The seventh servant: The implications of a truth drive in Bions theory of 'O'

Drawing upon Bion's published works on the subjects of truth, dreaming, alpha‐function and transformations in ‘O’, the author independently postulates that there exists a ‘truth instinctual drive’ that subserves a truth principle, the latter of which is associated with the reality principle. Further, he suggests, following Bion's postulation, that ‘alpha‐function’ and dreaming/phantasying constitute unconscious thinking processes and that they mediate the activity of this ‘truth drive’ (quest, pulsion), which the author hypothesizes constitutes another aspect of a larger entity that also includes the epistemophilic component drive. It purportedly seeks and transmits as well as includes what Bion (1965, pp. 147‐9) calls ‘O’, the ‘Absolute Truth, Ultimate Reality, O’ (also associated with infi nity, noumena or things‐in‐themselves, and ‘godhead’) (1970, p. 26). It is further hypothesized that the truth drive functions in collaboration with an ‘unconscious consciousness’ that is associated with the faculty of ‘attention’, which is also known as ‘intuition’. It is responsive to internal psychical reality and constitutes Bion's ‘seventh servant’. O, the ultimate landscape of psychoanalysis, has many dimensions, but the one that seems to interest Bion is that of the emotional experience of the analysand's and the analyst's ‘evolving O’ respectively (1970, p. 52) during the analytic session. The author thus hypothesizes that a sense of truth presents itself to the subject as a quest for truth which has the quality and force of an instinctual drive and constitutes the counterpart to the epistemophilic drive. This ‘truth quest’ or ‘drive’ is hypothesized to be the source of the generation of the emotional truth of one's ongoing experiences, both conscious and unconscious. It is proposed that emotions are beacons of truth in regard to the acceptance of reality. The concepts of an emotional truth drive and a truth principle would help us understand why analysands are able to accept analysts’ interpretations that favor the operation of the reality principle over the pleasure principle—because of what is postulated as their overriding adaptive need for truth. Ultimately, it would seem that Bion's legacy of truth aims at integrating fi nite man with infi nite man.     

The countertransference dream1

Can the analyst's night‐dream about his patient be considered as a manifestation of countertransference‐and, if so, under what conditions? In what way can such a dream represent more than just the disguised fulfillment of a repressed wish of the analyst? Is there not a risk of the analyst unconsciously taking up and ‘using’ the content of a session or other elements coming from the analytic situation for his own psychic reasons? The author, closely following Freud's dream theory, shows the mechanisms which can allow us to use the dream content in the analytical situation: preserved from the secondary processes of conscious thinking, other fantasies and affects than in the waking state can emerge in dream thought, following an ‘unconscious perception’. After examining the countertransference elements of Freud's dream, ‘Irma's injection’, which leads off The interpretation of dreams, the author presents a dream of her own about a patient and its value for understanding affects and representations which had hitherto remained unrepresented.     

ANALYTIC MIND USE AND INTERPSYCHIC COMMUNICATION: DRIVING FORCE IN ANALYTIC TECHNIQUE,PATHWAY TO UNCONSCIOUS MENTAL LIFE

Developed from established psychoanalytic knowledge among different psychoanalytic cultures concerning unconscious interpsychic communication, analysts' use of their receptive mental experience—their analytic mind use, including the somatic, unconscious, and less accessible derivatives—represents a significant investigative road to patients' unconscious mental life, particularly with poorly symbolized mental states. The author expands upon this tradition, exploring what happens when patients unconsciously experience and identify with the analyst's psychic functioning. The technical implications of the analyst's “instrument” are described, including the analyst's ego regression, creation of inner space, taking mind as object, bearing uncertainty and intense affect, and self‐analysis. Brief case vignettes illustrate the structure and obstacles to this work.     

Transcending the caesura: Reverie,dreaming and counter‐dreaming

The author reflects about our capacity to get in touch with primitive, irrepresentable, seemingly unreachable parts of the Self and with the unrepressed unconscious. It is suggested that when the patient's dreaming comes to a halt, or encounters a caesura, the analyst dreams that which the patient cannot. Getting in touch with such primitive mental states and with the origin of the Self is aspired to, not so much for discovering historical truth or recovering unconscious content, as for generating motion between different parts of the psyche. The movement itself is what expands the mind and facilitates psychic growth. Bion's brave and daring notion of ‘caesura’, suggesting a link between mature emotions and thinking and intra‐uterine life, serves as a model for bridging seemingly unbridgeable states of mind. Bion inspires us to ‘dream’ creatively, to let our minds roam freely, stressing the analyst's speculative imagination and intuition often bordering on hallucination. However, being on the seam between conscious and unconscious, dreaming subverts the psychic equilibrium and poses a threat of catastrophe as a result of the confusion it affords between the psychotic and the non‐psychotic parts of the personality. Hence there is a tendency to try and evade it through a more saturated mode of thinking, often relying on external reality. The analyst's dreaming and intuition, perhaps a remnant of intra‐uterine life, is elaborated as means of penetrating and transcending the caesura, thus facilitating patient and analyst to bear unbearable states of mind and the painful awareness of the unknowability of the emotional experience. This is illustrated clinically.     

The act of interpretation1

The author understands the interpreting act as an attempt to perceive what happens in the transference/countertransference fi eld and not just what happens in the patient's mind. Interpretation transcends mere intellectual communication. It is also an experience in which analysts’ emotions work as an important instrument in understanding their patients. Interpretation is seen to possess manifest as well as latent content; the latter would contain the analysts’ feelings, emotions and personality. The unconscious content of an interpretation does not inconvenience or preclude the development of the analytic process, but, on the contrary, it allows new associative material to emerge, and it transforms the analytic session into a human relationship. Analysts’ awareness of this content derived from patients’ apperceptions is a signifi cant instrument for understanding what is happening in the analytic relationship, and what transpires in these sessions provides fundamental elements for analysts’ self‐analysis. Some clinical examples demonstrate these occurrences in analytic sessions, and how they can be apprehended and used for a better understanding of the patient. The author also mentions the occurrence of diffi culties during the analytic process. These diffi culties are often the result of lapses in an analyst's perception related to unconscious elements of the relationship.     

Identification with the aggressor and the ‘normal traumas’: clinical implications

Ferenczi's (1933) surprisingly unknown concept of identification with the aggressor – an abuse victim's ‘eliminating’ her own subjectivity and ‘becoming’ precisely what an attacker needs her to be – has radical implications for our understanding of analytic technique. Its very frequent occurrence also forces us to broaden our understanding of what constitutes trauma. Ferenczi saw the experience of ‘traumatic aloneness’ or ‘emotional abandonment’ as the key element of trauma, since this is what enforces the traumatic responses of dissociation and identification with the aggressor. Identification with the aggressor operates in the analytic relationship in both patient and analyst. This has various consequences, including the structuring of the relationship through unconscious collusions – mutually coordinated, defensive identifications designed to help both participants feel secure. This view of the analytic relationship has clinical implications in at least four areas: the understanding of the patient's free associations, which may reflect the patient's compliance with the analyst's wishes rather than the contents of the patient's own unconscious; the need for some kind of mutuality of analysis; the traumatizing potential of the analyst's authority; and the tendency of some patients to take blame and responsibility reflexively, as a way of protecting the analyst.     

Unconscious fantasy (or phantasy) as clinical concept

A clinical phenomenology of the concept ‘unconscious fantasy’ attempts to describe it from a ‘bottom‐up’ perspective, that is, from the immediate experience of the analyst working in session. Articles of psychoanalytic authors from different persuasions are reviewed, which taken as a whole would shed some light on how the concept of unconscious fantasy takes shape in the analyst's mind during the session with the patient. A clinical phenomenology in three steps is described. Each step is illustrated by clinical material. Current controversies around the concept of unconscious fantasy (or phantasy) are still trapped in the discussion about if and how they are really unconscious. The strategy to describe from a ‘bottom‐up’ perspective the process of how the analyst's mind embraces the idea that an emerging phenomenon in the relationship with the patient can be defined as ‘unconscious fantasy’, allows us to elude the question as to whether or not we believe that unconscious fantasies exist at all, since we are neither required to assert or deny such a prior existence in order to describe the process of elaboration which, in the end, does formulate a fantasy as fantasy.     

Leaps of faith: Is forgiveness a useful concept?

Using detailed clinical vignettes, the author argues that, despite the current idealization of the concept of forgiveness, the term has no place in psychoanalytic work, and there are some hazards to giving it one. Clinically, the concept of forgiveness is seductive, implying that there should be a common outcome to a variety of injuries, stemming from different situations and calling for different solutions. Every instance of what we call forgiveness can be seen to serve a different defensive function. While the conscious experience of what is called forgiveness is sometimes confused with the unconscious process of reparation, the two can only be described at different levels of psychic life. Despite the fact that in ‘the unconscious’ there is no such thing as forgiveness, the term has an adhesive quality in our thinking that also blunts the analyst'’s appreciation of the aggressive components in the work. In a final vignette, the author illustrates an analytic outcome that has the appearance of forgiveness, but is best understood as the complex result of the everyday work of analysis.     

Psychotherapy in the aesthetic attitude

Abstract: Drawing upon the writings of Jungian analyst Joseph Henderson on unconscious attitudes toward culture that patients and analysts may bring to therapy, the author defines the aesthetic attitude as one of the basic ways that cultural experience is instinctively accessed and processed so that it can become part of an individual's self experience. In analytic treatment, the aesthetic attitude emerges as part of what Jung called the transcendent function to create new symbolic possibilities for the growth of consciousness. It can provide creative opportunities for new adaptation where individuation has become stuck in unconscious complexes, both personal and cultural. In contrast to formulations that have compared depth psychotherapy to religious ritual, philosophic discourse, and renewal of socialization, this paper focuses upon the considerations of beauty that make psychotherapy also an art. In psychotherapeutic work, the aesthetic attitude confronts both analyst and patient with the problem of taste, affects how the treatment is shaped and ‘framed’, and can grant a dimension of grace to the analyst's mirroring of the struggles that attend the patient's effort to be a more smoothly functioning human being. The patient may learn to extend the same grace to the analyst's fumbling attempts to be helpful. The author suggests that the aesthetic attitude is thus a help in the resolution of both countertransference and transference en route to psychological healing.     

Process‐orientated psychoanalytic work in initial interviews and the importance of the opening scene

From the very first moment of the initial interview to the end of a long course of psychoanalysis, the unconscious exchange between analysand and analyst, and the analysis of the relationship between transference and countertransference, are at the heart of psychoanalytic work. Drawing on initial interviews with a psychosomatically and depressively ill student, a psychoanalytic understanding of initial encounters is worked out. The opening scene of the first interview already condenses the central psychopathology – a clinging to the primary object because it was never securely experienced as present by the patient. The author outlines the development of some psychoanalytic theories concerning the initial interview and demonstrates their specific importance as background knowledge for the clinical situation in the following domains: the ‘diagnostic position’, the ‘therapeutic position’, the ‘opening scene’, the ‘countertransference’ and the ‘analyst's free‐floating introspectiveness’. More recent investigations refer to ‘process qualities’ of the analytic relationship, such as ‘synchronization’ and ‘self‐efficacy’. The latter seeks to describe after how much time between the interview sessions constructive or destructive inner processes gain ground in the patient and what significance this may have for the decision about the treatment that follows. All these factors combined can lead to establishing a differential process‐orientated indication that also takes account of the fact that being confronted with the fear of unconscious processes of exchange is specific to the psychoanalytic profession.     

Journal reviews

Articles reviewed: Astor, James: ‘Some Jungian and Freudian perspectives on the Oedipus myth and beyond’. Colman Warren: ‘That within which passes show: Hamlet and the unknowable Self’. Halberstadt-Freud H. C: ‘Electra versus Oedipus à Femininity reconsidered’. Kulish, Nancy & Holtzman, Deanna: ‘Persephone, the loss of virginity and the female Oedipus complex’ Hopkins, Linda B: ‘D. W. Winnicott's analysis of Masud Khan: a preliminary study of failures of object usage’. Miletic, Michael (ed.): ‘Perspectives on the analyst's self-disclosure during psychoanalysis’. Miletic, Michael J. (ed.): ‘Perspectives on the analyst's self-disclosure during psychoanalysis’. Ornstein, Anna: ‘The fate of narcissistic rage in psychotherapy’. Solomon, Hester McFarland: ‘Love, Paradox of Self and Other’. Stack, Carolyn: ‘The analyst's new clothes: the impact of the therapist's unconscious conflicts on the treatment process’. Von Der Tann, Matthias: ‘Was lesen Jungianer in Berlin für das Examen?’–‘What do Jungians in Berlin read for their final paper?’     

Between listening and expression

This paper sets out to conceptualize what goes on in the analyst's mind as he listens—and expresses something—to the patient. Bion's ideas of approaching the patient's O, without memory and desire, are discussed. An alternate, more permissive, attitude to desire is suggested. This is based on the idea that containment, instead of denoting a dyadic interaction between mother and child, is a process which links the child to a begetting couple, thus a triad. Containing the patient corresponds, in the unconscious, to thinking about a sexual couple in a mutually beneficent interaction. Since the patient's anxiety, in his unconscious, parallels a frightening primal scene, containment is viewed as a continuous translation of a primitive primal scene into a mature act of love. A specific kind of genital desire is thus necessary for containment. This finds expression in the analyst's resonance with the patient. Clinical material from an analysis with a 7-year old boy is provided.     

Space and time in psychoanalytic listening1

The analytic situation is by definition traumatic because it evokes hilflosigkeit, the state of helplessness of the newborn infant, which is the prototype of the traumatic situation, and at the origin of the experience of anxiety. The author addresses the chain of associations between the state of helplessness, repetition compulsion, trauma, infantile sexuality, pleasure and displeasure, which lie at the core of the transference experience, and which find their ultimate expression in the analyst's listening. The discovery of the compulsion to repeat instituted a paradigmatic shift in Freud's formulations, emphasizing the process of repetition of trauma, and instituting a link between the network of concepts indicated above. In the clinical example discussed, the author defines the psychoanalytic process by the primacy of sexuality, the erotic passivation in the transference that evokes the traumatic childhood sexual scene. Sexuality and sexual phantasies are at the centre of the elaboration of meaning. Furthermore, the author distinguishes between two types of interpretations, namely ‘open’ and ‘closed’.     

Pentheus rather than Oedipus: On perversion,survival and analytic ‘presencing’1

Following an introductory review of the main developments in the psychoanalytic thinking on perversion, the author focuses on her own understanding of perversion and its treatment, based on the psychoanalytic treatment of patients with severe sexual perversions. This paper uses the term ‘autotomy’ (borrowed from the fi eld of biology) to describe perversion formation as an ‘autotomous’ defence solution involving massive dissociative splitting in the service of psychic survival within a violent, traumatic early childhood situation; thus, a compulsively enacted ‘desire for ritualised trauma’ ensues. The specifi c nature of the perverse scenario embodies the specifi c experiential core quality of the traumatic situation. It is an actual repetition in the present of the imprint of a past destructive experience which is pre‐arranged and stage‐managed; it thus encounters haunting scenes of dread or psychic annihilation while, at the same time, controlling, sanitising and disavowing them. Hence, the world of severe perversion is no longer oedipal, but rather the world of Pentheus, Euripides's most tragic hero‐a world dominated by a mixture of a mother's madness, devourment, destruction and rituals of desire. According to this view, the (diffi cult) psychoanalytic treatment of perversion focuses on patient‐analyst interconnectedness‐brought about by the analyst's ‘givenness to being present’ or ‘presencing’‐at a deep, primary level of contact and impact (the emphasis being on the ontological dimension of experience). This evolving therapeutic entity creates and actualises a new, alternative experiential‐emotional reality within the pervert's alienated world, eventually generating a change in the perverse essence. The author illustrate this approach with three clinical vignettes.     

Living in Two Worlds. How ‘Jungian’ am I?

As a so‐called ‘Developmental Jungian’ the author of this paper was raised bilingual ‐ speaking both psychoanalytic and Jungian languages. Early on in her training an analysand brought a dream which seemed to capture an inherent tension regarding the analyst's role in the analytic relationship. The paper is a personal exploration of the potentially creative nature of this tension through focussing on the dream and the work with the dreamer.     

The analyst's countertransference to the psychoanalytic process1

There is countertransference, not just to individual patients, but to the process of psychoanalysis itself. The analytic process is a contentious topic. Disagreements about its nature can arise from taking it as a unitary concept that should have a single defi nition whereas, in fact, there are several strands to its meaning. The need for the analyst's free associative listening, as a counterpart to the patient's free associations, implies resistance to the analytic process in the analyst as well as the patient. The author gives examples of the self‐analysis that this necessitates. The most important happenings in both the analyst's and the patient's internal worlds lie at the boundary between conscious and unconscious, and the nature of an analyst's interventions depends on how fully what happens at that boundary is articulated in the analyst's consciousness. The therapeutic quality of an analyst's engagement with a patient depends on the freeing and enlivening quality, for the analyst, of the analyst's engagement with his or her countertransference to the analytic process.     

Alphabetizing in old age

Abstract: A long term, intensive analysis with a woman in old old age is reported. An attempt is made to answer the question, ‘What, in analytic work, is healing?’. The patient's previous classical Jungian work is contrasted with the author's developmental perspective. It is suggested that an enactment, representing what Neville Symington has called an analyst's act of freedom, was crucial in effecting a profound transformation in the patient's psyche.     

Trauma,narcissism and the two attractors in trauma1

In this paper, the author sets out to distinguish anew between two concepts that have become sorely entangled‐‘trauma’ and ‘narcissism’. Defi ning ‘narcissism’ in terms of an interaction between the selfobject and the self that maintains a protective shield, and ‘trauma’ as attacks on this protective shield, perpetrated by bad objects, he introduces two attractors present in trauma‐‘the hole attractor’ and the structure enveloping it, ‘the narcissistic envelope’. The hole attractor pulls the trauma patient, like a ‘black hole’, into a realm of emotional void, of hole object transference, devoid of memories and where often in an analyst's countertransference there are no reverberations of the trauma patient's experience. In the narcissistic envelope, on the other hand, motion, the life and death drive and fragments of memory do survive. Based on the author's own clinical experience with Holocaust survivors, and on secondary sources, the paper concludes with some clinical implications that take the two attractors into account.     

God of the hinge: treating LGBTQIA patients

This paper looks at systems of gender within the context of analysis. It explores the unique challenges of individuation faced by transsexual, transgender, gender queer, gender non‐conforming, cross‐dressing and intersex patients. To receive patients generously we need to learn how a binary culture produces profound and chronic trauma. These patients wrestle with being who they are whilst simultaneously receiving negative projections and feeling invisible. While often presenting with the struggles of gender conforming individuals, understanding the specifically gendered aspect of their identity is imperative. An analyst's unconscious bias may lead to iatrogenic shaming. The author argues that rigorous, humble inquiry into the analyst's transphobia can be transformative for patient, analyst, and the work itself. Analysis may, then, provide gender‐variant patients with their first remembered and numinous experience of authentic connection to self. Conjuring the image of a hinge, securely placed in the neutral region of a third space, creates a transpositive analytic temenos. Invoking the spirit of the Trickster in the construction of this matrix supports the full inclusion of gender‐variant patients. Nuanced attunement scaffolds mirroring and the possibility of play. Being mindful that gender is sturdy and delicate as well as mercurial and defined enriches the analyst's listening.     

Finding unconscious phantasy in the session: Recognizing form

The concept of unconscious phantasy has played – and still does play – a central role in psychoanalytic thinking. The author discusses the various forms by which unconscious phantasies manifest themselves in the analytic session as they are lived out and enacted in the transference relationship. This paper also aims at expanding the kleinian theory of symbol formation by exploring the impact that emotional aspects connected to early “raw’, “pre‐symbolic’ phantasies have in the analysis and how their corporeal elements interlock with the signifying process. The author follows the expressive forms of primitive unconscious phantasies as they appear in a psychoanalytic session and proposes that the emotional effect that can be experienced in the communication between patient and analyst depends in great measure on “semiotic’ aspects linked to primitive phantasies that are felt and lived out in embodied ways. Rather than a move from unconscious phantasies that typify symbolic equations to those showing proper symbolization, these can coexist and simultaneously find their way to what is communicated to the analyst. As early phantasies bear an intimate connection to the body and to unprocessed emotions when they are projected into the analyst they can produce a powerful resonance, sometimes also experienced in a physical way and forming an integral part of the analyst's counter‐transference.