The primitive edge of experience

T h e of P r i m i t i v e Experience Edge Other Books by T h o m a s H . Ogden Projective Identification a n d P ...

Author: Thomas H. Ogden

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T h e of

P r i m i t i v e Experience

Edge

Other Books by T h o m a s H .

Ogden

Projective Identification a n d P s y c h o t h e r a p t >eutic T e c h n i q u e (1982) T h e M a t r i x of the M i n d : Object R e l a t i o n s a n d t h e Psychoanalytic D i a l o g u e (1986)

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& J a s o n A r o n s o n Inc. Northvale, New Jersey London

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Certain chapters in this book are based on prior publications of the author. He acknowledges permission from the following journals to reprint this previously publishe Chapter 2: "On the dialectical structure of experience: some clinical and theoretical implications," Contemporary Psychoanalysis 24:17-45, 1988 (copyright c W. A. White Institute). This paper was originally written as a contribution to Master Clinicians on Treating the Regressed Patient, ed. L. B. Boyer and P. L. Giovacchini. Northvale, NJ: Jason Aronson, 1989. Chapter 3: "On the concept of an autistic-contiguous position," The International Journal of Psycho-Analysis 70:127-140, 1989 (copyright © Institute of Psycho-Analysis). Chapter 5: "The transitional Oedipal relationship in female development," The International Journal of Psycho-Analysis 68:485-498, 1987 (copyright © Institute of Psycho-Analysis). f

Chapter 6: "The threshold of the male Oedipus complex," The Bulletin of the Menninger Clinic 53:394-413, 1989 (copyright © The Menninger Foundation). Chapter 8: "Misrecognitions and the fear of not knowing," The Psychoanalytic Quarterly 57:643-666, 1988 (copyright © The Psychoanalytic Quarterly, Inc.). Jason Aronson Inc. gratefully acknowledges permission from New Directions Publishing Corporation to reprint an excerpt from Labyrinths by Jorge Luis Borges. Copyright © 1962, 1964 by New Directions Publishing Corporation. The publisher also gratefully acknowledges permission from Harcourt Brace, Jovanovich, Inc. to reprint excerpts from Four Quartets. Copyright © 1943 by T. S. Eliot and renewed 1971 by Esme Valerie Eliot. Copyright © 1989 by Thomas H. Ogden, M.D. 10

9 8 7 6 5 4 3 2 1

All rights reserved. Printed in the United States of America. No part of this book may be used or reproduced in any manner whatsoever without written permission from Jason Aronson Inc. except in the case of brief quotations in reviews for inclusion in a magazine, newspaper, or broadcast. Library of Congress Cataloging-in-Publication Data Ogden, Thomas H. The primitive edge of experience p. cm. Bibliography: p. Includes index. ISBN 0-87668-982-9 1. Psychoanalysis. I. Title. RC506.034 1989 616.89'17-dc20

Thomas H. Ogden.

89-6878 CIP

Manufactured in the United States of America. Jason Aronson Inc. offers books and cassettes. For information and catalog write to Jason Aronson Inc., 230 Livingston Street, Northvale, New Jersey 07647.

ly ial.

For my Pete and with

sons Ben, love

C o n t e n t s

1 Introduction

1

2 The

Structure

of Experience

9

Experience in a Depressive Mode 11 Experience in a Paranoid-Schizoid Mode T h e Autistic-Contiguous Mode of Generating Experience 30

18

3 The Autistic-Contiguous

Position

Primitive Organization of Experience T h e Nature of Sensation-Dominated Experience 52

47 49

vu

Contents

VIII

Autistic-Contiguous Experience and Pathological Autism 59 T h e Nature of Autistic-Contiguous Anxiety 67 Autistic-Contiguous Modes of Defense 70 Internalization in the Autistic-Contiguous Position 73 Autistic-Contiguous Anxiety and the Binding Power of Symbols 77

The Schizoid

Condition

83

Schizoid Phenomena 84 T h e Contributions of Winnicott and Guntrip Clinical Illustration: If a Tree Falls in the Forest 92

5 The

Transitional

Oedipal

in Female

Development

Relationship 109

T h e Female Oedipal Narrative 110 T h e Developmental Context 115 T h e Transitional Relationship 118 Psychopathology and the Oedipal Transitional Relationship 123 A Reevaluation of the Freudian Female Oedipal Narrative 130

87

Contents Transference-Countertransference Implications 133 Implications for the Development of Gender Identity 137

The

Threshold

Oedipus

of the

Complex

Male 141

Freud's Perspective 143 T h e Scylla and Charybdis of the Threshold of the Male Oedipus Complex 146 T h e Organization of Sexual Meaning 148 Transitional Oedipal Object Relatedness 152 Clinical Illustration 156 T h e Absence of Thirdness 165

7 The Initial

Analytic

Meeting

169

Creating Analytic Significance 170 Sustaining Psychological Strain in the Analytic Setting 175 Cautionary Tales 181 T h e Timing of Transference Interpretations Analytic Space 188 Anxious Questioning 190 Creating a History 191 Concluding Comments 193

184

Contents

8 Misrecognitions of Not

and

the

Knowing

Fear

195

A Theoretical Background 196 A Developmental Perspective 201 T h e Structuralization of Misrecognition 203 Misrecognition of Affect: A Clinical Illustration 210 Misrecognition as a Dimension of Eating Disorders 213 Psychological Change in the Area of Recognition and Misrecognition 215

References

Index

223

237

I

I n t r o d u c t i o n

T h i s b o o k , h a v i n g b e e n w r i t t e n , h a s b e c o m e p a r t of t h e given a n d m u s t now b e o v e r c o m e in t h e m i n d s of its r e a d e r s a n d its a u t h o r . H a v i n g b e e n w r i t t e n , it is static a n d n o longer b e c o m i n g a n y t h i n g other t h a n itself. T h e p o t e n t i a l value of this b o o k lies in the degree to w h i c h it creates a possibility for t h e given (of which it is n o w a p a r t ) to b e o v e r c o m e t h r o u g h i n t e r p r e t a t i o n b y the r e a d e r in a n e w a n d m o r e g e n e r a t i v e w a y . A s analysts, we a t t e m p t to assist the a n a l y s a n d in his efforts a t freeing himself from forms of o r g a n i z e d experience (his conscious a n d u n c o n s c i o u s " k n o w l e d g e " - o f himself) that e n t r a p h i m a n d p r e v e n t h i m from t o l e r a t i n g t h e e x p e r i e n c e of n o t k n o w i n g l o n g enbugH~to r c r e a t e u n d e r s t a n d i n g s in a different w a y . T h e value of develo p i n g n e w w a y s of k n o w i n g lies n o t simply in t h e g r e a t e r s e l f - u n d e r s t a n d i n g o n e m i g h t achieve, b u t as i m p o r t a n t l y in t h e possibility t h a t a w i d e r r a n g e of t h o u g h t s , feelings, a n d sensations m i g h t b e b r o u g h t into being.(Each insight, h o w e v e r valuable, i m m e d i a t e l y constitutes the next resist a n c e in t h a t t h e n e w k n o w l e d g e is already p a r t of t h e static k n o w n a n d m u s t b e o v e r c o m e in the process of freshly k n o w i n g .

The Primitive Edge of Experience It is necessary t h a t both t h e analytic discourse between analysts a n d t h e analytic dialogue b e t w e e n analyst a n d a n a l y s a n d serve as "containers" for t h e experience of confusion a n d n o t k n o w i n g . If all is g o i n g well in t h e analytic process, the a n a l y s a n d will inevitably c o m p l a i n t h a t he u n d e r s t a n d s even less at p r e s e n t t h a n he did at the b e g i n n i n g of the analysis. ( M o r e accurately, he u n d e r stands less t h a n h e thought he k n e w at t h e outset of the analysis, a n d h e is l e a r n i n g to tolerate n o t k n o w i n g . ) A r e a d e r , like a n a n a l y s a n d , d a r e s to experience the d i s t u r b i n g feeling of n o t k n o w i n g each t i m e he begins r e a d i n g a n e w piece of writing. W e r e g u l a r l y create the s o o t h i n g illusion for ourselves t h a t we h a v e n o t h i n g to lose from the experience of r e a d i n g , a n d t h a t we c a n only gain from it. T h i s rationalization is superficial salve for the w o u n d t h a t we a r e a b o u t to o p e n in t h e process of o u r effort to l e a r n . I n a t t e m p t i n g to l e a r n , we subject o u r selves to the t e n s i o n of dissolving the connections b e t w e e n ideas t h a t we h a v e t h u s far relied u p o n in a p a r t i c u l a r w a y : W h a t we think we k n o w helps us identify w h o we are (or m o r e accurately, who we t h i n k we are). R e a d i n g a psychoanalytic b o o k is a particularly difficult u n d e r t a k i n g in t h a t t h e r e a d e r h a s chosen to a t t e m p t to l e a r n a b o u t a b o d y of ideas ( a n d a t h e r a p e u t i c process) in w h i c h a principal focus is o n t h a t which c a n n o t be k n o w n : t h e u n c o n s c i o u s ' m i n d . T h e u n c o n s c i o u s is by definition u n k n o w a b l e in t h a t o n c e the individual h a s b e c o m e a w a r e of a given t h o u g h t , feeling, p h a n t a s y , sensation, o r the like, it is n o l o n g e r a n aspect of unconscious experience. T h e p s y c h o a n a l y s t is therefore in t h e u n f o r t u n a t e position of b e i n g a s t u d e n t of t h a t which c a n n o t be k n o w n . It is little w o n d e r t h a t we cling to o u r ideologies, o u r p a t r i a r c h s a n d m a t r i a r c h s , o u r a n a lytic heroes a n d heretics, a n d o u r analytic schools, all

Introduction of w h i c h serve us in o u r efforts to avoid a w a r e n e s s of o u r confusion. T h e O e d i p u s m y t h , so f u n d a m e n t a l to the psychoanalytic c o n c e p t i o n of t h e h u m a n d i l e m m a , is a n e n d lessly twisting l a b y r i n t h revolving a r o u n d the question of w h e t h e r it is b e t t e r to k n o w o r n o t to k n o w , better to be k n o w n o r n o t to be k n o w n . If O e d i p u s h a d k n o w n t h a t t h e m a n with w h o m he e n t e r e d into b a t t l e o n t h e r o a d from D e l p h i w a s his o w n father, w o u l d he h a v e d o n e otherwise? T h e q u e s t i o n , of c o u r s e , is m o o t — i t could n o t h a v e b e e n otherwise. O n e c a n n o t k n o w these things; the idea t h a t it is possible to k n o w t h e m is m e r e selfd e c e p t i o n . O e d i p u s ' s eventual k n o w l e d g e of his d u a l c r i m e b r o u g h t with it resolution a n d disaster of e q u a l m a g n i t u d e . W o u l d it h a v e b e e n b e t t e r n o t to h a v e k n o w n ? E v e n after h a v i n g recognized t h e t r u t h of T e i r e sias's w o r d s , O e d i p u s k n e w , b u t could n o t b e a r to k n o w (see) w h a t he saw. N o t k n o w i n g d e p r i v e s us of o u r sense of w h o we a r e , a n d yet to k n o w is to see t h a t w h i c h we c a n n o t b e a r to see. T h e a n a l y s a n d desperately d a r t s b e t w e e n wishes to k n o w a n d wishes n o t to k n o w . Similarly, it is o u r n e e d to k n o w t h a t leads u s to r e a d ; at the s a m e t i m e , we a r e d e t e r r e d from r e a d i n g b y o u r u n c o n s c i o u s knowledge t h a t the b o o k t h a t we a r e a b o u t to read (if it is w o r t h r e a d i n g ) will p l u n g e us into the experience of feeling t h a t we k n o w even less t h a n we t h o u g h t we d i d , a n d will lead us to feel t h a t we k n o w ourselves even less well t h a n we h a d thought. T o a l a r g e extent, this b o o k is c o n c e r n e d - w i t h t h e p r i m i t i v e e d g e of h u m a n experience, t h e " . . . frontiers of consciousness b e y o n d which w o r d s fail t h o u g h m e a n i n g s still exist" ( T . S. Eliot, 1950). T h e history of t h e d e v e l o p m e n t of British object

The Primitive Edge of Experience relations t h e o r y over the past t w e n t y y e a r s c a n be viewed as c o n t a i n i n g t h e b e g i n n i n g s of t h e exploration of a n a r e a of h u m a n e x p e r i e n c e t h a t lies b e y o n d t h e psychological states a d d r e s s e d b y Klein's concept of t h e p a r a n o i d - s c h i zoid a n d t h e depressive positions; b y F a i r b a i r n ' s conception of the w o r l d of u n c o n s c i o u s i n t e r n a l object relations; by Bion's c o n c e p t i o n of projective identification as a form of object relatedness a n d c o m m u n i c a t i o n ; or by W i n n i cott's c o n c e p t i o n of t h e early mother-rinfant u n i t . I shall i n t r o d u c e t h e concept of a n autistic-contiguous position as a w a y of conceiving of t h e m o s t p r i m i t i v e psychological o r g a n i z a t i o n t h r o u g h which t h e sensory "floor" of t h e e x p e r i e n c e of self is g e n e r a t e d . T T h e autistic-contiguous position is u n d e r s t o o d as a s e n s o r y - d o m i n a t e d , presymbolic a r e a of experience in which t h e m o s t p r i m i t i v e form of m e a n i n g is g e n e r a t e d on t h e basis of t h e o r g a n i z a t i o n of sensory impressions, particularly at t h e skin surface_/A u n i q u e form of anxiety arises in this psychological r e a l m : t e r r o r o v e r the prospect t h a t the b o u n d e d n e s s of one's sensory surface m i g h t be dissolved, with a r e s u l t a n t feeling of falling, leaking, d r o p p i n g , i n t o a n endless a n d shapeless space. I explore in this b o o k t h e idea t h a t h u m a n experience is the p r o d u c t of the dialectical interplay of t h r e e m o d e s of g e n e r a t i n g experience: the depressive, t h e p a r a n o i d schizoid, a n d t h e autistic-contiguous. E a c h m o d e creates, preserves, a n d n e g a t e s t h e other. J u s t as t h e idea of the conscious m i n d h a s n o m e a n i n g i n d e p e n d e n t of t h e idea of the u n c o n s c i o u s m i n d , no single m o d e of g e n e r a t i n g experience exists i n d e p e n d e n t l y of t h e o t h e r s . E a c h is the n e g a t i n g context for the o t h e r . F r o m this perspective, p s y c h o p a t h o l o g y is c o n c e p t u alized as a collapse of the dialectic in diejlirection.of._one o r the ojheFjof'"the".rnpclesôf g e n e r a t i n g experience- T h e

Introduction o u t c o m e of s u c h a collapse m a y b e a t y r a n n i z i n g e n t r a p m e n t in rigid, asymbolic p a t t e r n i n g s of sensation (collapse in t h e direction of t h e autistic-contiguous m o d e ) ; o r i m p r i s o n m e n t in a world of o m n i p o t e n t internal objects w h e r e i n t h o u g h t s a n d feelings a r e experienced as things a n d forces (collapse in the direction of the p a r a n o i d schizoid m o d e ) ; or t h e isolation of t h e self from t h e i m m e d i a c y of lived experience a n d t h e aliveness of bodily sensations (collapse in t h e d i r e c t i o n of t h e depressive mode). O n t h e basis of t h e ideas t h u s s u m m a r i z e d , I conclude t h a t a revised c o n c e p t i o n of t h e schizoid condition is r e q u i r e d . N o longer is it a d e q u a t e to g e n e r a t e u n d e r s t a n d i n g s of schizoid p h e n o m e n a b a s e d o n a view t h a t Klein's p a r a n o i d - s c h i z o i d position o r F a i r b a i r n ' s i n t e r n a l object world r e p r e s e n t s t h e most p r i m i t i v e psychological o r g a n i z a t i o n s . T h e autistic-contiguous position is viewed as t h e "underbelly" or primitive edge of t h e schizoid personality organization.[I p r o p o s e t h a t schizoid e x p e r M ence is g e n e r a t e d in a n a r e a of experience lying b e t w e e n I t h e r e a l m of s t r a n g u l a t e d i n t e r n a l object relations a n d 1 t h e r e a l m of t y r a n n i z i n g , ^ s y m b o l i c . , p a t t e r n i n g s of sen- | ! s a t i o n j T h r o u g h discussing certain aspects of the a n a l y s i s j of a schizoid p a t i e n t , I a t t e m p t to illustrate t h e ways in w h i c h analytic t h e o r y a n d t e c h n i q u e m u s t i n c o r p o r a t e a n u n d e r s t a n d i n g of the n a t u r e of t h e interplay of autisticc o n t i g u o u s , p a r a n o i d - s c h i z o i d , a n d depressive m o d e s of g e n e r a t i n g experience. * I n C h a p t e r s 5 a n d 6, t h e focus of the discussion shifts to a n e x a m i n a t i o n of the t r a n s i t i o n i n t o t h e O e d i p u s c o m p l e x in female a n d m a l e d e v e l o p m e n t . Since t h e r e is n o a s s u m p t i o n of s y m m e t r y b e t w e e n m a l e a n d female d e v e l o p m e n t , t h e transitions i n t o t h e m a l e a n d female O e d i p u s c o m p l e x are addressed separately.

The Primitive Edge of Experience Although- t h e O e d i p u s c o m p l e x h a s b e e n from the b e g i n n i n g o n e of the cornerstones of t h e psychoanalytic edifice, t h e psychological-interpersonal processes m e d i a t i n g t h e t r a n s i t i o n into the O e d i p u s c o m p l e x h a v e r e m a i n e d o b s c u r e . I n p a r t , this is a reflection of the fact t h a t , until relatively recently, analytic t h e o r y has failed to a d e q u a t e l y conceptualize the distinction b e t w e e n p r e O e d i p a l a n d O e d i p a l object relations; m o r e o v e r , t h e r e has b e e n a p a u c i t y of analytic concepts t h a t a d d r e s s the i n t e r p l a y of intrapsychic a n d i n t e r p e r s o n a l r e a l m s of experience. T h e c o n c e p t of a transitional O e d i p a l relationship is p r o p o s e d as a w a y of u n d e r s t a n d i n g t h e psychologicali n t e r p e r s o n a l processes m e d i a t i n g t h e e n t r y i n t o t h e female O e d i p u s complex. A s is t h e case with o t h e r transitional p h e n o m e n a , this transitional relationship serves t h e function of allowing the discovery of otherness in a form t h a t is experienced as b o t h me a n d not-me at the s a m e time. I n t h e context of t h e transitional relationship created by m o t h e r a n d d a u g h t e r at t h e threshold of the O e d i p u s c o m p l e x , t h e little girl falls in love with h e r m o t h e r w h o is unconsciously identified with h e r own ( i n t e r n a l object) O e d i p a l father. T h e q u e s t i o n of w h e t h e r t h e little girl is in love with her m o t h e r o r father (in love with a n i n t e r n a l object o r a n external object) n e v e r arises. By m e a n s of this transitional relationship, t h e little girl n o n t r a u m a t i c a l l y discovers t h e externality of the O e d i p a l father ( a n d m o t h e r ) in t h e context of t h e safety of a dyadic relationship with t h e p r e - O e d i p a l m o t h e r . As a result, paradoxically, t h e first h e t e r o s e x u a l love relationship unfolds in t h e context of a relationship involving two females; t h e initial t r i a n g u l a t i o n of object relations occurs within a dyadic relationship. It is necessary to g e n e r a t e a n u n d e r s t a n d i n g of t h e

Introduction t r a n s i t i o n into t h e O e d i p u s c o m p l e x t h a t is specific to m a l e d e v e l o p m e n t , a n u n d e r s t a n d i n g t h a t is not simply a t r a n s p o s i t i o n of one's conception of t h e e n t r y into t h e female O e d i p u s complex. T h e t r a n s i t i o n into t h e m a l e O e d i p u s c o m p l e x differs from t h e t r a n s i t i o n into t h e female O e d i p u s c o m p l e x in t h a t , for t h e m a l e , t h e r e is n o " c h a n g e of object." T h a t is, for t h e b o y , t h e m o t h e r is t h e object of b o t h p r e - O e d i p a l a t t a c h m e n t to a n o m n i p o t e n t i n t e r n a l object a n d O e d i p a l desire for a n external whole object. I view t h e psychological-interpersonal m o v e m e n t into t r i a n g u l a t e d O e d i p a l object relations as m e d i a t e d for the b o y by t h e e l a b o r a t i o n of m a t u r e forms of the p r i m a l scene p h a n t a s y , in conjunction with the d e v e l o p m e n t of a type of transitional O e d i p a l r e l a t i o n s h i p to the m o t h e r t h a t is distinctive to m a l e d e v e l o p m e n t . I n the transitional O e d i p a l relationship in m a l e d e v e l o p m e n t , the m o t h e r is b o t h t h e ( i n t e r n a l object) m o t h e r a n d the (external object) father ( t h r o u g h w h o m the little b o y is e m p o w e r e d phallically). T h e a c t u a l father is only secondarily the b e a r e r of t h e phallus. I t h e n t u r n in C h a p t e r 7 to a discussion of early e x p e r i e n c e of a different sort: t h e b e g i n n i n g s of t h e analytic experience. T h e analyst m u s t allow himself to be freshly surprised by the ideas a n d p h e n o m e n a t h a t h e takes m o s t for g r a n t e d . I n this c h a p t e r , I a t t e m p t to r e - a p p r o a c h t h e initial analytic m e e t i n g as if for t h e first time. I n this discussion, I view t h e initial face-to-face analytic m e e t i n g as n o t simply a p r e p a r a t i o n for t h e analysis, b u t as the actual b e g i n n i n g of t h e analysis. I p r o p o s e the n o t i o n t h a t , in the initial m e e t i n g , the analyst listens for t h e patient's " c a u t i o n a r y tales" —that is, for t h e patient's u n c o n s c i o u s w a r n i n g s to the analyst a n d to

oThe Primitive Edge of Experience himself r e g a r d i n g his reasons for feeling t h a t the analysis is a d a n g e r o u s a n d d o o m e d u n d e r t a k i n g . W h a t e v e r the n a t u r e of t h e patient's psychological difficulties, his u n conscious anxiety will be given form in t e r m s of the d a n g e r he experiences in relation to t h e prospect of b e g i n n i n g analysis. T h e analyst a t t e m p t s to u n d e r s t a n d t h e n a t u r e of these transference anxieties a n d to help t h e a n a l y s a n d p u t these fears into w o r d s . I n the final c h a p t e r , I discuss a specific form of » p r i m i t i v e anxiety: t h e u n c o n s c i o u s fear of n o t k n o w i n g . W h a t the individual is n o t able to k n o w is w h a t h e feels — a n d therefore w h o , if a n y o n e , h e .is. T h e t e r r o r associated with this t y p e of not k n o w i n g is w a r d e d off by m e a n s of t h e use of substitute formations ( m i s n a m i n g s a n d misrecognitions) t h a t create for the individual the illusion of k n o w i n g a n d of being. Defensive reliance on substitute formations further alienates t h e individual from himself, a n d fills the potential space in which personal m e a n i n g a n d desire m i g h t otherwise h a v e c o m e into being. T h i s type of fear of not k n o w i n g is by n o m e a n s restricted to a small g r o u p of alexithymic o r schizoid p a t i e n t s . It is a universal p h e n o m e n o n , o n e that, to s o m e d e g r e e , we continually b u m p u p against; it is experie n c e d , for e x a m p l e , each t i m e we expose ourselves to t h e h a z a r d s of l e a r n i n g .

• T h e

—

-

2

S t r u c t u r e

of

E x p e r i e n c e

The other one, the one called Borges, is the one things happen to . . . I know of Borges from the mail . . . It would be an exaggeration to say that ours is a hostile relationship; I live it, let. myself go on living, so that Borges may contrive his'literature, and this literature justifies me. J . L. Borges, "Borges and I"

Borges's prose p o e m "Borges a n d I" (1960) delicately teases a p a r t w h a t o r d i n a r i l y comprises the iIlusion__,of u n i t y of experience. I n a n infinitely m o r e clumsy w a y I w o u l d like to p r o p o s e a psychoanalytic framework w i t h i n w h i c h to t h i n k a b o u t t h e c o m p o n e n t s of t h e dialectical process g e n e r a t i n g j i u m a n _ „ e x p e r i e n c e . I will explore in this c h a p t e r the idea t h a t h u m a n experience is constituted b y the dialectical interplay of t h r e e different, m o d e s , of g e n e r a t i n g experience: the depressive mode,jhe,paranoid_schizoid m o d e , a n d the a u t i s t i c - c o n t i g u o u s - m o d e . T h e

10

The Primitive Edge of Experience

concept of t h e first two of these modes, w a s i n t r o d u c e d by M e l a n i e K l e i n 1 ; the third represents m y o w n synthesis, clarification, a n d extension of ideas i n t r o d u c e d p r i m a r i l y b y F r a n c e s T u s t i n , E s t h e r Bick, a n d D o n a l d M e l t z e r . E a c h of these m o d e s of g e n e r a t i n g experience is characterized b y its o w n form of s y m b o l i z a t i o n , m e t h o d of defense, q u a l i t y of object relatedness, a n d degree of subjectivity. T h e t h r e e m o d e s stand in a dialectical relationship to o n e a n o t h e r , e a c h c r e a t i n g , p r e s e r v i n g , a n d n e g a t i n g t h e others. T h e idea of a single m o d e functioning w i t h o u t relation to t h e o t h e r two is as m e a n ingless as the concept of t h e conscious m i n d in isolation from t h e concept of the unconscious m i n d ; each is a n e m p t y set filled b y t h e o t h e r pole o r poles of t h e dialectic. I will describe e a c h of the t h r e e m o d e s of g e n e r a t i n g experience with p a r t i c u l a r reference to t h e analytic experience. W h a t I h o p e will b e c o m e a p p a r e n t is that every psychological event is o v e r d e t e r m i n e d , n o t only in t e r m s of layers of u n c o n s c i o u s c o n t e n t , b u t also in t e r m s of m o d e s of e x p e r i e n c e g e n e r a t i n g t h e psychological m a t r i x within which m e n t a l c o n t e n t exists. Psychological_change ("structural change") will be discussed in t e r m s of shifts in the n a t u r e of t h e d i a l e c t i c a l J n t e r p l a y of m o d e s of genera t i n g experience. Paradoxically, the elements of the synchronicity of experience will, for the sake of clarity, b e p r e s e n t e d 'Although I am not a Kleinian, I have found many of Klein's ideas — when viewed independently of her developmental timetable, her concept of the death instinct, and her theory of technique —to be pivotal to the development of psychoanalytic thought. Two of her most important contributions to psychoanalysis are the concepts of the paranoid-schizoid and depressive positions. However, neither concept has been integrated into the main body of the American psychoanalytic dialogue.

11

The Structure of Experience

sequentially in this c h a p t e r . Like a novice j u g g l e r w h o r e q u i r e s t h e p a t i e n c e of his a u d i e n c e while h e gets his first b a t o n into solitary flight, l a s k for t h e r e a d e r ' s i n d u l g e n c e while I l a u n c h t h e initial sections of this c h a p t e r . I n t h e e n d , the r e a d e r m u s t b e c o m e t h e j u g g l e r h o l d i n g in g e n e r a t i v e t e n s i o n t h e multiplicity of m o d e s c o n s t i t u t i n g h u m a n experience.

Experience

in a Depressive

Mode

T h e concept of t h e depressive position was i n t r o d u c e d by M e l a n i e Klein (1935, 1948, 1958) to refer to t h e most m a t u r e form of psychological o r g a n i z a t i o n . A l t h o u g h this o r g a n i z a t i o n c o n t i n u e s to develop t h r o u g h o u t life, K l e i n believed t h a t it h a s its origins in the second q u a r t e r of t h e first y e a r of life. 2 Bion (1962) modified this concept to e m p h a s i z e n o t its place in a d e v e l o p m e n t a l s e q u e n c e , b u t its place in a d y n a m i c relationship w i t h t h e p a r a n o i d schizoid position. I n this c h a p t e r , m y focus is on the depressive m o d e n o t as a s t r u c t u r e o r a d e v e l o p m e n t a l p h a s e , b u t as a process t h r o u g h w h i c h perception is a t t r i b u t e d m e a n i n g in a p a r t i c u l a r w a y . T h i s is w h a t I h a v e in m i n d b y a m o d e of g e n e r a t i n g experience. T h e qualities of e x p e r i e n c e in each m o d e are i n t e r d e p e n d e n t , each p r o v i d i n g t h e context for t h e o t h e r . I n t h e depressive position, t h e m o d e of symbolization t e r m e d symbol formation proper (Segal, 1957) is o n e in which t h e symbol re-presents the symbolized a n d is experienced as different from it. Symbolic m e a n i n g is As will be seen, the debate over Klein's developmental timetable loses much of its significance when her "positions" are viewed not as developmental phases, but as synchronic dimensions of experience.

12


g e n e r a t e d by a subject m e d i a t i n g b e t w e e n the symbol a n d t h a t w h i c h it represents. It could be said t h a t it is in t h e space b e t w e e n the symbol a n d t h e symbolized t h a t a n i n t e r p r e t i n g subject comes into b e i n g . It could also be said with e q u a l validity t h a t it is the d e v e l o p m e n t of t h e c a p a c i t y for subjectivity, t h e e x p e r i e n c e of "I-ness," h o w ever subtle a n d u n o b t r u s i v e , t h a t m a k e s it possible for the i n d i v i d u a l to m e d i a t e b e t w e e n symbol a n d symbolized. Both a r e t r u e . Each constitutes t h e conditions necessary for the o t h e r ; n e i t h e r "leads to" o r "causes" t h e o t h e r in a l i n e a r , sequential sense. T h e a c h i e v e m e n t of symbol formation p r o p e r allows o n e to experience oneself as a p e r s o n t h i n k i n g one's t h o u g h t s a n d feeling one's feelings. I n this w a y , t h o u g h t s a n d feelings are experienced to a l a r g e degree as personal c r e a t i o n s t h a t c a n be u n d e r s t o o d ( i n t e r p r e t e d ) . T h u s , for b e t t e r o r for worse, o n e develops a feeling of responsibility for one's psychological actions ( t h o u g h t s , feelings, and behavior). A s o n e b e c o m e s capable of e x p e r i e n c i n g oneself as a subject, o n e at t h e s a m e t i m e (via projection a n d identification) b e c o m e s capable of e x p e r i e n c i n g one's "objects'' as also b e i n g subjects. T h a t is, o t h e r people a r e viewed as b e i n g alive a n d capable of t h i n k i n g a n d feeling in t h e s a m e w a y t h a t o n e experiences oneself as h a v i n g one's I o w n t h o u g h t s a n d f e e l i n g s . j T h i s is the world of whole object relations in which t h e individual exists as m o r e o r less t h e s a m e p e r s o n over t i m e , in relation to other people w h o also c o n t i n u e to be t h e s a m e people despite powerful affective shifts a n d m i x t u r e s of affect. N e w experience is a d d e d to old, b u t n e w experience does n o t u n d o o r n e g a t e t h e p a s t . T h e c o n t i n u i t y of e x p e r i e n c e of self a n d o t h e r t h r o u g h loving a n d h a t i n g feeling states, is t h e context for the d e v e l o p m e n t of t h e capacity for a m b i v a l e n c e .


13

Historicity is created in t h e depressive m o d e as t h e i n d i v i d u a l relinquishes his or h e r reliance on o m n i p o t e n t defenses. W h e n , in a p a r a n o i d - s c h i z o i d mode^ o n e feels d i s a p p o i n t e d or a n g r y at a n object, t h e object is n o l o n g e r experienced as the s a m e object t h a t it h a d b e e n , b u t as a n e w object. T h i s experience of t h e discontinuity of self a n d object o v e r t i m e precludes t h e c r e a t i o n of historicity. I n s t e a d t h e r e is a c o n t i n u a l , defensive recasting of t h e p a s t . I n a depressive m o d e , o n e is rooted in a history t h a t o n e creates t h r o u g h i n t e r p r e t i n g one's past. A l t h o u g h one's i n t e r p r e t a t i o n s of t h e past are evolving ( a n d therefore history is continually evolving a n d c h a n g i n g ) , the past is u n d e r s t o o d to b e i m m u t a b l e . T h i s knowledge b r i n g s with it t h e sadness t h a t one's past will n e v e r be all t h a t o n e h a d wished. F o r e x a m p l e , one's early relationships with one's p a r e n t s will n e v e r be all t h a t o n e h a s h o p e d . A t t h e s a m e t i m e , this r o o t e d n e s s in t i m e also b r i n g s a d e p t h a n d stability to one's experience of self. O n e ' s relation to the history t h a t o n e has created interpretively is a n i m p o r t a n t d i m e n s i o n of subjectivity, w i t h o u t w h i c h one's experience of "I-ness" feels a r b i t r a r y , erratic, a n d u n r e a l . I n a psychological state in w h i c h o t h e r people a r e \ e x p e r i e n c e d as subjects a n d n o t simply as objects, it is I possible to care a b o u t t h e m as o p p o s e d to simply v a l u i n g I t h e m as o n e would v a l u e a prized object, o r even such / essential objects as food o r air. Objects can be d a m a g e d I o r used u p ; only subjects c a n b e h u r t . T h e r e f o r e , only in t h e context of the experience of subjective others does t h e e x p e r i e n c e of guilt b e c o m e a p o t e n t i a l h u m a n e x p e r i e n c e ^ ] G u i l t h a s n o m e a n i n g in t h e a b s e n c e of the capacity for c o n c e r n for o t h e r people as subjects. G u i l t is a specific sort of p a i n t h a t one b e a r s over time in response to real o r i m a g i n e d h a r m that o n e has d o n e to s o m e o n e a b o u t

*14


w h o m o n e cares. O n e c a n a t t e m p t to m a k e r e p a r a t i o n for t h a t a b o u t which o n e feels guilty, b u t this does n o t u n d o w h a t o n e h a s d o n e . All the i n d i v i d u a l c a n d o is to a t t e m p t to m a k e u p for w h a t he has d o n e , in his s u b s e q u e n t relations with others a n d with himself. E m p a t h y b e c o m e s possible in this m o d e of experience, since others a r e experienced as subjects whose feelings c a n be u n d e r s t o o d to be like one's own. O n c e the other is experienced as a subject as well as a n object, o n e acknowledges t h e life of t h e other outside t h e a r e a of one's o m n i p o t e n c e . I n a world of subjects w h o m o n e a m b i v a l e n t l y loves a n d c a n n o t fully control, a distinctly n e w form of anxiety (not possible in t h e m o r e p r i m i t i v e m o d e s of experience) is g e n e r a t e d : the a n x i e t y t h a t one's a n g e r - h a s d r i v e n a w a y o r h a r m e d the p e r s o n o n e loves. Sadness, t h e e x p e r i e n c e of m i s s i n g s o m e o n e , loneliness, a n d the capacity for m o u r n i n g b e c o m e d i m e n sions of h u m a n experience as a c o n s e q u e n c e of the i n t e r p l a y of the qualities of experience in t h e depressive m o d e d e s c r i b e d above. A s will b e discussed, in a p a r a n o i d - s c h i z o i d m o d e , magical r e s t o r a t i o n of the lost object short-circuits these experTenceTTThere *is n o n e e d to, o r a n y possibility of,~missing o r m o u r n i n g a lost object w h e n a b s e n c e can be u n d o n e t h r o u g h o m n i p o t e n t t h i n k i n g a n d denial. T h e n a t u r e of the transference in a depressive m o d e n a s its o w n distinct qualities / i n a p a r a n o i d - s c h i z o i d m o d e , transference is based u p d n the wish a n d the belief t h a t o n e h a s emotionally r e c r e a t e d a n earlier object relationship in t h e p r e s e n t relationship; in a depressive m o d e , transference r e p r e s e n t s a n u n c o n s c i o u s a t t e m p t to r e c a p t u r e s o m e t h i n g of one's experience with an earlier object in t h e p r e s e n t r e l a t i o n s h i p ^ T h i s latter form of transference is rooted in the context of t h e sadness of


15

k n o w i n g t h a t t h e relationship with t h e original object is a p a r t of t h e past t h a t o n e will n e v e r h a v e a g a i n . At the s a m e t i m e , t h e past is n e v e r lost completely in a d e p r e s sive m o d e in t h a t o n e c a n r e p e a t s o m e t h i n g of t h e e x p e r i e n c e with the original object in a relationship with t h e n e w object ( O g d e n , 1986). T h i s , for e x a m p l e , u n d e r n o r m a l circumstances, m a k e s the w a n i n g of t h e O e d i p u s c o m p l e x possible. T h e little girl, for e x a m p l e , experiences sadness in h e r eventual acceptance of the fact t h a t she will n o t be able to h a v e the unconsciously wished-for r o m a n t i c a n d sexual relationship with h e r father. T h e p a i n of this r e n u n c i a t i o n is b e a r a b l e in p a r t b e c a u s e the experience with t h e father is kept alive transferentially in relationships w i t h n e w objects, a n d will f o r m a n i m p o r t a n t core of h e r m a t u r e , adult love relationships (cf. L o e w a l d , 1979; see also C h a p t e r 5). T h e depressive m o d e of g e n e r a t i n g experience t h a t h a s b e e n schematically described constitutes a dialectical pole t h a t exists only in relation to t h e p a r a n o i d - s c h i z o i d a n d autistic-contiguous poles. I n t h e n e v e r - a t t a i n e d ideal of the depressive m o d e , analytic discourse occurs b e t w e e n i n t e r p r e t i n g subjects, e a c h a t t e m p t i n g to use w o r d s to m e d i a t e between himself a n d his e x p e r i e n c e of t h e o t h e r . T h i s discourse b e t w e e n subjects is frequently blocked by u n c o n s c i o u s t h o u g h t s a n d feelings t h a t t h e subject finds too frightening o r u n a c c e p t a b l e to p u t into w o r d s . I a m referring h e r e n o t only to frightening a n d u n a c c e p t a b l e sexual a n d aggressive wishes, b u t also to o t h e r sorts of fears such as t h e u n c o n s c i o u s anxiety t h a t aspects of oneself a r e so p r i v a t e a ^ ^ ° . ^ ^ S t r ^ r t g ^ a n e n d a n g e r e d sense of b e i n g alive t h a t t h e v e r y a c t o f c o m m u n i c a t i o n will e n d a n g e r the_imegrity^pi_the^self. Still a n o t h e r form of anxiety t h a t d i s r u p t s the i n t e r s u b j e c t i v e H i s c o u r s e is„the.fear thatône's.life-sustaining^ries

J/

16


to one's i n t e r n a l objects may_b^jeopardized_throjjigh_any sort of discourse in whicôn^r_elijnqiusties control o v e r one's i n t e r n a l object world # by > r sharing„knowledge of it with a n o t h e r ^(Ogden7T983). ~"~" T h e analyst a n d a n a l y s a n d a t t e m p t to u n d e r s t a n d t h e "leading edgejojânxiety'^that constitutes the_principal source of the d i s r u p t i o n of t h e intersubjective discourse at a given m o m e n t . In a depressive m o d e , t h a t anxiety is always object-related in t h a t t h e u n c o n s c i o u s reasons for feeling fearful, guilty, a s h a m e d a n d the like h a v e to d o with o v e r d e t e r m i n e d . u n c o n s c i o u s p h a n t a s i e s 3 involving i n t e r n a l a n d external objects. T h e derivatives of these u n c o n s c i o u s object-related p h a n t a s i e s constitute the cont e n t of t h e analytic t r a n s f e r e n c e - c o u n t e r t r a n s f e r e n c e experience. T h e analyst h a s n o m e a n s of u n d e r s t a n d i n g the p a t i e n t except t h r o u g h his o r h e r o w n emotionally colored p e r c e p t i o n s of a n d responses to t h e p a t i e n t . O f these p e r c e p t i o n s a n d responses, only a small p r o p o r t i o n a r e conscious, a n d it is therefore i m p e r a t i v e t h a t the analyst l e a r n to detect, r e a d , a n d m a k e u s e of his own shifting u n c o n s c i o u s state as it unfolds in t h e analytic discourse. F o r e x a m p l e , early in his analysis a p a t i e n t , M r . M . , w a s talking with a p p a r e n t l y great intensity of feeling a b o u t his affection for a n d loyalty to his wife, a n d the fulfillm e n t h e found in their sexual relationship. I h a d n o conscious reason for d o u b t i n g his sincerity. H o w e v e r , I Fantasying is a mental activity with conscious and dynamically unconscious dimensions. In this volume I use the term phantasy, spelled with aph, to denote the unconscious dimensions of this mental activity. Fantasy, spelled with an / is used to refer to the more conscious facets of this psychic activity, for example, daydreams, conscious childhood sexual theories, and conscious masturbatory narratives (cf. Isaacs, 1952).


17

n o t e d a passing t h o u g h t of m y own t h a t was as e p h e m e r a l as a d r e a m as it recedes while o n e is a w a k e n i n g . I m a d e a conscious a t t e m p t to struggle against t h e weight of repression in a n effort to r e c a p t u r e it. T h e t h o u g h t t h a t I w a s r e p r e s s i n g w a s infused with a s o m e w h a t s m u g pleas u r e in t h e self-protective p r i v a c y i n h e r e n t in the role of analyst vis-a-vis the a n a l y s a n d . I w a s feeling safe in this peculiar relationship in which only t h e patient's "dirty l a u n d r y " is "aired." M y t h o u g h t s t h e n w e n t to the question of w h a t dirty l a u n d r y I suspected I was p r e t e n d i n g to b e free of at t h a t m o m e n t . T h e s e questions h e l p e d a l e r t ^ m e ^ t o t h e possibility t h a t t h e p a t i e n t w a s a t t h e t i m e d i s a v o w i n g his a n x i e t y in relation to t h e ideas he was discussing. A s M r . M . ' s associations c o n t i n u e d , his fears c o n c e r n i n g his wife's genitals w e r e very subtly h i n t e d at as he discussed the sexual i n t e r c o u r s e t h e y h a d h a d t h e previous n i g h t . H e said t h a t he very m u c h enjoyed their l o v e m a k i n g in "complete darkness" a n d m e n t i o n e d in p a s s i n g that he h a d w a s h e d his p e n i s afterward. T h i s u s e of the intersubjective r e s o n a n c e of u n c o n scious processes o c c u r r i n g in individuals e x p e r i e n c i n g o n e a n o t h e r as subjects is p a r a d i g m a t i c of t h e unconsciousp r e c o n s c i o u s level of e m p a t h y in a depressive m o d e . T h i s process can be t h o u g h t of as involving the analyst's u n c o n s c i o u s projection of himself into the patient's u n conscious experience of himself a n d his internal objects; t h e analyst's u n c o n s c i o u s identification with the patient's u n c o n s c i o u s experience of himself a n d his internal objects; a n d t h e creation of a n u n c o n s c i o u s intersubjective t h i r d ("the O t h e r " [ L a c a n , 1953]) b e t w e e n the patient a n d analyst. H o w e v e r it is described, it is a p r o c e s s i n which t h e analyst m a k e s available to t h e p a t i e n t his own uncorir scious c h a i n of symbolic . m e a n i n g s , througlTjwKicli^he

18


a t t e m p t s to experience s o m e t h i n g similar to the u n c o n sciousêxperience of t h e p a t i e n t , b u t in a less intense w a y a n d in a less conflicted a n d less powerfully repressed o r split-off way. H a v i n g described a conception of t h e depressive m o d e of experience, it is necessary to reiterate t h a t n o s u c h e n t i t y exists; every facet of h u m a n e x p e r i e n c e is t h e o u t c o m e of a dialectic constituted by t h e interplay of depressive, p a r a n o i d - s c h i z o i d , a n d autistic-contiguous m o d e s . As will be discussed later, even s y m p t o m a t o l o g y g e n e r a t e d in response to a conflict of subjective desire (for e x a m p l e , conflicted. O e d i p a l desires, fears, a n d loyalties) is only partially c o n s t r u c t e d in a depressive m o d e . At this point, I will delineate features of e a c h of t h e o t h e r t w o poles of t h e dialectic of experience. A g a i n , for p u r p o s e s of clarity, this will b e d o n e as if each m o d e could be isolated from the o t h e r a n d viewed in its p u r e s t form.

Experience

in a Paranoid-Schizoid

Mode

T h e paranoid-schizoid position is M e l a n i e Klein's (1946, 1952a, 1957, 1958) c o n c e p t i o n of a psychological o r g a n i z a t i o n m o r e primitive t h a n t h e depressive position. K l e i n (1948) conceived of t h e p a r a n o i d - s c h i z o i d position as h a v i n g its origins in the first q u a r t e r of t h e first y e a r of life. A g a i n , the e m p h a s i s in this c h a p t e r will b e shifted from Klein's diachronic c o n c e p t i o n of a s e q u e n c e of s t r u c t u r e s o r d e v e l o p m e n t a l p h a s e s , to a consideration of t h e dialectical interplay of s y n c h r o n i c m o d e s . T h e paranoid-schizoid m o d e of g e n e r a t i n g experience is based heavily u p o n splitting.as_a„defense„and as a w a y of o r g a n i z i n g experience. W h e r e a s the depressive


19

m o d e operates p r e d o m i n a n d y ^ n j t h e service of c o n t a i n jrnejtfj3Jêxpenen^ p a i n , tHe p a r a n o i d - s c h i z o i d m o d e is m o r e evenly divided b e t w e e n efforts at m a n a g i n g psychic .pain and^ efforts at t h e e v a c u a t i o n of p a i n t h r o u g h t h e defensive use of o m n i p o t e n t t h i n k i n g , denial, a n d the creation of discontinuities of "experience. *"" I n a paranoid-schizoid m o d e , t h e experience of loving a n d h a t i n g the s a m e object generates intolerable a n x i e t y , w h i c h constitutes t h e principal psychological d i l e m m a to be m a n a g e d . T h i s p r o b l e m is h a n d l e d in l a r g e p a r t b y s e p a r a t i n g loving a n d h a t i n g facets of oneself f r o n f l o v i n g a n d h a t i n g facets of t h e object. O n l y in this w a y ' c a n t h e individual safely love t h e object, in a state of u n c o n t a m i n a t e d security,.and safely h a t e w i t h o u t t h e fear of d a m a g i n g theJoyed f t object. Splitting defensively r e n d e r s object-related experience of a given e m o t i o n a l valence (for e x a m p l e , t h e r e l a t i o n s h i p of a loving self .to a loving object) discontinu o u s from object-related experience of other valences (for e x a m p l e , t h e relationship of a h a t i n g self to a h a t i n g object). E a c h t i m e a good object is d i s a p p o i n t i n g , it is n o l o n g e r experienced as a good object — n o r even as a disappointing good object —but as t h e discovery of a b a d * object in w h a t h a d b e e n m a s q u e r a d i n g as a good o n e . « I n s t e a d of the experience of a m b i v a l e n c e , t h e r e is t h e e x p e r i e n c e of u n m a s k i n g the t r u t h . T h i s results i n _ a • c o n t i n u a l r e w r i t i n g of history such t h a t the p r e s e n t e x p e r i e n c e of the object is projected b a c k w a r d a n d forward in t i m e c r e a t i n g a n e t e r n a l p r e s e n t t h a t h a s only a superficial r e s e m b l a n c e to t i m e as experienced in a depressive mode. T h e defensive use of discontinuity of experience (splitting) is c o m m o n l y e n c o u n t e r e d in w o r k with p a t i e n t s

20


suffering from b o r d e r l i n e a n d s c h i z o p h r e n i c d i s o r d e r s . W h e n the p a t i e n t is d i s a p p o i n t e d , h u r t , a n g r y , j e a l o u s , a n d so o n , h e feels t h a t he sees with powerful clarity t h a t he h a s b e e n d u p e d by the analyst a n d t h a t he is finally perceiving t h e reality of the situation as it is a n d as it always has b e e n : " T h e fact of t h e m a t t e r is t h a t I've d e l u d e d myself a b o u t you for a l o n g t i m e . It is obvious to m e n o w t h a t you h a v e absolutely n o r e g a r d for m e , otherwise you wouldn't forget f u n d a m e n t a l things a b o u t m e like m y girlfriend's n a m e t h a t I've m e n t i o n e d a t h o u s a n d times." R e w r i t i n g of history leadsjto a brittleness a n d instability of object relations t h a t are in c o n t i n u a l states of reversal. T h e r e is n o stable, s h a r e d e x p e r i e n c e of t h e history of t h e p a t i e n t - a n a l y s t relationship t h a t c a n form a f r a m e w o r k a n d c o n t a i n e r for p r e s e n t experience. In this m o d e of experience t h e r e is a n almost c o n t i n u o u s backg r o u n d of a n x i e t y „ d e r i y i n g , f r p m , the fact t h a t then individual unconsciously feels as if he o r she is perpetually in u n c h a r t e d territory in_jthe p r e s e n c e ^ p f unpredictablestrangers. A n a l y t i c t h e o r y n e e d n o t a p p e a l to the concept of t h e d e a t h instinct to account for the anxiety o c c u r r i n g w i t h i n such a b r i t d e c o n t a i n e r for psychological experience. I n a p a r a n o i d - s c h i z o i d m o d e , t h e r e is virtually_no space b e t w e e n symbol a n d symbolized; the two are emotionally e q u i v a l e n t . T h i s m o d e of symbolization, t e r m e d symbolic equation (Segal, 1957), generates a twod i m e n s i o n a l form of experience in which e v e r y t h i n g is w h a t it is. T h e r e is almost no i n t e r p r e t i n g subject m e d i ating b e t w e e n t h e percept ( w h e t h e r external o r internal) a n d one's t h o u g h t s a n d feelings a b o u t t h a t which o n e is perceiving. T h e patient o p e r a t i n g in a p r e d o m i n a n t l y p a r a n o i d - s c h i z o i d m o d e m a y say, "You can't tell m e I


21

don't see w h a t I see." I n this m o d e , t h o u g h t s a n d f e e l i n g s a r e n o t experienced as personal creations b u t as facts, things-in-themselves, t h a t simply exist. P e r c e p t i o n a n d i n t e r p r e t a t i o n a r e experienced as o n e a n d t h e same. T h e patient is t r a p p e d in t h e manifest since surface a n d d e p t h a r e indistinguishable. T h a t w h i c h would' be viewed as i n t e r p r e t a t i o n from 1 the perspective of the depressive m o d e , would b e experienced in a p a r a n o i d - s c h i z o i d m o d e as a n a t t e m p t to "twist the facts," to distract, deceive, a n d confuse t h r o u g h the "use of psychological bullshit." , T r a n s f e r e n c e in a paranoid-schizoid m o d e h a s b e e n t e r m e d ^delusionaT (Little, 1958) o r "psychotic" (Searles, 1963) transference. T h e analyst is not experienced as similar to t h e o r i g i n a l ^ K i l d h l 5 o ^ " o S j e £ t " l i ^ objecY " F o r ' e x a m p l e , a therapist m a d e s o m e inquiries d u r i n g a t h e r a p y h o u r a b o u t t h e details of a physical c o m p l a i n t t h a t his p a t i e n t , A . , was discussing. T h e p a t i e n t e x p e r i e n c e d this as a n a n x i o u s , intrusive overreaction o n t h e p a r t o f the therapist t h a t led the patient to experience the therapist as h a v i n g become h e r m o t h e r (not simply as b e i n g like her m o t h e r ) . T h e following d a y the patient consulted h e r internist w h o later in b e w i l d e r m e n t called the therapist a n d said t h a t A . h a d i n t r o d u c e d herself b y saying, "I'm A.'s m o t h e r . I'm v e r y worried a b o u t A.'s illness a n d w o u l d like to ask you some questions a b o u t it." I n this way, the p a t i e n t b e c a m e h e r therapist-mother and enacted the overanxiousness and intrusiveness of the t h e r a p i s t - m o t h e r . I n t h e a b s e n c e , of t h e x a p a c i t y to m e d i a t e b e t w e e n oneself a n d one's experience, a very limited,, i b r m _ of subjectivity is g e n e r a t e d . I n a p a r a n o i d - s c h i z o i d m o d e , Mlc the self is p r e d o m i n a n t l y a self as object, a self t h a t is buffeted by t h o u g h t s , feelings, a n d p e r c e p t i o n s as if they were e x t e r n a l forces or physical objects o c c u p y i n g o r

^' v

22


b o m b a r d i n g oneself. A n adolescent schizophrenic patient w o u l d violently t u r n his h e a d in o r d e r to "shake" (get rid of) a t h o u g h t t h a t w a s t o r m e n t i n g h i m . A n o t h e r schizop h r e n i c p a t i e n t r e q u e s t e d a n X - r a y film in o r d e r to be able to see w h a t it was inside of h i m t h a t w a s d r i v i n g h i m c r a z y . Still a n o t h e r patient "took a b i g shit" in the therapist's w a i t i n g r o o m toilet before each session in o r d e r n o t to h a r m t h e therapist with his toxic i n n e r contents d u r i n g t h e session. W h e n w o r k i n g with p a t i e n t s g e n e r a t i n g experience in a p r e d o m i n a n t l y paranoid-schizoid m o d e , o n e m u s t couch one's i n t e r v e n t i o n s in l a n g u a g e t h a t reflects the concreteness of the patient's experience; otherwise, p a tient a n d analyst h a v e t h e experience of talking in a w a y t h a t , in the w o r d s of o n e such p a t i e n t , "completely misses o n e a n o t h e r . " O n e does not talk a b o u t t h e patient's feeling t h a t h e is like a robot, o n e talks w i t h t h e patient a b o u t w h a t it feels like to be a robot; o n e does n o t talk with the p a t i e n t a b o u t his feeling that h e is infatuated with a . w o m a n , o n e talks with h i m a b o u t w h a t he feels w h e n he ' ^ / ^ e l i e v e s he is possessed o r h a u n t e d b y a w o m a n ; o n e does n o t talk a b o u t the patient's wish to be u n d e r s t o o d by the t h e r a p i s t , o n e talks a b o u t the patient's conviction t h a t t h e therapist —if he is to b e of a n y value at all to t h e patient— m u s t t h i n k the patient's t h o u g h t s a n d feel the patient's feelings. Psychological defense in a p a r a n o i d - s c h i z o i d m o d e is b a s e d in large p a r t on t h e principle t h a t o n e secures safety by s e p a r a t i n g t h e e n d a n g e r e d f r o m - t h e e n d a n g e r i n g (cf. G r o t s t e i n , 1985). T h i s is the psychological m e a n i n g of splitting,-.All defenses in a p a r a n o i d - s c h i z o i d m o d e a r e derived from this principle; for e x a m p l e , projection is a n effort to place a n e n d a n g e r i n g (or e n d a n g e r e d ) aspect of self o r object outside of the self while r e t a i n i n g the


23

e n d a n g e r e d (or e n d a n g e r i n g ) aspect of self or object w i t h i n . T h e o t h e r defenses in this m o d e of g e n e r a t i n g e x p e r i e n c e —introjection, projective identification, denial, a n d idealization — c a n b e seen as v a r i a t i o n s o n this theme. T h e p a r a n o i d - s c h i z o i d m o d e is c h a r a c t e r i z e d by o m n i p o t e n t t h i n k i n g t h r o u g h w h i c h the e m o t i o n a l complexities of loving a n d h a t i n g a r e magically "resolved," o r — m o r e a c c u r a t e l y — p r e c l u d e d from psychic reality. I n this m o d e , guilt (as it exists in a depressive m o d e ) , simply does n o t arise; it has n o place in t h e e m o t i o n a l v o c a b u l a r y of this m o r e primitive m o d e . Since one's objects, like oneself, are perceived in this m o d e as objects r a t h e r t h a n as subjects, o n e c a n n o t c a r e a b o u t t h e m o r h a v e concern for t h e m . 4 T h e r e is little to e m p a t h i z e with since one's objects a r e n o t experienced as people w i t h t h o u g h t s a n d feelings, b u t r a t h e r as loved, h a t e d , or feared forces o r things t h a t i m p i n g e o n oneself. O t h e r ( people c a n be v a l u e d for w h a t they can do for o n e , b u t o n e does n o t h a v e concern for t h e m —as one does n o t h a v e c o n c e r n for one's possessions, even t h e most i m p o r t a n t of t h e m . As described earlier, an object can b e d a m a g e d or used u p , b u t only a subject c a n be h u r t o r injured. In a paranoid-schizoid mode, what might become a feeling of "guilt", is dissipated t h r o u g h , i b r e x a m p l e , the use of o m n i p o t e n t r e p a r a t i v e p h a n t a s i e s . T h e injury to the object is d e n i e d t h r o u g h the use of a magical r e m e d y 4

Because the paranoid-schizoid mode never exists in isolation from the depressive mode (and the autistic-contiguous mode), the concept of the self-as-object (completely dissociated from the experience of self as subject) is phenomenologically meaningless. Due to the dialectical structure of experience, self-experience is never completely devoid of a sense of "I-ness," and one's objects are never simply objects altogether devoid of subjectivity.

24

-I

1


t h a t is i n t e n d e d to e x p u n g e from history t h e h a r m t h a t o n e h a s d o n e . H i s t o r y isTewritten a n d t h e n e e d foFgiiilt is t h e r e b y o b v i a t e d . F o r instance, a p a t i e n t o p e r a t i n g heavily in a paranoid-schizoid r n o a e often would l a u g h a n d say t h a t h e was only k i d d i n g after h a v i n g said s o m e t h i n g extremely cruel to his wife. H a v i n g said, "You k n o w I was o n l y k i d d i n g , " he felt t h a t h e h a d u n d o n e the d a m a g e b y magically c h a n g i n g the assault into s o m e t h i n g h u m o r o u s (by r e - n a m i n g it). W h e n his wife refused to p a r t i c i p a t e in this magical r e w r i t i n g of history, the p a t i e n t would escalate his efforts at joviality a n d begin to treat h e r with c o n t e m p t , accusing h e r of b e i n g a b a b y for n o t b e i n g able to "take it." T h i s a t t e m p t to m a k e use of p a r a n o i d - s c h i z o i d defenses (magical r e p a r a t i o n , denial, a n d r e w r i t i n g of history) for t h e p u r p o s e of w a r d i n g off depressive anxiety (guilt a n d , t h e fear of the loss of the object d u e to one's destructiveness) constitutes a m a n i c defense. L o e w a l d (1979) h a s described the way in which self-punishment c a n be similarly used to dissipate feelings t h a t t h r e a t e n to b e c o m e a n e x p e r i e n c e of guilt. I n this case, one uses a n o m n i p o t e n t p h a n t a s y t h a t the self-punishment eradicates t h e p r e s e n t a n d past existence of t h e c r i m e a n d therefore t h e r e is n o r e a s o n ^ o feel guilty.

Similarly, in a paranoid-schizoid m o d e o n e does n o t miss a lost o r a b s e n t object; o n e denies t h e loss, shortcircuits the feeling of sadness, a n d replaces the object ( p e r s o n ) with a n o t h e r person o r with oneself. Since t h e h e w p e r s o n o r aspect of self is e m o t i o n a l l y e q u i v a l e n t to the lost object, n o t h i n g h a s c h a n g e d ; t h e r e is n o n e e d to m o u r n w h a t is still present (cf. Searles, 1982). F o r e x a m p l e , a p a t i e n t explained t h a t m y v a c a t i o n t u r n e d out T J *i p to be a "blessing in disguise" since he h a d l e a r n e d t h r o u g h • * .fV* it that hh ee was WAS ntint nparl» so c-. dJ«e p e n d] e- n-'t on m e as I h a d led it that o t nearly •h


25

h i m to believe. I n this case, a n aspect of self was used to magically replace the a b s e n t object. In m y w o r k with this p a t i e n t , each of m y absences was regularly followed b y a n e n a c t m e n t of m a n i c defenses of v a r i o u s forms, such as t h r e a t e n e d d i s r u p t i o n s of t r e a t m e n t (which h e "no l o n g e r needed") o r g r u d g i n g a g r e e m e n t to c o n t i n u e analysis "if that's w h a t you t h i n k is best." Object relatedness in a p a r a n o i d - s c h i z o i d m o d e is p r e d o m i n a n t l y in the form of projective identification ( G r o t s t e i n , 1981; Klein, 1946; O g d e n , 1979, 1982b). T h i s psychological-interpersonal process reflects m a n y of t h e o t h e r facets of the p a r a n o i d - s c h i z o i d m o d e discussed t h u s far. It is b a s e d on t h e o m n i p o t e n t p h a n t a s y t h a t a n *> aspect of self (which is either e n d a n g e r e d o r e n d a n g e r i n g ) c a n b e placed in a n o t h e r person in such a w a y t h a t "the recipient" is controlled from w i t h i n (Klein, 1955). I n this way, o n e safeguards a n e n d a n g e r e d aspect of self, a n d at the s a m e t i m e a t t e m p t s to o m n i p o t e n d y c o n t r o l a n object relation ship b y t r e a t i n g t h e object as a n incompletely s e p a r a t e c o n t a i n e r for aspects of oneself. T h i s facet of t h e process of projective identification involves a n eyacuative m e t h o d of m a n a g i n g psychological strain. I n projective identification, the projector—by m e a n s of actual interpersonal interactions with t h e "recipients—unconsciously induces feeling states in the recipient t h a t a r e c o n g r u e n t with the "ejected".feelings. I n a d d i t i o n to s e r v i n g defensive p u r p o s e s , this constitutes a f u n d a m e n t a l form of c o m m u n i c a t i o n jand object ^ e l a t e d ness. T h e recipient of t h e projective identification c a n s o m e t i m e s retrospectively b e c o m e a w a r e that he is "playing a p a r t . . . in s o m e b o d y else's p h a n t a s y " (Bion, 1959a, p. 149). Projective identification is a "direct c o m m u n i c a t i o n " ( W i n n i c o t t , 1971c, p. 54) in t h a t it is u n m e d i a t e d b y i n t e r p r e t i n g subjects; i n s t e a d , it is pre-

26


d o m i n a n t l y a c o m m u n i c a t i o n b e t w e e n t h e unconscious of o n e p e r s o n a n d t h a t of a n o t h e r . F o r this r e a s o n , it is often experienced b y the recipient as coercive. T h e r e is n o choice: o n e not only finds oneself p l a y i n g a role in s o m e o n e else's internal d r a m a , o n e feels u n a b l e to stop d o i n g so. T h e recipient feels controlled from within. If h e is able to c o n t a i n the i n d u c e d feelings without simply d u m p i n g t h e m back into the projector, a shift in the relationship between the projector a n d the recipient c a n o c c u r that leads to psychological g r o w t h . T h e "processing" of a projective identification by the recipient is not simply a m a t t e r of r e t u r n i n g modified psychological contents to the projector. R a t h e r , it is a m a t t e r of altering t h e intersubjective m o d e of c o n t a i n m e n t g e n e r a t e d by the | i n t e r a c t i n g p a i r , t h u s g e n e r a t i n g a n e w way of experie n c i n g the old psychological c o n t e n t s . It is n o t so m u c h t h a t psychological c o n t e n d are^modifiedj it is, t h e intersubjective context of those contents t h a t is modified. T h i s ' c o n c e p t i o n of psychological c h a n g e is not limited to the u n d e r s t a n d i n g of projective identification. R a t h e r , what we h a v e arrived at in t h e course of this discussion is a basic principle of all psychological g r o w t h , J n c l u d i n g t h a t which occurs in t h e analytic process. / Psychological growth occurs n o t simply as a result of the modification of unconscious psychological contents; in a d d i t i o n , w h a t changes is the experiential context (the n a t u r e of the c o n t a i n m e n t of t h e psychological contents). U n c o n s c i o u s p h a n t a s y is timeless a n d is n e v e r destroyed ( F r e u d , 1911a). It is therefore m i s l e a d i n g to talk a b o u t the e r a d i c a t i o n of a n unconscious p h a n t a s y since t h a t implies t h a t t h e old p h a n t a s y is destroyed o r replaced by

f

a n e w one. [It is not the unconscious p h a n t a s y t h a t is destroyed o r replaced; r a t h e r , t h e p h a n t a s y j s . e x p e r i e n c e d


27

differently d u e to a. shift in the^jMychgtogica^ m a t r i x I within whichjt,exists. „J T h e idea t h a t it is not only c o n t e n t b u t context t h a t s

i l l £ t ^ t L P s ^ ^ , 6 S ^ c ^ " S . r 9 ^ S l ^ s i 1 £ ^ e f f * n ^ y articulated by a schizophrenic patient w h e n asked if he still h a d his h a l l u c i n a t o r y voices. H e replied, " O h yes, they're still t h e r e , t h e y j u s t don't talk a n y m o r e . " Similarly, in t h e course of analysis, o n e does n o t destroy t h e t h o u g h t s a n d feelings constituting the O e d i p u s c o m p l e x (Loewald, 1979); instead one experiences t h e c o m p o n e n t objectrelated feelings differently. A p a t i e n t , M r . K . , said in small bits o v e r the course of his fourth y e a r of analysis, "I a m still a w a r e that w h e n I a m with w o m e n teachers I could b e c o m e extremely a n x i o u s if I w e r e to allow myself to e x p e r i e n c e t h e m (as I used to) as m o t h e r s w h o m I a m afraid of h a v i n g sexual feelings a n d fantasies a b o u t . B u t I d o h a v e s o m e choice in t h e m a t t e r n o w a n d I realize t h a t t h e r e was s o m e pleasure a n d e x c i t e m e n t in i m a g i n i n g t h a t I could b e sufficiently special ( m o r e special t h a n m y father a n d b r o t h e r s ) to get m y m o t h e r to stop b e i n g a m o t h e r a n d start b e i n g a wife to m e . " W h a t h a d b e e n achieved b y this patient was n o t simply a c h a n g e in the c o n t e n t of his unconscious p h a n t a s y . T h e O e d i p u s complex h a d n o t b e e n "destroyed" o r "overcome." R a t h e r , t h e psychological context for t h e e x p e r i e n c i n g of his O e d i p a l wishes a n d fears h a d u n d e r g o n e c h a n g e . Previously, the set of u n c o n s c i o u s O e d i p a l desires a n d p r o h i b i t i o n s h a d b e e n c h a r a c t e r i z e d by powerful concreteness a n d i m m e d i a c y . M r . K . initially said t h a t he h a d n o idea w h y he h a d anxiety "attacks" w h e n talking with w o m e n t e a c h e r s . / "It is s o m e t h i n g t h a t j u s t h a p p e n s to m e a n d t h e r e is n o r e a s o n for it. I k n o w t h e r e is n o real d a n g e r . T h e anxiety . j u s t goes t h r o u g h m e like electricity." As a result, t h e

,

28


p a t i e n t h a d developed compulsive study habits in a n effort to b e c o m e a perfect s t u d e n t , a n d he b e c a m e terribly a n x i o u s before e x a m s even t h o u g h he h a d p r e p a r e d in a w a y that he recognized to be "overkill." O e d i p a l feelings a n d p h a n t a s i e s a r e always generated in p a r t in a depressive m o d e . T h e O e d i p a l d i l e m m a would h a v e n o p o w e r o r p o i g n a n c y if it were n o t the p r o b l e m of a subject (for e x a m p l e , the boy) w h o hates — a n d t h u s wishes to be forever rid of—the s a m e father he loves. I n o t h e r words, it is a d i l e m m a rooted in subjectivity, whole object relations, a m b i v a l e n c e , a n d historicity. H o w e v e r , i m p o r t a n t facets of this unconscious conflict a n d its r e s u l t a n t s y m p t o m a t o l o g y ( a n x i e t y attacks for e x a m p l e ) a r e experienced largely in a p a r a n o i d - s c h i z o i d m o d e . For e x a m p l e , M r . K . initially experienced his anxiety attacks not as a form of, o r reaction to, his feelings a n d fearful thoughts, b u t as a force s w e e p i n g over h i m t h a t frightened h i m . T h e patient's female teachers w e r e unconsciously experienced as not simply like his m o t h e r , b u t the same as his m o t h e r ; otherwise t h e full p o w e r of the incestuous d a n g e r would n o t h a v e p r e s e n t e d itself in such a concrete w a y . ( D r e a m m a t e r i a l in this p h a s e of analysis included the frightening shifting b a c k a n d forth of the identity of older w o m e n figures, which resulted in a feeling on t h e p a r t of M r . K . t h a t h e "didn't k n o w w h o was who.") T h e p a t i e n t w a s clearly n o t psychotic; b u t the transference to his female teachers was s i m u l t a n e o u s l y experienced in b o t h p a r a n o i d - s c h i z o i d a n d depressive m o d e s with a t e n d e n c y for t h e dialectical interplay b e t w e e n the two to "collapse" in t h e direction of the p a r a n o i d - s c h i z o i d m o d e d u r i n g anxiety attacks ( O g d e n , 1985b). I n his attacks of a n x i e t y , t h e r e was very little of a subject m e d i a t i n g between the p a t i e n t a n d the terrifying t h i n g h a p p e n i n g to h i m .


29

F r o m this point of view, psychoanalysis is a m e t h o d X of t r e a t m e n t designed n o t only to help t h e patient modify u n c o n s c i o u s p h a n t a s y c o n t e n t , b u t also, a process a i m e d at h e l p i n g t h e patient to experience unconscious c o n t e n t differently^ T h a t is, psychoanalysis is a process d i r e c t e d , at h e l p i n g t h e patient shift the b a l a n c e of t h e dialectical i n t e r p l a y b e t w e e n different m o d e s of g e n e r a t i n g experience in relation to specific u n c o n s c i o u s contents. W h a t m u s t h a p p e n in analysis is n o t a simple translation of psychological contents from o n e m o d e to a n o t h e r . T h e t h e r a p e u t i c process as I u n d e r s t a n d it involves t h e establ i s h m e n t , r e e s t a b l i s h m e n t , or e x p a n s i o n of a dialectical relationship b e t w e e n different m o d e s of experience. ' Before closing this section, I w o u l d like to briefly c o m m e n t o n t h e t e n d e n c y a m o n g analytic thinkers, in- J c l u d i n g K l e i n herself, to valorize t h e depressive m o d e a n d villainize t h e paranoid-schizoid m o d e . As Eigen (1985) h a s p o i n t e d o u t , the depressive m o d e is too often viewed as t h e full realization of the h u m a n potential. I n the depressive m o d e , it is held t h a t t h e i n d i v i d u a l develops the capacity for abstract symbolization, subjectivity a n d self-reflection, c o n c e r n for others, guilt, a n d r e p a r a t i v e wishes, all of which lead to c u l t u r a l p r o d u c t i o n . O n t h e o t h e r h a n d , t h e paranoid-schizoid m o d e is u n d e r s t o o d as g e n e r a t i n g a psychological state in which the individual relies on splitting a n d projective identification for the p u r p o s e of e v a c u a t i n g feelings a n d d e n y i n g reality. H o w ever, such a depiction of these m o d e s is based on a d i a c h r o n i c conception of the relationship b e t w e e n t h e two, a n d fails to a p p r e c i a t e t h e f u n d a m e n t a l dialectical n a t u r e of their relationship. T h e paranoid-schizoid m o d e a n d t h e depressive m o d e serve as essential n e g a t i n g a n d p r e s e r v i n g contexts for o n e a n o t h e r . T h e depressive m o d e is o n e of integration, resolution, a n d c o n t a i n m e n t ,

30


a n d if u n o p p o s e d , leads to c e r t a i n t y , s t a g n a t i o n , closure, a r r o g a n c e , a n d d e a d n e s s (Bion, 1962, 1963; Eigen, 1985). T h e p a r a n o i d - s c h i z o i d m o d e p r o v i d e s the necessary splitting of linkages a n d o p e n i n g u p of the closures of the depressive position, t h u s . r e e s t a b l i s h i n g the possibility of fresh linkages a n d fresh t h o u g h t s . T h e integrative t h r u s t of the depressive m o d e in t u r n provides t h e necessary antithesis for the p a r a n o i d - s c h i z o i d m o d e in l i m i t i n g the chaos g e n e r a t e d by t h e f r a g m e n t a t i o n of t h o u g h t , t h e discontinuity of e x p e r i e n c e , a n d the splitting of self a n d object.

The Autistic-Contiguous of Generating

Mode Experience

T h e c o n c e p t i o n s of the p a r a n o i d - s c h i z o i d a n d depressive m o d e s discussed t h u s far r e p r e s e n t ideas derived p r e d o m i n a n t l y from t h e work of Klein a n d Bion. T h e conception of a dialectic of experience constituted exclusively by these two m o d e s is incomplete, insofar as it fails to recognize a n e v e n m o r e p r i m i t i v e p r e s y m b o l i c , sensoryd o m i n a t e d m o d e t h a t I will refer to as the autisticcontiguous mode. T h e conception of a n autistic-contiguous pole of the dialectic of experience r e p r e s e n t s a n integration, i n t e r p r e t a t i o n , a n d extension of aspects of t h e w o r k of Bick (1968, 1986); M e l t z e r ( M e l t z e r 1975, 1986; M e l t z e r et al., 1975); a n d T u s t i n (1972, 1980, 1981, 1984, 1986). E a c h of these a u t h o r s was strongly influenced b y Bion's (1962, 1963) conception of the c o n t a i n e r a n d the c o n t a i n e d , as well as b y his t h e o r y of t h i n k i n g . I n this c h a p t e r , space allows for only a brief i n t r o d u c t i o n to a discussion of this m o d e of experience. ( I n C h a p t e r 3,


31

t h e concept of a n autistic-contiguous position will b e discussed in detail.) T h e autistic-contiguous position is a primitive psychological o r g a n i z a t i o n o p e r a t i v e from b i r t h t h a t generates the most e l e m e n t a l forms of h u m a n experience. It is a s e n s o r y - d o m i n a t e d . m o d e jnjyyhich,the__mostînchoate sense of self is built u p o n t h e r h y t h m of sensation ( T u s t i n , 1984), particularly t h e sensations .at the skin surface (Bick, 1968). T h e autistic-contiguous m o d e 6 of

5

The autistic-contiguous position is conceptualized in this book not as a prepsychological (biological) phase of development in which the infant lives in a world cut off from dynamic relations with external objects; rather, it is conceived of as a^psychological organization in S which sensory modes^f^geperatmg_experience are organized into defensive processes-in the-face'* of -perceived danger. Under circumstances of extreme, protracted anxiety, these defenses become hypertrophied and rigidified and come to constitute a pathologically autistic psychological structure. The development of a normal autisticcontiguous organization can occur only within the unfolding relationship with the mother as environment and the mother as object (cf. Winnicott, 1963a). 6

I have termed the most primitive of the modes of experience the autistic-contiguous mode in order to roughly parallel the method of naming the paranoid-schizoid mode, which takes its name from both the form of psychological organization and the form of defense associated with it. In the autistic-contiguous mode, psychic organization is derived in large part from sensory contiguity, that is, connections are established through the experience of sensory surfaces "touching" one another. Breakdown of this organization leads to the implementation of autistic defenses that are described in this book. It must be borne in mind throughout the book that the term autistic is being used to refer to specific features of a universal sensory-dominated mode of experience, and not to a form of severe childhood psychopathology. It would be as absurd to view infants or adults as being pathologically autistic while relying heavily on an

32


e x p e r i e n c i n g is a p r e s y m b o l i c , sensory m o d e a n d is therefore extremely difficult to c a p t u r e in words. R h y t h m i c i t y a n d experiences of sensory contiguity c o n t r i b u t e to t h e earliest psychological o r g a n i z a t i o n in this m o d e . Both r h y t h m i c i t y a n d experiences of surface contiguity a r e f u n d a m e n t a l to a person's earliest relations with objects: t h e n u r s i n g experience a n d the e x p e r i e n c e of b e i n g held, r o c k e d , spoken to a n d s u n g to in his m o t h e r ' s a r m s . T h e s e experiences a r e "object-related" in a very specific a n d 'very limited sense of t h e w o r d . IThe relationship to t h e object in this m o d e is certainly n o t a relationship b e t w e e n isubjects, as in a depressive m o d e ; n o r is it a relationship 'between objects, as in a p a r a n o i d - s c h i z o i d m o d e . R a t h e r , it is a r e l a t i o n s h i p of s h a p e to t h e feeling of enclosure, of b e a t to the feeling of r h y t h m , of h a r d n e s s to the feeling of Jejdgedness J Sequences, s y m m e t r i e s , ^periodicity, skinto-skin "molding" are all e x a m p l e s of contiguities t h a t a r e t h e ingredients o u t of which t h e b e g i n n i n g s of r u d i m e n t a r y self-experience arise. T h e e x p e r i e n c e of "self at this point is simply that of a nonretlective state ol sensory "going on b e i n g " ( W i n n i c o t t , 1956, p. 303) derived from "body needs" which only "gradually b e c o m e ego n e e d s as a psychology gradually e m e r g e s o u t of the [ m o t h e r - i n fant's] i m a g i n a t i v e e l a b o r a t i o n of physical experience" (p. 304).7 autistic-contiguous mode of generating experience, as it would be to think of them as being paranoid-schizophrenics while organizing experience in a paranoid-schizoid mode, or as being depressed while operating in a predominantly depressive mode. 7

Stern (1985), from a psychoanalytic developmental-observational vantage point, states, "Infants [from birth] . . . take sensations, perceptions, actions, cognitions, internal states of motivation and states of (non-self-reflective) consciousness and experience them directly in terms of intensities, shapes, temporal patterns, vitality


33

E a r l y experiences of sensory contiguity define a surface (the b e g i n n i n g s of w h a t will b e c o m e a sense of place) on which experience is created a n d o r g a n i z e d . T h e s e sensory experiences with "objects" (which only a n outside observer would be a w a r e of as objects) a r e the m e d i a t h r o u g h which the earliest forms of o r g a n i z e d a n d o r g a n i z i n g experience a r e c r e a t e d . C o n t i g u i t y of surfaces ( e . g . , "molded" skin surfaces, h a r m o n i c s o u n d s , r h y t h m i c r o c k i n g or sucking, s y m m e t rical shapes) generate the experience of a sensory surface r a t h e r t h a n the feeling of two surfaces c o m i n g t o g e t h e r either in m u t u a l l y differentiating opposition o r in m e r g e r . T h e r e is practically n o sense of inside a n d outside o r self a n d o t h e r ; r a t h e r , w h a t is i m p o r t a n t is the p a t t e r n , b o u n d e d n e s s , shape, r h y t h m , t e x t u r e , h a r d n e s s , softness, w a r m t h , coldness, a n d so on. A 29-year-old p a t i e n t , M r s . L . , c a m e to a n analytic h o u r after h a v i n g j u s t spent t i m e with h e r m o t h e r l a n d felt, for reasons that she "could n o t p u t h e r finger o n , " as if she were in a state of such severe anxiety a n d diffuse tension t h a t t h e only w a y to e n d the state of t e n s i o n would be to cut herself with a r a z o r all over h e r b o d y . It h a d taken great effort o n h e r p a r t to c o m e to the session instead of c u t t i n g herself as she h a d d o n e in t h e p a s t . T h e patient cried u n c o n t r o l l a b l y d u r i n g t h e h o u r . J i n t e r p r e t e d as m u c h of t h e situation as I t h o u g h t I u n d e r s t o o d o n t h e basis of w h a t I knew a b o u t t h e patient's relationship to h e r m o t h e r a n d the connection b e t w e e n these feelings a n d the t r a n s f e r e n c e - c o u n affects, categorical affects, and hedonic tones" (p. 67). This earliest mode of experience operates throughout life "out of awareness as the experiential matrix" (p. 67) for all succeeding subjective states.

34


tertransference anxieties of the previous few sessions. M r s . L. said that she felt as if she w e r e " c o m i n g a p a r t at the s e a m s . " I said t h a t I t h o u g h t she w a s feeling as if she were c o m i n g a p a r t in the m o s t literal way, a n d t h a t she felt as'if h e r skin were a l r e a d y lacerated in the w a y she h a d i m a g i n e d lacerating herself. It was late in the afternoon a n d getting cold in t h e office. I said, "It's cold in h e r e , " a n d got u p to t u r n o n the h e a t e r . She said, "It is," a n d seemed to calm d o w n soon after t h a t . She said t h a t for r e a s o n s t h a t she did n o t u n d e r s t a n d she h a d b e e n e x t r e m e l y "touched" b y m y saying t h a t it was cold a n d b y t u r n i n g the h e a t e r o n : "It w a s such a n o r d i n a r y t h i n g to say a n d d o . " \ £ believe t h a t m y p u t t i n g t h e h e a t e r on acknowledged a s h a r e d experience of the g r o w i n g coldness in the air a n d c o n t r i b u t e d to the creation of a sensory surface [^between u s j l was u s i n g m y o w n feelings a n d sensations in a largely unconscious " o r d i n a r y way" ( p e r h a p s like "an o r d i n a r y devoted m o t h e r " [ W i n n i c o t t , 1949]) which felt to the p a t i e n t as if I h a d physically t o u c h e d h e r a n d held h e r together. T h e sensory surface m u t u ally created in that w a y w a s t h e opposite of t h e e x p e r i e n c e of "coming a p a r t at the seams"; it facilitated a m e n d i n g of h e r psychological-sensory surface w h i c h felt as if it h a d b e e n s h r e d d e d in the course of t h e patient's interaction with her m o t h e r . T h i s sensory "holding" ( W i n n i c o t t , 1960a) d i m e n sion of the analytic relationship a n d setting operated in conjunction with the b i n d i n g p o w e r of symbolic interpretation (formulated on t h e basis of t h e intersubjectivity of the t r a n s f e r e n c e - c o u n t e r t r a n s f e r e n c e ) . C l e a r l y , t h e experience j u s t p r e s e n t e d was not a n e x a m p l e of " p u r e a n d u n d i l u t e d " experience in a n autistic-


35

c o n t i g u o u s m o d e . As is always t h e case, the autisticc o n t i g u o u s m o d e "borrows from" ( i n t e r p e n e t r a t e s with) t h e paranoid-schizoid m o d e in the creation of p h a n t a s y r e p r e s e n t a t i o n s for s e n s o r y - d o m i n a t e d experience, as well as b o r r o w i n g u p o n features of a depressive m o d e inc l u d i n g elements of subjectivity, historicity, a n d symbolization p r o p e r . T h e r e is a crucial distinction b e t w e e n a p u r e l y physiological reflex arc a n d experience in a n autisticc o n t i g u o u s m o d e despite the fact t h a t b o t h can be described in n o n s y m b o l i c , bodily t e r m s . A l t h o u g h the physiological reflex h a s a locus (from a n outside observer's point of view), a locus is different from t h e b e g i n n i n g s of a sense of a place in which experience is occurring; t h e physiological reflex m a y to a n o b s e r v e r h a v e periodicity, b u t periodicity is different from t h e feeling of r h y t h m ; t h e physiological reflex m a y h a v e a t e m p o r a l a n d spatial b e g i n n i n g a n d e n d , b u t t h a t is n o t t h e s a m e as a feeling of b o u n d e d n e s s . T h e r u d i m e n t s of the sensory experience of self in a n autistic-contiguous m o d e h a v e n o t h i n g to d o with t h e r e p r e s e n t a t i o n of one's affective states, either idiographically o r fully symbolically. T h e . s e n s o r y experience is t h e infant in this m o d e , a n d the a b r u p t d i s r u p tion jpjf^shape, s y m m e t r y " r h y t h m , skin m o l d e d n e s s , a n d so on^ m a r k s the e n d of t h e infant. T u s t i n (1984) a t t e m p t e d ' t o c o m m u n i c a t e the n a t u r e of experience at the infant's skin surface by asking us to try to experience the c h a i r we are sitting o n n o t as a n object, b u t simply as a sensory impression on o u r skin: "Forget yoUr chair. I n s t e a d , feel y o u r seat pressing against the seat of t h e chair. It will m a k e a 'shape.' If you wriggle, t h e s h a p e will c h a n g e . T h o s e 'shapes' will b e entirely personal to you" ( p p . 2 8 1 - 2 8 2 ) . In t h e autisticc o n t i g u o u s m o d e , t h e r e is n e i t h e r a chair n o r one's

36


b u t t o c k s , simply a sensory "impression" in the most literal sense of the w o r d . T u s t i n describes two sorts of sensory impressions constituting n o r m a l early experience: soft impressions which she t e r m s autistic shapes (1984) a n d h a r d a n g u l a r impressions which she t e r m s autistic objects (1980). T h e difference between these experiences of sensory surface constitutes forms of definition of experiental {content within this m o d e . ^ g x p e r i e n c e of a n autistic shape lis t h e feeling of softness that m u c h later we associate with / i d e a s like security, safety, relaxation, w a r m t h , a n d affection. T h e w o r d s t h a t seem to m e to b e closest to t h e sensory level of the experience a r e t h e w o r d s soothing a n d comforting. It is n o t a m a t t e r of m o t h e r c o m f o r t i n g m e —it l i s simply a soothing sensory experience. A r e l a t i o n s h i p to a n autistic s h a p e is different from a relationship to a transitional object ( W i n n i c o t t , 1951) in t h a t the "otherness" of t h e autistic s h a p e is of almost n o [significance.An transitional p h e n o m e n a , t h e experience centers on t h e p a r a d o x that the object is at t h e s a m e t i m e created a n d discovered by the subject, a n d t h a t therefore the object always has o n e foot in the w o r l d outside of the (individual's o m n i p o t e n c e ) T h i s is clearly n o t the case in relationships to autistic shapes a n d objects. M r . R . b e g a n analysis a n d found to his great distress t h a t he literally could not t h i n k of a n y t h i n g to say. H e felt utterly b l a n k a n d e m p t y . H e h a d looked forward to the b e g i n n i n g of analysis b u t found t h e analytic experience terrifying. H e h a d expected to b e able to talk w i t h o u t difficulty. M r . R . unconsciously m a n a g e d to create a sensory base for himself b y filling w h a t he later called t h e "holes" b o t h in himself (his inability to t h i n k o r talk), a n d in the analytic relationship (which h e experienced as nonexistent), b y focusing intently on a


37

r e c t a n g u l a r shape t h a t he d i s c e r n e d in t h e p a t t e r n of lines a n d t e x t u r e on the ceiling a b o v e t h e couch. T h e s e "holes" w e r e s u b s e q u e n t l y u n d e r s t o o d in p a r t as derivatives of the patient's early e x p e r i e n c e of t h e "holes" in i 5 * 3 . t h e early m o t h e r - i n f a n t r e l a t i o n s h i p associated with his m o t h e r ' s p r o f o u n d p o s t p a r t u m depression for which she w a s briefly hospitalized. S h e told h i m d u r i n g t h e course of t h e analysis t h a t she h a d held h i m as a b a b y only w h e n "absolutely necessary." H e h a d b e e n allowed t o cry in his crib for h o u r s on e n d while his m o t h e r hid in h e r r o o m . I n c o n t r a s t , the experience of a n autistic object is t h e feeling of a h a r d , a n g u l a r i m p r e s s i o n u p o n t h e skin t h a t is e x p e r i e n c e d as if it w e r e a h a r d shell-like quality of t h e skin. It is associated with t h e m o s t diffuse sense of d a n g e r , a n d with w h a t m a y b e r e p r e s e n t e d in a p a r a n o i d schizoid m o d e b y p h a n t a s i e s of a h a r d shell formed by t h e skin surface to be u s e d as a protective a r m o r . M r s . M . , a 35-year old a t t o r n e y , d e v e l o p e d — d u r i n g a n a c u t e regressive p h a s e of t r e a t m e n t —an e x t r e m e m u s c u l a r rigidity t h a t led to c r a m p i n g of h e r muscles, p a r t i c u l a r l y in t h e neck. She w o u l d frequently m a s s a g e h e r c r a m p e d muscles d u r i n g t h e sessions. T h e s e s y m p t o m s clearly h a d features r e s e m b l i n g a catatonic state w h e r e i n defense against u n c o n s c i o u s a n g e r is usually central. H o w e v e r , the c u r r e n t t r a n s f e r e n c e - c o u n t e r transference experience in this case did not c e n t e r a r o u n d t h e patient's fears of h e r destructiveness in relation to herself or to m e . R a t h e r , the m a t e r i a l j u s t p r i o r to t h e a c u t e regression h a d b e e n o r g a n i z e d a r o u n d feelings of u t t e r v u l n e r a b i l i t y r e p r e s e n t e d in d r e a m s by i m a g e s of b e i n g a p i n c u s h i o n . T h i s w a s

38


u n d e r s t o o d as a derivative of M r s . M . ' s feeling, which we h a d previously discussed, of b e i n g powerless to resist b e i n g taken over by h e r m o t h e r ' s ( a n d m y ) projections of ourselves into h e r . As a result, over t i m e I i n t e r p r e t e d t h e a c u t e regression in M r s . M . ' s analysis as a n effort b y h e r to create a h a r d n e s s in h e r b o d y t h a t w o u l d serve as a way of resisting m y a t t e m p t s to get inside of h e r in o r d e r —as she perceived it —to control h e r a n d t u r n h e r into w h a t I n e e d e d h e r to be for m e . M r s . M . ' s m a s s a g i n g of her muscles w a s viewed b o t h as a w a y of creating a sensory surface on which to locate herself, a n d as a way of r e a s s u r i n g herself t h a t the surface was a h a r d protective o n e . ( D u r i n g this s a m e regressed phase of analysis, t h e patient p r e s e n t e d n o p h a n t a s i e s o r d r e a m s of. b e i n g i n v a d e d o r of h a v i n g a shell; experience w a s p r e d o m i n a n d y in a sensory m o d e . ) T h e tension d i m i n i s h e d as t h e sensory experience was r e c o n n e c t e d with w o r d s by m e a n s of verbal interpretation. I c o n d u c t all phases of analysis a n d psychoanalytic t h e r a p y (despite major shifts in t h e dialectical b a l a n c e of the t h r e e m o d e s of experience) on t h e basis of the principle t h a t t h e r e is always a facet of t h e personality, n o m a t t e r h o w h i d d e n o r disguised, o p e r a t i n g in a depressive m o d e a n d therefore c a p a b l e of utilizing verbally symbolized i n t e r p r e t a t i o n s (Bion, 1957; Boyer a n d Giovacchini, 1967). Often the succession of t h e patient's associations, in c o n j u n c t i o n with affective shifts in a given m e e t i n g o r series of m e e t i n g s , serve as evidence that t h e patient has h e a r d a n d m a d e use of the analyst's i n t e r p r e t a t i o n . S o m e t i m e s o n e m u s t wait for years before the p a t i e n t gives direct evidence ( e . g . , by r e m i n d i n g t h e analyst of a n i n t e r p r e t a t i o n m a d e at a time w h e n the p a t i e n t seemed


39

i n c a p a b l e of o p e r a t i n g in a depressive m o d e ) that he o r she has utilized t h e i n t e r p r e t a t i o n . 8 T h e b r e a k d o w n of t h e c o n t i n u i t y of sensoryd o m i n a t e d experience b e i n g described results in t h e anxiety t h a t Bick (1968) a n d M e l t z e r ( M e l t z e r et al., 1975), on t h e basis of their w o r k w i t h pathologically autistic children as well as w i t h h e a l t h i e r children a n d a d u l t s , describe as t h e experience of one's skin b e c o m i n g a sieve t h r o u g h which one's insides leak o u t a n d fall into endless, shapeless space devoid of surface o r definition of a n y sort (see also Rosenfeld, 1984). Bion (1959b) refers to experience stripped of c o n t a i n m e n t a n d m e a n i n g as "nameless d r e a d . " ( P e r h a p s t h e t e r m formless dread m i g h t b e t t e r reflect t h e n a t u r e of anxiety in t h e autisticc o n t i g u o u s m o d e since the experience of shapes, r h y t h m s , a n d p a t t e r n s a r e the only "names" t h a t exist in this m o d e . ) M r s . N . , a 52-year-old w o m a n with a n extremely u n s t a b l e sense of c o n t i n u i t y of b e i n g , spent long periods of t i m e in every t h e r a p y h o u r silently att e m p t i n g to picture p h o n e n u m b e r s , b i r t h dates, street n u m b e r s , a n d so on of all of the people t h a t she h a d k n o w n since childhood. I n t h e m i d d l e of one of these e x t e n d e d r u m i n a t i v e silences, t h e p h o n e in m y office r a n g a n d was p r o m p t l y a n s w e r e d b y m y a n s w e r i n g m a c h i n e . M r s . N . was clearly s h a k e n b y this a n d left t h e office. T h i s was t h e first t i m e d u r i n g the course of 8

I believe that while there is always an aspect of the patient functioning in a depressive mode (a "non-psychotic part of the personality" [Bion, 1957]), there are always at the same time other aspects of experience that are defensively foreclosed from the realm of the psychological, for example, by means of the creation of psychosomatic illness (McDougall, 1974), alexithymia (Nemiah, 1977), and forms of "non-experience" (Ogden, 1980).

/

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h e r t r e a t m e n t that she h a d d o n e so. She r e t u r n e d in a b o u t five m i n u t e s . M u c h later in the t h e r a p y , M r s . N . told m e , with a m i x t u r e of s h a m e a n d relief, that she h a d left t h e r o o m on t h a t occasion to go to t h e b a t h r o o m because of h e r feeling t h a t she h a d soiled herself with feces o r u r i n e . T h i s experience was n o t r e p r e s e n t e d at t h e t i m e in the form of t h o u g h t s a n d was p r i m a r i l y a physical sensation. O n l y in retrospect could t h e p a t i e n t describe it as a feeling of h a v i n g b e e n "cut into" b y t h e u n e x p e c t e d d i s r u p t i o n of h e r r u m i n a t i v e t h o u g h t s . M r s . N . h a d a long history, b e g i n n i n g in early childhood, of violent d i s r u p t i o n s of h e r selfe x p e r i e n c e . F o r e x a m p l e , the p a t i e n t r e p o r t e d t h a t h e r m o t h e r w o u l d tie h e r a r m s a n d legs to h e r bedposts at n i g h t , w h e n she was 6 years old, in o r d e r to prevent h e r from m a s t u r b a t i n g .

T h e t e r r o r e n s u i n g from such d i s r u p t i o n of the c o n t i n u i t y of sensory experience calls i n t o play forms of defense specific to this m o d e of experience. Bick (1968, 1986) describes a type of defense t h a t she refers to as "second skin f o r m a t i o n , " T h i s is a self-protective effort at r e s u r r e c t i n g a feeling of the c o n t i n u i t y a n d integrity of one's surface. A n e x a m p l e of pathological second skin 9

Meltzer (Meltzer et al., 1975), building upon the work of Bick (1968), introduced the term adhesive identification to describe a form of identification more primitive than either introjective or projective identification. In an autistic-contiguous mode (which Meltzer refers to as the "world of two-dimensionality" [p. 225]), one utilizes adhesive identification in an attempt to create or defensively reconstitute a rudimentary sense of the cohesiveness of one's surface. The surface of the other is utilized as a substitute for an incompletely developed or deteriorating sense of one's own surface. Examples of the means by which the surface of the object is defensively "adhered


41

formation is t h e d e v e l o p m e n t of infantile e c z e m a t h a t Spitz (1965) u n d e r s t o o d as a p s y c h o s o m a t i c d i s o r d e r resulting from insufficiency o r i n a d e q u a c y of p a r e n t a l h o l d i n g in t h e first weeks a n d m o n t h s of life. T h e c o n t i n u a l scratching (often l e a d i n g to t h e necessity of w r a p p i n g the infant's h a n d s in gauze to prevent severe skin d a m a g e a n d infection) is u n d e r s t o o d from this perspective as t h e infant's d e s p e r a t e a t t e m p t to restore ( t h r o u g h h e i g h t e n e d skin sensation) a surface by m e a n s of w h i c h the t e r r o r of leakage a n d of falling i n t o shapeless space is allayed. W r a p p i n g a hospitalized patient snugly in sheets (while h e is continually a c c o m p a n i e d a n d related to b y a n e m p a t h i c staff m e m b e r ) is a n effective a n d h u m a n e way of t r e a t i n g s o m e o n e w h o is e x p e r i e n c i n g t h e t e r r o r of i m p e n d i n g a n n i h i l a t i o n in the form of the dispersal of the self into u n b o u n d e d space. T h i s form of i n t e r v e n t i o n r e p r e s e n t s a n a t t e m p t to almost literally supply t h e p a t i e n t with a second skin by m e a n s of t h e provision of a firm, p a l p a b l e , c o n t a i n i n g sensory a n d interpersonal surface. C o m m o n forms of second skin f o r m a t i o n e n c o u n tered clinically with a d u l t p a t i e n t s in p s y c h o t h e r a p y a n d U*^—> analysis include u n r e m i t t i n g eye contact t h a t begins in the " J w a i t i n g r o o m a n d is only painfully t e r m i n a t e d by the

to" in adhesive identification include imitation, mimicry, and clinging forms of sensory connectedness to an object that "can hold [one's] attention and thereby be experienced, momentarily at least, as holding the parts of the [sensory-dominated] personality together* (Bick, 1968, p. 49). Tustin (1986) prefers the term adhesive equation to the term adhesive identification since, in this defensive process, the individual's body is equated with the object in the most concrete, sensory way.

42

v


closing of t h e consulting r o o m d o o r at the end of the h o u r ; c o n s t a n t chatter on the p a r t of t h e patient filling every m o m e n t of the session l e a v i n g h a r d l y a m o m e n t of silence; continual holding of o n e object o r a n o t h e r that is either b r o u g h t to the session o r picked u p from the analyst's office (e.g., a tissue); p e r p e t u a l h u m m i n g o r r e p e a t i n g of sentences o r phrases, particularly w h e n a silence m i g h t otherwise ensue. T u s t i n (1980, 1981, 1984, 1986) h a s explored the defensive use of autistic objects a n d shapes in the face of t h r e a t e n e d d i s r u p t i o n of the sensory c o n t i n u i t y of self. Autistic shapes a n d objects offer a form of self-soothing that is "perfect" in a w a y t h a t n o h u m a n b e i n g can possibly be. T h e self-soothing activity, w h e t h e r it be h a i r twirling, s t r o k i n g the lobe of t h e e a r , t h u m b sucking, sucking on t h e i n n e r surface of the check, rocking, t a p p i n g one's foot, h u m m i n g , i m a g i n i n g s y m m e t r i c a l geometric designs or series of n u m b e r s , is absolutely a n d reliably p r e s e n t . Such activities always h a v e precisely the s a m e sensory qualities a n d r h y t h m s ; they n e v e r evidence shifts in m o o d , a n d a r e n e v e r a fraction of a second late w h e n t h e y a r e n e e d e d . N o h u m a n b e i n g c a n p r o v i d e such machinelike reliability. T h e individual h a s absolute control over the autistic activity; h o w e v e r , at t h e s a m e t i m e , the autistic activity c a n t y r a n n i z e t h e individual ( T u s t i n , 1984). T h e t y r a n n i c a l p o w e r of the activity derives from the fact t h a t a n individual relying on a n autistic m o d e of defense is absolutely d e p e n d e n t on t h e ability of t h e perfect r e c r e a t i o n of the sensory 1 0 e x p e r i e n c e to protect l0

Boyer*s (1986) version of the "fundamental rule" incorporates a full appreciation of the sensory dimension of the analytic experience. He at times directly and at times indirectly (e.g., through the questions he poses) asks his patients to attempt to notice and put into words the


43

h i m against u n b e a r a b l e t e r r o r ("formless dread"). I h a v e b e e n i m p r e s s e d b y the w a y in w h i c h b o t h aspects of this t y r a n n y —the individual's control of the autistic activity, a n d the activity's control over h i m —play i m p o r t a n t roles even in t h e psychoanalysis of a d u l t p a t i e n t s w h o h a v e achieved t h e capacity for stably g e n e r a t i n g experience in a p r e d o m i n a n t l y depressive m o d e .

A 42-year-old p a t i e n t , D r . E . , a p s y c h o t h e r a p i s t , bec a m e e n r a g e d if I w a s a m i n u t e late in b e g i n n i n g his analytic h o u r . ( H e w o r e a digital w a t c h . ) D r . E . said' t h a t he k n e w I u n d e r s t o o d t h e i m p o r t a n c e of "the frame," a n d t h a t if I violated it in this egregious w a y , I m u s t not c a r e a b o u t h i m or t h e analysis in the least. T h e "frame" w a s not j u s t an idea for this p a t i e n t , b u t a ^ p a l p a b l e feeling as tangible, h a r d , a n d enclosing as the 1 m e t a l frame a r o u n d a picture. T h i s m a n h a d i n d e e d 1 b e c o m e a d d i c t e d to t h e analytic frame as a n autistic I object} D r . E . m a d e it clear t h a t he n e e d e d not simply I reliability in o u r "relationship," b u t absolute certainty. As a result, he a t t e m p t e d to control e v e r y t h i n g in- ^s**t /r*~ e l u d i n g m y t h o u g h t s a n d feelings. H e w o u l d c o n t i n u £V ally tell m e w h a t I was t h i n k i n g a n d feeling; in t h a t w a y >** he could a t t e m p t to e n s u r e t h a t h e w o u l d n e v e r be o^V* s u r p r i s e d o r d i s a p p o i n t e d by m e . I n t e r p r e t a t i o n s of m i n e t h a t i n c o r p o r a t e d a n idea o r perspective t h a t D r . E . h a d n o t yet t h o u g h t of w e r e extremely distressing to h i m b e c a u s e they reflected t h e fact t h a t I h a d t h o u g h t s t h a t he h a d n o t created a n d therefore did n o t control in a n absolute w a y . T h i s set of feelings a n d this form of thoughts, feelings, and physical sensations that they experience in the sessions. He also asks the same of himself in his efforts to utilize his countertransference experience (Boyer, 1983, 1987).

44

The Primitive Edge of Experience relatedness a r e usually u n d e r s t o o d in t e r m s of analerotic obsession, o m n i p o t e n c e , a n d projective identification. T h e s e a r e n o d o u b t a c c u r a t e descriptions of this s y m p t o m a t o l o g y a n d form of relatedness, b u t t h e y n e e d to b e s u p p l e m e n t e d by a n u n d e r s t a n d i n g of t h e way in which t h e experience also involves t y r a n n i z i n g relatedness to a n autistic object.

^

\/

T h e topic of c o u n t e r t r a n s f e r e n c e responses to a n a lytic experience in a n autistic-contiguous m o d e can only briefly be t o u c h e d u p o n here. T h e analyst's feelings often include feelings of b e i n g t y r a n n i z e d by a n a u t o m a t o n (as in the case of D r . E . ) , feelings of i n a d e q u a c y for h a v i n g n o compassion with t h e patient o r for b e i n g u n a b l e to m a k e a n y c o n n e c t i o n w h a t e v e r with h i m o r h e r , a n d intense feelings of protectiveness for t h e p a t i e n t . T h i s relatively familiar r a n g e of feelings is n o t unlike the g r o u p of responses o n e has to p a t i e n t s o p e r a t i n g in p r e d o m i n a n t l y paranoid-schizoid a n d depressive m o d e s . M o r e specific to the autistic-contiguous m o d e of experience is c o u n t e r t r a n s f e r e n c e experience in which bodily sensations d o m i n a t e . S o m a t i c experiences like t w i t c h i n g of one's h a n d a n d a r m , stomach p a i n , feelings of b l o a t edness a n d so on a r e n o t u n c o m m o n . V e r y frequently the c o u n t e r t r a n s f e r e n c e experience is associated with skin sensations such as feelings of w a r m t h a n d coldness (see earlier discussion of M r s . L. in this c h a p t e r ) as well as tingling, n u m b n e s s , a n d a n e x a g g e r a t e d sensitivity to skin impressions like t h e tightness of one's tie o r one's shoes. At times, t h e space between the p a t i e n t a n d myself h a s felt as if it were filled with a w a r m s o o t h i n g substance. F r e q u e n t l y , this is associated with a d r o w s y c o u n t e r t r a n s f e r e n c e state t h a t h a s n o t h i n g to d o with b o r e d o m . It is a r a t h e r pleasant feeling of b e i n g sus-

45


p e n d e d b e t w e e n sleep a n d wakefulness. ( P e r h a p s this is t h e sensory d i m e n s i o n of Bion's [1962] idea of "reverie," a concept referring to the analyst's state of receptivity to the patient's u n c o n s c i o u s experience a n d t h e m o t h e r ' s receptivity to h e r infant's symbolic a n d asymbolic [or p r e s y m bolic] experience.) F r o m t h e perspective developed in this c h a p t e r , the autistic-contiguous m o d e , u n d e r n o r m a l c i r c u m s t a n c e s , c a n b e seen to p r o v i d e t h e b o u n d e d sensory "floor" (Grotstein, 1987) of experience. It offers sensory enclos u r e t h a t exists in dialectical tension with t h e f r a g m e n t i n g potential of t h e p a r a n o i d - s c h i z o i d m o d e . f T h e d a n g e r of* psychosis p o s e d b y t h e f r a g m e n t i n g a n d e v a c u a t i v e processes of t h e paranoid-schizoid m o d e are c o n t a i n e d in two ways: (1) " F r o m above" by the b i n d i n g capacity of symbolic linkages, historicity, a n d subjectivity of t h e depressive m o d e ; a n d (2) "from below" b y the sensory )ry c o n t i n u i t y , r h y t h m i c i t y , a n d b o u n d e d n e s s of the autisticticcontiguous mode.

Summary

I n this c h a p t e r , h u m a n experience is conceived of as t h e o u t c o m e of a dialectical relationship b e t w e e n t h r e e m o d e s of experience. T h e autistic-contiguous m o d e provides a good m e a s u r e of t h e sensory c o n t i n u i t y a n d integrity of experience (the sensory "floor"); t h e p a r a n o i d - s c h i z o i d m o d e is a principal source of t h e i m m e d i a c y of concretely symbolized experience; a n d t h e depressive m o d e is a principal m e d i u m t h r o u g h which historical subjectivity a n d the richness of symbolically m e d i a t e d h u m a n experience is g e n e r a t e d . E x p e r i e n c e is always g e n e r a t e d be-

46


tween the poles r e p r e s e n t e d by the ideal of t h e p u r e form of each of these m o d e s . T h e s e m o d e s of g e n e r a t i n g experience a r e a n a l o g o u s to e m p t y sets each filled in their r e l a t i o n s h i p with the others. Psych op athology can be t h o u g h t of as forms of collapse of t h e richness of experience g e n e r a t e d b e t w e e n these poles. Collapse m a y be in the direction of t h e autistic-contiguous pole, the p a r a n o i d - s c h i z o i d pole, o r t h e depressive pole. Collapse t o w a r d t h e autisticc o n t i g u o u s pole g e n e r a t e s i m p r i s o n m e n t in t h e m a c h i n e like t y r a n n y of a t t e m p t e d sensory-based escape from the t e r r o r of formless d r e a d , by m e a n s of reliance on rigid autistic defenses. Collapse into t h e p a r a n o i d - s c h i z o i d pole is characterized by i m p r i s o n m e n t in a nonsubjective world of t h o u g h t s a n d feelings experienced in t e r m s of frightening a n d protective things that simply h a p p e n , a n d t h a t c a n n o t b e t h o u g h t a b o u t o r i n t e r p r e t e d . Collapse in t h e direction of the depressive pole involves a form of isolation of oneself from one's bodily sensations, a n d from the i m m e d i a c y of one's lived e x p e r i e n c e , leaving o n e devoid of s p o n t a n e i t y a n d aliveness.

3 T h e

A u t i s t i c - C o n t i g u o u s P o s i t i o n

T h e e x c h a n g e of ideas constituting the British p s y c h o a n alytic discourse of the 1930s to t h e early 1970s revolved in large p a r t a r o u n d t h e w o r k of Klein, W i n n i c o t t , Fairb a i r n , a n d Bion. E a c h of these analysts p r o v i d e d the context for—as well as a c o u n t e r p o i n t t o — t h e ideas g e n e r a t e d b y the others. T h e history of t h e d e v e l o p m e n t of British object relations theory in t h e last t w e n t y years c a n be viewed as c o n t a i n i n g t h e b e g i n n i n g s of a n explor a t i o n of a n a r e a of experience lying outside of t h e experiential states a d d r e s s e d by Klein's (1958) concepts of t h e p a r a n o i d - s c h i z o i d a n d depressive positions; b y F a i r bairn's (1944) conception of the i n t e r n a l object world; b y Bion's (1962) c o n c e p t i o n of projective identification as a p r i m i t i v e form of defense, c o m m u n i c a t i o n , a n d containm e n t ; o r b y W i n n i c o t t ' s (1971a) conception of t h e evolution of t h e m o t h e r - i n f a n t relationship a n d t h e elaboration of transitional p h e n o m e n a . T h e clinical a n d theoretical w o r k of E s t h e r Bick (1968, 1986), D o n a l d M e l t z e r ( M e l t z e r , 1975; M e l t z e r et 47

48


a l . , 1975), a n d F r a n c e s T u s t i n (1972, 1980, 1981, 1984, 1986), developed in the context of their clinical w o r k with autistic c h i l d r e n , has served to define a heretofore insufficiently u n d e r s t o o d d i m e n s i o n of all h u m a n experience ( m o r e p r i m i t i v e t h a n the p a r a n o i d - s c h i z o i d position) t h a t I refer to as t h e autistic-contiguous position. T h e p r e s e n t c h a p t e r r e p r e s e n t s a synthesis, i n t e r p r e t a t i o n , a n d extension of t h e w o r k of these analytic t h i n k e r s . (A partial listing of o t h e r i m p o r t a n t c o n t r i b u t o r s to this a r e a of investigation includes: J . A n t h o n y 1958; A n z i e u 1970; Bion 1962; B o w e r 1977; Brazelton 1981; E i m a s 1975; F o r d h a m 1977; E . G a d d i n i 1969, 1987; R . G a d d i n i 1978, 1987 G r o t s t e i n 1978, 1983; K a n n e r 1944; S. Klein 1980 M a h l e r 1952, 1968; M i l n e r 1969 D . Rosenfeld 1984 S a n d e r 1964; Searles 1960; Spitz 1965; S t e r n 1977, 1985 T r e v a r t h a n 1979; a n d W i n n i c o t t 1960a.) I n the previous c h a p t e r , I t e r m e d t h e psychological o r g a n i z a t i o n g e n e r a t i n g the m o s t p r i m i t i v e state of b e i n g t h e autistic-contiguous position. (I used the t e r m position b e c a u s e I view this psychological o r g a n i z a t i o n as a develo p i n g a n d o n g o i n g m o d e ot g e n e r a t i n g experience^ as o p p o s e d to a p h a s e of d e v e l o p m e n t . I r e g a r d it as h a v i n g e q u a l o r g a n i z i n g significance to the p a r a n o i d - s c h i z o i d a n d depressive positions a n d as c o n t r i b u t i n g equallypowerfully to the dialectic c o n s t i t u t i n g h u m a n experie n c e . ) T h e e l a b o r a t i o n of this p r i m i t i v e o r g a n i z a t i o n r e p r e s e n t s a n integral p a r t of n o r m a l d e v e l o p m e n t t h r o u g h w h i c h a distinctive m o d e of experience is genera t e d . T h i s m o d e of o r g a n i z i n g e x p e r i e n c e is characterized b y specific types of defense a n d forms of object relatedr ness, a n d a q u a l i t y of anxiety a n d d e g r e e of subjectivity, t h a t a r e described a n d clinically illustrated in g r e a t e r detail in this c h a p t e r .

49

The Autistic-Contiguous Position

T h e state of b e i n g t h a t is g e n e r a t e d b y this psychological o r g a n i z a t i o n stands in b o t h a d i a c h r o n i c a n d a synchronic relationship to the p a r a n o i d - s c h i z o i d a n d depressive positions. A l t h o u g h t h e autistic-contiguous position h a s a p e r i o d of p r i m a c y earlier t h a n t h a t of t h e two psychological o r g a n i z a t i o n s described b y K l e i n , it coexists dialectically with the paranoid-schizoid a n d depressive positions from t h e b e g i n n i n g of psychological life. r T h e concepts of t h e depressive, the p a r a n o i d - s c h i z o i d , a n c N h e autistic-contiguous positions constitute p r e s e r v i n g a n d n e g a t i n g contexts for o n e a n o t h e r , j u s t as the ideas of night a n d d a y , d a r k n e s s a n d light, s o u n d a n d silence, consciousness a n d unconsciousness each create, p r e s e r v e , a n d n e g a t e t h e o t h e r y T h e delineation of t h e autistic-^ c o n t i g u o u s d i m e n s i o n of experience does n o t in a n y sense d i m i n i s h t h e significance of t h e paranoid-schizoid a n d depressive d i m e n s i o n s . T h e present c h a p t e r represents a n a t t e m p t to e x t e n d t h e concept of psychological "positions" o r o r g a n i z a t i o n s to include the m o s t p r i m i t i v e aspects of h u m a n experience.

Primitive

Organization

of

Experience

T h e autistic-contiguous o r g a n i z a t i o n is associated with a specific m o d e of a t t r i b u t i n g m e a n i n g to experience in which r a w sensory d a t a a r e o r d e r e d b y m e a n s of f o r m i n g p r e s y m b o l i c connections b e t w e e n sensory impressions t h a t c o m e to constitute b o u n d e d surfaces. It is o n these surfaces t h a t t h e experience of self has its origins: " T h e ego [the "I"] is first a n d foremost a bodily ego. . . . ( F r e u d , 1923, p . 26), i.e., the ego is ultimately derived from bodily sensations, chiefly from those s p r i n g i n g from

50


t h e surface of the body" ( F r e u d , 1923, p . 26, footnote a d d e d in 1927). I h a v e retained t h e w o r d autistic in t h e d e s i g n a t i o n of t h e m o s t p r i m i t i v e psychological o r g a n i z a t i o n despite t h e fact t h a t t h e t e r m is usually associated with a pathologically closed psychological system t h a t I d o not feel is characteristic of the n o r m a l autistic-contiguous m o d e . I h a v e d o n e so because I believe t h a t pathological forms of a u t i s m involve h y p e r t r o p h i e d versions of the types of defense, t h e m e t h o d of a t t r i b u t i n g m e a n i n g to experience, a n d the m o d e of object relatedness c h a r a c t e r i z i n g t h e n o r m a l autistic-contiguous o r g a n i z a t i o n . I believe the word contiguous is particularly apt in further n a m i n g this o r g a n i z a t i o n since, as is later disfcussed,(the experience of surfaces t o u c h i n g o n e a n o t h e r is | a principal m e d i u m t h r o u g h w h i c h connections a r e m a d e ca n d o r g a n i z a t i o n achieved in this psychological m o d e . T h e w o r d contiguous t h u s p r o v i d e s t h e necessary antithesis to t h e c o n n o t a t i o n s of isolation a n d disconnectedness c a r r i e d by t h e w o r d autistic. T h i s primitive psychological o r g a n i z a t i o n u n d e r n o r m a l c i r c u m s t a n c e s c o n t r i b u t e s t h e barely perceptible b a c k g r o u n d of sensory b o u n d e d n e s s of all s u b s e q u e n t subjective states. W h e n infantile anxiety is e x t r e m e (for constitutional a n d / o r e n v i r o n m e n t a l reasons) the system of defenses c h a r a c t e r i z i n g this m o d e b e c o m e s h y p e r t r o p h i e d a n d rigidified; this leads to a wide r a n g e of forms of pathological a u t i s m , r a n g i n g from pathological infantile a u t i s m to autistic features of p a t i e n t s who h a v e in o t h e r w a y s achieved a p r e d o m i n a n t l y n e u r o t i c psychological s t r u c t u r e (cf. S. K l e i n , 1980; T u s t i n , 1986). T h i s conception of a n autistic-contiguous position m u s t b e differentiated from M a h l e r ' s (1968) conception of " n o r m a l a u t i s m " (p. 7). She views the infant in the first


51

m o n t h s of life as existing in a "closed m o n a d i c system, self-sufficient in its hallucinatory wish fulfillment'' (p. 7). 1 I n contrast, I do n o t conceive of the autisticc o n t i g u o u s position as a c t o s e a ^ y j s t e m i n ^ h i c h ^ h e ^ i n f a n t is isolat^cTTrom, a n d u n r e s p o n s i v e to, his object world. "ATwllTtieîsCllssedrobject relations a r e experienced — in a n autistic-contiguous m o d e —in t e r m s of the sensory surfaces g e n e r a t e d b y the individual's interactions with his objects a n d by t h e sensory t r a n s f o r m a t i o n s o c c u r r i n g within the individual in t h e course of these interactions (cf. Bollas, 1979). T h e object (as sensory impression) is a t t r i b u t e d m e a n i n g a n d r e s p o n d e d to in a n o r g a n i z e d a n d o r g a n i z i n g w a y , a n d in a w a y t h a t involves a m u t u a l l y t r a n s f o r m i n g interplay of (nascent) self a n d object.' T h e o b s e r v a t i o n a l d a t a of Bower (1977), Brazelton (1981), E i m a s (1975), Stern (1977, 1983, 1985), T r e v a r t h a n (1979), a n d others h a v e p r o v i d e d powerful evidence for the capacity of the infant from t h e first days a n d weeks of life to perceive, m a k e discriminations a m o n g , a n d r e s p o n d to external objects in a w a y t h a t is inferred to reflect the infant's (at least sporadic) awareness of externality. (I h a v e elsewhere discussed central features of this b o d y of d a t a [ O g d e n , 1984].) O r d i n a r i l y , t h e interplay of the experience of oneness a n d that of separ a t e n e s s w i t h i n the early m o t h e r - i n f a n t relationship m a k e s tolerable t h e infant's m o m e n t s of awareness of his separateness. T h e n o r m a l e l a b o r a t i o n of the jmtistic-^ c o n t i g u o u s o r g a n i z a t i o n d e p e n d s u p o n t h e capacity of t h e m o t h e r a n d infant to generate forms of sensory experi-

'Stern (1985) reports that Mahler near the end of her life expanded her conception of the earliest period of development to include greater recognition of the infant's awareness of and responsiveness to his human and nonhuman environment.

If

52

V


ence t h a t "heal" or " m a k e b e a r a b l e " the a w a r e n e s s of the separateness t h a t is a n intrinsic c o m p o n e n t of early infantile experience ( T u s t i n , 1986). W h e n t h e m o t h e r - i n fant d y a d is u n a b l e to function in a w a y that provides t h e infant a h e a l i n g sensory experience, t h e holes in t h e fabric of t h e "emergent self* ( S t e r n , 1985) b e c o m e a source of u n b e a r a b l e "awareness of bodily separateness [which results in] a n a g o n y of consciousness" ( T u s t i n , 1986, p. 43). U n d e r such c i r c u m s t a n c e s , the infant's d e v e l o p m e n t is skewed in the direction of pathological a u t i s m t h a t involves the creation of a state of psychological d e a d n e s s , which M e l t z e r a n d colleagues (1975) comp a r e s to the "absence" in a petit mat seizure a n d which I ( O g d e n , 1980) h a v e described as a state of "nonexperience," a state in which t h e r e is a cessation o r paralysis of t h e process of a t t r i b u t i n g m e a n i n g to experience.

The Nature

of Sensation-Dominated

Experience

I n a n autistic-contiguous m o d e , it is experiences of sensation, particularly at t h e ^ l d n _ s u r | a c e , that a r e the principal m e d i a for the creation of psychological m e a n i n g a n d t h e r u d i m e n t s of the experience of self. Sensory contiguity of skin surface, a l o n g with t h e element of r h y t h m i c i t y , a r e basic to the m o s t f u n d a m e n t a l set of infantile object relations: the infant's experience of b e i n g held, n u r s e d , a n d spoken to by t h e m o t h e r . T h e s e early experiences a r e object-related in a specific sense of t h e word that is-related to the n a t u r e of subjectivity in the autistic-contiguous position. I n previous c o n t r i b u t i o n s ( O g d e n , 1986; see also C h a p t e r 2), I h a v e discussed Klein's concept of the depressive position as a psycholog-


53

ical o r g a n i z a t i o n in which t h e r e is a n i n t e r p r e t i n g subject m e d i a t i n g b e t w e e n symbol a n d symbolized, m e d i a t i n g b e t w e e n oneself a n d one's lived experience. I n a p a r a n o i d schizoid m o d e , t h e r e is very little sense of a m e d i a t i n g , i n t e r p r e t i n g "I"; instead, the self is to a l a r g e extent a self-as-object, a self t h a t only m i n i m a l l y experiences itself as t h e a u t h o r of its own t h o u g h t s , feelings, sensations, a n d perceptions. I n s t e a d , f i n a paranoid-schizoid m o d e ^ t h e individual experiences himself as buffeted by t h o u g h t s , feelings, a n d sensations as if t h e y w e r e forces o r t h i n g s t h a t simply h a p p e n . T h e n a t u r e of one's relationship to one's objects is d e t e r m i n e d to a large degree by t h e n a t u r e of t h e subjectivity (the form of "I-ness") that constitutes the context for those object relations. H n t h e a u t i s t i c ? c o n t i g u o u s position, t h e relationship to objects is o n e in which t h e o r g a n i z a t i o n of a r u d i m e n t a r y sense of "I-ness" arises from relationships of sensory contiguity (i.e., touching) that o v e r t i m e g e n e r a t e the sense of a b o u n d e d sensory surface o n which one's experience occurs (the b e g i n n i n g s of t h e feeling of "a place w h e r e one lives" [ W i n n i c o t t , 1971a]). E x a m p l e s of b o u n d e d n e s s generate< from relationships of contiguity include t h e sense of s h a p e c r e a t e d b y the impression of t h e infant's skin surface w h e n he rests his cheek against t h e m o t h e r ' s b r e a s t ; t h e sense of the c o n t i n u i t y a n d predictability of shape derived from the r h y t h m i c i t y a n d regularity of t h e infant's sucking activity (in the context of a m a t e r n a l l y p r o v i d e d h o l d i n g e n v i r o n m e n t ) ; t h e r h y t h m of the "dialogue" of c o o i n g e n g a g e d in by m o t h e r a n d infant; t h e feeling of e d g e d n e s s g e n e r a t e d b y t h e infant's pressing his g u m s tightly on t h e m o t h e r ' s nipple o r finger. T h e r u d i m e n t a r y b e g i n n i n g s of subjectivity in the autistic-contiguous position m u s t be described from t h e

54


perspective of two vertices s i m u l t a n e o u s l y . O n t h e o n e h a n d , t h e infant a n d m o t h e r a r e o n e : " T h e r e is n o such t h i n g as a n infant" ( W i n n i c o t t , 1960a, footnote on p. 39). F r o m this perspective t h e infant's subjectivity c a n b e t h o u g h t of as b e i n g held in t r u s t by t h e m o t h e r ( m o r e accurately, b y the aspect qf_the_ m o t h e r - i n f a n t t h a t a n outside observer would view as the m o t h e r ) . At the s a m e t i m e , from a n o t h e r perspective, t h e infant a n d ^ m o t h e r a r e never.absolutely-aUone,-and.the_infant's subjectivity in the autistic-contiguous position c a n b e t h o u g h t of as a n e x t r e m e l y subtle, non-self-reflective sense of "going o n b e i n g " ( W i n n i c o t t , 1956) in w h i c h sensory need is in t h e p r o c e s s of a c q u i r i n g features of subjective desire ( t h e sensory-level b e g i n n i n g s of a subject w i s h i n g for something) . f S e n s o r y experience in a n autistic-contiguous m o d e h a s a quality of r h y t h m i c i t y t h a t is b e c o m i n g c o n t i n u i t y of being; it has b o u n d e d n e s s that is the b e g i n n i n g of the experience of a place w h e r e o n e feels, thinks, a n d lives; it h a s such features as s h a p e , h a r d n e s s , coldness, w a r m t h , a n d t e x t u r e , t h a t are t h e b e g i n n i n g s of the qualities of w h o o n e is. "* T u s t i n (1980, 1984) h a s described two types of e x p e r i e n c e with objects t h a t c o n s t i t u t e i m p o r t a n t m e a n s of o r d e r i n g a n d defining experience in the autisticc o n t i g u o u s position. ( T h e s e m e a n s of o r g a n i z i n g a n d d e l i n e a t i n g experience a r e secondarily enlisted in the c o n s t r u c t i o n of psychological defense.) T h e first of these forms of relatedness to objects (which again only a n outside observer would recognize as a relationship to a n e x t e r n a l object) is the creation of "autistic shapes" (1984). S h a p e s g e n e r a t e d in a n autistic-contiguous m o d e 2

Tustin (1980, 1984), following the lead of J. Anthony (1958), conceives of a phase of "normal autism" (which she more recently has


55

m u s t be distinguished from w h a t we ordinarily think of as t h e s h a p e of a n object. T h e s e early shapes a r e "'felt' shapes" ( T u s t i n , 1986, p. 280) arising from the experience of soft t o u c h i n g of surfaces, which m a k e s a sensory i m p r e s s i o n . T h e experience of shape in a n autisticc o n t i g u o u s m o d e does n o t involve t h e conception of the "objectness" o r "thingness" of t h a t which is b e i n g felt. As T u s t i n (1984) p u t s it, w e c a n a t t e m p t to create for*^ ourselves t h e experience oT a n autistic shape if we r e d u c e \ the c h a i r we a r e sitting on to t h e sensation it makes on o u r | b u t t o c k s J F r o m this perspective t h e r e is n o sense of t h e j c h a i r as a n object aside from t h e sensation t h a t is g e n e r a t e d . T h e "shape" of t h a t i m p r e s s i o n is idiosyncratic to each of us, a n d changes as we shift in o u r seats. F o r the infant, the objects g e n e r a t i n g shapes in a n autistic-contiguous m o d e include t h e soft parts of his o w n b o d y a n d the b o d y of the m o t h e r as well as soft bodily s u b s t a n c e s ( i n c l u d i n g saliva, u r i n e , a n d feces). Experiences of s h a p e in a n autistic-contiguous m o d e c o n t r i b u t e to t h e sense of cohesion of self a n d also to t h e experience of p e r c e p t i o n of w h a t is b e c o m i n g t h e object. M u c h later in d e v e l o p m e n t , w o r d s like "comfort," "soothing," "safety," "connectedness," "holding," "cuddling," a n d "gentleness" will b e attached to t h e e x p e r i e n c e of shapes in a n autistic-contiguous m o d e . A second form of very early definition of sensory e x p e r i e n c e described by T u s t i n (1980), the experience of

designated the "auto-sensuous" [1986] phase of development). In this phase, the infant makes use of "shapes" in a way that resembles the shapes utilized by autistic children; however, the normal infantile utilization of shapes is not nearly as extensive or rigid, and does not serve to cut off relations with external objects, as is the case in pathological autism.

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"autistic objects," stands in m a r k e d contrast to the expeJ n e n c e of autistic s h a p e s . ^ n autistic object is the experiI ence of a h a r d , a n g u l a r sensory surface t h a t is c r e a t e d w h e n a n object is pressed h a r d against t h e infant's skin. I n this form of experience, the individual experiences his surface (which in a sense is all t h e r e is of h i m ) as a h a r d crust o r a r m o r t h a t protects h i m against u n s p e a k a b l e d a n g e r s t h a t only later will b e given n a m e s J K n autistic object is a safety-generating sensory i m p r e s s i o n of" edgedness t h a t defines, delineates, and^protects one's otherwise am [exposed a n d v u l n e r a b l e surface. \fts e x p e r i e n c e is m c r e a s ingly g e n e r a t e d in paranoid-schizoid a n d depressive m o d e s , w o r d s like " a r m o r , " "shell," "crust," " d a n g e r , " "attack," "separateness," "otherness," "invasion," "rigidity," "impenetrability," a n d "repulsion" a r e a t t a c h e d to t h e I q u a l i t y of sensory impressions c r e a t e d b y autistic objects. I worked for m a n y years in intensive p s y c h o t h e r a p y with a congenitally blind schizophrenic adolescent n a m e d R o b e r t (see O g d e n , 1982a, for a n e x t e n d e d discussion of this case). I n the initial y e a r s of this w o r k , which b e g a n w h e n the patient w a s 19 y e a r s old, h e spoke very little. T h e patient said t h a t h e w a s terrified of the millions of spiders t h a t w e r e all o v e r the floor, his food, a n d his b o d y . H e felt t h a t they w e r e crawling in a n d o u t of all his bodily o p e n i n g s i n c l u d i n g his eyes, m o u t h , ears, nose, a n u s , a n d penis as well as t h e pores of his skin. H e w o u l d sit in m y office t r e m b l i n g with his eyes rolled back into their sockets so t h a t only the sclerae were visible. A c c o r d i n g to the history given b y t h e patient's p a r e n t s , siblings, a n d o t h e r relatives, R o b e r t ' s m o t h e r ' s h a n d l i n g of h i m as a n infant was characterized b y u n p r e d i c t a b l e shifts from s m o t h e r i n g o v e r i n v o l v e m e n t


57

to e x t r e m e s of h a t r e d for h i m . H e w a s left alone in a mobile crib for h o u r s . R o b e r t w o u l d s t a n d u p in t h e crib, h o l d i n g o n t o t h e b a r f o r m i n g its u p p e r edge, a n d w o u l d propel himself a r o u n d t h e r o o m b y rhythmically b a n g i n g his h e a d against the b a r . H i s m o t h e r told m e t h a t h e h a d s e e m e d oblivious to t h e p a i n a n d t h a t she h a d b e e n horrified by his " d e m o n i a c a l willfulness." I n the p e r i o d of t r e a t m e n t t h a t I will b e focusing u p o n h e r e , R o b e r t refused to b a t h e despite every act of p r o d d i n g , cajoling, b r i b i n g , a n d t h r e a t e n i n g t h a t t h e n u r s i n g staff could devise. ( H e w a s hospitalized for t h e initial y e a r of t r e a t m e n t . ) H e rarely c h a n g e d his clothes even to sleep, a n d his h a i r was a m a s s of greasy c l u m p s . R o b e r t developed a n intense bodily o d o r t h a t silently a c c o m p a n i e d h i m a n d t h a t lingered for h o u r s following his d e p a r t u r e from m y office. H e would lie b a c k in the soft chair in m y consulting r o o m with- his greasy h a i r on t h e h a r d , p a d d e d b a c k of t h e chair. T h e aspect of t h e t r a n s f e r e n c e - c o u n t e r t r a n s f e r e n c e interaction t h a t I w a s most a w a r e of at t h e t i m e w a s the w a y in which I felt i n v a d e d b y this p a t i e n t . W h e n h e left m y office, I could n o t feel t h a t I h a d a respite from h i m . I felt as if he h a d m a n a g e d , in a literal w a y , to get inside of m e — t o get u n d e r m y skin —by m e a n s of his o d o r t h a t was s a t u r a t i n g m y furniture (with w h i c h I h a d b e c o m e closely identified). I eventually u n d e r s t o o d these feelings as m y response to (unconscious particip a t i o n in) a projective identification in which t h e p a t i e n t was e n g e n d e r i n g in m e his o w n feelings of b e i n g painfully a n d unwillingly infiltrated b y his int e r n a l object m o t h e r . I n retrospect I feel t h a t I did not give sufficient weight to a n aspect of the experience to which t h e p a t i e n t was unconsciously d i r e c t i n g m y a t t e n t i o n .

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W h e n I asked R o b e r t what it was a b o u t s h o w e r i n g t h a t most frightened h i m , he said, "the d r a i n . " I n o w feel that I u n d e r s t a n d in a fuller w a y t h a n I did at the t i m e iat ( R o b e r t was terrified of dissolving a n d literally Ding d o w n t h e d r a i n . T h u s he a t t e m p t e d to g r o u n d imself in t h e sensation of his o w n distinct bodily odor, which was of p a r t i c u l a r i m p o r t a n c e to h i m in the âbsence of t h e capacity to form well-defined visual i m a g e s , f H i s o d o r constituted a c o m f o r t i n g autistic s h a p e t h a t h e l p e d h i m to c r e a t e a place in w h i c h h e could feel ( t h r o u g h his bodily sensations) t h a t he existed. H i s t r e m b l i n g gave h i m a h e i g h t e n e d sense of his s k i n j h i s rolling of his eyes b a c k i n t o t h e vault of his skull insulated h i m from the b l u r r e d , edgeless shadows t h a t h e perceived visually. (Years later h e told m e t h a t these s h a d o w s were "worse t h a n seeing n o t h i n g at all" b e c a u s e t h e y m a d e h i m feel as if he w e r e d r o w n i n g . ) T h e patient's insistence o n h o l d i n g his h e a d against the b a c k e d g e of m y c h a i r served to p r o v i d e some d e g r e e of b o u n d e d n e s s for h i m . I n early childh o o d , R o b e r t h a d in a similar w a y desperately att e m p t e d to r e p a i r a failing sense of self-cohesiveness t h r o u g h his b a n g i n g of his h e a d against the h a r d edge of his crib in response to the disintegrative effect of long p e r i o d s of disconnectedness from his m o t h e r . T h i s early "relationship" to h a r d n e s s r e p r e s e n t s a form of pathological use of a n autistic object as a substitute for a h e a l i n g relationship with a n actual p e r s o n . T h e r h y t h m i c c o m p o n e n t of the h e a d - b a n g i n g a n d of the crib's m o t i o n c a n be viewed as a n effort at self-soothing t h r o u g h the use of a n autistic s h a p e .

E

F r o m this perspective, R o b e r t ' s insistence on n o t b a t h i n g is m o r e fully u n d e r s t a n d a b l e . T h e loss of his o d o r would h a v e b e e n equivalent to the loss of himself.

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H i s o d o r p r o v i d e d the r u d i m e n t s of b e i n g s o m e o n e ( s o m e o n e w h o h a d a p a r t i c u l a r odor), b e i n g s o m e w h e r e ( s o m e w h e r e in which h e could perceive his odor), a n d b e i n g s o m e t h i n g for a n o t h e r p e r s o n (a p e r s o n w h o could smell h i m , be infused b y h i m , a n d r e m e m b e r h i m ) . T h e use of o d o r as a n autistic s h a p e c a n in this case be viewed as nonpathological to t h e extent t h a t it existed as a p a r t of the t r a n s ference-co untertransference relationship that was to a large d e g r e e a i m e d at t h e e s t a b l i s h m e n t of a n object r e l a t i o n s h i p of contiguity (the "touch" of odor), a n d was n o t simply a n effort at c r e a t i n g a substitute for the object.

Autistic-Contiguous and

Pathological

Experience Autism

A l t h o u g h pathological a u t i s m c a n be t h o u g h t of as cons t i t u t i n g a n "asymbolic" r e a l m , t h e n o r m a l autisticc o n t i g u o u s m o d e is "presymbolic" in t h a t the sensorybased units of experience b e i n g o r g a n i z e d are p r e p a r a t o r y for the creation of symbols m e d i a t e d by experience of transitional p h e n o m e n a ( W i n n i c o t t , 1951). T h e d e v e l o p m e n t a l directionality of this process stands in c o n t r a s t to t h e static n a t u r e of a s y m b o l i c experience in pathological a u t i s m , w h e r e i n t h e effort is to m a i n t a i n a perfectly i n s u l a t e d closed system (in w h i c h sensory experience does n o t lead a n y w h e r e except b a c k to itself). Pathological a u t i s m a i m s at t h e absolute elimination of the u n k n o w n a n d the u n p r e d i c t a b l e . T h e m a c h i n e l i k e predictability of experiences with pathological autistic shapes a n d objects substitutes for experiences with inevitably imperfect a n d not entirely

i/

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p r e d i c t a b l e h u m a n beings. N o p e r s o n c a n c o m p e t e with t h e capacity of n e v e r - c h a n g i n g autistic shapes a n d objects to p r o v i d e absolutely reliable comfort a n d protection. f" E x p e r i e n c e at the skin surface is critically i m p o r t a n t [ d u r i n g infancy in that it constitutes a n a r e n a where t h e r e lis a c o n v e r g e n c e of the infant's idiosyncratic, presymbolic world of sensory impressions, a n d t h e interpersonal w o r l d m a d e u p of objects that —as viewed b y a n outside obs e r v e r — h a v e a n existence s e p a r a t e from the infant a n d outside of his o m n i p o t e n t control j i t is on this stage t h a t t h e infant will either elaborate a w a y of b e i n g in the w o r l d in relation to the m o t h e r a n d t h e rest of the object w o r l d , o r will elaborate s e n s o r y - d o m i n a t e d ways of being ( m o r e accurately a w a y of not-being) t h a t a r e designed to insulate a p o t e n t i a l self (that n e v e r comes into being) from all t h a t lies outside of his s e n s o r y - d o m i n a t e d world. T o the extent t h a t the bodily system is closed off from m u t u a l l y t r a n s f o r m i n g experiences with h u m a n beings, t h e r e is a n a b s e n c e of "potential space" ( W i n n i c o t t , 1971a; see also O g d e n , 1985b, 1986) between oneself a n d the o t h e r (a potential psychological space b e t w e e n self-experience a n d "sensory p e r c e p t i o n J . f T h i s closed bodily world is a world w i t h o u t r o o m in which to create a distinction between symbol a n d symbolized, a n d therefore a world in which t h e r e is n o possibility for the c o m i n g i n t o b e i n g of a n i n t e r p r e t i n g s u b j e c t s it is a world in w h i c h t h e r e is n o psychological space between t h e infant a n d the m o t h e r in w h i c h transitional p h e n o m e n a m i g h t be created/discovered. T h e s y n d r o m e of pathological infantile r u m i n a t i o n is p a r a d i g m a t i c of the self-enclosed circularity of t h e pathological autistic process: R u m i n a t i o n o r m e r y c i s m . . . [is] t h e active b r i n g i n g into t h e m o u t h of swallowed food which h a s already


61

reached t h e s t o m a c h a n d which m a y h a v e started to u n d e r g o t h e process of digestion. . . . T h e food m a y b e partially reswallowed, partially lost, with serious c o n s e q u e n c e s for t h e infant's n u t r i t i o n . U n l i k e reg u r g i t a t i o n , w h e r e t h e food r u n s o u t of the infant's m o u t h w i t h o u t a n y effort, in r u m i n a t i o n t h e r e are c o m p l e x a n d purposeful p r e p a r a t o r y m o v e m e n t s particularly of t h e t o n g u e a n d of t h e a b d o m i n a l muscles. I n some cases t h e h a r d p a l a t e is stimulated b y fingers in t h e m o u t h . W h e n t h e efforts b e c o m e successful a n d t h e milk a p p e a r s on t h e b a c k of the p h a r y n x , t h e child's face is p e r v a d e d b y a n ecstatic expression. [ G a d d i n i a n d G a d d i n i , 1959, p . 166] I n infantile r u m i n a t i o n , t h e b e g i n n i n g s of t h e awareness of otherness ( t h r o u g h t h e feeding interaction) is 1 short-circuited b y t h e infant's a p p r o p r i a t i n g to himself t h e entire feeding situation a n d t h e n e n g a g i n g in a tightly closed auto-sensory cycle of c r e a t i n g his food ( m o r e accurately, c r e a t i n g his autistic shapes). T h e s e autistic shapes t h e n substitute for the m o t h e r , t h u s t r a n s f o r m i n g the feeding experience from a n a v e n u e t o w a r d increasingly m a t u r e object relatedness, i n t o a p a t h w a y l e a d i n g to objectless "self-sufficiency" (in w h i c h t h e r e is n o self). I n the analytic setting, o n e form of e q u i v a l e n t of m e r y c i s m c a n b e seen in p a t i e n t s w h o t a k e the analysis into themselves. I n s t e a d of internalizing a n analytic space in w h i c h o n e t h i n k s a n d feels one's t h o u g h t s , feelings, a n d sensations, s u c h p a t i e n t s p r e s e n t a c a r i c a t u r e of analysis in w h i c h r u m i n a t i o n a n d i m i t a t i o n substitute for a n analytic process. T h e analyst's role h a s b e e n entirely co-opted. ( S u c h p a t i e n t s often p r e s e n t t h e u n c o n s c i o u s p h a n t a s y of h a v i n g "raised themselves" by t a k i n g into themselves t h e functions of b o t h p a r e n t a n d child, t h u s replacing g e n u i n e object relatedness with a n i n n e r world

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I

of p h a n t a s i e d object relations a n d experiences with autistic s h a p e s a n d objects. M r s . M . , a 62-year-old widow w h o m I saw in intensive p s y c h o t h e r a p y for eight years, h a d originally b e e n referred to m e by her internist after a suicide a t t e m p t . She h a d used a razor to carefully m a k e d e e p incisions across h e r wrists, a r m s , legs, a n d ankles. She t h e n got into a t u b filled with w a r m w a t e r a n d patiently w a i t e d for over three h o u r s to bleed to d e a t h . After l a p s i n g i n t o a c o m a , she was discovered b y a c l e a n i n g - w o m a n . W h i l e w a i t i n g to die, she h a d felt the relief of t h e e n d of d e c a d e s of oppressive obsessive-compulsive rituals. S p e a k i n g in clipped sentences a n d almost exclusively in response to direct questions, M r s . M . told m e t h a t she would stand for h o u r s in front of o n e d o o r o r a n o t h e r in h e r a p a r t m e n t before she w o u l d allow herself to go t h r o u g h it while she a t t e m p t e d to "get a t h o u g h t right." " G e t t i n g a t h o u g h t right" involvedg e n e r a t i n g for herself a perfect m e n t a l re-creation of some experience from h e r p a s t , i n c l u d i n g all of its sensory features. For y e a r s ( i n c l u d i n g t h e initial years of t h e t h e r a p y ) , this effort was focused on a n a t t e m p t to re-experience the taste of t h e first sip of a cold glass of w i n e that t h e p a t i e n t h a d tasted early in the relat i o n s h i p with h e r h u s b a n d s o m e thirty-eight y e a r s before. She could n o t allow herself to o p e n any d o o r of h e r a p a r t m e n t , w h e t h e r to go i n t o the next r o o m or o u t into t h e hallway, until she h a d successfully completed this task. She c o m p a r e d getting a t h o u g h t right to h a v i n g a n o r g a s m ; it w a s a fitting t o g e t h e r of different sensations a n d r h y t h m s in a very specific way. F o r years, such obsessive-compulsive activity filled virtually e v e r y m o m e n t of M r s . M . ' s life. T h i s activity w a s u n d e r s t o o d in t h e course of the t h e r a p y as p r o v i d i n g a


63

form of comfort t h a t was b o t h n i g h t m a r i s h l y t y r a n n i z i n g a n d yet life-sustaining. T h e patient was terrified of the d i s r u p t i o n of h e r bodily r h y t h m s , particularly h e r b r e a t h i n g . D u r i n g h e r obsessional m a r a t h o n s , M r s . M . felt terrified of suffoc a t i n g a n d felt that she would n o t be able to r e s u m e b r e a t h i n g n o r m a l l y until she "got t h e t h o u g h t right." I n t h e m e a n t i m e , she felt t h a t she h a d to take over t h e process of b r e a t h i n g with conscious control; she could n e v e r feel t h a t her b r e a t h i n g w a s n a t u r a l , a u t o m a t i c , a n d sufficient. T h e patient w a s convinced t h a t if she forgot to b r e a t h e she would suffocate. A l t h o u g h M r s . M . highly valued t h e t h e r a p y a n d was n e v e r late to her daily m e e t i n g s with m e , she found it extremely painful w h e n I spoke because this interfered w i t h h e r ability t o c o n c e n t r a t e . T h e experience of b e i n g with this patient was q u i t e different from t h a t of b e i n g with a silent p a t i e n t for w h o m o n e feels o n e is p r o v i d i n g a "holding e n v i r o n m e n t " ( W i n n i c o t t , 1960a). I n s t e a d , I generally felt useless. M r s . M . could a n d did r u m i n a t e at h o m e in precisely t h e w a y she was d o i n g with m e . If a n y t h i n g , I seemed to m a k e things worse for h e r by placing a n a d d i t i o n a l d e m a n d on h e r —the d e m a n d t h a t she felt from m e to b e acknowledged a n d m a d e u s e of as a h u m a n b e i n g a n d as a t h e r a p i s t . I said to h e r in small bits in t h e second year of o u r w o r k t h a t I a s s u m e d t h a t m y o w n wishes to b e experienced b y h e r as h u m a n were a reflection of a n aspect of herself, b u t t h a t she did n o t at t h e m o m e n t feel she could afford this complicated l u x u r y since she was so fully involved in fighting for h e r life. She w o u l d look at m e a n d n o d as if to say, "I u n d e r s t a n d w h a t you said, b u t I ' m too b u s y to talk n o w , " a n d t h e n w o u l d c o n t i n u e with h e r task. Occasionally she w o u l d b r e a t h e a sigh of relief,

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glance at m e , n o d h e r h e a d a n d smile in a joyless w a y , saying, "I got it right." She w o u l d t h e n seem to relax a n d stare at m e as if she w e r e c o m i n g o u t of anesthesia, looking to see who it was t h a t h a d b e e n with her d u r i n g h e r ordeal. She would t h e n b e g i n to b r a c e herself for t h e inevitable r e c u r r e n c e of t h e n e e d to chase a n o t h e r t h o u g h t so t h a t even these i n t e r i m periods were far from relaxed. M r s . M . was able to offer fragments of history d u r i n g t h e brief periods of respite before b e c o m i n g fully r e - i m m e r s e d in h e r r u m i n a t i o n . I learned t h a t she h a d deeply loved a n d a d m i r e d h e r h u s b a n d , a professor t w e n t y y e a r s her senior, a n d t h a t t h e y h a d lived v e r y h a p p i l y t o g e t h e r d u r i n g their t w e n t y - t w o y e a r s of m a r r i a g e . It was eight y e a r s after his d e a t h t h a t t h e p a t i e n t a t t e m p t e d suicide. r - " D r . a n d M r s . M . h a d h a d a large p h o t o g r a p h collection of their lives t o g e t h e r which the p a t i e n t impulsively threw o u t after D r . M . died, "because it w a s too m u c h at loose e n d s to p a c k . " (It p a i n e d m e to h e a r h e r speak of this since it felt as if she h a d b r u t a l l y sliced o u t a terribly i m p o r t a n t p a r t of herself in this mnpulsive a c t . J i M r s . M . h a d saved only o n e picture from t h a t collection, a p h o t o of herself a n d her h u s b a n d w i t h a "real lion" b e t w e e n whose o p e n j a w s h e r h u s b a n d w a s h o l d i n g his h a n d . M r s . M . ' s m o t h e r h a d b e e n a psychotic actress w h o believed that she could r e a d h e r d a u g h t e r ' s m i n d a n d k n e w w h a t she was t h i n k i n g b e t t e r t h a n h e r d a u g h t e r herself did. M r s . M . as a child w a s used as a p r o p in h e r m o t h e r ' s delusional d r a m a s . T h e child kept i m p o r t a n t trinkets a n d ticket stubs in a C h i n e s e b o x given to h e r b y h e r g r a n d m o t h e r . I n a fit of rage a b o u t t h e secretive n a t u r e of this child, t h e m o t h e r (when the


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p a t i e n t w a s 10 y e a r s old) t h r e w t h e b o x a w a y while t h e p a t i e n t was at school. W h e n M r s . M . told m e this, I said t h a t I t h o u g h t I finally w a s b e g i n n i n g to u n d e r s t a n d s o m e t h i n g of t h e m e a n i n g of h e r t h r o w i n g h e r p h o t o g r a p h s a w a y ; one's most precious possessions a r e only safe if t h e y are inside of y o u . O v e r t i m e , I realized t h a t this i n t e r p r e t a t i o n w a s i n c o m p l e t e in a n i m p o r t a n t w a y . M r s . M . often indic a t e d t h a t she h a d practically n o sense of a n i n t e r n a l space within which to keep a n y t h i n g . She told m e , "I h a v e n o insides. I h a d a h y s t e r e c t o m y w h e n I w a s 45." I later said to h e r t h a t I t h o u g h t t h a t w h e n she felt she h a d n o safe place in h e r to keep the people a n d t h i n g s t h a t w e r e most i m p o r t a n t to her, she felt that she h a d t o find a w a y to freeze t i m e . " G e t t i n g a t h o u g h t right" a b o u t the taste of t h e w i n e w a s not a n a t t e m p t to r e m e m b e r s o m e t h i n g . T o r e m e m b e r w o u l d be m u c h too painful b e c a u s e she w o u l d t h e n k n o w t h a t t h e m o m e n t w a s over. I said she gave m e t h e feeling t h a t she w a s a t t e m p t i n g to b e c o m e timeless a n d placeless— t h a t she could e n t e r the sensation, t h e taste, a n d b e c o m e it. E v e r y t h i n g w o u l d b e t h e r e t h a t she n e e d e d . It w a s only t h e r e t h a t she could relax. ( T h e p h o t o g r a p h of h e r h u s b a n d holding his h a n d between the lion's o p e n j a w s m u s t also h a v e c a p t u r e d for M r s . M . a feeling t h a t t i m e could really be frozen.) M r s . M . ' s r u m i n a t i v e s y m p t o m s h a d not b e g u n with h e r h u s b a n d ' s d e a t h . F r o m adolescence a n d before she h a d d e v o t e d h e r life to endless a t t e m p t s at living in a r e a l m of timeless sensations. I n t h e t h e r a p y , I initially a t t e m p t e d to u n d e r s t a n d the m e a n i n g of the choice of e a c h sensation, b u t o v e r t i m e I realized t h a t this patient's psychological world w a s not c o m p o s e d of accretions of m e a n i n g ; r a t h e r , she lived in a world of

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The Primitive Edge of Experience timeless sensory experience t h a t was n e i t h e r i n t e r n a l n o r e x t e r n a l . T h e r u m i n a t i v e activity w a s the essence of p u r e , u n c h a n g i n g sensation. M r s . M . ' s suicide a t t e m p t a n d h e r longing for d e a t h r e p r e s e n t e d h e r h o p e t h a t if this timeless state could n o t b e achieved in life, p e r h a p s it could be achieved in d e a t h . T h e e a r l y relationship b e t w e e n M r s . M . a n d h e r m o t h e r h a d n o t resulted in t h e c r e a t i o n of a g r a d u a l i n t e r n a l i z a t i o n of a holding e n v i r o n m e n t . I n s t e a d , M r s . M . h a d defensively a t t e m p t e d to create a substit u t e for such a n e n v i r o n m e n t . She could not t a k e for g r a n t e d t h a t the r h y t h m of h e r b r e a t h i n g would sustain itself a n d h e r without her consciously willing it. T h e patient's life w a s devoted to c r e a t i n g a s u b s t i t u t e for t h e space b e t w e e n m o t h e r a n d infant in w h i c h t h e infant o r d i n a r i l y finds a place to live b e t w e e n self a n d o t h e r . In t h e a b s e n c e of such a space (symbolized b y the b o x in which t h e patient h a d a t t e m p t e d to store precious bits of herself a n d h e r relations to e x t e r n a l objects), M r s . M . a t t e m p t e d to b e c o m e sensation itself.

In t h e course of eight y e a r s of t h e r a p y , M r s . M . b e g a n to be able to live for e x t e n d e d periods of t i m e in a state of m i n d relatively free of h e r obsessive r u m i n a tions. W h i l e this was o c c u r r i n g , I increasingly felt t h a t I w a s p e r c e i v i n g the faint g l i m m e r of a living h u m a n b e i n g in t h e r o o m with m e . A t t i m e s I saw brief glimpses of a little girl c a p a b l e of s o m e j o y as M r s . M . l a u g h e d a b o u t some h u m o r o u s event in h e r life with h e r h u s b a n d o r a b o u t s o m e t h i n g I h a d said t h a t she found funny. It was with a m i x t u r e of sadness a n d a vicarious sense of relief t h a t I received a p h o n e call I h a d b e e n half expecting from t h e m o m e n t I met M r s . M . : she h a d b e e n b r o u g h t to t h e hospital after a m a s s i v e stroke a n d died soon a f t e r w a r d .

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I view t h e autistic-contiguous m o d e as a n i m p o r t a n t d i m e n s i o n of all obsessive-compulsive defenses, a n d believe t h a t these defenses always entail t h e construction of a tightly o r d e r e d sensory c o n t a i n m e n t of experience t h a t is n e v e r s i m p l y a symbolic, ideational o r d e r i n g of experience designed to w a r d off, control, a n d express conflicted unconscious anal-erotic wishes a n d fears. T h i s form of defense regularly serves to p l u g sensonally >f sself t h r o u g h experienced holes in the individual's sense of w h i c h t h e p a t i e n t fears a n d feels (m. t h e most concrete sensory w a y ) t h a t n o t only ideas, b u t actual bodily c o n t e n t s , will leak. Obsessive-compulsive s y m p t o m s a n d defenses h a v e t h e i r origins in the infant's earliest efforts at o r d e r i n g a n d creating a sense of b o u n d e d n e s s for his sensory experience. V e r y early o n , such efforts at organ i z a t i o n a n d definition c o m e to b e utilized in the service of w a r d i n g off anxiety related to the d i s r u p t i o n of the s e n s o r y - d o m i n a t e d , r u d i m e n t a r y sense of self.

The Nature

of Autistic-Contiguous

Anxiety

E a c h of the t h r e e basic psychological o r g a n i z a t i o n s (the autistic-contiguous, the p a r a n o i d - s c h i z o i d a n d the depressive) is associated with its o w n characteristic form of a n x i e t y . I n each case, the n a t u r e of t h e anxiety is related to t h e e x p e r i e n c e of disconnectedness (dis-integration) w i t h i n t h a t m o d e of experience, w h e t h e r it be the d i s r u p tion of whole object relations in t h e depressive position, t h e f r a g m e n t a t i o n of p a r t s of self a n d object in t h e p a r a n o i d - s c h i z o i d position, o r the d i s r u p t i o n of sensory >ry cohesion a n d b o u n d e d n e s s in the autistic-contiguous position. D e p r e s s i v e anxiety involves t h e fear t h a t o n e h a s in

^

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fact or in p h a n t a s y h a r m e d o r d r i v e n a w a y a p e r s o n w h o m o n e loves; anxiety in a p a r a n o i d - s c h i z o i d m o d e is a t c o r e a sense ol i m p e n d i n g a n n i h i l a t i o n which is experienced in t h e form of f r a g m e n t i n g attacks on the self a n d o n one's objects; autistic-contiguous anxiety involves t h e e x p e r i e n c e of i m p e n d i n g d i s i n t e g r a t i o n of one's sensory surface o r one's " r h y t h m of safety" ( T u s t i n , 1986), r e s u l t i n g in t h e feeling ol leaking, dissolving, d i s a p p e a r ing, o r falling into shapeless u n b o u n d e d space (cf. Bick, 1968; E . G a d d i n i , 1987; Rosenfeld, 1984). C o m m o n manifestations of autistic-contiguous anxiety include terrifying feelings t h a t o n e is rotting; t h e sensation t h a t one's sphincters a n d o t h e r m e a n s of cont a i n i n g bodily contents are failing a n d t h a t one's saliva, tears, u r i n e , feces, b l o o d , m e n s t r u a l fluids, a n d so forth a r e leaking; fear t h a t o n e is falling-for e x a m p l e , anxiety c o n n e c t e d w i t h falling asleep for fear t h a t one will fall into endless, shapeless space. P a t i e n t s e x p e r i e n c i n g this form of i n s o m n i a often a t t e m p t to relieve their anxiety (their fear of "falling asleep") by tightly s u r r o u n d i n g themselves w i t h blankets a n d pillows, k e e p i n g bright lights o n in their b e d r o o m s o r p l a y i n g familiar m u s i c all night. M s . K . , a 25-year-old g r a d u a t e s t u d e n t , b e g a n t h e r a p y b e c a u s e of h e r t e r r o r of the fog a n d of t h e sound of t h e o c e a n . T h e fog was frighteningly suffocating: "You can't see the h o r i z o n . " T h e p a t i e n t was terrified of "going crazy" a n d of b e i n g u n a w a r e t h a t it was h a p p e n i n g ; she frequently beseeched t h e therapist to inform h e r if the therapist should sense t h a t the patient w a s losing t o u c h with reality. W h e n M s . K . was 4 m o n t h s old, h e r m o t h e r


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c o n t r a c t e d spinal m e n i n g i t i s a n d w a s hospitalized for fourteen m o n t h s . F r o m the t i m e the m o t h e r r e t u r n e d h o m e , she tyrannically ruled t h e h o u s e from t h e m e t a l wheelchair to which she was confined. T h e patient's earliest m e m o r y (which seemed to h e r as m u c h a d r e a m as a m e m o r y ) w a s of r e a c h i n g o u t to her m o t h e r in t h e wheel chair a n d b e i n g p u s h e d a w a y b y h e r . A t the s a m e m o m e n t , t h e p a t i e n t , in this m e m o r y , looked out of the w i n d o w a n d saw a small girl falling t h r o u g h the ice o n t h e p o n d t h a t was located j u s t b e h i n d the patient's h o u s e . M r s . K . said to her d a u g h t e r , "You'd b e t t e r go save h e r . " I view this " m e m o r y " as a vivid r e p r e s e n t a t i o n of t h e patient's experience of falling t h r o u g h t h e c o n t a i n i n g surface of self (initially created in t h e interaction of m o t h e r a n d infant). M s . K . is b o t h t h e small child falling t h r o u g h t h e ice a n d the older child w h o m u s t try to pull t h e y o u n g e r o n e o u t of t h e hole before she d r o w n s . T h e metallic, w h e e l c h a i r - m o t h e r is felt to be incapable of s a v i n g t h e child a n d in fact seems to b e the one w h o is unconsciously b e i n g b l a m e d for t h e little girl's fall t h r o u g h t h e hole (the m o t h e r ' s p u s h i n g M s . K . away). T h e o c e a n a n d the fog c a m e to b e experienced b y M s . K . as t h e ever-present d a n g e r of a n n i h i l a t i n g shapelessness into which she m i g h t fall. Because of the t e n u ousness of t h e patient's sense of cohesiveness of self, she lived in c o n s t a n t fear of "going crazy" (losing "touch" with reality in a literal, sensory w a y ) . n " h e p a t i e n t lacked the feeling of sensory g r o u n d e d n e s s t h a t is ordinarily p r o v i d e d b y t h e interpersonal "touch" of o u r shared sensory! experience of t h e world, which heavily c o n t r i b u t e s to o u n sense of b e i n g sane.

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The Primitive Edge of Experience Autistic-Contiguous

Modes

of

Defense

Defenses g e n e r a t e d in a n autistic-contiguous m o d e a r e directed at re-establishment of the continuity of the b o u n d e d sensory surface a n d of" t h e o r d e r e d r h y t h m i c i t y u p o n which t h e early integrity of self rests. W i t h i n the analytic h o u r , patients s p a n n i n g the full r a n g e of psychological m a t u r i t y c o m m o n l y a t t e m p t to reconstitute a sensory "floor" (Grotstein, 1987) of experience by m e a n s of activities like h a i r twirling o r foot t a p p i n g (even while lying on the couch); stroking of t h e lips, crjeek, o r e a r lobe; h u m m i n g , i n t o n i n g , p i c t u r i n g o r r e p e a t i n g series of n u m b e r s , focusing on s y m m e t r i c a l geometric shapes on the ceiling or wall, o r u s i n g a finger to trace shapes on t h e wall next to t h e couch. Such activities c a n be t h o u g h t of as self-soothing uses of autistic shapes. -"* Between analytic h o u r s , p a t i e n t s c o m m o n l y a t t e m p t to m a i n t a i n o r re-establish a failing sense of bodily cohesion by m e a n s of r h y t h m i c m u s c u l a r activities inc l u d i n g l o n g periods of bicycle riding, j o g g i n g , lap / s w i m m i n g , a n d the l i k e ^ / e a t i n g a n d p u r g i n g rituals; r o c k i n g (sometimes in a r o c k i n g chair); h e a d b a n g i n g (often against a pillow); r i d i n g buses a n d subways or d r i v i n g a car for h o u r s ; m a i n t a i n i n g a n d continually w o r k i n g on ("perfecting") a system of n u m b e r s o r geom e t r i c slyapes in one's h e a d or in c o m p u t e r p r o g r a m s ; a n d so o n . ( T h e absolute regularity of these activities is so essential to the process of allaying anxiety t h a t t h e individual c a n n o t o r will not allow a n y o t h e r activity to Jtake p r e c e d e n c e over t h e m . Bick (1968, 1986) uses t h e p h r a s e "second skin formation" to describe the w a y in which t h e individual a t t e m p t s to create a substitute for a d e t e r i o r a t i n g sense of


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t h e cohesiveness of skin surface. Often tthe individual a t t e m p t s to use the sensory experience of a a h e r i n g to t hiee )f surface of the object in o r d e r to resurrect t h e integrity of his o w n surface. M e l t z e r a n d colleagues (1975) h a v e i n t r o d u c e d the t e r m adhesive identification to refer to the defensive a d h e r ence to the object in the service o l allaying t h e anxiety of d i s i n t e g r a t i o n . I m i t a t i o n a n d m i m i c r y , lor instance, are utilized in a n effort to m a k e use of the surface of t h e object as if it were one's o w n . I n a n autistic-contiguous m o d e , o n e a t t e m p t s to defend against the anxiety of disintegration b y sticking bits of t h e surface of the object to one's o w n failing surface. M r s . R . , in a regressed phase of h e r analysis, w o u l d s p e n d h o u r s at a t i m e picking at h e r face. She suffered from severe i n s o m n i a in large p a r t d u e to a fear of n i g h t m a r e s t h a t she could not recall. O v e r t i m e h e r face b e c a m e covered with scabs, a n d she picked at these. As this "picking" was o c c u r r i n g in the analytic h o u r s , the patient was clearly in a painfully a n x i o u s state a l t h o u g h . s h e said t h a t she h a d "absolutely n o thoughts." M r s . R . took bits of tissue from the K l e e n e x b o x n e x t to the couch a n d stuck t h e m to the lesions she w a s c r e a t i n g on h e r face. (She w o u l d also take e x t r a pieces of these tissues h o m e with h e r at the e n d of the h o u r . ) It did n o t seem to m e t h a t either self-destructive wishes o r displaced hostility t o w a r d m e was at t h e core of this activity at this point in the analysis. I told her t h a t I t h o u g h t she m u s t feel as if she w e r e without skin; t h a t she did not sleep b e c a u s e w h e n she was asleep she m u s t feel psychologically defenseless to the d a n g e r of night-

72


m a r e s . I said that I could u n d e r s t a n d h e r a t t e m p t to cover herself with m y skin (tissues) since this seemed to m a k e h e r feel a little less r a w . I n the h o u r following this i n t e r v e n t i o n , M r s . R . fell asleep a n d slept for almost t h e entire session until I woke h e r to tell her t h a t o u r t i m e was u p . D u r i n g the next m e e t i n g , the patient said t h a t even t h o u g h she h a d n o t h a d a b l a n k e t while sleeping in m y office, she h a d the distinct feeling w h e n recalling that session that she h a d b e e n sleeping u n d e r some sort of cover. M r s . R . ' s capacity to sleep d u r i n g h e r session r e p r e s e n t e d a n e x p a n d e d a n d m o r e fully symbolic use of m e as a second skin. She h a d utilized m e a n d the analytic setting as a symbolic a n d yet tangibly felt m e d i u m in which to w r a p herself. She h a d t h u s felt sufficiently covered a n d held together to safely sleep. Before c o n c l u d i n g this section, I would like to briefly m e n t i o n two forms of s y m p t o m a t o l o g y in which t h e concept of autistic-contiguous m o d e s of defense m u s t s u p p l e m e n t u n d e r s t a n d i n g s f o r m u l a t e d in t e r m s of defenses erected to deal with anxiety resulting from conflicted sexual a n d aggressive wishes. F i r s t , ( c o m p u l s i v e m a s t u r b a t i o n often serves t h e p u r p o s e of c r e a t i n g a h e i g h t e n e d experience of a sensory surface in o r d e r to | j v a r d off feelings of loss of sensory c o h e s i o n J F o r e x a m ple, a female patient would m a s t u r b a t e for h o u r s each d a y w i t h o u t conscious sexual fantasy. O r g a s m was n o t t h e goal. W h e n o r g a s m did occur, it w a s experienced as a n u n w e l c o m e "anticlimax" w h i c h e n d e d the only p a r t of the patient's d a y d u r i n g which she felt "alive a n d in o n e piece." Secondly, painful, a n x i e t y r p r o d u c i n g procrastination also often serves t h e p u r p o s e of g e n e r a t i n g a p a l p a b l e

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sensory e d g e against w h i c h the p a t i e n t a t t e m p t s to define himself. T h e "deadline" is elevated to t h e position of a continually felt p r e s s u r e in t h e patient's e m o t i o n a l life t h a t c a n b e a felt presence at every m o m e n t , w h e t h e r o r not t h e p a t i e n t is consciously focused u p o n it. T h e s e p a t i e n t s describe the anxiety of t h e a p p r o a c h i n g d e a d l i n e as a p r e s s u r e t h a t they h a t e , a n d yet at the s a m e t i m e continually seem to create for themselves: "A d u e d a t e is s o m e t h i n g to p u s h u p against like a wall in front of m e . " U n d e r such circumstances, a d e a d l i n e t h a t is finally m e t does n o t usually p r o d u c e m o r e t h a n a sense of m o m e n t a r y relief, a n d instead often t h r o w s the patient into a state of panic. V e r y frequently such p a t i e n t s b e c o m e physically ill once the task h a s b e e n completed (usually at t h e last possible m o m e n t p r i o r to the deadline), e x p e r i e n c i n g such s y m p t o m s as m i g r a i n e h e a d a c h e s , d e r m a t i t i s , o r somatic delusions. S u c h s y m p t o m s c a n be u n d e r s t o o d as substitute efforts at m a i n t a i n i n g a sensory surface in t h e absence of the c o n t a i n i n g pressure of the deadline.

Internalization

in the

Autistic-Contiguous

Position

As previously m e n t i o n e d , in a psychological field in which t h e individual h a s little if a n y sense of i n t e r n a l space, the concept of internalization b e c o m e s virtually meaningless; this is especially t r u e w h e n t h e idea of internalization ( i n c l u d i n g identification a n d introjection) is linked to t h e n o t i o n of conscious a n d u n c o n s c i o u s fantasies a b o u t t a k i n g p a r t s o r all of a n o t h e r p e r s o n into oneself. N o n e theless, psychological c h a n g e c a n result from experience

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with external objects in a n autistic-contiguous m o d e ; such c h a n g e is m e d i a t e d in p a r t b y t h e process of imitation. I n autistic-contiguous forms of i m i t a t i o n , the individual experiences a c h a n g e in t h e s h a p e of his surface as a result of the ipfluence of his relations with external objects. At ftTmes,(imitation is o n e of t h e few ways the individual h a s ' o f h o l d i n g o n t o attributes of t h e object, in t h e absence of t h e experience of h a v i n g a n i n n e r space in which the o t h e r person's qualities or p a r t s c a n in p h a n t a s y be stored (cf. I?. G a d d i n i , 1969). Since in a n autistic-contiguous m o d e t h e feeling a n d p h a n t a s y of b e i n g e n t e r e d is s y n o n y m o u s with b e i n g t o r n o r p u n c t u r e d , i m i t a t i o n allows t h e influence of the o t h e r to be carried o n one's surface. I n pathological a u t i s m this s o m e t i m e s manifests itself as echolalia o r as a n endless repetition of a p h r a s e o r a w o r d uttered by another person.3 I m i t a t i o n as a m e t h o d of a c h i e v i n g a d e g r e e of . cohesiveness of self m u s t be distinguished from W i n nicott's (1963b) concept of a False Self personality org a n i z a t i o n . T h e r e is n o t h i n g false a b o u t autisticc o n t i g u o u s i m i t a t i o n in t h a t it does not stand in contrast to, o r serve to disguise o r protect, s o m e t h i n g t r u e r o r

(

m o r e g e n u i n e within: t h e r e is n o within o r w i t h o u t . Q n a n autistic-contiguous m o d e , o n e is one's surface, a n d therefore t h e act of imitation is a n effort at b e c o m i n g o r

3

Awareness of the importance of the role of imitation in normal early development — prior to the development of "internalization processes"—is reflected in Fenichel's (1945) comment (later elaborated upon 'by E. Gaddini [1969, 1987] and Schafer [1968]) that(?arly on, imitation represents an important aspect of sensory perception. One perceives the other by experiencing the other's qualities through one's own bodily sensations, in the process of creating (shaping) oneself in the likeness of the other.


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r e p a i r i n g a cohesive surface o n w h i c h a locus of self c a n I develop. J I m i t a t i o n serves not only as a form of perception, a defense, a n d a w a y of "holding o n t o " (being shaped by) t h e o t h e r , it serves also as an i m p o r t a n t form of object relatedness in a n autistic-contiguous m o d e . I n a previous p a p e r (1980), I described aspects of m y w o r k with a hospitalized chronically schizophrenic p a t i e n t w h o for y e a r s lived in a world so stripped of m e a n i n g t h a t people a n d things were t r e a t e d by h i m as completely i n t e r c h a n g e a b l e . Phil seemed psychologically d e a d as he lay on t h e floor of m y office o r w a s escorted from o n e hospital "activity" to a n o t h e r . T h e initial form of contact t h a t h e m a d e with m e in the t h e r a p y was by i m i t a t i n g m y p o s t u r e , m y t o n e of voice, m y every gesture, every w o r d I spoke, a n d every facial expression I m a d e . R a t h e r t h a n c e l e b r a t i n g this as his e n t r y into t h e land of t h e living, I experienced it at the t i m e as a n attack o n m y ability to feel alive. I felt as if m y s p o n t a n e i t y w a s b e i n g tyrannically d r a i n e d o u t of m e . N o t h i n g I did felt n a t u r a l . A t t h a t t i m e I u n d e r s t o o d this as a form of projective identification (cf. O g d e n , 1979, 1982b, 1983), in which the p a t i e n t was e n g e n d e r i n g in m e ( c o m m u n i c a t i n g to m e ) his o w n feelings of lifelessness a n d incapacity for s p o n t a n e i t y as well as his inability to feel alive in a n y w a y . H o w e v e r , I did not at the t i m e sufficiently u n d e r s t a n d t h e p h e n o m e n a t h a t I a m referring to h e r e as autisticc o n t i g u o u s to appreciate the n a t u r e of t h e affection in the patient's i m i t a t i o n of m e . H e was u s i n g m e as a second skin or c o n t a i n e r within which he was e x p e r i m e n t i n g in a p r i m i t i v e w a y with w h a t it m i g h t feel like to be alive. H e w a s p a y i n g m e a very great c o m p l i m e n t indeed by i n d i c a t i n g t h a t it was to be m y skin in which he would c o n d u c t this e x p e r i m e n t .

u

76


W i n n i c o t t (1965), in a letter to M i c h a e l F o r d h a m , a d d r e s s e d —from the perspective of t h e t r e a t m e n t of a n autistic child — the role of i m i t a t i o n as a primitive form of object relatedness. I k n o w a n autistic child w h o is t r e a t e d by v e r y clever i n t e r p r e t a t i o n s a n d w h o h a s d o n e m o d e r a t e l y well. W h a t started off the t r e a t m e n t w a s , h o w e v e r , somet h i n g w h i c h the first analyst d i d , a n d it is strarige t h a t I h a v e n e v e r b e e n able to get t h e second analyst to a c k n o w l e d g e the i m p o r t a n c e of w h a t I will describe. T h e first analyst, D r . M i d a H a l l , d i e d . D r . H a l l found this b o y w h o h a d g o n e autistic after b e i n g n o r m a l a n d sat in the r o o m with h i m a n d established a c o m m u n i c a t i o n b y d o i n g e v e r y t h i n g t h a t this b o y did. H e would sit still for a q u a r t e r of a n h o u r a n d t h e n m o v e his foot a little; she would m o v e h e r foot. H i s finger w o u l d m o v e a n d she would i m i t a t e , a n d this went on for a l o n g time. O u t of these b e g i n n i n g s e v e r y t h i n g showed signs of develo p i n g u n t i l she d i e d . If I could h a v e got t h e clever analyst to j o i n on to all this I t h i n k we m i g h t b y n o w h a v e h a d s o m e t h i n g like a c u r e instead of h a v i n g to p u t u p with o n e of those m a d d e n i n g cases w h e r e a lot of good w o r k h a s b e e n d o n e a n d e v e r y b o d y is very pleased b u t t h e child is not satisfactory. [ W i n n i c o t t , 1965, p p . 150-151] I m i t a t i o n in a n autistic-contiguous m o d e is by n o m e a n s restricted to p a t i e n t s suffering from pathological childhood a u t i s m , b o r d e r l i n e conditions, a n d schizophren i a . It is very c o m m o n for a therapist early in t r a i n i n g to a t t e m p t to i m i t a t e his supervisors o r his own therapist in

77


a n a t t e m p t to hide from himself the a b s e n c e of his own identity as a t h e r a p i s t . O n e such therapist described this experience as "using t h e skin of t h e supervisor" w h e n he was with his p a t i e n t s . T h i s "skin" w a s felt to-be "stripped off" w h e n a second supervisor w a s critical of this student's w o r k , l e a d i n g t h e t r a i n e e to feel painfully "raw." H e w o u l d t h e n i m m e d i a t e l y a t t e m p t to "take on the skin of the second supervisor." I n t h e r a p y , this patient i m i t a t e d his o w n p a t i e n t s by p r e s e n t i n g their difficulties as his o w n , t h u s d e f e n d i n g against his a w a r e n e s s of the feeling t h a t he did n o t h a v e a voice of his o w n with which to speak. I n s t e a d , the p a t i e n t desperately a t t e m p t e d to get t h e therapist to m a k e i n t e r p r e t a t i o n s a n d give advice w h i c h w o u l d serve as substitutes for t h e patient's o w n t h o u g h t s a n d feelings, as well as a substitute for a voice t h a t he could feel was his o w n .

Autistic-Contiguous and

the Binding

Power

Anxiety of

Symbols

As h a s b e e n discussed in this a n d the p r e v i o u s c h a p t e r , each of the t h r e e m o d e s of g e n e r a t i n g experience — the depressive, t h e paranoid-schizoid, a n d the autisticc o n t i g u o u s — r e p r e s e n t s a pole of a dialectical process b e t w e e n w h i c h experience is g e n e r a t e d . Psychopathology can be t h o u g h t of as a collapse of the g e n e r a t i v e dialectical interplay of m o d e s of experience (cf. O g d e n , 1985b, 1986).(Collapse in t h e direction of a n autistic-contiguous" m o d e results in a t y r a n n i z i n g i m p r i s o n m e n t in a closed system of bodily sensations t h a t p r e c l u d e s the developm e n t of "potential space" ( W i n n i c o t t , 1971a). Collapse in

78


the direction of a paranoid-schizoid m o d e results in a sense of e n t r a p m e n t in a world of things-in-themselves w h e r e i n o n e does not experience oneself as t h e a u t h o r of one's o w n t h o u g h t s a n d feelings; r a t h e r , t h o u g h t s , feelings, a n d sensations are experienced as objects o r forces b o m b a r d i n g , e n t e r i n g into, o r propelled from oneself. C o l l a p s e in t h e direction of a depressive m o d e results in the experience of a subject alienated from his bodily sensations a n d from the i m m e d i a c y a n d s p o n t a n e i t y of lived e x p e r i e n c e . A discussion of t h e diversity a n d complexity of the dialectical interplay of the depressive, the p a r a n o i d schizoid a n d t h e autistic-contiguous m o d e s was b e g u n in the p r e v i o u s c h a p t e r . I would like to offer some additional observations h e r e a b o u t a n aspect of this interplay of / m o d e s . ( T h e r e is a form of i n t e r p e n e t r a t i o n of autisticc o n t i g u o u s a n d depressive m o d e s t h r o u g h which t h e sensory b o u n d e d n e s s of the autistic-contiguous position, a n d t h e capacity for symbol f o r m a t i o n , historicity, a n d subjectivity of the depressive position, together cont r i b u t e to t h e creation of a whole t h a t is l a r g e r t h a n t h e s u m of its p a r t s . I n the absence of this m u t u a l l y g e n e r a tive i n t e r p l a y , specific forms of psychopathology are g e n e r a t e d . It is to these types of p a t h o l o g y t h a t I shall n o w t u r n t h e focus of discussion. D i s c o n n e c t e d n e s s of the depressive m o d e from t h e autistic-contiguous m o d e leads to psychological states in which the individual becomes either alienated from o r e n t r a p p e d in sensory experience. I n the former case,_ the individual defensively a t t e m p t s to use ideas, words, a n d o t h e r forms of symbol formation proper (Segal, 1957\ as substitutes l o r a n internal sensory g r o u n d e d n e s s in sensat i o n - d o m i n a t e d experience. T h i s form of alienation from


79

one's sensory experience is illustrated in t h e following clinical e x a m p l e . M r . D . , a n extremely bright g r a d u a t e s t u d e n t in philosophy, b e g a n analysis at t h e age of 25. H e told m e t h a t h e did n o t k n o w what it m e a n t to feel sexual desire. T h e p a t i e n t h a d , of c o u r s e , h e a r d o t h e r people describe such feelings, b u t he did not k n o w from his o w n e x p e r i e n c e w h a t it felt like to b e sexually excited. H e could, with effort, spend t i m e with a n d converse with fellow s t u d e n t s of b o t h sexes, b u t h e did not feel t h a t a n y t h i n g he did was " n a t u r a l . " I n fact, n o t h i n g in his life felt n a t u r a l with the exception of the t i m e he spent k a y a k i n g d u r i n g which h e could completely relax a n d "flow w i t h t h e river" in a n unself-conscious w a y . I n this case, n e i t h e r the autistic-contiguous m o d e n o r the depressive m o d e was absent, b u t each h a d b e c o m e disconnected from t h e o t h e r . M r . D . p e r p e t u ally felt like a visitor. T r a v e l i n g in an a i r p l a n e provided a n o t h e r of t h e r a r e occasions d u r i n g w h i c h he could relax: he k n e w he did not fit in t h e place h e h a d left a n d he k n e w he w o u l d n o t fit in the place to which he was going, b u t at least for the d u r a t i o n of t h e flight he felt less painfully o u t of place. It is only in the generative interplay of the autistic-contiguous a n d t h e depressive m o d e s of g e n e r a t i n g experience that o n e creates the feeling t h a t o n e h a s a place of one's o w n in t h e "order of t h i n g s , " a n d c a n do things in a w a y t h a t feels natural. I n the case of M r . D . , t h e collapse of the dialectical interplay of the autistic-contiguous a n d the depressive m o d e s —a collapse in his case in the direction of the depressive—led to a rigidly defensive a n d im-

80

The Primitive Edge of Experience p o v e r i s h e d psychological state t h a t m i g h t be t h o u g h t of as a schizoid state ( F a i r b a i r n , 1940) o r a "dis-affected state" ( M c D o u g a l l , 1984). P e r h a p s M r . D . ' s psychological state m i g h t be best described as a "de-sensate state."

T h e dialectic of the autistic-contiguous a n d t h e depressive m o d e s of g e n e r a t i n g e x p e r i e n c e m a y also collapse in the direction of the autistic-contiguous, l e a d i n g to a feeling of e n t r a p m e n t in a world of sensation t h a t is almost completely u n m e d i a t e d a n d undefined b y symbols. M a n y years ago, I i n a d v e r t e n t l y s t u m b l e d u p o n a w a y of c r e a t i n g for oneself this type of disconnection of t h e autistic-contiguous m o d e from the depressive m o d e . After d i n n e r o n e n i g h t , while I was still sitting at the d i n i n g - r o o m table, it s u d d e n l y o c c u r r e d to m e h o w s t r a n g e it w a s t h a t the t h i n g called a n a p k i n w a s n a m e d b y the conjunction of t h e sounds "nap" a n d "kin." I r e p e a t e d t h e two s o u n d s over a n d over until I b e g a n to get the very frightening feeling t h a t these s o u n d s h a d n o connection at all with this t h i n g t h a t I was looking at. I could not get these s o u n d s to n a t u r a l l y " m e a n " t h e t h i n g that t h e y h a d m e a n t only m i n u t e s before. T h e link w a s b r o k e n , a n d , to m y h o r r o r , could not be m e n d e d simply b y a n act of will. I i m a g i n e d t h a t I could, if I chose to, destroy t h e p o w e r of a n y a n d all w o r d s to " m e a n " s o m e t h i n g if I t h o u g h t a b o u t n h e m o n e at a t i m e in this w a y . £ \ t t h a t p o i n t , I h a d the very d i s t u r b i n g feeling that I h a d discovered a w a y to drive myself crazy. I i m a g i n e d t h a t all t h i n g s in the world could c o m e to feel as disconnected as the n a p k i n h a d b e c o m e for m e now t h a t it h a d b e e n disconnected from the w o r d t h a t h a d formerly n a m e d it. F u r t h e r , I felt t h a t I could b e c o m e utterly disconnected from t h e rest of the world b e c a u s e all o t h e r people would still share in a ' n a t u r a l " (i.e., a still meaningful) system of words. S u c h


81

is t h e n a t u r e of the b e g i n n i n g s of a collapse of the dialectic of e x p e r i e n c e in the direction of sensationd o m i n a t e d e x p e r i e n c e t h a t is u n m e d i a t e d by the use of symbols. It t o o k some years before t h e w o r d "napkin" r e - e n t e r e d m y v o c a b u l a r y in a fully unself-conscious w a y . T h e fact t h a t one's experience of self is powerfully r o o t e d in t h e dialectical interplay of the sensory a n d the symbolic is often highly visible in psychoanalytic w o r k with teachers a n d s t u d e n t s of l i n g u i s t i c s . r T h e s e patients! often e x p e r i e n c e anxiety states b o r d e r i n g o n p a n i c in association with the feeling t h a t t h e y a r e dissolving as t h e y d i s m a n t l e t h e b i n d i n g p o w e r of l a n g u a g e y T h i s h a s in e a c h case t h a t I h a v e e n c o u n t e r e d led to t h e patient's n e e d to leave t h e field of linguistics at least t e m p o r a r i l y .

Summary I n this c h a p t e r , t h e idea of an autistic-contiguous position h a s b e e n p r o p o s e d as a w a y of c o n c e p t u a l i z i n g a psychological o r g a n i z a t i o n m o r e p r i m i t i v e t h a n either the p a r a n o i d - s c h i z o i d o r t h e depressive position. T h e autisticc o n t i g u o u s m o d e is conceptualized as a sensoryd o m i n a t e d , p r e s y m b o l i c m o d e of g e n e r a t i n g experience w h i c h provides a good m e a s u r e of the b o u n d e d n e s s of h u m a n e x p e r i e n c e , a n d t h e b e g i n n i n g s of a sense of the place w h e r e one's experience occurs. A n x i e t y in this m o d e consists of a n u n s p e a k a b l e t e r r o r of t h e dissolution of b o u n d e d n e s s r e s u l t i n g in feelings of l e a k i n g , falling, o r dissolving i n t o endless, shapeless space. P r i n c i p a l forms of defense, w a y s of o r g a n i z i n g a n d defining experience, types of relatedness to objects, a n d a v e n u e s to psychological c h a n g e in t h e autistic-contiguous position, h a v e b e e n discussed a n d clinically illustrated in this c h a p t e r .

4 T h e

S c h i z o i d

C o n d i t i o n

. . . or music heard so deeply That it is not heard at all, but you are the music, T . S. Eliot, "The Dry Salvages"

It h a s b e e n half a c e n t u r y since F a i r b a i r n (1940) p u b lished his p i o n e e r i n g w o r k , "Schizoid factors in the personality." I believe t h a t most of w h a t is presently u n d e r s t o o d a b o u t schizoid p h e n o m e n a c a n be found in t h a t classic p a p e r a n d in t h e t h r e e t h a t followed shortly thereafter (1941, 1943, 1944). H o w e v e r , d e v e l o p m e n t s in analytic t h i n k i n g over the past t w e n t y years r e q u i r e t h a t we r e - e x a m i n e o u r conception of the schizoid personality. N o longer is it possible to m a i n t a i n t h e views of F a i r b a i r n a n d later of K l e i n (1946), that the schizoid o r g a n i z a t i o n r e p r e s e n t s t h e most primitive h u m a n psychological organ i z a t i o n . I n t h e present c h a p t e r , I p r o p o s e t h a t autisticc o n t i g u o u s p h e n o m e n a c a n b e t h o u g h t of as the " u n d e r belly"—or t h e primitive e d g e — o f the schizoid personality organization. 83

84


I shall begin by d e l i n e a t i n g w h a t it is t h a t I h a v e in m i n d w h e n I refer to the schizoid c o n d i t i o n . T h e initial p i c t u r e t h a t will be p r e s e n t e d r e p r e s e n t s a condensation of m y o w n i n t e r p r e t a t i o n of the w o r k of F a i r b a i r n a n d K l e i n . A l t h o u g h the metapsychologies of F a i r b a i r n a n d K l e i n differ in f u n d a m e n t a l w a y s , I h a v e found t h a t these analysts a r e in basic a g r e e m e n t with r e g a r d to t h e p h e n o m e n o l o g y of schizoid experience. T h i s will be followed by a discussion of aspects of t h e w o r k of W i n n i c o t t a n d G u n t r i p t h a t address the schizoid c o n d i t i o n . Finally, I shall discuss portions of the analysis of a schizoid p a t i e n t in a n effort to d e m o n s t r a t e t h e w a y in which analytic t h i n k i n g a b o u t schizoid p h e n o m e n a m u s t i n c o r p o r a t e a n u n d e r s t a n d i n g of the n a t u r e of the interplay of autisticc o n t i g u o u s a n d paranoid-schizoid m o d e s of g e n e r a t i n g experience.

Schizoid

Phenomena

( T h e schizoid p a t i e n t 1 to a large d e g r e e has retreated from ( o b j e c t relations with whole e x t e r n a l objects into a n I i n t e r n a l world comprised of conscious a n d unconscious 'The term schizoid is used in this chapter to refer to that aspect of all personalities that is organized around unconscious defensive attachment of asrvrts of the self to internal objects. When this universal dimension of the personality becomes nypertrophied for defensive purposes, it forms the basis for a range of types of psychopathology, including schizoid and narcissistic character disorders. Schizophrenia stands in marked contrast to the schizoid personality organization in that the former represents a fragmentation (disorganization) of the personality, whereas the latter represents a form of psychological cohesiveness based on stable (though often rigid) internal object relationships.

The Schizoid Condition

85

relations to i n t e r n a l objects. T h e s e p h a n t a s i e d object I relations are c o n d u c t e d in a realm of o m n i p o t e n t t h o u g h t \ with h e a v y reliance on splitting a n d projective identification as m o d e s of defense. It is a world of heroes a n d villains, of persecutors a n d victims; a world in which object ties a r e often addictive in n a t u r e , a n d loved objects are t a n t a l i z i n g a n d u n a t t a i n a b l e ; a world in which introjects a r e omniscient a n d c o n d u c t u n r e l e n t i n g l y critical n a r r a t i v e s of one's p h a n t a s i e d a n d actual b e h a v i o r . ( F o r i this individual, external objects are so t h o r o u g h l y ! eclipsed by transference projections of his internal object I world t h a t t h e qualities of the external object are barely I discernible. -* T o the e x t e n t that the external world is blanketed in a s h r o u d of transference projections, t h e individual is u n a b l e to l e a r n from experience. T h e p r e s e n t is m e r e l y a r e - e n a c t m e n t of t h e past u s i n g external objects as p r o p s for t h e re-creation of a timeless i n t e r n a l d r a m a . W h e n a n external object fails to conform to t h e unconscious script a n d direction of the p a t i e n t , t h e use of denial, c o n t e m p t , grandiosity, distortion of p e r c e p t i o n , a n d / o r e m o t i o n a l w i t h d r a w a l serve to reduce to a m i n i m u m the

2

For Fairbairn (1944, 1946), the stability of unconscious attachments to internal objects is the principal source of the stability of the organization of the personality of every individual. Unconscious attachment to internal objects is the "glue* that holds together all personality organizations. The schizoid individual has "too much glue" in the sense that his internal attachments are so intense as to almost completely foreclose emotional involvement with external objects, ylowever, in extreme cases, psychic energy is withdrawn n o t ! only from external object relations, but from internal object relations as well. The result is a catastrophic "loss of the ego" (Fairbairn 1941, p. 42)—in effect, a destruction of the schizoid ego organization and the onset of schizophrenic breakdown. (•

86


i m p a c t of the experience with t h e external object. As a result, the individual r e m a i n s u n c h a n g e d by his experience in the world. H e unconsciously knows t h a t h e is a n a c t o r t r a p p e d in his own i n t e r n a l d r a m a , a n d as a result experiences profound feelings of futility a n d e m p t i n e s s . """ T h e e m p t i n e s s of t h e schizoid patient is not simply the e m p t i n e s s of loneliness; it is also the emptiness of u n g r o u n d e d n e s s in a n y t h i n g outside of his own m i n d . It 'is the e m p t i n e s s of a self t h a t is i m a g i n a r y because it is disconnected from intersubjective h u m a n experience, t h r o u g h Which t n e sen o r d i n a r i l y acquires a sense of its o w n realness t h r o u g h recognition by t h e other ( H a •Bermas, WTO; Hegel, 1UU7; K o j e v e , 1934-1935). ( T h e schizoid patient is "occupied b y , " a n d preoccupied w i t h , his i n t e r n a l object relationships; a n d yet these relationships a r e , in themselves, i n s u b s t a n t i a l , l e a d i n g to a state n j f e m o t i o n a l i m p o v e r i s h m e n t T T h e situation is a n a l o g o u s to t h a t of t h e infant suffering from m e r y c i s m in which the s a m e food is swallowed, r e g u r g i t a t e d , a n d re-swallowed a g a i n a n d a g a i n . I n this process, the food is depleted of its n u t r i t i v e value a n d eventually t h e infant m a y starve to d e a t h despite the fact t h a t his m o u t h a n d s t o m a c h a r e regularly full. U. I believe t h a t b o t h F a i r b a i r n a n d Klein would be in full a g r e e m e n t with r e g a r d to w h a t h a s b e e n said t h u s far. O n e of F a i r b a i r n ' s distinctive c o n t r i b u t i o n s to t h e a n a lytic u n d e r s t a n d i n g of schizoid p h e n o m e n a is his interp r e t a t i o n of the n a t u r e of schizoid anxiety. W h e r e a s depressive anxiety is centered a r o u n d the fear of the loss of the object as a result of one's destructive wishes t o w a r d the object, schizoid anxiety is b a s e d u p o n the fear t h a t one's love is destructive to the object ( F a i r b a i r n , 1940). Since we are d e a l i n g with t h e earliest h u m a n relationship, t h a t of m o t h e r a n d infant, the n o t i o n of t h e infant's love

I

87


should be u n d e r s t o o d as virtually s y n o n y m o u s with the n o t i o n of t h e infant's w a y of b e i n g with a n d n e e d i n g t h e m o t h e r . T h e d i l e m m a is therefore a catastrophic o n e in t h a t t h e infant feels t h a t a n y sense of self t h a t he h a s a c q u i r e d , h o w e v e r r u d i m e n t a r y , is precisely t h a t which will destroy the object u p o n w h o m he fully d e p e n d s . 3 W i t h t h e b a c k g r o u n d of this u n d e r s t a n d i n g of t h e schizoid c o n d i t i o n , I shall focus on t h e most p r i m i t i v e s e n s a t i o n - d o m i n a t e d aspect of t h e schizoid personality, a d i m e n s i o n of experience barely touched u p o n in t h e w o r k of either K l e i n o r F a i r b a i r n . M will p r o p o s e t h a t t hie"V e schizoid condition can be t h o u g h t of as J a n u s - f a c e d : o nlee 1 face directed with fear a n d longing to t h e external object s/| w o r l d t h a t lies b e y o n d the reach of the patient's illusions/ delusions of o m n i p o t e n c e ; t h e o t h e r face directed to a s e n s o r y - d o m i n a t e d state m o r e p r i m i t i v e t h a n t h a t connected with the internal object w o r l d envisioned.by K l e i n a n d F a i r b a i r n . T h e latter "face" is t h e inarticulate u n d e r belly of schizoid experience in w h i c h p h a n t a s y gives w a y to p r e s y m b o l i c , s e n s o r y - d o m i n a t e d experience.

The

Contributions

of Winnicott

and

Guntrip

At this p o i n t , I w o u l d like to briefly discuss p o r t i o n s of t h e w o r k of D o n a l d W i n n i c o t t a n d H a r r y G u n t r i p , w h o , 3

Klein (1946, 1948, 1952b, 1955) understands schizoid anxiety as the outgrowth of inborn destructive impulses (derivatives of the death instinct) that undergo splitting and phantasied projection outward, thus creating a persecutory object world. Excessive splitting and evacuation of this sort pose a threat to the integrity of the ego, and are experienced in the form of a fear of impending annihilation. If fragmentation of the ego reaches a point where there is a breakdown of the paranoid-schizoid psychic organization, schizophrenic disorganization ensues.

88


a l o n g with F a i r b a i r n a n d K l e i n , I view as the principal architects of the analytic u n d e r s t a n d i n g of schizoid p h e n o m e n a . T h e discussion of W i n n i c o t t a n d G u n t r i p will c e n t e r o n their d e v e l o p m e n t of t h e b e g i n n i n g s of a c o n c e p t i o n of a sensory-based o r g a n i z a t i o n of experience m o r e p r i m i t i v e t h a n either Klein's conception of t h e p a r a n o i d - s c h i z o i d position o r F a i r b a i r n ' s notion of schizoid o r g a n i z a t i o n . Winnicott W i n n i c o n ' s w o r k shifted b o t h t h e K l e i n i a n a n d the F a i r b a i r n i a n p a r a d i g m s as t h e y relate to a conception of early psychological o r g a n i z a t i o n a n d to schizoid p h e n o m e n a . First, for W i n n i c o t t t h e u n i t of psychological develo p m e n t is n o t the infant, b u t a n intersubjective entity, t h e m o t h e r - i n f a n t u n i t ( W i n n i c o t t , 1952, 1956, 1971a). Secondly, W i n n i c o t t replaces t h e K l e i n i a n a n d F a i r b a i r n i a n conception of the splitting of the ego a n d object (followed b y the e l a b o r a t i o n of a n i n t e r n a l object world) with a c o n c e p t i o n of a different sort of splitting of t h e personality. F o r W i n n i c o t t (1960b, 1963b), the split in t h e personality involves t h e alienation of a r u d i m e n t a r y e x p e r i e n c e of self (the T r u e Self) from a c o m p l i a n t , extern ally-directed aspect of self (the False Self). T h e latter aspect of self is the W i n n i c o t t i a n equivalent of t h e schizoid aspect of personality. W i n n i c o t t (1963b) states t h a t in the b e g i n n i n g the space in w h i c h the infant lives is n o t a n "internal" (p. 185) world in a K l e i n i a n sense. R a t h e r , " ' i n n e r ' only m e a n s personal a n d 'personal' is n o t yet individual" (1963b, p. 185). T h e T r u e Self is a potential t h a t h a s its origins in t h e earliest bodily sensations as e x p e r i e n c e d in the context of t h e relationship with the e n v i r o n m e n t a l m o t h e r : " T h e

89


T r u e Self c o m e s from the aliveness of t h e b o d y tissues a n d t h e w o r k i n g s of t h e b o d y functions, i n c l u d i n g the heart's action a n d b r e a t h i n g " ( 1 9 6 0 b , p. 148). T h e infant's w o r l d at this stage is n o t a world of external a n d i n t e r n a l object relations, b u t a world of " m e r e p h e n o m e n a based on b o d y experiences" (1963b, p . 183). W i n n i c o t t believes t h a t e v e n t h o u g h the infant c a n n o t alone sustain its o w n p r i m i t i v e psychological o r g a n i z a t i o n , such self-organization (which is p r i m a r i l y of a sensory sort) does exist b e c a u s e it is created b y the m o t h e r - i n f a n t : ( " T h e T r u e " ! Self a p p e a r s as soon as there is a n y m e n t a l o r g a n i z a t i o n ! of t h e i n d i v i d u a l at all, a n d it m e a n s little m o r e t h a n t h e ! s u m m a t i o n of sensori-motor aliveness" (1960b, p . 149). I I n this w a y , W i n n i c o t t p o i n t s t h e w a y to a conception of a n aspect of personality ( m o r e primitive t h a n Klein's or F a i r b a i r n ' s i n t e r n a l object world) in w h i c nh t h e r e isfi p r e s y m b o l i c , nondefensive isolation of t h e most* if r u d i m e n t a r y sense of self, w h i c h is c e n t e r e d in b o d y e x p e r i e n c e ^ T h i s early psychological o r g a n i z a t i o n fully y_ d e p e n d s u p o n the m a t e r n a l provision of a facilitating e n v i r o n m e n t . I n the course of d e v e l o p m e n t b y m e a n s of experience with transitional p h e n o m e n a , the m a t e r n a l l y p r o v i d e d aspect of this state is t a k e n over b y t h e infant. (See W i n n i c o t t , 1951, a n d O g d e n , 1986, for discussion of this process.)

Guntrip G u n t r i p (1961, 1969) a t t e m p t e d a n i n t e g r a t i o n a n d ext e n s i o n of t h e work of W i n n i c o t t a n d F a i r b a i r n . H e p r o p o s e d t h a t in the course of t h e early d e v e l o p m e n t of every individual a p o r t i o n of t h e u n c o n s c i o u s ego (a split-off p a r t of F a i r b a i r n ' s [1944] "libidinal ego") u n d e r -

90


goes regression to a n insulated w o m b - l i k e state. (This regressed aspect of self r e m a i n s a p e r m a n e n t part of the s t r u c t u r e of the personality a n d exists in tension with m o r e object-related aspects of s e l f J D e e p l y regressed a n d insulated, this facet of the personality is far m o r e extensive in the schizoid personality t h a n in a m o r e m a t u r e personality o r g a n i z a t i o n . "In this regressed state, the place of the good object is t a k e n b y the good e n v i r o n m e n t , a n d t h e r e is a deep, o b s c u r e , b u t q u i t e definite experience of feeling 'good a n d comfortable inside somet h i n g ' " (1961, p . 435). T h e r e is safety a n d potential for the e m e r g e n c e of t h e individuality of the self in the isolation of this regressed state; b u t t h e r e is also t h e d a n g e r of p e r m a n e n t loss of c o n n e c t e d n e s s with b o t h e x t e r n a l a n d internal objects. P e r m a n e n t disconnectedness from b o t h the external a n d i n t e r n a l object world r e p r e s e n t s t h e threat of a terrifying loss of t h e self t h a t is experienced as a n i m p e n d i n g suffocation. T h e i n t e r n a l object w o r l d is of critical i m p o r t a n c e as a defense against irreversible loss of the self in the regressed womb-lilce state. T h u s , t h e schizoid o r g a n i z a t i o n oi internal object relations is viewed by G u n t r i p as a m i d d l e g r o u n d b e t w e e n external object relations a n d a p r i m i t i v e objectless s t a t e . 4 Guntrip equates the regressed libidinal ego with the notion of a Winnicottian True Self "in cold storage till it can obtain a second chance to be reborn" (Guntrip, 1961, p. 432). I believe that this aspect of Guntrip's attempted integration of Fairbairnian and Winnicottian theory is the least satisfactory aspect of his work. It is based upon a mixing of metapsychologies that creates serious theoretical confusion. In Fairbairn's (1944) thinking, the libidinal ego is a split-off portion of the ego engaged in an unsatisfactory relationship with tantalizing objects. The attachment to the object is addictive in nature and interferes with the development of fulfilling whole object


91

I shall close this section by q u o t i n g at some length a s t a t e m e n t b y M i c h a e l Balint (1955). Balint c a p t u r e s with r e m a r k a b l e clarity a n d elegance t h e limits of the Fairb a i r n i a n a n d K l e i n i a n conceptions of primitive experience a n d at the s a m e t i m e i n t r o d u c e s a vital n e w w a y of d e s c r i b i n g t h e realm of early b o d y experience alluded to in the w o r k of W i n n i c o t t a n d G u n t r i p . Practically all o u r technical t e r m s describing t h e early p e r i o d of m e n t a l life h a v e b e e n derived from objective p h e n o m e n a a n d / o r subjective experiences of the "oral" sphere; as for instance greed, incorpor a t i o n , introjection, i n t e r n a l i z a t i o n , part-objects, d e s t r u c t i o n b y sucking, c h e w i n g a n d biting, projection a c c o r d i n g to the p a t t e r n of spitting a n d vomiting, etc. Sadly e n o u g h , we h a v e almost completely neglected to enrich o u r u n d e r s t a n d i n g of these very early, v e r y primitive, p h e n o m e n a b y creating theoretical n o t i o n s a n d coining technical t e r m s u s i n g t h e experiences, i m a g e r y , a n d implications of o t h e r spheres. S u c h spheres are, a m o n g others, feelings of w a r m t h , r h y t h m i c noises a n d m o v e m e n t s , s u b d u e d n o n d e s c r i p t h u m m i n g , t h e irresistible a n d overw h e l m i n g effects of tastes a n d smells, of close bodily contact, of tactile a n d muscle sensations especially in t h e h a n d s , a n d t h e u n d e n i a b l e p o w e r of a n y a n d all of t h e s e for p r o v o k i n g a n d allaying anxieties a n d

relations and a genuine sense of self. Guntrip's "integration" therefore involves theoretical inconsistency in that it holds that the True Self (the core of one's individuality and sense of realness) has its origins in the libidinal ego, a portion of the personality engaged in a fundamentally pathological form of attachment to unattainable internal objects.

92

The Primitive Edge of Experience suspicions, blissful c o n t e n t m e n t a n d dire a n d desp e r a t e loneliness, [p. 241]

T h i s c h a p t e r , a n d the p r e v i o u s two, represent a partial r e s p o n s e to the "challenge" (p. 241) to psychoanalytic t h i n k i n g posed b y Balint (1955).

Clinical If a Tree

Illustration: Falls

in the

Forest

I shall n o w describe a n aspect of t h e analysis of a p a t i e n t , which h a s t a u g h t m e a good deal a b o u t t h e relationship b e t w e e n schizoid internal object relations a n d a n objectless, s e n s o r y - d o m i n a t e d world t h a t forms its silent c o u n terpart. M s . N . , a 23-year-old g r a d u a t e s t u d e n t , reluctantly b e g a n analysis b e c a u s e of i n t e r m i t t e n t b o u t s of crippling anxiety a n d a chronic feeling t h a t she "failed to see t h e point in b e i n g alive." T h e p a t i e n t presented herself at t h e first m e e t i n g in a strikingly u n a d o r n e d way. She w o r e a gray sweatshirt a n d j e a n s (which seemed identical to the clothing she w o u l d w e a r to every succeeding m e e t i n g for years); h e r h a i r was s h o r t , stringy, a n d u n w a s h e d . M s . N . w o r e n o m a k e - u p a n d later indicated t h a t to d o so w o u l d m a k e h e r feel like a clown. H e r m a n n e r was crisp, b r u s q u e , a n d s a r d o n i c . T h e patient n e v e r looked at m e directly, alt h o u g h she occasionally stole a glance in m y direction o u t of t h e c o r n e r of her eye w h e n e n t e r i n g o r leaving the office. D u r i n g t h e first m e e t i n g , M s . N . told m e t h a t the color of the walls of m y office m a d e the r o o m feel to h e r like a n ice cave.


93

I n t h e initial m o n t h s of analysis, M s . N . was extremely g u a r d e d , repeatedly telling m e h o w little she liked the i d e a of analysis, how a b s u r d the whole set-up w a s , h o w little h o p e she h a d of getting a n y t h i n g o u t of it, a n d h o w completely alienated she felt from m e . I n this p e r i o d t h e r e w e r e frequent silences t h a t , w h e n allowed to c o n t i n u e , filled* the entire m e e t i n g . T h e s e were tense silences t h a t the p a t i e n t said she experienced as "agonizing." M s . N . said t h a t she felt as if she were "drowning" in t h e futility of w h a t we were "not d o i n g . " It has b e e n m y experience t h a t such silences c a n b e c o m e a p e r n i c i o u s source of d e s p a i r for schizoid p a tients, l e a d i n g t h e m to retreat into a n increasingly withd r a w n state. I e n t e r t a i n e d the h y p o t h e s i s (in p a r t on t h e basis of m y countertransference experience of intense feelings of loneliness d u r i n g t h e silences) t h a t the silences in this case r e p r e s e n t e d a n e n a c t m e n t of pathological i n t e r n a l object relationships involving a m o t h e r a n d infant w h o each felt the o t h e r to b e i n c a p a b l e of u n d e r s t a n d i n g t h e p a i n of t h e isolation of t h e o t h e r . O n t h e basis of this hypothesis, I regularly talked to M s . N . a b o u t w h a t it was t h a t I t h o u g h t was g o i n g o n between u s , m a k i n g it'explicit t h a t these w e r e simply m y ideas a n d t h a t I could very well be quite w r o n g . M y efforts w e r e regularly m e t with t h e equivalent of the patient's rolling h e r eyes b a c k in h e r h e a d with disbelief a b o u t how stupid I could be. O n occasion she w o u l d g r u d g i n g l y a d m i t to the possibility t h a t t h e r e m i g h t be a g r a i n of t r u t h in w h a t I said, b u t t h e n would i m m e d i a t e l y ask w h a t good that bit of w i s d o m did h e r ; At times this form of interaction h a d t h e familiar feel of w o r k w i t h a n oppositional, b u t i n t a c t , adolescent p a t i e n t . (It h a s b e e n m y e x p e r i e n c e t h a t adolescent oppositionalism- is usually a defense against loving a n d

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sexual feelings in t h e positive a n d negative O e d i p a l transferences.) H o w e v e r , this w a s n o t m y p r e d o m i n a n t sense of w h a t was g o i n g on in t h e analysis of M s . N . T h e i m a g e of t h e ice cave m e n t i o n e d b y M s . N . in the initial m e e t i n g echoed t h r o u g h m e regularly d u r i n g the initial y e a r s of this work. J u s t as I w o u l d feel t h e greatest n e e d to e n c o u n t e r s o m e t h i n g living in t h e p a t i e n t , I would b e confronted b y a form of self-sufficiency in h e r that w a s so u n r e l e n t i n g as to m a k e m e feel t h a t I was d e a l i n g with a p e r s o n w h o h a d not succeeded in b e c o m i n g h u m a n . V e r y gradually, over t h e first two years of t h e analysis, M s . N . gave m e small bits a n d pieces of i n f o r m a t i o n a b o u t herself. She did this almost p a r e n t h e t ically in a n effort to d e n y t h e i m p o r t a n c e of a given m e m o r y o r c u r r e n t incident in h e r life. P e r h a p s even m o r e i m p o r t a n t to the patient w a s t h e n e e d to disguise the fact t h a t she h a d a n y desire w h a t e v e r for m e to k n o w s o m e t h i n g a b o u t h e r . M s . N.'s m o t h e r was described as " N o r m a l with a capital N . " She w a s a n extremely " m a t t e r of-fact" p e r s o n w h o believed strongly t h a t o n e can a c c o m plish w h a t o n e w a n t s to a n d t h a t a n y difficulty t h a t o n e h a s in life is a form of self-indulgence. A l m o s t entirely a b s e n t from h e r m o t h e r ' s v o c a b u l a r y was a n y m e n t i o n of feeling. T h e patient said t h a t she h a d o v e r h e a r d h e r m o t h e r telling a friend t h a t she h a d n o t breast-fed either of h e r children because it s o m e h o w s e e m e d "unhygienic." O n e could boil the r u b b e r nipples for plastic bottles, w h e r e a s in breast-feeding, t h e r e was n o w a y to kill t h e germs. M s . N . described her father as a m a n w h o seemed as if he should h a v e been s o m e b o d y else's father. She said t h a t h e liked playing with his v i n t a g e sports cars, of which h e h a d half a d o z e n . H e spent a l m o s t all of his free t i m e t i n k e r i n g with t h e m a n d "shining t h e m u p . " T h e patient


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said t h a t she h a d h a d t h e persistent fantasy as a child t h a t n e i t h e r of h e r p a r e n t s was h e r real p a r e n t . She i m a g ined t h a t t h e people w h o claimed to b e h e r p a r e n t s w e r e aliens w h o h a d secretly replaced h e r original p a r e n t s a n d w h o k n e w h o w to act j u s t like t h e m . She would devise q u e s t i o n s in h e r m i n d a b o u t m i n u t e details of past experiences w i t h h e r real p a r e n t s t h a t only they w o u l d know about. T h e p a t i e n t h a d a n older b r o t h e r w h o felt to M s . N . like "just a n o t h e r t e n a n t in t h e b o a r d i n g house." H e s e e m e d as if h e k n e w how to go t h r o u g h all the right m o t i o n s of getting good grades, d o i n g well at sports, a n d so o n , "but h e j u s t wasn't t h e r e a n d he didn't seem to k n o w it." ( T h e patient's descriptions of h e r family were like descriptions I h a v e h e a r d from o t h e r schizoid p a t i e n t s in t h a t I could n o t keep a picture of t h e people b e i n g described in m y m i n d for very long. F o r instance, I w o u l d often forget that the patient h a d a b r o t h e r . T h e figures in t h e patient's life did n o t "come to life" in t h e patient's accounts, j u s t as they h a d failed to c o m e to life in h e r experience-of t h e m . ) M s . N . was extremely secretive a b o u t t h e events of h e r c u r r e n t life. For instance, she took great pleasure in t h e fact t h a t she h a d lived in a n e w a p a r t m e n t for over a y e a r before I b e c a m e a w a r e of it t h r o u g h a hint t h a t she d r o p p e d . It was a full two years before she told m e t h a t she w a s d o i n g h e r doctoral studies in c o m p a r a t i v e literature. T h e p a t i e n t lived an extremely isolated a n d b a r r e n existence as a g r a d u a t e s t u d e n t . She w e n t to classes, h a d m i n i m a l c o n t a c t with teachers a n d classmates, a n d spent most of h e r t i m e in t h e various libraries of t h e university. T h e r e was a study cubicle in t h e stacks of the m a i n library m a n y floors below g r o u n d level (she n e v e r told m e exactly

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h o w m a n y ) t h a t was h e r "favorite place in t h e world." It h a d its own distinct smell of old, dusty books, its own p a r t i c u l a r coolness t h a t n e v e r c h a n g e d w i t h the t i m e of d a y o r with t h e seasons, a n d its o w n peculiar lighting "that always s e e m e d as if it were completely d a r k even t h o u g h the lights were o n . " I should e m p h a s i z e that a l t h o u g h w h a t I l e a r n e d from t h e p a t i e n t is p r e s e n t e d here in the form of a flowing n a r r a t i v e , this w a s n o t at all t h e style in which t h e information w a s conveyed to m e b y M s . N . T h e r e was far m o r e the feeling d u r i n g those h o u r s of painful pulling of teeth. T h e p a t i e n t w o u l d haltingly give m e a fragment of a story, a p p a r e n t l y to see if I would p o u n c e on it. If I displayed satisfactory restraint, I m i g h t be given a n o t h e r p a r t of the story days or weeks later. If I w e r e to ask a q u e s t i o n , t h e p a t i e n t would regularly fall silent for a period of five to ten m i n u t e s before giving m e h e r highly crafted reply. Often she would n o t reply at all. I would occasionally i n q u i r e a b o u t w h a t she w a s t h i n k i n g a n d feeling d u r i n g t h e periods of silence t h a t followed m y questions. M s . N . w o u l d tell m e t h a t she w a s not t h i n k i n g a n y t h i n g o r t h a t she was t h i n k i n g a b o u t m y q u e s t i o n . It often seemed to m e t h a t despite m y best efforts I h a d b e c o m e e n g a g e d in a struggle of wills in w h i c h t h e first player to display a n y intensity of wishing for a n y t h i n g from t h e o t h e r w a s t h e loser. I was a novice p l a y i n g against a g r a n d m a s t e r of the g a m e . I eventually said to M s . N . t h a t t h e r e was a good d e a l of h e r inability to talk to m e t h a t I t h o u g h t w a s b e y o n d h e r control. H o w e v e r , I suspected t h a t t h e r e w a s a space, h o w e v e r small, in which she m a d e conscious choices a b o u t t h a t which she would tell m e , h o w she would tell it to m e , a n d w h e n it would be told. I suggested t h a t it would be useful to p u t into w o r d s w h a t w e n t into


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the choices t h a t she m a d e . I a d d e d t h a t at times I suspected t h a t she w o u l d experience it as a h u m i l i a t i n g submission if she were to talk to m e , a n d t h a t she p r o b a b l y felt she w o u l d b e flushing d o w n t h e d r a i n w h a t little in h e r life she v a l u e d . I n response to these c o m m e n t s , M s . N . said t h a t w h e n she w a s 4 o r 5, o r p e r h a p s 6, she h a d o v e r h e a r d h e r a u n t asking h e r m o t h e r a question t h a t terrified h e r . H e r a u n t h a d asked h e r m o t h e r w h e t h e r a tree t h a t fell in t h e forest m a d e a n y noise if n o o n e were t h e r e to h e a r it. M s . N . said t h a t she h a d pictured herself alone in a forest yelling a n d n o t m a k i n g a n y noise at all. T h i s i m a g e h a d b e e n so terrifying to h e r t h a t she b e c a m e afraid of g o i n g to sleep for fear of w a k i n g u p alone in h e r r o o m . I u n d e r s t o o d M s . N . ' s reply to m y c o m m e n t s as h e r w a y of unconsciously e x p l a i n i n g to m e t h a t each t i m e she spoke to m e there w a s the risk of her feeling as she h a d in t h a t terrifying childhood i m a g e . I n the c o u r s e of the t h i r d year of w o r k w i t h M s . N . , I gradually b e c a m e a w a r e of t h e intensity of a p a r t i c u l a r kind of strain t h a t I experienced while with h e r . I found t h a t I felt a w k w a r d , ill at ease, a n d self-conscious in a w a y that, I rarely feel with p a t i e n t s with w h o m I h a v e w o r k e d for very long. It was as if m y o r d i n a r y w a y of c o n d u c t i n g myself as a n analyst w a s too rigid o r u n s u i t e d to h e r in a w a y t h a t I could not n a m e . I often felt as if I were t r y i n g n o t to b r e a t h e while with h e r . As I b e c a m e increasingly a w a r e of this set of countertransference feelings a n d b e g a n to u n d e r s t a n d t h e m in t e r m s of projective identification, I said to M s . N . that I t h o u g h t t h a t o u r b e i n g in t h e r o o m t o g e t h e r m u s t feel to her like two people, e a c h with a different c o m m u n i c a b l e disease, w h o h a d b e e n confined t o g e t h e r in a small, unventilated r o o m . (I w a s t h i n k i n g of h e r m o t h e r ' s p h a n t a s y of the b r e a s t c o n t a m -

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i n a t i n g the b a b y a n d the b a b y c o n t a m i n a t i n g t h e b r e a s t . I n that p h a n t a s y t h e g e r m s that constitute a n o r d i n a r y p a r t of t h e self w e r e experienced as p o s i n g a d a n g e r to t h e o t h e r . I also w a s r e s p o n d i n g to m y own fantasy of h a v i n g to hold m y b r e a t h while with this p a t i e n t — p e r h a p s this fantasy reflected m y o w n unconscious fear of b r e a t h i n g o u t m y o w n h u m a n g e r m s or b r e a t h i n g in h e r s . ) As M s . N . talked m o r e a b o u t h e r secret place in t h e library, she b e g a n to refer to the fascination with w o r d s , l a n g u a g e , a n d books t h a t h a d played a m a j o r p a r t in h e r life for as long as she could r e m e m b e r . S h e h a d spent endless h o u r s as a child c o n s t r u c t i n g e l a b o r a t e fantasies t h a t centered a r o u n d plays on words, neologisms, p u n s , a n a g r a m s , r h y m e s , h o m o n y m s , a n d so o n . She p a r t i c u larly liked a g a m e t h a t she h a d l e a r n e d in school in which o n e invents a story with a m o r a l t h a t s o u n d s like, o r is t h e r e - a r r a n g e m e n t of, the w o r d s of a n a p h o r i s m o r a famous saying. She h a d r e a d the dictionary for p l e a s u r e from the t i m e t h a t she w a s a 7-year-old, a n d i n c o r p o r a t e d a b s t r u s e w o r d s a n d t h e a r c h a i c use of w o r d s i n t o h e r o w n thoughts. As a child she w o u l d s p e n d almost e v e r y afternoon in a local public l i b r a r y r e a d i n g "shelf after s h e l P of books. T h e subject m a t t e r was of n o i m p o r t a n c e at all to h e r . She said t h a t o n e w o u l d t h i n k t h a t h e r k n o w l e d g e would h a v e b e c o m e encyclopedic, b u t in fact she r e m e m b e r e d almost n o t h i n g from w h a t she r e a d . She forgot t h e plots a n d facts as soon as she r e a d t h e m as if they h a d d r o p p e d into a n e n o r m o u s pit. She explained t h a t t h e r e were m a n y instances w h e n she r e a d t h e s a m e book twice, realizing only at the very e n d of the book t h a t she h a d previously read it. W h a t w o u l d r e m i n d h e r of h a v i n g r e a d t h e b o o k was not its contents, b u t some t o r n o r m i s s i n g p a g e o r some m a r k t h a t she r e m e m b e r e d on a p a g e . T h e p l e a s u r e


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w a s in the "feeling of r e a d i n g , " which was in p a r t a s o u n d in h e r h e a d , a soft, barely perceptible h u m m i n g o r b u z z i n g , "like a fluorescent light b u l b . " A g a i n , in a casual m a n n e r t h a t I w a s n o t supposed to p a y m u c h a t t e n t i o n to, M s . N . m e n t i o n e d t h a t as a 9-year-old she h a d discovered "treasure in the basem e n t " — a t r u n k full of w h a t she h a d a s s u m e d to be h e r father's collection of a n t i q u e rifles a n d pistols along with some bullets a n d two old "Civil W a r - l o o k i n g " swords. She said t h a t t h e discovery h a d b e e n e x t r e m e l y u p s e t t i n g to h e r , b u t t h a t she m e n t i o n e d it to n o one. It was as if h e r father's secret "arsenal" h a d m a d e h i m a different p e r s o n . She said that she r e m e m b e r s h a v i n g looked at his face to see if she could discover this secret p a r t of h i m in his eyes o r facial expression. I n this p e r i o d of the analysis (which at this point was in its fourth y e a r ) , t h e r e w a s a gradually e x p a n d i n g feeling of c a l m t h a t b r o u g h t to m i n d t h e i m a g e of two e n e m y a r m i e s in a delicate t r u c e d u r i n g which each passing h o u r carried reason for h o p e , b u t also the q u e s t i o n of h o w long t h e calm could possibly last a n d w h e t h e r one m i g h t be o p e r a t i n g u n d e r t h e influence of a d a n g e r o u s illusion. T h e a m o u n t of time M s . N . spent in the library stacks h a d d i m i n i s h e d greatly b y this point in the analysis. She h a d developed relationships with classm a t e s a n d often studied in the m a i n r e a d i n g r o o m with t h e m . H e r cubicle h a d b e c o m e a place to w h i c h she could retreat as o p p o s e d to b e i n g the c e n t e r of h e r life. Several weeks after t h e patient's telling m e a b o u t her discovery of t h e t r u n k in the b a s e m e n t , she c a m e to o n e of o u r m e e t i n g s in a state of e x t r e m e agitation. She b e g a n t h e h o u r b y accusing m e of secretly t a p e - r e c o r d i n g o u r m e e t i n g s . She felt furious at m e , a n d deeply b e t r a y e d . I asked M s . N . if she h a d a n y idea w h a t it w a s t h a t was

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frightening h e r . She said that she did n o t k n o w , b u t that e v e r y t h i n g w a s frightening a n d t h a t h e r m i n d was o u t of control. O v e r t h e w e e k e n d , she h a d not g o n e o u t of h e r a p a r t m e n t a n d h a d b e e n terrified of letting a n y t h i n g in o r out of it. She h a d u n p l u g g e d h e r p h o n e , h e r radio, a n d h e r television. M s . N . said t h a t she h a d n o t e a t e n or d r u n k a n y t h i n g except for bottled w a t e r b e c a u s e she was afraid of b e i n g poisoned. She w a s also terrified of u r i n a t i n g o r defecating a n d i m a g i n e d t h a t if she were to d o so, she w o u l d see blood a n d intestines in the toilet. I said to h e r t h a t t h e r e was n o w h e r e inside o r outside of h e r t h a t she felt safe, a n d t h a t t h e only t h i n g she felt she could d o w a s to try to keep w h a t is outside o u t a n d w h a t is inside in. M s . N . said t h a t t h a t w a s right, a n d t h a t she was so e x h a u s t e d b y the effort that she did n o t t h i n k t h a t she could hold on m u c h longer. She told m e t h a t h e r cubicle in t h e library w a s "losing its p o w e r . " O v e r the previous weeks she h a d been a w a r e of this .change, b u t h a d n o t w a n t e d to tell m e because t h a t w o u l d h a v e m a d e it m o r e real. T h e p a t i e n t h a d b e g u n to feel scared while in h e r library cubicle. F o r t h e first t i m e she b e g a n to worry t h a t s o m e b o d y m i g h t lock the d o o r l e a d i n g to h e r floor a n d she m i g h t be t r a p p e d there. T h e y m i g h t t u r n t h e lights out a n d she would starve to d e a t h w i t h o u t a n y o n e k n o w i n g it. She could n o t rid herself of the horrible i m a g e s she h a d of d e c a y i n g t h e r e at h e r desk. She said t h a t d u r i n g all the years t h a t she h a d gone to her cubicle, t h e t h o u g h t h a d n e v e r once o c c u r r e d to h e r that she m i g h t get locked in. It seemed to m e t h a t M s . N . w a s describing a n u m b e r of different kinds of fears that w e r e interconnected. I viewed the patient's experience in the library cubicle as o n e of b e i n g in a world d o m i n a t e d by autistic shapes — a self-soothing, almost completely insulated,


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asymbolic w o r l d of sensations in which t h e r e was h a r d l y a n y t h i n g of a self. She existed t h e r e ( o r p e r h a p s m o r e accurately did n o t exist) out of t i m e a n d place; she m a i n t a i n e d a t h i n film of b e i n g b y m e a n s of her reliance on the wholly predictable ( m e n t a l ) s o u n d of r e a d i n g , the smell of the b o o k s , t h e coolness of t h e air o n h e r skin, a n d t h e physical sensation of t h e lighting, all of which n e v e r c h a n g e d . It w a s a world r e m o v e d from t h e e b b a n d flow ( a n d u n p r e d i c t a b i l i t y ) of h u m a n relations. A l t h o u g h this autistic-contiguous w o r l d h a d b e c o m e a n increasingly limited p a r t of h e r life, M s . N . felt utterly reliant o n it as a place to which she could r e t r e a t . I said to her in t h e h o u r b e i n g described t h a t I t h o u g h t t h a t she h a d felt for a l o n g t i m e t h a t she w a s the ice cave t h a t she h a d m e n t i o n e d in o u r first m e e t i n g . It w a s n o t a m a t t e r of h e r living in a n ice cave or living a n y w h e r e for t h a t m a t t e r : she w a s the cave itself. T h e r e h a d at first b e e n n o t h i n g inside of it o r outside of i t — t h e r e was j u s t the cave. I w e n t o n to say t h a t I t h o u g h t t h a t o v e r t h e course of the p r e v i o u s years, t h e r e h a d b e g u n to be life inside a n d outside of t h e cave. A s a result, for t h e first t i m e , for b e t t e r o r for worse, she could feel t h e fear of b e i n g t r a p p e d b y herself; in t h e past few weeks in p a r t i c u l a r , it seemed t h a t she h a d b e g u n to feel t h a t t h e cave was a place in w h i c h she could die a n d decay. M s . N . t h e n said t h a t t h e idea of b e i n g t r a p p e d b y herself in t h e stacks of t h e library was like b e i n g t h e tree falling in t h e forest w h e r e t h e noise t h a t she m a k e s does n o t m a k e a s o u n d . It seemed to m e t h a t a l t h o u g h t h e y w e r e extremely frightening, t h e delusions arid p e r s e c u t o r y anxiety t h a t M s . N . was c u r r e n t l y e x p e r i e n c i n g took place in a world in w h i c h s o u n d s could be h e a r d . T h e p a t i e n t h a d att e m p t e d to create a w o r l d of autistic isolation over the w e e k e n d in h e r a p a r t m e n t , b u t h e r a t t e m p t s at securing

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safety in this w a y h a d failed. T h e r e was by n o w too m u c h of a sense of self to allow h e r to flee into a world of p u r e sensation, u n e n c u m b e r e d by external a n d i n t e r n a l objects. She was t r a p p e d in t h e world of objects. (I viewed the p e r s e c u t o r y delusions as u n c o n s c i o u s a t t e m p t s at holding on to t h e world of internal objects in a n effort to defend herself against autistic-contiguous anxiety, m a n ifested in the fear of rotting, leaking, a n d h a v i n g h e r insides fall out). Earlier in the analysis t h e r e h a d been n o psychological context in which t h e p a t i e n t could experience b e i n g alone in the cave because she was the inanim a t e cave. T h e r e h a d not yet b e e n a sense of a living self that could be t r a p p e d a n d could rot, die, leak, a n d so o n . I n the period of analysis that followed t h e session b e i n g described, all of this was discussed with M s . N . in m u c h t h e s a m e w o r d s t h a t I h a v e used h e r e except for t h e use of the technical t e r m s . T h e s u c c e e d i n g y e a r of analytic w o r k h a d m a n y of the features of a "contained psychosis," T h e r e was m u c h blocking in the sessions, a n d the patient w a s preoccupied with a series of delusional ideas; h o w e v e r , she was able to keep this psychotic process from interfering with the relationships t h a t she was d e v e l o p i n g with teachers, classm a t e s , a n d the s t u d e n t s with w h o m she was w o r k i n g as a t e a c h i n g assistant in h e r d e p a r t m e n t . T h i s c o n t a i n e d psychosis seemed to m e to represent the patient's experiencing, in t h e analysis, the chronic psychosis that she h a d n o t been able to experience in childhood (cf. W i n n i c o t t , 1974). T h e childhood psychosis h a d b e e n foreclosed t h r o u g h the use of defensive w i t h d r a w a l into a world of autistic shapes ( e . g . , the "sound" of r e a d i n g ) . T h i s period of the work was a p h a s e of "reworking" of t h e patient's autistic-contiguous a n x i e t y , in a p r e d o m i n a n t l y p a r a n o i d schizoid context of part-object relations, symbolic e q u a -


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tion, splitting, o m n i p o t e n t thinking, projective identification, a n d p e r s e c u t o r y anxiety. T h e following d r e a m of M s . N.'s is a n e x a m p l e of the w a y in w h i c h t h e patient unconsciously a t t e m p t e d to grapple with h e r fears of r o t t i n g (a manifestation of anxiety of a n autistic-contiguous t y p e ) in a m o r e symbolically g r o u n d e d , object-related psychological context:

T h e r e was a ferocious storm. T h e walls a n d ceilings of M s . N.'s a p a r t m e n t were covered with w a t e r t h a t was seeping t h r o u g h from the outside. T h e p a t i e n t discovered with h o r r o r t h a t a b o o k she v a l u e d m o r e t h a n a n y t h i n g in t h e world w a s swollen with w a t e r . As she picked u p t h e b o o k to see if she could d r y it out, the b i n d i n g c a m e a p a r t in c l u m p s in h e r h a n d s . She w o k e u p in a state of p a n i c .

T h e p a t i e n t w a s able to talk a b o u t this d r e a m in t e r m s of fears (with which she was b y this t i m e familiar) of h e r insides r o t t i n g a n d h e r skin d e c a y i n g . She w a s also able to u n d e r s t a n d t h a t for years she h a d felt t h a t this disaster was actually o c c u r r i n g d u r i n g h e r m e n s t r u a l periods. ( H e r periods, which h a d ceased w h e n she was 19, h a d r e s u m e d a b o u t six m o n t h s p r i o r to h e r r e p o r t i n g this d r e a m . ) M s . N . said t h a t for t h e first t i m e in h e r life she could feel h e r s t o m a c h inside of h e r . I n t h e past, she h a d b e e n u n a b l e to feel a n y t h i n g in her a b d o m e n w h e r e she k n e w h e r s t o m a c h should be. She guessed t h a t t h a t w a s w h y she could n o t b e s u r e that it would stay w h e r e it was supposed to. I n this r e w o r k i n g , t h e r e was a complicated interplay of all t h r e e m o d e s of experience including t h e depressive m o d e . ( T h e latter was reflected in p a r t in t h e patient's

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capacity to observe a n d i n t e r p r e t both h e r w a k i n g a n d d r e a m i n g experience.) A n i m p o r t a n t shift in the interplay of m o d e s of experience h a d t a k e n place. While in the initial years of analysis t h e r e w a s s t r o n g evidence of experience b e i n g g e n e r a t e d b o t h in autistic-contiguous a n d in paranoid-schizoid m o d e s , each m o d e served to isolate the patient n o t only from c o m m u n i c a t i o n with e x t e r n a l objects, b u t also from a conscious a n d u n c o n scious internal dialogue. T h e r e w o r k i n g involved in t h e patient's contained psychosis reflected t h e t r a n s f o r m a t i o n of pathologically h y p e r t r o p h i e d autistic-contiguous defenses (designed to p r e v e n t t h e d e v e l o p m e n t of the experience of self, a n d t h e formation of symbols with w h i c h to c o m m u n i c a t e t h a t experience), into a form of autistic-contiguous experience w h i c h increasingly c a m e to serve as a sensory foundation for the patient's sense of self. T h e latter is presymbolic (as opposed to asymbolic) a n d allowed the patient to g e n e r a t e the b e g i n n i n g s of a dialectical interplay b e t w e e n s e n s o r y - d o m i n a t e d experience of self, a n d forms of the experience of self t h a t w e r e m o r e g r o u n d e d in symbols a n d in relationships with e x t e r n a l a n d internal objects (i.e., experience in p a r a n o i d schizoid a n d depressive m o d e s ) . A s this w o r k progressed, M s . N . told m e —with i n t e n s e feelings of guilt a n d a conviction t h a t I would h a t e h e r — t h a t she h a d lied to m e . S h e said t h a t she h a d n o t simply " h a p p e n e d u p o n " t h e t r u n k in the b a s e m e n t of h e r p a r e n t s ' h o m e . It h a d b e e n necessary to " r u m m a g e t h r o u g h " the keys in h e r father's dresser d r a w e r , w h i c h was clearly p a r t of his "private stuff," in o r d e r to find t h e key t h a t she w a s looking for. M o r e o v e r , after discovering t h e c o n t e n t s of the t r u n k , she h a d n o t , as she h a d told m e , fearfully stayed a w a y from it. I n fact, over a period of years, she h a d m a d e r e g u l a r "visits" to the t r u n k in o r d e r


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to e x a m i n e a n d h a n d l e its c o n t e n t s . She h a d not simply b e e n horrified by h e r father's secret, she h a d felt excited by it a n d i m a g i n e d t h a t she, a n d she alone, h a d discovered his "boyish soul." She h a d cherished the idea t h a t he m u s t h a v e b e e n very m u c h like h e r , in h a v i n g these secrets. M s . N . h a d felt t h a t he too m u s t h a v e h a d his o w n p r i v a t e i n n e r world. A s she r e t u r n e d to this topic in s u b s e q u e n t meetings, she a d d e d t h a t the t r u n k h a d b e e n a source of sexual excitement for her a n d t h a t t h e sensations a n d images c o n n e c t e d with the rifles, swords, a n d bullets h a d b e e n a r e g u l a r p a r t of her m a s t u r b a t o r y fantasies. M s . N . said t h a t she n o w felt that her intrusion into h e r father's privacy w a s t h e e q u i v a l e n t of a n "act of r a p e . " She told m e t h a t she often experienced m e as a n i n n o c e n t , like h e r father. I seemed to h e r to b e completely u n a w a r e of the w a y in which she used all of h e r deviousness to get inside of m e , as she now felt t h a t she literally got inside of her father. (I h e a r d in this a reference to the patient's sexual interest in m e a n d h e r wish t h a t I find her sexually exciting. T h e s e wishes were in p a r t expressed in c h a n g e s in h e r w a y of c a r r y i n g herself a n d in t h e style of the clothes t h a t she w o r e , ) T h e p a t i e n t said that she h a d n e v e r succeeded in getting inside of h e r m o t h e r . It was as if she could "never find a n inside to get inside of." T h e p a t i e n t said t h a t she felt as sorry for h e r m o t h e r as she did for herself w h e n she described her m o t h e r in this way. T h i s led to the patient's talking a b o u t h o w lonely it m u s t h a v e b e e n for m e to h a v e b e e n so coldly treated by h e r for so long. She said t h a t for years she h a d experienced m e as t r y i n g to p r y h e r o p e n while r e m a i n i n g perfectly o p a q u e myself, b u t she n o w felt t h a t it w a s she w h o h a d b e e n t r y i n g to get inside of m e while r e m a i n i n g as i m p e n e t r a b l e as the m o n o l i t h in the film 2001. ( T h e

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\/

]y


sexual m e a n i n g of the idea of getting inside of a n o t h e r p e r s o n was n o t directly addressed at this p o i n t , b u t later b e c a m e a c e n t r a l focus of the analytic w o r k . ) I n a m e e t i n g t h a t followed s o m e weeks later, M s . N . u p o n e n t e r i n g m y office h a n d e d m e a w o r n p a p e r b a c k copy of F a u l k n e r ' s The Sound and the Fury. She said t h a t , as I well k n e w , she h a t e d "sentimental slop," b u t t h a t she w a n t e d to give m e this book. I t h a n k e d h e r a n d p u t it on t h e table beside m e . She told m e to "read the d a m n t h i n g a n d see if y o u can learn a n y t h i n g from it." She a d d e d t h a t she was certain I h a d already r e a d it, b u t t h a t I should r e a d it a g a i n . ( M s . N . was not g o i n g to risk h a v i n g m e tell h e r that I h a d already read the b o o k . I n fact, I h a d n e v e r r e a d t h e b o o k t h a t she gave m e b e c a u s e the book t h a t I w a s to read w a s most i m p o r t a n t l y her book.) W i t h t h a t she t u r n e d o v e r on t h e couch to face t h e wall, clearly i n d i c a t i n g t h a t I should begin r e a d i n g it right t h e r e arid t h e n . F o r t h e next few meetings, I r e a d . I felt u n d e r n o p r e s s u r e to d o a n y t h i n g b u t r e a d . It w a s n o t difficult to u n d e r s t a n d w h y this was a b o o k m u c h cherished by M s . N . I could feel m o r e powerfully t h a n I h a d in p r e v i o u s r e a d i n g s t h a t this b o o k was a sacred r e n d e r i n g of a m a n ' s m o s t p r i v a t e self. It h a d to b e r e a d as I i m a g i n e d t h e p a t i e n t w o u l d like to be listened to — with a state of m i n d t h a t allows w o r d s to wash o v e r t h e r e a d e r without the n e e d for e x p l a n a t i o n a n d with t r e m e n d o u s tolerance for confusion. T h i s kind of receptivity ( w h a t Bion [1962] w o u l d call "reverie") is the antithesis of the tree falling in t h e forest. T h e book r e m i n d e d m e of the patient: t h e r e was s o m e t h i n g wispy a n d r o m a n t i c a b o u t it (while all t h e t i m e d e n y i n g its r o m a n t i c i s m ) . A t t h e s a m e time, t h e r e w a s s o m e t h i n g t o u g h , u n c o m p r o m i s i n g , a n d unforgiving a b o u t the l a n g u a g e . F a u l k n e r allows the r e a d e r to k n o w only so m u c h a n d n o m o r e —there is a core t h a t o n e c a n


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glimpse fleetingly t h r o u g h one's senses, n o t t h r o u g h one's intellect. After a few meetings, the patient said t h a t I could finish r e a d i n g the b o o k on m y own if I w a n t e d to. She said t h a t she h a d liked s p e n d i n g the previous few sessions as we h a d , b u t t h a t n o w t h e r e w e r e t h i n g s t h a t she w a n t e d to talk a b o u t . O v e r t h e course of the following m o n t h s , M s . N . periodically r e t u r n e d to talking a b o u t those m e e t i n g s . T h e patient said that she h a d felt close to m e while I was r e a d i n g . She told m e t h a t d u r i n g most of the t i m e t h a t I w a s r e a d i n g she h a d n o t b e e n t h i n k i n g . I n s t e a d she h a d h a d t h e sense t h a t t h e r e w a s a "hub" in t h e m i d d l e of t h e room' between us. It w a s as if t h e r e h a d b e e n a k i n d of gravity t h a t h a d held u s to it a n d a kind of centrifugal force t h a t h a d kept us from b u m p i n g into o n e another. I n this p a r t of t h e analysis, t h e r e w a s further rew o r k i n g of autistic-contiguous e x p e r i e n c e , this t i m e in a p r e d o m i n a n t l y depressive m o d e . T h e patient's earlier feelings of h a v i n g b e e n the victim b o t h of h e r parents' coldness a n d of m y "analytic intrusiveness" were n o w experienced in a n e w psychological context. T h e patient recognized a n d took responsibility for h e r o w n coldness, h e r o w n fantasied a n d actual acts of p l u n d e r i n g t h e p r i v a c y of o t h e r s . M s . N . seemed able to begin to tolerate h e r o w n wishes for sexual aliveness b o t h in the present a n d in the p a s t . H e r sexual a n d r o m a n t i c love for m e in the p a t e r n a l transference was evident to both of us, a l t h o u g h n o t yet directly p u t into w o r d s . T h e r e was t h e capacity for e m p a t h y for m e , a n d e v e n the b e g i n n i n g s of c o m p a s s i o n for h e r m o t h e r ' s seemingly complete inability to g e n e r a t e h e r own internal life. T h e gift of t h e b o o k was a n i m p o r t a n t act of r e p a r a t i o n . N o t to h a v e accepted it w o u l d h a v e repre-

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sented a c o u n t e r t r a n s f e r e n c e acting-out of a n u n c o n scious identification with a n i n t e r n a l object incapable of tolerating, recognizing, a n d accepting the affection a n d r e p a r a t i v e wishes of the o t h e r . T h e gift was a n expression of the patient's love t h a t was only perfunctorily disguised; at the s a m e t i m e it seemed to r e p r e s e n t a plea t h a t I n o t try to find o u t all a b o u t her: I should u n d e r s t a n d t h a t t h e r e a r e s o m e things that m u s t n o t b e u n d e r s t o o d too well.

Summary D e s p i t e t h e e n o r m o u s clinical a n d theoretical i m p o r t a n c e of t h e concepts associated with F a i r b a i r n ' s conception of the i n t e r n a l object world, a n d Klein's notion of t h e p a r a n o i d - s c h i z o i d position, these ideas h a v e n o t b e e n sufficient T to provide a full u n d e r s t a n d i n g of schizoid p h e n o m e n a . In this c h a p t e r , I h a v e a t t e m p t e d to demon^ strate t h a t analytic work with schizoid p a t i e n t s m u s t be i n f o r m e d b y a n u n d e r s t a n d i n g of t h e w a y in which schizoid p h e n o m e n a represent a r e a l m of experience t h a t lies b e t w e e n a world of timeless, s t r a n g u l a t e d i n t e r n a l object r e l a t i o n s a n d a m o r e p r i m i t i v e , inarticulate, sensorybased w o r l d of autistic shapes a n d objects.

5 T h e

T r a n s i t i o n a l

O e d i p a l

R e l a t i o n s h i p

i n

F e m a l e

D e v e l o p m e n t

T r a n s i t i o n s from o n e psychological o r g a n i z a t i o n to a n o t h e r a r e of p a r t i c u l a r i m p o r t a n c e in psychoanalytic t h i n k i n g a n d yet a r e a m o n g the m o s t difficult aspects of psychological d e v e l o p m e n t to conceptualize. T h e p r e s e n t c h a p t e r a t t e m p t s to m a k e a c o n t r i b u t i o n to the psychoanalytic u n d e r s t a n d i n g of the t r a n s i t i o n in female developm e n t t h a t occurs at t h e threshold of t h e O e d i p u s complex. T h e early p h a s e of the female O e d i p u s c o m p l e x will be viewed as a pivotal m o m e n t in d e v e l o p m e n t in which a form of transitional relationship to t h e m o t h e r m e d i a t e s t h e little girl's e n t r y into O e d i p a l object love. T h i s transitional relationship is similar to, b u t distinct from, t h e earlier relationship to the t r a n s i t i o n a l object described b y W i n n i c o t t (1951, 1971a). T h e p a r a d o x i c a l n a t u r e of t h e little girl's transitional O e d i p a l relationship (created b y m o t h e r a n d d a u g h t e r ) lies in the fact t h a t the first triadic object relationship occurs in t h e context of a t w o - p e r s o n relationship; the first h e t e r o s e x u a l relation109

no


ship develops in a relationship between t w o females; t h e father as libidinal object is discovered in t h e m o t h e r . F r o m t h e perspective of this u n d e r s t a n d i n g of the little girl's e n t r y into the O e d i p u s c o m p l e x , t h e r e will be a r e e x a m i n a t i o n of Freud's conception of t h e role of castration fantasies a n d penis envy in the female O e d i p a l n a r r a t i v e . F o r m s of character p a t h o l o g y d e r i v i n g from i n a d e q u a c y of this transitional O e d i p a l relationship will be described. Finally, a form of t r a n s f e r e n c e - c o u n t e r transference difficulty e n c o u n t e r e d in t h e t r e a t m e n t of female p a t i e n t s will be u n d e r s t o o d as reflecting p r o b l e m s arising from t h e p e r i o d of early O e d i p a l d e v e l o p m e n t t h a t is u n d e r discussion.

The

Female

Oedipal

Narrative

R e d i r e c t i o n of t h e little girl's libidinal a t t a c h m e n t from h e r m o t h e r to h e r father in the positive O e d i p u s c o m p l e x is a d e v e l o p m e n t step that h a s not b e e n a d e q u a t e l y u n d e r s t o o d . M a n y analysts h a v e u n d e r s t o o d this m o v e m e n t as a reflection of i n n a t e heterosexuality ( C h a s s e g u e t Smirgel, 1964; H o r n e y , 1926; J o n e s , 1935; Klein, 1928; P a r e n s et al., 1976; Stoller, 1973). F r e u d (1933) rejected the notion of a biological e x p l a n a t i o n 1 for t h e shift in libidinal a t t a c h m e n t in 'Freud is somewhat self-contradictory here since the Oedipus complex is a structural concept positing a universal biologically determined organization of wishes and meanings (see Ogden, 1984). The positive Oedipus complex by definition includes genital-level sexual wishes toward the parent of the opposite sex, and therefore involves inherent, biologically determined heterosexual strivings. The negative Oedipus complex similarly posits (universal) inherent strivings toward a homosexual love relationship with the parent of the same sex.

The Transitional Oedipal Relationship in Female Development

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female O e d i p a l d e v e l o p m e n t , a n d insisted t h a t the m o v e m e n t t o w a r d t h e father b e u n d e r s t o o d in psychological t e r m s . F r e u d (1925, 1931, 1933) viewed c a s t r a t i o n a n x iety a n d s h a m e in c o n n e c t i o n with the lack of a penis as the major forces in t h e little girl's t u r n from the m o t h e r to the father. At the e n d of this first [pre-Oedipal] p h a s e of a t t a c h m e n t to t h e m o t h e r , t h e r e e m e r g e s , as t h e girl's strongest m o t i v e for t u r n i n g away from h e r , the r e p r o a c h t h a t h e r m o t h e r did not give h e r a p r o p e r penis —that is to say, b r o u g h t her into t h e w o r l d as a female. [1931, p . 234] T h e t u r n i n g a w a y from t h e m o t h e r is a c c o m p a n i e d b y hostility; t h e a t t a c h m e n t to the [ p r e - O e d i p a l ] m o t h e r ends in h a t e . [1933, p p . 121-122] . . . [we] learn from analyses t h a t girls hold their m o t h e r responsible for their lack of a penis a n d do n o t forgive her for their b e i n g t h u s p u t at a disadv a n t a g e . [1933, p . 124] I n this r e n d e r i n g of the female O e d i p u s n a r r a t i v e , t h e little girl is a s h a m e d a n d d i s a p p o i n t e d b y h e r discovery that she lacks a penis. She also feels c o n t e m p t for her "castrated" m o t h e r ( F r e u d , 1933). As a result, she t u r n s away in a n g e r a n d d i s a p p o i n t m e n t from the m o t h e r . I n the m i n d of the child, a c c o r d i n g to F r e u d , t h e m o t h e r ' s refusal to p r o v i d e the little girl with a penis reflects the m o t h e r ' s lack of love for h e r d a u g h t e r . T h e r e f o r e , in h e r feelings of deficiency a n d s h a m e (as well as c o n t e m p t ) , t h e little girl angrily t u r n s to h e r father as h e r r e p l a c e m e n t love object. She hopes t h a t her father's

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love ( a n d m o r e concretely, h e r father's b a b y ) will m a k e u p for h e r lack of a penis. N o t u n t i l the e m e r g e n c e of the wish for a penis [in the O e d i p u s complex] does t h e doll-baby b e c o m e a b a b y from the girl's father, a n d thereafter the a i m of t h e m o s t powerful feminine wish. H e r h a p p i n e s s is great if later on this wish for a b a b y finds fulfillment in reality, q u i t e especially so if t h e b a b y is a little b o y w h o b r i n g s the longed-for penis with h i m . [1933, p . 128] I believe t h a t t h e r e are significant theoretical difficulties posed by Freud's female O e d i p a l n a r r a t i v e . First of all, t h e r e is i n a d e q u a t e differentiation b e t w e e n p r e O e d i p a l a n d O e d i p a l object relations. T h e girl is seen as "shifting" h e r object cathexis from the m o t h e r to the father. W h a t is glossed over in this formulation of the "shift" is t h a t t h e status of the m o t h e r as "object" a n d t h e status of t h e father as "object" a r e n o t at all e q u i v a l e n t f T h e t r a n s i t i o n is n o t from o n e object to a n o t h e r , b u t from a relationship to a n i n t e r n a l object ( a n object t h a t is n o t completely separate from oneself) to a cathexis of a n e x t e r n a l object (an object t h a t exists outside of one's o m n i p o t e n c e ) J T h e external object e n c o u n t e r e d is n o t only t h e O e d i p a l father, b u t also t h e O e d i p a l m o t h e r with w h o m t h e O e d i p a l father h a s a relationship. ( T h i s relationship b e t w e e n the external m o t h e r a n d the external father is at the core of what generates the triangulation t h a t to a l a r g e extent defines the O e d i p u s c o m p l e x . ) ™" T h e p r e - O e d i p a l m o t h e r is a n object t h a t p a r t a k e s of t h e child's o m n i p o t e n c e . A b r u p t disillusionment in the p r e - O e d i p a l period leads not to a n a d v a n c e to wholeobject relatedness, b u t to a r e d o u b l i n g of the child's


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efforts at o m n i p o t e n t defensive solutions worked out in i relation to i n t e r n a l o b j e c t s J ( S e e Schafer, 1974, for a J critique of F r e u d ' s "shock theory" of the female e n t r y into t h e O e d i p u s c o m p l e x . ) fit is only a h e a l t h y , well-dosecT disillusionment process t h a t results in a m o v e m e n t from o m n i p o t e n t object relations to a n i n v e s t m e n t in external objects t h a t lie outside one's control. \ \ m o v e m e n t to a cathexis of b o t h the O e d i p a l m o t h e r a n d father is a d e v e l o p m e n t a l a d v a n c e to an i n v o l v e m e n t with external objects, a n d therefore r e q u i r e s a healthy w e a n i n g experience m e d i a t e d by transitional objects a n d p h e n o m e n a ( W i n n i c o t t , 1951; see also O g d e n , 1985a). D i s r u p t i o n of t h e p r e - O e d i p a l relationship with t h e m o t h e r in t h e m a n n e r described b y F r e u d would be expected to lead to t h e erection of narcissistic defenses a n d object relatedness, schizoid w i t h d r a w a l from external objects, a n d / o r a reintensification of reliance on o m n i p o t e n t defenses. T h e s e forms of defense allow t h e child the illusion of absolute control over his o r h e r object world (the world of internal objects). Secondly, O e d i p a l love is the foundation of healthy whole-object love relations. S h a m e a n d a sense of failure a n d defectiveness are not the ingredients t h a t propel o n e into a h e a l t h y love relationship. A love relationship e n t e r e d into as a result of a flight from s h a m e a n d narcissistic injury is almost certain to be constructed for t h e p u r p o s e of narcissistic defense, a n d is unlikely to involve g e n u i n e object love.Tit is only a foundation oT\ healthy narcissism, g e n e r a t i n g - f e d i n g s of h o p e a n d of I o p e n n e s s to t h e u n k n o w n , t h a t p r e p a r e s the w a y for t h e \ little girl's t a k i n g t h e risk of falling in love with t h e I external-object father—a p e r s o n outside of h e r o m n i p o - 1 t e n t c o n t r o l / Y r h e picture of the little girl shamefully, ] defeatedlyj^Snd angrily t u r n i n g a w a y from t h e m o t h e r to

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the father is at odds with o n e of the most f u n d a m e n t a l psychoanalytic propositions: t h e concept of the O e d i p u s c o m p l e x as the c o r n e r s t o n e of t h e d e v e l o p m e n t of m a t u r e object love. T h i r d l y , the F r e u d i a n n a r r a t i v e of the female O e d i p u s complex rests u p o n the a s s u m p t i o n that the little girl's discovery that she lacks a penis is, for h e r , a p r o f o u n d l y d i s a p p o i n t i n g event t h a t constitutes a t u r n i n g point in d e v e l o p m e n t . F e w analysts w o u l d dispute t h e idea t h a t p e n i s envy is e n c o u n t e r e d in the analysis of e v e r y female ( a n d every male) p a t i e n t . T h a t castration fantasies a n d penis envy exist in little girls is not t h e issue. T h e q u e s t i o n is w h e t h e r it is the little girl's a n g e r at h e r m o t h e r for n o t giving h e r a penis t h a t is t h e "strongest motive" ( F r e u d , 1931) l e a d i n g t h e little girl to reject t h e m o t h e r a n d t u r n t o . h e r father as the object of libidinal desire. O b s e r v a t i o n a l studies of P a r e n s a n d colleagues (1976) h a v e shown t h a t c a s t r a t i o n anxiety does n o t consistently p r e c e d e t h e a p p e a r a n c e of t h e little girl's e n t r y into the O e d i p u s c o m p l e x as reflected by a "seemingly heterosexual a t t i t u d e t o w a r d h e r father" (p. 85), h e r wish to h a v e a b a b y , a n d her rivalry with h e r m o t h e r . T h e r e is a question of whether, c a s t r a t i o n anxiety in girls p r i m a r i l y involves the p h a n t a s y of t h e loss of a oncepossessed penis, or w h e t h e r female castration a n x i e t y p r i m a r i l y involves p h a n t a s i e s of d a m a g e to the female genitals ( A p p l e g a r t h , 1985). T h e r e is a further q u e s t i o n of w h e t h e r the little girl p r e d o m i n a n t l y experiences h e r own genitals as reflecting t h e result of the loss of the penis; o r w h e t h e r , in n o r m a l d e v e l o p m e n t , she p r e d o m i n a n t l y perceives the female genitals to be t h e s t a n d a r d of n o r m a l c y , believing t h a t little boys possess defective e q u i p m e n t t h a t is "too closed" a n d "unreceptive" to w o r k well ( M a y e r , 1985).


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A n a r r a t i v e of the female O e d i p u s c o m p l e x m u s t a c c o u n t for t h e little girl's t u r n i n g from the m o t h e r to the father in t h e course of this p h a s e of d e v e l o p m e n t . I believe that the F r e u d i a n n a r r a t i v e m u s t be reformulated in the light of e n h a n c e d psychoanalytic u n d e r s t a n d i n g s of early object relations, a n d of t h e psychologicali n t e r p e r s o n a l processes m e d i a t i n g t h e n o n t r a u m a t i c m o v e m e n t from i n t e r n a l t o e x t e r n a l object relations.

The Developmental

Context

Before p r e s e n t i n g m y u n d e r s t a n d i n g of the transitional r e l a t i o n s h i p with the m o t h e r t h a t m e d i a t e s t h e e n t r y into t h e female O e d i p u s c o m p l e x , I would like to briefly review s o m e of t h e features of psychological d e v e l o p m e n t f o r m i n g the context for this m o m e n t in d e v e l o p m e n t . Psychological d e v e l o p m e n t involves the elaboration of a n i n c r e a s i n g capacity for a w a r e n e s s of otherness, m e d i a t e d b y interpersonal processes a n d the m a t u r a t i o n of the infant's biological a n d psychological capacities. A l t h o u g h t h e r e is progressive m o v e m e n t t h r o u g h o u t dev e l o p m e n t t o w a r d t h e "discovery of externality" ( W i n n i cott, 1968), t h e r e a r e critical periods of psychological r e o r g a n i z a t i o n in which n e w capacities for object relatedness a r e developed t h a t a r e qualitatively different from pre-existing forms of relatedness (cf. Spitz, 1965). Early infantile experience involves t h e coexistence of two aspects of relatedness to the m o t h e r . O n e aspect of t h e m o t h e r - i n f a n t relationship involves the relationship to t h e e n v i r o n m e n t a l m o t h e r (the m o t h e r as h o l d i n g e n v i r o n m e n t ) ; t h e other involves t h e relationship to t h e m o t h e r as object ( W i n n i c o t t , 1963b). I n t h e b e g i n n i n g , the former aspect of relatedness far outweighs the latter.

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T h e b a l a n c e shifts in the course of d e v e l o p m e n t until the relationship to the m o t h e r as e n v i r o n m e n t b e c o m e s the silent b a c k g r o u n d of object-related e x p e r i e n c e (variously referred to as the " b a c k g r o u n d object of p r i m a r y identification" [Grotstein, 1981], the " d r e a m screen" [Lewin, 1950], a n d t h e "matrix of t h e m i n d " [ O g d e n , 1985a, 1986]). I n the relationship to t h e e n v i r o n m e n t a l m o t h e r , e x p e r i e n c e is g e n e r a t e d in a p r e d o m i n a n t l y h o m o g e n e o u s field: t h e r e is very little experience of difference, for e x a m p l e , t h e difference between inside a n d outside, m e a n d n o t - m e , p r e s e n t a t i o n a n d r e - p r e s e n t a t i o n . T h i s psychological state is m e d i a t e d by the m o t h e r ' s provision of the illusion of the "subjective object" ( W i n n i c o t t , 1962, 1967a), w h e r e i n the m o t h e r m e e t s t h e infant's n e e d so u n o b t r u s i v e l y t h a t she is h a r d l y noticed. T h e subjective object is experienced as if it h a d b e e n "created" ( W i n n i cott, 1951) by the infant a c c o r d i n g to his needs. A n d yet the idea of t h e infant "creating t h e object" is misleading since the infant h a s little sense of himself as a s e p a r a t e entity, m u c h less the c r e a t o r of people a n d things. —' T h e q u e s t i o n arises as to h o w it is possible for t h e infant to m o v e n o n t r a u m a t i c a l l y from the protective illusion of t h e subjective object to a capacity to experience objects as i n d e p e n d e n t of h i m s e l f y T h e infant's discovery of a n e x t e r n a l reality (which l o n g p r e c e d e d h i m ) m u s t b e m e d i a t e d interpersonally. W i n n i c o t t (1951) h a s described this process (which begins at " a b o u t four to six to eight to twelve m o n t h s " [p. 4]) as one in which a psychological state based u p o n a series of p a r a d o x e s is g e n e r a t e d a n d m a i n t a i n e d b y m o t h e r a n d infant. T h e state of m i n d created in this w a y underlies t h e child's relationship to a transitional object. T h e transitional object is a n object


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t h a t is b o t h discovered a n d created; it is b o t h reality a n d fantasy; b o t h m e a n d n o t - m e ; b o t h t h e o m n i p o t e n t , protective, i n t e r n a l object mother, a n d the external object thing with its o w n fixed sensory qualities. M o s t i m p o r t a n d y , the q u e s t i o n of which it is—created o r discovered, m e o r n o t - m e —never arises. W i n n i c o t t ' s concept of the discovery of e x t e r n a l i t y \ m e d i a t e d b y a r e l a t i o n s h i p to the transitional object, is a I c o n c e p t i o n of d e v e l o p m e n t t h a t differs from a view of I d e v e l o p m e n t as a d v a n c i n g from u n i o n to separateness 1 t h r o u g h a g r a d u a l process of well-dosed frustration t h a t is I in step with t h e child's m a t u r i n g ego c a p a c i t i e s j T h e J relationship to a transitional object is not a halfway point in a w e a n i n g process t h r o u g h which a w a r e n e s s of separateness develops linearly in small i n c r e m e n t s . As I h a v e discussed elsewhere ( O g d e n , 1985a,b), transitional phen o m e n a h a v e a dialectical s t r u c t u r e . O n e n e s s a n d separateness, reality a n d t a n t a s y , m e a n d n o t - m e coexist with o n e a n o t h e r , e a c h creating, p r e s e r v i n g a n d n e g a t i n g the o t h e r . R e a l i t y d o e s not supersede fantasy a n y m o r e t h a n ! t h e conscious m i n d replaces the u n c o n s c i o u s m i n d in the course of d e v e l o p m e n t . R a t h e r , reality enters into a m u t u a l l y defining a n d e n r i c h i n g relationship with fant a s y J l t is only in the space between reality a n d fantasy^ created in this w a y t h a t subjectivity, personal m e a n i n g , symbol"formation, a n d i m a g i n a t i o n b e c o m e possible. As m e n t i o n e d a b o v e , the discovery of externality is a n Ongoing process from b i r t h , a n d yet t h e r e are critical periods of r e o r g a n i z a t i o n from which the capacity for qualitatively n e w m o d e s of object relatedness e m e r g e . T h e e n t r y into t h e O e d i p u s c o m p l e x r e p r e s e n t s o n e such pivotal period of d e v e l o p m e n t . T h e e n t r y into the O e d i p u s c o m p l e x involves the i n t r o d u c t i o n of a distinctly

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n e w form of otherness into t h e m o t h e r - i n f a n t d y a d t h a t r e q u i r e s a radical psychological-interpersonal reorganization.

The

Transitional

Relationship

T h e psychological r e o r g a n i z a t i o n involved in the e n t r y into the female O e d i p u s c o m p l e x is m e d i a t e d by a p a r t i c u l a r form of transitional relationship to the m o t h e r . A s with the earlier forms of t r a n s i t i o n a l p h e n o m e n a , the function of this relationship is' the i n t r o d u c t i o n of otherness in a form that is at first experienced as o t h e r a n d n o t - o t h e r at the same time. I n a state of m i n d in which such a p a r a d o x can be created a n d m a i n t a i n e d by m o t h e r a n d child, a m a n a g e a b l e transition is set in m o t i o n that will obviate t h e child's need to construct a rigid defensive system to protect the self from intolerable ( p r e m a t u r e ) a w a r e n e s s of separateness. I n the case of the O e d i p a l situation, t h e father is the principal representative of o t h e r n e s s . 2 I n addition, the m o t h e r of t h e O e d i p u s c o m p l e x is a far m o r e external object t h a n she h a d b e e n previously, a l t h o u g h the relationship to the O e d i p a l m o t h e r n e v e r loses its connection with the experience of t h e m o t h e r as subjective object (cf. G h o d b r o w , 1978). T h e discovery of the O e d i p a l m o t h e r ' s externality is Lacan (1956-1957) has pointed out that it is not the power of the individual personality of the father that is of central importance in liberating the infant from the "realm of the imaginary," in which the infant is imprisoned in a nonsubjective world of immediate lived sensory experience. Rather, the father's power lies in his role as the carrier of symbols, as representative of a system of meanings (organized in language) that provides the child with the means by which to mediate between himself and his sensory experience.


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always e x p e r i e n c e d , in p a r t , as a b e t r a y a l . T h e child says, in effect, I t h o u g h t t h a t we h a d a n a g r e e m e n t t h a t what's y o u r s is m i n e a n d what's m i n e is y o u r s , so w h y d o I h a v e to knock on t h e d o o r of y o u r b e d r o o m [that you s h a r e with father] before going in? I didn't h a v e to before." T h e a n g e r c o n n e c t e d with this is directed m o r e at the m o t h e r t h a n at t h e father, since, in the little girl's m i n d , it is the m o t h e r w h o is "defecting," " c h a n g i n g t h e rules." T h e psychological r e o r g a n i z a t i o n r e q u i r e d at the threshold of the female O e d i p u s c o m p l e x is extensive. Both m o t h e r a n d father a r e discovered (to a m u c h fuller degree t h a n before) as external objects. T h e child, becomes a w a r e of h e r p a r e n t s as people w h o h a v e a n i n t i m a t e relationship with o n e a n o t h e r t h a t does n o t include h e r . A t t h e s a m e time, a n intense, t r i a n g u l a t e d set of whole-object relationships is established in w h i c h the father is t a k e n as love object, while the m o t h e r is established as a n ambivalently loved rival. T h i s reorgan i z a t i o n takes place riontraumatically b e c a u s e it is m e d i ated b y a relationship with the m o t h e r t h a t e m b o d i e s the following p a r a d o x : the little girl falls in love with the motheras-father and with the father-as-mother. F r o m a psychoanalytic perspective, w h a t occurs in this transitional relationship is t h a t t h e little girl falls in love with the (not yet fully external) m o t h e r w h o is e n g a g e d in a n unconscious identification with h e r own father in h e r internal set of O e d i p a l object relations. T h e q u e s t i o n of w h e t h e r the little girl is in love with h e r m o t h e r or h e r father (in love with a n i n t e r n a l object or a n e x t e r n a l object) n e v e r arises. It is b o t h . She is in love with h e r mother-as-father a n d h e r f a t h e r - a s - m o t h e r . T h i s p a r a d o x is the core of w h a t allows the e n t r y into the O e d i p u s c o m p l e x to be achieved w i t h o u t o v e r w h e l m i n g disillusionment t h a t would r e q u i r e

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g r o w t h - l i m i t i n g defensive m a n e u v e r s . T h e little girl does n o t h a v e to reject the m o t h e r in o r d e r to love the father; she does n o t h a v e to r e n o u n c e a n i n t e r n a l object for a n external object. T h e role of the m o t h e r as O e d i p a l transitional object is to allow herself to b e loved as a> m a n (her o w n u n c o n s c i o u s identification with h e r o w n father). I n so d o i n g , she unconsciously says to h e r d a u g h t e r , "If I w e r e a m a n , I w o u l d b e in love with y o u , find you beautiful, a n d w o u l d very m u c h w a n t to m a r r y y o u . " Since t h e u n c o n s c i o u s m i n d k n o w s n o t h i n g of "If I w e r e . . . ," t h e m o t h e r ' s u n c o n s c i o u s c o m m u n i c a t i o n is m o r e accurately stated as "I a m a m a n , y o u r father, a n d a m in love with y o u , find y o u beautiful, a n d w a n t to m a r r y y o u . " T h e m o t h e r in this relationship allows herself to be used as a c o n d u i t to a relationship with "the other," w h o paradoxically is already a p a r t of herself in h e r o w n identification with the other ( h e r o w n father). G r e e n (1975), e x p a n d i n g u p o n W i n n i c o t t ' s (1960a) idea t h a t t h e r e is n o s u c h t h i n g as a n infant, has said that t h e r e is n o such t h i n g as a m o t h e r a n d infant, since the father is always r e p r e s e n t e d in the u n c o n s c i o u s m i n d of t h e m o t h e r . T h i s idea h a s p a r t i c u l a r significance at the m o m e n t in d e v e l o p m e n t that is b e i n g described. T h e m o t h e r ' s c a p a c i t y to serve in the transitional role u n d e r discussion is c o m p r o m i s e d to t h e d e g r e e to which her u n c o n s c i o u s relationship with h e r own O e d i p a l father is conflicted. T o s u m m a r i z e , t h e e n t r a n c e i n t o t h e female O e d i p u s c o m p l e x does n o t initially revolve a r o u n d a relationship with t h e father himself, b u t a r o u n d t h e m o t h e r ' s u n c o n scious identification with h e r o w n father ( m o r e accurately, the m o t h e r ' s internal object relationship w i t h h e r own father). T h e early period of female O e d i p a l devel-


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o p m e n t involves a t r i a n g u l a t i o n of object relations achieved in t h e context of a t w o - p e r s o n relationship. Before t h e little girl is capable of a relationship with t h e o t h e r (the father), she a n d her m o t h e r e n g a g e in a "dress rehearsal" for t h e later O e d i p a l d r a m a in w h i c h t h e actual father (a m u c h m o r e fully external object t h a n t h e m o t h e r - a s - f a t h e r ) will b e c o m e central. T h e m e t a p h o r of the dress r e h e a r s a l conveys s o m e t h i n g of t h e w a y in which t h e transitional O e d i p a l relationship with t h e m o t h e r is a form of play t h a t is a real experience in its o w n r i g h t , a n d yet is p r e p a r a t o r y for s o m e t h i n g else t h a t is felt to b e " m o r e real." T h e dress rehearsal is c o n d u c t e d in t h e safety of t h e p r i v a c y of t h e d y a d , a n d yet t h e o t h e r — t h e father —is very m u c h present (in i m a g i n a t i o n ) . I n latency a n d adolescence, the O e d i p a l transitional relationship b e t w e e n m o t h e r a n d d a u g h t e r is r e e n a c t e d in a wide variety of forms. O n e of t h e c o m m o n forms of this r e e n a c t m e n t is t h e " s h o p p i n g expedition" d u r i n g which t h e d a u g h t e r tries on clothes while t h e m o t h e r participates t h r o u g h a n identification with t h e m a n (unconsciously a n identification with t h e m o t h e r ' s o w n father in relation to herself as a little girl). T h e m o t h e r (as a m a n ) a d m i r e s h e r d a u g h t e r . T h e girl's father is physically a b s e n t at t h e m o m e n t , b u t is very m u c h the emotionally p r e s e n t third p a r t y in this d r a m a . It is to a large d e g r e e t h e father t h a t t h e little girl sees in t h e m o t h e r ' s gaze. T h e aspect of t h e m o t h e r - d a u g h t e r relationship that I a m focusing o n is different from t h e m o t h e r ' s vicarious e n j o y m e n t of h e r d a u g h t e r ' s pleasure in h e r (the d a u g h ter's) O e d i p a l r o m a n c e with t h e father. T h e latter is u n d o u b t e d l y a n i m p o r t a n t e l e m e n t in a later p h a s e of O e d i p a l d e v e l o p m e n t , a n d involves a revival of t h e p l e a s u r e the m o t h e r experienced in h e r O e d i p a l experience with h e r o w n father. H o w e v e r , this aspect of

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experience involves t h e actual i n v o l v e m e n t of the little girl's father, a n d therefore is d e v e l o p m e n t a l l y later t h a n the aspect of d e v e l o p m e n t I a m focusing o n . T h e transitional O e d i p a l relationship m u s t also b e distinguished from the female n e g a t i v e O e d i p u s c o m p l e x w h e r e i n the m o t h e r is taken as a r o m a n t i c a n d sexual object while t h e father is seen as t h e rival. I n the form of relatedness t h a t I a m describing, t h e m o t h e r b o t h is the father a n d is n o t the father; the question of w h e t h e r she is m o t h e r or father is n e v e r asked. I n c o n t r a s t , the love of the m o t h e r in t h e negative O e d i p u s c o m p l e x is a genitallevel r o m a n t i c a n d sexual a t t a c h m e n t of o n e female for a n o t h e r . F o r t h e little girl, the a m b i v a l e n t l y loved father is a n u n w e l c o m e interference w h o m she wishes to get rid of. T h i s is clearly q u i t e different from t h e situation involved in t h e transition into the positive O e d i p u s complex. It is t h e success of t h e early O e d i p a l transitional relationship t h a t paves t h e way for the little girl's act of c o u r a g e in allowing herself to fall in love with t h e actual father. H e r father, after all, is a p e r s o n w h o lies b e y o n d the r e a l m of t h e little girl's o m n i p o t e n c e , a n d she m u s t take h e r chances with h i m . It is possible t h a t he will not reciprocate h e r love, t h u s d i s a p p o i n t i n g a n d / o r humilia t i n g h e r . If this should occur, she inevitably d r a w s the conclusion t h a t t h e r e m u s t be s o m e t h i n g t h e m a t t e r with h e r t h a t w o u l d c a u s e h e r father to find h e r u n l o v a b l e . Since it is r o m a n t i c a n d sexual feelings, in a d d i t i o n to wishes to displace h e r m o t h e r , that a r e m o s t intense in the O e d i p a l p e r i o d , it is these aspects of herself t h a t a r e usually t h o u g h t to be the basis of h e r u n a c c e p t a b i l i t y . 3 3

These Oedipal-level feelings are much more circumscribed and nameable than are the earlier feelings of incompleteness or failure

The Transitional Oedipal Relationship in Female Development Psychopathology Transitional

and

the

Oedipal

Relationship

T h e O e d i p a l transitional relationship to t h e m o t h e r is a form of relatedness t h r o u g h which the m o t h e r u n c o n sciously gives h e r blessing to t h e little girl's O e d i p a l love of h e r father, a n d , from t h e r e , h e r love of other m e n . I n a d e q u a c y of this transitional r e l a t i o n s h i p stifles (in p h a n t a s y , involves a prohibition of) the d e v e l o p m e n t of the little girl's interest in t h e father. It b e c o m e s necessary for the little girl to d e n y wishes a n d strivings in relation to t h e father, a n d to d e n y t h e t h o u g h t t h a t t h e father h a s a n y t h i n g to offer h e r . If the father does n o t a t t e m p t to override t h e m o t h e r ' s u n c o n s c i o u s p r o h i b i t i o n of t h e O e d i p a l r o m a n c e , t h e little girl feels confirmed in h e r belief that she should n o t h a v e r o m a n t i c a n d sexual feelings for h e r father ( a n d rivalrous feelings for h e r m o t h e r ) a n d t h a t the feelings she does h a v e a r e b a d —too disloyal, too d i r t y , too intense, too greedy, directed at the w r o n g p e r s o n , a n d so o n . W h e t h e r or n o t t h e father is emotionally available to the little girl in this stage of d e v e l o p m e n t , t h e m o t h e r ' s inability or unwillingness to serve as a n O e d i p a l transitional object is i n t e r p r e t e d (often correctly so) as a n unwillingness on t h e p a r t of t h e m o t h e r to c o n d o n e t h e litde girl's e n t r y i n t o O e d i p a l object relations. S u c h a m o t h e r is u n a b l e to identify with

that result from a mother's inability to recognize and accept the infant's love. The earliest experience of a "lack of fit" between mother and infant leads the infant to feel that it is his or her way of loving that is hurtful (Fairbairn, 1940). This represents the most global and fundamental damnation of self. It is one's way of being with the other, and not simply one's hostility or sexual feelings, that are unacceptable.

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h e r own father in a w a y that serves a transitional function. T o e n t e r i n t o a n O e d i p a l relationship with the father u n d e r these c i r c u m s t a n c e s involves a d a n g e r o u s a t t e m p t to b y p a s s the m o t h e r . T h i s is a n e x t r e m e l y difficult task in the a b s e n c e of the father's active assistance. E v e n the wish to be like the father is experienced as a forbidden act a n d as a betrayal of the m o t h e r . T h i s identification w i t h t h e father is unconsciously experienced b y t h e little girl as a n a t t e m p t to be w h a t she c a n n o t , a n d should n o t , have. It is felt to be a n act of stealing w h a t she senses should n o t be hers. T h i s fear of identification with t h e O e d i p a l father frequently manifests itself in a d u l t h o o d as a "hyper-feminine" stance w h e r e i n t h e w o m a n acts as if she c a n n o t d o a n y t h i n g o r h a v e a n y knowledge of a n y t h i n g "masculine" — for e x a m p l e , b e i n g able to e n g a g e in logical, scientific t h o u g h t a n d discussion, b e i n g able to select a car, a n d d o i n g basic h o m e repairs. A n o t h e r form of c h a r a c t e r defense t h a t often originates as a result of pathology in the transitional O e d i p a l relationship is t h e pervasive feeling t h a t "there is n o t h i n g a m a n can d o t h a t I can't a n d therefore n o m a n h a s a n y t h i n g to offer m e . " T h i s represents a n o u t g r o w t h of t h e u n c o n s c i o u s conviction that love of t h e O e d i p a l father is a b e t r a y a l of t h e m o t h e r . O n e such a n a l y s a n d , e m ployed as a social w o r k e r , consistently p u t herself in d a n g e r o u s situations in relation to violent m a l e p a t i e n t s in o r d e r to unconsciously d e m o n s t r a t e t h a t t h e r e was n o t h i n g a m a n could d o t h a t she could n o t . She did not n e e d a n y b o d y ' s h e l p , particularly t h e assistance of t h e m a l e m e m b e r s of t h e staff. T h e r e w a s u t t e r denial of the fact that m o s t m e n w e r e larger a n d s t r o n g e r t h a n she. S u c h a n a c k n o w l e d g m e n t would h a v e b e e n profoundly h u m i l i a t i n g for h e r , since it was unconsciously e q u i v a l e n t


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to a n a c k n o w l e d g m e n t of her wish that h e r father w o u l d offer h e r s o m e t h i n g she v a l u e d a n d could n o t p r o v i d e for herself. I n t h e e x t r e m e , this, leads to a pathological form of h o m o s e x u a l object choice. I would n o w like to offer a brief clinical e x a m p l e illustrating transference experiences of transitional O e dipal object relatedness. T h e p a t i e n t , L . , was-a 27-year-old g r a d u a t e s t u d e n t at t h e t i m e she c a m e to t h e r a p y expressing feelings of e x t r e m e loneliness a n d pointlessness. She dressed in a r a t h e r m a s c u l i n e way, with severe-looking short h a i r . T h e therapist e x p e r i e n c e d herself w h e n with this patient as a c a r i c a t u r e of femininity a l t e r n a t i n g b e t w e e n t h e sweet, prissy litde girl a n d the e a r t h m o t h e r with e n o r m o u s , disgusting, suffocating breasts. ( T h i s was u n d e r s t o o d as a reflection of t h e patient's use of splitting a n d projective identification.) L. felt strongly t h a t m e n a r e ruthless, p o w e r - h u n g r y , a n d w i t h o u t feelings, while w o m e n a r e weak, ineffectual, a n d pathetic. T h e p a t i e n t derived n o pleasure from sex either with m e n o r with w o m e n a n d h a d given u p sex altogether five years earlier. She occasionally a t t e m p t e d to m a s t u r b a t e , b u t was u n a b l e to achieve o r g a s m . D u r i n g m a s t u r b a t i o n , she " u n a c c o u n t a b l y " found tears rolling d o w n h e r cheeks. She r e p o r t e d e x p e r i e n c i n g the faintest g l i m m e r of the feelings of sadness a n d futility, b u t t h e r e was n o conscious sexual fantasy o r i m a g e r y connected with the tears.

4

I concur with McDougall's (1986) conception that "the variations in psychosexual structure are so great that we are obliged to talk in the plural: of heterosexualities and homosexualities" (p. 20). A particular form of sexuality, whether heterosexual or homosexual, is considered pathological to the degree that it serves to circumvent the individual's entry into or "elaboration of . . . the depressive position" (p. 23).

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L.'s father h a d a b a n d o n e d h e r m o t h e r before t h e p a t i e n t was b o r n . T h e patient's m o t h e r h a d t h e n b u r i e d herself in h e r w o r k a n d h a d a series of relationships with m e n w h o m she n e v e r i n t r o d u c e d o r even m e n t i o n e d to the p a t i e n t . L.'s m o t h e r refused to tell h e r a n y t h i n g a b o u t h e r father. It is n o t possible h e r e to trace the d e v e l o p m e n t of this intensive t h e r a p y to the point in the sixth year of work t h a t will b e focused u p o n , o t h e r t h a n to say t h a t t h e schizoid w i t h d r a w a l a n d splitting defenses gradually dim i n i s h e d , giving w a y to the b e g i n n i n g s of a m b i v a l e n c e a n d whole-object relatedness. O v e r a period of m o n t h s in t h e sixth y e a r of t h e r a p y , L . w o u l d s t a r e at the therapist, s a y i n g at first that she saw s o m e t h i n g in h e r eyes b u t did n o t k n o w w h a t it was. O v e r t i m e she said she also h e a r d this s a m e t h i n g in t h e therapist's voice. It was unfamiliar, b u t fascinating—it was a " h a r d n e s s that wasn't h a r s h o r cold." T h e p a t i e n t said, after weeks of circumlocutions, t h a t there was s o m e t h i n g "sexy" a b o u t it, b u t a d d e d t h a t it was terribly i m p o r t a n t t h a t the therapist n o t m i s u n d e r s t a n d this as h o m o s e x u a l . It was n o t at all w h a t she h a d felt for w o m e n w h o m she h a d felt attracted to a n d at times felt she was in love w i t h . O n t h e other h a n d , it was a bodily experience t h a t she h a d not h a d in years a n d n e v e r expected to h a v e again. A t t h a t point in the t h e r a p y , t h e patient b e c a m e interested in a "purely intellectual way" in a m a l e professor several years older t h a n she. L . felt very selfconscious t a l k i n g to the therapist a b o u t this m a n , b u t eventually w a s able to haltingly talk a b o u t h o w the m a n lived in "an entirely different world" from h e r , a world in which she felt u n a b l e to speak the l a n g u a g e o r k n o w t h e c u s t o m s . A s a result she alternately felt either invisible or


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as if she w e r e a freak. She w a s e x t r e m e l y a n x i o u s t h a t b o t h the professor a n d t h e therapist m i g h t see h e r as a fool for b e i n g interested in a m a n w h o w o u l d obviously h a v e n o interest in h e r . I n a d d i t i o n , she b e c a m e a n g r y a n d s o m e w h a t p a r a n o i d a b o u t t h e fact t h a t the therapist also lived so comfortably in t h a t different world a n d w o u l d h a v e n o interest in h e l p i n g the p a t i e n t b e c o m e a p a r t of it, a n d in fact m i g h t actively a t t e m p t to exclude the p a t i e n t from it. I n h e r t h e r a p y , t h e link b e t w e e n these feelings a n d L.'s experience of h e r m o t h e r was interp r e t e d . A t t h e s a m e t i m e the p a t i e n t also felt t h a t to e n t e r t h a t world w o u l d b e a b e t r a y a l of h e r feminist a n d lesbian friends, a n d t h a t a b u n g l e d a t t e m p t at e n t e r i n g t h a t world w o u l d leave h e r absolutely alone, u n a b l e a n d u n d e s e r v i n g to t u r n in either direction. I n a state of panic, L . w i t h d r e w from t h e relationship with t h e professor a n d refocused h e r a t t e n t i o n on t h e "soft, feminine h a r d n e s s that wasn't coldness" that she saw a n d h e a r d in the therapist. L . confessed with great e m b a r r a s s m e n t t h a t she was very t a k e n with this quality of the t h e r a p i s t ; she said, h o w e v e r , "I'm n o t in love with y o u , b u t with t h a t feeling I b r u s h u p against in experie n c i n g t h a t p a r t of you I've b e e n t r y i n g to describe. T o fall in love with you would be like b e i n g t r a p p e d in a d a r k , m u s t y cave a n d I h a v e n o desire for that again [ s o m e t h i n g she h a d experienced in a brief h o m o s e x u a l affair]. T o fall in love with you in t h a t w a y w o u l d be to step o n t o wet grass a n d find you're s i n k i n g u p to y o u r knees, instead of sinking for a m o m e n t until t h e firmness of t h e g r o u n d holds y o u . " T h e p a t i e n t in this period said t h a t she was feeling c u r i o u s a b o u t h e r father for t h e first t i m e since childh o o d . She h a d looked at pictures t a k e n of herself from h e r childhood to t h e present ( a n activity she h a d b e e n phobic

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a b o u t to this point) in o r d e r to see if she could figure o u t w h a t h e r father looked like by "subtracting" the features she k n e w to b e h e r mother's. She h a d m a d e a conscious effort as a child not to look for h e r father in t h e m e n she saw o n the street. T h e therapist suggested t h a t the p a t i e n t was feeling t h a t there a r e m e n to b e found in w o m e n a n d w o m e n to b e found in m e n , a n d t h a t p e r h a p s this was t h e m e a n i n g of t h e patient's discovery of t h e h a r d n e s s t h a t wasn't coldness in the therapist. Several m o n t h s later, L . w o r e a skirt a n d blouse to h e r t h e r a p y session for the first t i m e . She was clearly a n x i o u s , walked into the office with h e r h e a d d o w n , h e r eyes fixed o n h e r shoes. W h e n she finally looked u p at t h e t h e r a p i s t , t h e y b o t h smiled. T h e patient's eyes filled with tears. She said t h a t the therapist's smile h a d b e e n o n e of t h e w a r m e s t a n d most quietly accepting m o m e n t s of h e r life. ( T h e therapist h a d to stifle h e r o w n tears b e c a u s e the p a t i e n t a p p e a r e d to h e r to b e p l a c i n g herself in the therapist's h a n d s so i n n o c e n d y a n d trustingly t h a t she w a s r e m i n d e d of experiences with b o t h h e r o w n children a n d h e r own m o t h e r . ) L . said that she h a d b e e n so afraid t h a t the therapist would l a u g h at h e r t h a t she h a d changed h e r clothes six t i m e s before finally m u s t e r i n g the c o u r a g e to w e a r t h e skirt a n d b l o u s e to t h e session. T h e m a t e r i a l at this point b e c a m e centered on the patient's fantasies of t h e therapist's relationship with h e r h u s b a n d , at first with the patient as t h e fantasied child. L a t e r , with considerable anxiety, t h e p a t i e n t reported a d r e a m in w h i c h the therapist's h u s b a n d asked his wife w h o t h a t w o m a n [the patient] w a s w h o m he h a d seen leaving the therapist's office. L . b e g a n to be able to e n t e r t a i n conscious sexual fantasies ( i n c l u d i n g d u r i n g m a s t u r b a t i o n ) which centered on a "torrid affair" between


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herself (identified with L a u r e n Bacall, "a gutsy w o m a n " ) and H u m p h r e y Bogart. T h e p a t i e n t in this sequence of e v e n t s h a d initially utilized schizoid w i t h d r a w a l a n d splitting defenses (inc l u d i n g t h e splitting of masculinity a n d femininity) to w a r d off t h e d a n g e r s a n d complexity of O e d i p a l relatedness. O n c e h a v i n g achieved t h e b e g i n n i n g s of t h e capacity for whole-object relatedness in t h e depressive position, she developed the potential for m o r e t h a n fleeting a n d scattered elements of O e d i p a l relatedness. T h i s w a s u s h e r e d in b y t h e patient's seeing a n d h e a r i n g in the therapist a hardness-in-softness, t h e father-inm o t h e r , maleness-in-femaleness. It was n o t t h e m o t h e r in a n e g a t i v e O e d i p a l transference t h a t w a s t h e p r e d o m i n a n t issue h e r e ; r a t h e r , it was the transitional role of the discovery of a heretofore frightening otherness in the familiar. It w a s essential that the familiar n o t b e too f a m i l i a r — t h a t is, n o t too m u c h the m o t h e r of the p r i m itive m o t h e r - i n f a n t d y a d (the d a r k , m u s t y cave a n d the wet g r o u n d t h a t swallows one u p ) . It w a s equally i m p o r t a n t t h a t t h e "other," t h e unfamiliar, n o t be too frighteningly alien a n d u n w e l c o m i n g (the "other world" the professor lived in). T h e patient's e x p e r i e n c e was of falling in love with t h e transference m o t h e r w h o w a s n o t entirely the m o t h e r ("It's not you I'm in love with"); a n d of falling in love with t h e father (in the m o t h e r ) , t h e h a r d n e s s in the softness, t h a t w a s n o t yet the father as fully external object. T h i s w a s a critical transferential experience (that was i n t e r p r e t e d ) , l e a d i n g to the patient's d a r i n g to m a k e a trial identification with t h e therapist as O e d i p a l m o t h e r in relation to t h e p h a n t a s i e d O e d i p a l father. T h e patient's w e a r i n g the skirt a n d blouse r e p r e s e n t e d a step into the O e d i p u s c o m p l e x p r o p e r , w h e r e i n the therapist's trans-

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ference role was shifting from t h a t of f a t h e r - i n - m o t h e r a n d m o t h e r - i n - f a t h e r to that of the m o t h e r identifying with the d a u g h t e r in h e r O e d i p a l r o m a n c e with t h e father. ( I n the c o u n t e r t r a n s f e r e n c e , the therapist experie n c e d affection a n d p r i d e in r e s p o n s e to the patient's silently a s k i n g for h e r loving blessing for the identification with the O e d i p a l m o t h e r , i n c l u d i n g h e r sexual a n d r o m a n t i c interest in the O e d i p a l father.) Following these d e v e l o p m e n t s , the patient's inhibition of h e r capacity for sexual fantasy d i m i n i s h e d , all o w i n g h e r to experience a n d t a k e pleasure in genital-level sexual e x c i t e m e n t , i n c l u d i n g m a s t u r b a t i o n . T h e sexual/ r o m a n t i c fantasies of the "torrid affair" between herself (identified with L a u r e n Bacall) a n d H u m p h r e y B o g a r t c a r r i e d with it evidence of the c o n t i n u i n g i m p o r t a n c e of t h e t r a n s i t i o n a l O e d i p a l object. Bacall (as m a n i n - w o m a n ) was, in p a r t , h e i r to t h e f a t h e r - i n - m o t h e r transference. H o w e v e r , in the B o g a r t - B a c a l l fantasy, t h e r e is a m o r e fully t r i a n g u l a t e d object relationship (the p a t i e n t , B o g a r t , a n d Bacall) in w h i c h t h e patient engages in a n identification with ( a n d enters into c o m p e t i t i o n with) t h e e x t e r n a l object m o t h e r — a n d t h u s (safely a n d p l e a s u r a b l y ) enters into a r o m a n t i c / s e x u a l relationship with the O e d i p a l father as external object.

A Reevaluation Female

of the

Oedipal

Freudian Narrative

A t this p o i n t , Freud's n a r r a t i v e of the female O e d i p u s complex can be reexamined and perhaps better understood. F r o m the perspective developed in this c h a p t e r , F r e u d ' s n a r r a t i v e of the female O e d i p u s c o m p l e x (partic-


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ularly his e m p h a s i s on the girl's t u r n i n g to t h e father o u t of s h a m e r e s u l t i n g from her a w a r e n e s s that she lacks a penis), c a n b e viewed as a n a c c u r a t e description of a very c o m m o n pathological o u t c o m e of female d e v e l o p m e n t a n d as a s u b - t h e m e of n o r m a l female d e v e l o p m e n t . W h e n a girl's O e d i p a l experience unfolds in relation to a m o t h e r whose own unconscious O e d i p a l s t r u c t u r e h a s u n d e r g o n e pathological d e v e l o p m e n t , t h e p a t h o l o g y will color the evolution of h e r d a u g h t e r ' s O e d i p a l s t r u c t u r e . For e x a m ple, w h e n t h e m o t h e r holds a n u n c o n s c i o u s belief t h a t to b e a female is to b e flawed a n d shamefully lacking, it w o u l d be expected t h a t her d a u g h t e r w o u l d n o t only identify with this sense of s h a m e a n d i n n e r defectiveness, b u t w o u l d also feel narcissistically w o u n d e d at h e r m o t h er's h a n d s . I n a d d i t i o n , it w o u l d be expected t h a t the d a u g h t e r , u n d e r these c i r c u m s t a n c e s , w o u l d be a n g r y a n d t u r n to h e r father in o r d e r to r e p a i r t h e narcissistic injury. T h e narcissistic w o u n d is concretized in p h a n t a s y as a bodily w o u n d , loss, or defect. T h e love of the father is n e e d e d to restore the little girl's self-esteem. T h e girl is d e p e n d e n t u p o n the love of h e r father ( a n d later the love of o t h e r m e n ) as a source of self-worth. A g a i n , this is t r a n s l a t e d in unconscious p h a n t a s y into bodily t e r m s w h e r e i n either the father's penis in intercourse or the father's b a b y is viewed as the t h i n g t h a t will complete t h e self. T h e excessive narcissism of w o m e n t h a t F r e u d (1933) c o m m e n t e d u p o n is not t h e inevitable o u t c o m e of female O e d i p a l d e v e l o p m e n t , b u t is frequently t h e outc o m e of pathological forms of t h e female O e d i p u s complex—for e x a m p l e , t h e result of a form of object relatedness a r i s i n g as t h e result of a narcissistic w o u n d i n c u r r e d w h e n t h e m o t h e r ' s u n c o n s c i o u s conception of b o t h herself a n d h e r d a u g h t e r is that of shamefully i n c o m p l e t e h u m a n beings. U n d e r such c i r c u m s t a n c e s the

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girl will experience the "dress rehearsal" type of experience described earlier as t h e m o t h e r ' s act of g r o o m i n g h e r d a u g h t e r to attach herself to a m a n i n - o r d e r to c o m p l e t e herself. E v e n w h e n the m o t h e r unconsciously conceives of herself as lacking in the w a y s d e s c r i b e d , it is possible t h a t the d a u g h t e r m a y be able to utilize a less pathological ( a n d less p a t h o g e n i c ) view held b y h e r father (cf. L e o n a r d , 1966). A healthy O e d i p a l r o m a n c e with the father m a y p r o v i d e a n experience with s o m e o n e w h o g e n u i n e l y loves t h e little girl a n d conveys the feeling t h a t he does n o t find h e r lacking. T h e d a u g h t e r , if sufficiently resilient, is able to recognize a n d m a k e use of this form of experience in s h a p i n g h e r e m e r g i n g identity. H o w e v e r , t h e less secure child responds to this n e w experience by feeling t h a t h e r self-esteem is d e p e n d e n t u p o n h e r father's u n i q u e ability to find h e r lovable, a n d t h a t h e r value does n o t o r i g i n a t e in a n y internal s t r e n g t h t h a t she holds i n d e p e n d e n t of his perception of h e r . I n o t h e r w o r d s , she feels t h a t it is h e r father w h o m a k e s h e r special. T h i s t h e n leads in adolescence a n d a d u l t h o o d to a n addictive search for m e n w h o will m a k e h e r feel special. T h e w o m a n does n o t value h e r o w n capacities since t h e y c a n n o t provide h e r with a sense of value. V a l u e o r i g i n a t e s in the m a n ' s act of finding h e r lovable. U n d e r such c i r c u m s t a n c e s , b e a u t y literally lies in t h e eye of the b e h o l d e r . H e n c e , such a w o m a n is likely to develop a p r e o c c u p a t i o n with clothes, m a k e - u p , j e w e l r y a n d the like, w h i c h a r e utilized for t h e p u r p o s e of a t t r a c t i n g the a t t e n t i o n of a m a n w h o will b r i n g v a l u e to h e r t h r o u g h his love. T h i s represents a special form of narcissistic d i s t u r b a n c e since the p a t i e n t is n o t looking for m i r r o r i n g in t h e object; r a t h e r , she is h o p i n g to revive a specific early love relationship in which


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h e r d a m a g e d self-esteem w a s r e n d e r e d less painful t h r o u g h the influence of t h e love of her father. H e r sense of injury w a s soothed b y the father, b u t not completely r e p a i r e d b y it since his love w a s n e v e r sufficiently i n t e r n a l i z e d as healthy narcissism. O n e o t h e r aspect of t h e F r e u d i a n n a r r a t i v e c a n n o w be u n d e r s t o o d in a n e w light. F r e u d viewed the little girl's a n g e r at h e r m o t h e r in t h e O e d i p u s complex as a reflection of t h e girl's b l a m i n g of her m o t h e r for n o t giving the little girl a penis, a n d t h e r e b y r e n d e r i n g t h e little girl i n c o m p l e t e a n d defective. F r o m t h e perspective b e i n g developed in this c h a p t e r , t h e little girl's a n g e r at h e r m o t h e r c a n be u n d e r s t o o d as a reflection of h e r feeling t h a t t h e O e d i p a l m o t h e r , n o w experienced as far m o r e external t h a n before, has b e t r a y e d h e r in h a v i n g a life of h e r o w n , a n d in p a r t i c u l a r in h a v i n g a separate a n d p r i v a t e r o m a n t i c a n d sexual life with t h e little girl's father.

Transference-

Countertransference

Implications

I w o u l d n o w like to describe a form of countertransfere n c e difficulty t h a t is n o t u n c o m m o n in t h e p s y c h o a n a lytic t r e a t m e n t of female p a t i e n t s . T h e countertransference p r o b l e m t h a t will be discussed seems to arise from a n i n t e r p l a y of t h e patient's early O e d i p a l transferences (which a r e often externalized in t h e form of projective identifications [cf. O g d e n , 1982b, 1983]) a n d the t h e r a pist's u n a n a l y z e d early O e d i p a l conflicts. ( T h e p r i n c i p a l focus h e r e will b e on the w o r k of female therapists with female p a t i e n t s . ) A m a j o r form of c o u n t e r t r a n s f e r e n c e difficulty r e s u l t i n g from i n a d e q u a c y of t h e transitional

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O e d i p a l r e l a t i o n s h i p 5 is a n inability on t h e p a r t of the female therapist to e n g a g e in a relatively unconflicted identification with h e r o w n father in her u n c o n s c i o u s set of O e d i p a l object relationships. W h e n the task of identifying with t h e unconscious O e d i p a l father m u s t be defended a g a i n s t , t h e female therapist e n c o u n t e r s great difficulty in c o n d u c t i n g analytic t h e r a p y with p a t i e n t s whose transferences h a v e their roots in t h e early O e d i p a l p h a s e u n d e r discussion. T h e therapist w h o m u s t defend against such a n identification feels unconsciously h u r t a n d a n g r y a b o u t the idea of b e i n g asked to p l a y a role that is transitional to a n i n v o l v e m e n t with t h e O e d i p a l father. S u c h a therapist unconsciously feels t h a t a n effort o n t h e p a r t of the p a t i e n t to m a k e use of her in this w a y is a s t a t e m e n t t h a t she (the therapist) is second best, is lacking, is only a p r e l i m i n a r y to "the real t h i n g . " T h e therapist unconsciously a t t e m p t s to hold o n t o the p a t i e n t , subtly o r not so subtly conveying t h e feeling that it is a betrayal of the therapist for the patient to b e c o m e involved with a m a n —even t h e therapist in t h e p a t e r n a l transference. U n d e r these c i r c u m s t a n c e s t h e therapist feels so a n x i o u s a b o u t , a n d alienated from, h e r o w n identification with h e r father t h a t she c a n n o t recognize herself as the object of the p a t e r n a l transference love. (See Searles, 1979, for a description of t h e therapist's j e a l o u s y of a n i n t e r n a l object within himself or herself.) Such a therapist will often defensively a t t e m p t to foster a regression in the p a t i e n t in o r d e r to avoid t h e identification

5

The effort to describe transference manifestations of a given unconscious object relationship is of necessity very schematic since transferences are always overdetermined — that is, derived from a multiplicity of internal object relations at a variety of developmental levels.


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u n d e r discussion. T h e therapist, for e x a m p l e , m i g h t "interpret d o w n w a r d " developmentally (for e x a m p l e , b y i n t e r p r e t i n g genital-level m a t e r i a l in oral t e r m s ) a n d in general treat the p a t i e n t as if she were q u i t e i n c a p a b l e of m a n a g i n g o n h e r o w n . T h i s is a n expression of t h e therapist's u n c o n s c i o u s wish to keep t h e patient a preO e d i p a l child forever in o r d e r to avoid e n t e r i n g into a t r i a n g u l a t e d Oedipal-level relationship w i t h h e r t h a t w o u l d r e q u i r e ( a m o n g a great m a n y o t h e r things) a n identification with h e r o w n unconscious O e d i p a l father. T h e t h e r a p i s t , w h e n conflicted in this way, m a y unconsciously foster t h e patient's e x p e r i e n c e of t h e t h e r a p y as a n alliance of two w o m e n against t h e world (unconsciously a m a l e world, a n d m o r e specifically, t h e world of t h e O e d i p a l father). T h e value system in t h e t h e r a p y m o v e s in a n u n s t a t e d w a y t o w a r d t h e i d e a t h a t t h e patient c a n "do it w i t h o u t m e n . " T h e idea of m a t u r i t y b e c o m e s unconsciously e q u a t e d with c o m p l e t e selfsufficiency. T h e aid of the therapist o r o t h e r w o m e n is n o t treated as a c o m p r o m i s e of the patient's i n d e p e n dence, b e c a u s e it is felt (unconsciously) t h a t d e p e n d e n c e on a n o t h e r w o m a n is n o t a n act of "selling out" to the e n e m y (the o t h e r , t h e O e d i p a l father). H e r e a g a i n , t h e p a t i e n t experiences O e d i p a l love for the father (even in the transference) as a b e t r a y a l of t h e m o t h e r whose role is b e i n g unconsciously t a k e n by the t h e r a p i s t . ( T h e patient b y m e a n s of projective identification often exerts great pressure o n t h e therapist to experience herself in this w a y . ) Since this aspect of the transference is b e i n g e n a c t e d by t h e t h e r a p i s t , it is left u n a n a l y z e d . A t this j u n c t u r e , t h e r e is often a d i s r u p t i o n of t r e a t m e n t . T h e patient feels, b u t often c a n n o t p u t into w o r d s , t h a t she is b e i n g faced w i t h a n impossible choice —she m a y h a v e either a father o r a m o t h e r , b u t n o t b o t h . D i s r u p t i o n , or

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t h r e a t e n e d d i s r u p t i o n , of the t h e r a p y is n o t so m u c h a n act of choosing the father over the m o t h e r as it is a refusal on t h e p a r t of the p a t i e n t to h a v e to choose between the two. P a t i e n t s being faced with this p r e d i c a m e n t in t h e r a p y regularly present d r e a m s a n d screen m e m o r i e s in which impossible choices h a v e to be m a d e . ( A n e x a m p l e of such a d r e a m is described later in this c h a p t e r . ) W h e n a patient does not d i s r u p t t h e t h e r a p y a n d decides to choose t h e jealous, possessive transference m o t h e r o v e r t h e transference father, t h e therapist (as the transference m o t h e r ) is experienced as a powerful phallic w o m a n w h o h a s d e v o u r e d the father a n d n o w possesses the penis. I n s t e a d of b e i n g experienced in t h e tranference as m o t h e r o n - t h e - w a y - t o - b e c o m i n g father (the other), the therapist is experienced as a c o n d e n s a t i o n of the powerful p r e - O e d i p a l m o t h e r a n d what m i g h t h a v e b e e n , o r used to be, t h e father. I n t h e case of o n e t h e r a p y stalemated by such difficulties, transference to t h e t h e r a p i s t as phallic m o t h e r was r e p r e s e n t e d by the patient in h e r fantasy t h a t the therapist w a s a " m a n - e a t e r " who h a d at o n e t i m e shared h e r office suite with m a l e t h e r a p i s t s b u t h a d c o n s u m e d t h e m vaginally in t h e act of intercourse. T h i s fantasy stands in contrast to a transference to a therapist able to accept the transference role as transitional O e d i p a l m o t h e r ( m o t h e r unconsciously identified with father). A patient r e p r e s e n t e d this latter form of transference in a d r e a m image of t h e therapist s t a n d i n g b e t w e e n two m i r r o r s , in which t h e patient could see serial i m a g e s of t h e therapist a l t e r n a t i n g with t h e i m a g e of an u n r e c o g n i z a b l e , b u t friendly a n d "familiar" m a n ; the i m a g e s e x t e n d e d infinitely b a c k w a r d . T h e m a n was "somehow also" t h e therapist. Before closing this p a r t of t h e discussion, I would like to briefly m e n t i o n that the early O e d i p a l transferences b e i n g discussed play an equally i m p o r t a n t p a r t in


137

the w o r k of m a l e t h e r a p i s t s t r e a t i n g female p a t i e n t s as they d o in t h e w o r k of female therapists t r e a t i n g female p a t i e n t s . I n t h e case of the male therapist, a different, b u t related set of c o u n t e r t r a n s f e r e n c e anxieties arises as h e is cast in t h e role of the m o t h e r at this p a r t i c u l a r j u n c t u r e in early O e d i p a l d e v e l o p m e n t . T h e m a l e analyst m a y feel "left out," even, t h o u g h the patient is talking a b o u t b e i n g in love with a m a n w h o clearly h a s the characteristics of t h e analyst himself. T h e psychic reality u n d e r l y i n g this observation is t h a t t h e patient is in love w i t h t h e father in t h e analyst-as-transference-mother, a n d n o t yet in love with t h e analyst as transference-father. A g a i n , the analyst m a y feel j e a l o u s of a n o t h e r part of himself from which he m a y feel a l i e n a t e d b e c a u s e it r e q u i r e s t h a t he experience himself as a w o m a n (the m o t h e r identifying with h e r father). T h i s early p h a s e of t h e female O e d i p u s c o m p l e x is easily overlooked in analyses c o n d u c t e d b y m a l e a n a lysts b e c a u s e t h e r e is the continuity of the p a t e r n a l e l e m e n t in b o t h the d e v e l o p m e n t a l l y earlier a n d later forms of transference: t h e d e v e l o p m e n t a l l y earlier form involves t h e m o t h e r c o n t a i n i n g the father, w h e r e a s the d e v e l o p m e n t a l l y later form involves a relationship with t h e father himself. (See Searles, 1959, for a discussion of O e d i p a l love in the countertransference as a necessary, b u t often very d i s t u r b i n g element of t h e w o r k of m a l e analysts with female p a t i e n t s manifesting O e d i p a l transferences.)

Implications

for

of Gender

the

Development Identity

T h e d i l e m m a of h a v i n g to choose b e t w e e n t h e m o t h e r a n d father (maleness a n d femaleness) that is g e n e r a t e d by a m o t h e r ' s fear of e n g a g i n g in a n identification with h e r o w n father is at the core of m a n y disorders of g e n d e r

138


identity. F r o m the point of view b e i n g developed here, the d e v e l o p m e n t of a healthy g e n d e r identity is a reflection of the creation of a dialectical interplay between m a s c u l i n e a n d feminine identities. T h i s occurs w h e n o n e does n o t h a v e to choose between loving ( a n d identifying with) one's m o t h e r a n d loving ( a n d identifying with) one's father. A m o n g the pivotal i n t e r p e r s o n a l experiences serving as a framework for this d e v e l o p m e n t is the O e d i p a l transitional relationship to t h e m o t h e r , in which the m o t h e r is m a l e a n d female ( m o t h e r - i n - f a t h e r a n d father.-in-mother). I n o r d e r for this experience to be g e n e r a t e d , m o t h e r a n d d a u g h t e r m u s t be able to create a n d m a k e use of a "play space" ( W i n n i c o t t , 1971b,c) t h a t b o t h c o n n e c t s a n d separates t h e m . T h e O e d i p u s c o m p l e x is a d r a m a to be played with in this s p a c e that is first c r e a t e d by t h e m o t h e r a n d d a u g h t e r a n d l a t e r e n t e r e d into by t h e father. If in t h e very b e g i n n i n g of t h e O e d i p a l p h a s e , the q u e s t i o n of w h o it is t h a t t h e child is in love with ( m o t h e r o r father) must b e a n s w e r e d , the play space "collapses" ( O g d e n , 1985b, 1986) a n d the O e d i p a l d r a m a b e c o m e s all too real. T h e e n t r y into the O e d i p u s complex u n d e r such c i r c u m s t a n c e s involves a n impossible choice. A p a t i e n t struggling with t h e t e r r o r of this choice ( b r o u g h t to life in the transference) p r e s e n t e d a d r e a m in which she was s t a n d i n g in the aisle of a n a i r p l a n e t h a t was a b o u t to crash. T h e p a t i e n t h a d to sit either with h e r m o t h e r o n o n e side of the aisle o r with h e r father o n t h e o t h e r side. T h e p a t i e n t k n e w t h a t whoever she sat with would survive a n d t h a t the other p a r e n t would die. T h e patient u n d e r s t o o d this d r e a m as r e p r e s e n t i n g a choice t h a t she felt she h a d to m a k e in w h i c h the o u t c o m e would be t h a t half of herself would die.


139

W h e n the choice h a s to be m a d e between* m o t h e r a n d father ( b e t w e e n m a l e n e s s a n d femaleness), o n e b e c o m e s n e i t h e r m a s c u l i n e n o r feminine since in healthy m a s c u linity a n d h e a l t h y femininity each d e p e n d s u p o n , a n d is c r e a t e d b y , t h e o t h e r . T h i s is p a r t of t h e implication of Freud's (1905, 1925, 1931) insistence on t h e f u n d a m e n t a l bisexuality of h u m a n beings. D i s o r d e r s of g e n d e r identity c a n b e u n d e r s t o o d as d i s t u r b a n c e s of t h e intrapsychic dialectical relationship of masculinity a n d femininity. A n a t t e m p t to m a k e the painful ( m a t r i c i d a l o r patricidal, a n d always suicidal) choice leads to the construction of a p s e u d o - i d e n t i t y . E x a m p l e s of s u c h pseudo-identities are seen in the lesbian c a r i c a t u r e of masculinity ("the dyke") a n d the m a l e homosexual's c a r i c a t u r e of femininity ("the queen"). S u c h brittle pseudo-identities lack t h e subtle r e s o n a n c e of the masculinity a n d femininity t h a t characterize m a t u r e g e n d e r identity. T h e t r i a n g u l a t i o n that is t h e o u t c o m e of a satisfactory O e d i p a l transitional relationship represents a r e s t r u c t u r i n g of t h e individual's f u n d a m e n t a l bisexuality in such a w a y t h a t femininity n e e d n o t be a flight from, o r denial of, masculinity ( a n d vice versa).

Summary T h e concept of the O e d i p a l transitional relationship is p r o p o s e d as a w a y of u n d e r s t a n d i n g t h e n a t u r e of t h e psychological-interpersonal process m e d i a t i n g t h e little girl's e n t r y into t h e O e d i p u s complex. T h i s transitional relationship serves to allow the little girl to n o n t r a u m a t i cally discover the father as external object in the context of the safety of t h e d y a d i c relationship to t h e m o t h e r . In this early p h a s e of O e d i p a l d e v e l o p m e n t , t h e little girl

140


falls in love with t h e m o t h e r - a s - f a t h e r a n d the fathera s - m o t h e r — t h a t is, falls in love w i t h t h e m o t h e r in h e r u n c o n s c i o u s identification with h e r ( t h e mother's) own father. In this way, paradoxically, the first t r i a n g u l a t e d object r e l a t i o n s h i p is e x p e r i e n c e d in a t w o - p e r s o n relationship; t h e first heterosexual r e l a t i o n s h i p develops in a relationship involving two females; the father as libidinal object is discovered in the m o t h e r .

6 T h e

T h r e s h o l d O e d i p u s

of

t h e

M a l e

C o m p l e x

T h e O e d i p u s c o m p l e x was in m a n y w a y s for F r e u d the centerpiece of psychoanalytic t h e o r y . H e saw in it the c o n v e r g e n c e of u n i v e r s a l psychological s t r u c t u r e , u n c o n scious p e r s o n a l m e a n i n g , a n d t h e influence of the p o w e r of desire e m a n a t i n g from t h e b o d y . A s a result, t h e O e d i p u s c o m p l e x h a s properly occupied a central position in analytic t h i n k i n g for m o r e t h a n n i n e t y years. 1 I n this c h a p t e r , I shall limit m y focus to a n aspect of t h e O e d i p u s c o m p l e x t h a t I believe h a s heretofore b e e n a relatively neglected p a r t of the analytic discourse c o n c e r n i n g early Oedipal development. A l t h o u g h it is generally a g r e e d t h a t t h e t r a n s i t i o n into t h e O e d i p u s c o m p l e x represents a critical j u n c t u r e in psychological d e v e l o p m e n t , I ' b e l i e v e t h a t psychoanalytic t h e o r y has n o t yet sufficiently e l a b o r a t e d a conception of

'Freud discussed the importance of the ideas constituting the Oedipus complex in his October 15, 1897, letter to Fliess, but did not use the term Oedipus complex in his publications until 1910. 141

142


t h e psychological-interpersonal processes m e d i a t i n g this t r a n s i t i o n in m a l e d e v e l o p m e n t . I n this c h a p t e r , I shall p r o p o s e t h a t the t r a n s i t i o n into the m a l e O e d i p u s c o m plex is m e d i a t e d by a transitional relationship with t h e m o t h e r , a n a l o g o u s to t h a t seen in female d e v e l o p m e n t (cf. C h a p t e r 5), b u t with a significant difference in e m p h a s i s . T h i s difference is a c o n s e q u e n c e of t h e fact t h a t the O e d i p a l m o t h e r is a n d is n o t the s a m e m o t h e r t h e little b o y loved, h a t e d , a n d feared p r i o r to his discovery of h e r ( a n d his father) as external O e d i p a l objects. T h e complications caused b y t h e psychological p r o x i m i t y of t h e p r e - O e d i p a l a n d O e d i p a l love objects (in the positive O e d i p u s complex) a r e specific to m a l e d e v e l o p m e n t , a n d necessitate a psychological solution t h a t is distinctive to t h e d e v e l o p m e n t of t h e b o y . Essential to the resolution of t h e p r o b l e m resulting from the coincidence of t h e object of t h e little boy's p r e - O e d i p a l a n d O e d i p a l love is t h e role of t h e p r i m a l scene p h a n t a s y 2 as a n unconscious organ i z e r of evolving sexual m e a n i n g a n d personal i d e n t i t y . 3 The term primal scene phantasy refers to a group of conscious and unconscious phantasies on the theme of observed parental intercourse. These phantasies are characterized by varying degrees of primitivity, a range of modes of object relatedness, different forms and intensities of identification with each of the figures in the phantasy, and so on. 3 In female development, there are overlapping but not identical psychological difficulties at the threshold of the Oedipus complex. For example, identification with the mother at this juncture inevitably carries with it the pull toward more primitive wishes to be at one with her (as opposed to simply being like her). It is beyond the scope of this chapter to discuss the role of primal scene phantasies in facilitating the little girl's differentiation of herself from her Oedipal and pre-Oedipal mother(s), her acknowledgment of sexual and generational difference, and the development of the female Oedipus complex.

The Threshold of the Male Oedipus Complex

143

T h i s set of p h a n t a s i e s ( p r i m a l scene phantasies) carries with it in b o t h male a n d female d e v e l o p m e n t a powerful sense of t h i r d n e s s . T h e space b e t w e e n m o t h e r a n d child p r o v i d e d b y the O t h e r (the t h i r d ) allows for the e l a b o r a tion of symbol formation p r o p e r , subjectivity, a n d the c o m p r o m i s e of personal o m n i p o t e n c e t h a t is involved in t h e discovery of externality a n d t h e recognition of sexual a n d g e n e r a t i o n a l difference. T h e m o v e m e n t into the m a l e O e d i p u s c o m p l e x necessarily involves a psychological state in which the externality of the Oedipal-object m o t h e r is continually in d a n g e r of b e i n g b l u r r e d by t h e s h a d o w cast b y t h e p r e - O e d i p a l m o t h e r . T h e psychological task of this phase of d e v e l o p m e n t for t h e b o y is not t h e r e n u n c i a t i o n of the p r e - O e d i p a l m o t h e r , b u t t h e e s t a b l i s h m e n t of a dialectical tension b e t w e e n p r e O e d i p a l a n d O e d i p a l love relationships with the m o t h e r .

Freud's

Perspective

D e s p i t e t h e fact t h a t F r e u d (1925, 1931) u n d e r s t o o d the i m p o r t a n c e of the psychological m o v e m e n t into the O e d i p u s c o m p l e x , he did n o t seem to recognize the n a t u r e of t h e u n c o n s c i o u s conflict i n h e r e n t in this transition for t h e b o y . "In b o t h cases [that is, for boys a n d for girls] the m o t h e r is t h e original object; a n d it is no surprise t h a t b o y s r e t a i n t h e object in the O e d i p u s complex" ( F r e u d , 1925, p . 251, italics a d d e d ) . I believe that F r e u d w a s n o t able to a d e q u a t e l y conceptualize the n a t u r e of t h e psychological p r o b l e m s faced b y the b o y in r e t a i n i n g his m o t h e r as love object in t h e O e d i p u s complex, b e c a u s e h e ( F r e u d ) h a d only b e g u n to develop a n u n d e r s t a n d i n g of i n t e r n a l object relations

144


in g e n e r a l a n d of the p r e - O e d i p a l relationship of the little b o y to his m o t h e r in p a r t i c u l a r . 4 F r e u d (1921) p r o p o s e d t h a t for boys, the construction of a n O e d i p u s c o m p l e x involves a n "irresistible a d v a n c e t o w a r d unification" (p. 105) of two initially i n d e p e n d e n t facets of psychological life: the boy's sexual tie to his m o t h e r a n d his idealization of his father. H e further believed that p r i m a l scene p h a n t a s i e s p l a y a n essential role in the "pre-history" of the O e d i p u s c o m p l e x . F r e u d u n d e r s t o o d p r i m a l scene p h a n t a s i e s to be u n i v e r sal, and" therefore felt t h a t it is n o t reasonable to a s s u m e t h a t t h e y arise from actual experience of witnessing p a r e n t a l intercourse. R a t h e r , he u n d e r s t o o d these p h a n tasies to be p a r t of a g r o u p of phylogenetically inherited " p r i m a l phantasies" ( F r e u d , 1916-1917), in other w o r d s , to b e biologically passed-on p o r t i o n s of t h e experience of the species. I believe [that in these p r i m a l phantasies] . . . t h e individual reaches b e y o n d his o w n experience into p r i m a e v a l experience at p o i n t s w h e r e his o w n exper i e n c e has b e e n too r u d i m e n t a r y . It seems to m e q u i t e possible t h a t all t h e things t h a t a r e told us t o d a y in analysis as p h a n t a s y —the s e d u c t i o n of c h i l d r e n , t h e inflaming of sexual excitement by o b s e r v i n g 4

Freud (1925, 1933) began to formulate a conception of the preOedipal relationship between the little girl and her mother in thecourse of attempting to understand what he believed to be the little girl's angry rejection of her mother at the threshold of the Oedipus complex. "We cannot understand women unless we appreciate this phase of their pre-Oedipus attachment to their mother" (Freud, 1933, p. 119). However, Freud continued to believe that the pre-Oedipal relationship between mother and child held significandy less importance in the development of the boy than in that of the girl (cf. Laplanche and Pontalis, 1967).


145

p a r e n t a l intercourse, the t h r e a t of castration (or r a t h e r castration itself)—were once real occurrences in the p r i m a e v a l times of t h e h u m a n family, a n d t h a t children in their p h a n t a s i e s a r e simply filling in t h e gaps in individual t r u t h with prehistoric t r u t h , [pp. 370-371] As I h a v e previously discussed ( O g d e n , 1984), this does n o t m e a n t h a t a given p h a n t a s y (a set of t h o u g h t s a n d feelings) is inherited; i n s t e a d , t h e r e is a s t r u c t u r a l , psychological readiness to o r g a n i z e experience along specific, p r e d e t e r m i n e d lines. I h a v e t e r m e d this form of s t r u c t u r e psychological deep structure a n d view it as a n a l o g o u s to linguistic d e e p s t r u c t u r e as described by C h o m s k y (1957, 1968). A l t h o u g h F r e u d viewed p r i m a l scene p h a n tasies as p a r t of the pre-history of t h e O e d i p u s c o m p l e x , he did n o t e l a b o r a t e his c o n c e p t i o n of t h e w a y this g r o u p of p h a n t a s i e s influences the d e v e l o p m e n t of the O e d i p u s c o m p l e x . A l t h o u g h F r e u d is often accused of d e a l i n g i n a d e q u a t e l y with the p r o b l e m s of female sexual develo p m e n t , I believe t h a t h e g a v e less a t t e n t i o n to t h e p r o b l e m of t h e little boy's e n t r y into the O e d i p u s c o m p l e x t h a n h e did to t h e p r o b l e m of t h e e n t r y into the female O e d i p u s c o m p l e x . I c o n c u r with Freud's acknowledgm e n t , "As r e g a r d s the pre-history of the O e d i p u s c o m p l e x in b o y s , we a r e far from complete clarity" (1925, p . 250). I n light of u n d e r s t a n d i n g s of p r e - O e d i p a l i n t e r n a l a n d external object relationships t h a t h a v e been develo p e d o v e r t h e past forty years (see, for e x a m p l e , B i o n , 1962; C h a s s e g u e t - S m i r g e l , 1984a; F a i r b a i r n , 1952; J a c o b s o n , 1964; K e r n b e r g , 1976; Klein, 1975; K o h u t , 1971; L e w i n , 1950; M a h l e r , 1968; Searles, 1966; Spitz, 1965; S t e r n , 1985; W i n n i c o t t , 1958), it is no l o n g e r sufficient to simply assert that "it is n o surprise t h a t boys r e t a i n [the m o t h e r as] . . . object in t h e O e d i p u s complex"


146

( F r e u d , 1925). O n the c o n t r a r y , I believe t h a t t h e r e a r e salient r e a s o n s for the b o y not to retain his m o t h e r as O e d i p a l object. I n addition to the psychological conflicts intrinsic to the O e d i p u s c o m p l e x (such as t h e incest t a b o o a n d aggressive wishes t o w a r d loved objects), the b o y m u s t t a k e a n object he h a d experienced as o m n i p o t e n t a n d only partially differentiated from himself as t h e focus of his r o m a n t i c a n d sexual wishes a n d p h a n t a s i e s . R a t h e r t h a n v i e w i n g t h e boy's O e d i p a l object choice as simply inevitable, I believe that we m u s t ask " H o w is it possible for t h e little b o y to take his m o t h e r as t h e object of his O e d i p a l love, a n d w h a t a r e t h e psychological-interp e r s o n a l processes m e d i a t i n g t h e t r a n s i t i o n from t h e p r e - O e d i p a l to the O e d i p a l r e l a t i o n s h i p with the m o t h e r ? " A l t h o u g h analytic.theory h a s a d d r e s s e d a great m a n y aspects of t h e p r e c o n d i t i o n s of t h e O e d i p u s complex, such as t h e role of p r i m a l scene p h a n t a s i e s ( C h a s s e g u e t S m i r g e l , 1984b; G r e e n , 1983; M c D o u g a l l , 1980, 1986), t h e t i m i n g of the onset of O e d i p a l object relations ( B i b r i n g , 1947; G a l e n s o n a n d R o i p h e , 1974; H e i m a n n , 1971; K l e i n , 1928; P a r e n s et al., 1976; Sachs, 1977), a n d s t r u c t u r a l a n t e c e d e n t s of the O e d i p u s c o m p l e x (Fairb a i r n , 1952; Klein, 1952b; W i n n i c o t t , 1960b), the a n a lytic discourse h a s not included a t h o r o u g h discussion of t h e psychological a n d i n t e r p e r s o n a l processes t h a t m e d i a t e t h e boy's e n t r y into t h e O e d i p u s complex.

The

Scylla

and

Charybdis

of the Male

Oedipus

of the

Threshold

Complex

T h e little boy's relationship with t h e p r e - O e d i p a l m o t h e r constitutes a critical a n d p r o b l e m a t i c p r e c o n d i t i o n of t h e


147

O e d i p u s c o m p l e x . T h e e n t r y into a n erotic a n d r o m a n t i c relationship with the O e d i p a l m o t h e r is fraught with anxiety in p a r t because she b e a r s a n u n c a n n y resemb l a n c e to t h e o m n i p o t e n t p r e - O e d i p a l m o t h e r . F o r the girl, t h e p r e p o n d e r a n c e of t h e psychological p r o b l e m involved in t h e c h a n g e of object at the threshold of t h e O e d i p u s c o m p l e x lies in her task of n o n t r a u m a t i c a l l y m a k i n g a t r a n s i t i o n from a r e l a t i o n s h i p to a n i n t e r n a l object t o a love relationship with a n e x t e r n a l object w h o m the little girl h a s not yet m e t a n d c a n n o t o m n i p o t e n t l y control ( O g d e n , 1985a). T h u s , t h e d a n g e r for the girl lies in large p a r t in m a k i n g a leap into t h e abyss of externality t h a t lies b e y o n d h e r o m n i p o t e n t control. As I discussed in C h a p t e r 5, this risk is m a d e b e a r a b l e by m e a n s of a transitional O e d i p a l relationship to a "father-in-mother" a n d "mother-in-father" w h e r e i n t h e question of w h e t h e r the little girl is e n g a g e d in a relationship with h e r ( O e d i p a l ) father o r with h e r ( p r e - O e d i p a l ) m o t h e r n e v e r arises. A s in o t h e r forms of transitional p h e n o m e n a , a n a r e a of illusion is created in t h e transitional m o t h e r d a u g h t e r relationship, w h e r e i n t h e relationship is to b o t h the ( k n o w n ) m o t h e r a n d the ( y e t - t o - b e - k n o w n ; external object) father. T h e r e is a hardness-in-softness (a fatheri n - m o t h e r ) t h a t allows the father to be simultaneously created a n d discovered, t h u s m a k i n g possible the leap of faith involved in the little girl's falling in love with h e r father w h o m she h a s n o t yet m e t as a n e x t e r n a l object. F o r t h e little b o y , there is a d u a l psychological p r o b l e m in w h i c h the distribution of psychological d a n g e r is different from t h a t e n c o u n t e r e d b y t h e girl at t h e threshold of t h e O e d i p u s complex. T h e d a n g e r in t h e boy's e n t r y into the O e d i p u s c o m p l e x does n o t lie only in the fact t h a t t h e O e d i p a l m o t h e r ( a n d father) a r e d a n g e r -


148

ously external a n d therefore u n k n o w n , u n p r e d i c t a b l e , a n d u n c o n t r o l l a b l e . W h a t m a k e s this psychological j u n c t u r e c o m p l e x in a w a y t h a t is distinctive t o t h e little b o y is the fact t h a t he m u s t struggle to create distance b e t w e e n himself a n d the powerful p r e - O e d i p a l m o t h e r while he falls in love with the O e d i p a l m o t h e r . H e h a s k n o w n the p r e - O e d i p a l m o t h e r as a primitive, o m n i p o t e n t , partially differentiated object by w h o m he h a s b e e n m e s m e r i z e d a n d p e n e t r a t e d , w h o m he has ruthlessly used a n d o m n i p otently d e s t r o y e d a n d recreated ( W i n n i c o t t , 1954). She also h a s t h e glow of w a r m t h a n d safety t h a t m a k e s h i m "dissolve" in a w a y t h a t is both blissful a n d terrifying at t h e s a m e t i m e , since this "dissolution" causes h i m to begin to lose t o u c h with his a c c r u i n g k n o w l e d g e of w h e r e he stops a n d w h e r e she begins.

The

Organization

of Sexual

Meaning

T h e task of t h e early O e d i p a l p e r i o d i n m a l e d e v e l o p m e n t is t h a t of safely n e g o t i a t i n g a passage b e t w e e n the d a n g e r of the t r a u m a t i c discovery of o t h e r n e s s a n d t h e d a n g e r of experiencing the Oedipal romance as overwhelmingly d o m i n a t e d b y the s h a d o w of t h e p r e - O e d i p a l m o t h e r . T h i s j o u r n e y between the Scylla of the externalOedipal-object m o t h e r a n d the C h a r y b d i s of the o m n i p otent p r e - O e d i p a l m o t h e r is in p a r t m e d i a t e d by the p o w e r of p r i m a l scene p h a n t a s i e s to organize sexual m e a n i n g a n d identity. F r o m this perspective, p r i m a l scene p h a n t a s i e s are not simply a n exciting c o m b i n a t i o n of sexual a n d aggressive t h o u g h t s a b o u t p a r e n t a l intercourse; r a t h e r , they are pivotal o r g a n i z e r s of internal a n d e x t e r n a l object relations t h a t will c o m e to constitute the m a t u r e O e d i p u s complex.


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T h e p r i m a l scene p h a n t a s y in its role as o r g a n i z e r of evolving sexual m e a n i n g a n d identity is b y n o m e a n s a static entity. R a t h e r , it is a constellation of t h o u g h t s a n d feelings in w h i c h t h e form of object relatedness, the d e g r e e of subjectivity, the m o d e s of defense, a n d the m a t u r i t y a n d complexity of affect are all in a state of evolution a n d flux. T h e image of o b s e r v e d p a r e n t a l intercourse serves as a m o l d , a w a y of t h i n k i n g a b o u t the u n t h i n k a b l e . T h e objects constituting the p h a n t a s y a r e in the b e g i n n i n g p r e d o m i n a n t l y part-objects engaged in frightening b a t t l e t h a t involves m y s t e r i o u s sexuality int e r m i n g l e d w i t h violence. T h e r e is initially very little of a n i n t e r p r e t i n g subject in t h e e x p e r i e n c i n g of these p h a n t a s i e s ; r a t h e r , t h e r e is p r e d o m i n a n t l y a self-as-object w h o is part of the scene with almost n o sense of b e i n g r e m o v e d from it, m u c h less a sense of b e i n g a n o b s e r v i n g subject c a p a b l e of t h i n k i n g a b o u t a n d u n d e r s t a n d i n g ( i n t e r p r e t i n g ) one's response to it. Nonetheless, t h e r e is always a r u d i m e n t a r y sense of thirdness i n h e r e n t in the s t r u c t u r e of the p r i m a l scene p h a n t a s y . T h e m o r e primitive versions of t h e p r i m a l scene p h a n t a s y c o n s t i t u t i n g the early edges of O e d i p a l experience a r e cast in a p r e d o m i n a n t l y p a r a n o i d - s c h i z o i d m o d e : 5 the b o y is part of a sexual/aggressive event that has t h e q u a l i t y of a n intense sensory experience in which 5

In brief, I use the term paranoid-schizoid mode to refer to a mode of generating experience characterized by (1) a very limited capacity to experience oneself as the author and interpreter of one's thoughts and feelings; (2) a form of symbolization in which the symbol is barely distinguishable from the symbolized ("symbolic equation," Segal, 1957); (3) part-object relatedness; and (4) the use of omnipotent thinking, splitting, and projective identification in the service of defense and the organization of experience. (See Chapter 2 and Ogden, 1986, for further discussion of the paranoid-schizoid mode.)

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h e is i m m e r s e d . T h e quality of this form of experience w a s vividly c a p t u r e d by a p a t i e n t in his third y e a r of analysis. T h e patient p r e s e n t e d a screen m e m o r y in which he, as a 7-year-old, "groped a r o u n d " in his p a r e n t s ' b e d r o o m for t h e light switch of t h e floor l a m p next to their b e d a n d accidentally p u t his fingers into the socket from which the b u l b was missing. W a v e s of a strange v i b r a t o r y sensation t h a t h e h a d n e v e r before felt o r even i m a g i n e d w e n t t h r o u g h his b o d y . H e h a d n o idea w h a t was h a p p e n i n g , b u t the experience w a s so powerful t h a t h e "knew" it w o u l d kill h i m if it did n o t stop within a few seconds. H e felt t h a t he h a d n o control over his b o d y o r his sphincters a n d could not r e m o v e his h a n d from t h e o p e n i n g . T h e patient r e p o r t e d t h a t h e h a d h a d the distinct feeling of b e i n g c a u g h t b e t w e e n t w o "things." H e later m a d e sense of this feeling by conceiving of the two "things" as t h e socket a n d the l a m p - s t a n d . H e felt as if h e h a d b e c o m e p a r t of it (them), as if h e w e r e a piece of t h e a p p a r a t u s h o l d i n g the two t o g e t h e r . H o w e v e r , at the t i m e , t h e r e was n o "as i f quality to t h e e x p e r i e n c e — h e was p a r t of this intense force c o n n e c t i n g the (penis-like) l a m p - s t a n d to t h e (vagina-like) socket. T h i s screen m e m o r y represents a psychological construction built u p o n a n unconscious p r i m a l scene p h a n tasy of a relatively primitive t y p e . T h e r e is t h e feeling of s o m e t h i n g d a n g e r o u s h a p p e n i n g of w h i c h the patient b e c a m e a p a r t a n d from which he could n o t extricate himself. T h e r e was barely the sense of a self with the capability of t h i n k i n g a n d a c t i n g — a n d w h a t little t h e r e was of such a self w a s felt to be dissolving into n o t h i n g (the fear of b e i n g killed in t h e intensity of the experience). In the patient's analysis it c a m e to b e u n d e r s t o o d t h a t this screen m e m o r y represented a n a t t e m p t at c r e a t i n g a


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n a r r a t i v e to c o n t a i n t h e terrifying a n d overly exciting u n c o n s c i o u s p r i m a l scene p h a n t a s i e s w i t h which he, as a child, h a d b e e n g r a p p l i n g . I n t h e p a r t i c u l a r screen m e m o r y t h a t was g e n e r a t e d , the patient was o m n i p o tently identified with t h e sexual force c o n n e c t i n g the m o t h e r a n d father, t h e penis a n d the v a g i n a . P e r h a p s m o r e accurately stated, he h a d b e c o m e t h a t force. I n this w a y , t h e p a t i e n t was n o t excluded from t h e sexual act; he w a s the p o w e r in it. Psychically, this p a t i e n t experienced himself as being the p o w e r (the d a n g e r o u s , disintegrating, exciting, c o n n e c t i n g force) in the sexual act, a n d only later w a s he able to a t t e m p t to possess t h a t sexual p o w e r . 6 E v e n in such primitive versions of t h e p r i m a l scene p h a n t a s y , t h e r e is a n e l e m e n t of t h i r d n e s s (for e x a m p l e , in t h e patient's t e n u o u s l y held capacity to observe a n d describe t h e experience). T h i s thirdness holds the p o t e n tial to b e c o m e in the course of d e v e l o p m e n t the fully t r i a n g u l a t e d object relations t h a t characterize m o r e m a t u r e versions of the p r i m a l scene p h a n t a s y a n d of t h e O e d i p u s c o m p l e x itself. 7 6

Lacan (1956-1957, 1958) has commented on the movement in male development from the unmediated sense of being the phallus (for the Other) to the symbolically mediated experience of having a phallus. 7 In both female and male development, the primal scene phantasy, even in its primitive forms, serves as an important vehicle for the creation of thirdness. The thirdness provided by primal scene phantasies seems to have differing significance in male and in female development. For the boy the mother as object of Oedipal desire is continually in danger of being eroded by his attachment to the pre-Oedipal mother (cf. Stoller, 1973). Since for the little girl there is an actual change of object, the erosion of the otherness of the object of Oedipal desire poses a somewhat lesser threat. However, in female development, there is the danger of the collapse of the little girl's mature Oedipal" identification with her mother, into a primitive sense of merger with the pre-Oedipal mother (cf. Ghodorow, 1978). This

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The Primitive Edge of Experience Transitional

Oedipal

Object

Relatedness

F o r t h e little b o y (as well as for the little girl), the t r a n s i t i o n from paranoid-schizoid versions of the p r i m a l scene p h a n t a s y into the m a t u r e O e d i p u s complex is psychologically a n d interperspnally m e d i a t e d by a relationship with t h e m o t h e r that is similar to, b u t developm e n t a l l y l a t e r t h a n , t h e relationship to transitional objects described b y W i n n i c o t t (1951). P a r a d o x i c a l l y , it is t h r o u g h a relationship with the m o t h e r , a female, t h a t t h e litde b o y acquires a phallus; 8 it is in t h e context of a d y a d i c r e l a t i o n s h i p with the m o t h e r t h a t O e d i p a l t r i a h gulation develops; it is in a r e l a t i o n s h i p with a w o m a n t h a t t h e boy's m a l e identification a n d p a t e r n a l idealization originate. T h e little b o y e n c o u n t e r s phallic t h i r d n e s s within the transitional O e d i p a l relationship to the m o t h e r . I n this relationship t h e m o t h e r is s i m u l t a n e o u s l y experienced as represents a psychological danger for the little girl that is somewhat analogous to, and yet distinctly different from, the collapse of the Oedipal mother (as love object) into the pre-Oedipal mother in male development. The differences between these forms1 of psychological danger in part determine the different ways in which primal scene phantasies are elaborated and made use of in male and female development. 8

The little boy is born with a penis, but this is not to say that he is born with a phallus. The former is an anatomical structure; the latter is a set of symbolic meanings that the boy comes to attribute to his sense of himself as a male in general, and to his psychic representation of his penis in particular. It is through the development of the capacity to attribute phallic significance to himself that the little boy becomes empowered sexually. (Since a phallus and a penis are not equivalent, litde girls similarly develop phallic significance for themselves in their sense of generativity, sexual potency, powerin-the-world, and the like.)


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f a t h e r - i n - m o t h e r a n d mother-in-father. T h e question of which is the case is n e v e r asked. It is t h e m o t h e r ' s set of unconscious i n t e r n a l O e d i p a l object relations that is t h e f r a m e w o r k w i t h i n w h i c h the O e d i p a l transitional relationship with t h e little b o y develops. T h e m o t h e r b r i n g s the phallic father t o t h e e m e r g i n g O e d i p a l relationship with h e r son t h r o u g h h e r own i n t e r n a l O e d i p a l father, with w h o m she is identified. T h e a b s e n c e of a firmly established i n t e r n a l object father in t h e m o t h e r ' s u n c o n s c i o u s O e d i p a l object relations g e n e r a t e s a n e m o t i o n a l v a c u u m t h a t r o b s the little b o y of o n e of t h e essential i n g r e d i e n t s with w h i c h to psychologically a n d interpersonally e l a b o r a t e t h e O e d i p u s c o m p l e x . T h e actual father is only secondarily the b e a r e r of the phallus with which the little b o y will identify in the process of g e n e r a t i n g phallic significance for himself. I n t h e b e g i n n i n g , t h e r e is n o such t h i n g as a m o t h e r a n d infant d u e to t h e p r e s e n c e of t h e father i m a g o in the m o t h e r ' s u n c o n s c i o u s m i n d (cf. G r e e n , 1975). T h e m o t h e r ' s unconscious O e d i p u s c o m p l e x involves a r e v e r b e r a t i n g , m u t u a l l y e n r i c h i n g set of object relations in which t h e m o t h e r is simultaneously a little girl in love with h e r father, h e r father in love with his d a u g h t e r , a m o t h e r in love with h e r h u s b a n d , a m o t h e r a n d father protectively g u a r d i n g g e n e r a t i o n a l b o u n d a r i e s . ( T h e s e object relations a r e of course only a small sample of the m u l t i t u d e of i n t e r n a l object relations c o n s t i t u t i n g the u n c o n s c i o u s O e d i p u s c o m p l e x . ) T h e m o t h e r w h o is identified w i t h e a c h of these i n t e r n a l objects is psychologically d r a w n u p o n in different ways by h e r son in t h e course of their evolving relationship. 9 A t t h e t h r e s h o l d of t h e 9

Since each child draws upon his or her mother's unconscious in different ways, no two children have the same mother.

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O e d i p u s c o m p l e x , t h e m o t h e r is b o t h t h e i n t e r n a l object father w h o sexually e m p o w e r s t h e boy, as well as the e x t e r n a l object m o t h e r w h o is t h e object of t h e boy's sexual desire. T h i s configuration is c a p t u r e d in "a c o m m o n fantasy of little children" ( M c D o u g a l l , 1986, p . 26): the child i m a g i n e s himself lying "between t h e t w o p a r e n t s , d u r i n g which t i m e the father p u t s his penis into the little boy w h o then develops a strong penis t h a t c a n go i n t o his m o t h e r " (p. 26). T h e p a r a d o x of masculinity-in-femininity, of t h i r d ness-in-twoness, t h a t is at t h e h e a r t of t h e t r a n s i t i o n a l O e d i p a l relationship c o m e s to constitute a n e w version of t h e p r i m a l scene p h a n t a s y as t h e little b o y begins to e n t e r i n t o m o r e m a t u r e O e d i p a l object relations. A t this j u n c t u r e , the p r i m a l scene p h a n t a s y is developed i n t o a n a r r a t i v e of the o b s e r v a t i o n of the father a n d the m o t h e r in the act of sexual i n t e r c o u r s e . T h e transitional O e d i p a l m o t h e r , who h a d in a p a r a d o x i c a l m a n n e r e m b o d i e d t h e f a t h e r - i n - t h e - m o t h e r a n d the mother-in-the-father, n o w b e c o m e s e l a b o r a t e d as a figure in a n a r r a t i v e in- w h i c h father a n d m o t h e r a r e m o r e distinctly differentiated a n d t h e n j o i n e d together in t h e act of sexual intercourse. I n o t h e r words, sexual difference is for the first t i m e clearly acknowledged a n d at t h e s a m e time a n e w u n i t y is c r e a t e d : the u n i t y of t h e child's knowledge of sexual i n t e r c o u r s e involving two p a r e n t s , each different from t h e other, a n d each distinct from himself. I n this m o r e differentiated version of t h e p r i m a l scene p h a n t a s y , t h e little b o y n o l o n g e r experiences himself as t h e e m b o d i m e n t of sexual excitement in a world of p a r t objects; r a t h e r , he is n o w a subject in a world of whole objects w h o experiences the sexual excitement of h a v i n g a p h a l lus, a n d w h o — t h r o u g h a m o r e m a t u r e identification w i t h


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his father—takes his m o t h e r as t h e object of his love a n d sexual desire. T h e fact t h a t he is at the s a m e t i m e "only" t h e observer of the sexual act sufficiently separates h i m from t h e d a n g e r of actual incest, which would t h r e a t e n h i m with t h e loss of his identity. (It is i m p o r t a n t to e m p h a s i z e t h a t w h a t is a t stake is n o t m e r e l y c a s t r a t i o n , b u t annihilation t h r o u g h t h e collapse of one's sense of self as it is s u b s u m e d b y t h e m o t h e r [cf. L o e w a l d , 1979].) T h e r e is a n i m p o r t a n t (but n o t altogether w e l c o m e d ) r e m i n d e r in this n e w version of t h e p r i m a l scene p h a n t a s y t h a t the little b o y is, after all, his mother's son, n o t his m o t h e r ' s h u s b a n d ; t h a t h e is, in reality, emotionally a n d sexually i m m a t u r e while his m o t h e r a n d father a r e e m o t i o n a l l y a n d sexually m a t u r e ; that he is his father's son a n d is not the father himself. T h e s e a m b i v a l e n t l y e x p e r i e n c e d r e m i n d e r s of external reality help t h e little b o y m a i n t a i n t h e p r i m a l scene p h a n t a s y in a p o t e n t i a l s p a c e in which u n c o n s c i o u s t h i n k i n g can o c c u r as o p p o s e d to hallucination a n d delusion. Excessively eroticized obj e c t relations with the m o t h e r r e n d e r these p h a n t a s i e s i n d i s t i n g u i s h a b l e from reality. U n d e r such c i r c u m s t a n c e s psychotic identification ("1 a m m y father") replaces m a t u r e identification ("I a m like m y father"). 1

Psychological development is short-circuited when overly sexualized object relations between mother and son lead the litde boy to delusionally experience his growing up as a magical process brought about by means of omnipotent wishes. This stands in contrast to a normal sense of the process of growing up as being a gradual one, in which one learns and develops over time on the basis of object-related experience and slowly maturing bodily and psychological processes. Such a short-circuiting of development, leading to a hypertrophy of omnipotent thinking, occurs both under circumstances in which actual incest has occurred as well as circumstances in which a

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The Primitive Edge of Experience Clinical

Illustration

I would n o w like to briefly describe p o r t i o n s of a n analysis in w h i c h the t r a n s f e r e n c e - c o u n t e r t r a n s f e r e n c e p h e n o m e n a shed light on a form of early difficulty in the transition into t h e m a l e O e d i p u s c o m p l e x . D r . L . , a 36-year-old biochemist, b e g a n analysis b e c a u s e h e e x p e r i e n c e d himself as d e s t i n e d to s p e n d his life b e i n g "pretty good, b u t n o t great at a n y t h i n g . " H e h a d h a d h o p e s of b e c o m i n g a university professor of chemistry, b u t h a d d o n e little to b r i n g this a b o u t . U p o n c o m p l e t i n g his doctoral studies in b i o c h e m i s t r y h e h a d accepted t h e first j o b offered to h i m by a recruiter for a p h a r m a c e u t i c a l c o m p a n y . Similarly, h e h a d m a r r i e d the first w o m a n w h o a p p e a r e d to love h i m a n d w h o w a n t e d to m a r r y h i m . It seemed b e y o n d belief to D r . L . t h a t a n y w o m a n would w a n t to m a r r y h i m . H e h a d t w o sons, b u t said t h a t it did n o t feel as if they w e r e his sons a n d t h a t h e did n o t k n o w w h a t it felt like to b e a father. ( H e later disclosed fantasies t h a t his children h a d b e e n conceived d u r i n g affairs t h a t h e i m a g i n e d his wife h a d h a d . ) D r . L . w a s preoccupied by the idea t h a t he h a d a small penis. H e would n e v e r take a s h o w e r in a m e n ' s locker r o o m n o r would he use a u r i n a l in a public lavatory. Initially, he w a s c o n c e r n e d t h a t t h e t r u t h t h a t analysis w o u l d reveal w o u l d be "the fact" t h a t h e w a s gay. H e e q u a t e d t h e idea of h a v i n g a small p e n i s with the idea of b e i n g gay. D r . L . explained t h a t h e h a d n e v e r b e e n sexually a t t r a c t e d to m e n a n d t h a t the i d e a of actually h a v i n g sex with a m a n revolted h i m . H e confessed t h a t he sexualized/o/iV a deux has resulted in a shared belief that mother and son have succeeded in creating a marriage that has eliminated the Other.


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h a d h a d a few h o m o s e x u a l d r e a m s , b u t quickly a d d e d t h a t he h a d r e a d t h a t this was " n o r m a l . " T h e analysis was r e m a r k a b l e for t h e striking lack of psychological-mindedness d e m o n s t r a t e d b y this analys a n d . D r . L . w a s a patient w h o seemed to b e t r y i n g extremely h a r d to be a good p a t i e n t , b u t despite —or p e r h a p s b e c a u s e of—his best efforts he c a m e u p with a pale imitation of insight. H e arrived at m y office d a y after d a y to toil a w a y at analysis a n d asked for n o help from m e , n o r did he seem to expect a n y . V e r y gradually it b e c a m e clear t h a t t h e patient did n o t anticipate t h a t a dialogue of a n y k i n d w o u l d take place b e t w e e n us. A b o u t a y e a r into the analysis, I told t h e p a t i e n t t h a t I t h o u g h t t h a t h e h a d little h o p e of the t w o of us ever really talking to o n e a n o t h e r , a n d that he h a d e v e n less h o p e of a n y t h i n g c h a n g i n g d u r i n g t h e c o u r s e of analysis. D r . L . was t a k e n b y surprise by these c o m m e n t s , saying t h a t it h a d n e v e r even occurred to h i m t h a t w e would ever talk to o n e a n o t h e r . W h y would I w a n t to talk to h i m ? H e said it was also t r u e t h a t he h a d n e v e r h a d m u c h h o p e t h a t t h e analysis w o u l d be of a n y value to h i m a n d he a d m i t t e d t h a t he h a d actually consulted m e only at his wife's u r g i n g . D r . L . said t h a t he h a d t h o u g h t I w o u l d n o t agree to work with h i m if he told m e in the b e g i n n i n g t h a t h e h a d n o expectation of getting a n y t h i n g o u t of o u r work t o g e t h e r . T h e p a t i e n t seemed relieved t h a t his "real" view of things could be "placed on t h e table in such a n u n g a r n i s h e d w a y . " T h i s i m a g e elicited m y o w n fantasy of t h e patient as a n u n g a r n i s h e d slab of m e a t t h r o w n on a d i n n e r plate (the couch) in abject passivity a n d utterly lacking in a p p e a l . I b e g a n to get a m o r e i m m e d i a t e sense of t h e w a y in which the only safety this p e r s o n could secure for himself was the safety of b e i n g s o m e o n e w h o expected a n d desired n o t h i n g . A n y r e m n a n t of his ca-

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pacity for desire was to b e carried b y o t h e r people—his wife, his c h i l d r e n , j o b recruiters, a n d n o w m e . D r . L.'s m o t h e r was described as a w o m a n w h o was c o n t e m p t u o u s of the patient's father b e c a u s e h e h a d failed to e a r n as m u c h m o n e y as her friends' h u s b a n d s e a r n e d ; She continually c o m p a r e d h i m with h e r o w n father w h o h a d b e e n a very wealthy b u s i n e s s m a n , s a y i n g t h a t h e r father h a d "genuinely" loved his family a n d t h a t it h a d always b e e n i m p o r t a n t to h i m t h a t t h e y feel p r o u d of h o w they lived, t h e h o u s e t h e y lived in, t h e w a y they dressed, a n d so o n . D r . L . described his own father as a w e l l - m e a n i n g m a n w h o was u n a b l e to stand u p to his wife. H e seemed to "plead guilty as accused" most of t h e t i m e , a l t h o u g h he would occasionally fight back w h e n b e i n g h a r p e d at by his wife. Following t h e i n t e r p r e t a t i o n of his hopelessness a b o u t achieving a n y t h i n g in analysis, D r . L . d i m i n i s h e d his effort to imitate the way he i m a g i n e d s o m e o n e else m i g h t b e h a v e in analysis. I n its place t h e r e developed a p r o f o u n d feeling of pointlessness. I c o m m e n t e d t h a t he seemed to feel t h a t h e h a d n o idea of how to m a k e use of m e o r of analysis, a n d t h a t as a result he felt n o t h i n g w a s h a p p e n i n g o r w a s likely to h a p p e n . But his experience of despair r e p r e s e n t e d a n i m p o r t a n t shift in t h e analysis: for t h e first t i m e it felt to m e as if t h e r e w e r e t w o people in the r o o m w h o w e r e e x p e r i e n c i n g feelings t h a t felt real a n d could b e given n a m e s t h a t seemed a c c u r a t e . Nonetheless, d u e to D r . L.'s sense of e x t r e m e alienation from m e (his sense that he did n o t k n o w w h a t he was d o i n g in m y office), t h e r e was a n almost complete a b s e n c e of a feeling of two people m e e t i n g together to d o a piece of w o r k . D r . L . talked enviously of his friends who "worshiped" o r "despised" their analysts; he did n o t u n d e r s t a n d


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their passions. T h e p a t i e n t said t h a t he could not see m e as a n y different from a n y b o d y else: "You get into y o u r p a n t s o n e foot at a t i m e . " T h i s conscious a n d u n c o n s c i o u s p h a n t a s y of m e w i t h o u t m y p a n t s c a p t u r e d the patient's experience of m e as the antithesis of a sexual, phallic presence. I n t h e u n c o n s c i o u s p h a n t a s y I w a s i n s e r t i n g m y penis into a v a g i n a ( m y foot into m y t r o u s e r leg), a n d yet b o t h t h e e x p e r i e n c e of phallic p o w e r a n d t h e d a n g e r of intercourse were e l i m i n a t e d b y r e d u c i n g t h e act to the m o s t b a n a l , m u n d a n e activity possible. I n a d d i t i o n , since b o t h the d e g r a d e d penis a n d the v a g i n a w e r e m i n e , the p h a n t a s y w a s of m y h a v i n g intercourse w i t h myself. I n this way h e refused to acknowledge sexual difference, o r to o w n o r to assign sexual p o w e r . ( T h e patient's lack of insightfulness h a d similarly created a n i n t e r p e r s o n a l ena c t m e n t in w h i c h n e i t h e r he n o r I was e m p o w e r e d phallically.) W i t h this b a c k g r o u n d , I will n o w focus o n a p o r t i o n of the analytic w o r k t h a t took place in t h e t h i r d y e a r of analysis. I n t h e course of the first two y e a r s of analysis t h e patient . h a d developed a significantly different v a n tage point from which to view his own a n d his m o t h e r ' s childhood relationships. H e said t h a t h e h a d formerly t h o u g h t of his m o t h e r a n d her father (his g r a n d f a t h e r ) as h a v i n g h a d a very special relationship with o n e a n o t h e r . T h e patient's g r a n d f a t h e r h a d seemed to b e so powerful a n d godlike for his m o t h e r t h a t "no o t h e r m a n could possibly replace h i m in h e r p a n t h e o n . " H e said t h a t he n o w t h o u g h t of t h a t relationship as involving a very strange idealization of his g r a n d f a t h e r b y his m o t h e r . T h e p a t i e n t h a d , in t h e c o u r s e of analysis, developed intense curiosity a b o u t t h e relationship between his m o t h e r a n d g r a n d f a t h e r . A s a result, he h a d spoken with his m a t e r n a l a u n t a n d uncle a b o u t their childhood experiences. T h e

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voyeuristic p l e a s u r e t h a t he derived from his "detective work" was referred to by D r . L . as "my m o r b i d fascination with m y m o t h e r ' s ' o t h e r life.' " D r . L . c a m e to view his m o t h e r ' s w o r s h i p of h e r father as h e r u n c o n s c i o u s effort to d e n y t h e fact t h a t she h a d felt quite neglected by h i m . T h e patient's g r a n d f a t h e r was, as far as t h e p a t i e n t could g a t h e r , a n extremely narcissistic m a n w h o paid very little a t t e n t i o n to his children or to his wife. W h e n he w a s at h o m e , he insisted on absolute q u i e t . H i s weekends were s p e n t at his club. T h e children ate separately from their p a r e n t s a n d w e r e sent to their floor of t h e house before h e a r r i v e d h o m e ; T h i s a r r a n g e m e n t c o n t i n u e d until the children were adolescents a n d w e r e t h o u g h t to be old e n o u g h to m a i n tain the silence a n d d e c o r u m t h a t t h e father r e q u i r e d . D r . L . was a w a r e of t h e satisfaction he w a s t a k i n g in constructing this version of his m o t h e r ' s family story. I n the s a m e period of the analysis, the p a t i e n t reported with a p r o f o u n d sense of s h a m e a m a s t u r b a t o r y fantasy ( m o r e accurately, a set of fantasies involving variations on a n u n c h a n g i n g central t h e m e ) t h a t h a d formed a m a j o r p a r t of his fantasy life from as early as he could r e m e m b e r . D r . L . said t h a t h e h a d h o p e d he w o u l d be able to "get t h r o u g h analysis" w i t h o u t e v e r talking to m e a b o u t this p a r t of his life. H o w e v e r , h e felt t h a t t h e r e w a s n o w n o alternative to discussing it b e c a u s e he was b e i n g p l a g u e d b y intrusive t h o u g h t s of h a v i n g a n a l intercourse with m e . H e was extremely a n x i o u s t h a t the fact that he was h a v i n g these t h o u g h t s m e a n t t h a t he was gay. H e felt o u t of control in a w a y t h a t h e h a d n e v e r before experienced a n d w a s afraid t h a t his difficulty in c o n c e n t r a t i n g w o u l d lead to his losing his j o b . » In these m a s t u r b a t o r y fantasies, w h i c h d a t e d from childhood, t h e p a t i e n t could h e a r his m o t h e r calling h i m


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from h e r d a r k e n e d b e d r o o m . H e r voice is sweet a n d inviting, b u t it h a s a "timbre" t h a t he h a s n e v e r before h e a r d from h e r so he is n o t certain t h a t it really is she. H e suspects t h a t she m a y b e possessed b y c r e a t u r e s from o u t e r space. H e feels b o t h excited a n d frightened, a n d wishes t h a t his father w e r e t h e r e to go in a n d see w h a t is h a p p e n i n g a n d tell the patient if it really is his m o t h e r a n d w h e t h e r it is safe to go in. H e feels t h a t h e m i g h t be killed b y w h a t e v e r it is in t h e r o o m if he w e r e to go in by himself. H o w e v e r , he does n o t feel t h a t h e c a n leave his m o t h e r alone in t h e r e because he does n o t w a n t h e r to b e h u r t o r killed b y w h a t e v e r it is t h a t h a s t a k e n control of h e r . H e feels t h a t he m u s t choose b e t w e e n saving his own life a n d t r y i n g to save his mother's. H e c a n n o t choose a n d is p a r a l y z e d b y t h e t e n s i o n . At t h e s a m e t i m e , h e w o n d e r s if he is lingering in o r d e r to h e a r the wonderfully exciting s o u n d that is c o m i n g from the b e d r o o m . T h e i n t r o d u c t i o n of this set of p h a n t a s i e s into the analytic discourse r e p r e s e n t e d a second t u r n i n g p o i n t in the analysis. It was followed b y a piece of e n a c t m e n t of the transference t h a t further elaborated t h e unconscious t h e m e s of t h e patient's m a s t u r b a t o r y p h a n t a s i e s . D r . L . b e g a n to e x p e r i e n c e a n u r g e n t n e e d to get his wife into analysis, a n d h e insistently, repeatedly, a n d at times pleadingly asked m e for t h e n a m e of a n analyst she m i g h t consult. I n o u r discussion of t h e p h a n t a s y u n d e r l y i n g this r e q u e s t / d e m a n d , it b e c a m e clear t h a t the p a t i e n t h a d in m i n d a "senior, m a l e analyst," s o m e o n e "who h a s b e e n a r o u n d for a while a n d knows w h a t he is d o i n g . " ( T h i s description stood in stark contrast to the patient's experience of me. at the t i m e . ) D r . L . t h r e a t e n e d to disrupt the analysis if I w o u l d n o t comply with his d e m a n d . T h e patient's a w a r e n e s s t h a t he could h a v e g o n e to several o t h e r people for t h e n a m e s of analysts for his wife did not

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in the least d i m i n i s h the tenacity with which h e sought m y participation in t h e e n a c t m e n t of this i n t e r n a l d r a m a . I told D r . L . t h a t I t h o u g h t h e felt hopelessly t r a p p e d b y m e in the analysis, as if he h a d n o escape from m y w e b o t h e r t h a n s o m e h o w finding a w a y of getting a father into the r o o m to see w h a t was going on. T h e p a t i e n t responded by s a y i n g t h a t h e felt as if he n o l o n g e r k n e w w h o I was, w h a t I w a n t e d with h i m , or h o w h e w o u l d ever b e able to leave m e a n d lead his own life. H i s wish t h a t I give h i m a referral for his wife was eventually u n d e r s t o o d b y t h e p a t i e n t as a n unconscious a t t e m p t to c r e a t e a family by getting m e (the transference p r e - O e d i p a l m o t h e r ) to take a "real" (phallic O e d i p a l ) h u s b a n d w h o could b e a "real father." ( I n a d d i t i o n , there w a s a p a t e r n a l transference in which he experienced m e as u n a b l e to be t h a t "real father.") H e l a t e r told m e that I seemed so m u c h like a w o m a n to h i m t h a t he t h o u g h t h e h a d smelled female genital odors in m y b a t h r o o m , w h i c h h e h a d associated with m e . H e said t h a t he h a d b e g u n to feel p a n i c k y w h e n h e anticipated c o m i n g to m y office, i m a g i n i n g it to b e a r o o m so small t h a t h e would n o t be able to b r e a t h e . ( H e h a d h a d a n elevator p h o b i a as a child a n d for y e a r s w o u l d climb m a n y flights of stairs in o r d e r to avoid u s i n g elevators.) T h e p a t i e n t t h e n described in m o r e detail s o m e t h i n g to which he h a d only vaguely alluded earlier in the analysis: from latency o n w a r d he h a d m a s t u r b a t e d while w e a r i n g his m o t h e r ' s u n d e r w e a r , a n d , after h e m a r r i e d , h a d c o n t i n u e d this practice with his wife's u n d e r w e a r . D r . L. said that at these times he i m a g i n e d himself to b e his m o t h e r with a penis, m a s t u r b a t i n g . I said to h i m t h a t in this fantasy he did not n e e d a father to go into t h e b e d r o o m with h i m since in this scene h e w a s his m o t h e r : there were n o fathers, n o sons, n o differences b e t w e e n


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m e n a n d w o m e n ; - e v e r y t h i n g h a d collapsed into a single p e r s o n , a single sex. D r . L . in this m a s t u r b a t o r y fantasy h a d c r e a t e d a delusional sexual identity with his m o t h e r , since t h e only sexuality t h a t exists in t h e fantasy (in t h e absence of a phallic father) is a form of female sexuality t h a t h a s s u b s u m e d w h a t m i g h t h a v e b e c o m e masculinity. T h e phallic third seems to h a v e b e e n only t e n u o u s l y p r e s e n t in t h e patient's m o t h e r ' s unconscious O e d i p a l object relations. T h e m o t h e r ' s defensively idealized father seems to h a v e b e e n only a s h a d o w of a vital O e d i p a l object. D r . L.'s own father could n o t fully c o m p e n s a t e for the insufficiently p r e s e n t O e d i p a l father in t h e m o t h e r ' s unconscious m i n d . ( N o external object c a n fully substit u t e for a fragile i n t e r n a l object.) I n this p h a s e of analysis, t h e p a t i e n t was able to u n d e r s t a n d the w a y in w h i c h n e i t h e r his m o t h e r n o r he could m a k e use of his father: the a c t u a l father was r e d u c e d to t h e status of a n i n a d e q u a t e r e p l a c e m e n t for a wished-for O e d i p a l father w h o h a d b a r e l y existed in the m o t h e r ' s u n c o n s c i o u s m i n d . T h e potential for a transitional O e d i p a l relationship to a f a t h e r - i n - m o t h e r seems to h a v e collapsed into a delusional relationship to a sexualized p r e - O e d i p a l m o t h e r w h o served to d e n y sexual difference. I n the course of t h e analytic w o r k , D r . L . b e g a n to view his father as h a v i n g strengths t h a t h e h a d n o t previously v a l u e d . H e c a m e to feel that his father n e e d n o t be viewed simply as a m a n w i t h o u t a m b i t i o n ; from a n o t h e r point of view, o n e t h a t the p a t i e n t h a d n e v e r before c o n s i d e r e d , he b e g a n to see his father as a m a n w h o did n o t care very m u c h a b o u t either social status or m a t e r i a l possessions. D r . L. said t h a t his father cared deeply a b o u t political causes t h a t h a d b e e n dismissed by the patient's m o t h e r as at best quixotic a n d at worst a

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self-indulgent waste of t i m e t h a t took his a t t e n t i o n a w a y from the "real world" of m o n e y a n d business. H i s father in t h e 1950s h a d , at considerable risk to himself, hired black e m p l o y e e s for responsible positions w h e n almost n o o t h e r whites in their S o u t h e r n city w e r e d o i n g so. T h i s aspect of his father, a l t h o u g h obviously p r e s e n t from t h e b e g i n n i n g of the patient's life, w a s n o t previously utilizable for p u r p o s e s of identification by t h e p a t i e n t . T h e p a t i e n t said t h a t there was s o m e t h i n g v e r y sad a b o u t his relationship w i t h his father: it w a s n o t a m a t t e r of his n o t h a v i n g h a d a father, b u t a case of his n o t h a v i n g recognized t h e fact t h a t he did h a v e o n e . H e said he n o t only deeply regretted h a v i n g missed o u t o n h a v i n g h a d a fuller r e l a t i o n s h i p with his father; he felt even worse a b o u t t h e fact t h a t he h a d cheated his father o u t of t h e e x p e r i e n c e of feeling like a father. I n the p a t e r n a l transference, D r . L . for the first t i m e b e c a m e a b l e to feel love for m e w i t h o u t i m m e d i a t e l y becoming anxious that both he and I had become women o r h o m o s e x u a l s in the process. T h i s a n x i e t y h a d previously taken t h e form of intrusive t h o u g h t s of h a v i n g a n a l i n t e r c o u r s e with m e . If the only sexuality t h a t exists is the c o n s u m i n g m a t e r n a l sexuality i m a g i n e d b y the p a t i e n t , t h e n t h e r e c o u l d b e n o loving relationship w i t h , o r sexual identification w i t h , a n o t h e r m a n t h a t does not ultimately reveal itself to b e "homosexual" (that is, a sexuality devoid of phallic thirdness). For this p a t i e n t , h o m o s e x u a l i t y was a reflection of the phallic father h a v i n g b e e n s u b s u m e d by the m o t h e r , leaving only a d e g r a d e d sexuality devoid of m a s c u l i n i t y . A s these feelings w e r e experienced a n d i n t e r p r e t e d in the transference, t h e intrusive "homosexual" t h o u g h t s receded. A l t h o u g h D r . L. h a d h e a r d from friends that I w r o t e


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books a n d articles, he h a d n e v e r r e a d a n y of t h e m , fearing that h e would either n o t like o r n o t u n d e r s t a n d t h e m . I n o t h e r words, he h a d feared t h a t his r e s p o n s e w o u l d b e to r e d u c e either himself o r m e to a d e g r a d e d state. A t this point in the analysis, D r . L . did read o n e of m y b o o k s a n d said t h a t his reaction surprised h i m : he felt p r o u d of m e . H e said t h a t he h a d n e v e r before felt p r o u d of a n y t h i n g of his o w n , o r of a n y o n e with w h o m he w a s associated.

The Absence

of

Thirdness

As illustrated b y t h e m a t e r i a l p r e s e n t e d from D r . L.'s analysis, a n i m p o v e r i s h e d identification of a boy's m o t h e r with h e r o w n father results in a sense (for the boy) of a m i s s i n g O t h e r (i.e., a missing father-in-mother). T h e little b o y t h e n finds himself psychologically alone with his O e d i p a l m o t h e r , a n d this fact p r o f o u n d l y influences several aspects of his d e v e l o p m e n t . First, t h e r e is very little sense of a phallic presence with w h i c h to identify, a n d therefore a scarcity of o p p o r t u n i t y to b e c o m e phallically e m p o w e r e d . Secondly, t h e litde b o y is n o t insulated b y t h e protective prohibition of t h e phallic t h i r d (the f a t h e r - i n - m o t h e r ) w h o claims his wife as his o w n object of love a n d sexual desire a n d t h u s helps to delineate a g e n e r a t i o n a l b o u n d a r y . T h e act of protective prohibition o r d i n a r i l y p r o v i d e d b y the father (initially the fatheri n - m o t h e r ) is of critical value to t h e little b o y in w a r d i n g off t h e c a t a s t r o p h i c feeling t h a t h e m a y actually h a v e his bluff called a n d b e invited into a real sexual u n i o n with his m o t h e r . W i t h o u t the protectively p r o h i b i t i n g fatheri n - m o t h e r w i t h w h o m to identify, t h e p r i m a l scene p h a n -

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tasy b e c o m e s terrifying a n d m u s t b e defended against by m e a n s of perverse 1 1 sexual solutions. T h e p r i m a l scene p h a n t a s y , in t h e a b s e n c e of a f a t h e r - i n - m o t h e r , is a p h a n t a s y of i n t e r c o u r s e with the o m n i p o t e n t m o t h e r of u n m e d i a t e d two-ness. H o w e v e r , in a d d i t i o n , this m o t h e r has b e g u n to t a k e on the terrifying s t r a n g e n e s s of genital female sexuality. T h i s female sexuality is n o t m a d e safe by a f a t h e r - i n - m o t h e r , a phallus within the v a g i n a (the m o t h e r ' s identification with h e r own father). U n o p p o s e d female sexuality b e c o m e s a frightening c a r i c a t u r e of sexuality for the b o y in t h a t it is m a r k e d b y t h e absence of the father w h o in p h a n t a s y h a s b e e n d e s t r o y e d by the m o t h e r (cf. M c D o u g a l l , 1982). It is sexuality i n s e p a r a b l e from the c a t a s t r o p h e of the destruction of the phallic father, a n d therefore a sexuality that blocks t h e little boy's e n t r a n c e into sexual a n d e m o t i o n a l m a t u r i t y a n d t h e a c h i e v e m e n t of m a t u r e masculine g e n d e r identity.

Summary I n this c h a p t e r , I h a v e proposed t h a t the e n t r y into the m a l e O e d i p u s c o m p l e x is m e d i a t e d b y the d e v e l o p m e n t of a transitional O e d i p a l object relationship in conjunction with the e l a b o r a t i o n of increasingly m a t u r e forms of t h e p r i m a l scene p h a n t a s y . I n the transitional O e d i p a l relationship in m a l e d e v e l o p m e n t , the m o t h e r is experienced simultaneously as t h e o m n i p o t e n t p r e - O e d i p a l m o t h e r , t h e sexually exciting external object m o t h e r , a n d n

I use the term "perverse" to refer to forms of sexuality that are used in the service of denying the separateness of external objects and sexual difference, and thus interfere with the elaboration of the depressive position (cf. McDougall, 1986).


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( t h r o u g h the m o t h e r ' s u n c o n s c i o u s identification with-her o w n father) t h e phallic O e d i p a l father. It is in this a r e a of illusion ( g e n e r a t e d b y m o t h e r a n d child) t h a t the external object O e d i p a l m o t h e r ( a n d father) are n o n t r a u m a t i c a l l y discovered a n d t h e t r i a n g u l a t e d O e d i p u s c o m p l e x b e g i n s to be e l a b o r a t e d . T h e m a l e O e d i p u s complex is built u p o n a foundation t h a t is v u l n e r a b l e to erosion. F o r t h e little b o y , the external object m o t h e r b e a r s a n u n c a n n y r e s e m b l a n c e to t h e p r e - O e d i p a l i n t e r n a l object m o t h e r . T h i s in p a r t derives from the fact t h a t t h e r e is n o c h a n g e of love object as is the case in female O e d i p a l d e v e l o p m e n t . T h e little boy's intense a t t a c h m e n t to —and his feeling of n e e d for—the p r e - O e d i p a l m o t h e r a r e powerful forces t e n d i n g to keep h i m a n infant a n d child forever. H e c a n n o t b e c o m e a m a n in relation to a magical sorceress; he c a n only e n g a g e in t h e ultimately futile effort to b e c o m e magical himself. O n e of the multiple functions of t h e p r i m a l scene p h a n t a s y is t h e use to which it is p u t b y t h e little b o y at t h e threshold of the O e d i p u s c o m p l e x in his effort to find a solution to this d i l e m m a . I n o n e version of t h e p r i m a l scene p h a n t a s y that develops at this j u n c t u r e , t h e little b o y is t h e excluded observer of p a r e n t a l sexual intercourse while at the s a m e t i m e b e i n g a p a r t i c i p a n t in it ( t h r o u g h identification with each of his p a r e n t s ) . I n this relatively differentiated version of t h e p r i m a l scene p h a n tasy the little b o y creates a n a r r a t i v e in which there exists recognition of sexual a n d g e n e r a t i o n a l difference, a father w h o is phallically e m p o w e r e d ( a n d e m p o w e r i n g ) , a n d a n external object m o t h e r w h o h a s ties to, b u t is not subsumed by, the omnipotent pre-Oedipal mother. T h e p h a n t a s y of t h e father's penis in the m o t h e r ' s v a g i n a concretely r e p r e s e n t s the presence of t h i r d n e s s t h a t t r i a n gulates the formerly dyadic relationship t h a t h a d existed

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b e t w e e n t h e little boy a n d t h e o m n i p o t e n t p r e - O e d i p a l m o t h e r . I n this version of the p r i m a l scene p h a n t a s y , the little b o y is b e c o m i n g a n i n t e r p r e t i n g subject (observer) w h o is sufficiently outside of the sexual act to be e q u a t e d with n e i t h e r the phallus, n o r with a n o m n i p o t e n t form of female sexuality, n o r with sexual e x c i t e m e n t itself. A n d yet at the s a m e t i m e he is sufficiently "inside" of the p h a n t a s y to experience himself as phallically e m p o w e r e d in identification with t h e father (who is at first the father-inrmother).

7 T h e

I n i t i a l

A n a l y t i c

M e e t i n g

We shall not cease from exploration And the end of all our exploring Will be to arrive where we started And know the place for the first time. T . S. Eliot, "Little Gidding"

P s y c h o a n a l y t i c concepts a n d t e c h n i q u e s , in o r d e r to retain their vitality, m u s t again a n d again be discovered b y t h e analyst as if for the first t i m e . T h e analyst m u s t allow himself to be freshly surprised by the ideas a n d p h e n o m e n a t h a t he takes most for g r a n t e d . F o r e x a m p l e , he m u s t b e able to allow himself to b e genuinely c a u g h t off g u a r d b y the pervasiveness of t h e influence of the u n c o n s c i o u s m i n d , b y the p o w e r of t h e transference, a n d by t h e i n t r a n s i g e n c e of resistance — a n d to only retrospectively apply t h e familiar n a m e s to these freshly rediscovered p h e n o m e n a . If t h e analyst allows himself to perpet169

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ually be t h e b e g i n n e r that h e is, it is s o m e t i m e s possible to learn t h a t which h e t h o u g h t h e a l r e a d y knew. T h i s c h a p t e r is a collection of t h o u g h t s a d d r e s s e d to myself ( a n d o t h e r novices) on the subject of t h e o p e n i n g of t h e analytic d r a m a . I will m a k e n o a t t e m p t to be exhaustive since the topic touches u p o n a l m o s t every aspect of psychoanalytic t h e o r y a n d t e c h n i q u e . M y starting point for a discussion of the first analytic m e e t i n g is the idea t h a t t h e r e is n o difference b e t w e e n t h e analytic process in the first m e e t i n g a n d t h a t in a n y o t h e r analytic m e e t i n g : t h e analyst in the initial m e e t i n g is n o m o r e or less a n analyst, t h e a n a l y s a n d n o m o r e o r less a n a n a l y s a n d , the analysis n o m o r e o r less a n analysis t h a n in a n y o t h e r meeting.

Creating

Analytic

Significance

E v e r y t h i n g t h a t the analyst does in t h e first face-to-face analytic session is intended as a n invitation to t h e patient to consider the m e a n i n g of his experience. All t h a t h a s b e e n most obvious to the p a t i e n t will n o l o n g e r be treated as self-evident; r a t h e r , the familiar is to be w o n d e r e d a b o u t , to b e puzzled over, to be newly c r e a t e d in t h e analytic setting. T h e patient's t h o u g h t s a n d feelings, his past a n d p r e s e n t , h a v e n e w significance, a n d therefore the p a t i e n t himself takes on a form of significance t h a t h e h a s n e v e r held before. T h e r e is a p a r t i c u l a r form of significance g e n e r a t e d in t h e analytic context that is u n i q u e to t h a t setting. For the a n a l y s a n d , the consulting r o o m is a profoundly quiet place as h e realizes t h a t h e m u s t find a voice with which to tell his story. T h i s voice is t h e s o u n d of his t h o u g h t s t h a t he m a y n e v e r h a v e h e a r d before. ( T h e a n a l y s a n d m a y find t h a t h e does n o t h a v e a

The Initial Analytic Meeting

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voice t h a t feels like his own. T h i s discovery m a y t h e n serve as the s t a r t i n g point of the analysis.) T h e analyst b o t h speaks a n d refrains from s p e a k i n g in a w a y t h a t c o m m u n i c a t e s t h e fact t h a t he accepts the patient as he is w i t h o u t j u d g m e n t ; a n d yet at the s a m e t i m e it is u n d e r s t o o d b y b o t h p a t i e n t a n d analyst t h a t they are m e e t i n g t o g e t h e r for the p u r p o s e of psychological c h a n g e . T h e analyst a t t e m p t s to u n d e r s t a n d why the patient is as he is a n d c a n n o t c h a n g e , a n d yet he implicitly asks t h e p a t i e n t to give u p his illness sufficiently to m a k e use of the analysis. F o r e x a m p l e , the schizoid patient m u s t e n t e r i n t o a.relationship with the analyst in o r d e r to o v e r c o m e his t e r r o r of even t h e m o s t m i n i m a l involvem e n t w i t h o t h e r people; the obsessional p a t i e n t , in o r d e r to get help with his endless r u m i n a t i o n s , m u s t give u p his r u m i n a t i o n s sufficiently to e n t e r into a n analytic dialogue; the hysterical patient m u s t i n t e r r u p t t h e d r a m a t h a t constitutes ( a n d substitutes for) his life long e n o u g h to b e c o m e a n observer of that life, in a d d i t i o n to b e i n g a n actor in it. T h e analyst is the object of the patient's transference feelings even before the first m e e t i n g . I n addition to viewing the analyst as a person t r a i n e d to u n d e r s t a n d a n d ( t h r o u g h s o m e as yet u n k n o w n process) help the patient find relief from psychic p a i n , t h e analyst is also freq u e n t l y experienced by the p a t i e n t as the h e a l i n g m o t h e r , t h e childhood transitional object, t h e wished-for O e d i p a l m o t h e r a n d father, a n d so on. W i t h these h o p e s comes the fear of d i s a p p o i n t m e n t . J u s t as t h e p a t i e n t has a ( p h a n t a s i e d ) analyst.before the first session, the analyst also h a s a patient ( m o r e accurately, he h a s m a n y patients) in his own m i n d p r i o r to t h e initial m e e t i n g . I n other w o r d s , p r i o r to m e e t i n g the p a t i e n t , the analyst h a s d r a w n u p o n such elements as the

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s o u n d of t h e patient's voice o n the t e l e p h o n e , the source of t h e referral, a n d the analyst's relationships with his c u r r e n t p a t i e n t s , as sources of conscious a n d unconscious feelings a b o u t the p a t i e n t t h a t he will b r i n g to the first analytic m e e t i n g . I n a d d i t i o n , t h e r e is regularly a feeling of suspense connected with the a n t i c i p a t i o n of the initial interview. Both patient a n d analyst a r e a b o u t to e n t e r into a n i n t e r p e r s o n a l d r a m a for w h i c h t h e r e a r e m a n y scripts a l r e a d y w r i t t e n (the analyst's a n d t h e patient's internal d r a m a s ) , a n d yet if the w o r k is to be p r o d u c t i v e , a d r a m a n e v e r before i m a g i n e d by either will h a v e to be created. A l o n g w i t h the sense of excitement, t h e r e is also a n edge of a n x i e t y . F o r b o t h analyst a n d p a t i e n t , the d a n g e r posed by t h e first m e e t i n g arises to a large extent from the prospect of a fresh e n c o u n t e r with one's o w n i n n e r world a n d the i n t e r n a l world of a n o t h e r p e r s o n . It is always d a n g e r o u s business to stir u p the d e p t h s of the u n c o n scious m i n d . T h i s anxiety is regularly misrecognized b y therapists early in practice. It is t r e a t e d as if it were a fear t h a t t h e p a t i e n t will leave t r e a t m e n t ; in fact t h e therapist is afraid t h a t t h e patient will stay. A p a t i e n t recently described to m e with u n u s u a l clarity a f r a g m e n t of h e r train of t h o u g h t p r i o r to the first m e e t i n g : " H o w m u c h should I say in t h e b e g i n n i n g a b o u t the t h i n g s of which I a m most afraid a n d a s h a m e d ? H o w should I p h r a s e it? I don't w a n t h i m to think I a m so crazy, so deceitful, so selfish, so seductive, t h a t w o r k i n g with m e will be experienced as so u n p l e a s a n t that he will soon find s o m e excuse for getting rid of m e . Is the h u m i l i a t i o n of revealing myself in this w a y w o r t h it? D i d I m a k e a m i s t a k e in d e c i d i n g to see h i m ? H e w a s d i s a p p o i n t i n g to m e w h e n I spoke to h i m on t h e p h o n e . I wish h e w e r e older, m o r e like a g r a n d f a t h e r . H e s o u n d e d a little crazy: h e didn't seem to k n o w his o w n address. H i s


173

office is in a k i n d of decrepit n e i g h b o r h o o d . I w o n d e r if he's h a v i n g t r o u b l e in his practice." W h e n a potential patient p h o n e s to i n q u i r e a b o u t w o r k i n g with m e in t h e r a p y o r analysis, I suggest t h a t we find a t i m e to m e e t for a consultation. I intentionally use t h e w o r d consultation in o r d e r to m a k e it clear t h a t this m e e t i n g will n o t necessarily be t h e b e g i n n i n g of o n g o i n g work for us t o g e t h e r (despite t h e fact t h a t I i n t e n d it to b e a n analytic e x p e r i e n c e regardless of w h a t t h e o u t c o m e of the m e e t i n g m i g h t be). I d o this b e c a u s e I c a n n o t k n o w a h e a d of t i m e w h e t h e r , after talking with t h e p a t i e n t , I will feel t h a t I c a n b e of help to h i m a n d will w a n t to w o r k with h i m . A m o n g t h e multiplicity of factors t h a t go into m a k i n g this d e t e r m i n a t i o n is t h e question of w h e t h e r I feel t h a t I generally like the patient a n d feel some concern for a n d interest in h i m . It is i m p o r t a n t t h a t the analyst a t t e m p t in p a r t to o r g a n i z e his t h i n k i n g diagnostically in a n effort to conceptualize the n a t u r e of t h e analytic w o r k t h a t the p a t i e n t will r e q u i r e a n d the n a t u r e of t h e difficulties t h a t t h e analytic p a i r is likely to e n c o u n t e r . H o w e v e r , with a few exceptions (such as d r u g - o r alcohol-addicted p a t i e n t s , violently acting-out sociopaths, a n d severely organically d a m a g e d patients), I a m generally o p e n to w o r k i n g analytically with patients suffering from a wide r a n g e of psychological d i s t u r b a n c e s (cf. Boyer, 1971; Giovacchini, 1969, 1979; O g d e n , 1982b, 1986). B u t it seems to m e t h a t o n e is c l a i m i n g too m u c h if one claims to b e able to work with a n y p a t i e n t w h o is interested in analysis. I believe t h a t we d o a p a t i e n t a disservice if we a g r e e to work with h i m w h e n we are a w a r e t h a t we d o n o t like h i m . It is s o m e t i m e s said t h a t the analyst o u g h t to b e able to analyze his negative c o u n t e r t r a n s f e r e n c e a n d therefore should b e able to work with a n y p a t i e n t w h o is otherwise

174


suitable for analytic work. I n t h e o r y this m a y be true; h o w e v e r , in practice, I believe t h a t t h e analytic task is difficult e n o u g h w i t h o u t a t t e m p t i n g to build the analytic edifice u p o n a foundation of a powerful negative countertransference (or a n intense n e g a t i v e transference). I n m y e x p e r i e n c e , this is so w h e t h e r o r n o t t h e analyst (or the p a t i e n t ) recognizes these transferences to be irrational. T h i s caveat h a s seemed to m e e q u a l l y applicable t o instances in which t h e r e are from t h e b e g i n n i n g very intense erotic transferences o r countertransferences. O n t h e o t h e r h a n d , w h e n s p e a k i n g with a patient I d o n o t refer to the initial m e e t i n g as a n "evaluation period" or "assessment phase" since these designations seem t o m e to c o n v e y the idea t h a t t h e p a t i e n t is to b e relatively passive in this enterprise. S u c h t e r m s would m i s r e p r e s e n t m y u n d e r s t a n d i n g t h a t t h e function of the first m e e t i n g centrally involves t h e initiation of the analytic process. T h e n a t u r e of the interaction of the first m e e t i n g is n o t simply that of o n e p e r s o n e v a l u a t i n g a n o t h e r o r even of two people e v a l u a t i n g each other. R a t h e r , it is in m y view a n i n t e r a c t i o n in which two people a t t e m p t to generate analytic significance, inc l u d i n g a n u n d e r s t a n d i n g of the m e a n i n g s of the decisionm a k i n g process that is involved in the initial m e e t i n g . It is m y i n t e n t i o n in this m e e t i n g to facilitate t h e creation of a n i n t e r a c t i o n t h a t will constitute a n analytic experience of s o m e value to the p a t i e n t , in t h a t it will p r o v i d e h i m with a sense of w h a t it m e a n s to be in analysis. D e s p i t e the fact t h a t transference anxiety is ext r e m e l y high in the period l e a d i n g to the initial interview, I d o n o t view it as t h e analyst's j o b to p u t t h e p a t i e n t at ease in the first m e e t i n g . O n the c o n t r a r y , I believe t h a t it is t h e analyst's task to help the p a t i e n t n o t miss a n

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i m p o r t a n t o p p o r t u n i t y to recognize a n d u n d e r s t a n d s o m e t h i n g a b o u t the transference t h o u g h t s , feelings, a n d sensations w i t h which h e h a s b e e n s t r u g g l i n g .

Sustaining

Psychological

in the Analytic

Strain Setting

As with all o t h e r analytic meetings, t h e initial h o u r begins in t h e w a i t i n g r o o m . T h e patient is a d d r e s s e d as D r . , M r . , or M s . , a n d the analyst i n t r o d u c e s himself in k i n d . T h e p a r a d o x i n h e r e n t in this formal i n t r o d u c t i o n is not lost to t h e p a t i e n t : t h e analytic relationship is o n e of the most formal a n d at the s a m e t i m e o n e of t h e most i n t i m a t e of h u m a n relationships. T h e formality is a reflection of respect for the a n a l y s a n d a n d for the analytic process. I n a d d i t i o n , it is a n expression of the fact t h a t the analyst is n o t p r e t e n d i n g to be, n o r does he aspire t o be, the a n a l y s a n d ' s friend. ( W e d o n o t p a y o u r friends to talk to u s . ) It is therefore m a d e clear from t h e outset t h a t t h e i n t i m a c y of t h e analytic relationship will b e a n i n t i m a c y in the context of formality. T h e r a p i s t s early in their t r a i n i n g often feel the i m p u l s e to "put the patient at ease" o r "to act h u m a n " as they walk with the patient from t h e w a i t i n g r o o m to the consulting r o o m . F o r instance, a therapist a t t e m p t i n g to ease t h e tension of the walk to t h e consulting r o o m m i g h t say, "I h o p e you didn't h a v e t r o u b l e finding a p a r k i n g space. P a r k i n g is awful a r o u n d here." T o m a k e such a c o m m e n t is n o t a kind t h i n g to d o from t h e point of view of t h e analytic process. I n fact, from the perspective b e i n g discussed in this c h a p t e r , such a therapist w o u l d be considered r a t h e r u n k i n d in several ways. First, he has

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c o m m u n i c a t e d to the p a t i e n t his unconscious feeling t h a t t h e patient is a n infant w h o h a s t r o u b l e m a k i n g his w a y in a hostile world, a n d also the fact t h a t the therapist feels guiltily responsible for n o t m a k i n g the patient's life less difficult. S u c h a c o m m e n t i m m e d i a t e l y p u t s the p a t i e n t into t h e analyst's debt a n d p u t s p r e s s u r e on h i m to r e t u r n t h e "kindness" —that is, to h e l p t h e analyst avoid feelings of discomfort. T h e r e is also a h i n t in the therapist's c o m m e n t t h a t he is not confident t h a t the t h e r a p y he will offer the patient is w o r t h the t r o u b l e to which the p a t i e n t is going. F u r t h e r m o r e , this sort of c o m m e n t is a n act of theft: it r o b s t h e p a t i e n t of t h e o p p o r t u n i t y to i n t r o d u c e himself to t h e analyst in the w a y .that h e consciously a n d u n c o n sciously chooses. T h e p a t i e n t h a s available to h i m a n infinite n u m b e r of ways of b e g i n n i n g the analytic discourse. H i s choice of t h e w a y h e will go a b o u t d o i n g this will b e r e p e a t e d by n o o t h e r a n a l y s a n d . O n e m u s t n o t d e p r i v e h i m of his o p p o r t u n i t y to write the o p e n i n g lines of his own analytic d r a m a b y b u r d e n i n g h i m with the analyst's own u n c o n s c i o u s c o n t e n t s before he e v e n sets foot in the consulting r o o m . ( T h e r e will be plenty of t i m e for t h a t later as the analyst inevitably b e c o m e s a n u n w i t t i n g a c t o r in the patient's u n c o n s c i o u s p h a n t a s i e s . ) Finally, a c o m m e n t of t h e type b e i n g discussed misleads the patient a b o u t t h e n a t u r e of the analytic experience. As analysts, we d o not i n t e n d to relieve a n x i e t y ( o u r own o r the patient's) t h r o u g h tensionr e d u c i n g activity such as r e a s s u r a n c e s , gift-giving, a n d the like. Since m a i n t a i n i n g psychological strain is n o t only s o m e t h i n g that we d e m a n d of ourselves, b u t also p a r t of w h a t we ask of the p a t i e n t , it m a k e s no sense to b e g i n the analytic relationship with a n effort at dissip a t i n g psychological strain. W h e t h e r or n o t the incident is


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ever spoken of a g a i n , t h e a n a l y s a n d unconsciously registers the fact t h a t the analyst h a s g r a n t e d himself license to h a n d l e his own anxiety by a c t i n g u p o n his c o u n t e r t r a n s ference feelings. T h e p a t i e n t b r i n g s to t h e first interview m a n y q u e s t i o n s a n d worries (usually u n s p o k e n ) a b o u t w h a t it m e a n s to be in analysis, w h a t it m e a n s to b e an analyst, a n d w h a t it m e a n s to b e a n a n a l y s a n d . T h e analyst's a t t e m p t s at a n s w e r i n g these questions in the form of e x p l a n a t i o n s of free association, t h e use of the c o u c h , frequency of meetings, differences b e t w e e n psychot h e r a p y and.psychoanalysis, differences between "schools of psychoanalysis," a n d so o n , a r e n o t only futile b u t i n v a r i a b l y highly limiting of t h e patient's o p p o r t u n i t y to p r e s e n t himself to t h e analyst in his own t e r m s . As is illustrated b y the following clinical vignette, t h e analyst's most e l o q u e n t e x p l a n a t i o n of w h a t it m e a n s to be "in analysis" is to c o n d u c t himself as a n analyst. M r . H . , a 42-year-old television p r o d u c e r , explained in the initial session t h a t he h a d c o m e to see m e b e c a u s e he felt intensely a n x i o u s a n d h a d "obsessional ideas" a b o u t d y i n g , including fears of suffocating in his sleep a n d of b e i n g t r a p p e d a n d killed d u r i n g a n e a r t h q u a k e . T h e p a t i e n t w a s also p r e o c c u p i e d b y the t h o u g h t t h a t his 6-year-old d a u g h t e r , w h o was mildly h e a r i n g - i m p a i r e d , would "not be able to m a k e it in t h e world." H e said t h a t he k n e w t h a t each of his fears was o v e r b l o w n , b u t this k n o w l e d g e did n o t d i m i n i s h t h e intensity of his anxiety. T h e patient said t h a t he h a d b e e n fearful from t h e t i m e h e was a small child. M r . H . ' s father, w h o was a college professor, was continually dissatisfied with t h e p a t i e n t , a n d insisted on "helping h i m " with his h o m e w o r k e a c h n i g h t . T h i s inevitably e n d e d with the father's shrieking at the son for his "incredible stupidity."

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M r . H . told m e that his success at work seemed u n r e a l to h i m . H e felt as if h e h a d to be continually p r e p a r i n g for the d a y w h e n he w o u l d n o l o n g e r b e able to function. As a result, he h o a r d e d every p e n n y t h a t he e a r n e d . H e gave several e x a m p l e s of feeling d a n g e r o u s l y depleted w h e n he spent m o n e y . I t h e n said t h a t it seemed as if he was suggesting t h a t the idea of p a y i n g for analysis would b e frightening b e c a u s e it w o u l d m e a n giving u p o n e of the few sources of protection t h a t he felt he h a d . M r . H . smiled a n d said t h a t h e h a d t h o u g h t a g r e a t d e a l a b o u t this, a n d t h a t the prospect of p a y i n g for analysis felt to h i m like a blood-letting in w h i c h t h e r e would be a race b e t w e e n his "cure" a n d his b l e e d i n g to d e a t h . W h e n I m e t M r . H . in the w a i t i n g r o o m for o u r second m e e t i n g , h e was p e r s p i r i n g a n d seemed to h a v e b e e n w a i t i n g for m e like a m a n anxiously a w a i t i n g some terribly i m p o r t a n t piece of n e w s , p e r h a p s a verdict. Immediately upon entering m y consulting room, he walked briskly across the r o o m a n d reached for t h e p h o n e , saying, "I locked m y keys in the c a r a n d so if it's all right, I'd like to call m y wife to ask h e r to m e e t m e h e r e with a s p a r e set of keys after o u r m e e t i n g . " I said t h a t . I t h o u g h t it m u s t seem to h i m as if his life d e p e n d e d on his m a k i n g t h e p h o n e call, b u t I t h o u g h t t h a t h e a n d I should talk a b o u t w h a t it was t h a t w a s h a p p e n i n g between u s before a t t e m p t i n g to Undo it. H e sat d o w n a n d said, "Actually, w h a t j u s t h a p p e n e d is k i n d of typical of m e . I d r o v e h e r e with m y l u n c h in the b a c k seat of m y car, a n d w h e n I arrived I saw a sign in t h e p a r k i n g garage t h a t said, ' L e a v e keys in car.' I felt u n e a s y a b o u t leaving m y l u n c h in a n unlocked car. I h a d the t h o u g h t t h a t someb o d y m i g h t t a m p e r with m y l u n c h a n d so I didn't w a n t to leave the c a r unlocked." I said to M r . H . t h a t w i t h o u t realizing it he seemed


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to h a v e d o n e b o t h things he h a d i n t e n d e d to do: he h a d locked his l u n c h in t h e car so it would n o t be t a m p e r e d with, a n d h a d left his keys in the car as the sign h a d directed. H e told m e that he h a d b e c o m e very panicky w h e n he realized t h a t his keys were locked in his car a n d i m m e d i a t e l y t h o u g h t of calling his wife from m y office. H e said t h a t h e h a d felt greatly relieved by this idea. I r e p e a t e d his realization t h a t he h a d t h o u g h t of m e as well as his wife at t h a t m o m e n t . H e said t h a t w a s t r u e , b u t that he h a d also t h o u g h t of m e earlier w h e n he saw the sign which s o m e h o w seemed to h a v e b e e n p u t t h e r e by m e . M r . H . explained t h a t the r e q u e s t to use m y p h o n e was also characteristic of h i m . H e said h e was almost always afraid t h a t people were a n g r y at h i m , a n d he regularly r e a s s u r e d himself t h a t people liked h i m by asking small favors of t h e m . F o r e x a m p l e , he frequently b o r r o w e d c h a n g e o r a pencil from colleagues at w o r k , or asked directions to a place w h e n he already knew perfectly well h o w to get there. H e told m e t h a t he was certain t h a t I already t h o u g h t he was "a real j e r k . " (I a s s u m e d t h a t t h e r e was a wish as well as a fear u n d e r l y i n g this feeling, b u t I did not i n t e r r u p t the p a t i e n t at this point since h e was in the midst of i n t r o d u c i n g m e to the cast of c h a r a c t e r s constituting his internal object w o r l d . ) M r . H . went on at this point to tell m e m o r e a b o u t his p a r e n t s . H i s father h a d died ten years earlier, b u t h a d lived his entire life as if he w e r e at death's d o o r . H e h a d suffered from renal disease o r i g i n a t i n g in childhood a n d w a s preoccupied with t h e fear of d e a t h . T h e p a t i e n t said t h a t as a child he h a d b e e n frightened that his father would die w h e n his father was yelling at h i m . M r . H . told m e t h a t his father could at times be very kind arid t h a t t h e patient h a d loved h i m despite the fact t h a t h e h a d b e e n frightened of h i m so m u c h of t h e time.

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I asked if t h e patient h a d expected t h a t I would yell at h i m for locking his keys in t h e car a n d for asking to use m y p h o n e . H e said t h a t he t h o u g h t he h a d h a d that feeling in a diffuse sort of way, b u t h a d n o t quite k n o w n why he was feeling so frightened while w a i t i n g in m y waiting r o o m . (It occurred to m e t h a t t h e patient m a y h a v e b e e n a t t e m p t i n g to call his wife in a n effort to get h e r to protect h i m from m e [as his m o t h e r h a d protected h i m from his father] a n d t o protect m e from himself.) I n the c o u r s e of the analytic work t h a t followed, m a n y layers of m e a n i n g of this transference e n a c t m e n t (referred to b y the patient as the "telephone caper") c a m e to light. O n e of these was the patient's wish to be treated as a helpless little boy, t h u s defending himself against his feelings of b e i n g a powerfully destructive p e r s o n who h a d d o n e great h a r m to his father a n d w h o w o u l d do h a r m to m e . A second aspect of this transference e n a c t m e n t involved the wish to provoke m e into a c t i n g in a m a n n e r similar to t h a t of his father, w h e r e i n I w o u l d yell at h i m for his stupidity. I n p a r t , he was afraid t h a t I would act in that w a y a n d w a s a t t e m p t i n g to reassure himself that I would n o t . In a n o t h e r way, he found sensual pleasure in such intense scoldings. I n a d d i t i o n , he felt relief at the prospect of b e i n g p u n i s h e d , since this is w h a t he u n c o n sciously felt he deserved for the c r i m e he i m a g i n e d he h a d c o m m i t t e d in relation to his father (that is, p r o v o k i n g h i m to the point t h a t he h a d m a d e h i m sick a n d ultimately h a d killed h i m ) . F u r t h e r m o r e , h e felt t h a t his father h a d d e m o n s t r a t e d love for h i m in the father's intense, controlling i n v o l v e m e n t . T h e patient unconsciously hoped to elicit from m e this form of love in the anticipated scolding. O v e r the course of the analysis, the "telephone caper" served again a n d again as a symbol of the analytic process.

The Initial Analytic Meeting Cautionary

181 Tales

I n the initial interview I listen from the outset for the patient's " c a u t i o n a r y tales" —that is, t h e patient's u n c o n scious e x p l a n a t i o n s of w h y he feels t h a t the analysis is a d a n g e r o u s u n d e r t a k i n g , a n d his reasons for feeling that the analysis is certain to fail. 1 T o say this is to say n o t h i n g m o r e t h a n t h a t I listen for ( a n d a t t e m p t to p u t into w o r d s for myself a n d for the p a t i e n t ) the l e a d i n g edge of transference anxiety. W h a t e v e r the n a t u r e of the analysand's d i s t u r b a n c e s , his anxieties will be given form in t e r m s of t h e d a n g e r of e n t e r i n g into a relationship with t h e analyst. T h e p a t i e n t unconsciously holds a fierce conviction (which h e has n o way of articulating) that his infantile a n d early childhood experience h a s t a u g h t h i m a b o u t the specific ways in which each of his object relationships will inevitably b e c o m e painful, d i s a p p o i n t ing, overly s t i m u l a t i n g , a n n i h i l a t i n g , lonely, u n r e l i a b l e , suffocating, overly sexualized, a n d so on. T h e r e is n o reason for h i m to believe t h a t the relationship into which he is a b o u t to e n t e r will be any different. I n this belief, t h e a n a l y s a n d is of course b o t h correct a n d incorrect. H e is correct in t h e sense t h a t transferentially, his i n t e r n a l object world will inevitably b e c o m e a living intersubjective d r a m a on the analytic stage. H e is incorrect to the extent t h a t the analytic context will not b e identical to the

1

Ella Freeman Sharpe (1943) used the term cautionary tales to refer to phantasies serving the purpose of instinctual impulse control.by means of unconscious self-warnings of bodily destruction. In this chapter, I use the term to refer to a more circumscribed and differently conceptualized set of phantasies: the patient's unconscious set of phantasies concerning the dangers of entering into the analytic relationship (McKee, 1969).

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original psychological-interpersonal context within which his i n t e r n a l object world was created —that is, the context of infantile a n d childhood p h a n t a s y a n d object relations. E v e r y t h i n g that the a n a l y s a n d says ( a n d does n o t say) in the first h o u r s can b e h e a r d in the light of a n unconscious w a r n i n g to the analyst c o n c e r n i n g the reasons why n e i t h e r the analyst n o r t h e patient should e n t e r into this d o o m e d a n d d a n g e r o u s relationship. It m u s t be e m p h a s i z e d t h a t the patient feels t h a t the analysis will e n d a n g e r the analyst as well as himself, a n d t h a t it is largely in a n effort to protect the analyst t h a t the patient balks at e n t e r i n g the relationship. T h e analyst, from this perspective, serves as the c o n t a i n e r for t h e patient's fears a b o u t b e g i n n i n g this relationship, as well as the c o n t a i n e r for the patient's h o p e s that i n t e r n a l c h a n g e is possible a n d t h a t pathological a t t a c h m e n t s to i n t e r n a l objects can be altered w i t h o u t sacrificing the life of the patient. T h e following account of an initial analytic m e e t i n g is a n illustration of o n e such way in w h i c h p a t i e n t s u n c o n sciously a t t e m p t to symbolize for themselves a n d for the analyst t h e d a n g e r s t h a t they a n t i c i p a t e . A n a n a l y s a n d b e g a n his first m e e t i n g by describing his e m p t y relationship with his wife a n d children, the b o r e d o m t h a t he felt at work, a n d t h e lack of j o y t h a t he felt in his life in general. H e said t h a t he h a d b e e n referred to m e b y his internist w h o t h o u g h t analysis would be of benefit to h i m . D e s p i t e M r . J . ' s presentation of his feelings of desolation, I suspected t h a t t h e r e were pleasures in his life that he felt he m u s t keep secret both from himself a n d from m e . I h a d the fantasy that M r . J . was h a v i n g a n affair—perhaps with a w o m a n , p e r h a p s with m u s i c , a r t , o r some o t h e r "passionate interest," p e r h a p s with the m e m o r y of a childhood r o m a n c e . T h i s fantasy w a s n o t the p r o d u c t of i n t u i t i o n , b u t a response to


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s o m e t h i n g a b o u t the patient's p r e s e n t a t i o n of himself. I n retrospect, it is easier to see t h a t this h a d b e e n c o m m u nicated to m e by his choice of words, b y his r h y t h m of speech, b y his gait, by his facial expressions a n d so o n . H e b e h a v e d like a m a n with a secret. I s u r m i s e d (but did not say to M r . J . ) t h a t he unconsciously seemed to feel that analysis w o u l d contain forms of pleasure that he would h a v e to k e e p well h i d d e n . As a result, I anticipated that analysis w o u l d h a v e a r a t h e r arid feeling to it (both for h i m a n d for m e ) for quite a long t i m e . T h e p a t i e n t said t h a t he felt convinced t h a t he n e e d e d t r e a t m e n t , a n d that he k n e w t h a t his wife a n d children would benefit if he were to get help. N o n e t h e less, he felt e x t r e m e l y guilty a b o u t s p e n d i n g m o n e y on analysis w h i c h could b e spent in b u y i n g things t h a t his whole family could enjoy. I said after some t i m e h a d elapsed in the first h o u r that t h e p a t i e n t seemed to feel that b e g i n n i n g analysis would be e q u i v a l e n t to h a v i n g a n affair. H e told m e how devoted he was to his wife a n d that he h a d n e v e r considered the idea of really h a v i n g a n affair. H o w e v e r , he said that it w a s s t r a n g e t h a t I h a d said w h a t I h a d b e c a u s e earlier t h a t week, for the first t i m e , he h a d h e a r d himself m a k i n g a c o m m e n t to his secretary t h a t w a s sufficiently a m b i g u o u s as to h a v e b e e n c o n s t r u e d as a proposition. She chose n o t to directly r e s p o n d to the a m b i g u o u s l y proposed affair. H e said that he h a d felt q u i t e disturbed by this episode a n d h a d left work early for the first t i m e in years. I n this instance, I elected to i n t e r p r e t a n aspect of what I u n d e r s t o o d to be M r . J . ' s l e a d i n g transference anxiety (that is, the most accessible unconscious/ preconscious set of transference a n d resistance m e a n ings). T h e i n t e r n a l d r a m a t h a t the p a t i e n t seemed to be b r i n g i n g to t h e analytic relationship was o n e in which

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there w a s a n anticipation of p a s s i o n a t e a t t a c h m e n t a n d intense secretiveness. It was within this a r e a of experience (the "affair") t h a t I suspected t h a t M r . J . was afraid the analysis w o u l d b e c o m e extremely painful a n d p e r h a p s impossible to c o n t i n u e . I n t h e course of the succeeding several years of analysis the p a t i e n t was able to m a k e sense of these feelings in t e r m s of a childhood r e l a t i o n s h i p he h a d h a d with a n a n n y w h o m he h a d loved deeply; it was a love t h a t he h a d unconsciously felt he h a d to k e e p secret from his m o t h e r . H i s feelings of a n g e r a n d guilt, as well as his fear of b e c o m i n g involved in similar impossible entanglem e n t s , h a d led to M r . J . ' s d e v e l o p i n g a c h a r a c t e r defense in w h i c h h e r e m a i n e d r a t h e r d e t a c h e d in all sectors of his life. T h e idea t h a t he was "only g o i n g t h r o u g h the motions" served i m p o r t a n t .defensive functions in the initial stages of his analysis.

The

Timing

of Transference

Interpretations

As a result of m y interest in ideas developed in the •British psychoanalytic dialogue, I h a v e often been asked if it is t r u e t h a t K l e i n i a n s interpret t h e transference from the very b e g i n n i n g of the analysis. T h e question is always a p u z z l i n g o n e to m e . It h a r d l y seems surprising t h a t o n e w o u l d a t t e m p t to talk with the p a t i e n t a b o u t w h a t it is a b o u t this n e w relationship (the analytic relationship) t h a t is so frightening, exciting, disappointing, futile, a n d so on. Generally, the initial session does not feel c o m p l e t e to m e unless t h e patient's anxiety in the t r a n s f e r e n c e h a s in some w a y b e e n a d d r e s s e d . O n e does n o t h a v e to be a K l e i n i a n to talk with one's patient a b o u t one's c u r r e n t ( a n d always tentative) u n d e r s t a n d i n g of


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w h a t it is t h a t is d i s t u r b i n g to t h e a n a l y s a n d a b o u t t h e initial m e e t i n g . 2 T h e following is a n illustration of a situation in which t h e r e w a s countertransference resistance to discussing transference anxiety in t h e initial m e e t i n g . A 32-year-old m a n m a d e a p h o n e call to a therapist for the p u r p o s e of setting u p a c o n s u l t a t i o n . H e told h e r in the course of asking for a n a p p o i n t m e n t t h a t he felt in d a n g e r of getting into disputes t h a t w o u l d e n d u p in his p u n c h i n g s o m e o n e . M r . N . said t h a t he is a large m a n , t h a t he speaks in a b o o m i n g voice, a n d t h a t people are often frightened by h i m even w h e n he is n o t a n g r y . H e said t h a t despite all this, he h o p e d t h a t t h e therapist would n o t b e afraid of h i m since h e was n o t a d a n g e r o u s person a n d h a d n e v e r attacked a n y b o d y . W h e n M r . N . a p p e a r e d for his initial m e e t i n g , the therapist w a s surprised to find t h a t the p a t i e n t was a m a n of a v e r a g e build w h o spoke in a p r e s s u r e d m a n n e r , b u t not a loud or bullying o n e . She l e a r n e d t h a t M r . N . was a successful o w n e r of a retail business. H e h a d b e e n b o r n to a psychotic m o t h e r a n d was placed in a foster h o m e j u s t before his first b i r t h d a y . M r . N . h a d seen n e i t h e r his m o t h e r n o r his father since t h a t t i m e . After a succession of five foster h o m e p l a c e m e n t s in a five-year period, he was finally a d o p t e d by a couple with w h o m he lived until h e left h o m e at 18 to j o i n t h e a r m y . D u r i n g t h e course of his latency a n d adolescence, the patient's a d o p t i v e p a r e n t s h a d b e c o m e alcoholics.

2

At the same time, clinical judgment must guide the analyst in every therapeutic situation. There are many instances in which the analyst senses that it is critical that he not be too "clever" (Winnicott, 1968, p. 86) or know too much, and therefore chooses to refrain from offering even the most tentative versions of what he thinks he understands (cf. Balint, 1968; Winnicott, 1971a,c).

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T h e therapist ( w h o h a d only recently c o m p l e t e d h e r t r a i n i n g ) did n o t discuss with t h e p a t i e n t his implicit, a m b i v a l e n t w a r n i n g t h a t she would b e well advised to h a v e n o t h i n g to d o with h i m . T h e r e seems to h a v e b e e n a n u n c o n s c i o u s belief o n the p a r t of the therapist t h a t talking to M r . N . a b o u t his fear of his destructiveness would m a k e h i m m o r e d a n g e r o u s to h e r . T h e r e was also a denial of h e r o w n fear of the p a t i e n t t h a t left h e r u n a b l e to think a b o u t his w a r n i n g . ( O t h e r therapists m i g h t h a v e refused to even m e e t with this p a t i e n t , t h u s e n g a g i n g in a transference-countertransference e n a c t m e n t of the p a tient's experience of himself as a d a n g e r to b o t h his internal a n d e x t e r n a l objects. T h e p a t i e n t , after all, h a d already —from t h e perspective of his u n c o n s c i o u s psychic reality —caused his original m o t h e r to b e c o m e .psychotic, l e a d i n g h e r to a b a n d o n h i m ; h a d been so u n l o v a b l e a n d p e r h a p s d a n g e r o u s as to h a v e caused five sets of foster p a r e n t s to refuse to keep h i m ; a n d h a d d r i v e n his adoptive p a r e n t s to alcoholism.) T h e p a t i e n t c a m e to his next four weekly m e e t i n g s in an increasingly agitated state. Several days after t h e fifth m e e t i n g , M r . N . p h o n e d the therapist s a y i n g t h a t h e h a d felt m o r e a n d m o r e anxious after each of his m e e t i n g s with h e r a n d t h a t it h a d b e c o m e u n b e a r a b l e . H e h a d therefore decided to discontinue t h e r a p y . T h e therapist suggested t h a t M r . N . c o m e to a n o t h e r m e e t i n g I n o r d e r to talk a b o u t these feelings. It was at this point that the therapist s o u g h t consultation on t h e case. I suggested to her t h a t t h e patient h a d indicated from t h e very outset that h e w a s terrified that his a n g e r (particularly in the m a t e r n a l transference) would frighten a n d d a m a g e the therapist. T h e therapist's unconscious fear of the patient h a d led h e r to suggest once-a-week m e e t i n g s with M r . N . despite indirect indi-


187

cations from h i m t h a t he felt he n e e d e d a n d could afford m o r e intensive t h e r a p y . T h i s unconscious decision on the p a r t of the therapist to seek a safe distance from the patient h a d confirmed the patient's belief t h a t t h e therapist would (with good reason) find h i m d a n g e r o u s , a n d w o u l d eventually refuse to see h i m . It s e e m e d to m e t h a t M r . N . h a d t e l e p h o n e d the therapist in o r d e r to see w h e t h e r she h a d b e e n injured in t h e p r e v i o u s m e e t i n g a n d t h a t he h a d b e e n t e m p o r a r i l y reassured by h e r asking h i m to c o m e to his next m e e t i n g . I h y p o t h e s i z e d t h a t M r . N . was in a rage at his (internal object) m o t h e r for b e i n g crazy a n d u n a b l e to love h i m a n d for h a v i n g a b a n d o n e d h i m . At t h e s a m e t i m e , he was terrified t h a t it was his a n g e r t h a t h a d d r i v e n his m o t h e r crazy a n d h a d led h e r to abandon him. M r . N . b e g a n the m e e t i n g t h a t followed the telep h o n e call by a s k i n g the therapist, " H o w a r e you?" as they walked from t h e w a i t i n g ' r o o m to the consulting r o o m . O n c e in t h e c o n s u l t i n g r o o m , he said t h a t his h e a r t was p o u n d i n g . T h e therapist suggested t h a t M r . N . was worried t h a t he h a d scared or p e r h a p s h u r t her at the previous m e e t i n g a n d that this h a d b e e n a c o n c e r n of his from the v e r y b e g i n n i n g . T h e p a t i e n t c a l m e d d o w n considerably after this i n t e r p r e t a t i o n . T h e therapist later in the m e e t i n g suggested t h a t since t h e p a t i e n t felt such intense anxiety in response to each m e e t i n g , it m i g h t be useful to m e e t m o r e frequently in o r d e r to discuss w h a t it w a s t h a t was frightening h i m . T o the therapist's surprise, M r . N . seemed receptive to this idea. I n a sense, the b e g i n n i n g of the analytic dialogue h a d b e e n p o s t p o n e d for six o r seven m e e t i n g s largely as a result of u n a n a l y z e d anxiety in the c o u n t e r t r a n s f e r e n c e , which h a d led to the therapist's inability to t h i n k a b o u t o r i n t e r p r e t the patient's transference anxiety.

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The Primitive Edge of Experience Analytic

Space

E n t r y into the analytic experience ( b e g i n n i n g in t h e initial interview) involves t h e e n l a r g e m e n t of t h e psychological space constituting the "matrix of the m i n d " ( O g d e n , 1986) in such a w a y t h a t this space m o r e o r less comes to a p p r o x i m a t e the analytic space; t h u s , the analytic space b e c o m e s t h e space in which the patient thinks, feels, a n d lives. I n a subtle w a y , the events m a k i n g u p - t h e patient's experience in relation to his internal a n d e x t e r n a l objects, the events m a k i n g u p his daily life a n d his responses to these events, c o m e to be i m p o r t a n t to h i m insofar as they c o n t r i b u t e to the analytic experience. E v e n t u a l l y , it is n o t the patient's individual psychological space b u t —to a large degree —the analytic space t h a t constitutes t h e space in which t h e patient's unconscious i n t e r n a l d r a m a is experienced. T h e evolution of this process includes, b u t is by n o m e a n s limited to, that which is usually referred to as the e l a b o r a t i o n of the transference neurosis a n d t h e transference psychosis. 4 T h a t which constitutes analytic space is individual to each analytic p a i r . J u s t as each m o t h e r l e a r n s (often t o h e r surprise) t h a t t h e process of c r e a t i n g a p l a y space differs greatly with each of h e r children, the analyst m u s t learn t h a t t h e process of creating analytic space is different with e a c h a n a l y s a n d ( G o l d b e r g , 1989). I n t h e s a m e From this perspective, the termination phase of an analysis is not simply a phase of resolution of conflicted unconscious transference meanings. As importantly, it is a period of the "contraction" of the analytic space such that the patient comes to experience himself as constituting the space within which he lives and within which the analytic process continues. If this does not occur, the prospect of the end of the analysis is experienced as tantamount to the loss of one's mind, or the loss of the space in which one feels alive.


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way t h a t each infant's u n i q u e c h a r a c t e r d r a w s u p o n a n d b r i n g s to life specific aspects of the e m o t i o n a l potential of t h e m o t h e r , t h e analyst m u s t allow himself to be c r e a t e d / m o l d e d by his p a t i e n t in reality as well as in p h a n t a s y . Since t h e infant has a role in creating his m o t h e r , n o two infants ever h a v e t h e s a m e m o t h e r . Similarly, n o two p a t i e n t s ever h a v e t h e s a m e analyst. T h e analyst experiences himself differently, a n d b e h a v e s in a subtly different m a n n e r , in each analysis. M o r e o v e r , this is n o t at all a static p h e n o m e n o n : in the course of e a c h analysis the analyst u n d e r g o e s psychological c h a n g e w h i c h in t u r n is reflected in the w a y h e conducts the analysis. M o r e seriously d i s t u r b e d patients m a y experience t h e analytic space as a v a c u u m which t h r e a t e n s to suck o u t of t h e m their m e n t a l contents (which are concretely experienced as bodily p a r t s o r contents). O n e such p a t i e n t b e g a n the first m e e t i n g by b a r r a g i n g m e with a n u n i n t e r r u p t e d series of obscenities. T a k e n aback b y the o n s l a u g h t , I decided to allow the patient to h a v e his say a n d to observe t h e i m p a c t t h a t he was h a v i n g on m e . It b e c a m e a p p a r e n t t h a t his b a r r a g e was far m o r e a n x i o u s t h a n it was hostile. After a b o u t five m i n u t e s , I said to h i m t h a t I t h o u g h t it was n o t easy for h i m to b e t h e r e with m e . H e quieted d o w n as I said this. I t h e n . t o l d h i m t h a t I t h o u g h t he h a d e m p t i e d his g a r b a g e into m e b e c a u s e he did n o t m i n d giving u p a p a r t of himself that he did not v a l u e . I said t h a t I guessed he h a d m o r e i m p o r t a n t things inside of h i m t h a t he felt he n e e d e d to p r o t e c t . Following this i n t e r v e n t i o n , t h e patient was able to tell m e m o r e a b o u t himself, albeit in a psychotic w a y . I, in t u r n , discussed with h i m t h e little bit of w h a t I t h o u g h t I u n d e r s t o o d of w h a t h e was telling m e . A l m o s t all of w h a t I said was a d d r e s s e d to the patient's fears a b o u t . b e i n g with m e .

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The Primitive Edge of Experience Anxious

Questioning

A n a l y s a n d s often pose direct questions in the initial m e e t i n g . A few of these I will a n s w e r directly. F o r e x a m p l e , I will in a "matter-of-course" w a y ( F r e u d , 1931, p. 131) a n s w e r t h e patient's questions a b o u t m y t r a i n i n g o r m y fee. M o s t questions, h o w e v e r , I d o n o t a n s w e r , including questions about whether I have a particular specialty, with which "school of psychoanalysis" I a m associated, w h e t h e r I see m o r e m e n t h a n w o m e n in m y practice, w h e t h e r I consider h o m o s e x u a l i t y to b e a n illness, a n d the like. T h e s e sorts of q u e s t i o n s a r e treated as r a t h e r u n d i s g u i s e d s t a t e m e n t s of the patient's p h a n t a sies a b o u t the specific ways in which I will fail -to u n d e r s t a n d h i m , d u e to m y own psychological difficulties, such as a fear of w o m e n o r m e n , a fear of h o m o sexuality o r heterosexuality, a n e e d to d o m i n a t e or s u b m i t to others, a n d so o n . W h e n a p a t i e n t persistently asks q u e s t i o n after question, I often say to h i m t h a t it m u s t feel too d a n g e r o u s to wait to see w h a t h a p p e n s between us; t h a t instead of waiting, the p a t i e n t seems to be t r y i n g to s a m p l e the future t h r o u g h t h e answers to his q u e s t i o n s , t h e r e b y short-circuiting t h e tension c o n n e c t e d with w a i t i n g . V e r y often t h e a n a l y s a n d uses q u e s t i o n s in a n a t t e m p t to get the analyst to fill the analytic s p a c e b e c a u s e the patient feels t h a t his own i n t e r n a l c o n t e n t s are shameful, d a n g e r o u s , worthless, a n d / o r in n e e d of protection from the analyst, or t h a t t h e r e is n o t h i n g at all inside of h i m with which to occupy the analytic space. O t h e r p a t i e n t s m a y quickly fall silent, t h u s inviting the analyst to fill the space with his (the analyst's) questions a n d therefore with t h e analyst's psychological o r g a n i z a tion, chain of associations, curiosity, a n d t h e like. U n d e r

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such circumstances, I a t t e m p t to talk with t h e patient a b o u t the aspect of his anxiety t h a t I t h i n k I u n d e r s t a n d . I n so d o i n g I m a k e it clear t h a t m y u n d e r s t a n d i n g is tentative, a n d t h a t in all likelihood it is q u i t e lacking in m a n y ways. I n this w a y , I invite t h e p a t i e n t to tell m e which parts of w h a t I h a v e said seem t r u e to h i m a n d w h i c h parts seem off t h e m a r k .

Creating

a

History

T h e question often arises as to w h e t h e r o n e "takes a history" in t h e initial m e e t i n g . T h e very form of the question seems to m e to h a v e significance. I a t t e m p t not to "take" a history from a p a t i e n t (by m e a n s of a series of questions), a n d instead m a k e every effort to allow t h e patient to give m e his conscious a n d u n c o n s c i o u s versions of his history in his o w n w a y . 5 T h e p a t i e n t h a s c o m e to see the the analyst for help with psychological p a i n , the n a t u r e of which h e (the patient) is often u n a b l e to accurately n a m e . H e m u s t be afforded all the t i m e a n d r o o m t h a t he n e e d s to tell the analyst, in w h a t e v e r w a y he h a s available to h i m , w h a t he k n o w s a b o u t himself. It is 5

It is essential to keep in mind that a patient's history 'is not a static entity that is gradually unearthed; rather, it is an aspect of the patient's conscious and unconscious conception of himself that is in a continual state of evolution and flux. In a sense, the patient's history is continually being created and re-created in the course of the analysis. Moreover, it is by no means to be assumed that the patient has a history (that is, a sense of historicity) at the beginning of analysis. In other words, we cannot take for granted the idea that the patient has achieved a sense of continuity of self over time, such that his past feels as if it is connected to his experience of himself in the present.

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i m p o r t a n t t h a t t h e analyst n o t interfere with the patient's efforts b y i n t r o d u c i n g a n a g e n d a of his o w n , b y d o i n g such things as collecting historical d a t a , m a k i n g treatm e n t r e c o m m e n d a t i o n s , o r l a y i n g out t h e " g r o u n d rules" of analysis (cf. F r e u d , 1913; see also S h a p i r o , 1984). I n the course of the patient's telling the analyst, h o w e v e r indirectly, a b o u t the n a t u r e of his p a i n ( a n d t h e w a y s he consciously a n d / o r unconsciously expects this p a i n to b e c o m e e x a c e r b a t e d in t h e course of analysis), his past experience will be articulated in two ways. First, to t h e extent t h a t the p a t i e n t tells the analyst a b o u t his u n d e r s t a n d i n g of the origins of his difficulties, he will be giving the analyst o n e form of historical d a t a — t h a t w h i c h t h e patient consciously conceives of as his past. I n e v i t a b l y t h e r e will be gaps, vaguenesses, o r complete omissions of l a r g e sectors of the patient's life experience. F o r e x a m p l e , a p a t i e n t m a y omit a n y reference to a given family m e m b e r , m a k e n o m e n t i o n of his sexual experience, or be silent a b o u t e v e r y t h i n g t h a t o c c u r r e d prior to the c u r r e n t crisis o r prior to his adolescence. U n d e r such c i r c u m stances, w h e n I feel t h a t t h e p a t i e n t has told m e w h a t h e w a n t s to a n d w h a t he is able t o , I m a y ask h i m if he h a s noticed his n o t m e n t i o n i n g , for e x a m p l e , a n y t h i n g a b o u t his father. ( T h i s is essentially a process of a d d r e s s i n g t h e patient's relationship to his external a n d internal objects from the point of view of resistance; t h a t is, from t h e point of view of the patient's conscious a n d u n c o n s c i o u s object-related anxiety.) As with a n y c o m m e n t a d d r e s s i n g resistance, it is n o t t h e information "behind" t h e resistance that is of central c o n c e r n ; the focus is o n w h a t it is t h a t the patient is afraid will h a p p e n if he tells the analyst a b o u t a given aspect of his i n t e r n a l life, a n d a b o u t his ways of p r o t e c t i n g himself a g a i n s t this d a n g e r . F r o m this perspective, t h e act of " t a k i n g a history" (by m e a n s of direct i n q u i r y ) is a form of

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o v e r r i d i n g the patient's resistances a n d t h e r e b y losing a good d e a l of w h a t is m o s t i m p o r t a n t to t h e analysis —for e x a m p l e , a n u n d e r s t a n d i n g of w h o in the patient's int e r n a l object world w o u l d be b e t r a y e d , injured, killed, lost, m a d e j e a l o u s , a n d so o n , if the patient were to talk a b o u t his feelings a b o u t "the past"; or w h a t sort of loss of control over the patient's relationships to his i n t e r n a l objects would be experienced in his giving u p exclusive access to t h e m . T h e second form of personal history provided b y t h e p a t i e n t is d a t a conveyed unconsciously in the form of t h e t r a n s f e r e n c e - c o u n t e r t r a n s f e r e n c e experience. T h i s is t h e patient's "living past," the set of object relations established in infancy a n d early childhood which h a s c o m e to constitute the s t r u c t u r e of the patient's m i n d , b o t h as c o n t e n t a n d context of his psychological life. It is therefore this past t h a t is of c e n t r a l analytic interest. O f course, the two forms of history u n d e r discuss i o n — t h e consciously symbolized past a n d the u n c o n scious living past —are i n t i m a t e l y intertwined. As the patient's internal object world is given intersubjective life in t h e t r a n s f e r e n c e - c o u n t e r t r a n s f e r e n c e d u r i n g analysis, b o t h p a t i e n t a n d analyst h a v e a n o p p o r t u n i t y to directly e x p e r i e n c e the forms of a t t a c h m e n t , hostility, j e a l o u s y , e n v y , a n d the like constituting t h e patient's i n t e r n a l object w o r l d . I n the t r a n s f e r e n c e - c o u n t e r t r a n s f e r e n c e , t h e past a n d the present converge as "old" contents are b r o u g h t to life in a n e w context, t h e context of the analytic relationship.

Concluding

Comments

T h e ideas t h a t I h a v e discussed in this c h a p t e r a r e simply t h a t —ideas. T h e y are not i n t e n d e d to be used as rules o r guidelines, n o r are t h e y i n t e n d e d as a s t a t e m e n t of h o w

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t h e initial analytic m e e t i n g should b e c o n d u c t e d . At the s a m e t i m e , the t h o u g h t s discussed h e r e a r e t h o u g h t s of a specific n a t u r e —they a r e psychoanalytic t h o u g h t s . T h i s r e p r e s e n t s o n e of the dialectics c o n s t i t u t i n g p s y c h o a n a lytic t e c h n i q u e : analytic t e c h n i q u e is g u i d e d by a set of ideas t h a t a r e roughly recognizable as f o r m i n g a m e t h o d o r g r o u p of m e t h o d s , with a set of principles t h a t gives coherence to this g r o u p of m e t h o d s . From, the first m e e t i n g , analytic practice occurs b e t w e e n the poles of the p r e d i c t a b l e a n d the u n p r e d i c t a b l e , t h e disciplined a n d t h e s p o n t a n e o u s , t h e m e t h o d i c a l a n d t h e intuitive.

Summary T h e initial face-to-face analytic m e e t i n g is v i e w e d as t h e b e g i n n i n g of the analytic process a n d n o t m e r e l y as a p r e p a r a t i o n for it. I n the first m e e t i n g all t h a t was familiar to t h e patient is n o longer t r e a t e d as self-evident. T h e a n a l y s a n d takes o n a form of significance for himself t h a t he h a s n e v e r held before. T h e analyst a t t e m p t s to convey to t h e patient s o m e t h i n g of w h a t it m e a n s to be in analysis, n o t by m e a n s of e x p l a n a t i o n s of t h e analytic process, b u t b y c o n d u c t i n g himself as a n analyst. T o this e n d , psychological strain is n o t dissipated t h r o u g h reass u r a n c e , suggestion, transference or c o u n t e r t r a n s f e r e n c e , acting o u t , a n d so o n . All t h a t t h e p a t i e n t says ( a n d does n o t say) in the initial m e e t i n g is u n d e r s t o o d as a n u n c o n s c i o u s w a r n i n g to the analyst ( a n d to the patient) c o n c e r n i n g t h e reasons w h y t h e p a t i e n t unconsciously feels t h a t e a c h of t h e m would be well advised not to e n t e r into this d o o m e d a n d d a n g e r o u s relationship. T h e analyst a t t e m p t s to u n d e r s t a n d the patient's w a r n i n g s in t e r m s of transference anxiety a n d resistance.

8 M i s r e c o g n i t i o n s F e a r

1

of

N o t

a n d

t h e

K n o w i n g

T h e w o r k of a g r o u p of British a n d F r e n c h psychoanalytic t h i n k e r s , i n c l u d i n g Bion, L a c a n , M c D o u g a l l , T u s t i n , a n d W i n n i c o t t , has led m e to u n d e r s t a n d certain psycho^ logical difficulties in t e r m s of a n u n c o n s c i o u s fear of notk n o w i n g . W h a t t h e individual is n o t able to k n o w is w h a t he feels, a n d therefore w h o , if a n y o n e , he is. T h e patient regularly creates the illusion for himself ( a n d secondarily for others) t h a t he is able to g e n e r a t e t h o u g h t s a n d feelings, wishes a n d fears that feel like his o w n . Althougl this illusion constitutes a n effective defense against t h e t e r r o r of n o t k n o w i n g what o n e feels o r w h o o n e is, it further alienates the individual from himself. T h e illusion of k n o w i n g is achieved t h r o u g h the creation o f - a - w i d e . — , r a n g e _ o f substitute formations t h a t fill t h e / " p o t e n t i a l ^ s p>ace a c e ^,W in w wm h iccnh adesire \ Wi ni nnniiccoott tt ,, i1971d) y / i a ; in e s i r e aainmd ifear, cai^ V_ap9pettte„.andfullness, love a n d h a t e mighTofherwise c o m e into being.—— ~—___^^ (The "misrecognitions*} t h a t a r e u s e d ^ a s defenses a g a i n s T l h e - f e a r - o f l i o t k n o w i n g r e p r e s e n t a less e x t r e m e . 195

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form of alienation from affective experience t h a n "alexi t h y m i a " ( N e m i a h , 1977), states of "non-experience" ( O g d e n , 1980, 1982b), a n d "disaffected" states ( M c D o u g a l l , 1984), w h e r e i n potential feelings a n d p h a n t a s i e s a r e foreclosed from the psychological sphere. It is also a less e x t r e m e psychological c a t a s t r o p h e t h a n schizophrenic f r a g m e n t a t i o n w h e r e i n t h e r e is v e r y little of a self c a p a b l e of creating, shaping, a n d o r g a n i z i n g t h e internal a n d e x t e r n a l stimuli that ordinarily constitute experience. T h e p a t i e n t s I will be focusing u p o n h a v e t h e capacity to g e n e r a t e a sense of self sufficiently integrated a n d sufficiently b o u n d e d to e n a b l e t h e m to k n o w t h a t they d o n o t k n o w . T h a t is, these a r e p a t i e n t s w h o a r e able to experience t h e b e g i n n i n g s of feelings of confusion, e m p t i n e s s , d e s p a i r , a n d p a n i c , as well as b e i n g able to mobilize defenses against these incipient feelings. A s will be discussed, in t h e course of a n infant's d e v e l o p m e n t a sense of self evolves in the context of t h e m a n a g e m e n t of need b y t h e m o t h e r - i n f a n t pair. W h e n t h e m o t h e r c a n satisfactorily tolerate the recognition of h e r o w n desires a n d fears, she is less afraid of the states of t e n s i o n g e n e r a t e d by h e r infant that a r e in the process of b e c o m i n g feelings. W h e n t h e m o t h e r is c a p a b l e of t o l e r a t i n g t h e infant's tension o v e r t i m e , it is possible for h e r to r e s p o n d to a given tension state as a quality of the infant's b e i n g alive.

A Theoretical

Background

T h e d e v e l o p m e n t of the idea of misrecognitions of one's i n t e r n a l state is in a sense s y n o n y m o u s with the developm e n t of psychoanalytic theory. O n e of the cornerstones u p o n w h i c h F r e u d constructed his t h e o r y of psychological

J

Misrecognitions and the Fear of Not Knowing

197

m e a n i n g s is t h e idea t h a t o n e k n o w s m o r e t h a n he t h i n k s 1 heTtnows. T h e c r e a t i o n o f psychological defenses c a n b e u n d e r s t o o d as the o r g a n i z a t i o n of systematic misrecogni- ^ tions (for e x a m p l e , it is n o t m y a n g e r t h a t I fear, it is y o u r s ) . F r e u d (1911b), in his discussion of the S c h r e b e r case, explored the idea t h a t psychosis involves the misrecognition of one's internal state t h r o u g h its a t t r i b u t i o n to e x t e r n a l objects. It is b e y o n d the scope of this c h a p t e r to review, o r even list, t h e m u l t i t u d e of c o n t r i b u t i o n s to t h e question of psychological misrecognition a n d the defenses associated with it. I n t h e following pages, h o w e v e r , I will briefly discuss a g r o u p of concepts developed by F r e n c h a n d L a c a n (1948) believed t h a t F r e u d in his later w o r k ^ "seems s u d d e n l y to fail to recognize the existence of e v e r y t h i n g t h a t the ego neglects, scotomizes, misconstrues in t h e sensations" (p. 22). Lacan's (1953) u n d e r - ^ s t a n d i n g of t h e ego as t h e psychic agency of meconnaissanceh (misrecognition) derives from his conception of the place j of t h e ego in relation b o t h to l a n g u a g e a n d to the i m a g i n a r y and_symbolic o r d e r s of experience. T h e r e a l m of t h e ^ u n a g i n a r u is t h a t of vital, u n m e d i a t e d , lived e x p e r i e h c © r - 1 r f m i s r e a l m , thpre if; n o space b e t w e e n oneself a n d one's experience. T h e acquisition of l a n g u a g e p r o v i d e s t h e individual a m e a n s b y which to m e d i a t e b e t w e e n the self as i n t e r p r e t i n g subject a n d one's lived experience. Since l a n g u a g e a n d the chain of signifiers t h a t constitute l a n g u a g e p r e d a t e e a c h of us as individuals, t h e register of symbols -that is m a d e available to u s t h r o u g h l a n g u a g e has n o t h i n g to d o with us as individuals. W e d o n o t _ c r e a t e j t h e symbols we use* we inherit t h e m . A s a result, l a n g u a g e m i s r e p r e s e n t s t h e u n i q u e n e s s

l

198


of o u r own lived experience: "It [language] is susceptible to every alienation o r lie, wilful o r not, susceptible to all t h e distortions inscribed in t h e very principles of t h e 'symbolic,' conventional d i m e n s i o n of g r o u p life" ( L e m a i r e , 1970, p. 57). I n b e c o m i n g a subject c a p a b l e of u s i n g symbols to r / i n t e r p r e t o u r experience, r a t h e r t h a n simply b e i n g T r a p p e d in o u r own lived sensory experience, we exc h a n g e o n e form of i m p r i s o n m e n t for a n o t h e r . W e a c q u i r e h u m a n subjectivity at the cbsfôf""Becoming p r o f o u n d l y alienated from o u r i m m e d i a t e sensory experience (which is n o w distorted a n d m i s r e p r e s e n t e d by t h e symbols we use to n a m e it). I n this way, we u n w i t t i n g l y e n g a g e in a form of self-deception, c r e a t i n g for ourselves the illusion that we express o u r experience in l a n g u a g e , while we a r e in fact, a c c o r d i n g to L a c a n , m i s n a m i n g a n d b e c o m i n g alienated from o u r experience. J o y c e M c D o u g a l l , a n i m p o r t a n t c o n t r i b u t o r to the F r e n c h psychoanalytic dialogue, h a s discussed h e r work with p a t i e n t s w h o seemed "totally u n a w a r e [and t h u s kept the analyst u n a w a r e ] of the n a t u r e of their affective reactions" (1984, p. 388). She u n d e r s t a n d s this p h e n o m e n o n as a dispersal of potential affect into a variety of addictive actions i n c l u d i n g d r u g abuse, compulsive sexuality, b u l i m i a , "accidental" injuries, a n d i n t e r p e r s o n a l crises. S u c h addictive activities are u n d e r s t o o d as compulsive ways of defending against psychotic-level anxieties. As the defensive use of t h e affect-dispersing action b e c o m e s overtaxed, the individual engages in psychoso^ r T h a t i c foreclosure an&^psychosornatic misinterpretation?' f ( M c D o u g a l l , 1989) of e v e n t s i n t h e ^ s y c h o l o g i c a l sphere. U n d e r such circumstances, w h a t m i g h t h a v e b e c o m e a symbolically r e p r e s e n t e d affective experience is relegated to the d o m a i n of the physiologic a n d b e c o m e s discon-


199

nected from the r e a l m of conscious a n d u n c o n s c i o u s m e n t a l representations. S u c h a conception of the destruction not only of psychological m e a n i n g , b u t of t h e a p p a r a t u s e s g e n e r a t i n g psychological m e a n i n g , r e p r e s e n t s a n elaboration of t h e w o r k of Wilfred Bion. Bion (1962) suggests t h a t in s c h i z o p h r e n i a ( a n d to lesser degrees in all personality organizations), there is a defensive attack on the psychological processes by which m e a n i n g is attached to experie n c e . T h i s represents a s u p e r o r d i n a t e defense in w h i c h psychological p a i n is w a r d e d off, n o t simply t h r o u g h defensive r e a r r a n g e m e n t s of m e a n i n g (such as projection a n d displacement) a n d i n t e r p e r s o n a l evacuation of end a n g e r e d a n d e n d a n g e r i n g i n t e r n a l objects (projective identification); in a d d i t i o n , t h e r e is an attack o n the psychological processes b y w h i c ^ m e a n i r i g - i t s e l f is crea t e d . T h e o u t c o m e is a state of/"non-experiencj" ( O g d e n , 1980, 1982b) in which the i n d i v i d u a l liveTârtly in a state of psychological d e a d n e s s — t h a t is, t h e r e a r e sectors of his personality in which e v e n u n c o n s c i o u s m e a n i n g s a n d affects cease to be e l a b o r a t e d . I n the course of his writing, W i n n i c o t t developed t h e concept of a "potential space" in which self-experience is c r e a t e d a n d recognized ( W i n n i c o t t , 1971d; see also O g - \ p r d e n , 1985b, 1986). \Potential space\is the^gpace in which the object is simultaneously created.and.discoy.ered / T h a t is, in this spaceT^Heobject is simultaneously.a-subjective—object (an object o m n i p o t e n t l y created) a n d a n object objectively perceived ( a n object experienced as lying outside~of th£Lrealm-QLQne.'s-omnipotenqe). T h e q u e s t i o n of w h i c h is the case —is the object created or discovered — n e v e r arises ( W i n n i c o t t , 1951). T h i s question is simply n o t a p a r t of the e m o t i o n a l v o c a b u l a r y of this a r e a of experience. W e do n o t m o v e t h r o u g h , o r grow o u t of, this

200


state of m i n d . It is n o t a d e v e l o p m e n t a l phase; r a t h e r , it is a psychological space between reality a n d p h a n t a s y t h a t is m a i n t a i n e d t h r o u g h o u t one's life. It is the space in which p l a y i n g occurs; it is t h e space in which we a r e .creative in the most o r d i n a r y sense of the w o r d ; it is t h e / s p a c e in which we experience ourselves as alive a n d as t h e / a u t h o r s of o u r bodily sensations, t h o u g h t s , feelings, a n d / p e r c e p t i o n s . In the absence of the capacity to g e n e r a t e / potential space, one relies on defensive substitutes for t h e / experience of b e i n g alive (such as t h e d e v e l o p m e n t of a I False Self personality organization [ W i n n i c o t t , 1960b]). T h e "fear o f ^ r x a I c d o w a ' ^ d e 8 e i 4 b e c U ^ ~ v V i p n i r Q t r (1974) r e p r e s e n t s a form of failure to g e n e r a t e experience in which t h e patient is terrified of e x p e r i e n c i n g for the first t i m e a c a t a s t r o p h e that h a s a l r e a d y occurred. T h e very early e n v i r o n m e n t a l failure t h a t constituted t h e c a t a s t r o p h e could not be experienced at the t i m e that it o c c u r r e d , b e c a u s e t h e r e was n o t yet a self capable of e x p e r i e n c i n g it —that is, capable of e l a b o r a t i n g the event psychologically, a n d of i n t e g r a t i n g it. As a result, the p a t i e n t forever fearfully awaits his o w n psychological breakdown. In this c h a p t e r I address a specific facet of the p h e n o m e n o n of the alienation from, a n d destruction of, experience. M y focus is on the anxiety associated with the d i m a w a r e n e s s t h a t o n e does n o t k n o w w h a t one feels a n d therefore does n o t k n o w w h o o n e is. I n this psychological state, the individual h a s not foreclosed experience psychosomatically o r failed to psychologically elaborate early experience, n o r h a s he entered into a state of "nonexperience." T h e patients discussed h e r e h a v e often att e m p t e d , b u t h a v e n o t entirely succeeded in, w a r d i n g off the anxiety of n o t k n o w i n g by m e a n s of addictive actions. T h e form of experience t h a t I a m interested in h e r e is o n e


201

in which t h e individual is sufficiently c a p a b l e of generating a space in which to live such t h a t h e is capable of k n o w i n g t h a t h e does n o t k n o w ; he n e v e r entirely frees himself of this t e r r o r , m u c h as he unconsciously a t t e m p t s to l u r e himself a n d the analyst i n t o m i s t a k i n g his systematic misrecognitions for g e n u i n e self-experience. Such experience is universal a n d is manifested in a wide variety of forms t h a t reflect the individual's personality organization.

A Developmental

Perspective

At the outset, it is the infant's r e l a t i o n s h i p with his m o t h e r t h a t is t h e m a t r i x within which psychological tension is sustained o v e r t i m e sufficiently for m e a n i n g s to be created a n d desire a n d fear to be g e n e r a t e d . For e x a m p l e , w h a t will b e c o m e h u n g e r is initially only a physiologic event (a certain blood sugar level registered by groups of n e u r o n s in t h e b r a i n ) . T h i s biological e v e n t b e c o m e s t h e experience of h u n g e r a n d desire (appetite) in t h e context of t h e m o t h e r ' s conscious a n d u n c o n s c i o u s response to the infant: h e r h o l d i n g , touching, n u r s i n g , a n d rocking t h e infant a n d e n g a g i n g in other activities t h a t reflect h e r u n d e r s t a n d i n g of (her conscious a n d u n c o n s c i o u s reson a n c e with) h i m ( W i n n i c o t t , 1967b). S u c h u n d e r s t a n d ings a n d a t t e n d a n t activities are t h e o u t c o m e of. a crucial psychological function provided b y the m o t h e r : the psychological process by which t h e m o t h e r a t t e m p t s to r e s p o n d to h e r infant in a way t h a t "correctly n a m e s " (or gives s h a p e to) t h e infant's internal state. T h e w o r k of Bick (1968), M e l t z e r (1975), a n d T u s t i n (1981, 1986) h a s afforded analytic t h e o r y a w a y of conceptualizing the earliest o r g a n i z a t i o n of experience

202


into s e n s a t i o n - d o m i n a t e d forms i n c l u d i n g autistic shapes ("felt shapes" [ T u s t i n , 1984]) a n d autistic objects ( T u s t i n , 1980). I n t h e d e v e l o p m e n t of " n o r m a l a u t i s m " (what I h a v e t e r m e d t h e e l a b o r a t i o n of the autistic-contiguous position [see C h a p t e r s 2 a n d 3]), the infant in t h e context of the m o t h e r - i n f a n t relationship achieves t h e earliest sense of b o u n d e d n e s s , t h e sense of h a v i n g (being) a place ( m o r e specifically, a surface) w h e r e one's e x p e r i e n c e occurs a n d w h e r e a sense of o r d e r a n d c o n t a i n m e n t is g e n e r a t e d . I n the earliest m o t h e r - i n f a n t relationship, the m o t h e r m u s t b e c a p a b l e of i m m e r s i n g herself in the infant's sensory w o r l d as she allows herself to d e - i n t e g r a t e into relative shapelessness. T h i s r e p r e s e n t s the sensory level of p r i m i t i v e e m p a t h y . T h e m o t h e r allows h e r identity as a p e r s o n a n d as a m o t h e r to "become liquid" (Scale, 1987) in a w a y t h a t parallels the i n t e r n a l state of the infant. T h i s "de-integration" ( F o r d h a m , 1977) is not experienced b y the m o t h e r as disintegration w h e n she is able to create for herself a generative dialectical tension between t h e shapeless a n d the formed, t h e p r i m i t i v e a n d the m a t u r e , the m y s t e r i o u s a n d the familiar, t h e act of b e c o m i n g a m o t h e r for the first t i m e a n d t h e experience of h a v i n g "been h e r e before" (in h e r identification with facets of h e r experience with h e r own m o t h e r ) . I n this way, the m o t h e r helps t h e infant give s h a p e , b o u n d e d ness, r h y t h m , e d g e d n e s s , h a r d n e s s , softness, a n d so on to his experience. T h e m o t h e r a n d infant m u s t a t t e m p t to sustain the strain of the v e r y inexact, t r i a l - a n d - e r r o r m e a n s by which each a t t e m p t s to "get to know" the o t h e r . T h e m o t h e r ' s efforts at u n d e r s t a n d i n g , comforting, a n d in other ways p r o v i d i n g for a n d i n t e r a c t i n g with h e r infant a r e inevitably narcissistically w o u n d i n g to the m o t h e r since she will often feel at a loss to k n o w w h a t it is h e r b a b y needs

203


a n d w h e t h e r it is w i t h i n the p o w e r of h e r personality to provide it e v e n if she s o m e h o w could discover w h a t he "wants." W i n n i c o t t ' s (1974) use of the w o r d agonies to refer to infantile anxieties applies equally to the p a i n of t h e m o t h e r ' s experience of not k n o w i n g .

The Structuralization

of

Misrecognition

T h e early relationship t h a t is of central interest in t h e analytic setting is n o t t h a t of m o t h e r a n d infant, b u t t h a t of the i n t e r n a l object m o t h e r a n d the i n t e r n a l object infant. T h i s i n t e r n a l object relationship is manifested in the transference-countertransference p h e n o m e n a that constitute the analytic d r a m a . A m o t h e r - i n f a n t relationship is n e v e r directly observable in the analytic setting even w h e n t h e p a t i e n t is a m o t h e r d e s c r i b i n g c u r r e n t experience with h e r child. I n s t e a d , w h a t we observe, a n d in p a r t experience, in analysis is a reflection of internal object relations ( o u r o w n a n d the patient's, a n d t h e interplay b e t w e e n t h e two). T h e r e f o r e , w h e n I speak of t h e i n t e r n a l relationship between m o t h e r a n d infant, it m u s t be b o r n e in m i n d t h a t the p a t i e n t is b o t h m o t h e r a n d infant. T h i s is so b e c a u s e a n internal object relationship consists of a relationship between two u n c o n s c i o u s aspects of the p a t i e n t , o n e identified with the self a n d the other identified with the object in the original relationship ( O g d e n , 1983). R e g a r d l e s s of how fully a u t o n o m o u s a n internal object m a y seem to the p a t i e n t , the i n t e r n a l object c a n h a v e n o life of its o w n aside from that deriving from the aspect of the self involved in this identification. I n w h a t follows I describe a set of pathological internal m o t h e r - i n f a n t relationships in w h i c h t h e p a t i e n t is b o t h

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m o t h e r a n d infant, b o t h the m i s - n a m e r a n d t h e misn a m e d , b o t h t h e confused a n d t h e confusing. T h e ( i n t e r n a l object) m o t h e r m a y defend against t h e feeling of n o t k n o w i n g by utilizing obsessive-compulsive defenses, for e x a m p l e , by relying on rigidly scheduled (symbolic) feedings of t h e (internal object) infant. I n this way, the m o t h e r (in this internal object relationship) invokes a n i m p e r s o n a l external o r d e r (the clock) to m i s n a m e h u n g e r . T h e infant is r e s p o n d e d to as if h e w e r e sated every four h o u r s a n d as if h e w e r e n o t h u n g r y b e t w e e n the scheduled feedings. S u c h m i s n a m i n g generates confusion- in t h e infant as well as a sense t h a t h u n g e r is a n externally g e n e r a t e d event. I n the e x t r e m e this m o d e of defense against n o t k n o w i n g b e c o m e s a persecutory a u t h o r i t a r i a n substitution of the m o t h e r ' s absolute knowle d g e for t h e infant's potential to g e n e r a t e his own t h o u g h t s , feelings, a n d sensations. M o t h e r s e n a c t i n g this sort of i n t e r n a l object relationship in their actual relationships to their o w n children a r e often "psychologically m i n d e d " a n d offer v e r b a l interpretations of their children's unconscious feeling states. F o r e x a m p l e , a m o t h e r b e i n g seen in analysis informed h e r 7-year-old child t h a t even t h o u g h h e claimed to be d o i n g the best j o b t h a t he could in l e a r n i n g to r e a d , t h e t r u t h of the m a t t e r w a s t h a t h e was a n g r y at h e r a n d was d o i n g a p o o r j o b of it b e c a u s e he k n e w precisely h o w to drive h e r crazy. S u c h "interpretations" m a y be partially a c c u r a t e ( d u e to t h e universality of such u n c o n s c i o u s feelings as a n g e r , j e a l o u s y , a n d envy in a m o t h e r - c h i l d relationship); b u t such c o m m e n t s p r e d o m i n a n t l y h a v e the effect of m i s n a m i n g the child's internal state. T h e effect of such i n t e r p r e t a t i o n is t h e creation in the child of a feeling t h a t he has n o idea h o w he "really feels" a n d t h a t only his m o t h e r has t h e capacity to k n o w this. T h i s patient's


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b e h a v i o r in relation to h e r child r e p r e s e n t e d a n e n a c t m e n t of an i n t e r n a l object relationship derived from h e r own experience with a m o t h e r w h o h a d used f u n d a m e n t a l i s t religious d o g m a in the misrecognition of t h e patient's childhood feeling states. W h e n such a relationship becomes established in t h e patient's i n t e r n a l object world, t h e role of this type of internal object m o t h e r is t h e n projected o n t o t h e analyst. As a result, t h e p a t i e n t comes to experience the analytic setting as a n e x t r e m e l y d a n g e r ous, a u t h o r i t a r i a n o n e w h e r e i n the analyst will certainly t e a r a p a r t the patient's c h a r a c t e r s t r u c t u r e ( i n c l u d i n g his conscious e x p e r i e n c e of himself) a n d "interpret" the shameful t r u t h r e g a r d i n g the patient's u n c o n s c i o u s t h o u g h t s a n d feelings. T h e analyst m a y unwittingly be i n d u c e d (as a n unconscious p a r t i c i p a n t in the patient's projective identification) to e n a c t t h e role of such a n a u t h o r i t a r i a n i n t e r n a l object m o t h e r (cf. O g d e n , 1982b). U n d e r such c i r c u m s t a n c e s t h e analyst m a y find himself i n t e r p r e t i n g m o r e "actively" a n d "deeply" t h a n is his u s u a l practice. H e m a y c o m e to view t h e analysis as b o g g e d d o w n , a n d to despair of the patient's ever a r r i v i n g at m e a n i n g f u l insight. T h e analyst m a y rationalize t h a t he n e e d s to use a m o r e didactic a p p r o a c h with the p a t i e n t in o r d e r to d e m o n s t r a t e to h i m w h a t it m e a n s "to t h i n k reflectively a n d in d e p t h . " Alternatively, the analyst m a y feel m o v e d to p u r s u e a line of analytic t h i n k i n g espoused by his "school of psychoanalysis," or based u p o n a n idea a b o u t which he h a s recently r e a d . R e l i a n c e u p o n analytic ideology r e p r e s e n t s a c o m m o n m e t h o d of w a r d i n g off the analyst's anxiety of n o t k n o w i n g . Balint (1968) h a s suggested t h a t t h e K l e i n i a n techn i q u e of "consistent i n t e r p r e t a t i o n " r e p r e s e n t s a c o u n t e r transference a c t i n g o u t of t h e role of a n omniscient

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i n t e r n a l object. F r o m t h e perspective of t h e ideas b e i n g explored in t h e p r e s e n t c h a p t e r , the analyst's u n c o n s c i o u s identification with t h e omniscient i n t e r n a l object m o t h e r represents a form of defense against the a n x i e t y of n o t k n o w i n g w h a t it is t h e patient is e x p e r i e n c i n g . ( O b v i ously, this is so w h e t h e r o r not the analyst is a K l e i n i a n . ) T h e patient's i n t e r n a l version of a n early object relationship is in this w a y b e i n g replicated in the analytic setting, a n d unless a n a l y z e d in the c o u n t e r t r a n s f e r e n c e a n d in the transference, this will reinforce the patient's u n c o n s c i o u s conviction t h a t it is necessary to utilize o m n i p o t e n t substitute f o r m a t i o n s in the face of confusion a b o u t w h a t he is e x p e r i e n c i n g a n d w h o he is. Analytic c a n d i d a t e s a n d other trainees frequently utilize this type of unconscious identification with a n o m n i p o t e n t i n t e r n a l object (such as a n idealized version of one's o w n analyst). T h i s identification serves as a defense against the anxiety that the c a n d i d a t e does n o t feel like a n analyst w h e n with his patients. Searles (1987) h a s described his own experience d u r i n g his psychiatric residency, w h e r e h e would "prop himself u p " w h e n talking with his p a t i e n t s by authoritatively offering t h e m i n t e r p r e t a t i o n s given to h i m only h o u r s earlier by his analyst. D e c a d e s later, he b e c a m e a w a r e t h a t h e h a d experienced his own analyst ( m o r e accurately his own internal object analyst) as similarly p r o p p e d u p a n d filled with self-doubt. T h i s d e e p e r level of insight reflects t h e w a y in which the omniscient internal object serves as a substitute formation o b s c u r i n g a n u n d e r l y i n g confusion a b o u t who o n e is a n d w h o the object is. Patients m a y also enact the role of t h e omniscient internal object m o t h e r , by d o i n g such things as controllingly i n t e r p r e t i n g t h e analyst's shifting in his c h a i r as a reflection of his anxiety, sexual excitement, a n g e r , or t h e


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like. W h e n consistently subjected to this form of "interpretation" (that is indistinguishable from accusation), t h e analyst m a y unconsciously identify with t h e i n t e r n a l object infant (within t h e patient) who is exposed to c o n t i n u a l m i s n a m i n g of his i n t e r n a l state. A n x i e t y arising in t h e analyst u n d e r s u c h circumstances m a y lead h i m into a form of c o u n t e r t r a n s f e r e n c e acting o u t in which h e a t t e m p t s to "assist t h e patient in reality testing" by d e n y i n g to the p a t i e n t t h a t he (the analyst) is feeling or acting in accord with t h e patient's i n t e r p r e t a t i o n s . A second form of defense against t h e fear of not k n o w i n g how to m a k e sense of the feeling state of t h e internal object infant is t h e unconscious effort on t h e p a r t of t h e patient to act as if he knows w h a t t h e i n t e r n a l object infant is experiencing. I n this w a y h e creates a substitute f o r m a t i o n for t h e feeling of b e i n g at a c o m p l e t e loss to m a k e use of his capacities for u n d e r s t a n d i n g a n d r e s p o n d i n g to the i n t e r n a l object infant. R e l i a n c e on such a set of defenses m a y result in a r a t h e r stereotypic form of self-knowledge. A m o t h e r while in analysis described h e r a t t e m p t s at b e i n g a m o t h e r by i m i t a t i n g t h e m o t h e r s p o r t r a y e d in books a n d on television, b y i m i t a t i n g h e r friends w h o h a d c h i l d r e n , a n d b y i m i t a t i n g the analyst's t r e a t m e n t of h e r . She a t t e n d e d every P T A a n d c u b scout function, a r r a n g e d for s w i m m i n g , t e n n i s , a n d m u s i c lessons, painstakingly b a k e d p u m p k i n pies at T h a n k s giving a n d m i n c e pies at C h r i s t m a s , a n d so o n . T h e schizophrenic child of a n o t h e r such m o t h e r told his m o t h e r , "You've b e e n j u s t like a m o t h e r to m e . " Such m o t h e r s are "just like" m o t h e r s , b u t d o n o t experience themselves ( n o r a r e t h e y experienced by their children) as b e i n g m o t h e r s . T h e self-esteem of such m o t h e r s is brittle, a n d these w o m e n often collapse into depression o r schizoid w i t h d r a w a l as they b e c o m e e m o t i o n a l l y ex-

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h a u s t e d in their efforts at i m i t a t i n g a psychological state from which they feel utterly alienated. A 30-year-old psychologist, D r . M . , in t h e course of his analysis g e n e r a t e d a t r a n s f e r e n c e - c o u n t e r t r a n s f e r ence externalization of t h e form of internal object relationship just described. D u r i n g the first two y e a r s of w o r k , I frequently q u e s t i o n e d the value of the analysis despite the fact t h a t all seemed to be p r o c e e d i n g well. I n t h e third year, the p a t i e n t b e g a n to wryly refer to m e as "the perfect analyst." H e described how he was t h e e n v y of all his colleagues for his u n u s u a l good fortune in h a v i n g the o p p o r t u n i t y to work with m e . O n l y recently h a d he b e g u n to b e c o m e a w a r e of his s t r o n g belief t h a t he a n d I were colluding in a n effort to hide o u r a w a r e n e s s of m y shallowness a n d e x t r e m e e m o t i o n a l d e t a c h m e n t . D r . M . presented a d r e a m in which h e h a d g r a d u a t e d from college b u t was completely illiterate. I n t h e d r e a m , t h e p a t i e n t was u n a b l e to w o r k b e c a u s e he could not r e a d a n d w a s u n a b l e to go b a c k to school for fear of s h a m i n g his teachers. T h i s d r e a m r e p r e s e n t e d D r . M . ' s e m e r g i n g feeling (that h a d b e e n t h e u n c o n s c i o u s context for t h e e n t i r e analysis) that he a n d I were m e r e l y g o i n g t h r o u g h t h e m o t i o n s of analysis. E v e n t u a l l y he would h a v e to p r e t e n d to be "cured," which w o u l d m e a n t h a t he would live in absolute isolation w i t h o u t h o p e of ever genuinely feeling a connection with a n y o n e . I n this case, the i n t e r n a l object relationship t h a t was recreated in the t r a n s f e r e n c e - c o u n t e r t r a n s fere nee involved t h e defensive use of an illusion of perfection (the reliance on form as a r e p l a c e m e n t for c o n t e n t ) as a substitute for the real work of analyst a n d p a t i e n t a w k w a r d l y a n d imprecisely a t t e m p t i n g to talk to one another.


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A t h i r d form of defense against t h e p a i n of feeling utterly confused a b o u t t h a t which the i n t e r n a l object infant is e x p e r i e n c i n g is pathological projective identification. I n this process o n e "knows" the other b y "in p h a n t a s y " o c c u p y i n g t h e o t h e r with one's own t h o u g h t s , feelings, a n d sensations, a n d in this w a y short-circuiting t h e p r o b l e m of t h e externality ( a n d unpredictability) of t h e o t h e r . U n d e r such c i r c u m s t a n c e s , a m o t h e r ( e n a c t i n g a n i n t e r n a l d r a m a in relation to h e r own infant) m a y decide to allow h e r infant to cry for h o u r s on e n d b e c a u s e she "knows" that t h e infant h a s such t y r a n n i c a l strivings ( t h e m o t h e r ' s o w n projected feelings a b o u t herself) t h a t it is essential t h a t she n o t b e bullied by this b a b y H i t l e r . U n d e r such c i r c u m s t a n c e s the m o t h e r is n o t only defending herself against the destructive p o w e r of h e r o w n t y r a n n i c a l internal object infant b y locating these feelings in the actual infant ( a n d at t h e s a m e t i m e m a i n t a i n i n g a n u n c o n s c i o u s c o n n e c t i o n with this p a r t of h e r i n t e r n a l object world); in a d d i t i o n , she is allaying t h e anxiety of n o t k n o w i n g by e x p e r i e n c i n g t h e actual infant as t h e fully k n o w n a n d predictable i n t e r n a l object for which she h a s a l o n g - s t a n d i n g , clearly defined p l a n of defensive action. I n a sense, transference in general c a n be viewed as serving t h e function of m a k i n g k n o w n the u n k n o w n object. T r a n s f e r e n c e is a n a m e we give to t h e illusion t h a t t h e u n k n o w n object is a l r e a d y k n o w n : each n e w object relationship is cast in the i m a g e of past object relations with w h i c h o n e is a l r e a d y familiar. As a result, n o e n c o u n t e r is experienced as entirely n e w . T r a n s f e r e n c e provides t h e illusion t h a t o n e has already b e e n t h e r e before. W i t h o u t this illusion, we would feel intolerably n a k e d a n d u n p r e p a r e d in t h e face of experience with a new person.

210 Misrecognition

The Primitive Edge of Experience of Affect:

A

Clinical

Illustration

M r s . R . , a 42-year-old w o m a n w h o h a d b e e n in analysis for almost t h r e e years, p u n c t u a t e d each m e e t i n g with efforts to cajole, trick, p l e a d , a n d in o t h e r ways coerce m e into "giving [her] s o m e t h i n g specific" in the form of advice or insight. She h o p e d t h a t w h e n she left m y office she w o u l d be able to take w i t h . h e r what I gave h e r d u r i n g t h e m e e t i n g , a n d apply it to h e r life outside the analysis. W h e n I was silent for a n entire session, t h e m e e t i n g was considered wasted since " n o t h i n g h a d h a p p e n e d . " M r s . R . r e s p o n d e d with a n intense display of e m o t i o n to a n y d i s r u p t i o n of analytic r o u t i n e . If I were a few m i n u t e s late in b e g i n n i n g the h o u r , she w o u l d either cry quietly o r r e m a i n angrily silent for t h e first ten to fifteen m i n u t e s of t h e h o u r . She would t h e n tell me 1 t h a t m y b e i n g late could only m e a n t h a t I did n o t give a d a m n a b o u t h e r . C o n s i s t e n t efforts at a n a l y z i n g t h e c o n t e n t a n d intensity of M r s . R . ' s reactions w e r e m a d e . She related this c u r r e n t set of feelings to h e r childhood e x p e r i e n c e of w a i t i n g for w h a t h a d seemed like h o u r s for h e r m o t h e r (a college professor) while she spoke with s t u d e n t s after class. H o w e v e r , t h e r e reached a point w h e n the m a t e r i a l did n o t b e c o m e a n y richer as t h e p a t i e n t repeatedly r e t u r n e d to t h e i m a g e of angrily w a i t i n g for h e r m o t h e r . I found myself b e c o m i n g increasingly a n n o y e d a n d was a w a r e of fantasies of m a k i n g sadistic c o m m e n t s as the patient cried in response to m y i n f o r m i n g h e r of a vacation b r e a k o r a r a r e c h a n g e in the t i m e of a given a p p o i n t m e n t . I n a session at t h e e n d of t h e t h i r d y e a r of analysis, I w a s t h r e e or four m i n u t e s late in b e g i n n i n g the session. M r s . R . was visibly upset w h e n I m e t h e r in the w a i t i n g r o o m . I n what h a d b e c o m e h e r c u s t o m a r y p a t t e r n , t h e p a t i e n t lay d o w n on the c o u c h , folded h e r a r m s across h e r


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chest a n d was silent for a b o u t ten m i n u t e s . She finally said t h a t she did not k n o w w h y she c o n t i n u e d in analysis with m e . I m u s t h a t e h e r , otherwise I would not treat h e r in s u c h a callous m a n n e r . I asked h e r if she were really feeling at t h a t m o m e n t t h a t m y lateness h a d reflected the fact t h a t I h a t e d h e r . She reflexively said, "Yes," b u t it w a s a p p a r e n t that the question h a d t a k e n h e r by surprise. After a few m i n u t e s , she said t h a t in fact m y lateness h a d n o t b o t h e r e d h e r even t h o u g h she h a d b e h a v e d as if it h a d . S h e said t h a t in retrospect h e r r e c e n t reactions to m e seemed to h e r to h a v e b e e n a little like play-acting, a l t h o u g h she h a d not h a d t h a t sense of things until I asked t h e q u e s t i o n t h a t I did t o d a y . I suggested t h a t b y acting as if she h a d felt crushed by m y lateness, she o b s c u r e d for herself t h e feeling t h a t she did n o t k n o w h o w she felt a b o u t it. O v e r t h e succeeding y e a r , as t h e analysis took on a n i n c r e a s i n g feeling of authenticity, it w a s possible to identify a p l e t h o r a of forms of defense against the anxiety c o n n e c t e d w i t h t h e feeling of n o t k n o w i n g . T h e p a t i e n t recognized t h a t she h a d b e e n u n a b l e to progress in h e r efforts to b e c o m e a n o p e r a singer b e c a u s e she h a d from t h e b e g i n n i n g of her t r a i n i n g b y p a s s e d various fundam e n t a l s of t e c h n i q u e . She could create a n initial i m p r e s sion of b e i n g a very accomplished singer, b u t this could n o t be s u s t a i n e d . T h e inability to "begin at t h e b e g i n n i n g " in h e r vocal t r a i n i n g a n d to tolerate t h e tension of n o t k n o w i n g h a d severely interfered with M r s . R . ' s ability to l e a r n . S h e h a d felt it necessary to create t h e illusion of b e i n g v e r y a d v a n c e d from t h e outset. M r s . R . also b e c a m e a w a r e t h a t it was e x t r e m e l y difficult for h e r to accurately identify h e r sensory experience, for e x a m p l e , to k n o w w h e t h e r she was a n x i o u s o r in physical p a i n , in w h a t p a r t of h e r b o d y the p a i n w a s arising, w h e t h e r a

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given sensation reflected sexual excitement o r a need to u r i n a t e , w h e t h e r she was h u n g r y or lonely, a n d so oh. T h e analysis t h e n centered on M r s . R . ' s fear of the "spaces" in t h e analytic h o u r t h a t h a d formerly been filled by w h a t she referred to as h e r "play-acting" o r by h e r p l e a d i n g with m e to give h e r s o m e t h i n g t h a t she could take with h e r from t h e session. D u r i n g t h e period of work in which these m a t t e r s were b e i n g discussed, M r s . R . b e g a n a session by saying that since she did not w a n t to o v e r d r a m a t i z e , n o r did she w a n t to t h r o w a t e m p e r t a n t r u m , she w a s h a v i n g t r o u b l e k n o w i n g what to say. L a t e r in t h e s a m e m e e t i n g t h e p a t i e n t r e p o r t e d t h e following d r e a m : she was in the office of a dentist w h o r e m o v e d t w o of her m o l a r teeth. S h e h a d n o t k n o w n he was g o i n g to d o this, b u t h a d t h e feeling t h a t she h a d s o m e h o w a g r e e d to h a v e it d o n e . W h e n he showed her t h e teeth, they looked perfect—they w e r e perfectly shaped a n d h a d g l e a m i n g white e n a m e l "like s o m e t h i n g you'd see in a storybook." She t h o u g h t it s t r a n g e t h a t they did n o t h a v e roots. T h e extraction h a d n o t b e e n painful, a n d afterward, instead of p a i n , t h e r e was simply a s t r a n g e feeling of e m p t y spaces at the b a c k of h e r m o u t h . T h e holes t h a t w e r e left in t h e g u m s rapidly closed over b y themselves a n d did n o t r e q u i r e stitches. I n m a k i n g h e r associations, M r s . R . was able to u n d e r s t a n d t h a t the two teeth h a d r e p r e s e n t e d two ways of b e h a v i n g t h a t she felt she was giving u p in the analysis: t h e o v e r d r a m a t i z a t i o n a n d t h e t e m p e r t a n t r u m s . She said t h a t like the teeth, these ways of b e i n g seemed to b e losses t h a t left a weird space. M o r e o v e r , this loss was a loss of s o m e t h i n g t h a t did n o t seem to be quite real —like "storybook teeth w i t h o u t roots." T h i s d r e a m r e p r e s e n t e d t h e b e g i n n i n g s of a p h a s e of t h e analysis in which the patient was able to b e c o m e g r a d u a l l y less reliant on misrecognition as a

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defense against the experience of n o t k n o w i n g . T h e s e misrecognitions h a d filled t h e potential space in which inchoate desires a n d fears m i g h t h a v e evolved into feelings t h a t could b e felt a n d n a m e d . 2

Misrecognition of Eating

as a

Dimension

Disorders

P a t i e n t s with a wide r a n g e of e a t i n g disorders i n c l u d i n g a n o r e x i a n e r v o s a a n d b u l i m i a regularly r e p o r t t h a t their o v e r e a t i n g o r refusal to eat has n o t h i n g w h a t e v e r to d o with t h e experience of appetite. T h e s e p a t i e n t s are rarely able to g e n e r a t e a n emotional/physiologic state t h a t they can correctly recognize as a n a p p e t i t e for food. T h e psychological difficulty u n d e r l y i n g the inability of these patients to g e n e r a t e appetite affects their capacity to g e n e r a t e almost every form of desire, i n c l u d i n g sexual desire, desire to l e a r n , desire to w o r k , desire to be with o t h e r people, a n d desire to be alone. I n the c o u r s e of m y work with p a t i e n t s suffering 'There are of course conflicted sexual and aggressive meanings suggested by the manifest content of this dream. However, it was necessary to analyze the patient's experience of not knowing what she was experiencing, before it became possible to analyze the conflictual content of that experience. 2 It is characteristic of the analytic process that each insight (recognition) immediately becomes the next resistance (misrecognition). The patient's awareness of and understanding of the experience of not knowing is no exception to this principle. Invariably, as the analysand recognizes his warded-off state of not knowing, the feeling of confusion itself is utilized in the service of defending against that which the patient consciously and unconsciously knows, but does not wish to know.

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from eating disorders, it has m a d e i n c r e a s i n g sense to m e to think of m a n y of these patients as suffering from a d i s o r d e r of the recognition of desire. A n i m p o r t a n t aspect of t h e experience of such a patient is his u n c o n s c i o u s fear t h a t he does n o t k n o w w h a t h e desires. T h i s leads h i m to w a r d off the p a n i c associated with such a w a r e n e s s b y b e h a v i n g as if it is food t h a t is desired. T h e p a t i e n t m a y t h e n obsessionally (usually ritualistically) eat a n d yet he n e v e r feels full since w h a t has been taken in is not a response to a desire for food. R a t h e r , the e a t i n g represents a n a t t e m p t to use food as if that is w h a t h a d b e e n desired w h e n in fact the individual does n o t k n o w w h a t it is to feel desire. I n o n e such case a n adolescent girl, in a state of e x t r e m e anxiety b o r d e r i n g on p a n i c , c o n s u m e d several loaves of b r e a d a n d two cooked chickens. T h i s resulted in g a n g r e n o u s changes in h e r s t o m a c h b e c a u s e of the c o m p r o m i s e of h e r blood supply, c a u s e d b y overdistention of t h e gastric walls. Surgical r e m o v a l of two thirds of h e r s t o m a c h was r e q u i r e d . She h a d told her m o t h e r over t h e course of the p r e c e d i n g week t h a t everything a p p e a r e d colorless. T h e m o t h e r h a d res p o n d e d by s a y i n g t h a t it was n a t u r a l to feel g r a y in the a u t u m n , t h a t e v e r y b o d y does. T h i s adolescent, in her frantic e a t i n g , w a s n o t a t t e m p t i n g to m e e t a n e e d o r to fulfill a desire; the p r o b l e m w a s t h a t she could not create a psychological space in which either n e e d or desire could b e g e n e r a t e d . T h e patient therefore felt, to a large d e g r e e , as if she already were psychologically d e a d a n d it was this feeling t h a t h a d led to h e r state of p a n i c . P a r a d o x i c a l l y , the patient was desperately eating in a n a t t e m p t to create the feeling of h u n g e r . M o r e accurately, she w a s e a t i n g in o r d e r to create t h e illusion that she could feel h u n g e r , which would serve as evidence t h a t she w a s alive.

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T h e early relationship between this p a t i e n t a n d h e r m o t h e r seems to h a v e b e e n characterized b y the s a m e fear of recognition of the i n t e r n a l state of t h e patient t h a t was reflected in t h e m o t h e r ' s c o m m e n t a b o u t t h e universality of feelings of grayness —of melancholy — in the a u t u m n . T h e bits of m e a n i n g t h a t the patient h a d m a n a g e d to attach to her o w n experience (in this case, t h e experience of colorless, lifeless depression) were stripped of m e a n i n g in t h e interaction with h e r m o t h e r (cf. Bion, 1962). T h e b e g i n n i n g s of m e a n i n g , g e n e r a t e d in a n i n t e r n a l psychological space, were t r a n s f o r m e d into a u n i v e r s a l a n d therefore i m p e r s o n a l t r u t h . T h i s h a d h a d the effect of obliterating n o t only t h e bits of m e a n i n g t h a t h a d b e e n created, b u t m o r e i m p o r t a n t l y , t h e internal psychological space t h a t t h e patient h a d tenuously achieved.

Psychological of Recognition

Change and

in the

Area

Misrecognition

T h e following is a n excerpt from t h e analysis of a 46-year-old c o m p u t e r scientist w h o b e g a n t r e a t m e n t n o t k n o w i n g why he h a d c o m e for t h e r a p y ( b u t s e e m i n g at the s a m e t i m e u n a w a r e of his n o t k n o w i n g ) . D u r i n g the initial face-to-face interviews prior to his b e g i n n i n g to use the couch, D r . L . described situations in w h i c h he felt a n x i o u s , such as while w a i t i n g to be assigned a table in a r e s t a u r a n t a n d before m a k i n g business p h o n e calls. T h e explanations t h e p a t i e n t offered for his anxiety in these situations w e r e f o r m u l a e extracted almost v e r b a t i m from his extensive r e a d i n g of p o p u l a r self-help books. By the t i m e he t u r n e d 40, D r . L. was i n t e r n a t i o n a l l y k n o w n a n d h a d a m a s s e d a large fortune as a result of his

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i n n o v a t i o n s in the a r e a of c o m p u t e r technology. E v e n t h o u g h the vast bulk of his m o n e y was n o w invested very conservatively, he experienced both his financial situation a n d his status in his field as extremely p r e c a r i o u s . T h e s e fears led h i m to devote himself with e v e r - i n c r e a s i n g intensity to his w o r k . O n l y after several m o n t h s of analysis did he say t h a t he awoke every n i g h t in a state of e x t r e m e anxiety. H e supposed h e w a s a n x i o u s a b o u t his w o r k , b u t h e w a s n o t sure since he was u n a b l e to r e m e m b e r his d r e a m s . It is b e y o n d the scope of this c h a p t e r to describe the analytic w o r k u n d e r l y i n g the psychological c h a n g e s t h a t e n s u e d . M y i n t e n t i o n h e r e is simply to illustrate the n a t u r e of psychological c h a n g e in the a r e a of the creation a n d recognition of desire. T h e following description of a d r e a m p r e s e n t e d by D r . L . at t h e b e g i n n i n g of t h e t h i r d y e a r of analysis is a n illustration of such c h a n g e .

I was s t a n d i n g in front of a large house a n d could see t h r o u g h the w i n d o w s t h a t the p a i n t on t h e ceiling was cracking as a result of w a t e r t h a t h a d leaked in from the roof. T o m y surprise, the old m a n w h o o w n e d the h o u s e c a m e o u t a n d asked m e to c o m e in a n d talk. H e asked m e if I k n e w w h o he was. I didn't a n d I told h i m t h a t . T h e old m a n t h a n k e d m e for b e i n g truthful. H e told m e w h o h e was. . . . I can't r e m e m b e r w h a t his n a m e was. H e told m e h e was going to die in two weeks a n d w o u l d like to give all of his m o n e y to m e . I said that I didn't w a n t the m o n e y . H e took m e into the next r o o m , w h i c h was lined with fine old books a n d very beautiful a n t i q u e furniture. H e offered m e t h e h o u s e a n d e v e r y t h i n g in it. I again said t h a t I didn't w a n t it.


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I told h i m t h a t I c o u l d get t h e w a t e r d a m a g e fixed. T h e old m a n said t h a t t h e peeling paint w a s p a r t of t h e h o u s e as h e k n e w it a n d h e didn't w a n t it c h a n g e d . I told h i m it could d a m a g e t h e house. T h e old m a n was very calm a n d explained t h a t he h a d lived a h a p p y life a n d t h a t he w o u l d b e d e a d in two weeks a n d so it didn't matter.

D r . L . said t h a t he woke u p from this d r e a m feeling a profound sense of c o n t e n t m e n t t h a t he associated with m e m o r i e s of his m a t e r n a l g r a n d f a t h e r . D r . L . recalled h o w his g r a n d f a t h e r at t h e age of 85 h a d loved his g a r d e n , p l a n t i n g seeds for flowers one d a y , seeds for lettuce t h e n e x t , seeds for o t h e r flowers t h e next, a n d so o n . O n e d a y w h e n the p a t i e n t w a s a b o u t 6 years old h e said to his g r a n d f a t h e r , w h o w a s t h e n p l a n t i n g flower seeds, " G r a n d p a , you p l a n t e d t h a t s a m e row with c a r r o t seeds yesterday." T h e patient's g r a n d f a t h e r l a u g h e d a n d said, "Bobby, you don't u n d e r s t a n d . T h e point is t h e p l a n t i n g , n o t the growing." T h e d r e a m a b o u t t h e u n f a m i l i a r old m a n a n d t h e h o u s e , a n d the associations to this d r e a m , r e p r e s e n t e d a l a y e r i n g of alterations of w h a t h a d previously b e e n misrecognitions of affect. D r . L . said t h a t it h a d b e e n "cleansing" to e x p e r i e n c e himself in the d r e a m as a p e r s o n w h o talked in l a n g u a g e t h a t "cut to the b o n e " in contrast to t h e "bullshit" with which he felt he usually filled his life. "I didn't k n o w w h o t h e old m a n was a n d I simply said so. I felt a g l i m m e r of t e m p t a t i o n to accept his m o n e y a n d all of his stuff, b u t I really didn't w a n t his m o n e y . O r d i narily, I w o u l d h a v e t h o u g h t t h a t w h a t I w a n t e d was his m o n e y . I c a n see myself acting in a w a y t h a t w o u l d h a v e

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m a d e h i m t h i n k t h a t that's what I w a s after. 3 Actually, I j u s t liked b e i n g with h i m . T h e old m a n a n d I offered o n e another: t h i n g s the other didn't w a n t o r h a v e a n y use for. W h a t m e a n t so m u c h to m e w a s t h e w a y w e explained ourselves to e a c h o t h e r . I could feel all t h e tension in m e subside w h e n the old m a n said t h a t he h a d lived in the house as it was a n d didn't w a n t it c h a n g e d . " O v e r t h e course of the m e e t i n g , t h e d r e a m was u n d e r s t o o d to be a r e p r e s e n t a t i o n of t h e w a y D r . L . wished t h a t he a n d I could talk together. I n t h e d r e a m t h e p a t i e n t h a d felt m o m e n t a r i l y freed from his usual isolation t h a t resulted from layer u p o n layer of m i s n a m i n g s a n d misrecognitions of his own i n t e r n a l state a n d t h a t of t h e o t h e r . T h e defensive internal m i s r e c o g n i t i o n s h a d m a d e it impossible for h i m to feel t h a t h e u n d e r s t o o d a n y t h i n g of w h a t he felt- toward other people a n d w h a t t h e y felt t o w a r d h i m . T h e s e m i s r e c o g n i t i o n s h a d left the patient feeling alone a n d disconnected from a self ( a n d t h e other) t h a t h e only dimly k n e w . I n t h e c o u r s e of the succeeding m o n t h s of analysis,

It had taken me most of the first year of the analysis to become aware of the way Dr. L. unconsciously attempted to lure me into misrecognitions of his internal state by repeatedly mislabeling them, giving me misleading pictures of himself and of his relationships, leaving out important details, leading me to believe that he understood what was going on in an interpersonal situation when he did not, and the like. If the individual is unable to know what he feels, he is equally at a loss to know what it is that the other is experiencing. This is simply another way of stating that in the internal object relationship under discussion, the individual is both internal object mother and internal object infant, both misrecognized and misrecognizing. The outcome is a feeling of alienation from the other experienced by both the self and the object component of the internal object relationship.


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D r . L . b e c a m e increasingly able to u n d e r s t a n d w h y he h a d c o m e to see m e in t h e first place a n d w h y he was c o n t i n u i n g in analysis. A l t h o u g h h e h a d b e e n u n a w a r e of it at t h e t i m e , t h e a n x i e t y t h a t h e h a d e x p e r i e n c e d in going into r e s t a u r a n t s a n d before m a k i n g business p h o n e calls h a d in p a r t reflected a n anticipation of the painful confusion a n d loneliness that he would feel in talking to people. H e unconsciously expected t h a t o n c e again t h e r e would b e only t h e illusion of two people talking to o n e another. D r . L . gradually related t h e set of feelings j u s t discussed to a persistent childhood feeling of isolation. H e h a d felt t h a t his p a r e n t s o p e r a t e d a c c o r d i n g to a logic t h a t he could not f a t h o m . I n the course of analysis, D r . L . was able to re-experience a n d articulate this powerful, b u t heretofore wholly u n r e c o g n i z e d , set of b a c k g r o u n d childr. h o o d feelings. T h e p a t i e n t , in discussing t h e events of his c u r r e n t life, w o u l d r e t u r n again a n d a g a i n to such s t a t e m e n t s as, " W h a t kind of sense does t h a t m a k e ? " " T h a t doesn't a d d u p . W h y can't a n y o n e see that?" " W h a t kind of bullshit is this?" "Doesn't a n y o n e h a v e a n y c o m m o n sense?" S u c h feelings were increasingly experienced in t h e transference, for e x a m p l e in relation to m y policy of billing the patient for missed a p p o i n t m e n t s . T h e s e feelings of o u t r a g e served a n i m p o r t a n t defensive function: it was necessary for t h e p a t i e n t to feel t h a t he k n e w b e t t e r t h a n a n y o n e else "what t h e story was." T h i s served to o b s c u r e t h e patient's feeling of b e i n g utterly confused a n d d i s c o n n e c t e d from a firmly g r o u n d e d sense of w h a t he was feeling, what h e w a n t e d , o r w h y he w a n t e d it — a n d , most basically, w h a t it m e a n t in a visceral sense to experience ( a n d n a m e ) desires a n d fears t h a t felt like his o w n . A s t h e analysis w e n t o n , the p a t i e n t increasingly

220


c a m e to e x p e r i e n c e m e as disturbingly i n s u b s t a n t i a l a n d infinitely malleable. D r . L . felt quite alone d u r i n g the sessions a n d said t h a t a t t e m p t i n g t o h a v e a r e l a t i o n s h i p with m e was like "trying to build a house on a foundation of Jello." H e b e c a m e p r e o c c u p i e d with the feeling t h a t h e h a d n o idea w h o I was. T h e patient e n g e n d e r e d in m e (by m e a n s of w h a t I eventually u n d e r s t o o d as a projective identification) a sense of d e t a c h m e n t t h a t I h a v e rarely experienced with a p a t i e n t . T h e couch concretely felt as if it were located at a v e r y great distance from m y c h a i r . A t these times I found it extremely difficult to focus on w h a t D r . L . was saying. T h e patient's sense of isolation in the relationship with m e w a s gradually u n d e r s t o o d in t e r m s of his i n t e r n a l relationship with a schizoid m o t h e r w h o "gave the a p p e a r a n c e of b e i n g t h e r e until you realized t h a t she was u n a b l e to think."

Summary I n this c h a p t e r , I h a v e discussed a set of u n c o n s c i o u s , pathological i n t e r n a l object relations in w h i c h misrecognitions of affect play a central role. T h e s e i n t e r n a l object relations timelessly p e r p e t u a t e t h e infant's subjective experience of t h e m o t h e r ' s difficulty in r e c o g n i z i n g a n d r e s p o n d i n g to t h e infant's internal state. I n t e r n a l object relationships a r e u n d e r s t o o d to involve a relationship b e t w e e n two u n c o n s c i o u s aspects of t h e ego, o n e identified with the self a n d t h e o t h e r identified with t h e object of t h e original object relationship. Accordingly, in the internal object relationship u n d e r discussion, t h e p a t i e n t is b o t h m o t h e r a n d infant, b o t h m i s r e c o g n i z e d a n d misrecognizing. I n the context of this i n t e r n a l relationship, t h e p a t i e n t experiences anxiety, a l i e n a t i o n , a n d


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d e s p a i r in c o n n e c t i o n with t h e feeling of n o t k n o w i n g w h a t it is t h a t he feels o r w h o , if a n y o n e , h e is. S u b s t i t u t e f o r m a t i o n s a r e utilized t o create t h e illusion t h a t the i n d i v i d u a l k n o w s w h a t he feels. E x a m p l e s of such substitute formations include obsessional, a u t h o r i t a r i a n , as-if, False Self, a n d projective identificatory forms of control o v e r one's internal a n d e x t e r n a l objects. W h i l e these substitute formations help to w a r d off t h e feeling of n o t k n o w i n g , they also h a v e t h e effect of filling the potential space in which feeling states (that are experienced as one's o w n ) m i g h t arise. I n the analytic setting, i n t e r n a l object relations a r e externalized a n d , t h r o u g h the m e d i u m of t h e transfere n c e - c o u n t e r t r a n s f e r e n c e , are given intersubjective life. Clinical illustrations h a v e b e e n p r e s e n t e d of analytic work a d d r e s s i n g t h e anxiety of not k n o w i n g one's i n t e r n a l state, a n d the defenses s e r v i n g to w a r d off this anxiety.

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I n d e x

Adhesive equation, 41 n Adhesive identification, 40-41n, 71 Agonies, 203 Alexithymia, 196 Analytic experience, 7-8 Analytic meeting, 169-194 Analytic setting, psychological strain in, 175-180 Analytic significance, 170-175 Analytic space, 188-189 Anthony, J . , 48, 54n, 233 Anxiety autistic-contiguous, 67-69, 77-81 castration, 111, 114 leading edge of, 16 and paranoid-schizoid mode, 20 and procrastination, 72-73 schizoid, 86-87 and the skin surface, 4" transference, 8, 174-175 unconscious, 15 Anxious questioning, 190-191 Anzieu, D., 48, 233

Applegarth, A., 114, 223 Autism normal, 50-51, 54-55n pathological, see Pathological autism Autistic-contiguous mode, 30-45 and anxiety, 67-69, 77-81 and countertransference, 44-45 defenses generated in, 70-73 and pathological autism, 59-67 and sensation-dominated experience, 52-59 Autistic-contiguous position, 4-5, 47-81 and boundedness, 202 internalization in, 73-77 Autistic objects, 36-38, 42, 55-56 Autistic shapes, 36-37, 42, 54-55 Balint, M., 91-92, 185n, 205, 223 237

238 Bibring, E., 146, 223 Bick, E., 10, 30-31, 39, 47, 68, 201, 223 on second skin formation, 40, 70-71 Bion, W. R., 4, 38, 45, 106, 145, 199, 215, 223 container concept of, 30 "nameless dread," 39 on projective identification, 25, 47 Bisexuality, 139 Bollas, C , 51, 224 Borges, J . L., 9, 224 Boundedness, 53 Bower, T. G. R., 48, 51, 224 Boyer, L. B., 38, 42-43n, 173, 224 Brazelton, T B., 48, 51, 224 Castration anxiety, 111, 114 Cautionary tales, 181-184 Chasseguet-Smirgel, J . , 110, 145-146, 224 Chodorow, N., 118, 151n, 225 Chomsky, N., 145, 225 Consultation, 173 "Contained psychosis," 102 Container concept, 30 Contiguity of surfaces, 33 Countertransference acting-out, 108 and autistic-contiguous mode, 44-45 and female therapists, 133-136 negative, 173-174 and omniscient internal object, 205-207

Index and transference anxiety, 185-187 Defenses autistic-contiguous modes of, 70-73 and homosexual object choice, 124-125 manic, 24-25 misrecognitions, 195-221 obsessive-compulsive, 67, 204-205 paranoid-schizoid, 22-23 pathological projective identification, 209 splitting, see Splitting Delusional transference, 21 Denial, 24-25 Depressive mode experience in, 11-18 valorization of, 29-30 Desire and the illusion of knowing, 195 and psychological change, 216-220 recognition of, 213-215 Dreams of impossible choices, 136, 138 Dream screen, 116 "The Dyke," 139 Eating disorders, 213-215 Ego bodily, 49-50 and misrecognition, 197 unconscious, 89-90 Eigen, M., 29-30, 225 Eimas, P., 51, 225

Index Eliot, T. S., 3,83, 169, 225 Empathy, 14 Experience in the autistic-contiguous mode, 30-45 in a depressive mode, 11-18 in a paranoid-schizoid mode, 18-30 primitive organization of, 49-52 sensation-dominated, 52-59 sensory "floor" of, 45, 70 structure of, 9-46 Externality, discovery of, 115-117 Fairbairn, W. R. D., 4, 47, 80, 85n, 145, 225 on damnation of self, 123n on libidinal ego, 90n on schizoid anxiety, 86 "Schizoid factors in the personality," 83 False self, 74, 88, 200 Fantasy definition, 16n masturbation, 105 reality and, 117 Father healthy Oedipal romance with, 132 narcissistic dependence on, 132-133 power of, 118n Faulkner, W., 106-107 Fear of breakdown, 200 of not knowing, 8, 195-221 Female development, 109-140

239 context of, 115-118 and gender identity, 137-139 Oedipal narrative, 110-115, 130-133 transitional relationship, 118-130 Fenichel, O., 74n, 226 Fliess, W., 141n Fordham, M., 76, 202, 226 Formless dread, 39 Freud, S., 26, 130-131, 139, 141, 190, 192, 226 on bodily ego, 49-50 on female development, 110-114, 133 and misrecognitions, 197 and the Oedipus complex, 143-146 and patients' questions, 190 "Fundamental rule," 42n Gaddini, E., 61, 68, 74, 226 Gaddini, R., 61, 226 Galenson, E., 146, 227 Gender identity, 137-139 Giovacchini, P. L., 38, 173, 227 Goldberg, P., 188, 227 Green, A., 120, 146, 153, 227 Grotstein, J . , 22, 25, 45, 70, 116, 227 Guilt, 13-14 Guntrip, H., 89-90, 228 Habermas, J., 86, 228 Hegel, G. W. F., 86, 228 Heimann, P., 146, 228 Historicity, 13, 191n History, creation of, 191-193

240 Holding, 34, 55 Homosexuality, 125, 164 Homey, K., 110, 228 Hunger, 201 Identity, gender, 137-139 Imitation, 74-75 Incest, 155 Infantile eczema, 41 Internalization, 73-77 Interpretation "consistent," 205 "downward," 135 by mothers, 204 by patient, 206-207 timing of, 184-187 transference, see Transference interpretations utilization of, 38-39 Interventions, 22 Isaacs, S., 16n, 228 Jacobson, E., 145, 228 Jones, E., 110, 228 Kanner, L., 48, 228 Kayaking, 79 Kernberg, O., 145, 228 Klein, M., 4, 10, 25, 47-48, 110, 145-146, 228-229 depressive position of, 11-12 paranoid-schizoid position of, 18 on schizoid anxiety, 87n Klein, S., 50,83, 229 Kohut, H., 145, 229 Kojeve, A.,86, 229

Index Lacan, J., 17, H8n, 151n, 197, 229-230 Language, 197-198 Laplanche, J . , 144n, 230 Learning and fear of not knowing, 211 hazards of, 8 Lemaire, A., 198, 230 Leonard, M., 132, 230 Lewin, B., 116, 145, 230 Little, M., 21, 230 Loewald, H., 15, 24, 27, 155, 230 Loneliness, 14 Mahler, M., 50-51, 145, 230 Manic defenses, 24-25 Masturbation, 125 compulsive, 72 fantasies, 105 while wearing women's ' underwear, 162-163 Matrix of the mind, 116, 188 Mayer, E., 114, 230 McDougall, J . , 39n, 80, 146, 166, 196, 198, 230-231 on the Oedipus complex, 154 on perverse sexuality, 166n on psychosexual structure, 125n McKee, B., 181n, 231 Meltzer, D., 10, 30, 39, 52, 201, 231 on adhesive identification, 40n, 71 clinical work of, 47-48 Milner, M., 48, 231 Misrecognitions, 195-221 and eating disorders, 213-215

Index structuralization of, 203-209 Mother aspects of relatedness to, 115-117 de-integration of, 202 delusional sexual identity with, 163 as environment, 115-116 inability to serve as transitional object, 123-124 "just like," 207-208 obsessive-compulsive, 204-205 phallic, 136 pre-Oedipal, 146-148 "psychologically minded," 204 transitional relationship to, 118-122, 152-155 Mourning, 14 Nemiah,J.,39, 196,231 Non-experience, 196, 199 Normal autism, 50-51, 54-55n, 202 Object relations and narcissistic wound, 131-132 schizoid, 84-87 transitional Oedipal, 152-155 whole, 12 Oedipal dilemma, 28 Oedipus complex, 5-7 in female development, 109-140 Freud's perspective on, 143-146 male, 141-168

241 negative, 122 and psychological growth, 27-28 transitional relationship, 118-130 waning of, 15 Oedipus myth, 3 Ogden, T., 15-16, 77, 147, 173, 203, 205, 231-232 on countertransference, 133 on depressive position, 52-53 on matrix of the mind, 116, 188 on non-experience, 196, 199 on "play space," 138 on projective identification, 25 psychological deep structure concept of, 145 on second skin formation, 75-76 on transitional phenomena, 113, 117 Omnipotent thinking, 23-24, 155n Omniscient internal object, 205-207

Paranoid-schizoid mode, 149n experience in, 18-30 and primal scene phantasies, 149-150 Parens, H., 110, 114, 232 Pathological autism, 50 and autistic-contiguous experience, 59-67 and psychological deadness, 52

242

Index'

Patient "The Queen," 139 anxious questioning by, 190-191 "Reverie," 45, 106 cautionary tales of, 181-184 Rhythm history of, 191-193 and continuity, 54 opening lines of, 176 of "dialogue," 53 phantasied analyst of, 171 periodicity and, 35 in role of omniscient internal Roiphe, H., 146, 227 object, 206-207 Rosenfeld, D., 39, 48, 68, 232 voice,of, 170-171 Rumination, infantile, 60-61 Penis envy, 114 Periodicity and rhythm, 35 Sachs, L., 146, 232 Perverse sexuality, 166 Sadness, 14 Phantasies, 16n Sander, L., 48, 232 cautionary tales, 181-184 Schafer, JR., 74n, 113, 232 omnipotent reparative, 23-24 Schizoid condition, 83-108 primal scene, 7, 142-145, "Schizoid factors in the person148-151, 154-155 ality" (Fairbairn), 83 timelessriess of, 26-27 Schreber case (Freud), 197 Play space Screen memory, 136, 150-151 creation of, 188 Seale, A., 202, 232 and Oedipus complex, 138 Searles, H., 21, 24, 145, 232 Pontalis, J.-B., 144n, 230 on Oedipal love, 137 Potential space, 199-200 on omniscient internal object, absence of, 60 206 filling of, 195 on therapist's jealousy, 134 Primal scene phantasies, 7, Second skin formation, 40, 142-145, 154-155 70-72, 75-76 as organizers of object relacommon forms of, 41-42 tions, 148-151 pathological, 40-41 terrifying, 165-166 and supervision, 77 Procrastination, 72-73 Segal, H., 11, 20, 78, 149n, Projective identification, 25-26 233 and imitation, 75 Self-punishment, 24 pathological, 209 Selves Psychological deep structure, false, 74, 88, 200 145 true, 88-89 Psychological growth, 26-27 Sexual meaning, 148-151 Psychosomatic misinterpretaShapiro, S., 192, 233 tion, 198 Sharpe, E. F., 181n, 233

Index Skin surface and anxiety, 4 contiguity of, 33 experience at, 35-36, 60 The Sound and the Fury (Faulkner), 106 Spitz, R., 41, 115, 145, 233 Splitting, 125 defensive, 19-20 excessive, 87n psychological meaning of, 22-23 of true and false selves, 88 Stern, D., 32n, 51-52, 145, 233 Stoller, R., 110, 151, 233 Subjective object, 116 Subjective others, 13-14 Subjects discourse between, 15-16 vs. objects, 13-14 Symbolic equation, 20-21, 149n Symbol formation proper, 11-12,78 Termination, 188n Therapist female, 133-134 jealousy of, 134-135 male, 137 as phallic mother, 136 Thirdness absence of, 165-166 presence of, 151 Transference, 209 delusional, 21 in a depressive mode, 14-15 before first meeting, 171 and illusion, 209 overdetermination of, 134n

243 in a paranoid-schizoid mode, 21 phallic mother, 136 Transference anxiety, 8 Transference enactment, 180 Transference interpretation, 187 and cautionary tales, 183-184 and intrusive "homosexuality," 164 timing of, 184-187 see also Interpretations Transitional objects creation and discovery of, 36 relationship to, 116-117 Transitional Oedipal relationship, 6-7 in female development, 109-140 in male development, 152-155 Transitional phenomena, 59-60, 89 Trevarthan, C , 48, 51, 234 True self, 88-89 Tustin, F., 10, 30-31, 42, 48, 50, 68, 201-202, 232 on adhesive equation, 41 n and autistic-contiguous anxiety, 68 on autistic shapes and objects, 54-56 on separateness, 52 on skin surface, 35-36 Winnicott, D. W., 4, 36, 47, 74, 109, 138, 146, 148, 195, 201, 234-235 agonies concept of, 203 and clinical judgment, 185n

244

Index

Winnicott, D. W. (continued) on discovery of externality, 115-117 on early psychological organization, 88-89 on experience of self, 32 false self personality organization, 200 on "holding," 34, 63

5 2 2 9

r

B3

on imitation, 76 "play space" concept of, 138 potential space, 60, 199 on projective identification, 25 subjective object, 116 on subjectivity, 53-54 on transitional phenomena, 47, 59, 113, 152

The primitive edge of experience

Primitive

Primitive

Primitive Thisness and Primitive Identity

Theories of Primitive Religion

L'âme primitive

Der Primitive

Primitive Passion

Primitive Mentality

Der Primitive

Primitive Classification

The Edge of Sleep

The Edge of Honor

The Edge of Forever

The Edge of Forever

The Edge of Chaos

The Edge of Human

The Edge of Destruction

The Edge of Never

The Edge of Heaven

The Edge of Human

The Edge of Eternity

The Edge of Night

The Edge of Trust

The Edge of Chaos

The Edge of Chaos

The Edge of Nowhere

The Edge of Night

The Edge of Heaven

The Edge of Light

The Edge of Courage

The primitive edge of experience

Primitive

Primitive

Primitive Thisness and Primitive Identity

Theories of Primitive Religion

L'âme primitive

Der Primitive

Primitive Passion

Primitive Mentality

Der Primitive

Primitive Classification

The Edge of Sleep

The Edge of Honor

The Edge of Forever

The Edge of Forever

The Edge of Chaos

The Edge of Human

The Edge of Destruction

The Edge of Never

The Edge of Heaven

The Edge of Human

The Edge of Eternity

The Edge of Night

The Edge of Trust

The Edge of Chaos

The Edge of Chaos

The Edge of Nowhere

The Edge of Night

The Edge of Heaven

The Edge of Light

The Edge of Courage

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