Mind Works

Technique and Creativity in Psychoanalysis

Antonino Ferro

• Publisher: Routledge
• Year: 2014
• Print ISBN: 9780415429924
• eBook ISBN: 9781317723974
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Is the analyst's mind a factor in the analytic process?

In Mind Works Antonino Ferro uses clinical material such as detailed reports of sessions, together with client's analytic histories, to develop Bion's original findings and illustrate complex concepts in the field of psychoanalytic technique. These concepts include:

• interpretive modalities
• the end of analysis
• psychosomatic pathologies
• narcissism.

Mind Works: Technique and Creativity in Psychoanalysis also suggests that dreaming is a fundamental moment in analytic work, and Ferro discusses how dreams can go beyond the present to become a continuous act of the mind in the waking state, allowing internal and external stimuli to be transformed into thoughts and emotions.

Focusing on how the minds of the analyst and the analysand work in psychoanalysis, this book will appeal to psychoanalysts, psychotherapists, and psychiatrists and will be helpful in psychoanalytic and psychotherapeutic work on a day-to-day basis.

---

1

Screenplays and film sets

---

In this chapter I wish to illustrate the high degree of interdependence between the patient’s and the analyst’s mental functioning and to show how it contributes to defining the field and its movements, as well as situations of turbulence or impasse. The implicit references for this chapter are all my recent contributions on the field–those involving developments of Bion’s thought – and certain narratological concepts that cannot but be relevant to a consideration of the models of psychoanalysis (Ferro 2002a, 2005a, 2005b, 2006).

The analyst, in my view, engages in an ongoing baseline activity of reverie, which is the way in which his¹ mind constantly receives, metabolizes and transforms everything that reaches it from the patient in the form of verbal, paraverbal and non-verbal stimulation. The same reverie activity operates in the patient in response to any interpretative or non-interpretative stimulus from the analyst. The purpose of analysis is first and foremost to develop this capacity to weave a fabric of images (which remain not directly knowable). These can be accessed indirectly through the ‘narrative derivatives’ of waking dream thought, as we shall see below. This baseline reverie activity is the cornerstone of our mental life, and our psychic health, illness or suffering is determined by its functional or dysfunctional status.

The same applies to another entity – namely, the ongoing activity of baseline projective identification, which is the indispensable engine of any reverie activity. In certain circumstances, reverie manifests itself in explicit and meaningful form – usually, but of course not exclusively, on the visual level.

Situations of sensory overload, greatly exceeding the mind’s capacity for digestion, transformation and visual representation, call for separate consideration. The following examples are drawn from the infinite range of possibilities:

• Sexual abuse in infancy, where the problem concerns not only sexuality but also unmanageable sensory overload (whether involving pleasure, pain or violence).

• Non-sexual infant abuse, for example, when, with the best of intentions, the staff of hypermedicalized neonatal pathology wards forbid the application of the ‘buffer solution’ of parental presence but when the parents could, at least in part, perform the functions of digestion and transformation of which the (often premature) baby’s mind is not yet capable.

• The enormously wide range of other situations of sensory overload that exceeds the mind’s capacity to represent, dream, and hence forget them. These extend from disasters to overintense proto-emotional impact situations and torture.

That said, let us now consider the possible ways in which a whole panoply of defences can be deployed against this kind of sensory violence. These defences range from autism – an extreme measure whereby the mind dismantles itself, as it were committing mental suicide in order to survive–to extreme forms of narcissism and disavowal, splitting, or indeed actual suicide, which is the most extreme form of defence possible against unmetabolizable floods of anxiety or pain. Why does this overload sometimes give rise to so-called psychosomatic illness and not merely to narrations of psychosomatic illness or of illness in general? This is the question that we shall address below.

The opening up of possible worlds

Saverio’s woods

Saverio is an eight-year-old boy, whose parents describe him as delicate and vulnerable. His mother tells me that, when she once gave him a little box as a present and asked him what she had put inside it, Saverio, to her surprise, replied: ‘The scent of the woods.’

The parents present themselves: the father is depressed and the mother hypomanic.

The therapist who brings this case to supervision describes Saverio as of frail build but always on the go, and her experience of him is that she ‘cannot find him’ and ‘never knows where he is’, because he is always dashing about from one place to another in the room.

Saverio immediately starts playing the ‘chameleon’, who fights and overcomes all his enemies; this is precisely his strategy for victory–to make himself invisible, to escape attention and to play repetitive games that leave not the slightest chink for access.

On one occasion he draws the enemies as frightening presences (see below). In a second drawing, they are represented as swords and bombs.

The enemies to be avoided seem to be precisely the emotions aroused by the encounter with the Other–lacerating emotions that would tear him to pieces. So not only emotions themselves but also the encounter generated by them are avoided. These enemies, Saverio says, are far away, in South America or Sweden (in other words, they cannot be reached by classical interpretation). His physical jumping about, and the way he leaps from one scribbled drawing to another, clearly form part of his strategy, as in Woody Allen’s film Zelig, whose chameleon-like hero is impossible to pin down.

One day, Saverio unexpectedly makes up a story about the ‘war of the stoppers’, in which a ‘yellow stopper’ always defeats all the other stoppers, who are stupid, but then they decide to organize so as to unmask the strategy of the ‘yellow stopper’ and thus find a way of fighting it on more equal terms. He seems to be realizing that, whereas by deploying the chameleon strategy he will always overcome the therapist, she is not merely suffering her defeat passively, but seeking a way of opposing the chameleon or an alternative approach.

Again and again, Saverio now brings comics along to his sessions; he makes drawings, which increasingly take the form of indecipherable scribbles, and so the available time goes by. The chameleon strategy has paralysed the field; the problem of Saverio as an adapted, emotionless child has become the problem of the field. The field has caught Saverio’s illness.

This, then, is a possible starting point for change and transformation, which can be mediated by a wide range of strategies. These might extend from the classical approach of demonstrating how Saverio controls the situation to the point of making it impossible for the therapist to think, via the more descriptive approach of showing how he makes time go by without anything being able or needing to happen, to the more directly relational approach (‘you seem to be behaving in the room as if I didn’t exist, or as if I was very dangerous’) – or, in other words, addressing the terror of the ‘chameleon’, which always has to use camouflage for fear of being torn apart by the beaks of birds of prey or by the therapist’s words. All these options would lead to the development of different possible stories.

Yet there is also another way: the therapist could help to modify the emotional and climatic coordinates of the field in such a way that Saverio would no longer need to play the part of the chameleon.

Thinking along these lines, I immediately associate to Giuseppe Ferrandino’s book Saverio of the North-West, an account of the thrilling adventures of a small boy who has somehow to survive in a remote Canadian forest and is confronted by difficulties of every kind, including a violent struggle with an eagle, which tears at him but which he is able to overcome, not to mention fights with a terrifying bear emerging from hibernation, as well as appalling weather conditions.

In this way a vista appears before my eyes, and then before the therapist’s, of those other woods of Saverio’s of which all that had remained ‘alive’ was the scent preserved in the little box, all the rest having been as it were freeze-dried, or rather split off and banished far, far away – even if it was constantly pressing to return to the field, giving rise to the defences of hesitation that Saverio equally constantly deployed. It was as if Saverio’s mother had basically provided her son only with a tiny little box of a mind, which could manifestly ‘contain’ only the scent of the woods and not all its denizens.

In this way, then, a ‘story of the woods’ is opening up with Saverio, with the little box containing the scent actually constituting its starting point, but which will gradually grow to fruition thanks to the work done in the therapy room.

A necessary oscillation exists between creativity and technique (C ↔ T). The one is in the service of the other: there are moments when technique predominates, with different possible options, and others in which reverie and fantasy are prevalent, as well as those massively fruitful moments that permit the opening up of new and unforeseen meanings. These, of course, are ‘couple-specific’, and steer the therapy in a particular direction, rather than in other directions that might be possible with other therapists who would have other reveries and would open up vistas on other possible worlds.

Of course, both therapeutic and ethical considerations require these worlds to be opened up on the basis of the emotional ingredients brought by the patient; they must not be worlds that alter the patient’s proto-narremes and do violence to them.

A more technically oriented interpretative choice is safer, but often less fertile. A more creative option is riskier in terms of subjective drift, but may afford access to previously unthinkable spaces. The analyst’s subjectivity (Renik 1993) obviously plays a major part – can he be himself and be creative, or does he need to operate like a ‘chameleon’, with a theory that protects him from the risk of original thinking?

Bion said that ‘thinking’ was a new function of living matter and was for that reason complex and difficult. The history of psychoanalysis includes some highly creative analysts–for instance, Melanie Klein or Bion himself – who were responsible for ‘leaps’ in general theory and the theory of technique, whose ideas were contested in their lifetime, and who subsequently became models to be imitated. An artistic analogy might be that of a painter with an idiosyncratic technique and poetic genius who meets with nothing but execration, whereas later the academies are full of works ‘in the style of…’. On a smaller scale, it is not unusual for this to occur in psychoanalytic societies or, to an even greater extent, psychoanalytic institutes, wherever grey conformity is valued most and any creative originality rings alarm bells. No student (or, I would say, teacher) of psychoanalysis should, in this connection, fail to read Otto Kernberg’s (1998) paper on thirty methods of preventing the development of creativity in young analysts.

Failure to listen

A seriously ill patient is asking his therapist questions about his anxieties and panic. Instead of helping him to expand on the subject of the day (anxiety and panic), the therapist defensively resorts to a kind of pedagogic description of the characteristics of panic attacks. The patient responds by describing his rage at his driving instructor, whom he felt like beating up. Then he immediately says that when he sees himself in the mirror, he looks different from when he was small, in particular since his recent motorcycle accident. Then he talks about how he has been abused, and the charges he would like to bring.

At this point, the therapist’s mobile rings; the patient tells her it is all right for her to answer it, but she turns it off and puts it on the table. When he asks ‘May I see it?’ the therapist replies ‘No’. He then mentions a woman doctor whom he hates: ‘I trusted her, but I don’t trust her any more.’ Finally, he tells the therapist directly that he would like her to be more human: perhaps they could go and have a drink together. The therapist responds by talking about the setting.

This session is in my view an exemplary demonstration of a constant series of misunderstandings, of breaks in microcommunication and of ongoing attempts by the patient–which are not picked up by the therapist–to kick the ball back into play. The patient broaches a subject: panic. The therapist withdraws. Her defence and nonavailability kindle anger towards the ‘driving instructor’, who is indeed failing to perform his/her task properly (teaching him to negotiate a path through the winding roads of his emotions). The patient then reflects on how he feels different at this point in the session from when he came in (‘when I was small’), i.e. after the accident (the lack of receptivity). So he ends up full of rage and anger, and is transformed and unrecognizable. He then immediately tells the therapist how he feels abused by her failure to listen and by the emotions that this has aroused inside him. He then hopes that the therapist will ‘answer’ the call and make herself available for listening; but once again, her answer is ‘No’. The patient then loses hope and trust in the possibility of feeling listened to and makes another attempt, hoping for ‘more humanity’ and simplicity in the encounter (going for a drink together), but the therapist takes the communication literally and defends herself against the possibility of a more ‘human’, receptive relationship.

Supervisions as detective stories

A particularly constructive approach to supervisions, which breathes life into the cases brought by supervisees, is to consider the ‘cases’, whether in individual or group supervisions, as detective stories, thrillers or mysteries, where everything that is presented is seen as evidence, clues or exhibits, all of which are highly significant. This entails, as it were, resetting all one’s knowledge of psychopathology to zero and proceeding in the manner of Lieutenant Columbo or Inspector Maigret, seeking the ‘key’ to the case without revealing what one is doing. From this point of view, no case is banal or repetitive or obvious from the beginning.

This approach is, of course, even richer and more creative in a group, owing to the availability of the amplifying apparatus constituted by the group itself and its γ-function (Corrao 1981), i.e. the group α-function.

Carla’s antidote

The ‘case’ is presented to me as follows: Carla, a woman of 45, is having therapy because of a court order. She says she has always been ‘rejected’ by her parents, who preferred her brother. She has two sons; the first she rejects because his birth was ‘unplanned’, while the second suffers from acid reflux and cannot keep anything down: ‘he spits poison’.²

Carla’s presenting symptom is bulimia, with uncontrollable vomiting. After the therapist has cancelled a session, she says that she puked and puked, that the house felt cramped to her, but that she now wants to wear only short, tight clothing, that she would like to set fire to the house, and that she does not give a toss about her husband. She likes going to bars, playing cards, and stuffing herself full. Then she says she can only show two per cent of herself … and that she would like to puke in her husband’s face…

Of course, these few communications could have an infinite range of meanings, but the first Gestalt that suggests itself to me is the theme of incontinence. In particular–and this is the key to mystery–there is the idea of bulimia as an antidote. Owing to the ‘rejection’ (of the history, the internal object and the Other), Carla is faced with more and more emotions – rag...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• 1 Screenplays and film sets
• 2 Digressions on interpretation
• 3 Psychosomatic pathology or metaphor: problems of the boundary
• 4 Homosexualities: a field ripe for ploughing
• 5 A model of the mind and its clinical implications: how to turn back in order to move forward
• 6 Instructions for seafarers and the shipwrecked: signals from the analytic field and emotional transformations
• 7 The patient’s response to interpretations and events in the field
• 8 Terminations orthodox and unorthodox
• 9 Narcissism and frontier areas
• References
• Index