Bion in Brazil

Supervisions and Commentaries

Wilfred R. Bion, Jose America Junqueira de Mattos, Gisele de Mattos Brito, Howard B. Levine

• Publisher: Routledge
• Year: 2018
• Print ISBN: 9781782203209
• eBook ISBN: 9780429911453
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

The discovery, translation into English, and publication of these previously unpublished recordings of Bion's clinical supervisions in Sao Paulo, Brazil, with commentaries by leading Brazilian psychoanalysts, gives readers the opportunity to experience for themselves his clinical and theoretical thought as it emerges and evolves through a series of fascinating case discussions.

Chapter One
Supervision A1

In the text that follows, T stands for translator; P1 and P2 stand for Iparticipants in the audience of the supervision.

T: This patient came to analysis concerned about all the lies he had told to the people with whom he lived in order, to appear as a “normal” person. One of the lies was that he met a girlfriend when he went away on vacation. When he returned from one of these trips, he was with his school friends and they were mostly girls. On the way up in the lift, they asked how things were going with his girlfriend and he became very disturbed. So, he didn’t go up the lift, he went up the escalator. Then, when he found the girls waiting for him, he realized that he had made up the story and felt ill with anguish and then he didn’t know who he really was, where he came from, or if he was meeting the same people again that he had met down below. This, the patient told to the analyst, in his first interview, while sitting on a chair, and moving about, posing as if he were a clown.

Bion: Can we just pause there? Supposing all of us saw this patient for the first time, does anybody have any idea what your impression would be about it? Take a guess. I’d like to suggest … Have you all got paper? Because, I think it might be quite interesting for you, if you’ll write here, how, in any order, the first impression that you get about this patient. Now, when you’ve done that … turn it over and hide it from yourself— like that! Just hide it from yourself. Just fold it over, so you don’t see it, turn it back, whichever you like! Shall we go on?

T: In his experience with this client, A came to know a fact that was very important. The story the patient told was that he had observed his father constantly worrying about economic security and how much money he had in the bank. The patient had similar worries and when he realized this he also realized that he wished that his father—whom he didn’t like, who was a very unlikable person, would die so that he could inherit his father’s wealth. Six months, later, when he was conscious of this death wish, in relation to his father, his father died unexpectedly of a very sudden illness.

Bion: Did he call it a death wish?

T: He called it a death wish and felt as if he had done something that, in fact, had killed his father.

Bion: … Anything about this case? Any impression that you get?

T: [At this point, the translator informs the group in Portuguese that she has an opinion] It’s not so much about the case, but (A) had said that he had the impression that the patient was a young man, but he actually was not a young man. What I noticed is that A is still speaking about him, as if he were a very young man.

P2: Like prince Hamlet! Denmark.

T: Now he is twenty-six years old.

Bion: I don’t know if you’d like to write again, once more, your diagnosis and fold it over again. Write it and hide it from yourself. We started by making our first correction of the impression, from the very first, the first goal and then hiding that. This is the second time we’re giving our impression. I’ll give you my impressions if you like. I don’t know whether you’d like me to give you my impressions now, because I’ve also changed in the same way!

P1: Give your impressions!

T: Yes!

Bion: I don’t want to make any pronouncements about the patient, but I would like to give you an idea of the way that I think about this patient. Now, one point is: why does he look young? Is it his skin? Is it his small muscles of the face? Is it his posture? Because none of that has to do with what he said—but it is what his body says. It’s what we can see, with our eyes, without touching him. There are one or two other things, which I would expect to notice. For example: was there an odor, a smell? Language corporal and psychic body language? Similarly, if I were a musician, how would I record the sounds that he makes? However, the first point is: how does the patient make you think what his age is? And how does he contradict that? If you feel that the patient is younger than he looks like.

P2: Is it a question that you are asking?

Bion: Well, I’m asking you to think of this; this is what I would be doing. Now, suppose the patient hasn’t said that he is twenty-six? Is there any way in which his body has said, that he is older than twenty-six? What part of his body has said, that he is younger than twenty-six? Now, if that is the case, does the body conflict with the body? Or are conflicts only up here? [Bion indicates his head].

We talked about conflicts and we usually mean mental conflicts. What I’m suggesting is that we forget all that and remember this idea of conflict. For example: the patient might disagree with me—in which case, he would certainly be disagreeing with himself and with me. I don’t want to bother about that. What I’m bothering about is that he looks younger than he is. What part of his body tells me he is older than he looks? What part of his body tells me that he looks younger than another part of his body tells me he is?

T: What was the second option … could you …?

Bion: Simply: the two sides of it! What says that he is old? What says that he is young? For example, if his voice and manner were that of the young man, but shall we say, that his hair was gray, would his hair be disagreeing with his muscles? That’s just to give an idea of why I would want to know how his body is contradicting his body. Now, the other point that strikes me is that he talks as if he had learnt how to imitate everybody, in relation with being aware of difference, imitates everybody else. But as if he were aware that he is not like everybody else. He’s learnt to look like everybody else, but he is not like everybody else—he is not in fact. Now, I don’t think I would want to say anything to him, but there is a difficulty, because if I were there, if I didn’t say anything, the patient might become too anxious. Therefore, I would want to watch in silence, but if the analyst’s silence is making the patient feel anxious, then he might leave the room and not come back again. So, this becomes a matter of difficulty for the analyst, because the analyst needs also to help the patient stay in the room. It might be a good thing to consider whether you would say anything or not, so far.

T: A would like to add something now.

Bion: Yes.

T: A is very grateful, in a way, because of the way we are talking about speaking and not speaking, in the session, because this arises, even today in his relation with the patient: speak and not speak. The patient, when he is silent, gets so anxious that he has the impression …

Bion: When who is silent?

T: When the analyst, is silent, the patient gets so anxious that he himself starts speaking, saying things like, for example: the interpretation he imagines he would hear if the analyst should speak to him. He says to the analyst: “Speak, tell me anything, make even a noise, because I can’t stand the silence.”

Bion: Now, here again, musicians have certain advantages, because they can make notes on paper, which represent notes of music. Musical sounds that patients make. But amongst these marks they make, they also have what they call: rests, breath stops, and so on … I don’t know if anybody is a musician, so, it would be quite a good thing to notice that the patient can’t stand the silence. Why some patients cannot tolerate silence … Now that is a very common thing. If you are dealing with a child patient, the parents find it very difficult to tolerate the analyst’s silence, having known you only through their child. So, very often, it is useful if the analyst can say to the parents: “Don’t talk to me, talk to Dr. X he’ll help you.” With a grown man, with the adult, it’s more difficult because he is the parent. But the statement the patient has made is, in fact, putting pressure on the analyst to make him talk—because if the analyst doesn’t talk, the patient might go away and never come back again. On the other hand, if the analyst does talk, he may be compelled to talk prematurely before he wants to. Now, why can’t this patient stand a silence?

T: P2 asked if he can speak to you?

Bion: Oh, yes!

T: P2 thinks that the patient, in this moment, is reviving some experience with his primary love object; in this case, his mother, and therefore he couldn’t know what was happening to him. He didn’t have a symbol to signify in the beginning what he wanted to say and he was demanding that the mother should … communicate with him. He asks Dr. X if the client expressed anything through his actions. It seems that the client doesn’t speak or doesn’t have much symbolic capacity.

Bion: Now, to get on to this second point, which I’m working on all the time, namely: the practice of analysis! Suppose we all agree, that we would think that, about the patient what would we do? What would you say to the patient? Would you say anything or not?

T: A would like to say, what he has been doing and P2 suggests he should say this at the end.

Bion: Well, again, I’d like to suggest that you write down, on a bit of paper, whether you’d say anything or not and if you would say something, what would that be—and again, turn it over! To fold a piece of paper is rather similar to forgetting. Notes, taking notes, memory, and desire. What I said before in terms of not keeping to memory or desire. Memory: the past; desire: anticipation. So, by hiding what you’ve written, is like forgetting it. Memory and desire in relation to taking notes. Now, here again, I’d like to tell you how I think about it. I would consider that the patient is having a very unpleasant experience. The unpleasant experience is being dependent and being all-alone. Being dependent and all-alone. They’re indistinguishable. The patient is all-alone with the analyst. He is both dependent on the analyst being there—which is a nasty feeling—and he is all-alone, which is also a nasty experience. If I thought the patient might walk out and leave the room, I think, although I mightn’t want to say anything, I would say what I’ve just said. I would say: “You are finding this very frightening to be all-alone in this room with me. Perhaps we shall find out, perhaps we shall understand this more later.” I would prefer, if I could, not to say anymore—but I would prefer, if I could, not to increase the patient’s anxiety, either by remaining silent, or by saying too much. But I would like to make it clear that, while I would like to be able to do that, I would hate to give the impression that I knew how to do it. Here, in this group, it’s much easier to talk about this. It’s much easier for me than for me with the patient. It’s different from being the analyst. I don’t think that I would be, at all, surprised if such a patient didn’t come back again—whichever I did.

T: P2 is asking if it wouldn’t be very bad for the patient, if this situation were repeated, from his childhood, in which he didn’t receive words or something from his primary love object and now the situation happens again. If it doesn’t repeat the situation of the frustrating object in the present situation?

Bion: There’s always that risk. That is why it is so much easier to talk about this, when the patient isn’t here. Psychoanalysis is extremely difficult. The theory is quite easy; it’s easy to theorize about this. That is why I don’t want to give the impression that I think that the practice of analysis is easy. So often and unfortunately, it is encouraged by institutions of psychoanalysis, that it’s considered to be a bad thing to lose a patient. Practice of analysis is much more difficult than the theory. Theory of psychoanalysis is much easier than practice. It may be a bad thing: but practicing analysts lose patients. There is no such thing, as a practicing analyst, who isn’t always losing patients. Losing patients … is it a bad thing losing a patient? When one is young and inexperienced, then one thinks it’s terrible to lose a patient! When you are my age you’ve gotten used to it. For the patient, it is also a terrible experience to get lost. He isn’t used to getting lost; feelings of getting lost. Frustrations that the patient experiences. Now, I think that this particular patient also, may not be at all familiar with frustrations, because I suspect, very strongly, that he has learnt to behave like everybody else, in the way that a good mimic can. The sort of mimic, who can professionally take up an acting profession. He isn’t good enough to be able to do that. So he’s not a professional actor/actress. But he isn’t good enough to be real either. So, this matter is difficult, because part of the analytic situation is, for the patient to get used to frustration and it helps him to feel that the analyst, likewise, is frustrated, but is not so frightened of it.

Now, I’m afraid it’s time, isn’t it? Hum … if you’ve got a moment, can you now write down what, in any order, any thoughts you have about this patient and then, if you’ll compare, what you’ve written on your first bit, with the second and also, if you’ll compare the order; if you take wh...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• ACKNOWLEDGEMENTS AND DEDICATION
• ABOUT THE EDITORS AND CONTRIBUTORS
• FOREWORD
• INTRODUCTION
• CHAPTER ONE Supervision A1
• CHAPTER TWO Supervision S12
• CHAPTER THREE Supervision A25
• CHAPTER FOUR Supervision A30
• CHAPTER FIVE Supervision A10
• CHAPTER SIX Supervision A3
• CHAPTER SEVEN Supervision A45
• CHAPTER EIGHT Supervision S28
• CHAPTER NINE Supervision D17
• CHAPTER TEN Supervision A36
• CHAPTER ELEVEN Supervision D11
• CHAPTER TWELVE Supervision A2
• CHAPTER THIRTEEN Supervision D8
• CHAPTER FOURTEEN A journey’s notes
• INDEX