THE ANALYST AT WORK
VANN SPRUIELL, NEW ORLEANS
This paper was given as a Plenary Address at the 33rd
International Psychoanalytical Congress, July 1983. It was published in
the International Journal of Psycho-Analysis in 1984, 65:13-30. Minor editorial
changes have been made in this version, and some meanings have been clarified
in small ways, but the text has not been fundamentally changed. The paper
is a follow-up of The Rules and Frames of the Analytic Situation, vs93b;
it makes use of experiences with the same patient, two years later, and
it operates with the same ideas about what I call the "analytic frame"
or analytic situation. Since the analytic material in this paper came two
years after the first, it is expectably more complex: the analytic work
was more sound. The patient was much more deeply involved with transference
experiences, resistances, etc. than he had been two years before. He was
much more aware of the inwardness of psychoanalysis, of the power of wishes
and fantasies, and the possibilities of change within himself. He was much
more ready to be candid; he understood better what analysis is about, and
could "use" me and my setting more constructively for his own
purposes. Similarly, the theoretical yield of the later work was more complex.
Other papers following this line of thinking were Thinking Blind,
vs84b, Kuhn's 'Paradigm
and Psychoanalysis, vs1983c,
Transference, vs94c,
The Indivisibility of Freudian object relations and drive theories,
vs1988, and Screens,
Splits, Frames and Keys: The analysis of an omnipotent man. vs1991c
It is a privilege to be a psychoanalyst. Our group is scandalously
small. There are only a few thousand professionals in the world who study
individual minds in the only way they can now be studied in depth. Many
more people study insects. And many, many more are consecrated to weapons.
At the same time, it is a gift of Eros that psychoanalysis is radically
therapeutic for a sufficient number of people. Otherwise neither official
science nor our individual subjects would permit it. Nor could any but
the most fanatic investigators bear to do it. Without therapeutic motivations
the enterprise would be intolerable; without an ample number of successes,
the discipline could not have survived.
It is an honor to be asked to present aspects of my daily work with one
patient. But it is also a burden: It is a difficult thing to do because
presentations of clinical material can only be partial.1
. Of course, my aim is to come as close to the truth in this account as
I can, keeping in mind the ubiquity of self-deception. Self-deception is
made more likely because the events I shall describe happened years ago.
It is more likely still because this presentation is to a large group instead
of a small number of intimates. If what I have to say is to have value,
it has to be a personal statement. Yet, how can one speak personally to
strangers? Public intimacy is a contradiction in terms, an absurdity. A
greater absurdity, one I hope to avoid, would be the pretence of impersonality:
how can the full-time analyst pretend to be impersonal about what he does
all day, every day?
Having no other choice, I intend to dwell for a time in this room of ambiguity
and invite you in. The floor of our imaginary room will be made of details
of one session from the middle of a patient's analysis. But first I will
try to describe the air of the room, so to speak, the medium of psychoanalytic
communication and evidence. Then I will outline and fill in, as well as
I can, the clinical and theoretical walls: first, the general context,
then the context of the particular session. The session's description,
the floor of our room, will occupy most of the time. Then we will return
to the delineation of the walls. About floor or walls, the account will
be biographical in nature, and it will also be, to a point, autobiographical.
I cannot describe how I see myself, at least to some extent, at work without
describing both the patient, his present and his past, along with how I
see myself as a psychoanalyst -- my professional present and past. We may
set up imaginary floor, walls and even atmosphere, more clearly understood
here, less there. But we will not be able to complete the room, much less
imagine a ceiling.
PSYCHOANALYTIC EVIDENCE
In the most optimistic of spirits, thinking about the public presentability
of psychoanalytic evidence confounds and addles the mind. For example,
I will talk about a quest to understand another man. The quest for understanding
was made from, not one or two, but five different standpoints. Try as I
might, there is no way to keep them separate. The standpoints are: (1)
A position within the analytic field in which I made up part of what Isakower
called the analyzing instrument, an unconscious teamwork composed jointly
by the patient's and my own shared fantasies and activities. (2) More rational,
somewhat more 'objective' -- but more detached -- observations during the
work, of the analytic situation and its phenomena. (3) Still more 'objective',
still more detached, annotations made hours later of notes made during
the session -- clarifications-but subject to the same distortions as are
the secondary elaborations of a dream. (4) The analysis of that material
years later, knowing by then how those years had turned out, knowing also
that over those years I too changed -- I am in ways no longer the same
person I was back then, and can be even less sure of how much condensation
and contamination has occurred to the memories. (5) And finally, this text
has had to be constructed -- selections made and discarded, edited, subdued
by concerns for confidentiality, taunted by wishes to be understood and
appreciated.
Every public text having to do with analytic intimacy is severely limited,
thus encumbered as scientific evidence – at least in the ways science has
until recently been understood. Psychoanalytic evidence, shared privately,
or semi-privately in small groups, is much more reliable. One of the temptations
for a writer or speaker is to present clinical material as if only the
analysand's mind were involved -- that of the analyst's presented as if
it were an autonomous ego speaking rational interpretations and concocting
reasonable formulations later. That may bring out certain truths about
the patient, but it will hide others. Honest work urges communications
about the operations of both minds at work in the analytic situation. Yet,
antinomies exist. Morality enjoins us to limit what is said in public;
discretion forces fictionalization; seemliness calls for euphemisms. If
that means that psychoanalysts are in some respects less than scientific,
it also means that they are more: they try to examine these contradictory
obligations, this complex material in process that is more complex than
any other known to us, examine it empirically and in the light of others'
works for comparisons, and finally present it as veridically as we can.
There is no other way known to describe scientifically the life of another
person's mind while it is in action.
Long ago, I learned to take process notes. In the beginning, I hoped to
take regular process notes of all my sessions with analytic patients. In
this, I followed Greenacre's advice (1975), instead of Freud's (1912).
I was never able to see that taking notes interfered with my own spontaneity
(although that might be true for other analysts). So I took mountains of
notes. The problem was that I hardly ever looked at them. Whatever masochistic
or compulsive traits I may have, they do not entail piles of unread notes.
After a short time as a full-time analyst, I kept a notepad by me, but
mostly doodled, drew pictures, occasionally wrote down a dream. Sooner
or later I usually destroyed the material. However, I also discovered that
there were times when I felt lost in a given analysis, or troubled by it
in some way that eluded me. Then, it was easy to take process notes again.
When I annotated them, usually in some free period during the day or night
following the session, a sort of self-supervision became possible.2
I was handicapped by not being able to write and talk at the same time;
the notes on my own interventions were more sketchy than the accounts of
what the analysand said. In part compensation, it was possible to jot down
references to my inner states and fantasies.
As a result, I have been left with a stock of examples of more or less
ordinary analytic sessions, even if at particular times they were not well-understood;
a small stock of dramatic 'turning points', or 'good hours'; and an even
smaller quantity of documentations of my very best technique, wisdom, wit,
or imaginativeness. On the other hand, the truly 'ordinary' sessions were
discarded because their epitaphs were only doodles. The tilt was always
toward non-ordinary notes. As any experienced analyst knows, each need
to supervise himself has to do with his own self-analysis and some particular
bit of 'frozen' transference (or countertransference, if you wish) in relation
to the work.
CLINICAL BACKGROUND
To proceed to sketch our metaphorical room, recently I published an account
of one day's work with an intelligent young man who was in some respects
unusual. The account was in 'The rules and frames of the analytic situation'
(1984). I chose that particular clinical vignette to illustrate an approach
to a theoretical problem: psychoanalysis needs but does not yet have, an
interactional (or interpersonal, or social) psychology which is truly compatible
with our highly developed intrapsychic psychology. It also needs a new
way to look at the concept of reality. This question about the nature of
reality has been largely ignored in the literature.3
The theoretical discussion in the earlier paper examined the mostly silently
shared rules of conduct which frame and define that unique social interaction
called the analytic situation. The clinical descriptions in that paper
were used to illustrate the theoretical propositions. Here, the clinical
discussion is central. The parallel theoretical propositions might add
light to the clinical understandings, but time will not allow their detailing
on this occasion.
To summarize that earlier clinical work, in the turbulent later years of
the 1960's, I began work with Professor L, who worked in an academic discipline
devoted to one of the arts. He was then nearly 30. He put on the airs of
a member of the 'counter-culture', but was not. His reddish hair was long
and disheveled; his dress was as casual as those of college students of
the time. He smoked marijuana every day -- more than I knew during the
first part of the work. At that time, L functioned far below capacity and
felt no sense of 'really' being a professional. 'Life seems to be slipping
by', he said, 'meaningless'. He supposed that he was 'chronically depressed';
he knew his close relationships seldom lasted; he knew the responsibility
for this was his but did not know how or why. He passionately hated most
direct authorities and complied with them like a burnt-out convict. Prospects
in the academic hierarchy seemed hopeless. His life was going badly.
The analysis, though ultimately satisfactory, was long and difficult. Despite
intellectual and artistic gifts, despite strong motivations, despite periods
of fascinating associations, nothing much happened for over a year. The
material seemed disorganized and vague; passive negativism alternated with
spells of active but unfocused hatred. Whatever interpretations I could
offer led only to despair, and worse, to behavior in the outside world
that was poorly understood and sometimes harmful to himself. From time
to time, I wondered whether I could, or should, maintain an analytic stance.
Interpretations were of no avail, either, in reducing the daily dependence
on drugs.
Finally, I told him I would not continue unless he agreed to stop their
use absolutely. Whether this 'parameter' could have been used earlier is
unanswerable. He did comply, but with rage that remained unspeakable for
a long time. During the following months, however, matters improved; associations
became less vague; his manner was not so bland. But brief periods of apparently
useful work would still be followed by long periods of resistance, in which
the patient alternated between the manners of an ex-nobleman and a constipated,
very miserable, little boy.
L's experiences as a baby and toddler, as nearly as they could be reconstructed
by the end of the analysis, were not unusual. There was indirect evidence,
by way of transference reactions, of exposure to early primal scenes; there
were family tales of much clinging to his mother when he was a toddler;
there were memories of battles that could only be identified as anal, manifested
by withholding bowel movements until he was--- or acted as though he was
-- in great pain, whereupon his mother would eventually insert a suppository.
Otherwise, it was impossible to make more than distant inferences of the
effects of parental psychopathology on the child.
But from the age of 4, L's years were stormy. The first of a series of
terrible separations came at 5, when both parents left him with relatives
and vanished. For two years he did not hear of his mother, except that
she was alive. When he was 7, she returned and reclaimed him. She then
had a new husband. L detested the man from the first moment; he tried to
kiss his 'new daddy', only to be rebuffed as a sissy. The family made several
abrupt moves subsequently; finances were chaotic.
As a lad he was messy, truculent, and contemptuous, protected from the
stepfather's hand by his mother. She indulged him in every way she could.
Except with her, the boy was forever the 'outsider', living by his wits.
He hated sports, but from an early age read constantly, voraciously. He
had intellectual friends but no playmates; later there were sexual encounters
but no authentic partners. By late adolescence he possessed a fine ability
to pick up information by listening, but had lost the pleasure of reading.
Beyond the bare minimum, he was rarely willing to read the literature of
his profession. He loved the art but hated theoreticians and most critics.
Yet he could speak as if he were learned indeed. Ashamed of the fraudulence,
he was nevertheless proud that others believed in his erudition. L was
often witty. Many people liked him, but the liking could never be reciprocated
long. Attachments often had a kind of fierce intensity, but they almost
always broke down. Mordant and crafty jibes, usually aimed at men, antagonized
or intimidated them. He yearned for fathers; yet he had to demolish them.
The session presented in the earlier paper did not portray a 'good hour',4
only an interesting, if complicated dream. The focus of the dream was a
play on the name, Erwin, which happens to be my middle name. The patient
was not aware that he knew that, but when I pointed out the possibility,
he remembered with a sense of shock that he had indeed read it in a directory
and then forgotten. I will not discuss the dream here except to say that
it demonstrated, reasonably clearly, that the latent content had to do
with the activation in the transference of poignant yearnings for the love
of an oedipal father, along with defenses against intense castration and
separation anxieties. Knowing the past material, it would have been possible
to interpret the dynamic complexities of this intricately constructed dream
in a wide variety of ways. But I chose only to interpret the resistances
to a closer awareness of homosexual wishes -- in his associations he had
already broached this material -- and his warded off concerns with me.
Partly on the basis of earlier material, but partly on the basis of the
dream itself and the associations to it, I believe (and here, I am not
sure how much of this I understood during the session, how much after I
reviewed it later, or after I studied it again years later), that the dream
represented on different levels: an ambivalent presentation, a gift, a
homosexual invitation, a masochistic provocation, and an attempt to have
the work done for him, served up to him to be intellectually but not affectively
received, more likely to be contemptuously denied. And it had to do with
murder. But it was also a creation for the analysis: an interpretable dream.
My dilemma at the time was obvious. Flooded with material, I could have
intervened too much. While I could extract a great deal of meaning from
the material, and while the patient could have extracted all sorts of intellectualized
understandings, there were only brief encounters of shared, immediate meanings.
The central and most difficult resistance in the analysis was the patient's
capacity to alter consciousness into sleepy, dreamy states. Almost at a
moment's notice, he could drift into a state of mind which he himself identified
as being like 'being stoned'. He could achieve the marijuana effect without
marijuana. However, these alterations were not akin to the withdrawal of
the psychotic individual, or the chronic 'false self' of the schizoid individual,
or the lack of relatedness described in so-called narcissistic personalities.
In most ways, most of the time, the patient had been until then merely
feigning being in analysis.5 He was frozen
in only one position: the only way he could see me was as an actual enemy.
It was not that the other transference representations did not exist; it
was that he had no affective access to them on any level near consciousness.
And it was not that he had an inherent difficulty 'testing' reality; it
was that his dynamic needs left no possibilities for challenges to certain
conscious 'realities'. He could not mutually constitute such realities.
In his dream, he had 'played' with my middle name, Erwin, in ways that
represented extraordinary condensations of tender wishes and paralyzing
fears. When I 'caught' him with my interpretations, he did not respond
with relief, or more material, or more insight. He responded as though
he were literally in danger. The stamp of 'reality' was placed on this
version of his relationship, which was not influenced at all by his 'rational'
conceptions of 'reality'. 'Rational reality', for that matter, did not
feel 'real' to L. While a transference neurosis might be fairly assumed,
its negative aspects, and its deeper positive aspects, were not analyzable
at that time.
For a long time, L was not able to function like 'good' analysands, for
dynamically valid psychological reasons. I believe early experiences (the
loss and lack of replacement of the father; the loss and tenuous recovery
of the mother) favored a distorted oedipal compromise. Concomitantly, there
was a lack of structuralization of certain ego and superego rules governing
ordinary interactions with others in intimate relationships. He was compliant
with the laws and the more obvious standards of 'appropriate' behavior
-- he was not a delinquent and certainly no 'psychopath'. Nevertheless,
certain rules were not 'made' for him. In fact, some rules ordinarily shared
with others did not exist for him in intimate relations. Material from
the analysis as a whole eventually allowed for a deeper understanding of
the origins of the patient's inability to place the 'stamp of reality'
on some social interactions and their various 'worlds'.
In other words, the patient assumed one set of rules governing ordinary
behavior while the analyst assumed another. There was little mutuality
in the framing. Thus, he had one set of realities and I had another. In
enacting and re-enacting other frames of experience in the encompassing
shared frame of analysis, all his past experiences led him to assume the
hatred of me and the fear of any positive contacts were factually based.
He could not discover that some 'facts' were illusory and some 'illusions'
were factual. Nor could he make use of the historically active positive
and negative oedipal events, and pre-oedipal precursors, as part of the
whole of his life.
The patient had a severe limitation in the scope of his worlds of realities.
It took time for L to 'procure for these shadows of imagination that willing
suspension of disbelief ... which constitutes poetic faith' (Coleridge,
1817, p. 171). He could not experience various transferences as 'alive'
or immanent. This was true on one level because of the unneutralized qualities
of the hateful and homosexual conflicts, which had to be warded off by
any available means. On another level, it was true because he was unable
to engage in a cooperative situation with another man whereby he could
allow free play for his imagination -- where he could place the accent
of reality on the reenactments in the transference of memories of the past
and continuing unconscious fantasies. Intrapsychically and interactionally,
his consciousness was caught in the rut of one dimension of inner reality,
and thus, of outer reality. He could not connect with other dimensions.
But there was something in that earlier session which represented a potentiality,
at least, for future shared analytic work. My inner responses to certain
adolescent memories brought up during the session represented the one area
of effortless 'shared play' -- not a part of an unconscious feigning or
duping -- that might provide a connection between us, an access to a transferential
reliving. And so it proved to be. The sharing marked, in retrospect, the
beginning of a workable analytic situation, as opposed to one that was
in some respects spurious.
THE CONTEXT OF THE SESSION TO BE DESCRIBED
Almost two years went by. The patient came five times a week and associated.
How can I tell you what happened, without resorting to analytic shorthand,
or clichés, or flood you with clinical examples? I listened and
did my best to maintain an analytic stance as the multiple frames of past
and present experience were verbally enacted before me and with me. Most
of my interpretations were aimed at resistances. I worked as a weaver,
and slowly, almost imperceptibly, my patient became a weaver too. He sought
less to break the prescriptive rules defining the analytic situation; at
the same time, he 'acted out' less in outside life.
Thus, his life improved: he began to have some successes professionally,
he found closer friends and tended more to keep them. He found potential
lovers as opposed to partners only in bed, but he was still afraid of women
who were his equals because he saw them as dangerous superiors. Within
the sessions, he adhered more to the prescriptive rules defining free association.
He became less frozen in the old dilemma of impossible yearnings for me
in a setting of a 'frozen' transference attitude, bearing the stamp of
reality, that I was, or would become, his enemy.
Imagine the slow, often frustrating, often tedious, work with an ordinary
obsessional and depressed patient who at the same time had the psychology
of the exception. And what showed as 'specialness'? A seemingly unending
set of attempts to manipulate me into a position in which I might take
an external part in his life rather than maintain my stance within the
analytic situation. He was an ingenious provocateur. From time to time
he provoked me, but nothing too awful happened. He externalized his morals
and ideals on to me more than most patients do. And he remained capable,
at times, of temporarily paralyzing the work by lapsing into sleepy, dreamy,
verbally and analytically almost incomprehensible states. Then he sought
to shut me out completely, not only as an analyst, but as a human being;
apparently he used the analysis at those times as a place on which he lay,
in blissful reunion, with the mother of his infancy. My interpretations
of the resistance values of these states were seen as almost intolerable
invasions.
The earlier transference reactions, at least those most available to his
or my consciousness, were to me as a man. In dim, almost unthinkable ways,
he related to me as a dangerous potential father, as a loving potential
father, as the phallic father and the father whose penis he coveted, adored,
hated and envied: the castrator and the castratee, an inaccessible, rejecting,
pursuing, intrusive, representative of reality and society, and the father
who would soon leave him again. But he came to see more consciously that
he also ascribed womanhood and motherhood to me. He would see, again dimly
and fragmentarily, that my role was on the one hand to restore and guarantee
his penis -- but on the other hand, as in the hells of infants' nightmares,
I might be the woman who destroyed and left. Conversely, I might be the
mother who had not left, who conducted loving and playful and hurtful exchanges
over that Wagnerian battleground, his anus. All these fantasied interactions
came into almost a climactic relief during the sessions before the one
to be presented in detail.
Yet, for the first time, he began to confront, at first tentatively, the
enormous systematic evasions within himself. He was shocked to recognize
his own implacable will for reparation and revenge. Every woman had to
be repaired. Every woman had to be punished and left, then brought back
to live a dreamy life to which she was bound by guilt. He himself had to
be repaired. He re-experienced the traumatic desertion, and the fights
between his parents before he was five, and the primal scene fantasies
before that, as threats of castration. Toward the end of the analysis,
long after the session to be described, we were able to see that originally
he experienced the ordinary separations from his mother in more expectable,
ordinary, even manageable ways. But memories of these losses too became
mythically transfigured in the light of the later, oedipal events. It has
been mentioned that, aside from the loving and ferocious and teasing anal
battles, his early development did not seem in any way unusual. Later,
he became convinced that the legendary tales about shadowing his mother
as a toddler, and his repetitive bowel crises with her, may have reflected
his awareness that there was some part of her that needed to get away.
However, this remained only a speculation about historical truth.
THE SESSION
The hour before the session to be described -- we might think of it as
the underfloor of our imaginary room -- began with a transference fantasy.
It had come while he was drinking coffee in a delicatessen just before
the session, beginning with an unexpected thought: it might be interesting
to bring me some of the coffee in a styrofoam cup. He quickly dismissed
the idea as ridiculous, and felt anxious even telling me about it.
He had never expressed such an inclination before, to the best of my memory.
For the first time, however, he had been preoccupied with eating, not for
the taste but, as he had said, for the 'rich, fatty sense of badness'.
He loved the tawdriness of the brown paper wrappings of the sandwiches
at the little delicatessen nearby. He skulked about the coffee bar and
when no one was looking added extra pseudo-cream. He actually gained some
weight, but not much. Oral impulses seemed irresistible. 'I exercise and
exercise. Then I eat and I eat and I eat.' In earlier sessions he had said
that being a few pounds overweight meant that he was fat and feminine.
He could analyze these struggles by this time directly by experiencing
some of the wishes to be a girl or a woman with me-as-a-man, or wishes
that I be the woman and he be either an adorable little Cupid or a glorious
Adonis. However, he described the experience of these fantasies only as
idealizations of me or wishes to be idealized by me. He wanted me to love
him and was afraid that I really might. He inferred, intellectually, that
there 'must be' genitally sexual feelings enmeshed in this, 'somewhere',
but he never experienced them in more than fleeting ways; when they came
they were joined to pangs of terror. He also inferred that he 'must be'
full of hateful and envious feelings for me, but these ideas too usually
remained on an intellectual level. It was more that he experienced transitory
emotional outbursts which would be quickly isolated and more or less willed
out of consciousness.
I felt puzzled by his fantasy of bringing me coffee, but said nothing immediately.
On my note-pad, I wrote simply, 'cup'. I thought of possibilities: that
this shy expression of affection meant that he wanted to be close to me,
take care of me, wake me up, bribe me, disguise other wishes. But my associations
led to nothing specific. (My notes do not indicate whether I consciously
thought of the transference meanings of stealing the pseudo-cream and bringing
me a drug in the form of caffeine. But later analytic material left no
doubts about his guilty wishes to steal his mother and steal a penis, along
with fantasies of corrupting the analysis.) His associations were steady
displacements. Usually they drifted into dullness. He began to drone about
details having to do with his outside life. Although he laced his comments
with playful witticisms, and obvious attempts to pleas me, they were more
the sorts of things a little boy might tell his doting mother at bedtime.
I felt frustrated, but said nothing. L said that he felt warm and safe
-- and sleepy. He felt no pressure.
I did recall his attention to the fantasy, but he dismissed it as relevant
only to the desire to 'share'. He wanted to 'bask in the glow here'. I
felt no such glow. In fact, I felt that he was using the analytic situation
as a way of being a temporarily complacent baby instead of anything connected
with analyzing. There was no sense of mutuality at all. A suggestion on
my part that the session was being used to cover quite different feelings
got no results. I felt a sense of lassitude myself, some puzzlement, and
an unwillingness, disguised by a sense of inability, to grapple more with
the issues. I assumed, although without much conviction, that the patient
'needed' a time to accept his 'idealizations'.
Later that day, I understood better, as a result of two inner parapraxes
of my own. When connected, they explained my inner startle when my patient
brought his fantasy. Working on a subject ostensibly totally unconnected
with L, I was exasperated when I blocked on a name. The time was just after
Hans Kohut's first articles on narcissism appeared. At that time, I was
intrigued - and still am - with Kohut's clinical insights, especially in
their considerations of countertransference reactions. Although I have
an imperfect knowledge of Greek mythology, I found myself thinking of the
fates of Narcissus and related mythological figures. I thought of Echo,
Nemesis, Anteros, and then of - what was his name? -- the beautiful young
shepherd son of the King of Troy who had been taken away by Zeus disguised
as an eagle. Zeus took him to replace Hebe, the goddess of youth. The latter,
poor girl, had lost her position as the cup-bearer to the gods because,
according to one account, Hera -- that deification of carping jealousy
-- got enraged at her for indecently exposing herself. Finally, I remembered
- the boy whose name I couldn't remember was Ganymede! I was interested
in Narcissus, Echo, Ganymede, Eros, Pan, and Anteros because the myths
all had to do with the puzzles of narcissism.
The second of my momentary parapraxes came a few hours later. As I was
annotating the notes that night after the session, I saw the word, 'cup'
at the beginning. For a moment I was mystified; I could not remember what
the word referred to. A little later the memory came back, and I could
see a meaning of his fantasy of bringing me coffee, a meaning I had obviously
wanted to avoid: for some reason I had not wanted to see L as Ganymede
-- or, evidently, myself as Zeus.
When I saw that connection, I realized again: why of course! But
I could not make out why I had repressed the connection and made the mental
slip. After all, by this time, the negative oedipal elements of this man's
conflicts had become abundantly clear. It seemed to me that I had been
comfortable with the transference implications of his various homosexual
wishes, and my own transferential responses to them.
I was at that time also intrigued with Kohut's (1968) concept of the idealizing
transference. In fact, there was an inclination to see the patient's idealization
of me in those terms. But it was just then, in the late 1960's, musing
about Ganymede and Prof L, that the first recognition dawned that Kohut's
'narcissistic transferences' seemed peculiarly devoid of infantile sexuality,
with all attendant exquisite pleasures, conflicts, terrors, and expectation
of disaster. This is not the place to evaluate the validity of Kohut's
contributions in general, but for a while then I was ready to accept the
desexualized qualities of some of his concepts: I was ready to side with
my patient in the temporary, defensive evasion of those raw, infantile,
homosexual implications -- which the Greek myth of Ganymede exemplifies.
(Incidentally, I had the thoughts about Ganymede, not my analysand
-- at least as far as I know. Yet I feel certain that neither one of us
wanted to acknowledge either the passive, receptive boy or the or the rapacious
and polymorphously sexual Zeus.6
As he walked in the next day, L hardly looked the academic
expert (as he was coming to be recognized in his specialized field). He
looked more like a mournful, red-headed hulk as he flopped on the couch,
sighing on the way down. He had been getting more sleep. In a tired way
he said he did not feel so tired. A lot had been going on in his mind.
He had been more sensitive to the needs of his students. The realization
that he had been insensitive to them in the recent past led to another
realization: if his graduate students were to him as he was to me, it would
be safer to keep out of their way! But his emphasis seemed empty; he seemed
to be only going through the motions. I did not comment on the probable
allusion to my own past insensitivity or possible improvement. With more
conviction, however, he commented on the understanding of a desperate 'wanting'
for me to do something for him, but just what it was that he wanted was
a mystery. At the same time, he recognized that his wish to use the analytic
situation as a cradling experience in itself meant that at the same time
he was somehow damaging me as an analyst; there had been times, he said,
that he could know that he desperately did want to hurt me in some way-really
damage me. But how or what or why was also a mystery. He had been trying
to do that, whatever that was, from the beginning.
He then spoke again of excluding women from his life -- although he had
been with them as much as ever. Mostly he felt friendly with them.
But at the time he had no regular relationship with any woman besides Boots,
a sexual partner he looked down on. He imagined that I disapproved fiercely
of the relationship. Boots, he said, was so long suffering -- she
must be a masochist. She put up with him, always ready on short notice,
always ready to do things for him, sleep with him, making no demands. (He
was conveniently forgetting a fantasy he had related only weeks before:
in it, she had suddenly grabbed a knife and scythed his penis; he found
the amputated member and rushed to the hospital looking for a doctor to
re-attach it.) He thought of Boots using 'speed' a lot. That made him think
of using amphetamines in the past himself, wanting to use them again, despite
never having felt good when he took them.
'To wake up', I said. 'Yes', he answered. Then he paused. 'Confessing'
(the word he used) that he wanted to use 'speed' seemed to make his mind
go blank. 'Reminds me', I remarked, 'of your thinking about bringing me
coffee yesterday'. (I think I had in mind not only the alterations of his
states of consciousness, with or without the use of drugs, but also his
fantasies of altering mine, by bringing or not bringing caffeine.)
'I don't know', he answered, 'I just don't have any thoughts'. I pressed:
'When you were talking about going to sleep and waking up, I said "to
wake up", and then you ...
'Went blank', he interrupted, 'I was confessing --I guess it was confessing
about the drugs. And then you go and cut me down -- in my mind I mean,
you cut me down. Goddam it, you interrupt! If I was confessing it would
have to mean I thought you didn't like it, didn't like what I wanted to
do'. In a louder, distinctly angry voice, 'I get so sick of this -- so
sick of you -- why the hell don't you just leave me alone! What you have
to say doesn't tell me anything I don't already know anyhow. You're nothing
but a picture on the wall!'
I had had several shifts in my mind from a kind of receptive listening,
with private fantasies, to more rational forms of thought. One had to do
with recognizing the resistance of the day before and its continuation
into the present session. More generally, I was interested in both of our
chronic, though subtle, changes of consciousness. I was surprised by his
sudden, alert, attack. Unfortunately, my intervention was not helpful.
'What was it I did for you to react that way?' (That night, reviewing the
notes, I thought that meant, unconsciously, 'I didn't do anything -- go
back to sleep'.)
'Oh, it wasn't what you did', he said tiredly. 'I guess its your doing
anything. I desperately want you to do something and then, if you do anything
-- well, it's my disapproval, not yours. Of course I make it yours all
the time.' He was quiet a moment, then said, 'it's enjoyment --
you're against any enjoyment in my mind. Stern. You might just erupt. Like
some goddamned tin god'. (But his speech was drifting back into a monotone.)
Without thinking, I asked, 'Jehovian?'
'Yeah!' he said. "But I make it that way, I take just your curiosity
and make it your goddamned holy displeasure. If I take pleasure it's bad,
bad ...'
'But I notice that you speak of tin god -- that's what you make
me, as inert as tin. And there are these "goddamns" ...' At that
moment, I cannot be really sure what was on my mind. I believe I had been
thrown off by the vague feeling of having slipped into the trap of making
an obvious remark, and then feeling for a moment startled and defensive
in the face of his jeering attack on me for being simplistic. And, after
all, the attack was justified and accurate in one way, if not in others.
I wanted to get something that might be consciously experienced as affectively
'real', by him, and so spontaneously asked, "Jehovian?' I do not think
I was conscious at that moment of the thoughts about Zeus and Ganymede
the night before, but clearly they were there. At any rate, I was surprised
by the sudden outburst of temper. But both rage and guilt were connected
with the central fantasy that his deepest infantile desires had created
disaster and always would. I had turned to it in my own mind again: that
bad things had happened and that as a child he was omnipotently convinced
that they had happened because of his own evil desires and hatreds. The
problem was to separate the historical actualities from his private, tenaciously
held, internal myths.
'To me, pleasure is suspect. Food. Even taking women to bed. Indulgence.
Things I do to soothe myself.' 'And,' I answered, 'the assumption is that
I take the same attitude, in a way that I'm part of you, that hateful part
of you that's pretty Jehovian itself. That attacks the man in you. And
attacks the woman in you too, for that matter.'
"That's right.' He was solemn. 'I wonder why I can't just attack my
mother -- just let it be that. I have to give her up --
let her be dead. If I'm a successful killer, I'll -- I'll lose.' Again
he paused briefly. 'I don't think I kill her. I just keep trying to get
her -- you -- to put suppositories in my behind.' Suddenly, the tone changed.
'But this is so abstract' He chuckled, and I was irritated by the chuckle.
"Well, I guess it has to do with you as a kind of intruder. The alarm
clock.'
In the space of seconds he had shifted keys. From erotic, infantile awakenings
having to do with the phallic father and phallic mother, he moved to an
intellectualized interpretation of his own, one that was quite 'true' --
I was often seen as the awakener, the alarm clock he so loved to
ignore or hate. But the feelings associated with these fantasies seemed
disavowed and the meanings isolated. After I failed to intervene with an
interpretation of the resistive rationalization -- that his murderous thoughts
and passive anal wishes were mere 'abstractions' -- he moved back to obsessionally-detailed
and mundane external events, interspersed with his own 'interpretations'
which were almost overtly intended to be satirical.
He was trying to get a burglar alarm set up at home. The windows were so
big. A hurricane might break them. Without the least expression of interest,
he said, 'Penetration, I guess. It's castration too'. He had enjoyed hurricanes
until the last one had sent shingles flying through the air, potentially
lethal with their sharp spinning edges. He then moved to a 'creepy, crawly'
vine next to his house, 'taking it over'. Before we knew it, he was talking
about the proper botanical name for the vine, chemicals that could or could
not kill it, etc. He was obsessing -- even though the themes relating to
drugs, murder, and being devoured showed through. I could have made any
of a variety of interpretations -- and each had in fact been made over
and over in the past. But I felt that intervening here would simply feed
the resistance: I would fall into still another little trap -- his wish
for me to do something, at this moment to draw obvious conclusions
for him to knock down. Anyhow, I assumed that he would come out of the
pseudo-intellectual ruminations on his own. And something -- just what
I don't know -- brought him back, at least a little. He seemed to change
the subject and, in a different tone of voice, spoke directly to me:
'I remember you saying something that impressed me. You said that something
was so -- so everywhere, it couldn't be noticed. Like nitrogen in the air.'
Again, I was faintly startled. Not only did I have no memory of ever saying
that, but I also failed to appreciate its profundity. (Perhaps I appreciated
it more later; it will be remembered that I used the atmosphere of our
'room' as part of the metaphor for the analytic frame.) But then, again
flatly, he began to talk about the lack of chemical reactivity of nitrogen
as a gas, but its dangers when it bubbles in the blood when a deep-sea
diver comes up too fast. I did not know what to react to -- as though I
were called upon to react. The lecturing of me as though I did not
exist as a person but as a fantasied student or class? That he was baiting
me with all-too-obvious symbolic allusions (having to do with diving deeply
into his mind and having life-giving oxygen, plus nitrogen which is at
best inert and at worst, in the form of bubbles in the blood, lethal?)
That I 'shouldn't' awaken him from his deep sleep too fast? What was that
'something' that was so 'everywhere' and so impressive?
Once again, he had moved through a sequence, from intimate wishes and feelings
to empty abstractions and intellectual -- usually pseudo-intellectual-ruminations.
He knew next to nothing about either botany or chemistry. I thought that
references to castration at the hands of terrible, unstoppable phallic
forces spoke of affect close to consciousness. But these fantasies were
also being used to get away from still another set of fantasies. It seemed
to me that I had an opportunity to shift the 'key' of the material.
'You just went through something you do so often automatically. You were
talking about those creepy vines', I said, 'and then you said something
about a remark of mine that impressed you -- but the next thing we knew
we were involved in science and stuff. But even then, the "science"
had to do with destroying something, killing something. Maybe you were
also talking without realizing it of roots -- your roots. Combining your
beginnings and past and what it has to do with you and me, and sexual roots
your 'root -- and what that has to do with you and me.' (This was hardly
a model interpretation, but that was the way it came out. Whatever its
redundancies, it seemed to have an effect.)
L seemed to let his breath out. 'I did get off into never-never land, didn't
I?' He paused. 'I do admire you. There have been things that jerked me
up and made me say "Wow!" to myself.' He seemed to be acknowledging
that I might not only awaken him but jerk him up by the roots, out of his
roots in the infantile past with his mother, and maybe jerk the root off
-- masturbate him or castrate him or both. And we knew from previous material
that the burglar alarm -- ascribed to me -- referred also to his impulses
to steal. I am not certain that all these thoughts were available consciously
at that moment, but they were preconsciously there because they were repetitive
themes. In any event, from the perspective I had years later, they were
correct -- they were further confirmed by L, over and over.
'But all of your wonderfulness is mixed up with poison. It's so complicated.'
He paused again. 'There, I just did it again, because -- and then he laughed
-- 'I was just thinking of two fluids which won't mix. One me, one you.
I get what I want out of you without getting mixed up with you.' He seemed
thoughtful and silent for some seconds. 'I'm so convinced that you're going
to hurt me. I just don't trust you. After all these years! Of course I
"really" trust you. But there is a not-trusting too. And that's
"really" too.'
Here, I believe it would have been a mistake to look on this material in
terms of 'primitive', 'oral', dynamics. There was certainly a defensive
element is his reference to immiscible liquids, but even more than the
earlier hurricanes, windows, flying, spinning, cutting roof tiles, creepy
vines, poisons, omnipresent nitrogen, the construction of the two liquids
made for an interesting metaphor, like a symptom -- or like a creative
act. His metaphorical liquids were only apparently separate. In fact, he
had one, representing himself, taking what it wanted from the other, me,
without getting 'mixed up' -- without loss of boundaries. And, it should
be stressed, not giving anything to me or having me take anything away
from him. I have no doubt that this condensation referred to fears and
wishes to fuse with the other person, fears and wishes to sleep, oral extractions,
anal withholdings. But I believe that the primary meanings during that
particular session had to do with oedipal fantasies, conflicts having to
do with genitals and murder. Stealing penises and having them stolen from
him -- and the terrible and wonderful wishes to avoid all that by becoming
my Ganymede. He yearned to avoid all that in turn by replacing the dyadic
relation with one still more ancient: a safe and warm infantile relationship
with his mother, protected by sleepiness and desire -- from awareness of
more dangerous, monstrous dangers of being destroyed -- certainly castrated,
certainly abandoned by her, by me. But I chose, I believe rightly, to remain
quiet.
'If I do let myself go -- I get into poisons and roots and things. And
you can tie them together for me. But I can't let you. Its like I have
to play like I can't do any of that at all. I can't let you get in. I can't
let you be an analyst.' He added: 'Heaven forbid that I let us do it together!'
After a pause, he added, 'I have to stand aside. I stand aside without
even realizing it. Oh, I copy from you all right -- I steal from you. I
admire you but don't trust you.'
'A pretty familiar story', I remarked. 'It's hard to see', he answered,
'even while I'm doing it -- standing aside, not letting my mind go. Not
standing aside, standing outside'. Suddenly he mocked himself with slogans:
'Civil Liberty! Eternal vigilance is the price of Liberty!' But without
pausing, he shifted keys. He began to talk about memories, not family accounts,
of being what he called enslaved by his mother-but then he added, he had
been the enslave. He had shadowed her. He couldn't let her out of his sight.
'Making sure she didn't leave', I said. 'Also', he answered, 'I was staying
away from the thought that "I tailed her". And I thought then
about her sexual "tail". But this was when I was a really little.'
I took it to mean when he was a toddler. 'There must have been some kind
of leavingness even back then. Maybe she did. I don't know. Guess I just
always hated, hated, hated. What a waste. It would be good to feel some
kind of connectedness.
'I could have kept up with my real father -- I just didn't. I made him
out to be an inconsiderable speck -- a piece of bug shit on the wall.'
'Like you do me', I answered, 'and like you do yourself'.
'Maybe', was his noncommittal response. 'I know I do that. It's safer.'
I tried again, 'You've been talking about experiences with me that are
the same as things that happened with both your parents. But you say too
that you have to stand aside -- outside. You're afraid to come in. To explain
it to yourself you "do me" like you "did" your father,
turn me into an insignificant speck.' This partial interpretation shifted
the 'key'. He began to speak with me about outside relationships as they
correlated with his past and the transference.
'Actually -- actually, that's what I do with people. I set them up as this
or that -- usually worthless -- that I don't see them as human beings.'
He paused. 'I have the strangest feeling. I can't describe it. Like in
the back of my head is a sort of weeping. So far back I don't feel anything.
It's -- it's alone.' He was quiet a few seconds. 'Thought -- telephone
exchange -- or one of those boards of connections -- but like somebody
laid sheet rock between the connections.' More quietly, distantly, 'I had
a picture of a man alone on a field of ice, all dressed up with heavy black
clothes, just standing there -- isolated.' (It was in fact the hottest
part of the summer.) 'Isolated -- ice elated!' It was his way of shaking
himself, with a quip, a pun, out of a dreadful fantasy. He cut the connections
off -- after all, I was at the back of his head. He turned his grief to
ice; 'elation' was denial. And there was another reference: one to a novel
he had mentioned recently, Kurt Vonnegut's 'Cat's Cradle'; in it, one crystal
of 'Ice Nine' could immediately freeze everything in the environment-in
fact the universe. There was his frozen rage.
'Cat's Cradle', I said. 'Um', was the response.
Then, after a moment's silence, he said, dreamily, 'Just sort of drifted
off -- hazy -- comfort. Feeling the time was up -- that you were extending
it -- hoping you were waiting.'
'You automatically dropped the haze down, like a curtain, or like the sheet
rock. Or the ice. You wanted to get out and I wouldn't let you.'
'True', he said more wakefully. 'I was thinking of getting a sandwich.
But there probably isn't time. Almost stubborn. I hang back. Can't feel.'
'But a while back you had a glimmer of a feeling -- in the back of your
head, the part closest to me. But you had to put something between your
head and me.'
'What? What? God, I just had a horrible picture of President Johnson screwing
Kennedy's brain after he was shot!' He collected himself. 'I was sad when
he was shot. Shot by some little shit.' Then, fervently, 'I want to get
out of here. I want to get out before you tell me the time is up. Jesus!'
And visibly anxious, he spontaneously got up and left, almost exactly at
the end of the session, although he was not wearing a watch. It was the
first time he had ever done that.
I had discovered the reason for taking the notes. I had not wanted to remember
Ganymede because I had not wanted to acknowledge a silent agreement with
the patient about the nature of his idealization. Temporarily, I had preferred
unconsciously to let the matter of either his or my being
cast as Jehovic or Jovian, or like Johnson or like Zeus, alone. Obviously,
I was in conflict about wishes and fears related to these primordial bisexual
deities. But I did not let myself get away with it.
It was as though my parapraxis and his unusual act with the cup demonstrated
a shared unconscious fantasy, close to consciousness in both, ready to
be analyzed. As if they were in some unconscious sense deliberately
produced to provide access to that fantasy: a glimpse of the 'analyzing
instrument', a joint unconscious creation.
Prof L Opened the next session by talking about the brief panic he had
experienced. To summarize the associations: he spontaneously identified
me with Johnson, the Kennedy brains with his phallic, intellectual prowess.
I was able to interpret that it worked the other way around, too. Reminding
him of his fantasies of taking something from me, he was Johnson.
Then he brought up a dream.
He had been standing in a peaceful field, watching some beautiful weather
balloons ascend. There was a man in one of them, operating instruments.
Suddenly something happened. In a long arc, the balloon and man crashed.
He ran to the scene. The man was horribly injured. He had to get a doctor.
He ran to get one. The dream ended. But when he remembered it, he also
remembered that the doctor he was planning to find had died of cancer years
before.
I will not attempt to describe all the associations to the dream. I will
mention only a few. The man in the balloon was spontaneously associated
to himself, his penis -- and then, to me. The scene referred to the session
just described. My interventions had stirred up dreadful possibilities
in the analysis. One memory went to a friend of his who, as an adolescent
hiker, had hurled himself into a waterfall, and been mangled by the rocks.
The boy had had a hemorrhage in his scrotum and it had swollen to huge
proportions, turning purplish black. This memory was connected with recent
hypochondriacal fantasies of having a cancer of a testicle. The boy hurling
himself into the waterfall was like hurling himself into the analysis.
Suffice it to say that these, and other associations, brought Prof L closer
to the affective consciousness of the realness of castration anxiety,
and its origins. My interventions were explicitly and implicitly directed
towards resistance, particularly to the connection between past and present,
inside and outside. And, in contrast to the earlier session, many months
before, so were the analysand's own 'interventions'; they were directed
toward the same aims. In the intrapsychic sense, the patient's associations
were much more free than they had been earlier; he seemed much 'closer'
to unconscious processes; he seemed to be able to engage in the unconscious
analyzing instrument. From an interactional point of view, it was apparent
that the proscriptive rules, the limits of permissible behavior, had become
almost completely silent -- that is, they were agreed to by both of us,
and the encompassing analytic frame was a 'reality' for both of us. The
prescriptive rules -- to associate freely -- had also become less
awkwardly applied by both analyst and analysand: there was more mutual
capacity to allow the enactment of other frames of reality and their connections:
the transference relationship, the outside world, and the past. Similarly,
there was much more flexibility in switching keys within a given frame,
or, in intrapsychic language, between primary process at one pole to more
secondary process thought at the other.
How good it would be to report that the working through of these new insights
was a steady process, operating in a steady direction! But of course no
analysis proceeds in that way. The analytic situation continued its stair-step
ways: the to-and-fro shifts to pre-oedipal wishes, and the memories of
separation, loss, omnipotent responsibility; maneuvers to evade oedipal
conflicts; attempt to return to the narcissism of dreamless sleep; the
use of me as part of his neurosis; to the agony of contact with
some of his memories; to the greater recognition that his infantile wishes
could not be gratified; to the slow working through to more freedom. More
years of work. But it was work that ultimately considered by both of us
to be successful.
It would be pleasant to report that the working through of these new insights
was a steady process, operating in a steady direction! But of course no
analysis proceeds in that way. The analytic situation continued its stair-step
ways: the to-and-fro shifts to pre-oedipal wishes, and the memories of
separation, loss, omnipotent responsibility; maneuvers to evade Oedipal
conflicts; attempts to return to the narcissism of dreamless sleep; the
use of me as part of his neurosis; to the agony of contact with some of
his memories; to the greater recognition that his infantile wishes could
not be gratified; to the slow working through to more freedom. More years
of work. But it was work that ultimately was considered by both of us to
be successful.
A PART FORMULATION
It is time to move further from the 'floor' of clinical description and
interpretation to the 'walls'. Some of the reasons this segment of the
analysis was chosen for presentation have to do with following up of themes
that were presented in the much earlier session, described in the earlier
paper (1983: vs83b). Several of these themes could only be inferred at
that time. L was a patient who had had a real disaster in the midst of
a crucial developmental phase. He was in the midst of an oedipal complex
significantly 'tilted' by a series of pre-oedipal excitements and traumata
which set up discrete fixations, anal and phallic struggles, and regressive,
defensive, oral cravings. The negative oedipal desires and fears almost
equalled the positive. After the desertion, he was in shock. He had to
survive however he could. Standardized defensive operations could be named:
isolation, disavowal, intellectualization, and alterations of consciousness.
He was unable to bring about the more usual methods of dealing with oedipal
dilemmas: repression, identifications, and the structuralization of a more
elaborate superego. Important events followed in what should have been
psychological latency and adolescence. The mother returned -- with a new
step-father. She colluded with the boy to allow a conviction that he had
triumphed over at least one of his oedipal rivals. Fears of castration
and separation were equated. The multiple moves interfered with ordinary
latency and adolescent events, in which separation from parents is supported
and encouraged by the corrective influences of peer relationships. Peculiar
defensive advantages were provided by the boy's intellectual and creative
gifts. All these influences supported an intrapsychic organization that
a facile diagnostician might have considered to be the result of 'deficits'
in developmental lines, or the result of 'narcissistic' or even 'borderline'
pathological developments.
I am not worried about nosological 'niceties,' but I saw Prof L as a special
kind of obsessional personality. The picture was complicated by unique
life events and by the blissful, fluid ego states of altered consciousness
conveyed by the marijuana toxicity. He was 'special', like the characters
described by Freud (1916). He regressed to infantile positions in which
his ego was much like the narcissistic ego ideal described by Reich (1960)
and De Saussure (1971): comparable to a giant balloon phallus, grandiose,
but easily pricked. He regressed easily to omnipotent fantasies, mainly
elaborated during the anal and early phallic periods (Ferenczi, 1913).
In addition, there was evidence of some degree of the organizational split
as described by Freud (1927, 1940), with a corresponding, but covert, perverse
psychic organization. But it should be mentioned that such dynamics exist
to some extent in us all.
It is important to add reference to the elements having to do with the
phenomena of screening (Greenson, 1958). In the sessions it was manifested
by the screening-isolation-of affect, altered states of consciousness,
smog, fog, a beautiful sky in which balloons ascend, the ice floe on which
a man stood alone in the center, the wall interposed between connections,
the wall in the back of his head, the wall on which there was a fly-speck
or a picture. All were manifestations of what has come to be known as the
Isakower phenomenon (1939, 1954) and Lewin's dream screen (1954, 1955).
These were factors in the development of character: pre-oedipally based
regularities of conflict resolution continued to be sanctioned by the ego
and superego (Calef, 1983, pp. 215-6). These tendencies, once they could
be encompassed by the analytic situation, and expressed within it, proved
to be organized on an oedipal level. The 'primitive' fantasies were regressive
versions of oedipal fantasies. The basis of his neurosis itself had to
do with the lack of resolution, and reissue, in altered form, of an infantile
neurosis.
The most difficult technical problem had to do with the confirmation, by
the realities of desertion and special treatment later, of L's more disastrous
oedipal fantasies. It is the same problem that a paranoid patient faces
when his delusions of persecution happen to be accurate according to usual
consensual views of reality. A related and equally severe technical problem
had to do with the analysand's inability -- because circumstances had interfered
with its development -- to engage in most forms of 'play'. He could not
accept multiple transference fantasies because they were too dangerous.
Until his analysis, he was fixed in almost totally 'frozen' fantasies,
around which he constructed his life- making do with his intellectual and
artistic gifts. Finally, the access to the emotions of the deserted 5 year
old made for wrenching times for both of us, before processes of grieving
could take place.
DISCUSSION
The walls of our 'room' also refer to me. To shift analogies, a typical
session in the middle of a long analysis is apt to be like a day in a jungle
valley, aimed by a frivolous compass. On some exceptional day, not an ordinary
one, there are glimpses of mountain landmarks. Of course, this analogy
has to be qualified. The middle sessions are not really as chaotic as they
might seem to some stranger-observer, bumbling about in his helicopter
so to speak, watching the travelers. The loose and untraced threads, the
vagaries, even that wavering compass, are in part the illusions of the
observer. The analyst and analysand have a shared history, much of it unconsciously
and preconsciously filed away. There is no way I know to convey that history
in a few minutes. And not only that: the analyst and analysand have a future
-- or think they have -- based on that history. And in this particular
presentation, I know how things turned out. I know what was then the future.
It was only after completing the clinical account that I understood, belatedly,
that what I had done was not simply to set forth selected material from
the middle of an analysis. I discovered that there were themes, interests
of mine, embedded in the text, and that these should be highlighted. They
have to do with the development of the superego -- that fragile bridge
between the inner life, the intrapsychic life, and the lives of the collective
others -- our families, groups, society itself. This fascination is available
to me professionally in only one dimension: the examination of the analytic
encounter, a peculiar, empirically and artificially constructed social
situation, a strange and unprecedented process, in which one mind, including
its unconscious aspects, might be revealed to whatever extent possible.
Another hidden and related theme concerns a more fundamental question:
What might we fairly think of as 'real', and what 'illusion'? Finally,
there were interests related to alterations of consciousness-in this particular
analysand, the study of sleep, or sleep-like states of mind-and dreams,
or dreaminess.
At best, theory can awaken. At worst it can be soporific, and so I hope
to keep rein on theoretical temptations on this occasion. But you will
know more if you know the context -- something of the theoretical world
through which I have journeyed, and in which and by which I live. To convey
that, it would be best to begin with the subject of becoming, in contrast
to being, a psychoanalyst. During the years just after graduation from
my Institute, I had a certain clinical measure of that tolerance for ambiguity
that Keats called Negative Capability. But theoretically, I was not 'capable
of being in uncertainties, mysteries, doubts', I did indeed have 'an irritable
reaching for facts and reason ...' (Keats, as quoted by Forman, 1935, p.
72). I tried too hard to understand my patients theoretically. Sometimes,
at least according to theory as I understood it, my patients seemed to
have two left feet, or two right; the theoretical shoes fit poorly, but
I forced them on anyhow. I do not believe these musings were inflicted
on my patients, to any great extent; the ill-fitting shoes did not hurt
them. They only hurt me.
A period of ennui followed. While holding to mainstream clinical theory,
I gave up trying to understand in the old way. At least that made for better
work with patients. Fortunately, like many other analysts, the idea gradually
got assimilated that I was a psychoanalyst, and gradually the accommodation
came too. I learned that it was not necessary to swallow anybody's abstractions,
but they did not always have to be spit out either. Many of them could
be taken with a grain of salt, sometimes a large grain of salt. This is
another way to describe the loss of the youthful urge to believe in abstractions
as though they represented entities-or the laws of Truth itself. I can
proudly claim some knowledge of the analytic situation and the process
of psychoanalysis, and with equal pride an acceptance of classical metapsychology
in general without having to be a True Believer.
It is not that the worth of abstractions should be underestimated. Clinical
experience and metapsychology are not two different things. They are the
same things viewed from different perspectives. There are authors who would
divorce clinical experience from metapsychology, or even amputate metapsychology
entirely. I disagree. We need the metempsychosis of metapsychology; we
need to breathe the soul of human experience back into it. We need not
only to accept but embrace its essentially metaphorical nature (cf. Shengold,
1981). And we need the 'walls'.
Like John Klauber (1981), whose work I admire, it seems essential to maintain
contact with Freud's metapsychology. In keeping with that view of
Freud, I can live comfortably with some ideas that have generally been
forgotten because they do not seem to fit current fashions. For example,
I am still fascinated with Groddeck's 'It'. And I live in my everyday life
with the concept of Isakower's 'analyzing instrument' (although I have
trouble integrating it with standard theory) (see Malcove, 1975). And I
believe that the body of thought developed by Bertram Lewin needs to be
kept alive. At this point, I will only mention the ideas of Lewin (1954,
1955) that are relevant to this paper. They are: (A) It would have been
better if psychoanalysis had not forgotten Freud's original approach of
analyzing the neurosis, or considering any individual session, as if it
were like a dream (or part of a whole mind -- Freud admitted that he himself
had 'forgotten' this when he made the dream equivalent to the psychotic
mind. (B) It is useful to approach the patient as a fractional sleeper
and dreamer. (C) In Lewin's words, 'Evidently, the analyst is not a unitary
element that can be directly mapped to a unitary spot in the diagram of
the psychic apparatus and into the psychology of sleep and the dream. In
fact ... the analyst belongs in several places in the diagram, also "around"
the diagram, and . .. he can be mapped in terms of dream psychology as
a day residue, as an external excitant, and as an external or "border"
soother' (1955, p. 192).
I still find problems converting my daily work into intellectual matter
communicable to others. The full-time work of doing analysis is for the
most part second nature now: it requires no effort most of the time; I
force myself less to try to understand. It took time to be able to follow
the insight of Freud's which complements the one that led to the fundamental
rule: to let the mutual work shape its own patterns, to allow, and trust
in, the analyst's free floating attention. This means that much of the
time I seem to be drifting with the material without a great deal of rational
understanding. Even when I try to put a particular patient's clinical progress
in conceptual terms, like as not I'll be able to do so immediately. It
might be thought by a non-analyst that some of my time is spent in a daze,
but that would not be true. Actually, there are shifting states of consciousness,
shifting states of alertness. At the same time, pieces of the puzzle eventually
seem to fall into place. If the picture does not for a long time become
coherent, I eventually begin to supervise myself.
I know of no other way to handle the spectacular number of variables involved
in the analytic transaction. In individual cases, some of these variables
may be examined more objectively later, perhaps even after the treatment
is over, as Freud suggested. Our great challenge is to find ways to examine
clinical material more systematically (and this means examine what was
going on in both minds at any particular time), while trying to minimize
the influence on the field made by the activities of observation itself.'7
And I had something else for guidance: the collective and often
internally contradictory evidence, beginning with Freud's work, and subtly
modified -- and even contested -- that has accumulated from our mutual
quests. Out of this collectivity I have managed my own ways of being an
analyst. These ways are based on the conviction that analysis is not
merely the analysis of a neurosis, or its more dolorous equivalents, not
merely the analysis of the transferences and resistances to it (although
these activities are the most central), not merely the analysis
of 'defenses,' not merely the reconstruction of the historical or mythological
past according to its influences on the present, not even merely the search
for that freedom for maximal imagination -- as freely association as possible
for both patient and analyst. All of these are essential, but psychoanalysis
is the analysis of one mind, as far as the method of psychoanalysis can
take it, without the analyst annexing responsibility for parts of
that mind or its concerns outside the analytic situation. The analyst's
interventions, too, follow the principle that governs all psychic acts:
the principle of multiple function (Waelder, 1936). The analyst's mind
is qualitatively like the patient's, although the analyst must have reached
a higher degree of organization at the beginning. His interventions contain
not only their rationally intended messages which interpret resistances
and which seek isomorphisms in the three spheres verbally enacted with
the hours -- the relationship between the two parties, the analysand's
outside life, and his historical or mythological part. The analyst's interpretations
contain more covert messages out of their origin in the whole of his mind
-- they contain covert 'piggy-back' messages as well -- 'hitchhikers',
according to Steele (1955). And the analyst's interpretations are received
not merely on their rational levels; the patient receives interpretations
according to the principle of multiple appeal (Hartmann, 1951).
This is still not all. The basic concepts -- the truths -- of psychoanalysis
come to be part of the ego ideal of the professional (cf, Rangell, 1983).
It is this accommodation to being an analyst that is almost impossible
to describe. The quotidian of doing analysis is part of me. It is this
state of being that guides strategy and tactics. It does not arise from
maxims; on the contrary, maxims are principles derived from good clinical
work. Such a position comes imperceptibly -- as a consequence -- with experience,
provided there is a deep commitment to the core of our disciplines. But
if an analyst cannot describe his work to a scientist, show me the pianist
who could describe to a scientist how he plays. Or the bicyclist how he
rides.
CONCLUSION
What have I been able to say to you? A host of threads have been left loose
and even tangled. Only some phenomena out of many have been posed. I could
have selected themes to wrap a neat packagte of abstractions. But my aims
have been to open the package, not tie ribbons around it.
I have simply tried, in different ways, to describe myself at work as a
psychoanalyst. Because there is far more that we do not know than we know,
I had to spend much of the time emphasizing how difficult that is
to do. Like John Klauber, I believe our difficulties should be faced. If
there any worthwhile tasks at all, that fascinated acknowledgment is amont
them. The 'room' is only partly made; the ceiling is not yet in view.
NOTES
1. This problem is addressed in all three of the papers
(Baranger et al, 1983; Blum, 1983; Sandler, 1983, prepublished for the
33rd International Psychoanalytical Congress.
2. See Greenacre (1975), Klauber (1981) and McDougall (1980)
for comparable practices. Weinshel (1983), in a fine overview of the psychoanalytic
process, called attention to the importance of studying 'not-so-good-hours'.
3. Wallerstein's papers (1973, 1983) are outstanding exceptions.
4. The word, 'feigning', should not be misunderstood. L
was not dishonest. But, more than most analyzable patients, early on, he
was simply unable consciously to conceive parts of the analytic relationship,
much less to commit himself emotionally to them.
5.. It was all to easy to see myself as my analysand's
desexualized saviour.
6. Many artists have depicted the rape of Ganymede by the
Eagle/Zeus.
7. Of course the temptations to attend to the scientific
nature of psychoanalysis, at the expense of its historical nature, lead
to fantasies -- sometimes acted out -- of using external observers and
even videotapes, to explore the process. This is like peering at the visible
surface of the moon and deciding that is a flat thing with no other side.
No scientific paraphernalia currently available can track the mind of the
mostly silent analyst.
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