Clinical Seminars and Other Works

Wilfred Bion, Wilfred R. Bion, FRANCESCA Bion

• Publisher: Routledge
• Year: 2018
• eBook ISBN: 9780429911989
• Topic: Psicología
• Subtopic: Historia y teoría en psicología

This selection of clinical seminars held by Wilfred Bion in Brasilia (1975) and Sao Paulo (1978) is the nearest we shall ever get to experiencing his application of his theories and views to consulting-room practice. It is also likely to be the only printed record of this area of his work. As those who underwent analysis with Bion will testify, nothing can approach the experience of the thing itself, but, failing that, these seminars may help to fill the gap now that his voice can only be heard through his published writings and lectures.

Part One
Clinical Seminars

Editor's Note

In 1975 Wilfred Bion and I were invited by Professor Virginia Bicudo to spend the month of April in Brasilia. During that time Bion worked with individuals and groups, gave three lectures at the university, and took part in three panel discussions (entitled 'Brasilia, A New Experience') at the Buriti Palace to mark the fifteenth anniversary of the founding of the city. Panel members, representing the arts and sciences, dealt with aspects of the character of the city and the problems involved in forming and developing a new community. I have included his contributions to these discussions.

In April 1978 we spent two weeks in Sāo Paulo—our third visit. Bion held fifty clinical seminars, daily consultations, and ten evening meetings (published in Bion in New York and São Paulo). Such a volume of work demonstrates his remarkable vigour and stamina at the age of eighty.

These clinical seminars, at which Bion preferred the number of analysts present not to exceed six, were all recorded. I am grateful to those responsible for having made possible this printed version.

Owing to the variable quality of the recordings, I have been unable to piece together some of the clinical material, and after a lapse of so many years it has proved impossible to retrieve what has been lost. The necessity for translation (in both directions) significantly reduced the amount of ground that could be covered in each hour.

I have chosen to publish only those seminars that are sufficiently complete to form a coherent whole. The necessary editing in transferring the spoken word to the printed page has not in any way altered the content of Bion's contributions or his style of expression. I have adopted the same methods as those I used in the past with his approval.

He had no prior view of the material presented; the patients under discussion were being 'seen' by him for the first time. His responses were, therefore, spontaneous and give a clear indication of how he worked as one of the psycho-analytic pair.

Francesca Bion
Abingdon, Oxfordshire
August 1987

Brasilia
1975

One

PRESENTER: I would like to discuss a session I had today with a thirty-year-old woman. She came into the consulting room and sat down; she never lies on the couch. She smiled and said, "Today I won't be able to stay sitting here." I asked her what that meant; she said she was very agitated. I asked her what she considered as being very agitated. She smiled and said, "My head is dizzy." She said her thoughts were running away, running over one another. I suggested that when she felt like that she also felt that she was losing control of her body. She smiled and said, "Perhaps; it looks as if that were true." When I continued, suggesting that when her mind was running away like that, her body had to follow her mind's movements, she interrupted me, saying, "Now, don't you try to make me stand still."

BION: Why should this patient think that the analyst would do anything? You cannot stop her coming or send her away; she is a grown woman and presumably therefore free to come and see you if she wants to; if she doesn't want to, she is free to go away. Why does she say that you would try to stop her doing something? I am not really asking for an answer to that question—although I would be very glad to hear any answer that you have—but simply giving an example of what my reaction is to this story.

Ρ: I was interested to know why she had said "Don't try to keep me still". She said she didn't know the answer to the question, so I suggested that she was preoccupied by my being quiet, still. She said that she did not regard me as being still, but as dominating my movements, my mind controlling my body.

Β: As you have been seeing this patient for some time, you both know a certain amount about one another. From the point of view of the group here, I wonder what any of us thinks so far. Do you get a feeling that you want to know more? Or do you feel that you would not want to see this patient again? In fact, I would like to hear what she had to say without my asking questions—were it not for the fact that that is such an extraordinary way to behave. We tend to forget that we may be much more used to analysis than the patient is. It would be quite natural to me to sit there silently and hear what the patient has to say, but the patient might not be able to stand that. A patient coming to me for the first time might be so frightened at such peculiar behaviour that he would get up and walk straight out. So as usual we come back to this point: in theory we can read what we like in all these great books on analysis; in practice we have to have a feeling about what the patient can stand. One's behaviour has to be a compromise; one has to have some concern and make allowances for the patient to whom this is such a frightening experience. I think this is an argument in favour of our behaving in a fairly conventional manner to make it easier for patients, who are under a strain anyway, to say whatever they want to say.

I would like to make a guess here as to what I would say to this patient—not in the first session but later on. "We have here these chairs, this couch, because you might want to use any of them; you might want to sit in that chair, or you might want to lie on that couch in case you feel that you couldn't bear sitting there—as you say today. That is why this couch was here when you first came. I wonder what has made you discover this today. Why is it that only today you have found that you may not be able to sit in that chair; that you may have to lie down or go away?" All that would be much more appropriate if she had discovered it at the first session. But she was too afraid to discover it.

Ρ: In earlier sessions this question of sitting in the chair and lying on the couch had already arisen. But I am considering the idea of this being the first session.

Β: Every session is really a first session. Today isn't yesterday; what the patient is saying today is because it is another day. Of course it is true that it is also because the patient happens to be that particular person.

Ρ: You mentioned making a compromise when the patient first comes for analysis. If every session is a first session, why would there be a reason for changing attitudes afterwards?

Β: Because time is passing and the patient is changing. If it were possible for the patient to make no change at all, there would still be a change because the world is going on; it doesn't stop because we refuse to grow up. It is made a bit easier if the analytic pair remains recognizably the same; it gives a certain familiarity. Similarly, the mother needs to be recognizably the same person every time she comes to the baby; the baby needs to feel it is the same mother. In the analytic situation it is more difficult because the patient is not a baby and the analyst is not the mother. So once more the analyst makes allowances for the patient by being recognizably the same person. But that doesn't mean that one has agreed that the situation should remain static, frozen. Indeed in this respect one is really putting pressure on the patient to grow up, not to remain a baby or a patient or a neurotic or a psychotic for ever. The analyst expects something from the patient besides just punctuality, fees and so on; he expects some improvement.

Ρ: Your suggestion of what to say to the patient seemed much simpler than what is usually said by an analyst.

Β: In a way psycho-analysis is extremely simple, but like every simple thing, for some reason it is awfully difficult to carry out. Similarly, while we always talk—and I think rightly— about sexual problems, it appears that physiologically and anatomically nothing could be easier than having a baby. The objects concerned only have to wait until they are fourteen, fifteen, maybe much earlier, and then they can have a baby. What could be simpler? But the trouble is that we, rightly or wrongly, believe that there is such a thing as a character or personality—the whole of psycho-analysis is based on that somewhat all-pervading theory. So this very simple activity is complicated if the person concerned knows that to have a baby there has to be long preparation beforehand—thirteen or fourteen years of it anyway—and a long time afterwards. Birth is nothing at all—it is a sort of milestone—but there is a long period of development both before and after it. When it comes to the mind or personality, we still don't know how long it takes to create that.

As the analyst, one hopes to go on improving—as well as the patient. That is why I think it is a good thing to leave oneself a chance of learning something and not to allow the patient, or anyone else, to insist that one is some sort of god who knows all the answers. If I knew all the answers I would have nothing to learn, no chance of learning anything. So while the mother or the father must be able to bring up the child even after birth, it is also necessary to leave room for the person to be able to behave like an ordinary human being. It is hopeless if one feels condemned to be, as it were, the great father, or great mother, or great psycho-analyst, or great anything. What one wants is to have room to live as a human being who makes mistakes.

To come back to this patient: if I make allowances and say, "All right, sit in the chair if you want to", or "Lie on the couch if you want to", will the patient make good use of that? Or will she feel that if I have allowed that much freedom, then she will take a bit more? For example, the patient can then say, "Well, all right; if I can lie down here, I'm going to lie down and go to sleep. I'm going to have a never-ending analysis. I'm going to spend the rest of my life coming to you for analysis. I'll camp out in your house."

Ρ: I felt that the patient was trying to feel free to talk with me, but that the liberty to talk with me was at variance with the terms she wanted to impose. I asked her what she would think if I behaved like she did—my mind not controlling my body. She said it would be excellent.

Β: I don't think I would want to ask that question because I would be afraid she would give me an answer which might not be the correct one.

Ρ: When she said it would be excellent, I suggested that she was telling me that she saw a chance of us both being connected, married. She said she didn't like the word, 'married'. She remembered then—although she insisted on not using the word, 'married'—that she had had a dream that night in which she saw our faces and mouths close together. The sensation was a very exciting one although there was no orgasm involved.

Β: She can say, "I'd like that", but this depends on the belief that you wouldn't do anything; she is sure—or thinks she is sure—that you would not marry her. In other words, she wouldn't mind saying how much she would like to have sexual intercourse, or how much she would like to be all alone with you, or her father, or her mother, provided she didn't have to do what fathers and mothers do. So far it's not so bad; she may have been very close to you, but it was only a dream so it doesn't matter. But we, as analysts, think dreams do matter, and so would this patient at some time in her life before she made a distinction between a fact when wide awake, and a fact when fast asleep.

I would begin to be a bit suspicious about this patient; I would wonder whether she really knows the difference between a dream and waking life, or whether she knows the difference between courtship—a love affair—and a psycho-analysis. However, the immediate point is, what shall we say to the patient? It is time, as it were, that we gave her an interpretation. There are millions of interpretations, but there is only one experience, and that is the experience which the analyst here had with this patient—while none of us had it. We can discuss the matter, but that is not analysis; that is about analysis. The feeling the analyst has that something is taking place, can only be known if the patient comes to him and gives him a chance to experience it.

Two

PRESENTER: The patient is a woman, about fifty years old. In the session I am presenting she arrived, kept silent, and then in a demonstrative way yawned and showed that she was sleepy. Then she said, "Why did I come here if I am sleepy? I should stay at home to sleep. I don't come here to sleep." Between each phrase she was silent. I said nothing. After a longer silence she asked, "Why do I come here?" I asked her, "Yes, why do you come? What does coming here mean to you?" She answered, "This means that; this is that." I pointed out to her that this didn't tell me anything. She continued, "Well, I come here to get to know myself better. I think that with your help perhaps things will be clearer to me." But she said this in a very unrealistic way.

BION: One could say that if that is the answer, then what is the trouble? She is hardly likely to come to ask a question to which she thinks she knows the answer. If you ask her, "Why did you come here?", then she can say that is what she is asking you. So I think I should simply leave it and say to her. "You have posed the question; perhaps later on you will be able to say what the answer is!", or simply say, "You have posed the question". I would rather leave her the chance of saying what the answer is when she has found it. It is as well to bear in mind also that there are two people in the room and that this question can apply to one or the other, or to both of them.

Ρ: Suddenly she Interrupted herself as if remembering something I had told her before. She lay down on the couch and turned her head towards me saying, "Didn't I say anything? Well, you said it doesn't mean anything," She stared at me and then said, "You said I didn't say anything—perhaps I didn't say anything." I said, "You look at me as if I know the right answer and that you are supposed to guess it but you can't." Then she said, "You could help me, but you keep saying that I have to do everything by myself here." I said she was attributing me with the ability to help her.

Β: I would have thought that you were working too much. My own feeling about this—as far as I can tell, not having been there—is that I would prefer to remain silent and leave the patient to tell me the answer to this question. If I wanted to say anything at all I would leave it in abeyance. She has asked a question and nobody has answered. The only thing I have heard is a silence; there is apparently no answer to it. I wonder in what way she knows that she has to do all the work. Who has told her this, and what is she hearing in this silence? I don't object to the silence because there are in fact some forms of communication in which people remain silent. There are 'rests' in music—the instruments don't play. So I think I would still leave it at that, or I might—depending on how familiar I think she is with this situation—draw her attention to the fact that she must have some way of hearing what has been said when nothing has been said. Either that, or it is not true. As far as I am concerned I would expect somebody to tell me if I have to do all the work. Otherwise you may get into a situation where you are supposed to help her with...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• PART ONE Clinical seminars
• PART TWO Four discussions (1976)
• PART THREE Four papers
• BION'S WORKS
• INDEX