Truth and the Unconscious in Psychoanalysis

Giuseppe Civitarese

• Publisher: Routledge
• Year: 2016
• eBook ISBN: 9781317355786
• Topic: Psicologia
• Subtopic: Salute mentale in psicologia

What is the truth of the unconscious? Truth and the Unconscious in Psychoanalysis explores the intersection of these two concepts within a Bionian framework. Giuseppe Civitarese maps out the unconscious in psychoanalysis, and focuses on the differences between the Freudian, Kleinian, Bionian and Lacanian schools of thought on this topic, as well as drawing on findings from neuroscience.

The book explores topics including the inaccessibility of the unconscious, dreams, body issues, issues of personality, the influence of field theory and the clinical implications of this theorising. It contains innovative comparison between Freudian metapsychology and the Bionian theory on thinking, and novel use of Bion's hallucinosis as an important new technical tool. An internationally recognised author, Civitarese provides fresh ideas throughout on a challenging subject, supported with vivid clinical material.

Truth and the Unconscious in Psychoanalysis will be of interest to anyone following the growing post-Bionian movement within contemporary psychoanalysis, enabling them to familiarize themselves with some of the most important current issues in psychoanalytic research. Truth and the Unconscious in Psychoanalysis will appeal to psychotherapists, psychologists and psychoanalysts, as well as undergraduate and postgraduate students studying in the field.

1 The inaccessible unconscious and reverie as a path of figurability

DOI: 10.4324/9781315666662-1

The treatment of patients with serious difficulties in symbolization is a riddle. How can we find a way to communicate with someone whose representational function is seriously impaired, to the extent that he is not able to give a personal meaning to experience? How can we begin to build some threads from experiences, however small, of sharing emotions, and then weave them with and for the patient into a fabric of thoughts? If repairing deficits in symbolization and representation depends upon intersubjective relationships and the patient is tenaciously avoiding every kind of contact, how can treatment go forward? It is my belief that an emotional connection can only be born out of living – or better, out of suffering – the same things, out of a moment of intersubjective connection between two separate subjects. But what is to be done when the patient – and sometimes the analyst, as well – has no language at their disposal with which to build this connection?

These difficulties are evident in overtly psychotic patients, but in this paper I shall deal with another category of patients who can be very difficult to treat: neurotic patients who possess autistic barriers or autistic nuclei (S. Klein, 1980; Tustin, 1986). These patients do not present the severe symptoms of the most serious cases, and their cognitive functions are in some areas usually well preserved. Nonetheless, the challenge they pose is that they suffer from a deficiency in their capacity for thinking, which originates in traumas that are filed in the so-called ‘inaccessible unconscious’. Although limited, this deficiency is significant enough to determine subtle situations of impasse in the analysis.

Bion (1997) maintained that alongside conscious and unconscious states of mind, there is a third psychic category, which he calls the ‘inaccessible’. He relates this mental category, which has never been psychically represented or conscious, mainly to intrauterine life and a conjectured type of primitive form of projective identification. However, the notion of a non-repressed, nonrepresentable unconscious goes far beyond Bion’s ‘imaginative speculations’ on the nature of foetal life in the womb and the persistence in the adult’s mind of embryonic vestiges of ‘thalamic’ or ‘sub-thalamic fears’. It was implicit in Freud (1915, 1923) and, indeed, its significance may extend to all forms of procedural, implicit or nondeclarative memory which are currently being discussed in contemporary psychoanalysis.

We now know that implicit and explicit memories are stored in different neuroanatomical structures, respectively subcortical and cortical. The former is the only memory ‘available’ in the first two years of life. This means that the most archaic mnestic traces, including those related to earliest traumas, can be registered only in a non-representational form. I propose to use Bion’s term, ‘inaccessible unconscious’, to refer generally to all these systems of basic and primitive memory. My aim is to highlight both Bion’s idea of a possible continuity between foetal and post-foetal life (Bion, 1976) and, above all, the link, which the term he employs suggests, between the traumas that we hypothesize have been inscribed in this inaccessible memory/unconscious and inaccessible patients who are difficult to reach.

Since these mnestic traces cannot be verbalized or ever become conscious (as memories that can be represented and recalled as ‘thoughts’), the question emerges as to how they can be evoked within the analytic setting, so that we may help our patients to work them through. Mancia (2003), following Freud, has noted that some traces of these very remote events can be found in dreams and of course in the transference. But what can be done when a patient does not dream or there seems to be no transference at all? What can we do in contexts where, rather than commenting on the film being screened and working on its plot, we first need to repair the actual device that projects images on the screen of the mind, that is, the alpha function of the patient?

It is my assumption that representational deficits connected with preverbal traumas that generate autistic or psychotic nuclei in the patient’s personality ‘force their way’ towards a stage of prerepresentability via projective identification, action and enactment. In particular, I believe that they speak ‘semiotically’: unlike ordinary repressed memories, they can emerge almost exclusively in the form of disturbances in the setting.¹ While such disturbances are most commonly thought to involve enactment and forms of action, they can also present themselves in a general feeling of blankness and deprivation; in a poverty of discourse or the relative incapacity to think or express emotions. Such patients appear frozen and stuck.

But this may be only half of the story. After a time, this void may reverse itself into a fullness of emotions, which overflows and overwhelms analyst and patient, as the terror that hides behind autistic nuclei breaks through. When this occurs, what will prove decisive is the analyst’s capacity for containment and reverie. If this proves sufficient, these tensions may take root in the subjectivity of the analyst and translate into particularly vivid images (an occurrence, however, that is not a sine qua non). It is the specificity and distinctive nature of these images that leads me to conjecture that they are triggered by projections of the inscriptions of early traumas ingrained in the inaccessible unconscious. I further believe that this vividness conveys the particular violence of their attendant emotions and at the same time bears witness to the genuine oneiric quality of the analyst’s reverie – i.e. that these images speak with the authenticity and truthfulness of the unconscious.

A parallel could be drawn between these analyst’s reveries and Freud’s (1937) description of überdeutlich or ultra-clear, quasihallucinatory memories, which may occur in patients in response to a construction.² In my experience, the analyst’s reverie connected with autistic nuclei in the mind of adult patients – and psychotic elements as well – is characterized by a certain powerful, ‘hallucinatory’ sensorial quality. The working hypothesis of this article is that the reverie of the analyst as conceptualized within the theory of the analytic field (Civitarese, 2008a) may represent not only a crucial tool in order to access these negative areas of the mind, but also an opportunity to produce a transformation in the patient.

From the perspective of a post-Bionian theory of the analytic field, I will attempt to show in a detailed clinical vignette how the analyst’s reverie can gradually lead to figurability (Botella and Botella, 2001) in the patient and that the more sensorial the quality of the analyst’s reverie, the higher the degree of thinkability achieved by the patient in relation to traumas originating in the non-verbal stages. Reverie is the place where the patient’s partially obstructed capacity to dream and the (hopefully more available) oneiric space of the analyst overlap – it is where the analysis actually takes place. The analyst’s core intervention in this context is therefore not so much an interpretation (i.e. a de-coding or putting into words), even if, from the point of view of the classical psychoanalytic theory, it could be described very much as an interpretation in the transference. Rather, it reflects the often silent, spontaneous, internal working through of the patient’s projected emotion and the analyst’s own emotion induced by the patient’s projections, which push us to tend towards fantasies and/or enactments of basic assumptions – i.e. a bipersonal unconscious phantasy.

Rather than reflect like a mirror, the analyst must try to be reflective by introducing his own mind as a function or locus of the analytic field and trying to detect its unconscious dimensions. In fact, reverie may be considered the equivalent of the slightly uncanny feeling whereby, as the unconscious comes to the surface, we may sense it as something situated not ‘underneath’ or ‘behind’ (as if in some sort of storage room/reservoir/sack/container) but inside consciousness. It is by creating a deep (somato-psychic) connection with the patient that the analyst can help the patient to expand both the area of ‘thinkability’ and that of his own psychic container (i.e. the process of weaving emotional threads which will be able to hold floating psychic contents), with container and contained understood as standing in a dialectical relationship with each other, comparable to the reversible dynamic figure/ground.

Step-down transformers

Some patients who protect themselves by building autistic barriers may, at times, make use of a mechanism comparable to what Meltzer et al. (1975) have termed ‘dismantling’. When this occurs, their senses follow different perceptual paths and no longer work in coordination with each other. At such moments, patients may, for example, focus exclusively on the sheer sound of the words they utter, rather than their meaning, like Beckett’s character, Krapp, who loses himself in the endless repetition of the word ‘spool’, drawing out the ‘oo’ sound in sensuous preoccupation and delight. In so doing, they reach a state in which they avoid thought and suspend their attention by hyper-attaching it to some form of sensorial self-stimulation. By scotomatizing their experience, they retreat from reality, make the object disappear and exorcise their terror of separation and loss.

The capacity to coordinate the senses is not fully developed at birth, but is strengthened through the introjection of a positive relationship with the caregiver and the process of somato-psychic integration that follows. When the senses are dismantled, these patients retreat to an illusory sense of continuity of their Self, which has not yet been confronted by the awareness of the separateness of the other – an experience that for them would trigger an unbearable feeling of dread. They thereby attempt to escape from their hypnotic fascination with the object, an entity which on the one hand could restore the dispersed fragments of their Ego, but on the other is perceived as a dangerous monster that could swallow or engulf them.

These patients almost never bring dreams to their sessions, and tend to endlessly and monotonously repeat the same stories from their daily lives. They drain words of their meaning, turning them into mere sensorial elements – dull, empty tones devoid of affective significance. Due to their extreme fragility, attempts to introduce something new into their arid mental landscapes may be experienced as painful. They perceive closeness as a threat and only allow emotions in on a Lilliputian scale. They seem lost in a two-dimensional reality, a grey-coloured world with neither stories nor characters (and when they do, on occasion, speak of characters, they are not engaging). The stage of their mind seems empty. Confronted with such desolate scenes, the analyst’s predominant feeling is that of conducting a dreary, hopeless analysis devoid of the living images that move us. All emotion feels as if it is being sucked into a black hole.

Like black holes, autistic nuclei create zones around themselves that defy contact and exchange. Here the trapped light is the emotions, and the radiations that reflect and reveal the existence of the autistic nuclei are the turbulences produced in the analyst. These turbulences – invariably occurring at moments where a new balance is about to be set – allow us to see things. However, they differ from turbulences developing in the treatment of borderline or psychotic disorders: in fact, they almost seem to be the opposite. Here, everything that occurs is characterized by negativity: ‘Nothing’ seems to be happening. And yet despite this, the analyst comes to feel a strong and almost intolerable tension. Sessions may become pervaded by a sense of stasis or death. While the analyst’s mind is powerfully solicited as container, it is as if we were present at the catastrophe of the collapse of time or a building suddenly imploded due to an abrupt increase in pressure on its surface. What instrument, then, should be used to make the terrible forces acting on the surfaces of the psyche visible? How may we reduce them to a bearable level? The answer is that the analyst must in some way experience (suffer) this collapse and, through reverie, try to transform this negativity into images and thoughts, restoring continuity, temporality and meaning.

In the autistic areas of the mind, the pressure I am trying to describe is connected with the tantalizing and dangerous nature of the object. The subject despairs of existing in the other’s desire and thus of being recognized and becoming alive. It is for this reason that, even though relationships are vital to the patient, he refuses all offers of them. The internal suffering is extremely intense, yet well hidden. It is comparable to a state of agony or near-death, but it is one which the patient barely feels, at least at first, and that the analyst personally perceives as boredom, uselessness and claustrophobic sensations. The analyst may be haunted with doubts, with the fear of finding himself trapped, empty and without resources, struggling to maintain composure, to stay still, alive or alert. Time never passes. It stops, melts away like the clock in Dali’s famous painting.

But even these feelings may be seen as a translation and representation of the indistinct, yet crushing, threat troubling the patient – who, as it were, senses the paralyzing presence of Godzilla without seeing him, because the monster is huge and towering above him. These experiences may also prove threatening to the analyst, who must resist the temptation to shut himself in a mirror-image state of autism of his own, turn off his attention, reset the tension and withdraw to his own private thoughts in order to survive.

What is therefore required of the analyst is a great deal of patience and the knowledge that transformations – if they do occur – can be painful and, for long periods, barely perceivable. The analyst needs to stay constantly and very closely in touch with these patients in the sense of sustaining, enhancing and strengthening their fragile narcissism, while being respectful of their self-protective need for stasis to avoid over-stimulation. Thus, the hypersensitivity of such patients, protected by the shield of autistic functioning, is best approached when the analyst painstakingly strives to detect the most minute signs of movement where everything seems to be still, looking for elements of growth where there only seems to be arrested development – granting hope and trust even when scepticism may seem the most sensible attitude.

As the analyst exposes the patient to his own capacity to tolerate frustration, to his ‘faith’ that it is possible to give things a meaning, and to his ‘thinking method’, this offers the patient the chance to internalize the transformational experience. The image used by Ferro (2006) to describe the analyst’s intervention in autistic states is that of ‘voltage’. If the voltage of an interpretation is too high, it may infuse an unsustainable tension into the relational field, incurring the risk that the field will collapse. When this happens, it implies that the analyst has failed to use an adequate ‘step-transformer’ to reduce the intensity and impact of his intervention.

Consequently, it is always necessary to activate the ‘security device’ of a second look (Baranger and Baranger, [1961–1962] 2008) or of an internal ‘monitor’ to try to catch the signals of the field and the moment to moment clues to its suffering. The voltage must be indirectly proportional to the extent of the patient’s deficiencies in alpha function or in the capacities of his thinking (and dreaming) apparatus. Sometimes, as in situations of massive trauma, the problem is an excessive sensorial influx, which may overwhelm the accepting and transforming capacity of even a sufficiently developed mind.

Less despairing than the image of a ‘black hole’ and with more room for potential positive movement, the metaphor of voltage points to the differential the analyst activates each time he introduces his opinion on what is happening. The points of view of two separate subjects can never completely overlap. If, however, they are similar enough, a fruitful interplay of identity and difference may occur – to be sure, in terms of psychic development, difference is no less important than emotional attunement – patient and analyst may share an emotional experience and the patient’s mind as container may become more elastic and expand.

The puma

I see A., a quiet and melancholic girl, once a week vis-à-vis. She is always on time. She puts her bag on the floor and sits up straight in the armchair, her head slightly tilted to one side, a shy and elusive look on her face. Then, she remains silent for three-quarters of an hour. Each time, I am immediately overwhelmed by a sense of oppression. Time seems to stand still. Perhaps A. needs to slow down until she stops time altogether. Perhaps too often, she went through traumatizing situations, events which have made her feel not really alive and without any control over things. Her nanny, whom A. considered her true mother, died when she was nine years old. Could this occurrence also represent the re-opening of an older wound?

Gradually, similar to the way in which when we turn off the sound of the TV and become more aware of the small details to which we were previously oblivious, I realize I am paying more attention to my own sensations and what is entering my visual field. I am getting more in tune with my own body and posture, as though A. wanted to draw my attention to these primitive levels of somato-psychic (non)-integration; as though she herself needed to entertain a purely fusional and sensorial relationship in the safe womb of the setting. I am reminded of Winnicott’s (1945) distinction between Id needs and Ego needs and think that perhaps here words would only be appropriate if they were in tune with the latter, otherwise they could be hurtful.

A. seems to be really far away, yet at the same time she is totally aware of my every move. During each session I try to get in contact with her, but to no avail. I resign myself to silence. Pure Beckett, I say to myself – but then I think that I do love Beckett...

Table of contents

• Cover Page
• Half Title Page
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Acknowledgements
• Introduction
• 1 The inaccessible unconscious and reverie as a path of figurability
• 2 Poetry of dream and de-personalization
• 3 Embodied field and somatic reverie
• 4 Transformations in hallucinosis and the receptivity of the analyst
• 5 The un/conscious as a psychoanalytic function of personality
• 6 Beneath, behind or inside? The un/conscious in clinical work
• 7 Giving body to the mind: a comparison between Freud’s and Bion’s metapsychologies
• 8 The Grid and the truth drive
• 9 Intermediarity as an epistemological paradigm in psychoanalysis
• 10 Bion’s Evidence and his theoretical style
• Postscript
• Notes
• Bibliography
• Index