Mental Space

David Alcorn, Salomon Resnik

• Publisher: Routledge
• Year: 2018
• eBook ISBN: 9780429916229
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

This book is a collection of lessons on psychotic experience. A question of experience of living and communicating rather than of lessons in the traditional sense. His contributions are the expression of a culture that is both psychoanalytical and psychiatric but above all bound up with the human sciences.

Chapter One
A space for psychoanalysis

I intend this chapter to be a first attempt at creating dialogue between us, an exchange of views between my mental space and yours in order to generate a space between us. I hope that the clinical material drawn from my practice as a psychoanalyst, together with sketches made by some of my patients and paintings by established artists, will help us to get closer to those aspects of our experience which, because they are intangible, are difficult to share.

Freud was fascinated by the work of artists and poets, for he believed them to be in intuitive contact with what remains concealed, repressed, or forgotten in everyday life. Obviously some consideration must be given here to the cultural context in which he was formulating his theories—fin-de-siècle Vienna—and to his ties with the intellectual and artistic life of the time.

In his biography of Freud, Ernest Jones (1953-1957) relates that when the philosopher Ludwig Klages, a friend of Freud's, was asked what was the best way to study and understand Freud's thinking, he replied: "By reading Freud." Jones himself says that the best way to understand the historical development of Freud's theories is to read his writings in chronological order. I recall that when I began my training in Argentina, students were required to read Freud sequentially during their first three years, in much the same way as medical students read anatomy.

Yet reading and quoting from a writer's work is no simple task; every reading is, in itself, an interpretation. Whenever I quote Freud or those of his pupils with whom I worked in London, I cannot avoid interpreting; my mind, my thoughts bring their own influence to bear on the words I read. The text is a domain over which my thoughts and intentions meander to extract a particular meaning, which I can then offer for your consideration (in Brentano's sense of "intentionality"—we know that Freud attended Franz Brentano's lectures at the same period as Husserl). We could say that in his own way Freud was a writer, a poet; see, for example, his "A Disturbance of Memory on the Acropolis" (Freud, 1936a). The etymology of the word "poetry" shows us its links with creation and invention. Freud was a discoverer and explorer who tried to set down what he experienced. He attempted to communicate what he had discovered through clinical material and the practical application of his hypotheses. His research on the activity of the mind, the concept of the unconscious, the meaning of dreams, psychopathology, and artistic creativity is intimately connected not only with his own experience of life, but also with his clinical practice. I, too, use clinical material in order to share with you my own experience as a psychoanalyst and to try to acquaint you with a certain number of theoretical concepts that I consider essential.

But, first, what is theory? It is a way of looking at things, of experiencing certain phenomena. In ancient Greece, θεωρία [Itheoria] meant looking, seeing, observing, contemplating—and, hence, speculation. Festugière, the famous scholar of ancient Greece, declared that the primary meaning of the word θεωρία refers to seeing [θεωρεῖυ: theorein], looking at landscapes, and implies the idea of marvellous (Festugière, 1936). Plato refers to θεωρΟί [theoroi] in the sense of exploratory journeys to far-off lands and seas.

If philosophy is a reflective experience of contemplating the world, the psychoanalytic adventure is an internal contemplation that enables us to look into ourselves and discover what has been excluded from consciousness. To help us do this, we require someone else, because psychoanalysis is an experience that concerns relationship. It is this that makes the notion of transference so important: something is transferred from one to the other, from patient to analyst and vice-versa—what in psychoanalytic terminology we call transference-countertransference. In an earlier book (Resnik, 1986), I suggested the idea of "double transference" in order to emphasize the fact that psychoanalysis is a sphere in which each protagonist takes something from the other and induces something in the other. Bion, with whom I trained in London, used to say that the way in which the patient perceives the analyst is very important; the further removed from authenticity the patient is, the more he requires to develop a semiology, a code for deciphering the other. It is important, too, for the psychoanalyst to understand how he is perceived; hence the idea of inter-dependence inherent in the very concept of therapy. (The term "therapist" is itself very ancient; in ancient Greece, the "therapeuts" were those who took care of the gods. It appears to designate some of Moses's followers, but was also applied to the Essenian sect, the Jewish contemplative order at the time of the Second Temple, whose task was to provide support and relief to anyone in difficulty. Philo of Alexandria describes them as a paleo-Christian sect.)

The psychoanalytic experience has to do also with the idea of investigation; each of us has his own individual world, inhabited by a kind of internal family, a universe of objects to be visited during the analysis. Mental space and internal world exist only if the world can be perceived as having three-dimensionality (see Laplanche & Pontalis, 1967, s.v. "Phantasy"; see also Ferenczi, 1909; Isaacs, 1952). The psychotic often lives in a "deflated" world, a flat landscape without hills or valleys, with no space for emotions or thoughts. Feeling, thinking, imagining—these require internal illumination; Paracelsus declared that the ability to imagine was the sign that an internal sun existed.

To return to the question of theory and praxis and our discussion of the concept of transference: Freud was borrowing an idea from Plotinus and the neo-platonists when he referred to the man within and to the impossibility of dissociating the inner self from the external world. This is precisely where the idea of transference comes in—part of this dynamic exchange with significant others is reproduced in the dyadic context of the psychoanalytic relationship. What we call "insight", the contemplation of our inner world, the discovery of what has remained hidden from consciousness, is not something that occurs in isolation: it is impossible to analyse oneself as though all that were required is to look in a mirror. Freud himself emphasized the limitations of self-analysis.

The mirror, however, is an appropriate metaphor when we refer to the development of imagination. For Winnicott (1958b), the first mirror we know is our mother's face when we look into her eyes; it is a very special mirror in that it reflects not only the baby himself, but also what the mother is feeling. For Melanie Klein, the creation of an imaginary world (psychic reality) is in itself a relationship experience, and the transference originates in such infantile experiences in the early stages of development (Klein, 1952). The term "transference", as I have pointed out, takes on a specific meaning in the psychoanalytic setting, precisely because of the fact that it has to do with relationship. It is for this reason that in psychoanalysis the concept of mental space is not synonymous with internal world; it includes the external world and interpersonal communication with others.

In the psychoanalytic experience, theory and practice are inter-dependent. Within this reciprocity, the analyst's craft and the patient's expertise grow together. Metaphorically speaking, if psychoanalysis is a skill (just like any other), the patient, too, has a task to do, and he has to leam how to do it. Psychoanalysis is ongoing training, further education; when someone strives to be truly himself in his social, family, or academic relationships, he has to develop his own way of doing things, not imitate others. From that point of view, analysis is a process of identification—I shall come back later to this highly complicated issue.

The psychoanalytic relationship is not built simply on the words spoken; it includes the atmosphere generated by a certain type of presence. Good things and bad things are deployed, depending on whether the atmosphere is one of empathy or of antipathy—but if there is apathy, absence of pathos, then there can be no movement, and nothing can occur.

Reaching out towards someone for the first time, in the first session, creates a kind of tension. A transference fantasy is already taking shape as the patient makes his way to the analyst's (in the street, the cafe, the bank). The analyst also experiences some degree of tension, an expectancy, a countertransference fantasy—somewhere on the far side of the transference, or on the other side of the street. The horizon is some distance away, but it may suddenly close in—we call this resistance, fear, or anxiety, in one or the other of the protagonists. The voice on the telephone asking for an appointment, the voice that answers, the exchange of letters—all this creates a context in which something is already being exchanged, it is part of the anticipation from which a relationship is born. The first session is an unveiling, the birth of something new, an exclusive relationship that will develop through time in the analysis. Anticipation gives rise to an illusion, i.e. projection of expectation and creation of an ideal. Once again we can turn to Winnicott and his primary hallucination—the "hallucinated breast", as opposed to the mother as a present and whole object. The concepts of ideal ego and ego ideal were developed by Freud in "On Narcissism: An Introduction" (1914c). Narcissistic satisfaction requires the ego ideal to be accomplished in the ideal ego. The ego ideal constructs an image or model—the ideal ego—a target that it attempts to attain. The ego ideal is always on the look-out for a "superior" or "aggrandized" image with which to disguise itself or to identify. At first, this image is narcissistic, and the supremacy of narcissism, the supremacy of an absolute and homogeneous identity principle, makes it difficult to acknowledge the other in his own right; expectations of him and idealized projections onto him may not coincide with what he really is. Authentic dialogue must be founded on the recognition that every encounter is necessarily asymmetrical; in accepting that the other is dif ferent from me, I discover the reality of my basic solitude (Winnicott, 1958a).

Given the structure of the situation, the psychoanalytic process is a voyage between illusion and disillusion. For analyst and patient to work together even when there is disagreement or when the transference is negative, the analytic process requires a setting, a space, a theatre in which the unexpected and the problematic may be worked out.

Fixing a time and a place for the sessions brings to mind the idea of "field work"—a concept made familiar by the topological writings of Kurt Lewin (1963). Lewin was a pupil of Stumpf, who had worked with Einstein. The notion of "field" belongs originally to the world of physics, Faraday's experiments, and Maxwell's theory of electromagnetism. To borrow the idea of field from electromagnetic theory, we can say that every space, even when it is experienced as a void, possesses its own specific identity and quality. Einstein himself pointed out that Descartes was correct: vacuum is also presence.

The expression "field work" is a metaphor derived from ethnology and anthropology, and as such was familiar to Freud (1912-13). Minkowski, whom Freud quotes, introduced the idea of reaching out towards the other on his own home ground (Malinowski, 1964; see also Kaberry, 1963; Malinowski, 1944). The metaphors Freud borrowed from other sciences—for example, from archaeology—are a typical component of the transference "field", though sometimes discreetly; psychoanalysis is a kind of archaeology that explores the λόγΟς [logos] of the ἀρχή [arkhe]—a quest directed towards the ancient and primitive, beginnings and origins.

"Field work" is a notion employed in American psychiatry, especially by practitioners influenced by psychoanalytic theories (Sullivan et al.), and in Argentina. Enrique Pichon-Rivière (1975) used to say that on closer examination of the very first meeting with a patient, we can see that all the essential imaginary ingredients both of the nervous disorder and of its cure were already present, together with the primitive or in-fantile patterns of object relations.

The idea of rhythm or tempo must also be taken into account. Rhythm requires discontinuity and pauses, and pauses are unavoidable "little deaths". A state of flux, "to become" (Heraclitus), is important, but it is just as crucial to stand still, "to be" (Pannenides), in order to take stock and reflect on the itinerary. Even if a pause is experienced as a loss, as something missing, as a mourning, it is also the ability to accept difference in the real world.

The setting, the space of the relationship, concerns the format of the psychoanalytic work. The patient is heedful not only of the surroundings and of the content of the analyst's comments, but also of the feelings the analyst communicates to him. If what we say corresponds to what we feel, even though the words may not be quite right or to the point, that is perfectly sound practice; but if there is conflict between our words and our feelings, the patient will introject a split image. Therein lies the complexity of the psychoanalytic situation; the unexpected is part of the psychoanalytic adventure, as in every other creative activity.

I think that the greatest quality a patient can acquire after a long time in analysis is ego flexibility, the ability to invent and create the analyst each time. A common language is constructed out of words and gesture, an atmosphere in which communication becomes possible (or, perhaps, impossible); there is presence, too, and a persona, corporeality, ways of behaving or of pretending that each of us possesses. "Reality, the unexpected", said Henri Maldiney.

I remember a story about Italo Calvino. I had asked him to take part in a symposium on creativity in Venice. He replied, "I am busy with the work of creating and inventing the novelist who is going to write my next book." The teaching of theory and technique is provisional; I, an experienced psychoanalyst of many years' standing, cannot foresee the language that will flow between a patient and myself, nor the role or roles I shall be called upon to embrace over and beyond my true self.

These considerations lead me to the theme of this book: mental space, an attempt to reclaim a locus for thinking about what is perceived, a locus that is often transformed or emptied or obstructed or deflated.

Blon, speaking about transference, used to say: "When we speak from within the transference, we bear witness." In this intimate encounter we call psychoanalysis, if the couple formed by patient and analyst are successful in their attempt to work together, then seeing, listening, and perceiving with all of our sense organs become possible. Even when mistakes occur, we can still communicate, for the ability to tolerate error implies the capacity to accept some degree of uncertainty.

With these topics in mind—rebirth, birth of self-knowledge, field work—patient and analyst endeavour to construct a framework to which we give the technical name "setting", a resourceful and enterprising workshop. Field, setting, constructing analytic space, the rhythm at which the work will be done—all are aspects of the analytic contract, which, like every contract, requires two parties.

In the following chapters, I draw on material from sessions with my patients; this is my way of inviting you into my workshop, even if only for a short time. I try to communicate some idea of the way I work, and from these clues you will be able to build up an image, an imaginary picture of a relationship between two people. Perhaps questions of theory and practice will spring to mind; this, in turn, will enable us to open up a space together, a space in which we can attempt to communicate and to build our own little—or big—workshop.

Chapter Two
A space for thinking

In this chapter I discuss some clinical material. I hesitated over this in chapter one because it was our initial contact, and we first had to get to know each other. Reaching out from oneself towards the other always entails a risk: interpersonal contact is indispensable but hazardous.

The analytic experience itself can be regarded as being replete with risk, insofar as what may occur is always different and unexpected. Given the magnitude of conscious and unconscious variables in operation, it requires, as I have said, great stability, which is why I have emphasized the idea of the therapeutic setting, the psychoanalytic situation, and the developmental history of the encounter within the psychoanalytic process.

The notions of sphere, setting, psychoanalytic space, and construction of place and rhythm for the work of psychoanalysis are the fundamental elements of the therapeutic contract. A good contract, just as in fair play, means that you can make the rules clear during implementation: it is creative, meaning that technique and schools of thought are less important than style and personal ethics. Living in a contractual society, we need to reach agreement about rules, but we have to leave some opening for inventing those most appropriate to each case.

The words we use must, at least metaphorically, reach out towards the patient's own language in the same way that in child analysis the words are the play sequences the child brings to his session. In the therapy it is essential for the analyst to maintain a playful ego, which can reach out to that of the patient, even though the latter may be limited, paralysed, or unresponsive.

Let me say a few words now about Liliane.

She is an intelligent and very sensitive woman, but fragile. My impression was that she was not very happy in her emotional life, but as far as I could judge she was not psychotic, and this is why I want to start with her case material. In Kleinian theory, the difference between psychosis and non-psychosis is relative, in that analysts do a lot of work with the psychotic nucleus in each patient, and with both psychotic and neurotic transference phenomena.

Liliane suffered from neurotic symptoms and behaviour disorders. She had a teenage daughter with wh...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Dedication
• ACKNOWLEDGEMENTS
• Contents
• FOREWORD
• PREFACE
• Introduction
• CHAPTER ONE A space for psychoanalysis
• CHAPTER TWO A space for thinking
• CHAPTER THREE A space for dreaming
• CHAPTER FOUR Mirrors, corridors, and tears
• CHAPTER FIVE Space, illusion, and hallucination
• CHAPTER SIX A geometry of space: mental space and the transference
• CHAPTER SEVEN A space for delusion, a space for creation
• CHAPTER EIGHT A space for concluding
• REFERENCES
• INDEX