Healing Within the Blur

Christopher Bollas Quotes
 from The Shadow of the Object: Psychoanalysis of the Unthought Known

Paula Heimann asked… Who is speaking?

To whom is this person speaking? (Heimann realized that at one moment the analysand was speaking to the mother, anticipating the father or reproaching, exciting or consoling a child – the child self of infancy, in the midst of separation at age two, in the oedipal phase, or in adolescence.)

What is the patient talking about and why now?

Little added…each analyst at any moment should be asking how is she feeling, why she is feeling this, and why now.

Bion wondered what is speaking or transpiring in what form, and linked to what.

The autistic child cannot tell you how he feels or what his psyche is made of; he can only show you, and this he does quite well if the clinician is willing to be used as an object and to be guided via his own internal world through the subject’s memory of his object relations.

The object can cast its shadow without a child being able to process this relation though mental representations or language, as, for example, when a parent uses his child to contain projective identifications. While we do know something of the character of the object which affects us, we may not have thought it yet. The work of clinical psychoanalysis, particularly of object relations in the transference and the countertransference, will partly be preoccupied with the emergence into thought of early memories of being and relating.

I think it is crucial that the clinician should find a way to make his subjective states of mind available to the patient and to himself as objects of the analysis even when he does not yet know what these states mean. I also believe that on rare but significant occasions the analyst may analyze his experience as the object of the patient’s transference in the presence of the patient.

COUNTERTRANSFERENCE READINESS

Alongside the analyst’s freely and evenly hovering attention which enables the analyst to listen simultaneously on many levels…he needs a freely roused emotional sensibility so as to perceive and follow closely his patients emotional movements and unconscious phantasies.

(Freud) … ‘must turn his own unconscious like a receptive organ towards the transmitting unconscious of the patient.’

The psychoanalyst’s establishment of mental neutrality is akin, in my view, to the creation of an internal potential space (Winnicott, 1974) … functions as a dream screen … it is there, but only as an area within the analyst which registers non-neutral feelings, phantasies and thoughts, just as the dream differs from that internal screen that bears it.

By cultivating a freely-aroused emotional sensibility, the analyst welcomes news from within himself that is reported through his own intuitions, feelings, passing images, phantasies and imagined interpretive interventions….

…the other source of the analysand’s free association is the psychoanalyst’s countertransference, so much so that in order to find the patient we must look for him within ourselves This process inevitably points to the fact that there are two ‘patients’ within the session and therefore two complementary sources of free association. (my bolding)

What the analyst feels, imagines, and thinks to himself, while with the patent, may at any one moment be a specific element of the patient’s projectively-identified psychic life… (Giovacchini’s concept of) an externalization to classify that creation of a total environment in which both patient and analyst pursue a ‘life’ together.

…This inevitable, ever-present, and necessary uncertainty about why we feel as we do gives to our private ongoing consideration of the countertransference a certain humility and responsibility.

The most ordinary countertransference state is a not-knowing-yet-experiencing one. I know that I am in the process of experiencing something, but I do not as yet know what it is, and I may have to sustain this not knowing for a long time. I do not mean that I am unaware of discrete affects and thoughts while with a patient – of course, such mental life continues and is clear up to a point. Nevertheless, I find that to see where I am, what I am, who I am, how I am meant to function and in what psycho- developmental time of the patient I live takes months and years to discover. The capacity to bear and value this necessary uncertainty defines one of our most important clinical responsibilities to the patient; and it enhances our ability to become lost inside the patient’s evolving environment, enabling the patient to manipulate us through transference usage into object identity. If our own sense of identity is certain then its loss within the clinical space is essential to the patient’s discovery of himself.

…the analyst must maximize his countertransference readiness, listening to the patient who is using him. Object usage can be discovered through the effect of the use. To answer the question ‘how does a patient at a preoedipal level employ us?’, we must turn to the countertransference and ask of ourself, ‘how do we feel used?’

More often than not we are made use of through our affects, through the patient generating the required feeling within us. In many ways this is precisely how a baby ‘speaks’ to its mother. … The infant within the adult person cannot find a voice, however, unless the clinician allows the patient to affect him, and this inevitably means that the analyst must become disturbed by the patient.

If the analyst is well analyzed and possesses confidence in his own ego functioning and object relatedness then I think it is more likely that he will have the necessary capacity for generative countertransference regression within the session.

Like most analysts working with quite disturbed patients, I have evolved a kind of generative split in my own analytic ego. I am receptive to varying degrees of ‘madness’ in myself occasioned by life in the patient’s environment. In another area of myself, however, I am constantly there as an analyst, observing, assessing and holding that part of me that is necessarily ill.

In moments such as these who is the patient? In my view, much of the work of analysis will have to take place within the analyst since it is the analyst who, through his situational illness, is the patient in greatest need. Indeed, in order to facilitate the analysand’s cure, the analyst will often have occasion to treat his own situational illness first. To be sure, in treating myself I am also attending to the patient, for my own disturbance in some way reflects the patient’s transference. Thus in turning to myself as that other patient, I am cognizant that I may be analyzing something of the patient’s mother or father, or some aspect of the patient’s mind which he finds unbearable.

THE ANALYST’S USE OF THE SUBJECTIVE

Because the analyst is the other patient, sustaining in himself some intersubjective discourse with the analysand, it is essential to find some way to put forward for analytic investigation that which is occurring in the analyst as a purely subjective and private experience. It is essential to do this because in many patients the free associative process takes place within the analyst, and the clinician must find some way to report his internal processes to link the patient with something that he has lost in himself and enable him to engage more authentically with the free associative process.

…As Winnicott said (1971), the analyst needs to play with the patient to put forth an idea as an object that exists in that potential space between the patient and the analyst, an object that is meant to be passed back and forth between the two and, if it turns out to be of use to the patient, it will be stored away as that sort of objective object that has withstood a certain scrutiny. …Winnicott regarded his own thoughts: they were for him subjective objects, and he put them to the patient as objects between patient and analyst rather than as official psychoanalytic decodings of the person’s unconscious life. The effect of his attitude is crucial, as his interpretations were meant to be played with – kicked around, mulled over, torn to pieces – rather than regarded as the official version of the truth.

Since so much of the psychic life in the clinical setting is within the analyst, one of our emerging technical difficulties is how either to give back to the patient what he has lost or bring his attention to those parts of himself that he may never have known.

SELF-RELATING IN THE ANALYST

Each one of us is perpetually engaged in a complex relationship to the self as an object…and the analyst demonstrates his own form of self-relating in the way he perceives and relates to his own interpretations in the presence of the patient. … in middle of an interpretation I may suddenly realize that I am slightly off base, and I will stop myself and say something like ‘nope, that’s not it, I can’t quite find what I want to say’… or… ‘no, I think what I have just said, as plausible as it is, is just not right’. I am well aware I live out a form of self-relating in the presence of the patient, with one part of me functioning as the source of the material – like the patient in the analysis – and another part of me functioning as the analyst. I do this because I think it is very difficult to put into words what I believe a patient’s mood to be.

SENSING

…As I am particularly concerned to work with the emotional core of the patient in each session, it is important to be able to signify what, amidst the patient’s associations, seems to announce true self-activity. By true self-activity I mean that which seems to work from the core of the self outward as a spontaneous gesture.

I am referring here to those sorts of feelings an analyst has in working with a patient, which can be described as intuitions, or more accurately as senses. By saying to a patient, ‘you know, I really don’t know whether what I am going to say is true, but I have a feeling that . . .’ or ‘I sense you have moved away from the completion of a feeling; you seem to be saying. . .’ I am endeavoring to establish a neutral vocabulary for the identification of the analysand’s affects and nascent ego development, which can, in my view, only be reached if the analyst can work from intuitive sensing. I have often found that when I say to a patient’s y sense that x is true, or that he has avoided y (x and y being words that struggle to express an unknown but recent state of mood or mind), such communications have proved to be important facilitators, so the patient can complete the developing feeling, thought or ego capacity which had been lost, discarded, or perhaps unappreciated by him up until that point … The analyst uses his relation to himself as a object to put his own subjective state into words and he may very well be speaking up for x (for what it means) before he knows what x is. That is, the analyst does not consciously understand what the patient means, but he has a sense of a meaning that is present and which requires his support in order to find its way towards articulation and the all-important task of analysis.

… The assessment of that which is true in the patient springs not inevitably from the rather over-intellectualized culling of unconscious themes as read by both patient and analyst, but instead from a mutual sense of having touched upon a detail in the session that gives both analyst and analysand a sense of appropriate conviction that the patient’s true self has been found and registered.

FROM INDIRECT TO DIRECT USE OF COUNTERTRANSFERENCE

… I make an indirect use of my countertransference, by putting verbal representations of my subjective states of mind to my patient for consideration. In so doing, I establish my subjectivity as a useful and consistent source of material in the psychoanalytic situation. This constitutes another source of freely associated material… the use of such self observations in the presence of the patient will enable the analysand to develop increased trust in the value of expressing as yet unknowable subjective states … the aim of this indirect use of the countertransference is to facilitate the articulation of heretofore inarticulate elements of psychic life, or what I term the unthought known. Once the patient’s self state is verbally represented, then it can be analyzed.

By direct use of the countertransference I mean that quite rare occasion, one which may be of exceptional value to the effectiveness of the analysis, when the analyst describes his experience as the object. To be sure, there are moments when it is difficult to distinguish between the indirect and the direct use of the countertransference, as, for example, when a patient is so persecutory or unreachable that the analyst’s expressed observation of his own feeling state or state of self is somewhere in between expressing the sense of the situation and declaring how he feels as the object of the patient’s transference. In such a case, communicating what the analyst senses about the patient in the session is an indirect use of the CT, and describing how he feels about being her object is a direct use.

… There are some patients to whom one could not ever usefully express one’s experience as their object and this must be accepted.

THE UNTHOUGHT KNOWN: EARLY CONSIDERATIONS

As I work to understand what I am in the transference, defined by the function elicited by the analysand, it may be possible in time to discover who I am, even if this ‘who’ is a composite of the patient’s mother, father and former child self.

Our psychoanalytic understanding of the transference has always been that this psychological phenomenon is a re-living in the analytic process of earlier states of being and experiencing. But I wonder now if this is strictly true. Can we say that what is occurring in the analysis has in its entirety ever been lived before? I think that in his discovery of psychoanalysis Freud created a situation, now with the person’s adult mental faculties present and functioning, in which the individual could live through for the first time elements of psychic life that have not been previously thought.

… The primary repressed must be that inherited disposition that constitutes the core of personality, which has been genetically transmitted, and exists as a potential in psychic space.