Rediscovering Psychoanalysis

Thinking and Dreaming, Learning and Forgetting

Thomas H. Ogden

• Publisher: Routledge
• Year: 2014
• Print ISBN: 9780415468626
• eBook ISBN: 9781317723462
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Winner of the 2010 Haskell Norman Prize for Outstanding Achievement in Psychoanalysis!

Rediscovering Psychoanalysis demonstrates how, by attending to one's own idiosyncratic ways of thinking, feeling, and responding to patients, the psychoanalyst can develop a "style" of his or her own, a way of practicing that is a living process originating, to a large degree, from the personality and experience of the analyst.

This book approaches rediscovering psychoanalysis from four vantage points derived from the author's experience as a clinician, a supervisor, a teacher, and a reader of psychoanalysis. Thomas Ogden begins by presenting his experience of creating psychoanalysis freshly in the form of "talking-as-dreaming" in the analytic session; this is followed by an exploration of supervising and teaching psychoanalysis in a way that is distinctly one's own and unique to each supervisee and seminar group. Ogden goes on to rediscover psychoanalysis in this book as he continues his series of close readings of seminal analytic works. Here, he makes original theoretical contributions through the exploration, explication, and extension of the work of Bion, Loewald, and Searles.

Throughout this text, Thomas Ogden offers ways of revitalizing and reinventing the exchange between analyst and patient in each session, making this book essential reading for psychoanalysts, psychotherapists, and other readers with an interest in psychoanalysis.

1

Rediscovering psychoanalysis

From the time I was six or seven years old, I was aware of psychoanalysis as a form of treatment for psychological problems, such as feeling unhappy and frightened all the time; but it was not until I was 16, on reading Freud’s (1916–1917) Introductory Lectures on Psycho-Analysis, that I first discovered psychoanalysis as a set of ideas concerning how we come to be who we are. In using the term discovered, I am borrowing a word from a memorable sentence in that introductory lecture series: “I shall not, however, tell it [psychoanalysis as a therapeutic method] to you but shall insist on your discovering it yourself” (1916–1917, p. 431). How better to be introduced to psychoanalysis than by means of an invitation not to be taught, but to discover?

I have spent a good deal of my life since that initial discovery rediscovering psychoanalysis. In an important sense, a psychoanalytic life cannot be spent in any other way. After all, psychoanalysis, both as a set of ideas and as a therapeutic method, is from beginning to end a process of thinking and rethinking, dreaming and re-dreaming, discovering and rediscovering.

The thread that weaves through every page of this book is the idea that it is the analyst’s task to engage in a process of rediscovering psychoanalysis in everything that he or she does: in each analytic session, in each supervisory hour, in each meeting of a psychoanalytic seminar, in each reading of an analytic work, and so on.

Rediscovering psychoanalysis entails an act of freedom of thought and an act of humility; an act of renewal and an act of fresh discovery; an act of thinking for oneself and an act of recognition that

no one who attempts to put forward to-day his views on hysteria and its psychical basis [or any other aspect of psychoanalysis] can avoid repeating a great quantity of other people’s thoughts . . . Originality is claimed for very little of what will be found in the following pages.

(Breuer and Freud, 1893–1895, pp. 185–186)

In this book, I will discuss three overlapping and interwoven forms of my own experience of rediscovering psychoanalysis: (1) creating psychoanalysis freshly in the process of talking with each patient in each analytic session; (2) rediscovering psychoanalysis in the experience of supervising and teaching psychoanalysis; and (3) “dreaming up” psychoanalysis for oneself in the act of reading and writing about analytic texts and literary works. Although I discuss each of these forms of rediscovery as separate subjects, the topics refuse to keep an orderly queue: thoughts on supervision creep into discussions of talking with patients; close readings of analytic texts invite themselves into discussions of supervision and teaching; responses to creative literature show up in analytic case discussions; and so on. In fact, all three of these forms of rediscovering psychoanalysis are in conversation with one another in each section of this chapter and in each of the succeeding chapters of this book.

Rediscovering psychoanalysis in the experience of talking with patients

A principal medium, perhaps the principal medium, in which I have the opportunity and the responsibility to engage in the work of rediscovering psychoanalysis (and, in so doing, rediscovering what it is to be a psychoanalyst) is the work of being with and talking with patients. Specifically, I view it as my role to create psychoanalysis freshly with each patient in each session of the analysis. A critically important aspect of this rediscovery of psychoanalysis is the creation of ways of talking with each patient that are unique to that patient in that moment of the analysis. When I speak of talking differently with each patient, I am referring not simply to the unselfconscious use of different tones of voice, rhythms of speech, choice of words, types of formality and informality, and so on, but also to particular ways of being with, and communicating with, another person that could exist between no other two people on this planet.

There are occasions when I am more aware than usual that the patient and I are talking in a way that I talk with no other person in my life. At these moments I have a strong feeling that I am a fortunate man to be able to spend so much of my life inventing with another person ways of talking about what is most important to the patient and to me. In this experience, I am being drawn upon, and am drawing upon myself, emotionally and intellectually, in ways that do not occur in any other part of my life. In this regard, Searles has put into words what I have often felt and thought but have not often had the courage to say, much less write. In discussing an experience that occurred in the psychotherapy of a schizophrenic patient, Searles (1959) states (in a way that only he could have put it), “While we were sitting in silence and a radio not far away was playing a tenderly romantic song . . . I suddenly felt that this man [the patient] was dearer to me than anyone else in the world, including my wife” (p. 294). (See Chapter 8 for a discussion of this and other aspects of Searles’s contribution to psychoanalysis.)

It requires a very long time – in my experience, something on the order of a decade or two of full-time clinical practice – to mature as an analyst to a point where one is able, with some consistency, to talk with each of one’s patients in a way that is uniquely one’s own, and unique to that moment in the analytic conversation with that particular patient. One must have thoroughly learned psychoanalytic technique before one is in a position to “forget it” – that is, to rediscover it for oneself. Talking with patients in the way I am describing requires that the analyst pay very careful attention to the analytic frame. When I am able to speak with a patient in this way, it feels to me that I have ceased “making interpretations” and offering other forms of “analytic interventions,” and am instead “simply talking” with the patient. “Simply talking” to a patient, in my experience, usually involves “talking simply” – that is, talking in a simple, clear way that is free of cliché, jargon, and “therapeutic” and other “knowing” tones of voice.

A recent experience in supervision comes to mind in this regard. A seasoned analyst consulted me regarding an analysis that he felt had “ground to a halt.” He told me about the various types of interpretations that he had made, none of which seemed to be of any value to the patient. As he spoke, I found myself feeling curious about the analyst. He seemed like an “odd duck” in an interesting and appealing way. Where had he grown up? Probably in the South – maybe Tennessee. What sort of boy had he been? Maybe a little lost, doing the right thing, but with a rebellious streak that he kept a well-guarded secret.

I said to the analyst that it seemed to me that the only thing he had not tried was talking to the patient. I suggested that he stop interpreting and, instead, try simply to talk with the patient as a person who had come to him with the hope and the fear of talking about what was most disturbing in her life. He responded by saying, “You mean I should stop doing analysis with this patient?” I responded by saying, “Yes, if ‘doing analysis’ means speaking and listening as the analyst you already know how to be. Why don’t you see what it would feel like to be an analyst with the patient who is different from the analyst you’ve been for any other patient you’ve ever worked with?”

At the end of the consultation session, the analyst said that he felt at a loss to know how to proceed with his patient. I thought that this response to the consultation was a good indication that the analyst had made use of our conversation. When we next met six weeks later, the analyst told me that after our consultation, he felt so lost that during the sessions with his patient that took place in the weeks immediately following the one he had read to me, he found himself saying very little. “Instead, I tried to listen for what I’ve been missing. Being quiet helped clear my mind, but straining to listen in that way, session after session, was exhausting. I found myself dreading the patient’s sessions.” The analyst then told me that at the beginning of a session about a month after our consultation, he finally “gave up” and asked the patient, “How can I be of help to you today?” He said that the patient seemed surprised by his question and responded by saying, “I’m so glad you asked me that. I’ve been feeling like such a failure at psychoanalysis that I’ve been thinking for a long time that I shouldn’t waste your time. I just don’t know how to think and talk the way you do. I was afraid before coming here today that you would tell me that you would be ending the analysis.” The patient was silent for a couple of minutes and then said, “If you really meant what you said, what I’d like your help with is how to be a better mother to my children. I’ve been a dreadful mother.”

The analyst then told me that for the first time in a very long time he had found what the patient was saying in that session to be genuinely interesting. I was reminded of my own curiosity and imaginings about the analyst in the first consultation session. It seemed to me in retrospect that I was “dreaming up” the analyst in response to his difficulty in “dreaming himself up” as an analyst in his own terms. The analyst responded to his patient by saying, “I think that you are full of dread when you try to be a mother and that makes you feel like a dreadful mother. I think that you find that trying to be a mother is not at all the same as simply being a mother. I think it terrifies you to feel that you have no idea how to go about just being a mother in a way that feels natural to you.”

I said to the analyst that there was no doubt in my mind that he and the patient had begun to talk with one another in a way that they had never before talked with one another, and that it seemed possible to me that neither of them had ever in their lives talked with anyone else in quite that way.

In the sequence described, it was necessary for the analyst to rediscover for himself the experience of becoming an analyst by “giving up” on being the analyst he already knew how to be. In so doing, the analyst began to be able to make room in himself for the experience of being at a loss to know how to be an analyst – how to listen to and how to talk with the patient. The patient was clearly relieved by her conscious and unconscious perception that the analyst had become better able to think and talk for himself and to live with the experience of being a “dreadful analyst” who had no idea what he was doing. It was only at that point that the patient was able to recognize and talk about her feeling of being a dreadful mother. Of course, what I have quoted is not taken from a transcript of what the patient and the analyst said; rather, it is my construction of the analyst’s construction of what occurred in the session. This is not a deficiency inherent in the method of enquiry I am using; it is an important element of that method in that it helps capture something of what was true to what occurred at an unconscious level in the analysis, in the supervision, and in the relationship between the analytic experience and the supervisory experience. (In Chapter 3, I discuss this and other aspects of the analytic supervisory experience.)

In discussing this supervisory experience, I have used the term dreaming in the phrase ‘“dreaming up” the analyst.’ The conception of dreaming that underlies the idea of dreaming up another person or dreaming oneself into being plays a fundamental role in all that follows in this book. In the tradition of Bion (1962a), I use the term dreaming to refer to unconscious psychological work that one does with one’s emotional experience. This work of dreaming is achieved by means of a conversation between different aspects of the personality (for example, Freud’s [1900] unconscious and preconscious mind, Bion’s [1957] psychotic and non-psychotic parts of the personality, Grotstein’s [2000] “dreamer who dreams the dream” and the “dreamer who understands a dream,” and Sandler’s [1976] “dream-work” and “understanding work”). When an individual’s emotional experience is so disturbing that he is unable to dream it (i.e. to do unconscious psychological work with it), he requires the help of another person to dream his formerly undreamable experience. Under these circumstances, it requires two people to think. In the analytic setting, the other person is the analyst; in supervision, it is the supervisor; and in a seminar setting, it is the group leader and the work group mentality (Bion, 1959).

Dreaming occurs continually both during sleep and in waking life, although we have little awareness of our dreaming while we are awake. Reverie (Bion, 1962a; see also Ogden, 1997a,b) and free association constitute forms of preconscious waking dreaming. Dreaming conceived of in this way is not a process of making the unconscious conscious (i.e. making derivatives of the unconscious available to conscious secondary process thinking); rather, it is a process of making the conscious unconscious (i.e. making conscious lived experience available to the richer thought processes involved in unconscious psychological work) (Bion, 1962a). Dreaming is the process by which we attribute personal symbolic meaning to our lived experience, and, in this sense, we dream ourselves and other people into existence. By extension, when an analyst helps a patient or a supervisee to dream his formerly undreamable experience, he is assisting the patient or supervisee in dreaming himself into existence (as an individual or as an analyst).

With this conception of dreaming in mind, I will turn to a form of rediscovery of psychoanalysis that occurred in the course of my work with patients who have very little, if any, capacity for waking dreaming (for example, free association) in the analytic setting. After years of analytic work with a number of such patients, I have found myself (without conscious intention) engaging in seemingly “unanalytic” conversations with these analysands about books, plays, art exhibits, politics, and so on. It took me some time to realize that many of these conversations constituted a form of waking dreaming which I came to think of as “talking-as-dreaming.” These conversations tended to be loosely structured, marked by mixtures of primary and secondary process thinking and replete with apparent non sequiturs. “Talking-as-dreaming” superficially appears to be unanalytic; but, to my mind, in the analyses to which I am referring, it represented a significant achievement in that it was often the first form of conversation to take place in these analyses that felt real and alive to both the patient and me.

As time went on in the work with these patients, talking-as-dreaming became established as a natural part of the give-and-take of the analytic relationship and began to move unobtrusively into and out of “talking about dreaming” – that is, self-reflective talk about what was occurring in the analytic relationship and in other parts of the patient’s life (past and present). These patients experienced their enhanced capacity to dream and to think and talk about their dreaming as an experience of “waking up” to themselves. Once able to “wake up,” their relationship to their waking and sleeping dreaming was profoundly altered – they could begin to think about their dreams as expressions of personal symbolic meaning. In our “discovery” of talking-as-dreaming, these patients and I were rediscovering dreaming and free association.

Dreaming up psychoanalysis in analytic supervision and teaching

Analytic supervision and the teaching of psychoanalysis in a seminar setting have been, for me, important forms of analytic work in which rediscovery of psychoanalysis takes place. I view not only the clinical practice of psychoanalysis but also analytic supervision and teaching as forms of “guided dream[ing]” (Borges, 1970a, p. 13). In analytic supervision and in case presentations that take place in the seminar setting, it is the task of the supervisory pair and the seminar group to “dream up” the patient whose analysis is being discussed. The patient being presented is not the person who lies down on the couch in the analyst’s consulting room. Rather, the patient is a fiction, a character in a story that the supervisee or presenter is creating (dreaming up) in the process of presenting the case. The creation of a fiction is not to be confused with lying. In fact, the two, in the sense I am using the terms, are opposites. Since the analyst cannot bring the patient to the supervisory meeting or to the seminar, he must create in words a fiction that conveys the emotional truth of the experience that he is living with his patient.

From this perspective, the presenter consciously and unconsciously not only tells, but also shows, the supervisor (or seminar group) the limits of his capacity to dream (to do conscious and unconscious psychological work with) what is occurring in the analysis. The function of the supervisor and the seminar group is that of helping the analyst to dream aspects of the experience with the patient that the analyst has been unable to dream.

Regardless of how many times I take part in the experience of dreaming with a patient, a supervisee, or a presenter, I am each time taken by surprise by the psychological event, and each time find that I have rediscovered the concept of projective identification. Projective identification at its core is a conception of one person participating in thinking/dreaming what another person has been unable to think/dream on his own. I have spent the past thirty-five years rediscovering this concept.

I will close this section by briefly mentioning two areas of ongoing discovery and r...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Acknowledgments
• 1. Rediscovering psychoanalysis
• 2. On talking-as-dreaming
• 3. On psychoanalytic supervision
• 4. On teaching psychoanalysis
• 5. Elements of analytic style: Bion’s clinical seminars
• 6. Bion’s four principles of mental functioning
• 7. Reading Loewald: Oedipus reconceived
• 8. Reading Harold Searles
• References
• Index