte Bronte did mourn on her own through the character Lucy Snowe, in her last novel, Villette, which is her most profound psychological novel, despite the more action paced and magical Jane Eyre. In reading many biographies of Charlotte Bronte, I discovered that Charlotte Bronte was able to transform her loss by going through her own grieving process because she had internalized a good enough mother. Therefore, she went through her grieving at the Oedipal level, and her creativity helped her to do it.

People can mourn on their own if they have a sufficiently internalized relatedness with their early mother, a mother who can register in the internal world as a good enough figure, becoming a whole object representation rather than a viscerally intrusive and disruptive internal object. When the Bronte sisters’ mother got ill with cancer her younger daughter Emily was two and two and a half, in the critical stages of separation-individuation. When the mother died Emily was three. Her sister Charlotte was already five and had much more sustained nurturance from a healthy mother, and was already moving into the realm of attachment with the Oedipal father. Emily Bronte, unlike her sister, Charlotte, became schizoid, and like Emily Dickinson, who also became schizoid, she secluded herself in her father’s home for life, until dying from illness in her thirties, turning her father’s home into a maternal womb, resisting ever leaving it. Emily Bronte tried to overcome the loss of her mother by idealizing her father and then seeking his fantasy equivalent, a male muse phantom, energized by internal object enactments. Emily’s muse inevitably turned demonic being eroticized by Emily as she sought the body merger of an infant overwhelmed with Oedipal level drive energies. Emily’s muse became her demon lover; just as her did Heathcliff become the demon lover for her alter-ego heroine, Catherine, in Wuthering Heights.

Lacking a sold sense of self, Emily Bronte sought self-agency through creating male characters in her work and then attempting to merge with them. The idealized masculine figure became the target of early cravings for her mother (expressed repeatedly in oral and anal terms). The muse mother/father figure, once eroticized and endowed with split off aggression, becomes the demon lover who lives upon the stage of the creative work, which becomes too exactly a replica of the internal world, rather than its evolving transformation as it was for Emily’s older sister, Charlotte. Virginia Woolf, Diane Arbus, Sylvia Plath, Camille Claudel, Anna O., Katherine Mansfield and Edith Sitwell are other examples of those who I have written who also operate in this desperate enactment within their creative work, as did Emily Bronte and Emily Dickinson. However, in the clinical cases at the end of the books I demonstrate how object relations psychoanalytic psychotherapy can heal the very splits created in such personalities. This is true when these personalities are able to mourn and find the meaning of the psychic fantasies attached to their extreme opposite self-states within the holding environment of treatment.

Dr. Summers: All of this raises a question for me: How do you know whether the trauma suffered was Oedipal or pre-Oedipal?

Dr. Kavaler-Adler: This can be determined from their biographies. Emily Bronte lost her mother when she was two and three, but her sister was five when her mother first got ill. Charlotte’s major loss was the disillusionment with her father. Emily’s internal loss led to the longing for an attachment to a male figure and led to her Demon Love Complex. Emily Dickinson has pathological story of her own. Dickinson had a mother who was a schizoid personality to begin with, and then was in a profound pathological mourning state when she lost several close family members just prior to the birth of her daughter, Emily. In each case, one can see the roots of the trauma in the maternal relationship and the dynamic picture.

Dr. Summers: Is there a problem here in your assuming a pre-Oedipal conflict in those women who are unable to resolve their conflicts and assuming an Oedipal conflict in those who can resolve their conflicts? Could there be circularity here?

Dr. Kavaler-Adler: There’s nothing circular about it at all. When I began my studies of women writers and artists I was expecting one thing and I found the other, through a careful review of the biographies and the creative work of the subjects of my study. I was hoping to find the positive capacities of the creative process as a format for the developmental mourning process, and instead I found that in the case of most of the writers and artists whom I studied, who tended to have profound fantasy systems around male fathers or male authority figures, there was evidence of early pre-Oedipal trauma that went hand in hand with arrests in mourning process within creative work and with the compulsive nature of the creativity, in contrast to those with free creative motivation (and love-creativity dialectic) who could mourn and self integrate through their creative work.

The female sculptor, Camille Claudel is a case in point. Her biography demonstrates how a cold and paranoid mother, along with a narcissistic father, who treated her as special due to her artistic talent, resulted in her living out a demon lover complex with the male sculptor Auguste Rodin. In the throes of disappointment with Rodin, from whom Claudel sought the love lacking with her mother and the role of a special child that she had with her father, Claudel smashed her sculptures, became suicidal and became profoundly paranoid about Rodin. After she broke up with Rodin as a lover and turned her story into that of him abandoning her (he did resist marrying her), Claudel viewed Rodin, as a malicious rival who was calculating day and night to steal her work and to impoverish her. In fact, Rodin attempted to support Camille as an artist, although he also co-opted some of her art. Perhaps Rodin envied Claudel’s talent, which he thought to be greater than his own. Far beyond any reality, Claudel developed a whole paranoid system around Rodin to avoid facing the hate and abandonment she felt in relation to her mother. Yet it was her mother who incarcerated Claudel in a mental hospital and refused to have her released, so that she died there after rotting away for thirty years.

This case demonstrates that Kohut was wrong when he assumed that a father’s attention and idealization could substitute for the failed early mother’s love. Claudel’s search for a father became an addiction and a compulsion to create, as opposed to a free motivation to do so. Her creative process became a captive of her psychodynamics. Her Oedipal issues were clearly overshadowed by the pre-Oedipal ones. Her attempt to mourn through the grief stricken figures that she portrayed in her artwork clearly failed, as she smashed the very sculptures she created in a ritual attack on the male father-god figures, father and Rodin, who had encouraged her to be an artist. Her attacks on the father muse gods through her attacks on her own sculpture express the level of hate that she had to dissociate in relation to her primal mother in order to psychically survive. Yet her attempts at psychic survival were tenuous and she ultimately succumbed to withdrawal from the world and to psychic death, a purgatory of deadness that lasted thirty years before her actual physical death.

Dr. Summers: Is there any difference between such a compulsion and the use of drugs or alcohol?

Dr. Kavaler-Adler: The “compulsion to create” is often accompanied by alcoholism and/or drug addiction, as in the cases of Camille Claudel and Anne Sexton. There is a similarity between addiction to a substance and to a creative process that is unconsciously representing the lost symbiotic mother of infancy, prior to the disruption of maternal bonding. Without an adequate mother of during the separation-individuation period there is no development of psychic dialectic because there is no internalized blue print of self and other in relationship to each other through states of both connection and autonomy. Without this psychic dialectic that becomes love-creativity dialectic and the dialectic between self and other in both the internal and external worlds, compulsion or blocking occurs in creative process and in life process. Such compulsion and/or blocking results in failure in the critical process of developmental change seen in mourning and grief. Only when aggressive states can be contained, modified and symbolized can mourning proceed so that new modes of developmentally advanced connection can proceed. Without such containment, modification and symbolization of aggressive states the internal aggression blocks the flow of thought and feeling that becomes creative process and psychoanalytic process. In other words, the unassimilated aggression, like Wilfred Bion’s beta elements, drives one into manic thrusts of compulsion.

Dr. Summers: And without creativity?

Dr. Kavaler-Adler: An addiction is inevitable.

Dr. Summers: And how does this fit with what you call “the creative mystique”?

Dr. Kavaler-Adler: The “creative mystique” is an addiction to one’s own image as an artist versus just being in the process of creating. For example, Edith Sitwell became manic in order to keep up the mystique of feeling recognized. She was desperate for a basic recognition that she could never get from an absent and disorganized borderline mother and a grossly grandiose narcissistic and schizoid father. She frantically sought this recognition by performing her poetic works, striving to feel wanted by the audience, an audience that she later attacked and devalued. Sitwell was desperate to create an idealized image of her as she performed, and this manic activity warded off the primal object loss of early trauma that was terrified of confronting. Creating her image through her art, seeking to be a “star” as an artist was her mystique. When Sitwell got too old to perform, she withdrew to her bed and compulsively drank a milk-laced brandy. Angry with an audience that couldn’t repair her, she stopped writing poetry, the one thing that had kept her going. Earlier when she had gotten close to her actual pain in her poetry, and had used the word mourning, and seen visions of a wounded and emaciated child self within her, she quickly aborted the process and stopped writing poetry for ten years. When she returned to writing poetry she placed herself above a devalued feminine child self in the role of a prophet, who looked down on the female masochistic self and the demon lover male figure to which it was always attached (like Fairbairn’s sealed-off libidinal and anti-libidinal egos). She used a manic psychic defense to go on compulsively writing, without the expression of the true self.

Dr. Summers: Is there a cultural aspect to this?

Dr. Kavaler-Adler: It started with the romantic poets: Keats, Shelley, Wordsworth, and Blake. These were great poets, but their followers tended to idealize the image of being an artist. This resulted in the cult of suicide and death that followed Sylvia Plath, Anne Sexton, and Diane Arbus, when the image of the artist was extended to the idealization of the artists who committed suicide.

Dr. Summers: Your work focuses on women, but is the process any different for men?

Dr. Kavaler-Adler: No. Van Gogh would be a good example. He was in a state of manic excitement on the day when he shot himself and continued at the same time to paint his last painting.

Dr. Summers: Do you see Van Gogh as dealing with the same issues as the women you’ve studied?

Dr. Kavaler-Adler: Yes. Van Gogh had a frantic need to express something from within, a need that was so intense because of his craving for the mothering he never had. He was searching for a mother’s basic recognition as well as for an authentic self, in the midst of his internal self being sealed off and divided from the world of external relations. The basic issues are the same for men and women artists, but they are dealt with differently. The male artist seeks a muse that is an externalization of a grandiose self, hoping to be inspired by this split off grandiose self. He feels that he receives inspiration and thus power, from his muse, which is often female. The developmentally arrested female artist often seeks a muse that turns against her, possessing her rather than inspiring her. By worshipping a muse god that turns demonic, and which enacts upon her a masculine form of domination that extends to sadism, she creates a masochistic position for herself. In this way, the arrested female artist re-experiences the helplessness of an infant dependent on an inadequate and unavailable mother.

Dr. Summers: How do we understand dynamically the difference between the male and female artist?

Dr. Kavaler-Adler: That’s a good question. For the man the mother is both the pre-Oedipal and Oedipal object. The boy feels a sense of power, and when he losses the mother he continues to seek an inspiration for his power. The little girl switches from the mother as pre-Oedipal object to the father as the Oedipal figure. Through the Oedipal longing, the female may seek a power she cannot have. If the father relationship is insufficient, the girl continues to seek the power that she feels resides in the male. She masculinizes and eroticizes the object of her primal cravings that stem back to her need for her mother.

Dr. Summers: It sounds like there is similarity here with the work of Jessica Benjamin.

Dr. Kavaler-Adler: There is an overlap. Benjamin speaks of the omnipotent angel figure and I speak of the muse/demon. We both touch on the archetypical dimensions of the primal infant yearnings that can become pathological in the developmentally arrested adult. Benjamin speaks of the lack of a symbolic third, and I speak of the lack of symbolism in those for whom separation-individuation has not taken place due to the lack of capacity to mourn. The failure to mourn I speak of involves the lack of the father as a differentiated third figure, as opposed to the father as an alternate mother or extension of mother Differentiation fails along with the failure of mourning. For Benjamin the female child can be consumed and engulfed by the tie to the mother when the father isn’t there to serve as a differentiated figure for identification, aside from his role as an Oedipal love object. However, in my work I emphasize that the father can never be perceived as differentiated, no matter how differentiated he is as an objective figure, unless developmental mourning has proceeded and allowed separation-individuation to take |place. All of this depends on the personality of the primal mother, and her capacity to negotiate the complex interplay of closeness and distance involved in the separation-individuation phases of development..

Dr. Summers: How does the male artist evade mourning?

Dr. Kavaler-Adler: When the parents are inadequate narcissistic compensation may be sought in the male through idealizing the father figure and then identifying with his own contrived image of omnipotence. Simultaneously, he devalued the underdeveloped child and infant self, seen as an inferior feminine self that is split off and projected into women. To defend against his impotent feelings, a boy can split of his feminine side and project it into females, so that his muse figures become part object self extensions, who have the air of devalued female cherubs. Thus, the male remains underdeveloped, and without re-owning his split off feminine side the work of mourning can never proceed. Consequently, the self remains in a manic state of narcissistic defense and lack of completion.

Dr. Summers: What do you feel the relevance of this is for clinical work?

Dr. Kavaler-Adler: What is needed developmentally is mourning and integration. What gets in the way in a pathological mourning state is the Demon Lover Complex, and this is what comes up with patients.

Dr. Summers: What is needed to mourn?

Dr. Kavaler-Adler: What’s needed is to symbolize and process affects related to loss, including aggression as well as grief. When that happens, the patient can internalize a containing internal object that creates a containing sense of self. The patient needs to do this with the therapist. If that occurs the patient replaces mourning with going-on-being, and becomes truly capable of being present with the self and with the internal or external other in the moment. From this stems all love and creativity.

Dr. Summers: And you believe that at the Oedipal level the patient can use creativity to mourn?

Dr. Kavaler-Adler: Yes. There is convincing evidence of this. Creativity can be used as the mourning process, and the person then can continue to be creative, as mourning also promotes the discovery of creativity within the self. Creativity is gained, not lost, is the person is healthy.

Dr. Summers: Can you say something about your new book, Mourning, Spirituality, and Psychic Change: A New Object Relations View of Psychoanalysis?

Dr. Kavaler-Adler: Mourning has been both implicit as well as explicit in psychoanalytic theory, stemming back to Freud’s Mourning and Melancholia. In Klein’s Mourning and Its Relation to Manic Depressive State, Klein first speaks of mourning as a critical clinical and developmental process. I have continued from Klein and have shown how Winnicott, Fairbairn, Balint and Bowlby are all dealing with mourning as well.

Winnicott’s ideas on object survival through the continuing presence of the analyst during the primitive rage affect storms of developmentally arrested patients, and survival through the relinquishing of interpretation when it is being experienced as retaliation, are all related to a dialectic with Klein that opens the pathway to grief and mourning, and to the free associative and symbolic processes that are a part of this mourning. Fairbairn’s whole theory of the addiction to a bad object is about a pathological mourning state and thus speaks implicitly to the theory of mourning. Since mourning requires that the subject experience more love than hate for the object, the possession by a primal bad object, related to the original real external object, obviously obviates mourning. Balint speaks explicitly of mourning in speaking of healing the basic fault. Bowlby, a follower and analysand of Klein, speaks of mourning as a fundamental developmental process in which aggression has an accepted role, rather than being seen as defensive as Klein would view it. In my new book I relate to all these theories in my discussion of mourning and psychic change and in my discussion of my own metapsychology. I am in dialogue with these theorists who are in dialogue with each other. However, I also add the element of spirituality to the mourning process, since it appears so vividly in some of my in-depth clinical cases. It has been reported recently that only three out of a thousand articles on psychoanalysis address spirituality. I wrote the case studies in this book some time ago and can now look back at the profound psychological change that emerged, as I remained attuned to the spiritual dimensions of the developmental mourning process. This is true whether these dimensions emerged directly in the clinical dialogue and the clinical associations, or they emerged in the art and dreams of the analysands.

Dr. Summers: That’s all the time we have to talk.

Dr. Kavaler-Adler: Thank you. It’s been a pleasure sharing my work and ideas with you.

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