Second Thoughts

Selected Papers on Psychoanalysis

Wilfred R. Bion

• Publisher: Routledge
• Year: 2018
• ISBN:
  9780429918803
• Edition: 1
• Topic: Psychologie
• Subtopic: Geschichte & Theorie in der Psychologie

Second Thoughts is a collection of papers on Schizophrenia, Linking and Thinking, and is a commentary upon them in the light of later work. Originally composed between 1950 and 1962, it derives its title from the lengthy critical commentary which Bion attached to these case histories in the year of publication, 1967, and represents the evolutionary change of position marked in his three previous books and brought to further refinement in the present work.

1
Introduction

IT is customary to find in a book of collected papers on psycho-analysis, a number of case histories; this book is no exception. Ostensibly there is an account of the patient’s history, some detailed reports of sessions with the patient’s associations and the interpretations the analyst has given. It has always seemed to me that such reports are open to the objection that the narrative and the interpretations given are only two different ways of saying the same thing or two different things said about the same fact. With the yean my suspicion has ripened into conviction. I have attempted to formulate this conviction in three books, Learning from Experience, Elements of Psycho-Analysis, and Transformations, each one carrying the discussion a little further and making the formulations more precise. Now the time has come to reprint old papers I find that the change in my views about psycho-analytic method makes me unwilling to let them go out without showing what that change is. For those who want the papers as they were originally printed, here the papers are, but I have added a commentary which involves an evolutionary change of opinion. I do not regard any narrative purporting to be a report of fact, either of what the patient said or of what I said, as worth consideration as a “factual account” of what happened. In the first place, I do not attribute to memory the significance it is usually given. The fact of involuntary distortions is so well established by psycho-analysis itself that it is absurd to behave as if our reports were somehow exempted from our own findings. Memory is born of, and only suited to, sensuous experience. As pyscho-analysis is concerned with experience that is not sensuous—who supposes that anxiety has shape, colour or smell?—records based on perception of that which is sensible are records only of the psycho-analytically irrelevant. Therefore in any account of a session, no matter how soon it may be made after the event or by what master, memory should not be treated as more than a pictorialized communication of an emotional experience. The accounts of cases in this book, though sincerely supposed by me at the time to be factually correct (I exclude alterations made and acknowledged on account of discretion), should now be regarded as verbal formulations of sensory images constructed to communicate in one form what is probably communicated in another; for example, as pyscho-analytic theory, either in the same paper or in some part of psycho-analytic literature. If this seems a harsh reassessment, I reply that progress in psycho-analytic work will cease unioss this reassessment is seen to be essential; it should be the jumping off point for a new attitude to scientific work—others no less than our own. The papers are reprinted in their original form for those who find it easier to regard them as factual reports. I have added commentary to express my changed view.

2
The Imaginary Twin¹

1. The patient from whose analysis I draw most of my material had had many years of psycho-therapy which ended when the therapist advised leucotomy. In view of a shocking family history and the strains to which the patient had been subjected in early childhood the doctor who referred him thought the oiitlook bad.

2. The patient had a sister 18 months’ older than himself who died of a disease, from which both suffered, when the patient was one year old; both had severe diarrhoea during the course of the illness.

3. The family associated closely with their neighbours whose children, two girls, one two years’ younger than my patient, the other seven years’ younger, were his only playmates until he was ten. The younger died in an asylum before the war; the other still survives but in a state of incurable insanity, supposedly schizophrenia.

4. Disunited parents complicated his childhood. This was spent abroad in a country which was developing its football and other sports so that when it was discovered that he was an athlete, and intelligent, then the way seemed clear for a popular and successful career. But the family fortunes deteriorated and the domestic relationships with them, until at thirteen the boy had had a breakdown from which he made no adequate recovery though he returned to, and has continued in, work. His Mother died after years of chronic and painful illness, when he was 17; the Father, many years later. His circumstances were further complicated at the time of his Mother’s death by the need to leave his native land and start afresh here.

5. When he came to me I saw a man of 43, just under 6 ft. in height, of wiry build, sallow complexion and dull expressionless features: by profession a teacher. The discussion of his difficulties was perfunctory, carried on for his part in monosyllabic listlessness. He agreed without enthusiasm to give analysis a trial.

6. My account of the next two years must necessarily be compressed. The central theme of the analysis was contamination: he had to protect his head from the pillow by resting his head on his hand; he could not shake hands; he felt that he contaminated the bath on which he relied to give him a feeling of cleanliness and that it contaminated him back again.

7. He feared that he drank too much; he wondered if his penis was erect; he could not bear to have someone sitting behind him on a bus; it was equally contaminating if he sat behind someone.

He began to wonder if he felt sexual with his students; before long suspicion turned to certainty, and this made him feel unclean.

In his associations a big part was played by phantasied therapeutic injections which he had given, only to fear that his needle might not have been properly sterilized.

8. During the whole of the first two years, I had great difficulty in being able to determine, from his reactions, what validity to assign to my interpretations. I did, on two widely separated occasions, hear, from an extra-analytic source, that the patient was said to be greatly improved. I, myself, saw no improvement; nor was I able to remark, what I now believe to be true, that a change began to manifest itself in him at the end of this period. Till that time his intonation had been uniformly drained of emotion and his statements correspondingly difficult to interpret for they almost always had the ambiguous character which admitted of different meanings if one considered them now with one emotional content, now with another.

9. There was plenty of oedipal material, produced on a most superficial level, which I duly interpreted, to meet with a perfunctory response or none at all.

My awareness of a change in the analysis developed over a period of some three months. At first it seemed as if my interpretations were only meeting with more than usually stubborn indifference, and then as if I was a parent who was issuing ineffectual exhortations and warnings to a refractory child. In due course I pointed this out to him and a change, not easily formulated, occurred. There was still the dreary monotone of associations but there was now a quality which derived from what I can best describe as the rhythm of his associations. It was as if two quite separate co-existent scansions of his material were possible. One imparted an overpowering sense of boredom and depression; the other, dependent on the fact that he introduced regularly spaced pauses in the stream of his associations, an almost jocular effect as if he were saying “Go on; it’s your turn”.

10. Examining the matter still further, I noticed that the associations were all stale associations inviting a stale response. If I broke the rhythm, he showed signs of anxiety or irritability; if I continued to give the interpretations, which it now became clear he both invited and expected, there emerged a sense of having reached a dead-end. I was not surprised when he said to me in the early part of the next session, that he felt the treatment was getting nowhere and was doing no good: did I think, he very reasonably asked, that it was worthwhile going on?

11. I replied that though estimations of progress in analysis were difficult to make there was no reason why we should not accept his evaluation as correct. But, I added, before we pass on to consider what should be done about it, we need to know what is meant by treatment. It might mean psychoanalysis; in which case it would appear that some other method of approach to his problems would have to be sought. A perhaps more obvious meaning would be, psycho-analysis as practised by myself, in which case the remedy would lie in a change of analyst rather than a change of method. There was, however, yet another possibility. We had already had reason to suppose that alleviation of symptoms was sometimes achieved by factors incidental to analysis; for example, the sense of security obtained from feeling there was someone to go to. It was possible that he was unconsciously referring to some factor of that kind.

12. There was a silence and since we have now reached the point at which I must introduce the topic to be discussed, I shall take this opportunity to place before you some details of the analysis of the previous years, which are necessary for an understanding of what follows.

These details were not at the time important, but belonged rather to the periphery of the main stream of his associations. They derived from the point at which he introduced some new episode or anecdote that he was recounting. Thus he would say about some story that it had been told him by his homosexual brother-in-law. Or else that it was while visiting such and such a friend that he experienced particularly distressing symptoms. His circle of acquaintances was very great and as the theme of the analysis derived from the content of the story, I had no reason to pay much attention to the various characters thus casually mentioned. It is to this aspect of his associations, now become central and not peripheral, that I must retrospectively turn.

13. But first I would draw your attention to this: he would say, “I was thinking of talking to Mr. X and telling him that etc., etc.” One day my attention was arrested by some peculiarity of phraseology, or maybe it was the somewhat improbable character of the remark, and I asked if he meant he had actually said whatever it was he told me. “Oh, no,” he replied, “I am just imagining it!” It then turned out that many conversations introduced by the phrase “I was thinking of talking to Mr. X” or “Mrs. Y” were imaginary conversations although not by any means all of them. I had mentioned then that it sounded as if no clear distinction was being made between the real and the imaginary, but at the time this feature had not the importance that it was now about to assume.

Among the characters to whom he had spoken, whether in fancy or fact, a considerable part was played by a man of his profession, of similar age, with the same symptoms as himself, married and with a family. He resided still on the Continent, worked full hours and with such success that no one even suspected he had any illness. This man was able to travel freely which my patient could not. My patient would seem to contrast himself unfavourably with him.

There was, as I have said, the homosexual brother-in-law, a man of the same age, perhaps stouter, but definitely homosexual and with an incestuous attraction, perhaps even relationship, with my patient’s wife.

There was a man with whom my patient played tennis; of this character I heard no more than that he played tennis.

There were a number of students of his, psychological cases he would remark, that had sent him other students. There was even one who had sent him a psychological case and he had wondered if he had realized that he was a psychological case when he sent him. (The ambiguity in the use of the relative pronoun is not a failure in grammar but rather a masterly expression of the patient’s ability to convey much information, too much information, concisely).

There was an unpleasant colleague, whom he had known as a child and who had been contemporaneous with him in school, and now taught close by, who occasionally looked after his students, but he was so unscrupulously thrusting that my patient proposed not to use him again.

14. Let us now return to the patient whom we left silent after my summary of the issues confronting him before he could make a decision about treatment: I asked him what he was thinking about.

He replied that he was thinking about a woman with rheumatic pain. “She’s always complaining about something or other and I thought,” he said, “that she’s very neurotic. I just advised her to buy some amytal and packed her off.”

This, I said, was probably a compact description of the treatment he was having from me, treatment of which he doubted the efficacy. My interpretations were felt by him to be vague complaints to which he paid scant attention; his associations were many of them stale associations employed more for the soporific effect they shared with amytal than for their informative value and designed to keep me employed without bothering him. But, I added, we should also consider how this situation was rendered tolerable for himself and I drew his attention to peculiarities in his behaviour, notably the rhythm of “association—interpretation—association” that indicated that I was a twin of himself who supported him in a jocular evasion of my complaints and thus softened his resentment. He could identify himself with any one of the three roles.

His response was striking. His voice changed and he said, in a depressed tone, that he felt tired and unclean. It was as if, in a moment, I had in front of me, unchanged in every respect the patient as I had seen him at the first interview. The change was so sudden as to be disconcerting. What on earth, I wondered, had happened to the twin and the complaining parent? It was as if he had swallowed them and was suffering the consequences.

That was the end of the session. When I had recovered from my surprise, I remembered that we had often had reason to suppose that he felt he had a poisonous family inside him but that was the first occasion on which I had had quite such a dramatic exhibition of himself in the act of introjecting objects.

15. At the next session, the patient reported that he had had a terrifying dream. It was this: he was driving in a car and was about to overtake another. He drew level with it and then instead of passing it kept carefully abreast of it. The rival car slowed down and stopped, he himself conforming to its movements. The two cars were thus parked side by side. Thereupon the other driver, a man much the same build as himself, got out, walked round to his door and leaned heavily against it. He was unable to escape as, by parking his car near to the other, he had blocked egress from the far door, while the figure blocked egress from his door. The figure leered menacingly at him through the window. He woke in terror, to remain filled with anxiety throughout the waking day.

16. I interpreted the dream thus: the menacing figure was myself who was also the imaginary twin of which he had last spoken at the previous session. The twin was imaginary because my patient had prevented the birth of the twin—there was in fact no twin. His use of a twin as a means of alleviating anxiety was therefore illegitimate and the twin was determined that he, the patient, should not now be born, or to put it in other words, achieve freedom or independence. He was thus shut in, both by the twin and by his own act in parking his car so near the twin’s car. The analysis had been the car from which I had not been allowed to emerge as a real being; the dream showed his fear that in the previous session I had become alive only to block his escape from analysis by using me as a personification of the bad part of himself from which he wished to be dissociated.

17. There now followed a period in which the prominent features of the analysis were exhibitions of introjection and projection, splitting, and, not least, personification of the split-off portions of his personality. In a sense there was nothing new about all this, but as at the same time his analysis became far more integrated and his fear of his mechanisms less pronounced, we were the more able to see them clearly for what they were. In retrospect, I could see how much the anxiety produced by interpretations, made before the emergence of the twin, derived not only from the content of his associations but from the mere fact that I was drawing attention to his intra-physic processes.

18. One result of the increased, integration of his analysis was that I was able to see that certain of his associations announced the theme around which the work, probably of several sessions, would centre. I shall take advantage of this fact to confine the discussion to two associations only, leaving the reader to assume that the material on which I based my interpretations was infinitely more copious than this necessarily compressed account would suggest.

19. The first association was produced before a week-end when he was going away to stay with friends. Week-end holidays and even annual holidays had not been thought of as possible until some six months previously when he had taken his first holiday for many years, but they had now become fairly regular occurrences. He said, “I am leaving a locum in charge of my students: he is not very experienced—the same age as myself but I don’t feel sure he will be able to cope. There is a girl who may become ill and she may have to be admitted to hospital. That would be fairly straightforward except that you have to know the ropes a bit or you may not get the child into hospital. Usually I have an arrangement with a doctor I know well by which he helps when I am away, but this has been mucked up by a misunderstanding.”

From the subsequent working through of this, it emerged that I had been the person who had messed up the understanding between the two doctors by my interpretation of the twin and the consequent forcing back into himself of the twin. The locum was a split-off portion of himself lacking in some essential qualities and in particular the ability to introdu...