Psychoanalytic Practice Today

A Post-Bionian Introduction to Psychopathology, Affect and Emotions

Antonino Ferro

• Publisher: Routledge
• Year: 2019
• eBook ISBN: 9781000022452
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Psychoanalytic Practice Today offers the reader a good understanding of the school of thought inspired by the late work of Wilfred R. Bion. The contributors share a belief in the curative power of the analytic encounter and in the capacity of the human mind to develop from the encounter with a mind capable of reverie, dreaming and thinking. The multitude of vignettes presented emphasise the necessity of the emotional involvement of the analyst with his or her patients for improvement to take place.

The book is divided in two parts: 'Psychopathology' and 'Emotions and Feelings'. The first part adapts a more classic description of psychiatric disorders by diagnostic criteria, from neuroses to psychoses and including depression and borderline states. The second part of the book takes a closer look at specific clinical manifestations of basic emotions such as anger, surprise, sadness and more complex ones such as jealousy, abandonment and betrayal. The common thread is represented by the central place of dreaming in the psychoanalytic field as a tool to understand these clinical manifestations, and to allow for their psychic representation as an emotional experience.

The contributions together offer a varied introduction to current ideas that are growing increasingly interesting to English speaking readers, with a sufficient character of originality, irreverence and creativity that bears witness to the maturity of Italian psychoanalysis. Psychoanalytic Practice Today will offer new ideas to the practicing psychoanalyst and psychodynamic psychotherapist.

Part I
Psychopathologies

Chapter 1
Anorexias and dyschronias

Antonino Ferro

We know that there are a variety of defence mechanisms against very primitive anxieties.

For purely illustrative purposes, we can list the following:

1. Modes of elimination:
   1. repression;
   2. splitting;
   3. evacuations.
   The last of these can occur
   • in the body: psychosomatic illnesses;
   • by inverting the functioning of sense organs: hallucinations;
   • in the body social: transformations in hallucinosis, characteropathies, and criminal behaviour.
2. Modes of “staunching and management” without large-scale evacuation (immediately perceptible):
   1. Hibernation: that mode in which the field is put to sleep, sedated: by boredom, for example. It is like a circus in which the lion-tamers and animals, especially the fierce ones, have been put to sleep. This comes about through particular communicative strategies: for example, a discourse based on a predominance of coordinate clauses (which form a kind of open plain that tends to grow misty in the absence of any alternation with the landscape of subordinate clauses) or through hypnagogic projective identifications. In these modes, emotions end up in hibernation.
   2. Bonsaification: this consists in the miniaturising of emotions, transforming them into mini-emotions with no force; it would be like turning an oak tree into a series of bonsai oaks. In this way, worlds of micro-emotions are created which find narrative voice in worn-out, cut-price stories where everything is made saccharine, free from conflict, and free from any kind of passion.
   3. Computerisation: this mode is not very different. Violent emotions are turned into computer games and role plays. It is not unlike the technique used by Quentin Tarantino in Kill Bill: whenever the emotions at work are too violent, the scenes with actors are turned into animated cartoons, losing their overwhelming, bloody violence.
   4. Glaciation: this is a mode in which freezing or petrification are used to extinguish emotions that are feared because of their indigestibility. When the bulls are running in Pamplona, if we lower the temperature to many tens of degrees below zero, or if the bulls are turned into statues, the problem of the uncontainability of these emotions is (apparently) solved.
3. Predominantly spatial modes:
   1. quashing;
   2. two-dimensionalising;
   3. linearisation.

These modes bring into play the defence mechanisms associated with the autistic spectrum, including those of Asperger’s syndrome. One example is Chekhov’s extraordinary story The Exclamation Mark. The story tells of an employee who has spent years writing or transcribing dossiers, always carrying out his work conscientiously. One day, at a social event, he is taxed with the inadequacy of his academic qualifications, given that all he does is edit or copy documents. On his return home, he cannot sleep because all the thousands, or tens of thousands, of immaculately written documents are running through his mind, and he remembers all the possible rules for commas, full stops, semicolons, even question marks.

But his tossing and turning stops dead when he is confronted by the exclamation mark.

He has no recollection of ever having used it. How does it work? He wakes his wife, who went all the way through college, and she proudly tells him she knows the whole grammar book by heart, explaining that the exclamation mark is used when you want to emphasise something or indicate an emotion: anger, joy, good fortune; any emotion, in short.

It seems clear enough to him how it should be used in a letter, but how would you do so in an official document? Once again he runs through the thousands of documents he’s written with not one exclamation mark in any of them, he’s sure of it.

The story highlights how a routine, factual existence is possible with everything just as it should be, with every i dotted and every t crossed, without ever feeling any emotion; anger, joy, jealousy, or anything else.

At this point, after his sleepless night, the story’s protagonist decides to see his head of department, and when he comes to sign the admissions book, after writing his name, Yefim Perekladin, he adds three exclamation marks. As Chekhov concludes, “as he wrote those three marks, he felt delight and indignation, he was joyful and he seethed with rage. ‘Take that, take that!’ he muttered, pressing down hard on the pen.”

Sometimes, if they become firmly established in the long term, these defence mechanisms (and sometimes others) take the form of a thorough-going pathology. In this connection, I would like to address the subject of anorexia and the difficulty of taking on the ephemeral nature of our existence: in other words, the difficulty or impossibility of accepting the linearity of time, thereby putting an incredible multiplicity of defences into play: atemporalities or dyschronias.

I put these two modes together because one predominantly concerns space, the other time.

1.1 Anorexias

Anorexia is often considered in terms of misperception: patients see themselves as fat, swollen, overweight, not the way they really are: thin, underweight, emaciated.

I think we should reverse the viewpoint and accept that the anorexic uses ultrasound to view her or himself. That is, they see gigantic emotions which they try to compress, attempting to starve them so as not to feel overwhelmed by them.

There is no end to the possible metaphors: it is as if they looked like chihuahuas and instead saw an enormous pit-bull lurking behind them with its fangs at the ready. In other words, they know they are dealing with a tangle of emotions which they are afraid will savage them and tear them apart.

The illusion is that by denying the pit-bull food, they can “dachshundify” or “chihuahuaise” it; that it might be possible to make violent passions containable and manageable.

An anorexic girl dreamed that, by taking some bricks out of a wall, she arrived at the start of the French Revolution just as the Bastille was being stormed.

She smelled burning and felt a sense of guilt. A seemingly good girl, on the other side of the wall she had access to this revolutionary world full of fire where everything was burning to ashes, which made her feel guilty.

Then she saw a “terrible dragon” in a Rorschach blot.

So here is the pit-bull I was talking about: the problem is how to alphabetise this mass of undifferentiated proto-emotions and transform them into their components so that the “proto-emotional lava” can become tolerable emotions.

The “dragon”, this magmatic proto-emotional nucleus, would have to find other ways of being managed.

But let’s go back to anorexia, where the strategy in operation was described by another patient who expressed her hatred for hot places like Naples and her love of cold places like Germany where every one queues obediently, maybe because the cold makes them calmer: there is also the idea that a glaciation of Vesuvian emotions could be helpful to those who are hungrier than the inmates of a concentration camp, the idea of a dream where “violent and explosive young people” were interned and made obedient, giving them just enough food for them to survive while having no strength left to express their own violence.

Figure 1.1 Distortion of an internal gaze

Perhaps Figure 1.1 expresses this way of conceiving of anorexia: the subject perceives, “sees” the giant mass of proto-emotions which usually escapes every gaze that doesn’t use ultrasound. It shows how ultrasound vision enables one to see what generally escapes normal sight.

Obviously bulimic behaviour is simply the other side of the coin: it would be like placating the Hound of the Baskervilles by stuffing it with food and putting it to sleep. Let’s remember Polyphemus, who falls deeply asleep after eating and drinking too much. So, if in anorexia there is the illusion of “taking away the energy” of emotions, in bulimia it is one of putting otherwise unmanageable emotions into hibernation.

The analyst’s task will be, with the patient, to dream the “fiery dragon” which is terrorising her and has no other way of being managed.

In many of his drawings, Fellini vividly portrays excessive emotions overflowing inadequate containers which have been left flattened by them (Figure 1.2).

Or else he shows the claustro-hypercontaining solution for emotions that would otherwise overflow.

We’ll look now at some examples using fragments from clinical histories; what can be managed by the anorexic mechanism (the “chihuahuaisation” of the pit-bull) can alternatively be managed by “computerisation” (or “bonsaification” if we prefer).

Ermanno is seriously school-phobic and dependent on his computer. We are faced with two scenarios or sets of over-intense emotions we are afraid of and want to avoid: not going to the place where emotions are activated – school – or emotions miniaturised into very low voltages (micro-voltages of information technology):

School 20,000 volts – Computer 0.25 volts

Figure 1.2 Drawing by Federico Fellini

Ermanno and his Virtual Struggle

Ermanno is unable to go to school because for him it’s Pamplona or the Plaza de Toros, where he is persecuted by rampant emotions. Instead he plays “video war games” in which he can miniaturise all violence.

Computerised miniaturisation is, like anorexia, an attempt to de-terrorise Pamplona by not giving any more food to the bulls/emotions by which one is afraid of being overwhelmed.

Ermanno either has phobias or he plays with his computer: he is a patient who alternates two kinds of functioning.

After a few months of analysis, he brings the following dream: he wakes up in bed … full of anxiety … he bursts into flames … his arms melt … a dream which seems to be a good description of how he “catches fire”. The igniting of anger and jealousy, of passions which he will need to learn to contain and metabolise.

Some time later he has another dream in which the zoo is short of keepers, and so the animals will have to be put to sleep with tranquillisers, and during this period the sessions start to be full of boredom which is evoked by calm speech full of parentheses and asides, and asides within asides, a narrative mode with no bridges or traffic lights, nothing but coordinate clauses, one inside another.

Hibernation is induced less by the contents than by the mode; it is a foggy plain without hills, rivers or mountains. But when the fog lifts, the “fierce animals” become clearly visible.

Valeria and the Fear of “Aliens”

Valeria has been self-harming, an act in which it is not hard to see the attempt/desire to eliminate alien aspects of herself: that Alien which it is impossible to eliminate or split off is, thus, by means of an illusion, transformed from an uncontainable pit-bull into a chihuahua which no longer frightens her.

Obviously the bulimic strategy is simply the mirror image of this: giving the mastiff so much to eat that it becomes stupefied and inert. It hardly matters what proto-emotions the mastiff is made of.

Before the explosion of anorexic symptomatology, Valeria had tried to “hide” her knot of proto-emotions by keeping busy with dance, music, and schoolwork. She begins therapy where she shows herself extremely eager to please her analyst in the sessions, and then sends him surprising text messages saying “You’re a bastard” or “I’d rather be ill.”

During therapy she will say, “I can’t look at myself,” “I can’t wash myself,” “I feel sick if I put on weight,” “I really want to lose weight,” and later she will even be able to say “I’m afraid of the emotions I feel”: her symptoms become evidence of the dialectic between truth and lies, according to which of her identities is predominant at that moment.

Claudia and the Light of Analysis

Claudia is also an anorexic girl who sees herself as fat and ugly, and so has been subjecting herself to a starvation diet for a long time.

After a long period of analysis, she brings this dream: she is with two friends, a girl and a boy, and the boy suddenly turns into a terrible creature, a werewolf; in the second part of the dream, the girl lights a match and its light and smoke act as a cure, a sort of antidote which can neutralise even a ravening beast.

The light and smoke of analysis seem to exorcise the aspects that are feared as diabolical. After a few months Claudia dreams she is in a meadow, and has got better at riding her pony, which takes her to an open-air concert in the country. The ferocious beast has been transformed into a pony, and something disastrous and devouring into something vital which takes her to a concert, an emotional music she has never experienced before.

1.2 Atemporalities (dyschronias)

Before I can attempt to disentangle them, I would like to put together all those situations in which it is impossible to accept the passing of time with all that entails.

The prototype could be what Elliott Jaques brilliantly described as “midlife crisis”, a crisis which few of us escape and which is located in the third decade of life. A classic example could be the incipit of the Divine Comedy: “In the middle of our life’s journey, I found myself in a dark wood, where the right path was lost” and it will take dozens of cantos “to see the stars again”, in the double sense, I would say, of leaving the infernal tunnel of depression and being able to come back to life and bear pain.

Now, with the lengthening of middle age, I prefer to speak of a “crisis of the zip years” which unfolds every ten years and, after a certain age, as often as every five years.

We can see ...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• List of contributors
• Acknowledgements
• PART I Psychopathologies
• PART II Emotions and feelings
• Index