From the category archives:

Infant development

This column also appears in the May/June, 2011; Volume 23, Issue 3 of The Therapist, published by the California Association of Marriage and Family Therapists (CAMFT).  Abstract page 74.

Abstract:

The capacity to use words and language as symbols of communication is a developmental achievement borne of the elegant and mutually regulating mother-infant dyad.  This paper examines what occurs when emotional catastrophe compromises this sensitive process, and speech and words come to be used instead to defend against annihilation anxiety, dread and psychic “black holes” associated with primitive mental states.  The perspectives of Bion, Ogden, Grotstein and Tustin are used in conjunction with case material to explore these early modes of self-other experience that might be construed as pre-object relations, as they are primarily sensory in nature.   Consideration is given to the ways speech is used as an autistic object/shape engendering isolation rather than as a symbolic mode of communication promoting enhanced relationality and subjective meaning.

Language was the conjurer, indeed the philosopher’s stone, language was a form of alchemy.  It was language that elevated meanness to the heights of art.  Like the irritating particle that bred the nacre of the pearl, language ameliorated the gnawing irritant of existence; it interceded between the wound and the dream. Henry Roth

Laurie’s uninterrupted speech knocked me about like a strong wave slamming into an unwitting swimmer who has unwisely turned her back on the sea to gaze anxiously toward the safety of shore.  She would commence speaking the moment she arrived in my consulting room and, if I didn’t intervene or attempt to interject a comment during the ensuing forty-five minutes, would continue until she departed.  I felt intrusive if I intervened, invisible if I didn’t.

For months I looked for meaning in this verbal splatter, something elemental in her eruptions that I might transform and return as both useful and usable.  I struggled to know her, tried to like her.  Feeling superfluous, I was ashamed to find myself looking at the clock repeatedly during sessions and exceedingly relieved when they ended.

Conceptual imagery and word shapes

Taking shape in my mind, her speech appeared as meaningless glyphs, disenfranchised words comprised of loosely formed letters, their varied sizes and shapes barging forward or receding.  Oblivious of the time frame, Laurie’s sessions began to seem endless, requiring gentle reminders to allow her ample preparatory time to reorganize herself and leave.  Any specific reference to the separation anxiety associated with endings would evoke another gush of speech that was almost impossible to interrupt.  I looked for the needy baby behind the noise.

Our sessions had no discernible beginning or ending, just an ongoing flood of speech.   There were few thoughtful troughs between waves, just endless sets rolling toward shore across the surface of a vast sea of words flooding the room.  For a long time, she and I were lost at sea. When she wasn’t speaking to me (or at me), she was talking on her phone, filling the waiting room with sounds that made me wince, and I felt violated by her incessant vacuity.

Collapsed psychological space

The Mona Lisa

Maternity

When we spoke on the phone, her compulsive speech would begin the moment I greeted her, regardless of the purpose of the call.  Unable to differentiate between a formal phone session and a simple business-related call, she leaked words in a manner that suggested her inability to sustain any sense of foundational boundedness.  She experienced words, thoughts and actual bodily contents as equivalencies and was unable to plug holes in her still rudimentary sense of self.  As Odgen described, she was “creating a substitute for the space between mother and infant in which the infant ordinarily finds a place to live between self and other (Ogden 1989, p.66).

Desperate verbiage filled any potential space in which we might have engaged one another meaningfully.   I felt like a theatrical prop that existed simply to absorb her bizarre recitation of the loosely associated and circuitous events of her life daily life, her errands and shopping excursions, her family irritations and interactions.

She would frequently wander through time leaving me to find links in the massive holes in her narrative.  A present time reference to her sister in once sentence would shift decades in the next, the pronoun “she” no longer representing her sibling but her aunt.  Why are you telling me this? I wondered.  What are you really trying to tell me?

She buried me with words, and any attempt to proffer an empathic interpretation or comment was bulldozed with a quick nod and continuation of her monologue.

Any pause in her continuous production of words seemed to provoke terrible dread and annihilation anxiety.  I began to dread her sessions with equal intensity.  No psychological space (Heller 2010) existed in which she and I might engage.  I frequently felt useless and unnoticed.  Who failed to acknowledge you? I wondered.  Who left you alone?  Who couldn’t or wouldn’t speak your language?

Her capacity to utilize the creative potential of psychological space had collapsed like a weak lung, or perhaps a lung that had never filled.  For many months, there was no space for me to offer anything other than my presence and willingness to be used as a container, an exogenous lung.  I felt suffocated, as if the air were being sucked from the room and experienced uncomfortably deliberate urges to fill my lungs to capacity and inhale great breaths of air.

I was to learn eventually that she had sustained a collapsed lung following a childhood accident, so the lung imagery that arose in the analytic third (Ogden 1994) during moments of reverie* were salient and permitted me to begin to comprehend and decode what she was broadcasting unconsciously.

Behind this blinding white water spew of distraction, I found that for a moment, I could grasp the sand with my toes and withstand the currents.   I listened and attended to her pressured and compulsive speech as if I were caring for a screaming infant.  Using a soothing and modulated tone of voice and carefully paced speech as swaddling, I began to open a small space in which we might initiate and share a relational exchange.

The importance of learning from experience

The repetitious nature of her narratives signified her inability to build upon her own ideas and thoughts or upon the co-constructed foundations of shared interpersonal moments.  She would repeat what appeared to be almost scripted sequences again and again, as if she’d never spoken them and I’d never heard them.  Each narration was isolated and unlinked to any other.  She could not make use of earlier versions to work through, learn from or adapt subsequent renditions.

From a Bionian object relations perspective, Laurie could not think with her thoughts (Bion 1962.) They functioned as impulses to speak, nothing more.

Her proto-thoughts existed as beta elements (Bion 1962), sensory bits that had yet to be symbolized and transformed by alpha function and language into meaningful ideas upon which she and I could build.  Paradoxically, Laurie used words not as symbols of communication but as protective amulets to avoid a dark psychic void, a whirling vortex of nonbeing from which she feared she might never return.   As her word waves crashed in, I felt the concomitant pull of dangerous rip tides.

Into the void

Psychic voids represent gaps and fissures in the emotional floor of an infant’s foundational and rudimentary sense of being that expand into gaping and engulfing black holes (Grotstein 1990).  They signify the reverberations of an emotional catastrophe (Tustin 1981) between mother and infant, precipitating what the young child experiences as an endless free-fall in unbounded space.

Despite her mother’s actual presence, Laurie’s needs exceeded what her distracted mother was able to provide.  Lacking adequate maternal protection and containment, Laurie was left to manage confusing and frightening sensory experiences without the aid of her mother, the one person who could symbolize, interpret and transform them into meaningful psychic structure.  Instead, Laurie’s inner landscape was filled with dangerous sensory-affective potholes into which she feared she might trip and fall forever.  She defended against these terrifying threats of annihilating engulfment by filling the holes with meaningless noise and word-spackle.

The autistic-contiguous mode of experience

Evidence of this ancient catastrophe was manifest in Laurie’s default defenses and select mode of experience that reflected presymbolic and sensory rather than more fully mentalized object relations, consistent with what Ogden (Ogden 1989) designated the autistic-contiguous mode of experience.

Lacking a psychological skin (Tustin 1994), Laurie used words as palpable, sensory objects to scab over her flayed emotional self.

While repetitious speech defended against perilous psychic voids, it preserved her stasis in isolation and precluded any viable relational connection.  Like an insect preserved for eons in amber, Laurie was frozen in time and continued to rely on the autistic-contiguous mode of experience with little variation and without the addition of more mature modes that would permit empathy, mutuality and relational engagement.   Once after having learned coincidentally a fact about my personal life, she remarked, “We don’t usually talk about you, do we?”  For a moment, she saw me not simply as an extension of herself but as a separate object with discrete subjectivity of my own.

Working in the transference-countertransference matrix

In response, I experienced potent sensory and somatic countertransference sensations, often feeling drowsy though not bored.  Cringing was my strong response to feeling “tyrannized by an automaton” (Ogden 1989, p.44).  I frequently felt as if I could “crawl out of my skin” or twitch out of my chair as I sat with her, tortured by her inane recitals until I realized that she needed to use my skin and body as a substitute for the psychic skin she lacked.  To contain her unformulated and fragmented self, the beta bits she could not integrate or use, she was trying to burrow under my skin where she might feel shielded by its consistent surface.

And the word-shapes I perceived in reverie* were the autistic shapes (Tustin 1984) that constituted Laurie’s early object relations.  These are sensory, felt “shapes” arising when an infant touches soft objects.  Not yet perceived as separate, they represent the sensory edge of experience whereby warm and sensual contact objects such as bath water and skin or mouth and nipple are experienced by the infant as conjoined.

Surface contact is identified as a soft shape with its own mode of proto-object relations.  This sensory position is operational throughout life but serves a primary function in infancy, preparing a baby to distinguish hard from soft, animate from inanimate, me from not-me.  Imagine the contact friction where the surface of your skin meets the clothes you are wearing as a soft, warm shape representing conjoined rather than separate objects.

Long after the infant acquires the capacity to discriminate self from other and has developed more mentalized modes of experience, the autistic-contiguous mode remains her portal to tactile sensuality and sexuality.   We might think of it as “regression in the service of sensation.”

My countertransference feelings of intrusiveness had their correlate in Laurie’s early life when she felt her infant self to be an unwelcome intruder in her mother’s world.  My feelings of invisibility were linked to Laurie’s experience of herself as ignored and unacknowledged.

Evidence of premature separateness

Before she had acquired the capacity for self or object constancy and a subjective sense of individuality, Laurie’s infant self could only experience premature separateness as annihilating.  Lacking an emotionally attuned mother to modulate and reflect her existence back to her with delight and joy, she felt obliterated.

To bridge the perilous gap between existing and not existing, Laurie made noise.  If she didn’t intrude, she felt herself disperse and disappear into the ethers.  Noise verified her existence.  Though exiled, she was alive.

Laurie’s fall through space was as endless as our sessions often seemed.  I tried to break her fall by acknowledging her sensory needs and bundling her in my psychic skin.  She longed for contact, but had isolated herself behind an autistic, synthesized crust that seemed impossible to penetrate.  Despite the endless topical speech, terrible feelings of isolation and meaninglessness (Grotstein 1990) permeated our sessions leaving me feeling drained and ineffectual.

Laurie’s inability to distinguish between major and minor, foreground and background, significant and insignificant suggested the severe degree to which her sensory-affective experience and nascent thoughts remained conjoined at the surface and undifferentiated qualitatively.  What had originally begun as an early mode of sensory experience, a primitive awareness of self and object-other, had become a concretized and unyielding state in which she was rigidly stuck.

She would talk to a complete stranger just as she talked at me.  Everyone existed to provide archaic psychological functions for her, all interchangeable heads.   I was indistinguishable from a store clerk or gardener or anyone who would listen.

Autistic objects and shapes

Speech served several vital functions for Laurie.  In addition to representing autistic shapes, she also used speech-words as autistic objects (Tustin 1980), sensory dominated object-things used in impersonal and idiosyncratic ways.  Just as individuals with dementia will touch the surface of a nearby table or an edge of cloth as a means of sensory orientation, a feeble attempt to locate themselves in space, Laurie attached herself to objects at a sensory level, using relentless speech as adhesive.  She used speech like sonar to locate herself in proximity to me.  Speech conveyed painful affect not meaningful content.  The significance of my empathic attunement was evident in her choice of words that suggested skin contact and sensation, frequently remarking that something I did or said “touched” her, though she rarely could articulate why.

Considered retrospectively, I am now aware of the frequency with which Laurie referenced geographic and personal space, using them as metaphors for terrifying sensory-affective experience and unmet needs.  She would describe in detail aspects of the homes in which she lived as if she were describing physiological topography, using distance, walls and the impress of small rooms as autistic shapes and objects.  Some rooms felt containing while others did not.

Laurie would occupy herself making mental “shapes” from the lines and holes on the acoustic ceiling tiles on the occasions when I was out of the consulting room and would describe them to me when I returned.  I came to comprehend that these shapes were metaphors for early sensory experience that had never been symbolized.  She was trying to construe something meaningful from the discrete self-states and events in her life that felt random and disconnected.

Young girl dreaming

These “holes” were indicative of primitive mental states associated with sensory experience, particularly touch and the skin.  She entered a very childlike state of reverie associated with bouts of childhood illness when she would lie feverishly in her bed and look for design patterns and shapes in the ceiling above her head.  Neglected for long periods of time by a narcissistic and depressed and disengaged mother, she was left to make meaning of her sensory-affective experiences alone.

Making meaning of trauma and discontinuous self states

Having experienced little continuity of being, Laurie used word-shapes and objects to bridge holes in her discontinuous self states.  Uninterrupted speech served a critical survival function.  It prevented her entire sensory floor from falling away beneath her, pitching her into a dark sea or an engulfing black hole (Grotstein 1990).

Her torrent of words represented the only net she could use to defend against the terror of discontinuity and the nullifying anxiety associated with fathomless psychic voids.  She chattered at the edge of a gravitational vortex she could not overcome any other way.

Instead of suggesting creative potentiality, psychic space (Heller 2010) threatened to devour or engulf her in a state of utter nonbeing.   Unspeakable traumata were smothered in meaningless talk.  Unless her discontinuous self states were tied together with word-strings, Laurie ceased to exist.  Together we worked at the edge of meaning, trying to find symbols to represent unformulated experience.

Speech-noise represented the only girdle holding her together.  She could use words like Lycra, but she couldn’t think with them.  When I once asked who hadn’t cared for her, she stopped talking and wept.

As I began to comprehend her great need for foundational and sensory stability, we began to work at that level, using language that described her bodily and skin sensations in an effort to improve the quality of relatedness and transmute vowels and consonants into psychic scaffolding that might provide a reliably sturdy structure upon which she could rest.  When she initiated a stereotyped recitation, I stopped her and shifted to affect and bodily sensations, and eventually, she began to say, “I feel…”

Using language to create ongoing and increasingly complex stories and narratives from her ceiling picture-shapes and beta elements, she began to acquire the capacity to forge links and symbolize her unformulated experiences rather than simply repeat isolated segments.  Continuity and creativity began to replace abbreviated repetition.

Using my own thoughts, feelings and pictorial imagery as finely tuned instruments to track her unconscious communication in the intersubjective matrix, I learned to gauge her needs.  We worked as alchemists, using alpha function to transform base words into meaningful language.

Every single moment of reflection or reciprocity constituted a decisive achievement, rising like a small island in an otherwise illimitable and unremitting sea.

By slowly symbolizing and linking Laurie’s experiences and self-states over time, using circles of communication (Greenspan 1997) to expand her capacities to both think and relate to me as a discrete other, we began to see a varied and enduring archipelago of meaning emerge from her sensory seabed and coalesce into psychic structure.

 

* Reverie: Bion’s (1962) idea describing the analyst’s state of receptivity to her patient’s unconscious experience that parallels a mother’s receptivity to her infant’s raw, asymbolic or pre-symbolic experience.

WARNING! This text is printed for the personal use of the subscriber to The Therapist Magazine and InsideOutJournal.com and is copyrighted by Mauri-Lynne Heller.  It is illegal to copy, distribute or circulate it in any form whatsoever without the author’s permission.

Citations

Bion, W.R. (1962). Learning from experience. Classic Books. (Locale unknown)

Bion, W.R. (1962). The psycho-analytic study of thinking. International Journal of Psycho-Analysis, 43:306-310.

Greenspan, S (1997).  Training conference, Anaheim, California.

Grotstein, J. (1990). Nothingness, meaninglessness, chaos and the black hole Part I – the

importance of nothingness, meaninglessness and chaos in psychoanalysis.  Contemporary Psychoanalysis, 26:257-290.

Heller, M.L. (2010). Working in psychological space Part I.  The Therapist, volume 22/issue 3, March-April.  Also posted online: Inside Out Journal at insideoutjournal.com

Heller, M.L. (2010) Working in psychological space Part II. The Therapist, volume 22/issue 4, May-June.  Also posted online: Inside Out Journal at insideoutjournal.com

Heller, M.L. (2010) Working in psychological space Part III.  The Therapist, volume 22, issue 5, July-August.  Also posted online: Inside Out Journal at insideoutjournal.com

Ogden, T.H. (1989) The primitive edge of experience. Jason Aronson Inc., New Jersey, London, p.66.

Ogden, T.H. (1994). The analytic third: working with intersubjective clinical facts. International Journal of Psycho-Analysis, 75, pp. 3-19.

Roth, H. (1994). From bondage. Picador USA, New York, p. 77.

Tustin, F. (1980). Autistic objects. International Review of Psycho-Analysis, 7:27-39.

Tustin, F. (1981).  Psychological birth and psychological catastrophe.  In Do I dare to disturb the universe: a memorial to W.R. Bion, ed. James Grotstein, Caesura Press, 181-196.

Tustin, F. (1984). Autistic shapes. International Review of Psycho-Analysis, 11:279-290.

Tustin, F. (1994). Autistic children who are assessed as not brain-damaged. Journal of Child Psychotherapy, 20:103-131.

 

 

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This column also appears in the March/April, 2011; Volume 23, Issue 2 of The Therapist, published by the California Association of Marriage and Family Therapists (CAMFT).  Abstract page 75.

Abstract:

This two-part series examines the psychological origins and antecedents of terrorism.  Object relations, intersubjective systems theory and contemporary relational psychoanalytic concepts are used to define and highlight the constellation of specific dynamics implicated in terrorist enactments, particularly the ways they replicate salient interactive patterns of early mother-infant communication.  This resonant, harmonic unit, characterized by interactive modes of touch, gaze and projection, establishes the creative sphere wherein an infant comes into selfhood and begins to develop nascent capacities for relationality, empathy and morality.  Emotional terrorism begins when a mother is unable to contain and modify her infant’s projected anxieties or, in reverse, projects her own, initiating a repetitious cycle of terrorist-victim or “doer and done-to.” Clinical and cultural implications of sadism, the perversion of empathy, are also considered.

The Emotional Terrorist Part I examined the psychological origins and attributes of terrorist-victim dynamics and the defensive processes that drive repetitious enactments.  It also explored the ways that sadism represents the perversion of empathy.  The Emotional Terrorist Part II explores case material to further clarify and exemplify these dynamics.

Clinical examples

A patient arrived for a session shortly after experiencing a serious break-up and began by disparaging her lost love object.  He was an idiot.  I never really loved him, anyway.  I’m better off without him. While these appraisals may very well have been accurate, they were also being used defensively to avoid abject feelings of jealousy, loss, loneliness and painful rejection.  These intolerable feelings were more safely managed after being externalized, projected and relocated in the lost object where they could then be attacked.

Poet's Dream

Envy and rage are difficult to tolerate, even by psychologically developed individuals, as they activate unpleasant feelings of inadequacy, incompetency and shame associated with the helplessness of infancy and distasteful dependency needs, traits that conflict with subsequent developmental achievements.

Because these undifferentiated, “not-me” (Stern 2009) self-states are kept out of awareness defensively, they pose unbearable conflicts referred to as the “agony of consciousness” (Tustin 1986, p. 43) when they begin to emerge and are quickly dispatched before they can be sufficiently modulated or integrated.  A state of non-experience is preferable to torment.

Preverbal pockets of early traumata and other unmetabolized self states can only be accessed or experienced initially by the therapist via non-linguistic modes of communication that rely frequently on unconscious projective processes (Ogden 1989).

As therapists, we decode or “read” patient projections by tracking ourselves in the intersubjective matrix of the transference-countertransference milieu, carefully attending to our own sensory reactions, feelings, observations, thoughts and reveries.

Following moment by moment shifts in affect, posture, gaze and relationality, we utilize our own means of empathic projection to access unconscious aspects of both self and other in the intersubjective field.  In this dynamic mode, our simultaneous access to the derivatives our own unconscious processes that would otherwise remain out of awareness help us understand what has yet to be formulated and spoken.

The Alexithymic Patient

During the analysis of a deeply frightened patient whose early environmental failures rendered him unable to access even the most basic language that might enable him to identify or conceptualize his emotional states, I learned to recognize when we had hit a preverbal pocket because he would look at me helplessly and shrug.  His episodic inability to give linguistic shape to the content of his affective self-states conveyed how he used the rapid dissociation of unformulated material to protect himself from terror and dread.

Successful in the trades, he and his wife assumed very traditional marital roles that required very little intimate communication, leaving them compatible but emotionally disengaged.  He said his wife complained of loneliness.  He didn’t know what she wanted.  People hadn’t talked about feelings when he was growing up he often said.  His narcissistic mother had filled him with her own projected terrors, leaving his early object world riddled with engulfing psychic voids (Grotstein 1990) rather than viable maternal representations that could be used to contain his feelings.

He had no inner mother on whom he might rely.  What little paternal comfort he had was lost when his parents divorced and his father moved away.

Invisibility was his shadow companion, and he cringed away from interpersonal intimacy and avoided social gathering that made him feel “put on the spot.”  He had sporting buddies but no real friends.  Rather than reactivating the internalized warmth embedded in early modes of concerned relationality provided by empathic maternal attunement, his unacknowledged and unformulated (Stern 1999) feelings simply backed up and congealed.

He loathed his mother’s visits and spoke of her relentless self-absorption, how her endless talking bombarded him with palpable word-objects.  There was no space for him, so he quietly endured her assaults until she left, leaving him “in peace.”  Unable to recognize his dissociated and projected desires for intimacy in his wife’s requests for contact, he felt helpless as she enacted his desperate pleadings, giving voice to his wordless scream.

Our sessions were characterized by lengthy silences during which I functioned as the container for his disavowed self-states.  He found these silences extremely embarrassing, frequently announcing that he wasn’t coming back again.   I understood this to mean that the conflict posed by the emergence of unspeakable affective states into consciousness was intolerable, so the dissociated terrors remained selectively unformulated and desperately avoided.

Tracking my own subtle reactions, I was able to apprehend his unformulated and dissociated feeling states and sought to find symbols and words that might describe them.  Once when talking about the drought, I shared my reverie of a quiet and pristine pool of water, describing his inner world as an aquifer waiting to be tapped.  This was the first symbol he’d ever linked to what had always been an unnamed part of himself.

As we sought descriptive language together, his unspeakable and amorphous feelings of annihilation dread found an outlet in discourse, and he began to formulate his own emotional language and a concomitant capacity to depict his inner world.  Congealed emotional terrors began to liquefy.

Spousal victim and victimizer

In clinical practice, we observe this terrorist dynamic of doer and done-to (Benjamin 2004) most floridly when working with couples.

Repetitiously terrorizing volleys might be construed as representing a game of hot potato with dissociated emotional projectiles and bad objects.  Both “bad me” and “not-me” aspects of self states are launched back and forth like missiles.  Disavowed and unformulated self-states are projected and subsequently attributed to the partner where they are more easily attacked.  Affect often alternates between self-loathing and rage toward the partner.

The patient whose emotional fragility feels too dangerous and alien to claim, projects it onto his spouse.  “She’s too emotional,” an emotionally blunted husband said of his wife.   The nascent emergence of strong conflictual feelings threatened the cohesion and regulatory aspects of his self-image, activating unwelcome dependency needs that made him feel small, needs that chafed against his branding as an autonomous adult.  So, he rid himself of conflict by projecting his needs, locating them in his wife and criticizing her.  In turn, she attacked his remote implacability.

Rather than experiencing the full spectrum of their sensory-affective selves, they terrorized each other with projected aspects of self states that would otherwise pose intolerable conflict. Each spouse representing one half of a broken plate (Stern 2009), they enacted in turn invariable roles of terrorist and victim.  Doer and done-to.

As therapists, we feel it most acutely when a couple closes ranks and directs its combined projective animus at us.  You don’t care about me.  This isn’t working.  You’re only here for the money.  Oh, I think we can talk to each other without you. Feelings of incompetence have been located within us, temporarily relieving a couple from experiencing the abrasive conflict required to resolve them (Stern 2009).

The Mona Lisa

Maternity

These feelings of incompetence that are experientially and dialectically incompatible with mastery can be evaded routinely by patient and therapist, compromising treatment, until the clinician is able and willing to examine conflictual aspects of her own “bad me” and “not me” self states first.

The clinical clue uncloaking a stealth projection of helplessness is a strong countertransference feeling of utter ineptitude.  We must be able to claim our own “not-me” states of ineffectuality.  If we disavow them, we have no option but to project them right back.  Like a juggler with several balls in the air, we must take care not to throw them.

Children and families

Projective dynamics are a bit more complex when working with children and adolescents.  Just as our therapeutic relationships begin to bear fruit and an attachment has been formed, the parents may pull the child from treatment, proffering transparent and superficial excuses.  Some affluent parents would actually prefer that we believe they are impoverished rather than frightened.  The Container-contained dynamics (Bion 1962) have been reversed, and the child is serving a psychological function that the parents will not relinquish.

The emergence into consciousness of their inner terrors would elicit unmanageable and threatening psychic conflict.  Therefore, any therapeutic effort to return projections to their rightful parental owners will be resisted to maintain the homeostatic benefit of selective avoidance.

Paradoxically, enduring change and growth require a willingness to tolerate in titrated doses the anxiety-provoking affective experience and self-states so strenuously avoided.

A patient I’d seen for many years, arrived for her appointment one afternoon and told me a remarkable story about a dinner conversation she’d recently had with her mother, a very anxious woman prone to massive denial.  My patient, a skilled sailing enthusiast who was very comfortable in the water, had experienced intermittent but recurrent nightmares about being engulfed by tidal waves since childhood.

Red boat with blue sails

While sailing, she often experienced intrusive and distressing images of being tossed from a sinking ship into turbid and roiling seas with nothing more than a flimsy kickboard for support, ostensibly to swim for help as her mother clung to the ship’s railing helplessly.  While we explored this imagery thoroughly, we could never quite plumb it to the psychological seabed satisfactorily.  Something elemental always seemed to be absent.  Her mother provided the missing link.

Having dinner together in a seaside restaurant with a lovely view of the bay and its sleek boats, her mother casually remarked that she’d experienced recurrent nightmares about tidal waves throughout her life.  My patient was stunned to realize that she’d been carrying her mother’s projected anxieties and nightmares since early childhood, beginning at a time when the family lived substantially removed from the sea.  Having reversed the container-contained dynamic (Bion 1962), her mother had flooded her daughter with dissociated self-states and annihilation anxiety in which her daughter was drowning.

This anxious and helpless woman, clinging to the railing of her psychologically sinking ship, had tossed her daughter into the vast sea of her own restless and unplumbed unconscious where she was engulfed by projected existential terrors.  My patient had been colonized and terrorized by her mother’s dissociated anxieties.  Soothed by the insight that her tiny kickboard provided the only psychological defense her child-self could summon against the titanic force of her mother’s fierce projections, she renounced it, and her nightmare has not recurred.

Conclusion

In conclusion, terrorism might be construed less as an act of “evil” volition and more as an enactment of unconscious proportions, a psychological trespass that has less to do with discrete ideology, deities or politics and everything to do with mother-infant dynamics and the defensive management of strong, presymbolized affective states.

Its wounds are two-fold.  The initial emotional impingement invades the sensory-affective foundations of the vulnerable infant’s body-mind as a kind of implicit soul piracy.  Occurring long before the infant has developed any capacity to comprehend or object, the trauma exists as terrifying, unspeakable pockets of unformulated and dissociated experience.  If this disavowed material is projected rather than linked to word-symbols where it can be understood and integrated, emotional terrorism ensues as a repetitious series of doer and done-to (Benjamin 2004) enactments.

Until they are mentalized and attain linguistic symbolization, these nameless sensory chards of “beta elements” (Bion 1962) are experienced as chaotic and remain selectively dissociated where they can be safely avoided.  Often these unprocessed elements feel as if they have acquired actual mass and become embedded deeply within the flesh, and the need to expel these uncomfortable psychic elements is urgent.  I often hear patients describe a compelling need to vomit or purge something that feels hard, solid and alien, to “get it up and out.”

The therapist’s state of receptivity to her patient’s unconscious experience is similar to that of an empathically attuned mother’s receptivity to her infant’s presymbolic and pre-linguistic experience (Ogden 1989).  From within the encircling safety of the therapeutic relationship, terrorizing self-states derived from ruptures or deficiencies in early mother-infant exchanges may finally begin to acquire meaningful shape and form where they can be understood, integrated and defused.

WARNING! This text is printed for the personal use of the subscriber to The Therapist Magazine and is copyrighted by Mauri-Lynne Heller.  It is illegal to copy, distribute or circulate it in any form whatsoever without the author’s permission.

Benjamin, J. (2004). Beyond doer and done to: an intersubjective view of thirdness. Psychoanalytic Quarterly, 73:5-46

Bion, W.R. (1962). Learning from Experience. London: Tavistock.

Grotstein, J. (1990).  Nothingness, meaninglessness, chaos and the “black hole” I – the importance of nothingness, meaninglessness and chaos in psychoanalysis.  Contemporary Psychoanalysis, 26:257-90.

Ogden, T. (1989) The primitive edge of experience.  Jason Aronson Inc., New Jersey, London.

Stern, D.B. (1999).  Unformulated experience: From dissociation to imagination in psychoanalysis.  In: Relational psychoanalysis, the emergence of a tradition.

Hillsdale, HJ: Analytic Press. (Original work published 1983)

Stern, D. (2009). Partners in thought. New York, N.Y., Routledge.

Tustin, F. (1986).  Autistic barriers in neurotic patients. London, Karnac.

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This column also appears in the January/February, 2011; Volume 23, Issue 1 of The Therapist, published by the California Association of Marriage and Family Therapists (CAMFT).  Abstract page 90.

Abstract:

This two-part series examines the psychological origins and antecedents of terrorism.  Object relations, intersubjective systems theory and contemporary relational psychoanalytic theories are used to define and highlight the constellation of specific dynamics implicated in terrorist enactments, particularly the ways they replicate salient interactive patterns of early mother-infant communication.  This resonant, harmonic unit, characterized by interactive modes of touch, gaze and projection, establishes the creative sphere wherein an infant comes into selfhood and begins to develop nascent capacities for relationality, empathy and morality.  Emotional terrorism begins when a mother is unable to contain and modify her infant’s projected anxieties or, in reverse, projects her own, initiating a repetitious cycle of terrorist-victim or “doer and done-to.” Clinical and cultural implications of sadism, the perversion of empathy, are also considered.

Terrorism, that shapeless haunt of latent danger associated with unpredictably nihilistic provocateurs and paranoiac agitation, is as readily identifiable as the plot of a Cold War spy thriller, yet not as easily understood.

What is terrorism, we might ask, and what, if anything, distinguishes it psychologically from other forms of violence.  What makes it so, well, terrifying?

As psychotherapists, how do we begin to think creatively about terrorism and its origins in ways that might disrupt the futility of rancorous recriminations and swift retaliation?  What can we learn from theory of mind and the psychological antecedents of terrorism to relieve the persisting and polarizing impasse of victim and victimizer, what Jessica Benjamin (Benjamin 2004) described as doer and done-to?

Can we use our theoretical knowledge and expertise to expand the narrow scope of conceptual thinking that delimits conventional understanding of terrorism?  Might we then redefine terrorism in ways that generate more enduring solutions than those provided by political and military pundits?  Are there ways to formulate less intrusive and more durable interventions to manage the amorphous dread and collective vigilance that suffuses the atmosphere like toxic vapor?

While preemptive or retaliatory militaristic actions successfully manage discrete acts of terrorism, they do nothing to dismantle the terrorist-victim dynamic that drives intimidating violence, leaving us mired in impasse and stalemate.  The antecedent psychological dynamics informing terrorist violence must be considered with gravitas equal to that of the disruptive behavioral discharge.  Lasting success will be more difficult to achieve if we obstruct the latter without concurrently understanding the former.

To loosen the conceptual stricture and rigid dialectics that dominate civic dialogue and circumscribe public policy, it is crucial to understand that the cycle of terrorist violence begins in the mind.

Psychoanalysis, with its richly diverse theoretical compendium, might illuminate the psychological dynamics of terrorism with a crispness and precision other paradigms lack.  Certainly, it would contribute a thoughtful dimension to a serious dialogue.  Psychoanalytic thinking posits that behavior reflects mentation and understands that mental life begins in infancy.

Therefore, it is imperative to examine the intersubjective sphere in which the budding infant mind begins to develop.  The early interactive modes of mother-infant communication and the projective processes crucial to early mental life represent the prototypical dynamics for those that subsequently galvanize the emotional terrorist.

The vitality of mutually regulating infant-mother communication

Projection denotes a normative, in fact, essential mode of infant communication.  Along with touch and gaze, it is one of the primary, post-natal emotional languages characterizing rudimentary mother-infant communication long before a child acquires the capacity for verbal discourse.  Winnicott (Winnicott 1963) proposed the phrase “maternal preoccupation” to describe the immense emotional and relational changes occurring in new mothers as they care for infants.  This heightened state of attentive focus insures infant survival, because only a mother (or father or primary caretaker serving maternal functions) is sufficiently identified with her infant’s needs to meet them fully.

The Newborn

The newborn

An empathically attuned mother receives her baby’s emotional projections like spoken language.  Organizing and returning these bits of sensory affect in ways her infant experiences as regulatory and containing, he is comforted.  An infant may think he has magically fulfilled or hallucinated his own sensory-affective needs, when it is his mother who has perceived and gratified them seamlessly.

Creating an environment in which her infant can safely mature, he begins to establish a nascent sense of himself as an individual whose unencumbered development was best described by Winnicott (Winnicott 1963) as “going on being.” Within this exquisitely cultivated surround, the unfettered infant is free to grow and begin to develop mental and relational capacities.

Bion (Bion 1962) referred to this rhythmic interpersonal dynamic intended to reduce infant fears as “container-contained.”  During communicative exchanges, mother and baby establish a mutually resonant and harmonic unit.  The subtlety of these early communicative interactions creates a sense of “thirdness,” a co-created, trusting intimacy that relieves the solipsistic isolation of the intrapsychic mind and brings the infant into relationality.  As Winnicott (Winnicott 1960) wrote, “There is no mother without a baby, and there is no baby without a mother.”

If the mother is unwilling or unable to contain and organize her child’s sensory-affective experience or, in reverse, projects her own unmetabolized anxiety onto her child, the overwhelmed infant has few options for deliverance.  Feeling his very existence at risk, he will either split himself off from this undigested emotional matter or use projection to rid himself of what he cannot yet tolerate.

It is this disorganized, unmetabolized emotional experience and the means by which it is kept out of awareness that ultimately pose a threat.  Lacking linguistic symbolization and eluding conscious awareness, it can only be acted out or discharged behaviorally.

The psychologically undeveloped maneuvers of the vulnerable infant grasping for survival eventually become the emotional propellant fueling terrorist enactments.  We are terrorized and scorched by the exploding fragments of projected traumata.

Projection, empathy and morality

Projection – the movement, shifting or sharing of sensory-affective experience in the absence of spoken language – is really a neutral dynamic having psychological implications well beyond infancy.  While it most often recognized as a defensive method employed to rid the body-mind of intolerable sensations or affect, projection may also be used in the service of creating experience-near, interpersonal bonds.

Projection used to locate a part of oneself in another to share or understand that person’s subjective experience constitutes the intrinsic basis for empathy and subsequently, ethical and moral life.   The acquisition of empathy is a developmental achievement, a byproduct of the healthy projective exchanges between mother and infant.  An infant must experience empathy before he can express or return it.

Clinical psychotherapy might best be defined as a science of empathy distinguishing it from the empiricism of research psychology.  Empathic attunement is the singular clinical feature common to all psychotherapeutic modalities.   As practicing psychotherapists, whatever our theoretical orientations, we routinely rely upon empathy as a point of departure to approach and convey understanding to clients and patients in ways that facilitate trust and evoke change.

Empathy is a two-person interpersonal dynamic not a one-person act of benevolence.

In fact empathy guides ethical conduct throughout life.  Moral choices reflect not simply the religious or secular laws that demand them but the earliest moments of flickering consciousness when a mother’s gaze, touch and responsiveness communicated safety and welcome.

Laws exist to regulate behavior when empathy and ethics have failed.

Sadism – the perversion of empathy

Conversely, sadism represents its perversion.  It is well known that the Nazis employed whistling bombs during the Blitz of London, because they knew empathically that the shrill crescendo of approaching incendiaries would terrify people below.  Theirs was a well-crafted mode of emotional terrorism.

Empathically attuned children know just how to injure their parents.  Nothing wounds more acutely than hearing an angry toddler shriek, “I don’t love you anymore.” The father who regards himself as his child’s best friend will cringe every time he hears his enraged offspring declare, “You’re not my best friend anymore.”

In our current mass-media surround, sadism is frequently exploited for cheap entertainment by pop-culture “therapists” who use brutality to shred the fragile defenses of vulnerably desperate client-participants by attacking their exposed psychological viscera most cruelly.  Rather than working to build psychic structure, they use empathy to shame and humiliate.  To amuse and entertain.

Televised “reality” or talk show programming is the bloodsport that has replaced the coliseum as the purveyor of vicarious sadism in the contemporary milieu.

Slathering at the celebrity slag heap, fans project their vicious envy, delighting in the public humiliation of the inconsequential and accomplished alike, often the same people they had idealized as demigods the day before.   John Lennon’s murder thirty years ago might be attributed to the terrorizing enactment of one such emotional fan who idealized then vilified a celebrity-stranger.

Externalization and projection of unmetabolized envy and murderous rage was followed by an actual murder in an ineffectual attempt to kill off unformulated, dissociated experience.  The media delivered death like episodic soap opera melodrama, unable to distinguish the significance of actual murder from the base sexual voyeurism permeating its customary medley of mindless tattle.

Dissociation and unformulated experience

The mind is very adept at devising creative tactics to manage unbearable feelings and traumatic experience.  Sometimes they are defensively and selectively kept out of awareness by avoidance.  Existing as content without form, they have yet to be sculpted by thought and language (Stern 2003).  For a vulnerable infant, these defenses insure survival, which is why they are often extremely difficult to modify later in life.

Dissociation and projection permit the temporary evasion of anxiety, but emotional stasis is maintained at the expense of learning and change.  Though evacuation removes or minimizes the psychological irritant and often leaves the emotional terrorist feeling vigorously self-righteous, serious problems arise when the disavowed attributes are attributed to someone or something else and attacked.

In futile Sisyphean style, the proverbial scapegoat must carry away communal guilt sins of “badness” each successive year, because the shameful feelings they evoke are never claimed and examined.  They can only be split off and dispatched.  The disavowed traits are psychologically transferred ritually to a neutral animal, preferably one young and untainted.  After carrying collective contamination into the wilderness of the unconscious mind, the young animal is destroyed, pushed off a cliff, ostensibly taking the badness with it.  Banished but not vanquished, the badness exists as unsymbolized, dissociated experience that can only be enacted.  This emotional content without symbolic form (Stern 1997) requires increasing degrees of defensive vigilance to circumvent its emergence into consciousness.

Consider for a moment that the one-way transfer of existential terrors from one body-mind to another might be construed as emotional terrorism.  Terrorist enactments, as we have come to know them in both secular and religious configurations, have their origins in the breakdown of communication between a mother and her infant.

Attachment to primary caregivers teaches an infant how to experience and manage feelings of love and hatred.  The qualitative reliability or deficiency of these early relationships forms the emotional substrate of our relational template.  If an infant’s defensive repertoire isn’t modulated by parental care, psychological maturation is hampered, and existential terrors remain unmetabolized, intolerable and unmanageable.

In these instances, unbearable feelings of envy, longing, desire and rage do not remain simply unformulated and emotionally shapeless within the intrapsychic mind.  They are externalized and cast out.  Once ejected, they are located elsewhere just as an infant projects unbearable feelings of distress onto his mother who can (hopefully) better tolerate and organize them.  No military engagement or body of law can assuage the unmediated, existential terrors of infancy and early childhood.

Reciprocity and Mutuality

Ideally, an infant’s archaic projective communications are part of a two-pronged interpersonal dynamic defined by mutual acknowledgment and reciprocity.  Received by his mother who organizes and returns them in digestible and titrated doses to help him develop increasingly differentiated psychic structure and relational capacities, they transpire within a mutually regulating intersubjective field.

Projections associated with terrorism are missing the regulatory and clarifying half of the exchange.  In this configuration, distressing affect is evacuated from the body-mind like a painful gas bubble but remains devoid of clarifying thought or symbolic language that might render it meaningful or psychologically useful.  Without the reparative and integrating response of an attuned parent or therapist, unbearable experience or affect is simply jettisoned like shrapnel and located elsewhere.  Unable to be used for learning, it can only be projected and attacked repeatedly.

Without the completing circle of communication, the “bad” qualities of these emotional projectiles are attributed to the external objects where they have been lobbed and are subsequently attacked “out there.”  While rage and envy may be temporarily subdued, enduring change is precluded, because the attack-retaliation cycle presents no viable opportunity for emotional refinement or growth.

Paradoxically, terrorism is less about hatred of others and more about self-hatred aged into vindictiveness that has been defensively misattributed to someone or something else and then attacked.  An individual with a developed sense of personal agency and only benign degrees of envy has no psychological need to destroy others.  We must distinguish clinically and politically between gratifying terrorist enactments and acknowledging the subjective realities of others in an attempt to promote mutuality and collaborative solutions.

Working with children

Board game imbroglios with young children offer wonderful opportunities to observe and modify defensive projection in action.  Because luck rather than skill is too often involved, a child who is not winning quickly grows frustrated and resorts to cheating.

My nephew and I were playing such a game one afternoon when he happened to select a color card that sent him back to the beginning square of the game.  I could see his entire body collapse with disappointment and downcast, he began to peek furtively at the underside of the cards to his best advantage.  His usual habit was to decide mid-game that he wanted to do something else.

I observed him for a while, weighing options, and finally remarked that he seemed very interested in winning and was very clever about doing so.  He responded with a crafty smile.  As we had played this game together many times, I risked going further, adding that this was a game of luck, and that winning wasn’t always possible.  Was it?  He smiled again and skillfully shifted a card or two.  “He cheats all the time,” his friend proclaimed from the kitchen where he was enjoying a snack, and at that moment, my nephew reached emotional saturation.  Quickly externalizing and projecting his frustration, he shouted, “You cheat!  You cheat!” and fled the room.

Object devaluation accompanies the psychological assault.  One of the first things the mind does to relieve the disappointment of being deprived of something it wants but cannot possess is to devalue as part of the attack.  This is an attempt to “sour the milk.”  The bad feelings of deprivation, envy, lack or loss are projected and superimposed on the unavailable or lost person or object of desire and then attacked vindictively.

For an hour or so after our rupture, my nephew said he didn’t want to play “that stupid game” ever again.  The game had been temporarily personified with projected badness.  After spending some conversational time together outside, he felt able to resume our engagement with enthusiasm and an increased tolerance for the vagaries of Candy land.

The Emotional Terrorist Part II examines theory and case material in depth, offering clinical examples with couples, families, children and individuals.

WARNING! This text is printed for the personal use of subscribers to The Therapist Magazine and Inside Out Journal and is copyrighted by Mauri-Lynne Heller.  It is illegal to copy, distribute or circulate it in any form whatsoever without the author’s permission.

Benjamin, J. (2004). Beyond doer and done to: an intersubjective view of thirdness. Psychoanalytic Quarterly, 73:5-46.

Bion, W.R. (1962). Learning from Experience. London: Tavistock

Stern, D.B. (1999).  Unformulated experience: From dissociation to imagination in psychoanalysis.  In: Relational psychoanalysis, the emergence of a tradition. Hillsdale, HJ: Analytic Press. (Original work published 1983)

Winnicott, D.W. (1960). The theory of the parent-infant relationship.  International Journal of Psycho-Analysis, 41:585-595.

Winnicott, D.W. (1963). Dependence in infant care, in child care, and in the psycho-analytic setting. International Journal of Psycho-Analysis, 44:339-344.

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This column also appears in the November/December 2010 issue of The Therapist, published by the California Association of Marriage and Family Therapists (CAMFT).

Abstract: This second in a two-part series explores the ways that the symbolic exploration of film imagery during the brief, one-year analysis of a patient suffering from the effects of very early childhood traumata expanded his capacity to think, engage and begin to integrate unformulated and dissociated aspects of himself for the first time.  Just as elements in a dream clothe the invisible man of the psyche, each movie element and character, by giving voice to personal feelings and meanings in novel and mutative ways, increased the mentalization of lived experience that had never before existed in the realm of conscious thought.

Q and I met four times weekly for a year, sometimes five when his skillfully managed emotional needs overwhelmed his narcissistic and intellectual defensive posturing.  More often, he held forth on arcane philosophical paradigms, epistemology and knowledge and his unabashed love of the ancients whom he imbued with the nearly superhuman qualities and capacities that deify celebrities in our own personality-infected culture.

More specifically, he imbued these archetypal figures with the god-like attributes an infant ascribes to his parents, those powerful people who represent our first gods, parents for whom he held deep unmet and unacknowledged longings that had festered over the years.

Q would talk about almost anything to avoid stirring the annihilation anxiety associated with his own lost infancy and compromised childhood.

Pierrot and harlequin

Like Romulus and Remus, Q suckled on mythology and raised himself, running with a pack of equally unparented boys.   Wielding his sharpened intellect like a monarch’s sword, he was really all alone in his kingdom.  Fortunately, these burnished topics were rich in metaphoric and symbolic imagery that permitted me to access and share his private world.  Though he didn’t know it when we began, I was to become his modern day she-wolf.

Primary, and for Q, mythic maternal themes of abandonment, rage and the wordless poignancy of love nearly grasped and lost informed Q’s brief, year-long analysis, offering repeated opportunities for us to examine and explore his experiences deeply.  Movie imagery and content represented the gateway linking inside and out, me and not-me, my world and his.  It gave borrowed form to what was yet the unformulated content (Stern 1997) of his wordless, inner world.

Despite its brevity, the fact that he was able to sustain a tenuous and conflict-laden connection to me for the duration represented a monumental relational and developmental achievement for Q, surpassing that of any prior association.   We struggled together, and the year exhausted both of us.

Almost immediately, he began enacting the Janus-faced, draining aspects of his stagnant and hopeless dialectic, a conflict characterized by a terrifying urge to flee appended to a powerful longing to immerse himself in my mind and body.

Anxious and confused, Q oscillated wildly between starkly opposing impulses, each fraught with danger and dread.  Flight insured safety but exacted isolation and madness, while relationships offered the comfort of companionship but were untrustworthy and portended abject disappointment.

The Persistence of Memory

The persistence of memory

Psychosis was preferable to abandonment.  Even a whiff sent Q running.  Withdrawal, silence, canceling appointments, “forgetting” or arriving late constituted some of the behavioral language he used to convey the full dimensions of his pre-verbal traumata.  I will leave you before you can leave me.

Our engagement was sometimes as basic and wordless as breathing together, and many sessions were spent in almost total silence.  But it was to become a shared silence, and Q was increasingly less encapsulated in the solipsistic bubble that threatened to devour him.

As our relationship acquired a reliable measure of accountability and consistency, we began to seek precise words to capture and describe unspeakable feelings that had never before been thought or conceptualized in mental terms, only dramatized or projected, what Fonagy (Fonagy 2000 and Fonagy 2002) described as mentalization.

Giving linguistic dimension and form to the amorphous content of lived experience released him from the endless behavioral enactments that condemned him to a stale and deadened life.  Though he fled repeatedly, I sustained and nurtured his dare-not-hope that the fragmented shadows of potential self might coalesce into a real boy.

In many respects, the last time we met was as awkward for Q as the first.  There was so much left to say and no more time.

Having fulfilled his one-year commitment, he was too proud to admit his reluctance to leave or remain.  I was left holding one end of severed and frazzled rope of hope that had bound us.  He had no idea where or how to begin.  I tried to express what he could not.

“Endings are hard, aren’t they?  (Nod)  It’s hard to say goodbye.  We don’t usually learn how to do endings well in life, do we?”

“Yeah.”  He mentioned a friend who had died of cancer.

“I think that we’ll each carry part of the other with us for a long time.”

“Yeah.  You’ve been good to talk to.”

“As have you.  Didn’t exactly know what you were getting into, did you?”

“Yeah, I did.”  A laugh gave him away.

I provided referrals and left future access open-ended.  He mentioned that when he told his parents about his analysis, instead of mirroring delight or offering support, they questioned his financial means.  They were unable to imagine why anyone would sponsor their child, because they rarely did.  He waited until he was nearly out the door to tell me.

Spring leavesShrugging as the shadow of wordless, unformulated feelings (Stern 1997) began to envelope him yet again, Q left ten minutes early.  I listened to his quick footsteps rush down the stairs and watched him drive away for the last time.   Relieved and wistful, I enjoyed a quietly restful moment, noticing with pleasure the spring leaves unfurling on the sycamore outside my window.  A few moments later I heard rustling in the waiting room and went back to work.

Two weeks after our last session as I was driving home from Trader Joe’s, my cell phone rang.  My car filled with groceries, I was thinking about dinner and the preciously guarded private evening unfolding ahead.  Finished with daily responsibilities, the remainder of that warm spring afternoon belonged to me, as pristine and crisp as a clean, blank page.

Though I knew it was Q, I answered the phone with my off-duty greeting, a casual hello.  Accustomed to a more professional announcement, he was thrown off balance, realizing he had entered my private life.  I was not simply waiting for him.  Sensing him stumble, the inflection of my voice rose with recognition, and I welcomed him into conversation.

“How are you?” I asked.

“I’m good,” he responded.

Yes, I thought with some satisfaction, you have acknowledged to yourself that you might miss me a little bit, that our relationship mattered, and you wanted me to know that you were okay.  He did not sound bleak, as he so often did, and I relaxed with relief.

I still hold you in mind.  I will care about you even when we don’t see one another.  Remember…

He was a bit nonchalant though talked for a moment about a pressing legal concern that had been resolved judiciously without serious repercussions as a result of his growing capacity to trust, exercise judgment and control impulsivity.

“Yes, you’ve made a wise choice.  I can see you’ve thought about it,” I said, thought being the operative word.

After a moment or two of quiet, as my foot pressed on the accelerator headed for home, he shifted to another topic.

“I watched That Obscure Object of Desire,” he announced, the real purpose of the phone call.

“No kidding,” I responded with delight.  “Where did you find it?”

“Oh, I rented it,” he answered.

“What did you think?”

Portals to Q’s representational world, conversations about films were always lively, characterized by genuine mutuality and thoughtful dialogue, and I had once recommended Luis Bunuel, a 20th c. master.

Cet Obscur Objet du Desir, a wonderful movie about a middle aged diplomat’s ferocious obsession with a seductive yet withholding young woman, swirled in a maelstrom of political terrorism.

“It was great!” he answered emphatically, “yeah, great.”

Bunuel’s main character, a poised and stately diplomat, was so completely besotted with a provocative young woman that his predictably composed life deteriorated into chaotic, obsessive fantasy.  This transpired as explosive terrorist incidents aimed at his political party increased.

The blue circus

This female character represented what the preeminent object relations theorist, Ronald Fairbairn, (Fairbairn 1946) described as an “enticing or exciting object,” symbolizing sadistic seduction with no hope of connection.  The inaccessible and unknowable mother represents the prototype for this subsequent chase-disappointment dynamic.  Representing Q’s elusive and remote mother, her imago was superimposed onto every subsequent relationship he initiated (and fled).

In fact, this character was a political and emotional terrorist.  To portray his fantasy, Bunuel employed two very different actresses to characterize the young woman, one dusky and voluptuous, the other elegant and lithe.  She was a blank screen for the diplomat’s projections.  He did not know her at all.

There ensued an endless series of enactments of sexual enticements and withholding, whereby the diplomat responded to her overtures and was repeatedly and ultimately frustrated.  Terrorist bombs exploded nearby one after another.

Via film imagery, Q and I witnessed emotional terrorism and the terrors of one’s own repetition compulsion (Freud 1914), the proverbial moth to the flame.

In one seduction scene, the diplomat was delirious with desire in response to the voluptuous character’s overtures.  As her clothing was removed, he believed himself about to embrace naked flesh.  Instead, he found her body bound by a tight corset with a tight stays and boning that could not be undone.  Struggling uselessly to release them, he abruptly collapsed in despair and rage, while she continued to taunt him and laugh.

This was the image of a boy trying to reach his mother’s breasts while she displayed but withheld them.  The boy could only begin to think, “I will never go there again, but if I do, I will leave her before she can leave me.”  And this became part of the emotional template of Q’s relational life.

“It took me a while to get it…that it was the same person, the girl, that he’d used two actresses, he continued.”

“Wasn’t that a great technique?”

“Yeah, it took me a while.”

“I think Bunuel was telling us that this man could not see beyond his own fantasies, only his projections.  We’re really looking at emotional terrorism.”

“Yeah,” he added enthusiastically.  “It was really great.”

By observing these characters and their follies, Q finally “got” what Jacques Lacan (1973) referred to as “the joke.”  Recognizing that his own inner terrorist was far worse than anything “out there,” he shed his hard shell for a moment.  Self-awareness was facilitated, because he could see what the diplomat could not.  Before Q was even aware of his insight, his unconscious mind knew what to do with it.  It took him a while to “figure it out,” but as he did, he tasted psychological liberty.  Q finally got the joke, and he was very pleased with himself.

Las dos Fridas

There were actually two very different women in his life, two maternal paradigms, his mother and her terrorizing imago, and me – imperfect but reliable, available, empathetic and steady.  We were not alike.  He had dented the severe organizing principle warning that everyone was and would always be just another variant of his abandoning mother.  There were two actresses, two possibilities, maybe two outcomes.  Perhaps more.

This moment of possibility represented the fruit of analytic “thirdness” (Ogden 1994), the opening of a shared and generative psychological space, one that bodes creative potential rather than stasis and engenders possibilities that break the rigid dialectic of doer and done-to, what Jessica Benjamin (2004) called complementarity.

It is not simply this or that.  It may be this and that or perhaps something completely different.  Q experienced a nascent awareness that he might end his own psychotic reign of terror.  He might liberate himself from his isolated and rigidly autistic, mechanistic mind-prison.

I turned from the main thoroughfare into my neighborhood, slowing down and shifting my hands slightly on the steering wheel.  A dog trotted across the street.

“I talked to my (attorney) uncle, and he told me what to do.”

He had found a way to bypass mother and access father.  He could observe himself and choose to avoid another episode of terrorizing repetition.  He could call me.

“Well, if you feel like it, when you get the information you need, let me know, and I’ll check it out.  He knew I was familiar with the context of his current circumstances.

“Ok.”

I’m still with you.  I will care about you even after you’ve gone. Perhaps this was a test.  Perhaps it was the final punctuation mark on our unfinished narrative but the beginning of another.

There was nothing left to say.  Pulling into my carport, I offered one last remark.

“I’ll be around.”

“Ok,” he said. “Thanks Mauri-Lynne.”

“Bye now.”

“Bye.”

I hung up the phone, releasing his hand hoping he would reach for others and find reciprocal warmth.  I opened the car door, encircled a big bag of groceries with my arms and went inside to make dinner.

There would be one more phone call some time later from this intensely funny and intelligent boy-man, but by then I had slowly begun to release him and his hold on my mind.  Luxuriating in the lightness of removing my own constricting stays, I felt unbound by the taut maternal preoccupation that had clenched so intensely during the past year.  Our trajectories had crossed and were now diverging.  I was glad for both experiences.

In the car running errands, my cell phone rang, this time from the bottom of a large bag.  I knew immediately it was Q.  I had lost a message shortly before and suspected he’d tried to call earlier.  (He had.)  I answered neutrally, though when I heard his voice, matched his tentative tone with my own enthusiasm.

“How are you?” I asked again.

“I’m good,” he responded, his voice stronger.  “I’m good.”

After a moment of quiet, he continued, “I think of you often.”

I think of you often. In my surrogacy, he had found a tangible realness.  I was no longer simply a projection, a wavering hologram of film pixels.  I had become a tentatively real object that he could access within himself and use productively and reliably, and as I did, he became real, too.  As his projections withered, available inner space opened for the imprint of new interpersonal and self-object experiences.  I had survived, and so had he, and we were both changed.

“Remember when I told you a long time ago that even after you’d gone away, I would continue to think of you?”

“Yes.”

Red boat with blue sails

We shared a sweetly quiet moment.  During that silence, I felt a transient but lofty affection for work and life.  I looked out the car window at the sky, as translucent as a watercolor wash.  I felt hope for him and for me.  At the end of his analysis, Q had managed to reach the beginning of the beginning.    He was trying to do for himself what I had tried to do with and for him.

He was using film imagery on his own as a trellis for self-support and was experiencing an emergent sense of himself as a cohesive being in the making, the resumption of his prematurely truncated going-on-being (Winnicott 1960).  Instead of hitting the replay button on the old movies of his past, I wondered whether he might now produce a new movie with an original script created anew.

We shared an incomplete experience.  Many issues remained unexplored.  We tolerated ruptures and bore anguish together.  An embryonic reflective capacity fluttered.  What emerged was nothing less that the basis for hope.

WARNING! This text is printed for the personal use of subscribers to The Therapist Magazine and/or Inside Out Journal and is copyrighted by Mauri-Lynne Heller.  It is illegal to copy, distribute or circulate it in any form whatsoever without permission of the author.

Benjamin, J. (2004). Beyond Doer and Done to: An Intersubjective View of Thirdness. Psychoanalytic Quarterly, 73:5-46.

Fairbairn, W.D. (1946). Object-Relationships and Dynamic Structure. International Journal of Psycho-Analysis, 27:30-37.

Fonagy, P. (2000). Attachment and Borderline Personality Disorder. Journal of the American Psychoanalytic Association, 48:1129-1146.

Fonagy, P., Gergely, G., Jurist, E and Target, M. (2002).  Affect regulation, mentalization, and the development of the self. New York: Other Press.

Freud, S. (1914). Remembering, Repeating and Working-Through (Further Recommendations on the Technique of Psycho-Analysis II). The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XII (1911-1913): The Case of Schreber, Papers on Technique and Other Works, 145-156.

Lacan, J. (1973) The four fundamental concepts of psycho-analysis. New York. W.W. Norton & company.

Ogden, T.H. (1994). The analytic third: working with intersubjective clinical facts.  International Journal of Psycho-Analysis, 75, pp. 3-19.

Stern, D.B. (1997).  Unformulated experience: From dissociation to imagination in psychoanalysis.  In: Relational psychoanalysis, the emergence of a tradition. Hillsdale, HJ: Analytic Press. (Original work published 1983)

Winnicott, D.W. (1960). The Theory of the Parent-Infant Relationship. International Journal of Psycho-Analysis, 41:585-595.

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This column also appears in the online edition of the September-October, 2010 issue of  The Therapist Magazine, the publication of the California Association of Marriage and Family Therapists.

Abstract: This two-part series will explore the ways that the symbolic exploration of film imagery during the brief, one-year analysis of a patient suffering from the effects of very early trauma expanded his capacity to engage and begin to integrate unformulated and dissociated aspects of himself for the first time.  Just as elements in a dream clothe the invisible man of the psyche, each movie element and character, by giving voice to personal feelings and meanings in novel and mutative ways, increased the mentalization of lived experience that had never before existed in the realm of conscious thought.

If a myth represents a collective dream, a dream signifies a personal myth written in the language of affect-laden imagery.

Nothing permits us such lush access to the workings of the unconscious mind like a rich dream.  For brief moments, dreamer and analyst breach what Jacques Lacan called the “gap” (Lacan 1977/1978) between conscious and unconscious thought and clothe this mostly invisible psychic man.  Examining each symbolic garment, we are able to apprehend and construe metaphors and personal meanings that might otherwise just flicker briefly like passing afternoon shadows across a dimly lit wall.

The Newborn

The newborn

Dream imagery is potent for significant reasons.  Imagery is the “vocabulary” of an infant’s first post-natal language.  A neonate gazes into his mother’s face as she gazes back, communicating deeply held feelings long before the capacity for spoken language is acquired.  An infant’s first smile is in response to her gaze of acknowledgment.  Because she sees him, he will begin to see himself.

Throughout life we associate enlightened consciousness with insight, creativity with vision.  Even as our modes of verbal communication expand developmentally and refine themselves over time, imagery conveys what words sometimes can’t quite capture.  Jacques Lacan (Lacan 1977/1978) referred to unspeakable (or unspoken) lived experience as the Real.  Sometimes a picture is worth a thousand words.

In our culture, movie imagery is the bridge linking social mythology with personal dreamscapes, connecting inner subjective experience and the cultural collective.  We analyze movie details symbolically and metaphorically as if we were deconstructing a dream.

As a result, we often begin to conceptualize parts of ourselves in new and original ways, perhaps even identifying and claiming dissociated aspects that have never yet been acknowledged or fully mentalized (Fonagy 1981), parts that have lived only through the dramatization of enactment (Stern 2010).  Parts considered “not me” have an opportunity to be transformed into “me.”

During a year-long analysis with Q, a young man who had been abandoned as an infant, long before he’d acquired sufficient verbal language to process or organize his trauma, movie imagery opened up a psychological third space (Ogden 1994) that bridged our worlds.

Without film imagery and art, we might have remained forever isolated from one another, he imprisoned in his tragic past and I in my chair across the room.

He and I often talked about movies when he was struggling to articulate an unbearable feeling or perhaps avoiding one.  The Matrix was one of his favorites, a movie I’d never seen except in fragments on television.  I liked movies about relationships so had never found it appealing.  Just prior to my early summer break, he loaned me his copy, so that the lace-like threads of our connection might not tear.  I tucked it in my briefcase where it remained until the last day of my break.  When I popped it into the DVD player, I felt him enter the room.

The Persistence of Memory

The persistence of memory

This is the dream.  The Matrix is a computer age, film noir movie reminiscent of earlier classics with similar anti-utopian themes.  Soylent Green was the dire environmental prophecy of the 1970’s. The 1960’s dangled ingénue Yvette Mimieux in The Time Machine, both examples of a depraved and desperate future.  Donald Winnicott’s iconic paper Fear of Breakdown (Winnicott 1974) described how the anxiously feared catastrophe looming “out there” in the future had actually transpired long ago.  The Matrix future is portrayed as the degenerate past.

In The Matrix vision of the future, people, like the zombies in one of Q’s recurrent dreams, feed off one another from within the matrix of an artificial, bleakly mechanistic environment.

Lawrence Hedges (1994) described the ways in which people functioning at an organizing/psychotic level prefer objects to people.  Guntrip (1995) examined the mechanistic qualities that characterize affectively withdrawn schizoid states often described by patients as empty and depersonalized.  Capable of living an intellectually efficient but impersonal outer life, Q relied upon fantasy to keep himself alive.  A pseudo-adult, a militarily taut exterior substituted for a more authentic and self-assured manliness.

At this archaic organizing level, Q found safety in the realm of things rather than people, though longed to escape his own matrix web and, therefore, found the movie quite compelling.  He watched it over and over and had several copies.  Infants were manufactured and then cannibalized to sustain the controlling artificial life forms, the reverse of caring human motherhood, whereby the mother nourishes her child.

Woman and Child

Woman and child

We are offered a psychotic, biblical end-time image signifying the loss of the maternal, of purity and empathic human concern, a model as remote from Winnicott’s (1953) good-enough mother as the cold and transparent man in the moon.  Reality deconstructed, it floated unmoored from comforting illusions.

Q struggled to differentiate waking from sleeping states, reality from illusion, believing he was the product of some “higher” agency, convinced that I existed only as a product of his own mind.  Experiencing himself as a non-corporeal entity having no mass or substance, indicative of the unorganized-organizing self that has yet to come into being, he ascribed the same hollow qualities to my existence.  If it doesn’t really exist, it can’t hurt me, I thought to myself as I watched the movie, listened to the dream.   Am I real or am I illusion?  Is there a baby without a mother?  Is there a mother without a baby? “I want someone to give a shit,” Q often said to me.

Q’s original trauma, initiated at conception and concretized when he was six months old, was the initial severing of psychic and then physical connection to mother who, after reproducing selfishly and thoughtlessly (mechanically), found herself unable to care for her infant and gave him away six months later.  He was transported out of state.

End times occur when your mother does not want you, and your (unknown) father wanted you aborted.

This horror becomes the template for your future, depicted as the decrepit past over and over on the screen of your mind, the origin of Q’s belief that he was “too much” for everyone.  His tiny infant self was too much for mother, too much for father.  Yet he loved his mother and raged that his love had been insufficient to keep her bound to him.  “What’s in this for you?” he often asked me.

Q relived this trauma daily, though had adorned himself in hero’s cloaks to disguise his fragility.  His organizing principle* dictated that serviceability and brilliance would garner meaningful interpersonal connections.  “I’m the only sane person in my family,” he often said.  “I try to advise the best I can.  Why else would anyone want me around?” he asked wanly.  Saving others from destruction, he struggled to save himself.   His pain and intellectual expansiveness mirrored an autistic and psychotic inner landscape.  Anguish kept him alive, pain being better than nothingness and the psychic void of emptiness (see Grotstein 1990).

His two-year military enlistment afforded one such opportunity to both enact this role and immerse himself in fraternity.  Q sought surrogacy everywhere, yet self and object constancy eluded him.  There were only particles and waves that dodged substantiality like bad TV reception.

Black pixels coalesced into Darth Vader, the father who abandoned, yet was ultimately able to redeem himself.

Q embodied and acted out both parts, the hero and the unknowable, treacherous, dark father who threatened to abort and consume like Kronos the Titan god who killed his father and devoured his children.

There is a gruesome scene in The Matrix whereby an infant, every orifice penetrated by black tubes, is either being fed liquefied human remains or is itself being consumed, posing Q’s terrible paradox – eat or be eaten – an endless enactment of doer or done-to (Benjamin 2004).  The therapeutic environment offered a third possibility, that of collaboration and co-creation, the possibility of achieving self and object constancy, the hope of experiencing object usage and living viability in an uncontaminated present.

The conclusion of this two-part series will appear in the November/December online edition of The Therapist, Volume 22, Issue 5.

* Deeply held emotional truths driving beliefs, thoughts and behavior that are not necessarily accurate.

WARNING! This text is printed for the personal use of the subscriber to The Therapist Magazine or Inside Out Journal and is copyrighted by Mauri-Lynne Heller. It is illegal to copy or distribute it in any form whatsoever without the author’s permission.

Benjamin, J. (2004). Beyond doer and done to: An Intersubjective View of Thirdness. Psychoanalytic Quarterly, 73:5-46.

Fonagy, P. (1991). Thinking about thinking: some clinical and theoretical considerations in the treatment of a borderline patient. International Journal of Psycho-Analysis, 72:639-656.

Grotstein, J. (1990). Nothingness, meaninglessness, chaos and the black hole – the importance of nothingness, meaninglessness and chaos in psychoanalysis.  Contemporary Psychoanalysis, 26:257-290.

Guntrip, H. (1995 11th printing). Schizoid phenomena, object relations and the self. Madison, Connecticut, International Universities Press, Inc. (Original publication date unknown)

Hedges, L. (1994). Working the organizing experience. Northvale New Jersey.  Jason Aronson, Inc.

Lacan, J. (1977). Ecrits; A Selection. New York: W.W. Norton & Co. (1973). The Four Fundamental Concepts of Psychoanalysis. New York. W.W. Norton & Co.

Ogden, T.H. (1994). The analytic third: working with intersubjective clinical facts. International Journal of Psycho-Analysis, 75, pp. 3-19.

Stern, D.B. (2010). Partners in thought. New York. Routledge – Taylor & Francis Group.

Winnicott, D.W. (1953). Transitional objects and transitional phenomena—a study of the first not-me possession. International Journal of Psycho-Analysis, 34:89-97.

Winnicott, D.W. (1974). Fear of breakdown. International Review of Psycho-Analysis, 1:103-107.

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This column also appears in the online edition of the July-August, 2010 issue of  The Therapist Magazine, the publication of the California Association of Marriage and Family Therapists.

Abstract:

Adapted from a presentation to the CAMFT Orange County chapter, this third in a three-part series examines the ways applied contemporary psychoanalytic theory, particularly Intersubjective Systems Theory, with its focus on recognition and mutuality, has refined and expanded our understanding of mental processes and clinical interaction, modifying therapeutic dynamics in ways that promote therapist-client resonance.  Exploring the intersubjective matrix of transference-countertransference engagement, specifically the various modes of therapist-client communication, readers will begin to think innovatively about the shared psychological space in which we work.

Part III

Enactment is the language of lived experience, that which has not yet been mentalized and articulated linguistically.

In Part II of this three part series, we explored the use of the analytic third and therapist reverie as specific ways of accessing and understanding the unconscious communication transpiring in the transference-countertransference milieu.  In this final column, various modes of client-therapist communication will be explored.

Spoken Language:

Spoken language, its idiomatic usage and accompanying vocal sounds are modes of communication that convey much more than simple content.  By paying very close attention to these elements, we gain significant clues to unconscious processes.

Jacques Lacan, the French psychoanalyst, proposed that the unconscious was actually structured like a language (Lacan 1973) and that only language could promote psychological change.

Poet's Dream

He also suggested that we are impacted by language before we are born, and this is certainly an accurate assessment of the ways familial organization or beliefs and cultural schemata embedded within our environmental surround begin to sculpt and impress our identity long before we have the capacity to begin to define ourselves.

The following clinical example explores the meaning behind the use of a common idiom.  A patient recently used the phrase “threw me for a loop” several times during the course of a forty-five minute session.  The first time she said it, I simply noticed that she selected that particular idiom instead of a number of others she might have chosen.   When she used it a second time, I began tracking it seriously.

She was describing a distressing recurrent dynamic in which she found herself once again unwittingly embroiled and caught off guard.  “It just threw me for a loop,” she said emphatically and paused briefly before continuing with her narrative.

The third time she used the phrase to describe her subjective experience of surprise, I understood what she was telling me and interpreted, “I think you are telling me that you are going in circles and are caught in a loop that you feel you can’t escape.”  By linking a commonly used idiom to a very personal aspect of her inner world, we arrived at a new understanding that shifted us to a place in the session where we could speak more consciously and precisely about the feelings of circularity and constriction that were deeply embedded in early childhood dynamics.  In that shared moment, unformulated content that had existed on the edge of consciousness had acquired linguistic form.

Another patient arriving for our first session sat in the waiting room filling out forms.  Blah, blah, blah, he read quietly until he reached the paragraph about fees and panicked.  I’d left my inner office door open and invited him to come in when he’d finished.

Anxious that his narcissistic defenses wouldn’t contain his shame, he bleated out to me, “How much are you going to charge me?”  Finding out shortly thereafter that he had been in the military, I decoded his remark to mean that he was really asking are you going to charge at me?  Will you wound me (like my mother)? Will you hurt me? This became an ongoing theme of his year-long, four times a week analysis in which withholding of fees predominated.

Somatic language:

Very early, infantile experience is preverbal, unformulated and encoded somatically.  The capacities to think and use language are developmental achievements acquired over time.

The psychoanalyst Wilfred Bion (Bion 1962) suggested that infants begin to think in order to cope with thoughts, the nascent, unformulated impulses that constitute early mental life.  The infant has not yet learned to use his thought-impulses for thinking.  They are, therefore, encoded and subsequently communicated somatically via projective processes that replicate one of the primary modes of communication used by a mother and her infant.

In a state of maternal preoccupation (Winnicott 1963, 1965), when a new mother has adapted herself entirely to her infant’s needs, she is in a state permitting her to be exquisitely attuned to her baby’s projections.  Decoding them as only she can, she responds empathically by making necessary environmental adjustments, providing the desired warmth, food, holding, touch or gaze.  As the baby develops and acquires more direct means of communication, maternal preoccupation concomitantly subsides.

The Mona Lisa

Maternity

The most profound clinical example of somatic communication that conveyed infantile annihilation anxiety occurred during the analysis of a functionally psychotic and autistic young man.  Imprisoned in his own solipsistic mental isolation, he was capable only of incorporating others into his own tortured mental schema.  My reveries in the analytic third enabled me to gather his (preverbal) imagery and projections, organize them and return them to him in explanatory bite-sized pieces that he could ingest and assimilate.

As he lay supine and still on the couch, speaking in flat, unemotional monotones about superficial concerns, I often found myself filling with unspeakable and wordless dread and terror.  After one such session, I went to the restroom and, as I was washing my hands, felt the building begin to roll and shake.  Recognizing an earthquake, I grabbed the counter edge to steady myself until the temblor passed.  When I regained my balance and could walk, I went directly outside expecting to see other folks congregating.  But I saw no one.

There had been no earthquake, other than the somatically projected transmission of abandonment, the non-verbal communication of what it had been like for this individual to have been discarded at six months of age.  His world fell apart.  Whatever developmental balance or stability he had initially achieved rolled out from beneath him.  My next step was to find ways to articulate this shattering experience that reverberated through every moment of this young man’s life, so that we might speak of it directly, so that we might arrive at new ways of being together.

Dream language:

Freud’s royal road to the unconscious is still paved with gold.  Dreams have always permitted us to clothe the invisible man of the mind in accessible, meaningful and personal ways.

Some patients have more access to dreams than others, and it’s interesting to track the arc of dream content and meaning across the period of treatment, observing how they shift.  With my patient’s permission, I will recount one of her dreams as an example.  What follows is a nearly verbatim record of her dream narrative:

I was in L.A. in a house. It was more a shelter.  A man was there with me.  There was a tornado in the desert –and strong winds.  I was trying to keep the door shut.  My foot is in it.  And then we were blown to smithereens.  I wasn’t afraid, though.  There was a huge light and everything evaporated.  I was very calm.  Like I ended up in a different place and time.

As she spoke, I tracked my own feelings, thoughts, images and reveries in the third.  As she alternated between present and past tense, I was aware that this dream had retained its potent sense of primary process immediacy.  We shifted back and forth in time and dream space.

My first spontaneous idea was that this dream used birth trauma imagery to convey the dreamer’s transition from one psychic space or place to another, from a desiccated and dry place to somewhere else.  I also considered that the desert might symbolize her emotional desertion and neglect as a young child.  Her foot in the door represented a feeble attempt to defend against retraumatization and the emergence of strong affect and memory.

Her quiet response to this interpretation was that the light was calming.  I ceased to exist on one level.  I existed in the light but was invisible. This was the way she described what it felt like to step into psychological space and engage unformulated experience.  Expecting a repetition of past trauma, instead she found calm.  She hadn’t quite yet created a new symbolic form to represent her unformulated content but was in transition and able to tolerate the uncertainty and necessary of creative disorder (Stern, 1983) whipped up and represented by the tornado.  This was also a dream about finally surrendering to authenticity while releasing stringent defenses.  Her foot in the door was an insufficient defense against the more compelling need to give birth to herself.

Because the man in her dream was familiar but mostly unseen, an accompanying entity, we imagined that he represented a deeply held transitional object (Winnicott 1953) supporting her during her psychological travels.  A transitional object, often a blanket or toy, is designated by the young child as the talisman that will accompany her during nascent and experimental forays into transitional (psychological) space.

Helping her individuate from the mommy-baby unit status of early infancy, the baby creatively imbues this object with sustaining elements associated with the nurturing mother.  This is why these poignantly tattered and beloved objects manage to find their way into college dormitories years later.  It is regarded with esteemed affection by parents and children.  Recognized by the infant as not-quite-me and not-quite-mom, it represents transition.

Transferentially, this image might also have represented the active (male) strength our relationship has provided for her in addition to the more feminine aspects of empathy.  Dream images are frequently condensed, and these represented aspects of self that she was beginning to integrate.

Her narrative continued, and she spoke of feeling stuck as she prepared for the state bar exam, dejected that she had lost meaningful direction and purpose.  Tired of giving her talents away, she experienced this dream as a means of redirecting herself.

This patient dreams of houses and rooms frequently, and these are symbols of mind, self and object world.  Transferentially, these motifs may also symbolize my office and her analysis and my capacity to hold and contain her affect, to provide ego strength when needed, to inspire curiosity and help her self-regulate.

My final interpretations were based on my reverie in the analytic third in which I envisioned the scene in the Wizard of Oz when Dorothy and her house are flying through the eye of the tornado, also a metaphor for vaginal birth contractions, in this instance auguring psychological birthing.

I shared my image with her, adding that this leitmotif also illustrated how she was looking for a psychological home.  Someplace to land without killing someone beneath her as a result.  In fact, outworn elements of her inner object world would, indeed, have to die.

Because she has worked with criminals, I added that she was trying to escape her internal prison.  This is a potent dream we’ve revisited several times and will continue to reexamine over the course of her analysis.

Enactments:

Enactments represent the behavioral language of lived experience dramatically expressed within the therapeutic dyad.  They represent unmentalized experience that has yet to be linguistically articulated where it can be examined, understood and altered.

The classical analytic position holds that enactments are indicative of poor treatment or the therapist’s inability to maintain her stance as neutral observer, while more contemporary thinking conceptualizes enactments as not only inevitable, but necessary and creative opportunities for growth.  They portray with immediacy exactly what is transpiring within the therapeutic dyad and are the road maps to mutative interventions.

The blue circus

From an intersubjective position, enactments in the clinical setting represent the co-constructed participation of both therapist and client.  Raymond Friedman and Joseph Natterson (Friedman, R., Natterson, J. 1999) suggested that enactments are “intersubjective inevitabilities” with the therapist as an active participant-observer rather than a more remote neutral observer.

While enactments represent the continuous living out of mostly unconscious fantasy within the therapeutic relationship, they can be identified as brief or extended (Friedman, R., Natterson, J. 1999).  An example of an extended enactment might crystallize around a client’s unconscious need for sponsorship and a therapist’s unconscious wish to be helpful.

The therapist’s contribution represents much more than a simple countertransference response to a client, but the activation of the therapist’s own unconscious material.  As the therapist begins to understand the meaning of the specific dynamics unfolding dramatically, they become useful elements employed in the service of furthering the clinical work.

Deleterious enactments lead to therapeutic impasse and the cessation of relational generativity that facilitates change and growth.  They often have a repetitive and stagnant aura, a scripted feel, and both therapist and client feel like they’re being acted upon by the other.  Reciprocity feels absent.   Jessica Benjamin (Benjamin 1999) described this coercive clinical stalemate “complementarity.”

Within the dyad, impasse enactments are often identified by the mutual feelings of misunderstanding, isolation and frustration they produce.  They can, however, be equally stimulating, as they reveal the near-conscious aspects of the analytic experience that can be more closely examined and interpreted.

Working to access, decode and understand the meanings conveyed by even the most rigid enactment permits the unfolding of significant growth and change.  Irwin Hoffman (Hoffman 1983, p. 73) suggested that enactments may be “paradoxically integral to the emergence of new understanding and of new ways of being in the analytic relationship and in the world.”

However, all enactments unfolding within the clinical setting between therapist and client or patient share in common a subtle blending of old and new features, old because they draw upon unconscious elements from both the patient’s and therapist’s unconscious histories and lives and new because the current dramatization being enacted is unique to them and a specific moment in their relationship.

The patient who had been abandoned as an infant reenacted his lethal rupture scenario in every relationship he ever had.  None had ever lasted more than a few months, and that included work relationships.  This individual was unable to hold a job and was frequently unemployed, impoverished and homeless.  He was dramatizing and communicating that an infant without a mother is homeless.

The salient and tragic feature was that he was reliving the scenario, not changing it.  Living in his truck was a metaphor for mother loss.  He had no psychological or actual home.  Psychological space was for him a terrifying psychic void; he had no inner mother there to support him.

Within a few weeks of beginning a year-long analysis, he began his malignant enactment by canceling or missing appointments, making excuses and arriving late.  His unconscious need for mothering and my unconscious need to fulfill those needs set the stage for the enactments that followed, as he prepared to leave me before I could leave him.

Had I simply pitted my will against his within a rigid dialectic about frame, I would have created a therapeutic impasse, a situation of complementarity from which he would have fled, once again trying to leave mother before she could leave him.  Instead, I used the dramatization as an opportunity to comprehend and convey my empathic understanding of his experience, his terror, his loss and grief.  Enactments permit us to say, “Oh, now I see what happened to you.  Now I understand.  You’re showing me what your life has been like.  We’re experiencing it together, and now we might change the outcome.”

Countertransference:

We are made aware of these unconscious elements by tracking our own feelings, sensations and thoughts.  Our sensory awareness responses are clues to what our client’s are experiencing within themselves and within the shared psychological space of the intersubjective matrix.  The psychoanalyst, Avedis Panagian, once remarked at a conference that we access our patient’s lives and traumas by activating our own.  This is why our reveries, feelings and thoughts, even when they seem unrelated are so vitally important to our work.  They represent an overlapping experiential juncture in the third “we” space, the analytic third (Ogden 1994).

Copyright Warning: This text is printed for the personal use of the subscriber to InsideOutJournal.com.  It is illegal to copy, distribute or circulate it in any form whatsoever.

Benjamin J (1999). Afterward. In: Mitchell S, Aron L, editors. Relational psychoanalysis: The emergence of a tradition, p. 201-10. Hillsdale, NJ: Analytic Press. 496 p.

Bion, W.R. (1962). The Psycho-Analytic Study of Thinking. International Journal of Psycho-Analysis, 43:306-310.

Friedman, R., and Natterson, J. (1999).  Enactments, An Intersubjective Perspective.  Psychoanalytic Quarterly, 68:220-247.

Hoffman, I. (1999). The patient as interpreter of the analyst’s experience.  In: Relational psychoanalysis, the emergence of a tradition. Hillsdale, N.J. The Analytic Press.  (Original work published in 1983.)

Lacan, J. (1973) The four fundamental concepts of psycho-analysis. New York. W.W.  Norton & company.

Ogden, T.H. (1994). The analytic third: working with intersubjective clinical facts. International Journal of Psycho-Analysis, 75:3-19.

Stern, D. (2003).  Unformulated experience: from dissociation to imagination in psychoanalysis. The Analytic Press, Inc. Hillsdale, N.J.

Winnicott, D.W. (1953). Transitional objects and transitional phenomena—a study of the first not-me possession. International Journal of Psycho-Analysis, 34:89-97.

Winnicott, D.W. (1963). Dependence in infant care, in child care, and in the psycho-analytic setting. International Journal of Psycho-Analysis, 44:339-344.

Winnicott, D.W. (1965). The maturational processes and the facilitating environment. London: The Hogarth Press and the Institute of Psycho-Analysis.

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This column also appears in the online edition of the May-June, 2010 issue of  The Therapist Magazine, the publication of the California Association of Marriage and Family Therapists (CAMFT).

Abstract:

Adapted from a presentation to the CAMFT Orange County chapter, this second in a three-part series examines the ways applied contemporary psychoanalytic theory, particularly Intersubjective Systems Theory, with its focus on recognition and mutuality, has refined and expanded our understanding of mental processes and clinical interaction, modifying therapeutic dynamics in ways that promote therapist-client resonance.  Exploring the intersubjective matrix of transference-countertransference engagement, specifically the co-created space identified as the analytic third and the use of reverie, readers will begin to think innovatively about the shared psychological space in which we work.

Part II

Christopher Bollas: In order to find the patient, we must look for him within ourselves.

Preverbal Experience:

Given that much of what transpires in psychological space is unconscious (because after all, as Donnell Stern suggested (Stern 2003), all thought originates unexpectedly from somewhere beyond consciousness, distinguishing what is kept out of awareness defensively and volitionally from what has simply not yet taken form is axiomatic), we can work on both these levels.

There is a difference between not wanting to know something and simply not knowing it yet.  Donald Winnicott (Winnicott 1975/1945) distinguished between unorganized and disorganized mental configurations.  The individual whose mental life is unorganized has yet to congeal whereas the disorganized individual’s mind was once organized and has come undone.  The former may be ego-syntonic, while the latter ego-dystonic.

These unconscious elements existing as unformulated experience are often preverbal, meaning that they are linguistically inaccessible.  The patient struggling to formulate verbal constructs for affective experience has hit such a preverbal pocket.  This material does not exist as a fully developed notion waiting simply to be discovered like a vein of gold within a mountain.

Preverbal elements have yet to be articulated and are generally experienced as amorphous affects – impulses, feelings, urges, fears, shadowy elements, etc.  They are the sensory bits like Lego pieces that are yet to be consciously molded and integrated linguistically.  Wilfred Bion (Bion 1962) called these unformed elements “beta bits.”  He also proposed that thinking is a way to deal with thoughts – these sensory, inchoate impulses that require formulation and linguistic articulation.

Artists are extremely adept at making use of unformulated experience, though all of life is essentially a work of art.  The poet, Sharon Olds, begins writing when “a poem has formed itself, or its beginning, within me, and it’s time to get a pen and notebook and sit over there on the rocking chair next to the window and try to bring forth that which is within.”

It’s not that the poem was hiding in its complete form in her unconscious; it began as an amorphous, inchoate impulse that she then mentalized and shaped into linguistic form.  The awareness of this urgent sensation represents the welcome but often inconvenient inclination that initiates every act of creative generativity.  It’s a stirring that compels creative action.

Shared Experience:

When we work clinically in psychological space, we are talking about co-creating a shared mind-body experience, a conjoint psychological space wherein we overlap in an attempt to access and understand each other’s subjective world.

This is another feature that distinguishes contemporary psychoanalysis from its more traditional relative.  Rather than simply adhering to a doctor-patient hierarchy, where the latter has all the questions and the former all the answers, we now conceptualize two subjectivities involved in the act of co-creation.  Ideally this relationship is defined by bi-directionality and mutuality, though it necessarily remains asymmetrical.  This interactive dynamic defines the intersubjective matrix or field.

The Analytic Third and the languages of psychological space

The body-mind speaks many languages from the behavioral to imagery to words.  Within the intersubjective sphere of the transference-countertransference milieu, we work to access and decode the many communications that we receive in the service of our clients and patients.

Thomas Ogden (Ogden 1994) defined this working, overlapping “we” space as the “analytic third.”  In his seminal paper, Ogden described how he tracks the moment-by-moment interplay of the oscillating therapist-patient engagement in this intersubjective matrix.  Its prototype is the mommy-baby unit of infancy described by Winnicott (Winnicott 1960) and the emergence of transitional space, yet it is more nuanced and complex, because while we are interacting with what we call the “analytic baby,” the more archaic components of self, we are also with the more intellectually developed adult.  We have to track on all levels.  There is no such thing as an analyst apart from the relationship with the analysand (Ogden 1994).

Beginning to work in the transference-countertransference milieu

We begin to work by attuning ourselves to the paradox our clients and patients bring to us, primarily the hopeful longing for some new relational experience appended like a barnacle to the dreaded expectation that nothing and no one will ever really be different.

The hope that maybe this person will understand is quickly quashed by the fear that the therapist will be just as disappointing as everyone else has been.  And this often includes prior therapists.  And so the transference-countertransference dance begins to develop in psychological space.

Our goal is to decode, organize and clarify the unformulated bits and pieces we receive, to apprehend in our well-trained nets the clues that help us begin to understand and formulate interventions.  We sit with a client, listening and observing with all our sensory organs until we begin to grasp something.  What we experience isn’t yet fully formed; in fact, it may be as unformed as our client’s subjective experience.  In truth, as Bollas suggested (Bollas 1994), we find our client within ourselves, within the greater context of the intersubjective field.

We scroll through the session without knowing what we will find, without preconceived expectations, as Bion (Bion 1970) suggested “without memory or desire,” until we begin to form our own associations.  We have an impulse, a strong feeling, an aversion, a sensation.  And this is how we begin to work in psychological space, the place where you and I overlap and become “we.”  This is the transference-countertransference milieu.

Accessing psychological space

It is impossible to know the unconscious or unformulated directly.  We can only access its derivatives, as they are like clothes on the psyche’s invisible man.

The analytic third is the overlapping psychic sphere wherein discrete subjectivities mingle and exchange communications.  It is the realm where unconscious meets unconscious.

Louis Aron (Aron 2006) has also written about this third space extensively: “What is meant by ‘the third’? The third is a concept that has become popular across a variety of schools of psychoanalysis. It has been developed and extended by some of the leading theorists of psychoanalysis, including Ogden, Green, Benjamin, and a variety of Lacan-influenced writers, but it is often defined ambiguously and inconsistently across schools. For some, the third refers to something beyond the dyad, a context within which we emerge; for others, the third is an emergent property of dyadic interaction, and yet for others, the third is a dyadic achievement that creates the psychic space necessary for reflexive awareness and mentalization.”

Jessica Benjamin (Benjamin 2004) wrote: “My interest is not in which “thing” we use, but in the process of creating thirdness—that is, in how we build relational systems and how we develop the intersubjective capacities for such co-creation. I think in terms of thirdness as a quality or experience of intersubjective relatedness that has as its correlate a certain kind of internal mental space; it is closely related to Winnicott’s idea of potential or transitional space.”

So the third is many things, a space in which communications are exchanged and reformulated, a function of relationship-building and a theoretical concept open to diverse interpretations.

Elements of Intersubjective communication

Reverie and Imagery:

Reverie and imagery give visual, if not palpable, shape and form to elements that swirl in this dynamic and interdependent field of intersubjectivity, particularly crystallizing communication that drifts from unconscious to unconscious, bypassing awareness.  This is the live edge of clinical work, the place where analyst and patient, therapist and client intersect, clothing the unseen communications in ways that make them accessible and amenable to articulation in language.

Mother and child in a boat

This kind of communication best describes the ways a mother intuits the needs of her baby.  Receiving her baby’s projections, she organizes and returns them in tolerable and digestible doses.  Did you ever have to put on a sweater because your mother was cold?

The focus is less on what originates where but on interpersonal co-creation of elements in the overlapping psychological space of the analytic third.

An example from my own practice is my awareness of surrounding airport sounds.  My office is very near the runway, so the sounds of jets taking off are generally background noise.  I only become aware of them distinctly when I sense that my patient’s thoughts or feelings are defensively taking flight, or perhaps they don’t yet have a (linguistic) place to land.  At those moments when I envision planes lifting off the runway, I may ask what thought or feeling just took off, and I will invariably receive a germane answer.  If the answer is “I don’t know,” we collaborate to discern what it might be.  I attempt to put words to mental pictures I receive, and we try them on for size together.

A more imagery-laden example of processing in the third derives from my work with a man who grew up in an Eastern Block country, though has lived in the States for many years.  He’s lost the fluidity of thinking and speaking in his native language yet struggles to express himself precisely in English.  Not only is this frustrating, but it pushes him back to a more archaic means of image-laden, unconscious communication.

Therefore, I experience lots of imagery in the third when we’re together.  On several occasions, I’ve “seen” a winter scenario of cold earth, frozen beneath soggy, fallen leaves and bare trees.  Translating this into emotional language, I offered him the interpretation that he felt like his feelings were suspended in permafrost.  Indeed, they were.  He has always identified himself as being emotionally cold.

Therapists often confuse their random but meaningful thoughts or countertransferential reveries with intrusive distractions that should be discarded, and sometimes they very well may be.  But even that is significant.

The question begging an answer is why did I need to distract myself at that particular moment?  What didn’t the client want me to know or what did he want me to avoid?  What couldn’t I bear to witness?  What must always be left unacknowledged, unformed, unsaid or isolated as dissociated material?  What was too painful to feel?  What really longed to be understood?  Most usually those very thoughts and images have something to do with what is going on within the client’s mind-body.

Recently while sitting with a patient, I beheld in my mind the image of a child prostitute and asked her if she felt like hooker in her marriage.  Indeed, she did, but that was the first time she’d been fully aware of her feelings.  She had communicated this unthought known (Bollas 1987) to me via imagery.  Now we speak of it explicitly, and it is amenable to change.

I frequently tell patients that split off aspects of themselves have lives of their own outside awareness revolving like isolated moons with no way to reconnect.  Our job is to set up a linguistic satellite system so that the moon can communicate with the mother ship.  You can’t enact a lunar landing if you don’t even recognize that a moon exists.

What makes this way of working with unconscious material contemporary are the ways in which it differs from Freud’s schema of the unconscious as the return of the fully-formed repressed, conceptualizing that insight and awareness were sufficient to illuminate the issues and produce change.

More current schemata suggest that unconscious elements are not simply inaccessible as a result of defenses, but unformed.

While insight is valuable, it is equally imperative that we attempt to access and comprehend what is unformulated, thereby facilitating the creative process whereby mental Lego pieces can be assembled and used.  Reverie and the analytic third provide a means for us to achieve that goal.

Aaron, L. (2006). Analytic Impasse and the Third: Clinical implications of intersubjectivity.  International Journal of Psycho-Analysis, 87:349-368.

Benjamin, J. (2004).  Beyond Doer and Done To: An Intersubjective View of Thirdness.  Psychoanalytic Quarterly, 73:5-46

Bollas, C. (1987). The Shadow of the object: psychoanalysis of the unthought known. Columbia University Press, N.Y., N.Y.

Bion, W.R. (1970). Attention and interpretation: a scientific approach to insight in psycho-analysis and groups, 1-130.  London: Tavistock.

Bion, W.R. (1962). Learning from experience. London: Tavistock.

Bion, W.R. (1962). The Psycho-Analytic Study of Thinking.  International Journal of Psycho-Analysis, 43:306-310.

Ogden, T.H. (1994). The Analytic Third: Working with Intersubjective Clinical Facts. International Journal of Psycho-Analysis, 75:3-19.

Winnicott, D.W. (1960). The Theory of the Parent-Infant Relationship. International Journal of Psycho-Analysis, 41:585-595.

Winnicott, D.W. (1975). Primitive emotional development. In: Collected papers:

through paediatrics to psycho-analysis. (pp. 145-156). (Original work published 1945). Basic Books. Locale unknow

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This column also appears in the online edition of the March-April, 2010 issue of  The Therapist Magazine, the publication of the California Association of Marriage and Family Therapists.

Abstract:

Adapted from a presentation to the CAMFT Orange County chapter, this first in a three-part series examines the ways applied contemporary psychoanalytic theory, particularly Intersubjective Systems Theory, with its focus on recognition and mutuality, has refined and expanded our understanding of mental processes and clinical interaction, modifying therapeutic dynamics in ways that promote therapist-client resonance.  Exploring developmental factors and transitional space, the origins of creativity and an expanded definition of the unconscious to include unformulated experience, readers will begin to think innovatively about the shared psychological space in which we work. [click to continue…]

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This column also appears in the Orange County Register.

Once upon a time when the young woman who would become me was a freshman at Cal Berkeley studying French, art history, anthropology, mythology, literature and on weekends, beer and poetic boys with long hair, she was lucky enough to get into a very crowded physical anthropology class taught by a professorial luminary whose name, almost four decades later, I can no longer recall. [click to continue…]

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On several occasions I’ve written about the ways in which we begin to come into being as unique persons from within an interpersonal mommy-daddy-baby matrix.  The impact of these early interactions are so vital and long-lasting, they inform our behavior and beliefs about relationships for the remainder of our lives. [click to continue…]

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