Post-Kleinian Psychoanalysis

The Biella Seminars

Kenneth Sanders

• Publisher: Routledge
• Year: 2018
• Print ISBN: 9780367326098
• eBook ISBN: 9780429917431
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

The author's book combines a historical approach to the literature of Freud, Klein and the Post Kleinian development, with demonstrations of the central role of dream analysis. Students and practitioners of psychoanalysis and psychotherapy, educationalists, social scientists, doctors, and alll those who value the endeavour to enrich their work with imagination will find fine food for thought in these seminars, both in the survay of the literature, the case histories described, and in the concluding question and answer debates.

Chapter One
Prologue and a consultation

"This in my view is the heart of the matter of Post-Kleinian psychology: that to Freud's four categories of exposition— dynamic, genetic, structural and economic—there has been added in increasing detail the investigation of geographic and epistemological aspects of mental functioning. Whether the Aesthetic aspect will eventually take on sufficient distinctness to add a seventh category remains to be seen."

Donald Meltzer, The Claustrum, 1992, p. 50

Psychoanalysis lends itself to a historical approach, and to following with awe the evolution of discoveries such as infantile sexuality, the transference, and the identification process that linked mourning and melancholia. There is also the drama of observing genius struggling with problems that only become clearer to subsequent generations.

In his autobiography, Freud (1925d [1924], p. 19) describes how his colleague Breuer told him about "the peculiar manner" that had allowed him to penetrate deeply into the causation and significance of hysterical symptoms, which also included "depressive confusion". The peculiar method was to ask Anna O—a 20-year-old woman—to tell him, under hypnosis, the thoughts that she had suppressed at her father's sickbed.

Freud was troubled by the absence of sexual factors in Breuer's report, until he realized that they were precisely the reason why Breuer was reticent about the final stages. After the work of catharsis had been completed, the girl had suddenly developed a condition of transference love; he had failed to connect this with her illness and had therefore retired in dismay.

Freud found that the method of free association was preferable to hypnosis as an aid to remembering and proposed that there was in the mind a dynamic conflict between an instinctual force and a resistance to it from the ego, with the consequence of repression into the unconscious. The relative strength of the opposing forces was an economic factor. The task of therapy was to uncover repressions and replace them by acts of judgement.

"I showed my recognition of the new situation by no longer calling my method of investigation and treatment catharsis but psychoanalysis" (Freud, 1925d [1924], p. 30). The interpretation of dreams became the core of the new method of free association and investigation of transference love.

Two other theoretical or "metapsychological" dimensions were named by Freud: the genetic—that, is, the connection with infancy and the development of infantile sexuality, and the structural—a model of the mind as a complex of different parts, ego, superego, and id. The dissolution of the Oedipus complex led to a parental "precipitate in the ego" named the superego, or the ego-ideal. This discovery of identification processes was a momentous step, linking mourning and depressive illness; it was to become the seedbed for growth of the concent of projective identification.

The Oedipus complex was of genital origin, but the gradual discovery over the next twenty years of the importance of the oral and anal zones and of pre-genital sexuality pointed to the intimacy of children of both sexes with the mother and the influence of toileting and feeding in infancy. In the 1920s and 1930s, when Melanie Klein was first reporting her experiences with the psychoanalysis of children (1932), she demonstrated that pregenital oedipal conflict involved the phantasy of intrusion into the interior of the mother's body, thereby bringing to the fore the question of confusion of identity. The motive for this "manic defence" is the desire to find relief from depressive anxiety, but the consequence is its replacement by persecutory anxiety.

Her emphasis on the role played by the mechanism she named "projective identification" (1946) led to a revised structural model of the mind as an internal family of parents and children in which inner reality was primary—a Platonic view of the limitations of knowledge of external reality.

Her pupils investigated further the confusional aspect of mental illness, and Meltzer in The Psychoanalytical Process (1967) described it as the sequential lessening of "geographical" confusion in both inner and outer reality. Twenty-five years later, in The Claustrum (1992) the geographic dimensions of the mental apparatus are listed as the external world, the womb, the interior of external objects, the interior of internal objects, the internal world, and the delusional system—geographically speaking "nowhere".

Meanwhile Bion (1962) found in the concept of projective identification a path of exploration that led to a theory of the origin and growth of thought. This psychoanalytical concept of epistemology added to the oedipal conflict a description of ambivalence towards the process of thinking itself. Bion described the parental object as a mind/breast, an apparatus that enabled embryonic thoughts to grow in complexity, while negative forces in the mind of the infant self oppose the pursuit of the truth about both inner and outer reality by opposition to symbolic thought. Mindlessness, psychotic, and psychosomatic states imply this interference and the genesis of the irrational and the anti-rational.

Meltzer's suggestion of a seventh category, the "aesthetic", relates to the desire to experience, express, and record those emotions that the "apprehension of beauty" touches and upsets (Meltzer & Harris Williams, 1988). The aesthetic category has a history in the attempts in psychoanalysis from Freud onward to include in a model of the mind the unique importance of beauty. Freud's concept of "sublimation" implies that artistic creativity springs from a guilty need to divert instincts to a non-sexual aim, while the Kleinian concepts of the paranoid-schizoid in conflict with the depressive positions emphasized the reparative aspect of creativity in a struggle between the life and death instincts. But the concept of the sublimation of instincts can now be seen to involve diminished individual responsibility for the negative, callous, and philistine in the life of the mind. Meltzer's emphasis has come from a combination of what has been learned from the observation of babies and their "aesthetic reciprocity" with their mothers, together with Bion's addition of the passion for knowledge, to those of love and hate. This potent combination of "LHK" in conflict with their negative "-LHK" has led Meltzer, in disagreement with Melanie Klein, to suggest that the depressive experience precedes the paranoid-schizoid, and that it arises in the presence of the mother, at birth, when it experiences "love at first sight".

This is the aesthetic conflict, which can be most precisely stated in terms of the aesthetic impact of the outside of the "beautiful" mother, available to the senses, and the enigmatic inside which must be construed by creative imagination. [Meltzer & Harris Williams, 1988, p. 22]

This anxiety about arriving at the truth about the aesthetic object— and therefore its value—makes for a "family resembance" (Wittgenstein) between artistic, scientific, theological, and philosophical endeavours to comprehend the mind with its passion to understand itself and its world, internal and external. But the truth, like beauty, has a blinding quality, and the offer of anaesthesia is constantly available from -LHK—that is, narcissistic organizations, internally and externally. Inevitably, the artist-scientist as psychoanalyst finds that the problems with which he grapples have already been addressed by the world's poets and artists—for example, this passage from a letter of William Blake's:

And I know that This World is a World of IMAGINATION & Vision. I see Every thing I paint In This World, but Every body does not see alike. To the Eyes of a Miser a Guinea is more beautiful than the Sun, & a bag worn with the use of Money has more beautiful proportions than a Vine filled with Grapes. The tree which moves some to tears of joy in the Eyes of others only a Green thing that stands in the way.

The "tree that stands in the way" I read as an expression of oedipal conflict about the father! Doubtless the impingement of these mysteries contributes to the desire to express and to record the experiences of the psychoanalytic consulting-room, and while the motives for seeking a psychoanalytic consultation are diverse, identity confusion is ubiquitous. When the confusion is acute, the metapsychological categories described above can be discerned in the manic confusion of scattered thoughts. Insight into the nature of illness in the mind by the self is a major achievement and requires agreement to work on the problem in an appropriate setting.

There follows a description of a consultation in which confusion presented as an emergency in a young man.

A woman from abroad on a visit to her daughter, Sarah, was distressed to discover the degree of anxiety and confusion in her daughter's fiancé. She encouraged the couple to seek help for his panic attacks and his inability to continue with his work, in which he had shown artistic promise.

"Mr A" came for the consultation accompanied by his fiancée:

He is tall and thin, dressed in jeans and shirt. He smiles anxiously, then talks freely, gathering momentum, impatient with my infrequent comments. It started, he says, when he was nineteen, four years ago, when he left home for college—he saw the college psychologist. A sudden depression, headaches, then unable to work at his studies. When he gets them, he goes to bed. It isn't logical—his father is logical, a civil servant. His work is as a draughtsman—Sarah does the same work, they met at college. These attacks are terrible, he is a perfectionist, obsessive, but depression is different. It comes from nowhere. He has been to see his GP, but she wasn't interested. He worries about money, the pay isn't very good—they pay you by the foot—he smiles at me and points to his foot—if they go to the USA, the pay is better—his last job was only twenty pounds a foot, there was an argument, he had to leave. It's not that, it's the depression, it lasts about a week or so and then it goes—it isn't logical. My mother says it's the subconscious—he breaks off and laughs at me—I hope you are not like that—she sent me to see her friend who is a therapist, a colour therapist, you think of different colours—what they mean, yellow, green—I went to talk to her, but.... I am obsessive—for example, I think living in a rented flat is expensive, it isn't perfect, my father is buying us an apartment, he has raised the mortgage on their house, but it means if we go to San Francisco there will be a problem—but we can rent it. I am worried about pollution, as I walk along the streets I feel worried about pollution, but that isn't—it's the attacks of depression. I'm not working just now, neither is Sarah, she gets depressed too, she weeps, her father died five years ago—I was saying I had this job, you draw cartoons, there are easy jobs where there isn't much movement—it's sixty frames per second, the figure is sitting or just slight movement of the head, like this (he moves his head a little), and there are jobs that need a lot of drawing where there is a lot of movement—you begin to feel that it isn't fair, they were paying two hundred pounds a foot—but I felt that it was too much money, it isn't worth that, and I got depressed and had to come home and go to bed....

Mr A has been talking nonstop for nearly an hour. I say we have to come to a conclusion, but he wants to continue talking. I interrupt to ask about his family: there is an older sister, she wasn't very good at college, she goes to parties a lot, I interrupt again to ask about Sarah—she thought she was pregnant two months ago and we were both frightened, but she wasn't—but she is four years older than me, twenty-eight, and she doesn't want to wait too long....

I intervene: "Well, we must conclude"—"No, can't we go on? It's this perfectionism, I can't explain it, and the depression. . . ."

I interrupt and say we have to stop, that I am in fact, like his mother, interested in the unconscious, but not in the way his mother is. Has he heard of psychoanalysis? He smiles and looks vague. I suggest that he wait a few days to find out the effect on his mind of our meeting and then return to see me. He smiles with disbelief and gets up reluctantly.

Sarah is waiting outside. She comes into the consulting-room: how much do we owe you? Mr A is reluctant to leave. I ask her if she knows about psychoanalysis. She says she remembers something they learned at school, she may have a book at home. I suggest they discuss the consultation, return if they are interested. I offer a referral if they prefer it. They leave, confused and smiling, but I hear no more. On reflection, one can sense the presence in his mind of familiar psychoanalytical themes. The anxiety and obsessional states are manifest, as is the manic element. Hypochondria, psychotic anxiety, and geographical confusion are present noticeably in the worry about pollution—an indication that a part of the self has been split off and projected into an internal space of the internal mother, presumably her rectum, and he fears retaliation for its intrusion. The inability to work can be understood as a equivalent to damage to the internal family of his mind and subsequent inability to think; the return to his bed as seeking the sanctuary of mother's arms or as intrusion into her interior. His awareness of inner reality, perhaps of Freud, is mentioned only to be ridiculed and denied.

Bion divided mental life into symbolic, non-symbolic, and anti-symbolic. The experiences of emotional life in the infant create primitive thoughts that have no meaning until they are subject to the thinking provided by the maternal reverie of the mother. This begins the process of symbol formation. Primitive thoughts that escape this treatment remain non-symbolic; they can be described as mindless or irrational and demand evacuation from the mind. In addition, forming symbolic thought is actively attacked by anti-symbolic forces, with the consequence of hallucinatory and other manifestations of psychosis.

In the work of psychoanalysis the mind/breast of the analyst functions like maternal reverie to toilet the mind of evacuated meaningless thoughts and to contain and modify primitive thoughts into symbolic form, so that thoughtfulness can take the place of confusion. Meanwhile this young man inhabits a threatening world of his own creation and it is difficult for him to understand that a more benevolent one exists in the mind of others, perhaps even in that of his fiancée.

Discussion

Q: What do you think will happen to this young man? Isn't it alarming that he has attempted to get help from his family doctor without success and hasn't taken up the offer of psychological help?

Q: I find it more sad than alarming—two young people who have been together for four years and feel themselves to be a couple, yet their future seems to be hopeless unless he can accept psychological help.

Q: Do you think the ultimate diagnosis might be psychosis—that he may lapse into schizophrenia?

A: I don't think it's possible to know, but the method of investigation remains the same—to provide a psychoanalytic setting and discover whether the patient can use it. If the patient does not "take to it", then he will try to find relief in other ways—for example, through the psychiatric and social services. The diagnostic labelling of mental illness familiar from psychiatry refers to the description of the outward behaviour. Once one abandons that, one finds that manic-depressive mechanisms of denial of inner reality, mechanisms of splitting and intrusive projective identification, neurotic states of anxiety and obsessionalism, and so on are all deployed against the experience of the depressive pain that originates in ambivalence.

If he does commence psychoanalysis, there will begin a very slow process in which the realization that he is ill will become meaningful to the healthy part of his personality. Donald Meltzer describes as the "preformed transference" the consequence of the confusion caused by splitting and intrusive identification—in other words, that analysands for a prolonged period assume that the analyst inhabits, and has the same view of, the world as themselves. The phrase "the same as" recurs frequently in many contexts. A true infantile dependent transference must await the realization that the analyst lives in a world of depressive rather than persecutory anxieties (Meltzer, 1967, 1986).

Q: On the surface there does not seem to be any obvious oedipal conflict.

A: True oedipal conflict only appears if the self is on the outside of the internal mother's body and experiences ambivalence to the couple. This does not happen if the phantasy is of living in the interior. In that case, the internal father as guardian of the mother's orifices has already been bypassed. The retaliation that is feared when living on the outside was described by Freud in genital terms as "castration anxiety". In a world of aggressive pre-genitality, oral and anal, the retaliation feared is appropriately oral and anal: biting criticism perhaps, or persecution by a polluted (rectal) atmosphere, and of being voided as worthless.

In Klein's terminology, the ambivalence is to the mother and father as a couple; in Bion's terms it is ambivalence to the mind itself and its capacity to be thoughtful, and he memorably remarked that the first hopeful sign in the psychotic individual is the realization that he is mentally ill.

It is helpful to be aware that these psychoanalytic ideas do have a striking affinity to the famous simile of the cave in Plato's Republic, which describes the mind's development from confusion and illusion to thoughtfulness and wisdom. His graphic description of people confined to a cave watching shadows projected onto a wall in front of them, like a cinema-screen mistaken for reality and ignorant of the sunlight and the world outside, also envisages the scepticism that would greet any more enlightened person returning to the cave to bring news of this other world. Clearly this also lends itself to a theological reading, and one begins to be aware that psychoanalysis is in fact one of a family of related attempts to comprehend the mystery of the mind and the thoughts it generates about the world.

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• ACKNOWLEDGEMENTS
• FOREWORD
• PREFACE
• 1 Prologue and a consultation
• 2 An adolescent emerges from confusion
• 3 Dreams: who writes the script?
• 4 Identification and the toileting of the mind
• 5 The mermaid and the sirens
• 6 The combined part-object: from "the woman with a penis" to "the breast-and-nipple"
• 7 The combined part-object in infant observation and practice
• 8 The Oedipus complex and introjective identification
• 9 Psychosomatic and somapsychotic
• 10 Epilogue: claustrophilia and the "perennial philosophy"
• REFERENCES
• INDEX