The Intimate Room

Theory and Technique of the Analytic Field

Giuseppe Civitarese

• Publisher: Routledge
• Year: 2020
• Print ISBN: 9780415575096
• eBook ISBN: 9781317723042
• Edition: 1
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

The Intimate Room provides an original exploration of psychoanalytic thought, showing how contemporary psychoanalysis seeks to answer the challenges raised by today's post-modern culture.

Offering a deeply personal and insightful reading of Bion, this book acts as a stimulating guide to the development of the theory of the analytic field and both its technical and clinical implications. As such topics of discussion include:

• the concept of the internal setting
• the rhetoric of interpretation
• the 'subversive' notion of Nachträglichkeit
• the role played by characters in analytic discourse
• the bi-personal field as virtual reality
• new concepts of transference.

Allowing the reader to engage with the inner space of analysis, The Intimate Room will be of interest to psychoanalysts, psychotherapists and all those with an interest in the field of psychoanalysis. It will also be a useful tool in psychoanalytic and psychotherapeutic work on a day-to-day basis.

1
Fire at the theatre (Un)reality of/in the transference and interpretation¹

In ‘Further recommendations on the technique of psychoanalysis’, Freud (1913, 1915a), with his usual inventiveness, successfully embeds a number of key metaphors for portraying the structure and dynamics of analytic work. Here they play an even more important role because, through the narrative and rhetorical turn sharply dramatizing the theoretical discourse, they seem to repeat a chapter in the history of psychoanalysis (and, in a word, of every analysis). If Freud (1913) begins with the reassuring image of a game of chess, evoking the order and precision of a sophisticated intellectual exercise, then, dealing with transference love (1915a), he presents a coup de théâtre: in its subject matter first of all, an ‘untoward event’ (1914a:12), and then in the figurative elements chosen to represent it. The irruption of passion, the transformation of the patient’s ‘affectionate transference’ into an ‘outbreak of a passionate demand for love’ (1915a: 162), is equated to the screams provoked by the outbreak of fire in a theatre. Behind this lies the episode of Anna O’s passion for Breuer, which induces him to abandon his patient (just as a similar feeling would distance Dora from Freud), but which leads to the formulation of the theory of sexual aetiology of neuroses and founds psychoanalysis.

In ‘Observations on transference love’, Freud (1915a) tackles a point that created a scandal for the new cure and his public reputation, now defused and encapsulated in one of the commonplaces about psychoanalysis, although not on a theoretical level. Here, instead, the problem of the nature of the facts of analysis and the type of ‘objectivity’ that belongs to it continue to be ‘scandalous’. The fire in a theatre is an incident, a real element that irrupts and causes the play to be stopped; it is a complete change of scene, a particularly surprising image. Indeed, in this passage Freud is not referring, as we might expect, to events in the external world or to facts of material reality, which might be so urgent and dramatic as to necessarily annul the as if functioning of the setting’s device, but rather to the flaring up of transference love, something that he now places inside the framework of the cure, after initially considering it an impediment. At this point, they are no longer real fires in play, but those within the analytic relationship and the setting; or, better, within the analyst’s internal setting (which can be defined as the capacity to hold oneself at a level of listening specifically directed towards understanding the patient’s unconscious). Then, in the following lines, the question becomes even more involved: on the one hand, Freud advises dealing with such an intense (and risky) transference manifestation as unreal; on the other, he acknowledges that its nature of a real, in other words not illusory, passion cannot be denied. In a few incisive lines, we thus find a series of complex themes: the nature of the transference and its constituent duality, the ambiguity of what is ‘real’, and the prerequisites for defining the setting.

The concept of transference can thus be considered as Freud’s solution to the problem of the relationship between external reality and the setting’s internal reality (a theory of knowledge can also be glimpsed here), between the stories of the patient’s present and past life and their transposition or re-edition, mediated by unconscious phantasy, on the analytic stage. Some contemporary (‘sceptical’) theoretical developments emphasize the ‘reality’ of the transference, indicating its rootedness in the patient–analyst relationship and no longer only in the definite, true reality of childhood history. In this way, the transference, displaced towards the existing and the present, interpreted in a wide sense, loses resolution as a concept, becoming unfocused and aspecific (Blum 2003; Smith 2003).

This happens, however (at least in some currents of psychoanalysis), within an area where the two polarities of the real and the imaginary, already contained in Freud’s discourse (reassumed in the image of the theatre on fire), remain in tension. It occurs within models that radicalize the ‘dream paradigm’ to different extents in their idea of clinical interaction, that consider the session as a dream (Langs 1971; Lothane 1983; Meltzer 1984; Kern 1987; Boyer 1999; Ferro 2002a; Ogden 2003a) and the analytic process as ‘symbol-poiesis in situation’ (Bezoari 2002). When the transference inclines towards the relationship, the reduced specific weight attributed to psychic reality on the one hand finds itself balanced on the other by the fact that in the dream of the session external reality – but also the analytic situation – by definition appears first of all under the form of the day’s residues; these, as in the night dream, are ‘nothing more than elements or signs used by the unconscious wish’ (Laplanche and Pontalis 1967:96) and by the phantasy.

The theoretical hypothesis of this chapter is that rigorous adoption of the dream paradigm in the session (an obvious Freudian principle, but which only finds in Bion’s extended idea (1962) of ‘waking dream thought’ a fully applicable field) succeeds in combining the radical antirealism expressed in the postulate by which all the patient’s communications concern the transference – as displacement and projection of the patient’s psychic elements – with the ‘reality’ of the transference and with the conviction that the facts of the analysis are codetermined by the patient–analyst dyad. It is moreover misleading to think of being able to separate the phantastic component from the real component in the analytic relationship, at least on an ‘entrance’, ‘horizontal’ level, for example, in nominalistic terms, with the simple fact of presupposing the transference/relation distinction. In other words, to separate it from all those aspects of the interaction that cannot be reduced to the basic idea of transference as misunderstanding and ‘false connection’.

For example, the perspective pertaining to a model of the analytic field – adopted in this chapter – considers on principle any element of the patient’s discourse as potentially ‘transfigured’ by the dreamwork and by the rhetoric of the dream; in short, filtered by psychic reality and by the transference. The intersubjective dimension, which is also intrinsic to this model, accounts instead for the analyst’s participation in the transference and in the patient’s realistic reactions to the analytic situation. So, in the patient’s interaction with the therapist, it will be possible to deduce, mostly a posteriori, the emotional quota bound to the transference – understood here in its narrowest meaning – from the quantitative disparity in answer to stimuli. It will be possible to find the mark of the transference in the outsize, excessive, eccentric, disproportionate effects, which it will in the end introduce into the cure (Imbeault 1997).

In my opinion, this is a satisfactory solution for a debatable point: what one includes in the transference and what one does not. Since Freud does not see any reason (not any more, at least) for abandoning the theatre in the case of transference love, what are, if they exist, those real elements that interrupt the setting? Those elements that cannot be taken back to the self-observing, virtual regime of the analytical device? What ‘facts’ belong instead by right to empirical reality and to what extent is it meaningful to maintain a setting even in their presence? This chapter would like to answer that the therapist’s inner setting is set on ‘fire’ every time the irreducible ambiguity or paradoxicality of the transference is defensively and exclusively resolved either in the patient’s external or intrapsychic imaginary reality.

Insomnia

‘I am ready to tell the facts. Pure facts. The insomnia perhaps started before, but my memories only go back to when I began going to nursery school. Not able to sleep and not able to dream or to play, but only and always to stay on the alert … keep watch … all night long … look at my parents’ door, then the corridor … convinced that they might go away and leave me alone. And then, after a bit, just seeing their bodies was no longer enough to reassure me, I needed to hear their voices … my mother’s voice. And every five minutes I used to wake her up to tell her that I loved her. I could only manage to keep my eyes closed for five minutes. Then, our roles changed. The sentinel was kept under surveillance. My mother began to observe my insomnia, stretched out on the floor beside my bed. Exasperated. Judged to be a naughty whim, a deviance to repress and correct, I was slapped and shouted at for a long time. And in the morning, taken to nursery school … there I was effectively abandoned; a tragedy because I absolutely didn’t want to be left and threw myself on the ground crying … Because this was the second of my unshakeable convictions: that they would leave me there. For me, every goodbye … every time … was as though it was the last.’

‘For a child, separation can be a terrible thing,’ I say to Alberto (in his second year of analysis, three sessions a week), and my words seem to alleviate the tension and produce a first change in the emotional climate of the session, as his reply shows.

‘It immediately went much better at elementary school,’ he says. ‘From the first day I changed. I had a gentle, loving, very affectionate teacher, a minute classroom, almost half the size of this room, all girls except for me; there were only six of us. Then, in the third year [an allusion to today’s session which, being Friday, is the third and last of the week, and to what happens every time he separates from analysis?] the teacher changed and everything began all over again, no discipline, and so on, until – and my mother still remembers this – I said, giving up: “Okay, if things are like this, from now on I will pretend to be a machine, disciplined and punctual!” And I added something horrendous: “But I will also pretend that the teacher is a machine too!” So I did, and I stopped being a problem for my parents.’

This is an extremely vivid, overbright, clearly traumatic, frozen memory belonging to the patient and to his story: a factual account of how a radical fracture was established in his being. But the patient’s insomnia is also for long stretches the insomnia of the analysis, ensnared in a dizzying, immobile vigil of intelligence and reflective logic, lacking – except in some rare moments – imagination, playfulness and humour.

Alberto brings a dream to the next session – Monday – which, although conserving the same glacial and suspended atmosphere, represents something new in the analysis. In the old house, in the dark, he is a child while looking at the road through the cracks in the shutters. His parents are also at home, by now resigned. All are living in the expectation of being ‘killed’.² In the dream, he says, ‘It’s impossible to sleep.’ He wakes from his nightmare in the grip of terrible anxiety.

The patient dryly, like an ‘insomniac’, relates his dream at the beginning of the session, as though he was expounding an abstract concept, a sort of theorem derived from various basic postulates: what he considers to be objective traumatic situations suffered in childhood, an old accident (concussion), scholastic ‘persecution’. I think that he is also talking about how he might have experienced the separation of the weekend and I tell him, to help him make contact with his emotions, that this dream is perhaps the real thread (much more violent) or at least the more subtle one hidden behind the fear of being left at nursery school (and I mean that separation for him is like dying), which he had talked to me about the session before.

Meanwhile, an earlier event returns to my mind. On beginning sessions after the Christmas break, just a few weeks ago, Alberto related a childhood memory: once, his mother, very angry, had lost control of herself and had hung him upside down because he did not want to leave his parents’ bedroom, and he had angrily grabbed on to the doorframe and nearly unhinged it. After a moment’s silence, he then talked to me at length about a friend who was in therapy with a renowned, respected analyst and we had laughed together about the complaints that he had been told in an ironic but affectionate tone about this colleague. The next session (having perhaps sensed the anger contained in a hypothetically depreciative element rather than an eventual ‘oneiric’ self-reference and an indication of how important it might be for him to refind the analysis!) I ‘forgot’ to close the door on entering the room while he was settling on the couch, arousing his protests. In fact, to myself, I thought it might have been an unconscious answer to what I had experienced perhaps as a provocation of his, along the lines of: ‘I don’t need you! You aren’t anybody!’ Arriving at the next session, a couple of days later, he placed what looked to me like some sort of strange instrument on a second chair (beyond the one the analyst sits in), visible to both and obviously empty. At a certain point I phantasied that it could be for recording our conversation. Then again in the next session – and I am still referring to the initial period of the year to which my mind had returned during the Monday session – distracted by unease and curiosity about the peculiar object (perhaps a new model of a mobile phone), ritually placed in the same place by the patient just before lying on the couch, I had inadvertently left the door open. A few seconds later … and both of us burst out laughing! Despite this, Alberto, pained, expressed his distress at my acting, repeated on two occasions, which he interpreted as an unconscious desire of mine to show him the door.

This sequence of events reported in an extremely synthetic form shows how the envelope of the analysis – and also the material arrangement of the setting – can be ‘breached’ when emotional contents that are too intense in a given moment do not meet a container capable of receiving and metabolizing them. However, one can ask oneself what more enlightening representations (realized by inducting the maternal ‘role’ into the analyst, and by repeating the old ‘expulsion’ on the stage of the setting) and more effective communic/a(c)tions could be given of the intensely persecutory experiences that can be found at the origin of the patient’s obscure ill?

The working through that followed this double crisis allowed the setting to be ‘repaired’, to represent with greater precision the intersecting plane between past history and present transference, and to advance an ‘allegorical’ reading of the same childhood memory (being thrown out of his parents’ bedroom) with respect to a lack of perhaps more primary care. Alberto was also able to positively see himself in the analyst’s same obviously imperfect humanity and obtain a ‘reward of humour’, without in any way feeling his old anxiety, set in motion by what had happened between us, devalued.

But it is only in the session of the dream – after a lapse of time – that I feel able to understand the significance of this episode of the analysis (which had occurred immediately after the holidays) and to outline sufficiently clearly, a posteriori, an acting → memory → dream sequence as elements of a progression – even when the contents are of the same emotional tone – towards an increased capacity for symbolization (and towards a consequently greater intimacy of the analytical relationship). These moments present themselves like the successive layers of old writing on parchment, each recursively throwing light on the preceding ones.

On the stage of the setting, patient and analyst interpret – also as spectators and critics – roles from a script that both take part in writing in the very moment they act it, each drawing from his own life. The plot unfolds against the background of the patient’s story (of his actual reality) and alludes to it – in a relationship of reciprocal involvement that decides the preliminary conditions for understanding it – but does not exactly reproduce it. As in a play, it reflects the author’s existential path, but at the same time it functions or it does not function, compared to the expressive aims declared, on the basis of its own internal dynamics, the observance of determined dramaturgical rules, and the quality of the stage set.

With regard to the clinical vignette described, the priority of the cure lies not so much in tracing Alberto’s insomnia or infantile neurosis to abstract phantastic nuclei, or to ‘deviances’ in a biography, but rather in allowing him to assume first in analysis and then in the theatre of his life new roles and viewpoints; to be able to dream. But, for him to be able to dream, he must feel sufficiently safe: it is necessary to look in his words and perceptions for the sense of the emotions that are activated in the reality of the meeting and from there move to lay the premises for possible transformations.

Alberto has been able to dream – certainly more of a nightmare than anything else in the sequence of sessions considered here, an ‘interrupted dream’. He was able to pass from the induction of acting in the analyst to the memory and then to the dream (which I consider also in its condition of second-level memory, more ‘real’ precisely because it is protected and indicated as fictitious by a further narrative frame) because many small transformations from ‘keeping vigil and punishing’ to ‘gentle, loving teacher’ must have occurred in the meantime. Many small moments of synchrony must have been lived, like the liberating burst of laughter that had opened the way to expressing a true feeling of sadness, something the ‘machine’ he had decided to become in order to hide his true self would not have been able to do. These moments were responsible for gradually improving his ability to sleep (it is a paradox – and at the same time a valuable example of the formation of a new awareness of the self– that the patient in sleep says ‘it is impossible to sleep’!) felt as a painful discontinuity of being, like the impossibility of immersing oneself again in a temporary state of fusion with the object.

This clinical vignette is useful for allegorically illustrating the paradigm behind the analytic work, that of dreaming. The ‘facts’, the ‘pure facts’, are in the first place the facts of the analysis. In the dream of the session...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Foreword
• Acknowledgements
• 1 Fire at the theatre (Un)reality of/in the transference and interpretation
• 2 The symbiotic bond and the setting
• 3 Metalepsis, or the rhetoric of transference interpretation
• 4 Immersion versus interactivity and analytic field
• 5 Nachträglichkeit
• 6 Transference, USA
• 7 Difference (a certain) identity transference
• 8 More affects … more eyes On postmodern issues and deconstruction(s) in analysis
• Notes
• Bibliography
• Index