A Spinozan lens onto the confusions of borderline relations

In this paper the author describes how, in his analytic work with difficult personality disorders, he uses a neo-Spinozan position or attitude of alpha-thinking and functioning to understand, clarify, and so to manage confused and confusing psychosomatic 'body-mind' and emotional relations, both internally and inter-personally. Two case examples are given, followed by reflections on technique and on the limits of mourning, transformation and irony. The author suggests that a private, ideational double-aspect, mind-body position may be helpful in working with these analysands. This analytic mode may create a radically different understanding by incorporating a relational system of containment, self-containment, observation and memory. In addition, the author gives his own version of the aetiology and dynamics of borderline states and relations, and weaves the two cases he reports on into reflections on his countertransferential responses, reactions, inter-actions and 'reverie' through the lens of a neo-Spinozan conceptual system.     

A word about words

The title of my paper comes from an essay by Václav Havel. In his essay, Havel addressed most evocatively the question of the unique power of words for thinking and to influence, for good or for harm, as well as to inform and to educate. As analysts our medium is the word. I suggest that it is of inestimable importance that we are able to listen deeply to our patients' words and to be aware of our own. The quality of our ability to think deeply and consistently about the unconscious experience of our patient is intimately related to our ability to hear what is being said. The effect of our own words upon the patient likewise cannot be overstated. I offer my reflections on words in the analytic relationship and I give some clinical examples that I hope will illustrate my thoughts as to the power and the importance of what and how we hear and of what we say.     

What's true and whose idea was it?

In this paper, the author explores the idea that psychoanalysis at its core involves an effort on the part of patient and analyst to articulate what is true to an emotional experience in a form that is utilizable by the analytic pair for purposes of psychological change. Building upon the work of Bion, what is true to human emotional experience is seen as independent of the analyst's formulation of it. In this sense, we, as psychoanalysts, are not inventors of emotional truths, but participant observers and scribes. And yet, in the very act of thinking and giving verbally symbolic 'shape' to what we intuit to be true to an emotional experience, we alter that truth. This understanding of what is true underlies the analytic conception of the therapeutic action of interpretation: in interpreting, the analyst verbally symbolizes what he feels is true to the patient's unconscious experience and, in so doing, alters what is true and contributes to the creation of a potentially new experience with which the analytic pair may do psychological work. These ideas are illustrated in a detailed discussion of an analytic session. The analyst makes use of his reverie experience-for which both and neither of the members of the analytic pair may claim authorship-in his effort to arrive at tentative understandings of what is true to the patient's unconscious emotional experience at several junctures in the session.     

On becoming a child: Reverie in the psychotherapy of children

My aim in this paper is to examine the role of reverie in facilitating the development of the child‐subject, that is, the child's continuous motion towards subjectivity. I begin by briefly reviewing the concept of reverie and proceed with an examination of elements I believe are fundamental and common to both reverie and child psychotherapy, that is, primary thought processes and primitive impulses. I then describe and demonstrate the atmosphere created by these elements using three examples from the psychotherapy of 8 year‐old Jonathan. Next, I discuss an intersubjective parallel of Bion's reverie and a developmentally oriented version of Ogden's reverie, focusing on its relation to processes of destruction and recognition. I argue that reverie provides the recognition of the child's struggle for his own birth and growth as a subject, that is, of his child‐subject. Finally, I refer to the presence of reverie from the primary preoccupation of mother and father till the child's reverie of himself, his day‐dreaming.     

Psychosomatic breast and alexithymic breast: A Bionian psychosomatic perspective

The author develops the concept of ‘psychosomatic breast’ in both clinical and theoretical terms, a concept developed by Bion (1962b) to account for a breast in charge of primary symbolization and of the psychosomatic integration of the infant's raw physiological, emotional and sensory experiences. As such, the psychosomatic breast is a prototype, a core in the mother endowed with the capacity for reverie insofar as the transformative function of the latter not only pertains to the primary symbolization of emotional life, but also to its secondary symbolization. The author contends that a primal failure in the transformation of such raw emotional and sensory experiences through the reverie of primary objects results in the incorporation of an ‘alexithymic breast’ – a kind of obstructive object that has become impervious to communication via projective identification and has been internalized as a source of psychic and physical breakdown. This early deficiency in parental reverie is experienced by the infant as a primitive disaster that establishes a point of fixation, a fault line in psychosomatic organization which the individual is likely to regress to, at a later stage, by developing physical illness. The author illustrates the dynamics and the economy of the conflict between psychosomatic and alexithymic breasts thanks to fragments from the analysis of a woman who developed cancer in the course of her psychoanalysis and was eventually cured.